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PubMed1989

Ethnic differences in response to adversity. A community sample of Bangladeshis and their indigenous neighbours.

A community sample of Bangladeshi immigrants were compared with their native-born near neighbours in one inner London housing estate on measures of adversity and distress. The Bangladeshi sample were found to be experiencing more serious life-events and chronic difficulties, and reported more symptoms of psychological disturbance than their indigenous neighbours. These higher rates of distress appeared to be accounted for by the higher levels of adversity to which they were exposed. The hypothesis that members of Asian ethnic minorities appear to use mental health services less because they are psychologically more robust in the face of difficulties therefore seems questionable. Sampling difficulties mean that these findings have to be considered tentatively. Further, striking differences between these and earlier findings obtained from other Asian communities suggest that local and historical factors may exert a major influence on patterns of results. Generalisations across Asian immigrant communities, therefore, need to be treated very cautiously.

Adult↗
PubMed1992

A comparative and correlational study of the cranial base in North American blacks.

The purpose of this investigation was to compare the cranial bases of blacks and whites in regard to length, angulation, and flexure, and to determine what proportion of the differences in facial measurements can be explained by the variability seen in the cranial base. Standardized cephalograms of 100 native-born North American black adults were traced, analyzed, and compared with white values. The measurements selected depicted dependency and independency from the cranial base. Mean differences between the races and the sexes were assessed with the Student's t test. Models of linear regression between the cranial base measurements and all other parameters were computed for both sexes and correlation coefficient values calculated. This study established that the length of the cranial base in North American blacks is significantly shorter from that of whites. A strong biologic relationship was demonstrated between the length of the cranial base of blacks and their denture bases, the palatal, and occlusal planes. The data suggest that most of the cephalometric differences between blacks and whites are not simply anatomic for measurements using sella nasion as their reference plane.

Adult↗
PubMed1977

Predicting success in psychiatric training for foreign medical graduates: II. Patterns in course.

Faculty ratings of 22 foreign medical graduates ('FMGs'), all of whom entered psychiatric residency training at the University of Missouri-Columbia from 1966 through 1973, were compared with those of a similar group of North American medical graduates ('AMGs'). An on-going evaluation programme provided data for a variety of parameters ranging from 'theoretical knowledge' to 'clinical skills'. Results indicated that in most of performance the median FMG started at a level substantially lower than that of the median AMG and very slowly caught up. When achievement criteria were utilized it became apparent that, at least by the third year of training, 'superior' FMGs could equal or surpass the median performance of 'superior' AMGs, whereas 'marginal' residents, whether foreign or native-born, seldom attained even competence in most major spheres of functioning. Implications of these findings and those in related studies are discussed.

Clinical Competence↗
PubMed1990

Cancer incidence in migrants to New South Wales from England, Wales, Scotland and Ireland.

Cancer incidence in migrants to New South Wales (NSW) from individual countries within the British Isles has been compared with that in the Australian-born population using data from the NSW Central Cancer Registry for the period 1972-84. Indirectly age-standardised incidence ratios (SIR) showed that, for cancer at all sites combined, Scottish migrants had a significantly higher, and English migrants a lower, incidence than the native-born Australians. Melanoma of skin was less common in migrants from all four countries while lung cancer was more common. In all except the Irish migrants, stomach cancer was more frequent than in the Australian-born. Raised SIRs for bladder cancer were found in men from all the countries and for breast cancer in all except the Irish women but only in the English migrants were these ratios significant. English migrants differed from those from Wales, Scotland and Ireland in that, compared with the Australian-born, they had significantly lower SIRs for cancer of the colon (both sexes), head and neck, larynx and prostate (men), gallbladder and kidney (women), and a higher SIR for ovarian cancer. Bone cancer was relatively more common in men born in Wales. 'Other genital' cancers (penis and scrotum; vulva and vagina) tended to be more frequent in migrants from each country than in the Australian-born.

England↗
PubMed1977

Epidemiology of cancer of the testis in upstate New York.

