Public Health Commons^™

Projected Smoking-Related Deaths Among U.S. Youth: A 2000 Update, Ellen J. Hahn, Mary Kay Rayens, Frank J. Chaloupka, Chizimuzo T.C. Okoli, Jun Yang

Nursing Reports

This paper projects the long term consequences of the rise in youth smoking in the 1990s by updating the state estimates for projected smoking-related deaths among youth in the U.S. using information from the Behavioral Risk Factor Surveillance System (BRFSS) 2000 and the U.S. Census 2000. This analysis is similar to that from an earlier study published by the Centers for Disease Control and Prevention (CDC), Office on Smoking and Health (MMWR, 45[44], November 8, 1996). The 1996 analysis used young adult smoking prevalence data from 1994 and 1995; whereas, the analysis presented here represents smoking prevalence data from 2000. …

Assessment Of Validity Of The National Public Health Performance Standards: The Local Public Health Performance Assessment Instrument., Joyce Beaulieu, F. Douglas Scutchfield

Preventive Medicine and Environmental Health Faculty Publications

The National Public Health Performance Standards Program (NPHPSP) has developed performance standards measurement instruments, based on the 10 "Essential Services of Public Health" that are being tested in several states. This article is a report on the face and content validity of the instrument designed for local public health systems. Judgments about the face validity of the standards were obtained in a survey of local public health systems that had used the instrument in a test state. The validity of each standard was addressed along the following dimensions: the importance of the standard as a measure of the Essential Service; …

Psychosocial Stress And Prostate Cancer: A Theoretical Model, Gary L. Ellison, Ann L. Coker, James R. Hebert, Maureen Sanderson, Charmaine D. Royal, Sally P. Weinrich

CRVAW Faculty Journal Articles

African-American men are more likely to develop and die from prostate cancer than are European-American men; yet, factors responsible for the racial disparity in incidence and mortality have not been elucidated. Socioeconomic disadvantage can lead to psychosocial stress and may be linked to negative lifestyle behaviors. Regardless of socioeconomic position, African-American men routinely experience racism-induced stress. We propose a theoretical framework for an association between psychosocial stress and prostate cancer. With the context of history and culture, we further propose that psychosocial stress may partially explain the variable incidence of prostate cancer between these diverse groups. Psychosocial stress may negatively …

Tractor Driving Among Kentucky Farm Youth: Results From The Farm Family Health And Hazard Surveillance Project, Steven R. Browning, Susan C. Westneat, Raeanne Szeluga

Epidemiology and Environmental Health Faculty Publications

This article documents the extent of children's involvement in tractor operations among a representative sample of Kentucky children living and working on family farms. Specifically, we describe children's exposures to tractor-related work activities, profile their use of the tractor (number of days worked), and assess compliance with generally recommended safety measures, such as using tractors equipped with ROPS (rollover protective structures), avoiding riding as passengers on tractors, and operating tractors on public roadways. Data for this study were collected in 1994 and 1995 as part of the NIOSH-sponsored Farm Family Health and Hazard Surveillance Project (FFHHSP). Despite recognition in the …

The Kentucky Plan: An Innovative Approach To Professional Doctoral Education In Public Health., Joel M. Lee, F. Douglas Scutchfield

Preventive Medicine and Environmental Health Faculty Publications

The Doctor of Public Health (Dr.P.H.) degree is designed to prepare graduates for the highest levels of leadership in public health related careers in both public and private settings. The Kentucky School of Public Health has developed an innovative generalist professional degree program offering an extensive battery of courses based on the body of professional public health knowledge. The degree includes extensive supervised field experience as part of the academic training, linking theory with practice. Issues related to professional degrees, curriculum, accreditation and certification, admission, evaluation, plans for institutional cooperation, and demand are addressed.

Assessment Of Clinical Partner Violence Screening Tools, Ann L. Coker, Brian O. Pope, Paige H. Smith, Maureen Sanderson, James R. Hussey

CRVAW Faculty Journal Articles

Objective: to compare the Women’s Experience with Battering Scale (WEB) with the Index of Spouse Abuse-Physical Scale (ISA-P) as screening tools to identify intimate partner violence (IPV).

