Scholarship & Creativity

Updated 4:00 PM February 8, 2006

Scholarship & Creativity

Poor, racially mixed areas lack supermarkets

Predominantly white and wealthy neighborhoods have far more healthy food options than poor minority areas, according to a U-M study.

Large supermarkets, with a payroll of more than 50 employees, are more prevalent in wealthier areas. This is significant because they tend to have a wide selection of nutritious foods at lower prices.

"If you pay attention to the environment, you realize the way the environment conditions your behavior in subtle ways," says Ana Diez Roux, associate professor of epidemiology at the School of Public Health. She is co-author of the study in the February issue of American Journal of Public Health.

Diez Roux and Latetia Moore analyzed 2000 U.S. Census data from 75 census tracts in Forsyth County, N.C.; 276 census tracts in the city of Baltimore and Baltimore County, Md.; and 334 census tracts in Manhattan and the Bronx, N.Y.

"Health researchers have focused on individual behavior as a risk for disease," Diez Roux says. "We want to understand what features of the environment shape behavior."

Other findings of the study:

• Natural food stores, fruit and vegetable markets, bakeries and specialty food stores were more common in predominantly white neighborhoods;

• Nineteen percent of stores in predominantly Black areas were 2,500 square feet or more, while 42 percent of stores in predominantly white areas were at least that large;

• Liquor stores were more common in the poorest than in the wealthiest neighborhoods.

Diez Roux says one implication of the study is that health outreach programs encouraging people to eat more fresh fruits and vegetables and cut down on high-fat foods need to take into account what's available nearby.

The researchers note that smaller stores might mean shoppers are more likely to walk instead of drive, since larger stores tend to be located on busy streets with huge parking lots, and shoppers might have more social interactions at smaller stores, as well.—Colleen Newvine, News Service

Parents find success discussing child behavior in group setting

Children with serious emotional disturbances behave better at home and school when their parents participate in support groups led by mental health professionals, a new study indicates.

"There is a stigma discussing child behavior problems with family and friends, but parents discussing these issues in a group with other parents facing similar experiences provides a structured, supportive environment," says Mary Ruffolo, lead author of the study and associate professor of social work.

A parent-professional team leadership model for group intervention was evaluated for families of youths with emotional and behavioral problems. The study specifically looked at the S.E.E. model—support, empowerment and education group intervention.

Parents' primary support typically has come from case managers but not other families coping with the same problems, says Ruffolo, whose research focuses on mental health interventions with children, adolescents and their families and the mental health services system.

Parents who participated in S.E.E. group intervention reported high levels of satisfaction with the sessions, the research shows. In addition, they improved their parenting skills, in part, because they shared their experiences with their child with other parents. They did not feel alone in their situations and felt confident in their abilities, the study says.

The study appears in the January issue of Social Work.—Jared Wadley, News Service

Few women opt to rebuild breast after cancer

Fewer than 20 percent of American women eligible for breast reconstruction following mastectomy, or removal of the breast due to cancer undergo the procedure, according to experts at the U-M Health System (UMHS).

In a letter published in the Jan. 25 issue of the Journal of the American Medical Association (JAMA), study lead author and UMHS plastic surgeon Dr. Amy Alderman, writes that despite mandated insurance coverage of breast reconstruction after mastectomy, disparities still exist in its use among certain races, including African Americans, Hispanics and Asians, and for women in certain regions of the country.

The findings, from a UMHS study of all women that underwent a mastectomy for breast cancer from 1998-2002, assessed the impact of the Women's Health and Cancer Rights Act (WHCRA). The WHCRA was established in 1999 to mandate insurance coverage of breast reconstruction after mastectomy.

The study revealed that, despite implementation of the WHCRA, there was no increase in breast reconstruction. Of the 51,184 women with breast cancer treated with a mastectomy between 1998-2002, only 16.5 percent of eligible patients underwent reconstruction.

"We know that women who undergo breast reconstruction gain large improvements in their emotional, social and functional well-being, and hoped the law would increase use of reconstruction following mastectomy, since prior to the law, insurance companies did not cover the procedure," says Alderman, assistant professor in the Department of Surgery at the Medical School and the Ann Arbor VA Health Care System. "But our study found that the law has done nothing to improve usage among women."

Where a woman lives can factor into the likelihood that she will undergo reconstruction. The study found high rates of reconstruction in Detroit and Atlanta, but low rates throughout the states of Iowa and Connecticut, for example.

Alderman's co-authors in the Department of Surgery were Yongliang Wei, research assistant; and Dr. John Birkmeyer, the George D. Zuidema Professor of Surgery and chair, Surgical Outcomes Research.—Krista Hopson, UMHS Public Relations

SOX fails to stop stock-option manipulation by executives

Sarbanes-Oxley has been less effective in putting a halt to stock-option manipulation than regulators hoped, say researchers at the Stephen M. Ross School of Business.

A new study by finance professors M.P. Narayanan and H. Nejat Seyhun suggests that although the prompt-disclosure requirement imposed by the Sarbanes-Oxley Act of 2002 (SOX) partly has curtailed managerial influence of grant date stock prices by executives seeking to increase the value of their option grants, such activities still occur.

"Backdating of grant dates and camouflaged timing appear to be practiced even after SOX, especially by smaller firms," Narayanan says. "In order to further restrict this behavior, the Securities and Exchange Commission needs to enforce the SOX two-day reporting rule and, if possible, limit the use of unscheduled option grants to legitimate purposes only."

Under SOX, executive option grants must be reported to the SEC within two business days of the grant date—a more stringent reporting requirement imposed in the wake of widespread corporate scandals. Since the exercise price usually is set at the stock price on the grant date, managers want to keep that price as low as possible, in hopes of reaping higher gains later when they exercise their options, the researchers say.

Small firms, which tend to have less official scrutiny, weaker corporate governance and lower institutional ownership, exhibited significantly higher average reporting lags —the time between the presumed grant date and the date of filing the grant with the SEC—post-SOX, averaging 19 business days compared to 12 days for the overall sample, the researchers say.

Top executives also appeared more in violation of SOX reporting requirements on average than other executives and larger grants provided more incentive to influence grant date stock prices, they say.—Bernie DeGroat, News Service

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