American Journal of Public Health April 2004 Highlights
- Binge drinking a national problem
- Child abuse and neglect lead to costly hospitalizations
- Speed humps help protect children from accidents
- Middle-aged women just as likely to suffer abuse
- Polluted water linked to health problems among surfers
The articles highlighted below appear in the April 2004 issue of the American Journal of Public Health, the Journal of the American Public Health Association.
Binge drinking a national problem
Binge drinking, defined as the consumption of five or more alcoholic beverages on an occasion, generally results in acute impairment and has numerous health consequences. While drinking is a problem nationwide, the percent of U.S. adults who binge drink varies substantially from one city to another.
According to a study of 120 metropolitan areas in 48 states and the District of Columbia, the median binge-drinking rate for metropolitan areas was 14.5 percent. The lowest rate of 4.1 percent was recorded in Chattanooga, Tenn., and the highest rate of 23.9 percent was recorded in San Antonio, Texas.
Using 1997 and 1999 federal survey data on almost 300,000 people, the researchers found that 17 of the 20 metropolitan areas with the highest binge drinking rates in the United States were located in the upper Midwest, Texas and Nevada. In 13 of these areas, at least one-third of 18- to 34- year-olds were binge drinkers.
The study’s authors suggest addressing the binge drinking problem by adopting such public health measures as increased alcohol excise taxes, better enforcement of the minimum legal drinking age and community-based programs that include education and enforcement.
[From: “Metropolitan-Area Estimates of Binge Drinking in the United States” Contact: Bob Brewer, MD, MSPH, Centers for Disease Control and Prevention, Atlanta, firstname.lastname@example.org , or Tim Naimi, MD, MPH, Centers for Disease Control and Prevention, Atlanta, email@example.com. ]
Child abuse and neglect lead to costly hospitalizations
Child abuse and neglect aren’t just emotionally costly. A study of 636,802 hospital stays for children age 18 or under showed when a child was hospitalized due to abuse or neglect, the costs for the stay were double. Children hospitalized because of abuse or neglect are also much more likely to die during the hospitalization and have longer stays than other children.
The study, which used data from the 1999 Nationwide Inpatient Sample of the Healthcare Costs and Utilization Project, found that children who were hospitalized due to abuse or neglect had an average of 6.3 diagnoses, compared with 2.8 for other children. Four percent of abused or neglected children died during hospitalization, compared with 0.5 percent of other children. The average total charges for children hospitalized due to abuse or neglect were $19,266 compared to $9,513 for other children. And the average hospital stay for cases connected to abuse or neglect: 8.2 days. Other children’s stays averaged four days.
The study’s authors said their estimates were conservative because abuse and neglect cases often go unidentified, but they pressed for further analysis of the diagnoses accompanying abuse and neglect. “Our findings provide the economic rationale for policies and programs to prevent child abuse and neglect,” the authors wrote.
[From: “The Economic Burden of Hospitalization Associated With Child Abuse and Neglect.” Contact: Sue L.D. Rovi, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, firstname.lastname@example.org ]
Speed humps help protect children from accidents
Speed humps help make a child's environment safer, according to a 5-year study of pediatric emergency department visits involving children struck by an automobile. In a study of children seen in the emergency department of Children's Hospital Oakland from March 1, 1995-March 1, 2000, researchers found that those children living on or near streets with speed humps were less likely to be injured or killed by automobiles than children who lived on streets without such speed humps. Living within a block of a speed hump was associated with a roughly two-fold reduction in the odds of injury within a child's neighborhood. Overall, living near a speed hump was associated with a 53-60 percent reduction in the odds of injury or death due to being struck by an automobile.
"These findings invite additional research on the protective effects of traffic calming interventions," the study's authors said. "Our study provides direct observational evidence that speed humps are associated with a reduction in the odds of childhood pedestrian injuries and supports installation of speed humps by traffic engineering departments."
[From: "A Matched Case-Control Study Evaluating the Effectiveness of Speed Humps in Reducing Child Pedestrian Injuries." Contact: June M. Tester, MD, MPH, Children's Hospital Oakland, email@example.com ]
Middle-aged women just as likely to suffer abuse
A study of more than 90,000 women age 50-79 found that abuse is a widespread problem in that age group.
Researchers found that 11.1 percent of the women surveyed reported being the victim of verbal and/or physical abuse at some time during the previous year. The study data came from survey responses recorded for the Women’s Health Initiative. Of the 91,749 women responding to questions about abuse on the study, 10,199 reported being abused within the previous 12 months. Most of the women in the survey were white, college-educated and married.
The findings suggest that older women are subject to abuse at about the same rate as younger women, pointing to a need for abuse screening across all age groups.
[From: “Prevalence and 3-Year Incidence of Abuse Among Postmenopausal Women.” Contact: Charles P. Mouton, MD, MS, University of Texas Health Science Center at San Antonio, firstname.lastname@example.org ]
Polluted water linked to health problems among surfers
Discharging untreated urban runoff onto public beaches can pose health risks, according to a study of hundreds of surfers at two California beaches.
Researchers compared rates of reported health symptoms among surfers in urban North Orange County and rural Santa Cruz County during the winters of 1998 and 1999. The urban surfers reported almost twice as many symptoms as the rural surfers in the rainy winter of 1998. And during both study years, reported symptoms increased by about 10 percent for each 2.5 hours of weekly water exposure. The health symptoms included fever, nausea, stomach pain, diarrhea, sore throat, eye redness and skin infection.
North Orange County was designated as the “urban” site because its watershed is one of the most developed areas of the world and generates highly polluted runoff waters. Santa Cruz County was the “rural” site because of its coastal water quality indicators and watershed characteristics.
“These potential health risks warrant greater public health surveillance, as well as greater efforts to reduce pollutants discharged on public beaches,” the study’s authors said. “Large-scale prospective investigations are needed to further characterize the health risks of people exposed to untreated urban runoff in coastal waters.”
[From: “Health Effects Associated With Recreational Coastal Water Use: Urban Versus Rural California.” Contact: Dean B. Baker, MD, MPH, University of California, Irvine Center for Occupational and Environmental Health, email@example.com ]