Public Health Commons^™

Modifying National Public Health Performance Standards For Local Public Health Department Accreditation, Jeffrey G. Kuhr

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Public health officials throughout the United States are currently preparing for a national accreditation initiative for local and state public health agencies. As a voluntary program, the accreditation process will measure the degree to which state, local, tribal, and territorial public health departments meet nationally recognized standards and measures. Proponents of the initiative feel that evaluating public health agencies on their capacities to achieve certain standards will lead to improved service quality, consistency of public health roles nationally, and a greater understanding of those roles among the general population. However, in planning for agency accreditation some potential barriers must be …

The Dynamics Of Income And Neighborhood Context For Population Health: Do Long Term Measures Of Socioeconomic Status Explain More Of The Black/White Health Disparity Than Single-Point-In-Time Measures?, D. Phuong Do

Faculty Publications

Socioeconomic status, though a robust and strong predictor of health, has generally been unable to fully explain the health gap between blacks and whites in the Untied States. However, at both the individual and neighborhood levels, socioeconomic status is often treated as a static factor with only single-point-in-time measurements. These cross-sectional measures fail to account for possible heterogeneous histories within groups who may share similar characteristics at a given point in time. As such, ignoring the dynamic nature of socioeconomic status may lead to the underestimation of its importance in explaining health and racial health disparities.

In this study, I …

Ethnic Differences In Trajectories Of Depressive Symptoms: Disadvantage In Family Background, High School Experiences, And Adult Characteristics, Katrina M. Walsemann, Gilbert C. Gee, Arline T. Geronimus

Faculty Publications

Although research investigating ethnic differences in mental health has increased in recent years, we know relatively little about how mental health trajectories vary across ethnic groups. Do these differences occur at certain ages, but not others? We investigate variations in trajectories of depressive symptoms, and examine the extent to which disadvantages in family background, high school experiences, and adult characteristics explain these differences. Employing random-coefficient modeling using the National Longitudinal Survey of Youth, we find that blacks and Hispanics experience higher symptom levels in early adulthood in comparison to whites, but equivalent levels by middle-age. Ethnic differences remained in early …

Argument Structure Effects In Action Verb Naming In Static And Dynamic Conditions, Dirk B. Den Ouden, Steve Fix, Todd B. Parrish, Cynthia K. Thompson

Faculty Publications

Argument structure, as in the participant roles entailed within the lexical representation of verbs, affects verb processing. Recent neuroimaging studies show that when verbs are heard or read, the posterior temporoparietal region shows increased activation for verbs with greater versus lesser argument structure complexity, usually bilaterally. In addition, patients with agrammatic aphasia show verb production deficits, graded based on argument structure complexity. In the present study, we used fMRI to examine the neural correlates of verb production in overt action naming conditions. In addition, we tested the differential effects of naming when verbs were presented dynamically in video segments versus …

Changes In Weight, Waist Circumference And Compensatory Responses With Different Doses Of Exercise Among Sedentary, Overweight Postmenopausal Women, Timothy S. Church, Corby K. Martin, Angela M. Thompson, Conrad P. Earnest, Catherine R. Mikus, Steven N. Blair

Faculty Publications

Background: It has been suggested that exercise training results in compensatory mechanisms that attenuate weight loss. However, this has only been examined with large doses of exercise. The goal of this analysis was to examine actual weight loss compared to predicted weight loss (compensation) across different doses of exercise in a controlled trial of sedentary, overweight or obese postmenopausal women (n=41).

Methodology/Principal Findings: Participants were randomized to a non-exercise control (n=94) or 1 of 3 exercise groups; exercise energy expenditure of 4 (n=139), 8 (n=85), or 12 (n=93) kcal/kg/week (KKW). Training intensity was set at the heart rate associated with …

Does Television Viewing Predict Dietary Intake Five Years Later In High School Students And Young Adults?, Daheia J. Barr-Anderson, Nicole I. Larson, Melissa C. Nelson, Dianne R. Neumark-Sztainer, Mary Story

Faculty Publications

Background: Prior research has found that television viewing is associated with poor diet quality, though little is known about its long-term impact on diet, particularly during adolescence. This study examined the associations between television viewing behavior with dietary intake five years later.

