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The purpose of this paper is to determine the influence of federal mine safety inspections on underground coal mine accidents. An economic incentives model is developed to relate federal enforcement activities to accident rates. The determinants of accident rates are analyzed for 535 coal mines during the period 1973-75. Estimates based on these data when applied to the model indicate that increasing inspections by 25 per cent would have produced a 13 per cent decline in fatal accidents and an 18 per cent decline in disabling accidents. (Am J Public Health 1985; 75:497-501.) [ABSTRACT FROM AUTHOR]

As soon as the authority of the Public Health and Welfare Section (PHW) of the Supreme Commander for Allied Powers waned in May 1951. the Japanese government overturned several measures it had implemented. Although the PHW contributed greatly toward improving public health conditions, not all of Its activities were models of cooperative success. Many Japanese perceived some measures — terminated pensions for wounded Japanese veterans, lack of support for segregated orphanages for mixed-race children, and suppression of Japanese atomic bomb medical reports — as promoting US national interest at the expense of Japanese public health needs. Similarly, the PHW's upgrade of nursing education and separation of the professions of medicine and pharmacy were reversed because neither professionals nor the public saw these measures as urgent. Their reinstitution toward the end of the twentieth century suggests that the progressive measures were sound, but broke too sharply with Japanese tradition and were enforced prematurely. (Am J Public Health. 2009; 99:1364-1375. doi:10.2105/AJPH.2008.150532) [ABSTRACT FROM AUTHOR]

Abstract: Dr. Salk's comments on our paper fall into four major categories: our use of the techniques of decision analysis, the assumptions we used, the fact that we did not include individual and social values in the model, and the way in which vaccine policies are developed in the United States. We believe that the methods were used correctly, that the assumptions we used are defensible, and that our conclusions were both appropriate and appropriately worded. We explicitly did not include individual and social values since we were addressing the scientific and epidemiologic issues rather than ethical and moral issues. Vaccine policy development in the United States is carried out in public forums with opportunity for presentation of all sides of an issue. INSET: AAP Urges Removing Religious Exemption Clauses in Child Abuse.... [ABSTRACT FROM AUTHOR]

The article presents a public health response to the war on drugs by the American Public Health Association. The response is focused on the reduction of alcohol, tobacco, and other drug problems among the American youth. One of the most pressing issues in the United states is the alcohol, tobacco, and other drug problems among the youth. There are several reasons why drug use prevention and reduction is not totally effective in the United States. One of the reasons is that the educational programs and mass media campaigns regarding the issue are poorly planned and inadequate.

Studies have shown that a considerable group of patients in short term hospitals could be treated more appropriately in extended care facilities. This paper discusses how this can be done on a planned basis in a given area. [ABSTRACT FROM AUTHOR]

Objectives. We investigated whether state-sponsored antitobacco advertisements are associated with reduced adult smoking, and interactions between smoking-related advertising types. Methods. We measured mean exposure to smoking-related advertisements with television ratings for the top-75 US media markets from 1999 to 2007. We combined these data with individual-level Current Population Surveys Tobacco Use Supplement data and state tobacco control policy data. Results. Higher exposure to state-sponsored, Legacy, and pharmaceutical advertisements was associated with less smoking; higher exposure to tobacco industry advertisements was associated with more smoking. Higher exposure to state- and Legacy-sponsored advertisements was positively associated with intentions to quit and having made a past-year quit attempt; higher exposure to ads for pharmaceutical cessation aids was negatively associated with having made a quit attempt. There was a significant negative interaction between state and Legacy-sponsored advertisements. Conclusions. Exposure to state-sponsored advertisements was far below Centers for Disease Control and Prevention-recommended best practices. The significant negative relationships between antismoking advertising and adult smoking provide strong evidence that tobacco-control media campaigns help reduce adult smoking. The significant negative interaction between state- and Legacy-sponsored advertising suggests that the campaigns reinforce one another. [ABSTRACT FROM AUTHOR]

