AJPH News Release July, 25 2006

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AJPH NEWS Release

EMBARGOED UNTIL July 25, 2005, 4 PM (ET)
CONTACT: For copies of articles, call Natalie Raynor, (202) 777-2511 or email: natalie.raynor@apha.org

All articles are online at www.ajph.org

American Journal of Public Health August 2005 Highlights

· Poverty a barrier to children's dental health
· Health care for immigrants significantly cheaper than for U.S.-born citizens
· Military newspapers send mixed messages on tobacco use
· Language barriers hamper breast and cervical cancer screening efforts
· Gulf war munitions suspected to increase brain cancer risk

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

Poverty a barrier to children's dental health
More than half of all low-income children without health insurance fail to go to a dentist for cleanings, and parents and other caregivers living in poverty say many factors keep them from bringing children to a dentist's office.
In one study based on data from the 2002 National Survey of America's Families, which includes more than 100,000 children and adults, researchers found that more than half of uninsured children living in low-income families had not had a preventive dental visit during the previous year. Only 20 percent of children with private dental coverage and 24 percent of those with public dental coverage failed to visit a dentist for preventive care in the previous year.
In another study that focused on barriers to children's dental health faced by low-income caregivers, researchers found that factors such as a fear of dentists and low expectations for good dental health kept the caregivers from bringing their children in for dental cleanings and screenings. The study's authors said providers, Medicaid administrators and schools must coordinate efforts to encourage caregivers to put dental health higher on their families' list of priorities.
[From: "Preventive Dental Care and Unmet Dental Needs Among Low-Income Children." Contact: Genevieve M. Kenney, PhD, Urban Institute, Washington, D.C., jkenney@ui.urban.org. Also from: "Barriers to Care-Seeking for Children's Oral Health Among Low-Income Caregivers." Contact: Susan Kelly, PhD, Department of Sociology, University of Louisville, Louisville, Ky., skelly@louisville.edu.]

Health care for immigrants significantly cheaper than for U.S.-born citizens
Despite arguments that providing health care to immigrants is burdening the nation's economy, a recent study found health care expenditures for immigrants are far lower than those for U.S.-born citizens.
Researchers used data from the 1998 Medical Expenditure Panel Survey and analyzed health expenditures for more than 18,000 U.S.-born citizens and almost 3,000 immigrants. The results: per capita total health care expenditures of immigrants were 55 percent lower than for U.S.-born people, and expenditures for uninsured and publicly insured immigrants were about half that of their U.S.-born counterparts. Immigrant children had 74 percent lower per capita health expenditures than U.S.-born children. The findings suggest that immigrant children are sicker when they arrive in the emergency room, probably because of little access to primary care. Emergency department visits were less likely for immigrant children, than for US-born children; however, per capita emergency department expenditures were higher because their costs per visit were higher.
"Our study refutes the assumption that immigrants represent a disproportionate financial burden on the U.S. health care system," the study's authors wrote. Yet the findings do show a disparity when it comes to immigrants' access to care.
[From: "Health Care Expenditures of Immigrants in the United States: A Nationally Representative Analysis." Contact: Sarita A. Mohanty, MD, MPH, Department of Medicine, Division of Geriatric and General Internal Medicine, University of Southern California, Los Angeles, samohant@usc.edu.]

Military newspapers send mixed messages on tobacco use
Tobacco control messages are underrepresented in military newspapers, and nearly 10 percent of those newspapers carry tobacco advertisements, according to a recent study.
In an analysis of tobacco-related articles and industry advertisements in 793 military newspapers, researchers found that tobacco use received the least coverage of any health topic. When the newspapers did write about tobacco control, the primary message used was that smokers are endangering their health, a message that has not proven to help users kick the habit.
"Military newspapers from the Army, Marines, and Navy may inadvertently send mixed messages to personnel by providing advertisements for tobacco while also reporting that tobacco is harmful," the study's authors wrote. "Therefore, installation newspapers provide an opportunity for the military to more effectively address tobacco use among its personnel."
[From: "An Analysis of Messages About Tobacco in Military Installation Newspapers." Contact: C. Keith Haddock, PhD, Department of Psychology, University of Missouri-Kansas City, haddockc@umkc.edu.]

Children rarely receive vaccinations as recommended
In a state-by-state analysis of childhood vaccinations, researchers found children ages 2-3 rarely get their recommended shots on time.
Timely vaccination rates ranged from a low of two percent in Mississippi to a high of 26 percent in Massachusetts for children ages 24-35 months, according to the study. Researchers looked at data 47,672 children in all states combined and the District of Columbia. They based their study on childhood vaccination recommendations from the Advisory Committee on Immunization Practices.
The study's authors said states could use the findings to "more fully understand and
monitor the strengths and weaknesses of their vaccination programs…prioritize needs, and… develop appropriate public health strategies."
[From: "Timelines of Childhood Immunizations: A State-Specific Analysis." Contact: Elizabeth T. Luman, PhD, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, ecl7@cdc.gov.]

Language barriers hamper breast and cervical cancer screening efforts
Breast and cervical cancer screening rates are lower among women who do not speak English.
According to a study of Chinese, Japanese, Hispanic and white women in the United States, reading and speaking only a language other than English as well as reading and speaking another language more fluently than English were associated with a drop in breast and cervical cancer screening rates. The 1,247 women in the study sample were participants in the Study of Women's Health Across the Nation, which is a multiethnic, multidisciplinary study of menopausal women.
The study's authors said their findings indicated that language barriers that hinder a woman's access to pap smears, mammograms and clinical breast exams create disparities in screening rates.
"It is time to recognize the role that language barriers play in health disparities and to begin to equip health care providers with the kinds of linguistic and interpreter resources they need to overcome these barriers."
[From: "Limited English Proficiency and Breast and Cervical Cancer Screening in a Multiethnic Population." Contact: Elizabeth A. Jacobs, MD, MPP, Chicago, ejacobs@rush.edu.]

Gulf war munitions associated with higher brain cancer risk
Gulf War veterans who may have been exposed to nerve agents during the March 1991 weapons demolitions in Khamisiyah, Iraq, appear to have a higher risk for brain cancer death than veterans who were not exposed. Researchers compared the causes of death in a group of 100,487 possibly exposed U.S. Army Gulf War veterans with those among 224,980 Army Gulf War veterans who were not exposed to nerve agents released during the demolitions. Exposed veterans were about twice as likely to have died from brain cancer as unexposed veterans. Those who were in the hazard area for two or more days had higher brain cancer death rates than those who were in the hazard area for only one day. The study's authors said additional research is needed to confirm their findings of a higher brain cancer death risk for some Gulf War veterans.
[From: "Mortality in US Army Gulf War Veterans Exposed to 1991 Khamisiyah Chemicals Munitions Destruction." Contact: William Page, Institute of Medicine, Washington, D.C., wpage@nas.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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