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This paper traces the development of the US federal government's program to provide personal and public health services to American Indians and Alaska Natives since the 1940s. Minimal services had been provided since the mid 19th century through the Bureau of Indian Affairs of the Department of the Interior. As a result of attempts by western congressmen to weaken and destroy the bureau during the 1940s, responsibility for health services was placed with the US Public Health Service. The transfer thus created the only US national health program for civilians. providing virtually the full range of personal and public health services to a defined population at relatively low cost. Policy changes since the 1970s have led to an emphasis on self-determination that did not exist during the 1950s and 1960s. Programs administered by tribal governments tend to be more expensive than those provided by the Indian Health Service, but appropriations have not risen to meet the rising costs, nor are the appropriated funds distributed equitably among Indian Health Service regions. The result is likely to be an unequal deterioration in accessibility and quality of care. [ABSTRACT FROM AUTHOR]

The President's Committee on Health Education was created by Richard M. Nixon in September 1971 and submitted its final report in September 1973. The committee resulted from the convergence of (1) a perceived national domestic policy need in response to escalating medical costs, (2) Nixon's personal and political ambitions, and (3) the dynamic political context of the late 1960s and early 1970s. Its work led to both private and public initiatives designed to influence the public's health through education; its findings and recommendations also laid the foundation for the National Consumer Health Information and Health Promotion Act of 1976 and thus contributed significantly to the development of subsequent national policy in health promotion and disease prevention. This paper places the work and contributions of the committee into historical perspective by analyzing the committee's origins and methods and the underlying politics that shaped its work and final report. The impact of the President's Committee is traced from the emergence of health education in the early 1970s as a potentially cost-effective alternative to medical care to the pivotal role health education now plays in health promotion and disease prevention efforts. [ABSTRACT FROM AUTHOR]

Abstract: One of the 1990 Health Objectives established by the U.S. Department of Health and Human Services is for 60 per ¢ of adults 18-65 years of age to be participating regularly in vigorous physical exercise. Unfortunately, no valid and practical measurement system is available that will allow assessment of leisure lime physical activity participation of large populations. Consequently, not only is it difficult to assess progress toward the 1990 goal, an accurate baseline from which to measure potential progress does not exist. This paper presents a time diary technique for measuring aggregate population physical activity participation and utilizes actual time diaries collected from adults by the Institute for Social Research in 1981 to arrive at a possible baseline. The results indicated that time diaries are a viable method for assessing aggregate physical activity behavior of large populations. American Adults were quite sedentary in 1981. Over a period of one week, 31% undertook no leisure time physical activity. Only 14 per ¢ expended more than 1600 kcals/week in leisure time physical activity, and 10 per ¢ met the DHHS physical activity requirements. (Am J Public Health 1987:77:455-460.) [ABSTRACT FROM AUTHOR]

This paper examines the potential of a Cooperative Extension Service to create a new context for the provision of health education services and offers a plan for the use of this potential in the health education of the public. [ABSTRACT FROM AUTHOR]

This paper describes the use of simulation modeling technique to support the management of family planning programs, using data in an organized way for problem diagnosis, forecasting and the examination of alternative strategies. [ABSTRACT FROM AUTHOR]

The article offers information on the challenges faced by the American Public Health Association on the development of the association's Medical Care Section in the U.S. On November 10, 1948, the American Public Health Association's Governing Council voted to approve the petition requesting the establishment of a Medical Care Section. In 1972, the association expanded their health services because of the changes on their needs and demands. In 1920, the association created a committee to study the municipal health departments and determine the extent of variation on the health services and procedures offered in a specific community.

