Abstract:
OBJECTIVES:We analyzed how ease of geographic access to emergency departments (EDs), defined as driving time to the closest ED, changed between 2001 and 2005, and whether access deterioration was more likely to occur in vulnerable communities. METHODS:We classified communities on the basis of American Hospital Association and Census data into 3 categories according to driving time to the nearest ED: no increase, less than a 10-minute increase, and a 10-minute or more increase. We estimated a multinomial logit model to examine the relative risk ratio (RRR) of various community characteristics. RESULTS:More than 95% of communities experienced no ED access deterioration. However, 11.4 million people experienced increased driving time to their nearest ED. Low-income communities had a higher risk of facing deteriorating access compared with high-income communities (urban: RRR = 3.67; P < .01; rural: RRR = 1.75; P < .10), and communities with higher shares of Hispanics also had higher risks of facing declines (urban: RRR = 3.41; P < .10; rural: RRR = 2.67; P < .01). CONCLUSIONS:Deteriorating access to EDs is more likely to occur in communities with economic hardship and high shares of Hispanic populations. The uneven access to critical services warrants increased attention from policymaking bodies.
journal_name
Am J Public Healthjournal_title
American journal of public healthauthors
Shen YC,Hsia RYdoi
10.2105/AJPH.2009.175828subject
Has Abstractpub_date
2010-08-01 00:00:00pages
1462-9issue
8eissn
0090-0036issn
1541-0048pii
AJPH.2009.175828journal_volume
100pub_type
杂志文章abstract:OBJECTIVES:We assessed the structure and functions of state health departments throughout the United States and compared our findings with those from a previous national assessment conducted in 1990. METHODS:In 2001, we sent a survey to the state health officers of all 50 states. The survey asked about the structure a...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2004.053439
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:This study investigated the associations of smoking, excess alcohol consumption, and physical inactivity with the use of hospital care. METHODS:A cohort of 19- to 63-year-old Finnish men (n = 2534) and women (n = 2668) were followed prospectively for 16 years. Number of hospital days was extracted from the ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.89.5.691
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVES:This study evaluated the long-term effectiveness of Draw the Line/Respect the Line, a theoretically based curriculum designed to reduce sexual risk behaviors among middle school adolescents. METHODS:The randomized controlled trial involved 19 schools in northern California. A cohort of 2829 sixth graders wa...
journal_title:American journal of public health
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2105/ajph.94.5.843
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVES:Because opinion leaders hold positions from which they may influence tobacco control efforts, this study examined their support for tobacco control policies and their involvement in tobacco control activities. METHODS:A telephone survey was administered to 712 California opinion leaders who were randomly se...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.90.8.1283
更新日期:2000-08-01 00:00:00
abstract::Public health is usually enacted through public policies, necessitating that the public engage in debates that, ideally, are grounded in solid scientific findings. Mistrust in science, however, has compromised the possibility of deriving sound policy from such debates, partially owing to justified concerns regarding u...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2014.302241
更新日期:2015-02-01 00:00:00
abstract::The advent of RU 486 (mifepristone), a steroid analogue capable of inducing menses within 8 to 10 weeks of a missed menstrual period, has provoked a firestorm of concern and controversy. When used in conjunction with prostaglandin (RU 486/PG), it is at least 95% effective. Used in France principally to terminate confi...
journal_title:American journal of public health
pub_type: 杂志文章,评审
doi:10.2105/ajph.82.10.1399
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVES:We examined the effect of New York's HIV Reporting and Partner Notification law on HIV testing levels and on the HIV testing decisions of high-risk individuals. METHODS:In-person interviews were administered to 761 high-risk individuals to assess their knowledge, attitudes, and behaviors regarding HIV testi...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2007.092742
更新日期:2008-04-01 00:00:00
abstract::While Job Corps Centers vary in size, location, and administrative structure, they are subject to uniform requirements for health services, established by federal regulation and must make individual decisions about whether to furnish dental care on-site or by some alternative arrangement in the community. Analysis of ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.70.12.1294
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVES:We assessed the impact of a tobacco control initiative over 10 years on cessation and prevention. METHODS:We examined 2000-2009 Behavioral Risk Factor Surveillance System cases of a metropolitan statistical area (MSA) with systematic tobacco control efforts throughout the decade (El Paso, TX) and 2 comparis...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2011.300346
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVES:We explored insurers' perceptions regarding barriers to reimbursement for oral rapid HIV testing and other preventive screenings during dental care. METHODS:We conducted semistructured interviews between April and October 2010 with a targeted sample of 13 dental insurance company executives and consultants,...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2013.301825
更新日期:2014-05-01 00:00:00
abstract::This study investigated the 18-month incidence of tooth loss in a random sample of 451 dentate noninstitutionalized Iowans aged 65 and older residing in two rural counties. They had a mean of 19.0 teeth at baseline and lost an average of 0.4 teeth during the subsequent 18 months. Twenty-one per cent of the population ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.78.10.1330
更新日期:1988-10-01 00:00:00
abstract::Given the public health importance of law modernization, we undertook a comparative analysis of policy efforts in 4 states (Alaska, South Carolina, Wisconsin, and Nebraska) that have considered public health law reform based on the Turning Point Model State Public Health Act. Through national legislative tracking and ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2008.140913
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:We sought to determine how part-year and full-year gaps in health insurance coverage affected working-aged persons with chronic health care needs. METHODS:We conducted multivariate analyses of the 2002-2004 Medical Expenditure Panel Survey to compare access, utilization, and out-of-pocket spending burden am...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2010.191569
