Risk for Suicide among Medicaid Beneficiaries

Demographic, diagnostic, and service expenditure characteristics of Florida Medicaid enrollees who died by suicide were investigated. Among persons receiving Medicaid and Supplemental Security Income (SSI), findings indicate the most powerful predictors of suicide were involuntary psychiatric examination, mental health hospitalization, and high mental health service use. Among Medicaid enrollees not receiving SSI, strongest suicide predictors were mental health hospitalization, high expenditures for physical health medications, and involuntary psychiatric examination. Findings suggest reducing involuntary psychiatric examinations and mental health hospitalizations while improving physical health may reduce suicide in the Medicaid population. Comprehensive hospital discharge planning, adherence monitoring with follow‐up care, training mental health providers in assessing suicide lethality, and providing adequate assessment time are all crucial to achieve these objectives.     

Parents Who Abuse: What Are They Thinking?

Child abuse is a major social concern around the world. Important to tackling the problem is an understanding of the mechanisms contributing to abusive parenting. This article brings together research on the cognitive variables associated with abusive or high-risk parenting. Considered are dysfunctional child-centered and parent-centered cognitions as potentially critical correlates of abusive behavior. The development of dysfunctional cognitions is also explored. Cognitive vulnerabilities alone are typically not sufficient for the occurrence of abuse. Interactions with additional factors, such as an ability to inhibit aggression, problem-solving capabilities, parenting skills, social isolation, and societal context are examined.     

Correlates of household smoking bans in low-income families of children with and without asthma

Exposure to secondhand smoke (SHS) harms all children's health, especially children with asthma. Yet, children with asthma are as likely to live with smokers as healthy children. Household smoking bans are being advocated to reduce children's harm from SHS. To measure the effect of household smoking bans on child SHS exposure and to examine correlates of strict smoking bans in a low-income, diverse sample, 91 children with asthma were matched to 91 healthy children. All had at least one smoker living in their homes. Nicotine dosimeters, child cotinine assays, and maternal reports quantified child SHS exposures. Maternal reports of household smoking rules, behaviors, and beliefs, and other family characteristics were also gathered. The presence of a strict household smoking ban vastly reduced children's SHS exposures and was associated with fewer cigarettes smoked by the mother and by other family members, the belief that SHS was a personal health risk, having children with asthma, and living in a single-family home. Many children are exposed to high levels of SHS at home. Strict household smoking bans greatly decrease, but do not eliminate children's SHS exposure. Even in disadvantaged families, mutable factors were associated with strict smoking bans. Increased dissemination and use of established public health strategies are needed to reduce children's SHS exposures.