Recruiters for the various US armed forces have free access to our nation's high schools, as mandated by the No Child Left Behind Act. Military recruiter behaviors are disturbingly similar to predatory grooming. Adults in the active military service are reported to experience increased mental health risks, including stress, substance abuse, and suicide, and the youngest soldiers consistently show the worst health effects, suggesting military service is associated with disproportionately poor health for this population. We describe the actions of a high school parent teacher student association in Seattle, Washington, which sought to limit the aggressive recruitment of children younger than 18 years into the military. [ABSTRACT FROM AUTHOR]

Young drivers are overrepresented in road trauma and vehicle-related deaths, and there is substantial evidence for the effectiveness of graduated driver licensing (GDL) policies that minimize young drivers' exposure to high-risk driving situations. However, it is unclear what role research plays in the process of making GDL policies. To understand how research is utilized in this context, we interviewed influential GDL policy actors in Australia and the United States. We found that GDL policy actors generally believed that research evidence informed GDL policy development, but they also believed that research was used to justify politically determined policy positions that were not based on evidence. Further efforts, including more effective research dissemination strategies, are required to increase research utilization in policy. [ABSTRACT FROM AUTHOR]

Mobile food vending is a component of the food environment that has received little attention in the public health literature beyond concerns about food sanitation and hygiene issues. However, several features of mobile food vending make it an intriguing venue for food access. We present key components of mobile vending regulation and provide examples from12 US cities to illustrate the variation that can exist surrounding these regulations. Using these regulatory features as a framework, we highlight existing examples of "healthy vending policies" to describe how mobile food vending can be used to increase access to nutritious food for vulnerable populations. [ABSTRACT FROM AUTHOR]

Objectives. We evaluated mammography rates for cognitively impaired women in the context of their life expectancies, given that guidelines do not recommend screening mammography in women with limited life expectancies because harms outweigh benefits. Methods. We evaluated Medicare claims for women aged 70 years or older from the 2002 wave of the Health and Retirement Study to determine which women had screening mammography. We calculated population-based estimates of 2-year screening mammography prevalence and 4-year survival by cognitive status and age. Results. Women with severe cognitive impairment had lower rates of mammography (18%) compared with women with normal cognition (45%). Nationally, an estimated 120000 screening mammograms were performed among women with severe cognitive impairment despite this group's median survival of 3.3 years (95% confidence interval=2.8, 3.7). Cognitively impaired women who had high net worth and were married had screening rates approaching 50%. Conclusions. Although severe cognitive impairment is associated with lower screening mammography rates, certain subgroups with cognitive impairment are often screened despite lack of probable benefit. Given the limited life expectancy of women with severe cognitive impairment, guidelines should explicitly recommend against screening these women. [ABSTRACT FROM AUTHOR]

Complex, transnational issues like the tobacco epidemic are major challenges that defy analysis and management by conventional methods, as are other public health issues, such as those associated with global food distribution and climate change. We examined the evolution of indoor smoke-free regulations, a tobacco control policy innovation, and identified the key attributes of those jurisdictions that successfully pursued this innovation and those that to date have not. In doing so, we employed the actor-network theory, a comprehensive framework for the analysis of fundamental system change. Through our analysis, we identified approaches to help overcome some systemic barriers to the solution of the tobacco problem and comment on other complex transnational problems. [ABSTRACT FROM AUTHOR]

In this descriptive case study, we analyze the unsuccessful struggle to access disability pensions by veterans sickened by tobacco use begun during service. Drawing on tobacco industry documents and other material, we show how the US government, tobacco industry, and veterans' organizations each took inconsistent positions to protect their interests. Congress and Department of Veterans Affairs leadership, concerned about costs, characterized veterans' smoking as "willful misconduct," thereby contradicting the government's position in a federal lawsuit that tobacco companies addicted smokers. Veterans' groups supported the pensions, despite previously defending smoking as a "right." The tobacco industry wavered, fearing liability. Securing pensions was complicated by the notion that smoking is primarily a personal choice. The US government should compensate veterans fairly and should abolish military practices that encourage tobacco addiction. [ABSTRACT FROM AUTHOR]

