Adam J Milam

Publications (11) View all

• Article: Neighborhood Environment and Urban Schoolchildren's Risk for Being Overweight.

  Damiya Whitaker, Adam J Milam, Camelia M Graham, Michele Cooley-Strickland, Harolyn M Belcher, C Debra Furr-Holden
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  ABSTRACT: Abstract Purpose. Child and adolescent obesity is increasingly prevalent and predisposes risk for poor physical and psychosocial health. Physical and social factors in the environment, such as neighborhood disorder, may be associated with childhood obesity. This study examines the association between living in a disordered neighborhood and being overweight among a sample of urban schoolchildren. Design. Baseline interview data, including height, weight, and hip circumference, were obtained from 313 elementary school-aged participants in a community-based epidemiologic study. Setting. The setting was Baltimore, Maryland, a large metropolitan city. Subjects. Subjects were elementary school students ages 8 to 12 years. Measures. To assess neighborhood characteristics, independent evaluators conducted objective environmental assessments using the Neighborhood Inventory for Environmental Typology instrument on the block faces (defined as one side of a city block between two intersections) where the children resided. Analysis. Logistic regression models with generalized estimating equations were used to examine the association between neighborhood disorder and children being overweight. Results. Neighborhood disorder showed a trend toward a statistically significant association with being overweight during childhood (odds ratio [OR], 1.03; confidence interval [CI], .99-1.07; p = .07) in the unadjusted model. Gender was significantly associated with being overweight, with female gender increasing the odds of being overweight by 50% in the sample (OR, 1.50; CI, 1.18-1.92; p < .01). After controlling for race, age, and comparative time spent on a sport, multivariable analyses revealed that gender (adjusted odds ratio [AOR], 2.42; CI, 1.63-3.59; p < .01) and neighborhood disorder (AOR, 1.09; CI, 1.03-1.15; p < .01) were associated with being overweight. Further, an examination of interactions revealed girls (AOR, 2.40; CI, 1.65-3.49; p < .01) were more likely to be overweight compared with boys (AOR, 2.20; CI, 1.57-3.11; p < .01) living in neighborhoods with the same level of neighborhood disorder. Conclusion. Results suggest neighborhood hazards warrant additional consideration for their potential as obesogenic elements affecting gender-based disparities in weight among urban schoolchildren. Future studies in this area should include longitudinal examinations.
  American journal of health promotion: AJHP 03/2013; · 2.37 Impact Factor
• Article: Risk for Exposure to Alcohol, Tobacco, and Other Drugs on the Route to and from School: The Role of Alcohol Outlets.

  A J Milam, C D M Furr-Holden, M C Cooley-Strickland, C P Bradshaw, P J Leaf
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  ABSTRACT: Despite the national push encouraging children to walk to school, little work has been done to examine what hazards children encounter on the route to school. This study examined the association between the presence of alcohol outlets on children's route to school and perceived safety on the route to school as well as exposure to alcohol, tobacco, and other drugs (ATOD). Data come from a community-based epidemiological study of 394 urban elementary school students. Participants' residential address, school location, and alcohol outlet data were geocoded and the route to school was mapped. The route to school layer and the geocoded alcohol outlet data were joined to determine the number of alcohol outlets children pass on the route to school. Logistic regression models estimated the association between the presence of alcohol outlets on the route to school, alcohol and drug exposure, and self-reported safety. Children with an alcohol outlet on the route to school were more likely to be offered ATOD (OR = 2.20, p = 0.02) as well as be exposed to drug selling (OR = 1.72, p = 0.02) and seeing people using drugs (OR = 1.93, p = 0.02). After adjusting for individual-level variables, the relationship between presence of alcohol outlets and being offered ATOD and seeing people using drugs remained significant. However, after adjusting for individual-level control variables and a proxy for the larger neighborhood context, the association between the presence of alcohol outlets and exposure to ATOD was no longer significant. As national campaigns are encouraging children to walk to school, it is essential to consider what children are exposed to on the route to school.
  Prevention Science 02/2013; · 2.63 Impact Factor
• Article: Neighborhood Disorder and Juvenile Drug Arrests: A Preliminary Investigation Using the NIfETy Instrument.

  Adam J Milam, C Debra M Furr-Holden, Paul T Harrell, Damiya E Whitaker, Philip J Leaf
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  ABSTRACT: Background: Disordered neighborhood environments are associated with crime, drug use, and poor health outcomes. However, research utilizing objective instruments to characterize the neighborhood environment is lacking. Objectives: This investigation examines the relationship between objective measures of neighborhood disorder and juvenile drug arrests (JDAs) in an urban locale. Methods: The neighborhood disorder scale was developed using indicators from the Neighborhood Inventory for Environmental Typology (NIfETy) instrument; a valid and reliable tool that assesses physical and social disorder. Data on 3146 JDAs from 2006 were obtained from the police department. Results: Negative binomial regression models revealed a significant association between neighborhood disorder and the count of JDAs in the neighborhood (β == .34, p < .001). The relationship between neighborhood disorder and JDAs remained significant after adjusting for percent African-Americans in the neighborhood (β == .24, p < .001). Conclusions: This preliminary investigation identified a positive and statistically significant relationship between an objective measure of neighborhood disorder and JDAs. Future investigations should examine strategies to reduce drug-related crime by addressing the larger neighborhood and social context in which drug involvement and crime occurs.
  The American Journal of Drug and Alcohol Abuse 07/2012; 38(6):598-602. · 1.55 Impact Factor
• Article: Mobilizing for policy: using community-based participatory research to impose minimum packaging requirements on small cigars.

  Adam J Milam, Lee Bone, Debra Furr-Holden, Megan Coylewright, Kathleen Dachille, Kerry Owings, Eric Clay, William Holmes, Soula Lambropoulos, Frances Stillman
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  ABSTRACT: Cigarette sales have declined in the United States over the past decade; however, small cigar sales have been rapidly increasing. In most urban areas, small cigars are inexpensive and are sold as singles without health warnings. PURPOSE OF ARTICLE: This paper describes a community- academic-practice partnership's (CAPP) efforts to decrease small cigar use in young adults living in Baltimore, Maryland, through legislative strategies. Survey data among young adults not in school indicated that 20% of individuals reported current small cigar use, often in combination with cigarettes. The community- academic partnership engaged the community in discussion about small cigar use in the fall of 2007. In collaboration with partners, bills were submitted to the legislative bodies for the city and state to impose minimum packaging requirements on small cigars. Collaborative partnerships between community-based organizations, public health agencies, and academic institutions can lead to policy initiatives with the potential to improve public health.
  Progress in community health partnerships: research, education, and action 01/2012; 6(2):205-12.
• Article: Metric properties of the Neighborhood Inventory for Environmental Typology (NIfETy): an environmental assessment tool for measuring indicators of violence, alcohol, tobacco, and other drug exposures.

  C D M Furr-Holden, K D M Campbell, A J Milam, M J Smart, N A Ialongo, P J Leaf
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  ABSTRACT: Establish metric properties of the Neighborhood Inventory for Environmental Typology (NIfETy). A total of 919 residential block faces were assessed by paired raters using the NIfETy. Reliability was evaluated via interrater and internal consistency reliability; validity by comparing NIfETy data with youth self-reported violence, alcohol, and other drug exposure and crime statistics. Validity and reliability metrics were moderate to exemplary for the total scale and subscales. NIfETy data correlated strongly with crime data and youth self-reported exposure. The NIfETy is valid and reliable. Future investigations will explore its use in other urban centers and association to other health outcomes.
  Evaluation Review 06/2010; 34(3):159-84. · 1.20 Impact Factor