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- Volume 24, 2003
Annual Review of Public Health - Volume 24, 2003
Volume 24, 2003
- Review Articles
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Geographic Information Systems and Public Health
Vol. 24 (2003), pp. 1–6More Less▪ AbstractGeographic information systems (GIS) and analyses based on GIS have become widespread and well accepted. GIS is not the complete solution to understanding the distribution of disease and the problems of public health but is an important way in which to better illuminate how humans interact with their environment to create or deter health.
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GIS and Disease
Vol. 24 (2003), pp. 7–24More Less▪ AbstractGeographic information systems (GIS) and related technologies like remote sensing are increasingly used to analyze the geography of disease, specifically the relationships between pathological factors (causative agents, vectors and hosts, people) and their geographical environments. GIS applications in the United States have described the sources and geographical distributions of disease agents, identified regions in time and space where people may be exposed to environmental and biological agents, and mapped and analyzed spatial and temporal patterns in health outcomes. Although GIS show great promise in the study of disease, their full potential will not be realized until environmental and disease surveillance systems are developed that distribute data on the geography of environmental conditions, disease agents, and health outcomes over time based on user-defined queries for user-selected geographical areas.
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GIS and Health Care
Vol. 24 (2003), pp. 25–42More Less▪ AbstractGIS and related spatial analysis methods provide a set of tools for describing and understanding the changing spatial organization of health care, for examining its relationship to health outcomes and access, and for exploring how the delivery of health care can be improved. This review discusses recent literature on GIS and health care. It considers the use of GIS in analyzing health care need, access, and utilization; in planning and evaluating service locations; and in spatial decision support for health care delivery. The adoption of GIS by health care researchers and policy-makers will depend on access to integrated spatial data on health services utilization and outcomes and data that cut across human service systems. We also need to understand better the spatial behaviors of health care providers and consumers in the rapidly changing health care landscape and how geographic information affects these dynamic relationships.
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Public Health, GIS, and Spatial Analytic Tools
Vol. 24 (2003), pp. 43–56More Less▪ AbstractWe review literature that uses spatial analytic tools in contexts where Geographic Information Systems (GIS) is the organizing system for health data or where the methods discussed will likely be incorporated in GIS-based analyses in the future. We conclude the review with the point of view that this literature is moving toward the development and use of systems of analysis that integrate the information geo-coding and data base functions of GISystems with the geo-information processing functions of GIScience. The rapidity of this projected development will depend on the perceived needs of the public health community for spatial analysis methods to provide decision support. Recent advances in the analysis of disease maps have been influenced by and benefited from the adoption of new practices for georeferencing health data and new ways of linking such data geographically to potential sources of environmental exposures, the locations of health resources and the geodemographic characteristics of populations. This review focuses on these advances.
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Public Health, GIS, and the Internet1
Vol. 24 (2003), pp. 57–82More Less▪ AbstractInternet access and use of georeferenced public health information for GIS application will be an important and exciting development for the nation's Department of Health and Human Services and other health agencies in this new millennium. Technological progress toward public health geospatial data integration, analysis, and visualization of space-time events using the Web portends eventual robust use of GIS by public health and other sectors of the economy. Increasing Web resources from distributed spatial data portals and global geospatial libraries, and a growing suite of Web integration tools, will provide new opportunities to advance disease surveillance, control, and prevention, and insure public access and community empowerment in public health decision making. Emerging supercomputing, data mining, compression, and transmission technologies will play increasingly critical roles in national emergency, catastrophic planning and response, and risk management. Web-enabled public health GIS will be guided by Federal Geographic Data Committee spatial metadata, OpenGIS Web interoperability, and GML/XML geospatial Web content standards. Public health will become a responsive and integral part of the National Spatial Data Infrastructure.
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Classification of Race and Ethnicity: Implications for Public Health*
Vol. 24 (2003), pp. 83–110More Less▪ AbstractEmerging methods in the measurement of race and ethnicity have important implications for the field of public health. Traditionally, information on race and/or ethnicity has been integral to our understanding of the health issues affecting the U.S. population. We review some of the complexities created by new classification approaches made possible by the inclusion of multiple-race assessment in the U.S. Census and large health surveys. We discuss the importance of these classification decisions in understanding racial/ethnic health and health care access disparities. The trend toward increasing racial and ethnic diversity in the United States will put further pressure on the public health industry to develop consistent and useful approaches to racial/ethnic classifications.
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Will a Healthy Lifestyle Help Prevent Alzheimer's Disease?