Alcohol use health consequences are considerable; prevention efforts are needed, particularly for adolescents and college students. The national minimum legal drinking age of 21 years is a primary alcohol-control policy in the United States. An advocacy group supported by some college presidents seeks public debate on the minimum legal drinking age and proposes reducing it to 18 years. We reviewed recenttrends in drinking and related consequences, evidence on effectiveness of the minimum legal drinking age of 21 years, research on drinking among college students related to the minimum legal drinking age, and the case to lower the minimum legal drinking age. Evidence supporting the minimum legal drinking age of 21 years is strong and growing. A wide range of empirically supported interventions is available to reduce underage drinking. Public health professionals can play a role in advocating these interventions. (Am J Public Health. 2010;100:986- 992. doi:10.2105/AJPH.2009.178004) [ABSTRACT FROM AUTHOR]

The Union Army disability pension was an early experiment in colorblind social policy. However, it shortchanged Blacks in 2 ways. First, the law was unable to account for the challenges Blacks faced in proving their eligibility because of the legacy of slavery and discrimination against Black troops during the Civil War. Second, the increasing leniency accorded White soldiers by the Pension Bureau was not extended in the same measure to Blacks. Active discrimination against Blacks resulted in part from local discretion, evidenced by the significantly lower approval rates for both White and Black veterans in the South. Furthermore, when Whites and Blacks claimed disabilities that were easily verifiable, outcomes were similar, but when verification required a degree of trust, Blacks fared considerably worse than Whites. [ABSTRACT FROM AUTHOR]

Objectives. We examined whether support for tobacco control policies varies by demographic group, including nativity status (i.e., immigrant versus US born). Methods. We analyzed 1995 to 2002 data from the Current Population Survey Tobacco Use Supplement (n=543951). The outcome was a summary attitudinal measure assessing support of smoking bans in 4 of 6 venues. Results. US-born respondents, smokers, male respondents, Native Americans, Whites, and those who were unmarried, of lower socioeconomic status, and whose workplaces and homes were not smoke free were less likely to support smoking bans. Immigrants exhibited stronger support for banning smoking in every venue, with a generation-specific gradient in which support eroded with increasing assimilation to the United States. Levels of support were more than twice as high among immigrants as among US-born respondents (odds ratio [OR]=2.16; 95% confidence interval [CI]= 2.08, 2.23). Naturalized citizens displayed higher support than US-born citizens, which may be relevant for mobilization of the electorate. Differences in population composition and contexts (e.g., smoke-free workplaces) only partially accounted for immigrants' stronger level of support. Conclusions. Immigrants and their children may be valuable tobacco control allies given their supportive attitudes toward smoke-free policies. (Am J Public Health. 2010;100:171-181. doi:10.2105/AJPH.2009.160218) [ABSTRACT FROM AUTHOR]

The National Institutes of Health and other federal health agencies are considering establishing a national biobank to study the roles of genes and environment in health. We assessed the public's attitudes toward the proposed biobank, including preferences for providing informed consent. Sixteen focus groups were conducted, and themes arising from the focus groups were tested in a large, representative survey (n=4659) of the general population. Our research demonstrates that when considering participating in a genomic biobank, individuals want ongoing choices and control over access to their samples and information. [ABSTRACT FROM AUTHOR]

Despite efforts to the contrary, disparities in health and health care persist in the United States. To solve this problem, federal agencies representing different disciplines and perspectives are collaborating on avariety of transdisciplinary research initiatives. The most recent of these initiatives was launched in 2006 when the Centers for Disease Control and Prevention's Office of Public Health Research and the Department of Health and Human Services' Office of Minority Health brought together federal partners representing a variety of disciplines to form the Federal Collaboration on Health Disparities Research (FCHDR). FCHDR collaborates with a wide variety of federal and nonfederal partners to support and disseminate research that aims to reduce or eliminate disparities in health and healthcare. Given the complexity involved in eliminating health disparities, there is a need for more transdisciplinary, collaborative research, and facilitating that research is FCHDR's mission. [ABSTRACT FROM AUTHOR]

