Prevalence and social correlates of cardiovascular disease risk factors in Harlem.
(17/19736)
OBJECTIVES: This study examined the prevalence, social correlates, and clustering of cardiovascular disease risk factors in a predominantly Black, poor, urban community. METHODS: Associations of risk factor prevalences with sociodemographic variables were examined in a population-based sample of 695 men and women aged 18 to 65 years living in Central Harlem. RESULTS: One third of the men and women were hypertensive, 48% of the men and 41% of the women were smokers, 25% of the men and 49% of the women were overweight, and 23% of the men and 35% of the women reported no leisure-time physical activity over the past month. More than 80% of the men and women had at least 1 of these risk factors, and 9% of the men and 19% of the women had 3 or more risk factors. Income and education were inversely related to hypertension, smoking, and physical inactivity. Having 3 or more risk factors was associated with low income and low education (extreme odds ratio [OR] = 10.2, 95% confidence interval [CI] = 3.0, 34.5 for education; OR = 3.7, CI = 1.6, 8.9 for income) and with a history of unstable work or of homelessness. CONCLUSIONS: Disadvantaged, urban communities are at high risk for cardiovascular disease. These results highlight the importance of socioenvironmental factors in shaping cardiovascular risk. (+info)
Evidence for a black-white crossover in all-cause and coronary heart disease mortality in an older population: the North Carolina EPESE.
(18/19736)
OBJECTIVES: This cohort study evaluated racial differences in mortality among Blacks and Whites 65 years and older. METHODS: A total of 4136 men and women (1875 Whites and 2261 Blacks) living in North Carolina were interviewed in 1986 and followed up for mortality until 1994. Hazard ratios (HRs) for all-cause and cause-specific mortality were calculated, with adjustment for sociodemographic and coronary heart disease (CHD) risk factors. RESULTS: Black persons had higher mortality rates than Whites at young-old age (65-80 years) but had significantly lower mortality rates after age 80. Black persons age 80 or older had a significantly lower risk of all-cause mortality (HR of Blacks vs Whites, 0.75; 95% confidence interval [CI] = 0.62, 0.90) and of CHD mortality (HR 0.44: 95% CI = 0.30, 0.66). These differences were not observed for other causes of death. CONCLUSIONS: Racial differences in mortality are modified by age. This mortality crossover could be attributed to selective survival of the healthiest oldest Blacks or to other biomedical factors affecting longevity after age 80. Because the crossover was observed for CHD deaths only, age overreporting by Black older persons seems an unlikely explanation of the mortality differences. (+info)
Potential explanations for the educational gradient in coronary heart disease: a population-based case-control study of Swedish women.
(19/19736)
OBJECTIVES: This study examined the association between educational attainment and coronary heart disease (CHD) and the factors that may explain this association. METHODS: This population-based case-control study included 292 women with CHD who were 65 years or younger and 292 age-matched controls. RESULTS: Compared with the adjusted odds ratio for CHD associated with college education, the age-adjusted odds ratio associated with mandatory education (< or = 9 years) was 1.87 (95% confidence interval [CI] = 1.23, 2.84) and the odds ratio for high school education was 1.35 (95% CI = 0.81, 2.25) (P for trend < .01). The odds ratio for mandatory education was reduced by 82%, to 1.16 (95% CI = 0.69, 2.09), after adjustment for psychosocial stress, unhealthy lifestyle patterns, hemostatic factors, hypertension, and lipids. CONCLUSIONS: Much of the increased risk of CHD in women with low education appears to be linked to psychosocial stress and lifestyle factors. Hemostatic factors, lipids, and hypertension also contribute to a lesser extent. These factors may be considered in strategies geared to reducing socioeconomic inequalities in cardiovascular health. (+info)
Is whole grain intake associated with reduced total and cause-specific death rates in older women? The Iowa Women's Health Study.
