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J W Collins

Publications and source records attributed to J W Collins.

At least 37 records · Page 2Linked to original sources
PubMed1997

Racial differences in the prevalence of small-for-dates infants among college-educated women.

We used Illinois vital records and U.S. Census data to quantify the association of race and small-for-dates rates among women with 16 or more years of education. The small-for-dates rate for African-Americans was 2.8%, compared with 1.2% for whites [odds ratio (OR) = 2.5; 95% confidence interval (CI) = 1.8-3.4]. Adjustment for measures of socioeconomic status did not reduce the racial disparity (OR = 2.9; 95% CI = 1.4-4.5). We conclude that unidentified variables occurring with greater prevalence among African-Americans increase the risk of small-for-dates infants among college-educated African-American mothers.

Adult↗
PubMed1997

Very-low-birthweight infants and income incongruity among African American and white parents in Chicago.

OBJECTIVES: Illinois vital records for 1982/1983 and US census income data for 1980 were analyzed to ascertain the relationship of income incongruity, race, and very low birthweight. METHODS: Positive income incongruity was considered present when study infants resided in wealthier neighborhoods than non-Latino Whites at the same level of parental education attainment and marital status. RESULTS: The odds ratios of very low birthweight for African Americans (n = 44,266) and Whites (n = 27,139) who experienced positive income incongruity were 0.7 (95% confidence interval [CI] = 0.5, 0.9) and 0.6 (95% CI = 0.5, 0.9), respectively. CONCLUSIONS: Positive income incongruity is associated with lower race-specific rates of very low birthweight.

Adolescent↗
PubMed1997

Adequacy of prenatal care utilization, maternal ethnicity, and infant birthweight in Chicago.

This study examines the extent to which the Adequacy of Prenatal Care Utilization Index explains the racial disparity in infant birthweight. A stratified analysis was performed on all African-American, Mexican-American, and non-Latino white singleton infants born in Chicago, Illinois between 1982 and 1983. This older cohort was chosen to avoid the confounding effect of cocaine associated with its increased local availability after 1985. The adequacy of prenatal care utilization varied by race and place of residence. However, in moderate-income areas (median family annual income of $20,001 to $30,000), the African-American birthweight disadvantage persisted among infants born to mothers who received adequate and adequate-plus prenatal care. Similarly, although race-specific term (gestational age > 37 weeks) low birthweight rates declined as prenatal care usage rose, the position of African Americans relative to Mexican Americans and whites was essentially unchanged. These findings indicate that maternal race or some factor closely related to it affects pregnancy outcome regardless of the adequacy of prenatal care utilization.

Black or African American↗
PubMed1997

Relation of maternal ethnicity to infant birthweight in east London, England.

OBJECTIVE: We sought to determine whether black race is a risk factor for very low birthweight in a developed country other than the United States. DESIGN: A cross-sectional study was performed. SETTING: We analyzed a dataset of 1987-1990 birth records from three hospitals in East London, England. PARTICIPANTS: All live born African (N = 3,495), West Indian (N = 3,471), and European white (N = 20,313) singleton infants born to East London residents. MAIN OUTCOME MEASURES: For each ethnic group, we calculated the proportion of very low birthweight (< 1500g) and moderately low birthweight (1500-2499g) infants. RESULTS: The very low birthweight rate was 2.9% for infants of West Indian descent and 2.2% for infants of African descent vs. 1.3% for European whites; odds ratio (95% confidence interval) = 2.1(1.7-2.8) and 1.8(1.2-3.1), respectively. West Indian and white mothers were similar in terms of age, social support, and prenatal care. African mothers were older and had less social support. The West Indian:white and African:white differentials in very low birthweight rates persisted among low risk mothers; odds ratio (95% confidence interval) = 2.7(1.7-4.0) and 2.3(1.5-3.6), respectively. CONCLUSIONS: We conclude that black race is a risk factor for very low birthweight in the United Kingdom.

Adult↗
PubMed1997

Urban violence and African-American pregnancy outcome: an ecologic study.

OBJECTIVES: To ascertain the extent to which residence in violent communities is an independent risk factor for adverse pregnancy outcomes among impoverished (census tract median family income < $10,000/year) African-American mothers. DESIGN: A cross-sectional study was performed. METHODS: We performed multivariate analyses on 1983 Illinois vital records, Chicago Police Department violent crime rates, and 1980 United States Census income data. RESULTS: African-American mothers who resided in the most violent communities had a low birth weight rate of 16% compared to 12% for infants (N = 315) with mothers who lived in the least violent communities; odds ratio = 1.5 (1.0-2.1). The proportion of small-for-gestational-age infants was substantially elevated in mothers who resided in the most violent communities compared to mothers who lived in the least violent communities: 7% vs. 3%; odds ratio = 2.6 (1.5-2.1). In multivariate logistic regression models that controlled for individual risk factors, the adjusted odds ratios for low birth weight and small-for-gestational-age infants among mothers who resided in the most (compared to the least) violent communities were 1.1 (0.9-1.2) and 1.5 (1.1-2.1), respectively. CONCLUSION: We conclude that a community's violent crime rate is associated with intrauterine growth retardation among infants born to African-American women.