Methods: We conducted a large cross-sectional survey of women age 18 to 65 attending one of two family practice clinics from 1997 to 1998. All women completed both the WEB and the ISA-P and a telephone interview. We figured agreement estimates between the two tools, used stratified analyses to evaluate attributes of those more likely to screen as battered or physically assaulted, and compared associations between the WEB and ISA-P and a range …

Hormonal And Barrier Methods Of Contraception, Oncogenic Human Papillomaviruses, And Cervical Squamous Intraepithelial Lesion Development, Ann L. Coker, Laura C. Sanders, Sharon M. Bond, Tsilya Gerasimova, Lucia Pirisi

CRVAW Faculty Journal Articles

We assessed the influence of hormonal (oral, injectable, or levonorgestrel [Norplant, Wyeth-Ayerst, Philadelphia, PA]) and barrier methods of contraception on the risk of cervical squamous intraepithelial lesions (SIL), while adjusting for high-risk (HR) HPV infection. Subjects were women receiving family planning services through the state health department clinics from 1995 to 1998. We selected 60 cases with high-grade cervical/SIL (HSIL) and 316 with low-grade cervical/SIL (LSIL) and controls (427 women with normal cervical cytology) and analyzed cervical DNA for HR-HPV, using Hybrid Capture I (Digene; Gaithersburg, MD).When assessing ever use, duration, recency, latency, and age at first use, neither oral …

Fatal Injuries Due To Logs Rolling Off Trucks At Sawmills, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Tractors/Logging

Logging is one of the most hazardous occupations in the nation as well as Kentucky. During 1994-1998, 45 fatalities in Kentucky were related to logging. Of those deaths, 7 were due to logs rolling off trucks at sawmills. The workers were all males and aged 31-64 years. Their experience varied from less than 1 year to more than 25 years. Below are brief case reports of three fatal events, followed by recommendations for prevention of similar events.

Chronic Arsenic Exposure And Risk Of Infant Mortality In Two Areas Of Chile, Claudia Hopenhayn-Rich, Steven R. Browning, Irva Hertz-Picciotto, Catterina Ferreccio, Cecilia Peralta, Herman Gibb

Preventive Medicine and Environmental Health Faculty Publications

Chronic arsenic exposure has been associated with a range of neurologic, vascular, dermatologic, and carcinogenic effects. However, limited research has been directed at the association of arsenic exposure and human reproductive health outcomes. The principal aim of this study was to investigate the trends in infant mortality between two geographic locations in Chile: Antofagasta, which has a well-documented history of arsenic exposure from naturally contaminated water, and Valparaíso, a comparable low-exposure city. The arsenic concentration in Antofagasta's public drinking water supply rose substantially in 1958 with the introduction of a new water source, and remained elevated until 1970. We used …

Population-Based Survey Of Complementary And Alternative Medicine Usage, Patient Satisfaction, And Physician Involvement, Robert Oldendick, Ann L. Coker, Darryl Wieland, James I. Raymond, Janice C. Probst, Bruce J. Schell, Carleen H. Stopskopf

CRVAW Faculty Journal Articles

Background. With an increasing proportion of Americans using complementary or alternative medicine (CAM), physicians need to know which patients are using CAM to effectively manage care.

Methods. In this cross-sectional study, telephone interviews were conducted with 1,584 South Carolina adults (ages 18 and older); 66% responded to the survey of demographics, general health, frequency of CAM use, perceived CAM effectiveness, and physician knowledge of CAM use.

Results. A total of 44% had used a CAM during the past year. Increasing age and higher education were significantly associated with CAM use. More than 60% perceived CAM therapy as very effective, and …

Intimate Partner Violence And Cervical Neoplasia, Ann L. Coker, Maureen Sanderson, Mary Kay Fadden, Lucia Pirisi

CRVAW Faculty Journal Articles

Intimate partner violence (IPV) is associated with a range of adverse physical health outcomes, including chronic and infectious diseases. An emerging literature suggests that partner violence and specifically sexual violence may be associated with an increased risk of cervical neoplasia. To assess the risk of preinvasive and invasive cervical cancer in a cross-sectional study of women screened for IPV by type, frequency and duration, 1152 women ages 18–65 were recruited from family practice clinics in 1997–1998. They were screened for IPV during a brief in-clinic interview, and health history and current status were assessed in a follow-up interview. Of 1152 …

The Hidden Work Of The Farm Homemaker, Deborah B. Reed, Susan C. Westneat, Steven R. Browning, Lana Skarke

Preventive Medicine and Environmental Health Faculty Publications

Despite women’s involvement in agricultural production, the work role of women residing in farm households has not been thoroughly examined. Data collected in 1994-1995 as part of the NIOSH-sponsored Farm Family Health and Hazard Surveillance Project were used to address task issues and health status of farm women in Kentucky. In 1996, the farm woman component of the Kentucky study was replicated in five counties in west Texas, allowing an examination of farm women in two large agricultural states. The Kentucky study employed a two-stage cluster design;the Texas study was based on a systematic quota sample of farms. Both studies …

Street-Based Female Adolescent Puerto Rican Sex Workers: Contextual Issues And Health Needs, Margarita Burgos, Donna L. Richter, Belinda Reininger, Ann L. Coker, Ruth Saunders, Margarita Alegria, Mildred Vera

CRVAW Faculty Journal Articles

Adolescent sex workers potentially have many health needs but are included rarely in health assessments; therefore, little is known about their needs or how to reach them. This study examines the motivations, social context, and health needs of street-based adolescent sex workers. The results show these youths are more likely to experience negative health outcomes, such as unintended pregnancies and sexually transmitted infections, when they are using drugs or are depressed. These findings suggest the need for comprehensive programming to include individual, interpersonal, and greater environmental interventions. Examples for reaching adolescent sex workers are discussed.

