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Biomedical subjects

T Mangione

Publications and source records attributed to T Mangione.

15 recordsLinked to original sources
PubMed1991

Health promotion versus health protection? Employees' perceptions and concerns.

The "second public health revolution" targets factors in the environment, together with lifestyle, to prevent illness and untimely death. Yet the growth of the "wellness movement" has driven a wedge between public health advocates who argue for environmental solutions and those whose major focus is individual behavior. This tension is nowhere more evident than in the workplace, where the new wellness professionals are at odds with specialists in occupational health and industrial hygiene. This paper reports findings from a cross-sectional survey of a sizeable sample of workers at six New England facilities of a very large American manufacturing firm, assessing their perceptions of risk in the two domains: environmental exposures and lifestyle risks. Multiple regression analyses reveal that both job risks and life risks are associated with a variety of potentially costly and disruptive health problems, even after controlling for demographic and occupational factors. This analysis suggests that wellness programs in the workplace will be more effective if they integrate environmental protection with efforts to reduce lifestyle risk.

Adult↗
PubMed1989

Barriers to bicycle helmet use among children. Results of focus groups with fourth, fifth, and sixth graders.

As a preliminary step in the development of a school-based educational intervention to promote bicycle helmet use among children, focus group encounters were conducted with fourth, fifth, and sixth graders at three elementary schools in the Boston, Mass, area. Analysis of transcripts of encounter tape recordings indicated that (1) the prevalence of helmet ownership and use was low, (2) children were concerned that helmet use would invite derision from their peers, and (3) children tended to respect other children who wore helmets. We concluded that focus groups can be useful in conceptualizing health education interventions and suggest that school-based peer-led bicycle helmet programs may be effective in developing normative change toward helmet use among elementary schoolchildren.

Adolescent↗
PubMed1989

Survey of AIDS knowledge and behavior changes among Massachusetts adults.

In October 1987, 1,323 Massachusetts residents were randomly interviewed by telephone to explore their exposure to AIDS educational efforts, levels of knowledge about AIDS, and whether that knowledge modified their behavior. Gay/bisexual males, iv drug users and heterosexual respondents were compared as were blacks, Hispanics, and whites. While 81% of respondents had read or heard mass media stories about AIDS, in the previous week, only 5% had ever been counseled about AIDS by a physician. Over 97% of black (N = 152) and white respondents (N = 1,057), as well as gay/bisexual males (N = 21) and iv drug users (N = 33) were aware that HIV can be transmitted by homosexual or heterosexual intercourse and by sharing needles when injecting drugs. However, 9% of the 55 Hispanics interviewed were unaware of male homosexual transmission, and 7% did not know about heterosexual transmission or the risks of needle sharing. Twenty percent of Hispanics, compared with 9% of other respondents, did not know HIV can be transmitted sexually by someone who appears healthy. Fifty-two percent of gay/bisexual males, 27% of iv drug users, and 21% of those who had multiple heterosexual partners in recent years reported adopting abstinence, monogamous relations, or condom use to avoid HIV exposure. Those who continued risky behavior were just as knowledgeable about HIV transmission, but they were less likely to report that they worry a great deal about getting AIDS, 14% vs 32%. The results indicate that new strategies and resources are needed to educate Hispanics. Physicians need to counsel more persons about HIV transmission and further efforts are needed to translate knowledge about HIV transmission into behavior change to avoid the virus.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Repeal of the Massachusetts seat belt law.

In November 1986, the Massachusetts mandatory seat belt use law repealed in a referendum by a 53 per cent to 47 per cent vote. In an anonymous random digit telephone survey of 1,046 adults in Massachusetts in summer 1986, while the law was in effect, 61 per cent of respondents had said they would vote in favor of the law. A post-repeal follow-up of 80 per cent of these persons revealed initial supporters and opponents of the law were equally likely to vote, but 15 per cent of the summer supporters switched their opinions and voted for repeal, compared to only 4 per cent of summer opponents who switched. In addition, a separate survey of 167 households that had refused to answer the summer survey indicated that survey nonrespondents were more likely to vote against the law than for it. Those opposing the law saw it as an infringement on personal liberty and believed it was not effective in reducing injury and death.

