All articles are online under First Look at www.ajph.org
American Journal of Public Health Highlights
- New York subway injuries offer prevention lessons
- Patients should be allowed to use their own terms when describing race/ethnicity
- Childhood poverty doubles obesity risk among black women
- Similar stigma attached to AIDS and SARS
The articles below are published online by the American Journal of Public Health under "First Look," and will appear in the March 2006 print issue of the Journal. "First Look" articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. Following the embargo, articles will appear under "First Look" at www.ajph.org/first_look.shtml. The American Journal of Public Health is published by the American Public Health Association and is available at www.ajph.org.
New York subway injuries offer prevention lessons
Devastating subway injuries, which often lead to amputation and can even be deadly, are more common during depressed economic times, according to a study of such injuries in New York between 1990 and 2003.
Researchers analyzed the trauma database and hospital emergency department admission logs on 208 patients who had suffered subway injuries. Eighty percent of the patients were male, with an average age of 38.8. One-fourth had a limb amputated, and almost 10 percent died from their injuries.
The study of subway injuries revealed highest rates in the early and late years of the study, with a trough in the years 1984-2000, "a period when the New York City economy was more robust." In other words, the study's authors said, depressed economic times can up the suicide rate among subway riders, and they recommend "the consideration of economic triggers for increased vigilance, as well as universal precautions, as methods for reducing the incidence of these devastating injuries." [From: "Public Health Lessons Learned from New York Subway Injuries." Contact: Amber Azniv Guth, MD, NYU School of Medicine, email@example.com.]
Patients should be allowed to use their own terms when describing race/ethnicity
Asking patients' race and ethnicity can be awkward and time consuming if providers have to read a long list of options. Is it feasible to ask this as an open-ended question and let patients use their own terms when describing their race and ethnicity instead of providing the standard check boxes?
Researchers who asked about 400 clinic patients to use their own racial and ethnic terms found the system worked well. In fact, it resulted in fewer missed results and unusable data than traditional methods of either providing standard descriptions or having a hospital registration clerk determine a patient's race or ethnicity.
Accurate collection of race and ethnicity data is an essential tool in eliminating disparities in health care, according to the study's authors. Among the multiethnic or multiracial study participants, a majority preferred using their own terms to describe themselves.
[From: "Developing and Testing a System for Rapidly and Accurately Collecting Patients' Race and Ethnicity." Contact: David W. Baker, MD, MPH, Feinberg School of Medicine, Northwestern University, Chicago, firstname.lastname@example.org.]
Childhood poverty doubles obesity risk among black women
Growing up poor significantly increases a black woman's risk of being obese, even if she overcomes poverty in adulthood. A study of 679 women in Pitt County, North Carolina, found that black women who had a low socioeconomic status in childhood were twice as likely to be obese in adulthood as those who grew up in less disadvantaged households.
Women who were still poor as adults faced the greatest obesity risk; however, even those who had lived in poverty as children, but who became middle class as adults, tended to be more obese than those who had never been poor. [From: "Life-course Socioeconomic Position and Obesity in African American Women: The Pitt County Study." Contact: Sherman A. James, PhD, Duke University, Durham, N.C., email@example.com.]
Similar stigma attached to AIDS and SARS
Even though AIDS has touched more than 122,000 New Yorkers compared to just nine reported cases of SARS, the two infectious diseases carry similar stigmatization.
Researchers surveyed about 1,000 New Yorkers asked such pointed questions as: "Should people with SARS and AIDS be quarantined?" "Should gay Chinese men be banned from entering the United States?" and "Are you afraid of catching AIDS or SARS?" They found if a person was misinformed or scared about one of the diseases, the same held true for the other disease.
Knowing more about AIDS/SARS was modestly associated with less stigmatization of people with the diseases. And For both diseases, being worried about getting the disease was associated with depression.
"There is abundant evidence that the stigmatization of AIDS has been detrimental to the health of those with AIDS and has played a role in limiting public health and medical efforts to control the disease," said the study's authors, who urged public education efforts that would shed light on all infectious diseases. [From: "Stigmatization of newly emerging infectious diseases: AIDS and SARS." Contact: Don C. Des Jarlais, PhD, Beth Israel Medical Center, New York, firstname.lastname@example.org.]