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IU Health & Wellness

Research and insights from Indiana University

FOR IMMEDIATE RELEASE
April 19, 2010

IU Health and Wellness for April discusses the following topics:

HVP vaccine for males age 9-26
The unhealthy relationship between cigarette smoking and alcohol and drug use
Visitability: homes designed for 21st century lifestyles

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HPV vaccine for men. Last fall the FDA approved Gardisil for men to prevent genital warts resulting from human papillomavirus (HPV), a sexually transmitted virus that also has been associated with cervical cancer in women and cancers of the head and neck in both sexes. While most women have been receptive to the vaccine, some health experts expect men to be slightly more reluctant to get the vaccine. "Men should consider getting the vaccine in order to protect themselves against genital warts, but also to protect their partners," says Dr. Judy Klein, a physician at the Indiana University Health Center. "Even if you have already had HPV, the vaccine can still be effective in protecting against other strains of the virus. However, current testing does not allow health professionals to determine which strain(s) of the virus an individual has." The vaccine is recommended for ages 9-26, but is most effective when given before the onset of sexual activity. However, health experts have been disappointed that fewer than 40 precent of pre-adolescent females have been getting vaccinated. Side effects may include headache, fever, pain at the injection site, itching, redness, swelling and bruising.

Klein said that men may be slightly more reluctant to get the vaccine than women for several reasons:

  • Women typically get routine annual exams, so not only are women more accustomed to addressing their sexual health, but they are also given more opportunities to receive information about sexual health topics such as the HPV vaccine.
  • Men don't have the additional fear of HPV leading to cervical cancer, and it is possible to receive treatment for genital warts.
  • The vaccine thus far has been poorly publicized and many men are unaware of the new vaccine and its benefits.

The HPV vaccine was approved by the FDA in 2006 for females ages 9-26. Gardasil protects against HPV strains 6 and 11, which are the most common strains that lead to genital warts, and also against strains 16 and 18, which are the most common strains that lead to cervical cancer in women. HPV is one of the most common sexually transmitted infections. It is a viral infection that is transmitted through skin-on-skin contact. It is possible for both sexes to carry the virus while showing no signs of infection, including testing negative for HPV.

The IU Health Center provides the HPV vaccine for both men and women. For more information about the vaccine, please visit the IU Health Center Web site at http://healthcenter.indiana.edu/quicklinks/gardasil.html. For additional assistance, contact Tracy James, at 812-855-0084 and traljame@indiana.edu, or Sarah Stephens, at sajsteph@umail.iu.edu. Top




Cigarette

Closing the gateway to alcohol and drug use. Smoking is not just a bad habit that can lead to premature death, but it also can lead to an increased use of certain drugs. An Indiana University study has found that increased smoking is strongly associated with increased use of alcohol, smokeless tobacco and other illicit drugs. "The empirical data provides evidence that tobacco still serves as a gateway drug. Furthermore, there is a dose response relationship with regard to monthly use of cigarettes and other substances across all grades surveyed," said Mohammad Torabi, Chancellor's Professor in the School of Health, Physical Education and Recreation and study co-author. "Tobacco is everyone's common enemy." The study, published in the American Journal of Health Education, reiterates the findings of Torabi's 1993 study that tobacco is a significant gateway drug. "In our current study, increased smoking was strongly associated with increased use of alcohol, smokeless tobacco, and five other drugs. This is a significant public health problem," Torabi said. "Probably one way to prevent other drug use is concentrating on tobacco prevention and cessation. That is not to say there is cause and effect relationship between tobacco use and other drugs." Every year tobacco is responsible for nearly 450,000 deaths in the United States. Its use affects the health and well-being of smokers and nonsmokers alike and it contributes significantly to skyrocketing health care costs. According to the study, tobacco has not only impacted the health but also the wealth of every member of our society. "As is known, a great majority of smokers start prior to the age of 25. That is why most of the marketing of tobacco is targeted toward younger people. If they are 'hooked' to this deadly product, they are almost always 'hooked' for life," Torabi said. The younger a person begins smoking, the greater the likelihood of addiction and disease. This study reveals that Indiana eighth graders used cigarettes, alcohol and marijuana at a much higher rate than the national average. Similar results were also found in other grade levels. According to the study, "the heavier the level of smoking, the greater the predicted probability of alcohol use." Parents constitute the most important ingredient in preventing youth tobacco use. The study makes the following recommendations:

  • School involvement. Schools need to employ smoking bans, to adopt evidence-based tobacco prevention curricula and to offer and promote smoking cessation programs.
  • Community involvement. Evidence-based community strategies include increasing taxes on cigarettes, interventions to reduce youth access to tobacco in combination with mobilization efforts, and counter-marketing campaigns. Communities as well as schools should increase stigmatization of smoking.
  • Adult involvement. Every parent, teacher and person who works with youth should recognize the powerful predictive relationship between cigarette smoking and the use of alcohol and other drugs and be able to have an open dialogue with the said youth.

