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PubMed2006

Factors associated with overweight and obesity among Mexican Americans and Central Americans: results from the 2001 California Health Interview Survey.

INTRODUCTION: Hispanics are the fastest growing demographic group in the United States; however, "Hispanic" is a broad term that describes people who are from or whose ancestors are from multiple countries of origin. This study examines, separately, the social, cultural, and behavioral factors associated with overweight and obesity among Mexican American adults and among Central American adults. METHODS: To estimate the prevalence of overweight and obesity among Mexican and Central Americans living in California, we conducted a cross-sectional analysis of data from the 2001 California Health Interview Survey using SUDAAN software to account for the survey's multistage sampling design. RESULTS: Of the 8304 Mexican Americans participating in the survey, 36.8% were overweight and 26.2% were obese. Of the 1019 Central Americans, 39.2% were overweight and 22.2% were obese. Among Mexican American men, age and marital status were associated with overweight and obesity; and education, acculturation, health insurance status, health status, and use of vitamins were associated with obesity only. Among Mexican American women, age, education, number of children, health status, and health behavior were associated with overweight and obesity. Among Central American men, age, education, and access to health care were associated with overweight, whereas marital status, acculturation, health care, and binge drinking were associated with obesity. Among Central American women, number of children was associated with overweight and obesity; and age and education were associated with obesity only. CONCLUSION: Our findings of high rates of overweight and obesity among Mexican and Central Americans in California indicate the need for a wide variety of effective weight-loss interventions targeting these populations, and the differences we found in the factors associated with overweight and obesity may suggest the need for unique intervention strategies for different Hispanic subgroups.

Adolescent↗
PubMed1991

Fatal injuries at work in California.

We examined deaths due to injury on the job reported from three readily accessible data sources in California for a 1-year period. Of 682 deaths identified as of February 1990 as having occurred on the job in 1983, county coroners identified 607 (89.0%), workers' compensation records identified 294 (43.1%), and the California Occupational Safety and Health Administration investigated 141 (20.7%). Most fatal injuries at work resulted from events that are not covered by current California Occupational Safety and Health Administration standards: transportation vehicle accidents and homicides. Demographic patterns suggest that fatal injuries on the job are nonrandom events, which may be prevented by additions to existing standards or increased enforcement of workplace safety standards and by efforts to target groups at highest risk. Improved surveillance of fatal occupational injuries will require changes in existing reporting mechanisms, similar to those proposed by the US Bureau of Labor Statistics.

Accidents, Occupational↗
PubMed1991

HMO market penetration and hospital cost inflation in California.

UNLABELLED: OBJECTIVE--Health maintenance organizations (HMOs) have stimulated price competition in California hospital markets since 1983, when the state legislature eliminated barriers to selective contracting by conventional health insurance plans. This study measures the impact of HMO-induced price competition on the rate of inflation in average cost per admission for 298 private, non-HMO hospitals between 1982 and 1988. DATA--HMO market penetration was calculated using discharge abstract data on insurance coverage, ZIP code of residence, and hospital of choice for 3.35 million patients in 1983 and 3.41 million patients in 1988. Data on hospital characteristics were obtained from the American Hospital Association and other sources. RESULTS: -HMO coverage grew from an average of 8.3% of all admissions in local hospital markets in 1983 to 17.0% of all admissions in 1988. The average rate of growth in costs per admission between 1982 and 1988 was 9.4% lower in markets with relatively high HMO penetration compared with markets with relatively low HMO penetration (95% confidence interval, 5.2 to 13.8). Cost savings for these 298 hospitals are estimated at $1.04 billion for 1988. CONCLUSION--Price competition between HMOs and conventional health insurers can significantly reduce hospital cost inflation if legislative barriers to selective contracting are removed. The impact of competition in California was modest, however, when evaluated in terms of the 74.5% average rate of California hospital cost inflation during these years.

California↗
PubMedDate not supplied

The impact of public-sector expenditures for contraceptive services in California.

A methodology previously used to calculate the number of unintended pregnancies averted nationally through publicly funded contraceptive services has been adapted for a state-level analysis in California. An estimated 136,800 unintended pregnancies--which would result in approximately 36,000 births, 85,100 abortions and 15,700 miscarriages--are averted each year because publicly funded contraceptive care is available from clinics and private physicians in California. Federal and state expenditures of $46 million for contraceptive services in California in FY 1989 resulted in an estimated savings of $232-$509 million in public costs for abortions, for prenatal and maternity care and for medical care, welfare and supplementary nutritional programs during the first two years after a birth. These savings represent an average of $7.70 saved for each dollar spent to provide contraceptive services. This savings/cost ratio is 75 percent higher than that previously estimated for the United States as a whole.

