Can David and Goliath get along? Federal land in local places.

It is often unclear what the role of a local jurisdiction is with regard to land use management on nearby federal properties. Yet federal lands clearly impact nearby local communities. The US Department of Energy (DOE), with over 100 sites across the United States with varying degrees of environmental contamination, may be in a very difficult position with regard to relationships with local government about land use. Yet few, if any, studies have examined DOE land use issues. This study asks: (1) In general, how do local planners feel about federal government relationships with them? (2) Do local planners feel differently about the DOE than they do about other federal agencies? (3) What reasons explain any differences observed in answer to the second question? To answer these questions, local planners were interviewed from communities adjacent to non-DOE federal properties, and their responses compared to those of planners located near DOE facilities in the same regions. Findings showed that compared to other federal agencies that own land in the same regions, the DOE is relatively poorer at actively involving local officials in land use decisions at its sites. Primary reasons are the historic legacy of a culture of secrecy, focus on mission, and especially the lack of experience, training, or mandates in local planning cooperation. Findings also suggest that this attitude is markedly stronger in areas west of the Rocky Mountains. Recommendations for improved federal-local communications include the development of a vision for local government involvement that is supported by top levels of management and filtered effectively to the site level.

Geographical dimensions and correlates of trust.

A sample of 323 residents of New Jersey stratified by neighborhood quality (excellent, good, fair, poor) was gathered to determine if trust in science and technology to protect public health and environment at the societal scale was associated with trust of the local officials, such as the mayor, health officer, developers, mass media, and legislators who are guardians of the local environment. Societal (trust of science and technology) and neighborhood (mayor, health officer) dimensions of trust were found. These societal and neighborhood trust dimensions were weakly correlated. Respondents were divided into four trust-of-authority groups: high societal-high neighborhood, low societal-low neighborhood, high societal-low neighborhood, and low societal-high neighborhood. High societal-high neighborhood trust respondents were older, had lived in the neighborhoods for many years, were not troubled much by neighborhood or societal environmental threats, and had a strong sense of control over their environment. In strong contrast, low societal-low neighborhood trust respondents were relatively young, typically had lived in their present neighborhood for a short time, were troubled by numerous neighborhood and societal environmental threats, did not practice many personal public health practices, and felt little control over their environment.

Region of birth and black diets: the Harlem Household Survey.

OBJECTIVES: This study compared dietary risk factors among Southern-born and other Blacks in Central Harlem. METHODS: A survey of residents of Central Harlem was used to compute a "healthy diet" score for 621 subjects. RESULTS: Southern-born respondents had the highest-risk diets. Although their numbers were small, Caribbean-born respondents, particularly those younger than 45 years, had the lowest-risk diets. CONCLUSIONS: The variation in diets in Central Harlem was considerable, with Southern-born Blacks at highest dietary risk for chronic diseases. These results remain to be tested elsewhere, as does the contribution of other chronic disease risk factors.

Region of birth and mortality from circulatory diseases among black Americans.

OBJECTIVES: This study examines the relationship between birth-place and mortality from circulatory diseases among American Blacks. METHODS: All Black deaths from circulatory diseases (International Classification of Diseases, 9th Revision. codes 390 through 459) were extracted from the National Center for Health Statistics mortality detail files for 1979 through 1991. Age-specific and age-adjusted mortality rates with 95% confidence intervals were calculated for males and females for combinations of five regions of residence at birth and four regions of residence at death. RESULTS: Males had higher mortality rates from circulatory diseases than females in every regional combination of birthplace and residence at death. For both genders, the highest rates were for those who were born in the South but died in the Midwest; the lowest rates were for those who were born in the West but died in the South. Excess mortality for both Southern-born males and females begins at ages 25 through 44. CONCLUSIONS: There is a region-of-birth component that affects mortality risk from circulatory diseases regardless of gender or residence at time of death. We must examine how early life experiences affect the development of circulatory disorders.

Gender differences in risk perception: effects differ in stressed vs. non-stressed environments.

Contrary to previous reports that women are more concerned about environmental risks than men, we hypothesized that men and women residing in neighborhoods stressed by multiple hazards would demonstrate similar concerns about local environmental conditions. Analysis of a national data base and an aggregate of ten local data bases found greater female than male concern about local technological, behavioral, and land use hazards in good neighborhoods, but, as expected, not in stressed ones. We urge analysts to conduct more studies in stressed neighborhoods in order to better understand the perspective of those who live with environmental risks.

Universities as resources to state health agencies.

In a survey of the 50 State health agencies in the spring of 1992, officials were asked about their manpower and research needs in the specific areas of administration, behavioral and social science, education and information, environmental health, environmental protection, epidemiology, laboratory, law, occupational health, policy and planning, and statistics. In all, 40 agencies (80 percent) responded. Indepth telephone interviews to determine whether universities and schools and graduate programs in public health filled these needs completed the data collection process. Agency officials indicated that their resources were least adequate in environmental protection, behavioral and social science, and occupational health. They did not feel their research needs were being met. There was a general feeling that universities and schools and programs in public health have different agendas than State agencies and that practical solutions to the shortage of research resources are not forthcoming from these sources. Suggestions are made as to what can be done to improve relationships between those who train public health personnel and those who employ them.

Evaluating HIV/AIDS education in the university setting.

