Template-Type: ReDIF-Article 1.0 Title: The role of community advisory boards: Involving communities in the informed consent process Journal: American Journal of Public Health Author-Name: Strauss, R.P. Author-Name: Sengupta, S. Author-Name: Quinn, S.C. Author-Name: Goeppinger, J. Author-Name: Spaulding, C. Author-Name: Kegeles, S.M. Author-Name: Millett, G. Year: 2001 Volume: 91 Issue: 12 Pages: 1938-1943 Abstract: Ethical research involving human subjects mandates that individual informed consent be obtained from research participants or from surrogates when participants are not able to consent for themselves. The existing requirements for informed consent assume that all study participants have personal autonomy; fully comprehend the purpose, risks, and benefits of the research; and volunteer for projects that disclose all relevant information. Yet contemporary examples of lapses in the individual informed consent process have been reported. The authors propose the use of community advisory boards, which can facilitate research by providing advice about the informed consent process and the design and implementation of research protocols. These activities could help reduce the number of individual informed consent lapses, benefiting study participants and the scientific integrity of the research in question. Handle: RePEc:aph:ajpbhl:2001:91:12:1938-1943_3 Template-Type: ReDIF-Article 1.0 Title: Understanding and responding to youth substance use: The contribution of a health and human rights framework Journal: American Journal of Public Health Author-Name: Gruskin, S. Author-Name: Plafker, K. Author-Name: Smith-Estelle, A. Year: 2001 Volume: 91 Issue: 12 Pages: 1954-1963 Abstract: This article examines the utility of a health and human rights framework for conceptualizing and responding to the causes and consequences of substance use among young people. It provides operational definitions of "youth" and "substances," a review of current international and national efforts to address substance use among youths, and an introduction to human rights and the intersection between health and human rights. A methodology for modeling vulnerability in relation to harmful substance use is introduced and contemporary international and national responses are discussed. When governments uphold their obligations to respect, protect, and fulfill human rights, vulnerability to harmful substance use and its consequences can be reduced. Handle: RePEc:aph:ajpbhl:2001:91:12:1954-1963_3 Template-Type: ReDIF-Article 1.0 Title: The relation between community bans of self-service tobacco displays and store environment and between tobacco accessibility and merchant incentives Journal: American Journal of Public Health Author-Name: Lee, R.E. Author-Name: Feighery, E.C. Author-Name: Schleicher, N.C. Author-Name: Halvorson, S. Year: 2001 Volume: 91 Issue: 12 Pages: 2019-2021 Abstract: Objectives. These studies investigated (1) the effect of community bans of self-service tobacco displays on store environment and (2) the effect of consumer tobacco accessibility on merchants. Methods. We counted cigarette displays (self-service, clerk-assisted, clear acrylic case) in 586 California stores. Merchant interviews (N = 198) identified consumer tobacco accessibility, tobacco company incentives, and shoplifting. Results. Stores in communities with self-service tobacco display bans had fewer self-service displays and more acrylic displays but an equal total number of displays. The merchants who limited consumer tobacco accessibility received fewer incentives and reported lower shoplifting losses. In contrast, consumer access to tobacco was unrelated to the amount of monetary incentives. Conclusions. Community bans decreased self-service tobacco displays; however, exposure to tobacco advertising in acrylic displays remained high. Reducing consumer tobacco accessibility may reduce shoplifting. Handle: RePEc:aph:ajpbhl:2001:91:12:2019-2021_0 Template-Type: ReDIF-Article 1.0 Title: The challenge and place of international human rights in public health Journal: American Journal of Public Health Author-Name: Easley, C.E. Author-Name: Marks, S.P. Author-Name: D'État, D. Author-Name: Morgan R.E., Jr. Year: 2001 Volume: 91 Issue: 12 Pages: 1922-1925 Handle: RePEc:aph:ajpbhl:2001:91:12:1922-1925_5 Template-Type: ReDIF-Article 1.0 Title: Biopreparedness and public health [2] Journal: American Journal of Public Health Author-Name: Henderson, D.A. Year: 2001 Volume: 91 Issue: 12 Pages: 1917-1918 Handle: RePEc:aph:ajpbhl:2001:91:12:1917-1918_7 Template-Type: ReDIF-Article 1.0 Title: What is community? An evidence-based definition for participatory public health Journal: American Journal of Public Health Author-Name: MacQueen, K.M. Author-Name: McLellan, E. Author-Name: Metzger, D.S. Author-Name: Kegeles, S. Author-Name: Strauss, R.P. Author-Name: Scotti, R. Author-Name: Blanchard, L. Author-Name: Trotter II, R.T. Year: 2001 Volume: 91 Issue: 12 Pages: 1929-1938 Abstract: Increased emphasis on community collaboration indicates the need for consensus regarding the definition of community within public health. This study examined whether members of diverse US communities described community in similar ways. To identify strategies to support community collaboration in HIV vaccine trials, qualitative interviews were conducted with 25 African Americans in Durham, NC; 26 gay men in San Francisco, Calif; 25 injection drug users in Philadelphia, Pa; and 42 HIV vaccine researchers across the United States. Verbatim responses to the question "What does the word community mean to you?" were analyzed. Cluster analysis was used to identify similarities in the way community was described. A common definition of community emerged as a group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings. The participants differed in the emphasis they placed on particular elements of the definition. Community was defined similarly but experienced differently by people with diverse backgrounds. These results parallel similar social science findings and confirm the viability of a common definition for participatory public health. Handle: RePEc:aph:ajpbhl:2001:91:12:1929-1938_9 Template-Type: ReDIF-Article 1.0 Title: Individualized or population risks: What is the argument? [4] Journal: American Journal of Public Health Author-Name: Gori, G.B. Year: 2001 Volume: 91 Issue: 12 Pages: 1919 Handle: RePEc:aph:ajpbhl:2001:91:12:1919_4 Template-Type: ReDIF-Article 1.0 Title: Can public health researchers and agencies reconcile the push from funding bodies and the pull from communities? Journal: American Journal of Public Health Author-Name: Green, L.W. Author-Name: Mercer, S.L. Year: 2001 Volume: 91 Issue: 12 Pages: 1926-1929 Abstract: Responding to growing impatience with the limited application of research findings to health practices and policies, both funding bodies and communities are demanding that research show greater sensitivity to communities' perceptions, needs, and unique circumstances. One way to assure this is to employ participatory research-to engage communities at least in formulating research questions and interpreting and applying research findings and possibly also in selecting methods and analyzing data. "Community" should be interpreted broadly as all who will be affected by the research results, including lay residents of a local area, practitioners, service agencies, and policymakers. Participatory research should not be required of every project, but when results are to be used for, in, and by communities, those communities should collaborate not only in applying findings but also in determining the ways in which the findings are produced and interpreted. Handle: RePEc:aph:ajpbhl:2001:91:12:1926-1929_2 Template-Type: ReDIF-Article 1.0 Title: Using signs, artwork, and music to promote stair use in a public building Journal: American Journal of Public Health Author-Name: Boutelle, K.N. Author-Name: Jeffery, R.W. Author-Name: Murray, D.M. Author-Name: Schmitz, M.K.H. Year: 2001 Volume: 91 Issue: 12 Pages: 2004-2006 Abstract: Objectives. This study assessed the impact on stair use of improving the attractiveness of a stairwell. Methods. Observations of stair usage were made in a university building during baseline, 2 interventions, and follow-up. The first intervention involved signs; the second intervention added artwork and music in the stairwell. Results. More participants used the stairs during the music and artwork intervention than at baseline or when signs alone were used. Conclusions. Improving the aesthetic qualities of a stairwell can increase rates of stair usage in a public building. Designs for buildings should take accessibility and aesthetic issues into consideration. Handle: RePEc:aph:ajpbhl:2001:91:12:2004-2006_8 Template-Type: ReDIF-Article 1.0 Title: Land use history and public health [1] Journal: American Journal of Public Health Author-Name: Stirling, D.A. Year: 2001 Volume: 91 Issue: 12 Pages: 1917 Handle: RePEc:aph:ajpbhl:2001:91:12:1917_5 Template-Type: ReDIF-Article 1.0 Title: Community advocates in public housing Journal: American Journal of Public Health Author-Name: Wolff, M. Author-Name: Young, S. Author-Name: Maurana, C.A. Year: 2001 Volume: 91 Issue: 12 Pages: 1972-1973 Handle: RePEc:aph:ajpbhl:2001:91:12:1972-1973_1 Template-Type: ReDIF-Article 1.0 Title: The interpretation of statistically significant results: The impact of the Taiwan helmet use law [5] Journal: American Journal of Public Health Author-Name: Chen, J.J. Year: 2001 Volume: 91 Issue: 12 Pages: 1919-1920 Handle: RePEc:aph:ajpbhl:2001:91:12:1919-1920_0 Template-Type: ReDIF-Article 1.0 Title: The visibility of illicit drugs: Implications for community-based drug control strategies Journal: American Journal of Public Health Author-Name: Saxe, L. Author-Name: Kadushin, C. Author-Name: Beveridge, A. Author-Name: Livert, D. Author-Name: Tighe, E. Author-Name: Rindskopf, D. Author-Name: Ford, J. Author-Name: Brodsky, A. Year: 2001 Volume: 91 Issue: 12 Pages: 1987-1994 Abstract: Objectives. This study examined differences between the visibility of drugs and drug use in more than 2100 neighborhoods, challenging an assumption about drug use in poor, minority, and urban communities. Methods. A telephone survey assessed substance use and attitudes across 41 communities in an evaluation of a national community-based demand reduction program. Three waves of data were collected from more than 42 000 respondents. Results. Measures of neighborhood disadvantage, population density, and proportion of minority residents explained more than 57% of the variance between census tracts in visibility of drug sales but less than 10% of tract-to-tract variance in drug use. Visible drug sales were 6.3 times more likely to be reported in the most disadvantaged neighborhoods than in the least disadvantaged, while illicit drug use was only 1.3 times more likely. Conclusions. The most disadvantaged neighborhoods have the most visible drug problems, but drug use is nearly equally distributed across all communities. Thus, efforts to address drug-related problems in poorer areas need to take into account the broader drug market served by these neighborhoods. Handle: RePEc:aph:ajpbhl:2001:91:12:1987-1994_8 Template-Type: ReDIF-Article 1.0 Title: Environmental and policy determinants of physical activity in the United States Journal: American Journal of Public Health Author-Name: Brownson, R.C. Author-Name: Baker, E.A. Author-Name: Housemann, R.A. Author-Name: Brennan, L.K. Author-Name: Bacak, S.J. Year: 2001 Volume: 91 Issue: 12 Pages: 1995-2003 Abstract: Objectives. This study examined (1) descriptive patterns in perceived environmental and policy determinants of physical activity and (2) associations between these factors and behavior. Methods. A cross-sectional study was conducted from 1999 to 2000 among US adults; individuals at lower income levels were oversampled. Results. Availability of areas for physical activity was generally higher among men than among women. The 4 most commonly reported personal barriers were lack of time, feeling too tired, obtaining enough exercise at one's job, and no motivation to exercise. Neighborhood characteristics, including the presence of sidewalks, enjoyable scenery, heavy traffic, and hills, were positively associated with physical activity. There was a high level of support for health policy-related measures. Up to one third of individuals who had used environmental supports reported an increase in physical activity. Conclusions. An array of environmental and policy determinants, particularly those related to the physical environment, are associated with physical activity and should be taken into account in the design of interventions. Handle: RePEc:aph:ajpbhl:2001:91:12:1995-2003_5 Template-Type: ReDIF-Article 1.0 Title: A population-based assessment of human rights abuses committed against ethnic Albanian refugees from Kosovo Journal: American Journal of Public Health Author-Name: Iacopino, V. Author-Name: Frank, M.W. Author-Name: Bauer, H.M. Author-Name: Keller, A.S. Author-Name: Fink, S.L. Author-Name: Ford, D. Author-Name: Pallin, D.J. Author-Name: Waldman, R. Year: 2001 Volume: 91 Issue: 12 Pages: 2013-2018 Abstract: Objectives. This study assessed patterns of displacement and human rights abuses among Kosovar refugees in Macedonia and Albania. Methods. Between April 19 and May 3, 1999, 1180 ethnic Albanian refugees living in 31 refugee camps and collective centers in Macedonia and Albania were interviewed. Results. The majority (68%) of participants reported that their families were directly expelled from their homes by Serb forces. Overall, 50% of participants saw Serb police or soldiers burning the houses of others, 16% saw Serb police or soldiers burn their own home, and 14% witnessed Serb police or soldiers killing someone. Large percentages of participants saw destroyed mosques, schools, or medical facilities. Thirty-one percent of respondents reported human rights abuses committed against their household members, including beatings, killings, torture, forced separation and disappearances, gun-shot wounds, and sexual assault. Conclusions. The present findings confirm that Serb forces engaged in a systematic and brutal campaign to forcibly expel the ethnic Albanian population of Kosovo. In the course of these mass deportations, Serb forces committed widespread abuses of human rights against ethnic Albanians. Handle: RePEc:aph:ajpbhl:2001:91:12:2013-2018_7 Template-Type: ReDIF-Article 1.0 Title: Implications for tobacco control of the multistate tobacco settlement Journal: American Journal of Public Health Author-Name: Daynard, R.A. Author-Name: Parmet, W. Author-Name: Kelder, G. Author-Name: Davidson, P. Year: 2001 Volume: 91 Issue: 12 Pages: 1967-1971 Abstract: The 1998 master settlement agreement between major tobacco manufacturers and the US states will have a profound effect on many tobacco industry practices and will significantly influence future settlements with the tobacco industry. This article analyzes the settlement's key provisions pertaining to youth sales, advertising, marketing, and lobbying. It also examines the ways in which the settlement restricts industry practices as well as the many industry practices that remain unregulated. Handle: RePEc:aph:ajpbhl:2001:91:12:1967-1971_0 Template-Type: ReDIF-Article 1.0 Title: Limitations on the use of a single screening question to measure sedentary behavior Journal: American Journal of Public Health Author-Name: Macera, C.A. Author-Name: Ham, S.A. Author-Name: Jones, D.A. Author-Name: Kimsey, C.D. Author-Name: Ainsworth, B.E. Author-Name: Neff, L.J. Year: 2001 Volume: 91 Issue: 12 Pages: 2010-2012 Abstract: Objectives. This study explored the limitations of identifying sedentary individuals via an existing screening question in a state-based surveillance system. Methods. A national sample (n = 7529) of adults, selected by random-digit dialing between November 1999 and May 2000, responded about participation in leisure-time physical activity. Results. Of those who initially reported no leisure-time physical activity (25%), 85% were engaging in at least some activity, and 20% were engaging in enough moderate- or vigorous-intensity activity to meet health-related recommendations. Conclusions. Public health programs that use only 1 screening question to identify sedentary behavior may not be able to target physical activity messages effectively, especially if physical activity is defined to include a broad range of activities beyond sports. Handle: RePEc:aph:ajpbhl:2001:91:12:2010-2012_2 Template-Type: ReDIF-Article 1.0 Title: Grassroots participation, peer education, and HIV prevention by sex workers in South Africa Journal: American Journal of Public Health Author-Name: Campbell, C. Author-Name: Mzaidume, Z. Year: 2001 Volume: 91 Issue: 12 Pages: 1978-1986 Abstract: Objectives. This microqualitative case study of a community-based peer education program led by sex workers at a South African mine examined the role of grassroots participation in sexual health promotion. Methods. The study involved in-depth interviews with 30 members of the target community. The interviews were analyzed in terms of social capital, empowerment, and identity. Results. The study yielded a detailed analysis of the way in which community dynamics have shaped the peer education program's development in a deprived, violent community where existing norms and networks are inconsistent with ideal criteria for participatory health promotion. Conclusions. Much remains to be learned about the complexities of translating theoretically and politically vital notions of "community participation" into practice among hard-to-reach groups. The fabric of local community life is shaped by nonlocal structural conditions of poverty and sexual inequality in ways that challenge those seeking to theorize the role of social capital in community development in general and in sexual health promotion in particular. Handle: RePEc:aph:ajpbhl:2001:91:12:1978-1986_2 Template-Type: ReDIF-Article 1.0 Title: Meeting the data needs of a local health department: The Los Angeles County Health Survey Journal: American Journal of Public Health Author-Name: Simon, P.A. Author-Name: Wold, C.M. Author-Name: Cousineau, M.R. Author-Name: Fielding, J.E. Year: 2001 Volume: 91 Issue: 12 Pages: 1950-1952 Abstract: Monitoring the health status of populations is a core function of all public health agencies but is particularly important at the municipal and community levels, where population health data increasingly are used to drive public health decision making and community health improvement efforts. Unfortunately, most local health jurisdictions lack important data for developing population health profiles, such as data on chronic disease prevalence, quality-of-life measures, functional status, and self-perceptions of health status. In addition, data on important determinants of health, including health behaviors and access to health care services, are rarely available locally. These data frequently are collected in national and state surveys (e.g., the National Health Interview Survey and the Behavioral Risk Factor Surveillance System) and provide critical information to assess progress toward achieving state and national health objectives. The surveys rarely serve local data needs, however, because of insufficient sample size and lack of flexibility to address local health issues.To address gaps in local health data, in 1997 the Los Angeles County Department of Health Services inaugurated the Los Angeles County Health Survey. Handle: RePEc:aph:ajpbhl:2001:91:12:1950-1952_0 Template-Type: ReDIF-Article 1.0 Title: Promoting stair use in a US-Mexico border community Journal: American Journal of Public Health Author-Name: Coleman, K.J. Author-Name: Gonzalez, E.C. Year: 2001 Volume: 91 Issue: 12 Pages: 2007-2009 Abstract: Objectives. This study sought to determine whether a culturally relevant health message would promote stair use in a predominantly Hispanic community. Methods. Observations of stair, elevator, and escalator use were collected over a 6-month period at 4 sites throughout the city of El Paso, Tex. The efficacy of individual and family health promotion signs was tested. Results. Stair use increased in response to both individual and family promotion health messages, and use varied widely by intervention site. Conclusions. These results underscore the importance of considering the physical characteristics of the environments targeted for health promotion campaigns. Handle: RePEc:aph:ajpbhl:2001:91:12:2007-2009_4 Template-Type: ReDIF-Article 1.0 Title: The impact on clients of a community-based infant mortality reduction program: The national Healthy Start Program survey of postpartum women Journal: American Journal of Public Health Author-Name: McCormick, M.C. Author-Name: Deal, L.W. Author-Name: Devaney, B.L. Author-Name: Chu, D. Author-Name: Moreno, L. Author-Name: Raykovich, K.T. Year: 2001 Volume: 91 Issue: 12 Pages: 1975-1977 Abstract: Objectives. This study assessed the effect of the national Healthy Start Program on its clients. Methods. We used a cross-sectional survey of a sample from Special Supplemental Nutrition Program for Women, Infants, and Children (WlC) rosters of women less than 6 months postpartum who were residents of Healthy Start Program areas. Results. Healthy Start clients revealed higher sociodemographic risk, but not behavioral risk, for adverse pregnancy outcome than other area residents. They did not differ from other residents in receipt of services except for a greater likelihood of receiving case management, using birth control at the time of the interview, and rating their prenatal care more highly. Conclusions. The Healthy Start Program succeeded in enrolling women at high risk. It had little effect on the immediately concluded pregnancy, but it might influence future outcomes. Handle: RePEc:aph:ajpbhl:2001:91:12:1975-1977_8 Template-Type: ReDIF-Article 1.0 Title: A bold new direction for environmental health research Journal: American Journal of Public Health Author-Name: Olden, K. Author-Name: Guthrie, J. Author-Name: Newton, S. Year: 2001 Volume: 91 Issue: 12 Pages: 1964-1967 Abstract: The biotechnology revolution has opened new opportunities for addressing current inadequacies in decision making regarding environmental health. Strategic investments need to be made (1) to develop high-throughput technologies that could accelerate toxicity testing and generate a mechanistic understanding of toxicity, (2) to incorporate individual susceptibility into risk assessments, and (3) to establish a rational basis for testing and regulatory decision making. New initiatives of the National Institute of Environmental Health Sciences, including the Environmental Genome Project and the Toxicogenomics Center, are discussed. Handle: RePEc:aph:ajpbhl:2001:91:12:1964-1967_7 Template-Type: ReDIF-Article 1.0 Title: Blood lead levels in relation to paint and dust lead levels: The Lead-Safe Cambridge Program Journal: American Journal of Public Health Author-Name: Potula, V. Author-Name: Hegarty-Steck, M. Author-Name: Hu, H. Year: 2001 Volume: 91 Issue: 12 Pages: 1973-1974 Handle: RePEc:aph:ajpbhl:2001:91:12:1973-1974_7 Template-Type: ReDIF-Article 1.0 Title: The influenza pandemic of 1918 Journal: American Journal of Public Health Author-Name: Fee, E. Author-Name: Brown, T.M. Author-Name: Lazarus, J. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 12 Pages: 1953 Handle: RePEc:aph:ajpbhl:2001:91:12:1953_3 Template-Type: ReDIF-Article 1.0 Title: Urban history, urban health. Journal: American Journal of Public Health Author-Name: Knowlton, K. Year: 2001 Volume: 91 Issue: 12 Pages: 1944-1946 Abstract: Over the course of the 20th century, the United States became an urban nation: 80% of Americans now live in metropolitan areas. Supplying basic sanitary services-drinking water, sewers, and garbage removal-to these cities is a gargantuan task, yet most people have little understanding of urban infrastructure systems and their enormous regional ecologic impacts. Municipalization of sanitary services, especially since 1880, distanced people from their wastes and gave city dwellers a simplistic experience of one-way material flow through cities, without knowledge of the environmental costs. Most sanitary infrastructures were built primarily for durability and lack the elasticity to meet changing needs. The challenge now is to adapt sanitary systems for flexibility and simultaneously move from unchecked material consumption toward resource-based thinking. Handle: RePEc:aph:ajpbhl:2001:91:12:1944-1946_4 Template-Type: ReDIF-Article 1.0 Title: The face of public health nursing: Carol Maureen Easley Allen. Journal: American Journal of Public Health Author-Name: Wilcox, J. Year: 2001 Volume: 91 Issue: 12 Pages: 1947-1949 Handle: RePEc:aph:ajpbhl:2001:91:12:1947-1949_6 Template-Type: ReDIF-Article 1.0 Title: A pilot study to evaluate a tobacco diversion program Journal: American Journal of Public Health Author-Name: Lazovich, D. Author-Name: Ford, J. Author-Name: Forster, J. Author-Name: Riley, B. Year: 2001 Volume: 91 Issue: 11 Pages: 1790-1791 Handle: RePEc:aph:ajpbhl:2001:91:11:1790-1791_0 Template-Type: ReDIF-Article 1.0 Title: Relying on surveys to understand abortion behavior: Some cautionary evidence Journal: American Journal of Public Health Author-Name: Jagannathan, R. Year: 2001 Volume: 91 Issue: 11 Pages: 1825-1831 Abstract: Objectives. The reliability of abortion self-reports has raised questions about the general usefulness of surveys in research about abortion behavior; however, the extent of underreporting remains a subject of some debate. This study sought to examine abortion reporting in a sample of welfare mothers and to determine factors in underreporting. Methods. In New Jersey, which covers abortions requested by welfare recipients under its Medicaid program, the responses of a randomly drawn sample of 1236 welfare mothers about abortion events were compared with the Medicaid claims records of these women. Results. Only 29% of actual abortions were self-reported by the women in the sample. This finding varied dramatically by race, with substantially higher rates of underreporting by Blacks than by Whites or Hispanics. Conclusions. Although race is the most consistent predictor of underreporting behavior, attitudinal factors and survey technology also help in explaining abortion reporting behavior. Handle: RePEc:aph:ajpbhl:2001:91:11:1825-1831_1 Template-Type: ReDIF-Article 1.0 Title: Constructing "sound science" and "good epidemiology": Tobacco, lawyers, and public relations firms Journal: American Journal of Public Health Author-Name: Ong, E.K. Author-Name: Glantz, S.A. Year: 2001 Volume: 91 Issue: 11 Pages: 1749-1757 Abstract: The tobacco industry has attacked "junk science" to discredit the evidence that secondhand smoke-among other environmental toxins-causes disease. Philip Morris used public relations firms and lawyers to develop a "sound science" program in the United States and Europe that involved recruiting other industries and issues to obscure the tobacco industry's role. The European "sound science" plans included a version of "good epidemiological practices" that would make it impossible to conclude that secondhand smoke-and thus other environmental toxins-caused diseases. Public health professionals need to be aware that the "sound science" movement is not an indigenous effort from within the profession to improve the quality of scientific discourse, but reflects sophisticated public relations campaigns controlled by industry executives and lawyers whose aim is to manipulate the standards of scientific proof to serve the corporate interests of their clients. Handle: RePEc:aph:ajpbhl:2001:91:11:1749-1757_3 Template-Type: ReDIF-Article 1.0 Title: Immigrant mother and child: Chicago, 1910 Journal: American Journal of Public Health Author-Name: Fee, E. Author-Name: Brown, T.M. Author-Name: Lazarus, J. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 11 Pages: 1764 Handle: RePEc:aph:ajpbhl:2001:91:11:1764_8 Template-Type: ReDIF-Article 1.0 Title: Junking science to promote tobacco Journal: American Journal of Public Health Author-Name: Yach, D. Author-Name: Bialous, S.A. Year: 2001 Volume: 91 Issue: 11 Pages: 1745-1748 Abstract: Despite the tobacco industry's claims that it has changed its practices, the toll of tobacco-related disease and death continues to grow worldwide, and the industry continues to use a vast array of strategies to promote its products and increase profits. This commentary discusses the ways the tobacco industry has created controversy about risk assessment and about the scientific evidence of the health hazards of secondhand smoke. The authors recommend that policymakers be more vigilant and that they demand transparency about affiliations and linkages between allegedly independent scientists and tobacco companies. They also urge policymakers to be prepared for new and continuing challenges posed by the tobacco industry, because, despite the industry's claims, there is little evidence of fundamental change in its objectives. Handle: RePEc:aph:ajpbhl:2001:91:11:1745-1748_6 Template-Type: ReDIF-Article 1.0 Title: Immigration and public health Journal: American Journal of Public Health Author-Name: Northridge, M.E. Year: 2001 Volume: 91 Issue: 11 Pages: 1735 Handle: RePEc:aph:ajpbhl:2001:91:11:1735_2 Template-Type: ReDIF-Article 1.0 Title: Growth status and related medical conditions among refugee children in Massachusetts, 1995-1998 Journal: American Journal of Public Health Author-Name: Geltman, P.L. Author-Name: Radin, M. Author-Name: Zhang, Z. Author-Name: Cochran, J. Author-Name: Meyers, A.F. Year: 2001 Volume: 91 Issue: 11 Pages: 1800-1805 Abstract: Objectives. This study analyzed growth and identified related medical conditions among refugee children in Massachusetts. Methods. Between July 1995 and June 1998, 1825 refugee children were screened. Variables included positive tuberculin (purified protein derivative; PPD) test; dental abnormalities; pathogenic parasites; weight-for-age, height-for-age, and weight-for-height z scores; and body mass index greater than the 84th percentile. Results. Of all the children, 21% had parasites, 62% had caries, and 25% had a positive PPD reaction. Twelve percent overall and 28% younger than 2 years had anemia. Eight percent had height-for-age z scores less than -2, and 6% had weight-for-age z scores greater than +2. Of those aged 1 to 9 years, 7% had weight-for-height z scores greater than +2. Weight-for-height z scores less than -2 were concentrated among Africans and East Asians (both 8%). Height-for-age z scores less than -2 were seen among African (13%), Near Eastern (19%), and East Asian (30%) children. Weight-for-height z scores greater than +2 and body mass index greater than the 84th percentile were concentrated among children from the former Yugoslavia (8% and 15%) and the former Soviet Union (8% and 14%). Conclusions. Recently arrived refugee children have significant growth abnormalities. European refugees were overweight; those from developing countries had growth retardation. Handle: RePEc:aph:ajpbhl:2001:91:11:1800-1805_9 Template-Type: ReDIF-Article 1.0 Title: Prenatal care use among selected Asian American groups Journal: American Journal of Public Health Author-Name: Yu, S.M. Author-Name: Alexander, G.R. Author-Name: Schwalberg, R. Author-Name: Kogan, M.D. Year: 2001 Volume: 91 Issue: 11 Pages: 1865-1868 Abstract: Objectives. This study examined the predictors of 3 patterns of prenatal care use (no care, late initiation of care, and inadequate use after early initiation) for 4 Asian American ethnic groups in the United States. Methods. Single live births to US resident mothers of Chinese, Japanese, Korean, and Vietnamese ancestry (n=273604) were selected from the 1992-1996 US natality files. Logistic regression was used to analyze the effects of maternal characteristics on the 3 use measures. Results. Korean Americans and Vietnamese Americans had the lowest levels of prenatal care use. Young or single motherhood, high parity for age, and low educational attainment were the main risk factors for low use. Conclusions. Considerable variability exists in prenatal care use among Asian American ethnic groups. Handle: RePEc:aph:ajpbhl:2001:91:11:1865-1868_1 Template-Type: ReDIF-Article 1.0 Title: Maternal smoking cessation intervention: Targeting women and their partners before pregnancy [4] (multiple letters) Journal: American Journal of Public Health Author-Name: De Weerd, S. Author-Name: Thomas, C.M.G. Author-Name: Cikot, R.J.L.M. Author-Name: Steegers, E.A.P. Year: 2001 Volume: 91 Issue: 11 Pages: 1733-1734 Handle: RePEc:aph:ajpbhl:2001:91:11:1733-1734_8 Template-Type: ReDIF-Article 1.0 Title: Effectiveness of postmigration screening in controlling tuberculosis among refugees: A historical cohort study, 1984-1998 Journal: American Journal of Public Health Author-Name: Marks, G.B. Author-Name: Bai, J. Author-Name: Stewart, G.J. Author-Name: Simpson, S.E. Author-Name: Sullivan, E.A. Year: 2001 Volume: 91 Issue: 11 Pages: 1797-1799 Abstract: Objectives. This study assessed the effectiveness of postmigration screening for the control of tuberculosis (TB) among refugee migrants. Methods. We conducted a historical cohort study among 24 610 predominantly Southeast Asian refugees who had arrived in Sydney, Australia, between 1984 and 1994. All had been screened for TB before arrival and had radiologic follow-up for 18 months after arrival. Incident cases of TB were identified by record linkage analysis with confirmatory review of case notes. Results. The crude annual incidence rate over 10-year follow-up was 74.9 per 100 000 person-years. Only 29.6% of the cases were diagnosed as a result of routine follow-up procedures. Conclusions. Enhanced passive case finding is likely to be more effective than active case finding for the control of TB among refugees. Handle: RePEc:aph:ajpbhl:2001:91:11:1797-1799_7 Template-Type: ReDIF-Article 1.0 Title: The contribution of maternal age to racial disparities in birthweight: A multilevel perspective Journal: American Journal of Public Health Author-Name: Rauh, V.A. Author-Name: Andrews, H.F. Author-Name: Garfinkel, R.S. Year: 2001 Volume: 91 Issue: 11 Pages: 1815-1824 Abstract: Objectives. This study assessed the contribution of age and other risk factors to racial disparities in rates of moderately low birthweight (MLBW; 1500-2499 g) and very low birthweight (VLBW; <1500 g). Methods. Logistic regression models were developed to determine the effects on MLBW and VLBW of maternal age, race, and poverty, adjusting for birth order, smoking, substance abuse, marital status, and educational level. The sample consisted of 158174 singleton births to US-born African American and White women in NewYork City between 1987 and 1993. Results. The effects of maternal age on MLBW varied by race and poverty, with the most extreme effects among poor African American women. The effects of maternal age on VLBW also varied by race, but these effects were not moderated by poverty. Community poverty had a significant effect on MLBW among African American women, but no effect on VLBW. The adverse effect of older maternal age on MLBW and VLBW did not vary with community poverty. Conclusions. Older maternal age is associated with reduced birthweight among infants born to African American women, and the age effect is exacerbated by individual poverty. Handle: RePEc:aph:ajpbhl:2001:91:11:1815-1824_5 Template-Type: ReDIF-Article 1.0 Title: A comparison of state-specific all-terrain vehicle - Related death rates, 1990-1999 Journal: American Journal of Public Health Author-Name: Helmkamp, J.C. Year: 2001 Volume: 91 Issue: 11 Pages: 1792-1795 Handle: RePEc:aph:ajpbhl:2001:91:11:1792-1795_8 Template-Type: ReDIF-Article 1.0 Title: Investigating neighborhood and area effects on health Journal: American Journal of Public Health Author-Name: Diez Roux, A.V. Year: 2001 Volume: 91 Issue: 11 Pages: 1783-1789 Abstract: The past few years have witnessed an explosion of interest in neighborhood or area effects on health. Several types of empiric studies have been used to examine possible area or neighborhood effects, including ecologic studies relating area characteristics to morbidity and mortality rates, contextual and multilevel analyses relating area socioeconomic context to health outcomes, and studies comparing small numbers of well-defined neighborhoods. Strengthening inferences regarding the presence and magnitude of neighborhood effects will require addressing a series of conceptual and methodological issues. Many of these issues relate to the need to develop theory and specific hypotheses on the processes through which neighborhood and individual factors may jointly influence specific health outcomes. Important challenges include defining neighborhoods or relevant geographic areas, identifying significant area or neighborhood characteristics, specifying the role of individual-level variables, incorporating life-course and longitudinal dimensions, combining a variety of research designs, and avoiding reductionism in the way in which "neighborhood" factors are incorporated into models of disease causation and quantitative analyses. Handle: RePEc:aph:ajpbhl:2001:91:11:1783-1789_0 Template-Type: ReDIF-Article 1.0 Title: Effects of cost sharing on care seeking and health status: Results from the Medical Outcomes Study Journal: American Journal of Public Health Author-Name: Wong, M.D. Author-Name: Andersen, R. Author-Name: Sherbourne, C.D. Author-Name: Hays, R.D. Author-Name: Shapiro, M.F. Year: 2001 Volume: 91 Issue: 11 Pages: 1889-1894 Abstract: Objectives. This study sought to determine the effect of cost sharing on medical care use for acute symptoms and on health status among chronically ill adults. Methods. Data from the Medical Outcomes Study were used to compare (1) rates of physician care use for minor and serious symptoms and (2) 6- and 12-month follow-up physical and mental health status among individuals at different levels of cost sharing. Results. In comparison with a no-copay group, the low- and high-copay groups were less likely to have sought care for minor symptoms, but only the high-copay group had a lower rate of seeking care for serious symptoms. Follow-up physical and mental health status scores were similar among the 3 copay groups. Conclusions. In a chronically ill population, cost sharing reduced the use of care for both minor and serious symptoms. Although no differences in self-reported health status were observed, health plans featuring cost sharing need careful monitoring for potential adverse health effects because of their propensity to reduce use of care that is considered necessary and appropriate. Handle: RePEc:aph:ajpbhl:2001:91:11:1889-1894_4 Template-Type: ReDIF-Article 1.0 Title: Providing hepatitis B vaccination to injection drug users: Referral to health clinics vs on-site vaccination at a syringe exchange program Journal: American Journal of Public Health Author-Name: Des Jarlais, D.C. Author-Name: Fisher, D.G. Author-Name: Newman, J.C. Author-Name: Trubatch, B.N. Author-Name: Yancovitz, M. Author-Name: Paone, D. Author-Name: Perlman, D. Year: 2001 Volume: 91 Issue: 11 Pages: 1791-1792 Handle: RePEc:aph:ajpbhl:2001:91:11:1791-1792_3 Template-Type: ReDIF-Article 1.0 Title: Evaluation and reform of Mexican National Epidemiological Surveillance System Journal: American Journal of Public Health Author-Name: Tapia-Conyer, R. Author-Name: Kuri-Morales, P. Author-Name: González-Urbán, L. Author-Name: Sarti, E. Year: 2001 Volume: 91 Issue: 11 Pages: 1758-1760 Abstract: To generate timely and reliable information for decision making in local health centers, Mexico's National Epidemiological Surveillance System (SINAVE) was evaluated and reformed. The reform was achieved by consensus through national meetings of epidemiologists, using a conceptual model of requirements, leadership, participation, and motivation. The new SINAVE is run by committees that use data from 16468 local health centers that generate homogeneous information from all health institutions. Indicators, flowcharts, and standardized instruments were created. The reforms modernized SINAVE and strengthened epidemiologists' leadership, consolidated local decision making, and assessed control actions needed to improve the health of the Mexican population. Handle: RePEc:aph:ajpbhl:2001:91:11:1758-1760_8 Template-Type: ReDIF-Article 1.0 Title: An ethics framework for public health Journal: American Journal of Public Health Author-Name: Kass, N.E. Year: 2001 Volume: 91 Issue: 11 Pages: 1776-1782 Abstract: More than 100 years ago, public health began as an organized discipline, its purpose being to improve the health of populations rather than of individuals. Given its population-based focus, however, public health perennially faces dilemmas concerning the appropriate extent of its reach and whether its activities infringe on individual liberties in ethically troublesome ways. In this article a framework for ethics analysis of public health programs is proposed. To advance traditional public health goals while maximizing individual liberties and furthering social justice, public health interventions should reduce morbidity or mortality; data must substantiate that a program (or the series of programs of which a program is a part) will reduce morbidity or mortality; burdens of the program must be identified and minimized; the program must be implemented fairly and must, at times, minimize preexisting social injustices; and fair procedures must be used to determine which burdens are acceptable to a community. Handle: RePEc:aph:ajpbhl:2001:91:11:1776-1782_0 Template-Type: ReDIF-Article 1.0 Title: Treatment outcomes and costs of dental sealants among children enrolled in Medicaid Journal: American Journal of Public Health Author-Name: Weintraub, J.A. Author-Name: Stearns, S.C. Author-Name: Rozier, R.G. Author-Name: Huang, C.