AJPH February 2019 Highlights

Date: Feb 21 2019

CONTACT: Megan Lowry, 202-777-3913

AJPH publishes research on transfat regulations, ACA and uninsurance among women, emergency behavioral services in Chicago, Caribbean health and more.

American Journal of Public Health April issue research highlights: 

New York 2006 transfat ban lowered levels of serum trans-fatty acids in New Yorkers’ blood

Researchers compared the level of serum trans-fatty acids in blood samples taken from New Yorkers before and after the 2006 policy restricting the use of trans-fatty acids in restaurant food. They found that among those who ate less than one restaurant meal per week, geometric mean of the sum of serum TFAs declined 51.1 percent from 44.6 to 21.8 micromoles per liter. The decline in the geometric mean was greater among those who ate four or more restaurant meals per week: 61.6 percent or from 54.6 to 21.0 micromoles per liter.

Authors concluded that New York City adult serum TFA concentrations declined between 2004 and 2014. The indication of greater decline in serum TFAs among those eating restaurant meals more frequently suggests that the municipal restriction on TFA use was effective in reducing TFA exposure.

[Author Contact: Sonia Y. Angell, New York City Department of Health and Mental Hygiene, Queens, New York. “Impact of a Municipal Policy Restricting Trans Fatty Acid Use in New York City Restaurants on Serum Trans Fatty Acid Levels in Adults”].

Affordable Care Act significantly reduced uninsurance rates, barriers to care for women ages 18-44 

Researchers found that the Affordable Care Act was associated with expanded insurance coverage and improvements in access to care for women of reproductive age, particularly for those with lower incomes. The decades long trend of increasing uninsurance among women ages 18-44 reversed after the major ACA coverage expansions in 2014, resulting in a significant reduction in uninsurance that grew from an 18 percent decrease from baseline in the first year of the policy to a 33 percent decline in the second and third years of implementation.

This research also found the probability of reproductive-age women reporting delaying or not receiving medical care because of cost in the past 12 months decreased by 1.5 percentage points in the second and third year of the ACA. In addition, the predicted probability of not having a usual source of care declined by 2.4 percentage points. Changes in insurance status and access to care were larger among reproductive-age women with family incomes less than or equal to 185 percent of the federal poverty level.

[Author Contact: Jamie R. Daw, Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York. “The Affordable Care Act and Access to Care for Reproductive-Aged and Pregnant Women in the United States, 2010–2016”].

Identifying Chicago’s places and people with the most behavioral health emergencies

Researchers linked Chicago Police Department arrest and Fire Department behavioral health-involved ambulance data. They identified at-risk individuals with at least one behavior health ambulance event and at least one arrest event between May 2016 and April 2017. 

Of 83,392 individuals and 116,105 events in the linked emergency events data, 1,842 at-risk individuals accounted for 2.2 percent of individuals, 5.6 percent of all events and 16 percent of behavioral health ambulance events with police involvement. A total of 330 high-use individuals accounted for 0.4 percent of individuals, 2 percent of events and 4.7 percent of Chicago Fire Department events with police involvement. The top 100 high-use locations accounted for 9 percent of ambulance events. Homeless shelters were the number one location for behavioral health emergency events.

Study authors concluded that integrated police and ambulance data hold promise to identify individuals at risk for behavioral health encounters with police, and to support proactive interventions to prevent or improve response at these encounters.

[Author Contact: Harold Pollack, University of Chicago School of Social Service Administration, Chicago. “Identifying Chicago’s High Users of Police-Involved Emergency Services”].

Which Caribbean states rank highest in health policy performance?

Researchers found large differences in health policy performance among Caribbean states. Martinique, Cuba and Guadeloupe had the highest performance scores, and Guyana, Belize and Suriname the lowest. Political affiliation, religious fractionalization, corruption, national income and population density were associated with health policy performance.

Authors concluded that differences in health outcomes between Caribbean states are partly attributable to variations in health policy implementation. Results suggest that many deaths can be prevented if Caribbean governments adopt best-practice policies.

[Author Contact: Soraya P. A. Verstraeten, St Martinus Center Otrobanda, Willemstad, Curaçao. “Health Policy Performance in 16 Caribbean States, 2010–2015”]. 

Find a full list of AJPH research papers published online below:

  • Health policy performance in 16 Caribbean states, 2010-2015
  • Sugar-Sweetened Beverage Consumption Three Years After the Berkeley Sugar-Sweetened Beverage Tax
  • Identifying Chicago's High Users of Police-involved Emergency Services
  • Investigating Variability in Teen Pregnancy Prevention Program Effects: A Meta-Analysis of Federally Funded Program Evaluations
  • The Affordable Care Act and Access to Care for Reproductive-Age and Pregnant Women in the United States
  • Food Insecurity among Formerly Homeless Individuals Living in Permanent Supportive Housing
  • Healthy Air Healthy Brains: Advancing Air Pollution Policy to Protect Children's Health
  • Early childhood obesity among underserved families: A multilevel community-academic partnership
  • Public Intoxication: Sobering Centers address a complex public health issue
  • Private Insurance Coverage for Diabetes before and after enactment of the pre-existing condition mandate of the Affordable Care Act, 2005-2016
  • Joinpoint Trend Analysis of Infant Mortality Disparities in Wisconsin, 1999-2016
  • Ethical Acceptability of Reducing the Legal Blood Alcohol Concentration Limit to .05
  • Validating the National Violent Death Reporting System as a Source of Data on Fatal Shootings of Civilians by Law Enforcement Officers
  • Can an intervention improve population health but widen disparities? Testing for the inequality paradox in a hospital-based workplace safety intervention
  • CommunityRx: A Real-World Controlled Clinical Trial of a Scalable, Low-Intensity Community Resource Referral Intervention
  • A Brief History of the Prevention and Public Health Fund: Implications for Public Health Advocates
  • Impact of a municipal policy restricting trans fatty acid use in New York City restaurants on adult serum trans fatty acid levels
  • Pharmaceutical Companies Support of US Patient-Advocacy Organizations: An International Context
  • City-level measures of health, health determinants and equity to foster population health improvement:  the City Health Dashboard

The articles above will be published online Feburary 21, 2019, at 4 p.m. ET by AJPH under “First Look.” “First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. AJPH is published by the American Public Health Association, and is available at www.ajph.org.

Complimentary online access to the Journal is available to credentialed members of the media. Address inquiries to Megan Lowry at APHA, 202-777-3913, or email her. A single print issue of the Journal is available for $35 from the Journal’s Subscriptions Department. If you are not a member of the press, a member of APHA or a subscriber, online single-issue access is $30, and online single-article access is $22 at www.ajph.org. For direct customer service, call 202-777-2516, or email us.

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The American Journal of Public Health is the monthly journal of the American Public Health Association. APHA champions the health of all people and all communities. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization that influences federal policy, has a nearly 150-year perspective and brings together members from all fields of public health. Visit www.apha.org.