Search

Persons with alcohol use disorders (AUDs) and substance use disorders (SUDs) appear to be heavily affected by cigarette smoking. In order to address the consequences of smoking in this population, an understanding of the current state of knowledge is needed. Epidemiologic research provides the opportunity to obtain detailed information on smoking behaviors in large community samples. The aim of this paper was to synthesize the epidemiologic evidence on smoking among persons with AUDs/SUDs and suggest directions for future research. Literature searches of Medline and PubMed were used to identify articles and additional articles were elicited from publication reference lists. To be included in the review, papers had to be published in English, analyze epidemiologic data, and examine an aspect of smoking behavior in persons with AUDs/SUDs. Twenty-nine studies met inclusion criteria and were included in the review. In summary, epidemiologic evidence to date suggests greater lifetime and current smoking, nicotine dependence, and non-cigarette tobacco use; lower quitting; and differences in quit attempts and withdrawal symptoms for persons with AUDs/SUDs compared to other people. Most studies examined nationally representative data and were conducted on persons in the United States and Australia. Few publications examined outcomes by demographics (e.g., gender, age) but these studies suggested that specific patterns differ by demographic subgroups. More research is needed on persons with AUDs/SUDs in order to develop the most effective public health and clinical interventions to reduce smoking behaviors, improve cessation outcomes, and reduce the harmful consequences of smoking for those with AUDs/SUDs. [ABSTRACT FROM AUTHOR]

Abstract Despite the influence of neo-Malthusian thinking in international development and environmental policy during the mid twentieth century, this story is often told from a US-centered perspective, with population control policies seen to roll out from the world geopolitical centers to the 'Global South' via the influence of large development institutions. Latin American perspectives on the population control question are seldom considered, except to suggest that the Catholic Church provided consistent, organized opposition to the expansion of family planning services. In this paper, using an political-intellectual history approach, I explore how the population question intersected with interrelated development issues in Latin America in the first half of the twentieth century: health and nutrition, food and agriculture, rural livelihoods, economic dependency, and women's rights. I focus on the relationship between public health crises and pro-natalist policies; the influences of the eugenics movement in supporting national population growth as a biopolitical strategy; anarcho-feminist thought that stressed the emancipatory potential of fertility control and new social roles for women; the Brazilian Josué de Castro's research on the causes of famine and malnutrition, which took a structuralist approach and explicitly rejected neo-Malthusian and other environmentally determinist approaches to understand the causes of poverty and hunger; and Latin American engagements with the international family planning and population control agenda in the 1960s. With this history in mind, we can trace alternative intellectual roots of political ecology's critique of neo-Malthusianism and other deterministic environment-development theories. [ABSTRACT FROM AUTHOR]

As some preventive medicine physicians have been denied medical licenses for not engaging in direct patient care, this paper attempts to answer the question, "Do preventive medicine physicians practice medicine?" by exploring the requirements of licensure, the definition of "practice" in the context of modern medicine, and by comparing the specialty of preventive medicine to other specialties which should invite similar scrutiny. The authors could find no explicit licensure requirement for either a certain amount of time in patient care or a number of patients seen. No physicians board certified in Public Health and General Preventive Medicine sit on any state medical boards. The authors propose that state medical boards accept a broad standard of medical practice, which includes the practice of preventive medicine specialists, for licensing purposes. [ABSTRACT FROM AUTHOR]

