[Treatment of priapism: "black pudding" or no black pudding].
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Hematoma↗
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Black dermographism: mechanism for formation of black color.
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Color↗
Differences in mineral homeostasis, volumetric bone mass and femoral neck axis length in black and white South African women.
In South Africa, appendicular and lumbar spine bone mineral density (BMD) have been found to be similar in black and white women. However, femoral BMD has been found to be higher in black than in white women. Two different techniques were used to recalculate BMD to eliminate the possible confounding influence of ethnic differences in height on areal BMD measurements. Volumetric bone mineral apparent density (BMAD) values were calculated and bone mineral content (BMC) was corrected for body and bone size. This report analyses differences in BMD (corrected for height and weight), BMAD, BMC (corrected for body and bone size), femoral neck axis length (FNAL), mineral homeostasis and bone turnover (BT) in a group of 20 to 49-year-old premenopausal (105 whites and 74 blacks) and 45 to 64-year-old postmenopausal (50 whites and 65 blacks) female South African nurses. The corrected BMD and BMC findings were congruous, showing that both pre- and postmenopausal blacks and whites have similar distal radius and lumbar spine bone mass but that whites have lower femoral neck bone mass than blacks. In contrast, BMAD findings suggest that pre- and postmenopausal whites have lower bone mass at the lumbar spine and femoral neck than blacks but similar bone mass at the distal radius to blacks. There is a greater rate of decline in BMD in postmenopausal whites than in blacks. BMD at the femoral neck was 12.1% lower in premenopausal whites and 16.5% lower in postmenopausal whites than in blacks. There was a positive association between femoral neck BMD and weight in premenopausal blacks (R2 = 0.5, p = 0.0001) but not in whites. Blacks had shorter FNAL than whites in both the pre- and post-menopausal groups. Blacks had lower serum 25-hydroxyvitamin D (25-(OH)D) and higher 1,25-dihydroxyvitamin D (1,25-(OH)2D) levels than whites. There were no ethnic differences in biochemical markers of bone formation (serum alkaline phosphatase and osteocalcin) or bone resorption (urine hydroxyproline and pyridinoline), or in dietary calcium intake in either the pre- or postmenopausal groups. In the postmenopausal group, whites had higher ionized serum calcium (p = 0.003), similar serum albumin, lower serum parathyroid hormone (p = 0.003) and higher urinary calcium excretion (p = 0.0001) than blacks. These results suggest that the higher peak femoral neck BMD in South African blacks than in whites might be determined by greater weight-bearing in blacks and that the significantly lower femoral neck BMD in postmenopausal whites than in blacks is determined by lower peak femoral neck BMD and a faster postmenopausal decline in BMD in whites. The higher incidence of femoral neck fractures in South African whites than in blacks is probably determined by the lower femoral neck BMD and longer FNAL in whites. The greater rate of decline in BMD in postmenopausal whites than in blacks is associated with an increase in urinary calcium excretion in whites. Measurement of biochemical markers of BT has not contributed to the understanding of ethnic differences in BMD and skeletal metabolism in our subjects.
Adult↗
Determinants of high-density lipoprotein cholesterol in blacks and whites: the second National Health and Nutrition Examination Survey.
