The articles highlighted below appear in the October issue of the American Journal of Public Health, the Journal of the American Public Health Association. This month’s issue theme is prison health. The October issue of the American Journal of Public Health will be released during a forum in Washington, D.C., on September 28. For more information visit www.apha.org or call Sabrina Jones at (202) 777-2509.
Prison time increases risk for homelessness
Former prisoners who have spent time behind bars and now live on the streets are at higher risk for use, mental illness and HIV infection than homeless persons who haven’t spent time behind bars.
A study of 1,426 homeless and "marginally housed" adults found that 23.1 percent had a history of imprisonment. Among adults, prison time was also associated with a higher risk of cocaine use, mental illness, HIV infection and having more than 100 sexual partners. Those homeless people who had been imprisoned also were most likely to currently sell drugs.
The study's authors said efforts to wipe out homelessness must also address "the unmet needs of inmates who are released from prison." [From: “ Revolving Doors: Imprisonment Among the Homeless and Marginally Housed Population.” Contact: Margot B. Kushel, MD, University of California San Francisco, firstname.lastname@example.org.]
Few mentally ill juvenile detainees receive treatment
Most juvenile detainees who suffer from mental disorders do not receive treatment, according to a recent study of nearly 2,000 detainees ages 10-18.
Researchers found that only 16 percent of juvenile detainees with mental disorders received treatment either at the correctional facility where they were being held or in the community. Treatment was more often provided in the detention center (15.4 percent) than in the community (8.1 percent). The authors defined mental disorder conservatively in their study. A youth was considered to need treatment if he or she met the criteria for a major depressive episode, manic episode or psychosis within the previous six months and had impaired functioning. In general, more than one in six juvenile detainees have a major mental disorder.
"The challenge to public health is to provide accessible, innovative, and effective treatments to a population that is often beyond the reach of traditional services," the study's authors wrote.
[From: "Detecting Mental Disorder in Juvenile Detainees: Who Receives Services?" Contact: Linda Teplin, PhD, Northwestern University Medical School, Chicago, email@example.com.]
TB still a widespread problem among inmates
Despite some improvements in tuberculosis infection control in prisons and jails, TB infection remains a troubling health problem.
A study of U.S. surveillance data from 1993-2003 showed 3.7 percent of all TB cases were reported within the correctional system. TB case rates for federal and state prisons were 29.4 and 24.2 per 100,000, respectively, compared to 6.7 per 100,000 in the general population. Inmates with TB also are more likely than the general population to forgo treatment, according to the study.
[From: “An Unanswered Health Disparity: TB Among Correctional Inmates: 1993-2003.” Contact: Jessica MacNeil, MPH, Massachusetts Department of Public Health, firstname.lastname@example.org.]
Recreational physical activity better than targeted exercising for alleviating low back pain
A study of hundreds of people suffering from low back pain found that general physical activity was better than specific back exercises for alleviating their pain.
In fact, according to the study, back exercises often made a patient’s back pain worse. Researchers studied about 700 low back pain patients for 18 months and found those who participated in recreational physical activity had the best pain relief results. By contrast, those patients who performed specific back exercises were most likely to continue to suffer from back pain and disability.
“These results suggest that individuals with low back pain should refrain from specific back exercises and instead focus on nonspecific physical activities to reduce pain and improve psychological health,” the study’s authors wrote.
[From: “Effects of Recreational Physical Activity and Back Exercises on Low Back Pain and Psychological Distress: Findings from the UCLA Low Back Pain Study.” Contact: Eric L. Hurwitz, DC, PhD, University of California School of Public Health, Los Angeles, email@example.com.]
Chlamydia screening needed for adolescent boys
While routine chlamydia screening currently is only recommended for sexually active adolescent girls, boys should be screened as well.
A screening program for northern California girls was expanded to include boys age 14-18 in 10 geographically diverse pediatric departments within a large health maintenance organization. At clinics where providers used a chlamydia screening intervention, screening rates among sexually active boys rose about 60 percent, and detected chlamydia in 4 percent of those boys screened.
Chlamydia infection is considered a major public health epidemic, with 3 million new cases diagnosed annually, which disproportionately affecting adolescents. One concern is that the infection usually has no symptoms among males.
The study’s authors said, “ it is time to reassess the need for screening sexually active young men to complement ongoing screening efforts among young women; it is even conceivable that these efforts would be synergistic.”
[From: “ Screening Sexually Active Adolescents for Chlamydia trachomatis: What About the Boys?” Contact: Kathleen B. Tebb, PhD, University of California San Francisco School of Medicine, firstname.lastname@example.org .]