Surveys to determine learning and behavioral changes that result from education about human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) should be constructed to account for high levels of background knowledge and knowledge of safer sex practices among college students. This article evaluates the learning and behavioral changes of students enrolled in an HIV/AIDS education course offered by the Department of Biological Sciences at Rutgers University as part of a university-wide HIV/AIDS education program. Responses of students in the HIV/AIDS class were compared with those of students enrolled in other biology classes, using paired and unpaired t tests and multivariate discriminant analysis. Participants revealed they had significant knowledge about HIV/AIDS as a result of the HIV/AIDS class, but students campus-wide had a far higher level of general knowledge about HIV/AIDS than the authors expected. In addition, many students already were practicing behaviors that would reduce their risk of HIV infection. Because students were so knowledgeable about HIV and claimed they practiced safer sex, it was difficult to demonstrate significant changes in behavior as a result of the classroom experience.

Cancer clusters: the importance of monitoring multiple geographic scales.

Analysis of cancer incidence data at a variety of geographic scales provides surveillance information that can allay fears of the general public, prevent costly and unwarranted epidemiologic studies driven by political pressures, and target appropriate cases for further investigation. We systematically examined New Jersey Cancer Registry data (1979-1985) for childhood and young adult (0-24 years) cancers at multiple geographic scales--at the state level, then by degree of urbanization, county boundaries, and minor civil divisions. The state had increased rates for some cancers when compared to four other SEER (Surveillance, Epidemiology and End Results) states. No meaningful patterns at either the most urban/suburban/most rural scales or at the county level of analysis were found. At the minor civil division level, the Ederer, Myers and Mantel method found evidence of clustering of pediatric and young adult cases statewide. Stratification of cases by race yielded even stronger findings and indicated that whites had clustering of cases for several cancer types. In-depth analysis of individual cases yielded hypotheses for investigating identified clusters.

Black leaders' perceptions of the year 2000 public health goals for black Americans.

We surveyed 1196 Black health and political leaders on their perceptions about the US Department of Health and Human Services' Healthy People 2000 public health goals. Respondents identified reducing the incidence of acquired immunodeficiency syndrome, improving maternal and infant health, and controlling sexually transmitted diseases as the three most important public health goals for Black Americans that are amenable to intervention. The leaders assigned nearly all responsibility for prevention efforts to the federal government and the individual. With the American health care system now in flux, Black leaders need to organize to see that these priority issues are addressed.

Childhood and young adult cancer in New Jersey.

Cancer incidence rates for 0 to 24 years of age were examined for New Jersey for 1979-1985. New Jersey rates generally were higher than the comparison states. They were most like those of Connecticut, the state most similar in demographics, geography, and degree of urbanization.

Ethical dilemmas and solutions for risk assessment scientists.

A sample survey of U.S. scientists who belong to the Society for Risk Analysis (SRA) was made to ascertain their observations of unethical behavior in the workplace and their opinions of the likely success of programs to prevent misconduct. SRA, an international organization with almost 1,700 U.S. members, includes toxicologists, epidemiologists, industrial hygienists, engineers, and social scientists, as well as experts in exposure assessment, statistics, and risk communications. Respondents reported relatively low rates of clearly unethical acts such as data destruction and fabrication (7%); however, 21% reported at least one observation of plagiarism. Reporting of other problematic behaviors ranged from less than 4% for human subjects violations to 51% observing deliberate overstatement of positive and deliberate understatement of negative results. SRA members did not think that government intervention would be effective in reducing misconduct. They were more supportive of formal education, seminars, videotapes, and a hotline that could be called for advice. We offer suggestions to ISEA and its members for developing a proactive approach to ethical misconduct.

Violence as a public health priority for black Americans.

This study investigated the extent to which black public health and political leaders believe that reducing violence should be a national public health priority for black Americans when compared with other public health problems such as acquired immunodeficiency syndrome, low birthweight, and access to health care. A survey asking whether violence in the black community is amendable to change and who (or what institutions) should be responsible for the reduction of violence was sent to 427 black health leaders, 326 black mayors, and 467 black legislators. Three hundred twenty responses were returned. Virtually all respondents placed violence as one of the top five, if not the highest, public health priority for black Americans. Health and political leaders differed in their beliefs about whether violence and violence-related behaviors can be ameliorated, and who should bear responsibility for the reduction of violence. While this survey had limitations, more than 300 black public health and political leaders indicated that violence among black Americans should be made a national public health priority. Policy implications are discussed, and a proactive role for the National Medical Association is advocated.

Choice of exercise: a predictor of behavioral risks?

After controlling for differences in gender, educational achievement, and exercise duration among a sample of 7,248 Americans 18-34 years old, we found that runners-joggers-fast walkers (RJWs) and tennis players were less likely to be obese, smoke, consume large quantities of alcohol, and drive without seat belts than those who participate in team and an aggregate of other sports. These behavioral differences might be explained by imprecise data, intervening variables such as exercise intensity, or other variables that were not measured. But a more interesting explanation is that running-jogging-fast walking and playing tennis are integral components of healthy lifestyles, and team sports and some other exercise behaviors are part of riskier ways of living. No consistent association was found between duration of exercise and behavioral risk.

The study of cancer in minorities.

Data inventories provide a concise reference base for researchers. The authors created a set of reference volumes listing databases used for studying cancer in New Jersey minorities. The process followed can be adapted for other disease outcomes or other regions.

Pediatric cancer mortality rates in New Jersey and the United States.

The authors studied pediatric mortality rates for four major categories of neoplasms for the years 1950 to 1985. This report indicates differences in trends between the rates of the New Jersey population and of the United States population, for males and females, and whites and nonwhites.

Activism for medical geographers: American, British and Canadian viewpoints.

This paper describes some of our personal efforts to launch research projects that address public health issues of interest to geographers in the United States, Canada and Britain. In pressing these agendas we have found through our experiences that there are personal and disciplinary costs associated with activism. We describe the loss of identity with geography; the frustration of trying to persuade bench scientists, corporate representatives, and government officials of the importance of our work; the loss of research time and contact with both our academic colleagues and students.