Newswise — The articles below will be published online June 14, 2012, 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 August 2012 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) Targeted helmet promotion should be geared to users of bicycle-sharing programs

Bike sharing programs are emerging around the country in popularity. A timely study from the American Journal of Public Health finds that cyclists utilizing a bike-sharing program in Washington, D.C., are much less likely to wear helmets than are their comparable counterparts riding personal bicycles.

Researchers set out to assess helmet use among users in Washington, D.C., in a cross-sectional study, observing riders for a 30-day period from September to October 2011 at 37 different locations within geographic range of the Capital Bikeshare program. A total of 2,297 cyclists were observed; of these, 1,410 were observed at time and locations consistent with being daily commuters and 887 being casual riders. They found that helmet use was significantly less common among Bikeshare users than comparable cyclists on their own. Persons observed using Capital Bikeshare at time and locations consistent with being a daily commuter had one fifth the odds of helmet use of those observed at the same time and locations on private bicycles.

“This research suggests that bike-sharing programs should invest effort in helmet promotion activities. Some have suggested mandatory helmet laws, and past research suggests that helmet laws would likely increase the proportion of cyclists wearing helmets, but they may also impede the use of bicycle-sharing programs.”

[From: “Helmet Wearing among Users of a Public Bicycle-Sharing Program in the District of Columbia and Comparable Riders on Personal Bicycles.” Contact: John Kraemer, Department of Health Systems Administration, Georgetown University School of Nursing and Health Studies, Washington, D.C., [email protected].]

(2) The choice of supermarket linked to obesity rates

Shopping at lower cost supermarkets may be closely linked to higher obesity rates, reports a recent study from the American Journal of Public Health.

Researchers sought to determine whether physical proximity to food stores or food prices within the store would be more strongly associated with obesity rates, adjusting for individual level demographics, education, and income.

Researchers obtained data through the Seattle Obesity Study, based on a representative sample of adult residents of King County, Washington, which includes the city of Seattle. Data on sociodemographics, food shopping behaviors, weights and health were obtained through a 25 minute telephone survey. Researchers collected and geocoded data on home addresses and food shopping destinations, including brand names and addresses of supermarkets that were identified as the primary food source. Supermarkets were stratified into three price levels based on the average cost of a market basket of 100 foods.

Researchers found that only one in seven respondents reported shopping at the nearest supermarket. They accounted for this by noting, “Although having a supermarket close by can shape shopping patterns in some urban locations, it may be less important in Seattle’s King County, where most people shop by car.”

In contrast, obesity rates were significantly different depending on the supermarket of choice. Obesity prevalence among shoppers in higher price supermarkets was nine percent, which is less than half of the county average (20.5%); whereas obesity prevalence among shoppers in lower price supermarkets was 27 percent, above the county average. Physical distance to the supermaket had no impact on obesity rates.

The main findings were that food costs trumped convenience. Bringing supermarkets closer to underserved areas may be one way to deal with the obesity epidemic. Reducing economic distance by making healthy foods more affordable is another strategy that should not be overlooked.

“Systematic efforts to reduce obesity will need to take economic inequalities into account. Ensuring equitable access to healthy affordable foods, with the emphasis on affordable, may be key,” concluded the study’s authors.

[From: "Obesity and Supermarket Access: Proximity or Price?" Contact: Adam Drewnowski, University of Washington, Seattle, Wash., [email protected].]

(3) Unemployment puts Americans at greater risk for mortality than their German counterparts, particularly minimum to medium skilled level employees

The different ways high-income capitalist countries organize their economies may have profound distributional consequences on the health of its workers, reports a recent comparative study between Germany and U.S. published the American Journal of Public Health. Americans will minimum and medium-skilled workers faired the worst, whereas their German counterparts had more safety nets.

Researchers examined the relationship between unemployment and mortality in Germany, a coordinated market economy, and the United States, a liberal market economy, among two comparable working age cohorts. They hypothesized that the higher levels of unemployment protection in Germany would mediate the effect of unemployment on mortality compared with the United States and that the gradient in the risk of unemployment on mortality by general education status would be steeper in the U.S. compared with Germany. They used the German Socio-Economic Panel and the American Panel Study of Income Dynamics to gather the two working-age cohorts from 1984 to 2005. While they found an increased risk of dying for all unemployed in both Germany and America, in almost all cases the relative risk was higher for American unemployed. Minimum-and medium-skilled unemployed Americans had the highest absolute risks of dying, not found among Germans.

The study’s authors stated, “These findings suggest that the unemployment-mortality relationship may be mediated by the institutional and economic environment.”

[From: “Unemployment and Mortality: A Comparative Study of Germany and the United States.” Contact: Christopher B. McLeod, School of Population and Public Health, University of British Columbia, [email protected].] ###

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