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AJPH NEWS Release

EMBARGOED UNTIL May 28, 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

American Journal of Public Health: June 2003 Highlights

• Cigarette smokers more likely to suffer memory loss in middle age
• Birth center prenatal care and delivery a safe alternative for low-risk moms
• TB in foreign-born Americans strikes rich and poor alike
• Condoms not popular among unmarried U.S. adults
• Juvenile prisoners need HIV prevention education

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

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Cigarette smokers more likely to suffer memory loss in middle age
Smoking more than 20 cigarettes a day can cause memory loss and other cognitive problems in middle age, according to a study of almost 2,000 British adults. The study participants were tested on verbal memory, speed and concentration at age 43 and again at age 53. Researchers found that heavy smokers suffered the largest decline in these cognitive functions. All smokers were susceptible to memory loss regardless of sex, race or socioeconomic status. And while heavy smokers often die younger than non-smokers from such illnesses as cancer and heart disease, those who do survive into old age are more likely to suffer from memory loss and dementia, or what the study's authors called "clinically significant cognitive decline."
[From: "Cigarette Smoking and Cognitive Decline in Midlife: Evidence From a Prospective Birth Cohort Study." Contact: Marcus Richards, PhD, MRC, Department of Epidemiology and Public Health, University College London, m.richards{at}ucl.ac.uk.]

Birth center prenatal care and delivery a safe alternative for low-risk moms.
Pregnant women who deliver their babies in a birth center under the Collaborative care of a nurse-midwife-obstetrician team, rather than in a traditional hospital setting are less likely to require medical interventions such as labor induction and episiotomy, according to a recent study of about 3,000 low-income women. Birth center deliveries analyzed in the study were as safe as hospital births for low-risk mothers and their babies. Almost 15 percent more women in birth center care than in traditional care had normal, spontaneous vaginal deliveries, and 23 percent fewer women in birth center care received episiotomies. This study was the first large prospective cohort study of a freestanding birth center program that rigorously balanced initial perinatal risk across the collaborative and traditional care groups. The study also examined outcomes of low-risk women from the time they began prenatal care, so it provides information to assist health program administrators as they consider the impact of offering collaborative midwife-obstetrician care and a freestanding birth center program to a broader population of women.
[From: "Outcomes, Safety, and Resource Utilization in a Collaborative Care Birth Center Program." Contact: Debra J. Jackson, RN, MPH, DSc, University of the Wetern Cape, School of Public Health, Cape Town, South Africa, bessrfam{at}iafrica.com, OR William Swartz MD FACOG, University of California, San Diego, School of Medicine, 541-247-0182.]

TB in foreign-born Americans strikes rich and poor alike
While tuberculosis has traditionally been a problem linked to poverty, the disease is striking across socioeconomic boundaries when it comes to foreign-born residents. According to a study of TB cases tracked in New Jersey from 1994-1999, substantial numbers of those cases occurred in patients living in more affluent neighborhoods. Of the 4,295 TB cases reported in New Jersey during the study's time period, about half were among foreign-born residents, with 27 percent of them living in affluent neighborhoods, compared with 18 percent of U.S.-born TB patients living in affluent neighborhoods. The study's authors believe TB cases among wealthier foreign-born residents are becoming more common across the country. "TB among foreign-born residents and their children will continue to be a challenge to TB control measures," the study's authors wrote, "a challenge likely to persist as long as TB remains endemic in much of the developing world."
[From: "Rethinking the Socioeconomics and Geography of Tuberculosis Among Foreign-Born Residents of New Jersey, 1994-1999." Contact: Amy L. Davidow, PhD, Department of Preventive Medicine and Community Health, New Jersey Medical School, davidoal{at}umdnj.edu.]

Condoms not popular among unmarried U.S. adults
Despite efforts to encourage condom use as an HIV/AIDS prevention method, the number of American adults using condoms has remained unchanged since 1996. In a survey of 5,743 adults , condom use remained steady at 19.5 percent of the adult population surveyed in 1996, 1998 and 2000. And while those people defined as at risk for HIV are more likely to use condoms than the general population, 64 percent did not use condoms with their ongoing sexual partner "and therefore were placing their partners or themselves at risk for acquiring or transmitting HIV." The Healthy People 2000 goal was to have 50 percent of unmarried adults using condoms, but this study puts that number at only 35.1 percent.
[From: "Condom Use and HIV Risk Among U.S. Adults." Contact: John E. Anderson, PhD, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, jea1{at}cdc.gov.]

Juvenile prisoners need HIV prevention education
Juvenile detainees are at high risk for HIV infection and should be a target of prevention efforts, according to a recent study. Researchers interviewed 800 youth detained at the Cook County Juvenile Temporary Detention Center in Chicago and found that the majority of them participated in several risky behaviors that can lead to HIV infection. For example, among girls age 16-18, almost 95 percent were sexually active, more than half had recent unprotected sex, more than 90 percent used alcohol or marijuana and more than half had been tattooed. Even in the youngest age group (age 10-13), 62 percent of boys and more than 40 percent of girls were sexually active.
[From: "HIV and AIDS Risk Behaviors in Juvenile Detainees: Implications for Public Health Policy." Contact: Linda A. Teplin, PhD, Northwestern University, psycho-legal{at}northwestern.edu.]

The American Public Health Association
The American Public Health Association (APHA) is an association of 50,000 members from over 50 occupations working to improve the public's health. Founded as a result of the public health movement to combat yellow fever and other diseases, APHA is the world's largest, oldest and most diverse public health association and celebrates more than 130 years of leadership.

APHA promotes the scientific and professional foundation of public health practice and policy, advocates the conditions for a healthy society, emphasizes prevention and enhances the ability of members to promote and protect environmental and community health. Based on the values of health, equity, diversity, empowerment, integrity, dignity and knowledge for individuals and communities, APHA is the leading professional association that promotes and protects the health of the people.

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