AJPH June 2016 highlights

Date: Jun 16 2016

AJPH Research: Return on investment in public health, cardiovascular risks for U.S. women, health effects of increased minimum wage

CONTACT: For copies of articles or full table of contents of an issue, contact Mandi Yohn at amanda.yohn@apha.org or 202-777-2509.

American Journal of Public Health highlights:

1. Return on investment in California county public health departments higher than investment in medical care

2. U.S. single working mothers have higher risk of heart disease, stroke and smoking

3. Increasing the minimum wage could decrease infant mortality and low birthweight

Return on investment in California county public health departments higher than investment in medical care

According to a new study in the American Journal of Public Health, the return on investment in California county public health departments is greater than investments in medical care.

Timothy Brown, PhD, with the School of Public Health, University of California, Berkeley, estimated the average return on investment for overall spending in California country public health departments from 2001-2009 by examining peer-reviewed journal articles published as part of a larger project to develop a method for determining public health return on investment by using a health economics framework. He then compared the return on investment for county departments of public health with returns on investment for various aspects of medical care.

Results showed that the return on investment for every $1 invested in California county public health departments ranged from $67.07 to $88.21. Comparatively, the estimated return on investment for medical care was much lower: returns on investment from Medicare’s investment in four major health conditions ranged from $1.10 to $4.80, and innovation in medical care ranged from $1.12 to $38.

“Given the high return on investment for public health, and what we know to be low levels of public health funding relative to medical care funding, an increase in public health funding would be a valuable investment,” Brown explains. “Investments in research must go hand-in-hand with investment in public health activities to obtain the long-term improvements in population health that we all work toward. “

[“Returns on Investment in California County Departments of Public Health.” Contact: Timothy Brown, PhD, School of Public Health, University of California, Berkeley, California.]

U.S. single working mothers have higher risk of heart disease, stroke and smoking

Single working mothers in the United States have a higher risk of heart disease, stroke and smoking than American women with other work-family histories, according to new research in the American Journal of Public Health.

Researchers examined data from the U.S. Health and Retirement Study and data from the Survey of Health, Aging and Retirement in Europe to identify distinct work-family typologies for women born between 1935 and 1956 in the U.S. and 13 European countries. Work-family trajectories were defined based on marriage, employment and child histories. They then determined if less-healthy work-family histories contribute to higher cardiovascular disease prevalence in American women compared to European women.

Results showed that being a single working mother predicted higher risk of heart disease, stroke and smoking for American women, and smoking for European women. U.S. women were also more likely to have had a history of working single motherhood than European women. However, differences in work-family histories explained only a small fraction of the higher cardiovascular risk of American women compared to European women.

“Policies and interventions that support women combining work and family roles may improve women’s cardiovascular health, but may only marginally contribute to reducing the health disadvantage of American women compared to European women,” the authors explain. “Further research should examine whether other aspects of women’s lives may be more important in understanding the differences in women’s health outcomes.”

[“Work-Family Trajectories and the Higher Cardiovascular Risk of American Women Relative to Women in 13 European Countries” Contact: Frank van Lenthe, Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.]

Increasing the minimum wage could decrease infant mortality and low birthweight

According to a new study in the American Journal of Public Health, if all states in 2014 had increased their minimum wage by $1, there would likely have been 2,790 fewer babies born with lower birthweights and 518 fewer postneonatal deaths.

Researchers estimated the effects of state-level minimum wage laws on infant outcomes by examining minimum wage laws across the 50 states from 1980 through 2011. State increases in minimum wage over the federal minimum wage were related to rates of low birthweight and postneonatal mortality.

Results showed a consistent pattern over time of health improvement associated with a higher state minimum wage. Across all models, a dollar increase in the minimum wage above the federal level was associated with a 1-2 percent decrease in low weight births and a 4 percent decrease in postneonatal mortality.

“The annual social and health cost of preterm or low weight births in the Unites States was at least $26.2 billion in 2005. The pain and suffering from the deaths of so many infants in their first year of life are incalculable,” Professor Kelli Komro, lead author of the study, noted. “That past modest changes to state minimum wage laws appear to have had such important effects bodes well for possible beneficial effects of a range of minimum wage increases currently under active public and policymaker discussion.”

[“The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight,” Contact: Kelli Komro, MPH, PhD, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.]

Find a full list of research papers to be published online on June 16, 2016, at 4 p.m. EDT below:

  • Intimate Partner Victimization and Health Risk Behaviors Among Pregnant Adolescents
  • Increasing Hepatitis B Vaccine Prevalence Among Refugee Children Arriving in the United States, 2006–2012
  • Willingness to Use Health Insurance at a Sexually Transmitted Disease Clinic: A Survey of Patients at 21 US Clinics
  • The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight
  • Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States
  • Projecting the Impact of the Affordable Care Act Provisions on Accessibility and Availability of Primary Care Providers for the Adult Population in Georgia
  • Returns on Investment in California County Departments of Public Health
  • Mortality Among Adults With Intellectual Disability in England: Comparisons With the General Population
  • Parental Race/Ethnicity and Adverse Birth Outcomes in New York City: 2000–2010
  • Reduced Prevalence of Obesity in 14 Disadvantaged Black Communities in the United States: A Successful 4-Year Place-Based Participatory Intervention
  • Evolution of Well-being and Happiness after Increases in Consumption of Fruit and Vegetables
  • Work–Family Trajectories and the Higher Cardiovascular Risk of American Women Relative to Women in 13 European Countries
  • Public Health Detailing — A Successful Strategy to Promote Judicious Opioid Analgesic Prescribing

The articles above will be published online June 16, 2016, at 4 p.m. EDT 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, and is available at www.ajph.org.

Complimentary online access to the Journal is available to credentialed members of the media. Address inquiries to Mandi Yohn at APHA, 202-777-2509, or email her. 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 www.ajph.org or for direct customer service, call 202-777-2516, or email.

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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 issue and policies grounded in research. More information is available at www.apha.org.