NEWS RELEASE January 25, 2005

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AJPH NEWS Release

EMBARGOED UNTIL Jan. 25, 2005, 4 PM (ET)
CONTACT: For copies of articles, call Natalie Raynor, (202) 777-2511

All articles are online at www.ajph.org. To view the preliminary table of contents, visit http://www.ajph.org/future/95.2.shtml

American Journal of Public Health February 2005 Highlights

· Health insurance a casualty of welfare reform
· Youth smoking tied to state tobacco control spending
· Elderly who feel neglected more likely to die
· Simple emergency room outreach strategy could bring insurance to thousands more kids
· Racism adds pressure that can lead to youth smoking
· Walking or biking to elementary school not an option for most students

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

Health insurance a casualty of welfare reform
Parents who meet the welfare reform goals of finding gainful employment and reducing their dependence on welfare do so at a price: significant loss and instability of health insurance.
A study of a random sample of almost 1,400 Illinois families receiving welfare in 1998 found those parents who were transitioning from welfare to work were likely to lose their health insurance in the years following the transition. By contrast, those parents who stayed on welfare kept their Medicaid coverage.
Losing health coverage put former welfare recipients at higher risk for poor job performance, absenteeism and even losing their newfound jobs, according to the study.
"Policymakers should reassess the ability of welfare reform and Medicaid policies to provide long-term, stable health insurance for all parents who transition from welfare to work because of the essential role that health insurance plays in sustaining the work promotion and welfare reduction goals of welfare reform," the study's authors said.
[From: "Welfare Reform and Health Insurance: Consequences for Parents." Contact: Jane L. Holl, MD, MPH, Institute for Health Services Research and Policy Studies, Chicago, j-holl@northwestern.edu.]

Youth smoking tied to tobacco control spending
Youth smoking rates would be three-14 percent lower if states and the District of Columbia had spent the federally recommended amount on tobacco control programs.
A study of cigarette demand using the Monitoring the Future survey results for eighth-, 10th- and 12th-grade students found that per capita spending on tobacco control had a significant impact on youth smoking prevalence and the number of cigarettes smoked daily. The Centers for Disease Control and Prevention's National Tobacco Control Program sets recommended tobacco control spending budgets for states and the District of Columbia. Yet few states have followed those recommendations and smoking rates are higher than they would be if states spent at the CDC recommended levels; however, the research indicates that smoking rates are currently lower than they would be had states not spent any money on tobacco control during the period covered by the study. [From: "State Tobacco Control Spending and Youth Smoking." Contact: John A. Tauras, PhD, Department of Economics, University of Illinois at Chicago, tauras@uic.edu.]

Elderly who feel neglected more likely to die
Older adults who perceive that their basic needs are not being met have a higher mortality rate than those who feel secure in their housing, food and other concerns.
A study using data from a probability sample of about 4,200 people age 65 and older used questions to assess whether a person felt their basic needs were being met. Those needs included safety, adequate housing and financial resources. The result: those who perceived their basic needs were not taken care of were more likely to have died 10 years after the initial survey than those who felt more secure, regardless of their actual income.
[From: "Perception of Unmet Basic Needs as a Predictor of Mortality Among Community-Dwelling Older Adults." Contact: Dan G. Blazer, MD, PhD, Duke University Medical Center, Durham, N.C., blaze001@mc.duke.edu.]

Simple emergency room outreach strategy could bring health insurance to thousands more kids
Millions of American children lack health insurance despite state and national efforts to reach them, yet a simple emergency room strategy could bring insurance to thousands more children.
An experiment launched in the emergency departments at four inner-city hospitals found that simply handing out insurance applications to families of uninsured children nearly quadrupled the odds of successful enrollment in Medicaid or the State Children's Health Insurance Program (SCHIP). On-site emergency department staff handed out SCHIP applications on the spot, and the study's authors estimate that adopting such an approach in emergency rooms nationwide could lead to insurance coverage for more than 250,000 more kids each year. SCHIP is the federal- state program that offers free or low-cost health care to children based on household income.
[From: "The State Children's Health Insurance Program: A Multicenter Trial of Outreach Through the Emergency Department." Contact: James A. Gordon, MD, MPA, Department of Emergency Medicine, Massachusetts General Hospital, Boston, jgordon3@partners.org.]

Racism adds pressure that can lead to youth smoking
African American teens and young adults who believe they are the victims of racial or ethnic harassment are twice as likely to smoke cigarettes as those who do not face such harassment.
A study of more than 2,100 black college students found that those who perceived harassment were two times as likely to use tobacco products daily as those who reported no harassment. The increased risk was recorded even after adjusting for such variables as gender, campus residence, grades, occupational status and age at first tobacco use.
Data for the study were drawn from a study of students at historically black colleges and universities in North Carolina. Tobacco use on all of the previous 30 days was considered daily use.
The report's authors said their study reaffirms previous findings that smoking is a common tool used to deal with the psychological stress of perceived racism.
[From: "Perceived Racial/Ethnic Harassment and Tobacco Use Among African American Young Adults." Contact: Gary G. Bennett, PhD, Harvard School of Public Health and Dana-Farber Cancer Institute, Boston, gbennett@hsph.harvard.edu.]

Walking or biking to elementary school not an option for most students
In the face of growing concerns about obesity among children as well as adults, findings from a study of elementary school students offer little encouragement on the exercise front.
Observations of eight randomly selected urban and suburban elementary schools in Columbia, SC, found that a mere five percent of students walked or bicycled to or from school. Rates of "active commuting" were not affected by socioeconomic status, weather conditions, temperature or even time of day. About 13 percent of students age 5-15 are estimated to walk or bike to or from school, according to the U.S. Department of Transportation, and previous studies have estimated regional active commuting rates range from four-25 percent.
The study's authors urge more study into the issue to determine why more kids aren't taking advantage of active commuting as one aspect of a healthier lifestyle.
[From: "Prevalence of Active Commuting at Urban and Suburban Elementary Schools in Columbia, SC." Contact: John R. Sirard, PhD, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, Calif., jsirard@stanford.edu.]

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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