Objective. We evaluated the effects of tax increases on alcoholic beverages in 1983 and 2002 on alcohol-related disease mortality in Alaska. Methods. We used a quasi-experimental design with quarterly measures of mortality from 1976 though 2004, and we included other states for comparison. Our statistical approach combined an autoregressive integrated moving average model with structural parameters in interrupted time-series models. Results. We observed statistically significant reductions in the numbers and rates of deaths caused by alcohol-related disease beginning immediately after the 1983 and 2002 alcohol tax increases in Alaska. In terms of effect size, the reductions were-29% (Cohen's d=-0.57) and-11% (Cohen's d=-0,52) for the 2 tax increases. Statistical tests of temporary-effect models versus long-term-effect models showed little dissipation of the effect over time. Conclusions. Increases in alcohol excise tax rates were associated with immediate and sustained reductions in alcohol-related disease mortality in Alaska. Reductions in mortality occurred after 2 tax increases almost 20 years apart. Taxing alcoholic beverages is an effective public health strategy for reducing the burden of alcohol-related disease. {Am J Public Health. 2009;99: 1464-1470. doi:10.2105/AJPH.2007.131326) [ABSTRACT FROM AUTHOR]

The Centers for Disease Control and Prevention has undertaken an advisory process to update its national HIV prevention plan. We offer observations on the magnitude of HIV prevention challenges in the United States and reflect on how these challenges might influence the structure of a new HIV prevention plan. We recommend a plan structure that (1) is based on fundamental principles of prevention, (2) enables accountability and midcourse correction, and (3) if achieved, would result in historic changes in the US HIV epidemic. The recommended plan structure would differentially prioritize serostatus determination and prevention and care interventions for people living with HIV while retaining goals directed at high-risk HIV-negative and general population members. (Am J Public Health. 2007;97:11631167. doi:10.2105/AJPH.2006. 095182) [ABSTRACT FROM AUTHOR]

In the United States, companies that use their own funds to test consumer products on their employees are subject to few regulations. Using previously undisclosed tobacco industry documents, we reviewed the history of that industry's efforts to create internal guidelines on the conditions to be met before employee taste testers could evaluate cigarettes made from tobacco treated with experimental pesticides. This history highlights 2 potential ethical issues raised by unregulated industrial research: conflict of interest and lack of informed consent. To ensure compliance with accepted ethical standards, an independent federal office should be established to oversee industrial research involving humans exposed to experimental or increased quantities of ingested, inhaled, or absorbed chemical agents. (Am J Public Health. 2006;96: 37-46.) [ABSTRACT FROM AUTHOR]

We applied standard cohort and multiple regression techniques to data on the dental utilization rates of 129,191 elderly individuals taken from the 1972, 1973, 1976, 1977, 1980, and 1981 Health Interview Surveys. The results indicate that the marked variation in dental contact rates is a reflection of cohort succession, and not a function of aging per se. Older cohorts having lower dental contact rates are being replaced by younger cohorts having higher dental contact rates. The dental contact rates of the individual birth cohorts themselves are quite stable over time. The results also indicate that economic barriers (especially liquid assets) have become more important than ever before, especially for the oldest-old. These findings have important implications for public policy about the oral health and health care of elderly Americans. (Am J Public Health 1989; 79:47-51.) INSET: New Techniques Saves Blood Usually Lost During Surgery. [ABSTRACT FROM AUTHOR]

