Beliefs about high blood pressure prevention in a survey of blacks and Hispanics.

Beliefs about the potential for high blood pressure prevention were assessed during a telephone survey of cardiovascular risk factor awareness among black and Hispanic adults in Chicago, Illinois. A high proportion of those interviewed-82% of blacks and 69% of Hispanics--thought a person could do something to prevent getting high blood pressure and either selected one or more of several possible preventive measures listed by the interviewer or volunteered other measures. Awareness of two widely cited prevention possibilities that may be particularly important for black and Hispanic populations--lowering salt intake and maintaining ideal weight--was low. Fewer than half of the respondents in this survey (44% of blacks and 26% of Hispanics) thought that lowering salt intake would help prevent high blood pressure. An even smaller number (10% of blacks and 20% of Hispanics) thought that maintaining ideal weight would help prevent high blood pressure. Moreover, other measures that are unrelated to high blood pressure or for which a relation to high blood pressure is not well established were selected frequently. These findings were contrary to our expectations, because black and Hispanic populations have been targeted by the National High Blood Pressure Education campaign and because high levels of awareness in other areas of cardiovascular disease risk were observed in this sample. These data suggest that awareness of potential strategies for high blood pressure prevention among black and Hispanic communities needs to be addressed specifically in related educational campaigns.

Public health and health care reform: the American Public Health Association's perspective.

This paper discusses the American Public Health Association's goals with regards to the current health care reform debate. By outlining the organization's historical context with regards to health care reform as well as the parameters of the current medical care and public health crises, the paper explains why APHA's advocacy efforts focused on two major issues: the adoption of a national health program that features universal coverage with a comprehensive set of benefits for all our nation's residents, and the enhancement of the federal, state, and local public health infrastructure. The paper argues that both medical care services and public health programs must be expanded if we are to improve the nation's overall health status.

Evaluation of an academic reinforcement program for health science students.

An Academic Reinforcement Program has been used for three years at the University of Texas Medical Branch to assist health science students with test taking, note taking, memorization, labeling, charting, and time-scheduling techniques. An evaluation indicated that the majority of students who have learned the techniques improved their academic grades with less expenditure of study time, learned to deal with some problems which affected their studies, and gained self-confidence through the encouragement and support of the staff who taught the techniques.

Health care access among Mexican Americans with different health insurance coverage.

This study describes the rates of health care access among Mexican Americans with different health insurance coverage. An interview questionnaire was used to collect information regarding sociodemographics, perceived health status, health insurance coverage, and sources of health care from a random sample of 501 Mexican Americans from San Antonio, Texas. Health care access was determined more by having health insurance coverage than by health care needs. Poor Mexican Americans with health insurance had higher health care access rates than did poor Mexican Americans without health insurance. Health care access may improve health care outcomes, but more comprehensive community-based campaigns to promote health and better use of health services in underprivileged populations should be developed.

A method for determining patients' perceptions of their health needs.

Success or failure in establishing a meaningful relationship between physician and patient depends to a large extent on how fully the patient communicates, and the physician understands, his/her health needs. Return visits, compliance with the physician's prescribed regimen, and the effectiveness of the treatment and rehabilitation are also closely related to the disclosure and assessment of the patient's health needs. A model of how health needs are determined is presented. Various behavioral outcomes which follow the identification of a health problem and assessment of health needs by a patient are discussed. A Health Needs Assessment Questionnaire is presented in English and Spanish to be used and tested as an aid to the family physician in assessing patient's health needs at the first encounter.

The representation of Hispanics in the health professions.

Hispanics are the country's second largest and fastest growing minority group. This investigation was conducted to review the preprofessional educational experience of Hispanics as well as their representation in the nation's schools of health professions. Findings revealed that Hispanics are the most undereducated major segment of the US population. The majority of all young Hispanics (60% to 75%) do not attend college at all and of those who do attend, less than 10% graduate. Deliberate policy decisions and a concerted national effort to recruit and train minority students in the health professions has resulted in a significant increase in the number of minority health professionals practicing in our country. However, available data clearly point to an underrepresentation of Hispanics in most of the health professions.

Vital and heath statistics for the US hispanic population.

PIP: The lack of adequate vital and health statistics for the Hispanic population of the United States is discussed, and recommendations are made for improving the quality and quantity of these data.^ieng

Quality of health care for ethnic/racial minority populations.

This article reviews the composition and characteristics of the health professions, the demographics of the national population, and factors that influence access to health care and satisfaction with care for ethnic/racial minority populations in the United States. In addition, an overview of publicly funded US health insurance programs for the poor is provided along with a discussion of the impact that managed care is having on the American health care system. Finally, the paper summarizes conference discussions regarding the problems, strategies, and approaches that the UK and the US have experienced with respect to providing quality health care for ethnic/racial minority populations.

Health care utilization barriers among Mexican Americans: evidence from HHANES 1982-84.