-C. Year: 2001 Volume: 91 Issue: 11 Pages: 1877-1881 Abstract: Objectives. This retrospective cohort analysis of children enrolled in the North Carolina Medicaid program compared the likelihood of restorative treatments and associated cumulative Medicaid expenditures for teeth with or without dental sealants, Methods. We assessed the dental experience of the cohort of 15438 children from 1985 to 1992 on the basis of enrollment and claims files. We conducted regression analyses for outcomes (cariesrelated services involving the occlusal surface [CRSOs] of permanent first molars) and cumulative expenditures, controlling for characteristics of the child, the treating dentist, and the child's county of residence. Results. Overall, 23% of children received at least 1 sealant and 33% at least 1 CRSO. Sealants were effective in preventing CRSOs, although the degree of effectiveness was highest for children with the greater levels of CRSOs before sealant placement. Estimated cumulative Medicaid expenditures indicated expenditure savings from sealants within 2 years of application for children with 2 or more prior CRSOs. Conclusions. Sealant placement was associated with expenditure savings to Medicaid for certain highrisk children, so Medicaid and, more broadly, society will benefit by providing for sealant placement in these children. Handle: RePEc:aph:ajpbhl:2001:91:11:1877-1881_6 Template-Type: ReDIF-Article 1.0 Title: Sex, lies, and silence: Reproductive health in a hostile environment Journal: American Journal of Public Health Author-Name: Chavkin, W. Year: 2001 Volume: 91 Issue: 11 Pages: 1739-1741 Handle: RePEc:aph:ajpbhl:2001:91:11:1739-1741_0 Template-Type: ReDIF-Article 1.0 Title: CDC promotes the female condom for HIV/STD prevention [3] (multiple letters) Journal: American Journal of Public Health Author-Name: Green, Y. Year: 2001 Volume: 91 Issue: 11 Pages: 1732-1733 Handle: RePEc:aph:ajpbhl:2001:91:11:1732-1733_2 Template-Type: ReDIF-Article 1.0 Title: Turning science into junk: The tobacco industry and passive smoking Journal: American Journal of Public Health Author-Name: Samet, J.M. Author-Name: Burke, T.A. Year: 2001 Volume: 91 Issue: 11 Pages: 1742-1744 Abstract: In this issue, Glantz and Ong offer a powerful analysis of the tobacco industry's attempt to discredit the scientific evidence on passive smoking, particularly the industry's use of the label "junk science" Environmental epidemiologic studies in other arenas have also been targets for the "junk science" label. Lessons for researchers involved in high-stakes issues in the public policy arena include a need for awareness of competing interests, for transparency concerning funding, and for adherence to rigorous quality assurance and peer review practices. The goal of "sound science" seems an admirable one; it should not, however, be used to dismiss available but uncertain evidence in order to delay action. Handle: RePEc:aph:ajpbhl:2001:91:11:1742-1744_0 Template-Type: ReDIF-Article 1.0 Title: Buckling up America: Making a difference at the local level Journal: American Journal of Public Health Author-Name: Golden, A. Author-Name: Hatcher, B.J. Year: 2001 Volume: 91 Issue: 11 Pages: 1795-1796 Handle: RePEc:aph:ajpbhl:2001:91:11:1795-1796_8 Template-Type: ReDIF-Article 1.0 Title: Predictors and prevention of nonfatal overdose among street-recruited injection heroin users in the San Francisco Bay Area, 1998-1999 Journal: American Journal of Public Health Author-Name: Seal, K.H. Author-Name: Kral, A.H. Author-Name: Gee, L. Author-Name: Moore, L.D. Author-Name: Bluthenthal, R.N. Author-Name: Lorvick, J. Author-Name: Edlin, B.R. Year: 2001 Volume: 91 Issue: 11 Pages: 1842-1846 Abstract: Objectives. This study sought to determine prevalence of and risk factors for nonfatal recent overdose among street-recruited injection heroin users. Methods. From August 1998 through July 1999, 1427 heroin injectors were recruited from 6 inner-city neighborhoods in the San Francisco Bay Area, Calif, and interviewed. Factors hypothesized to be associated with recent overdose were analyzed with logistic regression. Results. Of the 1427 participants, 684 (48%) had had an overdose, 466 (33%) had experienced 2 or more overdose events, and 182 (13%) had had a recent overdose. In multiple logistic regression, being younger (adjusted odds ratio [OR] for each year of increasing age=0.95; 95% confidence interval [Cl]=0.94, 0.97), having been arrested 3 or more times in the past year (adjusted OR=2.50; 95% Cl=1.61, 3.87), drinking 4 or more alcoholic drinks per day (adjusted OR=2.05; 95% Cl=1.37, 3.05), and having participated in methadone detoxification during the past year (adjusted OR=1.47; 95% Cl=1.03, 2.09) were independently associated with recent overdose. Being homeless; identifying as gay, lesbian, bisexual, or transgender; having spent 5 or more years in prison or jail; and having engaged in sex work also were associated with recent overdose. Conclusions. Targeted interventions that decrease risk for overdose are urgently needed. Handle: RePEc:aph:ajpbhl:2001:91:11:1842-1846_4 Template-Type: ReDIF-Article 1.0 Title: The relationship of neighborhood socioeconomic characteristics to birthweight among 5 ethnic groups in California Journal: American Journal of Public Health Author-Name: Pearl, M. Author-Name: Braveman, P. Author-Name: Abrams, B. Year: 2001 Volume: 91 Issue: 11 Pages: 1808-1814 Abstract: Objectives. This study sought to examine relationships between neighborhood socioeconomic characteristics and birthweight, accounting for individual socioeconomic characteristics, among 5 ethnic groups. Methods. Birth records were linked inked to census block-group data for 22304 women delivering infants at 18 California hospitals during 1994-1995. Information on income and additional factors was obtained from a surveyed subset of 8457 women. Neighborhood levels of poverty, unemployment, and education were examined. Results. After adjustment for mothers' individual socioeconomic characteristics and other risk factors, less-favorable neighborhood socioeconomic characteristics were associated with lower birthweight among Blacks and Asians. No consistent relationship between neighborhood socioeconomic characteristics and birthweight was found among Whites, US-born Latinas, or foreign-born Latinas overall, but birthweight increased with less-favorable neighborhood socioeconomic characteristics among foreign-born Latinas in high-poverty or high-unemployment neighborhoods. These findings were not explained by measured behavioral or cultural factors. Conclusions. In addition to individual socioeconomic characteristics, living in neighborhoods that are less socioeconomically advantaged may differentially influence birthweight, depending on women's ethnicity and nativity. Handle: RePEc:aph:ajpbhl:2001:91:11:1808-1814_4 Template-Type: ReDIF-Article 1.0 Title: Untangling the web: Race/ethnicity, immigration, and the nation's health Journal: American Journal of Public Health Author-Name: Lillie-Blanton, M. Author-Name: Hudman, J. Year: 2001 Volume: 91 Issue: 11 Pages: 1736-1738 Handle: RePEc:aph:ajpbhl:2001:91:11:1736-1738_7 Template-Type: ReDIF-Article 1.0 Title: Area-level characteristics and smoking in women Journal: American Journal of Public Health Author-Name: Tseng, M. Author-Name: Yeatts, K. Author-Name: Millikan, R. Author-Name: Newman, B. Year: 2001 Volume: 91 Issue: 11 Pages: 1847-1850 Abstract: Objectives. This study examined whether area-level characteristics are associated with individual smoking behavior among women. Methods. Analyses included 648 women enrolled as control patients in the Carolina Breast Cancer Study (1993-1996). Smoking and covariate information was obtained from interviews. Area-level characteristics included census block-group education level, poverty, unemployment, car-home ownership, crowding, and, for 431 women, city-level crime rates. Results. In multivariate logistic regression models, no area characteristics were clearly associated with a history of smoking. Among those who had ever smoked, continued smoking was associated with living in low-education areas (odds ratio [OR] = 1.7, 95% confidence interval [Cl] = 1.0, 2.9), high-unemployment areas (OR = 1.7, 95% Cl = 1.0, 2.8), and high-crime areas (OR = 1.6, 95% Cl = 0.8, 3.2). Conclusions. The present findings are consistent with a growing literature suggesting that area-level social and economic disadvantage influences individual smoking behavior. Handle: RePEc:aph:ajpbhl:2001:91:11:1847-1850_7 Template-Type: ReDIF-Article 1.0 Title: Health care for Latino children: Impact of child and parental birthplace on insurance status and access to health services Journal: American Journal of Public Health Author-Name: Granados, G. Author-Name: Puvvula, J. Author-Name: Berman, N. Author-Name: Dowling, P.T. Year: 2001 Volume: 91 Issue: 11 Pages: 1806-1807 Abstract: Objectives. This study sought to assess the impact of child and parental birthplace on insurance status and access to health care among Latino children in the United States. Methods. A cross-sectional, in-person survey of 376 random households with children aged 1 to 12 years was conducted in a predominantly Latino community. Children's insurance status and access to routine health care were compared among 3 child-parent groups: US born-US born (UU), US born-immigrant (UI), and immigrant-immigrant (II). Results. Uninsured rates for the 3 groups of children were 10% (UU), 23% (UI), and 64% (II). Rates for lack of access to routine health care were 5% (UU), 12% (UI), and 32% (II). Conclusion. Latino children of immigrant parents are more likely to lack insurance and access to routine health care than are Latino children of US-born parents. Handle: RePEc:aph:ajpbhl:2001:91:11:1806-1807_9 Template-Type: ReDIF-Article 1.0 Title: HIV-related behaviors and perceptions among adults in 25 states: 1997 Behavioral Risk Factor Surveillance System Journal: American Journal of Public Health Author-Name: Holtzman, D. Author-Name: Bland, S.D. Author-Name: Lansky, A. Author-Name: Mack, K.A. Year: 2001 Volume: 91 Issue: 11 Pages: 1882-1888 Abstract: Objectives. To assess the level of HIV-related risk behavior among the general US adult population, we analyzed data from the first sexual behavior questions available for states to use with the Behavioral Risk Factor Surveillance System. Methods. The Behavioral Risk Factor Surveillance System is a state-specific, population-based, random telephone survey. In 1997, 25 states collected sexual behavior data. Annual prevalence estimates for selected behaviors were calculated and examined by sociodemographic characteristics. The correlation between actual and perceived HIV risk also was determined. Results. Most (77.1%) of the respondents reported just 1 sexual partner in the past year; 26.0% reported using a condom at last intercourse. Males, persons who were younger, and Blacks were more likely to report 2 or more partners but also more likely to report using a condom at last intercourse. Only 4.1% of the respondents reported a risk factor for HIV infection; 7.7% reported that they were at medium or high risk for HIV. Actual and perceived HIV risk were positively associated. Conclusions. Most US adults do not engage in HIV-related risk behavior; those that do are more likely to report protective behavior. Handle: RePEc:aph:ajpbhl:2001:91:11:1882-1888_3 Template-Type: ReDIF-Article 1.0 Title: Promoting culturally competent care for the lesbian, gay, bisexual, and transgender population [1] (multiple letters) Journal: American Journal of Public Health Author-Name: Arnold, L.M. Year: 2001 Volume: 91 Issue: 11 Pages: 1731 Handle: RePEc:aph:ajpbhl:2001:91:11:1731_2 Template-Type: ReDIF-Article 1.0 Title: Reproductive health in eastern Europe: A collaborrative training project in Romania Journal: American Journal of Public Health Author-Name: Lüdicke, F. Author-Name: Horga, M. Author-Name: Campana, A. Year: 2001 Volume: 91 Issue: 11 Pages: 1761-1763 Abstract: Since the fall of the Berlin Wall, fundamental political changes in eastern Europe have affected the Soviet-style health care systems that formerly provided basic care for everyone. Many of these systems have collapsed, and the new systems of social insurance that have replaced them often are inadequate. Advanced Training in Reproductive Health in Romania aimed to create an authority in family planning and reproductive health in selected Romanian university centers and to improve training and research capabilities. Initially, the project had 2 main goals: to provide advanced training in reproductive health and family planning to Romanian obstetrics-gynecology specialists from the main university centers - which would allow them to train other physicians (obstetricians, gynecologists, and general practitioners) and medical students - and to develop, test, and finalize specific training materials in Romanian to be used by the new trainers. Handle: RePEc:aph:ajpbhl:2001:91:11:1761-1763_3 Template-Type: ReDIF-Article 1.0 Title: Strategies for motivating Latino couples' participation in qualitative health research and their effects on sample construction Journal: American Journal of Public Health Author-Name: Preloran, H.M. Author-Name: Browner, C.H. Author-Name: Lieber, E. Year: 2001 Volume: 91 Issue: 11 Pages: 1832-1841 Abstract: Many investigators report difficulties recruiting low-income Latinos into health research projects, especially when they seek to enroll more than one family member. We developed a series of strategies that proved effective in motivating candidates who were initially reluctant to enroll. There is a possibility that these strategies biased the composition of the sample. Predictably, the reasons participants gave for enrolling were correlated with the recruitment strategy that had brought them into the study. Furthermore, we found statistically significant associations between recruitment technique and key study variables (e.g., the domestic stability of the couple). By increasing investigators' ability to recruit Latinos, however, the strategies outlined should help to ensure that Latinos' experiences are given due weight in the deliberations of medical professionals and policymakers. Handle: RePEc:aph:ajpbhl:2001:91:11:1832-1841_4 Template-Type: ReDIF-Article 1.0 Title: Welfare reform and the perinatal health and health care use of latino women in California, New York city, and Texas Journal: American Journal of Public Health Author-Name: Joyce, T. Author-Name: Bauer, T. Author-Name: Minkoff, H. Author-Name: Kaestner, R. Year: 2001 Volume: 91 Issue: 11 Pages: 1857-1864 Abstract: Objectives. This study analyzed changes in the financing of prenatal care and delivery, the use of prenatal care, and birth outcomes among foreign-born vs US-born Latino women following enactment of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) in August 1996. Methods. We used a pre-post design with a comparison group. The sample consisted of resident Latinas in California, New York City, and Texas who delivered a live infant in 1995 or 1998. Results. The proportion of births to Latinas that initiated prenatal care in the first 4 months of pregnancy increased for all foreign-born Latinas in California, New York City, and Texas between 1995 and 1998 (P<.O5). Except for non-Dominicans in New York City, there was no increase in the proportion of low- or very-low-birthweight births among foreign-born vs US-bom Latinas in the 3 localities between 1995 and 1996. Conclusions. There is little evidence from vital statistics in California, New York City, and Texas that PRWORA had any substantive impact on the perinatal health and health care utilization of foreign-born relative to US-born Latinas. Handle: RePEc:aph:ajpbhl:2001:91:11:1857-1864_2 Template-Type: ReDIF-Article 1.0 Title: "Do it now!" Yakima, Wash, and the campaign against rural typhoid Journal: American Journal of Public Health Author-Name: Casner, N. Year: 2001 Volume: 91 Issue: 11 Pages: 1768-1775 Abstract: In 1911, Yakima, in western Washington, suffered a typhoid epidemic that turned the nation's attention to a crisis in public health. The response exemplified the ideals of the "new public health" as a more proactive, scientific, federal commitment to the problems of rural America. A US Public Health Service investigation led by Dr Leslie Lumsden found a typhoid mortality rate of nearly 5 times the national average. The cause was bad sanitation. Typhoid rates dropped dramatically as the community adopted pragmatic solutions. Lumsden helped organize a "Do It Now" sanitation campaign and one of the country's first city-county health units. Yakima provided a model for other rural areas and small towns across the country. This episode in one of the country's most productive fruit-growing regions raised serious questions regarding the geographic dynamics of disease. For Lumsden and other like-minded health officials, the countryside represented a dangerous reservoir of disease, a particular threat to the nation's agriculturally dependent urban populations. Yakima showed that the country needed a more comprehensive public health system that addressed urban and rural problems. Handle: RePEc:aph:ajpbhl:2001:91:11:1768-1775_1 Template-Type: ReDIF-Article 1.0 Title: Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States Journal: American Journal of Public Health Author-Name: Mays, V.M. Author-Name: Cochran, S.D. Year: 2001 Volume: 91 Issue: 11 Pages: 1869-1876 Abstract: Objectives. Recent studies suggest that lesbians and gay men are at higher risk for stress-sensitive psychiatric disorders than are heterosexual persons. We examined the possible role of perceived discrimination in generating that risk. Methods, The National Survey of Midlife Development in the United States, a nationally representative sample of adults aged 25 to 74 years, surveyed individuals self-identifying as homosexual or bisexual (n = 73) or heterosexual (n = 2844) about their lifetime and day-to-day experiences with discrimination. Also assessed were 1-year prevalence of depressive, anxiety, and substance dependence disorders; current psychologic distress; and self-rated mental health. Results, Homosexual and bisexual individuals more frequently than heterosexual persons reported both lifetime and day-to-day experiences with discrimination. Approximately 42% attributed this to their sexual orientation, in whole or part. Perceived discrimination was positively associated with both harmful effects on quality of life and indicators of psychiatric morbidity in the total sample. Controlling for differences in discrimination experiences attenuated observed associations between psychiatric morbidity and sexual orientation. Conclusions. Higher levels of discrimination may underlie recent observations of greater psychiatric morbidity risk among lesbian, gay, and bisexual individuals. Handle: RePEc:aph:ajpbhl:2001:91:11:1869-1876_4 Template-Type: ReDIF-Article 1.0 Title: The health of immigrants. 1943. Journal: American Journal of Public Health Author-Name: Hamilton, A. Year: 2001 Volume: 91 Issue: 11 Pages: 1765-1767 Handle: RePEc:aph:ajpbhl:2001:91:11:1765-1767_1 Template-Type: ReDIF-Article 1.0 Title: Alice Hamilton: settlement physician, occupational health pioneer. Journal: American Journal of Public Health Author-Name: Fee, E. Author-Name: Brown, T.M. Year: 2001 Volume: 91 Issue: 11 Pages: 1767 Handle: RePEc:aph:ajpbhl:2001:91:11:1767_7 Template-Type: ReDIF-Article 1.0 Title: Cholera prevention with traditional and novel water treatment methods: An outbreak investigation in Fort-Dauphin, Madagascar Journal: American Journal of Public Health Author-Name: Reller, M.E. Author-Name: Mong, Y.J.M. Author-Name: Hoekstra, R.M. Author-Name: Quick, R.E. Year: 2001 Volume: 91 Issue: 10 Pages: 1608-1610 Handle: RePEc:aph:ajpbhl:2001:91:10:1608-1610_0 Template-Type: ReDIF-Article 1.0 Title: Self-assessed health among indigenous Australians: How valid is a global question? Journal: American Journal of Public Health Author-Name: Sibthorpe, B. Author-Name: Anderson, I. Author-Name: Cunningham, J. Year: 2001 Volume: 91 Issue: 10 Pages: 1660-1663 Abstract: Objectives. This study assessed the validity of a global measure of self-assessed health among Indigenous Australians. Methods. Logistic regression was used to identify factors associated with self-assessed health in a nationally representative sample. Results. Among 8782 adult respondents, poorer self-assessed health was strongly associated with several factors, including age, number of health conditions, and recent health actions. The association with health conditions was attenuated when the respondent's primary language was not English. Conclusions. Self-assessed health may be a valid measure among indigenous Australians whose primary language is English. However, although the measure draws on common experiences of health and illness, it may obscure differences in how people incorporate these experiences into social actions. Handle: RePEc:aph:ajpbhl:2001:91:10:1660-1663_2 Template-Type: ReDIF-Article 1.0 Title: Using folk media in HIV/AIDS prevention in Rural Ghana Journal: American Journal of Public Health Author-Name: Panford, S. Author-Name: Nyaney, M.O. Author-Name: Amoah, S.O. Author-Name: Aidoo, N.G. Year: 2001 Volume: 91 Issue: 10 Pages: 1559-1562 Abstract: The pandemic of HIV/AIDS continues to pose a serious threat to the population of sub-Saharan Africa, despite ongoing public health efforts to control the spread of infection. Given the important role of oral tradition in indigenous settings throughout rural Africa, we are beginning an innovative approach to HIV/AIDS prevention based on the use of folk media. This commentary explains the types of folk media used in the traditional Ghanaian setting and explores their consistency with well-known theories. Folk media will be integrated with broadcast radio for interventions under the HIV/AIDS Behavior Change Communication Project being undertaken as part of the CARE-CDC Health Initiative (CCHI) in 2 districts in Ghana. Handle: RePEc:aph:ajpbhl:2001:91:10:1559-1562_2 Template-Type: ReDIF-Article 1.0 Title: Community health worker performance in the management of multiple childhood illnesses: Siaya District, Kenya, 1997-2001 Journal: American Journal of Public Health Author-Name: Kelly, J.M. Author-Name: Osamba, B. Author-Name: Garg, R.M. Author-Name: Hamel, M.J. Author-Name: Lewis, J.J. Author-Name: Rowe, S.Y. Author-Name: Rowe, A.K. Author-Name: Deming, M.S. Year: 2001 Volume: 91 Issue: 10 Pages: 1617-1624 Abstract: Objectives. To characterize community health worker (CHW) performance using an algorithm for managing common childhood illnesses in Siaya District, Kenya, we conducted CHW evaluations in 1998, 1999, and 2001. Methods. Randomly selected CHWs were observed managing sick outpatient and inpatient children at a hospital, and their management was compared with that of an expert clinician who used the algorithm. Results. One hundred, 108, and 114 CHWs participated in the evaluations in 1998, 1999, and 2001, respectively. The proportions of children treated "adequately" (with an antibiotic, antimalarial, oral rehydration solution, or referral, depending on the child's disease classifications) were 57.8%, 35.5%, and 38.9%, respectively, for children with a severe classification and 27.7%, 77.3%, and 74.3%, respectively, for children with a moderate (but not severe) classification. CHWs adequately treated 90.5% of malaria cases (the most commonly encountered classification). CHWs often made mistakes assessing symptoms, classifying illnesses, and prescribing correct doses of medications. Conclusions. Deficiencies were found in the management of sick children by CHWs, although care was not consistently poor. Key reasons for the deficiencies appear to be guideline complexity and inadequate clinical supervision; other possible causes are discussed. Handle: RePEc:aph:ajpbhl:2001:91:10:1617-1624_5 Template-Type: ReDIF-Article 1.0 Title: Community environmental health assessment in Peru's desert hills and rainforest Journal: American Journal of Public Health Author-Name: Baffigo, V. Author-Name: Albinagorta, J. Author-Name: Nauca, L. Author-Name: Rojas, P. Author-Name: Alegre, R. Author-Name: Hubbard, B. Author-Name: Sarisky, J. Year: 2001 Volume: 91 Issue: 10 Pages: 1580-1582 Abstract: Peru's expanding population and rapid urbanization - a result of migration to its largest cities - have stressed the country's public services infrastructure and the provision of public health and environmental health services. In response, the Ministry of Health established the General Directorate of Environmental Health (DIGESA), the branch charged with assuring adequate environmental health services to populations in rural and urban areas. The magnitude of the environmental health problems in peri-urban settlements, however, has exceeded the capacity of DIGESA to respond. The Urban Environmental Health Project is an effort to develop the ability of local communities to address these problems. Handle: RePEc:aph:ajpbhl:2001:91:10:1580-1582_7 Template-Type: ReDIF-Article 1.0 Title: Modeling and reinforcement to combat HIV: The MARCH approach to behavior change Journal: American Journal of Public Health Author-Name: Galavotti, C. Author-Name: Pappas-DeLuca, K.A. Author-Name: Lansky, A. Year: 2001 Volume: 91 Issue: 10 Pages: 1602-1607 Abstract: Theory and research suggest that behavioral interventions to prevent HIV/AIDS may be most effective when they are personalized and affectively compelling, when they provide models of desired behaviors, and when they are linked to social and cultural narratives. Effective strategies must also take into account the opportunities and obstacles present in the local environment. The Modeling and Reinforcement to Combat HIV (MARCH) projects combine key aspects of individual behavior change with efforts to change social norms. There are 2 main components to the program: entertainment as a vehicle for education (long-running serialized dramas on radio or television portray role models evolving toward the adoption of positive behaviors) and interpersonal reinforcement at the community level (support from friends, family members, and others can help people initiate behavior changes; support through changes in social norms is necessary for behavioral effects to be sustained over time). Both media and interpersonal intervention activities should be linked to existing resources in the community and, wherever possible, provide increased access to preventive services, supplies, and other supporting elements. Handle: RePEc:aph:ajpbhl:2001:91:10:1602-1607_9 Template-Type: ReDIF-Article 1.0 Title: Not just a drop in the bucket: Expanding access to point-of-use water treatment systems Journal: American Journal of Public Health Author-Name: Mintz, E.D. Author-Name: Bartram, J. Author-Name: Lochery, P. Author-Name: Wegelin, M. Year: 2001 Volume: 91 Issue: 10 Pages: 1565-1570 Abstract: Since 1990, the number of people without access to safe water sources has remained constant at approximately 1.1 billion, of whom approximately 2.2 million die of waterborne disease each year. In developing countries, population growth and migrations strain existing water and sanitary infrastructure and complicate planning and construction of new infrastructure. Providing safe water for all is a long-term goal; however, relying only on time- and resource-intensive centralized solutions such as piped, treated water will leave hundreds of millions of people without safe water far into the future. Self-sustaining, decentralized approaches to making drinking water safe, including point-of-use chemical and solar disinfection, safe water storage, and behavioral change, have been widely field-tested. These options target the most affected, enhance health, contribute to development and productivity, and merit far greater priority for rapid implementation. Handle: RePEc:aph:ajpbhl:2001:91:10:1565-1570_0 Template-Type: ReDIF-Article 1.0 Title: Obesity and undernutrition and cardiovascular risk factors in rural and urban Gambian communities Journal: American Journal of Public Health Author-Name: Van der Sande, M.A.B. Author-Name: Ceesay, S.M. Author-Name: Milligan, P.J.M. Author-Name: Nyan, O.A. Author-Name: Banya, W.A.S. Author-Name: Prentice, A. Author-Name: McAdam, K.P.W.J. Author-Name: Walraven, G.E.L. Year: 2001 Volume: 91 Issue: 10 Pages: 1641-1644 Abstract: Objectives. This study documented the prevalence of and cardiovascular risk factors associated with obesity and undernutrition in the Gambia. Methods. Adults (≥15 years; N=5373) from rural and urban areas completed a questionnaire; their height, weight, and waist and hip circumferences were measured, and their cardiovascular risk factors were assessed. Results. Prevalence of undernutrition (body mass index<18 kg/m2) was 18.0%; all strata of society were affected. Prevalence of obesity (body mass index≥30 kg/m2) was 4.0% but was higher (32.6%) among urban women 35 years or older. Cardiovascular risk factors were more prevalent among obese participants. Conclusions. Undernutrition coexists with obesity, demonstrating a "double burden of disease". Differential interventions should focus on high-risk groups; prevention needs a multisectorial approach. Handle: RePEc:aph:ajpbhl:2001:91:10:1641-1644_5 Template-Type: ReDIF-Article 1.0 Title: The CARE-CDC Health Initiative: A model for global participatory research Journal: American Journal of Public Health Author-Name: Riley, P.L. Author-Name: Nkinsi, L. Author-Name: Buhi, L. Year: 2001 Volume: 91 Issue: 10 Pages: 1549-1552 Handle: RePEc:aph:ajpbhl:2001:91:10:1549-1552_4 Template-Type: ReDIF-Article 1.0 Title: Saudi nutrition education for pregnant women, 1988 Journal: American Journal of Public Health Author-Name: Helfand, W.H. Author-Name: Lazarus, J. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 10 Pages: 1591 Handle: RePEc:aph:ajpbhl:2001:91:10:1591_8 Template-Type: ReDIF-Article 1.0 Title: Health status of the Pakistani population [1] (multiple letters) Journal: American Journal of Public Health Author-Name: Nanan, D. Author-Name: Akhter, M. Author-Name: Pappas, G. Year: 2001 Volume: 91 Issue: 10 Pages: 1545-1546 Handle: RePEc:aph:ajpbhl:2001:91:10:1545-1546_9 Template-Type: ReDIF-Article 1.0 Title: Care seeking during fatal childhood illnesses: Siaya District, Kenya, 1998 Journal: American Journal of Public Health Author-Name: Garg, R. Author-Name: Omwomo, W. Author-Name: Witte, J.M. Author-Name: Lee, L.A. Author-Name: Deming, M.S. Year: 2001 Volume: 91 Issue: 10 Pages: 1611-1613 Handle: RePEc:aph:ajpbhl:2001:91:10:1611-1613_2 Template-Type: ReDIF-Article 1.0 Title: Factors linked to bacterial vaginosis in nonpregnant women Journal: American Journal of Public Health Author-Name: Holzman, C. Author-Name: Leventhal, J.M. Author-Name: Qiu, H. Author-Name: Jones, N.M. Author-Name: Wang, J. Year: 2001 Volume: 91 Issue: 10 Pages: 1664-1670 Abstract: Objectives. The purposes of this study were to test the hypothesis that vaginal douching is linked to bacterial vaginosis in both symptomatic and asymptomatic women and to identify other demographic, reproductive, and lifestyle factors associated with bacterial vaginosis. Methods. In this cross-sectional study involving 3 clinic sites, 496 nonpregnant women completed a self-administered questionnaire. Their vaginal smears were assessed and cross-validated for bacterial vaginosis. Results. The prevalence of bacterial vaginosis across clinics ranged from 15% to 30%. In analyses restricted to site 1, adjusted odds ratios (ORs) for bacterial vaginosis remained significant for African American women with 13 or fewer years of education (OR=5.5, 95% confidence interval [CI]=2.1, 14.5), hormone use within the past 6 months (OR=0.5, 95% CI=0.2, 0.8), and vaginal douching within the past 2 months (OR=2.9, 95% CI=1.5, 5.6). Conclusions. Two lifestyle factors emerge as strongly associated with bacterial vaginosis: systemic contraceptives appear protective, whereas douching is linked to an increase in prevalence. The temporal relationship between douching and bacterial vaginosis needs further clarification. Handle: RePEc:aph:ajpbhl:2001:91:10:1664-1670_0 Template-Type: ReDIF-Article 1.0 Title: Seeking safe storage: A comparison of drinking water quality in clay and plastic vessels Journal: American Journal of Public Health Author-Name: Ogutu, P. Author-Name: Garrett, V. Author-Name: Barasa, P. Author-Name: Ombeki, S. Author-Name: Mwaki, A. Author-Name: Quick, R.E. Year: 2001 Volume: 91 Issue: 10 Pages: 1610-1611 Handle: RePEc:aph:ajpbhl:2001:91:10:1610-1611_5 Template-Type: ReDIF-Article 1.0 Title: Hormonal pregnancy tests in sub-Saharan Africa Journal: American Journal of Public Health Author-Name: Stanback, J. Author-Name: Raymond, E. Year: 2001 Volume: 91 Issue: 10 Pages: 1614-1615 Handle: RePEc:aph:ajpbhl:2001:91:10:1614-1615_5 Template-Type: ReDIF-Article 1.0 Title: Management of childhood illness at health facilities in Benin: Problems and their causes Journal: American Journal of Public Health Author-Name: Rowe, A.K. Author-Name: Onikpo, F. Author-Name: Lama, M. Author-Name: Cokou, F. Author-Name: Deming, M.S. Year: 2001 Volume: 91 Issue: 10 Pages: 1625-1635 Abstract: Objectives. To prepare for the implementation of Integrated Management of Childhood illness (IMCI) in Benin, we studied the management of ill children younger than 5 years at outpatient health facilities. Methods. We observed a representative sample of consultations; after each consultation, we interviewed caregivers and reexamined children. Health workers' performance was evaluated against IMCI guidelines. To identify determinants of performance, statistical modeling was performed and 6 focus groups with health workers were conducted to solicit their opinions. Results. Altogether, 584 children were enrolled and 101 health workers were observed; 130 health workers participated in focus group discussions. Many serious deficiencies were found: incomplete assessment of children's signs and symptoms, incorrect diagnosis and treatment of potentially life-threatening illnesses, inappropriate prescription of dangerous sedatives, missed opportunities to vaccinate, and failure to refer severely ill children for hospitalization. Quantitative and qualitative analyses showed various health facility-, health worker-, caregiver-, and child-related factors as possible determinants of health worker performance. Conclusions. Action is urgently needed. Our results suggest that to improve health care delivery, interventions should target both the health system and the community level. Handle: RePEc:aph:ajpbhl:2001:91:10:1625-1635_2 Template-Type: ReDIF-Article 1.0 Title: Growth in indigenous and nonindigenous Chilean schoolchildren from 3 poverty strata Journal: American Journal of Public Health Author-Name: Bustos, P. Author-Name: Amigo, H. Author-Name: Muñoz, S.R. Author-Name: Martorell, R. Year: 2001 Volume: 91 Issue: 10 Pages: 1645-1649 Abstract: Objectives. This study sought to determine whether the short stature of Mapuche children, an indigenous group in Chile, reflects poverty or genetic heritage and whether the international reference population, derived from studies of US children of mostly European origin, is appropriate for assessing growth failure in indigenous peoples of the Americas. Methods. The study assessed 768 schoolchildren of Mapuche and non-Mapuche ancestry, aged 6 to 9 years, living under conditions of extreme, medium, and low poverty. Results. Growth retardation was strongly related to poverty in both ethnic groups. Within poverty levels, there were no significant differences in stature between ethnic groups, and in low-poverty areas in Santiago, the capital city, mean stature was only slightly less than in the reference population. Conclusions. Poverty, not ancestry, explains the short stature of Mapuche children, and use of the international reference to assess growth in this population is appropriate. Handle: RePEc:aph:ajpbhl:2001:91:10:1645-1649_5 Template-Type: ReDIF-Article 1.0 Title: Results of the expanded program on immunization in the Macedonian refugee camps Journal: American Journal of Public Health Author-Name: Koop, D.G. Author-Name: Jackson, B.M. Author-Name: Nestel, G. Year: 2001 Volume: 91 Issue: 10 Pages: 1656-1659 Abstract: Objectives. This report summarizes the results of the Macedonian refugee camps' Expanded Program on Immunization. Methods. Government agencies and nongovernmental organizations implemented an immunization program consisting of 3 mass vaccination campaigns in each of the 7 camps. Before the second mass campaign, weekly immunization clinics were initiated in each camp. Children younger than 48 months were immunized against 8 antigens according to a schedule established by the Macedonian Ministry of Health. Results. Immunization coverage rates in the second campaign were 91% in Cegrane and 73% in Brazda. Coverage rates of the weekly clinics averaged 93%. Conclusions. Initiating an expanded immunization program in the absence of a stable population is problematic. Handle: RePEc:aph:ajpbhl:2001:91:10:1656-1659_1 Template-Type: ReDIF-Article 1.0 Title: Managing newborn health in the global community Journal: American Journal of Public Health Author-Name: Foege, W. Year: 2001 Volume: 91 Issue: 10 Pages: 1563-1564 Abstract: The largest health disparities in the world are found in maternal and neonatal mortality figures between the industrialized countries and the poorest sections of the poorest countries. Young lives would be saved if the skills and knowledge that have been accumulated by health workers around the world could be readily applied. The problems reside with lack of management resources rather than lack of scientific knowledge. The Healthy Newborn: A Reference Manual for Program Managers is a graduate course in management aimed at providing health to newborns and healthy newborns to communities. Handle: RePEc:aph:ajpbhl:2001:91:10:1563-1564_8 Template-Type: ReDIF-Article 1.0 Title: Making health a priority of US foreign policy Journal: American Journal of Public Health Author-Name: Fox, D.M. Author-Name: Kassalow, J.S. Year: 2001 Volume: 91 Issue: 10 Pages: 1554-1556 Handle: RePEc:aph:ajpbhl:2001:91:10:1554-1556_5 Template-Type: ReDIF-Article 1.0 Title: Mortality from unintentional injuries in Japan, 1899-1998 Journal: American Journal of Public Health Author-Name: Ichikawa, M. Year: 2001 Volume: 91 Issue: 10 Pages: 1615-1616 Handle: RePEc:aph:ajpbhl:2001:91:10:1615-1616_9 Template-Type: ReDIF-Article 1.0 Title: Treatment of tuberculosis in Haiti [2] (multiple letters) Journal: American Journal of Public Health Author-Name: Long, R. Author-Name: Scalcini, M. Author-Name: Ollé-Goig, J. Author-Name: Desvarieux, M. Author-Name: Johnson W.D., Jr. Author-Name: Pape, J.W. Year: 2001 Volume: 91 Issue: 10 Pages: 1546-1547 Handle: RePEc:aph:ajpbhl:2001:91:10:1546-1547_1 Template-Type: ReDIF-Article 1.0 Title: Impact of the safe water system on water quality in cyclone-affected communities in Madagascar Journal: American Journal of Public Health Author-Name: Mong, Y. Author-Name: Kaiser, R. Author-Name: Ibrahim, D. Author-Name: Rosoatiana Author-Name: Razafimbololona, L. Author-Name: Quick, R.E. Year: 2001 Volume: 91 Issue: 10 Pages: 1577-1579 Abstract: Cyclone Hudah struck the northeastern coast of Madagascar in the spring of 2000. Over a 5-month period, 11 700 relief kits consisting of bottles of water disinfectant and foldable jerry cans were distributed to the affected population. Five months after the cyclone, a survey was conducted in 12 villages to determine the impact of these relief kits on water quality. Seventy-six percent of the surveyed households reported using jerry cans, and 65% reported using the disinfectant. Stored water in households using both products had significantly less microbiological contamination than stored water in other households. To improve the prospects for a sustainable intervention, the response plan for future disasters should incorporate a transition to recovery and development, including formative research into local customs, beliefs, and water handling habits, and funding support to initiate social marketing. Handle: RePEc:aph:ajpbhl:2001:91:10:1577-1579_1 Template-Type: ReDIF-Article 1.0 Title: Collaboration, cholera, and cyclones: A project to improve point-of-use water quality in Madagascar Journal: American Journal of Public Health Author-Name: Dunston, C. Author-Name: McAfee, D. Author-Name: Kaiser, R. Author-Name: Rakotoarison, D. Author-Name: Rambeloson, L. Author-Name: Anh Thu Hoang Author-Name: Quick, R.E. Year: 2001 Volume: 91 Issue: 10 Pages: 1574-1576 Abstract: In November 1999, CARE Madagascar, Population Services International (PSI), and the Centers for Disease Control and Prevention (CDC) selected 30 poor communities in urban Antananarivo as the target population for launch of the Safe Water System. The system consists of behavior change techniques along with point-of-use treatment and safe storage of water. The project was launched in March 2000, ahead of schedule, because a cholera epidemic struck Madagascar in January. Because of the enormous demand created by the cholera epidemic and by 3 cyclones that followed in the next 3 months, the project grew to national scale in less than a year. The combination of community mobilization and social marketing resulted in increased demand for and use of the Safe Water System. Handle: RePEc:aph:ajpbhl:2001:91:10:1574-1576_5 Template-Type: ReDIF-Article 1.0 Title: Extrarelational sex among Mexican men and their partners' risk of HIV and other sexually transmitted diseases Journal: American Journal of Public Health Author-Name: Pulerwitz, J. Author-Name: Izazola-Licea, J.-A. Author-Name: Gortmaker, S.L. Year: 2001 Volume: 91 Issue: 10 Pages: 1650-1652 Abstract: Objectives. This study explored the risk of HIV and other sexually transmitted diseases (STDs) among married and cohabiting women in Mexico City, Mexico, derived from their partners' sexual behaviors. Methods. Results were derived from the first population-based household survey in Mexico that investigated male sexual behavior. Analyses were restricted to sexually active married or cohabiting men (n=3990). Results. Fifteen percent of the men reported extrarelational sex during the past year, 9% reported condom use during last intercourse, and 80% perceived no HIV risk. Most secondary partners were coworkers, mistresses, or friends. Conclusions. Targeted HIV and STD prevention efforts appear necessary because a substantial number of women may be at risk. Handle: RePEc:aph:ajpbhl:2001:91:10:1650-1652_4 Template-Type: ReDIF-Article 1.0 Title: Social medicine then and now: Lessons from Latin America Journal: American Journal of Public Health Author-Name: Waitzkin, H. Author-Name: Iriart, C. Author-Name: Estrada, A. Author-Name: Lamadrid, S. Year: 2001 Volume: 91 Issue: 10 Pages: 1592-1601 Abstract: The accomplishments of Latin American social medicine remain little known in the English-speaking world. In Latin America, social medicine differs from public health in its definitions of populations and social institutions, its dialectic vision of "health-illness," and its stance on causal inference. A "golden age" occurred during the 1930s, when Salvador Allende, a pathologist and future president of Chile, played a key role. Later influences included the Cuban revolution, the failed peaceful transition to socialism in Chile, the Nicaraguan revolution, liberation theology, and empowerment strategies in education. Most of the leaders of Latin American social medicine have experienced political repression, partly because they have tried to combine theory and political practice - a combination known as "praxis." Theoretic debates in social medicine take their bearings from historical materialism and recent trends in European philosophy. Methodologically, differing historical, quantitative, and qualitative approaches aim to avoid perceived problems of positivism and reductionism in traditional public health and clinical methods. Key themes emphasize the effects of broad social policies on health and health care; the social determinants of illness and death; the relationships between work, reproduction, and the environment; and the impact of violence and trauma. Handle: RePEc:aph:ajpbhl:2001:91:10:1592-1601_9 Template-Type: ReDIF-Article 1.0 Title: Melding disparate cultures and capacities to create global health partnerships Journal: American Journal of Public Health Author-Name: Bell, P.D. Author-Name: Stokes, C.C. Year: 2001 Volume: 91 Issue: 10 Pages: 1552-1554 Handle: RePEc:aph:ajpbhl:2001:91:10:1552-1554_6 Template-Type: ReDIF-Article 1.0 Title: A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: Results of the eat for life trial Journal: American Journal of Public Health Author-Name: Resnicow, K. Author-Name: Jackson, A. Author-Name: Wang, T. Author-Name: De, A.K. Author-Name: McCarty, F. Author-Name: Dudley, W.N. Author-Name: Baranowski, T. Year: 2001 Volume: 91 Issue: 10 Pages: 1686-1693 Abstract: Objectives. This study reports on Eat for Life, a multicomponent intervention to increase fruit and vegetable consumption among African Americans that was delivered through Black churches. Methods. Fourteen churches were randomly assigned to 3 treatment conditions: (1) comparison, (2) self-help intervention with 1 telephone cue call, and (3) self-help with 1 cue call and 3 counseling calls. The telephone counseling in group 3 was based on motivational interviewing. The primary outcome, assessed at baseline and 1-year follow-up, was fruit and vegetable intake as assessed by 3 food frequency questionnaires. Results. Change in fruit and vegetable intake was significantly greater in the motivational interviewing group than in the comparison and self-help groups. The net difference between the motivational interviewing and comparison groups was 1.38, 1.03, and 1.21 servings of fruits and vegetables per day for the 2-item, 7-item, and 36-item food frequency questionnaires, respectively. The net difference between the motivational interviewing and self-help groups was 1.14, 1.10, and 0.97 servings for the 2-item, 7-item, and 36-item food frequency questionnaires, respectively. Conclusions. Motivational interviewing appears to be a promising strategy for modifying dietary behavior, and Black churches are an excellent setting to implement and evaluate health promotion programs. Handle: RePEc:aph:ajpbhl:2001:91:10:1686-1693_7 Template-Type: ReDIF-Article 1.0 Title: US public health leaders shift toward a new paradigm of global health Journal: American Journal of Public Health Author-Name: Bunyavanich, S. Author-Name: Walkup, R.B. Year: 2001 Volume: 91 Issue: 10 Pages: 1556-1558 Handle: RePEc:aph:ajpbhl:2001:91:10:1556-1558_8 Template-Type: ReDIF-Article 1.0 Title: Improving surveillance for maternal and perinatal health in 2 districts of rural Tanzania Journal: American Journal of Public Health Author-Name: Kilonzo, A. Author-Name: Kouletio, M. Author-Name: Whitehead, S.J. Author-Name: Curtis, K.M. Author-Name: McCarthy, B.J. Year: 2001 Volume: 91 Issue: 10 Pages: 1636-1640 Abstract: Objectives. As part of a community-based reproductive health project in rural Tanzania, a maternal and perinatal health care surveillance system was established to monitor pregnancy outcomes. This report presents preliminary results. Methods. Village health workers were trained to collect data during health education visits to pregnant and postpartum women. Maternal and fetal or infant survival or deaths were tracked on a community monitoring board. Results. Among 904 pregnancies, the fetoneonatal mortality rate was 69.4 deaths per 1000 live births and fetal deaths; 4 maternal deaths occurred. Intrapartum and early neonatal deaths of infants with birthweights of 1500 g or greater represented a large proportion of deaths. Conclusions. These preliminary results will be used to prioritize project interventions, including increasing access to skilled delivery care. Handle: RePEc:aph:ajpbhl:2001:91:10:1636-1640_8 Template-Type: ReDIF-Article 1.0 Title: Smoking among youths in China Journal: American Journal of Public Health Author-Name: Hesketh, T. Author-Name: Qu Jian Ding Author-Name: Tomkins, A. Year: 2001 Volume: 91 Issue: 10 Pages: 1653-1655 Abstract: Objectives. To inform a prevention strategy, this study determined the prevalence of and attitudes toward smoking among Chinese secondary school students. Methods. Self-completion questionnaires were administered to 13- to 18-year-olds attending school in Zhejiang Province, eastern China. Results. Of the 6674 respondents, 15.9% (25.7% of the boys, 5.4% of the girls) were ever smokers. Only 0.3% were regular smokers. Of the ever smokers, 41.9% had smoked before 10 years of age and 7.9% before 5 years of age. Parental smoking was the strongest predictor of smoking. Conclusions. The very low prevalence of regular smoking found in this age group suggests that prevention programs in school may be beneficial. Parents should be encouraged to adopt more responsible attitudes toward smoking in the home. Handle: RePEc:aph:ajpbhl:2001:91:10:1653-1655_2 