March 2008 AJPH Highlights: National Health Care Systems

Newswise — The articles below will be published online Jan. 30, 2008, at 4 p.m. (EST) by the American Journal of Public Health under "First Look" at http://www.ajph.org/first_look.shtml, and they are currently scheduled to appear in the March 2008 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) Health effects of obesity may be related to body imageThe difference between actual and desired body weight is a stronger predictor of health than body mass index (BMI).

In a secondary analysis of the 2003 Behavioral Risk Factor Surveillance System (BRFSS) data set, researchers looked at a sample of 150,577 participants to examine the impact of desired body weight, independent of actual BMI, on the number of physically and mentally unhealthy days subjects report over one month. After controlling for BMI and age, researchers found that men who wished to lose 1 percent, 10 percent and 20 percent of their body weight, respectively, reported 0.1, 0.9 and 2.7 more unhealthy days per month than those who were happy with their weight. Among women, the corresponding increase in numbers of reported unhealthy days was 0.1, 1.6 and 4.3. Additionally, the desire to lose weight was more predictive of unhealthy days among women than among men, and among whites than among blacks or Hispanics.

"Our preliminary data suggest that some of the obesity epidemic may be partially attributable to social constructs that surround ideal body types," the study's authors said. [From: I Think Therefore I Am: Perceived Ideal Weight as a Determinant of Health. ]

(2) Public health approach to climate change proposedUsing the "Essential Services of Public Health" as a conceptual framework, a public health response to climate change is formulated.

There is scientific consensus that the global climate is changing. These changes are expected to have substantial impacts on human health. There are known, effective public health responses to many of these impacts, but the scope, timeline and complexity of climate change are unprecedented and call for a proactive approach. The authors of the article propose a public health approach to climate change, based on the essential public health services, that extends to both clinical and population health services and emphasizes the coordination of government agencies, academia, the private sector and nongovernmental organizations.

"The conceptual framework for responding draws on longstanding public health thinking," the paper's authors said. "An effective public health response to climate change is essential to preventing injuries and illnesses, enhancing public health preparedness, and reducing risk." [From: Climate Change: The Public Health Response. ]

(3) Children in child welfare system likely to maintain health coverageIn the first description of health insurance coverage patterns over time among a nationally representative sample of children in the child welfare system, researchers used data from four waves of the National Survey of Child and Adolescent Well-Being to examine coverage among 2,501 youths. Researchers found that a significant majority of the children maintained health coverage over a three-year period.

"[These findings are] a testament to the success of policies directed at securing stable insurance coverage for children," the study's authors said. "Given this vulnerable population's dependence on Medicaid, protection of existing entitlements to Medicaid is essential to preserve their stable insurance coverage." [From: Longitudinal Patterns of Health Insurance Coverage Among a National Sample of Children in the Child Welfare System. ]

(4) Smokeless tobacco ads continue to target youthsThe Smokeless Tobacco Master Settlement Agreement (STMSA) has had a limited effect on the advertising of smokeless tobacco products to youth.

Utilizing readership data, advertising data and a media planning program, researchers looked at the level of advertising of smokeless tobacco in magazines with high youth readership and the amount of marketing reach and frequency that was generated among readers aged 12 to 17. The study found that the STMSA appeared to have had a limited effect on the advertising of smokeless tobacco products; both before and after the agreement, smokeless tobacco companies advertised in magazines with high adolescent readership. Analysis also indicated that smokeless tobacco reach among adolescents increased from 2000 to 2002.

"These findings are significant because aggressive marketing tactics can play a role in influencing smokeless tobacco use among young people," the study's authors said. [From: Under the Radar: Smokeless Tobacco Advertising in Magazines With Substantial Youth Readership. ]

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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