February 2008 AJPH Highlights: Achieving Social Justice Through Public Health Practice

Newswise — (1) Poor and uninsured less likely than wealthy and insured to receive free prescription drug samplesIn this first population-based study to evaluate free drug-sample distribution,researchers analyzed data from the 2003 Medical Expenditure Panel Survey to examine characteristics of free drug sample recipients. Twelve percent of participants had received at least one free sample in 2003, and nearly 19 percent of those filling prescriptions in 2003 received at least one drug as a free sample. Of those receiving a free sample, 82.1 percent were insured all year, and only 17.9 percent of sample recipients were uninsured for all or part of the year. Similarly, the poor were the least likely to receive free samples, whereas individuals in the highest income category were the most likely to receive free samples.

"Although physicians may target samples to needy patients who enter their offices, these individual efforts fail to counteract society-wide factors that determine access to care and selectively direct free samples to the affluent," said the study's authors. "Our findings suggest that free drug samples serve as a marketing tool, not as a safety net." [From: "Recipients of Free Prescription Drug Samples: A Nationally Representative Analysis." ]

(2) Events of September 11 continue to negatively affect mental health of AmericansNegative terrorism-related beliefs and fears assessed in 2003 predicted distress and drinking outcomes in 2005.

Researchers examined the extent to which the salience of post"September 11 beliefs and fears, as assessed in 2003, predicted a range of psychological distress and deleterious alcohol use outcomes in 2005. Data was derived from a six-wave longitudinal mail survey, which began before September 11 and continued in 2005. Thirty percent of participants reported feeling very or extremely more pessimistic about world peace, and 27.6 percent reported that they had less faith in the government's ability to protect them. Results showed that negative beliefs and fears were associated with significantly increased levels of depression, anxiety, hostility, posttraumatic stress syndrome and drinking to escape in men and women, and drinking to intoxication in men. [From: "Macrolevel Stressors, Terrorism and Mental Health Outcomes: Broadening the Stress Paradigm." ]

(3) Distribution of commercial hospital discharge packs inhibits exclusive breastfeedingA longstanding marketing campaign by infant formula manufacturers has a negative impact on exclusive breastfeeding.

Researchers utilized data from the 2000 and 2001 Oregon Pregnancy Risk Assessment Monitoring System to evaluate the relationship between exclusive breastfeeding and the receipt of commercial hospital discharge packs (CHPD). Among women who had initiated breastfeeding, 68.4 percent reported receiving discharge packs. Data suggests that women who received CHPDs were less likely to exclusively breastfeed for at least 10 weeks than were women who had not received the packs.

"This study indicated that provision of CHPDs to new mothers who have initiated breastfeeding may be associated with early discontinuation of exclusive breastfeeding," said researchers. "One way to increase exclusive breastfeeding may be to halt the provision of CHPDs at the time of newborn hospital discharge." [From: Infant Formula Marketing Through Hospitals and the Impact of Commercial Hospital Discharge Packs on Breastfeeding." ]

(4) Young adults more likely than older adults to quit smoking successfullyYoung adults aged 18"24 are also more likely to have seriously tried to quit smoking than older adults aged 50"64.

The study utilized data from the 2003 Tobacco Use Supplement to the Current Population Survey to evaluate the relationship between smoking cessation rates and tobacco-related behaviors between the two age groups. Eighty four percent of 18"24 year olds reported seriously trying to quit in the past year, compared to 64 percent of 50"64 year olds. Additionally, the proportion of recent dependent smokers who had quit for at least six months generally decreased as age increased. Compared with older adults, young adults were more likely to come from smoke-free homes, were less likely to use pharmaceutical aids and smoked fewer cigarettes a day.

"It is likely that high cessation rates among 18- to 24-year-olds also reflect changing social norms over the previous decade," said researchers. "Future tobacco control efforts aimed at increasing cessation among young adult smokers should continue to target social norms." [From: Smoking Cessation Rates in the United States: A Comparison of Young Adult and Older Smokers." ]

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