Am Jrl of Public Health Highlights: January 2009

Newswise — The articles below will be published online Nov. 13, 2008, at 4 p.m. (ET) by the American Journal of Public Health under "First Look" at http://www.ajph.org/first_look.shmtl, and they are currently scheduled to appear in the January 2009 print issue of the Journal. "First Look" articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association, http://www.apha.org, and is available at http://www.ajph.org.

(1) Association of body weight to smoking and mental health differs by gender

Gender has a moderating role in the association between body weight and both smoking and mental health, a new study concludes. Researchers found that relative to their healthy-weight counterparts, overweight or obese men were less likely to smoke, whereas overweight women were more likely to smoke.

Data were collected from a statewide Minnesota telephone survey with a sample size of 16,289. Both smoking and mental health problems were examined in relation to relative body weight across the genders. The results showed that overweight or obese women were more likely to be current smokers, to view their mental health conditions negatively, and to have a mental health problem than healthy-weight women. In contrast with the men, either an association did not exist or the direction was reversed. "Gender-specific analysis may be a promising avenue for a full understanding of the association between body weight and behavioral health. In addition, the findings suggest that interventions may need to be gender-specific," the study's author stated.

[From: "Gender as a Moderator in the Association of Body Weight to Smoking and Mental Health" ].

(2) Intimate partner violence increases risk for maternal maltreatment of children

Researchers have found that mothers who experience intimate partner violence (IPV) are at greater risk for maltreating their children than are mothers who do not. Using a population-based sample of 2,508 participants from the Fragile Families and Child Well-Being Study, researchers examined the associations between IPV, parenting stress, and major depression relating to mothers' mistreatment of their three-year-old children. Researchers found that mothers who experienced IPV compared with those who did not used psychological and physical aggression against their children more frequently and had higher odds of spanking their children and of reporting at least one instance of neglect toward their children.

These findings remained even after controlling for mothers' parenting stress and major depression— two potential confounders of these associations—as well as nearly a dozen covariates associated with IPV and child maltreatment. An important limitation of this study is that only mothers' data was examined; no information was provided about fathers' aggression toward their children.

The researchers concluded, "The need to better integrate IPV and child maltreatment services and prevention efforts has long been recognized; such efforts must carefully balance the needs of both adult and child victims and do so in a way that does not overwhelm child welfare services. "¦ Furthermore, primary prevention strategies aimed at co-occurring family violence are needed. Given that the most successful child maltreatment prevention programs to date have limited effects in the presence of frequent IPV, enhanced home visitation programs are needed to address child maltreatment risk along with co-occurring IPV. Initiatives aimed at the primary prevention of IPV, especially those that target male and female adolescents, are crucial complements to direct child maltreatment prevention efforts and ought to have a significant indirect impact on the reduction of child maltreatment."

[From: "Intimate Partner Violence, Maternal Stress, Nativity, and Risk for Maternal Maltreatment of Young Children" ].

(3) Absence of Medicaid coverage impacts neonatal male circumcision rates

Lack of Medicaid coverage for neonatal male circumcision correlated with lower rates of circumcision, a new study found. In light of recent clinical trials in Africa that suggest uncircumcised males may face greater risk of HIV and other sexually transmitted infections, lack of Medicaid coverage for circumcision may translate into future health disparities for children born to poor families covered by Medicaid.

Data were pulled from the Nationwide Inpatient Sample, with a sample size of 417,282 male newborns. The average neonatal circumcision rate across the 683 hospitals in the sample was 55.9 percent. Circumcision rates were 24% higher in states whose Medicaid programs cover the procedure than in those that do not. The study's authors emphasize, however, "The African results relate to transmission from female sexual partners to uninfected men. However, in the United States, only 16 percent of all AIDS cases among men are linked to heterosexual transmission, whereas 18 percent are linked exclusively to drug use, and 65 percent are linked to male-to-male sexual contact."

[From: "Male Circumcision in the United States: Determinants and Policy implications" ].

(4) Terrorism-related fear and avoidance behavior disproportionately experienced by vulnerable populations

Vulnerable populations experience a disproportionate burden of the psychosocial impact of terrorism threats and our national response, according to a new study.

Researchers conducted a random telephone-based dial survey in six languages of the Los Angeles County population between October 2004 and January 2005. They questioned respondents about what color alert level the country was under, how often they worry about terrorist attacks and how often they avoid activities because of terrorism. Researchers found that African Americans, Latinos, Chinese Americans, Korean Americans, non-U.S. citizens, persons who are mentally ill and those who are disabled were more likely to perceive population-level risk as high, as measured by the estimated color-coded alert level. Furthermore, these groups reported more anxiety and avoidance behaviors because of concerns about terrorism.

"Ethnic minorities may presume that planners will focus on the majority population and ignore their needs or special circumstances"¦The disaster burden associated with terrorism and consequent policies may fall disproportionately on the vulnerable groups we studied," stated the study's authors. "Further studies should investigate the specific behaviors affected and further elucidate disparities in the disaster burden associated with terrorism and terrorism policies."

[From: "Terrorism-Related Fear and Avoidance Behavior in a Multiethnic Urban Population" ]