Abstract: In order to put Pennsylvania's Pharmaceutical Assistance Contract for the Elderly (PACE) Program in a national context, a nationwide mail survey and telephone follow-up to each of the 58 State Unit Directors on Aging in the United States and its territories identified 10 programs. The results reported in this article are specific to the seven state-level pharmaceutical assistance programs which were in operation during the fiscal year 1984-85. In general, the programs varied on select program characteristics and on their efforts to address major policy issues. Data from the non-program states indicated support, legislative efforts, and a high interest in fiscal concerns. The findings reflect a lack of program uniformity and have implications for program development and implementation. Suggestions on how to identify the "optimum" or best combination of program and policy options are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Conceptually, the only element that all Latin American countries share is not language, race, or culture, but political: the presence of United States foreign policy as pronounced in the Monroe Doctrine in 1823. The political relation between the US and Latin America has colored US domestic policy toward its populations of Latin American origin. From the beginning oF US-Latin American relations, there has been a constant confusion of race for national origin, compounded by the adoption of euphemistic terms such as "Spanish surname," The term "Latino", derived from "Latin American," is offered as the term that best reflects both the diverse national origins and the nearly unitary treatment of Latinos in the US. The term Latino is operationalized to include all persons of Latin American origin or descent, irrespective of language, race. or culture. Specifically excluded are individuals of Spanish national origin outside the Western Hemisphere. When a synthetic sample has been derived, the term should be modified to reflect the basis upon which the sample was derived, e.g.. "Latino (Spanish surname)." When working with Latinos from a specific national origin, that should be noted, e.g., "Mexican origin Latinos." [ABSTRACT FROM AUTHOR]

The article focuses on the emergence of the critical conflict between physicians involved in the public health field and members of the newly emerging profession of sanitary engineering following the creation of wastewater disposal and water quality policy in the U.S. in the beginning of the 20th century. Within the area of water quality, once the principle of state intervention had been established, the question of the direction and timing of policy often produced sharp conflict among involved professional groups. These clashes stemmed from different professional perspectives on the effectiveness of various strategies and the relative costs and benefits of actions taken to protect the public health.

The article shares the author's insights on the Canadian health policy decisions and their relevance to the U.S. The health care delivery system of the government in Canada and the US are so similar which can tend to overlook their important differences in the process of health policy development. The Canadian approach to universal health insurance has been the foundation of the most other major health policies in which their primary concern is to balance the family budget rather than the government budget. Further, the universal free health care in Canada that is run by the government has cost only one-fourth to administer as the US co-insurance ridden public-private system.

The article focuses on the use of political platforms for health issues in the U.S. It is commonly found that public and private interests does not appropriately represent their constituencies when they fail to participate in the platform process. The platform process is divided into three closely related phases including preparation, participation, and propitiation. The first phase starts prior to the platform committee hearings when a platform is drafted by appointed writers. The health planks of the political parties are considered as the predictor instrument for the introduction of new health programs or policies. Since 1952, the chief parties of the U.S. have had good records when it came to transforming these programs into action legislation.

Drinking among HIV-positive individuals increases risks of disease progression and possibly sexual transmission. We examined whether state alcohol sales policies are associated with drinking and sexual risk among people living with HIV. In a multivariate analysis combining national survey and state policy data, we found that HIV-positive residents of states allowing liquor sales in drug and grocery stores had 70% to 88% greater odds of drinking, daily drinking, and binge drinking than did HIV-positive residents of other states. High-risk sexual activity was more prevalent in states permitting longer sales hours (7% greater odds for each additional hour). Restrictive alcohol sales policies may reduce drinking and transmission risk in HIV-positive individuals. [ABSTRACT FROM AUTHOR]

The article profiles Charles Lee, head of the U.S. Environmental Protection Agency's (EPA) Office of Environmental Justice. His groundbreaking research "Toxic Wastes and Race" concerning the disproportionate effects of environmental hazards on minorities and the poor is discussed. His involvement with the United Church of Christ's Environmental Justice program began when North Carolina chose Warren County, predominantly African American and poor, to be the site of a polychlorinated biphenyls (PCB) landfill.

