Drug use, sexual behaviour and HIV risk of the homeless in Port-of-Spain, Trinidad

Data were collected from 88 homeless persons in Port-of-Spain, Trinidad to assess HIV risk. 68 percent of the sample were engaging in unprotected sex with multiple partners, 25 percent were exchanging sex for money, and 29.5 percent were regularly smoking crack cocaine. Many had two or more of these behaviours that put them at high risk of HIV infection. Females were significantly more likely to be sex traders, to engage in bisexual behaviour and to have a history of psychiatric illness. The relationship between psychiatric illness and HIV risk behaviours among homeless female persons is explored. Educational interventions are suggested to reduce the public health risks in this population.(AU)

Low birth weight: race and maternal nativity - impact of community income

BACKGROUND: The purpose of this article is to determine the effect of community income as a co-factor in the association of low birth weight, race, and maternal nativity in New York City. METHODS: New York City birth records, 1988 through 1994, provided data on maternal and infant characteristics. There were 274,121 white and 279,826 black mothers included in this study. Black mothers were classified as US-born (South and Northeast) and foreign-born (the Caribbean, South America, and Africa). Based on the 1990 US census income data, census tracts of the city were aggregated by tertile of per capita income as low-, middle-, and high-income communities. Incidence of low birth weight was estimated by race, maternal nativity in the city as a whole, and each income community. RESULTS: Overall, black women had a substantially higher risk of low birth weight infants (<2500 g) than did whites (13.1 percent vs 4.8 percent). Foreign-born black mothers had a birth weight advantage over US-born black mothers (10.0 percent vs 16.7 percent). After controlling for socioeconomic and medical characteristics, the risks of low birth weight for blacks compared with whites were 0.95 (95 percent confidence interval: 0.86-1.03) and 0.86 (0.69-1.02) for Caribbean- and African-born black mothers, respectively. Moreover, in low-income communities, compared with white mothers, the risks for Caribbean- and African-born black mothers were 0.88 (0.79-0.97) and 0.77 (0.61-0.96), respectively. By contrast, US and South American-born black mothers had a consistently higher risk of low birth weight infants, regardless of community income level. CONCLUSION: Low birth weight was significantly less frequent among whites than among blacks. However, this overall finding masked substantial variation among blacks, determined by maternal nativity and the income level of the community in which they lived. In fact, Caribbean- and African-born black mothers had birth outcomes generally similar to and, in poor communities, even more favorable than those for whites.(Au)

Analysis of food assistance programmes in Jamaica

Paper brings together information from several studies in a review of the elements of the Food Assistance Programme (FAP) in Jamaica, their impact on vulnerable groups, and suggests guidelines for reorganizing and financing the programme. The Food Assistance Programme comprises the Food Stamp Programme, instituted in 1984, the General Food Subsidies and the School Feeding Programme. This paper is part of a project - The "Jamaican Poverty Line Project" sponsored by the Planning Institute of Jamaica (PIOJ). This project is a collaborative undertaking between PIOJ staff and a research team from the UWI. The first phase of the project is directed towards the development of the Poverty Line, and the analysis of food support programmes. In this exercise, the project was able to draw upon data from the newly instituted series of Survey of Living Conditions (SLC) undertaken jointly by the PIOJ and the Statistical Institute of Jamaica(AU)

A community demand analysis of health services in suburban Jamaica: focus on Hermitage - August Town

A demand analysis of health services for the Hermitage - August Town community was done in the month of November 1986. This cross-sectional study focussed on the economic variables involved in service utilisation principally household income and health insurance. The Community Health Centre at the Department of Social and Preventive Medicine, University of the West Indies accounted for 51.2 percent of overall demand with University services accounting overall for over 75 percent . The public-to-private demand ratio was 6:1, with health insurance featuring as a major enabling factor towards the use of private services. There is a striking higher rise in the cumulative demand in the very low income group, (household income per capita less than $166.54) compared to the 'higher' income group. This means that the income elasticity of demand for all types of health services decreases as household income rises. The need for development of health services research especially in relation to the economic aspects of health care in Jamaica and for outreach activities aimed at very low income groups is stressed (AU)