In 19,521 subjects (8259 and 8561 white males and females; 1299 and 1402 black males and females) in the second National Health and Nutrition Examination Survey (NHANES II), we assessed black-white differences as major determinants of high-density lipoprotein (HDL) cholesterol to determine whether, and to what degree, higher levels of HDL cholesterol in blacks can be accounted for by black-white differences in nutrient intake, relative ponderosity, alcohol intake, cigarette smoking, leisure-time and habitual physical activity, hypertension, and diabetes. Lower intake of carbohydrate in blacks would be congruent with their higher levels of HDL cholesterol and lower triglyceride levels. In male and female youths and in adult males, there were no substantial black-white differences in Quetelet index; much higher Quetelet indices in black adolescent and adult females compared with whites would be consistent with the narrowing of black-white HDL cholesterol and triglyceride differences in females. There were no substantial differences between blacks and whites in frequency of alcoholic beverage intake, and it seems unlikely that differences in HDL cholesterol levels can be attributed to higher alcohol intake in blacks. Overall, blacks were more likely to have diabetes, were more often hypertensive, and were more often treated with antihypertensive agents; these factors would tend to reduce black-white differences in HDL cholesterol. Heavier smoking rates in whites might augment black-white differences in HDL cholesterol levels. There were no consistent black-white differences in leisure-time activity, although habitual physical activity was at a higher level in blacks. It seems unlikely, overall, that physical activity could account for black-white differences in HDL cholesterol. We speculate that whereas environment has a substantial effect on HDL cholesterol in both blacks and whites, there must be a substantial "genetic" vector accounting for higher levels of HDL cholesterol in blacks.
Adolescent↗
Inequalities in rates of gonorrhoea and chlamydia between black ethnic groups in south east London: cross sectional study.
OBJECTIVES: To examine differences in population based rates of gonorrhoea and chlamydia between black ethnic groups in Lambeth, Southwark and Lewisham Health Authority. METHODS: Episodes of gonorrhoea or chlamydia recorded among attenders at 11 genitourinary clinics in south and central London from 1 January 1994 to 31 December 1995 were retrieved. Complete data on chlamydia were only available for women. Ethnic group was assigned according to census categories--white, black Caribbean, black African, black other, Asian, or other. We calculated yearly incidence rates for episodes of gonorrhoea and chlamydia in residents of Lambeth, Southwark and Lewisham Health Authority. Random effects Poisson regression models were used to examine associations between infection rates and age, ethnic group, and material deprivation. RESULTS: During the study period there were 1996 episodes of gonorrhoea in men and women and 1376 episodes of chlamydia in women with complete data. For both infections rates among individuals from black Caribbean and black other ethnic groups were markedly higher than among black Africans. In men, the gonorrhoea rate among black Caribbean 20-24 year olds was 2348 (95% CI 1965 to 2831) episodes per 100,000 compared with 931 (95% CI 690 to 1288) in black African men and 111 (95% CI 100 to 124) per 100,000 in white men of the same age. Among women gonorrhoea rates were highest in black Caribbean 15-19 year olds (2612, 95% CI 2161 to 3190 per 100,000). In contrast, rates in black African women of the same age (331, 95% CI 154 to 846 per 100,000) were similar to those of white women (222, 95% CI 163 to 312). Chlamydia rates were also highest in black Caribbean 15-19 year old women (4579, 95% CI 3966 to 5314 per 100,000), compared with 1286 (95% CI 907 to 1888) in black African and 433 (95% CI 349 to 544) per 100,000 white women. Controlling for material deprivation and age only attenuated differences in rates between ethnic groups slightly. CONCLUSIONS: There are marked differences in rates of gonorrhoea and chlamydia between different black ethnic groups, with higher rates in black Caribbeans than black Africans. This study supports the hypothesis that assortative sexual mixing patterns can restrict epidemics of sexually transmitted infections within ethnic groups. Differences in disease occurrence between black ethnic groups should be explored before combining data, even when numbers of episodes are small.
Adolescent↗
Poor survival of black patients in carcinoma of the endometrium.
