Peer Reviewed: Binge Drinking and Occupation,North Dakota, 2004–2005

Introduction

Binge drinking is a leading cause of preventable death and results in employee absenteeism and lost productivity. Knowledge about the prevalence of binge drinking among employees of different occupations is limited.

Methods

We assessed the prevalence of binge drinking (i.e., consuming five or more drinks per occasion during the previous 30 days) by primary occupation using data from the 2004–2005 North Dakota Behavioral Risk Factor Surveillance System. We used logistic regression to assess the association between binge drinking and primary occupation.

Results

Overall, 24.1% (95% confidence interval [CI], 22.5–25.7) of North Dakota workers reported binge drinking. The prevalence was highest among farm or ranch employees (45.3%; 95% CI, 28.3–63.4), food or drink servers (33.4%; 95% CI, 23.9–44.4), and farm or ranch owners (32.5%; 95% CI, 26.3–39.4). The prevalence was lowest among health care workers (13.2%; 95% CI, 10.3–16.8). Compared with health care workers, the adjusted odds of binge drinking were highest among farm or ranch employees (adjusted odds ratio [AOR], 2.2; 95% CI, 0.9–5.5), food or drink servers (AOR, 2.1; 95% CI, 1.1–4.0), and farm or ranch owners (AOR, 1.7; 95% CI, 1.1–2.6). Health insurance coverage was lowest among employees in occupations with the highest prevalence of binge drinking.

Conclusion

We found occupational differences in the prevalence of binge drinking among employees in North Dakota. Many occupational categories had a high prevalence of binge drinking. We recommend the implementation of both employer-sponsored and population-based interventions to reduce binge drinking among North Dakota workers, particularly because employees in occupations with the highest rates of binge drinking had the lowest rates of health insurance coverage.     

Is the Prevalence of Specific Types of Congenital Heart Defects Different for Non-Hispanic White,Non-Hispanic Black and Hispanic Infants?

Background Our purpose was to determine the prevalence of specific types of CHD among non-Hispanic (NH)-Black, NH-White, and Hispanic infants. Methods We conducted a retrospective cohort study with 9,352 singleton infants diagnosed with conotruncal, right or left obstructive or septal CHDs from the Florida Birth Defects Registry, born 1998–2003 to resident NH-White, NH-Black, and Hispanic women aged 15–49. Defect-specific prevalence rates, prevalence ratios and P-values were calculated for each type of CHD and by number of defects for each racial/ethnic group. Results Compared to NH-Whites, NH-Blacks had higher rates of pulmonary valve atresia/stenosis but lower frequency of aortic valve atresia/stenosis and ventricular septal defect. Hispanics had lower rates of aortic valve atresia/stenosis and atrioventricular septal defects than NH-Whites. Conclusions Although few racial/ethnic differences in prevalence are present among infants with major CHD, observed differences are clinically meaningful. However, the underlying etiologies for the observed differences remain unknown.     

Correlates of Overweight and Obesity Among American Indian/Alaska Native and Non-Hispanic White Children and Adolescents: National Survey of Children’s Health, 2007

Risk factors for overweight and obesity may be different for American Indian and Alaska Native (AI/AN) children compared to children of other racial/ethnic backgrounds, as obesity prevalence among AI/AN children remains much higher. Using data from the 2007 National Survey of Children’s Health, behavioral (child’s sport team participation, vigorous physical activity, television viewing, and computer use), household (parental physical activity, frequency of family meals, rules limiting television viewing, and television in the child’s bedroom), neighborhood (neighborhood support, perceived community and school safety, and presence of parks, sidewalks, and recreation centers in the neighborhood), and sociodemographic (child’s age and sex, household structure, and poverty status) correlates of overweight/obesity (body mass index ≥85th percentile for age and sex) were assessed among 10–17 year-old non-Hispanic white (NHW) and AI/AN children residing in Alaska, Arizona, Montana, New Mexico, North Dakota, Oklahoma, and South Dakota (n = 5,372). Prevalence of overweight/obesity was 29.0 % among NHW children and 48.3 % among AI/AN children in this sample. Viewing more than 2 h of television per day (adjusted odds ratio [aOR] = 2.0; 95 % confidence interval [CI] = 1.5–2.8), a lack of neighborhood support (aOR = 1.9; 95 % CI = 1.1–3.5), and demographic characteristics were significantly associated with overweight/obesity in the pooled sample. Lack of sport team participation was significantly associated with overweight/obesity only among AI/AN children (aOR = 2.7; 95 % CI = 1.3–5.2). Culturally sensitive interventions targeting individual predictors, such as sports team participation and television viewing, in conjunction with neighborhood-level factors, may be effective in addressing childhood overweight/obesity among AI/AN children. Longitudinal studies are needed to confirm these findings.     