更新日期:2011-02-01 00:00:00
abstract::This paper models the prevailing political attack on government as a heuristic, a judgmental strategy that simplifies complex phenomena by applying simple tests to a limited set of relevant data. The heuristic of market individualism offers three tools for analyzing the problems of governing: the supremacy of the free...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.87.10.1607
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVES:This study determined infection risk for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) from needle reuse at a phlebotomy center that possibly exposed 3810 patients to infection. METHODS:We used a model for the risk of infection per blood draw, supplemented by subsequent testing results from 1699...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.91.4.636
更新日期:2001-04-01 00:00:00
abstract::Approximately 90,000 inmates are admitted annually to the New York City jail system, many of whom require a high level of medical or mental health services. According to our analysis of deaths in custody from 2001 to 2009, crude death rates have dropped significantly despite the increasing age of the population. Falli...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2012.301042
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:The National AIDS Behavioral Survey (1990-1992) of heterosexual adults (18-49 years) measured human immunodeficiency virus (HIV) risk factors, condom use, and HIV antibody testing, with a focus on major "high-risk" cities. METHODS:A longitudinal survey was conducted. RESULTS:There was little reduction in t...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.85.11.1492
更新日期:1995-11-01 00:00:00
abstract::Rabies antibody titers ranged from 0-9.3 IU/mL in 117 human volunteers one year after intradermal vaccination with one or two doses of human diploid cell rabies vaccine (HDCV). At that time, each volunteer received one 0.1-mL booster dose of HDCV intradermally. All 117 volunteers showed good anamnestic responses, with...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.74.5.503
更新日期:1984-05-01 00:00:00
abstract:OBJECTIVES:We examined whether characteristics of local health departments (LHD) and their geographic region were associated with using Facebook and Twitter. We also examined the number of tweets per month for Twitter accounts as an indicator of social media use by LHDs. METHODS:In 2012, we searched for Facebook and T...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2012.301166
更新日期:2013-09-01 00:00:00
abstract::For more than 40 years, the tobacco industry prevailed in lawsuits brought by injured smokers, despite overwhelming epidemiological evidence that smoking caused lung cancer. Tobacco lawyers were able to create doubt about causation. They sought to persuade jurors that "everybody knew" smoking was harmful but "nobody k...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2005.063917
更新日期:2006-01-01 00:00:00
abstract::This study examines the professional relationships between midwives and physicians providing obstetrical care in Washington State. Four hundred ninety-six randomly sampled family physicians and obstetrician-gynecologists and 211 certified nurse, licensed, and lay midwives were surveyed to learn more about midwife/phys...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.82.2.262
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVES:This study investigated the relationship between psychosocial and behavioral factors and the frequency of emergency department visits for childhood asthma. METHODS:Data obtained from a survey of parents of 445 children who were being treated for asthma in the emergency room of a large urban hospital were ex...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.86.10.1410
更新日期:1996-10-01 00:00:00
abstract::The results of 2 large field studies on the impact of the polio eradication initiative on health systems and 3 supplementary reports were presented at a December 1999 meeting convened by the World Health Organization. All of these studies concluded that positive synergies exist between polio eradication and health sys...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.92.1.19
更新日期:2002-01-01 00:00:00
abstract::African Americans and Hispanics are disproportionately affected by the HIV/AIDS epidemic. Within the most heavily affected cities, a few neighborhoods account for a large share of new HIV infections. Addressing racial and economic disparities in HIV infection requires an implementation program and research agenda that...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2013.301864
更新日期:2014-05-01 00:00:00
abstract::A survey on brand preference and cigarette advertising recall in 1,195 school children was conducted in Sydney, Australia. Four of the 130 available brands accounted for the cigarettes smoked by 78.7 per cent of smokers. Smokers were nearly twice as likely to correctly identify edited cigarette advertisements and slog...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.72.5.491
更新日期:1982-05-01 00:00:00
abstract:OBJECTIVES:We conducted an exploratory study to determine what organizational characteristics predict the provision of culturally competent services for American Indian and Alaska Native (AI/AN) veterans in Department of Veterans Affairs (VA) health facilities. METHODS:In 2011 to 2012, we adapted the Organizational Re...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2014.302140
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:We studied whether 5 regulatory agency advisories concerning the possible increased risk of suicidal behavior during antidepressant therapy had an effect on antidepressant prescription trends in Ontario. METHODS:We conducted a population-based, time-series analysis of new monthly antidepressant prescription...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2006.087262
更新日期:2007-04-01 00:00:00
abstract::In a matched case-control study of an occupational cohort in East Tennessee, data from the death certificates of 608 cases and controls were abstracted and analyzed in order to investigate possible risk factors associated with the certification on the death certificate of an ill-defined cause of death. There was a ver...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.82.3.455
更新日期:1992-03-01 00:00:00
abstract::Death certificate of children less than 8 years of age who were killed between 1979 and 1986 were linked to their Ohio birth certificates and compared with those of Ohio children born in 1983 (controls). Having an unmarried mother increased risk of homicide almost fivefold (odds ratio 4.87). Having a teenage mother, a...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.81.8.1052
更新日期:1991-08-01 00:00:00
abstract::During the 1980-81 academic year, 249 academic institutions were surveyed concerning professional preparation in patient education. Various degrees of involvement were reported by 39 institutions. Findings indicate that such programs are relatively new, and enrollment in degree programs and courses is limited. Placeme...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.72.2.180
更新日期:1982-02-01 00:00:00