Methods: Survey data, which included television viewing time and food frequency questionnaires, were analyzed for 564 middle school students (younger cohort) and 1366 high school students (older cohort) who had complete data available at Time1 (1998-1999) and five years later at Time 2 (mean age at Time 2, 17.2 ± 0.6 and 20.5 ± 0.8 years, respectively). Regression …

Cardiorespiratory Fitness As A Predictor Of Fatal And Nonfatal Stroke In Asymptomatic Women And Men, Steven P. Hooker, Xuemei Sui, Natalie Colabianchi, John E. Vena, James N. Laditka, Michael J. Lamonte, Steven N. Blair

Faculty Publications

Background and Purpose - Prospective data on the association between cardiorespiratory fitness (CRF) and stroke are largely limited to studies in men or do not separately examine risks for fatal and nonfatal stroke. This study examined the association between CRF and fatal and nonfatal stroke in a large cohort of asymptomatic women and men.

Methods - A total of 46,405 men and 15,282 women without known myocardial infarction or stroke at baseline completed a maximal treadmill exercise test between 1970 and 2001. CRF was grouped as quartiles of the sex-specific distribution of maximal metabolic equivalents achieved. Mortality follow-up was through …

Does Place Explain Racial Health Disparities? Quantifying The Contribution Of Residential Context To The Black/White Health Gap In The United States, Brian K. Finch, D. Phuong Do, Ricardo Basurto-Davila, Chloe E. Bird, José J. Escarce, Nicole Lurie

Faculty Publications

The persistence of the black health disadvantage has been a puzzling component of health in the United States in spite of general declines in rates of morbidity and mortality over the past century. Studies that have focused on well-established individual-level determinants of health such as socio-economic status and health behaviors have been unable to fully explain these disparities. Recent research has begun to focus on other factors such as racism, discrimination, and segregation. Variation in neighborhood context - socio-demographic composition, social aspects, and built environment - has been postulated as an additional explanation for racial disparities, but few attempts have …

Light-Dependant Biostabilisation Of Sediments By Stromatolite Assemblages, David M. Paterson, Rebecca J. Aspden, Pieter T. Visscher, Mireille Consalvey, Miriam S. Andres, Alan W. Decho, John F. Stolz, R. Pamela Reid

Faculty Publications

For the first time we have investigated the natural ecosystem engineering capacity of stromatolitic microbial assemblages. Stromatolites are laminated sedimentary structures formed by microbial activity and are considered to have dominated the shallows of the Precambrian oceans. Their fossilised remains are the most ancient unambiguous record of early life on earth. Stromatolites can therefore be considered as the first recognisable ecosystems on the planet. However, while many discussions have taken place over their structure and form, we have very little information on their functional ecology and how such assemblages persisted despite strong eternal forcing from wind and waves. The capture …

The Community-Driven Approach To Environmental Exposures: How A Community-Based Participatory Research Program Analyzing Impacts Of Environmental Exposure On Lupus Led To A Toxic Site Cleanup, Julien A. Terrell, Edith M. Williams, Christine M. Murekeyisoni, Robert Watkins, Laurene Tumiel-Berhalter

Faculty Publications

Community-based participatory research (CBPR) is a mechanism to improve environmental quality in communities primarily inhabited by minorities or low income families. A collaborative partnership between the University at Buffalo and the Toxic Waste Lupus Coalition was formed to investigate the high prevalence of lupus in the area and whether cases of disease were linked to chemicals found at a nearby New York State Superfund site in East Buffalo. The purpose of the study was to use CBPR practices to educate impacted residents and enable their participation in efforts to get a nearby contaminated waste site remediated. Community members were active …

Association Between Muscular Strength And Mortality In Men: Prospective Cohort Study, Jonatan R. Ruiz, Xuemei Sui, Felipe Lobelo, James R. Morrow Jr., Allen W. Jackson, Michael Sjöström, Steven N. Blair

Faculty Publications

Objective: To examine prospectively the association between muscular strength and mortality from all causes, cardiovascular disease, and cancer in men.

Design: Prospective cohort study.

Setting: Aerobics center longitudinal study.

Participants: 8762 men aged 20-80.

Main outcome measures: All cause mortality up to 31 December 2003; muscular strength, quantified by combining one repetition maximal measures for leg and bench presses and further categorised as age specific thirds of the combined strength variable; and cardiorespiratory fitness assessed by a maximal exercise test on a treadmill.

Results: During an average follow-up of 18.9 years, 503 deaths occurred (145 cardiovascular disease, 199 cancer). Age …

Heart Rate Variability Characteristics In Sedentary Postmenopausal Women Following Six Months Of Exercise Training: The Drew Study, Conrad P. Earnest, Carl J. Lavie, Steven N. Blair, Timothy S. Church

Faculty Publications

Background: Decreased heart rate variability (HRV) is associated with a higher risk of mortality. Overall, postmenopausal women have lower levels of HRV than premenopausal women, which may be additionally complicated by lifestyle related behaviors such as physical inactivity and obesity. Though cardiorespiratory exercise training increases HRV, little is known regarding the exercise dose necessary to promote improvement.