Template-Type: ReDIF-Article 1.0 Title: Developing public health management training capacity in Nicaragua Journal: American Journal of Public Health Author-Name: McEwan, E. Author-Name: Conway, M.J. Author-Name: Bull, D.L. Author-Name: Malison, M.D. Year: 2001 Volume: 91 Issue: 10 Pages: 1586-1588 Abstract: The Cooperative for Assistance and Relief Everywhere (CARE) and Centers for Disease Control and Prevention (CDC) Health Initiative in Nicaragua is distinctive in its focus on developing a cadre of in-country trainers whose aim is to equip frontline public health managers with widely applicable tools and techniques to assist them in identifying and solving implementation problems. Since 1999, 137 trainees - 37% more than originally planned - have demonstrated competence by completing and presenting applied management projects. Nineteen professors from the preventive medicine faculty at the Autonomous University of Nicaragua also have been trained. The country office now has a cadre of seasoned trainers who can meet the ongoing management training needs of CARE staff and their counterparts in the Ministry of Health and in other nongovernmental organizations. Handle: RePEc:aph:ajpbhl:2001:91:10:1586-1588_9 Template-Type: ReDIF-Article 1.0 Title: Transportation for maternal emergencies in Tanzania: Empowering communities through participatory problem solving Journal: American Journal of Public Health Author-Name: Schmid, T. Author-Name: Kanenda, O. Author-Name: Ahluwalia, I. Author-Name: Kouletio, M. Year: 2001 Volume: 91 Issue: 10 Pages: 1589-1590 Abstract: Inadequate health care and long delays in obtaining care during obstetric emergencies are major contributors to high maternal death rates in Tanzania. Formative research conducted in the Mwanza region identified several transportation-related reasons for delays in receiving assistance. In 1996, the Cooperative for Assistance and Relief Everywhere (CARE) and the Centers for Disease Control and Prevention (CDC) began an effort to build community capacity for problem-solving through participatory development of community-based plans for emergency transportation in 50 villages. An April 2001 assessment showed that 19 villages had begun collecting funds for transportation systems; of 13 villages with systems available, 10 had used the system within the last 3 months. Increased support for village health workers and greater participation of women in decision making were also observed. Handle: RePEc:aph:ajpbhl:2001:91:10:1589-1590_1 Template-Type: ReDIF-Article 1.0 Title: Predictors of low back pain onset in a prospective British study Journal: American Journal of Public Health Author-Name: Power, C. Author-Name: Frank, J. Author-Name: Hertzman, C. Author-Name: Schierhout, G. Author-Name: Li, L. Year: 2001 Volume: 91 Issue: 10 Pages: 1671-1678 Abstract: Objectives. This study examined predictors of low back pain onset in a British birth cohort. Methods. Univariate and multivariate analyses focused on individuals who experienced onset of low back pain at 32 to 33 years of age (n=571) and individuals who were pain free (n=5210). Participants were members of the 1958 British birth cohort. Results. Incident pain was elevated among those with psychological distress at 23 years of age (adjusted odds ratio [OR]=2.52, 95% confidence interval [CI]=1.65, 3.86) and among persistent moderate or heavy smokers (adjusted OR=1.63, 95% CI=1.23, 2.17). Significant univariate associations involving other factors (e.g., social class, childhood emotional status, body mass index, job satisfaction) did not persist in multivariate analyses. Conclusions. This prospectively studied cohort provides evidence that psychological distress more than doubles later risk of low back pain, with smoking having a modest independent effect. Other prospective studies are needed to confirm these findings before implications for low back pain prevention can be assessed. Handle: RePEc:aph:ajpbhl:2001:91:10:1671-1678_7 Template-Type: ReDIF-Article 1.0 Title: Challenges in implementing a point-of-use water quality intervention in rural Kenya Journal: American Journal of Public Health Author-Name: Makutsa, P. Author-Name: Nzaku, K. Author-Name: Ogutu, P. Author-Name: Barasa, P. Author-Name: Ombeki, S. Author-Name: Mwaki, A. Author-Name: Quick, R.E. Year: 2001 Volume: 91 Issue: 10 Pages: 1571-1573 Abstract: To prevent diarrheal diseases in western Kenya, CARE Kenya initiated the Water, Sanitation, and Education for Health (WASEH) Project in 1998. The project targets 72 farming and fishing communities with a total population of 43 000. Although the WASEH Project facilitated construction of shallow wells and pit latrines, the water quality still needed improvement. Consequently, in 2001, CARE implemented the Safe Water System (which consists of point-of use water treatment with sodium hypochlorite, safe storage, and behavior change techniques) within the already established WASEH infrastructure, using existing community organizations in combination with a social marketing approach that introduced affordable products. The project has resulted in adoption rates of 33.5% for chemical water treatment and 18.5% for clay pots modified for safe water storage. Handle: RePEc:aph:ajpbhl:2001:91:10:1571-1573_0 Template-Type: ReDIF-Article 1.0 Title: Partner violence among adolescents in opposite-sex romantic relationships: Findings from the national longitudinal study of adolescent health Journal: American Journal of Public Health Author-Name: Halpern, C.T. Author-Name: Oslak, S.G. Author-Name: Young, M.L. Author-Name: Martin, S.L. Author-Name: Kupper, L.L. Year: 2001 Volume: 91 Issue: 10 Pages: 1679-1685 Abstract: Objectives. This report examines (1) the prevalence of psychological and minor physical violence victimization in a nationally representative sample of adolescents and (2) associations between sociodemographic factors and victimization. Methods. Analyses are based on 7500 adolescents who reported exclusively heterosexual romantic relationships in the National Longitudinal Study of Adolescent Health. Items from the Conflict Tactics Scale were used to measure victimization. Associations between victimization patterns and sociodemographic characteristics were assessed with polytomous logistic regression. Results. One third of adolescents reported some type of victimization, and 12% reported physical violence victimization. Although most sociodemographic characteristics were significantly associated with victimization, patterns varied by sex and type of victimization. Conclusions. Psychological and minor physical violence victimization is common in opposite-sex romantic relationships during adolescence. The sex-specific associations between sociodemographic characteristics and patterns of partner violence victimization underscore the importance of pursuing longitudinal, theory-driven investigations of the characteristics and developmental histories of both partners in a couple to advance understanding of this public health problem. Handle: RePEc:aph:ajpbhl:2001:91:10:1679-1685_2 Template-Type: ReDIF-Article 1.0 Title: Trapping the vector: Community action to curb sleeping sickness in Southern Sudan Journal: American Journal of Public Health Author-Name: Joja, L.L. Author-Name: Okoli, U.A. Year: 2001 Volume: 91 Issue: 10 Pages: 1583-1585 Abstract: South Sudan experienced a resurgence of trypanosomiasis (sleeping sickness) in the 1990s. In 1997 in Tambura County, public health officials combined standard mass screening and treatment techniques for infected persons with an additional component - trapping the vectors of the disease. The intent of this integrated approach was to lower the number and concentration of the tsetse flies that spread the disease while reducing the level of infection in the human population to make the likelihood of transmission extremely low. Because the trapping project depends on village participation (making, setting, and maintaining the traps), village volunteers and their neighbors learned more about the causes and prevention of sleeping sickness and became much more willing to participate in serosurveys and to seek treatment. Handle: RePEc:aph:ajpbhl:2001:91:10:1583-1585_2 Template-Type: ReDIF-Article 1.0 Title: Eligibility under state children's health insurance programs Journal: American Journal of Public Health Author-Name: Ullman, F. Author-Name: Hill, I. Year: 2001 Volume: 91 Issue: 9 Pages: 1449-1451 Abstract: Objectives. This study analyzed associations between income eligibility criteria under the State Children's Health Insurance Program (SCHIP) and state characteristics. Methods. We used multivariate methods to explore relations between eligibility expansions under SCHIP and percentages of uninsured children from low-income families, per capita income, and political characteristics. Results. Proportions of uninsured children, per capita income, and states' preexisting eligibility thresholds were statistically associated with changes in eligibility thresholds, whereas only per capita income was associated with overall SCHIP eligibility thresholds. Political dynamics were not statistically related to SCHIP expansions. Conclusions. State demographic characteristics were associated with changes in eligibility from preexisting levels but rarely were associated with SCHIP eligibility thresholds. Handle: RePEc:aph:ajpbhl:2001:91:9:1449-1451_6 Template-Type: ReDIF-Article 1.0 Title: Drug prices and emergency department mentions for cocaine and heroin Journal: American Journal of Public Health Author-Name: Caulkins, J.P. Author-Name: Schoeff, D. Year: 2001 Volume: 91 Issue: 9 Pages: 1446-1448 Abstract: Objectives. In this report, the author illustrates the historic relation between retail drug prices and emergency department mentions for cocaine and heroin. Methods. Price series based on the Drug Enforcement Administration's System to Retrieve Information From Drug Evidence database were correlated with data on emergency department mentions from the Drug Abuse Warning Network for cocaine (1978-1996) and heroin (1981-1996). Results. A simple model in which emergency department mentions are driven by only prices explains more than 95% of the variation in emergency department mentions. Conclusions. Fluctuations in prices are an important determinant of adverse health outcomes associated with drugs. Handle: RePEc:aph:ajpbhl:2001:91:9:1446-1448_0 Template-Type: ReDIF-Article 1.0 Title: Registry-driven, community-based immunization outreach: A randomized controlled trial Journal: American Journal of Public Health Author-Name: Wilcox, S.A. Author-Name: Koepke, C.P. Author-Name: Levenson, R. Author-Name: Thalheimer, J.C. Year: 2001 Volume: 91 Issue: 9 Pages: 1507-1511 Abstract: Objectives. This study evaluated the effectiveness of registry-driven, community-based outreach directed toward children with immunization delays. Methods. A sample of 1856 children aged 6 to 10 months was randomly assigned to receive either outreach or no intervention. Results. Children in the outreach group were more likely to receive an immunization during the observation period than children in the control group (61% vs 43%). Outreach was most effective for children with multiple risks, as measured by their immunization record; it was not effective for children whose mothers had received inadequate prenatal care. Conclusions. Registry-driven outreach can effectively identify high-risk children and bring them to care. Handle: RePEc:aph:ajpbhl:2001:91:9:1507-1511_4 Template-Type: ReDIF-Article 1.0 Title: Differential HIV risk in bathhouses and public cruising areas Journal: American Journal of Public Health Author-Name: Binson, D. Author-Name: Woods, W.J. Author-Name: Pollack, L. Author-Name: Paul, J. Author-Name: Stall, R. Author-Name: Catania, J.A. Year: 2001 Volume: 91 Issue: 9 Pages: 1482-1486 Abstract: Objectives. This report investigates differences in risk behaviors among men who have sex with men (MSM) who went to gay bathhouses, public cruising areas, or both. Methods. We used a probability sample of MSM residing in 4 US cities (n =2881). Results. Men who used party drugs and had unprotected anal intercourse with nonprimary partners were more likely to go to sex venues than men who did not. Among attendees, MSM who went to public cruising areas only were least likely, and those who went to both public cruising areas and bathhouses were most likely to report risky sex in public settings. Conclusions. Distinguishing between sex venues previously treated as a single construct revealed a significant association between pattern of venue use and sexual risk. Targeting HIV prevention in the bathhouses would reach the segment of men at greatest risk for HIV transmission. Handle: RePEc:aph:ajpbhl:2001:91:9:1482-1486_6 Template-Type: ReDIF-Article 1.0 Title: Estimation of health benefits from a local living wage ordinance Journal: American Journal of Public Health Author-Name: Bhatia, R. Author-Name: Mitchell, K. Year: 2001 Volume: 91 Issue: 9 Pages: 1398-1402 Abstract: Objectives. This study estimated the magnitude of health improvements resulting from a proposed living wage ordinance in San Francisco. Methods. Published observational models of the relationship of income to health were applied to predict improvements in health outcomes associated with proposed wage increases in San Francisco. Results. With adoption of a living wage of $11.00 per hour, we predict decreases in premature death from all causes for adults aged 24 to 44 years working full-time in families whose current annual income is $20 000 (for men, relative hazard [RH] = 0.94, 95% confidence interval [Cl] = 0.92, 0.97; for women, RH = 0.96, 95% Cl = 0.95, 0.98). Improvements in subjectively rated health and reductions in the number of days sick in bed, in limitations of work and activities of daily living, and in depressive symptoms were also predicted, as were increases in daily alcohol consumption. For the offspring of full-time workers currently earning $20 000, a living wage predicts an increase of 0.25 years (95% Cl = 0.20, 0.30) of completed education, increased odds of completing high school (odds ratio = 1.34, 95% Cl = 1.20, 1.49), and a reduced risk of early childbirth (RH = 0.78, 95% Cl = 0.69, 0.86). Conclusions. A living wage in San Francisco is associated with substantial health improvement. Handle: RePEc:aph:ajpbhl:2001:91:9:1398-1402_1 Template-Type: ReDIF-Article 1.0 Title: Local increases in coronary heart disease mortality among Blacks and Whites in the United States, 1985-1995 Journal: American Journal of Public Health Author-Name: Barnett, E. Author-Name: Halverson, J. Year: 2001 Volume: 91 Issue: 9 Pages: 1499-1506 Abstract: Objectives. This study analyzed coronary heart disease (CHD) mortality trends from 1985 to 1995, by race and sex, among Black and White adults 35 years and older to determine whether adverse trends were evident in any US localities. Methods. Log-linear regression models of annual age-adjusted death rates provided a quantitative measure of local mortality trends. Results. Increasing trends in CHD mortality were observed in 11 of 174 labor market areas for Black women, 23 of 175 areas for Black men, 10 of 394 areas for White women, and 4 of 394 areas for White men. Nationwide, adverse trends affected 1.7% of Black women, 8.0% of Black men, 1.1% of White women, and 0.3% of White men. Conclusions. From 1985 to 1995, moderate to strong local increases in CHD mortality were observed, predominantly in the southern United States. Black men evidenced the most unfavorable trends and were 25 times as likely as White men to be part of a local population experiencing increases in coronary heart disease mortality. Handle: RePEc:aph:ajpbhl:2001:91:9:1499-1506_4 Template-Type: ReDIF-Article 1.0 Title: Confronting global AIDS: Prevention and treatment Journal: American Journal of Public Health Author-Name: Berkman, A. Year: 2001 Volume: 91 Issue: 9 Pages: 1348-1349 Handle: RePEc:aph:ajpbhl:2001:91:9:1348-1349_9 Template-Type: ReDIF-Article 1.0 Title: Cigarettes and the surgeon general's report [1] (multiple letters) Journal: American Journal of Public Health Author-Name: Bergner, L. Author-Name: Parascandola, M. Year: 2001 Volume: 91 Issue: 9 Pages: 1345 Handle: RePEc:aph:ajpbhl:2001:91:9:1345_4 Template-Type: ReDIF-Article 1.0 Title: Minority women and advocacy for women's health Journal: American Journal of Public Health Author-Name: Kumanyika, S.K. Author-Name: Morssink, C.B. Author-Name: Nestle, M. Year: 2001 Volume: 91 Issue: 9 Pages: 1383-1388 Abstract: US minority health issues involve racial/ethnic disparities that affect both women and men. However, women's health advocacy in the United States does not consistently address problems specific to minority women. The underlying evolution and political strength of the women's health and minority health movements differ profoundly. Women of color comprise only one quarter of women's health movement constituents and are, on average, socioeconomically disadvantaged. Potential alliances may be inhibited by vestiges of historical racial and social divisions that detract from feelings of commonality and mutual support. Nevertheless, insufficient attention to minority women's issues undermines the legitimacy of the women's health movement and may prevent important advances that can be achieved only when diversity is fully considered. Handle: RePEc:aph:ajpbhl:2001:91:9:1383-1388_9 Template-Type: ReDIF-Article 1.0 Title: The precautionary principle and electric and magnetic fields Journal: American Journal of Public Health Author-Name: Jamieson, D. Author-Name: Wartenberg, D. Year: 2001 Volume: 91 Issue: 9 Pages: 1355-1358 Abstract: Current environmental regulation represents a paternalistic policy, more concerned to avoid false positives than false negatives, limiting opportunities for individuals to make choices between risk-avoidance and risk-taking alternatives. For example, many exposures to magnetic fields could be reduced at little or no cost but are not considered seriously, owing to the uncertainty of risk and the concern to avoid false positives. Even though precautionary approaches that focus on avoiding false negatives often do not lead to adverse economic consequences or irrational choices, such approaches usually are not taken. The value of autonomy and the proper role of governmental paternalism with respect to environmental policy need to be considered more carefully in environmental decision making. Handle: RePEc:aph:ajpbhl:2001:91:9:1355-1358_9 Template-Type: ReDIF-Article 1.0 Title: Cost-effectiveness of earlier initiation of antiretroviral therapy for uninsured HIV-infected adults Journal: American Journal of Public Health Author-Name: Schackman, B.R. Author-Name: Goldie, S.J. Author-Name: Weinstein, M.C. Author-Name: Losina, E. Author-Name: Zhang, H. Author-Name: Freedberg, K.A. Year: 2001 Volume: 91 Issue: 9 Pages: 1456-1463 Abstract: Objectives. This study was designed to examine the societal cost-effectiveness and the impact on government payers of earlier initiation of antiretroviral therapy for uninsured HIV-infected adults. Methods. A state-transition simulation model of HIV disease was used. Data were derived from the Multicenter AIDS Cohort Study, published randomized trials, and medical care cost estimates for all government payers and for Massachusetts, New York, and Florida. Results. Quality-adjusted life expectancy increased from 7.64 years with therapy initiated at 200 CD4 cells/μL to 8.21 years with therapy initiated at 500 CD4 cells/μL. Initiating therapy at 500 CD4/μL was a more efficient use of resources than initiating therapy at 200 CD4/μL and had an incremental cost-effectiveness ratio of $17 300 per quality-adjusted life-year gained, compared with no therapy. Costs to state payers in the first 5 years ranged from $5500 to $24900 because of differences among the states in the availability of federal funds for AIDS drug assistance programs. Conclusions. Antiretroviral therapy initiated at 500 CD4 cells/μL is cost-effective from a societal perspective compared with therapy initiated later. States should consider Medicaid waivers to expand access to early therapy. Handle: RePEc:aph:ajpbhl:2001:91:9:1456-1463_3 Template-Type: ReDIF-Article 1.0 Title: Radioactivity and rights: Clashes at Bikini Atoll Journal: American Journal of Public Health Author-Name: Guyer, R.L. Year: 2001 Volume: 91 Issue: 9 Pages: 1371-1376 Handle: RePEc:aph:ajpbhl:2001:91:9:1371-1376_4 Template-Type: ReDIF-Article 1.0 Title: The smoke you don't see: Uncovering tobacco industry scientific strategies aimed against environmental tobacco smoke policies Journal: American Journal of Public Health Author-Name: Muggli, M.E. Author-Name: Forster, J.L. Author-Name: Hurt, R.D. Author-Name: Repace, J.L. Year: 2001 Volume: 91 Issue: 9 Pages: 1419-1423 Abstract: Objectives. This review details the tobacco industry's scientific campaign aimed against policies addressing environmental tobacco smoke (ETS) and efforts to undermine US regulatory agencies from approximately 1988 to 1993. Methods. The public availability of more than 40 million internal, once-secret tobacco company documents allowed an unedited and historical look at tobacco industry strategies. Results. The analysis showed that the tobacco industry went to great lengths to battle the ETS issue worldwide by camouflaging its involvement and creating an impression of legitimate, unbiased scientific research. Conclusions. There is a need for further international monitoring of industry-produced science and for significant improvements in tobacco document accessibility. Handle: RePEc:aph:ajpbhl:2001:91:9:1419-1423_7 Template-Type: ReDIF-Article 1.0 Title: Geographic variations in asthma mortality in Erie and Niagara counties, western New York, 1991-1996 Journal: American Journal of Public Health Author-Name: Almeida, J.P. Author-Name: Lwebuga-Mukasa, J.S. Year: 2001 Volume: 91 Issue: 9 Pages: 1394-1395 Handle: RePEc:aph:ajpbhl:2001:91:9:1394-1395_4 Template-Type: ReDIF-Article 1.0 Title: The quality improvement - Research divide and the need for external oversight Journal: American Journal of Public Health Author-Name: Bellin, E. Author-Name: Dubler, N.N. Year: 2001 Volume: 91 Issue: 9 Pages: 1512-1517 Abstract: Historically, quality assurance studies have received scant ethical attention. The advent of information systems capable of supporting research-grade continuous quality improvement projects demands that we clearly define how these projects differ from research and when they require external review. The ethical obligation for the performance of quality assurance projects, with its emphasis on identifiable immediate action for a served population, is a critical distinction. The obligation to perform continuous quality improvement is a deliverable of the social contract entered into implicitly by patients and health care providers and systems. In this article, the authors review the ethical framework that requires these studies, evaluate the differences between quality assurance studies and classic research, and propose criteria for requiring external review. Handle: RePEc:aph:ajpbhl:2001:91:9:1512-1517_9 Template-Type: ReDIF-Article 1.0 Title: Informational privacy and the public's health: The model state public health privacy act Journal: American Journal of Public Health Author-Name: Gostin, L.O. Author-Name: Hodge J.G., Jr. Author-Name: Valdiserri, R.O. Year: 2001 Volume: 91 Issue: 9 Pages: 1388-1392 Abstract: Protecting public health requires the acquisition, use, and storage of extensive health-related information about individuals. The electronic accumulation and exchange of personal data promises significant public health benefits but also threatens individual privacy; breaches of privacy can lead to individual discrimination in employment, insurance, and government programs. Individuals concerned about privacy invasions may avoid clinical or public health tests, treatments, or research. Although individual privacy protections are critical, comprehensive federal privacy protections do not adequately protect public health data, and existing state privacy laws are inconsistent and fragmented. The Model State Public Health Privacy Act provides strong privacy safeguards for public health data while preserving the ability of state and local public health departments to act for the common good. Handle: RePEc:aph:ajpbhl:2001:91:9:1388-1392_0 Template-Type: ReDIF-Article 1.0 Title: Local lead data are needed for local decision making Journal: American Journal of Public Health Author-Name: Payne-Sturges, D.C. Author-Name: Breugelmans, J.G. Year: 2001 Volume: 91 Issue: 9 Pages: 1396-1397 Handle: RePEc:aph:ajpbhl:2001:91:9:1396-1397_2 Template-Type: ReDIF-Article 1.0 Title: Health and federal budgetary effects of increasing access to antiretroviral medications for HIV by expanding medicaid Journal: American Journal of Public Health Author-Name: Kahn, J.G. Author-Name: Haile, B. Author-Name: Kates, J. Author-Name: Chang, S. Year: 2001 Volume: 91 Issue: 9 Pages: 1464-1473 Abstract: Objectives. This study modeled the health and federal fiscal effects of expanding Medicaid for HIV-infected people to improve access to highly active antiretroviral therapy. Methods. A disease state model of the US HIV epidemic, with and without Medicaid expansion, was used. Eligibility required a CD4 cell count less than 500/mm3 or viral load greater than 10 000, absent or inadequate medication insurance, and annual income less than $10 000. Two benefits were modeled, "full" and "limited" (medications, outpatient care). Federal spending for Medicaid, Medicare, AIDS Drug Assistance Program, Supplemental Security Income, and Social Security Disability Insurance were assessed. Results. An estimated 38 000 individuals would enroll in a Medicaid HIV expansion. Over 5 years, expansion would prevent an estimated 13 000 AIDS diagnoses and 2600 deaths and add 5816 years of life. Net federal costs for all programs are $739 million (full benefits) and $480 million (limited benefits); for Medicaid alone, the costs are $1.43 and $1.17 billion, respectively. Results were sensitive to awareness of serostatus, highly active antiretroviral therapy cost, and participation rate. Strategies for federal cost neutrality include Medicaid HIV drug price reductions as low as 9% and private insurance buy-ins. Conclusions. Expansion of the Medicaid eligibility to increase access to antiretroviral therapy would have substantial health benefits at affordable costs. Handle: RePEc:aph:ajpbhl:2001:91:9:1464-1473_0 Template-Type: ReDIF-Article 1.0 Title: Does investor ownership of nursing homes compromise the quality of care? Journal: American Journal of Public Health Author-Name: Harrington, C. Author-Name: Woolhandler, S. Author-Name: Mullan, J. Author-Name: Carrillo, H. Author-Name: Himmelstein, D.U. Year: 2001 Volume: 91 Issue: 9 Pages: 1452-1455 Abstract: Objectives. Two thirds of nursing homes are investor owned. This study examined whether investor ownership affects quality. Methods. We analyzed 1998 data from state inspections of 13693 nursing facilities. We used a multivariate model and controlled for case mix, facility characteristics, and location. Results. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit facilities and 43.0% higher than public facilities. In multivariate analysis, investor ownership predicted 0.679 additional deficiencies per home; chain ownership predicted an additional 0.633 deficiencies. Nurse staffing was lower at investor-owned nursing homes. Conclusions. Investor-owned nursing homes provide worse care and less nursing care than do not-for-profit or public homes. Handle: RePEc:aph:ajpbhl:2001:91:9:1452-1455_3 Template-Type: ReDIF-Article 1.0 Title: Night shift in a glass factory Journal: American Journal of Public Health Author-Name: Helfand, W.H. Author-Name: Lazarus, J. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 9 Pages: 1370 Handle: RePEc:aph:ajpbhl:2001:91:9:1370_3 Template-Type: ReDIF-Article 1.0 Title: Psychologic distress and natural menopause: A multiethnic community study Journal: American Journal of Public Health Author-Name: Bromberger, J.T. Author-Name: Meyer, P.M. Author-Name: Kravitz, H.M. Author-Name: Sommer, B. Author-Name: Cordal, A. Author-Name: Powell, L. Author-Name: Ganz, P.A. Author-Name: Sutton-Tyrrell, K. Year: 2001 Volume: 91 Issue: 9 Pages: 1435-1442 Abstract: Objectives. This study examined the association between psychologic distress and natural menopause in a community sample of African American, White, Chinese, Hispanic, and Japanese women participating in a national women's health study. Methods. A cohort of 16 065 women aged 40 to 55 years provided information on menstrual regularity in the previous year, psychosocial factors, health, and somatic-psychologic symptoms. Psychologic distress was defined as feeling tense, depressed, and irritable in the previous 2 weeks. Results. Rates of psychologic distress were highest in early perimenopause (28.9%) and lowest in premenopause (20.9%) and postmenopause (22%). In comparison with premenopausal women, early perimenopausal women were at a greater risk of distress, with and without adjustment for vasomotor and sleep symptoms and covariates. Odds of distress were significantly higher for Whites than for the other racial/ethnic groups. Conclusions. Psychologic distress is associated with irregular menses in midlife. It is important to determine whether distress is linked to alterations in hormone levels and to what extent a mood-hormone relationship may be influenced by socioeconomic and cultural factors. Handle: RePEc:aph:ajpbhl:2001:91:9:1435-1442_5 Template-Type: ReDIF-Article 1.0 Title: The precautionary principle also applies to public health actions Journal: American Journal of Public Health Author-Name: Goldstein, B.D. Year: 2001 Volume: 91 Issue: 9 Pages: 1358-1361 Abstract: The precautionary principle asserts that the burden of proof for potentially harmful actions by industry or government rests on the assurance of safety and that when there are threats of serious damage, scientific uncertainty must be resolved in favor of prevention. Yet we in public health are sometimes guilty of not adhering to this principle. Examples of actions with unintended negative consequences include the addition of methyl tert-butyl ether to gasoline in the United States to decrease air pollution, the drilling of tube wells in Bangladesh to avoid surface water microbial contamination, and villagewide parenteral antischistosomiasis therapy in Egypt. Each of these actions had unintended negative consequences. Lessons include the importance of muitidisciplinary approaches to public health and the value of risk-benefit analysis, of public health surveillance, and of a functioning tort system-all of which contribute to effective precautionary approaches. Handle: RePEc:aph:ajpbhl:2001:91:9:1358-1361_5 Template-Type: ReDIF-Article 1.0 Title: Neighborhood poverty and the resurgence of tuberculosis in New York City, 1984-1992 Journal: American Journal of Public Health Author-Name: Graham Barr, R. Author-Name: Diez-Roux, A.V. Author-Name: Knirsch, C.A. Author-Name: Pablos-Méndez, A. Year: 2001 Volume: 91 Issue: 9 Pages: 1487-1493 Abstract: Objectives. The resurgence of tuberculosis (TB) in New York City has been attributed to AIDS and immigration; however, the role of poverty in the epidemic is unclear. We assessed the relation between neighborhood poverty and TB at the height of the epidemic and longitudinally from 1984 through 1992. Methods: Census block groups were used as proxies for neighborhoods. For each neighborhood, we calculated TB and AIDS incidence in 1984 and 1992 with data from the Bureaus of Tuberculosis Control and AIDS Surveillance and obtained poverty rates from the census. Results. For 1992, 3343 TB cases were mapped to 5482 neighborhoods, yielding a mean incidence of 46.5 per 100 000. Neighborhood poverty was associated with TB (relative risk = 1.33; 95% confidence interval = 1.30, 1.36 per 10% increase in poverty).This association persisted after adjustment for AIDS, proportion foreign-born, and race/ethnicity. Neighborhoods with declining income from 1980 to 1990 had larger increases in TB incidence than did neighborhoods with increasing income. Conclusions. Leading up to and at the height of the TB epidemic in New York City, neighborhood poverty was strongly associated with TB incidence. Public health interventions should target impoverished areas. Handle: RePEc:aph:ajpbhl:2001:91:9:1487-1493_1 Template-Type: ReDIF-Article 1.0 Title: Retaining hard-to-reach women in HIV prevention and vaccine trials: Project ACHIEVE Journal: American Journal of Public Health Author-Name: Brown-Peterside, P. Author-Name: Rivera, E. Author-Name: Lucy, D. Author-Name: Slaughter, I. Author-Name: Ren, L. Author-Name: Chiasson, M.A. Author-Name: Koblin, B.A. Year: 2001 Volume: 91 Issue: 9 Pages: 1377-1379 Abstract: Project ACHIEVE, which conducts HIV prevention research studies, maintains a women's site in the South Bronx in New York City. Owing to a focused retention effort at the South Bronx site, high retention rates were achieved in a vaccine preparedness study for women at high risk of HIV infection. Comparable retention rates have been achieved in HIV vaccine trials with similar cohorts of women at this site. These results suggest that concerns about retaining hard-to-reach populations should not cause these populations to be excluded from HIV vaccine and prevention trials. Handle: RePEc:aph:ajpbhl:2001:91:9:1377-1379_2 Template-Type: ReDIF-Article 1.0 Title: Seat belt use in top-grossing movies vs actual US rates, 1978-1998 Journal: American Journal of Public Health Author-Name: Jacobsen, H.A. Author-Name: Kreuter, M.W. Author-Name: Luke, D. Author-Name: Cadburnay, C.A. Year: 2001 Volume: 91 Issue: 9 Pages: 1395-1396 Handle: RePEc:aph:ajpbhl:2001:91:9:1395-1396_1 Template-Type: ReDIF-Article 1.0 Title: Poverty, race/ethnicity, and psychiatric disorder: A study of rural children Journal: American Journal of Public Health Author-Name: Costello, E.J. Author-Name: Keeler, G.P. Author-Name: Angold, A. Year: 2001 Volume: 91 Issue: 9 Pages: 1494-1498 Abstract: Objectives. This study examined the effect of poverty on the prevalence of psychiatric disorder in rural Black and White children. Methods. A representative sample of 541 Black children and 379 White children aged 9 to 17 was drawn from 4 predominantly rural counties. Structured interviews with parents and children collected information on psychiatric disorders, absolute and relative poverty, and risk factors for psychiatric disorder. Results. Three-month prevalence of psychiatric disorder was similar to that found in other community samples (20%). Federal criteria for poverty were met by 18% of the White and 52% of the Black families. Black and White children were exposed to equal numbers of risk factors overall, but the association between poverty and psychopathology was stronger for White children (odds ratio [OR] = 2.1; 95% confidence interval [Cl] = 1.1, 4.2) than for Black children (OR = 1.5; 95% Cl = 0.9, 2.6). Family history of mental illness, poor parenting, and residential instability mediated this association in both groups. Conclusions. In this rural sample, poverty was only weakly associated with child psychiatric disorders. Risk factors for both racial/ethnic groups were family mental illness, multiple moves, lack of parental warmth, lax supervision, and harsh punishment. Handle: RePEc:aph:ajpbhl:2001:91:9:1494-1498_0 Template-Type: ReDIF-Article 1.0 Title: Changes in access to mental health care among the poor and nonpoor: Results from the health care reform in Puerto Rico Journal: American Journal of Public Health Author-Name: Alegría, M. Author-Name: McGuire, T. Author-Name: Vera, M. Author-Name: Canino, G. Author-Name: Matías, L. Author-Name: Calderón, J. Year: 2001 Volume: 91 Issue: 9 Pages: 1431-1434 Abstract: Objectives. Health care reforms associated with managed care may adversely affect the health care safety net for disadvantaged populations. This study compared changes in health care use among poor and nonpoor individuals enrolled in managed care. Methods. Data from 3 waves of a random community sample were collected on approximately 3000 adults. Changes in use of mental health services were assessed in a pretest-posttest, quasi-experimental design. Results. Managed care increased use of specialty services among the nonpoor while maintaining the same level of use for the poor in the public sector. Conclusions: Reallocation of mental health services may be a result of expanding Medicaid eligibility. Handle: RePEc:aph:ajpbhl:2001:91:9:1431-1434_0 Template-Type: ReDIF-Article 1.0 Title: Reenergizing public health through precaution Journal: American Journal of Public Health Author-Name: Kriebel, D. Author-Name: Tickner, J. Year: 2001 Volume: 91 Issue: 9 Pages: 1351-1355 Abstract: The precautionary principle has provoked a spirited debate among environmentalists worldwide, but it is equally relevant to public health and shares much with primary prevention. Its central components are (1) taking preventive action in the face of uncertainty; (2) shifting the burden of proof to the proponents of an activity; (3) exploring a wide range of alternatives to possibly harmful actions; and (4) increasing public participation in decision making. Precaution is relevant to public health, because it can help to prevent unintended consequences of well-intentioned public health interventions by ensuring a more thorough assessment of the problems and proposed solutions. It can also be a positive force for change. Three aspects are stressed: promoting the search for safer technologies, encouraging greater democracy and openness in public health policy, and stimulating reevaluation of the methods of public health science. Handle: RePEc:aph:ajpbhl:2001:91:9:1351-1355_2 Template-Type: ReDIF-Article 1.0 Title: Keeping the unemployed healthy: The effect of means-tested and entitlement benefits in Britain, Germany, and the United States Journal: American Journal of Public Health Author-Name: Rodriguez, E. Year: 2001 Volume: 91 Issue: 9 Pages: 1403-1411 Abstract: Objectives. Although considerable evidence about the health effects of unemployment exists, little is known about the possible protective effects of various social interventions. This study examined the role that means-tested and entitlement programs could have in ameliorating the health impact of unemployment in Britain, Germany, and the United States. Methods. Logistic regression models were used to analyze panel data from Britain (1991-1993), Germany (1991-1993), and the United States (1985-1987) available in the Household Panel Comparability Project database. The analysis included 8726 respondents from Britain, 11086 from Germany, and 11668 from the United States. The health-dependent variable used was a single measure of perceived health status. Results. Evidence was found of differences in perceived health status between groups of unemployed people characterized by the types of benefits they receive. When socioeconomic characteristics and previous health and employment status are controlled for, means-tested benefits do not seem sufficient to reduce the impact of unemployment on health. Conclusions. Monitoring the possible health effects of changes in public assistance benefits should be given priority in the research and political agenda. Handle: RePEc:aph:ajpbhl:2001:91:9:1403-1411_8 Template-Type: ReDIF-Article 1.0 Title: The short-term impact of national smoke-free work place legislation on passive smoking and tobacco use Journal: American Journal of Public Health Author-Name: Heloma, A. Author-Name: Jaakkola, M.S. Author-Name: Kähkönen, E. Author-Name: Reijula, K. Year: 2001 Volume: 91 Issue: 9 Pages: 1416-1418 Abstract: Objectives. This study sought to evaluate the short-term impact of national smoke-free workplace legislation on employee exposure to environmental tobacco smoke at work and on employee smoking habits. Methods. We performed 2 cross-sectional studies in 9 medium-sized and large Finnish workplaces, before and after implementation of national smoke-free workplace legislation. We assessed tobacco smoke exposure via questionnaire and indoor air nicotine measurements. Results. Exposure to environmental tobacco smoke declined considerably after the legislation was implemented. Tobacco consumption among smokers diminished. Nicotine concentrations fell significantly. Conclusions. Legislation was more efficient than voluntary workplace-specific smoking restrictions in reducing passive smoking and cigarette consumption. Handle: RePEc:aph:ajpbhl:2001:91:9:1416-1418_0 Template-Type: ReDIF-Article 1.0 Title: Use of protease inhibitors and non-nucleoside reverse transcriptase inhibitors among medicaid beneficiaries with AIDS Journal: American Journal of Public Health Author-Name: Sambamoorthi, U. Author-Name: Moynihan, P.J. Author-Name: McSpiritt, E. Author-Name: Crystal, S. Year: 2001 Volume: 91 Issue: 9 Pages: 1474-1481 Abstract: Objectives. This study compared the use of new antiretroviral treatments across sociodemographic subgroups during the 3 years after the introduction of these treatments and examined diffusion of the therapies over time. Methods. Merged surveillance and claims data were used to examine use of protease inhibitors and non-nucleoside reverse transcriptase inhibitors (PI/NNRTIs) among New Jersey Medicaid beneficiaries with AI DS. Results. In 1996, there were sharp disparities in use of PI/NNRTI therapy among racial minorities and injection drug users, even after control for other patient characteristics. These gaps had decreased by 1998. Higher PI/NNRTI treatment rates were also observed among beneficiaries enrolled in a statewide HIV/AIDS-specific home- and community-based Medicaid waiver program. Conclusions. Even within a population of individuals similar in regard to health coverage, there were substantial sociodemographic differences in use of PI/NNRTIs during the early years after their introduction. These differences narrowed as new treatments became standard. Participation in a case-managed Medicaid waiver program seems to be associated with a more appropriate pattern of use. These results suggest a need to address nonfinancial barriers to care. Handle: RePEc:aph:ajpbhl:2001:91:9:1474-1481_3 Template-Type: ReDIF-Article 1.0 Title: Public health law reform Journal: American Journal of Public Health Author-Name: Gostin, L.O. Year: 2001 Volume: 91 Issue: 9 Pages: 1365-1368 Abstract: Public health law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of public health agencies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for public health agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the public health system. Handle: RePEc:aph:ajpbhl:2001:91:9:1365-1368_7 Template-Type: ReDIF-Article 1.0 Title: Public health and changes in illicit drug prices Journal: American Journal of Public Health Author-Name: Hagan, H. Year: 2001 Volume: 91 Issue: 9 Pages: 1350 Handle: RePEc:aph:ajpbhl:2001:91:9:1350_6 Template-Type: ReDIF-Article 1.0 Title: Air pollution, weather stress, and blood pressure [2] (multiple letters) Journal: American Journal of Public Health Author-Name: Linn, W.S. Author-Name: Gong H., Jr. Author-Name: Ibald-Mulli, A. Author-Name: Peters, A. Year: 2001 Volume: 91 Issue: 9 Pages: 1345-1346 Handle: RePEc:aph:ajpbhl:2001:91:9:1345-1346_4 Template-Type: ReDIF-Article 1.0 Title: Coverage of smoking cessation treatment by union health and welfare funds Journal: American Journal of Public Health Author-Name: Barbeau, E.M. Author-Name: Sorensen, G. Author-Name: Conlan, K.M. Author-Name: Youngstrom, R. Author-Name: Emmons, K. Year: 2001 Volume: 91 Issue: 9 Pages: 1412-1415 Abstract: Objectives. This study determined the level of insurance coverage for smoking cessation treatment and factors associated with coverage among health and welfare funds affiliated with a large labor union. Methods. A self-administered written survey was mailed to fund and union officials. Analyses were conducted by χ2 tests. Results. Twenty-nine percent of funds provided coverage for some type of smoking cessation treatment, with the odds of coverage significantly increased among funds whose administrators reported having received members' requests for smoking cessation treatment in the past year (odds ratio = 4.9, P= .05). Conclusions. Coverage for smoking cessation services is low, comparable to coverage offered by other health insurers. Interventions with union members and fund officials are needed to provide union members with access to affordable and effective smoking cessation treatments. Handle: RePEc:aph:ajpbhl:2001:91:9:1412-1415_3 Template-Type: ReDIF-Article 1.0 Title: Cigarette smoking behavior among US Latino men and women from different countries of origin Journal: American Journal of Public Health Author-Name: Pérez-Stable, E.J. Author-Name: Ramirez, A. Author-Name: Villareal, R. Author-Name: Talavera, G.A. Author-Name: Trapido, E. Author-Name: Suarez, L. Author-Name: McAlister, J. Author-Name: Marti, A. Year: 2001 Volume: 91 Issue: 9 Pages: 1424-1430 Abstract: Objectives. This study sought to compare smoking behavior among Latino men and women from different countries of origin. Methods. A telephone-administered survey was conducted in 8 cities with Latino men and women of different national origin living in census tracts with at least 70% Latino individuals. Results. A total of 8882 participants completed the survey; 53% were women. The average age of respondents was 44 years; 63% were foreign-born, and 59% preferred Spanish for the interview. Current smoking was more prevalent among men (25.0%, 95% confidence interval [Cl] = 23.7, 26.3) than among women (12.1%, 95% Cl = 11.1, 13.0). Smoking rates were not significantly different by national origin among men, but Puerto Rican women had higher rates of smoking than other women. Central American men and women had the lowest smoking rates. Foreign-born respondents were less likely to be smokers (odds ratio [OR] = 0.77, 95% Cl = 0.66, 0.90) than US-born respondents, and respondents with 12 years or less of education had an increased odds of smoking (OR = 1.17, 95% Cl = 1.01, 1.35). High acculturation was associated with more smoking in women (OR = 1.12, 95% Cl = 1.00-1.25) and less smoking in men (OR = 0.86, 95% Cl = 0.78-0.95). Puerto Rican and Cuban respondents were more likely to be current smokers and to smoke more than 20 cigarettes per day. Conclusions. Older, US-born, and more-educated respondents were less likely to be current smokers. Respondents of Puerto Rican and Cuban origin were more likely to smoke. Acculturation has divergent effects on smoking behavior by sex. Handle: RePEc:aph:ajpbhl:2001:91:9:1424-1430_2 Template-Type: ReDIF-Article 1.0 Title: Coverage of tobacco dependence treatments for pregnant smokers in health maintenance organizations Journal: American Journal of Public Health Author-Name: Pickett, K.E. Author-Name: Abrams, B. Author-Name: Schauffler, H.H. Author-Name: Savage, J. Author-Name: Brandt, P. Author-Name: Kalkbrenner, A. Author-Name: Chapman, S.A. Year: 2001 Volume: 91 Issue: 9 Pages: 1393-1394 Handle: RePEc:aph:ajpbhl:2001:91:9:1393-1394_5 Template-Type: ReDIF-Article 1.0 Title: Modeling the cost and outcomes of pharmacist-prescribed emergency contraception Journal: American Journal of Public Health Author-Name: Marciante, K.D. Author-Name: Gardner, J.S. Author-Name: Veenstra, D.L. Author-Name: Sullivan, S.D. Year: 2001 Volume: 91 Issue: 9 Pages: 1443-1445 Abstract: Objectives. This study investigated the effect on the risk and cost of unintended pregnancies of emergency contraceptive pills obtained directly from a pharmacist. Methods. We used a decision model to compare outcomes for private and public payers following unprotected intercourse from. Results. Obtaining emergency contraceptive pills from a pharmacy, compared with obtaining them from a physician or clinic, resulted in a $158 (95% confidence interval (Cl) = $76, $269) reduction in costs for private payers and a $48 (95% Cl = $16, $93) reduction for public payers. Conclusions. Our findings suggest that under varied assumptions, obtaining emergency contraceptive pills directly from a pharmacist reduces the number of unintended pregnancies and is cost saving. Handle: RePEc:aph:ajpbhl:2001:91:9:1443-1445_2 Template-Type: ReDIF-Article 1.0 Title: The professions of public health Journal: American Journal of Public Health Author-Name: Fox, D.M. Year: 2001 Volume: 91 Issue: 9 Pages: 1362-1364 Abstract: Law has been an essential tool of public health practice for centuries. From the 19th century until recent decades, however, most histories of public health described, approvingly, the progression of the field from marginally useful policy, made by persons learned in law, to effective policy, made by persons employing the methods of biomedical and behavioral science. Historians have recently begun to change this standard account by documenting the centrality of law in the development of public health practice. The revised history of public health offers additional justification for the program of public health law reform proposed in this issue of the Journal by Gostin and by Moulton and Matthews, who describe the new program in public health law of the Centers for Disease Control and Prevention. Handle: RePEc:aph:ajpbhl:2001:91:9:1362-1364_4 Template-Type: ReDIF-Article 1.0 Title: De morbis artificum diatriba [diseases of workers]. 