This Issue of Public Health Reports weaves an interesting and unintended message in subtext—the importance of making healthy choices before having sex or, once pregnant, maintaining healthy choices and practices for healthy babies and children. Collectively, four articles plus the Surgeon General's Perspectives (SGP) highlight this message.
An article entitled “Degrading and Non-Degrading Sex in Popular Music: A Content Analysis” (p. 593) concludes that degrading references to sexual activity are more common in popular music than non-degrading references. It also concludes that references to degrading sex in popular music frequently appear with references to other risky behaviors. Another article on condom use among high-risk adolescents (p. 601) finds that nearly two-thirds of adolescents did not use condoms at the time of last intercourse and that many adolescents either feel that condoms reduce sexual pleasure or fear partner reactions if they initiate condom use. A third article regarding prenatal smoking prevalence (p. 586) reports that about 15% of women smoke during pregnancy. A fourth article, “Place Matters: Variation in the Black/White Very Preterm Birth Rate Across U.S. Metropolitan Areas, 2002–2004” (p. 576), shows that black women have three times the mean very preterm (VPT) birth rate when compared with white women. (There was no statistical difference in VPT birth rates for Hispanic women when compared with white women.) Understanding the determinants of these differences will help reduce the racial disparity in VPT birth rates.
Directly related to the latter article is this issue's SGP column, which focuses on preterm birth. The Acting U.S. Surgeon General, RADM Steven K. Galson, notes in the SGP that the number of infants born prematurely in the U.S. has risen greatly in the past few decades. Nearly 500,000 babies in the U.S. are born preterm (one in every eight births) and this number continues to rise. (The rate of preterm birth has increased about 25%, from 10.6 per 100 live births in 1990 to 12.7 per 100 live births in 2005.) Preterm birth is a major cause of infant mortality and places infants at increased risk for serious lifelong morbidity and disability, such as cerebral palsy, vision and hearing problems, asthma, poor motor skills, and learning disabilities. Conversely, infants who are born full-term experience lower rates of health problems throughout their lives. RADM Galson also reflects on the racial and economic disparities associated with preterm births.
To raise awareness and help mitigate this important public health problem, the Office of the Surgeon General recently sponsored a national conference on preterm birth that established a national agenda and call to action. National leaders in the field attended this one-time, two-day conference that established an agenda covering six general topic areas: biomedical research, epidemiologic research, psychosocial and behavioral considerations, professional education and training, public communications and outreach, and quality of health care and health services. Despite the diligent efforts of many government agencies and health advocacy groups over the past few decades to address this serious public health problem, the agenda developed at this conference will provide much needed national focus on mitigation strategies. (Note: A PHR Web cast on this topic has been scheduled for November 3, 2008. Details on this Web cast are available on our website, www.publichealthreports.org.)