Methodology/Principle Findings: Our primary aim was to measure HRV in post-menopausal women following 6-moths of exercise training. We examined supine resting HRV in 373 post-menopausal women (45-75 y) after 6-months of randomly assigned and double-blinded administered exercise training exercise training at 50%, 100% …

Maximal Exercise Electrocardiography Responses And Coronary Heart Disease Mortality Among Men With Diabetes Mellitus, G. William Lyerly, Xuemei Sui, Timothy S. Church, Carl J. Lavie, Gregory A. Hand, Steven N. Blair

Faculty Publications

Background - An abnormal ECG during maximal exercise testing has been shown to be a powerful predictor of future coronary heart disease (CHD) mortality in asymptomatic men. However, little is known about the relationship between exercise ECG responses and CHD risk in men with diabetes mellitus.

Methods and Results - We examined the association between exercise ECG responses and mortality in 2854 men with documented diabetes mellitus (mean age 49.5 years) who completed a maximal treadmill exercise test during the period from 1974 to 2001 and who were without a previous cardiovascular disease (CVD) event at baseline. Mortality due to …

Accumulating Disadvantage Over The Life Course: Evidence From A Longitudinal Study Investigating The Relationship Between Educational Advantage In Youth And Health In Middle Age, Katrina M. Walsemann, Arline T. Geronimus, Gilbert C. Gee

Faculty Publications

Recent studies suggest the importance of examining cumulative risk or advantage as potential predictors of health over the life course. Researchers investigating the cumulative health effects of education, however, have mainly conceptualized education in years or degrees, often disregarding educational quality and access to educational opportunities that may place individuals on divergent academic trajectories. We investigate whether educational advantages in youth are associated with an individual's health trajectory. We develop a novel index of educational advantage and employ random-intercept modeling using data from the National Longitudinal Survey of Youth. We find a widening health disparity in adulthood between respondents with …

Early Life Determinants Of Physical Activity In 11 To 12 Year Olds: Cohort Study, Calum Mattocks, Kevin Deere, Sam D. Leary, Andy R. Ness, Kate Tilling, Steven N. Blair, Chris J. Riddoch

Faculty Publications

Objective: To examine factors in early life (up to age 5 years) that are associated with objectively measured physical activity in 11-12 year olds.

Design: Prospective cohort study

Setting: Avon longitudinal study of parents and children, United Kingdom.

Participants: Children aged 11-12 years from the Avon longitudinal study of parents and children.

Main outcome measure: Physical activity levels in counts per minute (cpm) and minutes of moderate to vigorous physical activity for seven days measured with a uniaxial actigraph accelerometer.

Results: Valid actigraph data, defined as at least three days of physical activity for at least 10 hours a day, …

The Effect Of Question Order On Reporting Physical Activity And Walking Behavior, Brent E. Hutto, Patricia A. Sharpe, Michelle L. Granner, Cheryl L. Addy, Steven P. Hooker

Faculty Publications

Background: Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module. Methods: A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared. Results: …

Crude Birth Rates Among New York City’S Racial/Ethnic Groups And Latino Nationalities In 2002, Victoria Stone

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report analyzes crude birth rates among women in the three primary racial/ethnic groups, White, Black, and Latina, and further examines birth rates by age-specific groups in the five boroughs of New York City in 2002. In addition, this report presents the crude birth rates for six Latino nationalities: Mexican, Ecuadorian, Dominican, Colombian, Puerto Rican and Cuban.

Methods: The data examined here was derived from the NYC Vital Statistics 2002 Report and the Census 2000 SF4 table on Sex by Age by race and Latino nationality. The birth rates were calculated by dividing live birth numbers (Vital Statistics report) …

Assessment Of Seminary Education On End Of Life Issues, Stefan Hakon Pomrenke

Theses and Dissertations

Background: The US health care system faces increased costs from end of life (EOL) care. The intensive approach to EOL treatment with greater use of procedures in ICUs has led to decedent spending six times greater than that of survivors in the hospital. Experts in ICU and Palliative care fields have called for greater utilization of end of life planning and education. To date, EOL education has been dominated by the technologically driven medical field and the church has been under-utilized. The US population relies on clergy support for many mental health and EOL issues. Clergy report feeling uncomfortable in …

Crude Birth Rates And Contraceptive Use By Racial/Ethnic Group In The U.S., 1990-2000, Victoria Stone

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report analyzes crude birth rates and contraceptive use among women in the three primary racial/ethnic groups, White, Black, and Latina, and further examines birth rates by age-specific groups in the United States between 1990 and 2000.

