AJPH research: Harmful ads in at-risk neighborhoods, food prices and blood sugar levels, dental screenings save money

Date: Feb 20 2014

Contact: For copies of articles, call or email Kimberly Short, 202-777-2511.

In this month’s release find research about the prevalence of harmful ads in non-white, lower-income communities; healthy food prices and their association with blood sugar levels for individuals with type 2 diabetes; and the health care savings that could result from chronic health screenings at the dentist.

Contact: For copies of articles or full table of contents of this month’s released studies, call Kimberly Short at 202-777-2511 or email her

American Journal of Public Health highlights:

  1. Harmful advertising is more present in non-white, lower-income neighborhoods
  2. Food prices are associated with blood sugar levels among adults with type 2 diabetes
  3. Dental office screenings for chronic disease could save U.S. health care system millions            

Harmful advertising is more present in non-white, lower-income neighborhoods
New research from the American Journal of Public Health finds that harmful advertisements that could negatively impact health are disproportionately present in non-white, lower-income communities.

Researchers photographed outdoor advertising signs in seven Los Angeles sites of varying socioeconomic status, racial and ethnic makeup and income levels. Harmful advertising was classified into five categories: addictive behaviors like alcohol and tobacco use, violence, unhealthy eating, unsafe environments for women and content inappropriate for children.

Results indicated that in a neighborhood with a majority of Asian American residents, 44 percent of outdoor advertisements contained harmful material, the greatest out of any other area. Further, a community with income insecurity, education risk, a large number of youths and other risks, contained advertisements where 35.4 percent were unhealthy ads.

“Individuals who are continually confined – physically, financially or socially – to harmful environments are at increased risk for functional decline and accelerated mortality. In this way, outdoor advertising becomes a component of a localized environmental riskscape, a factor among many that adversely impacts human health and well-being,” the researchers conclude.

[“The Prevalence of Harmful Content on Outdoor Advertising in Los Angeles: Land Use, Community Characteristics, and the Spatial Inequality of a Public Health Nuisance,” Contact: Bryce C. Lowery, MS, MLA, Sol Price School of Public Policy, University of Southern California, Los Angeles].

Food prices are associated with blood sugar levels among adults with type 2 diabetes
Higher prices for healthy foods are associated with increased blood sugar levels among people with type 2 diabetes, according to new research from the American Journal of Public Health.

Researchers used data from the National Health and Nutrition Examination Survey and the Quarterly Food-at-Home Price Database to calculate the average price of food items in 10 food groups and then analyze the relationship of these prices with the blood sugar of a nationally representative sample of adults with type 2 diabetes, controlling for socio-demographic and health variables that are associated with blood sugar levels.

Results indicated that the prices of produce and low-fat dairy were positively associated with blood sugar. Further, the prices of calories, sugar and saturated fat were negatively associated with blood sugar. In addition, the relationship between food prices and blood sugar was strongest among the poor.

“These findings suggest that low-income U.S. adults with type 2 diabetes benefit more (in terms of blood sugar) from low prices of healthy food than their higher-income counterparts,” the researchers wrote.

“Taken together [previous research] and the present study underscore the importance of the affordability of healthy diets for mitigating the risk of chronic diseases among U.S. adults, a topic of continuing interest in the research and policymaking communities,” they conclude.

[“The Association Between Food Prices and the Blood Glucose Level of U.S. Adults With Type 2 Diabetes,” Contact: Tobenna Anekwe, ScD, Economic Research Service, U.S. Department of Agriculture, Washington, D.C.].

Dental office screenings for chronic disease could save U.S. health care system millions
New findings from the American Journal of Public Health reveal that conducting chronic disease screenings at the dentist could save the U.S. health care system up to $65.3 million over the course of a year, or $20.82 per person screened.

Researchers sought to determine the cost savings of medical screenings in the dental office for adults ages 40 and over who had not been previously diagnosed with chronic health conditions, such as diabetes, hypercholesterolemia and hypertension, and who had not visited a physician’s office in the past 12 months. The study used population data, estimates of chronic disease prevalence, rates of medication adherence and medical cost estimates from various data sets and studies to develop its estimates.

Findings indicated that, depending on the rate to which referral from dentist to physician occurred, medical screenings for diabetes, hypercholesterolemia and hypertension at the dentist office could save the health care system between $5.1 million to $65.3 million per year.

