MCH Alert


National Center for Education in Maternal and Child Health

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June 11, 2004

1. Surgeon General Releases Report and Companion Resources on the Health Effects of Smoking
2. Kids Count 2004 Data Book Released
3. Report Presents Key Findings and Strategies for Strengthening the Safety Net
4. AAP Issues Clinical Report on Sexual Orientation and Adolescents
5. Article Assesses Availability and Perceived Effectiveness of Public Health Activities

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1. SURGEON GENERAL RELEASES REPORT AND COMPANION RESOURCES ON THE HEALTH EFFECTS OF SMOKING

The Health Consequences of Smoking: A Report of the Surgeon General updates the 1964 report on the health effects of active smoking. Prepared by the Centers for Disease Control and Prevention's Office on Smoking and Health, the report identifies a number of diseases of which smoking has been found to be a cause that were not previously causally associated with smoking, including cancers of the stomach, uterine cervix, pancreas, and kidney; acute myeloid leukemia; pneumonia; abdominal aortic aneurysm; cataract; and periodontitis. The report updates both the methodology for evaluating evidence and the conclusions from earlier reports concerning smoking as a cause of a particular disease. The report also outlines broad strategies and courses of action for tobacco control in the future.

The U.S. Department of Health and Human Services has also released a companion database containing more than 1,600 articles cited in the report. The database can be used to find detailed information on the specific effects of smoking as well as to develop customized analyses, tables, and figures. The database will be updated as new studies are published. An animated Web site for the public has also been launched to show the hazards of smoking and the benefits of quitting. The printed report, a full-color summary, the companion database, and the public Web site are available at http://www.surgeongeneral.gov/library/smokingconsequences.

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2. KIDS COUNT 2004 DATA BOOK RELEASED

The 2004 KIDS COUNT Data Book presents an annual analysis of 10 key measures of well-being for children in the United States. The report was produced by the Annie E. Casey Foundation and represents a national and state-by-state effort to track the status of children. A companion Web site focuses on an interactive presentation of data from the annual data book and allows users to generate custom graphs, maps, ranked lists, and state-by-state profiles, as well as to download the entire KIDS COUNT data set as delimited text files. Supplemental data on education, health, and economic conditions for each state are also included. The data book and other 2004 KIDS COUNT products are available at http://www.aecf.org/kidscount/databook.

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3. REPORT PRESENTS KEY FINDINGS AND STRATEGIES FOR STRENGTHENING THE SAFETY NET

Walking a Tightrope: The State of the Safety Net in Ten U.S. Communities presents findings from safety net assessments across the country and identifies common characteristics, opportunities, and challenges for communities that wish to provide better health care to uninsured and underserved individuals. The report is a companion to individual safety net assessments conducted by the Urgent Matters program, a national initiative of the Robert Wood Johnson Foundation. Urgent Matters is based on the assumption that there is an important relationship between emergency department use and the performance of the health care safety net. The report illustrates differences among many of the communities and provides an overarching perspective of problems that affect safety nets across the country. The report is intended to inform the health care dialogues in these communities and the nation and to lay a foundation for change and improvement. The report and the Urgent Matters safety net assessments are available at http://www.urgentmatters.org/about/sna_reports.htm#report.

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4. AAP ISSUES CLINICAL REPORT ON SEXUAL ORIENTATION AND ADOLESCENTS

There is a "critical need to address and seek to prevent the major physical and mental health problems that confront nonheterosexual youths in their transition to healthy adulthood," state the authors of an American Academy of Pediatrics (AAP) clinical report published in the June 2004 issue of Pediatrics. The AAP issued its first statement on homosexuality and adolescents in 1983 and revised it in 1993. The report reflects the growing understanding of adolescents of differing sexual orientations and reaffirms the physician's responsibility to provide comprehensive health care and guidance in a safe and supportive environment for all adolescents, including nonheterosexual adolescents and those struggling with issues of sexual orientation.

The report topics include definitions, etiology and prevalence, special needs and considerations, office practice, comprehensive health care, and community advocacy.

The authors present the following physician guidelines:


The authors note that "the overall goal in caring for youth who are or think they may be gay, lesbian, or bisexual is the same as for all youth: to promote normal adolescent development, social and emotional well-being, and physical health."

Frankowski BL and the Committee on Adolescence. 2004. Sexual orientation and adolescents. Clinical Report. Pediatrics 113(6):1827-1832. Available at http://aappolicy.aappublications.org/cgi/content/abstract/pediatrics;113/6/1827?etoc.


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5. ARTICLE ASSESSES AVAILABILITY AND PERCEIVED EFFECTIVENESS OF PUBLIC HEALTH ACTIVITIES

"The availability and perceived effectiveness of public health activities appear far from ideal within the communities in which most Americans reside," state the authors of an article published in the June 2004 issue of the American Journal of Public Health. The authors write that the performance of the nation's public health system has received growing attention in recent years as the system has been challenged by emerging health threats and by trends in health policy and the health care marketplace, but little systematic evidence exists regarding the role in the system of organizations other than official public health agencies. This study sought systematic evidence about who contributes to basic public health activities at the community level. The authors focused on public health jurisdictions with 100,000 or more residents.

Study participants included 497 health departments that reported serving jurisdictions of at least 100,000 residents during 1996-1997. A self-administered survey was mailed to the director of each department, and usable responses were received from 356 departments. The surveys included questions in four categories: (1) availability of 20 activities important for maintaining and improving public health at the community level, (2) effectiveness of these activities, (3) local health department contribution to these activities, and (4) types of organizations other than the health department that participate in performing each activity.

The authors found that

* On average, two thirds of the 20 public health activities were performed in the jurisdictions surveyed.

* On average, directors rated the effectiveness of their jurisdiction's public health activities at 35% of the maximum possible score that would be obtained if all activities were performed at levels fully meeting community needs.

* Directors reported that their agencies were directly responsible for contributing an average of 67% of the total effort devoted to the 20 public health activities in their jurisdictions, suggesting that the remaining one third of the community public health effort was contributed by organizations other than the local health department.

* In most jurisdictions, a mix of state and local government agencies, medical care providers, and nonprofit community agencies contributed to performing public health activities, along with the local public health agency.

The authors conclude that "these findings suggest that many of the nation's largest local public health systems have relatively limited capacities for ensuring that available public health resources are being used most effectively and efficiently to improve community health."

Mays GP, Halverson PK, Baker EL. 2004. Availability and perceived effectiveness of public health activities in the nation's most populous communities. American Journal of Public Health 94(6):1019-1026.

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MCH Alert © 2004 by National Center for Education in Maternal and Child Health and Georgetown University.  MCH Alert is produced by MCH Library Services at the National Center for Education in Maternal and Child Health under its cooperative agreement (6U02 MC 00001) with the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. The Maternal and Child Health Bureau reserves a royalty-free, nonexclusive, and irrevocable right to use the work for federal purposes and to authorize others to use the work for federal purposes.
 
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The editors welcome your submissions, suggestions, and questions.  Please contact us at the address below.

EDITORS:  Jolene Bertness, Tracy Lopez
COPYEDITOR:  Ruth Barzel

National Center for Education in Maternal and Child Health
Georgetown University
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