Methods: The data examined here was derived from the NYC Vital Statistics 2002 Report and the Census 2000 SF4 table on Sex by Age by race and Latino nationality. The birth rates were calculated by dividing live birth numbers (Vital Statistics report) by total population count by age and racial/ethnic group (Census 2000 data) and multiplying this number by 1000.

Results: In …

Where's The Kale? Environmental Availability Of Fruits And Vegetables In Two Racially Dissimilar Communities, Edith M. Williams, Bamidele O. Tayo, Beverly Mclean, Ellen Smit, Christopher T. Sempos, Carlos J. Crespo

Faculty Publications

Minority communities across the United States have limited numbers of stores that offer a variety of fruits and vegetables, creating major barriers to good eating habits and nutritional practices among minority groups such as African Americans. Factors like environmental availability of healthy food options have not been fully investigated as possible sources of current cross-population differences in disease. The present study examined whether a predominantly African American neighborhood had disproportionately less availability of fruits and vegetables than a predominantly non-Hispanic White neighborhood. Availability was judged on the bases of the types of stores available in each community and the specific …

Use Of Accelerometers In A Large Field-Based Study Of Children: Protocols, Design Issues, And Effects On Precision, Calum Mattocks, Andy R. Ness, Sam D. Leary, Kate Tilling, Steven N. Blair, Julian Shield, Kevin Deere, Joanne Saunders, Joanne Krikby, George Davey Smith, Jonathan Wells, Nicholas Wareham, John J. Reilly, Chris J. Riddoch

Faculty Publications

Background: Objective methods can improve accuracy of physical activity measurement in field studies but uncertainties remain about their use.

Methods: Children age 11 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), were asked to wear a uni-axial accelerometer (MTI Actigraph) for 7 days.

Results: Of 7159 children who attended for assessment, 5595 (78%) provided valid measures. The reliability coefficient for 3 days of recording was .7 and the power to detect a difference of 0.07 SDs (P ≤ .05) was > 90%. Measures tended to be higher on the first day of recording (17 counts/min; 95% CI, …

Physical Activity And Blood Pressure In Childhood: Findings From A Population-Based Study, Sam D. Leary, Andy R. Ness, George Davey Smith, Calum Mattocks, Kevin Deere, Steven N. Blair, Chris J. Riddoch

Faculty Publications

The pathological processes associated with development of cardiovascular disease begin early in life. For example, elevated blood pressure (BP) can be seen in childhood and tracks into adulthood. The relationship between physical activity (PA) and BP in adults is well-established, but findings in children have been inconsistent, with few studies measuring PA mechanically. Children aged 11 to 12 years were recruited from the Avon Longitudinal Study of Parents and Children. 5505 had systolic and diastolic BP measurements, plus valid (at least 10 hours for at least 3 days) accelerometer measures of PA; total PA recorded as average counts per minute …

State Policies Matter: The Case Of Outpatient Drug Treatment Program Practices, Jamie Chriqui, Yvonne Terry-Mcelrath, Duane C. Mcbride, D Eidson

Faculty Publications

This study examined relationships between state policy requirements governing outpatient substance abuse treatment services and reported outpatient treatment program practices. State policies effective as of February 1, 2003, and February 1, 2004, were collected and analyzed via primary legal research; data were validated by state officials (88% response rate; > 90% validation rate). Treatment practice data were obtained from the National Survey of Substance Abuse Treatment Services for the years 2003 and 2004. Multivariate analyses clustered by state were conducted, controlling for state, program, and state-aggregated client admission characteristics. Results indicated that treatment programs located in states with requirements for comprehensive …

Effect Of Endothelin 1 Genotype On Blood Pressure Is Dependent On Physical Activity Or Fitness Levels, Tuomo Rankinen, Timothy S. Church, Treva Rice, Nathan Markward, Arthur S. Leon, Dabeeru C. Rao, James S. Skinner, Steven N. Blair, Claude Bouchard

Faculty Publications

Contributions of the DNA sequence variation at the endothelin 1 locus to the risk of hypertension and to endurance training-induced changes in blood pressure were investigated in the Aerobics Center Longitudinal Study and the Health, Risk Factors, Exercise Training and Genetics Family Study cohorts. We identified 586 normotensive control subjects and 607 incident hypertensive case subjects from the Aerobics Center Longitudinal Study cohort (all whites) who were normotensive and healthy at their first clinical visit. The case subjects were diagnosed with hypertension during an average follow-up of 9.5 years, whereas the control subjects remained normotensive. The allele and genotype frequencies …

