American journal of preventive medicine
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The National Heart, Lung, and Blood Institute (NHLBI) has funded the Preventive Cardiology Academic Award (PCAA) for more than a decade. The background for focusing on physicians in training and prevention is reviewed, as well as the status of the 49 medical schools that have received the award. This report presents a synthesis of the objectives for the award, curricular approaches, and teaching strategies employed by awardees and also the framework for program evaluation. The degree of institutionalization of the programs and the diffusion nationally as well as trends in the program over the past decade are examined.
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Hip fractures are a major cause of morbidity and mortality in the United States. Twenty to 40% of persons who fracture their hips die within 6 months of the injury, and many survivors need long-term care. To assess the public health impact of hip fractures in the United States, we analyzed sample-based data from the National Hospital Discharge Survey, National Center for Health Statistics, for the United States for the period 1970-83. ⋯ Never-married and divorced persons had higher hospitalization rates than currently married persons. The percentage of mortality before discharge from hospital fell from 11% in 1970 to 6% in 1983, with most of the decrease occurring among persons 75 years of age or older. The age-adjusted mean length of hospital stay declined 24%, from 23.9 days in 1970 to 18.2 days in 1983.(ABSTRACT TRUNCATED AT 250 WORDS)
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This study analyzes the relationships of cigarette smoking and smoking histories to employment status and occupation. Data from a large, representative sample of U. S. adults in 1985 were analyzed separately for white men, white women, black men, and black women, with controls for age, education, and marital status included in all analyses. ⋯ These differences in smoking adoption had begun at young ages, before most people have adopted adult roles, which suggests that the differences in smoking adoption were not caused by unemployment or occupation. Rather, it appears that certain personal characteristics or early experiences influenced both smoking adoption and adult unemployment or occupation. In addition, unemployment may decrease smoking cessation, and employment in professional occupations may increase smoking cessation.
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Although Medicaid has increased access to medical care for low-income pregnant women, the Medicaid population remains at high risk for poor pregnancy outcomes. In 1983 the Michigan Department of Public Health conducted 1 week of in-hospital, postpartum interviews addressing risk factors for poor pregnancy outcome among 1,945 women. These births represented over 90% of the births during the study period and constituted a sample of approximately 1.5% of the yearly births in Michigan. ⋯ In terms of behavioral risks, more Medicaid recipients reported tobacco and alcohol use than did the other mothers. Finally, the infants of Medicaid recipients were 200 g lighter than the other infants. We suggest that the Medicaid program--the major source of prenatal health care for these women--is not adequate to address their risks for poor pregnancy outcomes.