September 2008 AJPH Highlights: Schools of Public Health

Newswise — The articles below will be published online July 16, 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 September 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, www.apha.org, and is available at http://www.ajph.org. To stay up to date on the latest in public health research, sign up for new Journal content e-mail alerts at http://www.ajph.org/subscriptions/etoc.shtml>ck=nck.

American Journal of Public Health Highlights:

Effects on mental health assessed after devastating tsunami in Sumatra

Researchers examined the levels of post traumatic stress reactivity (PTSR) of over 20,000 adult tsunami survivors by analyzing survey data from coastal Aceh and North Sumatra, Indonesia. The findings are from the first wave of a long-term prospective longitudinal follow-up study examining the nature and course of mental health consequences and moderating influences among a population in Indonesia affected by the 2004 Indian Ocean tsunami. Survey respondents were classified into three damage zones using satellite imagery of their pre-tsunami locations of residence from before and after the disaster. Overall, 34 percent of the respondents experienced the trauma of either hearing the tsunami wave or screams about it and 6 percent watched family or friends struggle or disappear. Both exposure to traumatic events at the time of the tsunami and subsequent PTSR scores were highest for respondents from heavily damaged areas. Scores declined over time for respondents from all three damage zones. Gender and age were significant predictors of PTSR, whereas socioeconomic status before the tsunami was not.

"We expect that this 5-year study will provide important knowledge about long-term mental health outcomes after catastrophic disaster and a rationale for attention by international health organizations to sustain interventions beyond the immediate postcrisis period, and will guide the use of stratified public mental health postdisaster programs," the study's authors forecast. [From: "Mental Health in Sumatra After the Tsunami," ].

Menthol in cigarettes promotes smoking among adolescents and young adults

Researchers examined U.S. cigarette brands popular among youth to determine whether or not tobacco manufacturers manipulate menthol in an effort to target young, experimental smokers. Menthol in cigarettes masks harshness and irritation for new smokers. Menthol is used as an additive in approximately 90% of cigarettes manufactured in the United States, although only about one-third of these cigarettes are explicitly marketed as mentholated. This study used data from tobacco industry documents on menthol product development, lab testing results of U.S. menthol brands, market research reports, and the 2006 National Survey on Drug Use and Health, an annual nationally representative survey among U.S. residents aged 12 years and older. The researchers found that tobacco companies control menthol in specific brands to target the sensory preferences of new or younger smokers, primarily by creating milder menthol brands, thereby easing smoking initiation. Menthol brands that have used this strategy have been most successful in attracting youth and young adult smokers and have grown in popularity.

"For decades, tobacco manufacturers have controlled levels of menthol in commercial cigarettes to promote smoking among adolescents and young adults," the authors said. "To protect public health, tobacco products should be federally regulated and additives such as menthol should be included in that regulation." [From: "Tobacco Industry Control of Menthol in Cigarettes and Targeting of Adolescents and Young Adults," ].

Neighborhood psychosocial hazards connected to cardiovascular disease: Case study in Baltimore

Researchers analyzed the associations between cardiovascular disease and neighborhood psychosocial hazards, such as violent crimes, abandoned buildings, and signs of incivility, that lead to an increased sense of threat and vigilance in residents within 65 contiguous neighborhoods in Baltimore, Maryland. A total of 1,140 residents participated in this study who were aged 50 to 70 years and residents of Baltimore for at least 5 years. After adjusting for individual heart disease risk factors, researchers found that residents in neighborhoods with scores in the highest quartile of the psychosocial hazards scale had more than 4 times higher odds of a history of myocardial infarction and more than 3 times higher odds of myocardial infarction, stroke, transient ischemic attack, or intermittent claudication compared with residents living in neighborhoods scoring in the lowest quartile.

"A new wave of research is examining the health consequences of various aspects of residential neighborhoods," the study's author said. "Daily exposure to psychosocial hazards in the neighborhood is known to activate a physiological stress response. These findings suggest new targets for intervention and policy change." [From: "Neighborhood Psychosocial Hazards and Cardiovascular Disease: The Baltimore Memory Study," ].

U.S. child labor violations found in the retail and service industry

Results from this study found that a substantial proportion of U.S. adolescents working in the retail and service industry were employed in violation of the child labor laws. The Fair Labor Standards Act (FLSA) of 1938 limits the types of jobs youths ages 14 to 17 are allowed to perform, the number of hours they may devote to work, and the timing of these hours. The child labor provisions of this act were created to limit work's interference with youths' schooling and to minimize their health and safety risks. Contemporary studies have found that adolescents working more than 20 hours per week during the school year can experience several negative health behaviors and decrements to mental health. In addition, surveillance data show that hundreds of thousands of adolescents are injured at work as a result of performing hazardous tasks. Data for this study were obtained through a survey of a nationally representative sample of working adolescents, and the study investigated reports of select child labor violations. Approximately 37 percent of respondents reported a violation of the Hazardous Occupations Orders, and 40 percent reported a work permit violation. Less than 2 percent reported working more than the maximum weekly hours allowed during the school year, yet 11 percent reported working past the latest hour allowed on a school night, and 15 percent reported working off the clock.

"Further research on child labor violations should examine more carefully how shifts in enforcement activities over the past decade are affecting the detection of violations and the safety of young workers." The study's authors urge, "More-detailed research on the reasons for employer noncompliance will help inform and direct future enforcement efforts." [From: "US Child Labor Violations in the Retail and Service Industries: Findings of a National Survey of Working Adolescents," ].

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