
Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
August 31, 2007
1. MCH Library Expands Availability and
Access to Historical Documents
2. National Healthy Start Association Releases Toolkit
for First Infant Mortality Awareness Month
3. AMCHP Highlights Recent Efforts to Advance Adolescent
Reproductive Health
4. Study Examines Mental Health, Work,
and Mental Health Service Use Among Mothers with Low Incomes
5. Article Assesses the Impact of Banning Amalgam
Restoration
6. Authors Examine Associations Between Bullying and
Family, Peer, and School Relations for White, Black, and Hispanic
Adolescents
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Special Notice: In response to the Consumer Product Safety Commission's
(CPSC's) recent toy hazard recalls, the American Academy of Pediatrics
has compiled selected resources to help health professionals and
families keep children safe. The resources include frequently asked
questions, a list of toys recalled because of possible lead content,
guidelines for parents on toy safety, a list of age-appropriate toys
and toys to avoid, information about screening for lead exposure in
children, and AAP's policy statement on preventing, detecting, and
managing lead exposure in children. The AAP resources are available at http://www.aap.org/new/toyrecall.htm.
A comprehensive list of CPSC's toy hazard recalls is available at http://www.cpsc.gov/cpscpub/prerel/category/toy.html.
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1. MCH LIBRARY EXPANDS AVAILABILITY AND ACCESS TO HISTORICAL
DOCUMENTS
The Maternal and Child Health (MCH) Library Web site now includes over
300 historical documents published by the U.S. Children's Bureau
between 1912 and 1969, the earliest years of the federal agency. The
documents have been made available electronically on the library's Web
site with support from the Health Resources and Services
Administration's Maternal and Child Health Bureau. Many of the
documents are being made available online for the first time and are
accessible only from the MCH Library. Selected topics include child
health, infant mortality, child labor, and public health services for
mothers and children, including children with physical and cognitive
disabilities. The collection is available at http://www.mchlibrary.info/history/index.html.
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2. NATIONAL HEALTHY START ASSOCIATION RELEASES TOOLKIT FOR FIRST INFANT
MORTALITY AWARENESS MONTH (SEPTEMBER 2007)
The National Healthy Start Association's (NHSA's) Infant Mortality
Awareness Month Toolkit is designed to increase national awareness of
the factors that contribute to infant mortality in the United States
and to urge community leaders to get involved in efforts to reduce
infant mortality rates. The toolkit was produced by NHSA with support
from the Annie E. Casey Foundation following the introduction of a
Congressional resolution to observe September as Infant Mortality
Awareness Month. Contents include promotional materials, suggested
fundraising and advocacy activities, statistical resources, and public
relations and marketing tips. The toolkit is intended for use by
Healthy Start programs and others to help raise awareness of infant
mortality throughout the country and to gain community support for
activities to reduce infant mortality. The toolkit is available at http://www.healthystartassoc.org/tkguide.html.
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3. AMCHP HIGHLIGHTS RECENT EFFORTS TO ADVANCE ADOLESCENT REPRODUCTIVE
HEALTH
Adolescent Preventive Health Watch is an electronic resource that
provides an overview of activities related to adolescent reproductive
health that have taken place over the last year. The tool, produced by
the Association of Maternal and Child Health Programs (AMCHP), presents
a rationale for an adolescent reproductive health focus and includes
selected information and resources categorized in five sections. The
first section highlights AMCHP's efforts to strengthen collaboration
between state health agencies and state education agencies to support
and improve prevention education in schools and to provide state
adolescent health coordinators with opportunities for professional
development, networking, and resource-sharing. Other sections address
national and state performance measures related to adolescent
reproductive health; success stories from state agencies in California,
Connecticut, New Jersey, and New York; and research about
abstinence-only education, HIV and AIDS, sexually transmitted diseases,
unintended and adolescent pregnancy, and other sexual health risk
behaviors. The final section highlights new resources that may be
helpful to state agencies working on adolescent reproductive health.
The tool is available at
http://www.amchp.org/policy/adolescent-ahw07.htm
and http://www.amchp.org/policy/Downloads/AMCHP%20Adolescent%20Health%20Watch%202007.pdf.
