Race-ethnic differences in stroke risk factors among hospitalized patients with cerebral infarction: the Northern Manhattan Stroke Study

African-Americans have an unexplained increased incidence and mortality from stroke compared with whites, and little is known about stroke in Hispanics. To investigate cross-sectional differences in sociodemographic and stroke risk factors, we prospectively evaluated 430 patients hospitalized for acute ischemic stroke (black 35%. Hispanic 46%, white 19%) over the age of 39 from Northern Manhattan. Blacks and Hispanics were younger than whites (mean ages, blacks 70, Hispanics 67, whites 80; p < 0.001) and were more likely to have less than 12 years of education than whites. Hypertension was more prevalent in blacks and Hispanics with stroke than whites (blacks 76%, Hispanics 79%, whites 63%; p < 0.05) and was often untreated in blacks. Left ventricular hypertrophy by ECG was more frequent in blacks (blacks 20%, whites 9%; p = 0.02). History of cardiac disease (atrial fibrillation, myocardial infarction, angina, and congestive heart failure) was less prevalent in both blacks and Hispanics. Black women were significantly more obese than white women (mean Quetelet Index percent, blacks 3.9%, whites 3.6%; p < 0.05). Heavy alcohol use was more often reported by blacks and Hispanics; cigarette smoking was increased only in blacks. Moreover, blacks were less likely to have visited a physician 1 year after their stroke (blacks 85%, whites 98%; p < 0.05), and Hispanics less often lived alone compared with whites. These cross-sectional differences suggest that the burden of stroke risk factors is increased in both blacks and Hispanics with stroke. Further studies controlling for stroke risk factors are needed to establish whether race-ethnicity is an independent determinant of stroke risk.     

Incidence of surgically treated uveal melanoma by race and ethnicity

OBJECTIVE: The purpose of the study was to determine the race- and ethnicity-specific incidence of histologically confirmed uveal melanoma. DESIGN: The study design was a retrospective study of histologically confirmed cases of primary uveal melanoma submitted to the Florida Cancer Data System (FCDS). MAIN OUTCOME MEASURES: Race-, gender-, and Hispanic-specific incidence rates of uveal melanoma were measured. Calculations are based on Florida census data and Hispanic population estimates from the University of Florida Bureau of Economic and Business Research. RESULTS: From 1981 through 1993, 873 histologically confirmed uveal melanomas were reported to the FCDS. Four melanomas occurred in black non-Hispanics, 47 in white Hispanics, and none in black Hispanics. The relative risk of uveal melanoma for blacks compared to non-Hispanic whites was 0.03 (95% confidence interval, 0.01-0.08). Non-Hispanic white men had 72 times the risk of uveal melanoma compared to black men; non-Hispanic white women experienced a 22-fold risk compared to black women. White Hispanics were less likely to develop uveal melanoma than white non-Hispanics (relative risk, 0.36; 95% confidence interval, 0.27-0.48). CONCLUSION: The risk of uveal melanoma in blacks is exceptionally low. The reason for lower risk of uveal melanoma in white Hispanics than in white non-Hispanics is not known but could be related to the protective effects associated with dark skin pigmentation or may be because of unknown cultural-environmental exposures or socioeconomic factors.     

Race-ethnicity and determinants of carotid atherosclerosis in a multiethnic population. The Northern Manhattan Stroke Study