Peer Reviewed: Children’s Active Commuting to School: Current Knowledge and Future Directions

Introduction

Driven largely by international declines in rates of walking and bicycling to school and the noted health benefits of physical activity for children, research on children''s active commuting to school has expanded rapidly during the past 5 years. We summarize research on predictors and health consequences of active commuting to school and outline and evaluate programs specific to children''s walking and bicycling to school.

Methods

Literature on children''s active commuting to school published before June 2007 was compiled by searching PubMed, PsycINFO, and the National Transportation Library databases; conducting Internet searches on program-based activities; and reviewing relevant transportation journals published during the last 4 years.

Results

Children who walk or bicycle to school have higher daily levels of physical activity and better cardiovascular fitness than do children who do not actively commute to school. A wide range of predictors of children''s active commuting behaviors was identified, including demographic factors, individual and family factors, school factors (including the immediate area surrounding schools), and social and physical environmental factors. Safe Routes to School and the Walking School Bus are 2 public health efforts that promote walking and bicycling to school. Although evaluations of these programs are limited, evidence exists that these activities are viewed positively by key stakeholders and have positive effects on children''s active commuting to school.

Conclusion

Future efforts to promote walking and bicycling to school will be facilitated by building on current research, combining the strengths of scientific rigor with the predesign and postdesign provided by intervention activities, and disseminating results broadly and rapidly.     

Peer Reviewed: Characteristics of Young Women Who Gave Birth in the US-Mexico Border Region, 2005: The Brownsville-Matamoros Sister City Project for Women’s Health

Introduction

Childbearing during adolescence and young adulthood is associated with adverse effects on health and quality of life. Lowering birth rates among young women is a binational priority in the US-Mexico border region, yet baseline information about birth rates and pregnancy risk is lacking. Increased understanding of the characteristics of young women who give birth in the region will help target high-risk groups for sexual and reproductive health services.

Methods

We examined data on reproductive health characteristics collected in hospitals from 456 women aged 24 years or younger who gave birth from August 21 through November 9, 2005, in Matamoros, Tamaulipas, Mexico, and Cameron County, Texas. We calculated weighted percentages and 95% confidence intervals (CIs) for each characteristic and adjusted odds ratios (AORs) for Matamoros and Cameron County women by using multiple logistic regression techniques.

Results

Numbers of births per 1,000 women aged 15 to 19 years and 20 to 24 years were similar in the 2 communities (110.6 and 190.2 in Matamoros and 97.5 and 213.1 in Cameron County, respectively). Overall, 38.5% of women experienced cesarean birth. Matamoros women reported fewer prior pregnancies than did Cameron County women and were less likely to receive early prenatal care but more likely to initiate breastfeeding. Few women smoked before pregnancy, but the prevalence of alcohol use in Cameron County was more than double that of Matamoros. In both communities combined, 34.0% of women used contraception at first sexual intercourse.

Conclusion

Despite geographic proximity, similar ethnic origin, and comparable birth outcomes, young Mexican and US women showed different health behavior patterns. Findings suggest possible pregnancy prevention and health promotion interventions.     