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4. STUDY EXAMINES MENTAL HEALTH, WORK, AND MENTAL HEALTH SERVICE USE
AMONG MOTHERS WITH LOW INCOMES
"This investigation of the relationships between mental health status,
work, and mental health service use provides some provocative initial
findings," state the authors of a discussion paper produced by the
Urban Institute's Low-Income Working Families project. More public
policy is focusing on work as an avenue that allows families to move
ahead. The paper includes a review of studies that have examined how
mothers' mental health affects work, findings on the connection between
mental health and work and on the relationship between insurance
coverage and mental health treatment, conclusions, and policy
implications.
The sample for the current study, drawn from the 2002 National Survey
of America's Families, included 5,758 mothers with incomes under 200%
of the federal poverty level, representing about 10.4 million women
nationwide. (Mothers who were receiving disability benefits from the
Supplemental Security Income program were excluded.) Measures included
mental health status; health insurance status; mental health service
use; income; and employment. The final analysis estimated the
relationship between employment outcomes and mental health status using
models that predicted work of any amount at the time of interview,
while controlling for other factors that might independently affect
work (age, race and ethnicity, marital status, number of children, age
of youngest child, education, work experience, spouse's employment, and
poor overall health). One model included a mental health score, and the
other included indicator variables for mental health (very poor, poor,
fair-good). Estimates for all mothers with low incomes and for single
mothers were analyzed separately.
The authors found that
- Almost 10% of mothers with low incomes were in very poor mental
health, and another 18% were in poor mental health.
- Less than one-third of mothers with low incomes in very poor
mental health, and 16% of those in poor mental health, received any
treatment in the past year.
- Mothers with low incomes in very poor mental health were
significantly less likely to work than other mothers with low incomes,
even after controlling for many risk factors. In addition, among
mothers with low incomes who did work, single mothers in poor mental
health were less likely to work full time than other mothers.
- Mothers with low incomes in very poor mental health were as
likely to have health insurance coverage as their counterparts
reporting better mental health. But 25% of these mothers were uninsured.
- Having health insurance coverage significantly increased the
likelihood of receiving mental health services (controlling for mental
health status and other factors).
- Mothers with low incomes with public health insurance coverage
had higher rates of treatment than those with private coverage.
The authors conclude that "given the negative impact of mental health
problems on work and the evidence that effective mental health
treatments are available, it is important for policymakers to consider
how to improve access to and use of treatment for low-income mothers."
Loprest PJ, Zedlewski SR, Schaner SG. 2007. Mental health, work, and
mental health service use among low-income mothers. Washington, DC:
Urban Institute. Available at http://www.urban.org/UploadedPDF/411522_low_income_mothers.pdf.
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5. ARTICLE ASSESSES THE IMPACT OF BANNING AMALGAM RESTORATIONS
"State legislators need to balance the evidence of any adverse effects
of amalgams on patients and the environment and the impact of the ban
on access to dental care and oral health," state the authors of an
article published in the September-October 2007 issue of Public Health
Reports. Amalgam -- the predominant and clinically preferred material
for restoring most posterior teeth -- is composed of a mixture of
silver, other metals, and mercury. There is growing concern about the
urinary mercury levels in the population. It is known that amalgam
restorations release a mercury vapor during mastication and that
children and adults with multiple amalgam restorations have slightly
elevated urinary mercury levels. Another concern is possible
environmental contamination from the residual mercury used in the
preparation of amalgams. For these reasons, bills have been introduced
in the federal and state legislatures to restrict the use of amalgam
restorations. The purpose of this article is to examine the financial
impact that would result if amalgam restorations were banned in select
population subgroups or in the entire population.
The authors calculated the current rate of change in amalgam use based
on claims and enrollment data from Delta Dental of Michigan, Ohio, and
Indiana and also based on data from the American Dental Association
surveys of dental services rendered. Claims and enrollment data from
1992 through 1994 were used to estimate the per capita use of dental
amalgams, and then population projections were used to obtain national
estimates of annual amalgam use as of January 1, 2005, and beyond. The
authors also used the dental component of the Consumer Price Index for
1992-1994 to estimate the annual rate of change in dental fees. These
two estimates enabled the authors to calculate the number of dental
amalgams affected by the regulation, and the fees for each of the years
2005 through 2020.
The authors found that
- The mean price of restorations would increase from $278 before
2005 to $330 after a ban on amalgam restorations, an increase of $52
(18.6%).
- As the price of restorations increased because of the ban, there
would be 15,444,021 fewer restorations inserted per year, a 9% decline.
- A ban on the use of amalgam restorations for children and
adolescents from birth through age 19 only would increase dental
expenditures by about $1.1 billion per year and by $13 billion from
2005 to 2020 and would result in more than 4 million fewer restorations.