BACKGROUND AND PURPOSE: Risk factors for carotid atherosclerosis have been studied in white populations but infrequently in multiethnic cohorts. The aim of this study was to determine the importance of race-ethnicity and other factors associated with carotid atherosclerosis in a mixed population of Hispanics, blacks, and whites. METHODS: As part of the Northern Manhattan Stroke Study, 526 stroke-free community residents (aged > or = 40 years; 41% men, 59% women; 46% Hispanic, 31% black, 23% white) were recruited through random-digit dialing and had vascular risk factor evaluations. Maximum internal carotid artery plaque thickness (MICPT) was measured with B-mode ultrasound. The frequency distribution of MICPT was examined in the three race-ethnic groups, and multivariate regression was performed to identify factors that were independently associated with MICPT. RESULTS: Mean MICPT in the entire sample was 1.5 +/- 1.4 mm, increased directly with age, and was greater in whites and blacks than Hispanics. Other independent determinants of MICPT included smoking, glucose, LDL cholesterol, and hypertension. After we controlled for these covariates, Hispanic (versus non-Hispanic) race-ethnicity was still an independent determinant of less carotid plaque. There was a significant interaction between race-ethnicity and LDL cholesterol, with a greater effect of increasing LDL cholesterol among Hispanics. CONCLUSIONS: Atherosclerotic risk factors were predictive of MICPT in this mixed-ethnic cohort. Hispanics had significantly less carotid plaque after adjustment for other known risk factors, but they also had a greater impact of increasing LDL cholesterol.     

Effects of depressive disorders on coronary artery disease: a review

In 1992, 112 pregnancies occurred per 1,000 U.S. women aged 15-19; of these, 61 ended in births, 36 in abortions and 15 in miscarriages. Black teenagers' rates of pregnancies, births and abortions were 2-3 times those of whites; Hispanic teenagers had rates of births and abortions between those of blacks and whites. While similar proportions of pregnant black and non-Hispanic white teenagers had abortions (40% and 38%, respectively), the proportion was lower among Hispanics (29%). Among all women 15-19, the birthrate rose 12 points between 1987 and 1991; one-third of the rise (four points) may be attributable to a fall in the abortion rate. Between 1991 and 1995, the birth rate of black teenagers fell from 116 to 96 per 1,000, a level well below that of Hispanics (106 per 1,000). Among the states, pregnancy rates per 1,000 teenagers in 1992 ranged from 159 (in California) to 59 (in North Dakota), birth rates per 1,000 varied from 84 (Mississippi) to 31 (New Hampshire) and abortion rates per 1,000 ranged from 67 (Hawaii) to nine (Utah). The pregnancy rates of white and black teenagers are negatively correlated.     

Stroke recurrence is more frequent in Blacks and Hispanics

This study was designed to measure recurrent stroke rates and identify their determinants in a mixed ethnic population. A cohort of 299 patients (110 black, 57 Hispanic and 132 white) admitted to a large urban hospital with an acute stroke between November 1, 1991, and July 1, 1993, was followed for a mean of 17.8 months. Demographic and historical data and stroke subtype and severity were recorded at the time of the index stroke. The main outcome measure was stroke recurrence. The unadjusted relative risk of stroke recurrence for blacks, relative to white, was 2.0 (95% CI: 0.9-4.4) and for Hispanics, relative to whites, it was 2.6 (95% CI: 1.08-60). Ethnicity appeared to be associated with recurrence risk only among first-ever strokes: the risk for blacks, relative to whites, was 2.4 (95% CI: 1.02-5.5) and for Hispanics it was 2.9 (95% CI: 1.2-7.4). None of the other putative risk factors for stroke recurrence identified at the time of initial hospitalization were associated with risk of recurrence.     

Motor vehicle occupant deaths among Hispanic and black children and teenagers

OBJECTIVE: To determine the risk of motor vehicle occupant deaths per unit of travel for Hispanic, non-Hispanic black, and non-Hispanic white children (aged 5-12 years) and teenagers (aged 13-19 years). DESIGN: Comparison of 1989 to 1993 motor vehicle occupant death rates of children and teenagers by race, ethnicity, and sex by using data on mortality from the National Center for Health Statistics, travel data from the 1990 Nationwide Personal Transportation Survey, and 1990 US census data. RESULTS: Among children 5 to 12 years old, race/ ethnicity differences per 100000 persons were unremarkable, but per billion vehicle-miles of travel, the rates were 14 for non-Hispanic blacks, 8 for Hispanics, and 5 for non-Hispanic whites. Among teenagers aged 13 to 19, the rates per 100000 persons were highest for non-Hispanic whites; however, the rates per billion vehicle-miles were 45 for Hispanics, 34 for non-Hispanic blacks, and 30 for non-Hispanic whites. Black and Hispanic male teenagers had substantially higher death rates per billion vehicle-miles of travel than either white male teenagers or female teenagers in any racial/ethnic group. CONCLUSIONS: Black and Hispanic children and teenagers are at higher risk of dying in motor vehicle crashes when they travel. Greater public health attention is needed to address these increased risks.     