Peer Reviewed: Workers’ Health Risk Behaviors by State,Demographic Characteristics,and Health Insurance Status

Introduction

Employers often lack data about their workers'' health risk behaviors. We analyzed state-level prevalence data among workers for 4 common health risk behaviors: obesity, physical inactivity, smoking, and missed influenza vaccination (among workers older than 50 years).

Methods

We analyzed 2007 and 2008 Behavioral Risk Factor Surveillance System data, restricting the sample to employed respondents aged 18 to 64 years. We stratified health risk behavior prevalence by annual household income, educational attainment, health insurance status, and race/ethnicity.

Results

For all 4 health risk behaviors, we found significant differences across states and significant disparities related to social determinants of health — income, education, and race/ethnicity. Among uninsured workers, prevalence of smoking was high and influenza vaccinations were lacking.

Conclusion

In this national survey study, we found that workers'' health risk behaviors vary substantially by state and by workers'' socioeconomic status, insurance status, and race/ethnicity. Employers and workplace health promotion practitioners can use the prevalence tables presented in this article to inform their workplace health promotion programs.     

Peer Reviewed: Fitness-Related Activities and Medical Claims Related to Hospital Admissions — South Africa, 2006

Introduction

We report on the effect of an incentive-based wellness program on medical claims and hospital admissions among members of a major health insurer. The focus of this investigation was specifically on fitness-related activities in this insured population.

Methods

Adult members of South Africa''s largest private health insurer (n = 948,974) were grouped, a priori, on the basis of documented participation in fitness-related activities, including gym visits, into inactive (80%, equivalent to ≤3 gym visits/y), low active (7.0%, 4-23 gym visits/y), moderate active (5.2%, 24-48 gym visits/y), and high active (7.4%, >48 gym visits/y) groups. We compared medical claims data related to hospital admissions between groups after adjustment for age, sex, medical plan, and chronic illness benefits.

Results

Hospitalization costs per member were lower in each activity group compared with the inactive group. This same pattern was demonstrated for admissions rates. There was good agreement between level of participation in fitness-related activities and in other wellness program offerings; 90% of people only nominally engaged in the wellness program also were low active or inactive, whereas 84% of those in the high active group also had the highest overall participation in the wellness program.

Conclusion

Participation in fitness-related activities within an incentive-based health insurance wellness program was associated with lower health care costs. However, involvement in fitness-related activities was generally low, and further research is required to identify and address barriers to participation in such programs.     

Peer Reviewed: Assessing Local Health Department Performance in Diabetes Prevention and Control — North Carolina, 2005

Introduction

To improve the public health system''s ability to prevent and control chronic diseases, we must first understand current practice and develop appropriate strategies for measuring performance. The objectives of this study were to measure capacity and performance of local health departments in diabetes prevention and control and to investigate characteristics associated with performance.

Methods

In 2005, we conducted a cross-sectional mailed survey of all 85 North Carolina local health departments to assess capacity and performance in diabetes prevention and control based on the 10 Essential Public Health Services and adapted from the Local Public Health System Performance Assessment Instrument. We linked survey responses to county-level data, including data from a national survey of local health departments.

Results

Local health departments reported a median of 0.05 full-time equivalent employees in diabetes prevention and 0.1 in control. Performance varied across the 10 Essential Services; activities most commonly reported included providing information to the public and to policy makers (76%), providing diabetes education (58%), and screening (74%). The mean score on a 10-point performance index was 3.5. Characteristics associated with performance were population size, health department size and accreditation status, and diabetes-specific external funding. Performance was not better in localities where the prevalence of diabetes was high or availability of primary care was low.

Conclusion

Most North Carolina local health departments had limited capacity to conduct diabetes prevention or control programs in their communities. Diabetes is a major cause of illness and death, yet it is neglected in public health practice. These findings suggest opportunities to enhance local public health practice, particularly through targeted funding and technical assistance.     