Toward A Population Health Model Of Segmented Assimilation: The Case Of Low Birth Weight In Los Angeles, Brian K. Finch, Nelson Lim, William Perez, D. Phuong Do

Faculty Publications

The authors adapt the segmented assimilation theory to a model population health, which posits that assimilation is actually harmful to migrants' health. The authors also specify models of individual and contextual factors to indirectly test the theory of segmented assimilation - a theory that posits interactions between individual and residential circumstances. Using Year 2000 vital statistics data merged with 2000 U.S. census data from Los Angeles County, the authors model the probability of being born low birth weight among the native and foreign born. Results confirm an immigrant advantage at the individual level and protective effects of immigrant coresidence at …

Physical Activity And Public Health: Updated Recommendation For Adults From The American College Of Sports Medicine And The American Heart Association, William L. Haskell, I-Min Lee, Russell R. Pate, Kenneth E. Powell, Steven N. Blair, Barry A. Franklin, Caroline A. Macera, Gregory W. Heath, Paul D. Thompson, Adrian Bauman

Faculty Publications

Summary - In 1995 the American College of Sports Medicine and the Centers for Disease Control and Prevention published national guidelines on Physical Activity and Public Health. The Committee on Exercise and Cardiac Rehabilitation of the American Heart Association endorsed and supported these recommendations. The purpose of the present report is to update and clarify the 1995 recommendations on the types and amounts of physical activity needed by healthy adults to improve and maintain health. Development of this document was by and expert panel of scientists, including physicians, epidemiologists, exercise scientists, and public health specialists. This panel reviewed advances in …

Physical Activity And Public Health In Older Adults: Recommendation From The American College Of Sports Medicine And The American Heart Association, Miriam E. Nelson, W. Jack Rejeski, Steven N. Blair, Pamela W. Duncan, James O. Judge, Abby C. King, Carol A. Macera, Carmen Castaneda-Sceppa

Faculty Publications

Objective - To issue a recommendation on the types and amounts of physical activity needed to improve and maintain health in older adults.

Participants - A panel of scientists with expertise in public health, behavioral science, epidemiology, exercise science, medicine, and gerontology.

Evidence - The expert panel reviewed existing consensus statements and relevant evidence from primary research articles and reviews of the literature. Process: After drafting a recommendation for the older adult population and reviewing drafts of the Updated Recommendation from the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) for Adults, the panel issued a …

Perceived Individual, Social, And Environmental Factors For Physical Activity And Walking, Michelle L. Granner, Patricia A. Sharpe, Brent E. Hutto, Sarah Wilcox, Cheryl L. Addy

Faculty Publications

Background: Few studies have explored associations of individual, social, and environmental factors with physical and walking behavior. Methods: A random-digit-dial questionnaire, which included selected individual, social, and environmental variables, was administered to 2025 adults, age 18 y and older, in two adjacent counties in a southeastern state. Logistic regressions were conducted adjusting for age, race, sex, education, and employment. Results: In multivariate models, somewhat different variables were associated with physical activity versus regular walking. Self-efficacy (OR = 19.19), having an exercise partner (OR = 1.47), recreation facilities (OR = 1.54), and safety of trails from crime (OR = 0.72) were …

Collaboration Addresses Information And Education Needs Of An Urban Public Health Workforce, Deborah H. Charbonneau, Ellen B. Marks, Annette M. Healy, Carrie F. Croatt-Moore

Library Scholarly Publications

Addressing the health information needs of diverse, multiethnic, and multilingual communities can be both a challenge and an opportunity for libraries. The Vera P. Shiffman Medical Library at Wayne State University in Detroit, Michigan, is the only academic medical library in the Detroit area open to the public. The library provides services to many communities in southeastern Michigan. The diverse geographic area served by the library includes the nation’s highest concentration of Arab Americans. A review of the literature reveals that limited research has addressed how libraries can meet the health information needs of this target community. An understanding of …

Neighborhood Context And Ethnicity Differences In Body Mass Index: A Multilevel Analysis Using The Nhanes Iii (1988-1994), D. Phuong Do, Tamara Dubowitz, Chloe E. Bird, Nicole Lurie, José J. Escarce, Brian K. Finch

Faculty Publications

A growing body of literature has documented a link between neighborhood context and health outcomes. However, little is known about the relationship between neighborhood context and body mass index (BMI) or whether the association between neighborhood context and BMI differs by ethnicity. This paper investigates several neighborhood characteristics as potential explanatory factors for the variation of BMI across the United States; further, this paper explores to what extent segregation and the concentration of disadvantage across neighborhoods help explain ethnic disparities in BMI. Using data geo-coded at the census tract-level and linked with individual-level data from the Third National Health and …