October 2007 AJPH Press Release

American Journal of Public Health Highlights

·         Alcohol and drug use more prevalent among Mexican migrants and their family members than other Mexicans

·         Higher-educated individuals less likely to be persistent cocaine users

·         Increasing cigarette prices don’t discourage low-income smokers

·         Lack of universal access to new AIDS drugs has exacerbated health disparities

·         Damp, moldy houses may contribute to depression

Alcohol and drug use more prevalent among Mexican migrants and their family members than other Mexicans

The prevalence of alcohol, marijuana and cocaine use and risk of alcohol abuse is significantly higher among Mexican migrants and family members of Mexican migrants than among other Mexicans.

Researchers utilized the World Mental Health version of the Composite International Diagnostic Interview to conduct 5,826 interviews. Participants were aged 18 to 65 and lived in Mexico in cities with a population of at least 2,500 people. After controlling for age, gender, education, marital status and region, researchers found that the prevalence of alcohol, marijuana and cocaine use at least once in a lifetime was significantly higher in migrants and family members of migrants than among other Mexicans. Among those who reported using substances at least once in their lives, both migrants and family members of migrants had significantly higher risk for alcohol abuse and family members of migrants had significantly higher risk of drug abuse than did other Mexicans.

“These findings suggest that patterns of substance use disorders in Mexico are linked to broader social changes associated with transnational migrations,” the study’s authors said. “In addition to the direct exposure of individuals who migrate to substance use opportunities in the United States, the transfer of social norms of substance use and the economic means for consuming drugs also appear to be involved.” [From: The Effect of Migration to the United States on Substance Use Disorders Among Mexican Migrants and Their Families. Contact: Guilherme Borges, DSc., National Institute of Psychiatry and the Metropolitan Autonomous University, Mexico City, Mexico, guibor@imp.edu.mx.]

Higher-educated individuals less likely to be persistent cocaine users

Persistent cocaine use among highly educated individuals dramatically decreased after 1990, whereas use among non–high school graduates remained constant.

Researchers used data from the National Household Survey on Drug Abuse to investigate the relationship between cocaine use and educational achievement among adults aged 19–50 between 1979 and 2002. Although non–high school graduates had a relatively constant proportion of persistent cocaine use over all survey years, the proportion of persistent use among college graduates dramatically decreased after 1990 and fell below that of non–high school graduates. The proportion of recent-onset cocaine use diminished steadily for all levels of education achievement.

“These results highlight the need for improved intervention programs that target adults with lower levels of educational achievement who persist in their cocaine use, not just prevention of first use,” the researchers said. [From: Cocaine Use and Educational Achievement: Understanding a Changing Association Over the Past 2 Decades. Contact: Valerie S. Harder, MHS, Johns Hopkins Bloomberg School of Public Health, valharder@hotmail.com]

Increasing cigarette prices don’t discourage low-income smokers

Despite increases in cigarette prices, smoking prevalence remains unchanged among low-income populations.

Researchers used data from the 1984-2004 Behavioral Risk Factor Surveillance System surveys linked to information on cigarette prices to examine the adjusted prevalence of smoking by income group and time period. Analyses included data 14 years before and 6 years after the Master Settlement Agreement (MSA) of 1998. Although smoking declined over the 20-year period, data showed that gaps in smoking participation among income groups have widened. The proportion of low-income smokers pre-MSA was 27.7 percent, increasing to 28.6 percent post-MSA; for higher-income persons smoking declined from 23.9 percent to 21.6 percent.

In addition, analysis of smoking prevalence pre- and post-MSA showed that although there was a significant effect of cigarette price on smoking before MSA, there was a dramatic drop in price sensitivity among both lower- and higher-income persons. “These findings, in turn, suggest that cigarette excise taxation may have become an ineffectual public health tobacco-control policy in the post-MSA era,” the study’s authors said.

[From: “Cigarette Prices, Smoking and the Poor: the Implications of Recent Trends.” Contact: Peter Franks, MD, Center for Health Services Research in Primary Care, School of Medicine, UC Davis, Sacramento, Calif., pfranks@ucdavis.edu.]

Lack of universal access to new AIDS drugs has exacerbated health disparities

As medical advances have brought highly effective AIDS drugs to the forefront, access to these drugs is not universal, further widening the racial and gender gap in AIDS treatment, especially among women and the elderly.

Researchers examined national AIDS deaths both before and after the advent of highly active antiretroviral treatment (HAART), a cocktail of drugs that has allowed a significant number of HIV-positive individuals to live long and productive lives. They found that the difference in the rate of AIDS-related deaths between men and women and blacks and whites widened after the widespread use of HAART, but not in every community. As with many health conditions, low-income individuals were less likely than the more affluent to have access to HAART and thus had higher death rates from AIDS.

“Further study of relatively successful communities may improve public health theory and lead to increased national equity in outcomes, even as we reap the harvest already engendered by current innovations,” the study’s authors said. [From: “Black-White Mortality from HIV-disease Before and After Introduction of HAART in 1996.” Contact: Robert S. Levine, Department of Family and Community Medicine, Meharry Medical College, Nashville, Tenn., rlevine@msm.edu.]

Damp, moldy houses may contribute to depression
Living in a damp and moldy house can contribute to depression independently of other personal and housing characteristics.

Based on a study of almost 6,000 adults living in eight European cities, researchers found that dampness and mold in a home is associated with elevated risk of depression.  This heightened risk seemed to be due to both a perceived lack of control over the housing environment and physical health problems that are likely to be related to mold exposure.