Peer Reviewed: National Trends and Disparities in the Incidence of Hepatocellular Carcinoma, 1998–2003

Introduction

Previous studies indicate that the incidence of hepatocellular carcinoma in the United States is increasing. These reports, however, have contained limited information on population groups other than whites and blacks.

Methods

We assessed recent incidence rates and trends for hepatocellular carcinoma by using newly available national data from cancer registries participating in the Centers for Disease Control and Prevention''s National Program of Cancer Registries and the National Cancer Institute''s Surveillance, Epidemiology, and End Results Program. Data from registries in 38 states and the District of Columbia met our criteria; these data covered 83% of the U.S. population. We computed age-adjusted incidence rates and annual percentages of change from 1998 through 2003.

Results

The registries that we used reported 48,048 cases of hepatocellular carcinoma (3.4 cases per 100,000 population per year) for the study period. Whites accounted for three-fourths of cases. The incidence rate for blacks was 1.7 times higher than that for whites, and the rate for Asians/Pacific Islanders was 4 times higher than that for whites. Hispanics had 2.5 times the risk of non-Hispanics. Among Asian/Pacific Islander subgroups, rates were highest for people of Vietnamese and Korean origin. For all races/ethnicities combined, the annual percentages of change were 4.8% for males and 4.3% for females (P < .05). The annual percentage of change was highest for people aged 45–59 years (9.0%, P < .05). The annual percentage of change for Asians/Pacific Islanders was statistically unchanged.

Conclusion

We document rising incidence rates of hepatocellular carcinoma in the United States during a time when the overall incidence of cancer has stabilized. Efforts to collect representative etiologic data on new hepatocellular carcinoma cases are needed to enable better characterization of trends and to guide the planning and evaluation of prevention programs.     

Peer Reviewed: Cognitive Health Messages in Popular Women’s and Men’s Magazines, 2006-2007

Introduction

Growing evidence suggests that physical activity, healthy diets, and social engagement may promote cognitive health. Popular media helps establish the public health agenda. In this study, we describe articles about cognitive health in top-circulating women''s and men''s magazines.

Methods

To identify articles on cognitive health, we manually searched all pages of 4 top-circulating women''s magazines and 4 top-circulating men''s magazines published in 2006 and 2007 to identify articles on cognitive health. We examined article volume, narrative and illustrative content, information sources, and contact resources.

Results

Women''s magazines had 27 cognitive health articles (5.32/1,000 pages), and men''s magazines had 26 (5.26/1,000 pages). Diet was the primary focus (>75% of content) in 30% of articles in women''s magazines and 27% of men''s magazines. Vitamins/supplements were the focus of 15% of articles in men''s magazines and 11% in women''s magazines. Articles mentioned physical activity, cognitive activity, and social interaction, although these subjects were rarely the focus. Articles focused more on prevention than treatment. Topics were primarily "staying sharp," memory, and Alzheimer''s disease. Colleges/universities were most often cited as sources; contacts for further information were rare. Most articles were illustrated.

Discussion

Although the volume of cognitive health articles was similar in the magazines, content differed. More articles in men''s magazines discussed multiple chronic conditions (eg, Alzheimer''s disease), whereas more in women''s magazines discussed memory. Including more articles that focus on physical activity and direct readers to credible resources could enhance the quality of cognitive health communication in the popular media.     

Family Functioning in Hispanic Parents of Adolescents: Who Benefits Most from a Family-Based HIV and Substance Use Preventive Intervention?

Prevention Science - To understand which families are likely to benefit most from resource-intensive family-based, evidence-based interventions (EBIs), we must examine the key, modifiable...     

Non-Hispanic White Women’s Exposure to Decreased Neighborhood Income and Small for Gestational Age Births: A Population-Based Study

Maternal and Child Health Journal - The relationship between non-Hispanic White (NHW) women’s decreased neighborhood income between early-life and adulthood, individual risk-status at...     