Vol. 24 (2003), pp. 111–132More Less▪ AbstractAlzheimer's disease (AD) appears to resemble other chronic diseases, whereby a myriad of interconnected factors, including those associated with lifestyle, are involved in disease development. In this paper, we examine accepted and proposed risk factors for AD and explore health behaviors, including diet, exercise, prevention of injury, and cognitive stimulation, that may help prevent AD. Adherence to a healthy lifestyle may directly protect against AD or may prevent diseases associated with AD, such as vascular disease and diabetes. A healthy lifestyle to prevent AD may be important throughout life rather than after disease manifestation and may be particularly relevant if other factors, such as genetic predisposition, also increase risk of AD. If changes in lifestyle can help prevent AD by reducing modifiable risk factors, this knowledge can aid individuals who wish to take action to protect themselves and their families from the disease.
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Health Issues of Air Travel
Vol. 24 (2003), pp. 133–151More Less▪ AbstractEvery day in the United States the airline industry boards over 1.7 million passengers for a total of 600 million passengers per year. As these passengers enter the cabin of their aircraft few are aware of the artificial environment that will protect them from the hazards of flight. Passengers are exposed to reduced atmospheric pressure, reduced available oxygen, noise, vibration, and are subject to below zero temperatures that are only a quarter inch away—the thickness of the aircraft's skin. Over the past decade there have been both technical and lay articles written on the perception of poor cabin air quality. Studies have, in part, supported some of those concerns, but, in general, the air quality exceeds that found in most enclosed spaces on terra firma.
Since the events of September 11th, passengers have not only been exposed to the physical stress of flight, but also to social and emotional stress preceding departure. There has been a significant increase in air rage on board aircraft, which poses a threat to flight safety and a fear of harm to passengers and crew. The phrase “economy class syndrome” has received popular press attention and refers to the possibility of deep vein thrombosis (DVT) in the tight confines of an aircraft cabin. Studies have been conducted that demonstrate DVT can occur in flight just as it occurs in other modes of transportation or with prolonged sitting.
In part, because of the stress related to commercial flight it is not a mode of transportation for everyone. Certain cardiovascular, pulmonary, and neuropsychiatric conditions are best left on the ground. Although medical problems and death are rare in flight, they do occur, and one major airline reported 1.52 medical diversions per billion revenue passenger miles flown. To provide medical support at 36,000 ft (11,000 m) most airlines now carry on-board medical kits as well as automatic external defibrillators. A recent survey conducted by a major airline revealed that there was at least one physician on 85% of all its flights.
Both passenger and cargo aircraft have proven to be vectors of disease in that they transport humans, mosquitoes, and other insects and animals who, in turn, transmit disease. Transmission to other passengers has occurred with tuberculosis and influenza. Vectors for yellow fever, malaria, and dengue have been identified on aircraft. Although there are numerous health issues associated with air travel they pale in comparison to the enormous benefits to the traveler, to commerce, to international affairs, and to the public's health.
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One Foot in the Furrow: Linkages Between Agriculture, Plant Pathology, and Public Health
Vol. 24 (2003), pp. 153–174More Less▪ AbstractPlant pathology is a field of biology that focuses on understanding the nature of disease in plants as well as on more practical aspects of preventing and controlling plant diseases in crop plants that are important to agriculture. Throughout history, plant diseases have had significant effects on human health and welfare. Several examples, in both historical and contemporary contexts, are presented in this review to show how plant pathogens, biotechnology, and farming practices have affected public health. Specific topics illustrating clear linkages between agriculture and human health include allergens in the environment, food-safety and agricultural practices, mycotoxigenic fungi, agrobioterrorism, and the biological control of plant diseases. The further argument is made that in order to monitor and ensure that good health and safety practices are maintained from “farm to fork,” public health specialists may benefit from the resources and expertise of agricultural scientists.
Man does not live by bread alone—but he must have bread. And he must have
bread that is truly a staff of life, not a scepter of death (44).
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The Health of U.S. Hired Farm Workers
Vol. 24 (2003), pp. 175–193More Less▪ AbstractDespite a recent surge in knowledge about U.S. hired farm workers, little is known about the health of this population. No national data are available on the size of the population, mortality or morbidity data, or on chronic health indicators. Demographic data show that these workers are mostly Mexican immigrant or migrant males, and nearly two thirds live in poverty. At least half of all current hired farm workers are undocumented. Fewer than one in five have health insurance, either through their employer or through government programs. However, programs targeting women farm workers, such as WIC or, in California, emergency MediCal, are more effective in helping them obtain needed services. The federal Migrant Health Program serves about 13% of the total of workers plus dependent family members. This paper reviews what is known in the following topical areas: (a) mortality and morbidity; (b) access to health care services; (c) control of infectious diseases; (d) maternal and child care; (e) occupational health; (f) violence; and (g) chronic health indicators. It is suggested that future research incorporate a minimal physical examination of all patients or subjects in order to establish baseline information for the population. Such information will be helpful in targeting interventions and measuring their effectiveness.