PURPOSE: To compare the prognostic factors and survivals of black and white patients with endometrial carcinoma. METHODS AND MATERIALS: A retrospective study was undertaken of a total of 290 patients with endometrial carcinoma who were treated similarly at the Health Science Center at Brooklyn and Kings County Hospital Center from 1975 and 1990. One hundred and thirty-six of 290 (47.2%) were black and 135/290 (46.9%) were white. Well-known prognostic factors affecting endometrial carcinoma were studied in black and white group of patients. Their overall survival and comparison of survival in each prognostic group were also estimated using multi-variate analysis. RESULTS: Fifty-four percent of white patients had Stage I disease, compared to 45.9% in black patients. In Stage II, 51.6% were white and 48.4% were black, and in Stage III, 88.89% were black and 11.1% were white patients (p = 0.034). Fifty six percent Grade 1 patients were white and 44% were black. In Grade 2, 53.3% were white and 46.7% were black and in Grade 3 disease, 70.5% were black and 29.5% were white (p = 0.008). Up to the inner third of myometrial invasion had occurred in 60.6% of white patients and 39.4% in black patients. The middle third of the myometrium was invaded in 60.7% of white patients, and 39.3% of black patients. Thirty-seven percent of outer third of myometrial invasion was found in white patients and 63% in black patients (p = 0.038). Seventy-two percent of positive lymph nodes were found in black patients and 28.0% in white patients (p = 0.01). Sixty-one percent of patients with positive peritoneal cytology were black as compared to 38.7% in white patients (p = 0.017). The overall ten-year corrected survival for white and black patients was 72% and 40%, respectively (p = 0.0003). Survivals comparisons, when stratified by race and each prognostic group, showed statistically significant overall survival differences in favor of white patients. CONCLUSION: Black patients with endometrial carcinoma have poor survival. Low socio-economic status (SES) would not explain these findings. More research is required to determine the cause of poor survival in black patients with endometrial carcinoma.
Adult↗
Interaction of platinum(II) tetrachlorodianion (Fast Black)2 with superhelical DNA and with radiation in vitro and in vivo.
A new complex of tetrachloroplatinum(II) and the azoic diazo dye, Fast Black K, Pt(Fast Black)2, was made in an attempt to produce an uncharged molecule which could readily gain access into cells and could bring a high concentration of tetrachloroplatinum into the vicinity of the DNA. Even the lowest concentration of Pt(Fast Black)2 tested in the superhelical pBR322 plasmid DNA assay in vitro completely converted the superhelical DNA to the circular and linear forms by 24 h. When the cytotoxicity of the Pt(Fast Black)2 and Fast Black were tested in exponentially growing EMT6 cells. Pt(Fast Black)2 was slightly more toxic to normally oxygenated than to hypoxic cells at pH 7.40, but was far more toxic to cells at pH 6.45 with no difference based on cellular oxygenation. Fast Black was much less toxic than Pt(Fast Black)2 and its cytotoxicity was unaffected by pH. Pt(Fast Black)2 had a small radiosensitizing effect on hypoxic EMT6 cells with a dose-modifying factor of 1.3, but exposure to the drug entirely removed the shoulder region on the radiation survival curves for both the oxygenated and hypoxic cells. In contrast, Fast Black reduced the shoulder in hypoxic but not in oxygenated cells. When Pt(Fast Black)2 (500 mg/kg), Fast Black (300 mg/kg) (the maximally tolerated dose), or misonidazole (1 g/kg) were given intraperitoneally 15 min prior to irradiation of FSaIIC tumors with 0, 10, 20, or 30 Gy, Pt(Fast Black)2 alone caused a tumor growth delay of 6 days versus 3 days for Fast Black. With radiation, Pt(Fast Black)2 produced the greatest enhancement in tumor growth delay of the drugs tested, especially at the lowest (10 Gy) radiation dose (i.e., in the in vivo "shoulder region"). These results indicate that Pt(Fast Black)2 may be suitable for clinical development because it causes both significant direct cytotoxicity and enhancement of radiation killing. The fact that its cytotoxicity is markedly increased at an acidic pH and its radiation enhancing effects are greatest in combination with relatively low single-fraction radiation doses make it especially interesting. The cytotoxicity of Pt(Fast Black)2 may be influenced by the tumor environment, and the radiosensitizing properties appear well suited for use with radiation fraction sizes that are employed in the clinic.
Animals↗
Drinking patterns among black and nonblack adolescents: results of a national survey.
