American Journal of Public Health Highlights: December 2008

Newswise — The articles below will be published online October 15, 2008, at 4 p.m. (ET) 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 November 2008 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, http://www.apha.org, and is available at http://www.ajph.org.

Steroid use may be connected to increased violence in U.S. young adult males

Young male adults who used anabolic-androgenic steroids reported greater involvement in violent behaviors, such as shooting or stabbing someone, according to a new study.

In a nationally representative sample of 6,283 young adult U.S. males, researchers examined the relationship between anabolic-androgenic steroid use and involvement in different types of violent behavior. Anabolic-androgenic steroids are muscle-building synthetic compounds closely related to make sex hormones and legally available only by prescription. The study controlled for the effects of key demographic variables, previous violent behavior, and other drug use. Researchers concluded that the use of anabolic-androgenic steroids is related to heightened levels of violent behaviors.

The study's authors stated, "the current research suggests that the media attention and public concern surrounding anabolic-androgenic steroid use may be justified given its association with violence among males in the United States."

[From: "Anabolic-Androgenic Steroid Use and Involvement in Violent Behavior in a Nationally Representative Sample of Young Adult Males in the United States" ].

Another reason to quit: Smoking may be linked to a higher cognitive decline

When compared to non-smokers, researchers found that smokers scored lower in global cognitive function, speed, and flexibility at middle age.

The sample consisted of 1,964 men and women in the Netherlands aged 43 to 70 years. Researchers examined them for cognitive function twice, at the baseline and five years later. Researchers found at the baseline smokers scored lower than never smokers in global cognitive function, speed, and flexibility; at the five-year follow-up, decline among smokers was 1.9 times greater for memory function, 2.4 times greater for cognitive flexibility, and 1.7 times greater for global cognitive function than among never smokers.

"Our results indicate that giving up smoking at any age may prevent further smoking-induced cognitive decline," the study's authors declared. "The results stress the need for stop-smoking interventions in order to postpone cognitive decline among middle-aged persons."

[From: "Smoking and Cognitive Decline Among Middle-Aged Men and Women: The Doetinchem Cohort Study" ].

Ex-prisoners experience higher mortality rate than general population

Underscoring their medical vulnerability and the need to improve correctional and community preventive health services, a new study found that ex-prisoners are at greater mortality risk than the general population.

Using North Carolina prison records with state death records from 1980 to 2005, researchers studied a total of 168,001 black and white male former prisoners aged 20 to 69 years. They discovered that deaths from homicide, accidents, substance abuse, HIV, liver disease, and liver cancer were greater than would have been expected of the general population. In addition, deaths from cardiovascular disease, lung cancer, respiratory diseases, and diabetes were at least 30 percent greater than expected for white ex-prisoners, but less than expected for black ex-prisoners.

Researchers stated, "The public health implications of these findings for the United States is troubling given the large size of the U.S. ex-prisoner population, the heavy burden of disease among prisoners, and the legal sanctions and social stigma that diminish access to resources after release from prison."

[From: "All-Cause and Cause-Specific Mortality Among Men Released From State Prison, 1980-2005" ].

Ethnic disparities in access to care remain in post-Apartheid South Africa

Fourteen years after the end of apartheid, "blacks" and those of mixed race in South Africa are still underserved and disadvantaged compared with their white and Asian counterparts, especially regarding health care, researchers report.

Researchers examined ethnic disparities in obtaining medical care among the four major ethnic groups—blacks, whites, "coloreds" (those of mixed race), and Asians—in post-Apartheid South Africa. A total of 40.8 percent of blacks and 22.9 percent of coloreds reported going without medical care at some point in the past year, compared with 10.9 percent of whites and 6.9 percent of Asians.

"Although there have been advances in the equalizing of services, there has also been a deterioration of the public health system. With the proliferation of HIV/AIDS in South Africa, that system is overburdened and unable to care for those most in need," the study's authors claimed.

[From: "Ethnic Disparities in Access to Care in Post-Apartheid South Africa" ].

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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