Background. Tobacco companies have actively promoted the substitution of cigarettes with purportedly safer tobacco products (e.g., smokeless tobacco, e-cigarettes) as tobacco harm reduction (THR). Given the tobacco, e-cigarette, and pharmaceutical industries' substantial financial interests, we quantified industry influence on support for THR. Objectives. To analyze a comprehensive set of articles published in peer-reviewed journals assessing funding sources and support for or opposition to substitution of tobacco or nicotine products as harm reduction. Search Methods. We searched PubMed, Embase, Web of Science, and PsycINFO with a comprehensive search string including all articles, comments, and editorials published between January 1, 1992, and July 26, 2016. Selection Criteria. We included English-language publications published in peer-reviewed journals addressing THR in humans and excluded studies on modified cigarettes, on South Asian smokeless tobacco variants, on pregnant women, on animals, not mentioning a tobacco or nicotine product, on US Food and Drug Administration–approved nicotine replacement therapies, and on nicotine vaccines. Data Collection and Analysis. We double-coded all articles for article type; primary product type (e.g., snus, e-cigarettes); themes for and against THR; stance on THR; THR concepts; funding or affiliation with tobacco, e-cigarette, pharmaceutical industry, or multiple industries; and each author's country. We fit exact logistic regression models with stance on THR as the outcome (pro- vs anti-THR) and source of funding or industry affiliation as the predictor taking into account sparse data. Additional models included article type as the outcome (nonempirical or empirical) and industry funding or affiliation as predictor, and stratified analyses for empirical and nonempirical studies with stance on THR as outcome and funding source as predictor. Main Results. Searches retrieved 826 articles, including nonempirical articles (21%), letters or commentaries (34%), editorials (5%), cross-sectional studies (15%), systematic reviews and meta-analyses (3%), and randomized controlled trials (2%). Overall, 23.9% disclosed support by industry; 49% of articles endorsed THR, 42% opposed it, and 9% took neutral or mixed positions. Support from the e-cigarette industry (odds ratio [OR] = 20.9; 95% confidence interval [CI] = 5.3, 180.7), tobacco industry (OR = 59.4; 95% CI = 10.1, +infinity), or pharmaceutical industry (OR = 2.18; 95% CI = 1.3, 3.7) was significantly associated with supportive stance on THR in analyses accounting for sparse data. Authors' Conclusions. Non–industry-funded articles were evenly divided in stance, while industry-funded articles favored THR. Because of their quantity, letters and comments may influence perceptions of THR when empirical studies lack consensus. Public Health Implications. Public health practitioners and researchers need to account for industry funding when interpreting the evidence in THR debates. [ABSTRACT FROM AUTHOR]

Objectives. To evaluate recent levels and trends in trust in sources of health information on e-cigarettes in the United States. Methods. We obtained data from nationally representative samples of adults in 2015 (n = 5389), 2016 (n = 5273), and 2017 (n = 5389) that reported trust in 13 sources of health information on e-cigarettes in the United States. We used weighted linear regression models to examine temporal trends in trust levels. Results. Doctors, health organizations, the Centers for Disease Control and Prevention (CDC), health experts and scientists, the National Institutes of Health (NIH), the Food and Drug Administration (FDA), and family and friends were trusted, whereas news media, e-cigarette users, social media, vape shop employees, and e-cigarette and cigarette companies were distrusted. From 2015 to 2017, trust significantly increased for CDC, FDA, health experts and scientists, and news media (P s <.01). Trust also increased for NIH between 2016 and 2017 (P <.01). Conclusions. US adults trust public health sources and distrust entities with commercial interest in e-cigarettes. This suggests 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. [ABSTRACT FROM AUTHOR]

An editorial is presented which addresses the authors' views about implementing innovations which are designed to improve public health preparedness and response (PHPR) communications in America, and it mentions evidence-based PHPR and the PERRCoLate (Preparedness and Emergency Response Research and Learning) Project. Public health agencies in Washington State are examined, along with online surveys, Web sites, and semistructured interviews.

