Improving Equitability and Inclusion for Testing and Detection of Lead Poisoning in US Children.

Policy Points Child lead poisoning is associated with socioeconomic inequity and perpetuates health inequality. Methods for testing and detection of child lead poisoning are ill suited to the current demographics and characteristics of the problem. A three-pronged revision of current testing approaches is suggested. Employing the suggested revisions can immediately increase our national capacity for equitable, inclusive testing and detection. ABSTRACT: Child lead poisoning, the longest-standing child public health epidemic in US history, is associated with socioeconomic inequity and perpetuates health inequality. Removing lead from children's environments ("primary prevention") is and must remain the definitive solution for ending child lead poisoning. Until that goal can be realized, protecting children's health necessarily depends on the adequacy of our methods for testing and detection. Current methods for testing and detection, however, are no longer suited to the demographics and magnitude of the problem. We discuss the potential deployment and feasibility of a three-pronged revision of current practices including: 1) acceptance of capillary samples for final determination of lead poisoning, with electronic documentation of "clean" collection methods submitted by workers who complete simple Centers for Disease Control and Prevention-endorsed online training and certification for capillary sample collection; 2) new guidance specifying the analysis of capillary samples by inductively coupled plasma mass spectrometry or graphite furnace atomic absorption spectrometry with documented limit of detection ≤0.2 µg/dL; and 3) adaptive "census tract-specific" universal testing and monitoring guidance for children from birth to 10 years of age. These testing modifications can bring child blood lead level (BLL) testing into homes and communities, immediately increasing our national capacity for inclusive and equitable detection and monitoring of dangerous lower-range BLLs in US children.

Past Child Abuse and Neglect in Adults From Northern Mexico: Development of a Scale and Prevalence.

Child abuse has been present in Mexico but there have been few studies that analyze its effects in adults. There are no Mexican validated scales that measure the relationship between abuse experienced in childhood and its effects into adulthood. The purpose of this study is to develop a past child abuse and neglect scale to measure these phenomena in adults and also to analyze the relationship the effects have with other psychological variables (e.g., anxiety, depression, self-esteem, partner-violence, personality, and fatalism). There were 763 participants from Juarez City, located on the northern border of Mexico. All participants were above the age of 18 years. The scale was developed, and its psychometric properties were analyzed. A first analysis consisted of analyzing the factor structure of the scale items with an Exploratory Factor Analysis (EFA), and then a Confirmatory Factor Analysis (CFA) was used to corroborate the factor structure. The resulting factors were guilt, relationship with parents, strong physical abuse, sexual abuse, mild physical and verbal abuse, and basic care. The internal reliabilities for all factors in both analyses were between Cronbach's alpha values of .77 and .92. Correlations of these factors with psychological variables were analyzed, and several statistically significant correlations were found. The scale has a good factor structure that correctly reflects the indicators of child abuse and neglect with good internal reliability values. The analysis showed that the prevalence rates of child abuse and neglect in Juarez were higher than those reported by the World Health Organization (WHO) in other locations worldwide. Actions by governments, universities, and civil associations should take place to reduce these rates, especially because of their long-term physical, emotional, and psychological consequences.

Relationship Between Different Types of Violence and Mental Health in High School Students From Northern Mexico.

Different types of violence have been present in Mexico but there have been few studies that have analyzed their relationship with mental health in adolescents, especially in cities with high rates of social violence. It is important to compare different violence types and their relationship with mental health since not all relationships are the same. It appears that social violence has a stronger relationship with mental health, and for this reason it receives more attention, but other types of violence have a stronger relationship and do not receive as much attention. Chihuahua has been one of the most violent states in Mexico, and Juarez has been the most violent city in the world in 2009 and 2010. The purpose of the study is to compare the relationship of different types of violence (social, cyberbullying, partner violence, and child abuse and neglect) with mental health indicators (depression, anxiety, stress, self-esteem, and paranoid thoughts). There were 526 high school students, from the cities of Juarez (n = 282) and Chihuahua (n = 244). The mean age was 16.5 (SD = 1.4) years and 50.6% reported being males. The relationships among the variables were analyzed using Pearson's correlations and multiple linear regressions. Both cities that have experienced social violence like carjacking, kidnapping, and sexual assault, but they have very small or no relationships with mental health indicators. Other types of violence have stronger correlations. Our findings suggest that interventions should not focus only in preventing and dealing with social violence, but that other types of violence must also be addressed in adolescents.

Psychological Aggression, Attitudes About Violence, Violent Socialization, and Dominance in Dating Relationships.

Psychological aggression is a widespread form of abuse in dating relationships, especially in collectivist societies with ties to patriarchal beliefs. Despite the prevalence of psychological aggression, it has seldom been studied in connection with known antecedents of interpersonal violence, including dominance, attitudes supportive of violence, and violence socialization processes during childhood. The present study sought to test relationships among these variables in young men and women. A total of 500 Mexican undergraduate students in northern Mexico reported on their experiences with psychological aggression, the dominance of a dating partner, and violent socialization during childhood, as well as on their approval of violence within and outside the family. The results indicate that the dominance of a dating partner is directly linked to male and female intimate partner violence (IPV) perpetration. Violent socialization and proviolent attitudes appear to be related to female dominance. Female and male psychological aggression victimization was predicted by the participant's own perpetration. In general, a dyadic approach appears to be useful for explaining psychological aggression perpetration and victimization in a collectivist society, in light of recent changes in normative beliefs held by young educated Mexicans. Implications for future research and public policy are discussed.

The Possible Protective Effect of Marital Status in Quality of Life Among Elders in a U.S.-Mexico Border City.

The purpose of this study was to determine how marital status may have an impact on quality of life in a group of older adults living in a U.S.-Mexico border city. Two-hundred and seventy-six older adults completed the Spanish version of the World Health Organization Quality of Life Assessment, composed of four domains: physical health, psychological health, social relationships, and environment. Participants answered a measure of sociodemographic variables. In the psychological health component of quality of life, single and married older adults had the highest scores as compared to widowed and divorced. Similarly, married older adults had the highest quality of life in social relationships. Marital status may play an important role when analyzing quality of life among older adults, this study suggests that being married may offer a protective mechanism against depressive symptoms and therefore against mental illnesses during late adulthood.

Factor structure and internal reliability of an exercise health belief model scale in a Mexican population.

BACKGROUND: Mexico is one of the countries with the highest rates of overweight and obesity around the world, with 68.8% of men and 73% of women reporting both. This is a public health problem since there are several health related consequences of not exercising, like having cardiovascular diseases or some types of cancers. All of these problems can be prevented by promoting exercise, so it is important to evaluate models of health behaviors to achieve this goal. Among several models the Health Belief Model is one of the most studied models to promote health related behaviors. This study validates the first exercise scale based on the Health Belief Model (HBM) in Mexicans with the objective of studying and analyzing this model in Mexico. METHODS: Items for the scale called the Exercise Health Belief Model Scale (EHBMS) were developed by a health research team, then the items were applied to a sample of 746 participants, male and female, from five cities in Mexico. The factor structure of the items was analyzed with an exploratory factor analysis and the internal reliability with Cronbach's alpha. RESULTS: The exploratory factor analysis reported the expected factor structure based in the HBM. The KMO index (0.92) and the Barlett's sphericity test (p < 0.01) indicated an adequate and normally distributed sample. Items had adequate factor loadings, ranging from 0.31 to 0.92, and the internal consistencies of the factors were also acceptable, with alpha values ranging from 0.67 to 0.91. CONCLUSIONS: The EHBMS is a validated scale that can be used to measure exercise based on the HBM in Mexican populations.