Abortion, Induced↗
PubMed1990

Recent trends in cesarean section use in California.

Cesarean section use in the United States has increased to 24.7% of deliveries in 1988 and is the most common hospital surgical procedure. California cesarean section rates were examined to measure recent trends in obstetric practices and to project future patterns of cesarean section use. Using discharge abstracts from 1983 to 1987 California hospital deliveries, total cesarean section rates were found to increase from nearly 22% in 1983 to 25% in 1987, an increase of 15%. Using a series of least-squares regression models, time trends in the distribution of indications associated with cesarean section among all deliveries and indication-specific cesarean section rates were evaluated. Increases in the number of women with previous cesarean section and fetal distress contributed to rising cesarean section rates. In addition, indication-specific cesarean section rates increased for breech presentation and dystocia. These trends were counterbalanced, in part, by declining rates of repeat cesarean sections. Trends noted for July 1985 through 1987 did not differ substantially from those observed for January 1983 to June 1985, suggesting that recent policy attempts to alter cesarean section use have not had a measurable effect on existing trends. Projections suggest that California cesarean section rates will rise to a level of 34% by the year 2000.

Breech Presentation↗
PubMed1989

Penicillinase-producing Neisseria gonorrhoeae in California. Report of a major outbreak and control recommendations.

A major outbreak of penicillinase-producing Neisseria gonorrhoeae occurred in California beginning in late 1986. After a state public health emergency was declared in April 1987, a statewide, cooperative federal-state-local treatment and control program was implemented. It was successful in reducing the reported incidence by 59%. Despite the success of this effort, penicillinase-producing N gonorrhoeae is not controlled in California, and, while not nearly the magnitude reported in Florida, an increasing number of cases are again being reported in California. We present recommendations for clinicians and local public health officials, including the epidemiologic and empiric treatment of suspected gonorrhea cases with ceftriaxone when the incidence of penicillinase-producing gonococcal cases in a community exceeds 1% of all reported gonorrhea cases.

California↗
PubMed1989

Assessing the cost of albuterol inhalers in the Michigan and California Medicaid Programs: a total cost-of-care approach.

A study was conducted to determine whether the addition of albuterol inhalers to the Medicaid formulary of California would increase patient costs. Data on the treatment of asthma in 1,463 patients were obtained from the Michigan Medicaid formulary files for the period from July 1983 to December 1984. Annual inhalant costs for albuterol users were higher (+60.47) than for metaproterenol users (+47.66). However, the costs of additional asthma drugs and the total asthma drug costs were lower for the albuterol than metaproterenol users. Other asthma-related medical costs, including emergency-room and physician or clinic visits and days in hospital, were lower for the albuterol than metaproterenol users (+765 vs +1,135 per patient per year, P less than 0.05). These Michigan data were used to determine the costs in California. It was estimated that the addition of albuterol to the California Medicaid formulary would result in an annual per-patient saving of +3.46 in asthma medication and +521.33 in asthma-related medical costs.

Adult↗
PubMed1985

Factors associated with the spread of clinical vesicular stomatitis in California dairy cattle.

In 1983, vesicular stomatitis entered the state of California through infected cattle purchased in Idaho and sold to 5 California dairies. This study examined management, environmental, and host factors which were thought to be associated with disease spread. The use of coarse roughage and hard-pelleted concentrates, the presence of uneaten feed potentially contaminated with virus-laden saliva, increased interpen movement of cows, poor ground surface conditions, poor milking hygiene, and poor teat sanitation were management factors observed to be associated with clinical signs. The amount of milk production, age, or days in milk of individual cows seemed to have an important role in the spread of clinical disease. Recommendations are given for control and prevention of clinical signs and, therefore, the severity of disease during epizootics of vesicular stomatitis in California dairies.

Animals↗
PubMed1988

Evaluation study of the California Expanded Food and Nutrition Education Program: 24-hour food recall data.

The California Expanded Food and Nutrition Education program (EFNEP) Evaluation Study evaluated the effectiveness of the California program. The eating habits of 683 persons were studied in a group receiving EFNEP instruction (355 participants) and a control group (328 participants) that received no instruction. The 24-hour food recall was used to assess eating habits using the Synectics method. At the beginning of the study, there were no differences in food recall scores between the EFNEP and the control groups. After 6 months of instruction in the EFNEP group, there was a significant increase in food recall score for that group and no change in the control group. The improvements observed in the EFNEP group resulted from increased intakes from the milk, protein, and fruit and vegetable food groups. The program characteristics that led to those changes were determined to be in the length of the EFNEP visit, the number of EFNEP visits, and the EFNEP instruction topics. These results show that the California EFNEP is effective in producing significant changes in the eating habits of the low-income individuals it serves.