The overall objective of this study was to identify factors that relate to the use of alcohol among black and nonblack students and that might serve to explain the lower prevalence of drinking among black students. Black students were shown to differ from nonblack students with respect to both demographic variables associated with social class and variables associated with exposure to and involvement with alcohol. Multivariate analyses, controlling for the effects of demographic status, yielded several predictors of the frequency and quantity of alcohol consumption. Among the major predictors of alcohol use were exposure to friends as drinking models, attitudes emphasizing the importance of social effects of alcohol, ease of access to alcohol, and behavior patterns of social transgressions and illicit drug use. While degree of religiosity and attainment of good school grades were inversely related to frequent and heavier use of alcohol among nonblack students, they were not related to patterns of alcohol use by black students. For the most part, however, there were more similarities than differences in the predictors of alcohol use among black and nonblack students. These findings suggest that environmental factors associated with the use of alcohol are similar for black and nonblack students. While the overall use of alcohol is lower among black students, the onset of drinking is grade-related but later in onset relative to nonblack drinkers. Despite the fact that the same predictors of drinking are common to both black and nonblack students, there is need to identify the environmental factors that delay exposure to a more extensive network of peer drinking models and access to alcohol. Comparisons between black and nonblack abstainers revealed that black abstainers reported lower proportions of school peers to be drinkers. This differential exposure to drinking models between black and nonblack abstainers may be implicated in the delay of onset of drinking among black students. A second factor that may be implicated in the delay of onset of drinking among black students related to differences in the perception of alcohol between blacks and nonblacks. Black abstainers, compared to nonblacks, viewed the personal effects of drinking as more important reasons for drinking. These reasons stress the use of alcohol as a coping mechanism to deal with personal stress and problems. Future studies need to address the status of these variables with regard to their implications in delaying the onset of drinking among black students.
Adolescent↗
Breast cancer in black women.
PURPOSE: To review the current knowledge about breast cancer in black women--including epidemiology, risk factors, screening practices, pathology, clinical manifestations, treatment, and outcome--with emphasis on issues that might explain why the survival rate in this population of women is lower than that in white women. DATA SOURCES: The MEDLINE database from 1966 to 1995 and the bibliographies of all related articles. STUDY SELECTION: Review articles and clinical studies related to all aspects of breast cancer in black women. DATA SYNTHESIS: The incidence of breast cancer is lower in black women (95.8 cases per 100 000 women) than in white women (112.7 cases per 100 000 women). Differences in reproductive factors may partially explain the lower risk for breast cancer among black women in the United States. Breast tumors in black women are consistently diagnosed at a more advanced stage of disease: Forty-two percent of black women present with cancer confined to the breast compared with 53% of white women. In addition, the cancers of black women tend to be more poorly differentiated and are less likely to be estrogen receptor positive. Treatment of breast cancer in black women appears to be similar to that in white women, but little is known about systemic therapy choices and efficacy. Overall, despite their lower risk for breast cancer, black women have a mortality rate from breast cancer similar to that of white women because they have a lower 5-year disease-specific survival rate (64% in black women compared with 80% in white women). CONCLUSIONS: The discrepancy in survival rate between black and white women exists because black women have tumors that are more advanced at the time of diagnosis, because tumor biology in black women is different from that in white women (in particular, black women have a higher frequency of poorly differentiated tumors and a lower frequency of hormone receptor-positive tumors), and because of confounding comorbid conditions and socioeconomic factors. Current efforts to improve survival rates in black women with breast cancer should focus on community education, screening efforts, and early detection. As more information is gained about breast cancer treatment in black women, this may also be an important area for intervention.
Black or African American↗
Pulmonary inflammatory, chemokine, and mutagenic responses in rats after subchronic inhalation of carbon black.
