Empirical evidence from European countries has shown that economic conditions in early life are associated with mortality risk. This study aims to assess the effects of economic conditions in early life, as well as their interaction with parental education, on the risk of adult mortality in the U.S. To capture exogenous variation of economic conditions early in life, we use the Gross Domestic Product (GDP) cyclical deviation during a respondent’s birth year. Using the linked U.S. General Social Survey and National Death Index data (1979–2008), we employed parametric frailty survival models to examine the effects of economic conditions in early life on all-cause and cause-specific mortality. We found that exposure to recession in the first year of life was associated with increased all-cause mortality only among women (hazard ratio = 1.54, 95

AbstractObjectiveThe Farmers’ Market Fresh Fund Incentive Program is a policy, systems and environmental intervention to improve access to fresh produce for participants on governmental assistance in the USA. The current study examined factors associated with ongoing participation in this matched monetary incentive programme.DesignRelationship of baseline factors with number of Fresh Fund visits was assessed using Poisson regression. Mixed-effects modelling was used to explore changes in consumption of fruits and vegetables and diet quality.SettingSan Diego, California.SubjectsRecipients of Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Security Income (SSI) who attended participating farmers’ markets from 2010 to 2012 (n 7298).ResultsAmong those with participation for ≤6 months, factors associated with increased visits included reporting more daily servings of fruits and vegetables (F&V) at baseline, being Vietnamese or Asian/Pacific Islander, and eligibility because of SNAP/CalFresh or SSI (v. WIC). Among those who came for 6–12 months, being Asian/Pacific Islander, eligibility because of SNAP/CalFresh and enrolling in the autumn, winter or spring were associated with a greater number of Fresh Fund visits. Among those who came for >12 months, being male and eligibility because of SSI were associated with a greater number of visits. Overall, the odds of increasing number of servings of F&V consumed increased by 2 % per month, and the odds of improved perception of diet quality increased by 10 % per month.ConclusionsSustaining and increasing Fresh Fund-type programme operations should be a top priority for future policy decisions concerning farmers’ market use in low-income neighbourhoods.

INTRODUCTION AND AIMS:Patterns of polydrug use among people who inject drugs (PWID) may be differentially associated with overdose and unique human immunodeficiency virus (HIV) risk factors. Subgroups of PWID in Tijuana, Mexico, were identified based on substances used, route of administration, frequency of use and co-injection indicators.DESIGN AND METHODS:Participants were PWID residing in Tijuana age ≥18 years sampled from 2011 to 2012 who reported injecting an illicit substance in the past month (n = 735). Latent class analysis identified discrete classes of polydrug use characterised by 11 indicators of past 6 months substance use. Multinomial logistic regression examined class membership association with HIV risk behaviours, overdose and other covariates using an automated three-step procedure in mplus to account for classification error.RESULTS:Participants were classified into five subgroups. Two polydrug and polyroute classes were defined by use of multiple substances through several routes of administration and were primarily distinguished from each other by cocaine use (class 1: 5%) or no cocaine use (class 2: 29%). The other classes consisted primarily of injectors: cocaine, methamphetamine and heroin injection (class 3: 4%); methamphetamine and heroin injection (class 4: 10%); and heroin injection (class 5: 52%). Compared with the heroin-only injection class, memberships in the two polydrug and polyroute use classes were independently associated with both HIV injection and sexual risk behaviours.DISCUSSION AND CONCLUSIONS:Substance use patterns among PWID in Tijuana are highly heterogeneous, and polydrug and polyroute users are a high-risk subgroup who may require more tailored prevention and treatment interventions. [Meacham MC, Roesch SC, Strathdee SA, Lindsay S, Gonzalez-Zuniga P, Gaines TL. Latent classes of polydrug and polyroute use and associations with human immunodeficiency virus risk behaviours and overdose among people who inject drugs in Tijuana, Baja California, Mexico. Drug Alcohol Rev 2018;37:128-136].

