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Author Moaddab, A.; Dildy, G.A.; Brown, H.L.; Bateni, Z.H.; Belfort, M.A.; Sangi-Haghpeykar, H.; Clark, S.L. file  url
Title Health Care Disparity and State-Specific Pregnancy-Related Mortality in the United States, 2005-2014 Type
Year 2016 Publication Obstetrics and Gynecology Abbreviated Journal Obstet Gynecol  
Volume 128 Issue 4 Pages 869-875  
Keywords Centers for Disease Control and Prevention (U.S.); Ethnic Groups/statistics & numerical data; Female; *Healthcare Disparities; Humans; Infant; Infant Mortality; Maternal Mortality; *Maternal-Child Health Services; *Perinatal Care; Pregnancy; United States/epidemiology  
Abstract OBJECTIVE: To investigate factors associated with differential state maternal mortality ratios and to quantitate the contribution of various demographic factors to such variation. METHODS: In a population-level analysis study, we analyzed data from the Centers for Disease Control and Prevention National Center for Health Statistics database and the Detailed Mortality Underlying Cause of Death database (CDC WONDER) that contains mortality and population counts for all U.S. counties. Bivariate correlations between maternal mortality ratio and all maternal demographic, lifestyle, health, and medical service utilization characteristics were calculated. We performed a maximum likelihood factor analysis with varimax rotation retaining variables that were significant (P<.05) in the univariate analysis to deal with multicollinearity among the existing variables. RESULTS: The United States has experienced a continued increase in maternal mortality ratio since 2007 with rates of 21-22 per 100,000 live births in 2013 and 2014. This increase in mortality was most dramatic in non-Hispanic black women. There was a significant correlation between state mortality ranking and the percentage of non-Hispanic black women in the delivery population. Cesarean deliveries, unintended births, unmarried status, percentage of non-Hispanic black deliveries, and four or less prenatal visits were significantly (P<.05) associated with increased maternal mortality ratio. CONCLUSION: Interstate differences in maternal mortality ratios largely reflect a different proportion of non-Hispanic black or unmarried patients with unplanned pregnancies. Racial disparities in health care availability, access, or utilization by underserved populations are an important issue faced by states in seeking to decrease maternal mortality.  
Call Number Serial 2252  
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Author Newman, L.A.; Kaljee, L.M. file  url
Title Health Disparities and Triple-Negative Breast Cancer in African American Women: A Review Type Journal Article
Year 2017 Publication JAMA Surgery Abbreviated Journal JAMA Surg  
Volume 152 Issue 5 Pages 485-493  
Keywords Africa South of the Sahara/ethnology; Africa, Eastern/ethnology; Africa, Western/ethnology; African Americans/ethnology/genetics/*statistics & numerical data; Anthropology, Medical; Diet; European Continental Ancestry Group/genetics/*statistics & numerical data; Female; Health Services Accessibility; *Health Status Disparities; Humans; Incidence; Life Style; Socioeconomic Factors; Triple Negative Breast Neoplasms/*ethnology/genetics/mortality; United States/epidemiology  
Abstract Importance: Variation in cancer incidence and outcome has well-documented correlations with racial/ethnic identity. In the United States, the possible genetic and ancestral hereditary explanations for these associations are confounded by socioeconomic, cultural, and lifestyle patterns. Differences in the breast cancer burden of African American compared with European/white American women represent one of the most notable examples of disparities in oncology related to racial/ethnic identity. Elucidating the source of these associations is imperative in achieving the promise of the national Precision Medicine Initiative. Observations: Population-based breast cancer mortality rates have been higher for African American compared with white American women since the early 1980s, largely reflecting declines in mortality that have been disproportionately experienced among white American patients and at least partly explained by the advent of endocrine therapy that is less effective in African American women because of the higher prevalence of estrogen receptor-negative disease. The increased risk of triple-negative breast cancer in African American women as well as western, sub-Saharan African women compared with white American, European, and east African women furthermore suggests that selected genetic components of geographically defined African ancestry are associated with hereditary susceptibility for specific patterns of mammary carcinogenesis. Disentangling health care access barriers, as well as reproductive, lifestyle, and dietary factors from genetic contributions to breast cancer disparities remains challenging. Epigenetics and experiences of societal inequality (allostatic load) increase the complexity of studying breast cancer risk related to racial/ethnic identity. Conclusions and Relevance: Oncologic anthropology represents a transdisciplinary field of research that can combine the expertise of population geneticists, multispecialty oncologists, molecular epidemiologists, and behavioral scientists to eliminate breast cancer disparities related to racial/ethnic identity and advance knowledge related to the pathogenesis of triple-negative breast cancer.  