Malnutrition in children attending a Barbadian polyclinic

Given the relatively high standards of living in Barbados, indicated by the per capita income of U.S. $3.500, level of education and health care, and the activities of the National Nutrition Centre since 1972, it was felt that the prevalence of malnutrition (8.8 percent) reported in the 1981 National Health and Nutrition Survey was still relatively high. It was, therefore, decided to determine the prevalence of malnutrition in a clinic and factors associated with the nutritional status of the children. Weights and ages of all children 6-42 months of age on clinic records were noted. Then the parents or guardians of 104 children (52 malnourished or index and 52 normal or comparison) attending the clinic were interviewed. Anthropometric measurements (weight, height and head circumference) of the 104 children were taken; and information from both their clinic records and their mothers' maternity records was noted. In the index group (46 percent) mothers were employed compared with 40 (77 percent) in the comparison group, a difference that was statistically significant. There were 20 and 39 houses in the index group with piped water in the house and in poor state of disrepair respectively compared with 37 and 49 in the comparison group, differences that were significant at the 1 percent and 5 percent level respectively. The comparison group had significantly more households with gas stove (50), kitchen appliances (31), telephone (30) and refrigerators (42), than the index group: gas stove (41), kitchen appliances (18), telephone (19) amd refrigerator (31). In the study 22 children in the index group compared with all 52 children in the comparison group were receiving their first solid food too early and too late respectively; these differences were statistically significant. In the present diet, significantly larger numbers of children in the comparison group were receiving milk and cereal, 38 and 32 children respectively, than in the index group, 25 and 21 children. However, significantly more children (18) in the index group were receiving bush teas than the comparison group, 2 children. In the index group 21, children had low birth weights (i.e. 2500g) compared with 1 child in the comparison group. Similarly, more children (34) in the index group than the comparison group (21) were ill; and 23.1 percent of the index sick children had 3 or more episodes compared with 3.8 percent in the comparison group. All these differences were significant at p<0.001. In addition to those factors already mentioned, there are a number of other factors thought to be associated with poor nutritional status but which were not found to be so in this study. For example, there was no difference in the level of educational attainment of mothers in the index group (19 primary, 33 post-primary) and the comparison group (19 primary, 33 post-primary). Further, both groups had a similar family size: index 6.7 and comparison 6.3. Other factors not associated were presence of male head (50.0 percent index, 63.5 percent comparison); working male head and mothers' age and union status. Yet it should be noted that there was a tendency for the comparison group to have higher values than the index group. It was concluded that: (1) the socioeconomic or standard of living conditions in the comparison group were better than those of the index groups indicated by mother's employment, mean household income, crowding, better housing and household amenities such as gas stove, refrigerator and telephone. (2) Feeding practices in the comparison group were generally better than in the index group as indicated by dilution of milk formula, age first solid foods were given and receiving cereals and milk in their diet (3) children who are sick and have frequent episodes of illnesses are more likely to have low nutritional status; and (4) children with normal birth weights are more likely to have better nutrition status (AU)

A study of undernutrition, poverty and national development in Jamaica

A socio-economic survey of 301 households was conducted in the parish of St. James, during 1982. Households were chosen from enumeration districts, randomly selected from within three ecologically defined strata. Urban households from wealthy districts and rural households farming over 10 acres of land were excluded. The data suggest that the prevalence of urban undernutrition has increased over the past 7-9 years. Of the observed variation in nutritional status, 28 percent was explained by 10 socio-economic variables. Of 7 categories of households identified, least at risk were those supported by professional and technical persons or farmers operating over 2.5 acres, while those most at risk were dependent on the urban unskilled and the skilled self-employed. Casual analysis revealed that although child health and food consumption were the direct precursors of child malnutrition, these were in turn due to poor household and community socio-economic conditions. The households' inability to provide adequate diets and child care appeared related to inadequate and unstable income and employment opportunities. Two public policies were evaluated. The data suggest that while the Food Assistance Plan will save some of the most at-risk from nutritional disaster, the benefits are too little to be generally effective. Better targeting and commodity choice would improve the plan. Additionally, an income supplement might be a better alternative to food stamps. The First Rural Development Project was found to have improved the incomes of beneficiaries. However, insufficient selection bias, inadvertent displacement of squatters, the number of beneficiaries and the real size of income increases make its impact small in relation to need. The study confirms the necessity to approach nutrition improvements through socio-economic development, and underscores the importance of far reaching social restructuring to prevent the continuous occurrence of malnutrition in Jamaica (AU)