Chronic inhalation of carbon black can produce carcinomas in rat lungs. At present the mechanisms underlying the rat lung tumor response to carbon black are unknown, although a significant role for inflammation and cell proliferation has been postulated. To investigate the processes which may contribute to development of rat lung tumors after carbon black exposure, we characterized the effects of subchronic inhalation of carbon black by rats on mutagenesis in alveolar epithelial cells, pulmonary inflammation, inflammatory cytokine/growth factor expression, and lung histopathology. Briefly, rats were exposed for 6 hr/day, 5 days/week for up to 13 weeks to 1.1, 7.1, and 52.8 mg/m3 carbon black and the effects on the lung were characterized after 6.5 and 13 weeks of exposure and 3 and 8 months of recovery. Endpoints characterized after carbon black exposure included mutation in the hprt gene of alveolar epithelial cells, changes in bronchoalveolar lavage fluid markers of lung injury and inflammation, expression of mRNA for the chemokines, MIP-2 and MCP-1, and lung histopathology. Lung burdens of carbon black were also determined. After 13 weeks of exposure to 1.1, 7.1, and 52.8 mg/m3 carbon black, lung burdens were 354, 1826, and 7861 micrograms carbon black, respectively. The lung clearance of carbon black appeared impaired after exposure to 7.1 and 52.8 mg/m3 carbon black, with the effects being more pronounced at the higher exposure level. Subchronic inhalation of 1.1 mg/m3 carbon black did not elicit any detectable adverse lung effects. A significant increase in hprt mutation frequency in alveolar epithelial cells was detected immediately after 13 weeks of exposure to 7.1 and 52.8 mg/m3 carbon black as well as after 3- and 8-month recovery periods for the group exposed to 52.8 mg/m3. No increase in hprt mutation frequency was observed for epithelial cells obtained from rats exposed to 1.1 mg/m3 carbon black. The observation that genotoxic effects (i.e., mutations) on alveolar epithelial cells occurred only after carbon black exposures which resulted in significant inflammation and epithelial hyperplasia supports the hypothesis that inflammatory cell-derives oxidants and increased cell proliferation play a role in the pathogenesis of rat lung tumors in response to carbon black.
Administration, Inhalation↗
A comparison of kidney transplant survival in white and black recipients.
This study was an analysis of graft survival in patients transplanted during the 1984 to 1988 cyclosporine era. 1. The 1-year first cadaver donor graft survival rate was 77 in whites and 70 in blacks. This difference increased by the third year to 65 in whites and 49 in blacks. 2. The corresponding second graft survival was 67 for whites and 60 for blacks in the first year and 53 for whites and 39 for blacks in the third year. 3. The same graft survival was noted in whites for patients older than 15. For blacks, the 3-year survival for older patients (over 45 years of age) was higher (50%) than for those 15 to 30 years old (43%). 4. The yearly trend for whites has been that older patients have had graft survival equivalent to young patients. However, among blacks, survival in young patients did not improve with the introduction of cyclosporine, and survival of older blacks was the same as for older whites. 5. The difference in graft survival between whites and blacks was greater for young males than females. 6. In both races, immunologic failures occurred more often in young patients than in older ones. 7. Patients with various original diseases consistently showed superior survival in whites as compared to blacks. Only in SLE patients did blacks have higher survival rates. 8. The half-life of transplants in blacks was lower than in whites in the 1974 to 1979 period as well as from 1980 to 1988. The half-life was about 8 years in whites and about 4 years in blacks. 9. Parental donor and HLA-identical sibling donor grafts in blacks had about the same graft survival as corresponding grafts in whites. Thus, when the HLA chromosome had been matched, the race effect disappeared. 10. We postulate that noncompliance may have been the major factor resulting in lower graft survival in young black males. A suggested ideal solution to the problem is recruitment of more black cadaver donors in order to achieve excellent matches.
Black People↗
Comparison of cardiovascular risk factors in obese blacks and whites.
