Laurie F. Beck

Multiple lifestyle and psychosocial risks and delivery of small for gestational age infants

Objective To examine the occurrence of multiple risk behaviors during pregnancy among women who delivered a live birth and to examine the risk of delivering small for gestational age (SGA) infants for women with multiple risks. Methods We used data from the Pregnancy Risk Assessment Monitoring System to conduct the research. Pregnancy Risk Assessment System is a population-based, mixed-mode surveillance system that collects information on maternal behaviors and experiences. We used data for 1997 from 13 (n = 19,331) states that had response rates of over 70%. We considered ten self-reported individual risk behaviors or exposures (eg, smoking, unintended pregnancy) and several demographic variables. The main outcome was SGA. Results Pregnant women engage in or are exposed to multiple risks and often these risks are inter-related. The occurrence of multiple risks appears to be associated with an increased likelihood of delivering an SGA infant. Compared with women with no reported risks or exposures, the adjusted odds ratios for delivering an SGA infant were as follows: 1.29 (95% confidence interval [CI] 0.69, 2.43) for one, 1.86 (95% CI 1.00, 3.44) for two, 1.67 (95% CI 0.90, 3.10) for three, 2.06 (95% CI 1.10, 3.89) for four, 3.53 (95% CI 1.71, 7.30) for five, and 3.82 (95% CI 1.97, 7.41) for six or more risks or exposures. Conclusion A large proportion of pregnant women engage in or are exposed to multiple risks. Women with a larger number of risks are at greater risk for delivering an SGA infant than women with fewer or no risks.

Associations Between Sociodemographics and Safety Belt Use in States With and Without Primary Enforcement Laws

OBJECTIVES secondary enforcement laws (police may issue a safety belt citation only if the vehicle has been stopped for another reason). METHODS We analyzed 2002 Behavioral Risk Factor Surveillance System data from 50 states and the District of Columbia. We performed multivariable, log-linear regression analyses to assess the effect of sociodemographic characteristics and safety belt laws on safety belt use. Analyses were stratified by the type of enforcement permitted by state laws. RESULTS Reported safety belt use was higher in states that had primary versus secondary enforcement laws, both overall and for each sociodemographic characteristic examined. Safety belt use was 85% in states that had primary enforcement laws and 74% in states that had secondary enforcement laws. Cross-sectional data suggested that primary enforcement laws may have the greatest effect on sociodemographic groups that reported lower levels of safety belt use. CONCLUSIONS Primary enforcement laws are an effective population-based strategy for reducing disparities in safety belt use and may, therefore, reduce disparities in crash-related injuries and fatalities.

Seat belt use in States and territories with primary and secondary laws--United States, 2006.

PROBLEM Motor-vehicle crashes are a leading cause of death in the United States. In the event of a crash, seat belts are highly effective in preventing serious injury and death. METHODS Data from the 2006 Behavioral Risk Factor Surveillance System were used to calculate prevalence of seat belt use by state and territory and by type of state seat belt law (primary vs. secondary enforcement). RESULTS In 2006, seat belt use among adults ranged from 58.3% to 91.9% in the states and territories. Seat belt use was 86.0% in states and territories with primary enforcement laws and 75.9% in states with secondary enforcement laws. DISCUSSION Seat belt use continues to increase in the United States. Primary enforcement laws remain a more effective strategy than secondary enforcement laws in getting motor-vehicle occupants to wear their seat belts.

Self-reported seatbelt use, United States, 2002-2010: Does prevalence vary by state and type of seatbelt law?

PROBLEM Motor-vehicle crashes are a leading cause of death in the United States. Seatbelts are highly effective in preventing serious injury and death in the event of a crash. Not all states have primary enforcement of seatbelt laws. METHODS Data from the 2002, 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System were used to calculate prevalence of seatbelt use by state and type of state seatbelt law (primary vs. secondary enforcement). RESULTS AND DISCUSSION Self-reported seatbelt use among adults in the United States increased steadily between 2002 and 2010, with the national prevalence reaching 87% in 2010. Overall, seatbelt use in 2010 was 9 percentage points higher in the states with primary enforcement laws than in the states with secondary enforcement laws (89% vs. 80%). IMPACT ON INDUSTRY Primary enforcement seatbelt laws and enhanced enforcement of seatbelt laws are proven strategies for increasing seatbelt use and reducing traffic fatalities.

Self-Reported Alcohol-Impaired Driving in the U.S., 2006 and 2008

BACKGROUND Alcohol-impaired driving caused 10,839 deaths in 2009. Alcohol-impaired driving fatalities as a percentage of all motor vehicle fatalities decreased from 1982 to 1999 but have remained stable since. Understanding characteristics of those who engage in this behavior is critical to achieving future reductions. PURPOSE The purpose of this study is to estimate the number of episodes of self-reported alcohol-impaired driving and to explore the related demographic factors and drinking patterns. METHODS Data from the 2006 and 2008 Behavioral Risk Factor Surveillance System were used in 2010 to produce annualized estimates of alcohol-impaired driving episodes. Logistic regression modeling was used to explore the effects of drinking patterns, seatbelt use, and sociodemographics. RESULTS The percentage of the population reporting at least one alcohol-impaired driving episode in the past 30 days was 2.2% for 2006 and 2008 combined. The number of annualized episodes of alcohol-impaired driving was 147 million. Annualized episode rates varied across states from 165 to 1242 episodes per 1000 population. Characteristics associated with alcohol-impaired driving differed by gender. The strongest correlate of alcohol-impaired driving was binge drinking, with those reporting binge drinking at least once per month being five to six times as likely to report alcohol-impaired driving when adjusting for all other variables. CONCLUSIONS Understanding who is most likely to report alcohol-impaired driving is important in developing interventions to prevent this behavior. Interventions that are known to be effective, such as sobriety checkpoints and installing ignition interlocks on the vehicles of people convicted of alcohol-impaired driving, should be widely implemented.