Based on a focus group study conducted in New York City (NYC), this paper examines the traditional staples (i.e., nostalgic foods) that Latinas regularly consume in the U.S., along with their beliefs regarding the impact of such foods on weight gain and related body image. Our research findings highlight the "double-bind" of nostalgic foods, defined by Latinas' retention of highly caloric familiar items along with their progressive abandonment of fresh produce and fruits. Despite participants' efforts to eat healthy staples from their homelands, they mostly kept foods perceived as unhealthy (e.g., fatty meats, fried foods). This phenomenon was informed by the "same-food paradox," represented by Latinas' beliefs that the same traditional foods that would make them lose weight in their native countries would lead them to gain weight in the U.S. Our qualitative data show that participants' concerns about their weight gain in the U.S. is in tune with their general body dissatisfaction, as indicated by our quantitative results. Finally, our findings reveal the role of stress in promoting Latinas' deleterious daily habits, including their consumption of fat-saturated snacks. Overall, these results speak to the cultural and structural barriers to healthy eating that financially strapped study participants experienced in NYC. In order to design successful public health interventions targeting Latinas, the nostalgic aspects of food preferences should be considered in conjunction with the barriers that keep them from engaging with healthier lifestyles in the U.S. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Following cigarette excise tax increases, smokers may use cigarette price minimization strategies to continue their usual cigarette consumption rather than reducing consumption or quitting. This reduces the public health benefits of the tax increase. This paper estimates the price reductions for a wide-range of strategies, compensating for overlapping strategies. Method: We performed regression analysis on the 2009–2010 National Adult Tobacco Survey (N=13,394) to explore price reductions that smokers in the United States obtained from purchasing cigarettes. We examined five cigarette price minimization strategies: 1) purchasing discount brand cigarettes, 2) using price promotions, 3) purchasing cartons, 4) purchasing on Indian reservations, and 5) purchasing online. Price reductions from these strategies were estimated jointly to compensate for overlapping strategies. Results: Each strategy provided price reductions between 26 and 99cents per pack. Combined price reductions were possible. Additionally, price promotions were used with regular brands to obtain larger price reductions than when price promotions were used with generic brands. Conclusion: Smokers can realize large price reductions from price minimization strategies, and there are many strategies available. Policymakers and public health officials should be aware of the extent that these strategies can reduce cigarette prices. [Copyright &y& Elsevier]

Starting in the 1930s, the Tennessee Valley Authority (TVA) created a globally influential model of regional development through centralized planning of massive public works to re-engineer social and natural systems in impoverished areas. TVA invested heavily in malaria control, since its own reservoirs created perfect breeding grounds for malaria-carrying anopheles mosquitoes. Eventually, both the TVA and malaria control would become key elements in an influential metanarrative in which an American ideology of 'technological modernism' dominated international development in the post-World War II era, until modern environmentalism and other social movements undermined the assumptions and goals of this ideology. This paper argues that a more subtle understanding of the history of ecological thought in regional development and malaria control challenges the dominant metanarrative. TVA malaria control actually reflected a tension between two important and competing ideological threads of TVA's master ethos of integrated regional development: socio-ecological holism and techno-scientific reductionism. Socio-ecological holism provided the grand vision for a transformation of nature and society, conceived as a unitary whole. But it was techno-scientific reductionism, which accommodated intimate, ecologically grounded knowledge of the habitats and behaviors of anopheles mosquitoes, that made malaria control possible. In this way, the TVA experience reflected theory and practice in malaria control internationally, before the advent of DDT. [ABSTRACT FROM AUTHOR]

Abstract: Traditionally, the No-Observed-Adverse-Effect-Level (NOAEL) approach has been used to determine the point of departure (POD) from animal toxicology data for use in human health risk assessments. However, this approach is subject to substantial limitations that have been well defined, such as strict dependence on the dose selection, dose spacing, and sample size of the study from which the critical effect has been identified. Also, the NOAEL approach fails to take into consideration the shape of the dose–response curve and other related information. The benchmark dose (BMD) method, originally proposed as an alternative to the NOAEL methodology in the 1980s, addresses many of the limitations of the NOAEL method. It is less dependent on dose selection and spacing, and it takes into account the shape of the dose–response curve. In addition, the estimation of a BMD 95% lower bound confidence limit (BMDL) results in a POD that appropriately accounts for study quality (i.e., sample size). With the recent advent of user-friendly BMD software programs, including the U.S. Environmental Protection Agency''s (U.S. EPA) Benchmark Dose Software (BMDS), BMD has become the method of choice for many health organizations world-wide. This paper discusses the BMD methods and corresponding software (i.e., BMDS version 2.1.1) that have been developed by the U.S. EPA, and includes a comparison with recently released European Food Safety Authority (EFSA) BMD guidance. [Copyright &y& Elsevier]

Objective: Beverage taxes came into light with increasing concerns about obesity, particularly among youth. Sugar-sweetened beverages have become a target of anti-obesity initiatives with increasing evidence of their link to obesity. Our paper offers a method for estimating revenues from an excise tax on sugar-sweetened beverages that governments of various levels could direct towards obesity prevention. Model: We construct a model projecting beverage consumption and tax revenues based on best available data on regional beverage consumption, historic trends and recent estimates of the price elasticity of sugar-sweetened beverage demand. Results: The public health impact of beverage taxes could be substantial. An estimated 24% reduction in sugar-sweetened beverage consumption from a penny-per-ounce sugar-sweetened beverage tax could reduce daily per capita caloric intake from sugar-sweetened beverages from the current 190–200cal to 145–150cal, if there is no substitution to other caloric beverages or food. A national penny-per-ounce tax on sugar-sweetened beverages could generate new tax revenue of $79 billion over 2010–2015. Conclusion: A modest tax on sugar-sweetened beverages could both raise significant revenues and improve public health by reducing obesity. To the extent that at least some of the tax revenues get invested in obesity prevention programs, the public health benefits could be even more pronounced. [Copyright &y& Elsevier]

