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AJPH NEWS Release

EMBARGOED UNTIL December 1, 2003, 4:00 PM (ET)
CONTACT: For copies of articles, contact Natalie Raynor, (202) 777-2511, natalie.raynor{at}apha.org

All articles are online after the embargo date at www.ajph.org
To view the preliminary table of contents, visit www.ajph.org/future/93.12.shtml

American Journal of Public Health: December 2003 Highlights

• Secondhand smoke exposure increases adult asthma risk
• Among high-risk adults, flu shots less likely for blacks than whites
• Race, income and insurance status all have effect on obesity rates among children and adolescents
• Anti-smoking campaign helping prevent California teens from smoking
• Uninsured people more likely to suffer substance abuse and least likely to receive addiction treatment

The articles highlighted below appear in the December 2003 issue of the American Journal of Public Health, the Journal of the American Public Health Association.

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Secondhand smoke exposure increases adult asthma risk
Adults exposed to secondhand cigarette smoke are much more likely to develop asthma. A recent study is the first to establish a link between the chronic lung condition and both lifetime secondhand smoke exposure as well as recent secondhand smoke exposure. Researchers looked at all newly diagnosed asthma cases in South Finland from mid-1997 through March 2000. Asthma was defined as a history of at least one asthma-like symptom (prolonged cough, wheezing, attacks of or exercise-induced shortness of breath or night time cough or wheezing) accompanied by measurable airways narrowing. It was estimated that among people who had developed asthma in adult age and who had been exposed to secondhand smoke during the previous year at home or at work this exposure was responsible for 49.2 percent of newly diagnosed asthma cases. "Our results indicate that [environmental tobacco smoke] is an important preventable cause of asthma," the study's authors wrote.
[From: "Environmental Tobacco Smoke and Adult-Onset Asthma: A Population-Based Incident Case-Control Study." Contact: Maritta S. Jaakkola, MD, DSc, Institute of Occupational Health, University of Birmingham, UK, M.Jaakkola{at}bham.ac.uk.]

Among high-risk adults, flu shots less likely for blacks than whites
Adults who are at high-risk from flu complications are strongly urged to get an influenza vaccination this year, yet a study shows a racial disparity in the response. In an analysis of data from the 1999 Health Interview Study, researchers found that white adults with diabetes, chronic heart conditions and cancer were much more likely to get a flu shot than blacks with the same conditions. White patients with two or more high-risk conditions also were more likely to receive flu shots than blacks with the same health conditions. The study data included 7,655 adults with diabetes, chronic heart conditions, chronic obstructive pulmonary disease, cancer and asthma. For the adults over age 65, 72 percent of whites with two or more of the health conditions were vaccinated against influenza, compared with 58 percent of the black patients with the same health conditions. "Missed vaccination opportunities need to be exploited," the study's authors wrote," especially in light of data suggesting that a physician's recommendation strongly influences a patient's decision to be vaccinated."
[From: "Racial/Ethnic Differences in Influenza Vaccination Coverage in High-Risk Adults." Contact: Leonard E. Egede, MD, Medical University of South Carolina, egedel@musc.edu.]

Race, income and insurance status all have effect on obesity rates among children and adolescents
In the quest to figure out why so many American youth are struggling with obesity, new research shows overweight among children and teens is linked to race as well as insurance status. A study of 3775 children and adolescents included in the 1996 Medical Expenditure Panel Survey found that among children age 6-11, blacks and Latinos were more than twice as likely than other racial or ethnic groups to be overweight. Among children age 12-17, both Latinos and Asian/Pacific Islanders were most likely to be overweight. In the older group, those who either lacked health insurance or were covered by a public program such as Medicaid also were most likely to be overweight. In addition, adolescents from families with higher incomes in this study were more likely to be overweight than teens from poorer families. Overweight children are more likely to become obese adults, facing associated health problems such as increased risk of heart disease and diabetes.
[From: "The Association of Race, Socioeconomic Status, and Health Insurance Status With the Prevalence of Overweight Among Children and Adolescents." Contact: Jennifer S. Haas, MD, MSPH, Division of General Medicine, Brigham and Women's Hospital, jhaas{at}partners.org.]

Anti-smoking campaign helping prevent California teens from smoking
Tobacco control programs are keeping California teens away from cigarettes, according to an analysis of smoking trends in the state. Since widespread anti-smoking campaigns started in California in 1990, the proportion of adolescents who had never smoked rose from 60 percent for males and 66 percent for females to about 70 percent for both sexes. Researchers looked at the California population age 12-17 and analyzed data from the 1990-1991, 1992 and 1993 California Tobacco Survey and the 1994-1999 annual California Youth Tobacco Survey. Data from 26,536 survey respondents were used to find the percentage of youth who had never smoked. Youth were much less likely to try cigarettes if they were born after 1978. The authors attribute this to the California statewide anti-smoking programs because these kids were the target population of the Californian programs since 1990.
[From: "Secular Trends in Adolescent Never Smoking From 1990 to 1999 in California: An Age-Period-Cohort Analysis." Contact: Xinguang Chen, MD, PhD, Wayne State University School of Medicine, Detroit, MI 48201. jimchen{at}med.wayne.edu.]

Uninsured people more likely to suffer substance abuse and less likely to receive addiction treatment.
When it comes to alcohol and drug addiction, people without health insurance are more likely both to suffer from substance abuse and to face barriers to treatment. A study of 25,500 people interviewed in 1998 as part of the National Household Study on Drug Abuse found that only 9 percent of people lacking health insurance and suffering from drug or alcohol dependence had received any treatment in the past year. And non-Hispanic whites were three times more likely than blacks to receive substance abuse treatment or counseling. The study's authors urged more research into the issue, saying "increased attention from the research and policy sectors should focus on the needs of the uninsured population. They appear to face more barriers to services for substance abuse than persons covered through public programs."
[From: "Substance Use, Dependence, and Service Utilization Among the US Uninsured Nonelderly Population." Contact: Li-Tzy Wu, ScD, Center for Risk Behavior and Mental Health Research, RTI International, Research Triangle Park, N.C., liwu@rti.org.]

The American Journal of Public Health is the monthly journal of the American Public Health Association, the oldest and largest organization of public health professionals in the world. APHA is a leading publisher of public health-related books and periodicals promoting high scientific standards, action programs and policy for good health. More information is available at www.apha.org.

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