A Health at Every Size (HAES) approach has been proposed to address weight bias and stigma in individuals living with obesity, and more recently articulated as a promising public health approach beyond the prevailing focus on weight status as a health outcome. The purpose of this article is to examine our understanding of HAES within the context of public health approaches to obesity, and to present strengths and limitations of the available evidence. Advancing our understanding of HAES from a public health perspective requires us to move beyond an ideological debate and give greater attention to the need for empirical studies across a range of populations. Only then can the value of HAES, as a weight-neutral, public health approach for the prevention of obesity and other chronic diseases, be fully understood. (Am J Public Health. 2015;105: e38–e42. doi:10.2105/AJPH.2015.302552) [ABSTRACT FROM AUTHOR]

The article reports on health promotion strategy developed by the Johns Hopkins Health Institutions. The strategy involves the development of two nationally syndicated health news series for television based on the content and storylines of the television program " ER" and the CBS series "Chicago Hope." It involves the broadcasting of the health news segments on the local news following each of the respective episodes and together reach an estimated 80 million U.S. citizens each week. Both initiatives are aimed at linking scientific information and community resources to educate viewers.

The article focuses on the message of the World Health Organization (WHO) which calls the greater participation of the people in health education in the U.S. for the past 25 years of service. WHO emphasized that health education is not a place only for few practitioners with a given skill but it is an area that needs people from all walks of life in the field of health activities and community developments. WHO had brought so many resolutions prepared by the WHO Executive Board and WHO Assembly that were recommended to all WHO programs and in the strengthening of the health education programs. The U.S. is a member of the organization and is therefore has a serious responsibility of the program.

Objectives. This study evaluated the costs and cost-effectiveness of a school-based grade 6 universal vaccination program against hepatitis B. Methods. We performed a descriptive cost study and cost-effectiveness analysis of British Columbia's vaccination program for 1994 and 1995. since 1992, public health nurses have administered hepatitis B vaccine to grade 6 students in schools. We measured costs of vaccine, vaccine administration, and net program costs and used a validated Markov model to calculated the cost-effectiveness of the program. Results. Vaccinating each student cost $44, $24 of which was the cost of vaccine administration. The net cost was $9 per person, considering productivity. Marginal cost per life year gained was $2100. Universal adolescent vaccination is also economically attractive in the United States but less attractive in regions with incidence rates below 3 cases per 100,000 per year. Conclusions. Hepatitis B vaccine can be delivered in North American schools at a reasonable cost. adolescent vaccination is economically attractive in North American regions of high and average incidence rates. Our analysis supports vaccinations in adolescents who remain at risk for hepatitis B virus infection. [ABSTRACT FROM AUTHOR]

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 a position paper from the American Public Health Association relative to the effective nutrition education methodology for the general public in the U.S. The association advocates Department of Health, Education, and Welfare, the Department of Agriculture, and the Federal Trade Commission to undertake research for ascertaining effective nutrition education methodology for the general public. It also petitions these agencies to cooperatively or individually earmark funds for the purpose. Other significant decisions of the group are presented.

The article reports on the move of the U.S. Agency for International Development to withdraw its contribution to the United Nations Fund for Population Activities (UNFPA). UNFPA is the largest internationally funded source of population and family planning assistance in the world. It is noted that U.S. participation in the UNFPA has been integral to the stated purpose of the international population aid program furthering American policy influence and financial support in promoting high quality and voluntary family planning programs.

The article presents news briefs related to public health programs and project experiences at the community level. The New York City Department of Health conducted a telephone survey aimed to profile pathways and barriers to the city's prenatal care system. A program to address the problems of community health promotion through local minority youth.

The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO'S multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society—nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals. [ABSTRACT FROM AUTHOR]

During the past 5 years, the exchange of sterile needles and syringes for dirty injecting equipment has gained increasing acceptance outside the United States as a potential means of reducing the transmission of the human immunodeficiency virus (HIV) among intravenous drug users. This articles describes the controversy over attempts to establish a needle and syringe exchange scheme in New York City between 1985 and 1991. The response to a health crisis is used as an indicator of patterns of social and institutional practice. Advocates of needle exchanges had reached a statement with the promoters of law enforcement, and the strategic reformulation of the policy problem in terms of the research process seemed to offer a solution. The article discusses the practical limitations on designing and carrying out a controversial health promotion policy; the use (under constraint) of a restrictive research process to constitute - rather than simply to guide or monitor -- public policy; and the potential ethical hazards of heath professionals' seeking a polemical recourse to the clinical trial. The efforts to establish a needle exchange in New York thus illustrate more general problems for AIDS prevention. [ABSTRACT FROM AUTHOR]