Abstract: This paper traces responses to house flies in US cities as health departments attempted to control pollution and disease in the early twentieth century. It speaks to other historical geographies about the state, citizens, and the urban environment by showing how medical entomology prescribed contradictory changes to civic and domestic space, and how urban people and nature resisted these changes. With the advent of medical entomology, health reformers came to see house flies as agents that wove the entire city together as an interconnected ecology, carrying diseases from neighborhood to neighborhood and across the threshold of the home. But different reformers argued for quite distinct exercises of power in the urban landscape and ecological processes. Some physicians and entomologists argued that the state must modernize networks of fly-breeding organic matter, most notably horse manure and human waste. Such interventions were intended to be preventive and holistic, and aimed to protect all city dwellers. Other reformers, however, doubted the capacity of the state to tame material flows of waste, and instead sought changes to domestic space that would require householders – especially women – to shore up the boundaries of the house against flies. When city governments adopted these distinct interventions they encountered quite distinct sorts of resistance because of the house fly''s tight links with urban nature and domestic practices. [Copyright &y& Elsevier]

Agricultural policy in the United States is often structured around conflicts and relationships within particular production regions. These regional solutions may evolve into national policies. This paper explores a historical example of this, the development of fluid milk policy and the fluid milk economy in the Chicago milkshed between 1900 and the New Deal. This example is particularly interesting because it was part of the rise of the post-World War II modern food system. Both urban and rural groups were important in this development. Urban groups took a particular interest in milk production and regulation due to its importance as a nutritious but highly perishable staple. Rural groups responded to urban attempts to control production practices by organizing cooperatives. Negotiations and strikes resulted in an agreement in 1929 that was positive for farmers, the Chicago Department of Health, and other major entities in the milkshed. It attempted to place regulatory barriers around the milkshed. However, it soon failed due to improvements in transportation technology and new distribution systems that allowed for cheaper retail prices. The group then proposed a marketing plan to the USDA, which became the ancestor of the federal milk marketing order program. This story sheds light on the manner in which local interest groups and internal politics within the U.S. Department of Agriculture combined to shape New Deal agricultural legislation. [Copyright &y& Elsevier]

Previous estimates of childhood lead poisoning prevention benefits have quantified the present value of some health benefits, but not the costs of lead paint hazard control or the benefits associated with housing and energy markets. Because older housing with lead paint constitutes the main exposure source today in the US, we quantify health benefits, costs, market value benefits, energy savings, and net economic benefits of lead-safe window replacement (which includes paint stabilization and other measures). The benefit per resident child from improved lifetime earnings alone is $21,195 in pre-1940 housing and $8685 in 1940–59 housing (in 2005 dollars). Annual energy savings are $130–486 per housing unit, with or without young resident children, with an associated increase in housing market value of $5900–14,300 per housing unit, depending on home size and number of windows replaced. Net benefits are $4490–5,629 for each housing unit built before 1940, and $491–1629 for each unit built from 1940–1959, depending on home size and number of windows replaced. Lead-safe window replacement in all pre-1960 US housing would yield net benefits of at least $67 billion, which does not include many other benefits. These other benefits, which are shown in this paper, include avoided Attention Deficit Hyperactivity Disorder, other medical costs of childhood lead exposure, avoided special education, and reduced crime and juvenile delinquency in later life. In addition, such a window replacement effort would reduce peak demand for electricity, carbon emissions from power plants, and associated long-term costs of climate change. [Copyright &y& Elsevier]

