All articles are online at www.ajph.org
American Journal of Public Health February 2006 Highlights
- Cigarette smoking
- Smokers less likely to breastfeed
- Poor and racially mixed neighborhoods have more grocers, fewer supermarkets
- Doctors' mistaken beliefs lead to disparities in recommending cardiac bypass for black patients
- Poverty tied to poor dental health
The articles highlighted below appear in the February 2006 issue of the American Journal of Public Health, the Journal of the American Public Health Association.
Youth cigarette smoking sparked by many factors
Having parents or friends who smoke, dropping out of high school and trying cigarettes at a young age are all linked to adolescents being more likely to become smokers.
A study based on a national sample of more than 14,000 young adults 21.8 years old on average found many common factors contribute to smoking among youth. Depression, for example, increases a young person's risk of becoming a smoker, as does finding cigarettes pleasurable when first trying them. Being a "novelty seeker" also tends to lead children and teens to smoke.
Overall, according to the study, minority youth are less likely than white to try cigarettes, become daily smokers once they do try cigarettes and become dependent on nicotine once becoming daily smokers. While graduating from high school lowers white and black adolescents' risk for smoking, a high school diploma actually increased smoking rates among Hispanics in the study. [From: "Epidemiology and Correlates of Daily Smoking and Nicotine Dependence Among Young Adults in the United States" Contact: Denise B. Kandel, PhD, Columbia University, New York, N.Y., firstname.lastname@example.org.]
Smokers less likely to breastfeed
Kicking the smoking habit before or during pregnancy increases the likelihood a mother will breastfeed her infant, even if she picks up cigarettes again after her baby is born.
A study of about 3,500 Oregon mothers found that when their babies were 10 weeks old, 25.7 percent of the women who initially nursed their infants had quit breastfeeding. Mothers who quit smoking during pregnancy and stayed smoke-free after pregnancy or relapsed and began smoking again after their baby's birth did not have a significantly higher risk for early weaning than did non-smoking moms. But those women who had smoked before, during and after pregnancy were more than twice as likely not to breastfeed at 10 weeks postpartum. Women who smoked more than 10 cigarettes a day postpartum were 2.3-2.4 times more likely to wean their babies than non-smoking mothers.[From: "Breastfeeding Duration and Perinatal Cigarette Smoking in a Population-based Cohort." Contact: Jihong Liu, ScD, University of South Carolina, Columbia, S.C., email@example.com.]
Poor and racially mixed neighborhoods have more grocers, fewer supermarkets
Poverty and the racial makeup of a neighborhood seem to have a lot of influence on the type of food stores available to local residents. For example, poor neighborhoods tend to have more liquor stores and small grocers yet fewer supermarkets and fresh produce stands, according to a study of neighborhoods in North Carolina, Maryland and New York. In the study, predominantly minority and racially mixed neighborhoods had twice as many grocers as predominantly white neighborhoods, and low-income neighborhoods had four times as many grocers and half as many supermarkets as the wealthiest neighborhoods. In general, poorer neighborhoods and non-white neighborhoods had fewer fruit and vegetable markets, bakeries and natural food stores. Liquor stores were more common in poorer than in richer neighborhoods.
"Our results provide empirical support for the often-cited claim that food options differ across neighborhoods and that healthy food options may be reduced in poor and minority areas," the study's authors said. "The location of food stores depends on a complex set of factors, including the marketing decisions of large corporations, the perception of the market by small businesses, consumer demand and purchasing power, competition, local regulations and also local culture. Thus, changing the local food environment will require intersectorial approaches." [From: "Associations of Neighborhood Characteristics with the Location and Type of Food Stores." Contact: Ana V. Diez Roux, MD, PhD, University of Michigan, Ann Arbor, M.I., firstname.lastname@example.org.]
Doctors' mistaken beliefs lead to disparities in recommending cardiac bypass for black patients
Doctors may not be recommending a specific cardiac surgery to their black male patients because of misconceptions about those patients' likelihood to adhere to treatment regimens, activity level and level of education.
A study based on data from about 500 cardiac patients at eight New York hospitals showed doctors were not less likely to recommend coronary artery bypass graft surgery for black women than for white women but were significantly less likely to recommend the procedure for black male patients. Researchers surveyed doctors on the doctor's perceptions of each patient and that found if the doctors believed their patients were less educated and/or likely to be sedentary, they were less likely to recommend the surgical procedure even though the patient was clinically appropriate for the procedure.
"Our findings point to the importance of research and intervention strategies addressing the ways in which providers' beliefs about patients mediate disparities in treatment," the study's authors said. "In addition, they highlight the need for discourse and consensus development on the role of social factors in clinical decision-making." [From: "Physicians' Perceptions of Patients' Social and Behavioral Characteristics and Race Disparities in Treatment Recommendations for Men With Coronary Artery Disease" Contact: Michelle van Ryn, PhD, MPH, University of Minnesota, Minneapolis, M.N., email@example.com.]
Poverty tied to poor dental health
Lower income and education levels are tied to poor dental health, according to a study based on data from more than 15,000 people living in North Carolina, Mississippi, Minnesota and Maryland.
Researchers found that the lower a person's income and education level, the more likely that person would suffer from severe periodontitis, or advanced gum disease that can lead to tooth loss. The finding remained true even after adjusting for age, gender and neighborhood income level. Living in a lower socioeconomic neighborhood wasn't always linked to poor dental health, but, in this study, low-income whites living in disadvantaged neighborhoods had almost twice the rate of severe periodontitis as the general population.
The study's authors suggest more research into the ways neighborhoods can influence health-related behaviors, especially among less-educated and lower-income individuals.
[From: "Socioeconomic Disadvantage and Periodontal Disease: The Dental Atherosclerosis Risk in Communities Study." Contact: Luisa N. Borrell, DDS, PhD, Mailman School of Public Health, Columbia University, New York, N.Y., firstname.lastname@example.org.]