To request copies of articles or for information on scheduling interviews with an expert, please contact Megan Lowry.

EMBARGOED UNTIL November 29, 4 p.m. ET

American Journal of Public Health January issue research highlights:

Shootings are reduced by mowing, greening and cleaning vacant land in cities

Researchers in this randomized controlled trial found that greening, mowing and picking up trash in vacant lots significantly reduced shootings that resulted in injury or death around the lots. The study randomly selected vacant lots in Philadelphia for either greening, less intensive mowing and trash cleanup, or no intervention. Greening vacant lots resulted in a reduction of the monthly number of shootings that resulted in injury or death near the vacant lots by 10.6 percent, and mowing vacant lots resulted in an 8.4 percent reduction. The study also showed that these improvements had a spillover effect, reducing shootings within 300-600 meters of the vacant lots, and that the surrounding area didn’t suffer from a displacement effect.

The study authors concluded that their findings provide strong causal evidence in support of place-based initiatives that remediate the city’s built environment to reduce gun violence.

In the study discussion, authors suggest that cleaning and greening vacant lots is effective because it encourages recreation and socialization in these spaces, increases the presence of residents in the area and promotes a sense of social cohesion and willingness to act for the common good.

[Author Contact: John M. MacDonald, Department of Criminology, University of Pennsylvania, Philadelphia, Pennsylvania. “Effect of Remediating Blighted Vacant Land on Shootings: A Citywide Cluster Randomized Trial”].


Opioid- and amphetamine-affected births increased between 2004 and 2015

Researchers found that opioid-affected births increased from 1.5 per 1,000 hospital deliveries in 2004-2005 to 6.5 per 1,000 hospital deliveries in 2014-2015. In total, by 2014-2015, maternal opioid use complicated nearly 3 percent of all hospital deliveries in the rural Northeast. Amphetamine-related deliveries increased to 2.4 per 1,000 hospital deliveries by 2014-2015. The study also found that amphetamine and opioid-related deliveries were both associated with worse health outcomes for mothers and higher costs compared with other deliveries.

The study found that maternal amphetamine use disproportionately affected rural compared with urban counties in the West, Midwest and South. The highest incidence of amphetamine-related deliveries in 2014-2015 was in the rural West. By 2014-2015, the highest incidence of opioid-related deliveries was in the rural Northeast, representing 28.7 out of every 1,000 hospital deliveries.

Amphetamine births were also found to be more dangerous for mothers. Compared with opioid-related deliveries, amphetamine-related deliveries were associated with higher levels of preterm delivery, severe maternal mortality and preeclampsia.  The study also quantified the cost of these births, and found that amphetamine and opioid-related deliveries were associated with greater mean costs.

[Author Contact: Lindsay K. Admon, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan. “Amphetamine- and Opioid-Affected Births: Incidence, Outcomes, and Costs, United States, 2004–2015”].


Survey shows people trust public health on e-cigarette information, distrust news media and social media

Researchers found in this survey that when it comes to e-cigarettes, U.S. adults trust public health sources and distrust entities with commercial interest in e-cigarettes.

The survey showed that doctors, health organizations, the Centers for Disease Control and Prevention, health experts and scientists, the National Institutes of Health, the Food and Drug Administration and family and friends are trusted as sources of health information on e-cigarettes. The survey also showed that the news media, e-cigarette users, social media, vape shop employees, and e-cigarette and cigarette companies were distrusted for their health information on e-cigarettes. From 2015 to 2017, trust significantly increased for CDC, FDA, health experts and scientists, and news media. Trust also increased for NIH between 2016 and 2017.

Researchers concluded that evidence-based messaging and information on health effects of e-cigarettes from public health professionals can effectively counter e-cigarette promotion and improve public understanding about e-cigarettes.

[Author Contact: Lucy Popova, Tobacco Center of Regulatory Science, School of Public Health, Georgia State University, Atlanta, Georgia. “Trends in Trust in the Sources of Health Information on E-Cigarettes Among US Adults, 2015–2017”].


State vaccine exemption proposals increasing, but few pass

This review of vaccine-related state legislation found that state legislatures proposed 175 vaccine-related laws between 2011 and 2017. Researchers found that the volume of these bills increased over time. Ninety-two bills, or 53 percent, expanded access to exemptions, and 83, or 47 percent, limited the ability to exempt. Of the 13 bills signed into law, 12, or 92 percent, limited the ability to exempt. Bills that expanded access to exemptions were more likely to come from Republican legislators and Northeastern and Southern states.

Researchers concluded that although most proposed legislation would have expanded access to vaccine exemptions, bills that limited exemptions were more likely to be enacted into law. Legal barriers to exempt children from vaccination persist despite vaccine hesitancy, which is encouraging for public health.

[Author Contact: Neal D. Goldstein, Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania. “Trends and Characteristics of Proposed and Enacted State Legislation on Childhood Vaccination Exemption, 2011–2017”].


Find a full list of AJPH research papers published online below:

  • The leadership style of the people's doctor: A contemporary look back at New York state commissioner of health, David Axelrod, MD
  • Estimating the prevalence of HIV and sexual behaviors among the US transgender population: a systematic review and meta-analysis, 2006-2017
  • Work-related stressors and increased risk of benzodiazepine long-term use: Findings from the CONSTANCES population-based cohort
  • Evidence based pain management: Building on the foundations of Cochrane systematic reviews
  • Building New York state centers of excellence in children's environmental health: A replicable model in a time of uncertainty
  • Access to pain management as a human right
  • The global burden of musculoskeletal pain - where to from here?
  • The strengths and weaknesses of current U.S. policy to address pain
  • The socio-economic burden of pain from war in the United States
  • A healthy retail intervention in native American convenience stores: The thrive community-based participatory research study
  • The share project: Building capacity of justice-involved individuals, policymakers, and researchers to collectively transform healthcare delivery
  • Reduction in gaps in high cd4 count and viral suppression between transgender and cisgender persons living with HIV in New York City, 2007-2016
  • Effect of remediating blighted vacant land on shootings: A citywide cluster randomized trial
  • Quantifying the adequacy of opioid analgesic consumption globally: An updated method and early findings
  • Trends in trust in the sources of health information on electronic cigarettes among US adults, 2015-2017
  • The legacy of 1987 Boreali v. Axelrod: board of health rule-making under siege
  • Solving the global crisis in access to pain relief access: Lessons from country responses
  • Amphetamine- and opioid-affected births: Incidence, outcomes, and costs, United States 2004-2015
  • Trends and characteristics of proposed and enacted state legislation on childhood vaccination exemption, 2011-2017
  • California’s senate bill 277: Local health jurisdictions experiences with the elimination of nonmedical vaccine exemptions
  • Where is the opioid use epidemic in Mexico? A cautionary tale for policymakers south of the US-Mexico border
  • Walksafe keeps walking for 15 years: A program review
  • Growth and persistence of place-based mortality in the United States: The rural mortality penalty
  • A tale of Palestinian-Israeli friends and foes
  • Pain management and opioid regulation: Continuing public health challenges

The articles above will be published online November 29, 2018, at 4 p.m. ET by AJPH under “First Look.” “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. AJPH is published by the American Public Health Association, and is available at

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The American Journal of Public Health is the monthly journal of the American Public Health Association. APHA champions the health of all people and all communities. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization that influences federal policy, has a nearly 150-year perspective and brings together members from all fields of public health. Visit