Physical Violence During Pregnancy: Maternal Complications And Birth Outcomes, Vilma E. Cokkinides, Ann L. Coker, Maureen Sanderson, Cheryl Addy, Lesa Bethea

CRVAW Faculty Journal Articles

Objective: To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes.

Methods: We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women's physical violence during pregnancy were based on self-reports of partner-inflicted physical hurt and being involved in a physical fight. Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes.

Results: The prevalence …

Knotted Log Rolls Off Truck And Kills Logger At Sawmill, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

A 42-year-old logger (the victim) was killed when he was struck by a log rolling off a loaded truck at a sawmill. At about 6:10 a.m., the victim and the truck driver arrived at the sawmill with a load of logs on the 20-foot flatbed truck. The stack of logs was rounded above the height of the 53-inch standards and secured by only one chain on the middle of the load. When they arrived, the victim got out of the truck and assisted the driver in backing the vehicle into place for unloading. The victim was in view of the …

Log Rolls Off Truck At Sawmill Killing Employee, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

In December 1998, a 31-year-old male (the victim) sawmill employee was killed when struck by a log that rolled off the top of the truck. He was preparing the truck to be unloaded when the log rolled off. While most of the logs received by the sawmill were delivered by independent loggers, the company did own one boom truck that their employees used to pick up timber. This was the truck the victim was driving the day of the incident. At the time of the incident, he was working alone.

When the victim returned to the sawmill, the logs were …

Lumber Company Employee Falls 48" From Storage Rack To His Death, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

In October 1998, a 58-year-old male truck driver/yard worker died of traumatic head injuries when he fell 48" from a storage rack. The employee had climbed onto the storage rack to retrieve 3/4" round molding, 8 feet in length for a customer to load into his truck. The employee placed his feet on pine boards that were being stored on the middle row and was trying to retrieve molding being stored above (approximately 9 feet off the floor). After he cut the bundle string to release the individual molding pieces, he began to pull the pieces out which were being …

Log Rolls Off Truck At Sawmill Killing The Truck Driver, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

In November 1998, a 32-year-old male truck driver was killed when he was struck by a log that rolled off the top of his tractor trailer truck while preparing the truck for unloading at a sawmill complex. The victim accompanied by his father, had picked up a load of logs and transported them approximately 220 miles to the sawmill complex. He arrived at the mill with the logs secured by straps and stacked well above the standards of the trucks trailer. He drove to an unloading area. The victim and his father exited the truck and while the father waited …

Farmer Killed When Tractor Punctures Gas Line Causing An Explosion, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

A 62-year-old male was killed when the tractor he was operating punctured an aboveground gas line. He had recently moved to the area and was in the process of acquiring some land for farming. The land was overgrown with weeds and brush about 5 feet high. On a warm, clear afternoon he went out to clear the land with a tractor and rotary mower. Although the incident was unwitnessed, apparently he began mowing the field near a roadway and was likely on the third pass when the front of the tractor ran into an aboveground valve of a natural gas …

Farm Tractor Safety In Kentucky, 1995, Steven R. Browning, Susan C. Westneat, Helena Truszczynska, Deborah Reed, Robert Mcknight

Preventive Medicine and Environmental Health Faculty Publications

Objective: Tractor rollovers are a major cause of farm injuries and fatalities. The authors used data from a statewide surveillance study to estimate the prevalence of safety features such as rollover protective structures, seat belts, and power take-off shields on farm tractors in Kentucky.

Methods: Using data from the Farm Family Health and Hazard Surveillance Project, the authors report on the prevalence of farm tractor safety features by size of farm, by region of the state, by number of tractors per farm, and by tractor age and estimate the prevalence of tractors equipped with rollover protection by region and for …

Tractor Driver Killed In Overturn While Mowing, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

A 44-year-old farm owner was killed when the tractor he was driving overturned. Using a rotary mower attached to a Ford 600 tractor, the farmer was mowing an area along the gravel road leading to his home in a very remote area of the county. On the east side was a fence and on the west a brush covered embankment. At the top of the seven-foot embankment was a sloping field that had been mowed earlier in the season. The tractor, having been purchased six weeks earlier, had undergone maintenance work but was not equipped with a Roll Over Protective …

Factory Worker Caught In Overhead Conveyor While Hanging Transformers, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

