May 2020 Highlights

Date: Mar 19 2020

To request a full copy of any of these studies or for information on scheduling interviews with an expert, contact Arnice Cottom

American Journal of Public Health May issue research highlights:

Risk of child maltreatment or entering foster care varies by race, ethnicity

While American Indian and Alaska Native children are more likely to be at risk of entering foster care, black children are at higher risk of maltreatment, according to a May study in APHA’s American Journal of Public Health that examined the two factors.

Researchers looked at data from the Adoption and Foster Care Analysis and Reporting System, the National Child Abuse and Neglect Data, and the U.S. Centers for Disease Control and Prevention. They found that as of 2016, more than 5% of U.S. children were likely to be in foster care at some time in their lives.

About 11% of American Indian and Alaska Native children were at risk of being placed in foster care, as were 9% of black children. Asian and Pacific Islander children were at lowest risk for foster care placement, with 1.5% of such children moved into foster care. White and Hispanic children fell between the ranges.

Risks also varied by race and ethnicity for child maltreatment, the study found. Researchers examined confirmed cases of child maltreatment, which included both abuse and neglect, finding that 11.7% of all U.S. children were at risk of maltreatment in 2016.

Black children were at highest risk for confirmed maltreatment, at 18.4%, followed by American Indian and Alaska Native children, at 15.8%. White and Hispanic children were at 11% risk, and Asian and Pacific Islander children were at 3.5% risk for confirmed maltreatment.

The number of children in U.S. foster care increased slightly during the study period, while confirmed maltreatment cases remained about the same. But as child maltreatment can often go unreported and undetected by child protective services, actual numbers may be underestimated, researchers said.

The study highlights “the need for broader public health and social service interventions for vulnerable populations, who disproportionately suffer from poor health in childhood and beyond,” the researchers said.

[Author Contact: , PhD, Department of Policy Analysis and Management, Cornell University, Ithaca, NY. “Cumulative Prevalence of Confirmed Maltreatment and Foster Care Placement for US Children by Race/Ethnicity, 2011-2016.”]

Gonorrhea increasing among young low-income women in U.S.

Gonorrhea is increasing among low-income women in the U.S., while declining among low-income men, a study in the May issue of AJPH finds.

Researchers examined gonorrhea tests of over 400,000 men and women ages 16 to 24 who were enrolled in the National Job Training Program, which is open to socioeconomically disadvantaged young adults seeking job skills. The program, overseen by the Department of Labor, includes gonorrhea and chlamydia screening for all enrollees.

In 2000, almost 3% of women tested positive, but over the next 11 years, cases declined to below 2%. By 2017, gonorrhea infections among women had risen to 2.7%, the study said. Men testing positive declined from 1.4% to 0.8% from 2003 through 2017.

For women, most gonorrhea infections have no symptoms, but can cause pregnancy complications.

For both genders, positive tests were mostly found among blacks, American Indian and Alaska Natives, and people living in the South and Midwest.

“Diverging trends among men and women suggest that screening and prevention efforts may be adequate for men but may need to be targeted and strengthened to reverse the increasing prevalence among women in this high-risk sentinel population,” researchers said.

[Author Contact: Emily R. Learner, PhD, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.” Gonorrhea Prevalence Among Young Women and Men Entering the National Job Training Program, 2000–2017 “]

Underserved communities exposed to disproportionate amount of air pollution

All people benefit from breathing less particulate matter when coal-powered power plants close, but disadvantaged communities gain less than white communities, a May study in AJPH finds.

Researchers calculated air pollution and health impact based on coal-powered plant emission listings in the National Emissions Inventory for 2008, 2011 and 2014.

Between 2015 and 2017, 92 power plants closed. Researchers omitted the emission levels of the closed power plants in calculations for 2017, then compared the outcomes to mean burdens of a model analysis.

Though particulate matter emissions declined in all communities near where plants had closed, the decrease was not equitable. Low-income and minority communities had the higher burdens of particulate matter than white and high-income communities, researchers said.

“Our results indicate that subgroups living in poverty experience the greatest absolute burdens from (particulate matter),” the researchers said. “These findings support the conclusion that those living in non-white or impoverished communities are at higher risk.”

State and local policymakers involved in air quality management under the Clean Air Act could use the study findings to promote a broad strategy that promotes equity and reduces particulate matter emissions, the researchers suggested.