Hypertensive vascular disease as a cause of death in blacks versus whites: autopsy findings in 587 adults

Cardiovascular disease is the major cause of excess mortality among urban US blacks, but autopsy data comparing black-white differences in underlying pathological causes of cardiovascular death are lacking. We reviewed all 720 adult cases autopsied in 1991 in the New York City Medical Examiner's Office in which the coded cause of death was cardiovascular disease (International Classification of Diseases, 9th Revision, codes 391, 393 to 398, 401 to 404, 410, 411, 414 to 417, 420 to 438, and 440 to 444). After exclusion of 133 cases because race was missing or coded as other than black or white, gender was not coded, or there was an unusual circumstances of death or extreme obesity, 587 cases were available for analysis. There were 314 black and 273 white subjects. Black women were younger than white women at time of death (mean age, 54.7 versus 61.5 years; P<.001), whereas black and white men did not differ in mean age at death. Hypertensive vascular disease was the autopsy cause of death in 42% of blacks compared with 23% of whites (P<.001). Conversely, atherosclerotic heart disease was the autopsy cause of death in 64% of white subjects but only 38% of blacks. These patterns were consistent in both sexes and after adjustment for age. Hypertensive vascular disease was far more common than atherosclerotic heart disease as the cause of death at autopsy among blacks compared with whites in New York City, whereas atherosclerotic heart disease was more common in whites. These findings suggest that ineffective control of hypertension is a major factor contributing to excess cardiovascular mortality among urban blacks.     

Racial and ethnic disparities in self-assessed health status: evidence from the National Survey of Families and Households

We examined racial and ethnic disparities in global health assessment and functional limitations of daily activities among whites, blacks and Hispanics, and within the Hispanic origin among Mexicans, Puerto Ricans, Cubans, and 'Others'. Logistic regression were employed to estimate the log odds of reporting 'poor health' and 'having functional limitations' among 12,814 respondents from the 1987-1988 National Survey of Families and Households. Compared with whites, blacks had an increased risk of reporting poor health and functional limitations. Hispanics had even a higher risk of reporting poor health, but did not have an increased risk of reporting functional limitations. Among Hispanics, Mexicans were more likely than whites to report poor health, whereas Puerto Ricans were more likely than whites to experience functional limitations. Both race and ethnicity remain important factors in explaining the disparities in self-assessed health status independent of socioeconomic status (SES). Meanwhile, the way self-assessed health status varies with ethnicity is importantly stratified by SES as measured by income and education. These results suggest that future research should analyze the interplay between ethnicity and SES rather than assuming measuring either captures all the important variation.     

Endovascular technique in aortic aneurysm. A promising alternative to open surgery]

Reports of human immunodeficiency virus-associated nephropathy (HIVAN) occurring in Hispanics, females and heterosexuals are scarce. We reviewed 858 charts from our total HIV population to determine the prevalence and epidemiology of HIVAN at our center, and to evaluate the renal and patient survival among individual groups, according to race, sex and HIV risk factor. The prevalence of HIVAN was low (1.9%), relative to other centers (4-13%). Although Hispanics accounted for 56% of the HIV population, only 38% of HIVAN patients were Hispanic. The absolute risk of HIVAN in blacks was 3. 6%, and in Hispanics was 1.3%. The relative risk of blacks vs. Hispanics was 2.8% (p < 0.04). Women and men were represented equally in both the HIVAN and HIV populations. The mean (+/- SE) rate of decline in glomerular filtration rate was 3.7 +/- 0.9 ml/min/month, and patient survival following the onset of HIVAN was 23.6 +/- 4.8 months. We found no difference in renal or patient survival between individual groups. In summary, the risk of HIVAN in Hispanics is similar to that for whites. Male sex is not an independent risk factor. Both renal and patient survival are similar in blacks and Hispanics, and in men compared to women.     

