Infant mortality receiving increasing attention

Article Abstract:

Understanding the epidemiology of infant mortality is a complex process and involves an appreciation of the social and medical conditions surrounding the infant's birth. Although linking death certificate data with birth certificate records is critical, no linkage study was performed between 1960 and 1980. The missing data to connect cause of death with important variables, such as birth weight, and type of delivery, began to accumulate in 1983 through a collaborative effort by the states, the CDC (Centers for Disease Control), and other US Public Health Service agencies. That project, the National Infant Mortality Surveillance, revealed a decline in infant mortality for single- delivery infants of 53 percent from 1960 to 1980 (the years studied). The US currently ranks 19th among developed nations in infant mortality. According to the report, the strongest predictor of mortality was low birth weight (less than 2,500 grams). The percentage of very-low-birth-weight babies born to whites declined during those 20 years, but it increased for blacks. In fact, an enormous gap exists between white and black infant mortality. Black infants are two times as likely to die during their first year of life, with the greatest differences for infants heavier than 2,500 grams. Infant mortality varies among states, which now conduct their own linkage studies. A different type of birth certificate is used now in many areas, in which medical complications of infant and mother are described, and women receive a questionnaire (the PRAMS, Pregnancy Risk Assessment Monitoring System) from CDC four months after delivery. Unintended pregnancies appear to result in lower-birth-weight infants, so the percentage of pregnancies in this category is also of interest. References to recent research studies on this topic are provided. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mortality, Patient outcomes, Demographic aspects, Birth weight, Low, Low birth weight, Infants (Newborn), Newborn infants, Infant mortality, Infant health services

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CDC's hot line: 'America responds to AIDS'

Article Abstract:

One aspect of the Centers for Disease Control's (CDC's) anti-AIDS (acquired immunodeficiency syndrome) program is the National AIDS Hotline, a set of toll-free telephone numbers that can be called for answers to questions about AIDS in English (1-800-342-AIDS, 24 hours a day, seven days per week), Spanish (1-800-344-SIDA, 8 AM to 2 AM, seven days per week), and for the deaf with (1-800-AIDS-TTY, 243-7889, 10 AM to 10 PM weekdays). Deaf persons use a teletypewriter to call the Hotline; they type their questions and receive teletyped responses. When 'America Responds to AIDS' messages are broadcast on television, calls to the Hotline increase; more than 200,000 calls were received in June 1988 after the 'Understanding AIDS' pamphlet was mailed. Hotline numbers were included by rock stars Madonna and Kiss on recent albums. Questions to the Hotline are answered anonymously and confidentially by information specialists who have access to a special database developed by CDC. Information regarding hospitals, legal services, testing sites, counselling and support groups, and other relevant issues is provided. The National AIDS Information Clearinghouse, to which callers may be referred, distributes free educational materials. The Hotline was initially established at the Office of the Assistant Secretary of Health in Washington, D.C., in 1983, and moved to the CDC in 1985. The Hotline serves two purposes that would be impossible for any media campaign to duplicate: it allows people to be involved in a response to AIDS, and it provides a private atmosphere for asking questions in as extensive detail as is wished. This aspect of interpersonal communication will always be missing from the television screen. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Usage, Innovations, Information services, Hotlines (Counseling), AIDS (Disease), Communication in medicine, Medical communication

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Coping with violence epidemic

Article Abstract:

Violence-related injury and death have become critical problems, but epidemiologists believe they could be prevented through a public health perspective. Homicide is currently the 11th leading cause of death in the US, and, among 15- to 24-year-olds, it is the third leading cause. One branch of the CDC (Centers for Disease Control), the intentional injuries section, addresses such problems. Its criminologist, Linda Saltzman, believes that the approaches of both the criminal justice and the public health systems must be brought to bear on the issue of violence. Spouse abuse is associated with certain risk factors, and the public health model asks which women are likely to suffer abuse. The only factor consistently associated with being a victim of abuse in adult life is having witnessed it at home as a child or teenager. Questions also arise regarding the identity of the batterer. Six risk factors exist here: sexual aggression toward wives or partners, violence toward their children, alcohol use, poor income and occupational status, low educational level, and witnessing violence as a child or teenager. One out of six homicides occur within the family. Although the epidemiology of this is complex, traditional epidemiological approaches can still be used to identify who is at risk, create programs to reduce the risk, the evaluate the outcomes. Saltzman's work now concentrates on the identifying a pattern of agency contact prior to battering that might identify those at risk. Identification of such a pattern will be a first step in intervening to alter abuse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Child abuse, Family violence, Domestic violence, Conjugal violence

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