Blacks are known to have higher blood pressure levels, a higher prevalence of hypertension, and higher body weights than whites. However, the interrelationships of these and other cardiac risk factors have not been analyzed in an obese population. We compared blood pressure (BP) and lipid levels in 174 obese blacks and 939 obese white patients who were entering a weight loss program; we also assessed the effects of weight loss on these factors. Prevalence of treated hypertension was similar in blacks and whites (28% vs. 25%, respectively). In patients not taking BP medication, black women weighed more (108 kg) than white women (102 kg) and black and white males' weights were similar (135 kg vs. 131 kg). Systolic and diastolic BP were similar in black and white women; black males had similar SBP but a significantly lower DBP than white males (83 mmHg vs. 89 mmHg, respectively). Lipid levels were similar in black and white women except black women had lower triglycerides (1.30 mmol/L) than white women (1.58 mmol/L, p < 0.05); and black males compared to white males had significantly lower total cholesterol (4.76 mmol/L vs. 5.56 mmol/L), LDL-cholesterol (3.15 mmol/L vs. 3.52 mmol/L) and triglycerides (1.31 mmol/L vs. 2.17 mmol/L, p < 0.05). Adult-onset obesity adversely affected a number of cardiovascular risk factors in whites, but not in blacks. Blacks lost significantly less weight (-13 kg) than whites (-19 kg). However, controlling for the difference in weight loss, blacks sustained comparable improvement in lipids and blood pressure, except for TC/HDL-C (whites improved significantly more, -0.36 kg/m2, than blacks, 0.03 kg/m2). Thus, the impact of obesity on cardiovascular risk factors seems ameliorated in blacks compared to whites.
Adult↗
Differences of Ca2+ regulation in skin fibroblasts from blacks and whites.
Black people have a higher propensity than caucasians toward essential hypertension. To explore the possibility that this racial difference relates to cellular Ca2+ metabolism, we measured 45Ca2+ washout and uptake and cytosolic free concentration of Ca2+ [Ca2+]i in serially passed skin fibroblasts from normotensive black and white males. Depending on the experimental conditions, 45Ca2+ washout in these cells was described by either two or three exponential functions, whereas 45Ca2+ uptake was described only by a two-exponent function. There were no racial differences in 45Ca2+ uptake and washout of unstimulated fibroblasts. However, stimulation by human serum resulted in an increase in the 45Ca2+ washout that was higher in fibroblasts from blacks than from whites. The racial differences were expressed primarily by higher values of the apparent washout rate constant (k1) of 45Ca2+ from the largest and most rapidly exchangeable cellular pool. The effect of human serum was not related to its origin (blacks vs. whites). In 2 mM Ca2+ medium and 10% serum from blacks, the respective k1 (mean +/- SEM; x 10(-2)/min) values for fibroblasts from blacks and whites were 89.68 +/- 5.23 and 73.29 +/- 4.0; in the presence of 10% serum from whites, the k1 values for cells from blacks and whites were 84.14 +/- 2.80 and 76.36 +/- 3.23 (overall significance of P less than .01). In Ca2+-deficient medium in the presence of 10% human serum, the k1 for fibroblasts from blacks and whites were 115.57 +/- 3.76 and 102.15 +/- 3.30 (P less than .05). Serum substantially increased the 45Ca2+ uptake in fibroblasts from both blacks and whites; however, racial differences were not observed. Basal levels of [Ca2+]i were not different in fibroblasts of blacks vs. whites (46.8 +/- 6.8 and 43.2 +/- 7.1 nM for blacks and whites, respectively). However, the peak response of Cai2+ transients for cell stimulated by 5% human serum was significantly higher in blacks than whites (blacks = 963 +/- 213, whites = 481 +/- 162 nM; P = .0286). We conclude that Ca2+ regulation is different in serum-stimulated fibroblasts from blacks and whites and that, at least in part, this difference may relate to a greater agonist-induced mobilization of Ca2+ in fibroblasts from blacks.
Adult↗
Epidemiologic and clinical comparison of renal artery stenosis in black patients and white patients.