1713. Journal: American Journal of Public Health Author-Name: Ramazzini, B. Year: 2001 Volume: 91 Issue: 9 Pages: 1380-1382 Handle: RePEc:aph:ajpbhl:2001:91:9:1380-1382_8 Template-Type: ReDIF-Article 1.0 Title: Cautiously adjusting to the new millennium: Changing to the 2000 population standard Journal: American Journal of Public Health Author-Name: Pamuk, E.R. Year: 2001 Volume: 91 Issue: 8 Pages: 1174-1176 Handle: RePEc:aph:ajpbhl:2001:91:8:1174-1176_7 Template-Type: ReDIF-Article 1.0 Title: Promoting public health through electronic media: A challenge for schools of public health Journal: American Journal of Public Health Author-Name: Sorensen, A.A. Year: 2001 Volume: 91 Issue: 8 Pages: 1183-1185 Abstract: The term 'the digital divide' trivializes the yawning chasm in access to computer technology between the haves and the have-nots in the United States.... The inequities abroad are even more striking. Handle: RePEc:aph:ajpbhl:2001:91:8:1183-1185_9 Template-Type: ReDIF-Article 1.0 Title: Colorectal cancer screening participation: Comparisons with mammography and prostate-specific antigen screening Journal: American Journal of Public Health Author-Name: Lemon, S. Author-Name: Zapka, J. Author-Name: Puleo, E. Author-Name: Luckmann, R. Author-Name: Chasan-Taber, L. Year: 2001 Volume: 91 Issue: 8 Pages: 1264-1272 Abstract: Objectives. The relation of personal characteristics, health and lifestyle behaviors, and cancer screening practices to current colorectal cancer (CRC) screening was assessed and compared with those factors' relation to current mammography screening in women and prostate-specific antigen (PSA) screening in men. Methods. A cross-sectional random-digit-dialed telephone survey of 954 Massachusetts residents aged 50 and older was conducted. Results. The overall prevalence of current CRC screening was 55.3%. Logistic regression results indicated that family history of CRC (odds ratio [OR] = 1.98; 95% confidence interval [Cl] = 1.02; 3.86), receiving a regular medical checkup (OR = 3.07; 95% Cl = 2.00, 4.71), current screening by mammography in women and PSA in men (OR = 4.40; 95% Cl = 2.94, 6.58), and vitamin supplement use (OR = 1.87; 95% Cl = 1.27, 2.77) were significant predictors of CRC screening. Conclusions. Health and lifestyle behaviors were related to increased current CRC, mammography, and PSA screening. Personal factors independently related to CRC screening were not consistent with those related to mammography and PSA screening. This lack of consistency may reflect different stages of adoption of each type of screening by clinicians and the public. Handle: RePEc:aph:ajpbhl:2001:91:8:1264-1272_5 Template-Type: ReDIF-Article 1.0 Title: Black-White differences in infectious disease mortality in the United States Journal: American Journal of Public Health Author-Name: Richardus, J.H. Author-Name: Kunst, A.E. Year: 2001 Volume: 91 Issue: 8 Pages: 1251-1253 Abstract: Objectives. This study determined the degree to which Black-White differences in infectious disease mortality are explained by income and education and the extent to which infectious diseases contribute to Black-White differences in all-cause mortality. Methods. A sample population of the National Longitudinal Mortality Study from 1979 through 1981 was analyzed and followed up through 1989. Results. Infectious disease mortality among Blacks was higher than among Whites, with a relative risk of 1.53 after adjustment for age and sex and 1.34 after further adjustment for income and education. Death from infectious diseases contributed to 9.3% of the difference in all-cause mortality. Conclusions. In the United States, infectious diseases account for nearly 10% of the excess all-cause mortality rates in Blacks compared with Whites. Handle: RePEc:aph:ajpbhl:2001:91:8:1251-1253_3 Template-Type: ReDIF-Article 1.0 Title: Adolescent sexual orientation and suicide risk: Evidence from a national study Journal: American Journal of Public Health Author-Name: Russell, S.T. Author-Name: Joyner, K. Year: 2001 Volume: 91 Issue: 8 Pages: 1276-1281 Abstract: Objectives. Sexual orientation has been a debated risk factor for adolescent suicidality over the past 20 years. This study examined the link between sexual orientation and suicidality, using data that are nationally representative and that include other critical youth suicide risk factors. Methods. Data from the National Longitudinal Study of Adolescent Health were examined. Survey logistic regression was used to control for sample design effects. Results. There is a strong link between adolescent sexual orientation and suicidal thoughts and behaviors. The strong effect of sexual orientation on suicidal thoughts is mediated by critical youth suicide risk factors, including depression, hopelessness, alcohol abuse, recent suicide attempts by a peer or a family member, and experiences of victimization. Conclusions. The findings provide strong evidence that sexual minority youths are more likely than their peers to think about and attempt suicide. Handle: RePEc:aph:ajpbhl:2001:91:8:1276-1281_7 Template-Type: ReDIF-Article 1.0 Title: Post-rape care in hospital emergency rooms [1] (multiple letters) Journal: American Journal of Public Health Author-Name: Goldenring, J.M. Author-Name: Allred, G. Author-Name: Smugar, S.S. Author-Name: Spina, B.J. Author-Name: Merz, J.F. Author-Name: Birden, H. Author-Name: Frerichs, R.R. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 8 Pages: 1169-1170 Handle: RePEc:aph:ajpbhl:2001:91:8:1169-1170_1 Template-Type: ReDIF-Article 1.0 Title: The effect of different definitions of a patient on immunization assessment Journal: American Journal of Public Health Author-Name: O'Connor, M.E. Author-Name: Maddocks, B. Author-Name: Modie, C. Author-Name: Pierce, H. Year: 2001 Volume: 91 Issue: 8 Pages: 1273-1275 Abstract: Objectives. In this report, the authors compare immunization assessment using 2 definitions of a patient. Methods. Two Clinical Assessment Software Application (CASA) assessments were performed. The first sampled 200 two-year-olds seen at least once since birth. The second sampled 200 two-year-olds seen in the previous year. Children with incomplete immunizations in the first sample were contacted. Results. In the second sample, 72% of children had complete immunizations, compared with 46% in the first sample. In the first sample, 78% of children with incomplete immunizations had not been seen during the past year. Of 134 children in the first sample seen in the past year or successfully contacted 75% had complete immunizations. Conclusions. The CASA assessment's definition of a patient underestimates immunization rates. Handle: RePEc:aph:ajpbhl:2001:91:8:1273-1275_0 Template-Type: ReDIF-Article 1.0 Title: Increasing voluntary HIV testing by offering oral tests in incarcerated populations Journal: American Journal of Public Health Author-Name: Bauserman, R.L. Author-Name: Ward, M.A. Author-Name: Eldred, L. Author-Name: Swetz, A. Year: 2001 Volume: 91 Issue: 8 Pages: 1226-1229 Abstract: Objectives. This study reports responses of incarcerated persons to voluntary blood and oral HIV testing. Methods. Males and females in local detention and juvenile justice facilities in Maryland (n = 1314) chose oral or blood testing and reported reactions to the oral HIV test. The relationship of demographics and HIV risk factors to test choice was examined. Results. Reactions to oral testing were very favorable; some participants reported that they would not otherwise have been tested. Participants who chose oral testing were more likely to be male and African American, but they did not differ from those who chose blood testing in most risk factors or in seroprevalence. Conclusions. Oral HIV testing in correctional settings may promote voluntary testing among persons who otherwise would refuse or avoid testing, especially among groups (males and African Americans) disproportionately affected by HIV. Handle: RePEc:aph:ajpbhl:2001:91:8:1226-1229_0 Template-Type: ReDIF-Article 1.0 Title: Can unsafe sex behind bars be barred? Journal: American Journal of Public Health Author-Name: Spaulding, A. Author-Name: Lubelczyk, R.B. Author-Name: Flanigan, T. Year: 2001 Volume: 91 Issue: 8 Pages: 1176-1177 Handle: RePEc:aph:ajpbhl:2001:91:8:1176-1177_2 Template-Type: ReDIF-Article 1.0 Title: Challenges associated with increased survival among parents living with HIV Journal: American Journal of Public Health Author-Name: Lee, M. Author-Name: Rotheram-Borus, M.J. Year: 2001 Volume: 91 Issue: 8 Pages: 1303-1309 Abstract: Objectives. This study examined sociodemographic and psychosocial factors that predict survival among parents living with HIV. Methods. Parents with HIV (n = 307) were recruited from 1993 to 1995 in New York City and repeatedly assessed. Survival was monitored among the sample (81% mothers; 45% Latino, 34% African American). Results. Over a median period of 28 months (range = 0-53 months), 44% (n = 135) of the parents died. Having an AIDS diagnosis and being African American were associated with earlier death. Sex, age, and financial status were not related to survival. Parents who survived had initially higher levels of anxiety that decreased over time; in contrast, parents who died reported initially lower, but constant, levels of anxiety over time. After HIV diagnostic status was controlled for, it was found that parents who reported having more children, using a coping style of seeking social support, and being sexually active at baseline survived longer. Conclusions. The counterintuitive findings raise hypotheses regarding the role of change and responsibilities in the survival of parents with HIV. Handle: RePEc:aph:ajpbhl:2001:91:8:1303-1309_7 Template-Type: ReDIF-Article 1.0 Title: Is child health at risk while families wait for housing vouchers? Journal: American Journal of Public Health Author-Name: Sharfstein, J. Author-Name: Sandel, M. Author-Name: Kahn, R. Author-Name: Bauchner, H. Year: 2001 Volume: 91 Issue: 8 Pages: 1191-1192 Handle: RePEc:aph:ajpbhl:2001:91:8:1191-1192_9 Template-Type: ReDIF-Article 1.0 Title: A conceptual framework to measure performance of the public health system Journal: American Journal of Public Health Author-Name: Handler, A. Author-Name: Issel, M. Author-Name: Turnock, B. Year: 2001 Volume: 91 Issue: 8 Pages: 1235-1239 Abstract: Objectives. This article describes a unifying conceptual framework for the public health system as a way to facilitate the measurement of public health system performance. Methods. A conceptual framework for the public health system was developed on the basis of the work of Donabedian and a conceptual model previously developed by Bernard Turnock and Arden Handler. Results. The conceptual framework consists of 5 components that can be considered in relationship to each other: macro context, mission, structural capacity, processes, and outcomes. Although the availability of measures for each of these components varies, the framework can be used to examine the performance of public health systems as well as that of agencies and programs. Conclusions. A conceptual framework that explicates the relationships among the various components of the public health system is an essential step toward providing a science base for the study of public health system performance. Handle: RePEc:aph:ajpbhl:2001:91:8:1235-1239_8 Template-Type: ReDIF-Article 1.0 Title: Bringing the mountain to Mohammed: A mobile dental team serves a community-based program for people with HIV/AIDS Journal: American Journal of Public Health Author-Name: Zabos, G.P. Author-Name: Trinh, C. Year: 2001 Volume: 91 Issue: 8 Pages: 1187-1189 Abstract: In spite of the direct referral system and family-centered model of primary oral health care linking medical and dental care providers, most HIV-positive patients at the Columbia Presbyterian Medical Center received only emergency and episodic dental care between 1993 and 1998. To improve access to dental care for HIV/AIDS patients, a mobile program, called WE CARE, was developed and colocated in community-based organizations serving HIV-infected people. WE CARE provided preventive, early intervention, and comprehensive oral health services to minorities, low-income women and children, homeless youths, gays and lesbians, transgender individuals, and victims of past abuse. More efforts to colocate dental services with HIV/AIDS care at community-based organizations are urgently needed. Handle: RePEc:aph:ajpbhl:2001:91:8:1187-1189_4 Template-Type: ReDIF-Article 1.0 Title: ". . . So that others may walk": The March of Dimes Journal: American Journal of Public Health Author-Name: Helfand, W.H. Author-Name: Lazarus, J. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 8 Pages: 1190 Handle: RePEc:aph:ajpbhl:2001:91:8:1190_7 Template-Type: ReDIF-Article 1.0 Title: Heart rate as a predictor of mortality: The MATISS project Journal: American Journal of Public Health Author-Name: Seccareccia, F. Author-Name: Pannozzo, F. Author-Name: Dima, F. Author-Name: Minoprio, A. Author-Name: Menditto, A. Author-Name: Noce, C.L. Author-Name: Giampaoli, S. Year: 2001 Volume: 91 Issue: 8 Pages: 1258-1263 Abstract: Objectives, This study sought to verify the independent role of heart rate in the prediction of all-cause, cardiovascular, and noncardiovascular mortality in a low-risk male population. Methods. In an Italian population-based observational study, heart rate was measured in 2533 men, aged 40 to 69 years, between 1984 and 1993, Data on cardiovascular risk factors were collected according to standardized procedures. Vital status was updated to December 1997. Results. Of 2533 men followed up (representing 24457 person-years), 393 men died. Age-adjusted death rates for 5 heart rate levels showed increasing trends. The adjusted hazard rate ratios for each heart rate increment were 1.52 (95% confidence interval [Cl] =1.29, 1.78) for all-cause mortality, 1.63 (95% Cl = 1.26, 2.10) for cardiovascular mortality, and 1.47 (95% Cl = 1.19, 1.80) for noncardiovascular mortality. Relative risks between extreme levels were more than 2-fold for all endpoints considered. Conclusions, Heart rate is an independent predictor of cardiovascular, noncardiovascular, and total mortality in this Italian middle-aged male population. Handle: RePEc:aph:ajpbhl:2001:91:8:1258-1263_9 Template-Type: ReDIF-Article 1.0 Title: Continuing-education needs of the currently employed public health education workforce Journal: American Journal of Public Health Author-Name: Allegrante, J.P. Author-Name: Moon, R.W. Author-Name: Auld, M.E. Author-Name: Gebbie, K.M. Year: 2001 Volume: 91 Issue: 8 Pages: 1230-1234 Abstract: Objectives. This study examined the continuing-education needs of the currently employed public health education workforce. Methods. A national consensus panel of leading health educators from public health agencies, academic institutions, and professional organizations was convened to examine the forces creating the context for the work of public health educators and the competencies they need to practice effectively. Results. Advocacy; business management and finance; communication; community health planning and development, coalition building, and leadership; computing and technology; cultural competency; evaluation; and strategic planning were identified as areas of critical competence. Conclusions. Continuing education must strengthen a broad range of critical competencies and skills if we are to ensure the further development and effectiveness of the public health education workforce. Handle: RePEc:aph:ajpbhl:2001:91:8:1230-1234_1 Template-Type: ReDIF-Article 1.0 Title: The association between extreme precipitation and waterborne disease outbreaks in the United States, 1948-1994 Journal: American Journal of Public Health Author-Name: Curriero, F.C. Author-Name: Patz, J.A. Author-Name: Rose, J.B. Author-Name: Lele, S. Year: 2001 Volume: 91 Issue: 8 Pages: 1194-1199 Abstract: Objectives. Rainfall and runoff have been implicated in site-specific waterborne disease outbreaks. Because upward trends in heavy precipitation in the United States are projected to increase with climate change, this study sought to quantify the relationship between precipitation and disease outbreaks. Methods. The US Environmental Protection Agency waterborne disease database, totaling 548 reported outbreaks from 1948 through 1994, and precipitation data of the National Climatic Data Center were used to analyze the relationship between precipitation and waterborne diseases. Analyses were at the watershed level, stratified by groundwater and surface water contamination and controlled for effects due to season and hydrologic region. A Monte Carlo version of the Fisher exact test was used to test for statistical significance. Results. Fifty-one percent of waterborne disease outbreaks were preceded by precipitation events above the 90th percentile (P =.002), and 68% by events above the 80th percentile (P =.001). Outbreaks due to surface water contamination showed the strongest association with extreme precipitation during the month of the outbreak; a 2-month lag applied to groundwater contamination events. Conclusions. The statistically significant association found between rainfall and disease in the United States is important for water managers, public health officials, and risk assessors of future climate change. Handle: RePEc:aph:ajpbhl:2001:91:8:1194-1199_3 Template-Type: ReDIF-Article 1.0 Title: Global environmental change as "risk factor": Can epidemiology cope? Journal: American Journal of Public Health Author-Name: McMichael, A.J. Year: 2001 Volume: 91 Issue: 8 Pages: 1172-1174 Handle: RePEc:aph:ajpbhl:2001:91:8:1172-1174_2 Template-Type: ReDIF-Article 1.0 Title: Retrospective validation of a surveillance system for unexplained illness and death: New haven county, connecticut Journal: American Journal of Public Health Author-Name: Kluger, M.D. Author-Name: Sofair, A.N. Author-Name: Heye, C.J. Author-Name: Meek, J.I. Author-Name: Sodhi, R.K. Author-Name: Hadler, J.L. Year: 2001 Volume: 91 Issue: 8 Pages: 1214-1219 Abstract: Objectives. This study investigated retrospective validation of a prospective surveillance system for unexplained illness and death due to possibly infectious causes. Methods. A computerized search of hospital discharge data identified patients with potential unexplained illness and death due to possibly infectious causes. Medical records for such patients were reviewed for satisfaction of study criteria. Cases identified retrospectively were combined with prospectively identified cases to form a reference population against which sensitivity could be measured. Results. Retrospective validation was 41% sensitive, whereas prospective surveillance was 73% sensitive. The annual incidence of unexplained illness and death due to possibly infectious causes during 1995 and 1996 in the study county was conservatively estimated to range from 2.7 to 6.2 per 100 000 residents aged 1 to 49 years. Conclusions. Active prospective surveillance for unexplained illness and death due to possibly infectious causes is more sensitive than retrospective surveillance conducted through a published list of indicator codes. However, retrospective surveillance can be a feasible and much less labor-intensive alternative to active prospective surveillance when the latter is not possible or desired. Handle: RePEc:aph:ajpbhl:2001:91:8:1214-1219_8 Template-Type: ReDIF-Article 1.0 Title: Acculturation and leisure-time physical inactivity in Mexican American adults: Results from NHANES III, 1988-1994 Journal: American Journal of Public Health Author-Name: Crespo, C.J. Author-Name: Smit, E. Author-Name: Carter-Pokras, O. Author-Name: Andersen, R. Year: 2001 Volume: 91 Issue: 8 Pages: 1254-1257 Abstract: Objectives. This study examined the relationship between acculturation and leisure-time physical inactivity among Mexican American adults. Methods. Using data from the Third National Health and Nutrition Examination Survey, we estimated the prevalence of physical inactivity according to place of birth and language used at home. Results. Spanish-speaking Mexican Americans had a higher prevalence of physical inactivity during leisure time than those who spoke mostly English, independent of place of birth. Conclusions, Acculturation seems to be positively associated with participation in leisure-time physical activity. Handle: RePEc:aph:ajpbhl:2001:91:8:1254-1257_4 Template-Type: ReDIF-Article 1.0 Title: Beyond assumptions of negligible risk: Sexually transmitted diseases and women who have sex with women Journal: American Journal of Public Health Author-Name: Bauer, G.R. Author-Name: Welles, S.L. Year: 2001 Volume: 91 Issue: 8 Pages: 1282-1286 Abstract: Objectives. This study evaluated the association of female-female sexual behavior with sexually transmitted diseases (STDs). Methods. Female participants (n = 286) were recruited from the Twin Cities Gay/Lesbian/Bisexual/Transgender Pride Festival. Logistic regression was used to examine the association between female-female sexual behavior and STDs. Results. Women in all partner history groups, including 13% of women with only female partners, reported a history of STD. Increased sexual exposures with women predicted an increase in the likelihood of STDS after known risk factors had been controlled. Neither number of female partners nor number of exposures was associated with obtaining regular STD testing. Conclusions. The risk of STDs through female-female sexual exposure is not negligible. Nevertheless, patterns of STD testing do not reflect this risk. Handle: RePEc:aph:ajpbhl:2001:91:8:1282-1286_8 Template-Type: ReDIF-Article 1.0 Title: Trends in HIV testing among pregnant women: United States, 1994-1999 Journal: American Journal of Public Health Author-Name: Lansky, A. Author-Name: Jones, J.L. Author-Name: Frey, R.L. Author-Name: Lindegren, M.L. Year: 2001 Volume: 91 Issue: 8 Pages: 1291-1293 Abstract: Objectives. This study evaluated 1995 guidelines for HIV testing of pregnant women. Methods. Analysis focused on Behavioral Risk Factor Surveillance System data for the years 1994 through 1999. Data were aggregated across states. Results. Percentages of pregnant women tested for HIV increased from 1995 to 1996 (from 41% to 53%) and again from 1997 (52%) to 1998 (60%). Conclusions. After implementation of the guidelines, the percentage of pregnant women tested for HIV increased, although nearly half had not been tested. More efforts are needed to encourage women to undergo testing for HIV during pregnancy, thus maximizing opportunities for offering antiretroviral therapy. Handle: RePEc:aph:ajpbhl:2001:91:8:1291-1293_4 Template-Type: ReDIF-Article 1.0 Title: Association of normal weather periods and El Niño events with hospitalization for viral pneumonia in females: California, 1983-1998 Journal: American Journal of Public Health Author-Name: Ebi, K.L. Author-Name: Exuzides, K.A. Author-Name: Lau, E. Author-Name: Kelsh, M. Author-Name: Barnston, A. Year: 2001 Volume: 91 Issue: 8 Pages: 1200-1208 Abstract: Objectives. This study examined associations between weather and hospitalizations of females for viral pneumonia during normal weather periods and El Niño events in the California counties of Sacramento and Yolo, San Francisco and San Mateo, and Los Angeles and Orange. Methods. Associations between weather and hospitalizations (lagged 7 days) for January 1983 through June 1998 were evaluated with Poisson regression models. Generalized estimating equations were used to adjust for autocorrelation and overdispersion. Data were summed over 4 days. Results. Associations varied by region. Hospitalizations in San Francisco and Los Angeles increased significantly (30%-50%) with a 5°F decrease in minimum temperature. Hospitalizations in Sacramento increased significantly (25%-40%) with a 5°F decrease in maximum temperature difference. The associations were independent of season. El Niño events were associated with hospitalizations only in Sacramento, with significant decreases for girls and increases for women. Conclusions. The results suggest that viral pneumonia could continue to be a major public health issue, with a significant association between weather and hospitalizations, even as the global mean temperature continues to rise. An understanding of population sensitivity under different weather conditions could lead to an improved understanding of virus transmission. Handle: RePEc:aph:ajpbhl:2001:91:8:1200-1208_4 Template-Type: ReDIF-Article 1.0 Title: The effect of primary care physician supply and income inequality on mortality among Blacks and Whites in US metropolitan areas Journal: American Journal of Public Health Author-Name: Shi, L. Author-Name: Starfield, B. Year: 2001 Volume: 91 Issue: 8 Pages: 1246-1250 Abstract: Objectives. This study assessed whether income inequality and primary care physician supply have a different effect on mortality among Blacks compared with Whites. Methods. We conducted a multivariate ecologic analysis of 1990 data from 273 US metropolitan areas. Results. Both income inequality and primary care physician supply were significantly associated with White mortality (P<.01). After the inclusion of the socioeconomic status covariates, the effect of income inequality on Black mortality remained significant (P<.01), but the effect of primary care physician supply was no longer significant (P>.10), particularly in areas with high income inequality. Conclusions. Improvement in population health requires addressing socioeconomic determinants of health, including income inequality and primary care availability and access. Handle: RePEc:aph:ajpbhl:2001:91:8:1246-1250_3 Template-Type: ReDIF-Article 1.0 Title: Prevalence of genital chlamydial infection in young women entering a national job training program, 1990-1997 Journal: American Journal of Public Health Author-Name: Mertz, K.J. Author-Name: Ransom, R.L. Author-Name: St. Louis, M.E. Author-Name: Groseclose, S.L. Author-Name: Hadgu, A. Author-Name: Levine, W.C. Author-Name: Hayman, C. Year: 2001 Volume: 91 Issue: 8 Pages: 1287-1290 Abstract: Objectives. This analysis describes trends in the prevalence of genital chlamydial infection in economically disadvantaged young women entering a national job training program. Methods. We examined chlamydia test data for May 1990 through June 1997 for women aged 16 to 24 years who enrolled in the program. The significance of trends was evaluated with the Χ2 test for trend. Results. Prevalence of chlamydial infection declined 32.9%, from 14.9% in 1990 to 10.0% in 1997 (P<.001). Prevalence decreased significantly in all age groups, racial/ethnic groups, and geographic regions. Conclusions. The decrease in prevalence of chlamydial infection suggests that prevention activities have reached disadvantaged women across the United States; however, prevalence of chlamydial infection remains high, and enhanced prevention efforts in disadvantaged communities are urgently needed. Handle: RePEc:aph:ajpbhl:2001:91:8:1287-1290_8 Template-Type: ReDIF-Article 1.0 Title: Accessibility of primary care services in safety net clinics in New York City Journal: American Journal of Public Health Author-Name: Weiss, E. Author-Name: Haslanger, K. Author-Name: Cantor, J.C. Year: 2001 Volume: 91 Issue: 8 Pages: 1240-1245 Abstract: Objectives. This study analyzed data from a survey of New York City ambulatory care facilities to determine primary care accessibility for low-income patients, as evidenced by the availability of enabling services, after-hours coverage, and policies for serving the uninsured. Methods. Ambulatory care facilities were surveyed in 1997, and analysis was performed on a set of measures related to access to care. Only sites that provided comprehensive primary care services were included in the analysis. For comparison, sites were classified by sponsorship (public, nonprofit voluntary hospital, federally qualified health center, non-hospital-sponsored community health center). Results. Publicly sponsored sites and federally qualified health center sites showed the strongest performance across nearly all the measures of accessibility that were examined. Conclusions. As safety net clinics confront the financial strain of implementing mandatory Medicaid managed care while also dealing with declining Medicaid caseloads and increasing numbers of uninsured, their ability to sustain the policies and services that support primary care accessibility may be threatened. Handle: RePEc:aph:ajpbhl:2001:91:8:1240-1245_6 Template-Type: ReDIF-Article 1.0 Title: Changing to the 2000 standard million: Are declining racial/ethnic and socioeconomic inequalities in health real progress or statistical illusion? Journal: American Journal of Public Health Author-Name: Krieger, N. Author-Name: Williams, D.R. Year: 2001 Volume: 91 Issue: 8 Pages: 1209-1213 Abstract: Objectives. This study determined the effects of changing from the 1940 to the 2000 standard million on monitoring socioeconomic and racial/ethnic inequalities in health. Methods. Using the 1940, 1970, and 2000 standard million, we calculated and compared age-adjusted rates for selected health outcomes stratified by socioeconomic level. Results. Changing from the 1940 to the 2000 standard million markedly reduced the age-adjusted relative risks for self-reported fair or poor health status of poor Americans compared with high-income Americans. Conclusions. Public health researchers and practitioners should give serious consideration to the implications of the change to the 2000 standard million for monitoring social inequalities in health. Handle: RePEc:aph:ajpbhl:2001:91:8:1209-1213_4 Template-Type: ReDIF-Article 1.0 Title: Brief intervention for heavy-drinking college students: 4-Year follow-up and natural history Journal: American Journal of Public Health Author-Name: Baer, J.S. Author-Name: Kivlahan, D.R. Author-Name: Blume, A.W. Author-Name: McKnight, P. Author-Name: Marlatt, G.A. Year: 2001 Volume: 91 Issue: 8 Pages: 1310-1316 Abstract: Objectives. This study examined long-term response to an individual preventive intervention for high-risk college drinkers relative to the natural history of college drinking. Methods. A single-session, individualized preventive intervention was evaluated within a randomized controlled trial with college freshmen who reported drinking heavily while in high school. An additional group randomly selected from the entire screening pool provided a normative comparison. Participant self-report was assessed annually for 4 years. Results. High-risk controls showed secular trends for reduced drinking quantity and negative consequences without changes in drinking frequency. Those receiving the brief preventive intervention reported significant additional reductions, particularly with respect to negative consequences. Categorical individual change analyses show that remission is normative, and they suggest that participants receiving the brief intervention are more likely to improve and less likely to worsen regarding negative drinking consequences. Conclusions. Brief individual preventive interventions for high-risk college drinkers can achieve long-term benefits even in the context of maturational trends. Handle: RePEc:aph:ajpbhl:2001:91:8:1310-1316_9 Template-Type: ReDIF-Article 1.0 Title: Using technology to advance the public's health Journal: American Journal of Public Health Author-Name: Arons, R.R. Year: 2001 Volume: 91 Issue: 8 Pages: 1178-1179 Abstract: If future health practitioners and researchers are to advance the public's health, they must be equipped with the technical skills and tools needed to help reduce suffering, cure illness, and promote health for all. Handle: RePEc:aph:ajpbhl:2001:91:8:1178-1179_5 Template-Type: ReDIF-Article 1.0 Title: An outbreak of syphilis in alabama prisons: Correctional health policy and communicable disease control Journal: American Journal of Public Health Author-Name: Wolfe, M.I. Author-Name: Xu, F. Author-Name: Patel, P. Author-Name: O'Cain, M. Author-Name: Schillinger, J.A. Author-Name: St. Louis, M.E. Author-Name: Finelli, L. Year: 2001 Volume: 91 Issue: 8 Pages: 1220-1225 Abstract: Objectives. After syphilis outbreaks were reported at 3 Alabama State men's prisons in early 1999, we conducted an investigation to evaluate risk factors for syphilis infection and describe patterns of syphilis transmission. Methods. We reviewed medical, patient interview, and prison transfer records and documented sexual networks. Presumptive source cases were identified. Odds of exposure to unscreened jail populations and transfer from other prisons were calculated for case patients at 1 prison. Results. Thirty-nine case patients with early syphilis were identified from 3 prisons. Recent jail exposure (odds ratio [OR] = 8.0, 95% confidence interval [Cl] = 0.3, 158.7, P = .14) and prison transfer (OR = 32.0, 95% Cl = 1.6, 1668.1, P < .01) were associated with being a source case patient. Conclusions. Probable sources of syphilis introduction into and transmission within prisons included mixing of prisoners with unscreened jail populations, transfer of infected inmates between prisons, and multiple concurrent sexual partnerships. Reducing sexual transmission of disease in correctional settings is a public health priority and will require innovative prevention strategies. Handle: RePEc:aph:ajpbhl:2001:91:8:1220-1225_3 Template-Type: ReDIF-Article 1.0 Title: Encouraging stair use: Stair-riser banners are better than posters Journal: American Journal of Public Health Author-Name: Kerr, J. Author-Name: Eves, F. Author-Name: Carroll, D. Year: 2001 Volume: 91 Issue: 8 Pages: 1192-1193 Handle: RePEc:aph:ajpbhl:2001:91:8:1192-1193_6 Template-Type: ReDIF-Article 1.0 Title: Health information systems and health communications: Narrowband and broadband technologies as core public health competencies Journal: American Journal of Public Health Author-Name: Riegelman, R. Author-Name: Persily, N.A. Year: 2001 Volume: 91 Issue: 8 Pages: 1179-1183 Abstract: The revolution in information systems and the efforts to take advantage of new opportunities are likely to alter the structure and function of schools of public health, the relationships among disciplines, and the health professions. Handle: RePEc:aph:ajpbhl:2001:91:8:1179-1183_9 Template-Type: ReDIF-Article 1.0 Title: An intervention for parents with AIDS and their adolescent children Journal: American Journal of Public Health Author-Name: Rotheram-Borus, M.J. Author-Name: Lee, M.B. Author-Name: Gwadz, M. Author-Name: Draimin, B. Year: 2001 Volume: 91 Issue: 8 Pages: 1294-1302 Abstract: Objectives. This study evaluated an intervention designed to improve behavioral and mental health outcomes among adolescents and their parents with AIDS. Methods. Parents with AIDS (n = 307) and their adolescent children (n = 412) were randomly assigned to an intensive intervention or a standard care control condition. Ninety-five percent of subjects were reassessed at least once annually over 2 years. Results. Adolescents in the intensive intervention condition reported significantly lower levels of emotional distress, of multiple problem behaviors, of conduct problems, and of family-related stressors and higher levels of self-esteem than adolescents in the standard care condition. Parents with AIDS in the intervention condition also reported significantly lower levels of emotional distress and multiple problem behaviors. Coping style, levels of disclosure regarding serostatus, and formation of legal custody plans were similar across intervention conditions. Conclusions. Interventions can reduce the long-term impact of parents' HIV status on themselves and their children. Handle: RePEc:aph:ajpbhl:2001:91:8:1294-1302_2 Template-Type: ReDIF-Article 1.0 Title: Readers respond to "Cholera in Paris". Journal: American Journal of Public Health Author-Name: Frerichs, R.R. Year: 2001 Volume: 91 Issue: 8 Pages: 1170 Handle: RePEc:aph:ajpbhl:2001:91:8:1170_2 Template-Type: ReDIF-Article 1.0 Title: Readers respond to "Cholera in Paris". Journal: American Journal of Public Health Author-Name: Birden, H. Year: 2001 Volume: 91 Issue: 8 Pages: 1170 Handle: RePEc:aph:ajpbhl:2001:91:8:1170_6 Template-Type: ReDIF-Article 1.0 Title: California adolescents offer a glimpse into the future of multiethnicity [2] Journal: American Journal of Public Health Author-Name: Unger, J.B. Year: 2001 Volume: 91 Issue: 7 Pages: 1136-1137 Handle: RePEc:aph:ajpbhl:2001:91:7:1136-1137_9 Template-Type: ReDIF-Article 1.0 Title: Jogging and bone mineral density in men: Results from NHANES III Journal: American Journal of Public Health Author-Name: Mussolino, M.E. Author-Name: Looker, A.C. Author-Name: Orwoll, E.S. Year: 2001 Volume: 91 Issue: 7 Pages: 1056-1059 Abstract: Objectives. This cross-sectional population-based study assessed the association of jogging with femoral bone mineral density (BMD) in men. Methods. Data are from a nationally representative sample of 4254 men aged 20 to 59 years from the Third National Health and Nutrition Examination Survey (NHANES III). Total femoral BMD was measured by dual energy x-ray absorptiometry. Jogging was self-reported. Results. Jogging (any vs none) was strongly associated with higher BMD in multivariate models (P < .01) for both young and middle-aged men. Men who jogged 9 or more times per month had higher BMD levels than those who jogged only 1 to 8 times per month (P = .01). Conclusions. Jogging is associated with higher femoral neck BMD in men. Additional large-scale studies that measure all aspects of jogging are warranted. Handle: RePEc:aph:ajpbhl:2001:91:7:1056-1059_8 Template-Type: ReDIF-Article 1.0 Title: Zoning, equity, and public health Journal: American Journal of Public Health Author-Name: Maantay, J. Year: 2001 Volume: 91 Issue: 7 Pages: 1033-1041 Abstract: Zoning, the most prevalent land use planning tool in the United States, has substantial implications for equity and public health. Zoning determines where various categories of land use may go, thereby influencing the location of resulting environmental and health impacts. Industrially zoned areas permit noxious land uses and typically carry higher environmental burdens than other areas. Using New York City as a case study, the author shows that industrial zones have large residential populations within them or nearby. Noxious uses tend to be concentrated in poor and minority industrial neighborhoods because more affluent industrial areas and those with lower minority populations are rezoned for other uses, and industrial zones in poorer neighborhoods are expanded. Zoning policies, therefore, can have adverse impacts on public health and equity. The location of noxious uses and the pollution they generate have ramifications for global public health and equity; these uses have been concentrated in the world's poorer places as well as in poorer places within more affluent countries. Planners, policymakers, and public health professional must collaborate on a worldwide basis to address these equity, health, and land use planning problems. Handle: RePEc:aph:ajpbhl:2001:91:7:1033-1041_1 Template-Type: ReDIF-Article 1.0 Title: Paradigm lost: Race, ethnicity, and the search for a new population taxonomy Journal: American Journal of Public Health Author-Name: Oppenheimer, G.M. Year: 2001 Volume: 91 Issue: 7 Pages: 1049-1055 Abstract: The Institute of Medicine (IOM) recently recommended that the National Institutes of Health (NIH) reevaluate its employment of "race," a concept lacking scientific or anthropological justification, in cancer surveillance and other population research. The IOM advised the NIH to use a different population classification, that of "ethnic group," instead of "race." A relatively new term, according to the IOM, "ethnic group" would turn research attention away from biological determinism and toward a focus on culture and behavior. This article examines the historically central role of racial categorization and its relationship to racism in the United States and questions whether dropping "race" from population taxonomies is either possible or, at least in the short run, preferable. In addition, a historical examination of "ethnicity" and "ethnic group" finds that these concepts, as used in the United States, derive in part from race and immigration and are not neutral terms; instead, they carry their own burden of political, social, and ideological meaning. Handle: RePEc:aph:ajpbhl:2001:91:7:1049-1055_4 Template-Type: ReDIF-Article 1.0 Title: The serostatus approach to fighting the HIV epidemic: Prevention strategies for infected individuals Journal: American Journal of Public Health Author-Name: Janssen, R.S. Author-Name: Holtgrave, D.R. Author-Name: Valdiserri, R.O. Author-Name: Shepherd, M. Author-Name: Gayle, H.D. Author-Name: De Cock, K.M. Year: 2001 Volume: 91 Issue: 7 Pages: 1019-1024 Abstract: In the United States, HIV prevention programs have historically tailored activities for specific groups primarily On the basis of behavioral risk factors and demographic characteristics. Through the Serostatus Approach to Fighting the Epidemic (SAFE), the Centers for Disease Control and Prevention is now expanding prevention programs, especially for individuals with HIV, to reduce the risk of transmission as a supplement to current programs that primarily focus on reducing the risk of acquisition of the virus. For individuals with HIV, SAFE comprises action steps that focus on diagnosing all HIV-infected persons, linking them to appropriate high-quality care and prevention services, helping them adhere to treatment regimens, and supporting them in adopting and sustaining HIV risk