A health assessment of refugee children from former Yugoslavia in Tarrant County.

This study was conducted to provide an assessment of the health status and health care utilization of children from former Yugoslavia living in Tarrant County. In addition, an assessment of barriers and problems encountered by these families in obtaining health care for their children was presented. One hundred thirteen households of refugee families arriving in Tarrant County from 1998 through 2000 participated by answering a 79-item health information questionnaire. The results revealed that most of the refugee families had no regular health care provider to assure continuity of medical care. Lack of access to dental care and inappropriate utilization of hospital emergency facilities were also identified as problems. Insufficient understanding of health insurance issues and inability to access health information were additional problems. Local and state health care agencies may help to improve health care delivery for these and future refugee children by addressing these problem areas.

An analysis of osteoporosis-related hip fractures using hospital discharge data.

The purpose of this study was to assess whether physicians in practice inadequately diagnose osteoporosis in a high-risk population of postmenopausal women who have sustained hip fractures. Using the Texas Hospital Discharge Data-Public Use Data File (PUDF) provided through the Texas Health Care Information Council, the authors conducted a review of all postmenopausal women older than 55 years with fractured hips discharged from Texas hospitals during 1999. A total of 13,628 patients meeting these criteria were found using the PUDF. In their diagnoses, physicians for 2233 (16.3%) of these 13,628 women also specified the code for osteoporosis (P < .001) from the ninth revision of the International Classification of Diseases. It is estimated that between 40% and 50% of postmenopausal women have osteoporosis. Therefore, women with fragility fractures form an even more at-risk subset of the population--so much so that one would expect a majority of these women to carry diagnoses of osteoporosis. The age distribution in each group was comparable, implying that receiving a coded diagnosis for osteoporosis was not related to the age of the patient when she was admitted to the hospital. Further, when data was analyzed by race or ethnicity, percentages for each group (ie, diagnosed with hip fracture only versus diagnosed with hip fracture and osteoporosis) were comparable. In conclusion, physicians practicing in Texas during calendar year 1999 inadequately diagnosed osteoporosis in a high-risk population of postmenopausal women who were admitted to hospitals with fractured hips. Future analysis of subsequent annual databases will identify whether continuing medical education efforts cause physicians to diagnosis osteoporosis in this high-risk population more frequently.

Association of body mass index and health status in firefighters.

This study evaluates the usefulness of body mass index (BMI) as a preventive screening tool for general health and duty fitness status among firefighters. Two major BMI categorization methods were used: (1) "standard" [low (< 27), medium (> or = 27 < 30), high (> 30)]; and (2) WHO [(normal (< 25), overweight (> or = 25 < 30), obese (> or = 30 < 39), morbidly obese (> or = 39)]. Using the "standard" categorization, nearly 60% of individuals had medium or high BMI's; using the World Health Organization categorization, 80.7% of individuals were found to be overweight, obese, or morbidly obese. Statistically significant, inverse correlation between BMI and each of the following parameters was noted: systolic and diastolic blood pressure, VO2max, METS, and total cholesterol. Inconsistent or statistically insignificant correlation was found between BMI and HDL, Chol/HDL ratio, triglycerides, FVC% predicted, and FEV1 second% predicted. Findings were similar to previous studies of such correlates. BMI continues to prove useful as a screening tool and may be useful in identifying individual firefighters for health and fitness intervention measures.

Line-of-duty injury or illness in an Air National Guard unit.

Line-of-duty injuries or illnesses (LODs) suffered by members of Air National Guard units may demonstrate the status of unit safety, unit readiness and deployability, a potentially significant area of unit expenditures, and areas of needed health promotion. This descriptive pilot study was conducted at the unit commander's request to investigate an apparent doubling of the expected number of LODs over a recent quarterly period. Twenty cases were investigated. The vast majority of LODs were musculoskeletal in nature. Decreased fitness level (identified as increased body mass index) among males and increased age were related to increased LODs. Recommendations are given to improve tracking, identify individuals at increased risk, provide pretraining assessment, and institute health promotion focused on musculoskeletal injuries.