Does the type of CIA policy significantly affect bar and restaurant employment in Minnesota cities?

Clean indoor air (CIA) policies that include free-standing bars and restaurants have been adopted by communities to protect employees in all workplaces from exposure to environmental tobacco smoke, most notably employees working in restaurants and free-standing bars. However, due to the perception of negative economic effects on alcohol-licensed hospitality businesses, partial CIA policies (those that provide an exemption for free-standing bars) have been proposed as a means to reduce the risk of economic effects of comprehensive CIA policies applied to all worksites. Bar and restaurant employment per capita were used to determine if partial CIA policies produced differential economic effects compared to comprehensive CIA policies. Ten cities in the state of Minnesota were studied from 2003-2006. Economic data were drawn from monthly employment in bars and restaurants, and a pooled time-series was completed to evaluate three types of local CIA policies: Comprehensive, partial, or none beyond the state law. Communities with a comprehensive CIA policy had a decrease of 9 employees per 10,000 residents compared with communities with partial CIA policies (p = 0.10). Communities with any type of CIA policy (partial or comprehensive) had an increase of 3 employees per 10,000 residents compared to communities without any CIA policies (p = 0.36). There were no significant differential economic effects by CIA policy type in Minnesota cities. These findings support the adoption of comprehensive CIA policies to provide all employees protection from environmental tobacco smoke exposure.

The relationship between local clean indoor air policies and smoking behaviours in Minnesota youth.

BACKGROUND: While clean indoor air (CIA) policies are intended to reduce exposure to second-hand smoke in the workplace, restrictions in public workplaces have the potential to discourage youth smoking. There is growing evidence from cross-sectional and ecological studies, but limited evidence from longitudinal studies that this is so. OBJECTIVE: To evaluate the association between local CIA policies and smoking behaviours among Minnesota youth over time. DESIGN, SETTING AND SUBJECTS: A cohort of 4233 Minnesota youths, ages 11 to 16 at baseline, was interviewed via telephone for 6 years (2000-2006). Individual, family and community level variables were collected from participants every 6 months. A generalised estimating equation (GEE) logistic regression was used to assess the relationship between CIA policies and past-month smoking in youth over time. The analysis was controlled for potential confounders at individual and community levels. RESULTS: There was not significant association between CIA policies and youth smoking behaviours in the multivariate analyses. At the individual level, parental smoking significantly increased the odds of smoking nearly 40% and close friend smoking increased the odds of past-month smoking by nearly 100% for each close friend. Banning smoking in the home was significantly associated with a 12% reduction in the odds of past-month smoking. CONCLUSION: After accounting for other community and individual level factors known to be associated with youth smoking, there was no significant association between CIA policies and past-month smoking for youth over time.

5 a day fruit and vegetable intervention improves consumption in a low income population.

OBJECTIVE: This study evaluated the Michigan Farmers' Market Nutrition Program in one Michigan county to determine its effect on fruit and vegetable consumption behavior. SUBJECTS/SETTING: Subjects were selected from WIC and Community Action Agency populations: 564 low income women completed the pretest; 455 completed the posttest. Attrition rate was 19.3%. INTERVENTION: Subjects were assigned to one of 4 interventions: education about the use, storage and nutritional value of fruits and vegetables, distribution of farmers' market coupons, both education and coupons, or no intervention. DESIGN: Education-only and coupon and education groups were randomly assigned; clinic appointment timing determined assignment to no-intervention and coupon-only groups. MAIN OUTCOME MEASURES: A self-administered questionnaire before and after intervention measured attitudes about fruit and vegetable consumption and intake of fruits and vegetables. WIC records documented redemption of coupons. STATISTICAL ANALYSES: Data analysis included 2-way multivariate analysis of covariance, univariate analysis of covariance, logistic regression, and covariance structure modeling. RESULTS: Both the education interventions and the coupon interventions had positive effects. Coupons had a direct effect on increasing fruit and vegetable consumption behavior but no effect on attitudes. Education had a direct effect on attitudes and seemed to exert an effect on consumption behavior through attitudes. The maximum impact of the intervention was achieved through a combination of education and coupons. APPLICATIONS: This study demonstrated that a low-income population may be more likely to increase its fruit and vegetable consumption behavior when incentives such as coupons improve affordability.

The challenge of developing community profiles for use in community health assessment: lessons from Michigan's experience.

In Michigan, a number of steps have been undertaken to revitalize a key public health function--community health assessment. This article reports on the activities of these initiatives, focusing on the beginning stage of the community health assessment process--the development of community health profiles. The findings and lessons learned from Michigan's experience, although state specific, appear to have broad applicability to the entire local public health community. It is hoped their publication will stimulate replication of this process among this community in other states.

An analysis of the adequacy of preparation for end-stage renal disease care in Michigan. Michigan Renal Plan Task Force.

The Michigan Renal Plan Task Force has been charged with the development of a comprehensive plan to optimize the management of renal disease in Michigan. To assess the preparedness of new patients with end-stage renal disease (ESRD) patients in Michigan, surveys were sent to all outpatient ESRD facilities in the state concerning all new ESRD outpatients starting treatment during the first quarter of 1994. Responses were received from 69% of these facilities, covering 439 patients; 73% of patients were admitted to the hospital at the initiation of dialysis, and 69% required a temporary dialysis catheter. The median time to first outpatient dialysis was 10 days. Hospital admittance and use of temporary catheters were associated with a lower serum albumin at 1 month of follow-up. Temporary dialysis catheter usage was highest (85%) in rural areas, and lowest (59%) in suburban centers. Fifty-four percent of patients had a 1 month serum albumin of < or = 3.5 g/dl. At 1 month, nearly 60% of patients had a plasma hemoglobin of < or = 10.0 g/dl. These results suggest that better patient preparation for ESRD is needed to reduce the need for hospital admittance, to reduce the use of temporary catheters with their associated risks, and to improve the nutritional and psychosocial rehabilitation of these patients.

HIV-related knowledge and precautions among Michigan nurses.

OBJECTIVES: The present study examined human immunodeficiency virus (HIV)-related knowledge and precautionary behaviors in a large random sample of registered nurses in all regions of the state of Michigan, allowing for comparisons among nurses in a wide range of occupational experiences, exposures, and backgrounds related to HIV. METHODS: A random sample of all registered nurses living in Michigan completed surveys in the fall of 1989. RESULTS: Although nearly all respondents indicated a high level of knowledge of known viable routes of HIV transmission, many respondents also reported misconceptions about several unverified nonviable routes of HIV transmission. Of the respondents who were involved in situations with potential risk of exposure to HIV, many failed to consistently use the universal precautions recommended by the Centers for Disease Control and Prevention. The respondents also reported significant barriers in applying infection control procedures. CONCLUSIONS: The findings of the present study support the need for continued and intensified efforts to ensure that nurses have the knowledge necessary to provide quality care, are aware of the risk of potential exposures to HIV, and are engaging in appropriate precautionary behaviors.