Choice Behavior↗
PubMed1987

Health problems reported by residents of a neighborhood contaminated by a hazardous waste facility.

A symptom prevalence survey was conducted of a neighborhood exposed to airborne hazardous wastes. Residents' responses were compared to those of a nearby control population. The results revealed that the exposed group had more self-reported complaints referable to the respiratory system (wheezing, shortness of breath, chest discomfort, persistent colds, coughs), constitutional complaints (always fatigued, bowel dysfunction), and irregular heart beat. When the effect of a documented irritant source in a small portion of the control population was removed, the exposed group also complained more often of irritation of the eyes and nose. There was a biological gradient for several of these effects. Efforts to eliminate the influence of confounding and recall bias are discussed. The results suggest either that the general population reacts to chemicals at levels much lower than the available occupational literature would indicate or that the effects are more long lasting than previously thought.

Adolescent↗
PubMed1987

Effects of Maine's 1981 and Massachusetts' 1982 driving-under-the-influence legislation.

In 1981, Maine passed a drunk driving law with mandatory penalties and a new civil charge to increase the conviction rate. One year later, Massachusetts increased drunk driving penalties, particularly for repeat offenders and intoxicated drivers involved in fatal crashes. In Maine, single-vehicle nighttime fatal crashes declined 22 per cent the year before passage of the law, and 33 per cent the year after. Maine's rates returned to pre-law levels by the third post-law year. Prior to Massachusetts' new law, single-vehicle nighttime and overall fatal crashes there also declined 20% and 22%, whereas after this law fatal crash rates did not decline further compared with the pre-law year or other New England states. Pre- and post-law surveys indicate that both laws were followed by some increases in public perceptions that drunk drivers stopped by police would be arrested, convicted, and receive automatic penalties. But, few believed it was very likely that drunk drivers would be stopped. For only two of three years studied after Maine's law did more people there report decisions not to drive because they had drunk too much. In Massachusetts, reported driving after heavy drinking declined as much the year before as the three years after its law.

Accidents, Traffic↗
PubMed1984

Legislation raising the legal drinking age in Massachusetts from 18 to 20: effect on 16 and 17 year-olds.

The 1979 Massachusetts law raising the legal drinking age from 18 to 20 is examined--the effects on the drinking, drinking and driving, and nonfatal and fatal crash involvement of 16-17 yr-olds, teenagers immediately younger than those targeted by the law. Data from Massachusetts are compared with those from New York State, where the drinking age remained at 18. A total of 3 yr of survey data from the two states and 6 yr of data from the Department of Transportation's Fatal Accident Reporting System provide for pre- and postlaw comparisons. The findings suggest that raising the drinking age had minimal effects on the drinking behavior of Massachusetts teenagers. Although there was a significant reduction in nonfatal crashes in Massachusetts compared with New York, no decline in single-vehicle nighttime fatal crashes or in overall fatal crashes was observed. It is suggested that changes in the drinking age may offer some reduction in teenage driving after drinking and traffic crash involvement, but that teenage drinking and driving after drinking remain serious problems even in states that raise their drinking ages.

Accidents, Traffic↗
PubMed1983

Impact of legislation raising the legal drinking age in Massachusetts from 18 to 20.

