Components of Population Vulnerability and Their Relationship With Climate-Sensitive Health Threats.

Climate change is increasingly being framed as risks that will impact the poorest and most vulnerable communities among us. This has led to more efforts to estimate climate change risks across populations and in the context of human health and health equity. We describe the public health dimensions of climate vulnerability-exposure, population sensitivity, and adaptive capacity-and explore how these dimensions can modify population health impacts and their distribution. An overview of health disparities associated with specific climate risks is presented, and we offer potential solutions grounded in equitable urban development and improved characterization of climate vulnerabilities.

Pregnancy outcomes and risk factors in Mexican Americans: the effect of language use and mother's birthplace.

Effects of acculturation have been thought to contribute adversely to poor reproductive health in Mexican immigrants, and a traditional Mexican orientation has been hypothesized to be protective against poor birth outcomes. A population-based cross-sectional study of 4404 births of Mexico-born and U.S.-born Mexican-American women was conducted in California in 1992 to examine the effect of language use (as a proxy measure of acculturation) on reproductive outcomes. Utilizing birth certificates, supplemental questionnaires, and 1990 U.S. Census data, the study analyzed differences in the proportions of pregnancy risk factors, low birth weight infants, and preterm deliveries in six nativity/language subgroups. Compared to U.S.-born English-speakers, U.S.-born Spanish-speakers had a higher risk profile and Mexico-born English-speakers had a lower risk profile for adverse pregnancy outcomes. After controlling for covariates, U.S.-born Spanish-speakers had the highest odds for low birth weight (OR = 1.98, 95% C.I. = 1.00, 3.93) and Mexico-born English-speakers had the lowest odds for preterm delivery (OR = 0.70, 95% C.I. = 0.35, 1.40) compared to U.S.-born English-speakers. These nativity/language differences in risk profiles and pregnancy outcomes suggest that Mexican Americans do not experience a simple negative mode of adaptation to U.S. society, but rather a complex process of positive and negative acculturation, which may be dependent on socio-economic conditions or selection factors related to immigration.

Illness and absenteeism among California highway patrol officers responding to hazardous material spills.

Highway patrol officers are the primary responders to hazardous material spills in California, yet little is known regarding the health effects resulting from this exposure. A historical cohort study of 993 California highway patrol officers who responded to hazardous material spills in 1984 was conducted. The records of officers who were exposed to acutely toxic chemicals were followed for the subsequent week to determine if they demonstrated more absenteeism or illness compared to officers who were not exposed to toxic chemicals. No significant differences in the frequency of absenteeism or illness was found between the two groups during the week following exposure. No indication was found that exposure to hazardous materials during a highway patrol spill response results in increased absenteeism.

Assessment of compensatory renal function and [125I]iothalamate clearance in sheep.

Compensatory renal function and sodium [125I]iothalamate clearance were studied in 4 adult Merino ewes. Renal clearances of inulin (CIN), iothalamate (CIOT), and p-aminohippurate (CPAH) were used to measure renal function before and 7 and 170 days after 50% and 75% reductions in renal mass. Renal mass reduction to 50% of normal was achieved by ligation of the right renal artery, and to 25% of normal by ligating the right renal artery and branches of the left renal artery. Renal function (CIN and CPAH) after 50% renal mass reduction was 78% of normal on postligation day (PLD) 7 and 64% of normal on PLD 170. This decrease in renal function between PLD 7 and 170 was significant (P less than 0.05). Renal function (CIN and CPAH) after 75% renal mass reduction was 55% of normal on PLD 7 and 48% on PLD 170; however, this decrease in renal function between PLD 7 and 170 was not significant. Results indicated that, shortly after 50% renal mass reduction by renal arterial ligation, renal function in ewes was greater than that previously reported after unilateral nephrectomy and that a further decrease in renal function developed within 6 months after ligation. The mean CIOT in healthy ewes was 2.46 ml/min/kg of body weight. In healthy ewes and in ewes after renal mass reduction, regression of the simultaneous CIOT and CIN was CIOT = 0.276 + 1.05 CIN. The CIOT was higher than the corresponding CIN, and remained significantly (P less than 0.01) and consistently higher. Therefore, iothalamate can be used to estimate glomerular filtration rate in sheep, although a correction factor is required.

Clinical assessment of renal function in the dog with a reduction in nephron number.

The viewpoint presented is that, because compensatory functional adjustment of the residual nephrons occurs in chronic renal disease, reduction in nephron number usually exceeds 70% before a diagnosis is made. The case that earlier diagnoses are likely if laboratory medicine values are measured and interpreted with a maximum of efficiency is then made. The laboratory data more commonly used in practice for the clinical assessment of renal function in the dog are presented and some comparisons with findings in man are made. The information originates from clinical and experimental observations of the authors, as well as from a literature review. The laboratory data presented and discussed includes glomerular filtration rate and the clearance of nitrogenous waste (urea and creatinine), plasma protein concentration, plasma osmolality, renal concentrating capacity, and urinary constituents, particularly its protein concentration and sediment (centrifuge deposit). All parameters recommended for the clinical assessment of chronic renal failure are considered qualitatively, and some are also dealt with quantitatively.