Am Jrl of Public Health: June 2012 Highlights

EMBARGOED UNTIL April 19, 2012, 4 PM (EDT)

CONTACT: For copies of articles or full table of contents of issue, call Patricia Warin, 202-777-2511, or e-mail [email protected].

The articles below will be published online April 19, 2012, at 4 p.m. (EDT) by the American Journal of Public Health® under “First Look” at http://www.ajph.org/first_look.shmtl, and they are currently scheduled to appear in the June 2012 print issue of the Journal. “First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association, www.apha.org, and is available at www.ajph.org.

(1) Sleep environment hazards contribute largely to sudden unexpected infant deaths

Placing infants on their backs on a firm crib mattress without soft bedding or other objects in the crib as well as not practicing bed sharing with adults are key practices that help to prevent sudden unexpected infant deaths, a recent study from the American Journal of Public Health suggests.

Researchers obtained data from the National Child Death Review Case Reporting System. They pulled data between years 2005 to 2008 from nine U.S. states to assess 3,136 sleep-related sudden unexpected infant deaths, or SUIDs. They discovered that only 25 percent of infants were sleeping in a crib or on their back when found. Seventy percent were on a surface not intended for infant sleep, such as an adult bed. Sixty-four percent of infants were sharing a sleep surface, and almost half of these infants were sleeping with an adult. Infants whose deaths were classified as suffocation or an undetermined cause were significantly more likely than infants whose deaths were classified as sudden infant death syndrome to be found on a surface not intended for infant sleep and to be sharing that sleep surface. By identifying the modifiable sleep environment risk factors for sudden infant death syndrome, awareness about preventive steps can be made.

The study’s authors concluded, “Our findings have important implications for preventing injuries and reducing SUID mortality. We identified modifiable sleep environment risk factors in a large proportion of SUIDs, regardless of the ultimate cause of death classification.”

[From: “Sudden Unexpected Infant Deaths: Sleep Environment and Circumstances.” Contact: Patricia G. Schnitzer, Sinclair School of Nursing, University of Missouri, Columbia, Mo., [email protected].]

(2) Poor urban areas experience higher rate of road traffic injuries; Traffic volume and road design to blame

Significantly more road traffic injuries occur in poor urban areas compared with wealthier areas, indicates a study published in the American Journal of Public Health. This may be attributable to differences in roadway environment.

Researchers performed a multilevel observational study of 19,568 road users injured over five years at 17,498 intersections in a large urban area in Montreal, Canada. Researchers used intersection-level characteristics, such as traffic estimates, major roads and number of legs, and area-level characteristics, defined by population density, commuting travel modes and household income.

They found that traffic volume at intersections increased significantly with poverty. At intersections in the poorest census tracts, there were an average 6.3 times more pedestrians injured, 3.9 times more cyclists injured and 4.3 times more motor vehicle occupants injured than in the wealthiest census tracts. They concluded that roadway environment can explain a substantial portion of the excess rate of road traffic injuries in the poorest urban area.

“Our results contribute to identifying plausible causal pathways for inequalities in road traffic injuries across neighborhoods. They also suggest that large-scale environmental preventive strategies, such as traffic volume reduction and safer roadway design, may have large public health benefits by reducing crashes,” the study’s authors conclude.

[From: "Neighborhood Social Inequalities in Road Traffic Injuries: The Influence of Traffic Volume and Road Design." Contact: Patrick Morency, MD, PhD, Direction de santé publique de Montréal, Montréal, Québec, [email protected].]

(3) Disparities exist among US high school drivers in safety belt usage

Primary safety belt laws help to increase compliance among teens to wear their safety belt, reports a new study from the American Journal of Public Health. This practice is proven to lower mortality rates associated with automobile deaths.

Using data from the 2006 National Young Driver Survey comprising a national representative sample of 3,126 high-school drivers, researchers examined associations between safety belt laws and belt use. Specifically they looked at the reported safety belt use, for both drivers and passengers, among teenagers with learner’s permits, provisional licenses and unrestricted licenses in states with primary or secondary enforcement of safety belt laws. They found that teenage drivers were 12 percent less likely to wear a safety belt as drivers and 15 percent less likely to wear one as passengers in states with a secondary safety belt law than in states with a primary law. The apparent reduction in belt use among teenagers as they progressed from learner to unrestricted license holder occurred only in secondary enforcement states. Groups reporting particularly low use of safety belts included African American drivers, rural residents, academically challenged students and those driving pick-up trucks.

“This study showed that primary enforcement safety belt laws may play a key role in mitigating the disparity in safety belt use among certain teenaged subpopulation groups. … Because some teenaged subpopulations have lower safety belt use, even with primary enforcement laws, combined approaches that include upgrades to laws with campaigns and enforcement might be warranted.”

[From: “Safety Belt Laws and Disparities in Safety Belt Use Among US High-School Drivers.” Contact: Dr. J. Felipe García-España, Center for Injury Research and Prevention, The Children’s Hospital of Philadelphia, Philadelphia, Pa., [email protected].] ###

The American Journal of Public Health is the monthly journal of the American Public Health Association® (APHA), the oldest and most diverse organization of public health professionals in the world. APHA is a leading publisher of books and periodicals promoting sound scientific standards, action programs and public policy to enhance health. More information is available at www.apha.org.

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