Increase in cancer of the corpus uteri in the San Francisco-Oakland standard metropolitan statistical area, 1960--75.

A significant rise in the incidence of carcinoma of the corpus uteri in women of the San Francisco-Oakland standard metropolitan statistical area (SMSA) was reported by the Resource for Cancer Epidemiology. The incidence among white females increased by over 50% in the 6 years between 1969 and 1975. The increase was limited to the groups over 50 years old and to invasive cancers of the endometrial lining. The increase occurred in all five of the SMSA counties and, in white women in Aalmeda County, the average annual incidence for the 50- to 74-year age group tripled in 15 years. The rise was greatest in the areas of most affluence. Possible spurious causes of increase, such as changing diagnostic criteria, better case finding, or better reporting were examined and ruled out. The data suggested that the increase was due to the recent introduction of a potent endometrial carcinogen to the population group affected.

Private troubles and public issues: providing abortion amid competing definitions.

Sixteen years after the Supreme Court liberalized abortion policy, the United States continues to debate two competing and seemingly irreconcileable definitions of abortion. The experience of those who provide abortion has received relatively little research attention despite this unique set of historical circumstances. This paper presents findings from an exploratory study of 130 abortion workers (physicians, nurses and counselors). The data suggest that, despite formal beliefs about abortion rights, the situated experience of providing legal abortion evokes a range of abortion definitions. Seven central definition themes were cited repeatedly by the respondents: abortion as a woman's right, a destructive act, part of the practitioner's work, a technical procedure, a positive act, murder and an irresponsible act. Respondents perceived each definition to fit within one of three fixed and familiar perspectives: medical, pro-choice or pro-life. Each perspective was understood to have its own exclusive meanings, vocabulary and imagery which automatically remanded the situated definitions to a broader social context. Each definition of abortion was seen to define the event itself as well as to input specific meaning and differential value to what is aborted, the woman terminating her pregnancy, the nature of abortion work and the role of the practitioner. These definition components were perceived to be specific, codified and mutually exclusive within the different definition themes. They also were found to be linked to expected and specified feelings. The co-existence of feelings or definitions that were perceived as consistent was hardly noted by respondents.(ABSTRACT TRUNCATED AT 250 WORDS)

The physical and emotional health of grandmothers raising grandchildren in the crack cocaine epidemic.

This article explores the physical and emotional health status of 71 African-American grandmothers raising their grandchildren as a result of the crack cocaine involvement of the children's parents. A comparison of self-assessed health ratings with qualitative responses revealed a tendency for respondents to downplay their own health problems and symptoms.

Community interventions to support grandparent caregivers.

Community interventions and service programs for grandparents raising grandchildren are being identified and tracked through the Brookdale Grandparent Caregiver Information Project. Based on the first year's examination of 124 such programs, an overview of community intervention effort is provided, with special attention to support groups and comprehensive multi-service programs for grandparent caregivers. Lack of funding and institutional support, and the consequent inability to provide child care, were among key obstacles faced, while sponsorship by health and social service agencies often played a vital role in providing in-kind support and part-time professional staff.

Raising grandchildren from crack-cocaine households: effects on family and friendship ties of African-American women.

Changes in family and friendship networks of 71 African-American grandmothers raising grandchildren as a consequence of the crack-cocaine epidemic are examined. Despite continued strong social ties, many of the women reported decreased contact with family and friends other than confidantes and a decline in marital satisfaction. Implications of the findings for research, policy, and practice are discussed.

The decreasing incidence of endometrial cancer: public health implications.

The incidence of endometrial cancer in the San Francisco area between 1969 and 1979 is compared to trends in estrogen sales and prescriptions. Both estrogen use and endometrial cancer incidence increased steadily until 1975 and then decreased significantly. The data support the previously documented association between endometrial cancer and estrogen use, but suggest that short-term usage may carry only slightly increased risk which can be eliminating entirely upon termination of therapy.

Combining research, advocacy, and education: the methods of the Grandparent Caregiver Study.

This article presents a case study of the effective synergy of health education inquiry, community collaboration, and policy advocacy. Using the Grandparent Caregiver Study as the example, the authors focus on key methodological decisions that enabled them to incorporate research, education, and advocacy activities into an ever-growing project on a modest budget. The study itself centered on two in-depth interviews with each of 71 African American grandmothers raising young grandchildren due to the crack cocaine epidemic in Oakland, California. The case study demonstrates ways in which health education research can increase the efficacy of individuals and disenfranchised groups to define problems, voice their concerns, and advocate for more just and healthy public policies. Through discussion of the authors' methods and activities, they suggest strategies through which research participants, service providers, and policymakers can work together to bring a new issue to the policy arena through a collaborative and empowering research process.

Health of grandmothers raising children of the crack cocaine epidemic.

OBJECTIVES: Approximately 3.2 million children live with their grandparents or other relatives-a 40% increase in 10 years. This article presents selected findings from an exploratory study of the experience of 71 African-American women raising their grandchildren because of the crack epidemic. METHODS: The study was designed to describe the caregivers' self-reported physical and emotional health status and health-care-related behaviors through a combination of qualitative and quantitative data collected during two in-home interviews. RESULTS: Most respondents rated their health as good or fair, with little change over the previous year, or since caregiving began. Employed women were more likely not only to rate their health as excellent or good, but also to report that their health had deteriorated over the previous year. Other subgroups showing evidence of deteriorating health were those caring for several grandchildren and great-grandmothers. Caregivers without a confidante reported a positive health change. Although 80% of the sample reported receiving regular health care, one third had not been to the doctor in 3 years. Half reported breaking a medical appointment in the last year, most often because of caregiving demands. CONCLUSIONS: These findings have relevance for physicians and other health-care providers because they suggest that many grandparent caregivers may be or soon become the "hidden patients" of the crack cocaine epidemic.