Fasting hyperinsulinemia and cardiovascular disease risk factors in nondiabetic adults: stronger associations in lean versus obese subjects. Atherosclerosis Risk in Communities Study Investigators

The association between hyperinsulinemia and atherogenic risk factors has not been well studied in blacks and may be different for obese versus lean individuals. To investigate this possibility and to confirm the associations of hyperinsulinemia with cardiovascular disease risk factors in blacks and whites, we analyzed the joint associations of fasting serum insulin and obesity with risk factors in the Atherosclerosis Risk in Communities (ARIC) Study (1,293 black men, 4,797 white men, 2,033 black women, and 5,445 white women). Insulin values > or = 90th percentile (> or = 21 microU/mL) constituted hyperinsulinemia; body mass index (BMI) values > or = 27.3 kg/m2 for women and > or = 27.8 for men constituted obesity. Participants with hyperinsulinemia in all four race-sex groups had more atherogenic levels of most risk factors studied than those with normoinsulinemia. Among black men and women, mean levels of triglycerides, low-density lipoprotein cholesterol (LDL-C), apolipoprotein (apo) B, glucose, and fibrinogen (men only) were higher in hyperinsulinemic lean participants as compared with the normoinsulinemic obese group. Furthermore, most associations between insulin level and risk factors were stronger among lean versus obese subjects. For example, among lean black men, the difference in mean triglyceride concentration between those with hyperinsulinemia and those with normoinsulinemia was 147 - 99 = 48 mg/dL; among obese black men, the difference was 155 - 121 = 34 mg/dL (P < .05 for the interaction). Generally, similar negative interactions between BMI and insulin concentration were also observed among whites.(ABSTRACT TRUNCATED AT 250 WORDS)     

Prevalence and identification of abnormal lipoprotein levels in a biracial population aged 23 to 35 years (the CARDIA Study). The Coronary Artery Risk Development in Young Adults Study

This study examines the prevalence of abnormal low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels in young adults to determine the ability of National Cholesterol Education Program Adult Treatment Panel (ATP) guidelines to identify persons with elevated LDL cholesterol, to compare other algorithms with those of the ATP, and to determine the contributions of race, gender, and other coronary artery disease risk factors to identifying patients with elevated LDL and low HDL cholesterol. The cohort was population-based, aged 23 to 35 years, and included relatively equal numbers of blacks and whites, and men and women. The prevalence of LDL cholesterol > or = 160 mg/dl (> 4.1 mmol/L) was 5% in black women, 4% in white women, 10% in black men, and 9% in white men. ATP identified most participants with elevated LDL cholesterol (range: 58.8% of white men to 70.7% of black women). Lipoprotein panels would have been required in 6% to 7% of women and to 15% to 18% of men. Algorithms that used nonlipid risk factors required more lipoprotein panels and identified fewer additional participants at risk. The prevalence of HDL cholesterol < 35 mg/dl (0.9 mmol/L) was 3% in women, 7% in black men, and 13% in white men. Algorithms that used nonlipid risk factors before measuring HDL cholesterol would require HDL cholesterol measurements in 35% of whites and 56% of blacks, but reduced sensitivity for identifying low HDL cholesterol (range: 58% in white men to 93% in black women). In young adults, algorithms based on nonlipid risk factors and family history have lower sensitivity, and increase rather than decrease the number of fasting lipoprotein panels required when compared with ATP levels.     