OBJECTIVES:No studies have focused on socioeconomic disparities in obesity within and between cohorts. Our objectives were to examine income gradients in obesity between birth-cohorts (inter-cohort variations) and within each birth-cohort (intra-cohort variations) by gender and race/ethnicity.METHODS:Our sample includes 56,820 white and black adults from pooled, cross-sectional National Health and Nutrition Examination Surveys (1971-2012). We fit a series of logistic hierarchical Age-Period-Cohort models to control for the effects of age and period, simultaneously. Predicted probabilities of obesity by poverty-to-income ratio were estimated and graphed for 5-year cohort groups from 1901-1990. We also stratified this relationship for four gender and racial/ethnic subgroups.RESULTS:Obesity disparities due to income were weaker for post-World War I and II generations, specifically the mid-1920s and the mid-1940s to 1950s cohorts, than for other cohorts. In contrast, we found greater income gradients in obesity among cohorts from the 1930s to mid-1940s and mid-1960s to 1970s. Moreover, obesity disparities due to income across cohorts vary markedly by gender and race/ethnicity. White women with higher income consistently exhibited a lower likelihood of obesity than those with lower income since early 1900s cohorts; whereas, black men with higher income exhibited higher risks of obesity than those with lower income in most cohorts.CONCLUSIONS:Our findings suggest that strategies that address race and/or gender inequalities in obesity should be cognizant of significant historical factors that may be unique to cohorts. Period-based approaches that ignore life-course experiences captured in significant cohort-based experiences may limit the utility of policies and interventions.

The purpose of the study was to evaluate whether routinely collected clinical factors can predict in vitro fertilization (IVF) failure among young, “good prognosis” patients predominantly with secondary infertility who are less than 35 years of age.

BACKGROUNDLess nocturnal blood pressure (BP) dipping has been associated with greater odds for the metabolic syndrome (MetS), a constellation of risk factors associated with cardiovascular disease (CVD). Little work has examined this association in Hispanics, who have elevated rates of MetS, or investigated differences in this relationship by level of acculturation. The purpose of this study was to examine the association between BP dipping and MetS in Hispanic women and to determine if this association is moderated by acculturation status.METHODSTwo hundred eighty-six Mexican American women underwent assessment of MetS components (BP, waist circumference, fasting glucose, high-density lipoprotein cholesterol, and triglycerides) and completed a 36-hour ambulatory BP monitoring protocol, during which systolic BP (SBP) and diastolic BP readings were obtained. Nocturnal BP dipping was calculated as the percentage difference between average daytime and nighttime BP. Acculturation was defined by the language (Spanish, English) in which participants preferred to complete study instruments.RESULTSAlthough no significant main effects for BP dipping or acculturation emerged for MetS, the SBP dipping by acculturation interaction was significantly related to MetS (P < 0.01). Simple slope analyses revealed that less SBP dipping related to greater odds of MetS in high-acculturated women, but SBP dipping and MetS were unrelated in low-acculturated women.CONCLUSIONSThe strength of the association between BP dipping and CVD risk (as measured by MetS) appears to vary by acculturation in Hispanic women. Future studies should explore mechanisms behind the BP dipping and CVD risk association and relevant modifying factors.

INTRODUCTION:Farmers market programs may increase access to more healthful foods and reduce the high prevalence of obesity in low-income communities. The objective of this study was to examine outcomes of the Fresh Fund farmers market program serving low-income neighborhoods in San Diego, California.METHODS:Through its Farmers Market Fresh Fund Incentive Program, the County of San Diego Health and Human Services Agency offered monetary incentives to government nutrition assistance recipients to purchase fresh produce at 5 farmers markets. Participants enrolled at participating markets from June 1, 2010, through December 31, 2011; they completed baseline and follow-up surveys of daily consumption and weekly spending on fruits and vegetables. We examined enrollment, participation, participant health perceptions, and vendor revenue.RESULTS:During the study period, 7,298 eligible participants enrolled in Fresh Fund; most (82%) had previously never been to a farmers market. Among 252 participants with matched surveys at baseline and 12-month follow-up, the proportion who reported their diet to be "healthy" or "very healthy" increased from 4% to 63% (P < .001); nearly all (93%) stated that Fresh Fund was "important" or "very important" in their decision to shop at the farmers market. Vendors reported that 48% of all market revenue they received was received through the Fresh Fund program. At 2 markets, revenue from June 1, 2011, through January 31, 2012, increased by 74% and 68% compared with revenue from June 1, 2010, through January 31, 2011.CONCLUSION:Participants in the Fresh Fund program self-reported increases in daily consumption and weekly spending on fruits and vegetables, and vendors at participating farmers markets also increased their revenue.