[Author Contact: Jennifer Richmond-Bryant, National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC.. “Disparities in Distribution of Particulate Matter Emissions from US Coal-Fired Power Plants by Race and Poverty Status After Accounting for Reductions in Operations Between 2015 and 2017”]

Socioeconomics, risk factors drive higher heart disease death rate for blacks

Differences in socioeconomic status and risks factors may explain why U.S. blacks die at a higher rate from cardiovascular disease than whites, a study in May’s AJPH finds.

Researchers examined data from a 2003-2007 medical records of over 30,000 blacks and whites who were ages 45 and older. Other records were used to determine causes of death and learn more on demographics. Participants were followed from their baseline examination between 2003 and 2007 to their death or to the end 2016 if they did not die. About 1,550 participants died of cardiovascular disease.

Black people in the study tended to die earlier than whites, the researchers found. The black-white ratio of heart disease mortality rate was 2.23 and 1.21, respectively, for people younger than age 65, the study said. For participants 65 and older, the mortality rate was 1.58 and 1.12.

Risk factors for heart disease include cigarette smoking, high cholesterol, inactivity and obesity. Researchers determined that health risk factors explained 57% of mortality differences between blacks and whites younger than 65, and 41% of mortality differences for those age 65 and older.

In addition, socioeconomic factors — such as lack of a high school diploma, health insurance or low income — explained 21% of mortality differences between blacks and whites younger than 65 years and 38% of mortality difference for those 65 and older.

Policymakers should consider ways to ensure that affordable health insurance is available to low-income black people, researchers said, citing the success of the Affordable Care Act, which increased insurance among U.S. blacks by 7% between 2011 and 2014. For people 65 and older, policymakers should consider providing subsidies for Medicare beneficiaries who are ineligible for Medicaid.

“Implementing national policies aimed at addressing social determinants of health could also potentially decrease the black-white difference in CVD mortality risk,” the researchers said.

[Author Contact: Gabriel S. Tajeu, Department of Health Services Administration and Policy, Temple University, Philadelphia, PA. “Black–White Differences in Cardiovascular Disease Mortality: A Prospective US Study, 2003–2017”]

Check out the full list of AJPH research papers that will be published online March 19:

  • A short history of occupational safety and health in the United States
  • OSHA at 50: protecting workers in a changing economy
  • Health implications of housing assignments for incarcerated transgender women
  • Disparities in distribution of particulate matter emissions from U.S. coal-fired power plants by race and poverty status after accounting for recent reductions in operations between 2015 and 2017
  • The influence of heat on daily police, medical, and fire dispatches in Boston, MA: relative risk and time-series analyses
  • The "abortion pill" misoprostol in Brazil: women’s empowerment in a conservative and repressive political environment
  • Legal liability for returning firearms to suicidal persons who voluntarily surrender them in 50 U.S. states.
  • Community health worker intervention in subsidized housing, New York City, 2016-2017
  • Influenza vaccination coverage of healthcare personnel in Los Angeles county hospitals, 2016-2017
  • Black-white differences in cardiovascular disease mortality, a prospective us study, 2003-2017
  • Cumulative prevalence of confirmed maltreatment and foster care placement for U.S. children, 2012-2016
  • Gonorrhea prevalence among young women and men entering the national job training program, 2000-2017
  • Russian Twitter accounts and the partisan polarization of vaccine discourse, 2015-2018
  • Flavored tobacco sales prohibition and non-cigarette tobacco products in retail stores, New York City, 2009-2017
  • New systematic therapies and trends in cutaneous melanoma deaths among us caucasians, 1986-2016
  • Policy changes and child blood lead levels by age 2 for children born in Illinois 2001-2014

The articles above were published online March 19, at 4 p.m. ET by AJPH.

These articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. AJPH is published by the American Public Health Association and is available at ajph.org

Complimentary online access to the Journal is available to credentialed members of the media. Address inquiries to Arnice Cottom at APHA. A single print issue of the Journal is available for $35 from the Journal’s Subscriptions Department. If you are not a member of the press, a member of APHA or a subscriber, online single-issue access is $30, and online single-article access is $22 at AJPH.org. For direct customer service, call 202-777-2516, or  email us.

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