Adult↗
PubMed1986

Cultural foods education: an exploratory study of dietitians and Plan IV programs in California.

California dietitians require skills in working with the large ethnic populations in that state. Cultural foods education needs must be identified and evaluated so that they can be appropriately addressed in the nutrition and dietetics curriculums. Dietitians employed in California hospitals were surveyed to assess their cultural foods knowledge and determine cultural foods education needs. Demographic and opinion data were requested, and knowledge of the food habits of the six largest ethnic groups in the state was tested. California colleges and universities offering ADA Plan IV programs were sent questionnaires regarding the goals, content, and methodology of and the enrollment in cultural foods courses. Results of the dietitian survey (no. = 184; response rate 51%) showed a positive association (p less than .05) between the total score on the cultural foods knowledge test (average score = 62% correct) and completion of a college cultural foods course. Results of the Plan IV program survey (no. = 16; response rate 93%) indicate that 86% of the colleges and universities offer at least one cultural foods course. In 53% of those colleges and universities, Plan IV students are required to take such a course. Course content corresponds well to needs identified in the answers to the dietitian questionnaire. More emphasis on "ethnic food habits" and "disease and food habits" is recommended in the nutrition and dietetics curriculums.

Black or African American↗
PubMedDate not supplied

California's use of health statistics in child health planning.

The California Health Plan for Children, 1979, compiled by the Committee on Health Planning of California, District IX of the American Academy of Pediatrics, is an extensive report on health problems unique to the children of California. Since its publication, many local and state health agencies have been using it as a guide and source of data in their planning efforts for child and youth health. The creation of the plan demonstrated a successful working relationship between health care practitioners and biostatisticians, the acceptance by health professionals of the use of health statistics in planning, the different uses of health statistics in formulating recommendations, and an approach to organizing and summarizing large bodies of data. Nevertheless, our experience indicates that although collection systems for data on population, mortality, natality, morbidity, and health services statistics abound, their use in community health planning for subpopulations is still limited by problems in the definition, validity, and completeness of the data elements. The establishment of an individualized data system for the entire population, to be developed, coordinated, and controlled by one central agency, could be a significant step toward solving these long-standing problems in our data systems.

Adolescent↗
PubMed1985

An epizootic of leptospirosis in California sea lions.

Between May and December 1984, an epizootic of leptospirosis in California sea lions (Zalophus californianus) occurred along the west coast of the United States from Monterey County, Calif, northward to Seattle, Wash. Clinical signs observed were severe depression, excessive thirst, and tucked-up posturing, with associated leukocytosis and increased globulin, BUN, and creatinine values. Effective antibiotic therapy consisted of tetracycline (22 mg/kg of body weight every 8 hours, orally) or potassium penicillin G (44,000 U/kg every 12 hours, orally or IM) for 10 to 14 days. Sixty-six sea lions were treated successfully and released. Necropsies of animals that died indicated marked kidney swelling, darkened reniculi, and poorly differentiated cortices and medullae, thick, black bile in gallbladders, thick, pale yellow pericardial fluid, and friable hemorrhagic mesentery. Primary histologic lesions were tubular nephritis and glomerulonephritis. Darkfield microscopy of kidney macerates and/or urine, and results of the microscopic agglutination test, using Leptospira serovar pomona-killed antigen led to a presumptive diagnosis of leptospirosis. Bacteriologic isolation and identification is ongoing. The epizootic primarily affected juvenile or subadult male California sea lions migrating northward from breeding rookeries of southern California's Channel Islands.

Animal Population Groups↗
PubMed1979

Estimation of economic loss associated with anaplasmosis in California beef cattle.

On the basis of questionnaire surveys and personal interviews with veterinarians, ranchers, and livestock farm advisors, the seriousness of anaplasmosis in California was determined. In 1976, the economic loss due to anaplasmosis in the study sample of beef cattle was $2,203,150. When inferences were made from the sample population to include the whole population of beef cattle, this loss was estimated to be $5,244,319. These values were in contrast to a farm advisors' estimate of $11 million loss due to anaplasmosis, which was included in a total estimated loss of $300 million due to all livestock diseases of economic importance in California. It appeared that anaplasmosis, although having a substantial economic impact in California, is not as economically devastating as it was once thought to be. It was concluded that private programs currently in use (vaccination and treatment) are sufficient to control anaplasmosis.