We collected data on the 434 individuals reported with cancer of the testis to the New York State Tumor Registry, 1960-64, from upstate New York. We compared these with the 410 members of a random sample of the upstate population interviewed from 1959 to 1962. A high risk of developing cancer of the testis was associated with professional occupations, native-born parentage, rural residence, and having been married, especially while young. These findings paralleled some other studies, as well as our earlier inquiry. Each of these factors carried a higher risk even when considered in the context of the other traits, and risk increased with an increase in the number of characteristics possessed.

Adolescent↗
PubMed1990

Cancer incidence in European migrants to New South Wales.

The incidence of cancer in migrants to New South Wales (NSW) from Italy, Greece, Yugoslavia, Germany, the Netherlands, Poland and USSR has been compared with that in the Australian-born population using data from the NSW Central Cancer Registry for 1972-84. The indirectly age-standardized incidence ratios (SIR) in all seven countries were low for melanoma of skin and high for gastric cancer. Cancers of the colon, oesophagus and lip also tended to have low SIRs. Migrants from Italy, Greece and Yugoslavia had significantly less cancer at all sites than the native-born Australians mainly due to low SIRs for cancers of colon, lung (except Yugoslavian-born men), prostate and, in men, 'head and neck' (excluding nasopharynx). Cancers of breast and testis were relatively less common in migrants from Italy and Yugoslavia. SIRs were high for cancers of bladder (in Italian-born men), liver (in Greek- and Yugoslavian-born men) and nasopharynx (in Greek-born men and Italian-born men and women). Amongst migrants from the four more northerly European countries, ovarian cancer was relatively more common in women from Germany and Poland as was bladder cancer in men, but not women, from Germany and the Netherlands. Cancers which had significantly increased SIRs in one migrant group only were lung (Dutch-born men), cervix uteri and body of uterus (German-born women), gallbladder and bile ducts (Polish-born women), thyroid (Italian-born women), connective and other soft tissue (Russian-born men) and brain (Greek-born men and women computed together). Lymphomas were relatively less common in men born in Yugoslavia.

Emigration and Immigration↗
PubMed1991

HIV-2 infection in an American.

HIV-2 is endemic in West Africa but rare elsewhere. In the USA there have been 18 reported cases of HIV-2 infection; most identified people have been West Africans. We recently diagnosed the first case of HIV-2 infection in a native-born US citizen, a woman whose serum was found to be reactive to anti-HIV-1 enzyme immunoassay (EIA) when she attempted to donate blood in 1986. Although both HIV-1- and HIV-2-specific EIAs were reactive, the anti-HIV-2 Western blot (WB) was positive, while the anti-HIV-1 WB was positive or indeterminate on different occasions. Synthetic peptide testing was reactive for HIV-2 but not HIV-1. HIV-2 DNA was detected using the polymerase chain reaction procedure. Although she had travelled to West Africa, it is unclear how she became infected with HIV-2.

Adult↗
PubMed1990

HMO enrollment by Medicare beneficiaries in heterogeneous communities.

This study examines the effect of ethnicity, race, and other socioeconomic and utilization variables on belonging to a fee-for-service or capitated plan by Medicare beneficiaries. Native-born beneficiaries cite health status, physical access to health care facilities, and income levels as affecting their choice. Immigrants, on the other hand, mention age, a lifestyle of living alone, and income as influencing their decision. Among foreign-born nationals, race appears to play an important role in choosing health care plans. A key factor affecting enrollment among immigrant populations appears to be the availability of ethnic sensitive providers of health care. While the elderly Hispanic immigrant population utilizes participating providers in prepaid plans catering to a Spanish-speaking population, the lack of similar facilities among predominantly black immigrant neighborhoods inhibits participation in HMOs by elderly immigrants from places such as Haiti and the Caribbean Basin. Policy implications are discussed.

Aged↗
PubMed1977

Histocompatibility determinants in Israeli Jewish patients with multiple sclerosis.