reduction behavior. SAFE couples a traditional infectious disease control focus on the infected person with behavioral interventions that have been standard for HIV prevention programs. Handle: RePEc:aph:ajpbhl:2001:91:7:1019-1024_7 Template-Type: ReDIF-Article 1.0 Title: On the wrong side of the tracts? Evaluating the accuracy of geocoding in public health research Journal: American Journal of Public Health Author-Name: Krieger, N. Author-Name: Waterman, P. Author-Name: Lemieux, K. Author-Name: Zierler, S. Author-Name: Hogan, J.W. Year: 2001 Volume: 91 Issue: 7 Pages: 1114-1116 Abstract: Objectives. This study sought to determine the accuracy of geocoding for public health databases. Methods. A test file of 70 addresses, 50 of which involved errors, was generated, and the file was geocoded to the census tract and block group levels by 4 commercial geocoding firms. Also, the "real world" accuracy of the best-performing firm was evaluated. Results. Accuracy rotes in regard to geocoding of the test file ranged from 44% (95% confidence interval [CI] = 32%, 56%) to 84% (95% CI=73%, 92%). The geocoding firm identified as having the best accuracy rate correctly geocoded 96% of the addresses obtained from the public health databases. Conclusions. Public health studies involving geocoded databases should evaluate and report on methods used to verify accuracy. Handle: RePEc:aph:ajpbhl:2001:91:7:1114-1116_6 Template-Type: ReDIF-Article 1.0 Title: Mental health services for youths in foster care and disabled youths Journal: American Journal of Public Health Author-Name: DosReis, S. Author-Name: Zito, J.M. Author-Name: Safer, D.J. Author-Name: Soeken, K.L. Year: 2001 Volume: 91 Issue: 7 Pages: 1094-1099 Abstract: Objectives. This study assessed whether mental health services for youths differ with respect to medical assistance aid category. Methods. Computerized claims for 15 507 youths with Medicaid insurance in a populous county of a mid-Atlantic state were used to establish population-based prevalence estimates of mental disorders and psychotherapeutic treatments during 1996. Results. An analysis of service claims revealed that the prevalence of mental disorders among youths enrolled in foster care (57%) was twice that of youths receiving Supplemental Security Income (SSI; 26%) and nearly 15 times that of other youths receiving other types of aid (4%). Rates of mental health Service use were pronounced among foster care youths aged 6 to 14 years. Attention-deficit/hyperactivity disorder, depression, and developmental disorders were the most prevalent disorders. Stimulants, antidepressants, and anticonvulsants were the most prevalent medications. Conclusions. Youths enrolled in foster care and youths receiving SSI Use far more mental health services than do youths in other aid categories. Additional research should evaluate the complexity and outcomes of mental health services for youths in foster care. Handle: RePEc:aph:ajpbhl:2001:91:7:1094-1099_7 Template-Type: ReDIF-Article 1.0 Title: Remission from drug abuse over a 25-year period: Patterns of remission and treatment use Journal: American Journal of Public Health Author-Name: Price, R.K. Author-Name: Risk, N.K. Author-Name: Spitznagel, E.L. Year: 2001 Volume: 91 Issue: 7 Pages: 1107-1113 Abstract: Objectives. Using an epidemiologically obtained sample, we examined patterns of illicit drug use, abuse, and remission over a 25-year period and recent treatment use. Methods. The surviving members of the cohort (n = 841), previously surveyed in 1972 and 1974, comprised 3 subsamples of Vietnam War enlisted men and civilian controls. Retrospectively obtained year-to-year measures from the 1996-1997 survey included use and remission of sedatives, stimulants, marijuana, cocaine, and opiates, as well as substance abuse and psychiatric treatment use. Results. Relatively stable patterns of frequent use in adulthood were found, with the mean duration from initiation to the last remission ranging from 9 to 14 years. A majority attempted to quit; however, most did not use traditional drug treatment in their last attempts. Fewer than 9% of the then-current drug users were treated in inpatient or outpatient settings at the time of data collection. Conclusions. Most drug abusers who had started using drugs by their early 20s appeared to gradually achieve remission. Spontaneous remission was the rule rather than the exception. Nonetheless, considerable unmet needs existed for those who had continued use into middle age. Handle: RePEc:aph:ajpbhl:2001:91:7:1107-1113_4 Template-Type: ReDIF-Article 1.0 Title: Expanding the research infrastructure for lesbian health Journal: American Journal of Public Health Author-Name: Bradford, J. Author-Name: Ryan, C. Author-Name: Honnold, J. Author-Name: Rothblum, E. Year: 2001 Volume: 91 Issue: 7 Pages: 1029-1032 Abstract: Interest in research about lesbian health has increased dramatically since the late 1980s and gained national attention in 1999 when the Institute of Medicine published the groundbreaking report Lesbian Health; Current Assessments and Directions for the Future. In March 2000, the Department of Health and Human Services and partner organizations presented the Science Workshop on Lesbian Health, during which invited experts on lesbian health worked with federal representatives to develop action steps to implement recommendations in the Institute of Medicine report. National priorities were thus established for the emerging field of lesbian health research. Although researchers of various sexual orientations and gender identities will contribute to this field, lesbian researchers have a unique perspective and an important role to play. This commentary focuses on the preparedness of these individuals to respond to challenges set forth by the Institute of Medicine and Scientific Workshop reports. Despite differences in their academic backgrounds, lesbian researchers have reported common experiences and needs. Substantial proportions have encountered barriers because they were lesbians or conducted lesbian research, and many expressed willingness to mentor others, to help others to conduct research about lesbians, or both. Handle: RePEc:aph:ajpbhl:2001:91:7:1029-1032_7 Template-Type: ReDIF-Article 1.0 Title: Biomechanical and psychosocial risk factors for low back pain at work Journal: American Journal of Public Health Author-Name: Kerr, M.S. Author-Name: Frank, J.W. Author-Name: Shannon, H.S. Author-Name: Norman, R.W.K. Author-Name: Wells, R.P. Author-Name: Neumann, W.P. Author-Name: Bombardier, C. Year: 2001 Volume: 91 Issue: 7 Pages: 1069-1075 Abstract: Objectives. This study determined whether the physical and psychosocial demands of work are associated with low back pain. Methods. A case-control approach was used. Case subjects (n = 137) reported a new episode of low back pain to their employer, a large automobile manufacturing complex. Control subjects were randomly selected from the study base as cases accrued (n = 179) or were matched to cases by exact job (n = 65). Individual, clinical, and psychosocial variables were assessed by interview. Physical demands were assessed with direct workplace measurements of subjects at their usual jobs. The analysis used multiple logistic regression adjusted for individual characteristics. Results. Self-reported risk factors included a physically demanding job, a poor workplace social environment, inconsistency between job and education level, better job satisfaction, and better coworker support. Low job control showed a borderline association. Physical-measure risk factors included peak lumbar shear force, peak load handled, and cumulative lumbar disc compression. Low body mass index and prior low back pain compensation claims were the only significant individual characteristics. Conclusions. This study identified specific physical and psychosocial demands of work as independent risk factors for low back pain. Handle: RePEc:aph:ajpbhl:2001:91:7:1069-1075_4 Template-Type: ReDIF-Article 1.0 Title: Property, politics, and public health Journal: American Journal of Public Health Author-Name: Scalar, E. Author-Name: Northridge, M.E. Year: 2001 Volume: 91 Issue: 7 Pages: 1013-1015 Handle: RePEc:aph:ajpbhl:2001:91:7:1013-1015_8 Template-Type: ReDIF-Article 1.0 Title: Journals of the plague years: Documenting the history of the AIDS epidemic in the United States Journal: American Journal of Public Health Author-Name: Markel, H. Year: 2001 Volume: 91 Issue: 7 Pages: 1025-1028 Abstract: This commentary discusses several journalistic, literary, and historical accounts of the AIDS epidemic as it has unfolded in the United States over the past 2 decades. By examining the different ways that different types of storytellers chronicle the political, social, public health, medical. and economic aspects of epidemic disease, this essay will demonstrate why the AIDS epidemic has been of such intense interest not only to physicians and public health experts but also to journalists, novelists, playwrights, memoirist, and historians AIDS is a particularly fascinating example of society's broad concern with epidemics because it both is a global pandemic and, in recent years, has become a chronic disease. Handle: RePEc:aph:ajpbhl:2001:91:7:1025-1028_3 Template-Type: ReDIF-Article 1.0 Title: HIV in the United States at the turn of the century: An epidemic in transition Journal: American Journal of Public Health Author-Name: Karon, J.M. Author-Name: Fleming, P.L. Author-Name: Steketee, R.W. Author-Name: De Cock, K.M. Year: 2001 Volume: 91 Issue: 7 Pages: 1060-1068 Abstract: Objectives. The current status of and changes in the HIV epidemic in the United States are described. Methods. Surveillance data were used to evaluate time trends in AIDS diagnoses and deaths. Estimates of HIV incidence were derived from studies done during the 1990s; time trends in recent HIV incidence were inferred from HIV diagnoses and seroprevalence rates among young persons. Results. Numbers of deaths and AIDS diagnoses decreased dramatically during 1996 and 1997 but stabilized or declined only slightly during 1998 and 1999. Proportional decreases were smallest among African American women, women in the South, and persons infected through heterosexual contact. HIV incidence has been roughly constant since 1992 in most populations with time trend data, remains highest among men who have sex with men and injection drug users, and typically is higher among African Americans than other racial/ethnic groups. Conclusions. The epidemic increasingly affects women, minorities, persons infected through heterosexual contact, and the poor. Renewed interest and investment in HIV and AIDS surveillance and surveillance of behaviors associated with HIV transmission are essential to direct resources for prevention to populations with greatest need and to evaluate intervention programs. Handle: RePEc:aph:ajpbhl:2001:91:7:1060-1068_3 Template-Type: ReDIF-Article 1.0 Title: Counteracting tobacco motor sports sponsorship as a promotional tool: Is the tobacco settlement enough? Journal: American Journal of Public Health Author-Name: Siegel, M. Year: 2001 Volume: 91 Issue: 7 Pages: 1100-1106 Abstract: Objectives. This study sought to quantify television advertising exposure achieved by tobacco companies through sponsorship of motor sports events and to evaluate the likely effect of the Master Settlement Agreement on this advertising. Methods. Data from Sponsors Report, which quantifies the exposure that sponsors of selected televised sporting events receive during broadcasts of those events, were compiled for all motor sports events covered by the service for the period 1997 through 1999. Results. From 1997 through 1999, tobacco companies achieved 169 hours of television advertising exposure and $410.5 million of advertising value for their products by sponsoring motor sports events. If tobacco companies comply with the Master Settlement Agreement and maintain their advertising at 1999 levels, they will still be able to achieve more than 25 hours of television exposure and an equivalent television advertising value of $99.1 million per year. Conclusions. Despite a federal ban on tobacco advertising on television, tobacco companies achieve the equivalent of more than $150 million in television advertising per year through their sponsorship of motor sports events: The Master Settlement Agreement likely will do little to address this problem. Handle: RePEc:aph:ajpbhl:2001:91:7:1100-1106_2 Template-Type: ReDIF-Article 1.0 Title: Adults buy cigarettes for underaged youths [4] Journal: American Journal of Public Health Author-Name: Klonoff, E.A. Author-Name: Landrine, H. Author-Name: Lang, D. Author-Name: Alcaraz, R. Author-Name: Figueroa-Moseley, C. Year: 2001 Volume: 91 Issue: 7 Pages: 1138-1139 Handle: RePEc:aph:ajpbhl:2001:91:7:1138-1139_0 Template-Type: ReDIF-Article 1.0 Title: Tobacco, betel quid, alcohol, and illicit drug use among 13- to 35-year-olds in I-Lan, rural Taiwan: Prevalence and risk factors Journal: American Journal of Public Health Author-Name: Chen, K.-T. Author-Name: Chen, C.-J. Author-Name: Fagot-Campagna, A. Author-Name: Narayan, K.M.V. Year: 2001 Volume: 91 Issue: 7 Pages: 1130-1134 Abstract: Objectives. This study determined the prevalence of and risk factors for substance use among rural Taiwanese. Methods. We used a survey of a representative sample of 6318 participants aged 13 to 35 years in I-Lan, Taiwan, in 1996 through 1997. Results. Perceived use of illicit drugs by peers, tobacco smoking, betel quid chewing, and male gender were the strongest predictors of illicit drug use. The prevalence of illicit drug use ranged from 0.3% among those who did not use any other substance to 7.1% among those using tobacco, betel quid, and alcohol. Conclusions. Preventive measures should address substance use in general rather than aiming at single substances. Handle: RePEc:aph:ajpbhl:2001:91:7:1130-1134_3 Template-Type: ReDIF-Article 1.0 Title: Activity limitations reported in the National Health Interview Survey: An anomaly and its effect on estimates of national well-being [1] Journal: American Journal of Public Health Author-Name: Anderson, J.P. Year: 2001 Volume: 91 Issue: 7 Pages: 1135-1136 Handle: RePEc:aph:ajpbhl:2001:91:7:1135-1136_3 Template-Type: ReDIF-Article 1.0 Title: Immunization and symptoms of atopic disease in children: Results from the International Study of Asthma and Allergies in Childhood Journal: American Journal of Public Health Author-Name: Anderson, H.R. Author-Name: Poloniecki, J.D. Author-Name: Strachan, D.P. Author-Name: Beasley, R. Author-Name: Björkxtén, B. Author-Name: Asher, M.I. Year: 2001 Volume: 91 Issue: 7 Pages: 1126-1129 Abstract: Objectives. This study tested the hypothesis that immunization is related to the prevalence of atopic disease in childhood. Methods. We used data from the International Study of Asthma and Allergies in Childhood to perform an ecologic analysis of national and local immunization rates for tuberculosis, diphtheria and tetanus toxoids and pertussis (DTP), and measles and prevalence of atopic disease symptoms (asthma, allergic rhinoconjunctivitis, and atopic eczema). Results. In 13- to 14-year-old children, there were significant negative associations with local birth-year immunization rates for DTP and measles but none with rates for tuberculosis. No associations were found in 6- to 7-year-old children No associations with national immunization rates were found. Conclusions. International variations in childhood atopic diseases are unlikely to be explained by variations in immunization. Handle: RePEc:aph:ajpbhl:2001:91:7:1126-1129_5 Template-Type: ReDIF-Article 1.0 Title: Measuring statewide merchant compliance with tobacco minimum age laws: The Massachusetts experience Journal: American Journal of Public Health Author-Name: DiFranza, J.R. Author-Name: Celebucki, C.C. Author-Name: Mowery, P.D. Year: 2001 Volume: 91 Issue: 7 Pages: 1124-1125 Abstract: Objectives. This study evaluated merchant compliance with laws prohibiting the sale of tobacco to minors in Massachusetts. Methods. Stratified cluster sampling was used to select outlets from which youths aged 13 to 17 years attempted to purchase tobacco. Results. Illegal sales were more common when the youth purchasing the tobacco was older, when the clerk was male, and when tobacco was obtained from a self-service display or unlocked vending machine. Failure to request proof of age was the strongest predictor of illegal sales. Conclusions. Measured compliance rates are strongly influenced by the age of the youths used to purchase tobacco. Handle: RePEc:aph:ajpbhl:2001:91:7:1124-1125_7 Template-Type: ReDIF-Article 1.0 Title: Effects of alcohol-related disease on hip fracture and mortality: A retrospective cohort study of hospitalized medicare beneficiaries Journal: American Journal of Public Health Author-Name: Yuan, Z. Author-Name: Dawson, N. Author-Name: Cooper, G.S. Author-Name: Einstadter, D. Author-Name: Cebul, R. Author-Name: Rimm, A.A. Year: 2001 Volume: 91 Issue: 7 Pages: 1089-1093 Abstract: Objectives. This study investigated the effect of alcohol-related disease on hip fracture and mortality. Methods. A retrospective cohort design was used. The study cohort consisted of hospitalized Medicare beneficiaries with alcohol-related disease (n = 150 119) and randomly matched controls without alcohol-related disease (n = 726 218) identified through the 1988-1989 inpatient claims file. Incidence rates of hip fracture and mortality were examined. Results: During the study period, 20 620 patients developed hip fracture, with 6973 cases among patients with alcohol-related disease and 13 647 cases among patients without alcohol-related disease. After adjustment for potential confounders, patients with alcohol-related disease had a 2.6-fold increased risk of hip fracture relative to patients without alcohol-related disease (95% confidence interval = 2.5, 2.6). Patients with alcohol-related disease had a higher risk of mortality at 1 year after hip fracture. Conclusions: Alcohol-related disease increases the risk of hip fracture significantly and reduces long-term survival. The present results suggest that patients hospitalized for alcohol-related disease should be targeted for hip fracture prevention programs. Handle: RePEc:aph:ajpbhl:2001:91:7:1089-1093_4 Template-Type: ReDIF-Article 1.0 Title: Causal influence of car mass and size on driver fatality risk Journal: American Journal of Public Health Author-Name: Evans, L. Year: 2001 Volume: 91 Issue: 7 Pages: 1076-1081 Abstract: Objectives. This study estimated how adding mass, in the form of a passenger, to a car crashing head-on into another car affects fatality risks to both drivers. The study distinguished the causal roles of mass and size. Methods. Head-on crashes between 2 cars, one with a right-front passenger and the other with only a driver, were examined with Fatality Analysis Reporting System data. Results. Adding a passenger to a car led to a 14.5% reduction in driver risk ratio (risk to one driver divided by risk to the other). To divide this effect between the individual drivers, the author developed equations that express each driver's risk as a function of causal contributions from the mass and size of both involved cars. Adding a passenger reduced a driver's frontal crash fatality risk by 7.5% but increased the risk to the other driver by 8.1%. Conclusions. The presence of a passenger reduces a driver's frontal crash fatality risk but increases the risk to the driver of the other car. The findings are applicable to some single-car crashes, in which the driver risk decrease is not offset by any increase in harm to others. When all cars carry the same additional cargo, total population risk is reduced. Handle: RePEc:aph:ajpbhl:2001:91:7:1076-1081_2 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic trends in the hospitalization of elderly medicare patients for pneumonia, 1991-1998 Journal: American Journal of Public Health Author-Name: Baine, W.B. Author-Name: Yu, W. Author-Name: Summe, J.P. Year: 2001 Volume: 91 Issue: 7 Pages: 1121-1123 Abstract: Objectives. This study determined hospitalization rates of elderly Americans for pneumonia from 1991 through 1998. Methods. Epidemiologic data were described for 273-173 pneumonia hospitalizations. Results. Annual hospitalizations for aspiration pneumonia increased by 93.5%. Pneumonia hospitalization rates increased steeply with age, especially among men. Black men were at highest risk for aspiration, unspecified, Klebsiella, "other gram-negative," and staphylococcal pneumonia; White men had the highest Haemophilus and pneumococcal pneumonia rates. Among women, Blacks predominated in aspiration and Klebsiella pneumonia; Whites had the highest Haemophilus and bronchopneumonia rates. Conclusions. An epidemic of hospitalization for aspiration pneumonia smoldered over 8 years. Significant disparities existed in hospitalization risks by race, sex, and principal diagnosis. Handle: RePEc:aph:ajpbhl:2001:91:7:1121-1123_1 Template-Type: ReDIF-Article 1.0 Title: HIV in the late 1990s: What we don't know may hurt us Journal: American Journal of Public Health Author-Name: Rosenberg, P.S. Year: 2001 Volume: 91 Issue: 7 Pages: 1016-1017 Handle: RePEc:aph:ajpbhl:2001:91:7:1016-1017_6 Template-Type: ReDIF-Article 1.0 Title: Emergency contraceptive pills can prevent abortion [3] Journal: American Journal of Public Health Author-Name: Grossman, R. Year: 2001 Volume: 91 Issue: 7 Pages: 1137-1138 Handle: RePEc:aph:ajpbhl:2001:91:7:1137-1138_4 Template-Type: ReDIF-Article 1.0 Title: Underuse of invasive procedures among medicaid patients with acute myocardial infarction Journal: American Journal of Public Health Author-Name: Philbin, E.F. Author-Name: McCullough, P.A. Author-Name: DiSalvo, T.G. Author-Name: Dec, G.W. Author-Name: Jenkins, P.L. Author-Name: Weaver, W.D. Year: 2001 Volume: 91 Issue: 7 Pages: 1082-1088 Abstract: Objectives. The purpose of this study was to determine whether underuse of cardiac procedures among Medicaid patients with acute myocardial infarction is explained by or is independent of fundamental differences in age, race, or sex distribution; income; coexistent illness; or location of care. Methods. Administrative data from 226 hospitals in New York were examined for 11 579 individuals hospitalized with a primary diagnosis of acute myocardial infarction. Use of various cardiac procedures was compared among Medicaid patients and patients with other forms of insurance. Results. Medicaid patients were older, were more frequently African American and female, and had lower median household incomes. They also had a higher prevalence of hypertension. diabetes, lung disease, renal disease, and peripheral vascular disease. After adjustment for these and other factors, Medicaid patients were less likely to undergo cardiac catheterization, percutaneous transluminal coronary angioplasty, and any revascularization procedure. Conclusions. Factors other than age, race, sex, income, coexistent illness, and location of care account for lower use of invasive procedures among Medicaid patients. The influence of Medicaid insurance on medical practice and process of care deserves investigation. Handle: RePEc:aph:ajpbhl:2001:91:7:1082-1088_8 Template-Type: ReDIF-Article 1.0 Title: Them and us: The politics of population taxonomy Journal: American Journal of Public Health Author-Name: Willis, D.P. Year: 2001 Volume: 91 Issue: 7 Pages: 1048-1049 Handle: RePEc:aph:ajpbhl:2001:91:7:1048-1049_7 Template-Type: ReDIF-Article 1.0 Title: Circumstances at HIV diagnosis and progression of disease in older HIV-infected Americans Journal: American Journal of Public Health Author-Name: Zingmond, D.S. Author-Name: Wenger, N.S. Author-Name: Crystal, S. Author-Name: Joyce, G.F. Author-Name: Liu, H. Author-Name: Sambamoorthi, U. Author-Name: Lillard, L.A. Author-Name: Leibowitz, A.A. Author-Name: Shapiro, M.F. Author-Name: Bozzette, S.A. Year: 2001 Volume: 91 Issue: 7 Pages: 1117-1120 Abstract: Objectives. This study identified age-related differences in diagnosis and progression if HIV by analyzing a nationally representative sample of HIV-infected adults under care in the United States. Methods. We compared older (≥50 years) and younger participants stratified by race/ethnicity. Regression models controlled for demographic, therapeutic, and clinical factors. Results. Older non-Whites more often had HIV diagnosed when they were ill. Older and younger patients were clinically similar. At baseline, however, older non-Whites had fewer symptoms and were less likely to have AIDS, whereas at follow-up they had a trend toward lower survival. Conclusions. Later HIV diagnosis in non-Whites merits public health attention; clinical progression in this group requires further study. Handle: RePEc:aph:ajpbhl:2001:91:7:1117-1120_3 Template-Type: ReDIF-Article 1.0 Title: The color line: Race matters in the elimination of health disparities Journal: American Journal of Public Health Author-Name: Thomas, S.B. Year: 2001 Volume: 91 Issue: 7 Pages: 1046-1048 Handle: RePEc:aph:ajpbhl:2001:91:7:1046-1048_9 Template-Type: ReDIF-Article 1.0 Title: 2000 Presidential address: Eliminating health disparities Journal: American Journal of Public Health Author-Name: Allen, C.E. Year: 2001 Volume: 91 Issue: 7 Pages: 1142-1143 Handle: RePEc:aph:ajpbhl:2001:91:7:1142-1143_2 Template-Type: ReDIF-Article 1.0 Title: Measles elimination: A mass immunization campaign in Romania Journal: American Journal of Public Health Author-Name: Ion-Nedelcu, N. Author-Name: Craciun, D. Author-Name: Pitigoi, D. Author-Name: Popa, M. Author-Name: Hennessey, K. Author-Name: Roure, C. Author-Name: Aston, R. Author-Name: Zimmermann, G. Author-Name: Pelly, M. Author-Name: Gay, N. Author-Name: Strebel, P. Year: 2001 Volume: 91 Issue: 7 Pages: 1042-1045 Handle: RePEc:aph:ajpbhl:2001:91:7:1042-1045_3 Template-Type: ReDIF-Article 1.0 Title: Do census data reflect true female mortality? [6] (multiple letter) Journal: American Journal of Public Health Author-Name: Bartlett, E.E. Author-Name: Cohen, A. Year: 2001 Volume: 91 Issue: 7 Pages: 1140-1141 Handle: RePEc:aph:ajpbhl:2001:91:7:1140-1141_9 Template-Type: ReDIF-Article 1.0 Title: An HIV agenda for the new administration Journal: American Journal of Public Health Author-Name: Levi, J. Year: 2001 Volume: 91 Issue: 7 Pages: 1015-1016 Handle: RePEc:aph:ajpbhl:2001:91:7:1015-1016_4 Template-Type: ReDIF-Article 1.0 Title: HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: Implications for public health intervention Journal: American Journal of Public Health Author-Name: Clements-Nolle, K. Author-Name: Marx, R. Author-Name: Guzman, R. Author-Name: Katz, M. Year: 2001 Volume: 91 Issue: 6 Pages: 915-921 Abstract: Objectives. This study described HIV prevalence, risk behaviors, health care use, and mental health status of male-to-female and female-to male transgender persons and determined factors associated with HIV. Methods. We recruited transgender persons through targeted sampling, respondent-driven sampling, and agency referrals; 392 male-to-female and 123 female-to-male transgender persons were interviewed and tested for HIV. Results. HIV prevalence among male-to-female transgender persons was 35%. African American race (adjusted odds ratio [OR] = 5.81; 95% confidence interval [CI] = 2.82, 11.96), a history of injection drug use (OR - 2.69; 95% CI = 1.50, 4.62), and low education (adjusted OR = 2.08; 95% CI =1.17, 3.68) were independently associated with HIV. Among female-to-male transgender persons, HIV prevalence (2%) and risk behaviors were much lower. Most male-to-female (78%) and female-to-male (83%) transgender persons had seen a medical provider in the past 6 months. Sixty-two percent of the male-to-female and 55% of the female-to-male transgender persons were depressed; 32% of each population had attempted suicide. Conclusion. High HIV prevalence suggests an urgent need for risk reduction interventions for male-to-female transgender persons. Recent contact with medical providers was observed, suggesting that medical providers could provide an important link to needed prevention, health, and social services. Handle: RePEc:aph:ajpbhl:2001:91:6:915-921_0 Template-Type: ReDIF-Article 1.0 Title: Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women Journal: American Journal of Public Health Author-Name: Marrazzo, J.M. Author-Name: Koutsky, L.A. Author-Name: Kiviat, N.B. Author-Name: Kuypers, J.M. Author-Name: Stine, K. Year: 2001 Volume: 91 Issue: 6 Pages: 947-952 Abstract: Objectives. The purpose of this study was to examine frequency of and attitudes toward Papanicolaou (Pap) test screening in women who have sex with women (WSW) and to determine prevalence of genital human papillomavirus (HPV). Methods. Women were eligible if they reported having engaged in sex with another woman in the preceding year Medical and sexual histories were obtained. Cervical specimens for Pap tests and cervical and vaginal specimens for HPV DNA testing were collected. Results. HPV DNA was detected in 31 of 248 WSW (13%). Women who had never had sex with men were less likely to have undergone pelvic examinations and had fewer recent Pap tests, Reasons for not undergoing Pap tests included lack of insurance, previous adverse experiences, and belief that Pap tests were unnecessary. Conclusions Despite the occurrence of genital HPV, WSW do not receive adequate Pap test screening Pap test screening recommendations should not differ for WSW, regardless of sexual history with men. Handle: RePEc:aph:ajpbhl:2001:91:6:947-952_4 Template-Type: ReDIF-Article 1.0 Title: Predictors of accidental fatal drug overdose among a cohort of injection drug users Journal: American Journal of Public Health Author-Name: O'Driscoll, P.T. Author-Name: McGough, J. Author-Name: Hagan, H. Author-Name: Thiede, H. Author-Name: Critchlow, C. Author-Name: Alexander, E.R. Year: 2001 Volume: 91 Issue: 6 Pages: 984-987 Abstract: Objectives. This study evaluated factors associated with accidental fatal drug overdose among a cohort of injection drug users (IDUs). Methods. In a prospective cohort study of 2849 IDUs in King County, Washington, deaths were identified by electronically merging subject identifiers with death certificate records. Univariate and multivariate Cox regression analyses were performed to identify predictors of overdose mortality. Results. Thirty-two overdoses were observed. Independent predictors of overdose mortality were bisexual sexual orientation (relative risk [RR]=4,86; 95% confidence interval [CI]=2.30, 13.2), homelessness (RR=2.30; 95% CI=1.06, 5.01), infrequent injection of speedballs (RR=5.36; 95% CI=1.58, 18.1), daily use of powdered cocaine (RR=4.84; 95% CI=1.13, 20.8), and daily use of poppers (RR=22.0; 95% CI=1.74, 278). Conclusions. Sexual orientation, homelessness, and drug use identify IDUs who may benefit from targeted interventions. Handle: RePEc:aph:ajpbhl:2001:91:6:984-987_5 Template-Type: ReDIF-Article 1.0 Title: Hiv and sexually transmitted infection risk behaviors among men seeking sex with men on-line Journal: American Journal of Public Health Author-Name: Bull, S.S. Author-Name: McFarlane, M. Author-Name: Rietmeijer, C. Year: 2001 Volume: 91 Issue: 6 Pages: 988-989 Handle: RePEc:aph:ajpbhl:2001:91:6:988-989_5 Template-Type: ReDIF-Article 1.0 Title: Sexual orientation data collection and progress toward Healthy People 2010 Journal: American Journal of Public Health Author-Name: Sell, R.L. Author-Name: Becker, J.B. Year: 2001 Volume: 91 Issue: 6 Pages: 876-882 Abstract: Without scientifically obtained data and published reports, it is difficult to raise awareness and acquire adequate resources to address the health concerns of lesbian, gay, and bisexual Americans. The Department of Health and Human Services must recognize gaps in its information systems regarding sexual orientation data and take immediate steps to monitor and eliminate health disparities as delineated in Healthy People 2010. A paper supported by funding from the Office of the Assistant Secretary for Planning and Evaluation explores these concerns and suggests that the department (1) create work groups to examine the collection of sexual orientation data; (2) create a set of guiding principles to govern the process of selecting standard definitions and measures; (3) recognize that racial/ethnic, immigrant-status, age, socioeconomic, and geographic differences must be taken into account when standard measures of sexual orientation are selected; (4) select a minimum set of standard sexual orientation measures; and (5) develop a long-range strategic plan for the collection of sexual orientation data. Handle: RePEc:aph:ajpbhl:2001:91:6:876-882_9 Template-Type: ReDIF-Article 1.0 Title: Health-related characteristics of men who have sex with men: A comparison of those living in "gay ghettos" with those living elsewhere Journal: American Journal of Public Health Author-Name: Mills, T.C. Author-Name: Stall, R. Author-Name: Pollack, L. Author-Name: Paul, J.P. Author-Name: Binson, D. Author-Name: Canchola, J. Author-Name: Catania, J.A. Year: 2001 Volume: 91 Issue: 6 Pages: 980-983 Abstract: Objectives. This study investigated the limitations of probability samples of men who have sex with men (MSM), limited to single cities and to the areas of highest concentrations of MSM ("gay ghettos"). Methods. A probability sample of 2881 MSM in 4 American cities completed interviews by telephone. Results. MSM who resided in ghettos differed from other MSM, although in different ways in each city. Non-ghetto-dwelling MSM were less involved in the gay and lesbian community. They were also less likely to have only male sexual partners, to identify as gay, and to have been tested for HIV. Conclusions. These differences between MSM who live in gay ghettos and those who live elsewhere have clear implications for HIV prevention efforts and health care planning. Handle: RePEc:aph:ajpbhl:2001:91:6:980-983_4 Template-Type: ReDIF-Article 1.0 Title: Trans health crisis: For us it's life or death Journal: American Journal of Public Health Author-Name: Feinberg, L. Year: 2001 Volume: 91 Issue: 6 Pages: 897-900 Handle: RePEc:aph:ajpbhl:2001:91:6:897-900_9 Template-Type: ReDIF-Article 1.0 Title: Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the national comorbidity survey Journal: American Journal of Public Health Author-Name: Gilman, S.E. Author-Name: Cochran, S.D. Author-Name: Mays, V.M. Author-Name: Hughes, M. Author-Name: Ostrow, D. Author-Name: Kessler, R.C. Year: 2001 Volume: 91 Issue: 6 Pages: 933-939 Abstract: Objectives. This study examined the risk of psychiatric disorders among individuals with same-sex sexual partners. Methods. Data are from the National Comorbidity Survey, a nationally representative household survey. Respondents were asked the number of women and men with whom they had sexual intercourse in the past 5 years. Psychiatric disorders according to Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) criteria were assessed with a modified version of the Composite International Diagnostic Interview. Results. A total of 2.1% of men and 1.5% of women reported 1 or more same-sex sexual partners in the past 5 years. These respondents had higher 12-month prevalences of anxiety, mood, and substance use disorders and of suicidal thoughts and plans than did respondents with opposite-sex partners only. Decomposition showed that the elevated same-sex 12-month prevalences were largely due to higher lifetime prevalences. Ages at onset and persistence of disorders did not differ between the same-sex and opposite-sex subsamples. Conclusions. Homosexual orientation, defined as having same-sex sexual partners, is associated with a general elevation of risk for anxiety, mood, and substance use disorders and for suicidal thoughts and plans. Further research is needed to replicate and explore the causal mechanisms underlying this association. Handle: RePEc:aph:ajpbhl:2001:91:6:933-939_2 Template-Type: ReDIF-Article 1.0 Title: The GLBT health access project: A state-funded effort to improve access to care Journal: American Journal of Public Health Author-Name: Clark, M.E. Author-Name: Landers, S. Author-Name: Linde, R. Author-Name: Sperber, J. Year: 2001 Volume: 91 Issue: 6 Pages: 895-896 Handle: RePEc:aph:ajpbhl:2001:91:6:895-896_9 Template-Type: ReDIF-Article 1.0 Title: Uneasy promises: Sexuality, health, and human rights Journal: American Journal of Public Health Author-Name: Miller, A.M. Year: 2001 Volume: 91 Issue: 6 Pages: 861-864 Abstract: Although attention to the links between health and human rights is growing globally, the full potential of a progressive human rights approach to health has not yet been explored, and it is even more faintly understood in the United States than in the rest of the world. At the same time, global claims for sexual rights, particularly for those identifying as gay, lesbian, transsexual, or bisexual, are increasingly being made as human rights claims. All of these approaches to rights advocacy risk limiting their own transformative impact unless advocates critique their own strategies. Paradoxically, using health as a way to bring attention to nonheteronormative sexualities can be both helpful and potentially dangerous, especially when coupled with human rights. Recognizing sexuality as a critical element of humanity, and establishing a fundamental human right to health, can play a role in broader social justice claims, but the tendency of both public health and human rights advocacy to "normalize" and regulate must be scrutinized and challenged. Handle: RePEc:aph:ajpbhl:2001:91:6:861-864_4 Template-Type: ReDIF-Article 1.0 Title: Ethics that exclude: The role of ethics committees in lesbian and gay health research in South Africa Journal: American Journal of Public Health Author-Name: De Gruchy, J. Author-Name: Lewin, S. Year: 2001 Volume: 91 Issue: 6 Pages: 865-868 Abstract: Prevailing state and institutional ideologies regarding race/ethnicity, gender, and sexuality help to shape, and are influenced by, research priorities. Research ethics committees perform a gatekeeper role in this process In this commentary, we describe efforts to obtain approval from the ethics committee of a large medical institution for research into the treatment of homosexual persons by health professionals in the South African military during the apartheid era. The committee questioned the "scientific validity" of the study, viewing it as having a "political" rather than a "scientific" purpose. They objected to the framing of the research topic within a human rights discourse and appeared to be concerned that the research might lead to action against health professionals who committed human rights abuses against lesbians and gay men during apartheid. The process illustrates the ways in which heterosexism, and concerns to protect the practice of health professionals from scrutiny, may influence the decisions of ethics committees. Ethics that exclude research on lesbian and gay health cannot be in the public interest. Ethics committees must be challenged to examine the ways in which institutionalized ideologies influence their decision making. Handle: RePEc:aph:ajpbhl:2001:91:6:865-868_1 Template-Type: ReDIF-Article 1.0 Title: The continuing HIV epidemic among men who have sex with men Journal: American Journal of Public Health Author-Name: Catania, J.A. Author-Name: Osmond, D. Author-Name: Stall, R.D. Author-Name: Pollack, L. Author-Name: Paul, J.P. Author-Name: Blower, S. Author-Name: Binson, D. Author-Name: Canchola, J.A. Author-Name: Mills, T.C. Author-Name: Fisher, L. Author-Name: Choi, K.-H. Author-Name: Porco, T. Author-Name: Turner, C. Author-Name: Blair, J. Author-Name: Henne, J. Author-Name: Bye, L.L. Author-Name: Coates, T.J. Year: 2001 Volume: 91 Issue: 6 Pages: 907-914 Abstract: Objective. This study characterized the AIDS epidemic among urban men who have sex with men (MSM). Methods. A probability sample of MSM was obtained in 1997 (n=2881; 18 years and older) from New York, Los Angeles, Chicago, and San Francisco, and HIV status was determined through self-report and biological measures. Results. HIV prevalence was 17% (95% confidence interval = 15%, 19%) overall, with extremely high levels in African Americans (29%), MSM who used injection drugs (40%), "ultraheavy" noninjection drug users (37%), and less educated men (.001). In 83 metropolitan areas with HIV prevalence of less than 20%, anti-OTC laws were associated with HIV incidence rates of 1% or greater (pseudo-P>.001 ). Population proportions of injection drug users did not vary by presence of anti-OTC laws. Conclusions. Anti-OTC laws are not associated with lower population proportions of injection drug users. Laws restricting syringe access are associated with HIV transmission and should be re pealed. Handle: RePEc:aph:ajpbhl:2001:91:5:791-793_0 Template-Type: ReDIF-Article 1.0 Title: Use of antiretroviral therapies among HIV-infected men who have sex with men: A household-based sample of 4 major American Cities Journal: American Journal of Public Health Author-Name: Stall, R. Author-Name: Pollack, L. Author-Name: Mills, T.C. Author-Name: Martin, J.N. Author-Name: Osmond, D. Author-Name: Paul, J. Author-Name: Binson, D. Author-Name: Coates, T.J. Author-Name: Catania, J.A. Year: 2001 Volume: 91 Issue: 5 Pages: 767-773 Abstract: Objectives: This study sought to determine the prevalence and determinants of use of recommended antiretroviral regimens among urban seropositive men who have sex with men (MSM). Methods: A probability telephone sample of MSM was taken within regions of Chicago, Los Angetes, New York, and San Francisco. Analysis focused on use of antiretroviral therapies. Results: Although the majority of seropositive MSM with CD4 counts below 500 per microliter were using recommended antiretroviral regimens, 26% of seropositive MSM were not receiving such care. Men who were younger, who reported a sexual orientation other than homosexual, who had a more recent interview date, who were at middle levels of affiliation with the gay community, and who reported higher levels of perceived exclusivity on the part of the gay community were less likely to be using recommended antiretroviral regimens. Conclusions: Although current efforts to make antiretroviral therapies available to HIV-seropositive MSM are reasonably effective, additional efforts are needed for MSM characterized by relative youth and lower social support. Handle: RePEc:aph:ajpbhl:2001:91:5:767-773_8 Template-Type: ReDIF-Article 1.0 Title: The association of school environments with youth physical activity Journal: American Journal of Public Health Author-Name: Sallis, J.F. Author-Name: Conway, T.L. Author-Name: Prochaska, J.J. Author-Name: McKenzie, T.L. Author-Name: Marshall, S.J. Author-Name: Brown, M. Year: 2001 Volume: 91 Issue: 4 Pages: 618-620 Abstract: Objectives. This study assessed the association of school environmental characteristics with student physical activity on campus. Methods. Physical activity areas (n = 137) at 24 public middle schools were assessed for area type, size, and improvements (e.g., basketball courts). Student physical activity and the presence of equipment and supervision were directly observed before school, after lunch, and after school. Results. Environmental characteristics explained 42% of the variance in the proportion of girls who were physically active and 59% of the variance for boys. Conclusions. School environments with high levels of supervision and improvements stimulated girls and boys to be more physically active. Handle: RePEc:aph:ajpbhl:2001:91:4:618-620_4 Template-Type: ReDIF-Article 1.0 Title: Maturational timing and overweight prevalence in US adolescent girls Journal: American Journal of Public Health Author-Name: Adair, L.S. Author-Name: Gordon-Larsen, P. Year: 2001 Volume: 91 Issue: 4 Pages: 642-644 Abstract: Objectives. This study examined the relation of age at menarche to overweight in US adolescent girls. Methods. Effects of age at menarche and race/ethnicity on overweight were estimated via logistic regression, after adjustment for sociodemographic characteristics, in a sample of 6507 Hispanic, Black, White, and Asian American girls who participated in wave 2 of the National Longitudinal Study of Adolescent Health. Results. Overweight prevalence rates were significantly higher in early maturing adolescents of all racial/ethnic groups but highest (57.5%) among early maturing Black girls. Early maturation nearly doubled the odds of being overweight (body mass index at or above the 85th percentile). Conclusions. Greater public health attention should be focused on the high prevalence of overweight, particularly among minority female adolescents. Handle: RePEc:aph:ajpbhl:2001:91:4:642-644_3 Template-Type: ReDIF-Article 1.0 Title: Environmental exposures and childhood cancer: Our best may not be good enough Journal: American Journal of Public Health Author-Name: Savitz, D.A. Year: 2001 Volume: 91 Issue: 4 Pages: 562-563 Handle: RePEc:aph:ajpbhl:2001:91:4:562-563_1 Template-Type: ReDIF-Article 1.0 Title: Emergency department screening for domestic violence [1] (multiple letters) Journal: American Journal of Public Health Author-Name: Johnson, R.M. Author-Name: Larkin, G.L. Year: 2001 Volume: 91 Issue: 4 Pages: 651-652 Handle: RePEc:aph:ajpbhl:2001:91:4:651-652_9 Template-Type: ReDIF-Article 1.0 Title: Strange bedfellows: The history of collaboration between the Massachusetts Restaurant Association and the tobacco industry Journal: American Journal of Public Health Author-Name: Ritch, W.A. Author-Name: Begay, M.E. Year: 2001 Volume: 91 Issue: 4 Pages: 598-603 Abstract: Objectives. This article examines the historical relationship between the tobacco industry and the Massachusetts Restaurant Association, a nonprofit trade association aligned with the food and beverage industry. Methods. The study analyzed data from Web-based tobacco industry documents, public relations materials, news articles, testimony from public hearings, requests for injunctions, court decisions, economic impact studies, handbooks, and private correspondence. Results. Tobacco industry documents that became public after various state lawsuits reveal that a long history of collaboration exists between the Massachusetts Restaurant Association and the tobacco industry. For more than 20 years, their joint efforts have focused primarily on the battle to defeat state and local laws that would restrict smoking in public places, particularly in beverage and food service establishments. The resources of the tobacco industry, combined with the association's grassroots mobilization of its membership, have fueled their opposition to many state and local smoke-free restaurant, bar, and workplace laws in Massachusetts. Conclusions: The universal opposition of the Massachusetts Restaurant Association to smoking bans in food and beverage establishments is a reflection of its historic relationship with the tobacco industry. Handle: RePEc:aph:ajpbhl:2001:91:4:598-603_1 Template-Type: ReDIF-Article 1.0 Title: Effects of air pollution on blood pressure: A population-based approach Journal: American Journal of Public Health Author-Name: Ibald-Mulli, A. Author-Name: Stieber, J. Author-Name: Wichmann, H.