Am Jrl of Public Health Highlights: October 2010

Newswise — The articles below will be published online August 19, 2010, 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 October 2010 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,www.apha.org, and is available at www.ajph.org.

(1) U.S. nursing home assistants report high rate of workplace assaults

A new nationwide study from the American Journal of Public Health reports a high incidence of workplace assaults on nursing assistants found in U.S. nursing homes.

Researchers analyzed data from the 2004 National Nursing Assistant Survey linked it with facility information from the 2004 National Nursing Home Survey. They found that 34 percent of the surveyed nursing assistants reported experiencing physical injuries from residents’ aggression in the previous year, including 12 percent who reported injuries from human bites during the past year. Nursing assistants employed in nursing homes with Alzheimer care units were more likely to experience injuries such as bites, whereas nursing assistants employed by nursing homes with a waiting list of residents or for-profit facilities were not associated with such incidents. Researchers found that mandatory overtime and nursing homes that were understaffed had stronger associations of workplace assault experiences.

“Workplace violence prevention efforts that focus on nursing home settings with specialized wings or wards for Alzheimer’s disease should be developed,” the study’s authors suggest. “In addition, nursing home managers should maintain appropriate staffing levels to reduce the workload of their nursing assistants.”

[From: “Workplace Assaults on Nursing Assistants in U.S. Nursing Homes: A Multilevel Analysis.” ].

(2) Higher mortality rate and health risks found among those with HIV who smoke

Smoking heightens health risks among persons with HIV and may negate many positive benefits of HIV treatment, finds a new multi-national study in the American Journal of Public Health.

Researchers evaluated the relationship between baseline smoking status and the development of AIDS-related or serious non-AIDS events and overall deaths. The study included an analysis of data from 5,472 HIV-infected persons enrolled from 33 countries in the Strategies for Management of Antiretroviral Therapy clinical trial. Out of all the participants, 40.5 percent were current smokers and 24.8 percent were former smokers, while 34.7 percent never smoked. They found that health risks were higher for current smokers than for non-smokers in the categories of overall mortality, major cardiovascular disease, non-AIDs cancer and bacterial pneumonia. Overall, smoking contributed to substantial morbidity and mortality in this HIV-infected population.

“The high prevalence of smoking among this population and other HIV-infected populations should cause encouraging smoking cessation to become a high priority for clinicians and other HIV service providers to promote health and reduce morbidity and mortality in their patients,” the study’s authors advocate.

[From: “Smoking-Related Health Risks Among Persons with HIV in the Strategies for Management of Antiretroviral Therapy Clinical Trial.” ].

(3) More alcohol retailers in a population predict higher demographic health disparities

Greater alcohol retail density correlates with urban areas that have higher levels of poverty and higher proportions of blacks and Latinos, a new American Journal of Public Health study indicates.

The study examined whether the geographic density of alcohol retailers was greater in areas with higher levels of demographic characteristics that predict health disparities. After obtaining locations of all alcohol retailers in the continental United States, the researchers created a map depicting alcohol retail outlet density at the U.S. Census tract level, accounting for measures of poverty, education, density of population and race/ethnicity. They found that in urban areas (but not rural), retail alcohol density was significantly higher in neighborhoods with higher proportions of Blacks, Latinos, and impoverished families, and lower median education level. In addition, retail alcohol density showed larger increases in census tracts that were in the top of 25 percent for each health disparity measure.

“Public health professionals and policy-makers should consider variations in retail alcohol exposure among disparate groups,” wrote the study’s authors. “The strong association between retail alcohol density and predictors of health disparities may have implications at both the individual and the community levels, creating an opportunity to reduce the risks of morbidity and mortality in the community.”

[From: “Alcohol Retail Density and Demographic Predictors of Health Disparities: A Geographic Analysis.” ].

The American Journal of Public Health is the monthly Journal of the American Public Health Association (APHA), the oldest and most diverse organization of public health professionals in the world. APHA is a leading publisher of books and periodicals promoting sound scientific standards, action programs and public policy to enhance health. More information is available at www.apha.org.

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