Dose of hemodialysis and survival: differences by race and sex

CONTEXT: Although blacks receive lower doses of hemodialysis than whites, their survival when receiving dialysis treatment is better than that for whites. Previous studies of the relationship between the dose of dialysis and patient survival have not controlled for differences in patient characteristics. OBJECTIVE: To examine the association of mortality with the dose of hemodialysis for clusters of patients categorized by race and sex. DESIGN: Retrospective analysis of laboratory data and mortality outcomes from 1994, using a national database of hemodialysis patients. PATIENTS: A total of 18144 black and white patients receiving hemodialysis 3 times weekly who either lived the entire year receiving hemodialysis or died. MAIN OUTCOME MEASURES: The fractional reduction of urea in a single dialysis session as the measured hemodialysis dose (urea reduction ratio [URR]) after controlling for race, sex, age, and diabetes mellitus. Mortality was determined by strata of URRs and albumin and creatinine levels. RESULTS: Across all age categories, blacks had lower URRs than whites, and men had lower URRs than women. In an age-adjusted model for evaluating interactions among URRs, race, sex, and diabetes, the association of URR with mortality risk was weak among blacks, particularly black men. After adjustment for age and diabetes, death probability curves were most steep for white women with URR values less than 60%. The death probability curves were least steep for black men. There was no meaningful difference between death probability and albumin or creatinine concentration among the race by sex clusters. CONCLUSION: Using URR, the usual measure of hemodialysis dose, the assumption that the association between dialysis dose and survival is uniform across demographic groups appears incorrect. Comparisons of the quality of dialysis patient care should not rely on URR alone to predict patient survival.     

Evaluation of hilar pulmonary vessels using magnetic resonance angiography (MRA)

OBJECTIVE: To assess the relationship between ethnicity and decision-makers expressing healthcare wishes in a group of frail older persons enrolled in the Program of All-inclusive Care for the Elderly (PACE). DESIGN: A retrospective chart review of 1193 participants in the PACE program. SETTING: Program of All-inclusive Care for the Elderly, a comprehensive managed care demonstration program serving frail older participants at 10 sites across the nation. PARTICIPANTS: A total of 1193 older adults, all of whom met state criteria for nursing home level of care. Three hundred were non-Hispanic whites, 364 were black, 156 were Hispanic, and 288 were Asian. MEASUREMENTS: Demographic characteristics of the patients and the presence or absence of an alternative decision-maker; the characteristics of alternative decision-makers included the relationship to the participant as recorded in the patient's medical record. RESULTS: Ninety-one percent of white patients expressed their own healthcare wishes in contrast to only 85% of Hispanic, 83% of Asian, and 67% of black patients. An alternative decision-maker was identified for about 15% of Asians and Hispanics and for one-third of blacks, but only about 8% of whites had an alternative decision-maker. Black and Hispanic patients were most likely to have a daughter as an alternative decision-maker, Asians were most likely to have a son, and whites patients were most likely to have a spouse as an alternative decision-maker. Blacks, particularly black men, were the most likely to have a relative other than a spouse or child as an alternative decision-maker. CONCLUSIONS: In this population, we found significant ethnic variation in the person identified to be the decision-maker in a group of frail older people. Ethnic variation reflected sociodemographic as well as cultural differences. However, there are important limitations to this study, and caution should be used in extrapolating the results to other populations or in attributing the results to ethnicity alone. An awareness of cross-cultural patterns in identified or de facto decision-makers can be significant for healthcare workers when they approach patients and their families about issues surrounding end of life decisions.     

The prevalence of risk factors among women in the United States by race and age, 1992-1994: opportunities for primary and secondary prevention