Comprehensive land use plans and their corresponding regulations play a role in determining the nature of the built environment and community design, which are factors that influence population health and health disparities. To determine the level in which a plan addresses healthy living and active design, there is a need for a systematic, reliable and valid method of analyzing and scoring health-related content in plans and regulations. This paper describes the development and validation of a scoring tool designed to measure the strength and comprehensiveness of health-related content found in land use plans and the corresponding regulations. The measures are scored based on the presence of a specific item and the specificity and action-orientation of language. To establish reliability and validity, 42 land use plans and regulations from across the United States were scored January-April 2016. Results of the psychometric analysis indicate the scorecard is a reliable scoring tool for land use plans and regulations related to healthy living and active design. Intraclass correlation coefficients (ICC) scores showed strong inter-rater reliability for total strength and comprehensiveness. ICC scores for total implementation scores showed acceptable consistency among scorers. Cronbach's alpha values for all focus areas were acceptable. Strong content validity was measured through a committee vetting process. The development of this tool has far-reaching implications, bringing standardization of measurement to the field of land use plan assessment, and paving the way for systematic inclusion of health-related design principles, policies, and requirements in land use plans and their corresponding regulations. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Hispanic women in Texas have among the highest rates of cervical cancer incidence and mortality in the country. Increasing regular Papanicolaou test screening and HPV vaccination are crucial to reduce the burden of cervical cancer among Hispanics. This paper presents lessons learned from community-based cervical cancer control programs for Hispanics and highlights effective intervention programs, methods and strategies. Methods: We reviewed and summarized cervical cancer control efforts targeting Hispanic women, focusing on interventions developed by researchers at the University of Texas, School of Public Health. We identified commonalities across programs, highlighted effective methods, and summarized lessons learned to help guide future intervention efforts. Results: Community–academic partnerships were fundamental in all steps of program development and implementation. Programs reviewed addressed psychosocial, cultural, and access barriers to cervical cancer control among low-income Hispanic women. Intervention approaches included lay health worker (LHW) and navigation models and used print media, interactive tailored media, photonovellas, client reminders, one-on-one and group education sessions. Conclusions: Small media materials combined with LHW and navigation approaches were effective in delivering Pap test screening and HPV vaccination messages and in linking women to services. Common theoretical methods included in these approaches were modeling, verbal persuasion, and facilitating access. Adaptation of programs to an urban environment revealed that intensive navigation was needed to link women with multiple access barriers to health services. Collectively, this review reveals 1) the importance of using a systematic approach for planning and adapting cervical cancer control programs; 2) advantages of collaborative academic–community partnerships to develop feasible interventions with broad reach; 3) the use of small media and LHW approaches and the need for tailored phone navigation in urban settings; and 4) coordination and technical assistance of community-based efforts as a way to maximize resources. [Copyright &y& Elsevier]

Abstract: Objectives: This paper presents a new, comprehensive tool for communities to assess opportunities for active living and healthy eating and to mobilize all sectors of society to conquer obesity and chronic disease. Method: Relevant existing tools and input from an expert panel were considered to draft the Community Healthy Living Index (CHLI). CHLI covers five major sectors where people live, work, learn, and play: schools, afterschools, work sites, neighborhoods, and the community-at-large. CHLI and the accompanying procedures enable community teams to assess programs, the physical environment, and policies related to healthy living and to plan improvement strategies. In 2008, with local YMCAs acting as conveners, community assessment teams from six US communities pilot-tested CHLI for cognitive response testing, inter-rater reliability, and implementation feasibility. CHLI was revised to reflect the test results. Results: Pilot analyses demonstrated that the process was feasible, with most questions being interpreted as intended and showing substantial to almost perfect agreement between raters. The final CHLI is being disseminated nationally. Conclusions: Preliminary data illustrate CHLI obtains reliable results and is feasible to implement. CHLI is a promising tool for community-based prevention efforts to draw attention to opportunities for healthy living and create impetus for community changes. [Copyright &y& Elsevier]

Abstract: Objective: US transportation systems have been identified as a problem for public health, as they often encourage automobile transportation and discourage physical activity. This paper provides a case study examination of the Public Health Component of the Wasatch Front Regional Council''s Regional Transportation Plan. This plan provides an example of what transportation planners at Utah''s largest metropolitan planning organization (MPO) are doing to encourage physical activity through transportation. Methods: Existing active living research was used to guide recommendations using a process that included a comprehensive literature review and a review of existing state programs, advisory group and stakeholder meetings, and policy recommendations based on existing local conditions. Results: Stakeholders from a diversity of background and interests came together with one common goal: to improve public health. Based on this collaborative process, nine policy approaches were specifically recommended for approval and integration in the Wasatch Front Regional Transportation Plan. Conclusion: By using current research as a guide and integrating a variety of interests, the Wasatch Front Regional Council is setting a new standard for a collaborative multi-modal focus in transportation planning, which can be replicated nationwide. [Copyright &y& Elsevier]