Call Number Serial 2123  
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Author Jiang, N.; Lee, Y.O.; Ling, P.M. file  url
Title Association between tobacco and alcohol use among young adult bar patrons: a cross-sectional study in three cities Type Journal Article
Year 2014 Publication BMC Public Health Abbreviated Journal BMC Public Health  
Volume 14 Issue Pages 500  
Keywords Adolescent; Adolescent Health Services; Adult; Alcohol Drinking/*epidemiology/prevention & control; Cities; Cross-Sectional Studies; Female; Humans; Logistic Models; Male; Restaurants; Smoke-Free Policy; Smoking/*epidemiology/prevention & control; Substance-Related Disorders/epidemiology/prevention & control; Tobacco; United States/epidemiology; Young Adult  
Abstract BACKGROUND: Bars and nightclubs are key public venues where young adults congregate and use both tobacco and alcohol, and young adult bar patrons are at high risk for substance use. This study examined the association between cigarette smoking and alcohol use among a random sample of young adult bar patrons from three different cities in the USA. METHODS: Cross-sectional data was collected from a random sample of young adult bar patrons aged 18-29 in San Diego, CA (N = 1,150), Portland, ME (N = 1,019), and Tulsa, OK (N = 1,106) from 2007-2010 (response rate 88%) using randomized time location sampling. Respondents reported the number of days they smoked cigarettes, drank alcohol, and binge drank in the past 30 days. Multinomial logistic regression was used to analyze the association between smoking (nonsmoker, occasional smoker, and regular smoker) and drinking and binge drinking for each city controlling for age, gender, race/ethnicity, and education. Predicted probabilities of each smoking category were calculated by drinking and binge drinking status. The association between smoking and drinking and binge drinking among combined samples was also analyzed, controlling for demographic variables and city. RESULTS: Respondents reported high current smoking rates, ranging from 51% in Portland to 58% in Tulsa. Respondents in Tulsa were more likely to report regular smoking than those in San Diego and Portland, with demographic variables being controlled. Young adult bar patrons also exhibited a strong association between smoking and drinking. In general, as the frequency of drinking and binge drinking increased, the predicted probability of being a smoker, especially a regular smoker, increased in each city. CONCLUSIONS: Young adult bar patrons consistently reported a high smoking rate and a strong relationship between smoking and drinking, regardless of the different bar cultures and tobacco control contexts in each of the three cities. While smoke-free bar policies were negatively associated with regular smoking, these policies alone may not be enough to influence the association between smoking and drinking, particularly if tobacco marketing continues in these venues, or in the absence of programs specifically addressing the co-use of tobacco and alcohol.  
