The Persistent Southern Disadvantage in Us Early Life Mortality, 1965‒2014

Background: Recent studies of US adult mortality demonstrate a growing disadvantage among southern states. Few studies have examined long-term trends and geographic patterns in US early life (ages 1 to 24) mortality, ages at which key risk factors and causes of death are quite different than among adults. Objective: This article examines trends and variations in early life mortality rates across US states and census divisions. We assess whether those variations have changed over a 50-year time period and which causes of death contribute to contemporary geographic disparities. Methods: We calculate all-cause and cause-specific death rates using death certificate data from the Multiple Cause of Death files, combining public-use files from 1965‒2004 and restricted data with state geographic identifiers from 2005‒2014. State population (denominator) data come from US decennial censuses or intercensal estimates. Results: Results demonstrate a persistent mortality disadvantage for young people (ages 1 to 24) living in southern states over the last 50 years, particularly those located in the East South Central and West South Central divisions. Motor vehicle accidents and homicide by firearm account for most of the contemporary southern disadvantage in US early life mortality. Contribution: Our results illustrate that US children and youth living in the southern United States have long suffered from higher levels of mortality than children and youth living in other parts of the country. Our findings also suggest the contemporary southern disadvantage in US early life mortality could potentially be reduced with state-level policies designed to prevent deaths involving motor vehicles and firearms

KIDS COUNT Indicator Brief: Reducing the Teen Death Rate

Reviews data on causes of teen deaths and outlines strategies for improving motor vehicle safety; preventing violence, risky behavior, and suicide; supporting role models; and enhancing families' and communities' capacity to support healthy development

Social Problems of Tobacco Marketing in Southwestern Nigeria: A Behavioral Study

Tobacco industries has always shown much interest in marketing their line of products and have been very successful in portraying smoking as a socially acceptable behavior to billions of people throughout the world. Studies have shown in developed nations that tobacco marketing leads to the onset of smoking among adolescents; in Nigeria no such study has been done. The purpose of this research is to assess the potential influence of tobacco marketing on tobacco consumption and its effects on the society and among residents in the southwestern region of Nigeria. The survey was designed in which thirty-six items, self-administered questionnaire was administered to six hundred people in southwestern Nigeria using a cross-sectional design. The study involved 436 males (72.7%) and 164 females (27.3%). Of these, 336 came from rural areas and 264 came from urban areas respectively. Some 337 respondents (56.2%), indicated that they were influenced by tobacco marketing to smoke, while 263 (43.8%) indicated that they were not influenced. Chi square statistic was used to test the null hypotheses. The result shows a positive significant relationship that supports the notion that tobacco marketing has a positive influence on tobacco consumption in the study areas. This study also revealed that more males in the urban area are being influenced by tobacco marketing to smoke

Antiretroviral Therapy outcomes among adolescents and youth in rural Zimbabwe

Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10-30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10-15 (young adolescents) 15.1-19 years (adolescents), 19.1-24 years (young adults) and 24.1-29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17-4.35). Young adults and adolescents had a 2-3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62-4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults

A brief review of self-asphyxial risk-taking behaviour in adolescents

Adolescence is often viewed as a time for experimentation and risk-taking behaviour. For instance, when I was a teenager, my friends and I used to occasionally play a game that we called ‘Headrush’ where we would have our breathing temporarily stopped by someone holding onto our chests after a deep expiration and hyperventilation (so that we could not breathe). It induced feelings of light-headedness and dizziness followed by temporary unconsciousness (usually lasting 10 to 15 seconds). I did it twice and on both occasions I felt as though I had lived a whole other life while I was unconscious. I cannot remember exactly why I had engaged in such a potentially life-threatening behaviour except that all my friends were doing it

The Relationship Between Community Violence and Trauma: How Violence Affects Learning, Health, and Behavior

Research on trauma is frequently featured in mainstream news outlets, pointing to its connection to a range of behavioral and health outcomes. While trauma can have multiple interpretations, for the purposes of this report, it is the result of experiencing or witnessing chronic and sustained violence, or specific events that can have lasting effects on individuals. Researchers have identified 13 distinct types of trauma, including community violence. Community violence is an umbrella term that encompasses experiencing or witnessing firearms violence as well as exposure to drug markets. In addition to the commonly understood, more immediate impacts of gun violence on the victims and their friends and family, this report will provide an overview of the consequences of community violence on health and well-being, specifically illuminating the impact of trauma caused by the longer-term, frequently cumulative effects of living with the fear of violence. This report is intended for members of the gun violence prevention community and policymakers and is designed to provide a foundation of key concepts and research on trauma in the context of gun violence in an easily accessible format

Determinants Of the Prevalence of Diarrhoea in Adolescents Attending School: A Case Study of an Indian Village School

In developing countries, including India, diarrhoea is a leading killer throughout the age pyramid. However, most of the medical literature on the determinants of diarrhoea focuses only on young children or the elderly, with health policy mainly targeting the former. Thus, the present article attempts to contribute to a better understanding of the determinants of diarrhoea in adolescents -- the understudied population. The paper develops a model using the medical literature, refines it to fit an Indian village context and tests the hypotheses identified through administering a questionnaire to 114 adolescents in an Indian village school. Results confirm the well known importance of household sanitation. In addition, the contribution of the present study is to assert that access to school toilets and usage of school toilets are also crucial. Furthermore, usage of toilets at school varies as a function of gender and the existence of a toilet in the student's household. Finally, the installation of toilets in schools is not enough, sustainable financial models must be found to maintain toilets and induce students to use them

Funding Cuts to Public Health in Massachusetts: Losses Over Gains

Examines ten public health areas, from children's health to substance abuse, and describes the widening health disparities, reduced data collection, and other effects of budget cuts to programs in prevention, outreach, training, and technical assistance