-E. Author-Name: Koenig, W. Author-Name: Peters, A. Year: 2001 Volume: 91 Issue: 4 Pages: 571-577 Abstract: Objectives. This analysis assessed the association between blood pressure, meteorology, and air pollution in a random population sample. Methods. Blood pressure measurements of 2607 men and women aged 25 to 64 years who participated in the Augsburg Monitoring of Trends and Determinants in Cardiovascular Disease survey were analyzed in association with 24-hour mean concentrations of air pollutants. Results. During the air pollution episode in Europe in January 1985, an association between blood pressure and air pollution was observed, which disappeared after adjustment for meteorology. Continuous concentrations of total suspended particulates and sulfur dioxide were associated with an increase in systolic blood pressure of 1.79 mm Hg (95% confidence interval [CI] = 0.63, 2.95) per 90 μg/m3 total suspended particulates and 0.74 mm Hg (95% CI=0.08, 1.40) per 80 μg/m3 sulfur dioxide. In subgroups with high plasma viscosity levels and increased heart rates, systolic blood pressure increased by 6.93 mm Hg (95% CI= 4.31, 9.75) and 7.76 mm Hg (95% CI= 5.70, 9.82) in association with total suspended particulates. Conclusions. The observed increase in systolic blood pressure associated with ambient air pollution could be related to a change in cardiovascular autonomic control. Handle: RePEc:aph:ajpbhl:2001:91:4:571-577_1 Template-Type: ReDIF-Article 1.0 Title: Household solvent exposures and childhood acute lymphoblastic leukemia Journal: American Journal of Public Health Author-Name: Freedman, D.M. Author-Name: Stewart, P. Author-Name: Kleinerman, R.A. Author-Name: Wacholder, S. Author-Name: Hatch, E.E. Author-Name: Tarone, R.E. Author-Name: Robison, L.L. Author-Name: Linet, M.S. Year: 2001 Volume: 91 Issue: 4 Pages: 564-567 Abstract: Objectives. This study explored the risk of childhood acute lymphoblastic leukemia (ALL) associated with participation by household members in hobbies or other home projects involving organic solvents. Methods. Participants in this case-control study were 640 subjects with ALL and 640 matched controls. Results. Childhood ALL was associated with frequent (>4 times/month) exposure to model building (odds ratio [OR]= 1.9; 95% confidence interval [95% CI] =0.7, 5.8) and artwork using solvents (OR=4.1; 95% CI= 1.1, 15.1). We also found elevated risk (OR = 1.7; 95% CI= 1.1, 2.7) among children whose mothers lived in homes painted extensively (>4 rooms) in the year before the children's birth. Conclusions. In this exploratory study, substantial participation by household members in some common household activities that involve organic solvents was associated with elevated risks of childhood ALL. Handle: RePEc:aph:ajpbhl:2001:91:4:564-567_8 Template-Type: ReDIF-Article 1.0 Title: HIV infection in parents of youths with behaviorally acquired HIV Journal: American Journal of Public Health Author-Name: Chabon, B. Author-Name: Futterman, D. Author-Name: Hoffman, N.D. Year: 2001 Volume: 91 Issue: 4 Pages: 649-650 Handle: RePEc:aph:ajpbhl:2001:91:4:649-650_2 Template-Type: ReDIF-Article 1.0 Title: Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women Journal: American Journal of Public Health Author-Name: Cochran, S.D. Author-Name: Mays, V.M. Author-Name: Bowen, D. Author-Name: Gage, S. Author-Name: Bybee, D. Author-Name: Roberts, S.J. Author-Name: Goldstein, R.S. Author-Name: Robison, A. Author-Name: Rankow, E.J. Author-Name: White, J. Year: 2001 Volume: 91 Issue: 4 Pages: 591-597 Abstract: Objectives. This study examined whether lesbians are at increased risk for certain cancers as a result of an accumulation of behavioral risk factors and difficulties in accessing health care. Methods. Prevalence estimates of behavioral risk factors (nulliparity, obesity, smoking, and alcohol use), cancer screening behaviors, and self-reported breast cancer histories derived from 7 independently conducted surveys of lesbians/bisexual women (n = 11 876) were compared with national estimates for women. Results. In comparison with adjusted estimates for the US female population, lesbians/bisexual women exhibited greater prevalence rates of obesity, alcohol use, and tobacco use and lower rates of parity and birth control pill use. These women were also less likely to have health insurance coverage or to have had a recent pelvic examination or mammogram. Self-reported histories of breast cancer, however, did not differ from adjusted US female population estimates. Conclusions. Lesbians and bisexual women differ from heterosexual women in patterns of health risk. These women would be expected to be at especially greater risk for chronic diseases linked to smoking and obesity. Handle: RePEc:aph:ajpbhl:2001:91:4:591-597_4 Template-Type: ReDIF-Article 1.0 Title: Environmental health training of promotoras in colonias along the Texas-Mexico border Journal: American Journal of Public Health Author-Name: Ramos, I.N. Author-Name: May, M. Author-Name: Ramos, K.S. Year: 2001 Volume: 91 Issue: 4 Pages: 568-570 Handle: RePEc:aph:ajpbhl:2001:91:4:568-570_7 Template-Type: ReDIF-Article 1.0 Title: Promoting breast and cervical cancer screening at the workplace: Results from the woman to woman study Journal: American Journal of Public Health Author-Name: Allen, J.D. Author-Name: Stoddard, A.M. Author-Name: Mays, J. Author-Name: Sorensen, G. Year: 2001 Volume: 91 Issue: 4 Pages: 584-590 Abstract: Objectives. This article reports findings from a peer-delivered intervention designed to increase use of breast and cervical cancer screening. Methods. Twenty-six worksites were randomly assigned to the intervention or comparison group. The 16-month intervention consisted of group discussions, outreach, and educational campaigns. Data were collected from a random sample of women employees stratified by age (baseline n=2943; final n=2747). Cross-sectional analyses were conducted to evaluate the impact of the intervention on screening behaviors. Results. Relative to comparison worksites, the intervention group experienced greater increases in the percentage of women who reported a recent mammogram (7.2% vs 5.6%), clinical breast examination (5.8% vs 2.1%), and Papanicolaou (Pap) test (4.7% vs 1.9%). After worksite cluster and age strata were controlled for, the observed increase in Pap tests was significantly greater in the intervention group (odds ratio [OR]=1.28; 95% confidence interval [CI]=1.01, 1.62); however, differences in mammography screening rates (OR=1.14; 95% CI=0.90, 1.44) and clinical breast examination (OR=1.19; 95% CI=0.96, 1.49) were not statistically significant. Conclusions. Intervention activities produced a modest increase in cervical cancer screening, but they did not accelerate breast cancer screening rates above the observed secular trend. Handle: RePEc:aph:ajpbhl:2001:91:4:584-590_9 Template-Type: ReDIF-Article 1.0 Title: The influence of a family program on adolescent tobacco and alcohol use Journal: American Journal of Public Health Author-Name: Bauman, K.E. Author-Name: Foshee, V.A. Author-Name: Ennett, S.T. Author-Name: Pemberton, M. Author-Name: Hicks, K.A. Author-Name: King, T.S. Author-Name: Koch, G.G. Year: 2001 Volume: 91 Issue: 4 Pages: 604-610 Abstract: Objectives. This study examined a family-directed program's effectiveness in preventing adolescent tobacco and alcohol use in a general population. Methods. Adolescents aged 12 to 14 years and their families were identified by random-digit dialing throughout the contiguous United States. After providing baseline data by telephone interviews, they were randomly allocated to receive or not receive a family-directed program featuring mailed booklets and telephone contacts by health educators. Follow-up telephone interviews were conducted 3 and 12 months after program completion. Results. The findings suggested that smoking onset was reduced by 16.4% at 1 year, with a 25.0% reduction for non-Hispanic Whites but no statistically significant program effect for other races/ethnicities. There were no statistically significant program effects for smokeless tobacco or alcohol use onset. Conclusions. The family-directed program was associated with reduced smoking onset for non-Hispanic Whites, suggesting that it is worthy of further application, development, and evaluation. Handle: RePEc:aph:ajpbhl:2001:91:4:604-610_4 Template-Type: ReDIF-Article 1.0 Title: Elective amniocentesis in low-risk pregnancies: Decision making in the era of information and uncertainty Journal: American Journal of Public Health Author-Name: Lesser, Y. Author-Name: Rabinowitz, J. Year: 2001 Volume: 91 Issue: 4 Pages: 639-641 Abstract: Objectives. Rational choice theory was applied to explain women's use of amniocentesis. Variables included knowledge about prenatal diagnostics, attitudes, and emotional preferences. Methods. Using structured instruments at 9 to 14 and at 29 to 34 weeks' gestation, we interviewed 232 Israeli women who had low-risk pregnancies. Results. Women who had elective amniocentesis (n=39) were more knowledgeable about prenatal diagnostics, risks of invasive procedures, and probability of fetal abnormality in high maternal age; had fewer children; and had less favorable attitudes toward parenthood than those who had medically indicated amniocentesis (n=57) and those who did not have amniocentesis (n=136). Conclusions. The use and possible overuse of amniocentesis were associated with having more information about prenatal diagnostics and definite emotional preferences. Handle: RePEc:aph:ajpbhl:2001:91:4:639-641_6 Template-Type: ReDIF-Article 1.0 Title: Donora, Pennsylvania: An environmental disaster of the 20th century Journal: American Journal of Public Health Author-Name: Helfand, W.H. Author-Name: Lazarus, J. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 4 Pages: 553 Handle: RePEc:aph:ajpbhl:2001:91:4:553_1 Template-Type: ReDIF-Article 1.0 Title: The effectiveness of housing policies in reducing children's lead exposure Journal: American Journal of Public Health Author-Name: Brown, M.J. Author-Name: Gardner, J. Author-Name: Sargent, J.D. Author-Name: Swartz, K. Author-Name: Hu, H. Author-Name: Timperi, R. Year: 2001 Volume: 91 Issue: 4 Pages: 621-624 Abstract: Objectives. This study evaluated the relation of housing policies to risk of subsequent lead exposure in addresses where lead-poisoned children had lived. Methods. Addresses where children with lead poisoning lived between May 1992 and April 1993 were selected from lead screening registries in 2 northeastern states differing in their enforcement of lead poisoning prevention statutes. Blood lead levels of subsequently resident children, exterior condition, tax value, age, and census tract characteristics were collected. The odds of elevated blood lead levels in subsequently resident children were calculated with logistic regression. Results. The risk of identifying 1 or more children with blood lead levels of 10 μg/dL or greater was 4 times higher in addresses with limited enforcement. Controlling for major confounders had little effect on the estimate. Conclusions. Enforcement of housing policies interrupts the cycle of repeated lead exposure. Handle: RePEc:aph:ajpbhl:2001:91:4:621-624_8 Template-Type: ReDIF-Article 1.0 Title: Physical activity and mortality: A prospective study among women Journal: American Journal of Public Health Author-Name: Rockhill, B. Author-Name: Willett, W.C. Author-Name: Manson, J.E. Author-Name: Leitzmann, M.F. Author-Name: Stampfer, M.J. Author-Name: Hunter, D.J. Author-Name: Colditz, G.A. Year: 2001 Volume: 91 Issue: 4 Pages: 578-583 Abstract: Objectives. This study examined the association between recreational physical activity and mortality in middle-aged and older women and the possibility that physical activity serves as an important marker of health. Methods. Analyses were conducted among participants in the Nurses' Health Study. Levels of physical activity were assessed by questionnaire in 1980 and updated every 2 to 4 years. Results. Levels of physical activity were inversely associated with mortality risk; however, each activity level above the reference level had approximately the same level of risk reduction (20%-30%). The inverse association was stronger for cardiovascular deaths than for cancer deaths and was strongest for respiratory deaths. Women who died of noncardiovascular, noncancer causes were more likely to have reported that poor health limited their physical activity than were women who died of other causes or who remained alive. Conclusions. Part of the link between physical activity and mortality risk is probably spurious and difficult to remove analytically; however, on the basis of epidemiologic evidence, much of the health benefit of activity is real. Handle: RePEc:aph:ajpbhl:2001:91:4:578-583_6 Template-Type: ReDIF-Article 1.0 Title: Earth day plus 30 years: Public concern and support for environmental health Journal: American Journal of Public Health Author-Name: Greenberg, M. Year: 2001 Volume: 91 Issue: 4 Pages: 559-562 Abstract: A clear majority of Americans are concerned about environmental threats to public health and do not want to weaken antipollution regulations. The strongest supporters for maintaining environmental regulations are affluent mainstream White suburban populations who are thriving economically, but support is also strong in every other major segment of the population. Overt attempts to weaken the basic regulations are unlikely, barring an obvious economic downturn that would cause a large proportion of the public to consider loosening standards in the belief that such changes would increase the number of available jobs. Given this context, environmental health was and will continue to be a core topic in the Journal. We will emphasize the nexus of environmental health and policy by publishing research, exemplary public health practice, and the views of key decision makers. Handle: RePEc:aph:ajpbhl:2001:91:4:559-562_5 Template-Type: ReDIF-Article 1.0 Title: Discovering unrecognized lead-smelting sites by historical methods Journal: American Journal of Public Health Author-Name: Eckel, W.P. Author-Name: Rabinowitz, M.B. Author-Name: Foster, G.D. Year: 2001 Volume: 91 Issue: 4 Pages: 625-627 Abstract: Objectives. Our objective was to enumerate unrecognized former lead smelters in the United States. Methods. Defunct smelters were identified by historical research. The compiled list was compared with government registries of hazardous sites. Soil samples were taken from 10 sites. Results. Approximately 430 sites were unknown to the federal authorities. Only 5 of 319 sites were known to authorities in the top 8 states. Nine of the 10 sites sampled exceeded residential standards for soil lead level. Conclusions. Approximately 430 former lead-smelting sites were unrecognized in the United States. Sampling results indicate that the sites may pose a threat to public health. Handle: RePEc:aph:ajpbhl:2001:91:4:625-627_9 Template-Type: ReDIF-Article 1.0 Title: Risk of infection from needle reuse at a phlebotomy center Journal: American Journal of Public Health Author-Name: Porco, T.C. Author-Name: Aragón, T.J. Author-Name: Fernyak, S.E. Author-Name: Cody, S.H. Author-Name: Vugia, D.J. Author-Name: Katz, M.H. Author-Name: Bangsberg, D.R. Year: 2001 Volume: 91 Issue: 4 Pages: 636-638 Abstract: Objectives. This study determined infection risk for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) from needle reuse at a phlebotomy center that possibly exposed 3810 patients to infection. Methods. We used a model for the risk of infection per blood draw, supplemented by subsequent testing results from 1699 patients. Results. The highest risk of transmission was for HBV infection: 1.1 × 10-6 in the best case and 1.2 × 10-3 in the (unlikely) worst case. Subsequent testing yielded prevalence rates of 0.12%, 0.41%, and 0.88% for HIV, HBV, and HCV, respectively, lower than National Health and Nutrition Examination Survey III prevalence estimates. Conclusions. The infection risk was very low; few, if any, transmissions are likely to have occurred. Handle: RePEc:aph:ajpbhl:2001:91:4:636-638_3 Template-Type: ReDIF-Article 1.0 Title: Processes for obtaining nonmedical exemptions to state immunization laws Journal: American Journal of Public Health Author-Name: Rota, J.S. Author-Name: Salmon, D.A. Author-Name: Rodewald, L.E. Author-Name: Chen, R.T. Author-Name: Hibbs, B.F. Author-Name: Gangarosa, E.J. Year: 2001 Volume: 91 Issue: 4 Pages: 645-648 Abstract: Objectives. This study sought to determine the specific processes required for obtaining religious and philosophical exemptions to school immunization laws. Methods. State health department immunization program managers in the 48 states that offer nonmedical exemptions were surveyed. Categories were assigned to reflect the complexity of the procedure within a state for obtaining an exemption. Results. Sixteen of the states delegated sole authority for processing exemptions to school officials. Nine states had written policies informing parents who seek an exemption of the risks of not immunizing. The complexity of the exemption process, in terms of paperwork or effort required, was inversely associated with the proportion of exemptions filed. Conclusions. In many states, the process of claiming a nonmedical exemption requires less effort than fulfilling immunization requirements. Handle: RePEc:aph:ajpbhl:2001:91:4:645-648_6 Template-Type: ReDIF-Article 1.0 Title: Who's afraid of the truth? Journal: American Journal of Public Health Author-Name: Healton, C. Year: 2001 Volume: 91 Issue: 4 Pages: 554-558 Abstract: The November 1998 Master Settlement Agreement between tobacco manufacturers and state attorneys general significantly restricted the marketing of tobacco products, made possible markedly expanded tobacco control programs in the states, and provided for the creation of a new foundation whose primary purpose is to combat tobacco use in the United States. This commentary describes the American Legacy Foundation, with particular emphasis on one of its efforts - the "truth" Campaign, a counter-marketing effort to reduce smoking among youths. The "truth" Campaign has been well received by the public and has been effective in reducing smoking among youths. The only negative reaction to the campaign has been, predictably, from the tobacco industry. Handle: RePEc:aph:ajpbhl:2001:91:4:554-558_0 Template-Type: ReDIF-Article 1.0 Title: Privatization and the scope of public health: A national survey of local health department directors Journal: American Journal of Public Health Author-Name: Keane, C. Author-Name: Marx, J. Author-Name: Ricci, E. Year: 2001 Volume: 91 Issue: 4 Pages: 611-617 Abstract: Objectives. This study sought to obtain and analyze nationally representative data on (1) privatization of local health department services. (2) local health department directors' beliefs and perspectives on the desirable role and focus of health departments, and (3) the influence of these views on privatization practices. Methods. A stratified representative national sample of 380 local health department directors was drawn, and 347 directors were interviewed by telephone. Logistic regression established the independent effects of various factors on decisions to privatize. Results. Almost three quarters (73%) of the local health departments privatized public health services of some type. The 12% of the directors who believed that local health departments should be restricted to the core public health functions and move entirely out of direct provision of personal health care were more likely to privatize services. The 77% of the directors who believed that local health departments should be involved in an increasing array of social problems were more likely to privatize. Conclusions. Privatization has quietly and quickly become commonplace in public health, and privatization practices are intimately related to divergent conceptions of public health and the role of local health departments. Handle: RePEc:aph:ajpbhl:2001:91:4:611-617_4 Template-Type: ReDIF-Article 1.0 Title: Using aggregate geographic data to proxy individual socioeconomic status: Does size matter? Journal: American Journal of Public Health Author-Name: Soobader, M.-J. Author-Name: LeClere, F.B. Author-Name: Hadden, W. Author-Name: Maury, B. Year: 2001 Volume: 91 Issue: 4 Pages: 632-636 Abstract: Objectives. This study assessed whether aggregate-level measures of socioeconomic status (SES) are less biased as proxies for individual-level measures if the unit of geographic aggregation is small in size and population. Methods. National Health Interview Survey and census data were used to replicate analyses that identified the degree to which aggregate proxies of individual SES bias interpretations of the effects of SES on health. Results. Ordinary least squares regressions on self-perceived health showed that the coefficients for income and education measured at the tract and block group levels were larger than those at the individual level but smaller than those estimated by Geronimus et al. at the zip code level. Conclusions. Researchers should be cautious about use of proxy measurement of individual SES even if proxies are calculated from small geographic units. Handle: RePEc:aph:ajpbhl:2001:91:4:632-636_9 Template-Type: ReDIF-Article 1.0 Title: Sexual behavior and condom use among patients with sexually transmitted disease in Jinan, China Journal: American Journal of Public Health Author-Name: Wang, J. Author-Name: Jiang, B. Author-Name: Siegal, H. Author-Name: Falck, R. Author-Name: Carlson, R. Year: 2001 Volume: 91 Issue: 4 Pages: 650-651 Handle: RePEc:aph:ajpbhl:2001:91:4:650-651_3 Template-Type: ReDIF-Article 1.0 Title: Minding the world's health: World Health Day 2001 Journal: American Journal of Public Health Author-Name: Neugebauer, R. Year: 2001 Volume: 91 Issue: 4 Pages: 551-552 Handle: RePEc:aph:ajpbhl:2001:91:4:551-552_2 Template-Type: ReDIF-Article 1.0 Title: Further thoughts on burden of disease methods in Pakistan [2] (mutiple letters) Journal: American Journal of Public Health Author-Name: Nanan, D. Author-Name: White, F. Author-Name: Hyder, A.A. Author-Name: Morrow, R.H. Year: 2001 Volume: 91 Issue: 4 Pages: 652-653 Handle: RePEc:aph:ajpbhl:2001:91:4:652-653_9 Template-Type: ReDIF-Article 1.0 Title: Crash and injury reduction following installation of roundabouts in the United States Journal: American Journal of Public Health Author-Name: Retting, R.A. Author-Name: Persaud, B.N. Author-Name: Garder, P.E. Author-Name: Lord, D. Year: 2001 Volume: 91 Issue: 4 Pages: 628-631 Abstract: Objectives. This study estimated potential reductions in motor vehicle crashes and injuries associated with the use of roundabouts as an alternative to signal and stop sign control at intersections in the United States. Methods. An empiric Bayes procedure was used to estimate changes in motor vehicle crashes following conversion of 24 intersections from stop sign and traffic signal control to modern roundabouts. Results. There were highly significant reductions of 38% for all crash severities combined and of 76% for all injury crashes. Reductions in the numbers of fatal and incapacitating injury crashes were estimated at about 90%. Conclusions. Results are consistent with numerous international studies and suggest that roundabout installation should be strongly promoted as an effective safety treatment. Handle: RePEc:aph:ajpbhl:2001:91:4:628-631_1 Template-Type: ReDIF-Article 1.0 Title: The essential tension between absolute and relative causality Journal: American Journal of Public Health Author-Name: Morabia, A. Year: 2001 Volume: 91 Issue: 3 Pages: 355-357 Handle: RePEc:aph:ajpbhl:2001:91:3:355-357_1 Template-Type: ReDIF-Article 1.0 Title: Can legislation prevent debauchery? Mother Gin and public health in 18th-century England Journal: American Journal of Public Health Author-Name: Warner, J. Author-Name: Her, M. Author-Name: Gmel, G. Author-Name: Rehm, J. Year: 2001 Volume: 91 Issue: 3 Pages: 375-384 Abstract: The "gin epidemic" of 1720 to 1751 in England was the first time that government intervened in a systematic fashion to regulate and control sales of alcohol. The epidemic therefore provides an opportunity to gauge the effects of multiple legislative interventions over time. Toward that end, we employed time series analysis in conjunction with qualitative methodologies to test the interplay of multiple independent variables, including real wages and taxes, on the consumption of distilled spirits from 1700 through 1771. The results showed that each of the 3 major gin acts was successful in the short term only, consistent with the state's limited resources for enforcement at the local level, and that in each instance consumption actually increased shortly thereafter. This was true even of the Gin Act of 1751, which, contrary to the assumptions of contemporaries and many historians, succeeded by accident rather than by design. The results also suggest that the epidemic followed the inverse U-shaped trajectory of more recent drug scares and that consumption declined only after the more deleterious effects of distilled spirits had been experienced by large numbers of people. Handle: RePEc:aph:ajpbhl:2001:91:3:375-384_0 Template-Type: ReDIF-Article 1.0 Title: Trends in infectious disease hospitalizations among American Indians and Alaska Natives Journal: American Journal of Public Health Author-Name: Holman, R.C. Author-Name: Curns, A.T. Author-Name: Kaufman, S.F. Author-Name: Cheek, J.E. Author-Name: Pinner, R.W. Author-Name: Schonberger, L.B. Year: 2001 Volume: 91 Issue: 3 Pages: 425-431 Abstract: Objectives. This study sought to describe trends in hospitalizations associated with infectious diseases among American Indians and Alaska Natives. Methods. Infectious disease hospitalizations and rates among American Indians and Alaska Natives from 1980 through 1994 were examined via Indian Health Service hospital discharge data and compared with published trends for the general US population. Results. Annual hospitalization rates for infectious diseases among American Indians and Alaska Natives decreased by 31.0% between 1980 and 1994. Infectious disease hospitalizations accounted for 16.3% of all hospitalizations in 1980 and 21.2% in 1994, an increase of 30.1%. In 1994, the age-adjusted infectious disease hospitalization rate for American Indians and Alaska Natives was 1863 per 100 000 population, approximately 21% greater than that for the general US population. Conclusions. Hospitalization trends for infectious diseases show that there has been improvement in the health status of American Indians and Alaska Natives but also indicate that this population has a higher infectious disease burden than the general US population. Handle: RePEc:aph:ajpbhl:2001:91:3:425-431_8 Template-Type: ReDIF-Article 1.0 Title: A comparison of knowledge and attitudes about diet and health among 35- to 75-year-old adults in the United States and Geneva, Switzerland Journal: American Journal of Public Health Author-Name: Girois, S.B. Author-Name: Kumanyika, S.K. Author-Name: Morabia, A. Author-Name: Mauger, E. Year: 2001 Volume: 91 Issue: 3 Pages: 418-424 Abstract: Objectives. This study compared responses of US and Geneva residents to items on analogous questionnaires concerning knowledge and attitudes about diet and health. Methods. Comparable data were available from 2 population-based sample surveys: the Cancer Control Supplement of the 1987 National Health Interview Survey and the 1994 Bus Santé 2000 in Geneva, Switzerland. Samples included 10366 US respondents and 698 Geneva respondents, aged 35 to 74 years. The analysis involved descriptive statistics, contingency tables, and linear regression models. Results. In both the United States and Geneva, health consciousness was greater among women and more highly educated persons than among other groups. Compared with Americans, Genevans assigned more importance to avoiding salt, sugar, and overweight (odds ratio=1.6, 2.9, and 5.9, respectively) and less importance to lowering cholesterol (odds ratio=0.6). Genevans were more likely to recognize the relatively high fiber content of lettuce, carrots, and apples. Recognition of low-fat foods was slightly better in the United States. Conclusions. Knowledge and attitudes differed despite high general diet and health awareness in both populations. Identifying why generally similar dietary guidance messages are embraced to different extents across cultures may facilitate global implementation. Handle: RePEc:aph:ajpbhl:2001:91:3:418-424_7 Template-Type: ReDIF-Article 1.0 Title: Political competencies and public health leadership [7] Journal: American Journal of Public Health Author-Name: Freudenberg, N. Author-Name: Kotelchuck, D. Year: 2001 Volume: 91 Issue: 3 Pages: 468 Handle: RePEc:aph:ajpbhl:2001:91:3:468_2 Template-Type: ReDIF-Article 1.0 Title: Cancer culture: Epidemics, human behavior, and the dubious search for new risk factors Journal: American Journal of Public Health Author-Name: Colditz, G.A. Year: 2001 Volume: 91 Issue: 3 Pages: 357-359 Handle: RePEc:aph:ajpbhl:2001:91:3:357-359_4 Template-Type: ReDIF-Article 1.0 Title: Public health is already a profession [2] Journal: American Journal of Public Health Author-Name: Cohen, A. Year: 2001 Volume: 91 Issue: 3 Pages: 465-466 Handle: RePEc:aph:ajpbhl:2001:91:3:465-466_7 Template-Type: ReDIF-Article 1.0 Title: Efficacy of a preventive intervention for youths living with HIV Journal: American Journal of Public Health Author-Name: Rotheram-Borus, M.J. Author-Name: Lee, M.B. Author-Name: Murphy, D.A. Author-Name: Futterman, D. Author-Name: Duan, N. Author-Name: Birnbaum, J.M. Author-Name: Lightfoot, M. Year: 2001 Volume: 91 Issue: 3 Pages: 400-405 Abstract: Objectives. HIV transmission behaviors and health practices of HIV-infected youths were examined over a period of 15 months after they received a preventive intervention. Methods. HIV-infected youths aged 13 to 24 years (n=310; 27% African American, 37% Latino) were assigned by small cohort to (1) a 2-module ("Stay Healthy" and "Act Safe") intervention totaling 23 sessions or (2) a control condition. Among those in the intervention condition, 73% attended at least 1 session. Results. Subsequent to the "Stay Healthy" module, number of positive lifestyle changes and active coping styles increased more often among females who attended the intervention condition than among those in the control condition. Social support coping also increased significantly among males and females attending the intervention condition compared with those attending the control condition. Following the "Act Safe" module, youths who attended the intervention condition reported 82% fewer unprotected sexual acts, 45% fewer sexual partners, 50% fewer HIV-negative sexual partners, and 31% less substance use, on a weighted index, than those in the control condition. Conclusions. Prevention programs can effectively reduce risk acts among HIV-infected youths. Alternative formats need to be identified for delivering interventions (e.g., telephone groups, individual sessions). Handle: RePEc:aph:ajpbhl:2001:91:3:400-405_2 Template-Type: ReDIF-Article 1.0 Title: Sudden infant death syndrome, maternal smoking during pregnancy, and the cost-effectiveness of smoking cessation intervention Journal: American Journal of Public Health Author-Name: Pollack, H.A. Year: 2001 Volume: 91 Issue: 3 Pages: 432-436 Abstract: Objectives. This study analyzed the relationship between prenatal maternal smoking and sudden infant death syndrome (SIDS) and examined the cost-effectiveness of smoking cessation interventions. Methods. All recorded US singleton SIDS deaths from the 1995 birth cohort with birthweight exceeding 500 g were investigated. Infants with available maternal smoking data were matched with controls who survived to 1 year. Conditional logistic regression was used to estimate SIDS risks and accompanying cost-effectiveness. Results. A total of 23.6% of singleton SIDS deaths appear to be attributable to prenatal maternal smoking. Typical cessation services available to all pregnant smokers could avert 108 SIDS deaths annually, at an estimated cost of $210 500 per life saved. Conclusions. Typical prenatal smoking cessation programs are highly cost-effective but have limited impact on the population incidence of SIDS. Handle: RePEc:aph:ajpbhl:2001:91:3:432-436_2 Template-Type: ReDIF-Article 1.0 Title: Dieting and smoking initiation in early adolescent girls and boys: A prospective study Journal: American Journal of Public Health Author-Name: Austin, S.B. Author-Name: Gortmaker, S.L. Year: 2001 Volume: 91 Issue: 3 Pages: 446-450 Abstract: Objectives. This analysis tested the relation between dieting frequency and risk of smoking initiation in a longitudinal sample of adolescents. Methods. From 1995 to 1997, 1295 middle school girls and boys participated in a nutrition and physical activity intervention study. The prospective association between dieting frequency at baseline and smoking initiation 2 years later was tested. Results. Compared with girls who reported no dieting at baseline, girls who dieted up to once per week had 2 times the adjusted odds of becoming smokers (odds ratio=2.0; 95% confidence interval=1.1, 3.5), and girls who dieted more often had 4 times the adjusted odds of becoming smokers (odds ratio=3.9; 95% confidence interval=1.5, 10.4). Conclusions. Dieting among girls may exacerbate risk of initiating smoking, with increasing risk with greater dieting frequency. Handle: RePEc:aph:ajpbhl:2001:91:3:446-450_1 Template-Type: ReDIF-Article 1.0 Title: A definition of"social environment" [1] Journal: American Journal of Public Health Author-Name: Barnett, E. Author-Name: Casper, M. Year: 2001 Volume: 91 Issue: 3 Pages: 465 Handle: RePEc:aph:ajpbhl:2001:91:3:465_6 Template-Type: ReDIF-Article 1.0 Title: Trends in cardiovascular disease risk factor prevalence among male transport workers: Bulgaria, 1986 to 1997 Journal: American Journal of Public Health Author-Name: Stein, A.D. Author-Name: Mincheva, V. Author-Name: Stoyanovsky, V. Year: 2001 Volume: 91 Issue: 3 Pages: 455-457 Abstract: Objectives. This study investigated cardiovascular risk factors among male transport workers in Bulgaria. Methods. Comparisons were made of data from independent surveys conducted among male transport workers aged 30 to 59 years in Sofia, Bulgaria, during 1986 (n = 1146) and 1996-1997 (n=638). Results. Smoking prevalence increased from 49% to 59% between 1986 and 1996-1997. Among current smokers, the percentage smoking 15 or more cigarettes per day decreased. The prevalence of elevated body mass index, hypertension, or angina pectoris did not change. Conclusions. Smoking prevalence rates increased during the study period; the prevalence of other risk factors remained high. Handle: RePEc:aph:ajpbhl:2001:91:3:455-457_9 Template-Type: ReDIF-Article 1.0 Title: All-cause and cause-specific mortality of immigrants and native born in the United States Journal: American Journal of Public Health Author-Name: Singh, G.K. Author-Name: Siahpush, M. Year: 2001 Volume: 91 Issue: 3 Pages: 392-399 Abstract: Objectives. This study examined whether US-born people and immigrants 25 years or older differ in their risks of all-cause and cause-specific mortality and whether these differentials, if they exist, vary according to age, sex, and race/ethnicity. Methods. Using data from the National Longitudinal Mortality Study (1979-1989), we derived mortality risks of immigrants relative to those of US-born people by using a Cox regression model after adjusting for age, race/ethnicity, marital status, urban/rural residence, education, occupation, and family income. Results. Immigrant men and women had, respectively, an 18% and 13% lower risk of overall mortality than their US-born counterparts. Reduced mortality risks were especially pronounced for younger and for Black and Hispanic immigrants. Immigrants showed significantly lower risks of mortality from cardiovascular diseases, lung and prostate cancer, chronic obstructive pulmonary diseases, cirrhosis, pneumonia and influenza, unintentional injuries, and suicide but higher risks of mortality from stomach and brain cancer and infectious diseases. Conclusions. Mortality patterns for immigrants and for US-born people vary considerably, with immigrants experiencing lower mortality from several major causes of death. Future research needs to examine the role of sociocultural and behavioral factors in explaining the mortality advantage of immigrants. Handle: RePEc:aph:ajpbhl:2001:91:3:392-399_5 Template-Type: ReDIF-Article 1.0 Title: The influence of geopolitical change on the well-being of a population: The Berlin Wall Journal: American Journal of Public Health Author-Name: Héon-Klin, V. Author-Name: Sieber, E. Author-Name: Huebner, J. Author-Name: Fullilove, M.T. Year: 2001 Volume: 91 Issue: 3 Pages: 369-374 Abstract: Objectives. Social cohesion is recognized as a fundamental condition for healthy populations, but social cohesion itself arises from political unity. The history of the Berlin Wall provides a unique opportunity to examine the effects of partition on social cohesion and, by inference, on health. Methods. This ethnographic study consisted of examination of the territory formerly occupied by the Wall, formal and informal interviews with Berlin residents, and collection of cultural documents related to the Wall. Transcripts, field notes, and documents were examined by means of a keyword-in-context analysis. Results. The separation of Berlin into 2 parts was a traumatic experience for the city's residents. After partition, East and West Germany had divergent social, cultural, and political experiences and gradually grew apart. Conclusions. The demolition of the Wall - the symbol and the instrument of partition - makes possible but does not ensure the reintegration of 2 populations that were separated for 40 years. The evolution of a new common culture might be accelerated by active attempts at cultural and social exchange. Handle: RePEc:aph:ajpbhl:2001:91:3:369-374_7 Template-Type: ReDIF-Article 1.0 Title: It's time we became more political as a profession [5] (multiple letters) Journal: American Journal of Public Health Author-Name: Chen, M. Author-Name: Sommer, A. Author-Name: Akhter, N.M. Year: 2001 Volume: 91 Issue: 3 Pages: 467 Handle: RePEc:aph:ajpbhl:2001:91:3:467_1 Template-Type: ReDIF-Article 1.0 Title: The search for cancer risk factors: When can we stop looking? Journal: American Journal of Public Health Author-Name: Begg, C.B. Year: 2001 Volume: 91 Issue: 3 Pages: 360-364 Abstract: In recent decades, countless cohort, case-control, and ecologic studies have been conducted in the search for cancer risk factors. On the basis of knowledge gained from these studies, various influential commentaries have endeavored to classify the extent to which the total cancer burden is attributable to general categories of risk, such as diet, tobacco, sun exposure, and others. These commentaries have led to the conventional wisdom that most of the cancer burden is caused by environmental factors and relatively little is directly attributable to genetic susceptibility. In the face of the apparent knowledge that the cancer burden is essentially fully "explainable" on the basis of known environmental risks, this article addresses the conceptual and empirical basis of the continued search for new risk factors. It proposes that the extent of the aggregation of cancer within individuals in the population - that is, the occurrence of second primary cancers - is a crucial statistic in this context. A study of the incidence of second primary melanoma suggests that the bulk of the risk variation in this disease cannot be explained by known risk factors. The implications of these ideas for research strategy and for public health policy are discussed. Handle: RePEc:aph:ajpbhl:2001:91:3:360-364_5 Template-Type: ReDIF-Article 1.0 Title: "Regularizing" public health practitioners [4] (multiple letters) Journal: American Journal of Public Health Author-Name: Lundgren, B.S. Author-Name: Sommer, A. Author-Name: Akhter, M.N. Year: 2001 Volume: 91 Issue: 3 Pages: 466-467 Handle: RePEc:aph:ajpbhl:2001:91:3:466-467_0 Template-Type: ReDIF-Article 1.0 Title: Professionalizing public health [3] (multiple letters) Journal: American Journal of Public Health Author-Name: Wright, J. Author-Name: Wohlfeiler, D. Author-Name: Sommer, A. Author-Name: Akhter, M.N. Year: 2001 Volume: 91 Issue: 3 Pages: 466 Handle: RePEc:aph:ajpbhl:2001:91:3:466_9 Template-Type: ReDIF-Article 1.0 Title: Pregnancy complications and outcomes among overweight and obese nulliparous women Journal: American Journal of Public Health Author-Name: Baeten, J.M. Author-Name: Bukusi, E.A. Author-Name: Lambe, M. Year: 2001 Volume: 91 Issue: 3 Pages: 436-440 Abstract: Objectives. This study examined the associations between prepregnancy weight and the risk of pregnancy complications and adverse outcomes among nulliparous women. Methods. We conducted a population-based cohort study with 96801 Washington State birth certificates from 1992 to 1996. Women were categorized by body mass index. Multivariate logistic regression was performed. Results. The rate of occurrence of most of the outcomes increased with increasing body mass index category. Compared with lean women, both overweight and obese women had a significantly increased risk for gestational diabetes, preeclampsia, eclampsia, cesarean delivery, and delivery of a macrosomic infant. Conclusions. Among nulliparous women, not only prepregnancy obesity but also overweight increases the risk of pregnancy complications and adverse pregnancy outcomes. Handle: RePEc:aph:ajpbhl:2001:91:3:436-440_6 Template-Type: ReDIF-Article 1.0 Title: Educating the public health workforce [6] Journal: American Journal of Public Health Author-Name: Dandoy, S. Year: 2001 Volume: 91 Issue: 3 Pages: 467-468 Handle: RePEc:aph:ajpbhl:2001:91:3:467-468_9 Template-Type: ReDIF-Article 1.0 Title: Prevalence and predictors of physical partner abuse among Mexican American women Journal: American Journal of Public Health Author-Name: Lown, E.A. Author-Name: Vega, W.A. Year: 2001 Volume: 91 Issue: 3 Pages: 441-445 Abstract: Objectives. This study determined the lifetime prevalence of physical abuse by a current partner among women of Mexican origin and assessed factors associated with abuse. Methods. Data are for a subsample of 1155 women with current partners from a larger population-based cross-sectional survey of US residents of Mexican origin. Results. The self-reported prevalence of physical abuse by a current partner was 10.7%. In multivariate analysis, factors associated with physical abuse included US birthplace (odds ratio=2.1;95% confidence interval=1.24, 3.56), young age, urban residence, and having 4 or more children. Social support and regular church attendance were protective. Conclusions. The self-reported prevalence of physical abuse among Mexican American women is high. US birth is associated with increased risk of abuse. Community-based prevention efforts should be aimed at this population. Handle: RePEc:aph:ajpbhl:2001:91:3:441-445_4 Template-Type: ReDIF-Article 1.0 Title: The impact of referral to a primary physician on cervical cancer screening Journal: American Journal of Public Health Author-Name: Gill, J.M. Author-Name: McClellan, S.A. Year: 2001 Volume: 91 Issue: 3 Pages: 451-454 Abstract: Objectives. The purpose of this study was to determine whether referral to a primary physician led to an increase in screening for cervical cancer among women enrolled in Delaware Medicaid. Methods. Medicaid claims data were used to compare annual Papanicolaou (Pap) test rates for women referred to a primary care physician or obstetrician (n = 365) with rates for age-matched comparison women who were not referred (n = 1799). Results. Thirty-eight