Abstract: After four inmates at two New Mexico prisons converted their tuberculosis skin tests, a mass screening program was carried out at all of the State's adult correctional facilities (2,240 inmates). Previously unknown converters were found with a disproportionally high per ¢ of converters (6.8 per ¢ and 6.3 per ¢) and reactors (14.4 per ¢ and 12.2 per ¢) at the first two prisons. No index cases were found. State policy has been revised to include two-stage skin testing of new inmates, annual testing thereafter, and screening of all new correctional staff. 507-509.) [ABSTRACT FROM AUTHOR]

Abstract: Cases of rubella continue to occur among adults in the United States because 10-20 per ¢ of persons in this age group remain susceptible. To evaluate the potential preventability of these cases, we present a method for assessing missed opportunities for rubella immunization, based on immunization recommendations of the Immunization Practices Advisory Committee (ACIP) of the US Public Health Service (PHS). Immunization programs Faced with limited resources can use analysis of missed opportunities to focus on those gaps in implementation contributing most to the remaining rubella cases. (Am J Public Health 1987: 77:1347-1349.) [ABSTRACT FROM AUTHOR]

The article presents the policy statement of the American Public Health Association concerning medically uninsured citizens' health care initiatives of each state in the country. In response to the fact that there is an increasing number of medically uninsured residents in the country and that most states are exerting effort in addressing their needs, the Association agrees in the need for a high quality, universal national health program which has a comprehensive scope, has state and local administration and is equitably financed. It also reorganizes and encourages state health initiatives for the uninsured population.

The article presents a position paper from the American Public Health Association relative to the revision of the National Food Guide and preparation of National Dietary Guidelines in the U.S. The association urges the U.S. Department of Agriculture and the Department of Health, Education, and Welfare to cooperatively modify the National Food Guide and develop National Dietary Guidelines based upon the Recommended Dietary Allowances, Health and Nutrition Examination Survey, the Center for Disease Control Nutrition Surveillance Program, and the Nationwide Food Consumption Study.

The article presents the policy statement of the American Public Health Association concerning health hazards brought by naturally occurring radon. The association believes that radon exposure can cause lung cancer that is why it recommends performance of adequate testing for the determination of areas with high level of naturally occurring radon be done by federal and state governments. It also urges state and local governments to provide information and outreach programs regarding radon exposure as well as financial assistance to those households that need remediation and testing activities.

The article presents the policy statement of the American Public Health Association concerning equitable and full employment. The Association believes that employment has an impact on health and poverty that is why it is urging the country's Department of Health and Human Services to include employment availability in its objectives. It also calls for a public employment and wage maintenance program and encourages researches which focus on public health effect of inadequate wages and unemployment.

The article presents the policy statement of the American Public Health Association concerning occupational diseases and injuries surveillance. The Association believes that surveillance of occupational injuries and diseases is vital to the effectiveness of preventive programs and can increase awareness of both the employee and employer about work-related health problems. It is also convincing the Congress to mandate a reporting system for occupational diseases and calls the attention of concerned federal agencies to develop an occupational injury and disease surveillance system.

The author reflects on the issues of indigent care and patient dumping in the U.S.A. He argues that 20 percent of Americans are without health insurance and are potential subjects of economic transfer or patient dumping, which is determined by the patient's ability or inability to pay. He contends that the anti-dumping provisions of laws enacted by the government is a failure due to several reasons including the unreleased regulations in interpreting and implementing the law by the Health Care Finance Administration (HCFA) and the need of cooperation of hospitals. He suggests that hospitals violating the anti-dumping law to be required to provide a substantial amount of charity care and loss of tax-exempt status.

The article presents the policy statement of the American Public Health Association concerning state and local departments programs on injury control. In response to the fact that there is an increase in deaths caused by intentional and unintentional injuries and that these incidences cost the country a lot of money, aside from pain, suffering and grief, the Association urges state legislators and governors to establish programs focusing on injury control. It also encourages engineering and medicine-related schools and institutions to expand their training and research programs on injury epidemiology and control.