Background. The national objectives in Healthy People 2000, drafted by health professionals aware of currently available public health interventions, represents a wealth of information about near-term future mortality and morbidity. Methods. Life table methods were used to calculate the impact of projected changes in mortality and activity limitation rates on life expectancy and expected disability years. Results. Meeting the mortality objectives would increase life expectancy at birth by 1.5 to 2.1 years, raising life expectancy to 76.6 to 77.2 years. In addition, meeting the target for disability from chronic conditions would increase the number of years of life without activity limitations from 66.8 years to 69.3-69.7 years. If the targets for coronary heart disease and unintentional injury were changed to reflect recent trends, a greater improvement in life expectancy at birth would be achieved: from 1.8 to 2.7 years to 76.9 to 77.8 years. Conclusions. Meeting the targets would have an important demographic impact. Including changes in the coronary heart disease and injuries targets, life expectancy in the year 2000 would be above the middle of the ranges used in current Census Bureau projections. [ABSTRACT FROM AUTHOR]

Four local health departments in California tested a process of state/local negotiations for the purpose of implementing model standards in community preventive health services. The standards. which covered five program areas, had been developed by a collaborative work group of representatives from the United States Conference of City Health Officers, the National Association of County Health Officials, the Association of State and Territorial Health Officials, the American Public Health Association. and the US Department of Health, Education. and Welfare. Evaluation of the project indicates that the success of the negotiation transactions and results varied, both among local health departments and program areas. A number of factors have been identified as influencing the negotiations, including the availability of baseline data the extent to which individual programs are currently affected by required standards of performance, and health department attitude toward the project. The future utility of this model is considered within the broader context of changes now occurring in the financing and organization of public health within the United Stales. Project findings suggest that the Model Standards negotiations Could provide stale and local levels of government with a valuable management tool for determining health care priorities and generating objective programmatic data for budget justification. (Am J Public Heath 1982: 72:1230-1237.) [ABSTRACT FROM AUTHOR]

A set propositions is offered to provide a frame of reference for proposed strategies to improve healthful behavior by placing personal choice-making in the context of societal option-setting. The health status of populations at a given point in time is seen as a result of customary personal choice-making. These choices in turn are limited by both the perceived and actual options available to individuals, depending on their personal and their community's resources, from which to make choices, Most people, most of the time will make the easiest choices, i.e., will do the things, develop the patterns or life-styles, which seem to cost them less and/or from which they will gain more of what they value in tangible and/or intangible terms. The range of options available to them, and the ease with which they may choose certain ones over others, is typically set by organizations, public and private, formal and informal. The more powerful the organization, i.e., the more effective it is in carrying out its policies, the more it affects the populations, whether or not these effects are immediately perceived by individuals in their day-by-day choicemaking. Implications for health education strategies are noted. [ABSTRACT FROM AUTHOR]

Three techniques for improving immunization levels among school-age children were tested and then compared for most effective use of school nurses' time. Method A involved reviewing school immunization records, specifically inviting immunization-deficient children to a school-based clinic, with some follow-up to achieve good response. Method B involved sending out permission slips for a school-based clinic to all students without additional investment of nursing time. Method C involved a health education program encouraging parents to have their children immunized on their own. Using an average of 38 hours of school nurse time, Method A succeeded significantly better than Method B in immunization levels, while giving fewer unnecessary improvement of immunization levels. [ABSTRACT FROM AUTHOR]

A questionnaire survey of the 50 state CHP agencies and a case study of a single state CHP agency were conducted to contrast the concept of comprehensive health planning with the practice of health planning at the state level. Both the survey and the case study evidenced a substantial disparity between concept and practice. For example, the survey indicated that the following tasks had not been completed by the following percentages of the responding agencies: defining the system of interest (64%), ranking problems (50%), setting targets (74%), thoroughly analyzing intervention alternatives (71%), selecting criteria and procedures for intervention evaluations (57%). The state CHP agencies were found to be lacking in the following areas: (a) technical analyses, (b) explicitness, (c) priority setting, (d) attention to health status indices and preventive interventions, and (e) integration of planning activities. The implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

