Medication use among children with asthma in East Harlem.

PURPOSE: To examine daily use of antiinflammatory medication among children with asthma in East Harlem, where hospitalization rates for asthma are among the highest in the United States. METHODS: We analyzed parent/guardian reports of medications used by children with current asthma (defined as physician diagnosis and wheezing during the previous 12 months) identified from a cross-sectional survey conducted in 2 elementary schools. RESULTS: From an overall sample of 1319 children, 298 with current asthma were included in this analysis. Most of those with asthma were Puerto Rican (136 [46%]) or black (98 [33%]), 168 (57%) were boys, and the median age was 8 years old. Overall, 65 (22%) were using antiinflammatory medication on a daily basis. A subgroup of 107 children with asthma had been hospitalized during the previous 12 months or had used beta(2)-agonist on a daily basis, suggesting persistent or severe asthma. Of these 107 children, 42 (39%) were taking antiinflammatory medication on a daily basis. Multivariate analysis of these 107 children revealed that daily use of antiinflammatory medication was associated with using a spacer tube (adjusted odds ratio [AOR]: 3. 08; 95% confidence interval [CI]: 1.27,7.47) and having seen a physician in the past 6 months (AOR: 3.46; CI: 1.01,11.9). Compared with Puerto Ricans, blacks (AOR:.32; CI:.12,.89) or children of other races/ethnicities (AOR:.27; CI:.09,.85) were less likely to use antiinflammatory medication on a daily basis. CONCLUSION: Daily use of antiinflammatory medication for children with persistent or severe asthma in East Harlem was underused. Differences in access to care may explain some findings; however, reasons for ethnic differences in use remain unclear. Both community interventions and additional provider education are needed.

Knowledge, attitudes, and screening practices among older men regarding prostate cancer.

OBJECTIVES: This study determined population-based rates of reported prostate cancer screening and assessed prostate cancer-related knowledge, attitudes, and screening practices among men in New York aged 50 years and older. METHODS: Two telephone surveys were conducted. One was included in the 1994 and 1995 statewide Behavioral Risk Factor Surveillance System interviews, and the other was a community-level survey that targeted Black men (African-American Men Survey). Prevalence estimates were computed for each survey, and prostate cancer screening practices were assessed with logistic regression models. RESULTS: Overall, fewer than 10% of the men in each survey perceived their prostate cancer risk to be high; almost 20% perceived no risk of developing the disease. Approximately 60% of the men in each survey reported ever having had a prostate-specific antigen (PSA) test. In both surveys, physician advice was significantly associated with screening with a PSA test or a digital rectal examination. Also, race was significantly associated with screening in the statewide survey. CONCLUSIONS: Many New York men appear to be unaware of risk factors for prostate cancer. However, a substantial percentage reported having been screened for the disease; physician advice may have been a major determining factor in their decision to be tested.

Independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease.

The authors examined the independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease using data from the 1989 baseline survey for the New York State Healthy Heart Program. This telephone survey used the Centers for Disease Control Behavioral Risk Factor Survey interview instrument and was conducted in eight communities (total population, approximately 1.24 million people) in New York State. The response rate was 65.5% (n = 4,179); 3,606 subjects aged 20-64 years with self-described ethnicity of white (n = 1,935), black (n = 1,035), or Hispanic (n = 636) and of known educational status were retained in the analysis. After adjustment for age, sex, and ethnicity, significant associations were found between educational attainment and smoking, lack of regular exercise, overweight, diet atherogenicity, and knowledge about blood pressure and cholesterol. After adjustment for age, sex, and educational attainment, associations were found between ethnicity and most of these same variables. Blacks and Hispanics generally had less favorable risk factor profiles. These data indicate that the differences in cardiovascular disease risk profiles between whites and blacks or Hispanics cannot be fully explained by underlying differences in educational attainment. The differing patterns of risk factor distribution by educational attainment within ethnic groups have implications for the segmentation of risk reduction programs.

Age, sex, educational attainment, and race/ethnicity in relation to consumption of specific foods contributing to the atherogenic potential of diet.

BACKGROUND: We examined which specific foods contributed to the atherogenic potential of diet in population segments defined by age, sex, educational attainment, and race/ethnicity. Data from the 1989 New York State Healthy Heart Program baseline survey were analyzed. METHODS: This telephone survey was conducted in eight communities (total population approximately 1.24 million people) in New York State. Response rate was 65.5% (N = 4,179); 3,606 subjects ages 20 to 64 years who reported their level of educational attainment with self-described ethnicity of white (N = 1,935), black (N = 1,035), or Hispanic (N = 636) were retained in the analysis. Diet was assessed using a 17-item food frequency questionnaire which focused on commonly eaten food high in saturated fat and cholesterol. Connor's cholesterol/saturated-fat index was used as a scale of the atherogenic potential of the diet. RESULTS: Eggs, whole milk, cheese, beef, and butter/margarine were the foods contributing most to the cholesterol/saturated-fat index score in all age-, sex-, and race/ethnicity-specific population segments examined, together contributing a total of 52 to 72% of the cholesterol/saturated-fat index score as measured by the 17-item diet questionnaire. CONCLUSIONS: The implication for public health campaigns directed at reducing the atherogenic potential of diet atherogenicity and for primary care practitioners seeking to influence the diet of patients with high blood cholesterol is that substitutions of less atherogenic food choices for these five foods would appear to be appropriate for most adults.