BACKGROUNDThe physical features of fetal alcohol syndrome include smooth philtrum, thin vermillion border, short palpebral fissures, microcephaly, and growth deficiencies on weight and height. However, little is known about the specific quantities of alcohol exposure, pattern of drinking, timing of exposure, and magnitude of risk for each of these features.METHODSUsing data on 992 subjects collected prospectively in California between 1978 and 2005, we examined the patterns and timing of alcohol exposure in relation to these features. Structural features were assessed by a dysmorphologist who performed a blinded physical examination of all infants. Patterns of drinking were evaluated by drinks per day, number of binge episodes, and maximum number of drinks. Timing of exposure was evaluated 0 to 6 weeks postconception, 6 to 12 weeks postconception, first trimester, second trimester, and third trimester.RESULTSHigher prenatal alcohol exposure in every pattern was significantly associated with the incidence of smooth philtrum but not with short palpebral fissures. The strongest associations were with timing of exposure in the second half of the first trimester (RR 1.25, 95% CI 1.14 to 1.36 for average number of drinks per day; RR 1.17, 95% CI 1.09 to 1.26 for maximum number of drinks in 1 episode). Similarly, thin vermillion border was most strongly associated with exposure in the second half of the first trimester. Findings with respect to timing of exposure were similar for microcephaly and reduced birth weight. However, reduced birth length was increased with exposure in any trimester. These associations were linear, and there was no evidence of a threshold.CONCLUSIONSReduced birth length and weight, microcephaly, smooth philtrum, and thin vermillion border are associated with specific gestational timing of prenatal alcohol exposure and are dose-related without evidence of a threshold. Women should continue to be advised to abstain from alcohol consumption from conception throughout pregnancy.

Alcohol: Clinical and Experimental ResearchVolume 36, Issue 7 p. 1300-1300 Letter to the Editor Response to Roehm Letter to the Editor Haruna S. Feldman, Corresponding Author Haruna S. Feldman Department of Pediatrics , University of California, San Diego, La Jolla, CaliforniaReprint requests: Haruna S. Feldman, Department of Pediatrics, University of California San Diego, 9500 Gilman Drive MC 0828, La Jolla, CA 92093-0828; Tel.: 858-246-1769; Fax: 858-246-1735; E-mail: [email protected]Search for more papers by this authorKenneth L. Jones, Kenneth L. Jones Department of Pediatrics , University of California, San Diego, La Jolla, CaliforniaSearch for more papers by this authorSuzanne Lindsay, Suzanne Lindsay Graduate School of Public Health , San Diego State University, San Diego, CaliforniaSearch for more papers by this authorDonald Slymen, Donald Slymen Graduate School of Public Health , San Diego State University, San Diego, CaliforniaSearch for more papers by this authorHillary Klonoff-Cohen, Hillary Klonoff-Cohen Department of Family and Preventative Medicine , University of California, San Diego, La Jolla, CaliforniaSearch for more papers by this authorKelly Kao, Kelly Kao Department of Pediatrics , University of California, San Diego, La Jolla, CaliforniaSearch for more papers by this authorSmriti Rao, Smriti Rao Department of Pediatrics , University of California, San Diego, La Jolla, CaliforniaSearch for more papers by this authorChristina Chambers, Christina Chambers Department of Pediatrics , University of California, San Diego, La Jolla, California Department of Family and Preventative Medicine , University of California, San Diego, La Jolla, CaliforniaSearch for more papers by this author Haruna S. Feldman, Corresponding Author Haruna S. Feldman Department of Pediatrics , University of California, San Diego, La Jolla, CaliforniaReprint requests: Haruna S. Feldman, Department of Pediatrics, University of California San Diego, 9500 Gilman Drive MC 0828, La Jolla, CA 92093-0828; Tel.: 858-246-1769; Fax: 858-246-1735; E-mail: [email protected]Search for more papers by this authorKenneth L. Jones, Kenneth L. Jones Department of Pediatrics , University of California, San Diego, La Jolla, CaliforniaSearch for more papers by this authorSuzanne Lindsay, Suzanne Lindsay Graduate School of Public Health , San Diego State University, San Diego, CaliforniaSearch for more papers by this authorDonald Slymen, Donald Slymen Graduate School of Public Health , San Diego State University, San Diego, CaliforniaSearch for more papers by this authorHillary Klonoff-Cohen, Hillary Klonoff-Cohen Department of Family and Preventative Medicine , University of California, San Diego, La Jolla, CaliforniaSearch for more papers by this authorKelly Kao, Kelly Kao Department of Pediatrics , University of California, San Diego, La Jolla, CaliforniaSearch for more papers by this authorSmriti Rao, Smriti Rao Department of Pediatrics , University of California, San Diego, La Jolla, CaliforniaSearch for more papers by this authorChristina Chambers, Christina Chambers Department of Pediatrics , University of California, San Diego, La Jolla, California Department of Family and Preventative Medicine , University of California, San Diego, La Jolla, CaliforniaSearch for more papers by this author First published: 10 July 2012 https://doi.org/10.1111/j.1530-0277.2012.01847.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume36, Issue7July 2012Pages 1300-1300 RelatedInformation