An examination of dietary intakes in a low-income area of Jamaica

An account of the scarcity of information existing on dietary intakes, the time lapse since any such data have been collected and because of the rapid increases in the cost of living during the last 10 years, a survey was designed to investigate the diets of low-income families concentrating on the most vulnerable members-the pre-school children. Fifteen households in Central Village, a low-income suburban area, and their 22 children between the ages of 6 months and 3 years were studied. The food intakes of the households were measured by the inventory method over a period of 7 days, whilst intakes of the children were measured over the same period by weighing all food eaten for a minimum period of three days supplemented by dietary recall on other days. The survey lasted from November, 1973 until August, 1974 and the weights and heights of the children were measured on three occasions. Household income was assessed by detailed questions on expenditure and the food budget was obtained from the cost of the food items listed in the inventory. A constant surveillance of food prices was maintained throughout the study, from which the foods of best cost-nutrient value were determined. Dietary patterns of both groups were also examined and the nutritional status and dietary intakes of the children compared. The mean weekly income was J$58.69 of which 43 percent was spent on food. Families on the whole shopped wisely and the children were not noticeable underfed. Dietary intakes were on average low, protein and vitamin C being the most satisfactory. Cereals were of greatest importance in the diets of the households whilst dairy products were more outstanding in the diets of the children. 68.2 percent of the children were less than the expected weight for age. However correlation between nutritional status of the children and dietary intakes was not statistically significant (AU)

Psychiatric assessment of 30 chronic users of cannabis and 30 matched controls

A study done in Jamaica of 30 chronic cannabis smokers (use for at least seven years) and 30 matched controls revealed no significant differences between the two groups in the incidence of mental illness or of abnormalities of mood, thought, or behavior. Nor did the groups differ significantly with regard to criminal records, use of other drugs, or upward or downward movement in social or economic position.(AU)

Heights and weights of Jamaicans

Jamaican children in a low income rural area were smaller and lighter than comparable children in urban areas. Differences were lower than London children. There was no comparable difference in the size of adults. Heights and weights of rural and urban Jamaican adults were considerably below those of United States adults. (AU)

Social, economic, and dietetic features of tuberculosis in British Guiana

Certain aspects of the hygienic, social and economic condition and the food of 251 families comprising 1,189 persons and including newly notified cases of tuberculosis and their family contacts in the county of Demerara, British Guiana, are discussed. The extent of overcrowding as measured by both the English and the inadequate local legal standards reveal that over half of these families live under conditions of overcrowding, and that more than half of the houses violate even the latter inadequate standards. The incomes and earnings in these families disclose that they belong to a variety of economic levels; but that vast majority of the families investigated belong to the very income groups. Positive correlation was observed to exist between income and floor space. Whereas with equal incomes floor space varied inversely as the size of the family, the type of house and the number and size of rooms varied directly as the income. The budgets of a large proportion of these families were almost completely absorbed by rent and food, though in a large number of cases the amount spent on food was amazing low in relation to local costs. In the majority of families investigated the diet was deficient and unbalanced. In 61.9 per cent of families it was deficient in total calories. In 59 per cent it was deficient in total protein and in 43.9 per cent it was deficient in first-class proteins. Fat and carbohydrate were relatively high in proportion but actually deficient in quantity in the diets deficient in calories (Summary)

A case study of nutrition in rural development

A case-comparison study was conducted to examine the nutritional status of 5 Project Land Lease (PLL) beneficiaries of Jerusalem Mountain in rural Jamaica (Westmoreland). The comparison group of 5 non-PLL beneficiaries (NPLL) was drawn from the surrounding communities and each household used in the final sample for both PLL and NPLL had between 3-5 acres available for farming and at least one child less than 5 years old at the time of the study. An indepth study was intended using participant observation along with direct interviews with householders and certain key informants from the community with the help of a pre-tested checklist. The following variables were studied in both groups: Household characteristics, household budgets (income and expenditure), nutritional status (anthropometry and food consumption), food production and farming, methods marketing, health services. The results showed that there was a tendency for both PLL and NPLL households to be similar in most respects but the study also indicated that if all the benefits written into PLL were available to PLL beneficiaries, then they would be at a far greater advantage than NPLL. Some of the benefits like marketing and health services would be equally beneficial to both groups and would contribute towards upward mobility among the farmers in the area. The study further indicated that the PLL programme, while it made a limited amount of land available to the farmers who benefitted, was poorly managed and all the necessary agricultural inputs were missing especially over the last few years and as a result left the farmers virtually unable to farm any better than the non-beneficiaries with equal land size. (Summary)