The distribution of 24 HLA antigens of the A and B loci was investigated in 197 Israeli Jewish patients with multiple sclerosis (MS) from various Jewish ethnic origins including central and eastern Europe, countries bordering the Mediterranean, the Middle East and from native-born Israelis. The results were compared with the HLA antigen frequencies in a control sample of 455 unrelated individuals representing the general Jewish population. The frequency of HLA-Bw40 among all MS patients (15%) was significantly greater (P less than 0.001) than among the controls (7%). In contrast to the findings in MS patients from other populations, there was no increased frequency of A3 and B7 and Dw2 was present in only one out of 28 patients. The study showed a similar distribution of HLA-A and -B locus antigens, especially of Bw40, in Jews of diverse ethnic origins represented in the control group.

Epitopes↗
PubMed1978

Tuberculosis among immigrants in Britain. Memorandum from the Joint Tuberculosis Committee.

Tuberculosis is much commoner among immigrants to Britain than among the native-born. In 1971, 5% of the population were immigrants yet they accounted for 32% of tuberculosis cases. The notification rate among immigrants is falling in some areas but rising in others, and many immigrants are still arriving in Britain. Most immigrants arrive at London Airport, and as many as possible are x=rayed there with the resources available; Many cases escape detection, however, and it is therefore important that accurate information about all immigrants is sent to the medical officer for environmental health at their destination. New arrivals should then be sought out, tuberculin-tested, and positive reactors x-rayed. All those who are tuberculin-negative should be vaccinated with BCG whatever their age. Positive reactors should undergo annual radiography and be encouraged to report symptoms early. For both new and established immigrants with strongly positive tuberculin reactions chemoprophylaxis is suggested. All children of immigrants should be given BCG at birth and tuberculin-tested when they start school so that omissions can be rectified. Implementation of these recommendations could contribute considerably to the control of tuberculosis in Britain.

Africa↗
PubMedDate not supplied

Risk of low birthweight and prematurity among foreign-born mothers.

Data collected during postnatal visits were used to study the risk of low birthweight (LBW) and prematurity among foreign-born mothers and mothers born in Canada. 2,913 singleton live births were included in the analysis. Odds ratios (OR) and 95% confidence intervals (CI) for LBW and prematurity were estimated using a logistic regression model. Foreign-born mothers did not have a higher risk of LBW or prematurity as compared to native-born mothers (OR = 1.1, 95% CI = 0.8-1.5; OR = 1.0, 95% CI = 0.7-1.4, respectively). For both LBW and prematurity, women in the intermediate category of length of stay (1-3 years) had a somewhat lower risk and women with the shortest length of stay (less than one year) had a slightly higher risk than women with the longest length of stay (more than 3 years). However, none of these results was statistically significant. Results of this study suggest that foreign-born mothers do not have a higher risk than Canadian-born mothers of bearing a LBW or premature infant. This finding differs from the widespread perception that immigrant mothers are at high risk for adverse birth outcomes.

Asia, Southeastern↗
PubMed1990

Epidemiology of alimentary cancers in New South Wales, 1973-82.

Incidence and mortality data from New South Wales (NSW) for 1973-82 were examined using log-linear regression to determine the temporal trends of cancers of the alimentary tract. There were significant increases in incidence of cancers of the colon (1.7%/year), rectum (2.6%/year), and liver (4.0%/year) and decreases for cancers of the oesophagus (-2.2%/year) and stomach (-1.4%/year). By contrast, the mortality decreased significantly for cancers of the colon (-1.0%/year) and pancreas (-1.4%/year) as well as for cancers of the oesophagus (-3.4%/year) and stomach (-4.1%/year). Cancers of the colon, rectum and oesophagus were generally less frequent, and cancer of the stomach was more frequent, among migrants to NSW than among the native-born Australians in NSW. This pattern was most evident in migrants from Greece, Italy, Yugoslavia and England and was absent in migrants from Scotland and New Zealand. When compared with the state as a whole, rural NSW had significantly lower incidences of cancers of the oesophagus, stomach, colon and rectum.

