AJPH News Release

EMBARGOED UNTIL Oct. 27, 2005, 4 PM (ET)
CONTACT: For copies of articles, call Natalie Raynor, (202) 777-2511 or e-mail at natalie.raynor@apha.org

All articles are online at www.ajph.org

American Journal of Public Health November 2005 Highlights

· SIDS deaths still disproportionately affect babies from lower socioeconomic families
· Health clubs not easily accessible to people with disabilities
· Adults with mental disorders more likely to be victims of violent crime
· Racial, ethnic and socioeconomic disparities persist in disability among elderly
· Depression increases risk for disability
· Disability prevalence varies widely among states

The articles highlighted below appear in the November 2005 issue of the American Journal of Public Health, the Journal of the American Public Health Association.


SIDS deaths still disproportionately affect babies from lower socioeconomic families
While the nationwide "Back to Sleep" campaign has helped reduce Sudden Infant Death Syndrome cases overall, risk among more educated women has declined most. Researchers conducted a population-based study during 1989-1991 and 1996-1998, using the U.S. Linked Birth/Infant Death Data Sets. Social class was measured by mother's education level.
"The introduction of an inexpensive, easy, public health intervention has not reduced social inequalities in SIDS; in fact, the gap has widened," the study's authors said. "Although the risk of SIDS has been reduced for all social class groups, women who are more educated have experienced the greatest decline." [From: "Widening Social Inequalities in Risk for Sudden Infant Death Syndrome." Contact: Kate E. Pickett, PhD, Department of Health Sciences, University of York, York, England, kp6@york.ac.uk.]

Health clubs not easily accessible to people with disabilities
People with mobility disabilities and visual impairments generally have a tough time accessing health and fitness clubs, according to a recent study.

Researchers assessed 35 health clubs and fitness facilities as part of a national field trial of the new Accessibility Instruments Measuring Fitness and Recreation Environments test. The test is designed to assess the accessibility of health clubs in the areas of built environment, equipment, swimming pools, information, facility policy and professional behavior. Researchers found that all facilities studied had a low-to-moderate level of accessibility. Problems ranged from a lack of wheelchair-accessible exercise equipment to staff members' lack of eye contact when speaking with people with disabilities. The majority of facilities were likely to have precautions such as slip-resistant flooring, adjustable lighting levels, hand-held shower heads, family changing rooms and grab bars in elevators and bathroom stalls. [From: "Accessibility of Health Clubs for People With Mobility Disabilities and Visual Impairments." Contact: James H. Rimmer, PhD, University of Illinois at Chicago, Ill., jrimmer@uic.edu.]

Adults with mental disorders more likely to be victims of violent crime
Having a mental disorder increases a person's risk of becoming a victim of violent crime. In a study of about 1,000 people born in Dunedin, New Zealand, between 1972 and 1973, researchers found that when compared with people with no mental disorder, people with anxiety disorders were more likely to be a victim of sexual assault, people with schizophrenia and related disorders as well as those with alcohol dependence disorders experienced more completed physical assaults, and those with marijuana dependence problems were more likely to have been threatened with an attempted assault. The results held true even when researchers adjusted for the study participants' own violent behavior.

The study's authors suggested the need for more research into the reasons mental disorders seem to contribute to victimization. "In the meantime, increasing public awareness of the vulnerabilities of people with mental disorders to victimization should help reduce the public's perception of mental disorder solely as something to be feared, which may in turn reduce the stigma and rejection that are typically experienced by people with mental disorders, they observed. [From: "Mental Disorder and Violent Victimization in a Total Birth Cohort." Contact: Eric Silver, PhD, The Pennsylvania State University, University Park, Penn., exs44@psu.edu.]

Racial, ethnic and socioeconomic disparities persist in disability among elderly
Over the last 20 years, Racial and ethnic disparities in old-age disability have persisted and socioeconomic disparities have increased.

Researchers used data from the 1982-2002 National Health Interview Surveys that reported on about 172,000 people ages 70 and older. They found a decline in self-reported disabilities among all groups during the 20-year time period. Yet the declines were smallest among those with lower incomes and educational status. Furthermore, the percentage reporting the most severe disability--difficulty with personal care activities such as eating, bathing, dressing or getting around the home--decreased for the more advantaged groups but actually increased among the lowest income and education groups. Non-Hispanic Whites and minorities experienced similar average annual percentage declines in personal care disability.
"The increase in the need for help for personal care disability among the least educated group is a disturbing finding," the study's authors said. "...to close completely the gaps in late-life functioning may require a combination of medical, behavioral, and environmental interventions over the lifetime of a cohort. Additional research is needed to identify which interventions might be most effective in reducing disability among disadvantaged as well as advantaged populations."[From: "Persistent and Growing Socioeconomic Disparities in Disability Among the Elderly: 1982-2002." Contact: Robert F. Schoeni, University of Michigan, Ann Arbor, Mich., bschoeni@umich.edu.]

Depression increases risk for disability
People suffering from depression are more likely to develop a disability that affects their daily lives.
In a study of about 6,800 people ages 54-65, the risk of developing a disability that affected activities of daily living were 4.3 times higher for depressed adults. Among depressed adults in the study, 18.7 percent of Blacks, 8 percent of Whites and 7.8 percent of Hispanics developed disability within two years. Examples of basic activities of daily living disability include the inability to dress, toilet, bathe, eat, walk across a room and get in and out of bed.

The study's authors said prevention and/or public health programs and policies that lead to more effective and accessible mental health and medical care could reduce the development of disability among depressed adults. [From: "Incidence of Disability Among Pre-Retirement Adults: The Impact of Depression." Contact: Dorothy Dunlop, PhD, Northwestern University, Chicago, Ill., ddunlop@northwestern.edu.]

Disability prevalence varies widely among states
Both state and regional estimates for disability among residents vary widely, giving credence to the need for tailored prevention, assistance and treatment programs.
Researchers analyzed Behavioral Risk Factor Surveillance System data for all 50 states and the District of Columbia as well as 103 metropolitan areas. Their finding: State disability estimates ranged from 10.5 percent in Hawaii to 25.9 percent in Arizona. Regional metropolitan medians for disability ranged from 17.0-19.7 percent and were similar across the Northeast, Midwest, and South and were highest in the West. In the 20 metropolitan areas with the highest disability estimates, the prevalence of disability generally increased with age and was higher for women and those with a high school education or less.

The study's authors said the estimates could be used to guide state and local efforts to prevent, delay, or reduce disability and secondary conditions in persons with disabilities. Arthritis or rheumatism, back or spine problems, and heart trouble/hardening of the arteries are the leading causes of disability. [From: "State and Metropolitan-Area Estimates of Disability in the United States, 2001." Contact: Catherine A. Okoro, MS, Centers for Disease Control and Prevention, Atlanta, Ga., cokoro@cdc.gov.]

The American Journal of Public Health is the monthly journal of the American Public Health Association, the oldest 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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