- A ban on the use of amalgam restorations in the entire population
would increase dental expenditure by about $8.2 billion in the first
year and by $88.1 billion from 2005 through 2020 and would result in
15.4 million fewer restorations.
The authors conclude that "there is no evidence that this restorative
material is having an adverse impact on health, and there is
substantial evidence that a ban will increase access and oral health
disparities."
Beazoglou T, Eklund S, Heffley D. 2007. Economic impact of regulating
the use of amalgam restorations. Public Health Reports. 122(5):657-663.
Available at http://www.publichealthreports.org/userfiles/122_5/14_PHR122-5_657-663.pdf.
Readers: More information on oral health is available from the
knowledge path, Oral Health and Children and Adolescents, at http://www.mchlibrary.info/KnowledgePaths/kp_oralhealth.html.
The knowledge path was produced by the MCH Library and the National
Maternal and Child Oral Health Resource Center.
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6. AUTHORS EXAMINE ASSOCIATIONS BETWEEN BULLYING AND FAMILY, PEER, AND
SCHOOL RELATIONS FOR WHITE, BLACK, AND HISPANIC ADOLESCENTS
"Bullying perpetration was associated with more family, peer and school
factors than were victimization or bully-victimization," state the
authors of an article published in the September 2007 issue of the
Journal of Adolescent Health. Research has supported the influential
role of three factors in the development of bullying behaviors: family,
peers, and schools. Despite the substantial impact demonstrated by
bullying prevention programs in selected settings, results are
inconsistent. Although some studies have explored racial and ethnic
differences in bullying prevalence, no study to date has explored
whether correlates of bullying behavior vary by race and ethnicity. The
article presents findings from a study designed to address this gap.
The authors examine the relevance of perceived family, peer, and school
relations to bullying behaviors for white, black, and Hispanic
adolescents using nationally representative data.
The present study was a secondary analysis of the Health Behavior in
School-Aged Children data set. The final analytic sample included
11,033 students in grades 6-10. Measures were obtained from standard
self-completion questionnaires including questions about personal and
social resources, health-related behavior, health outcomes, and
demographic information. Models were stratified by race and ethnicity
to determine factors associated with bullying involvement for each
racial and ethnic group, after adjustment for demographic variables.
Relative risk ratios quantified associations between predictor
variables and the probability of being in each of the outcome
categories (victim, bully, bully-victim) relative to the referent
category (non-involved).
The authors found that
- A substantial proportion of white, black, and Hispanic students
(21%) reported involvement in bullying at school as a victim,
perpetrator, or both in 2001.
- Black students reported a lower prevalence of victimization than
white and Hispanic students.
- Family, peer, and school factors were related to bullying
perpetration more consistently across racial and ethnic groups than to
victimization or bully-victimization.
- Bully-victims did not differ from non-involved peers on most
factors examined.
- Family structure was related to bullying outcomes for white
students only.
- Difficult parental communication was associated with bullying
outcomes for all three racial and ethnic groups.
- A low level of parental school involvement was associated with
bullying outcomes for white and black students.
- Bullies' concurrent social integration and poor classmate
relations, as well as victims' social isolation, were similar across
race and ethnicity.
- School factors (perceived academic achievement, liking school,
and feeling safe at school) were largely unrelated to bullying
behaviors for black students, with the exception of bullies’ lower
school satisfaction.
"Current bullying prevention programs, with their emphasis on peer
contexts within the school, address risk factors for bullying that are
common across racial [and] ethnic groups. However, most programs
neglect other potentially important contexts (especially familial),"
state the authors. "Improving the effectiveness of bullying prevention
programs will require attention to these neglected domains and
tailoring of interventions to the population served," they conclude.
Spriggs AL, Iannotti RJ, Nansel TR, et al. 2007. Adolescent bullying
involvement and perceived family, peer and school relations:
Commonalities and differences across race/ethnicity. Journal of
Adolescent Health 41(3):283-293. Abstract available at http://www.jahonline.org/article/PIIS1054139X07001802/abstract.
Readers: More information is available from the MCH Library's
bibliography, Bullying, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_bullying.html&-MaxRecords=all&-DoScript=auto_search_bullying&-search.
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MCH Alert © 1998-2007 by National Center for Education in Maternal
and
Child Health and Georgetown University. MCH Alert is produced by
Maternal and Child Health Library at the National Center for Education
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MCH Alert
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