Adolescent↗
PubMed1996

Relation of maternal race to the risk of preterm, non-low birth weight infants: a population study.

The authors used 1982-1983 Illinois vital records and 1980 US Census income data to determine the contribution of maternal race to the risk of preterm (< 260 days), non-low birth weight (> 2,500 g) infants. This older cohort was chosen to avoid the confounding effect of cocaine associated with its increased local availability after 1985. In Chicago, the unadjusted preterm, non-low birth weight rate was 14% for African Americans (n = 43,059) compared with 9% for Mexican Americans (n = 10,397) and 7% for whites (n = 26,152) (odds ratio = 1.7, 95% confidence interval 1.6-1.8; odds ratio = 2.4, 95% confidence interval 2.3-2.5, respectively). In logistic models that included maternal sociodemographic and prenatal care variables, the adjusted odds ratio of preterm, non-low birth weight for. African Americans compared with Mexican Americans and whites was 1.6 (95% confidence interval 1.4-1.8) and 1.5 (95% confidence interval 1.2-1.7), respectively. The authors conclude that some factor closely linked to the African-American race, not underserved minority status per se, is a fundamental cause of preterm, non-low birth weight.

Adult↗
PubMed1996

Methodologic issues in intervention research--health care.

To better understand the methodological challenges faced by intervention research in health care, workshops reviewed two intervention studies to reduce back injuries among nursing home staff and two studies on the use of precautions to prevent occupational transmission of bloodborne pathogens. These studies adapted rigorous designs to real-world settings and made good use of multiple measures to detect effects and communicate this information to policy makers. The studies grappled with issues about implementation integrity and would benefit from better theory of administrative practices associated with a safety-conscious work environment.

Back Injuries↗
PubMed1996

NIOSH research initiatives to prevent back injuries to nursing assistants, aides, and orderlies in nursing homes.

Over the past 100 years, advances in nutrition, modern medicine, public health, and a multitude of public health improvements have increased the life expectancy of U.S. residents. The fact that Americans are living longer has resulted in extensive growth in our elderly population and a rapid employment growth that delivered about 2 million new jobs between 1980 and 1989 in the health care workforce. The Bureau of Labor Statistics Injury and Illness Data for nursing homes rose from 10.7 to 18.6 injuries or illnesses per 100 full-time workers between 1980 and 1992. The injury and illness rates among nursing home workers are partly due to the physical stress of providing round-the-clock assistance with the basic activities of daily living, such as getting in and out of a bed or chair, as well as bathing and toileting. The National Institute for Occupational Safety and Health (NIOSH) is conducting a series of research studies to identify strategies to reduce the risk of musculoskeletal injuries to workers in nursing homes. NIOSH has funded two laboratory evaluations of resident transferring methods and one field study in an actual nursing home. The purpose of this paper is to describe the key findings from past NIOSH research initiatives and to present an overview of future research.

Activities of Daily Living↗
PubMed1994

Prevalence of low birth weight among Hispanic infants with United States-born and foreign-born mothers: the effect of urban poverty.

Although Hispanics are a poorly educated and medically underserved minority, the incidence of low birth weight (less than 2,500 g) Hispanic infants is similar to that of non-Hispanic whites. The authors used 1982-1983 Illinois vital records and 1980 US census income data to determine the contribution of maternal nativity and place of residence to this epidemiologic paradox. The proportion of low birth weight Hispanic (n = 22,892) infants ranged from 4.3% for Mexicans to 9.1% for Puerto Ricans. Maternal age, education, trimester of prenatal care initiation, and place of residence were associated with the prevalence of low birth weight infants among Puerto Rican but not foreign-born Mexican or Central-South American mothers. In very low-income (less than $10,000/year) census tracts, Mexican and other Hispanic infants with US-born mothers had low birth weight rates of 14 and 15%, respectively. In contrast, Mexican and other Hispanic infants with foreign-born mothers who resided in these areas had low birth weight rates of 3 and 7%, respectively. In a logistic model that included only impoverished infants, the adjusted odds ratio of low birth weight for those with US-born mothers equalled 6.3 (95 percent confidence interval 2.3-16.9). The authors conclude that urban poverty is negatively associated with Hispanic birth weight only when the mother is Puerto Rican or a US-born member of another subgroup.

Adult↗
PubMed1993

Race and birthweight in biracial infants.