percent of referred women and 27% of comparison women underwent Pap tests (adjusted odds ratio = 1.71; 95% confidence interval = 1.33, 2.20). Conclusions. Referral to a primary physician had a positive impact on cervical cancer screening among the study participants. Handle: RePEc:aph:ajpbhl:2001:91:3:451-454_0 Template-Type: ReDIF-Article 1.0 Title: Evaluating OSHA's ethylene oxide standard: Exposure determinants in massachusetts hospitals Journal: American Journal of Public Health Author-Name: LaMontagne, A.D. Author-Name: Kelsey, K.T. Year: 2001 Volume: 91 Issue: 3 Pages: 412-417 Abstract: Objectives. This study sought to identify determinants of workplace exposures to ethylene oxide to assess the effect of the Occupational Safety and Health Administration's (OSHA's) 1984 ethylene oxide standard. Methods. An in-depth survey of all hospitals in Massachusetts that used ethylene oxide from 1990 through 1992 (96% participation, N=90) was conducted. Three types of exposure events were modeled with logistic regression: exceeding the 8-hour action level, exceeding the 15-minute excursion limit, and worker exposures during unmeasured accidental releases. Covariates were drawn from data representing an ecologic framework including direct and indirect potential exposure determinants. Results. After adjustment for frequencies of ethylene oxide use and exposure monitoring, a significant inverse relation was observed between exceeding the action level and the use of combined sterilizer-aerators, an engineering control technology developed after the passage of the OSHA standard. Conversely, the use of positive-pressure sterilizers that employ ethylene oxide gas mixtures was strongly related to both exceeding the excursion limit and the occurrence of accidental releases. Conclusions. These findings provide evidence of a positive effect of OSHA's ethylene oxide standard and specific targets for future prevention and control efforts. Handle: RePEc:aph:ajpbhl:2001:91:3:412-417_6 Template-Type: ReDIF-Article 1.0 Title: Selective risk taking among needle exchange participants: Implications for supplemental interventions Journal: American Journal of Public Health Author-Name: Valente, T.W. Author-Name: Vlahov, D. Year: 2001 Volume: 91 Issue: 3 Pages: 406-411 Abstract: Objectives. This study characterized social network context of HIV risk behavior among injection drug users who participated in a needle exchange program. Methods. Interviews were conducted with 1184 injection drug users at the Baltimore Needle Exchange Program enrolled in an evaluation cohort. Analysis consisted of multiple logistic regression with statistical adjustment for the inter-dependence of observations. Results. Of the 203 (17.1%) injection drug users who reported using a syringe after someone else, 78.3% reported sharing with close friends, and the adjusted odds ratio of any sharing and sharing with close friends was 30.9. Injection drug users were more likely to report sharing with a strong-tie close friend (adjusted odds ratio= 1.52) and less likely to report sharing with other close friends if those friends were weak ties and new to their network. Friendship ties were not stable, with fewer than 30% of the friends being repeat nominations. Conclusions. These data show that many injection drug users engage in selective risk taking that may minimize their disease risk exposure in the short term. The turnover in networks, however, suggests that programs need to emphasize the importance of exclusive use. Handle: RePEc:aph:ajpbhl:2001:91:3:406-411_5 Template-Type: ReDIF-Article 1.0 Title: Is economic policy health policy? Journal: American Journal of Public Health Author-Name: Kaplan, G.A. Author-Name: Lynch, J.W. Year: 2001 Volume: 91 Issue: 3 Pages: 351-353 Handle: RePEc:aph:ajpbhl:2001:91:3:351-353_5 Template-Type: ReDIF-Article 1.0 Title: Emergency department screening for asymptomatic sexually transmitted infections Journal: American Journal of Public Health Author-Name: Todd, C.S. Author-Name: Haase, C. Author-Name: Stoner, B.P. Year: 2001 Volume: 91 Issue: 3 Pages: 461-464 Abstract: Objectives. This study assessed the prevalence and correlates of asymptomatic genital tract infection with Neisseria gonorrhoeae and Chlamydia trachomatis among emergency department patients. Methods. Individuals seeking emergency department evaluation for nongenitourinary complaints provided urine samples for N gonorrhoeae and C trachomatis testing by ligase chain reaction and completed a sociodemographic and behavioral questionnaire. Results. Asymptomatic N gonorrhoeae or C trachomatis was found in 9.7% of persons tested. Correlates of C trachomatis infection included younger age, residence in high-morbidity zip code areas, previous history of N gonorrhoeae or C trachomatis, and number of sex partners in the past year. Conclusions. Urine-based screening of asymptomatic emergency department patients detected significant numbers of N gonorrhoeae and C trachomatis infections. Targeted screening programs may contribute to community-level prevention and control of sexually transmitted infections. Handle: RePEc:aph:ajpbhl:2001:91:3:461-464_3 Template-Type: ReDIF-Article 1.0 Title: Medicaid managed care in New York City: Recent performance and coming challenges Journal: American Journal of Public Health Author-Name: DeLia, D. Author-Name: Cantor, J.C. Author-Name: Sandman, D. Year: 2001 Volume: 91 Issue: 3 Pages: 458-460 Abstract: Objectives. This study evaluated New York City's voluntary Medicaid managed care program in terms of health care use and access. Methods. A survey of adults in Medicaid managed care and fee-for-service programs during 1996-1997 was analyzed. Results. Responses showed significant favorable risk selection into managed care but little difference in use of health care services. Although some measures of access favored managed care, many others showed no difference between the study groups. Conclusions. The early impact of mandatory enrollment will probably include an increase in the average risk of managed care enrollees with little change in beneficiary use and access to care. Handle: RePEc:aph:ajpbhl:2001:91:3:458-460_7 Template-Type: ReDIF-Article 1.0 Title: Prevention of toddler drowning in pools: Isolation vs perimeter fencing [8] (multiple letters) Journal: American Journal of Public Health Author-Name: Wirtz, S.J. Author-Name: Barrett-Miller, J. Author-Name: Barrow, S. Author-Name: Bates, R. Author-Name: Baxter, L. Author-Name: Huddart- Wolfe, L. Author-Name: Kerr, M. Author-Name: Lawrence, D. Author-Name: Rose, D. Author-Name: Trent, R. Author-Name: Weiss, B. Author-Name: Woo, S. Author-Name: Woods, R. Author-Name: Yuwiler, J. Author-Name: Zenzola, T. Author-Name: Morgenstern, H. Year: 2001 Volume: 91 Issue: 3 Pages: 468-470 Handle: RePEc:aph:ajpbhl:2001:91:3:468-470_0 Template-Type: ReDIF-Article 1.0 Title: The privatization of risk Journal: American Journal of Public Health Author-Name: Rockhill, B. Year: 2001 Volume: 91 Issue: 3 Pages: 365-368 Abstract: The privatization, or individualization, of risk factor knowledge has been largely responsible for a rising fide of criticism of epidemiology. The current debate seems polarized into 2 sides, those who support and those who attack "risk factor" epidemiology. This commentary aims to reinvigorate some of Geoffrey Rose's central arguments and show that this debate may miss a key point: a risk factor is a probabilistic concept that applies to an aggregate of individuals, not to a specific individual. Risk factor knowledge compels those in public health to seek actions that shift population distributions of these factors and, to do so, to understand their social, economic, and political determinants. The author links Rose's qualitative distinction between the causes of cases and the causes of incidence to an examination of the conceptual and quantitative limits of "individual risk" estimation. The attempt to predict individuals' futures on the basis of risk factor profile is especially prominent now with breast cancer. The author suggests reasons why a policy promoting private decision making about risk, while likely ineffective from a population standpoint, is viewed as the only feasible primary prevention option against this disease. Handle: RePEc:aph:ajpbhl:2001:91:3:365-368_7 Template-Type: ReDIF-Article 1.0 Title: State-level income inequality and individual mortality risk: A prospective, multilevel study Journal: American Journal of Public Health Author-Name: Lochner, K. Author-Name: Pamuk, E. Author-Name: Makuc, D. Author-Name: Kennedy, B.P. Author-Name: Kawachi, I. Year: 2001 Volume: 91 Issue: 3 Pages: 385-391 Abstract: Objectives. Previous studies have linked state-level income inequality to mortality rates. However, it has been questioned whether the relationship is independent of individual-level income. The present study tests whether state-level income inequality is related to individual mortality risk, after adjustment for individual-level characteristics. Methods. In this prospective, multilevel study design, the vital stares of National Health Interview Survey (NHIS) respondents was ascertained by linkage to the National Death Index, with additional linkage of state-level data to individuals in the NHIS. The analysis included data for 546888 persons, with 19379 deaths over the 8-year follow-up period. The Gini coefficient was used as the measure of income inequality. Results. Individuals living in high-income-inequality states were at increased risk of mortality (relative risk = 1.12; 95% confidence interval = 1.04, 1.19) compared with individuals living in low-income-inequality states. In stratified analyses, significant effects of state income inequality on mortality risk were found, primarily for near-poor Whites. Conclusions. State-level income inequality appears to exert a contextual effect on mortality risk, after income is adjusted for, providing further evidence that the distribution of income is important for health. Handle: RePEc:aph:ajpbhl:2001:91:3:385-391_5 Template-Type: ReDIF-Article 1.0 Title: Dr Button and the airplane. Journal: American Journal of Public Health Author-Name: Helfand, W.H. Author-Name: Lazarus, J. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 3 Pages: 354 Handle: RePEc:aph:ajpbhl:2001:91:3:354_0 Template-Type: ReDIF-Article 1.0 Title: The cigar revival and the popular press: A content analysis, 1987-1997 Journal: American Journal of Public Health Author-Name: Wenger, L. Author-Name: Malone, R. Author-Name: Bero, L. Year: 2001 Volume: 91 Issue: 2 Pages: 288-291 Abstract: Objectives. The purpose of this study was to examine print media coverage of cigars during the period 1987 to 1997. Methods. A content analysis of 790 cigar-focused newspaper and magazine articles was conducted. Results. Cigar-focused articles increased substantially over the study period, paralleling increased cigar consumption. Articles focused on cigar business (39%) and events (19%). Only 4% of articles focused on health effects. Sixty-two percent portrayed cigars favorably. The tobacco industry was mentioned in 54% of articles and portrayed positively in 78%. Forty-two percent of the individuals quoted or described in articles were affiliated with the tobacco industry; only 5% were government/public health figures. Conclusions. Print coverage of cigars failed to communicate health risk messages and contributed to positive images of cigars. Handle: RePEc:aph:ajpbhl:2001:91:2:288-291_8 Template-Type: ReDIF-Article 1.0 Title: Influence of a counteradvertising media campaign on initiation of smoking: The Florida "truth" campaign Journal: American Journal of Public Health Author-Name: Sly, D.F. Author-Name: Hopkins, R.S. Author-Name: Trapido, E. Author-Name: Ray, S. Year: 2001 Volume: 91 Issue: 2 Pages: 233-238 Abstract: Objectives: The purpose of this study was to assess the short-term effects of television advertisements from the Florida "truth" campaign on rates of smoking initiation. Methods: A follow-up survey of young people aged 12 to 17 years (n = 1820) interviewed during the first 6 months of the advertising campaign was conducted. Logistic regression analyses were used to estimate the independent effects of the campaign on smoking initiation while other factors were controlled for. Results: Youths scoring at intermediate and high levels on a media effect index were less likely to initiate smoking than youths who could not confirm awareness of television advertisements. Adjusted odds ratios between the media index and measures of initiation were similar within categories of age, sex, susceptibility, and whether a parent smoked. Conclusions: Exposure to the "truth" media campaign lowered the risk of youth smoking initiation. However, the analysis did not demonstrate that all such media programs will be effective. Handle: RePEc:aph:ajpbhl:2001:91:2:233-238_8 Template-Type: ReDIF-Article 1.0 Title: Smoking during pregnancy in Finland: Determinants and trends, 1987-1997 Journal: American Journal of Public Health Author-Name: Jaakkola, N. Author-Name: Jaakkola, M.S. Author-Name: Gissler, M. Author-Name: Jaakkola, J.J.K. Year: 2001 Volume: 91 Issue: 2 Pages: 284-286 Abstract: Objectives. This study examined determinants of and trends in smoking during pregnancy in Finland from 1987 through 1997. Methods. A repeated cross-sectional investigation of 694926 women was conducted. Results. The prevalence of smoking during pregnancy remained similar from 1987 through 1997 (at 15%). In 1997, prevalences of smoking were alarmingly high among young (37%), single (30%), and less educated (25%) women and among women living in northern (20%) and eastern (19%) Finland. These determinants were persistent over time, with the exception of an increase in regional differences. Conclusions. Despite increasing knowledge of adverse effects, smoking during pregnancy has not declined in Finland over the past decade. Handle: RePEc:aph:ajpbhl:2001:91:2:284-286_9 Template-Type: ReDIF-Article 1.0 Title: The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease Journal: American Journal of Public Health Author-Name: Steptoe, A. Author-Name: Kerry, S. Author-Name: Rink, E. Author-Name: Hilton, S. Year: 2001 Volume: 91 Issue: 2 Pages: 265-269 Abstract: Objectives. This study assessed stages of change in fat intake, physical activity, and cigarette smoking during a randomized controlled trial of behavioral counseling. Methods. Twenty general practices (primary health care centers) were randomized to lifestyle counseling by behavioral methods or to usual health promotion. A total of 883 patients were selected for the presence of 1 or more of the following risk factors: cigarette smoking, high cholesterol, or a combination of a high body mass index and low physical activity. Stage of change (precontemplation, contemplation, preparation, and action/maintenance) was assessed at baseline and after 4 and 12 months. Results. The odds of moving to action/maintenance for behavioral intervention vs control patients at 4 months were 2.15 (95% confidence interval [CI]=1.30, 3.56) for fat reduction, 1.89 (95% CI=1.07, 3.36) for increased physical activity, and 1.77 (95% CI=0.76, 4.14) for smoking cessation. The likelihood of achieving action/maintenance was related to baseline stage for all 3 behaviors. Conclusions. Brief behavioral counseling based on advice matched to stage of readiness for change may be valuable in encouraging healthy lifestyles among patients in primary care at raised risk of cardiovascular disease. Handle: RePEc:aph:ajpbhl:2001:91:2:265-269_5 Template-Type: ReDIF-Article 1.0 Title: Tobacco use and quit attempts among methadone maintenance clients Journal: American Journal of Public Health Author-Name: Richter, K.P. Author-Name: Gibson, C.A. Author-Name: Ahluwalia, J.S. Author-Name: Schmelzle, K.H. Year: 2001 Volume: 91 Issue: 2 Pages: 296-299 Abstract: Objective: This study examined tobacco use prevalence, types of tobacco used, interest in quitting, and prior quit attempts among persons in methadone maintenance treatment. Methods: Counselors collected surveys from 84% (550 of 655) of all clients in a 4-county metropolitan area. Results: Most clients (77%) smoked cigarettes. Of the 59 former tobacco users, only 6 reported using a cessation pharmacotherapy to quit. Three quarters of the current smokers had attempted to quit at least once, with an average of 5 attempts. Most smokers (80%) were "somewhat" or "very" interested in quitting. Conclusions: The quit ratio among methadone maintenance treatment clients was 12%, compared with 50% nationwide. To reduce morbidity and mortality, cessation interventions must be developed and disseminated. Handle: RePEc:aph:ajpbhl:2001:91:2:296-299_6 Template-Type: ReDIF-Article 1.0 Title: Why we need an international agreement on tobacco control Journal: American Journal of Public Health Author-Name: Satcher, D. Year: 2001 Volume: 91 Issue: 2 Pages: 191-193 Handle: RePEc:aph:ajpbhl:2001:91:2:191-193_7 Template-Type: ReDIF-Article 1.0 Title: Diabetes care in community health centers: A reasonable standard of comparison? [1] Journal: American Journal of Public Health Author-Name: Rust, G. Author-Name: Curtin, T. Year: 2001 Volume: 91 Issue: 2 Pages: 318-319 Handle: RePEc:aph:ajpbhl:2001:91:2:318-319_7 Template-Type: ReDIF-Article 1.0 Title: Do socioeconomic disadvantages persist into old age? Self-reported morbidity in a 29-year follow-up of the Whitehall Study Journal: American Journal of Public Health Author-Name: Breeze, E. Author-Name: Fletcher, A.E. Author-Name: Leon, D.A. Author-Name: Marmot, M.G. Author-Name: Clarke, R.J. Author-Name: Shipley, M.J. Year: 2001 Volume: 91 Issue: 2 Pages: 277-283 Abstract: Objectives. This study examined (1) the relation of employment grade in middle age to self-reported poor health and functional limitations in old age and (2) whether socioeconomic status at approximately the time of retirement modifies health differentials in old age. Methods. Survivors of the Whitehall Study cohort of men were resurveyed. Respondents were aged 40 to 69 years when they were originally screened in 1967 to 1970. Results. Compared with senior administrators, men in clerical or manual (low-grade) jobs in middle age had quadruple the odds of poor physical performance in old age, triple the odds of poor general health, and double the odds of poor mental health and disability. At most, 20% of these differences were explained by baseline health or risk factors. Men who moved from low to middle grades before retirement were less likely than those who remained in low grades to have poor mental health. Conclusions. Socioeconomic status in middle age and at approximately retirement age is associated with morbidity in old age. Handle: RePEc:aph:ajpbhl:2001:91:2:277-283_1 Template-Type: ReDIF-Article 1.0 Title: The benefits of interventions for work-related stress Journal: American Journal of Public Health Author-Name: Van der Klink, J.J.L. Author-Name: Blonk, R.W.B. Author-Name: Schene, A.H. Author-Name: Van Dijk, F.J.H. Year: 2001 Volume: 91 Issue: 2 Pages: 270-276 Abstract: Objectives. This quantitative meta-analysis sought to determine the effectiveness of occupational stress-reducing interventions and the populations for which such interventions are most beneficial. Methods. Forty-eight experimental studies (n=3736) were included in the analysis. Four intervention types were distinguished: cognitive-behavioral interventions, relaxation techniques, multimodal programs, and organization-focused interventions. Results. A small but significant overall effect was found. A moderate effect was found for cognitive-behavioral interventions and multimodal interventions, and a small effect was found for relaxation techniques. The effect size for organization-focused interventions was nonsignificant. Effects were most pronounced on the following outcome categories: complaints, psychologic resources and responses, and perceived quality of work life. Conclusions. Stress management interventions are effective. Cognitive - behavioral interventions are more effective than the other intervention types. Handle: RePEc:aph:ajpbhl:2001:91:2:270-276_5 Template-Type: ReDIF-Article 1.0 Title: Editors' note: The power of pictures Journal: American Journal of Public Health Author-Name: Northridge, M. Author-Name: Wilcox, J. Year: 2001 Volume: 91 Issue: 2 Pages: 194 Handle: RePEc:aph:ajpbhl:2001:91:2:194_5 Template-Type: ReDIF-Article 1.0 Title: Support for smoke-free restaurants among Massachusetts adults, 1992-1999 Journal: American Journal of Public Health Author-Name: Brooks, D.R. Author-Name: Mucci, L.A. Year: 2001 Volume: 91 Issue: 2 Pages: 300-303 Abstract: Objectives: The authors examined trends and predictors of public support for smoke-free restaurants in Massachusetts. Methods: Since 1992, the Massachusetts Behavioral Risk Factor Surveillance System has asked survey respondents about their attitudes toward smoking in restaurants. Analyses using data from 1992 to 1999 characterized changes over time in support for smoke-free restaurants and the role of demographic and smoking-related factors in predicting support. Results: During 1992 to 1999, the rate of support for smoke-free restaurants increased from 37.5% to 59.8%, with similar increases among current, former, and never smokers. After adjustment for smoking status, support was associated with socioeconomic characteristics, race/ethnicity, and household smoking roles. Among current smokers, lighter smokers and those who were trying to quit were more likely to endorse smoke-flee restaurants. Conclusions: There has been a substantial increase in support for smoke-free restaurants among both smokers and nonsmokers in Massachusetts. Handle: RePEc:aph:ajpbhl:2001:91:2:300-303_7 Template-Type: ReDIF-Article 1.0 Title: Simulated effect of tobacco tax variation on population health in California Journal: American Journal of Public Health Author-Name: Kaplan, R.M. Author-Name: Ake, C.F. Author-Name: Emery, S.L. Author-Name: Navarro, A.M. Year: 2001 Volume: 91 Issue: 2 Pages: 239-244 Abstract: Objectives. This study simulated the effects of tobacco excise tax increases on population health. Methods. Five simulations were used to estimate health outcomes associated with tobacco tax policies: (1) the effects of price on smoking prevalence; (2) the effects of tobacco use on years of potential life lost; (3) the effect of tobacco use on quality of life (morbidity); (4) the integration of prevalence, mortality, and morbidity into a model of quality adjusted life years (QALYs); and (5) the development of confidence intervals around these estimates. Effects were estimated for 1 year after the tax's initiation and 75 years into the future. Results. In California, a $0.50 tax increase and price elasticity of -0.40 would result in about 8389 QALYs (95% confidence interval [CI]=4629, 12113) saved the first year. Greater benefits would accrue each year until a steady state was reached after 75 years, when 52136 QALYs (95% CI=38297, 66262) would accrue each year. Higher taxes would produce even greater health benefits. Conclusions. A tobacco excise tax may be among a few policy options that will enhance a population's health status while making revenues available to government. Handle: RePEc:aph:ajpbhl:2001:91:2:239-244_8 Template-Type: ReDIF-Article 1.0 Title: Variation in youthful risks of progression from alcohol and tobacco to marijuana and to hard drugs across generations Journal: American Journal of Public Health Author-Name: Golub, A. Author-Name: Johnson, B.D. Year: 2001 Volume: 91 Issue: 2 Pages: 225-232 Abstract: Objectives. Much research has documented that youthful substance use typically follows a sequence starting with use of alcohol or tobacco or both and potentially proceeding to marijuana and then hard drug use. This study explicitly examined the probabilities of progression through each stage and their covariates. Methods. A secondary analysis of data from the National Household Survey on Drug Abuse (1979-1997) was conducted with particular sensitivity to the nature of substance use progression, sampling procedures, and reliability of self-report data. Results. Progression to marijuana and hard drug use was uncommon among persons born before World War II. The stages phenomenon essentially emerged with the baby boom and rose to a peak among persons born around 1960. Subsequently, progression risks at each stage declined. Progression risks were also higher among younger initiators of alcohol, tobacco, or marijuana use. Conclusions. The recent increase in youthful marijuana use has been offset by lower rates of progression to hard drug use among youths born in the 1970s. Dire predictions of future hard drug abuse by youths who came of age in the 1990s may be greatly overstated. Handle: RePEc:aph:ajpbhl:2001:91:2:225-232_9 Template-Type: ReDIF-Article 1.0 Title: Tobacco use among high school students in Buenos Aires, Argentina Journal: American Journal of Public Health Author-Name: Morello, P. Author-Name: Duggan, A. Author-Name: Adger H., Jr. Author-Name: Anthony, J.C. Author-Name: Joffe, A. Year: 2001 Volume: 91 Issue: 2 Pages: 219-224 Abstract: Objectives. This study assessed the prevalence and correlates of tobacco use among high school students in Buenos Aires, Argentina. Methods. Anonymous, self-administered questionnaires were given to 3909 8th and 11th graders in a stratified random sample of 49 public and private schools. The instrument included items from American surveys, translated and validated among Argentinean teens. Multiple logistic regression analysis was used to estimate possible effects on smoking behavior of environment, students' personal characteristics, and their knowledge, beliefs, and attitudes regarding smoking. Results. Of 8th and 11th graders, 20% and 43%, respectively, were classified as current smokers. Overall, 29% of males and 32% of females were current smokers. Students attending public schools were more likely to smoke than those in private schools (P<.05). Current smoking was associated with having a best friend who smokes, reporting that more than 50% of friends of the same sex smoke, having positive attitudes and beliefs toward smoking, and having a positive intention to smoke within the next year (all P<.001). Conclusions. Over 20% of the 8th graders in our sample were current smokers; prevention efforts must therefore start early. Handle: RePEc:aph:ajpbhl:2001:91:2:219-224_9 Template-Type: ReDIF-Article 1.0 Title: Television campaigns and adolescent marijuana use: Tests of sensation seeking targeting Journal: American Journal of Public Health Author-Name: Palmgreen, P. Author-Name: Donohew, L. Author-Name: Lorch, E.P. Author-Name: Hoyle, R.H. Author-Name: Stephenson, M.T. Year: 2001 Volume: 91 Issue: 2 Pages: 292-296 Abstract: Objectives: This study evaluated the effectiveness of targeted televised public service announcement campaigns in reducing marijuana use among high-sensation-seeking adolescents. Methods: The study used a controlled interrupted time-series design in 2 matched communities. Two televised antimarijuana campaigns were conducted in 1 county and 1 campaign in the comparison community. Personal interviews were conducted with 100 randomly selected teenagers monthly in each county for 32 months. Results: All 3 campaigns reversed upward developmental trends in 30-day marijuana use among high-sensation seekers (P<.002). As expected, low-sensation seekers had low use levels, and no campaign effects were evident. Conclusions: Televised campaigns with high reach and frequency that use public service announcements designed for and targeted at high-sensation-seeking adolescents can significantly reduce substance use in this high-risk population. Handle: RePEc:aph:ajpbhl:2001:91:2:292-296_5 Template-Type: ReDIF-Article 1.0 Title: Ten-year changes in smoking among young adults: Are racial differences explained by socioeconomic factors in the CARDIA study? Journal: American Journal of Public Health Author-Name: Kiefe, C.I. Author-Name: Williams, D. Author-Name: Lewis, C.E. Author-Name: Allison, J.J. Author-Name: Sekar, P. Author-Name: Wagenknecht, L.E. Year: 2001 Volume: 91 Issue: 2 Pages: 213-218 Abstract: Objectives. This study investigated whether socioeconomic factors explain racial/ethnic differences in regular smoking initiation and cessation. Methods. Data were derived from the CARDIA study, a cohort of 5115 healthy adults aged 18 to 30 years at baseline (1985-1986) and recruited from the populations of 4 US cities. Respondents were followed over 10 years. Results. Among 3950 respondents reexamined in 1995-1996, 20% of Whites and 33% of African Americans were smokers, as compared with 25% and 32%, respectively, in 1985-1986. On average, African Americans were of lower socioeconomic status. Ten-year regular smoking initiation rates for African American women, White women, African American men, and White men were 7.1%, 3.5%, 13.2%, and 5.1%, respectively, and the corresponding cessation rates were 25%, 35.1%, 19.2%, and 31.3%. After adjustment for socioeconomic factors, most 95% confidence intervals of the odds ratios for regular smoking initiation and cessation in African Americans vs Whites included 1. Conclusions. Less beneficial 10-year changes in smoking were observed in African Americans, but socioeconomic factors explained most of the racial disparity. Handle: RePEc:aph:ajpbhl:2001:91:2:213-218_4 Template-Type: ReDIF-Article 1.0 Title: Where children sit in cars: The impact of Rhode Island's new legislation Journal: American Journal of Public Health Author-Name: Segui-Gomez, M. Author-Name: Wittenberg, E. Author-Name: Glass, R. Author-Name: Levenson, S. Author-Name: Hingson, R. Author-Name: Graham, J.D. Year: 2001 Volume: 91 Issue: 2 Pages: 311-313 Abstract: Objectives. This study evaluated the impact of Rhode Island's legislation requiring children younger than 6 years to sit in the rear of motor vehicles. Methods. Roadside observations were conducted in Rhode Island and Massachusetts in 1997 and 1998. Multivariate regression was used to evaluate the proportion of vehicles carrying a child in the front seat. Results. Data were collected on 3226 vehicles carrying at least 1 child. In 1998, Rhode Island vehicles were less likely to have a child in the front seat than in 1997 (odds ratio=0.6; 95% confidence interval=0.5, 0.7), whereas no significant changes in child passenger seating behavior occurred in Massachusetts during that period. Conclusions. Rhode Island's legislation seems to have promoted safer child passenger seating behavior. Handle: RePEc:aph:ajpbhl:2001:91:2:311-313_2 Template-Type: ReDIF-Article 1.0 Title: Importance of attributable risk in monitoring adverse events after immunization: Hepatitis B vaccination in children Journal: American Journal of Public Health Author-Name: De Serres, G. Author-Name: Duval, B. Author-Name: Boulianne, N. Author-Name: Rochette, M. Author-Name: Dionne, M. Author-Name: Fradet, M.D. Author-Name: Massé, R. Year: 2001 Volume: 91 Issue: 2 Pages: 313-315 Abstract: Objectives. Most vaccine safety data present only the postvaccination incidence of all adverse events rather than an estimate of attributable risk. This study sought to illustrate the difference between the 2 estimates with data from a hepatitis B immunization program. Methods. The incidence of health problems occurring before and after each dose of hepatitis B vaccine in a cohort of 1130 children were compared. Results. Although 47.5% of all children reported an adverse event during the 4 weeks following each of the 3 doses, adverse events attributable to immunization occurred in only 10.6% of children. Conclusions. Postimmunization incidence systematically overestimates the risk of adverse events. Estimating actual attributable risk is necessary to avoid false beliefs regarding immunization. Handle: RePEc:aph:ajpbhl:2001:91:2:313-315_9 Template-Type: ReDIF-Article 1.0 Title: Environmental tobacco smoke and periodontal disease in the United States Journal: American Journal of Public Health Author-Name: Arbes S.J., Jr. Author-Name: Ágústsdóttir, H. Author-Name: Slade, G.D. Year: 2001 Volume: 91 Issue: 2 Pages: 253-257 Abstract: Objectives. Cigarette smoking is a leading risk factor for periodontal disease. This cross-sectional study investigated the relation between environmental tobacco smoke (ETS) and periodontal disease in the United States. Methods. Data were obtained from the Third National Health and Nutrition Examination Survey (1988-1994). The outcome was periodontal disease, defined as 1 or more periodontal sites with attachment loss of 3 mm or greater and a pocket depth of 4 mm or greater at the same site. Exposure to ETS at home and work was self-reported. The study analyzed 6611 persons 18 years and older who had never smoked cigarettes or used other forms of tobacco. Results. Exposure to ETS at home only, work only, and both was reported by 18.0%, 10.7%, and 3.8% of the study population, respectively. The adjusted odds of having periodontal disease were 1.6 (95% confidence interval = 1.1, 2.2) times greater for persons exposed to ETS than for persons not exposed. Conclusions. Among persons in the United States who had never used tobacco, those exposed to ETS were more likely to have periodontal disease than were those not exposed to ETS. Handle: RePEc:aph:ajpbhl:2001:91:2:253-257_2 Template-Type: ReDIF-Article 1.0 Title: Exposure of adolescent girls to cigar images in women's magazines, 1992-1998 Journal: American Journal of Public Health Author-Name: Feit, M.N. Year: 2001 Volume: 91 Issue: 2 Pages: 286-288 Abstract: Objectives. This study assessed the exposure of adolescent girls to cigar images in women's magazines from 1992 to 1998. Methods. Data were obtained from the 5 women's magazines with the highest readership of adolescent girls. Results. We found a significant upward trend in cigar images portrayed in women's magazines and a significant increase in the portrayal of women cigar smokers over the period observed. Cigar images were less likely than cigarette images to promote tobacco or nontabacco products. Among advertisements, nearly all those that featured cigars promoted nontobacco products; advertisements featuring cigarettes overwhelmingly promoted tobacco products. Conclusions. Between 1992 and 1998, adolescent readers of women's magazines were increasingly exposed to images of cigars. Handle: RePEc:aph:ajpbhl:2001:91:2:286-288_8 Template-Type: ReDIF-Article 1.0 Title: Improving diabetes care in community health centers [2] (multiple letters) Journal: American Journal of Public Health Author-Name: Gaston, M.H. Author-Name: Vinicor, F. Author-Name: Chin, M.H. Author-Name: Auerbach, S.B. Author-Name: Cook, S. Author-Name: Harrison, J. Author-Name: Koppert, J. Author-Name: Jin, L. Author-Name: Thiel, F. Author-Name: Karrison, T.G. Author-Name: Harrand, A. Author-Name: Schaefer, C.T. Author-Name: Takashima, H.T. Author-Name: Egbert, N. Author-Name: Chiu, S.-C. Author-Name: McNabb, W. Year: 2001 Volume: 91 Issue: 2 Pages: 319-320 Handle: RePEc:aph:ajpbhl:2001:91:2:319-320_8 Template-Type: ReDIF-Article 1.0 Title: Intention to use the female condom following a mass-marketing campaign in Lusaka, Zambia Journal: American Journal of Public Health Author-Name: Agha, S. Year: 2001 Volume: 91 Issue: 2 Pages: 307-310 Abstract: Objectives. This report examines intention to use the female condom among men and women in Lusaka, Zambia, who were exposed to mass-marketing of the female condom. Methods. The study used data from a representative sample of consumers at outlets that sell or distribute the female condom and the male condom. Results. In spite of a high level of awareness of the female condom, use of this method in the last year was considerably lower than use of the male condom. Intention to use the female condom in the future was highest among respondents who had used only the female condom in the last year. Conclusions. The female condom is likely to be most important for persons who are unable or unwilling to use the male condom. Handle: RePEc:aph:ajpbhl:2001:91:2:307-310_3 Template-Type: ReDIF-Article 1.0 Title: The new battleground: California's experience with smoke-free bars Journal: American Journal of Public Health Author-Name: Magzamen, S. Author-Name: Glantz, S.A. Year: 2001 Volume: 91 Issue: 2 Pages: 245-252 Abstract: Objectives. This study examined the tobacco industry's tactics in the political, grassroots, and media arenas in attempting to subvert California's smoke-free bar law, and the efforts of health advocates to uphold and promote the law by using the same 3 channels. Methods. Interviews with key informants involved in the development and implementation of the smoke-free bar law were conducted. Information was gathered from bill analyses, internal memoranda, tobacco industry documents, media articles, and press releases. Results. The tobacco industry worked both inside the legislature and through a public relations campaign to attempt to delay implementation of the law and to encourage noncompliance once the law was in effect. Health groups were able to uphold the law by framing the law as a health and worker safety issue. The health groups were less successful in pressing the state to implement the law. Conclusions. It is possible to enact and defend smoke-free bar laws, but doing so requires a substantial and sustained commitment by health advocates. The tobacco industry, will fight this latest generation of clean indoor air laws even more aggressively than general workplace laws. Handle: RePEc:aph:ajpbhl:2001:91:2:245-252_1 Template-Type: ReDIF-Article 1.0 Title: Association of smoking with serum and dietary levels of antioxidants in adults: NHANES III, 1988-1994 Journal: American Journal of Public Health Author-Name: Wei, W. Author-Name: Kim, Y. Author-Name: Boudreau, N. Year: 2001 Volume: 91 Issue: 2 Pages: 258-264 Abstract: Objectives. This study examined the association of smoking with serum levels and dietary intakes of antioxidants in a nationally representative sample. Methods. This study classified 7873 apparently healthy adults aged 17 to 50 years from National Health and Nutrition Examination Survey III (NHANES III) data as nonsmokers or as smokers if their serum cotinine levels were either lower than 14 ng/mL or 14 ng/mL or greater, respectively. SUDAAN software was used for the statistical analysis. Results. Smokers of both sexes had significantly (P<.001) lower serum levels of vitamin C, α-carotene, β-carotene, β-cryptoxanthin, and lutein/zeaxanthin. Reduction in the serum vitamin E, lycopene, and selenium levels in smokers was slight. Smokers also had significantly lower dietary intakes of vitamin C and β-carotene. A significant (P<.001) inverse relation was found between serum vitamin C and β-carotene levels and cotinine levels independent of diet effect, and a positive relation (P<.001) was found between serum levels and dietary intakes. Conclusions. Antioxidants appear to have differing declines in serum levels as a result of reduced dietary intakes and the effects of smoking. Handle: RePEc:aph:ajpbhl:2001:91:2:258-264_5 Template-Type: ReDIF-Article 1.0 Title: Trends in cigarette smoking in 36 populations from the early 1980s to the mid-1990s: Findings from the WHO MONICA Project Journal: American Journal of Public Health Author-Name: Molarius, A. Author-Name: Parsons, R.W. Author-Name: Dobson, A.J. Author-Name: Evans, A. Author-Name: Fortmann, S.P. Author-Name: Jamrozik, K. Author-Name: Kuulasmaa, K. Author-Name: Moltchanov, V. Author-Name: Sans, S. Author-Name: Tuomilehto, J. Author-Name: Puska, P. Year: 2001 Volume: 91 Issue: 2 Pages: 206-212 Abstract: Objectives. This report analyzes cigarette smoking over 10 years in populations in the World Health Organization (WHO) MONICA Project (to monitor trends and determinants of cardiovascular disease). Methods. Over 300 000 randomly selected subjects aged 25 to 64 years participated in surveys conducted in geographically defined populations. Results. For men, smoking prevalence decreased by more than 5% in 16 of the 36 study populations, remained static in most others, but increased in Beijing. Where prevalence decreased, this was largely due to higher proportions of never smokers in the younger age groups rather than to smokers quitting. Among women, smoking prevalence increased by more than 5% in 6 populations and decreased by more than 5% in 9 populations. For women, smoking tended to increase in populations with low prevalence and decrease in populations with higher prevalence; for men, the reverse pattern was observed. Conclusions. These data illustrate the evolution of the smoking epidemic in populations and provide the basis for targeted public health interventions to support the WHO priority for tobacco control. Handle: RePEc:aph:ajpbhl:2001:91:2:206-212_0 Template-Type: ReDIF-Article 1.0 Title: Maternal smoking and the risk of early weaning: A meta-analysis Journal: American Journal of Public Health Author-Name: Horta, B.L. Author-Name: Kramer, M.S. Author-Name: Platt, R.W. Year: 2001 Volume: 91 Issue: 2 Pages: 304-307 Abstract: Objectives. This study reviewed evidence on the effect of maternal smoking on early weaning. Methods. The following databases and journals were searched: Medline, Scientific Citation Index, Pediatrics, Journal of Pediatrics, New England Journal of Medicine, and Lancet. Analysis was restricted to studies in which infants who had never been breastfed were excluded or the prevalence of breastfeeding initiation was more than 90%. Results. In smoking vs nonsmoking mothers, the random effects odds ratio for weaning before 3 months was 1.93 (95% confidence interval [CI]=1.55, 2.40). An adjusted odds ratio of 1.50 (95% CI=1.34, 1.68) was shown in studies that had lost-to-follow-up rates below 15% and included adequate adjustment for confounding. Conclusions. Maternal smoking increases the risk of early weaning. Handle: RePEc:aph:ajpbhl:2001:91:2:304-307_6 Template-Type: ReDIF-Article 1.0 Title: When is a cigar not a cigar? African American youths' understanding of "cigar" use Journal: American Journal of Public Health Author-Name: Yerger, V. Author-Name: Pearson, C. Author-Name: Malone, R.E. Year: 2001 Volume: 91 Issue: 2 Pages: 316-317 Handle: RePEc:aph:ajpbhl:2001:91:2:316-317_4 Template-Type: ReDIF-Article 1.0 Title: Cigarettes and the US Public Health Service in the 1950s. Journal: American Journal of Public Health Author-Name: Parascandola, M. Year: 2001 Volume: 91 Issue: 2 Pages: 196-205 Abstract: The conclusion of the United States Surgeon General's Advisory Committee on Smoking and Health in 1964 that excessive cigarette smoking causes lung cancer is cited as the major turning point for public health action against cigarettes. But the surgeon general and US Public Health Service (PHS) scientists had concluded as early as 1957 that smoking was a cause of lung cancer, indeed, "the principal etiologic factor in the increased incidence of lung cancer." Throughout the 1950s, however, the PHS rejected further tobacco-related public health actions, such as placing warning labels on cigarettes or creating educational programs for schools. Instead, the agency continued to gather information and provided occasional assessments of the evidence as it came available. It was not until pressure mounted from outside the PHS in the early 1960s that more substantive action was taken. Earlier action was not taken because of the way in which PHS scientists (particularly those within the National Institutes of Health) and administrators viewed their roles in relation to science and public health. Handle: RePEc:aph:ajpbhl:2001:91:2:196-205_9 Template-Type: ReDIF-Article 1.0 Title: The "truth" Tobacco Memorial. Journal: American Journal of Public Health Author-Name: Helfand, W.H. Author-Name: Lazarus, J. