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PubMed1985

Epidemiologic study of infant botulism in Pennsylvania: Report of the Infant Botulism Study group.

The majority of the almost 400 confirmed cases of infant botulism in the United States have occurred in California, Pennsylvania, and Utah. In Pennsylvania, 44 of 53 (83%) cases occurred within a geographic area of Southeastern Pennsylvania which represents one tenth of the Commonwealth's area and one third of the population at risk for infant botulism. In Southeastern Pennsylvania, a map of the residences of cases circumscribes a discrete ring around Philadelphia. A case-control study performed to seek host-related risk factors, identifies the significant associations of botulism with infants who are white, breast-fed, and born at term into two-parent families with hospitalization insurance. County control studies were performed to identify differences in host-related factors between areas of high and low prevalence of botulism. Although some "protection" could be afforded Philadelphia infants by their feeding and family characteristics, the differences in case rates between Philadelphia and the botulism "ring counties" cannot be explained entirely by host-related factors. Further, the absence of botulism in counties just outside of the botulism "ring," where infants were found to have identical potential risk factors, suggests that an uneven distribution of botulinal spores in the environment is the most significant determinant of case rate.

Botulism↗
PubMed1985

Work-site health promotion. Five-year trend in employee health care costs.

Participants in work-site health promotion programs are compared with other employees at the same work-site in terms of health care utilization as measured by insurance claims. Participants tended to incur higher health care costs than nonparticipants for the six-month period after the program began. However, a cohort analysis of one of the groups shows that participants' costs declined in relation to nonparticipants' for subsequent periods. Overall, for 4.75 years after the program, participants averaged 24% lower health care costs than nonparticipants. The imputed savings in health care costs exceeds program costs for this cohort by a factor of 1.45. The findings substantially strengthen the conclusions of other controlled studies that work-site health promotion reduces health care costs.

Blue Cross Blue Shield Insurance Plans↗