AJPH November 2017 highlights

Date: Nov 21 2017

AJPH research on age and the opioid epidemic, HPV vaccine, US life expectancy, adolescent girls and sex education

CONTACT: For copies of articles or for information on scheduling interviews with an expert, please contact Megan Lowry

American Journal of Public Health January issue research highlights:

Individuals born between 1947 and 1964 and between 1979 and 1992 are particularly afflicted by the opioid epidemic

Researchers found that, compared with those born in 1977 and 1978, individuals born between 1947 and 1964 experienced excess risks of prescription opioid overdose death and of heroin overdose death. Those born between 1979 and 1992 also experienced an increased risk of heroin overdose death. The cohort effects were consistent between sexes. This study assessed cohort effects in prescription opioid and heroin overdose mortality in the U.S., using the National Center for Health Statistics’ multiple-cause-of-death file for 1999 to 2014.

Authors concluded that individuals born between 1947 and 1964 and between 1979 and 1992 are particularly afflicted by the opioid epidemic, and that Intervention programs are needed to reduce the excess overdose mortality in these specific demographic groups.

["Increasing Prescription Opioid and Heroin Overdose Mortality in the United States, 1999-2014: An Age-Period-Cohort Analysis." Contact: Guohua Li, MD, DrPH, Department of Epidemiology, Mailman School of Public Health, New York, NY].

Declines in anogenital warts among age groups most likely to be impacted by HPV vaccination

This study found that the prevalence of anogenital warts decreased among men and women in the age groups most likely to be affected by human papillomavirus (HPV) vaccination. Researchers noted that decreased prevalence in young men is likely attributable to herd protection from vaccination among females.

Researchers estimated annual anogenital wart prevalence during 2006 to 2014 using health care claims among U.S. private health insurance enrollees aged 15 to 39 years. Researchers measured a decline in prevalence during 2008 to 2014 among females aged 15 to 19 years, during 2009 to 2014 among women aged 20 to 24 years and among women aged 25 to 29 years. They also observed significant declines among men aged 20 to 24 years. Prevalence increased or was stable in all other sex and age groups.

["Declines in Anogenital Warts Among Age Groups Most Likely to Be Impacted by Human Papillomavirus Vaccination, United States, 2006-2014." Contact: Elaine W. Flagg, PhD, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA].

Achieving National Academy of Medicine 2030 life expectancy target will be difficult

This study quantified the improvement in U.S. life expectancy required to reach parity with high-resource nations by 2030—a U.S. health care system goal recommended by the National Academy of Medicine in 2012. 

Researchers found that, to achieve the United Nations’ projected mortality estimates for Western Europe in 2030, U.S. life expectancy must grow at 0.32 percent a year between 2016 and 2030. Although authors found that this rate is possible and does exist in some U.S. states, achieving necessary growth to meet that goal over the next 15 years will be challenging.

Authors attributed this to the fact that much all-cause mortality is structured decades earlier and, at present, older-age mortality reductions in the U.S. are decelerating. They note that addressing mortality decline at all ages will require enhanced political will and a strong commitment to health equity.

["Likelihood of the United States Meeting the Institute of Medicine’s 2030 Life Expectancy Target." Contact: David Kindig, MD, PhD, University of Wisconsin-Madison Population Health Institute, Madison, WI].

Sexual assertiveness skills and sexual decision-making in adolescent girls: randomized controlled trial of an online program

Researchers evaluated the efficacy of an interactive, online sexual health program (Health Education and Relationship Training [HEART]) for developing sexual assertiveness skills and enhancing sexual decision-making in adolescent girls. In fall 2015, 222 10th-grade girls in the Southeastern U.S. participated in either the HEART intervention or an attention-matched control. Researchers then assessed participants at pretest, immediate posttest and four-month follow-up.

At immediate posttest, girls who completed the HEART program demonstrated better sexual assertiveness skills measured with a behavioral task, higher self-reported assertiveness, intentions to communicate about sexual health, knowledge regarding HIV and other sexually transmitted diseases (STDs), safer sex norms and attitudes and condom self-efficacy compared with the control condition.