OBJECTIVE: To analyze the prevalence of 11 modifiable behavioral risk factors, including multiple risk factors, among white, black, Asian and Pacific Islander, American Indian, and Hispanic women in the United States. DESIGN: We used Behavioral Risk Factor Surveillance System (BRFSS) data for 1992 to 1994 to examine risk factors (smoking; obesity; diabetes; heavy alcohol consumption; sedentary lifestyle; and inadequate use of seat belts, pap smears, consumption of fruits or vegetables, mammography and colorectal screening, and immunization), among women age 18 to 49, 50 to 64, and 65 and older. We also conducted a multiple regression analysis, comparing the odds of having either 1-2 versus 0 or 3 or more versus 0 risk factors among racial/ethnic groups, controlling for education and family income, to see if racial/ethnic differences can be attributed to socioeconomic differences. RESULTS: US women engage in a variety of behaviors that place them at risk for many causes of morbidity and mortality. Risk profiles vary substantially among racial/ethnic populations: Pacific Islanders have relatively low prevalences of most major risk factors, while blacks and American Indians have relatively high prevalences of many major risk factors. Prevalence differences among racial/ethnic populations are diminished but not eliminated when socioeconomic factors are accounted for. CONCLUSIONS: Appropriately designed programs to help women reduce their behavioral risk factors are needed. Action by health care providers, communities, and policy makers can substantially improve the health of women in the United States.     

Race differences in labor force attachment and disability status

We used the first wave of the Health and Retirement Survey to study the effect of health on the labor force activity of black and white men and women in their 50s. The evidence we present confirms the notion that health is an extremely important determinant of early labor force exit. Our estimates suggest that health differences between blacks and whites can account for most of the racial gap in labor force attachment for men. For women, when participation rates are comparable, our estimates imply that black women would be substantially more likely to work than white women were it not for the marked health differences. We also found for both men and women that poor health has a substantially larger effect on labor force behavior for blacks. The evidence suggests that these differences result from black/white differences in access to the resources necessary to retire.     

Race Composition and Earnings: Effects by Race, Region, and Gender

For more than 40 years, studies have reported that the higher the proportion of blacks in a community, the more white men earn, but the less black men earn. Researchers have speculated that black men earned less because earnings discrimination increases with percent black. Others have suggested that the negative effect of black representation on black men's earnings reflects black men's limited occupational opportunities. This study (1) investigates whether pay discrimination and regional location condition the relationship between black representation and workers' earnings and (2) examines the relationship between black representation and earnings for women. The results, based on 1980 Census data for black and white workers from 267 SMSAs, show that black representation was associated with higher earnings for white men and lower earnings for black men in both the north and south, and that part of the effect for southern black men stemmed from earnings discrimination. Southern black men's earnings gains from black representation offset some of the effects of discrimination, while northern black men encountered costs of black representation even in the absence of earnings discrimination. These findings reflect the disparate economic opportunities of black men in each region as manufacturing jobs have disappeared from the north and relocated to the south. For women, black representation led to higher earnings for blacks and whites. I argue that black representation does not lower black women's earnings because occupational sex segregation prevents black women from threatening white men's economic status.     

Differential effects of BMI on diabetes risk among black and white Americans

OBJECTIVE: To determine whether the associations of BMI and fat distribution with diabetes risk are modified by race. RESEARCH DESIGN AND METHODS: Data from the National Health and Nutrition Examination Survey, Epidemiologic Follow-up Study (1971-1992), were used to investigate potential interactions of BMI and fat distribution with race. Incident diabetes was defined by self-report of physician-diagnosed diabetes, hospital and nursing home discharge records, and death certificates. RESULTS: Among the 1,531 black and 9,852 white subjects who were nondiabetic at baseline, 1,139 (10.0%) developed diabetes during 20 years of follow-up. Although the cumulative risk of diabetes increased with baseline BMI in all four race-sex groups, the sex-specific odds ratios (ORs) for black:white subjects decreased with increasing BMI. In particular, for BMI of 22 kg/m2, the OR of diabetes for black:white individuals was 1.87 and 1.76 (P < 0.01) for men and women, respectively; for BMI of 32 kg/m2, the OR decreased to 0.99 and 1.20 (NS) for men and women, respectively. Skinfold ratio was also associated with increased diabetes risk in all race-sex groups, but did not modify the association between race and diabetes. CONCLUSIONS: These findings suggest that the effect of BMI on diabetes risk is different for black and white Americans, with a larger risk for blacks than whites at low BMI and an equivalent risk for both groups at high BMI. A lower degree of visceral adiposity among blacks at higher BMI or a greater impact of visceral adiposity among blacks at low BMI may help explain the interaction of race and BMI on diabetes risk.     

