Browsing jGPHA Volume 5, Number 1 (2015) by Subjects
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Association between air temperature and heart disease death rates in Georgia countiesBackground: In this ecological study, global warming theory was tested on a local level, in Georgia. The hypothesis was that warmer counties would be associated with higher death rates. Methods: Heart disease death rates (HDDR) for 2008-2010 by Georgia county were compared to air temperature, also by county for the same years. Three race categories for HDDR were studied: black, white, and all races. Since there is evidence that living at higher land elevations provides a protective effect against heart disease, land elevation by county was included as a second predictor. Results: Correlation analyses revealed low strength, statistically significant correlations with white and all races HDDR as follows: direct for air temperature and indirect for land elevation. Correlations for blacks were negligible strength and statistically non-significant. Thus, multiple linear regressions (MLRs) were considered appropriate for whites and all race HDDR. In MLRs, temperature and elevation essentially cancelled each other relative to HDDR, resulting in statistically non-significant regression coefficients for each in both race categories (p > 0.15). This may have in part been due to the slight collinearity that was observed between the two predictors (variance inflation factor = 10.6 for both predictors in both race categories). The study is limited by: a) its (ecological) design, where individual exposures are unknown; and b) the-less-than ideal regression model that revealed slight collinearity between the predictors. Further research is required to verify these findings. Conclusions:
Substance use-related brief interventions with emergency department patients reduce mental health co-morbiditiesBackground: Research on screening and brief interventions (SBIs) has shown that, in addition to reducing alcohol use, interventions delivered in healthcare settings can reduce trauma readmissions, hospitalization days, driving offenses, and future healthcare utilization and costs. Mental health co-morbidities often accompany unhealthy alcohol and drug use, but few studies have examined the impact of SBIs on the mental health of patients. The present study determined if SBIs focused on reducing alcohol or drug use affected the mental health status of patients at a six-month follow-up. Methods: Participants (N=1152) were randomly sampled from patients receiving SBIs for at-risk alcohol or drug use after presenting to one of two urban emergency departments (EDs) in Georgia. Telephone follow-up interviews were completed with 698 of the original participants at six months after the intervention. Mental health co-morbidities were measured at both time points using the Global Assessment of Individual Needs Short Screener (GAIN-SS) and the SF-12. Analyses were conducted using paired samples t-tests. Results: Analyses found significant reductions in the percentage of patients reporting feelings of anxiety (45% to 33%, p<0.001), depression (52% to 37%, p<0.001), and suicidal ideation (13% to 8%, p<0.001) as well as improvements in global mental health measures (SF12 mental health score and internalizing and externalizing subscales of the GAIN-SS). Conclusions: Six months after receiving SBIs for alcohol and drug use in EDs, several measures of the mental health of participants showed significant improvements. Widespread implementation of SBIs in Georgia's EDs may affect a broad array of public health concerns, including mental health.
Variations in public health governanceBackground: Studies of public health departments have found mixed results regarding the relevance of governance through local boards of health (LBOHs). Some studies find that LBOHs can be an important component in higher performance by local health departments. Other analyses, however, find no advantage for local health departments having or not having a LBOH. The hypothesis was that a typology of LBOHs nationwide can define different types of LBOHs based on their powers and responsibilities. Methods: Using national profile sample data from the National Association of Local Boards of Health, LBOHs were categorized using 34 variables based on four domains of responsibilities and duties: enforcement powers, regulatory powers, human resource powers, and budgetary powers. Correlations between types of LBOHs defined by this typology were then computed, and whether they shared significant characteristics in terms of the race, ethnicity, sex, and educational demographics of their board members was determined. ArcGIS was used to analyze the data spatially for regional and national patterns. Results: LBOHs vary considerably across the country - from LBOHs with no budgetary, enforcement, regulatory, or human resources authorities to those that have all four. Conclusions: Different types of LBOHs may have different influences on their associated local boards of health. This study provides a typology for future research to allow analysts to distinguish different types of LBOHs nationally.