At four-month follow-up, group differences remained in knowledge regarding HIV and other STDs, condom attitudes and condom self-efficacy. This study concluded that the brief online sexual health program can improve short-term outcomes among adolescent girls and offers an exciting new option in the growing array of digital health interventions available.

[“Sexual Assertiveness Skills and Sexual Decision-Making in Adolescent Girls: Randomized Controlled Trial of an Online Program.” Contact: Laura Widman, North Carolina State University, Raleigh, NC].

Exposure to marijuana marketing after legalization of retail sales: Oregonians’ experiences, 2015–2016

This study found that most surveyed adults reported exposure to marijuana advertising following the start of retail marijuana sales in Oregon. People who do not use marijuana and those aged 18 to 24 years were as exposed to advertising, along with other groups.

Researchers conducted an online survey of 4,001 Oregon adults aged 18 years and older in November 2015 and April-May 2016. More than half of adults (54.8 percent) statewide reported seeing marijuana advertising in the past month. Exposure did not significantly differ by participant’s age or marijuana use but was higher among those living in counties with retail sales (56.5 percent) than in counties without (32.5 percent). Study authors note that advertising restrictions may be needed to protect youth and young adults from pro-use messages.

[“Exposure to Marijuana Marketing After Legalization of Retail Sales: Oregonians’ Experiences, 2015-2016.” Contact: Steven C. Fiala, MPH, Program Design and Evaluation Services, Oregon Public Health Division, Portland, OR].

Find a full list of AJPH research papers published online below:

  • The Nazi Physicians as Leaders in Eugenics and "Euthanasia":  Lessons for Today
  • Challenging and Preventing Policies that Prohibit Local Civil Rights Protections for LGBTQ People
  • Evaluation of the Environmental Scoring System in Multiple Child Asthma Intervention Programs in Boston, MA
  • Impact Of The 2010 U.S. Healthy Hunger-Free Kids Act: A Longitudinal Analysis Of School Breakfast And Lunch Participation Rates Between 2008-2015.
  • Evaluating Public Health Interventions: Let The Subject Matter Choose The Effect Measure: Ratio, Difference Or Something Else Entirely
  • Increasing Prescription Opioid And Heroin Overdose Mortality In The United States, 1999-2014: An Age-Period-Cohort Analysis
  • Can the U.S. Realistically Meet the National Academy of Medicine's 2030 Life Expectancy Target?
  • Sexual Assertiveness Skills and Sexual Decision-Making in Adolescent Girls: Randomized Controlled Trial of an Online Program
  • Risk of Concussion during Sports and Physical Education among New Mexico Middle and High School Students
  • From Nuremberg to Guantanamo: Uses of Physicians in the War on Terror
  • Characteristics of HIV-positive Transgender Men Receiving Medical Care, U.S., 2009-2014
  • American Doctors at the Nuremberg Medical Trial
  • Exposure to marijuana marketing after legalization of retail sales: Oregonians' experiences, 2015-2016
  • Declines in Anogenital Warts Among Privately Insured Males and Females, United States, 2006-2014
  • Long-Term Health Consequences of Movement Restrictions during Political Conflict
  • Beyond Nazi War Crimes Experiments:  The Voluntary Consent Requirement of the Nuremberg Code at 70

The articles above will be published online November 21, 2017, at 4 p.m. EST by AJPH under “First Look.” “First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed on paper or posted online by issue. AJPH is published by the American Public Health Association and is available at www.ajph.org.

Complimentary online access to the AJPH is available to credentialed members of the media. Address inquiries to Megan Lowry at APHA, 202-777-3913, or email her. A single print issue of the AJPH 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. For direct customer service, call 202-777-2516, or email us.

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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. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization that influences federal policy, has a 145-year perspective and brings together members from all fields of public health. Visit www.apha.org