“The dental community could serve as a beneficial resource for helping individuals unaware of their disease status to engage with the primary health care system. To ensure that chairside medical screening in a dental setting is a cost-beneficial strategy that also improves patients’ outcomes, attention to developing formal referral mechanisms between the dentist and the physician and identifying optimum approaches to ensuring referral completion is warranted,” the study’s authors suggest.

[“Effect of Oral Health Professionals on Health Care Dollars Through Chairside Chronic Disease Screenings: A Cost-Benefit Model.” Contact: Kamyar Nasseh, PhD, Health Economist, Health Policy Resources Center, American Dental Association, Chicago, Ill.].

Find a full list of research papers to be published online on Feb. 13, 2014, at 4 p.m. below:

  • Health Department Capacity for Healthcare-Associated Infection Prevention Enhanced through Recovery Act-Funded Programs
  • Assessing the impact of a pertussis active surveillance program on provider testing behavior, Minnesota 2005-2009
  • Organizational Capacity for Service Integration in Community-Based Addiction Health Services  
  • Lifecourse socioeconomic status and longitudinal accumulation of allostatic load in adulthood : Multi-Ethnic Study of Atherosclerosis 
  • Effectiveness of the Cigarette Ignition Propensity Standard in Preventing Unintentional Residential Fires in Massachusetts
  • Trends in BMI and Prevalence of Extreme High Obesity among Pennsylvania Children and Adolescents, 2007-2011: Promising but Cautionary 
  • State Indoor Tanning Laws and Adolescent Indoor Tanning 
  • A Rapid Needs Assessment of the Rockaway Peninsula in New York City after Hurricane Sandy and the relationship of socioeconomic status to recovery. 
  • Drinking Water Systems, Hydrology, and Childhood Gastrointestinal Illness in Central and Northern Wisconsin 
  • Determinants of care-seeking for children with pneumonia and diarrhoea in Guatemala: implications for intervention strategies 
  • The Prevalence of Harmful Content on Outdoor Advertising in Los Angeles: Land use, community characteristics, and the spatial inequality of a public health nuisance
  • Healthy Homes: In-Home Environmental Asthma Intervention in a Diverse Urban Community 
  • Employment Impact of Sugar-Sweetened Beverage Taxes 
  • The Impact of Food Prices on the Blood Glucose Levels of U.S. Adults with Type 2 Diabetes 
  • Mortality differentials by immigrant groups in Sweden: The contribution of socioeconomic position 
  • The Prevalence and Treatment of Latent Tuberculosis Infection Among Newly Arrived Refugees in San Diego County; January 2010-October 2012 
  • Cumulative Risk of Guillain-Barré Syndrome among Vaccinated and Unvaccinated Populations during the 2009 H1N1 Influenza Pandemic 
  • Self-presentation on the web: Agencies serving abused and assaulted women
  • Community Violence Perpetration and Victimization among Adults with Mental Illness
  • A Multisite Study of the Prevalence of HIV using Rapid Testing in Mental Health Settings 
  • Bridging the Divide: HIV prevention research and Black men who have sex with men. 
  • Homelessness and other risk factors for HIV infection in the current outbreak among injecting drug users in Athens, Greece 
  • Transitions in Smoking Behavior during emerging adulthood: A Longitudinal Analysis of the Effect of Home Smoking Bans 
  • Do Household Smoking Bans Really Reduce Household Smoking? 
  • Tooth Loss in Appalachia and the Mississippi Delta Relative to Other Regions in the United States, 1999-2010 
  • A prospective study of clinical outcomes related to third molar removal or retention 
  • Recommendations for third molar removal: a practice-based cohort study 
  • Can oral health professionals save healthcare dollars through chairside chronic disease screenings? A cost-benefit model 
  • Strong Smokefree Laws are Associated with Dentist's Advice to Quit Smoking in 2006/07 
  • Social branding to decrease smoking among young adults in bars 
  • A Longitudinal Analysis of Cigarette Prices in Military Retail 
  • Physical Activity and Inactivity and Risk of Hip Fractures in Men

The articles above will be published online Feb. 13, 2014, at 4 p.m. (EST) by the American Journal of Public Health® under “First Look.”  “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.

The American Journal of Public Health ® is the monthly journal of the American Public Health Association. APHA champions the health of all people and all communities by strengthening the profession of public health, sharing the latest research and information, promoting best practices and advocating for public health issues and policies grounded in research.

More information is available at APHA online.

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