The concept of central place theory is examined and a method is described for determining the optimal locations for Maternal and Infant Care Projects so that health services are accessible to and utilized by the greatest number of eligible persons. [ABSTRACT FROM AUTHOR]

The article discusses several myths and misconceptions underlying nutritional and health care programs in the U.S. Medical myths have led to the development of health care programs as well as the abolishment of some programs believed to have negative physiological effects. Many health programs developed by the federal government and medical organizations are believed to prevent diseases and responsible for the marked drop in mortality rates and the population boost. However, these myths and misconceptions have greatly affected the design and execution of health programs which has real medical relevance.

The article discusses the study that probes the effectiveness of the public health model created to decrease the availability of firearms to suicidal persons in the U.S. Whether such a program would be worth continuing would depend in part on whether it resulted in a significant reduction in the suicide rate. If there were no significant reduction in the suicide rate, then this program should be terminated. According to the researchers, decreasing the availability of the major means of committing suicide, in the public health model proposed, could be integral to this effort.

The article focuses on the occupational survey about the interest, attitudes and involvement of the forty-four dentists who are serving on a comprehensive health planning advisory committees in the U.S. The survey aims to help dentists in formulating ideas on planning, as well as background and guidelines on legislation and provide some of their experience in the planning process. The data gathered in the survey were used as base of the short-term training course offered by the Columbia University School of Public Health and Administrative Medicine. The training course covers a wide range of materials that pertains on the comprehensive health planning legislation, public health law, and regional medical program legislation.

The article discusses the potential and role of podiatry in community health programs in the U.S. The author emphasized on the education of the podiatrist, his activities in various health programs and related matters. Podiatry is the smallest of the medical profession categories. However, podiatric education has reacted sharply to societal needs, bringing new emphasis to present health problems. The health system is faced with the necessity for providing both quality and quantity care at a time when trained medical manpower is in short supply.

The article presents a speech by Myron E. Wegman, president of the American Public Health Association (APHA), delivered at the 100th annual meeting of APHA. She discusses the concept of national health policy and the U.S. government's shortcomings in implementing the policy. She emphasizes the role of APHA in monitoring and promoting a high standard of health services.

Observations reported here were made in the course of a study for the American Academy of Pediatrics. Part of the study was to examine newer public medical care programs for children, and to identify aspects and mechanisms which were useful and might appropriately be used in community health programs. Newer programs emphasize a multidisciplinary approach to health and welfare problems. [ABSTRACT FROM AUTHOR]

A mail survey dealing with abortion coverage in the United States under Title 19 was conducted with State Commissioners of Health and Welfare of the 55 states and Territories. The results are reported and discussed. [ABSTRACT FROM AUTHOR]

Poor health and low living standards prevail in Chinese-American communities. This report discusses some social and cultural origins of health needs among Chinese-Americans and describes the role of community participation in health programming for one Chinese community, the Chinatown of Boston. [ABSTRACT FROM AUTHOR]

The National Legal Program on Health Problems of the Poor is discussed in terms of its organization, responsibilities and activities. During its short existence of only a few years it has developed and utilized a number of legal tools and become involved in a wide range of health problems. [ABSTRACT FROM AUTHOR]

The School Health Education Study Group developed a health curriculum designed to teach certain values. What is relationship between the values of a school population and its response the Study Group's health concepts? This report attempts to deal with this question in terms of sample of sixth grade students in a southwestern city. [ABSTRACT FROM AUTHOR]

Three referral patterns in a comprehensive health care delivery program are described and analyzed. Findings are discussed and interpreted. [ABSTRACT FROM AUTHOR]

The article reports on the evaluation of health programs focusing on the Louisiana Family Planning Program. The program was aimed at developing a family planning delivery system which is capable of identifying, educating and providing all indigent families of the metropolitan area with family planning services and information. The program was predicted on demographic and social studies of medically indigent patients, studies of the availability of existing health services, and a detailed evaluation of all facilities and resources.