Individual Differences in Trait Motivational Reactivity Influence Children and Adolescents’ Responses to Pictures of Taboo Products

This study examined how children and adolescents respond to pictures of products whose use, for them, is socially or legally restricted (e.g., beer, liquor, cigarettes). It was theorized and found that these pictures, referred to as taboo, elicit an automatic motivational activation whose direction and intensity are influenced by age and individual differences in defensive system activation. Results show that 11–12-year-old children demonstrate primarily aversive responses to taboo products, 13–15-year-old children have less aversive responses, and 16–17-year-old children have mixed appetitive and aversive motivational responses. Further, those with high defensive system activation show larger aversive and smaller appetitive responses across the age groups. These results suggest that placing pictures of these products in prevention messages may work for the prevention goal of reduced experimentation and risk in younger children but against the prevention goal for the older children who may be more likely to be exposed to opportunities for experimentation and use.     

Peer Reviewed: Adult Tobacco Use Among Racial and Ethnic Groups Living in the United States, 2002–2005

Introduction

U.S. data on adult tobacco use and the relationship between such use and tobacco-related health disparities are primarily limited to broad racial or ethnic populations. To monitor progress in tobacco control among adults living in the United States, we present information on tobacco use for both aggregated and disaggregated racial and ethnic subgroups.

Methods

We used data from the nationally representative sample of adults aged 18 years or older who participated in the National Survey on Drug Use and Health conducted 4 times during 2002–2005. We calculated 2 outcome measures: 1) use of any tobacco product (cigarettes, chewing or snuff tobacco, cigars, or pipes) during the 30 days before each survey and 2) cigarette smoking during the 30 days before each survey.

Results

The prevalence of tobacco use among adults aged 18 years or older varied widely across racial or ethnic groups or subgroups. Overall, about 3 of 10 adults living in the United States were tobacco users during the 30 days before being surveyed. The population groups or subgroups with a tobacco-use prevalence of 30% or higher were African Americans, American Indians or Alaska Natives, Native Hawaiians or other Pacific Islanders, Puerto Ricans, and whites.

Conclusion

These results indicate that the prevalence of adult tobacco use is still high among several U.S. population groups or subgroups. Our results also support the need to design and evaluate interventions to prevent or control tobacco use that would reach distinct U.S. adult population groups or subgroups.     

Hispanic Parents of Overweight and Obese Children and Their Outcome Expectations for Children’s Television Viewing: A Qualitative Study

ObjectiveExplore parental outcome expectations (OE) regarding children’s television (TV) viewing among parents of overweight or obese children.MethodsQualitative study using semi-structured interviews with 20 parents of 5- to 8-year-old overweight or obese children.ResultsParent’s positive OE for allowing TV viewing were the convenience of using TV for entertainment or as a babysitter. Hispanic parents would limit children’s TV viewing to improve their children’s health, restrict content, and promote other activities. Negative OE such as children misbehavior and the loss of positive OE for allowing TV emerged as reasons parents may not limit TV.Conclusions and ImplicationsAlthough Hispanic parents expected to improve their child’s health by limiting TV, the negative OE may prevent them from doing so. Interventions targeting children’s TV viewing, as a strategy to fight childhood obesity, may be more effective if they promote parent’s positive OE and address parent’s negative OE for children’s TV viewing.     

Peer Reviewed: Increasing Prevalence of Gestational Diabetes and Pregnancy-Related Hypertension in Los Angeles County,California, 1991–2003

Introduction

Gestational diabetes and pregnancy-related hypertension can lead to adverse health effects in mothers and infants. We assessed recent trends in the rates of these conditions in Los Angeles County, California.

Methods

Hospital discharge data were used to identify all women aged 15–54 years who resided in the county, had a singleton delivery from 1991 through 2003, and had gestational diabetes or pregnancy-related hypertension listed as a discharge diagnosis at the time of delivery. The prevalence of each condition was calculated by calendar year, race/ethnicity, and age group. Temporal trends in the rates were assessed by using negative binomial regression models, controlling for race/ethnicity and age. Separate models were run for each racial/ethnic and age group.