Systemic lupus erythematosus with pulmonary hypertension--normalization of pulmonary artery pressure by long-term administration of beraprost sodium

OBJECTIVE: To determine the predictive value of angina pectoris diagnosed by Rose questionnaire for cardiovascular disease among treated hypertensives. METHODS: The cardiovascular experience of 4093 patients who had no history of cardiovascular disease and had been administered the Rose questionnaire for angina in a worksite treatment program was evaluated. RESULTS: Among 2659 men and 1434 women of similar age (53 versus 54 years), the race distribution was 44 versus 31% whites, 27 versus 41% blacks and 29 versus 28% Hispanics. Overall, the prevalence of angina by Rose questionnaire in women (15%) was twice that in men (7%) in all three races, with Hispanics having the highest (20 versus 10%) prevalence. Those with angina (Rose-plus) and those without (Rose-minus) had similar initial and final blood pressures. In 4.0 years of average follow-up study, the crude incidence rates (per 1000 person-years) of the recorded 120 myocardial infarctions and 35 strokes did not differ significantly between Rose-plus and Rose-minus patients, except for myocardial infarction in Hispanic men (20.5 versus 5.9). When myocardial infarction incidence was adjusted for age within each sex-race subgroup, only Rose-plus Hispanic men had a significantly greater relative risk with Rose-minus as referent (relative risk 3.13, 95% confidence interval 1.31-7.50). Overall, in the Cox proportional hazards regression model, angina by Rose questionnaire was not predictive of myocardial infarction after accounting for other recognized risk factors. CONCLUSIONS: The present data suggest that the Rose questionnaire as a diagnostic tool for angina is not predictive of subsequent clinical events among treated hypertensive patients.     

Abortion patients in 1994-1995: characteristics and contraceptive use

Results of a 1994-1995 national survey of 9,985 abortion patients reveal that women who live with a partner outside marriage or have no religious identification are 3.5-4.0 times as likely as women in the general population to have an abortion. Nonwhites, women aged 18-24, Hispanics, separated and never-married women, and those who have an annual income of less than +15,000 or who are enrolled in Medicaid are 1.6-2.2 times as likely to do so; residents of metropolitan counties have a slightly elevated likelihood of abortion. When age is controlled, women who have had a live birth are more likely to have an abortion than are those who have never had children. Catholics are as likely as women in the general population to have an abortion, while Protestants are only 69% as likely and Evangelical or born-again Christians are only 39% as likely. Since 1987, the proportion of abortions obtained by Hispanic women and the abortion rate among Hispanics relative to that for other ethnic groups have increased. The proportion of abortion patients who had been using a contraceptive during the month they became pregnant rose from 51% in 1987 to 58%. Nonuse is most common among women with low education and income, blacks, Hispanics, unemployed women and those who want more children. The proportion of abortion patients whose pregnancy is attributable to condom failure has increased from 15% to 32%, while the proportions reporting the failure of other barrier methods and spermicides have decreased.     

Changes in drinking problems among whites, blacks, and Hispanics: 1984-1992

This paper reports changes in drinking problems among Whites, Blacks, and Hispanics between 1984 and 1992. A probability sample including 1,777 Whites. 1,947 Blacks, and 1,453 Hispanics in the United States adult household population was interviewed in 1984. In 1992 a subsample consisting of 788 Whites, 723 Blacks, and 703 Hispanics was reinterviewed. Results show a decrease in problem prevalence among Whites, stability among Blacks, and an increase among Hispanics. Problem incidence was higher among Hispanics than among Whites and Blacks, put problem remission was higher among Whites. Women had a lower problem incidence but a higher problem remission than men, independent of ethnicity. The two best predictors of problem status in 1992 were reporting a problem in 1984 and reporting a high level of consumption in 1984.