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 author reflects on the potential of television as a tool for health education in the U.S. Despite various criticisms that television had been a tool of ranging violence and illiteracy, public health professionals initiates the possibility for the medium to be a tool for health educations. In particular, cases regarding the effectivity of the medium for heath awareness are posted. Furthermore, barriers for the accomplishment of this plan which highlights the cost of air time are discussed.

Abstract: Community-oriented primary care (COPC) represents a specific variation on the general primary care model. Seven case studies from vastly different health care settings were examined and this report describes the diversity of expression of the principles of COPC observed. The results suggest that COPC is not limited to publicly funded programs, but can find expression in the private sector as well. The organization of financing and the lack of feasible quantitative tools hinder the full development of the model. (Am J Public Health 1986; 76:279-281.) INSET: Expanded Nurse Training Program Includes Home Health Care. [ABSTRACT FROM AUTHOR]

International trends and recently proposed changes risk confining the duties of epidemiologists to support of health services delivery or to serving as functionaries within exclusively clinical departments pose a threat to the future role and training of epidemiologists. It is argued that these attempts would weaken the academic focus for epidemiologists and compromise the system of recognition and rewards available through the hierarchy of the discipline. [ABSTRACT FROM AUTHOR]

The article reflects on the author's view on the promotion of public health awareness and movement in response to health threats in smoking in the U.S. The author stresses that despite persuading evidences which are available to demonstrate that smoking contributes a great deal to death and disability, there are still signs signifying that all is not well. He believes that public health movement understand public attitudes and lifestyles as foundations for effective programs.

The article focuses on the historical background on the health campaign of the U.S. government's against influenza epidemic. The Congress has appropriated $135,064,000 for the production and distribution of a Swine flu vaccine. The author has presented the recommendation of the Public Health Service Advisory Committee on Immunization Practices.

The article discusses the cooperative efforts of the state and federal animal health officials to combat bovine tuberculosis in the U.S. The government made changes in program in order to prevent the eradication effort from degenerating into a static control program. National program statistics and studies of current outbreaks have shown the need for better surveillance and condemnation of all exposed cattle in herds with spreading infection. It was also mentioned that detailed epidemiological investigations are essential to finding and eliminating the remaining foci of disease.

A report is presented on six years activity of a good local program for pregnant young women, many unmarried, and for others who wish to prevent pregnancy. Stress is put on the heed for various services with prominence for health education. [ABSTRACT FROM AUTHOR]

An example is presented of a practical design for evaluation of a school health program, planned by the nursing service of a local health department in conjunction with faculty of an academic institution. Focusing on high absence pupils, the study is to determine whether systematic nursing service will reduce their health problems. [ABSTRACT FROM AUTHOR]

The article provides information on the Housing Health Education and Abstinence Program (HHEAP) of the District of Columbia. The program is a 5-year demonstration project being funded by the Centers for Disease Control. It aims to reduce the risk factors for chronic disease among the African American residents of public housing. The program, which covers eight public housing communities in the District, emphasizes the principles of community empowerment and ownership. HHEAP, then, is directed by a coalition of public housing residents.

The article presents resolutions concerning advertising and promotion of tobacco products passed by the American Public Health Association in the U.S. Recognizing that such products posed a serious threat to public health, the association strongly opposed the idea of advertising and promoting them in any form of media. In addition, the association noted that such campaigns are contrary to the efforts directed to health promotion and to obtain a smoking free-society by year 2000. Consequently, it supported the state and federal laws and legislation which bans such advertisement and promotion.

The article reports on the initiative of the American Public Health Association (APHA) in recognizing the importance of communication between health care providers and recipients to have effective public health programs in the U.S. It is said that the APHA opposes Proposition 63, which would violate essential public health methods of controlling communicable diseases and improving the public's health. The association supports the use of multi-language materials in public health information and education.