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AJPH NEWS Release

EMBARGOED UNTIL Nov. 22, 2005, 4 PM (ET)
CONTACT: For copies of articles, call Natalie Raynor, (202) 777-2511 or email at natalie.raynor@apha.org

All articles are online at www.ajph.org

American Journal of Public Health December 2005 Highlights

· Maternal age, race increase stillborn risk
· A few highly educated neighbors can improve community's health
· Low birth weight infants more likely to die at minority-serving hospitals
· Choice of infants' bedding, bedroom environment could contribute to childhood asthma
· Exercise one key to staying mentally sharp in middle age

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

Although the rate of stillbirth in the United States has dropped significantly over the past three decades, black women are still much more likely to suffer a stillbirth than white women, and stillbirth rates have actually risen among women older than 35.

Researchers analyzed more than 71 million singleton births from 1981-2000 in the United States and found stillbirth rates dropped 33 percent among blacks and 46 percent among whites during that time period. Stillbirths were more common among mothers older than 35 or younger than 20. Depending on their mother's age, black babies were up to three times as likely to be stillborn as white babies during the study's time period.

The study's authors noted that one of the Healthy People 2010 goals is to reduce health disparities, including those related to pregnancy outcomes. They recommend further study into the issue to determine causes for the persistent racial disparity for stillbirths and more study into the "biological mechanisms of aging" to help explain rising stillbirth
rates among older mothers. [From: "Stillbirths in the United States, 1991-2000: An Age, Period and Cohort Analysis." Contact: Cande V. Ananth, PhD, MPH, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, N.J., cande.ananth@umdnj.edu.]

Highly educated neighbors can improve community's health
A few highly educated residents sprinkled throughout a low-income neighborhood can mean better health for the entire neighborhood.
Researchers studied the association between distribution of education and rates of eight health indicators, such as access to prenatal care and death from several chronic diseases, in 59 neighborhoods in New York City.
In separate adjusted ecological models, neighborhoods with fewer higher-educated residents had better population health indicators that might plausibly be associated with short-term changes such as homicide and infant mortality rate, in the social environment. They found there was no association between education distribution and health indicators more likely to be associated with long-term accumulation of social and behavioral stressors, such as cardiovascular disease and chronic lung disease mortality rates.
The presence of highly educated people in a neighborhood may be helpful for all residents, independent of the potentially harmful consequences of poverty, the study's authors concluded.
[From: "Distribution of Education and Population Health: An Ecological Analysis of New York City Neighborhoods." Contact: Sandro Galea, MD, DrPH, University of Michigan School of Public Health, Ann Arbor, sgalea@mich.edu.]

Low birth weight infants more likely to die at minority-serving hospitals
In hospitals where more than 35 percent of very low birth weight infants are black, neonatal death rates are significantly higher than in hospitals where less than 15 percent of very low birth weight infants are black.
Researchers analyzed medical records for 74,050 black and white very low birth weight infants treated by 332 hospitals from 1995-2000. Very low birth weight was defined as infants born weighing between 500 and 1,500 grams, or 1.1-3.3 pounds.
So-called "minority-serving hospitals" had a higher infant mortality rates for babies of all races, and the higher rates were not explained by hospital or treatment variables. "Minority-serving hospitals may provide lower quality of care to [very low birth weight] infants compared with other hospitals," the study's authors said. "Because [very low birth weight] black infants are disproportionately treated by minority-serving hospitals, higher neonatal mortality rates at these hospitals may contribute to racial disparities in infant mortality in the United States."
[From: "Mortality Among Very Low-Birth weight Infants in Hospitals Serving Minority Populations." Contact: Leo S. Morales, MD, PhD, Los Angeles, morales@rand.org.]

Choice of infants' bedding, bedroom environment could contribute to childhood asthma
Infants who sleep with synthetic or natural fiber blankets and pillows that trap allergens are more than twice as likely to suffer wheezing at age 7 than those infants whose parents avoid such bedding, according to an Australian study.
The study was based on 863 children whose parents participated in a 1988 survey when the children were infants and a follow-up survey in 1995 in Tasmania, Australia. At the time of the first survey, sheepskin "cocoons," similar to a sleeping bag with a hood, were popular bedding for infants. Researchers found a marked increase in asthma symptoms among children who, as infants, had slept with pillows, synthetic or sheepskin blankets or cocoons that were likely to trap house dust mites. The asthma risk was increased if the children had, as infants, slept in heated bedrooms with wall-to-wall carpeting or where the room had been painted within the previous year.
[From: "Infant Sleeping Environment and Asthma at 7 Years: A Prospective Cohort Study." Contact: Anne-Louise Posonby, PhD, MBBS, FAFPHM, Murdoch Children's Research Institute, Australia, anne-louise.posonby@mcri.edu.au.]

Exercise one key to staying mentally sharp in middle age
Middle-aged couch potatoes are upping their risk for losing cognitive function.
Based on data collected from 10,308 British civil servants age 35-55 at baseline and 46-68 at the end of the study period, researchers found low levels of physical activity were a risk factor for poor performance on a measure of fluid intelligence. Previous studies have shown a lack of exercise affects mental functioning among the elderly.
"Our results showed a small but significant association between physical activity and cognitive functioning in middle age," the study's authors wrote. "Further research is required to examine whether fluid intelligence remains at risk as individuals age and whether other aspects of cognitive ability, such as verbal fluency, also become increasingly associated with levels of physical activity."
[From: "Effects of Physical Activity on Cognitive Functioning in Middle Age: Evidence From the Whitehall II Prospective Cohort Study."Contact: Archana Singh-Manoux, PhD, National Institute of Health and Medical Reasearch, France, archan.singh-manoux@st-maurice.inserm.fr]

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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