The characteristic facial features of the more severe end of Fetal Alcohol Spectrum Disorders (FASD) include smooth philtrum, thin vermillion of the upper lip, and short palpebral fissures. A systematic evaluation of a comprehensive list of minor structural defects in association with varying patterns of prenatal exposure to alcohol has not been performed. We examined the patterns and timing of prenatal alcohol exposure to minor structural malformations occurring in at least 5% of the sample. Patterns of drinking were evaluated by drinks per day, number of binge episodes, and maximum number of drinks. Timing of exposure was evaluated 0-6 weeks post-conception, 6-12 weeks post-conception, first trimester, second trimester, and third trimester. Naevus flammeus neonatorum is significantly associated with various patterns of drinking during the second half of the first trimester (RR 1.14, 95% CI 1.04, 1.24 for average number of drinks per day; RR 1.04, 95% CI 1.02, 1.07 for number of binge episodes; RR 1.08, 95% CI 1.01, 1.15 for maximum number of drinks in one episode) and similar for number of binge episodes in all categories of timing of exposure and in the second trimester for average number of drinks per day. Other minor malformations occurring in at least 5% of the sample were not found to be significantly associated with prenatal alcohol exposure. Expected minor malformations were not found to be significantly associated with prenatal alcohol exposure. Naevus flammeus neonatorum appears to be part of the spectrum of features associated with prenatal alcohol exposure.

Background: Policies over the past 15 years have resulted in changes to the physical border between the U.S. and Mexico, as well as increases in the number of border patrol agents.Purpose: The purpose of this study is to characterize the trends and epidemiology of physically traumatic border-crossing injuries sustained over an 8-year period in San Diego County.Methods: This is a time series study using existing data collected by the University of California, San Diego Level 1 Trauma Center between 2000 and 2007. This study includes data for individuals traumatically injured owing to a jump or fall in an attempt to cross over the border fence. Time-trend analysis was conducted using Poisson regression. A multiple linear regression was conducted to determine whether there was an increase in the severity of injuries to border crossers between 2000 and 2007.Results: Analysis demonstrated a significant increase in the number of those injured each year specifically as a result of jumping or falling from the border fence, from 13 in 2000 to 52 in 2007, even though there was a decrease in the number of apprehensions for illegal entry into the U.S. On average, each year, the injury severity decreased by 0.38 between the years 2000 and 2007.Conclusions: Jumping and falling injuries at the San Diego Mexico border increased during a time when apprehensions were decreasing. Further studies are needed to identify strategies to mitigate this problem. (Am J Prey Med 2010;38(5):548-550) (C) 2010 American Journal of Preventive Medicine