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 2 Pages: 195 Handle: RePEc:aph:ajpbhl:2001:91:2:195_5 Template-Type: ReDIF-Article 1.0 Title: Structural pluralism and all-cause mortality Journal: American Journal of Public Health Author-Name: Young, F.W. Author-Name: Lyson, T.A. Year: 2001 Volume: 91 Issue: 1 Pages: 136-138 Abstract: Objectives. This study tested the hypothesis that "structural pluralism" reduces age-standardized mortality rates. Structural pluralism is defined as the potential for political competition in communities. Methods. US counties were the units of analysis. Multiple regression techniques were used to test the hypothesis. Results. Structural pluralism is a stronger determinant of lower mortality than any of the other variables examined - specifically, income, education, and medical facilities. Conclusions. These findings support the case for a new structural variable, pluralism, as a possible cause of lower mortality, and they indirectly support the significance of comparable ecologic dimensions, such as social trust. Handle: RePEc:aph:ajpbhl:2001:91:1:136-138_5 Template-Type: ReDIF-Article 1.0 Title: A new paradigm for international disease control: Lessons learned from polio eradication in Southeast Asia Journal: American Journal of Public Health Author-Name: Andrus, J.K. Author-Name: Thapa, A.B. Author-Name: Withana, N. Author-Name: Fitzsimmons, J.W. Author-Name: Abeykoon, P. Author-Name: Aylward, B. Year: 2001 Volume: 91 Issue: 1 Pages: 146-150 Abstract: Objectives. This study evaluated the impact of international coordination on polio eradication in Southeast Asia. Methods. Active surveillance systems for acute flaccid paralysis were assessed. Analyses focused on surveillance proficiency and polio incidence. Results. Ten countries coordinated activities. Importations occurred and were rapidly contained in China and Myanmar. Countries that have been free of indigenous polio transmission for at least 3 years include Sri Lanka, Indonesia, Myanmar, and Thailand. In the remaining endemic countries - India, Nepal, and Bangladesh - poliovirus transmission has been substantially reduced; however, these countries still harbor the world's largest polio reservoir. Conclusions. Unprecedented international coordination in Southeast Asia resulted in dramatic progress in polio eradication and serves as a paradigm for control of other infectious diseases such as malaria and tuberculosis. Handle: RePEc:aph:ajpbhl:2001:91:1:146-150_8 Template-Type: ReDIF-Article 1.0 Title: Health, Pakistan, and globalization Journal: American Journal of Public Health Author-Name: Akhter, M.N. Author-Name: Pappas, G. Year: 2001 Volume: 91 Issue: 1 Pages: 13-14 Handle: RePEc:aph:ajpbhl:2001:91:1:13-14_9 Template-Type: ReDIF-Article 1.0 Title: Hepatitis C among drug users: Déjà vu all over again? Journal: American Journal of Public Health Author-Name: Des Jarlais, D.C. Author-Name: Schuchat, A. Year: 2001 Volume: 91 Issue: 1 Pages: 21-22 Handle: RePEc:aph:ajpbhl:2001:91:1:21-22_5 Template-Type: ReDIF-Article 1.0 Title: Tobacco industry allegations of "illegal lobbying" and state tobacco control Journal: American Journal of Public Health Author-Name: Bialous, S.A. Author-Name: Fox, B.J. Author-Name: Glantz, S.A. Year: 2001 Volume: 91 Issue: 1 Pages: 62-67 Abstract: Objectives. This study assessed the perceived effect of tobacco industry allegations of "illegal lobbying" by public health professionals on policy interventions for tobacco control. Methods. Structured interviews were conducted with state health department project managers in all 17 National Cancer Institute-funded American Stop Smoking Intervention Study (ASSIST) states. Documentation and media records related to ASSIST from the National Cancer Institute, health advocates, and the tobacco industry were analyzed. Results. The tobacco industry filed formal complaints of illegal lobbying activities against 4 ASSIST states. These complaints had a temporary chilling effect on tobacco control policy interventions in those states. ASSIST states not targeted by the tobacco industry developed an increased awareness of the industry's tactics and worked to prepare for such allegations to minimize disruption of their activities. Some self-reported self-censorship in policy activity occurred in 11 of the 17 states (65%). Conclusions. Public health professionals need to educate themselves and the public about the laws that regulate lobbying activities and develop their strategies, including their policy activities, accordingly. Handle: RePEc:aph:ajpbhl:2001:91:1:62-67_0 Template-Type: ReDIF-Article 1.0 Title: A randomized trial of augmented prenatal care for multiple-risk, medicaid-eligible African American women Journal: American Journal of Public Health Author-Name: Klerman, L.V. Author-Name: Ramey, S.L. Author-Name: Goldenberg, R.L. Author-Name: Marbury, S. Author-Name: Hou, J. Author-Name: Cliver, S.P. Year: 2001 Volume: 91 Issue: 1 Pages: 105-111 Abstract: Objectives. This project investigated whether augmented prenatal care for high-risk African American women would improve pregnancy outcomes and patients' knowledge of risks, satisfaction with care, and behavior. Methods. The women enrolled were African American, were eligible for Medicaid, had scored 10 or higher on a risk assessment scale, were 16 years or older, and had no major medical complications. They were randomly assigned to augmented care (n = 318) or usual care (n = 301). Augmented care included educationally oriented peer groups, additional appointments, extended time with clinicians, and other supports. Results. Women in augmented care rated their care as more helpful, knew more about their risk conditions, and spent more time with their nurse-providers than did women in usual care. More smokers in augmented care quit smoking. Pregnancy outcomes did not differ significantly between the groups; however, among patients in augmented care, rates of preterm births were lower and cesarean deliveries and stays in neonatal intensive care units occurred in smaller proportions. Both groups had lower-than-predicted rates of low birthweight. Conclusions. High-quality prenatal care, emphasizing education, health promotion, and social support, significantly increased women's satisfaction, knowledge of risk conditions, and perceived mastery in their lives, but it did not reduce low birthweight. Handle: RePEc:aph:ajpbhl:2001:91:1:105-111_5 Template-Type: ReDIF-Article 1.0 Title: Health status of the Pakistani population: A health profile and comparison with the United States Journal: American Journal of Public Health Author-Name: Pappas, G. Author-Name: Akhtar, T. Author-Name: Gergen, P.J. Author-Name: Hadden, W.C. Author-Name: Khan, A.Q. Year: 2001 Volume: 91 Issue: 1 Pages: 93-98 Abstract: Objectives. The health status of the Pakistani population was compared with that of the US population to provide a better understanding of the health problems in a developing nation and shed light on the dynamics of selected diseases. Methods. Results from the National Health Survey of Pakistan (n = 18315) and the US National Health and Nutrition Examination Survey (n=31311) were compared. Standardized and comparable methods were used in both surveys. Results. Indicators of undernutrition among children were high throughout Pakistan. Among adults, there were urban-rural differences and economic gradients in indicators of undernutrition and risk factors for heart disease and cancer. In comparison with the US population, the Pakistani population has a higher rate of undernutrition, a lower rate of high cholesterol, and an approximately equal rate of high blood pressure. Conclusions. There are major inequalities in health within Pakistan and between Pakistan and the United States. Standardized national health examination survey methodology can be used to monitor health status and plan health transition policy in developing countries. Handle: RePEc:aph:ajpbhl:2001:91:1:93-98_5 Template-Type: ReDIF-Article 1.0 Title: Patterns of prostate cancer treatment by clinical stage and age Journal: American Journal of Public Health Author-Name: Meltzer, D. Author-Name: Egleston, B. Author-Name: Abdalla, I. Year: 2001 Volume: 91 Issue: 1 Pages: 126-128 Abstract: Objectives. This study analyzed prostate cancer treatment rates by age and clinical stage and contrasted these with rates by most accurate stage. Methods. We determined surgery and radiation rates by most accurate and clinical stage by using 1996 Surveillance, Epidemiology, and End Results data. Results. Treatment rates by clinical stage vs best stage differ significantly. For example, surgery rates for stages B, C, and D are 37%, 78%, and 13% by most accurate stage but 33%, 6%, and 1% by clinical stage. Treatment patterns by clinical stage vary substantially by age. Conclusions. Treatment patterns should be described by clinical stage rather than most accurate stage, and they vary by age. Handle: RePEc:aph:ajpbhl:2001:91:1:126-128_8 Template-Type: ReDIF-Article 1.0 Title: Prevalence of HIV, hepatitis B, and hepatitis C in people with severe mental illness Journal: American Journal of Public Health Author-Name: Rosenberg, S.D. Author-Name: Goodman, L.A. Author-Name: Osher, F.C. Author-Name: Swartz, M.S. Author-Name: Essock, S.M. Author-Name: Butterfield, M.I. Author-Name: Constantine, N.T. Author-Name: Wolford, G.L. Author-Name: Salyers, M.P. Year: 2001 Volume: 91 Issue: 1 Pages: 31-37 Abstract: Objectives. This study assessed seroprevalence rates of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) among individuals with severe mental illness. Methods. Participants (n=931) were patients undergoing inpatient or outpatient treatment in Connecticut, Maryland, New Hampshire, or North Carolina. Results. The prevalence of HIV infection in this sample (3.1%) was approximately 8 times the estimated US population rate but lower than rates reported in previous studies of people with severe mental illness. Prevalence rates of HBV (23.4%) and HCV (19.6%) were approximately 5 and 11 times the overall estimated population rates for these infections, respectively. Conclusions. Elevated rates of HIV, HBV, and HCV were found. Of particular concern are the high rates of HCV infection, which are frequently undetected. Individuals with HCV infection commonly fail to receive appropriate treatment to limit liver damage and unknowingly may be a source of infection to others. Handle: RePEc:aph:ajpbhl:2001:91:1:31-37_7 Template-Type: ReDIF-Article 1.0 Title: Enhancing the value of cancer registries and other data sources [3] Journal: American Journal of Public Health Author-Name: Pandiani, J.A. Author-Name: Banks, S.M. Year: 2001 Volume: 91 Issue: 1 Pages: 157 Handle: RePEc:aph:ajpbhl:2001:91:1:157_3 Template-Type: ReDIF-Article 1.0 Title: Factors associated with prevalent hepatitis C: Differences among young adult injection drug users in lower and upper Manhattan, New York City Journal: American Journal of Public Health Author-Name: Diaz, T. Author-Name: Des Jarlais, D.C. Author-Name: Vlahov, D. Author-Name: Perlis, T.E. Author-Name: Edwards, V. Author-Name: Friedman, S.R. Author-Name: Rockwell, R. Author-Name: Hoover, D. Author-Name: Williams, I.T. Author-Name: Monterroso, E.R. Year: 2001 Volume: 91 Issue: 1 Pages: 23-30 Abstract: Objectives. This study examined correlates of prevalent hepatitis C virus (HCV) infection among young adult injection drug users in 2 neighborhoods in New York City. Methods. Injection drug users aged 18 to 29 years were street recruited from the Lower East Side and Harlem. Participants were interviewed about drug use and sex practices; venipuncture was performed for hepatitis B virus (HBV), HCV, and HIV serologies. Results. In both sites, testing positive for HCV antibody (anti-HCV) was associated with having injected for more than 3 years. Additionally, HCV infection was positively associated with injecting with someone known to have had hepatitis (but the association was significant only in the Lower East Side) and with sharing cotton (but the association was statistically significant only in Harlem). Being in drug treatment and older than 24 years were associated with HCV in the Lower East Side but not in Harlem. Receiving money for sex was associated with anti-HCV positivity in Harlem but not in the Lower East Side. Conclusions. Several differences in factors associated with prevalent HCV infection existed among 2 populations of young injection drug users from the same city. Indirect transmission of HCV may occur. Handle: RePEc:aph:ajpbhl:2001:91:1:23-30_4 Template-Type: ReDIF-Article 1.0 Title: Financial difficulty in acquiring food among elderly disabled women: Results from the Women's Health and Aging Study Journal: American Journal of Public Health Author-Name: Klesges, L.M. Author-Name: Pahor, M. Author-Name: Shorr, R.I. Author-Name: Wan, J.Y. Author-Name: Williamson, J.D. Author-Name: Guralnik, J.M. Year: 2001 Volume: 91 Issue: 1 Pages: 68-75 Abstract: Objectives. This study described the prevalence and characteristics of financial difficulty acquiring food and its relation to nutritional biomarkers in older disabled women. Methods. Baseline data were analyzed from the Women's Health and Aging Study, a population-based survey of 1002 community-dwelling, disabled women 65 years and older from Baltimore, Md. Results. Minority women (49.5%) were more likely than White women (13.4%) to report financial difficulty acquiring food (odds ratio [OR] = 6.2, 95% confidence interval [CI] = 4.5, 8.6). Of the women reporting financial difficulty acquiring food, only 19.3% received food stamps and fewer than 7% participated in food assistance programs. Women reporting financial difficulty acquiring food had higher levels of psychologic depression than women not reporting such difficulty. Greater likelihood of financial difficulty acquiring food was associated with poorer quality of life and physical performance among White women and with more medical conditions among minority women. Finally, anemia (hemoglobin < 120 g/L) was associated with financial difficulty acquiring food (age-adjusted OR = 2.9, 95% CI = 1.9, 4.3). Conclusions. Financial difficulty acquiring food was common, and receipt of nutritional services was rare, in community-dwelling, older disabled women. Nutrition assistance programs for the elderly should reexamine their effectiveness in preventing nutritional deficits in older disabled women. Handle: RePEc:aph:ajpbhl:2001:91:1:68-75_4 Template-Type: ReDIF-Article 1.0 Title: Pricing and promotion effects on low-fat vending snack purchases: The CHIPS study Journal: American Journal of Public Health Author-Name: French, S.A. Author-Name: Jeffery, R.W. Author-Name: Story, M. Author-Name: Breitlow, K.K. Author-Name: Baxter, J.S. Author-Name: Hannan, P. Author-Name: Snyder, M.P. Year: 2001 Volume: 91 Issue: 1 Pages: 112-117 Abstract: Objectives. This study examined the effects of pricing and promotion strategies on purchases of low-fat snacks from vending machines. Methods. Low-fat snacks were added to 55 vending machines in a convenience sample of 12 secondary schools and 12 worksites. Four pricing levels (equal price, 10% reduction, 25% reduction, 50% reduction) and 3 promotional conditions (none, low-fat label, low-fat label plus promotional sign) were crossed in a Latin square design. Sales of low-fat vending snacks were measured continuously for the 12-month intervention. Results. Price reductions of 10%, 25%, and 50% on low-fat snacks were associated with significant increases in low-fat snack sales; percentages of lowfat snack sales increased by 9%, 39%, and 93%, respectively. Promotional signage was independently but weakly associated with increases in low-fat snack sales. Average profits per machine were not affected by the vending interventions. Conclusions. Reducing relative prices on low-fat snacks was effective in promoting lower-fat snack purchases from vending machines in both adult and adolescent populations. Handle: RePEc:aph:ajpbhl:2001:91:1:112-117_9 Template-Type: ReDIF-Article 1.0 Title: Backpack = back pain Journal: American Journal of Public Health Author-Name: Guyer, R.L. Year: 2001 Volume: 91 Issue: 1 Pages: 16-19 Handle: RePEc:aph:ajpbhl:2001:91:1:16-19_3 Template-Type: ReDIF-Article 1.0 Title: Prevalence of individuals with skinfolds too large to measure [1] Journal: American Journal of Public Health Author-Name: Himes, J.H. Year: 2001 Volume: 91 Issue: 1 Pages: 154-155 Handle: RePEc:aph:ajpbhl:2001:91:1:154-155_1 Template-Type: ReDIF-Article 1.0 Title: A novel approach to directly observed therapy for tuberculosis in an HIV-endemic area Journal: American Journal of Public Health Author-Name: Desvarieux, M. Author-Name: Hyppolite, P.-R. Author-Name: Johnson W.D., Jr. Author-Name: Pape, J.W. Year: 2001 Volume: 91 Issue: 1 Pages: 138-141 Abstract: Objectives. This study evaluated a novel approach to the delivery of directly observed therapy (DOT) for tuberculosis in Haiti. Methods. A total of 194 patients (152 HIV seropositive, 42 HIV seronegative) received daily unsupervised triple-drug therapy for 4 to 8 weeks, followed by twice-weekly 2-drug therapy for the remainder of the 6-month period. DOT was deferred until initiation of the twice-weekly phase. Results. A total of 169 of 194 patients (87.1%) completed the 6-month course. The program of deferred DOT had an effectiveness of 85%. Overall cost was reduced by approximately 40%. Conclusions. Flexible approaches to DOT, integrating behavioral knowledge, cost considerations, and practicality may improve completion rates and program effectiveness. Handle: RePEc:aph:ajpbhl:2001:91:1:138-141_1 Template-Type: ReDIF-Article 1.0 Title: Population-based estimates of mortality associated with diabetes: Use of a death certificate check box in North Dakota Journal: American Journal of Public Health Author-Name: Tierney, E.F. Author-Name: Geiss, L.S. Author-Name: Engelgau, M.M. Author-Name: Thompson, T.J. Author-Name: Schaubert, D. Author-Name: Shireley, L.A. Author-Name: Vukelic, P.J. Author-Name: McDonough, S.L. Year: 2001 Volume: 91 Issue: 1 Pages: 84-92 Abstract: Objectives. Overall and cause-specific mortality among persons with diabetes in North Dakota was estimated and compared with estimates from previous population-based studies. Methods. Data were derived from North Dakota death certificate data, which included unique information on decedents' diabetes status and Behavioral Risk Factor Surveillance System estimates of the diabetic and nondiabetic adult populations of North Dakota. Results. The risk of death among adults with diabetes was 2.6 (2.2, 2.9) times that of adults without diabetes. Relative risks of death among adults with diabetes were at least twice as high for heart disease, cerebrovascular disease, accidents and adverse events, and kidney disease and 70% to 80% higher for pneumonia and influenza, malignant neoplasms, arterial disease, and other causes. Risks remained substantial in the oldest age group. These findings are comparable to results of other population-based studies. Conclusions. Diabetes status information enhanced the usefulness of death certificate data in examining mortality associated with diabetes and confirms that the effect of diabetes on death is substantial. Handle: RePEc:aph:ajpbhl:2001:91:1:84-92_0 Template-Type: ReDIF-Article 1.0 Title: Socioeconomic inequality in voting participation and self-rated health Journal: American Journal of Public Health Author-Name: Blakely, T.A. Author-Name: Kennedy, B.P. Author-Name: Kawachi, I. Year: 2001 Volume: 91 Issue: 1 Pages: 99-104 Abstract: Objectives. This study tested the hypothesis that disparities in political participation across socioeconomic status affect health. Specifically, the association of voting inequality at the state level with individual self-rated health was examined. Methods. A multilevel study of 279066 respondents to the Current Population Survey (CPS) was conducted. State-level inequality in voting turnout by socioeconomic status (family income and educational attainment) was derived from November CPS data for 1990, 1992, 1994, and 1996. Results. Individuals living in the states with the highest voting inequality had an odds ratio of fair/poor self-rated health of 1.43 (95% confidence interval [CI] = 1.22, 1.68) compared with individuals living in the states with the lowest voting inequality. This odds ratio decreased to 1.34 (95% CI = 1.14, 1.56) when state income inequality was added and to 1.27 (95% Cl = 1.10, 1.45) when state median income was included. The deleterious effect of low individual household income on self-rated health was most pronounced among states with the greatest voting and income inequality. Conclusions. Socioeconomic inequality in political participation (as measured by voter turnout) is associated with poor self-rated health, independently of both income inequality and state median household income. Handle: RePEc:aph:ajpbhl:2001:91:1:99-104_7 Template-Type: ReDIF-Article 1.0 Title: Socioeconomic status and the prevalence of health problems among married couples in late midlife Journal: American Journal of Public Health Author-Name: Wilson, S.E. Year: 2001 Volume: 91 Issue: 1 Pages: 131-135 Abstract: Objectives. This study analyzed the association between socioeconomic status (SES) and the prevalence of mutually occurring health problems among married couples in late midlife. Methods. Data consisted of 4746 married couples aged 51 to 61 years from the 1992 US Health and Retirement Study. Two health measures were used: (1) self-assessed health status and (2) an index of functional limitations and activity restrictions. SES indicators were household income, education, and insurance coverage. Results. In general, after adjustment for age cohort, a strong association was found between the health of a married individual and the health of his or her spouse. SES was highly associated with the joint occurrence of health problems among marriage partners. Conclusions. Public health policy should pay particular attention to the interaction between health, SES, and interpersonal relationships. Handle: RePEc:aph:ajpbhl:2001:91:1:131-135_0 Template-Type: ReDIF-Article 1.0 Title: Prevalence and duration of hepatitis C among injection drug users in San Francisco, Calif Journal: American Journal of Public Health Author-Name: Lorvick, J. Author-Name: Kral, A.H. Author-Name: Seal, K. Author-Name: Gee, L. Author-Name: Edlin, B.R. Year: 2001 Volume: 91 Issue: 1 Pages: 46-47 Handle: RePEc:aph:ajpbhl:2001:91:1:46-47_3 Template-Type: ReDIF-Article 1.0 Title: Sharing of drug preparation equipment as a risk factor for hepatitis C Journal: American Journal of Public Health Author-Name: Hagan, H. Author-Name: Thiede, H. Author-Name: Weiss, N.S. Author-Name: Hopkins, S.G. Author-Name: Duchin, J.S. Author-Name: Alexander, E.R. Year: 2001 Volume: 91 Issue: 1 Pages: 42-46 Abstract: Objectives. This study investigated the sharing of drug preparation equipment as a possible route of hepatitis C virus (HCV) transmission. Methods. HCV seroconversion was measured in a cohort of 317 injection drug users who tested negative for HCV antibody at recruitment. Results. Cumulative HCV incidence was 16.7% per year. Among those who did not share syringes, HCV seroconversion was associated with sharing drug cookers and filtration cotton (adjusted risk ratio=5.9; 95% confidence interval=1.1, 31.7);54% of HCV infections in injection drug users who did not share syringes were attributable to cooker/cotton sharing. Conclusions. Among injection drug users who do not share syringes, an important proportion of HCV infections may be attributed to cooker/cotton sharing. Handle: RePEc:aph:ajpbhl:2001:91:1:42-46_2 Template-Type: ReDIF-Article 1.0 Title: Socioeconomic status and type 2 diabetes in African American and non-Hispanic White women and men: Evidence from the Third National Health and Nutrition Examination Survey Journal: American Journal of Public Health Author-Name: Robbins, J.M. Author-Name: Vaccarino, V. Author-Name: Zhang, H. Author-Name: Kasl, S.V. Year: 2001 Volume: 91 Issue: 1 Pages: 76-83 Abstract: Objectives. This study examined the associations of poverty income ratio (PIR), education, and occupational status with type 2 diabetes prevalence among African American and non-Hispanic White (White) women and men aged 40 to 74 years. Methods. We analyzed cross-sectional data from the Third National Health and Nutrition Examination Survey, controlling for age and examination-related variables. Results. Among African American women, there was a strong, graded association between PIR and diabetes, which remained significant after other risk factors were adjusted for. All 3 variables were significantly associated with diabetes among White women. Among White men, only PIR was significantly associated with diabetes. Controlling for risk factors substantially attenuated these associations among White women. There were no significant associations for African American men. Conclusions. Socioeconomic status is associated with type 2 diabetes prevalence among women, but not consistently among men. Diabetes prevalence is more strongly associated with PIR than with education or occupational status. These associations are largely independent of other risk factors, especially among African American women. Economic resources should be addressed in efforts to explain and reverse the increasing prevalence of diabetes in the United States. Handle: RePEc:aph:ajpbhl:2001:91:1:76-83_6 Template-Type: ReDIF-Article 1.0 Title: Trends in adolescent suicide: Misclassification bias? Journal: American Journal of Public Health Author-Name: Mohler, B. Author-Name: Earls, F. Year: 2001 Volume: 91 Issue: 1 Pages: 150-153 Abstract: Objectives. This study investigated the effect of misclassification of accidental deaths and undetermined deaths on age-, sex-, and race/ethnicity-specific adolescent suicide rates from 1979 through 1994. Methods. Official mortality data were used to present suicide mortality trends. Two estimates of misclassified suicides in other death categories were applied to calculate "corrected" trends of adolescent suicide. Results. The corrected trends showed a downward adjustment for Black adolescent males and young adolescents. This result does not, however, substantially alter the trend toward a recent increase in suicide in these groups. Conclusions. Despite misclassification, the true direction of trends in adolescent suicide is reflected in recent official data. However, suicide rates should continuously be tested for misclassification, mainly in populations with proportionately high accidental and undetermined death rates. Handle: RePEc:aph:ajpbhl:2001:91:1:150-153_2 Template-Type: ReDIF-Article 1.0 Title: Breast cancer size and stage in Hispanic American women, by birthplace: 1992-1995 Journal: American Journal of Public Health Author-Name: Hedeen, A.N. Author-Name: White, E. Year: 2001 Volume: 91 Issue: 1 Pages: 122-125 Abstract: Objectives. This study examined whether Hispanic women with breast cancer have tumor characteristics associated with delayed detection and whether these characteristics vary by birthplace. Methods. Surveillance, Epidemiology, and End Results program data were used in examining breast cancer size and stage by racial/ethnic group and birthplace. Results. Hispanic women with breast cancer had a higher percentage of tumors larger than 1 cm (77.7%) than non-Hispanic Whites (70.3%), as well as a higher percentage of tumors larger than 2 cm (45.9% vs 33.0%). Furthermore, in comparison with Hispanic women born in the United States. Hispanic American women born in Latin America had higher percentages of tumors larger than 1 cm (82.2% vs 75.2%) and larger than 2 cm (54.1% vs 41.7%). Conclusions. These findings suggest that Hispanic women with breast cancer, especially first-generation Hispanic Americans, have a relative delay in the timeliness of their cancer diagnosis. First-generation Hispanic American women should be targeted in interventions designed to increase the use of breast cancer screening. Handle: RePEc:aph:ajpbhl:2001:91:1:122-125_2 Template-Type: ReDIF-Article 1.0 Title: Sentinel surveillance as an alternative approach for monitoring antibiotic-resistant invasive pneumococcal disease in Washington State Journal: American Journal of Public Health Author-Name: Jernigan, D.B. Author-Name: Kargacin, L. Author-Name: Poole, A. Author-Name: Kobayashi, J. Year: 2001 Volume: 91 Issue: 1 Pages: 142-145 Abstract: Objectives. As an alternative to statewide, mandated surveillance for antibiotic-resistant Streptococcus pneumoniae, a sentinel surveillance network of 27 hospitals was developed in Washington State. Methods. The utility of targeted surveillance in population centers was assessed, current laboratory susceptibility testing practices were evaluated, and a baseline of pneumococcal resistance in Washington State was obtained for use in a statewide campaign promoting the judicious use of antibiotics. Results. Between July 1997 and June 1998, 300 cases were reported; 67 (22%) had diminished susceptibility to penicillin. Only 191 (64%) were fully tested with penicillin and an extended-spectrum cephalosporin (ESC) as nationally recommended; 10.5% were resistant to penicillin and 6.8% were resistant to an ESC. The number of isolates inadequately tested declined through the year. The findings were similar to those from more comprehensive active surveillance in Oregon for the same time period. Conclusions. Targeted surveillance may be an adequate alternative for limited monitoring of antibiotic resistance for states that choose not to mandate reporting. Handle: RePEc:aph:ajpbhl:2001:91:1:142-145_4 Template-Type: ReDIF-Article 1.0 Title: The association of race/ethnicity, socioeconomic status, and physician recommendation for mammography: Who gets the message about breast cancer screening? Journal: American Journal of Public Health Author-Name: O'Malley, M.S. Author-Name: Earp, J.A.L. Author-Name: Hawley, S.T. Author-Name: Schell, M.J. Author-Name: Mathews, H.F. Author-Name: Mitchell, J. Year: 2001 Volume: 91 Issue: 1 Pages: 49-54 Abstract: Objectives. This study investigated the association between physician recommendation for mammography and race/ethnicity, socioeconomic status, and other characteristics in a rural population. Methods. In 1993 through 1994, we surveyed 1933 Black women and White women 52 years and older in 10 rural counties. Results. Fifty-three percent of the women reported a physician recommendation in the past year. White women reported recommendations significantly more often than did Black women (55% vs 45%; odds ratio= 1.49). Controlling for educational attainment and income eliminated the apparent racial/ethnic difference. After control for 5 personal, 4 health, and 3 access characteristics, recommendation for mammography was found to be more frequent among women who had access to the health care system (i.e., had a regular physician and health insurance). Recommendation was less frequent among women who were vulnerable (i.e., were older, had lower educational attainment, had lower annual family income). Conclusions. Socioeconomic status, age, and other characteristics - but not race/ethnicity - were related to reports of a physician recommendation, a precursor strongly associated with mammography use. Efforts to increase physician recommendation should include complementary efforts to help women address socioeconomic and other barriers to mammography use. Handle: RePEc:aph:ajpbhl:2001:91:1:49-54_2 Template-Type: ReDIF-Article 1.0 Title: Productivity and economic burden associated with diabetes Journal: American Journal of Public Health Author-Name: Valdmanis, V. Author-Name: Smith, D.W. Author-Name: Page, M.R. Year: 2001 Volume: 91 Issue: 1 Pages: 129-130 Abstract: Objectives. This report assessed the cost and burden of diabetes in broad terms of economic status, underlying disability, and barriers to health care - that is, as reflected in employment, income, disability days, general health status, and access to medical care. Methods. We used the 1990 to 1995 Behavioral Risk Factor Survey in Oklahoma to compare persons with diabetes with age-, sex-, and race/ethnicity-matched respondents without diabetes. Results. Persons with diabetes were significantly and substantially worse off on all economic, disability, and access measures. Conclusions. Compared with nondiabetic persons, diabetic persons have fewer resources to deal with higher levels of disability and poorer health status. Handle: RePEc:aph:ajpbhl:2001:91:1:129-130_5 Template-Type: ReDIF-Article 1.0 Title: Prevalence of hepatitis C among injection drug users in England and Wales: Is harm reduction working? Journal: American Journal of Public Health Author-Name: Hope, V.D. Author-Name: Judd, A. Author-Name: Hickman, M. Author-Name: Lamagni, T. Author-Name: Hunter, G. Author-Name: Stimson, G.V. Author-Name: Jones, S. Author-Name: Donovan, L. Author-Name: Parry, J.V. Author-Name: Gill, O.N. Year: 2001 Volume: 91 Issue: 1 Pages: 38-42 Abstract: Objectives. This study sought to establish the prevalence of hepatitis C antibodies (anti-HCV) and hepatitis B antibodies (anti-HBc) among injection drug users in England and Wales. Methods. A voluntary cross-sectional survey collected oral fluid samples and behavioral information; 2203 injectors were recruited through drug agencies, and 758 were recruited in the community. Results. Prevalence was 30% for anti-HCV, 21% for anti-HBc, and 0.9% for HIV antibodies. Anti-HCV prevalence rates were significantly greater among those with longer injecting careers, those in older age groups, those residing in London, those recruited in drug agencies, those positive for anti-HBc, and those with a previous voluntary HIV test. Conclusions. Anti-HCV prevalence rates among injectors in England and Wales, where comprehensive harm reduction programs exist, are lower than rates in other industrialized countries. Handle: RePEc:aph:ajpbhl:2001:91:1:38-42_3 Template-Type: ReDIF-Article 1.0 Title: Targeted mailed materials and the medicare beneficiary: Increasing mammogram screening among the elderly Journal: American Journal of Public Health Author-Name: Fox, S.A. Author-Name: Stein, J.A. Author-Name: Sockloskie, R.J. Author-Name: Ory, M.G. Year: 2001 Volume: 91 Issue: 1 Pages: 55-61 Abstract: Objectives. Older women have the highest breast cancer rates but are underscreened relative to their risk. Racial/ethnic minority women especially have low screening rates, often because of financial constraints. In response, Medicare introduced subsidized biennial mammogram benefits in 1991. This study examined the effect on mammography rates of an intervention that informed women about the Medicare benefit. Methods. A list frame method of subject selection was used to select random samples of eligible women from the Health Care Financing Administration's master beneficiary file. Women were interviewed by telephone in 1991 (N=917) before the targeted mailing and in 1993 (N=922). One control and 2 treatment communities participated. Results. Mammogram use increased significantly among minorities in the treatment groups. Among minorities who received the intervention, Black women were twice as likely (odds ratio=1.97) and Hispanic women were more than twice as likely (odds ratio=2.33) to undergo screening relative to their untreated cohorts. Conclusions. A targeted low-cost mailed intervention can help increase screening rates among elderly minority women. The Health Care Financing Administration should promote its benefits aggressively if it expects to reach its target - elderly beneficiaries. Handle: RePEc:aph:ajpbhl:2001:91:1:55-61_0 Template-Type: ReDIF-Article 1.0 Title: Small world, big challenges: A report from the 9th International Congress of the World Federation of Public Health Associations Journal: American Journal of Public Health Author-Name: Des Jarlais, D.C. Author-Name: Jones, A. Year: 2001 Volume: 91 Issue: 1 Pages: 14-15 Handle: RePEc:aph:ajpbhl:2001:91:1:14-15_2 Template-Type: ReDIF-Article 1.0 Title: Socioeconomic data in cancer registries [2] Journal: American Journal of Public Health Author-Name: Krieger, N. Year: 2001 Volume: 91 Issue: 1 Pages: 156-157 Handle: RePEc:aph:ajpbhl:2001:91:1:156-157_5 Template-Type: ReDIF-Article 1.0 Title: Lack of awareness of hepatitis C risk among persons who received blood transfusions before 1990 Journal: American Journal of Public Health Author-Name: Buffington, J. Author-Name: Rowel, R. Author-Name: Hinman, J.M. Author-Name: Sharp, K. Author-Name: Choi, S. Year: 2001 Volume: 91 Issue: 1 Pages: 47-48 Handle: RePEc:aph:ajpbhl:2001:91:1:47-48_0 Template-Type: ReDIF-Article 1.0 Title: Racial trends in age-specific breast cancer mortality rates in US women Journal: American Journal of Public Health Author-Name: Marbella, A.M. Author-Name: Layde, P.M. Year: 2001 Volume: 91 Issue: 1 Pages: 118-121 Abstract: Objectives. This study examined recent trends in age- and race-specific patterns of breast cancer mortality. Methods. We analyzed breast cancer mortality data for 1979 through 1996. Results. From 1993 to 1996, White women of all age groups experienced average annual decreases in breast cancer mortality. Throughout the study, young Black women had higher rates of breast cancer mortality than young White women. Older Black women had lower mortality rates than older White women in the earlier years of the study but experienced higher rates in the later years (1993-1996). Conclusions. Trends in risk factors and early detection do not provide an adequate explanation for this recent substantial increase in breast cancer mortality among older Black women. Handle: RePEc:aph:ajpbhl:2001:91:1:118-121_4 Template-Type: ReDIF-Article 1.0 Title: Editors' note Journal: American Journal of Public Health Author-Name: Hartnett, J.P. Author-Name: Minkowycz, W.J. Year: 2001 Volume: 91 Issue: 6 Pages: 901 DOI: 10.1016/S0735-1933(05)00095-3 File-URL: http://hdl.handle.net/10.1016/S0735-1933(05)00095-3 Handle: RePEc:aph:ajpbhl:10.1016/S0735-1933(05)00095-3_1 Template-Type: ReDIF-Article 1.0 Title: Editors' note Journal: American Journal of Public Health Author-Name: Fee, E. Author-Name: Brown, T.M. Year: 2001 Volume: 91 Issue: 6 Pages: 901 Handle: RePEc:aph:ajpbhl:2001:91:6:901_9 Template-Type: ReDIF-Article 1.0 Title: On encompassing sexuality Journal: American Journal of Public Health Author-Name: Kelly, B.C. Year: 2001 Volume: 91 Issue: 11 Pages: 1731-1732 Handle: RePEc:aph:ajpbhl:2001:91:11:1731-1732_8 Template-Type: ReDIF-Article 1.0 Title: Veneral disease and gay men: Opening remarks Journal: American Journal of Public Health Author-Name: Lear, W.J. Year: 2001 Volume: 91 Issue: 6 Pages: 901 Handle: RePEc:aph:ajpbhl:2001:91:6:901_0 Template-Type: ReDIF-Article 1.0 Title: Fee and brown respond Journal: American Journal of Public Health Author-Name: Fee, E. Author-Name: Brown, T.M. Year: 2001 Volume: 91 Issue: 12 Pages: 1918-1919 Handle: RePEc:aph:ajpbhl:2001:91:12:1918-1919_4 Template-Type: ReDIF-Article 1.0 Title: Erratum: The association environments with youth physical activity (American Journal of Public Health (2001) 91 (618-720)) Journal: American Journal of Public Health Author-Name: Sallis, J.F. Author-Name: Conway, T.L. Author-Name: Prochaska, J.J. Author-Name: McKenzie, T.L. Author-Name: Marshall, S.J. Author-Name: Brown, M. Year: 2001 Volume: 91 Issue: 9 Pages: 1346 Handle: RePEc:aph:ajpbhl:2001:91:9:1346_9 Template-Type: ReDIF-Article 1.0 Title: Tempo and scale of change Journal: American Journal of Public Health Author-Name: Northridge, M.E. Year: 2001 Volume: 91 Issue: 8 Pages: 1171 Handle: RePEc:aph:ajpbhl:2001:91:8:1171_6 Template-Type: ReDIF-Article 1.0 Title: Health and human rights Journal: American Journal of Public Health Author-Name: Northridge, M.E. Year: 2001 Volume: 91 Issue: 12 Pages: 1921 Handle: RePEc:aph:ajpbhl:2001:91:12:1921_0 Template-Type: ReDIF-Article 1.0 Title: Editor's note Journal: American Journal of Public Health Author-Name: Wilcox, J. Year: 2001 Volume: 91 Issue: 6 Pages: 897 Handle: RePEc:aph:ajpbhl:2001:91:6:897_9 Template-Type: ReDIF-Article 1.0 Title: Monitoring behavioral risk factors for cardiovascular disease in Russia Journal: American Journal of Public Health Author-Name: Zabina, H. Author-Name: Schmid, T.L. Author-Name: Glasunov, I. Author-Name: Potemkina, R. Author-Name: Kamardina, T. Author-Name: Deev, A. Author-Name: Konstantinova, S. Author-Name: Popovich, M. Year: 2001 Volume: 91 Issue: 10 Pages: 1613-1614 Handle: RePEc:aph:ajpbhl:2001:91:10:1613-1614_6 Template-Type: ReDIF-Article 1.0 Title: Faces of public health: Editor's note Journal: American Journal of Public Health Author-Name: Wilcox, J. Author-Name: Northridge, M. Year: 2001 Volume: 91 Issue: 1 Pages: 16 Handle: RePEc:aph:ajpbhl:2001:91:1:16_8 Template-Type: ReDIF-Article 1.0 Title: "Defeat cancer" [Vaincre le cancer] Journal: American Journal of Public Health Author-Name: Helfand, W.H. Author-Name: Lazarus, J. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 1 Pages: 20 Handle: RePEc:aph:ajpbhl:2001:91:1:20_4 Template-Type: ReDIF-Article 1.0 Title: Labor day and public health Journal: American Journal of Public Health Author-Name: Northridge, M.E. Year: 2001 Volume: 91 Issue: 9 Pages: 1347 Handle: RePEc:aph:ajpbhl:2001:91:9:1347_5 Template-Type: ReDIF-Article 1.0 Title: Untitled (one day this kid ...), by David Wojnarowicz Journal: American Journal of Public Health Author-Name: Sember, R. Year: 2001 Volume: 91 Issue: 6 Pages: 859-860 Handle: RePEc:aph:ajpbhl:2001:91:6:859-860_2 Template-Type: ReDIF-Article 1.0 Title: Cigarrette taxes and smoking during pregnancy Journal: American Journal of Public Health Author-Name: Ringel, J.S. Author-Name: Evans, W.N. Year: 2001 Volume: 91 Issue: 11 Pages: 1851-1856 Abstract: Objectives. This study sought to estimate how changes in state cigarette excise taxes affect the smoking behavior of pregnant women. Methods. Detailed information about mothers and their pregnancy was used to examine the impact of taxes on the propensity of pregnant women to smoke. The 1989 to 1995 Natality Detail Files were used in conducting analyses to assess the impact of taxes on smoking among different subpopulations. Results. Higher cigarette excise taxes reduced smoking rates among pregnant women. A tax hike of $0.55 per pack would reduce maternal smoking by about 22%. Overall, a 10% increase in price would reduce smoking rates by 7%. Estimates for subpopulations suggested that nearly all would be very responsive to tax changes, including the subpopulations with the highest smoking rates. Conclusions. Smoking rates among pregnant women are responsive to tax hikes. Handle: RePEc:aph:ajpbhl:2001:91:11:1851-1856_3 Template-Type: ReDIF-Article 1.0 Title: One world: Global health Journal: American Journal of Public Health Author-Name: Northridge, M.E. Author-Name: Wilcox, J. Year: 2001 Volume: 91 Issue: 10 Pages: 1548 Handle: RePEc:aph:ajpbhl:2001:91:10:1548_6 Template-Type: ReDIF-Article 1.0 Title: Erratum: Psychosocial work environment and depression: Epidemiologic assessment of the demand-control model (American Journal of Public Health (2000) 90 (1765-1770)) Journal: American Journal of Public Health Author-Name: Mausner-Dorsch, H. Author-Name: Eaton, W.W. Year: 2001 Volume: 91 Issue: 5 Pages: 828 Handle: RePEc:aph:ajpbhl:2001:91:5:828_0 Template-Type: ReDIF-Article 1.0 Title: New Jersey's electronic birth certificate program: Variations in data sources Journal: American Journal of Public Health Author-Name: Smulian, J. Author-Name: Ananth, C. Author-Name: Knuppel, R. Author-Name: Hanky, M. Year: 2001 Volume: 91 Issue: 5 Pages: 814-816 DOI: 10.1016/S0029-7844(99)90065-0 File-URL: http://hdl.handle.net/10.1016/S0029-7844(99)90065-0 Abstract: Objectives. This study sought to determine primary sources of data for electronic birth certificates. Methods. A survey was administered from 1997 through 1998 to maternity facilities in New Jersey requesting information about what primary information sources were used for 53 electronic birth certificate variables. Potential information sources included the facilities' maternal and infant medical records, the prenatal record, and a parent-completed birth certificate worksheet. Results. Among the 66 maternity facilities responding, there was significant variation in the choice of primary data sources for the electronic birth certificate variables examined. Conclusions. The variability of primary sources for electronic birth certificate data acquisition represents a potential cause of systematic error in reported vital statistics information. Handle: RePEc:aph:ajpbhl:10.1016/S0029-7844(99)90065-0_9 Template-Type: ReDIF-Article 1.0 Title: Readers respond to "Cholera in Paris" [2] (multiple letters) Journal: American Journal of Public Health Author-Name: Birden, H. Author-Name: Frerichs, R.R. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 8 Pages: 1170 Handle: RePEc:aph:ajpbhl:2001:91:8:1170_3 Template-Type: ReDIF-Article 1.0 Title: Erratum: Who's afraid of the truth? (American Journal of Public Health (2001) 91 (554-558)) Journal: American Journal of Public Health Author-Name: Healton, C. Year: 2001 Volume: 91 Issue: 5 Pages: 828 Handle: RePEc:aph:ajpbhl:2001:91:5:828_4 Template-Type: ReDIF-Article 1.0 Title: Strengthening the legal foundations for public health practice: A framework for action Journal: American Journal of Public Health Author-Name: Moulton, A.D. Author-Name: Matthews, G.W. Year: 2001 Volume: 91 Issue: 9 Pages: 1369 Abstract: Growing concern that public health laws may be inadequate to the challenges that confront public health practitioners has led to adoption of a Healthy People 2010 objective for improved laws and policies. It has also led to concerted efforts to strengthen the legal foundation for public health practice. In this editorial, the authors present a framework for collaborative research, analysis, and development to strengthen public health laws, skill in applying laws, and law-related information resources. Handle: RePEc:aph:ajpbhl:2001:91:9:1369_5 Template-Type: ReDIF-Article 1.0 Title: Erratum: The economic implications of self-care: The effect of lifestyle, functional adaptations, and medical self-care among a national sample of Medicare beneficiaries (American Journal of Public Health (2000) 90 (1608-1612)) 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: 2001 Volume: 91 Issue: 1 Pages: 158 Handle: RePEc:aph:ajpbhl:2001:91:1:158_4 Template-Type: ReDIF-Article 1.0 Title: "You can help defeat cancer": A multi-cultural society confronts a disease Journal: American Journal of Public Health Author-Name: Helfand, W.H. Author-Name: Lazarus, J. Author-Name: Theerman, P. Year: 2001 Volume: 91 Issue: 7 Pages: 1018 Handle: RePEc:aph:ajpbhl:2001:91:7:1018_0 Template-Type: ReDIF-Article 1.0 Title: Erratum: The short-term impact of national smoke-free workplace legislation on passive smoking and tobacco use (American Journal of Public Health (2001) 91 (1416-1418)) Journal: American Journal of Public Health Author-Name: Heloma, A. Author-Name: Jaakkola, M.S. Author-Name: Kähkönen, K. Author-Name: Reijula, K. Year: 2001 Volume: 91 Issue: 12 Pages: 1920 Handle: RePEc:aph:ajpbhl:2001:91:12:1920_1 Template-Type: ReDIF-Article 1.0 Title: Population growth [5] Journal: American Journal of Public Health Author-Name: Becker, S. Year: 2001 Volume: 91 Issue: 7 Pages: 1139-1140 Handle: RePEc:aph:ajpbhl:2001:91:7:1139-1140_0