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For Immediate Release

News from the May 2011 American Journal of Public Health

AJPH News Release


EMBARGOED UNTIL March 17, 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 March 17, 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 May 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:

·         Parents confusion over enrollment, eligibility leads to underutilization of public health insurance for eligible children

·         Current laws ineffective at preventing adolescents’ use of indoor tanning 

·         Antidrug advertising found to be most effective on eighth-grade girls

Parental confusion over enrollment, eligibility leads to underutilization of public health insurance for eligible children

A new study from the American Journal of Public Health reports the complexity of the enrollment process and parental confusion over eligibility and coverage status leads to the underutilization of public health insurance among their eligible children of low-income families in Oregon. 

Researchers identified characteristics of Oregon children who were eligible for the Oregon Health Plan (OHP), the state’s combined Medicaid-Children’s Health Insurance Program (CHIP), but who were not enrolled in January 2005. They assessed whether parents’ confusion regarding their children’s status affected nonenrollment. Researchers also looked at the Food Stamp Program, a state program with similar eligibility requirements to those of OHP. Linking the two administrative databases, researchers selected a random sample of 10,175 households throughout six regions in the state and found that approximately 23 percent of children enrolled in the Food Stamp Program were not enrolled in OHP.

They then conducted a mail-out survey to assess whether parent’s confusion regarding their children’s status affected nonenrollment and received 2,681 responses. Their results indicated that more than 20 percent of parents with children not administratively enrolled in OHP reported that their children were enrolled. Parents of 11.3 percent of children who were administratively enrolled reported that they were not. They also found that eligible but nonenrolled children have higher odds of being older, having higher family incomes, and having employed and uninsured parents.

The study’s authors commented, “Our data suggest that insurance coverage is a transient phenomenon for many low-income children.” They continued, “If Medicaid and CHIP are to be pillars in future health insurance reforms, public health programs should continue to work toward providing stable coverage and systems that increase parental knowledge and awareness of their children’s eligibility and enrollment status.”

[From: “Public Health Insurance: Underenrollment of Eligible Children and Parental Confusion About Children’s Enrollment Status.” Contact: Jennifer E. DeVoe, MD, Oregon Health and Science University, Portland, Ore.,].          

Current laws ineffective at preventing adolescents’ use of indoor tanning  

A new nationwide study from the American Journal of Public Health reports that current laws are not effectively working to curb adolescents’ use of indoor tanning,  proven to increase the risk for melanoma. In addition, parental attitudes of indoor tanning were found to be a large behavioral influencer on their children.

Researchers interviewed 6,125 adolescents (aged 14-17 years) and their parents, analyzed state indoor tanning laws, conducted interviews with enforcement experts, computed density of tanning facilities and evaluated these 3,399 facilities’ practices regarding access by youths. They found that in the past year, 17.1 percent of girls and 3.2 percent of boys had used indoor tanning. Several psychosocial and demographic variables significantly predicted use, including being female, older and white; having a larger allowance and a parent who used indoor tanning and allowed their adolescent to use it; and holding certain beliefs about indoor tanning’s consequences. In addition, living within 2 miles of a tanning facility was also a significant predictor. Alternatively, residing in a state with youth-access legislation was not significantly associated with use.

The study’s authors conclude, “Our data suggest that current laws, most of which involve parental consent requirements, are not working. The high rate of indoor tanning by older adolescent girls suggests that better laws are needed, preferably in the form of bans for those younger than 18 years as recommended by the World Health Organization. Parents who influence their adolescents’ indoor tanning behavior both by modeling this behavior themselves and by granting their permission for their adolescents to tan could play an important role in lowering their adolescents’ melanoma risk.”

[From: “Adolescents’ Use of Indoor Tanning: A Large-Scale Evaluation of Psychosocial, Environmental, and Policy-Level Correlates,” Media Contact: Gina Jacobs,; Lead Author: Joni A. Mayer, PhD, Institute for Behavioral and Community Health, San Diego State University, San Diego, Calif.,].           

Antidrug advertising found to be most effective on eighth-grade girls

Antidrug advertising may be an effective way to delay initiation of and reduce marijuana use among eighth-grade adolescent girls, reports a recent study from the American Journal of Public Health.  

Researchers examined the relationship between exposure to the Above the Influence antidrug campaign in 210 U.S. media markets and adolescent marijuana and alcohol use from 2006 to 2008. They analyzed monthly advertising exposure data from the Office of National Drug Control Policy and drug use data from the Monitoring the Future study. They targeted students in grades 8, 10 and 12 in their study. They found that the antidrug advertising efforts were most effective for eighth-grade adolescent girls, whereas the associations were not significant for adolescent boys or for students in grades 10 and 12.

“By grade 10 and 12 most adolescents may have already made decisions about whether to initiate marijuana use, leaving less room for antidrug advertising to have any meaningful effect,” the study’s researchers stated. “Early adolescence is a period of major transition and vulnerability. Consequently, eighth-grade adolescent girls might be especially receptive to the Above the Influence campaign’s antidrug advertisements about achievement and living life above negative influences.”  

[From: “Exposure to the Above the Influence Antidrug Advertisements and Adolescent Marijuana Use in the United States, 2006-2008.” Contact: Christopher S. Carpenter, Paul Merge School of Business at UC Irvine, Irvine, 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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