Highlights from the American Journal of Public Health: July 2013 issue

Newswise — In this month’s release, find new research about bullying against gay, lesbian and bisexual youth; health care patterns of older Americans; and targeted efforts that could help eliminate tuberculosis.*

AJPH News Release

EMBARGOED UNTIL May 16, 2013, 4 p.m. (EDT)*

The articles below will be published online May 16, 2013, at 4 p.m. (EDT)* 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 July 2013 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.

American Journal of Public Health highlights:

1.) Bullying prevalent against youths perceived as gay, lesbian or bisexual2.) Health needs, more than financial needs, determine older Americans’ use of health care services3.) Targeting high-risk neighborhoods may eliminate tuberculosis (not under embargo)*

1. Bullying prevalent against youths perceived as gay, lesbian or bisexual New research from the American Journal of Public Health reveals a prevalence of bullying against youth because of perceived sexual orientation. As a result, youth that experience such bullying may also have a lower quality of life.

The study used data from the “2010 Washington State Healthy You Survey,” which included questions about bullying as a result of perceived sexual orientation, quality of life and depressed mood. The study analyzed survey responses from more than 24,000 youth in grades eight through 12.

Results from the analysis found 14 percent, 11 percent and 9 percent of students in the eighth, 10th and 12th grades, respectively, experienced bullying because of perceived sexual orientation. Furthermore, these students had the lowest quality of life scores, and a higher proportion reported depressed mood when compared with students bullied for other reasons and students not bullied at all.

“Possibly, as youths develop and mature emotionally and socially, instances of bullying may decrease, and experiences of bullying because of perceived sexual orientation may decrease accordingly,” wrote the authors. “These findings underscore the need for early prevention efforts before 10th grade.”

“Bully-prevention or harm-reduction programs must address bullying because of perceived sexual orientation. All youths are entitled to safe school environments and support is essential for those who are most vulnerable to being bullied because of perceived sexual orientation.”

[Bullying and quality of life in youths perceived as gay, lesbian or bisexual in Washington state, 2010.” Contact: Donald L. Patrick, PhD, MSPH, Seattle Quality of Life Group and Biobehavioral Cancer Training Program, University of Washington, [email protected]].
For more new research on health issues among youth, the following studies may be of interest:• “Reducing traumatic brain injuries in youth sports? Youth sports TBI laws April 2009-August 2012” by Hosea Harvey, JD, PhD

• “Increasing children’s physical activity during school recess periods” by John J. Chin, PhD

2. Health needs, more than financial means, determine older Americans’ use of health care servicesFinancial status has little to do with older individuals’ decisions in seeking medical care, according to a new study in the American Journal of Public Health. Instead, their health needs and changes in health tend to guide their use of medical services.Researchers used data from the Health and Retirement Study, a survey intended to understand health among older adults, taken from 2006 and 2008. The study captured data including types of medical use, frequency of use, transition in and out of use, income, health insurance status and various other health, income and demographic related items. The data allowed researchers to investigate the potential motivating factors for older adults who continuously or intermittently used medical care.

Results indicated that the older population’s use of medical care services was largely correlated with their health status or changes in health status. Those with more chronic conditions or with poorer health were more likely to utilize such services. This was true for both those who used medical services intermittently and continuously. Financial status, contrastingly, was less significantly correlated and in some cases produced an unanticipated correlation. For example, those of lower income status were more likely to be repeat inpatient hospital and home health care users.

“Knowing the correlates of older Americans’ repeated medical care use or transitions into and out of such use over time is essential in designing policies to help curb the growth of our national health care use and expenditures,” observed the authors.

“Our findings suggest that even an economic downturn as serious as the recent one is unlikely to arrest the Medicare and near Medicare population’s contributions to this growth,” the authors conclude.

[“Patterns of older Americans’ health care utilization over time.” Contact: Richard J. Manski, DDS, MBA, PhD, University of Maryland School of Dentistry, Baltimore, Md., [email protected]].

For more new research on health care utilization, the following studies may be of interest:• “Factors explaining racial/ethnic disparities in rates of physician recommendation for colorectal cancer screening” by Nasar U. Ahmed, PhD

• “Racial/ ethnic disparities in health care receipt among male cancer survivors” by Nynikka R. A. Palmer, DrPH, MPH

3. Targeting high-risk neighborhoods may eliminate tuberculosis (not under embargo)*Identifying specific neighborhoods that have a high incidence of tuberculosis followed by testing and treating the residents proved to eliminate those communities’ cases of tuberculosis, according to new research published in the American Journal of Public Health.A latent tuberculosis infection, called LTBI, accounts for the development of most tuberculosis cases. By identifying geographic areas with persistent high incidence of both LTBI and active tuberculosis disease, researchers were able to locate two specific neighborhoods in Smith County, Texas, with a high risk of tuberculosis. In 1996, researchers performed community-based screenings of the infection among 2,258 eligible individuals. Results indicated that 1,291 individuals were tested, 229 tested positive for the LTBI infection and 147 received treatment.

Over the next 10 years, between 1996 and 2006, the two neighborhoods saw no cases of tuberculosis, compared to a period between 1985 and 1995 in which there were 15 cases. The study showed a positive result from geographically targeting specific high-risk clusters and predicts that an estimated seven to 14 tuberculosis cases were prevented as a result of the targeted screening and treatment.

“The keys to active, community-based screening and preventive treatment would be to target high-risk populations with an efficient strategy, maximize participation and minimize losses to follow-up so that the entire process becomes cost-effective,” according to the authors.

“In simple terms, the past location of tuberculosis in a community, epidemiologically speaking, may be the best predictor of the location of future tuberculosis cases,” the authors suggest.

[“Eliminating tuberculosis one neighborhood at a time.” Contact: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, [email protected]]

The American Journal of Public Health ® is the monthly journal of the American Public Health Association, 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.

Complimentary online access to the Journal is available to credentialed members of the media. Address inquiries to Kimberly Short at APHA, 202-777-2511, or via email,[email protected]. A single print issue of the Journal is available for $35 from the Journal’s Subscriptions department at www.ajph.org/subscriptions. If you are not a member of the press, a member of APHA or a subscriber, online single issue access is $30 and online single article access is $22 at www.ajph.org or for direct customer service, call 202-777-2516, or email [email protected].

To stay up-to-date on the latest in public health research, sign up for new content e-mail alerts at www.ajph.org/subscriptions/etoc.shtml?ck=nck.

*The study, “Eliminating tuberculosis one neighborhood at a time,” is not under embargo. It has been previously released on “First Look” online and is currently available to the public. It will be included in print, for the first time, in the July issue of the American Journal of Public Health.

Register for reporter access to contact details