Call Number Serial 1947  
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Author Weinberger, A.H.; Platt, J.; Jiang, B.; Goodwin, R.D. file  url
Title Cigarette Smoking and Risk of Alcohol Use Relapse Among Adults in Recovery from Alcohol Use Disorders Type Journal Article
Year 2015 Publication Alcoholism, Clinical and Experimental Research Abbreviated Journal Alcohol Clin Exp Res  
Volume 39 Issue 10 Pages 1989-1996  
Keywords Adolescent; Adult; Aged; Alcoholism/*epidemiology/*prevention & control; Anxiety Disorders/epidemiology; Female; Humans; Male; Middle Aged; Mood Disorders/epidemiology; Recurrence; Risk Factors; Smoking/*epidemiology; Substance-Related Disorders/epidemiology; Tobacco Use Disorder/epidemiology; United States/epidemiology; Young Adult; Alcohol Use Disorders; Epidemiology; Nicotine Dependence; Relapse; Smoking  
Abstract BACKGROUND: Individuals in recovery from alcohol use disorders (AUDs) frequently continue to smoke cigarettes. The purpose of this study was to examine the relationship between cigarette smoking status and risk of AUD relapse in adults with remitted AUDs among adults in the United States. METHODS: Data were drawn from Wave 1 (2001 to 2002) and Wave 2 (2004 to 2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Analyses included the subsample of respondents who completed both waves of data collection reported a history of alcohol abuse and/or dependence prior to Wave 1 (N = 9,134). Relationships between Wave 1 cigarette smoking status (nonsmoker, daily cigarette smoker, and nondaily cigarette smoker) and Wave 2 alcohol use, abuse, and dependence were examined using logistic regression analyses. Analyses were adjusted for Wave 1 demographics; mood, anxiety, and substance use disorders; nicotine dependence; and AUD severity. RESULTS: Both daily and nondaily cigarette smoking at Wave 1 were significantly associated with a lower likelihood of alcohol use and a greater likelihood of alcohol abuse and dependence at Wave 2 compared to Wave 1 nonsmoking. These relationships remained significant after adjusting for demographics, psychiatric disorders, substance use disorders, AUD severity, and nicotine dependence. CONCLUSIONS: Among adults with remitted AUDs, daily and nondaily use of cigarettes was associated with significantly decreased likelihood of alcohol use and increased likelihood of alcohol abuse and alcohol dependence 3 years later. Concurrent treatment of cigarette smoking when treating AUDs may help improve long-term alcohol outcomes and reduce the negative consequences of both substances.  
Call Number Serial 1946  
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Author Kohler, P.K.; Manhart, L.E.; Lafferty, W.E. file  url
Title Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy Type Journal Article
Year 2008 Publication The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine Abbreviated Journal J Adolesc Health  
Volume 42 Issue 4 Pages 344-351  
Keywords Adolescent; Female; Health Surveys; Humans; Pregnancy; Pregnancy in Adolescence/*prevention & control/statistics & numerical data; Program Evaluation; Risk Reduction Behavior; Sex Education/*methods; *Sexual Abstinence; *Sexual Behavior/statistics & numerical data; Sexually Transmitted Diseases/epidemiology/prevention & control; United States/epidemiology  
Abstract PURPOSE: The role that sex education plays in the initiation of sexual activity and risk of teen pregnancy and sexually transmitted disease (STD) is controversial in the United States. Despite several systematic reviews, few epidemiologic evaluations of the effectiveness of these programs on a population level have been conducted. METHODS: Among never-married heterosexual adolescents, aged 15-19 years, who participated in Cycle 6 (2002) of the National Survey of Family Growth and reported on formal sex education received before their first sexual intercourse (n = 1719), we compared the sexual health risks of adolescents who received abstinence-only and comprehensive sex education to those of adolescents who received no formal sex education. Weighted multivariate logistic regression generated population-based estimates. RESULTS: Adolescents who received comprehensive sex education were significantly less likely to report teen pregnancy (OR(adj) = .4, 95% CI = .22- .69, p = .001) than those who received no formal sex education, whereas there was no significant effect of abstinence-only education (OR(adj) = .7, 95% CI = .38-1.45, p = .38). Abstinence-only education did not reduce the likelihood of engaging in vaginal intercourse (OR(adj) = .8, 95% CI = .51-1.31, p = .40), but comprehensive sex education was marginally associated with a lower likelihood of reporting having engaged in vaginal intercourse (OR(adj) = .7, 95% CI = .49-1.02, p = .06). Neither abstinence-only nor comprehensive sex education significantly reduced the likelihood of reported STD diagnoses (OR(adj) = 1.7, 95% CI = .57-34.76, p = .36 and OR(adj) = 1.8, 95% CI = .67-5.00, p = .24 respectively). CONCLUSIONS: Teaching about contraception was not associated with increased risk of adolescent sexual activity or STD. Adolescents who received comprehensive sex education had a lower risk of pregnancy than adolescents who received abstinence-only or no sex education.  
Call Number Serial 1685  
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