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For Immediate Release

News from the July Issue Am Jrl of Public Health

AJPH News Release


EMBARGOED UNTIL May 12, 2011, 4 P.M. (ET)


CONTACT:  For copies of articles or full table of contents of issue, call Patricia Warin, 202-777-2511, or e-mail


The articles below will be published online May 12, 2011, at 4 p.m. (ET) by the American Journal of Public Health under “First Look” at, and they are currently scheduled to appear in the July 2011 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. The American Journal of Public Health is published by the American Public Health Association,, and is available at


American Journal of Public Health Highlights:

·         More progress needed to prevent urban tuberculosis in the U.S.

·         An increased distrust of health care system is associated with lower utilization of breast and cervical screenings among women

·         Some social smokers find it difficult to quit

More progress needed to prevent urban tuberculosis in the U.S.

A new study from the American Journal of Public Health finds a significant TB burden in large U.S. cities.

Researchers investigated tuberculosis incidence rates and characteristics of patients with TB in large U.S. cities. They categorized 48 cities annually from 2000 to 2007 as reporting decreasing or non-decreasing rates with the data from the Centers for Disease Control and Prevention’s National Tuberculosis Surveillance System. They compared demographic, clinical and treatment characteristics of patients with TB. They found that 42,448 patients with TB in 48 cities accounted for 36 percent of all U.S. patients with TB, comprising 15 percent of the total U.S. population. Researchers also discovered that 29 of the 48 cities showed no significant change in TB incidence over the course of the study, which raises concerns for the elimination of TB.     

The study’s authors wrote, “Our study illustrates the need to address the continuing challenges of urban TB control and highlights some of the factors contributing to variability of TB trends among cities. It is important to detail how specific characteristics of the urban environment shape health and how observations may extend to different urban contexts.”

[From: “Epidemiology of Urban Tuberculosis in the United States, 2000-2007.” Contact: Eyal Oren, Tuberculosis Control Program, Public Health – Harbor View Medical Center, Seattle, Wash.,].           

An increased distrust of health care system is associated with lower utilization of breast and cervical screenings among women

Published today in the American Journal of Public Health, a new study reports an increased distrust of the U.S. health care system as a barrier for women from receiving preventive screening measures of breast and cervical cancer.

Researchers investigated whether health care system distrust served as a hindrance to breast and cervical cancer screening and whether different dimensions of distrust have varying impacts on cancer screenings. They utilized data on 5,268 women 18 years old and above living in Philadelphia and analyzed their use of screening services, using data from the Philadelphia Health Management Corporation’s 2008 Southeastern Pennsylvania Household Health Survey. They found high levels of health care system distrust to be associated with lower utilization of breast and cervical cancer screening services. Individual health care resources and health status were associated with utilization of cancer screening.

The study’s authors conclude, “Because distrust plays an important role in the utilization of cancer screening tests, rebuilding trust in the health care system among the American public should be a priority. The values and competence distrust in the health care system has been a barrier to public health research. Maintaining a high level of service quality and responsiveness (for example, reducing medical errors, providing transparency to patients) may reduce both competence and values distrust and, in turn, may increase the utilization of cancer screening tests.”

[From: “Effect of Health Care System Distrust on Breast and Cervical Cancer Screening in Philadelphia, Pennsylvania,” Author Contact: Tse-Chuan Yang, Population Research Institute at Pennsylvania State University,].            

Some social smokers find it difficult to quit

Self-identified “social smokers” may be considered a high-risk group with particular challenges for cessation, reports a national study from the American Journal of Public Health.  

Researchers compared the association between three different definitions of social smoking—a common pattern among young adults—and cessation indicators. The three different definitions of social smoking they used included: (1) self-identified; (2) smoking mainly with others; or (3) smoking only with others. They used a Web-enabled, cross-sectional national survey of 1,528 young adults between the ages of 18 and 25 from a panel maintained by the research group. The total sample was ethnically diverse, with 61 percent identifying themselves as White American, 13.9 percent as African American, 18.3 percent as Hispanic American, 3.9 percent as other non-Hispanic and 3 percent as biracial Hispanic. The sample was equally distributed between men and women. Researchers found that self-identified social smokers were less likely to have cessation intentions; whereas behavior social smokers (mainly or only smoked with others) were more likely than self-identified social smokers to have cessation intentions or attempts.

The study’s authors suggest, “Smoking cessation in young adults — particularly among social smokers — is both a challenge and an opportunity. ...Clinicians and researchers need to address the differences between self-identification and behavior as a social smoker to develop more effective smoking cessation strategies tailored to these two distinct groups.” 

[From: “Social Smoking among Young Adults: Investigation of Intentions and Attempts to Quit.” Contact: Anna V. Song, PhD, Tobacco Control Research and Education, University of California, San Francisco, Calif.,].   



The American Journal of Public Health is the monthly Journal of the American Public Health Association (APHA), the oldest and most diverse organization of public health professionals in the world. APHA is a leading publisher of books and periodicals promoting sound scientific standards, action programs and public policy to enhance health. More information is available at


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