OBJECTIVES: The purpose of the study was to determine the role of infant race as a determinant of the Black-White disparity in low birthweight (< 2500 g). METHODS: Univariate analysis and multivariate logistic regression were performed on Illinois vital records from 1982 and 1983 and on 1980 United States census income data. RESULTS: Fourteen percent of the infants born to Black mothers and White fathers were of low birthweight, compared with 9% of infants born to White mothers and Black fathers and 6% of a random sample of White infants. Both groups of biracial infants were more likely to have been born to unmarried mothers and to reside in very low-income (< $10,000 per year) census tracts than were White infants. When all confounding variables were entered into a logistic model, the adjusted odds ratio of low birthweight for biracial infants born to Black mothers and White fathers equaled 1.4. When biracial infants born to White mothers and Black fathers were compared with White infants, the adjusted odds ratio of low birthweight equaled 1.0. CONCLUSIONS: Paternal and consequent infant race does not affect the birthweight distribution of those born to White mothers and Black fathers. Unidentified factors closely related to maternal race underlie the Black-White disparity in infant birthweight.

Adult↗
PubMed1992

Disparate black and white neonatal mortality rates among infants of normal birth weight in Chicago: a population study.

To determine the extent to which disparities in risk status and access to tertiary care affect racial differences in neonatal mortality rates among normal birth weight infants, we conducted a vital records study concerning normal weight black (N = 44,399) and white (N = 48,146) singleton births in Chicago. Neonatal mortality rate among black infants was twice that among white infants (3.3 deaths per 1000 births vs 1.5 deaths per 1000 births); the unadjusted black relative risk equaled 2.2 (95% confidence interval, 1.7 to 2.9). Because prematurity, growth retardation, congenital anomalies, low Apgar scores at 5 minutes, teenage mothers, and poverty were more common among black infants, multivariate analyses were performed. The disparity in mortality rate was greatest between black and white infants with none of these risk factors; relative risk for black infants equaled 3.6 (95% confidence interval, 2.0 to 6.7). Approximately 30% of all deaths of black infants were attributable to birth in nontertiary hospitals. When the confounding variables, including hospital of birth, were put into a multivariate logistic-regression model, the adjusted relative risk estimate (odds ratio) for black infants equaled 1.5 (95% confidence interval, 1.1 to 2.0). Traditional risk factors fail to explain the racial disparity in neonatal mortality rate among normal birth weight infants. Level of perinatal care available, or some factor closely related to this level, is an important determinant of neonatal chance of survival for normal birth weight urban black infants.

Black or African American↗
PubMed1992

Differences in neonatal mortality by race, income, and prenatal care.

To determine the extent to which the social and physical environment affects the association between prenatal care and black pregnancy outcome in Chicago, we performed a stratified analysis of 1982-1983 Illinois vital records and 1980 United States census income data. Median family income of the mother's census tract was used as the ecologic variable. In very-low-income census tracts (less than $10,000 per year), 40% of blacks and 47% of whites received adequate prenatal care. There was no racial disparity in the percentage of low-birth-weight infants attributed to inadequate prenatal care among poor mothers. For mothers who resided in moderate-income areas ($20,001 to $30,000 per year), 50% of blacks and 67% of whites received adequate prenatal care. Although adequate (compared to inadequate) prenatal care was associated with improved birthweight distribution independent of community income, only in moderate-income areas was it related to black neonatal survival. For term black infants who received adequate prenatal care, residence in impoverished areas was associated with a nearly fourfold greater neonatal mortality rate (deaths per 1000 live births): 5/1000 vs 1/1000; RR = 3.8 (1.3-11.0). We conclude that place of residence is an important risk factor for black neonatal mortality.

Black or African American↗
PubMed1991

A controlled trial of insulin infusion and parenteral nutrition in extremely low birth weight infants with glucose intolerance.

To determine whether a continuous insulin infusion improves glucose tolerance in extremely low birth weight infants, we conducted a prospective, randomized trial in 24 neonates 4 to 14 days old (mean birth weight 772.9 +/- 128 gm; mean gestational age 26.3 +/- 1.6 weeks). Infants who had glucose intolerance were randomly assigned to receive either intravenous glucose and total parenteral nutrition with insulin through a microliter-sensitive pump or standard intravenous therapy alone. One infant assigned to receive insulin never required it. The groups were similar in birth weight, gestational age, race, gender, medical condition, and energy intake before the study. The mean duration of therapy was 14.6 days (range 7 to 21 days). During the study, the 11 insulin-treated infants tolerated higher glucose infusion rates (20.1 +/- 2.5 vs 13.2 +/- 3.2 mg/kg/min (1.1 +/- 0.1 vs 0.7 +/- 0.2 mmol/L); p less than 0.01), had greater nonprotein energy intake (124.7 +/- 18 vs 86.0 +/- 6 kcal/kg/day; p less than 0.01), and had better weight gain (20.1 +/- 12.1 vs 7.8 +/- 5.1 gm/kg/day; p less than 0.01) than the 12 control infants. The incidence of hypoglycemia, electrolyte imbalance, chronic lung disease, and death did not differ between groups. We conclude that a controlled insulin infusion improves and sustains glucose tolerance, facilitates provision of calories, and enhances weight gain in glucose-intolerant premature infants.