"Obviously, this study demonstrated that tobacco use is one of the most critical public health problems," Torabi said. "If we make an investment in prevention and cessation, it not only saves premature death and suffering, but it saves taxpayers' resources in the long term and will reduce our skyrocketing health care costs."

Torabi, chair of the School of HPER's Department of Applied Health Science, can be reached at 812-855-4808 or torabi@indiana.edu. Top

Visitable House

Visitability: Housing designed to be welcoming place for all. New housing construction has yet to catch up with 21st century lifestyles, where more people want to stay in their homes as they age, young parents juggle strollers and groceries and people of all ages live with various disabilities. Visitability, a nationwide movement, asks people without disabilities to think about how features such as wider doors, a stepless entry and a bathroom on the main floor can make their day-to-day lives easier now, not to mention when they're older. These features also make homes more welcoming for older relatives and friends who might have disabilities. "Visitability is a home construction and design approach that incorporates basic accessibility into newly-built homes and housing." Simply put, "it makes life easier" and makes a home more welcoming for those with disabilities, says Sharon Hauss, research associate at the Indiana Institute on Disability and Community. "It's a terrible feeling when you realize you can't have friends in your own home." Having a broken leg or joint replacement can make a person's own home seem unwelcoming. Car accidents, military service, illnesses and other situations can leave people unexpectedly injured or with a disability. "Our physical abilities change over time," says Hauss. "As a result, our homes may have to change as well, but think of how beneficial it would be if those features had been included from the beginning."

Including visitability features in new construction is estimated to cost an additional 1 percent, which is less than it would cost to retrofit a house. The following are the defining features of a visitable home:

  • Stepless entrance. An entrance either at the front, side, rear of the house, or from the garage that does not have any steps.
  • Wide doorways. Doors on the main level that are 36 inches wide, allowing 34 inches clear passage. The typical 30 inch door found in the majority of homes is not accessible for most wheelchair access and other modes of mobility.
  • Bathroom on main level. At least a half-bath on the main level with reinforced walls for grab bars as well as space for a wheelchair to maneuver.

Here are some of the benefits of visitability features:

  • Convenience. Activities such as bringing in groceries, rolling in the stroller, hauling in the new refrigerator, or struggling with luggage, are easier. Dealing with a sprained ankle, using a wheelchair or crutches is less difficult. "Steps also get harder when you get older," says Hauss.
  • Flexibility/Planning for future. Be ready for all of life's seasons and realize that aging should not have to mean moving. "Most older people want to age in place and stay in their homes," says Jane Harlan-Simmons, research associate also at the Institute.
  • Hospitability. Excluding friends and family with mobility limitations from visiting your home will no longer be an issue.
  • Marketability. "You can make a stepless entrance look attractive and enhance the resale value of the house," says Harlan-Simmons.

According to Hauss and Harlan-Simmons, mandatory and voluntary visitability initiatives have been put into practice in parts of Arizona, Texas, Illinois and Georgia. For example, in Bolingbrook, Ill., it was mandated that all new homes be visitable. Harlan-Simmons and Hauss said contractors might have a lack of experience or knowledge of various visitability features, so people interested in such a home should be prepared to explain what they want. They also encourage home shoppers to mention the desire for such features to their realtors. "Builders and realtors need to know that there is a market for houses that accommodate the needs of aging baby boomers," says Harlan-Simmons.

To learn more about visitability, talk to your building professional about constructing a veritable home or call Indiana Builders Association at (317) 236-6334. The following are helpful resources about visitability:

The Indiana Institute on Disability and Community, Indiana's University Center for Excellence on Disabilities, works to increase community capacity in disability through academic instruction, research, dissemination and training, and technical assistance. Visit the Institute on the Web at www.iidc.indiana.edu.

For more information or to request a free copy of the Visitability brochure mentioned above, e-mail Jane Harlan-Simmons at jeharlan@indiana.edu, or Sharon Hauss at sahauss@indiana.edu, or telephone the Institute at 812-855-6508. Top

For additional assistance with these items, contact Tracy James, University Communications, at 812-855-0084 or traljame@indiana.edu.

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