Results

The age-adjusted prevalence of gestational diabetes increased more than threefold (from 14.5 cases per 1000 women in 1991 to 47.9 cases per 1000 in 2003). The age-adjusted prevalence of pregnancy-related hypertension also increased (from 40.5 cases per 1000 in 1991 to 54.4 cases per 1000 in 2003). In the multivariable regression analysis, the annual rate increase for gestational diabetes was 8.3% overall and was highest among Hispanics (9.9%). The annual rate increase for pregnancy-related hypertension was 2.8% overall and was highest among blacks (4.8%).

Conclusion

The rates of gestational diabetes and pregnancy-related hypertension are increasing in Los Angeles County. Further research is needed to determine the causes of the observed increases and the growing racial/ethnic disparities in those rates.     

Drinking and Swimming: Investigating Young Australian Males’ Intentions to Engage in Recreational Swimming While Under the Influence of Alcohol

Drowning, a largely preventable problem, continues to be a serious issue worldwide, with young men particularly at risk. Alcohol and drugs are often present among young males and, particularly for males aged 18–34 years, alcohol is considered to be a significant risk factor for drowning. The current study aimed to understand the motivations guiding the intentions of young Australian men to engage in drinking and swimming, a behaviour not yet examined systematically. A cross-sectional correlational design was adopted to investigate the ability of the theory of planned behaviour (TPB) and additional variables to predict males’ intentions to drink and swim. Males (N = 211) aged 18–34 years (Mage = 23.93, SD = 4.01) completed a survey either on-line or paper-based. The survey assessed the TPB constructs of attitude, subjective norm, and perceived behavioural control (PBC); and additional variables of group norms, anticipated regret, objective (i.e. swimming ability) and perceived (i.e. perceived severity and perceived susceptibility) risk perceptions, and past behaviour. Support was found for the TPB constructs of attitude and subjective norm, but not PBC, as well as the additional constructs of group norm, anticipated regret, objective risk, and past behaviour in predicting males’ intentions to drink and swim; explaining an overall 76 % of variance. Knowledge gained from this study will help to inform resultant interventions designed to discourage alcohol use in, on, or around water and, thus, prevent drownings in this at risk group.     

Peer Reviewed: Prenatal HIV Testing in the US-Mexico Border Region, 2005: The Brownsville-Matamoros Sister City Project for Women’s Health

Introduction

Routine prenatal human immunodeficiency virus (HIV) screening provides a critical opportunity to diagnose HIV infection, begin chronic care, and prevent mother-to-child transmission. However, little is known about the prevalence of prenatal HIV testing in the US-Mexico border region. We explored the correlation between prenatal HIV testing and sociodemographic, health behavior, and health exposure characteristics.

Methods

The study sample consisted of women who delivered live infants in 2005 in hospitals with more than 100 deliveries per year and resided in Matamoros, Tamaulipas, Mexico (n = 489), or Cameron County, Texas (n = 458). We examined univariate and bivariate distributions of HIV testing in Matamoros and Cameron County and quantified the difference in odds of HIV testing by using logistic regression.

Results

The prevalence of prenatal HIV testing varied by place of residence — 57.6% in Matamoros and 94.8% in Cameron County. Women in Cameron County were significantly more likely than those in Matamoros to be tested. Marital status, education, knowledge of methods to prevent HIV transmission (adult-to-adult), discussion of HIV screening with a health care professional during prenatal care, and previous HIV testing were significantly associated with prenatal HIV testing in Matamoros, although only the latter 2 variables were significant in Cameron County.

Conclusion

Although national policies in both the United States and Mexico recommend prenatal testing for HIV, a greater proportion of women in Cameron County were tested, compared with women in Matamoros. Efforts between Matamoros and Cameron County to improve HIV testing during pregnancy in the border region should consider correlates for testing in each community.