Blood Glucose↗
PubMed1991

Bad outcomes in black babies: race or racism?

The gap between black and white infant death rates in the United States has grown over the last three decades. Epidemiologic and medical studies by investigators seeking to understand and reverse this adverse trend have been unsuccessful. Researchers have looked in vain for the combination of social and environmental risk factors that are more common among blacks and would therefore explain this group's poor reproductive outcomes. The implicit alternate hypothesis is genetic differences between blacks and whites. In fact, there is more of a gap between black and white mothers of higher socioeconomic position than between overall black and white rates without socioeconomic stratification. An alternative to the genetic theory explains these results, however, on the basis of social risk factors that, because of the presence of widespread discrimination in the society under study, apply only to blacks. Such factors are the effects of racism, not race per se. Several lines of research are needed to investigate the effects of racism on perinatal outcomes, including studies on psychophysiological reactions to racial discrimination and on ethnic group differences in coping mechanisms, social supports, and physical environment. Analysis of trends over the past 37 years indicates that improvements in white (and total US) infant mortality rates cannot be anticipated until the racial gap is closed.

Black or African American↗
PubMed1991

The treatment of mild to moderate hypertension in patients with diabetes mellitus.

The treatment of mild to moderate hypertension in patients with diabetes mellitus is reviewed in this article. The effect of diabetic hypertension on the heart and kidney is discussed. Treatment guidelines for diabetic hypertension are provided, based on principles derived from the pathophysiology. These principles include choosing an agent that maintains or improves lipids, potassium, insulin sensitivity, and quality of life. Individuals with diabetic hypertension should be assessed for their risk of developing coronary artery disease or nephropathy, since certain antihypertensive agents may help prevent these diseases. A simple method for selecting appropriate drugs is also presented.

Antihypertensive Agents↗
PubMed1990

Differential survival rates among low-birth-weight black and white infants in a tertiary care hospital.

Birth-weight-specific mortality is lower for black prematures than white prematures of similar low birth weight. The reason for this well-recognized phenomenon is unknown. We investigated the extent to which black and white infants differ in their gestational maturity and incidence of potentially lethal risk factors, and the effect these factors might have on differential mortality risk. The population studied comprised babies born alive in a tertiary care hospital with birth weights from 700 to 1800 g over a 4 1/2-year period. Univariate analysis showed no important difference between races for the incidence of lung disease, Apgar scores, birth weight, or gestational age. Infants with a birth weight below the 10th percentile (small for gestational age) were more likely to be black, and infants with a birth weight above the 90th percentile (large for gestational age) who had a survival disadvantage were usually white. The crude odds ratio for the white race was 1.79 (1.18-2.73). When the demographic, morbidity, and growth variables were put into a logistic model, the odds ratio changed only slightly, to 1.52 (1.14-2.03). We conclude that the majority of the black-white difference in birth-weight-specific survival is not due to a higher incidence of black small-for-gestational-age infants, nor is it due to differences in major morbidities associated with death.

Academic Medical Centers↗
PubMed1990

Intrauterine growth retardation: altered hepatic energy and redox states in the fetal rat.

We determined the extent to which ligating both maternal uterine arteries affects fetal hepatic energy and redox states in the fetal rat. Bilateral maternal uterine artery ligation on d 18 of the rat's 21.5-d gestation significantly inhibits fetal growth; sham surgery limits growth to a lesser extent. Within 12 h of surgery and persisting to d 19, small-for-gestational age (SGA) fetuses had significantly diminished ATP/ADP and adenylate charge ratios, whereas sham fetuses had values intermediate between SGA and normal. Hepatic mitochondrial redox state demonstrated similar changes. Cytosolic redox state in SGA fetuses at 12 and 24 h after surgery was significantly elevated. SGA fetuses had significantly diminished plasma insulin and elevated glucagon concentrations. On d 19 and 20, hepatic ATP/ADP and cytosolic NAD+/NADH correlated directly for sham and normal but not SGA fetuses. Alterations in glucose, insulin, and glucagon availability and hypoxia were responsible for the changes in energy and redox states. They may also have disassociated hepatic cytosolic from mitochondrial redox states and altered the equilibrium between adenine and nicotinamide nucleotides. These altered cellular functions retarded fetal growth. Newborn SGA, sham, and normal rat pups had similar hepatic ATP/ADP, cytosolic, and mitochondrial redox states at 10 and 240 min after delivery suggesting that the hypoglycemia which developed in SGA pups was not attributable to alterations in these variables.

Animals↗