AJPH March 2016 highlights

Date: Mar 17 2016

AJPH Research: Burdens to Texas women seeking abortions, California water conservation, disability-free life expectancy

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. Women in Texas seeking abortions face challenges in access to care after clinic closures

2. Recycled water as conservation strategy in California reduces water, energy use, greenhouse gas emissions

3. Older women living fewer active years than men, despite longer lives

Women in Texas seeking abortions face challenges in access to care after clinic closures

Following the 2013 passage of House Bill 2 — a Texas law that places restrictions on abortion providers — women seeking abortions whose nearest clinic closed as a result of the law traveled farther and had greater out-of-pocket expenses than women whose nearest clinic stayed open, according to a new study in the American Journal of Public Health.

Researchers surveyed Texas-resident women in mid-2014 seeking abortions in 10 Texas facilities, including both Planned Parenthood–affiliated clinics and independent providers that performed more than 1,500 abortions in 2013 and provided procedures up to a gestational age of at least 14 weeks from last menstrual period. They compared indicators of burden for women whose nearest clinic in 2013 closed and those whose nearest clinic remained open.

Results showed that for women whose nearest clinic closed as a result of House Bill 2, the mean one-way distance traveled to a clinic was 85 miles, compared with 22 miles for women whose nearest clinic did not close. Further, after adjustment, more women whose nearest clinic closed traveled more than 50 miles, had to stay overnight, incurred out-of-pocket expenses greater than $100, had a frustrated demand for a medication abortion and reported that it was somewhat or very hard to get to the clinic.

“In a large state, closures of abortion clinics following the implementation of a Targeted Regulation of Abortion Provider law can impose a substantial burden on women seeking abortion care by making them travel farther, making them spend more time and money and causing them to undergo a different kind of procedure from the one they prefer,” the authors explain. “These burdens are in addition to any increase in wait times or costs that may be spread evenly over all women seeking abortion care and those that result in making legal abortion an unattainable option for some women.”

[“Impact of Clinic Closures on Women Obtaining Abortion Services After Implementation of a Restrictive Law in Texas.” Contact: Caitlin Gerdts, PhD, MPH, Ibis Reproductive Health, Oakland, California.]

Recycled water as conservation strategy in California reduces energy use and greenhouse gas emissions, improves health

According to new research in the American Journal of Public Health, expanding the use of recycled water as a conservation strategy reduces water and energy use, cuts greenhouse gas emissions and benefits public health in California – a state experiencing severe drought.

Researchers from the Fielding School of Public Health at the University of California, Los Angeles, expanded upon their health impact assessment of urban water conservation alternatives in California. They compared current conservation efforts to two options with the greatest potential impact on water and energy use in California: banning landscape irrigation and expanding alternative water sources, such as desalination and recycled water. The assessment evaluated the links among urban water use, energy consumption, greenhouse gas emissions and public health.

Results showed that among water conservation strategies evaluated, expanded use of recycled water had the greatest potential to reduce water and energy use and lower greenhouse gas emissions. Recycled water use also showed positive health benefits, including being used to: more extensively maintain green spaces; decrease air pollution; and reduce respiratory disease associated with a lower need for energy-intensive imported water.

“California’s current drought has inspired increased urgency for innovative drought solutions,” the authors explain. “Wise, effective action now can help make future reductions easier without compromising the economic, quality-of-life and health benefits provided by water.”

[“Impacts of Urban Water Conservation Strategies on Energy, Greenhouse Gas Emissions, and Health: Southern California as a Case Study.” Sharona Sokolow, MPH, Fielding School of Public Health, University of California, Los Angeles.]

Older women living fewer active years than men, despite longer lives

Older women are no longer living more active years than men, despite living longer lives, according to a new study in the American Journal of Public Health.

Researchers examined data from the 1982 and 2004 National Long Term Care Survey and the 2011 National Health and Aging Trends Study, studies designed to track long-term disability. Both samples are representative of Medicare enrollees 65 years and older. Researchers used the data to estimate age-specific mortality and disability rates, the overall chances of survival and of surviving without disability and years of active life for men and women.

Results indicated that the chances beyond age 65 of overall survival and survival without disability have increased, but different patterns of change are evident for men and women. For older men, longevity has increased, disability has been postponed to older ages, disability prevalence has fallen and the percentage of life spent active has increased. For older women, however, small increases in longevity have come with even smaller postponements in disability, an upward trend in moderate disability and stagnation of active life as a percentage of life expectancy.

“Our analysis suggests that greater focus on quality rather than quantity of life, emphasizing risk factors more commonly found among women, may be an effective strategy for extending active life. Women are more likely than men to develop a number of debilitating conditions and have fewer economic resources than men with which to accommodate declines in functioning in ways that stave off disability,” the authors explained. “Enhanced attention to these and other preventable causes of limitations among older women could extend active life and help offset impending long-term care pressures related to population aging.”

[“Disability-Free Life Expectancy Over 30 Years: A Growing Female Disadvantage in the U.S. Population,” Vicki Freedman, PhD, MA, Institute for Social Research, University of Michigan, Ann Arbor, Michigan.]

Find a full list of research papers to be published online on March 17, 2016, at 4 p.m. EDT below:

  • Sexual Orientation and All-Cause Mortality Among US Adults Aged 18 to 59 Years, 2001–2011
  • Validity of Single-Item Screening for Limited Health Literacy in English and Spanish Speakers
  • Food Gardeners’ Productivity in Laramie, Wyoming: More Than a Hobby
  • A Longitudinal Study of Multiple Drug Use and Overdose Among Young People Who Inject Drugs
  • Health Disparities in Drug- and Alcohol-Use Disorders: A 12-Year Longitudinal Study of Youths After Detention
  • Emergency Care for Homeless Patients: A French Multicenter Cohort Study
  • Food Environments and Obesity: Household Diet Expenditure Versus Food Deserts
  • Barriers to Health Care Among Adults Identifying as Sexual Minorities: A US National Study
  • Sexual Orientation Disparities in Preventable Disease: A Fundamental Cause Perspective
  • Impacts of Urban Water Conservation Strategies on Energy, Greenhouse Gas Emissions, and Health: Southern California as a Case Study
  • Community Health Workers Versus Nurses as Counselors or Case Managers in a Self-Help Diabetes Management Program
  • Impact of State Ignition Interlock Laws on Alcohol-Involved Crash Deaths in the United States
  • Sexual Identity Disparities in Smoking and Secondhand Smoke Exposure in California: 2003–2013
  • Homicides by Police: Comparing Counts From the National Violent Death Reporting System, Vital Statistics, and the Federal Bureau of Investigation Supplementary Homicide Reports
  • Prevalence and Co-Occurrence of Heavy Drinking and Anxiety and Mood Disorders Among Gay, Lesbian, Bisexual, and Heterosexual Canadians
  • Disability-Free Life Expectancy Over 30 Years: A Growing Female Disadvantage in the U.S. Population
  • Benzodiazepine Use and Hepatitis C Seroconversion in a Cohort of Persons Who Inject Drugs
  • Neighborhood Walkability and Body Mass Index Trajectories: Longitudinal Study of Canadians
  • Educational Interventions to Promote Healthy Nutrition and Physical Activity Among Older Chinese Americans: A Cluster-Randomized Trial
  • Impact of Clinic Closures on Women Obtaining Abortion Services After Implementation of a Restrictive Law in Texas

The articles above will be published online March 17, 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 issues and policies grounded in research. More information is available at www.apha.org.