Age Factors↗
PubMed1989

American fertility in transition: new estimates of birth rates in the United States, 1900-1910.

This article presents new estimates of age-specific overall and marital fertility rates for the entire United States for the period 1900-1910. The estimation techniques are the two-census parity increment method and the own-children method. The data sources are the 1900 census public use sample and tabulations of 1910 census fertility data published with the 1940 census. Estimates are made for the total population, whites, native-born whites, foreign-born whites, and blacks. Low age-specific marital fertility at younger ages is consistent with a view of a distinctive American fertility pattern at this time.

Age Factors↗
PubMed1978

Recent net alien immigration to the United States: its impact on population growth and native fertility.

Estimates of the size and structure of recent alien immigration to the United States are made. Substituting these revised estimates in the Series II projections of the U.S. Bureau of the Census implies a future U.S. population smaller than that implied by the Census Bureau's estimates of immigration. The analysis of Coale (1972)--which calculates the decline in native-born fertility required to accommodate immigration and, at the same time, maintain a stationary population--is replicated, using both the Census Bureau's estimates and the revised estimates reported here. The revised estimates indicate a smaller reduction in native fertility and a smaller ultimate size of the stationary population than are implied by the Census Bureau's immigration estimates. The importance of age structure in all of these calculations is demonstrated.

Adolescent↗
PubMed1989

Reproductive health of Asian women: a comparative study with hospital and community perspectives.

A comparative study of Asian and non-Asian women's reproductive health was performed. The hospital case notes of 48 Asian and 51 non-Asian women, matched for age, were examined. Asian women had shorter stature, bigger families, booked later for antenatal care, and were less likely to have a cervical smear taken. Of the above, 30 Asian and 24 non-Asian women were interviewed in their homes. Many Asian women had difficulties with the English language and a low literacy rate which gave rise to communication barriers during health care. Their knowledge of procedures and tests such as amniocentesis, self examination of the breast etc. was comparatively low. Fewer Asians attended parent-craft classes or did post-natal exercises. Many disliked, and some refused, vaginal examination by male doctors. Despite equal access, Asian women were less well informed and made lesser use of services. Lack of knowledge and difficulties of communication, rather than negative attitudes, may explain Asian women's lesser use of services and to some extent the poor outcome of pregnancy observed in many studies.

Adult↗
PubMed1991

Teenage pregnancy in Scotland: trends and risks.

Teenage pregnancy, considered to be associated with social and medical risks, is seen as a growing problem. Population based information from the Registrar General (Scotland) and Notification of Abortion permitted an analysis of the trends in the numbers, rates and outcomes of pregnancies among women aged less than 20 years. In addition, clinical information is available on all deliveries in Scottish hospitals from the standard hospital discharge document permitting analysis of the association of defined complications with age. Contrary to current perceptions, pregnancies and births among teenagers are not more frequent in 1988 when compared to 1975. There has been, however, a large increase in births to single women, a group with particular problems. The obstetric risks when compared to older women, are small and probably socially, not age related. These include a slightly higher rate of pre-term delivery and low birthweight and a later presentation for specialist antenatal care. The proportion of pregnancies affected by neural tube defects which are terminated is lower among women under 20. These medical risks are small, however, compared to the well-documented social and economic problems which will have long term and indirect effects on health.

Abortion, Induced↗
PubMed1992

Birth spacing and child mortality in a Caribbean population.

Ten independent variables were used to predict death before the first birthday for 4411 births that took place from 1878 to 1976 to 978 women of native ancestry on the island of St. Barthélemy. Significant predictors of death include the death of the mother within a year, the birth year, multiple birth, whether the preceding child also died before 1 year of age, and whether the next child was conceived before the index child was 1 year old. Unlike most prior studies, birth-spacing variables were only weakly related to death in the first year. The relative absence of contraceptive techniques to control birth spacing in the study population and the use of vital records rather than survey data distinguish this project from others and may account at least partly for the unusual findings.

Birth Intervals↗