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Redefining the Role of Public Health in Disability*
Vol. 24 (2003), pp. 195–208More Less▪ AbstractThe stated mission of current public health activities is to prevent mortality, morbidity, and disability. Though this mission is a noble challenge, attention is now being drawn to that group of the public who are not prevented from living with a disability. This chapter seeks to redefine the functions of public health in the field of disability. It describes the changing demographics of disability and provides a framework for addressing the complex issues associated with defining disability. Finally, we outline a strategy for stronger and clearer public health presence to improve the health and well-being of people with disabilities.
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Violence Prevention and Control Through Environmental Modifications
Vol. 24 (2003), pp. 209–225More Less▪ AbstractViolence traditionally had been considered a problem exclusively within the criminal justice domain, although it is now widely viewed as a public health issue as well. Public health has brought new and complementary tools for understanding and preventing violence. Whereas public health has long recognized the environment as a determinant of disease and injury, it has paid less attention to the environment when considering violence prevention strategies. For several decades though, some criminologists and others have been researching environmental factors in crime prevention. This article aims to discuss the main environmental crime-prevention strategies, provide examples of promising interventions, review public health literature that uses these strategies, discuss what public health can contribute, and suggest public health research to test the hypothesis that violence can be prevented and controlled through environmental modifications.
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The Challenge and Potential of Childhood Immunization Registries
Vol. 24 (2003), pp. 227–246More Less▪ AbstractRecent efforts to attain near-complete coverage of child populations by recommended vaccines have included initiatives by federal and state agencies, as well as private foundations, to develop and implement statewide or community-based childhood immunization registries. Plans for a single, national registry have been set aside in favor of a national network of local and state registries linked through the use of common definitions and unique child identifiers. However, both operational/technical and financing difficulties have slowed their development. The experience to date in selected areas has provided useful lessons for further development of a registry system and has underscored the potential of such systems to assure the success of childhood immunization initiatives.
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The Role of Health Plans in Tobacco Control
Vol. 24 (2003), pp. 247–266More Less▪ AbstractHealth plans play an important role in tobacco control. In this chapter we present an overview of the scientific research on health plan involvement in clinical and community interventions regarding tobacco use. Also included are interventions that have been undertaken by health plans to lower smoking rates among their members and the general population. We conclude with a new model that can be used to engage health plans in tobacco control efforts and a case study that outlines how one health plan has implemented this new model.
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Implications of the Tobacco Industry Documents for Public Health and Policy
Vol. 24 (2003), pp. 267–288More Less▪ AbstractThe release of previously secret internal tobacco industry documents has given the public health community unprecedented insight into the industry's motives, strategies, tactics, and data. The documents provide information that is not available from any other source and describe the history of industry activities over the past 50 years. The documents show that the tobacco industry has been engaged in deceiving policy makers and the public for decades. This paper begins with a brief history of the tobacco industry documents and describes the methodological challenges related to locating and analyzing an enormous number of poorly indexed documents. It provides an overview of selected important findings of document research conducted to date, including analyses of industry documents on nicotine and addiction, product design, marketing and promotion, passive smoke, and internal activities. The paper concludes with a discussion of the implications of tobacco document research for public health and the application of such research to fields other than tobacco control.
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Management of Chronic Disease by Patients
Vol. 24 (2003), pp. 289–313More Less▪ AbstractChronic conditions dominate health care in most parts of the world, including the United States. Management of a disease by the patient is central to control of its effects. A wide range of influences in the person's social and physical environments enhance or impede management efforts. Interventions to improve management by patients can produce positive outcomes including better monitoring of a condition, fewer symptoms, enhanced physical and psychosocial functioning, and reduced health care use. Successful programs have been theory based. Self-regulation is a promising framework for the development of interventions. Nonetheless, serious gaps in understanding and improving disease management by patients remain because of an emphasis on clinical settings for program delivery, neglect of the factors beyond patient behavior that enable or deter effective management, limitations of study designs in much work to date, reliance on short-term rather than long-term assessments, and failure to evaluate the independent contribution of various program components.