PURPOSE: This study was undertaken to compare the epidemiologic and clinical features of renal artery stenosis (RAS) in black patients and white patients. METHODS: Data on all patients identified with 50% or greater RAS from 1984 to 1990 were collected and analyzed. The study was conducted at the Cleveland Clinic Foundation, which is a referral center for patients with renal artery disease. Eight hundred nineteen patients with RAS were identified from an institutional registry that records information on patients with this disease. This group comprises 40 black patients (4.9%) and 779 white patients (95.1%). The presence of RAS was determined by abdominal aortography in all patients. Black patients and white patients with RAS were compared with respect to their age, sex, presence and severity of hypertension, renal function, type and extent of renal artery disease, extrarenal vascular disease, and risk factors such as history of smoking, diabetes, and hyperlipidemia. RESULTS: The mean age of black patients and white patients was 62 years; however, a greater proportion of black patients were women (p = 0.01). RAS was due to atherosclerosis in 95% and 92% of blacks and whites, respectively. Although the extent and severity of RAS were equivalent in black patients and white patients, more blacks were diagnosed with severe (p = 0.01) or refractory (p = 0.05) hypertension. Extrarenal vascular disease was present in 95% and 70% of blacks and whites, respectively (p < 0.01). The incidence of coronary artery disease (p < 0.01), cerebrovascular disease (p < 0.01), and peripheral vascular disease (p < 0.01) was greater among black patients. A history of smoking was more common among black patients (p < 0.01). Serum total cholesterol and low-density lipoprotein cholesterol levels were equivalent among black patients and white patients; however, black patients had higher high-density lipoprotein cholesterol (p = 0.03) and lower triglyceride (p < 0.01) levels. CONCLUSIONS: There are significant differences between black patients and white patients with RAS. The basis for these findings and their relationship to the cause and true prevalence of RAS in blacks requires further study.
Adult↗
Focusing "down low": bisexual black men, HIV risk and heterosexual transmission.
INTRODUCTION: Black men who have sex with men (MSM) and women but who do not identify as gay or disclose their bisexual activities to main female partners, also known as men "on the down-low," have been cited as the main reason for the increase in HIV infections in black women. METHODS: Three online databases (PsychInfo, MEDLINE and AIDSLINE) were searched for scientific articles related to men on the down-low. A total of 24 articles and two conference abstracts were selected for review. RESULTS: Data from existing studies of MSM reveal low agreement between professed sexual identity and corresponding sexual behavior among black and other MSM; show that black MSM are more likely than MSM of other racial or ethnic groups to be bisexually active or identified; and, compared with white MSM, are less likely to disclose their bisexual or homosexual activities to others. However, black MSM who do not disclose their homosexual or bisexual activities engage in a lower prevalence of HIV risks than black MSM who do disclose; and black men who are currently bisexually active account for a very small proportion of the overall population of black men (2%). CONCLUSION: The high prevalence of HIV in the black community and the greater likelihood of bisexuality among black men place heterosexual black women at risk for HIV infection. However, the contribution of high-risk heterosexual black men to the rising HIV caseload among black women has been largely ignored. Future research must evaluate the relative contributions of bisexual men and exclusively heterosexual black men to HIV cases among black women.
Black or African American↗
Plasma high-density lipoprotein cholesterol comparisons in black and white populations. The Lipid Research Clinics Program Prevalence Study.
High-density lipoprotein (HDL) cholesterol distributions were compared among 191 black and 1341 white males and 233 black and 1088 white females, ages 5-44 years, examined in five of the Lipid Research Clinic (LRC) population-based surveys. Mean HDL cholesterol was higher in blacks than whites in each 5-year age group for males and in seven of the eight age groups for females. The black-white mean HDL cholesterol difference was greater for males than females at each age studied. Mean HDL cholesterol was 4.8 mg/dl higher in black than white males ages 5-19 years, after statistical adjustment for age, Quetelet index and plasma total cholesterol differences between blacks and whites (p < 0.001); mean HDL cholesterol was 9.5 mg/dl higher in black than white adult males ages 20-44 years. Adjustment for levels of plasma triglyceride, which were lower in blacks than whites, reduced but did not eliminate the magnitude of the statistical significance in black-white differences: The adjusted means were 2.9 mg/dl higher in black children and 7.9 mg/dl higher in black adults. The finding of higher levels of HDL cholesterol in black males persisted after additional adjustment for alcohol consumption, smoking and educational levels. Adult U.S. black males have lower and black females have higher coronary heart disease mortality rates than their white peers. The magnitude of the black-white difference in HDL cholesterol for males in the LRC studies was within the range associated with coronary heart disease incidence reported in other studies.
