February 2022 highlights from the American Journal of Public Health

Date: Jan 27 2022

To request a full copy of any of these studies or for information on scheduling interviews with an expert, contact APHA Media Relations.

American Journal of Public Health February issue highlights:

  • Progress on reducing sodium intake stalling
  • Paid family leave tied to fewer hospitalized infants
  • Most U.S. adults with opioid addiction not receiving treatment
  • Flu vaccination rates lower in rural communities

Progress on reducing sodium intake stalling

Food manufacturers reduced sodium in their products in the early 2010s, but progress stalled out more recently, according to new research in the February AJPH.

High sodium consumption is a risk factor for hypertension, a major cause of heart disease and stroke, which are two of the nation’s leading causes of death. In 2009, the National Salt Reduction Initiative convened with a goal of reaching a 20% reduction in U.S. population sodium intake by 2014 and set voluntary reduction targets for industry. The AJPH study used the initiative’s Packaged Food Database to assess the proportion of products meeting reduced sodium targets between 2009 and 2018.

Overall, researchers found an 8.5% sales-weighted mean reduction in sodium over the study period, with most change happening between 2009 and 2012. Little change happened in the following years. The proportion of packaged foods meeting the 2012 and 2014 targets increased 48% and 45%, respectively, from 2009 to 2012, with no additional improvements through 2018.

“Our findings suggest the need for both monitoring and continued government action to ensure ongoing progress in sodium reduction in the food supply,” researchers wrote.

[Author contact: Alyssa Moran, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. “US Food Industry Progress Toward Salt Reduction, 2009-2018”]

Paid family leave tied to fewer hospitalized infants

Paid family leave is associated with fewer young infants being admitted to the hospital for a common respiratory virus, finds a new study published in the February issue of AJPH

Researchers assessed the impact of New York state’s eight-week paid family leave policy, which went into effect in 2018, on babies being hospitalized with respiratory syncytial virus bronchiolitis or any acute lower respiratory tract infection. Infants are at particular risk for hospitalization if infected with the virus, and out-of-home childcare is a known risk factor.Using hospital discharge data, the study found hospitalization rates among young infants for both conditions decreased by 30% after the introduction of paid family leave. Researchers noted that no reductions were found among babies 1 year old, “supporting the conclusion that our estimates reflected a policy effect rather than decreases attributable to other underlying factors.”

Currently, 41 U.S. states have no paid family leave law.“This work provides evidence of another avenue through which paid family leave may play an important role in improving child health through the prevention of respiratory infection in young infants,” researchers wrote.

[Author contact: Jennifer Hutcheon, BC Children’s & Women’s Hospital, Vancouver, British Columbia, Canada. “Respiratory Syncytial Virus Bronchiolitis Hospitalizations in Young Infants After the Introduction of Paid Family Leave in New York State, 2015-2019”]

Most U.S. adults with opioid addiction not receiving treatment

Less than a third of U.S. adults with an opioid use disorder receive treatment, according to a study in February’s AJPH.

Researchers examined 2015-2019 data from the National Survey on Drug Use and Health, which included more than 1.9 million U.S. adults with a past-year opioid use disorder. They found that 10.5% reported a need for treatment for an opioid use disorder, with older adults and nonwhite adults more likely to face a treatment gap than younger and white adults.

Overall, fewer than 30% of adults with an opioid use disorder received treatment, nearly three-quarters faced a treatment gap, and only about one in 10 perceived a need for treatment. Affordability was the most commonly reported barrier to treatment, followed by access, lack of readiness to quit and stigma. 
The study also found lower odds of a treatment gap among adults with public insurance, compared to those with private insurance.
“Despite efforts to improve uptake of (medications for opioid use disorder) treatment, racism, lack of affordability, access and stigma all continue to play a role in limiting treatment access,” researchers wrote.

[Author contact: Danya Qato, School of Pharmacy, University of Maryland, Baltimore, Maryland. “Self-Reported Treatment Need and Barriers to Care for Adults With Opioid Use Disorder: The US National Survey on Drug Use and Health, 2015 to 2019”]

Flu vaccination rates lower in rural communities

U.S. rural communities have lower influenza vaccination rates than their urban counterparts, finds a study in the February issue of AJPH.

Using data from the 2019 National Health Interview Survey for adults 18 and older, researchers found that about 48%, 46% and more than 43% of adults from large metropolitan, small and medium metropolitan, and nonmetropolitan areas, respectively, received a flu shot. Self-reported flu vaccination rates were lower in rural areas for adults of all ages and among both men and women.

The study also found a trend toward lower flu vaccination rates among racial and ethnic minority groups from rural areas than from more urban ones.
“Using community leaders for health promotion, augmentation of the community health care workforce, and provision of incentives for providers to integrate influenza vaccination in regular visits may expand influenza vaccine coverage,” researchers wrote.

[Author contact: Joseph Alexander Paguio, Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania. “Rural-Urban Differences in Influenza Vaccination Among Adults in the United States, 2018-2019”]

Check out the full list of AJPH research papers that published online in our First Look area.

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 APHA Media Relations. 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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