NEWS RELEASE March 29, 2005 4 PM (ET)

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AJPH NEWS Release

EMBARGOED UNTIL March 29, 2005, 4 PM (ET)
CONTACT: For copies of articles, call Natalie Raynor, (202) 777-2511 or natalie.raynor@apha.org

All articles are online at www.ajph.org

American Journal of Public Health April 2005 Highlights

· Healthy food options out of reach for many poor, minority communities
· Asthma sufferers more likely to contemplate suicide
· Fat Europeans following in Americans' footsteps
· Primary care access decreases death risk even for poorest communities
· Childhood sexual abuse victims more likely to turn to injection drug use
· Prenatal care access a problem for many immigrants

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

Healthy food options out of reach for many poor, minority communities
One reason low-income Americans are more likely to be overweight or obese -- they often have fewer healthy food choices than the middle class or affluent, according to two new studies.
Researchers looked at the availability of healthy food options in South Los Angeles restaurants and found, compared to wealthier neighborhoods, the pickings were slim. And in poorer L.A. neighborhoods, not only were healthy restaurants offerings more difficult to find than in wealthier areas, but residents were more likely to be exposed to marketing efforts aimed at encouraging them to eat fatty and calorie-rich foods.
In another study, researchers looked at the accessibility of large grocery stores, comparing poorer Detroit neighborhoods to the more affluent areas of the city. The findings: "Racial residential segregation disproportionately places African
Americans in more-impoverished neighborhoods in Detroit and consequently reduces
access to supermarkets" the study's authors wrote. Even among poor neighborhoods, those with higher proportions of black residents were 1.15 miles further away from the nearest supermarket than predominately white neighborhoods.
[From: "African Americans Access to Healthy Food Options in South Los Angeles Restaurants." Contact: LaVonna Blair Lewis, PhD, MPH, University of Southern California, School of Policy, Planning and Development, llewis@usc.edu. Also from: "Neighborhood Racial Composition, Neighborhood Poverty, and the Spatial Accessibility of Supermarkets in Metropolitan Detroit." Contact: Shannon N. Zenk, University of Illinois at Chicago, szenk@uic.edu. ]

Asthma sufferers more likely to contemplate suicide
Adults with asthma are more likely both to think about suicide and to attempt it than those who do not suffer from the chronic disease.
A study of about 2,000 Baltimore residents found that people with asthma were up to three times as likely to think about suicide and to attempt it than those who did not have asthma. The likelihood of attempting suicide was not due to co-occurring depression.
"These results provide important implications for future research," the study's authors wrote. "The mechanism of the observed association between asthma and suicidal ideation, and asthma and suicide attempt, remains unclear. These data may help to rule out several possibilities, provide preliminary support for others, and to contribute useful information for directions for additional research."
[From: "Asthma, suicidal ideation and suicide attempts: Findings from the Baltimore Epidemiologic Catchment Area Followup Study." Contact: Renee Goodwin, PhD, Columbia University, Lawrence G. Kolb Research Center, rdg66@columbia.edu.]

Fat Europeans following in Americans' footsteps
The expanding average American waistline may soon be mirrored in many European countries, according to a recent study.
In a random survey that followed about 5,500 Geneva men and 5,500 Geneva women, overweight and obesity increased from 48 percent to 60 percent among the men and from 25 percent to 35 percent among the women from 1993-2002. High cholesterol and diabetes also became more prevalent during the study time period.
"Population-based interventions are need to prevent further obesity-related disorders," the study's authors wrote.
[From: "The obesity epidemic as harbinger of a metabolic disorder epidemic: trends in overweight, hypercholesterolemia, and diabetes treatment in Geneva, Switzerland, 1993-2002." Contact: Alfredo Morabia, University Hospitals of Geneva, alfredo.morabia@hcuge.ch.]

Primary care access decreases death risk even for poorest communities
While low-income Americans have higher death rates than the more affluent, having access to primary care can go a long way toward lowering those death rates.
According to a study of mortality rates in almost 4,000 counties, areas with the highest levels of primary care resources had 2-3 percent lower mortality rates than counties will less primary care. For the study, primary care was defined as doctors of medicine per 10,000 civilian population in active, office-based patient care in family medicine, internal medicine and pediatrics. Primary care physicians per 10,000 residents ranged from a low of zero in some counties to a high of 40 in the counties with the most access.
"A system of good-quality primary care services may be able to ameliorate some of the ultimate consequences of social inequalities at the population level by contributing to reduced levels of disease transmission, lowering aggregate levels of risk factors (such as hypertension, smoking, weight gain), improving county-wide screening and early diagnosis activities, and developing systems to coordinate care," the study's authors wrote. " Exercise of these functions should contribute to improved functioning of the health system at large since strong primary care not only means more prevention, but, ideally, can also lead to more efficient referral, coordination, and continuity of care."
[From: "Primary Care, Social Inequalities, and All-Cause, Heart Disease, and Cancer Mortality in U.S. Counties, 1990." Contact: Leiyu Shi, DrPH, MBA, MPA, Johns Hopkins University School of Public Health, Baltimore, lshi@jhsph.edu.]

Childhood sexual abuse victims more likely to turn to injection drug use
Victims of childhood sexual abuse are likely to start using injection drugs at a younger age than their peers.
A study of 2,143 injection drug users found that those who had been victims of sexual abuse during childhood starting injecting drugs at an average age of 19. The average age injection drug users started their habit if they had not been sexually abused as children was 24, according to the study.
The findings indicate a need to incorporate services for victims of childhood sexual abuse into substance abuse treatment and prevention programs, the study's authors said.
[From: "Childhood Sexual Abuse and Age at Initiation of Injection Drug Use." Contact: Danielle C. Ompad, PhD, New York Academy of Medicine, Center for Urban Epidemiologic Studies, dompad@nyam.org.]

Prenatal care access a problem for many immigrants
Prenatal care is out of reach for many immigrant groups in America, according to a study of pregnant women in New York.
Researchers compared "geographical access" to prenatal clinics in Brooklyn, N.Y., between immigrant and U.S.-born women and among immigrant groups. The results: Pakistani and Bangladeshi women had low geographical access to prenatal care, despite their relatively high need for such care. In the study of birth records for the 39,000 Brooklyn women who gave birth in 2000, 52 percent were born outside the United States. While U.S.- and foreign-born women had similar geographical access to prenatal care clinics, access was widely varied among immigrant groups. Immigrants from the Caribbean and Central American had high access to such clinics, while Pakistani and Bangladeshi mothers had much lower clinic access.
"As immigration reshapes health care needs in U.S. cities, such information is crucial for developing health service networks that are responsive and effective for improving population health," the study's authors wrote.
[From: "Immigration and Geographical Access to Prenatal Clinics in Brooklyn, NY: A GIS Analysis." Contact: Sara McLafferty, PhD, University of Illinois, smclaff@uiuc.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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