(20/19736)
OBJECTIVES: This study sought to determine whether nutrient-rich whole grains reduce mortality risk. METHODS: The study included 38,740 Iowa women, aged 55 to 69 years. A food frequency questionnaire was used to obtain data on grain intake. RESULTS: Median whole grain intake quintiles ranged from a median of 0.2 to more than 3 servings per day. Women with higher intakes had healthier lifestyles and less baseline disease. The total death rate decreased in increasing quintiles, and the pattern repeated for cancer, cardiovascular disease, and other causes combined. Adjusted for lifestyle and baseline disease, the relative hazard rate ratio for total death was about 0.85 in daily consumers of whole grain. Findings persisted in strata of baseline healthy and diseased and were not explained by dietary fiber. Rates of total mortality, but not cardiovascular disease mortality, were higher among frequent consumers of refined grain. CONCLUSIONS: Total mortality risk was inversely associated with whole grain intake and positively associated with refined grain intake. Refined grains contributed more than 20% of energy intake, and whole grains contributed 1%. Substitution of whole for refined grain may reduce chronic disease risk in the United States. (+info)
Sexual harassment and generalized workplace abuse among university employees: prevalence and mental health correlates.
(21/19736)
OBJECTIVES: This study hypothesized that interpersonal workplace stressors involving sexual harassment and generalized workplace abuse are highly prevalent and significantly linked with mental health outcomes including symptomatic distress, the use and abuse of alcohol, and other drug use. METHODS: Employees in 4 university occupational groups (faculty, student, clerical, and service workers; n = 2492) were surveyed by means of a mailed self-report instrument. Cross-tabular and ordinary least squares and logistic regression analyses examined the prevalence of harassment and abuse and their association with mental health status. RESULTS: The data show high rates of harassment and abuse. Among faculty, females were subjected to higher rates; among clerical and service workers, males were subjected to higher rates. Male and female clerical and service workers experienced higher levels of particularly severe mistreatment. Generalized abuse was more prevalent than harassment for all groups. Both harassment and abuse were significantly linked to most mental health outcomes for men and women. CONCLUSIONS: Interpersonally abusive workplace dynamics constitute a significant public health problem that merits increased intervention and prevention strategies. (+info)
What's driving an epidemic? The spread of syphilis along an interstate highway in rural North Carolina.
(22/19736)
OBJECTIVES: The purpose of this study was to determine whether county syphilis rates were increased along Interstate Highway 95 (I-95) in North Carolina during a recent epidemic. METHODS: Ecological data on syphilis cases demographic data, highway data, and drug activity data were used to conduct a cross-sectional and longitudinal study of North Carolina countries from 1985 to 1994. Crude and adjusted incidence rate ratios (IRRs) were determined by means of standard and longitudinal Poisson regression models adjusted for sociodemographic factors and drug use. RESULTS: Ten-year syphilis rates in I-95 counties greatly exceeded rates in non-I-95 counties (38 vs 16 cases per 100,000 persons) and remained higher after adjustment for race, age, sex, poverty, large cities, and drug activity (adjusted IRR = 2.05, 95% confidence interval [CI] = 1.84, 2.28). Syphilis rates were stable until 1989, when rates increased sharply in I-95 counties but remained stable in non-I-95 counties. Increased drug activity in I-95 counties preceded the rise in syphilis cases. CONCLUSIONS: A better understanding of the relationship between high-ways and the spread of sexually transmitted diseases may guide future prevention interventions. (+info)
Neighborhood safety and the prevalence of physical inactivity--selected states, 1996.
(23/19736)
Physical inactivity is an important risk factor for premature morbidity and mortality, especially among high-risk populations. Although health-promotion programs have targeted high-risk groups (i.e., older adults, women, and racial/ethnic minorities), barriers exist that may affect their physical activity level. Identifying and reducing specific barriers (e.g., lack of knowledge of the health benefits of physical activity, limited access to facilities, low self-efficacy, and environmental issues [2-6]) are important for efforts designed to increase physical activity. Concerns about neighborhood safety may be a barrier to physical activity. To characterize the association between neighborhood safety and physical inactivity, CDC analyzed data from the 1996 Behavioral Risk Factor Surveillance System (BRFSS) in Maryland, Montana, Ohio, Pennsylvania, and Virginia. This report summarizes the results of this analysis, which indicate that persons who perceived their neighborhood to be unsafe were more likely to be physically inactive. (+info)
Socioeconomic and behavioral factors leading to acquired bacterial resistance to antibiotics in developing countries.
(24/19736)
In developing countries, acquired bacterial resistance to antimicrobial agents is common in isolates from healthy persons and from persons with community-acquired infections. Complex socioeconomic and behavioral factors associated with antibiotic resistance, particularly regarding diarrheal and respiratory pathogens, in developing tropical countries, include misuse of antibiotics by health professionals, unskilled practitioners, and laypersons; poor drug quality; unhygienic conditions accounting for spread of resistant bacteria; and inadequate surveillance. (+info)