Am. Jrl. of Public Health Highlights: January 2011

Newswise — The articles below will be published online November 18, 2010, 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 January 2011 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) Primary disease prevention is not only good for our health, but also our budgets

In a new study from the American Journal of Public Health, researchers found that primary disease prevention would lead to huge potential national and state medical care savings.

Researchers estimated potential national and state-level medical care cost savings achievable through modest reductions in the prevalence of several diseases associated with the same lifestyle-related risk factors. Researchers used Medical Expenditure Panel Survey Household Component data from 2003-2005 to estimate the effects on medical spending over time of reductions in prevalence of diabetes, hypertension and related conditions amenable to primary prevention by comparing simulated and counterfactual morbidity and medical care expenditures to actual disease and expenditure patterns. Nationally, they estimated that reducing diabetes and hypertension prevalence by 5 percent would save approximately $9 billion annually in the near term. Furthermore, with resulting reductions in comorbidities, savings could rise to approximately $24.7 billion annually in the medium term. They found that returns were greatest in absolute terms for private payers, but greatest in percentage for Medicare. Of note, state savings varied with demographic make-up and prevailing morbidity.

The study’s authors stated, “Our estimate that $24.7 billion in excess medical spending would be avoided annually if primary prevention were able to achieve a 5% reduction in only the conditions we examined can be considered a conservative estimate of the investment in prevention activities that could be offset by medical care savings alone.” They continued that although additional research is needed to provide direct evidence for large-scale efficacy and costs of this type of intervention, “The large potential savings to government health programs may provide justification for public investments in this research.”

[From: “Potential National and State Medical Care Savings from Primary Disease Prevention.” ].

(2) Connections exist between neighborhoods and the risk of chronic disease onset in later life

A new study from the American Journal of Public Health found the neighborhoods in which we live are associated with chronic disease onset in later life.

Researchers examined associations between multiple neighborhood features and two-year onset of six common conditions (hypertension, heart problems, stroke, diabetes, cancer and arthritis) using a national sample of older adults. The sample included adults ages 55 years and older in the 2002 Health and Retirement Study. Depending on the given condition, the final sample sizes varied from 2,731 to 7,414 for women and 2,780 to 5,363 for men. They hypothesized that all three domains — the economic, social and built environment — would contribute to increased risks of chronic conditions later in life. Researchers found that living in more economically disadvantaged areas predicted the onset of heart problems for women. Also, living in more highly segregated, higher-crime areas was associated with greater chances of developing cancer in men and women.

The study’s authors said, “We call for further inquiries into the social and biological mechanisms that underlie these associations and point to promising additions in recent years of biologic measures to national surveys that will make these public health investigations possible.”[From: “Neighborhoods and Chronic Disease Onset in Later Life.” ]. (3) Urban areas with smaller food markets may be bad for your waistline

Living in an urban environment with smaller food markets may be bad for the waistline, reports a new study from the American Journal of Public Health.

The study’s author examined the relationship between neighborhood food environment and adult weight status. Individual-level data on adults from the 1998-2004 survey years of the National Longitudinal Survey of Youth was combined with ZIP code-level data on the neighborhood food environment. The study’s author found that for residents of urban areas, the neighborhood density of small grocery stores was positively and significantly related to obesity and body mass index. Also, for individuals who moved from a rural area to an urban area over a two-year period, the author found that changes in neighborhood supermarket density, small grocery store density and full-service restaurant density were significantly related in the change in body mass index over that period. It was noted that smaller grocers tend to carry more unhealthy snack foods, and less vegetables and fruits.

The study’s author suggested, “The finding that the neighborhood density of small grocery stores was positively and significantly related to the current obesity and BMI of residents of urban areas raises the question of whether policies that offer incentives for food retail establishments to increase the relative availability of healthy food or policies that foster the creation of neighborhood stores specializing in healthy food would be expected to improve food choices and health outcomes for neighborhood residents.”

[From: “The Neighborhood Food Environment and Adult Weight Status: Estimates from Longitudinal Data.” ].