Data from the Hispanic Health and Nutrition Examination Survey (HHANES) conducted by the National Center for Health Statistics in 1982-1984 were analyzed to document the type of barriers encountered which prevented Mexican Americans from obtaining health care, the sociodemographic subgroups most vulnerable to such barriers, and to examine the combined effects of predisposing, enabling, and need characteristics on these barriers. The findings suggest, in general, that low income groups, younger age groups, the less acculturated, those who lack health insurance coverage, those with functional limitations, and those in poorer perceived health status encounter more barriers than others, and are prevented by these barriers from obtaining health care for themselves.

Utilization of curanderos by Mexican Americans: prevalence and predictors. Findings from HHANES 1982-84.

Data from the Southwest sample of the Hispanic Health and Nutrition Examination Survey (HHANES) were analyzed to examine whether the use of a curandero or other folk medicine practitioner hindered, enhanced, or did not affect the utilization of western health care services by Mexican Americans. Findings revealed that only 4.2 percent of the HHANES sample persons between the ages of 18-74 years reported consulting a curandero, herbalista, or other folk medicine practitioner within the 12 months prior to the survey. Income, self-perceived health status, the language of the interview, and dissatisfaction with modern medical care recently received independently predicted curandero utilization (adjusted OR 2.01 and 1.66, respectively). Low income and self-perceived health status were less strongly related to curandero utilization.

Reproductive characteristics of Mexican-American, mainland Puerto Rican, and Cuban-American women Data from the Hispanic Health and Nutrition Examination Survey.

Data from the Hispanic Health and Nutrition Examination Survey were used to investigate reproductive characteristics of Hispanic females aged 15 to 45 years. Mexican-American and Puerto Rican women reported approximately 1.9 and 1.7 live births each, respectively, whereas Cuban-American women reported 1.1. Mexican-American women were more likely to be using oral contraceptives and were more likely to have had a hysterectomy or an oophorectomy than were Cubans and Puerto Ricans. The largest percentage of tubal ligations were found among Puerto Rican women. Mexican women who had been pregnant in the previous 12 months were more likely than their Puerto Rican and Cuban-American counterparts to be breastfeeding. Further research is needed to investigate the decision processes and/or cultural variations that may be responsible for these differences in reproductive traits across national origin groups.

The participation of Hispanics in US schools of Public Health, 1975-79.

Hispanic student and faculty representation at US Schools of Public Health from 1975-1979 was investigated. Findings indicate a substantial underrepresentation of Hispanic students and faculty members at these schools. Hispanic public health graduates were found to be less likely than other graduates to receive an MPH degree or a doctorate. It appears that the University of Puerto Rico graduates one-half of all Hispanic graduates and employs two-thirds of all Hispanic public health faculty.

Hispanic Health and Nutrition Examination Survey: methodological considerations.

The Hispanic Health and Nutrition Examination Survey (HHANES) was the first special population survey undertaken by the National Center for Health Statistics. The HHANES was designed to assess the health and nutritional status and needs of Mexican Americans, mainland Puerto Ricans and Cuban Americans. Data were collected using five data collection techniques: direct physical examinations, diagnostic testing, anthropometry, laboratory analyses, and interviews. Unlike other surveys conducted by the National Center for Health Statistics, the HHANES was not designed as a national survey. The HHANES was a survey of three Hispanic subgroups of the population in selected areas of the United States with a survey universe that included approximately 76 percent of the 1980 Hispanic-origin population in the United States. This article discusses statistical issues that should be addressed by researchers when analyzing HHANES data. Specifically, analysts need to account for the complex sample design, nonresponse bias, potential non-coverage bias, and the regional nature of the HHANES sample.

Alcohol consumption patterns among Mexican American mothers and among children from single- and dual-headed households: findings from HHANES 1982-84.

Data from the southwestern United States sample of the Hispanic Health and Nutrition Examination Survey were employed to compare the patterns of alcohol use among Mexican American mothers and children in female-headed households with use patterns among mothers and children in couple-headed households. Single female heads of household drank more alcoholic beverages on more days than females from dual-headed households. As a whole, the children of single heads of household still living at home did not demonstrate significantly different drinking patterns from their dual-headed household counterparts. While male children of single-headed households drank more days and total drinks than their dual-headed household counterparts, female children of dual-headed households drank more days and total drinks than female children from single-headed households.

Health insurance coverage and utilization of health services by Mexican Americans, mainland Puerto Ricans, and Cuban Americans.

This investigation examines data on 13,000 Mexican Americans, Puerto Ricans, and Cuban Americans between 6 months and 74 years of age who were interviewed from 1982 through 1984 in the Hispanic Health and Nutrition Examination Survey. In addition, data from the 1989 Current Population Survey (N = 145,000) conducted by the US Bureau of the Census are presented for the white and black non-Hispanic populations as well as the three Hispanic national origin groups. The study revealed that over one third of the Mexican-American population, one fifth of the Puerto Rican population, and one fourth of the Cuban-American population is uninsured for medical expenditures compared with one fifth of the black, non-Hispanic population and one tenth of the white, non-Hispanic population. Furthermore, compared with Hispanics with private health insurance, uninsured Hispanics are less likely to have a regular source of health care, less likely to have visited a physician in the past year, less likely to have had a routine physical examination, and less likely to rate their health status as excellent or very good.