ABSTRACT. Objectives. To describe characteristics of emergency department (ED) encounters for pediatric patients with an acute mental health diagnosis.Methods. Data are from the National Hospital Ambulatory Medical Care Survey, which includes abstracts from the medical records of a national probability sample of visits to EDs. Analysis was limited to records of patients who were younger than 19 years and had a diagnosis of either confirmed or suspected mental disorder or a suicide attempt.Results. There was an estimated annual average of 434 000 ED pediatric mental health visits from 1993 to 1999, an average annual rate of 326.8 visits per 10 000 people. Visit rates varied by patient's region, age, race, and gender. Psychosis was the diagnosis in 10.8% of these patients, and suicide attempt was the diagnosis in 13.6%. ED pediatric mental health visits accounted for 1.6% of all ED visits in this age group. Conclusions. The significant increase in emergency department pediatric mental health (EDPMH) visits from

This article explores knowledge, attitudes, and behaviors regarding HIV/AIDS for persons aged 50-64 by using data from the 1996 Behavioral Risk Factor Surveillance System. It examines what percentage have been tested for HIV, where and why they have been tested, knowledge about condom effectiveness, and self-perceived risk. The purpose is twofold: First, it presents an epidemiologic analysis of HIV/AIDS-related attitudes and behaviors of adults aged 50-64; second, it explores whether theoretical models used on other groups fit well with this age group. The authors conclude that the conceptual model is less robust for this group and there is a substantial need for health promotion efforts directed at older adults.

Most states experienced increases in safety belt use, mammography, and adult vaccinations. Trends for smoking and binge alcohol use are disturbing, and obesity data support previous findings. Trend data are useful for targeting state preventive health efforts.

Most US adults do not engage in HIV-related risk behavior; those that do are more likely to report protective behavior.

OBJECTIVES: It has been proposed that individuals aged 55 to 64 years be allowed to buy into Medicare. This group is more likely than younger adults to have marginal health status, to be separating from the workforce, to face high premiums, and to risk financial hardship from major medical illness. The present study examined prevalence of health insurance coverage by demographic characteristics and examined how lack of insurance may affect use of preventive health services. METHODS: Data were obtained from the Behavioral Risk Factor Surveillance System, an ongoing telephone survey of adults conducted by the 50 states and the District of Columbia. RESULTS: Many near-elderly adults least likely to have health care coverage were Black or Hispanic, had less than a high school education and incomes less than $15,000 per year, and were unemployed or self-employed. Health insurance coverage was associated with increased use of clinical preventive services even when sex, race/ethnicity, marital status, and educational level were controlled. CONCLUSIONS: Many near-elderly individuals without insurance will probably not be able to participate in a Medicare buy-in unless it is subsidized in some way.

OBJECTIVES: Variations among states in household exposure to firearms, loaded firearms, and handguns were examined. METHODS: Data from the Behavioral Risk Factor Surveillance System in 22 states were used to estimate the prevalence of adults and children exposed to household firearms. RESULTS: The prevalence of adults living in households with firearms ranged from 12% to 57%; the corresponding ranges were 1% to 23% for loaded firearms and 5% to 36% for handguns. The prevalence of children less than 18 years of age living in households with loaded firearms ranged from 2% to 12%. CONCLUSIONS: Important variations among states exist in the prevalence of adults and children living in households with firearms, loaded firearms, and handguns.

OBJECTIVES: This study examined trends in perceived cost as a barrier to medical care. METHODS: The Behavioral Risk Factor Surveillance System was used to analyze monthly telephone survey data from 45 states. RESULTS: Overall, the percentage of persons perceiving cost as a barrier to medical care increased from 1991 until early 1993 and then declined to baseline values in late 1996. Perceived cost was a greater barrier in 1996 than in 1991 for persons with low incomes and for those who were unemployed and uninsured. For self-employed persons, percentages increased until mid-1993 and then remained constant. CONCLUSIONS: Further efforts are needed to improve access to medical care for socially disadvantaged populations.

Among adults aged 18-64, rates of uninsurance increased in most states from 1992 through 2001. Decreased availability of employer-sponsored health insurance, rising health care costs, and state fiscal crises are likely to worsen the growing uninsurance problem.