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An introduction to the journal is presented in which the editor discusses the significance of the "As If Equity Mattered" symposium that was held in the autumn of 2009 at the campus of the University of California in Berkeley, California.

The article presents the author's insights on the acknowledgement of two speakers on Natural Resources Journal (NRJ) during the American Bar Association (ABA)'s 27th Annual Water Law Conference in San Diego, California. It notes that the journal was recognized by Owen Olpin, former special master of California Supreme Court, and by Gary King, the attorney General of New Mexico. It implies on the influence of the articles and the impact of the alumni in the success of the journal.

Objectives: This study analyzed the prospective association between attending religious services and all-cause mortality to determine whether the association is explainable by 6 confounding factors: demographics, health status, physical functioning, health habits, social functioning and support, and psychological state., Methods: The association between self-reported religious attendance and subsequent mortality over 5 years for 1931 older residents of Marin County, California, was examined by proportional hazards regression. Interaction terms of religion with social support were used to explore whether other forms of social support could substitute for religion and diminish its protective effect., Results: Persons who attended religious services had lower mortality than those who did not (age- and sex-adjusted relative hazard [RH] = 0.64; 95% confidence interval [CI] = 0.52, 0.78). Multivariate adjustment reduced this relationship only slightly (RH = 0.76; 95% CI = 0.62, 0.94), primarily by including physical functioning and social support. Contrary to hypothesis, religious attendance tended to be slightly more protective for those with high social support., Conclusions: Lower mortality rates for those who attend religious services are only partly explained by the 6 possible confounders listed above. Psychodynamic and other explanations need further investigation.

A statewide tobacco control campaign in California has been highly successful in reducing public exposure to the health hazards of secondhand smoke. Over 250 cities and counties in California have enacted local ordinances to regulate smoking in public places and workplaces. Although low-income people of color are disproportionately affected by the use of tobacco, the issue of regulating secondhand smoke tends to be a lower priority in communities that are confronted by other, more immediately pressing social justice issues, such as high rates of violence and lack of economic opportunity. This article describes the process undertaken by a county health department to mobilize a low-income African American community in a San Francisco Bay Area city to support a local ordinance mandating 100% smoke-free workplaces and restaurants. These efforts are more likely to succeed if health advocates (1) reframe issues in a context that acknowledges the political, economic, and social justice realities and strengths of the community; (2) organize within existing local networks and foster the integration of tobacco issues into the group's existing work; and (3) can defer their own agendas during times of community grieving and healing.

Background: The purpose of this study was to obtain information concerning the health status of the theoretically advantaged elderly population of Marin County, California, and to compare these data with those from other populations with different levels of socioeconomic status., Methods: An age-stratified sample of 2,018 community-dwelling elderly residents of Marin was selected, and these participants were interviewed between 1989 and 1991. Interview items included medical history of life-threatening diseases and chronic conditions, reported and observed disabilities, and life-style characteristics., Results: While the residents of Marin had lower mortality rates than the total U.S. population, there were few meaningful differences in measures of health and function in comparison to other elderly populations with substantially lower levels of socioeconomic status. The main exceptions were better memory performance and lower depressive symptomatology in Marin. Because of the many methodological differences, these comparisons must be viewed with caution., Conclusion: The general pattern of findings in this study indicates that while death has been postponed in this socioeconomically advantaged population, the prevalence of disease and disability has not. If true, this implies that residents of an affluent community can spend a longer rather than shorter period of their late life in a state of infirmity and in need of medical care. This appears to be especially true for women.

An ecologic study design was used to investigate the relationship between exposure to air emissions produced by the petroleum and chemical industries, and average annual cancer incidence and major cause mortality rates among whites in Contra Costa County, California. Estimates for the exposure to major industrial sources of sulfur dioxide, hydrocarbons and oxides of nitrogen were used to subdivide the county by level of exposure to petroleum refinery and chemical plant emissions. Cancer incidence and major cause mortality rates were then calculated for whites in each of the exposure areas. In both males and females, residential exposure to petroleum and chemical air emissions was associated with an increased incidence of cancer of the buccal cavity and pharynx. In males, age-adjusted incidence rates for cancers of the stomach, lung, prostate and kidney and urinary organs were also associated with petroleum and chemical plant air emission exposures. In both sexes, we found a strong positive association between degree of residential exposure and death rates from cardiovascular disease and cancer, and a less strong positive association between exposure and death rates from cerebrovascular disease. There was also a positive association in men for deaths from cirrhosis of the liver. Although these observed associations occurred across areas of similar socioeconomic and broad occupational class, confounding variables and the "ecologic fallacy" must be considered as possible explanations. In particular, the stronger findings in men suggest an occupational explanation of the cancer incidence trends, and the effect observed in cirrhosis mortality suggests that lifestyle variables such as alcohol consumption were not adequately controlled for. While the public health implications of our findings remain unclear, the evidence presented is sufficient to warrant follow-up studies based on individual data in which possible biases can be more readily controlled.

An overview of the epidemiologic studies of amyotrophic lateral sclerosis (ALS) and parkinsonism-dementia (PD) from 1945 through 1972 is presented. During this period 350 cases of ALS were documented. PD, which is apparently unique to the native Chamorro population, was not recognized during the early years of the study. A total of 213 PD patients have now been seen. The rates of both diseases have declined by approximately 50 per cent since 1965. In the early years incidence per 100,000 for ALS males approached 60; for females it was about 40. For PD males it was about 50; for females it was close to 20. The declines in both diseases have occurred in both sexes and at all age groups and no cohort phenomenon was observed. Marked geographic differences in the distribution of the diseases were observed with southern villages having the highest rates and western villages having the lowest rates; the remainder of the island was intermediate. Recent declines have been most marked in the southern high-rate villages. Chamorros living on the island of Rota have rates similar to those on Guam; those on Saipan have lower rates. A possible excess of ALS among Filipino residents ofGuam was noted; ALS has not been seen among other ethnic groups. Geographic mapping even in high incidence areas did not reveal true clusters or foci. Extensive case-control studies did not reveal any patterns of prior illness, life-style, or exposures distinguishing patients. A tendency for patients to be of somewhat lower socioeconomic level, have less education, eat more homegrown foods and raw meats, and more contact with animals was found. No Mendelian genetic patterns were observed; males were affected more frequently than female for both diseases. Cases did not occur before age 20, reached maximum frequency between ages 55 and 65 and there-after declined. Environmental factors associated with some aspects of the traditional way of life seem to be causally involved, but, since most aspects of the traditional life have changed in the past 50 years, the specific factors remain elusive.

A careful study of more than 100 fatal cases due to intravenously administered narcotics provides further evidence of the complexity involved in the certification of death. The wide range of blood morphine concentrations found in these cases indicates that tissue concentrations alone will not always provide the necessary information. High concentrations of morphine, the major metabolite of heroin, in blood and other tissues may be consistent with overdose. But in those cases involving very low concentrations at the time of death, other criteria must be considered.