On April 16, 1979, Massachusetts raised its legal drinking age from 18 to 20 years. Massachusetts was compared with New York State, exclusive of New York City and Nassau County. New York State retained an 18-year-old drinking age. Random telephone surveys with approximately 1,000 16-19 year olds in each state were undertaken prior to the law's enactment and twice at yearly intervals after the law to assess the law's impact on teenage drinking, driving after drinking, and non-fatal accident involvement. Fatal crash data reported to the US Department of Transportation by each state from April 16, 1976-April 15, 1981 were also analyzed. After the law, although the modes of procuring alcohol changed. No significant changes were observed in Massachusetts relative to New York in the proportion of surveyed teenagers who reported that they drank or in the volume of their consumption. The proportion of teenagers who drove after drinking heavily (six or more drinks at one time) did not decline in Massachusetts relative to New York. However, the frequency that teenagers reported driving after any drinking declined significantly in Massachusetts. Frequency of teenage driving after marijuana use and non-fatal teenage accidents declined at comparable rates in both states. The numbers of teenage nighttime single vehicle fatal accidents declined more in Massachusetts than New York, in the 18-19 year age group. Overall fatal accident trends among 16-19 year olds in the two states were similar.

Accidents, Traffic↗
PubMedDate not supplied

Evidence for cohort or generational differences in the drinking behavior of older adults.

Data from a survey of 928 older Bostonians show that there is a negative correlation between age and alcohol consumption among older adults: i.e., "old-old" people- those who are seventy-five years old or older-are more likely to abstain and less likely to drink in any quantity than the "younger-old"-those age sixty-seventy-five years old. Since the study collected only cross-sectional data, it is not clear whether there are developmental trends in alcohol consumption-that people drink less as they grow older-or whether there are cohort or generational effects. However, several retrospective data suggest that there are cohort or generational patterns of drinking behavior by older adults. Very old respondents, who now drink less than their younger counterparts, report consistently different patterns of life-long drinking habits; they report different parental drinking habits, and they have consistently different attitudes toward the effects of alcohol consumption upon health. The survey provides no insight into the nature of the historical factors which account for the differences in alcohol use. However, Prohibition, Repeal, and the Depression are likely to have played important roles.

Age Factors↗
PubMedDate not supplied

Researching and preventing alcohol problems at work: toward an integrative model.

PURPOSE OF PROPOSAL. A consolidated framework is proposed to highlight modifiable factors in work organizations that may contribute to alcohol-related problems. This research model serves to organize existing knowledge, highlight pathways for new research initiatives, and offer insights into the design of primary and secondary preventive strategies. CONTRIBUTING INFLUENCES. Current research on problem drinking in the workplace either locates problems in individual drinkers or looks to the social environment to understand how drinking problems unfold. There is a clear need for a more complete theoretical model which incorporates social, cultural, organizational, and personal factors. PROPOSAL SUMMARY. This article elaborates on a model for examining problem drinking at work which integrates policy, normative, and psychosocial influences. It emphasizes the structures within which health-related decisions and actions are contained and constrained. The focus here on the connections between alcohol use and work builds on the premise that health is socially produced.

Alcoholism↗
PubMedDate not supplied

A pilot survey of aquatic activities and related consumption of alcohol, with implications for drowning.

The investigators considered the relationship between participation in aquatic activities and the consumption of alcohol, with their implications for the risk of drowning. In a telephone survey with random-digit dialing, interviewers asked Massachusetts residents ages 20 years and older how often they engaged in various aquatic activities, in what settings, and how often they drank alcohol in connection with participation in aquatic activities. Of 294 respondents, 79 percent of the men and 72 percent of the women reported participating in aquatic activities during August 1988, the month prior to the interview. Respondents were asked to identify their most recent aquatic activity. The mean number of days of participation in the month was 13. The most frequently reported aquatic activities were swimming (76 percent), followed by sunbathing (74 percent), power boating (25 percent), and fishing from shore (15 percent). Among those persons reporting participation in aquatic activities, 55 percent had been at the ocean on the most recent occasion, 26 percent at lakes or ponds, 17 percent at pools, and 2 percent at rivers. Among those persons reporting aquatic activities, 36 percent of the men and 11 percent of the women reported having drunk alcohol on the most recent occasion. Those who reported drinking in aquatic settings were more likely to report driving after drinking than those who did not drive. Implementation of new Federal regulations and State laws concerning drinking and boating should be accompanied by public education on the risks of drowning if aquatic activities and alcohol consumption are combined.

Adult↗