American journal of public health
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We analyzed data from a survey of occupational factors and pregnancy outcome to examine the effects of cigarette, alcohol, and coffee consumption on pregnancy outcome. Clear and statistically significant associations were found between cigarette and alcohol consumption and spontaneous abortion. There was a weaker but statistically significant association with coffee consumption: If the associations were casual, 11% of the spontaneous abortions could be attributed to smoking, 5% to alcohol, and 2% to coffee.
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The logistic regression model is being used with increasing frequency in all areas of public health research. In the calendar year 1989, over 30% of the articles published in the American Journal of Public Health employed some form of logistic regression modeling. In spite of this increase, there has been no commensurate increase in the use of commonly available methods for assessing model adequacy. ⋯ Failure to address model adequacy may lead to misleading or incorrect inferences. Recommendations are made for the use of methods for assessing model adequacy and for future editorial policy in regard to the review of articles using logistic regression.
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Historical Article
The Tuskegee Syphilis Study, 1932 to 1972: implications for HIV education and AIDS risk education programs in the black community.
The Tuskegee study of untreated syphilis in the Negro male is the longest nontherapeutic experiment on human beings in medical history. The strategies used to recruit and retain participants were quite similar to those being advocated for HIV/AIDS prevention programs today. Almost 60 years after the study began, there remains a trail of distrust and suspicion that hampers HIV education efforts in Black communities. ⋯ These theories range from the belief that the government promotes drug abuse in Black communities to the belief that HIV is a manmade weapon of racial warfare. An open and honest discussion of the Tuskegee Syphilis Study can facilitate the process of rebuilding trust between the Black community and public health authorities. This dialogue can contribute to the development of HIV education programs that are scientifically sound, culturally sensitive, and ethnically acceptable.
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Of 10,524 homeless veterans assessed in a 43-site VA program, 50 percent served during the Vietnam War era, compared to only 29 percent of all veterans in the general population. This reflects the greater risk of homelessness among men aged 30-44 rather than the impact of Vietnam Era service. The proportion of homeless veterans who served in the Vietnam Theater (44.9 percent), and the proportion exposed to combat fire (40.5 percent) were similar to those of nonhomeless veterans. Homeless combat veterans who are not White were more likely to have psychiatric, alcohol, and medical problems than homeless noncombat Vietnam veterans who are not White.
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In November 1986, a Detroit, Michigan city ordinance requiring mandatory jail sentences for illegally carrying a firearm in public was passed to preserve "the public peace, health, safety, and welfare of the people." ⋯ Our findings are consistent with a model in which the ordinance had a dampening effect on firearm homicides occurring in public in Detroit. The apparent preventive effect evident in the time series analyses may have been due to publicity about the ordinance, whereas the small nature of the effect may have been due to the lack of enforcement.