A 29-year-old male factory worker (the victim) died after his head became caught at the point where an overhead chain conveyor made contact with an idler, or pinwheel, that allowed the conveyor to make a 90-degree turn. The conveyor was over seven feet above the floor, but the victim, who was 6'7" tall, was standing on a platform that enabled him to reach the hooks on the conveyor to hang transformer canisters for delivery to a paint booth. No one saw the victim get caught at the nip point, but his supervisor heard him call out and immediately pushed the …

Tractor Operator Killed By Rotary Mower While Mowing Highway Right-Of-Way, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

A 23-year-old male (the victim) was killed when he fell from the tractor he was operating and was run over by the attached rotary mower. The victim had been mowing near an interstate highway on-ramp at about 1:15 pm, when his right front tractor wheel hit a concrete drainage culvert, apparently jolting him off, into the path of the mower. Although he was working with a crew, none of his co-workers witnessed the event. A passing commercial truck driver saw the victim fall, pulled over, and called emergency medical services (EMS) on his cellular phone. EMS personnel arrived within minutes …

Factory Worker Entangled In Conveyor Belt Rollers, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

An 18-year-old male chop saw operator (the victim) died when his right arm became caught in the roller mechanism underneath a conveyor belt. He was pulled into the roller mechanism and suffered compressional asphyxia and blunt force injuries. The victim had left his usual work station for a break. When he did not return on time, his supervisor began to search for him. He saw the victim's legs hanging from the conveyor belt and immediately ran to him and shut off the power to the conveyor belt, radioing a guard to call for emergency medical services (EMS). He and another …

Logger Fatally Injured By Falling Limb, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

A 60-year-old male logger (the victim) was killed when a falling limb struck him on the head. He had been involved in the logging industry all of his life and had been working for a small logging business for six days when the fatal incident occurred. At about 9 a.m. on the day of the incident, the owner of the company went with the victim to where he would be felling trees. The victim was not wearing any personal protective equipment (PPE). They talked for a few minutes then the owner left on the bulldozer. When he returned 20-25 minutes …

53-Year-Old Dies In Tricycle Tractor Overturn While Transporting Round Bale, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

A 53-year-old full-time farmer (the victim) was crushed to death when the tractor he was operating overturned. At 1:45 pm, the victim was moving a large round bale of hay with a hay spike mounted on the front of a tractor. The tractor was not equipped with a rollover protective structure (ROPS) or a seatbelt. The farmer, who was sharecropping, was moving rolled hay from a field to a wagon in preparation for transportation to his farm. Hydraulics were used to lift the approximately 1500-pound spiked bale, and the farmer began driving toward the wagon. He proceeded along a tobacco …

66-Year-Old Male Dies In Tractor Overturn While Mowing, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

A 66-year-old male (the victim) was killed while mowing his farm land. He was driving a Case tractor model 1212 with a front-end loader and 4-foot rotary mower attachments. The tractor had a homemade canopy attached for sun protection but it was not intended to function as a Rollover Protective Structure (ROPS). Tracks in the field show that he had made several passes and had likely worked for about three hours when the incident occurred. It was about 1 p.m. when he began mowing along the edge of the woods that bordered the field. Although the field was relatively flat, …

Farmer Run Over By Tractor, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Tractors/Logging

An 80-year-old male farmer (the victim) died when he was run over by the right rear wheel of his tractor. He had backed the tractor to the door of a shed in order to hook a tiller to it. After parking the tractor on a slight incline in front of the shed, he left it in neutral while he went inside for the tiller. The parking brake did not hold, however, and the tractor began to roll. He apparently noticed this and tried to remount the tractor, but was knocked down by the wheel and run over. To prevent similar …

Electrician Dies In 6-Foot Fall From Ladder, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

A 51-year-old male electrician (the victim) died after falling approximately six feet to the concrete floor of a fertilizer plant. The victim had been doing electrical work while standing on an aluminum extension ladder at a switch box attached to a steel post near a rear exit of the plant. His co-worker, who was approximately 20 feet away, heard him hit the floor, but did not see him fall. The co-worker ran for help. A 911 call was placed at 8:46 am, and Emergency Medical Services (EMS) personnel arrived in three minutes. The victim was transported to the local hospital, …

Experiencing Physical Violence During Pregnancy: Prevalence And Correlates, Vilma E. Cokkinides, Ann L. Coker

CRVAW Faculty Journal Articles

Violence during pregnancy directly impacts the mental and physical health of pregnant women. We assessed the prevalence and correlates of physical violence around the time of pregnancy in a representative sample of 6,718 women in South Carolina. Physical violence, defined as "being physically hurt by husband or partner" or "being involved in a physical fight" was reported by 10.9% of recently pregnant women. These were correlates of violence: experiencing increased numbers of stressful life events, being unmarried, having increased parity, being on Medicaid, and having an unwanted pregnancy. Screening to identify violence in pregnancy in health care settings is vital …