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Methodologic Advances and Ongoing Challenges in Designing Community-Based Health Promotion Programs
Vol. 24 (2003), pp. 315–340More Less▪ AbstractCommunity intervention trials continue to attract researchers as potential ways to achieve widespread, long-term change in health behaviors. The first generations of community studies were somewhat unsophisticated in design and analysis, and their promise may have been overstated. As design and analysis issues were better defined, as secular trends caught up with the behaviors that researchers were trying to change, or as other unknown variables affected community studies, small effects of interventions were observed in community trials. Discussions were held in professional meetings and reported in the literature: Should community trials be discontinued? In general, the answer was a qualified no. In this paper, we briefly review some of the many advances made in community intervention trials, and address in more detail the challenges ahead.
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The Anatomy of a Disparity in Infant Mortality
Vol. 24 (2003), pp. 341–362More Less▪ AbstractThis article suggests that while disparities in infant mortality have been longstanding, the mechanisms of disparity creation are undergoing intense change. This dynamic character is explored by first developing an analytic model that examines the interaction between social factors and the public health and clinical capacity to intervene. Disparities in infant mortality are then broken down into their component parts and linked to specific arenas of intervention. Disparities in postneonatal mortality are being shaped by differential access to interventions designed to prevent infant death from congenital anomalies and the Sudden Infant Death Syndrome. Disparities in neonatal mortality are primarily determined by factors that influence the birthrate of extremely premature infants and access to specialized obstetrical and pediatric care. This analysis suggests that the epidemiology and social meaning of disparities in infant mortality are intensely dynamic and increasingly reflect the interaction between social forces and technical innovation.
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Measuring Quality of Care and Performance from a Population Health Care Perspective
Vol. 24 (2003), pp. 363–384More Less▪ AbstractPopulation health care is health information and clinical services provided to individuals of a defined population. From a population health care perspective, quality of care involves the health status of the entire population, and thus issues of access, cost of care, and efficiency matter. In this paper, we describe the definitions of quality health care and the framework for measuring quality, with emphasis on the performance of organizations involved in the delivery and assurance of population health care. We describe quality measurement sets and systems, criteria for the choice of measures, data sources, and how quality measurements are used to improve health care and outcomes from a population health care perspective.
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What's Behind the Health Expenditure Trends?
Vol. 24 (2003), pp. 385–412More Less▪ AbstractIn this paper, we review the literature on a number of the potential explanations for the rise in health care expenditures in the United States: the aging population, the costs of dying, technology, physician incomes, administrative costs, prescription drugs, managed care, and the underfunding of public health. Our goal is not to pass definitive judgment on the force(s) driving health care costs, but rather to make the reader a more educated consumer of these widely cited data. We place special emphasis on how health expenditures are measured and the inherent weaknesses in the methodology. We find that frequently it is difficult to accurately estimate how individual forces influence total health care expenditures. Moreover, we conclude that interpreting the causes of the rise in expenditures goes beyond simple observations of trends and depends on how we value various segments and aspects of health and health care.
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Previous Volumes
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Volume 45 (2024)
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Volume 44 (2023)
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Volume 43 (2022)
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Volume 42 (2021)
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Volume 41 (2020)
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Volume 40 (2019)
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Volume 39 (2018)
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Volume 38 (2017)
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Volume 37 (2016)
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Volume 36 (2015)
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Volume 35 (2014)
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Volume 34 (2013)
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Volume 33 (2012)
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Volume 32 (2011)
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Volume 31 (2010)
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Volume 30 (2009)
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Volume 29 (2008)
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Volume 28 (2007)
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Volume 27 (2006)
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Volume 26 (2005)
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Volume 25 (2004)
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Volume 24 (2003)
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Volume 23 (2002)
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Volume 22 (2001)
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Volume 21 (2000)
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Volume 20 (1999)
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Volume 19 (1998)
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Volume 18 (1997)
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Volume 17 (1996)
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Volume 16 (1995)
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Volume 15 (1994)
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Volume 14 (1993)
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Volume 13 (1992)
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Volume 12 (1991)
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Volume 11 (1990)
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Volume 10 (1989)
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Volume 9 (1988)
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Volume 8 (1987)
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Volume 7 (1986)
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Volume 6 (1985)
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Volume 5 (1984)
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Volume 4 (1983)
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Volume 3 (1982)
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Volume 2 (1981)
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Volume 1 (1980)
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Volume 0 (1932)