Adolescent↗
The association between birthplace and mortality from cardiovascular causes among black and white residents of New York City.
BACKGROUND: Life expectancy is shorter and mortality from cardiovascular disease higher among blacks than among whites in the United States. We studied whether place of birth was associated with mortality from cardiovascular causes among non-Hispanic black and white residents of New York City. METHODS: We linked mortality records from 1988 through 1992 with 1990 U.S. census data for New York City. Mortality data for blacks born in the U.S. South and Northeast and in the Caribbean were compared with those for whites born in the Northeast. RESULTS: Among blacks, the rates of overall mortality and mortality from cardiovascular causes exceeded those among whites. Among persons born in the Northeast, the rates of death from cardiovascular disease for white men (285 per 100,000), as compared with black men (299), and for white women (155), as compared with black women (165), were similar. However, Southern-born black men and women both had mortality from cardiovascular disease that was substantially higher than that of their counterparts born in the Northeast, and Caribbean-born blacks had rates substantially lower than their Northeastern-born counterparts. The differences among the groups in the rates of death from coronary heart disease were greater than those for death due to stroke or hypertension. In each category defined by age and sex, Caribbean-born blacks had significantly lower rates of death from coronary heart disease than did whites. Black men who were 25 to 44 years of age and were born in the South had a rate of death from coronary heart disease that was 30 percent higher than that of Northeastern-born blacks, and four times that of Caribbean-born blacks of the same sex and age. CONCLUSIONS: The higher rate of mortality from cardiovascular causes among blacks, as compared with whites, in New York City masks substantial variation among blacks based on their place of birth.
Adult↗
Screening mammography performance and cancer detection among black women and white women in community practice.
BACKGROUND: Despite improvement in mammography screening attendance, black women continue to have poorer prognosis at diagnosis than white woman. Data from the Carolina Mammography Registry were used to evaluate whether there may be differences in mammography performance or detected cancers when comparing black women with white women who are screened by mammography. METHODS: Prospectively collected data from community-based mammography facilities on 468,484 screening mammograms (79,397 in black women and 389,087 in white women) were included for study. Mammograms were linked to a pathology data base for identification of cancers. Sensitivity, specificity, positive predictive value, and cancer detection rates were compared between black women and white women. Logistic regression methods were used to control for covariates associated with performance characteristics. Differences in cancer characteristics were compared between black women and white women using chi-square statistics. RESULTS: Screening mammography performance results for black women compared with white women were as follows: sensitivity, odds ratio (OR) = 1.07 (95% confidence interval [95% CI], 0.83-1.39); specificity, OR = 1.02 (95% CI, 0.98-1.06); and positive predictive value, OR = 1.07 (95% CI, 0.94-1.23). Among women with no previous screening, black women had a larger proportion of invasive tumors that measured > or = 2 cm (38% vs. 26%; P = 0.04). The cancer detection rate was highest among black women who reported symptoms at screening (13.9 per 1000 black women vs. 7.9 per 1000 white women). Invasive cancers in black women were poorer grade (P = 0.001), and more often had negative estrogen receptor status and progesterone receptor status (P < 0.001). CONCLUSIONS: Overall, screening mammography performed equally well in black women and white women controlling for age, breast density, and time since previous mammogram. Black women who reported symptoms had larger and higher grade tumors compared with white women. Educational efforts need to be strengthened to encourage black women to react sooner to symptoms, so that the tumors detected will be smaller and black women will have a better prognosis when they appear for mammography.
Adult↗