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Papers by D. Prothrow-stith

Ethnicity & disease, 1997

A growing number of studies have documented the deleterious health consequences of the experience... more A growing number of studies have documented the deleterious health consequences of the experience of racial discrimination in African Americans. The present study examined the association of racial prejudice--measured at a collective level--to black and white mortality across the United States. Cross-sectional ecologic study, based on data from 39 states. Collective disrespect was measured by weighted responses to a question on a national survey, which asked: "On the average blacks have worse jobs, income, and housing than white people. Do you think the differences are: (A) Mainly due to discrimination? (yes/no); (b) Because most blacks have less in-born ability to learn? (yes/no); (c) Because most blacks don't have the chance for education that it takes to rise out of poverty? (yes/no); and (d) Because most blacks just don't have the motivation or will power to pull themselves up out of poverty? (yes/no)." For each state, we calculated the percentage of respondent...

Pediatric Emergency Care, 1989

To extend the study of the epidemiology of interpersonal violence into the area of nonfatal inten... more To extend the study of the epidemiology of interpersonal violence into the area of nonfatal intentional injury, a retrospective study was undertaken of patients admitted to a major city hospital for intentional injury during a single year (1984-1985). This study focused on interpersonal assaultive injury, excluding sexual assault, child abuse, and self-inflicted injuries. Relevant injuries made up three-quarters of all admitted intentional injuries and represented a total of 671 patients (4.5% of all hospital admissions). The intentionally injured were compared to the catchment area population and to the remaining admitted hospital population, by age, sex, and race. Medical records of intentionally injured adolescents (n = 133) were reviewed and compared to a sample of adolescent homicide victims regarding the circumstance of the event and the relationship of victim to assailant. Relevant findings are that: (1) in the area served by this hospital, male adolescents are at relatively high risk for nonfatal intentional injury; (2) among adolescents, the majority of these intentional injuries are the result of interpersonal conflicts between acquaintances, paralleling the etiology of homicide: (3) a prevalence of missing data in the medical records of older male adolescents is symptomatic of the lack of attention that has been paid to understanding and preventing intentional injury among adolescents. It is concluded that: (1) more area-specific and hospital-based studies of intentional injury are needed as a guide to such preventive efforts; and (2) medical personnel providing acute care to victims of intentional injury are an important resource for this research and prevention effort.

Patient Education and Counseling, 1995

Clinical settings provide excellent opportunities for educating adolescent patients about violenc... more Clinical settings provide excellent opportunities for educating adolescent patients about violence prevention. This paper reports on the experience of the Violence Prevention Project of Boston in implementing comprehensive violence prevention activities in different clinical settings. The project's evaluation revealed that staff training, specialized educational materials and staff commitment are required for both initial and sustained implementation of the education. Waiting room brochures and videos are inadequate to address the problem. Conversely, clinical settings can host a variety of educational experiences that generate significant response from patients, families and friends. Clinical settings can also be integrated into broader community-based efforts.

Journal of Health Politics, Policy and Law, 1993

... The single most important lesson of smallpox eradication was the demonstration that it is pos... more ... The single most important lesson of smallpox eradication was the demonstration that it is possible to ... An estimated 28 percent of violent crime victims suffered injuries; over 13 ... order to break down barriers that impede the advancement of violence prevention and control activities ...

Journal of Adolescent Health, 1995

To investigate the association of exposure to a community-based youth violence prevention project... more To investigate the association of exposure to a community-based youth violence prevention project with adolescents' knowledge and attitudes about violence. Two samples of 400 teens each from Boston neighborhoods were surveyed by random-digit dialed telephone techniques: one at the start of the project and one after 1 year of implementation. Regression analyses were used to investigate associations between exposure to different educational formats and outcome measures. Only self-reported exposure to the mass media campaign was significantly associated with higher scores in both knowledge and attitudes. An independent interaction between gender and exposure to the mass media campaign was found among males. Analyses using a historic control group support a program effect and not recall bias. Exposure to workshops or one-on-one discussions about violence prevention were not significantly associated with outcome scores. The measurable effect of the mass media may be somewhat related to the strength of that stimulus over the study period and suggests that 12 months is too short a time frame for evaluating community-based educational efforts.

Journal of Adolescent Health, 1994

Educational interventions directed to the prevention of youth inter-personal violence make assump... more Educational interventions directed to the prevention of youth inter-personal violence make assumptions about the educational needs of adolescents for violence-prevention despite little available data. This paper provides new information on background levels of adolescents' knowledge of, attitudes about and experience with violence. Over 400 teens across Boston's neighborhoods were surveyed by rando-digit dialed telephone techniques. Results show that while boys are more often involved in violence, almost one quarter of girls report fighting. Black teens witness more violence and are threatened more often than whites, but they do not fight more. Knowledge scores indicate a need for improvement in adolescents' understanding of risk factors. Attitude scores indicate that adolescents believe fighting can and should be avoided, but they lack knowledge of behavioral options. Regression analyses show a positive relationship between violence experience and knowledge and attitudes. These data suggest that preventive interventions should be directed to both improving adolescents' knowledge and understanding of personal risk and increasing their repertoire of conflict-resolution skills.

Understanding and …, 1994

... Such a task is particularly challenging in the context of domestic assaults, child abuse ... ... more ... Such a task is particularly challenging in the context of domestic assaults, child abuse ... links one traffic accident to the likelihood of another occurring, one suicide to another, or ... In approaches to injury prevention, for example, safety engineers and public health analysts gradually ...

BMJ, 1998

To determine the effect of inequalities in income within a state on self rated health status whil... more To determine the effect of inequalities in income within a state on self rated health status while controlling for individual characteristics such as socioeconomic status. Cross sectional multilevel study. Data were collected on income distribution in each of the 50 states in the United States. The Gini coefficient was used to measure statewide inequalities in income. Random probability samples of individuals in each state were collected by the 1993 and 1994 behavioural risk factor surveillance system, a random digit telephone survey. The survey collects information on an individual's income, education, self rated health and other health risk factors. All 50 states. Civilian, non-institutionalised (that is, non-incarcerated and non-hospitalised) US residents aged 18 years or older. Self rated health status. When personal characteristics and household income were controlled for, individuals living in states with the greatest inequalities in income were 30% more likely to report their health as fair or poor than individuals living in states with the smallest inequalities in income. Inequality in the distribution of income was associated with an adverse impact on health independent of the effect of household income.

American Journal of Public Health, 1997

Journal of Adolescent Health, 1992

This paper describes the implementation of a community-based youth violence prevention project th... more This paper describes the implementation of a community-based youth violence prevention project that utilized an educational curriculum and a mass media campaign. The extent of penetration of the intervention into target areas and the degree of contamination of control areas are assessed, and the most frequently contacted forms of educational outreach are identified. Two sources of data, provider interviews and a random digit dialed telephone survey, were used to track the source and extent of teens' exposure to the intervention. Agency provider data revealed that 40% of the 92 contacted agencies actually conducted violence prevention education, reaching 22% of the target area teens. Approximately one-half of the surveyed teens reported some exposure to the program, with 13% of the teens in target areas reporting participation in interactive educational activities associated with the project. The most common source of exposure was the media campaign. Most teens report a single exposure, usually to the media campaign, although 29% report contact with more than one form of violence prevention education. While the project did not achieve community saturation, the data show that the community-based model of intervention for violence prevention is feasible and effective in reaching teenagers. This research highlights some difficulties in evaluating prevention programs, including reconciling community ownership with project identification, the ethics of curtailing services for control purposes, and factors influencing recall of participation.