Anaplasmosis↗
PubMed1968

Coronary care units. The status in California.

In order to determine the status of Coronary Care Unit activity in California hospitals, especially as it pertains to nurse training, a survery was conducted by the California State Department of Public Health. More than 95 percent of hospitals that were questioned responded. Only one-third of the hospitals reported they neither had a unit nor plans to build one. All units in operation were either directed by an individual medical director or by a Coronary Care Unit Committee. The survey indicated that in some hospitals with operational units, nurses were not permitted to perform life-saving resuscitative procedures. All operational units reported in-service education programs of some type. Many hospitals indicated they would like to have Coronary Care Unit training programs to which they could send nurses. The reasons why nurses may not perform important resuscitative procedures are discussed as well as the need for Coronary Care Unit training programs for both physicians and nurses in California.

California↗
PubMed1968

Drug abuse: recommendations for California treatment and research facilities.

The California Legislature has directed the Regents of the University of California to collect and act as an information exchange on research and services relating to drug abuse, and to provide advice with respect to fields in which research is needed. The current report, prepared under that directive, outlines the method by which data on drug abuse research and treatment facilities will be collected, and how this data will be prepared so that appropriate recommendations can be made to the state legislature. This initial report also outlines areas of immediate concern in the area of drug abuse for the benefit of the state legislature. These areas include current state policies which interfere with investigators competing for federal research funds; pharmacological misclassification of various agents of drug abuse (including marijuana, cocaine and mescaline); lack of awareness of the major adolescent drug abuse problem in California, namely that associated with methamphetamine abuse; the inconsistent and destructive effects of current Nalline clinic programs, and legal restraints which interfere with the proper treatment of drug abusers by physicians trained in treating such patients.

California↗
PubMed1966

Autopsy in California.

From information complied from death certificates registered in 1952 and 1962 an examination was made of California's autopsy performance and the characteristics of deaths in which autopsy was done. The data indicated that California had an overall autopsy rate of 37 per cent of total deaths in 1962, probably higher than any other state. In the decade reviewed, there was a 62 per cent absolute increase in autopsies and a 7 per cent increase relative to total deaths. Substantial increases in the proportion of deaths in which autopsy was done were found for physician-certified deaths in both metropolitan and nonmetropolitan counties and for coroner-certified deaths in nonmetropolitan counties. For all but two of forty-five selected natural causes of death there were increases in the proportion of deaths in which autopsy was done. Seventy per cent of deaths occurred in some type of facility. About one-half of all deaths occurred in general hospitals, and autopsy was done in 42 per cent of such cases. The dual factors of a high autopsy rate and overrepresentation of deaths brought to autopsy in white males, ages 35-64, support the validity of a reported decline in California's death rate for arteriosclerotic heart disease.

Autopsy↗
PubMed1978

Prevalence of vesicular exanthema of swine antibodies among feral mammals associated with the southern California coastal zones.

Serum-neutralizing antibodies to both vesicular exanthema of swine virus (VESV) and San Miguel sea lion virus (SMSV) were found in a number of animal species having an association with the southern California coastal zones. California sea lions (Zalophus californianus) had antibodies to 9 VESV types (A48, C52, D53, E54, F54, G55, I55, J56, and K56). Fur seals (Callorhinus ursinus) and elephant seal pups (Mirounga angustirostris) were tested for antibodies to 6 VESV types and all were negative. California gray whales (Eschrichtius robustus) were tested for antibodies to 9 VESV types, and sperm whale (Physeter catodon), finback whale (Balaenoptera physalus), and sei whale (Balaenoptera borealis) were tested for 6 VESV types. Among the last 4 species, antibodies were present for each VESV type except C52, and all species were positive for antibodies to 2 or more VESV types. Feral swine from both Santa Cruz Island and Santa Catalina Island were tested and antibodies were present for 8 of 9 VESV types and all SMSV types except SMSV-4. One donkey from San Miguel Island was positive for VESV I55 and 2 were positive for SMSV-2.

Animals↗
PubMed1984

Salary survey of the Medical Library Group of Southern California and Arizona.

The 1982 salary survey of the Medical Library Group of Southern California and Arizona (MLGSCA) indicates that 211 health sciences librarians in Southern California and Arizona earned a mean annual salary of $20,910 for 1982. Data analysis shows a positive correlation between salary and educational level. Other factors found to affect salary were job history, number of positions held, MLA certification, and professional responsibility. Age, gender, and MLA certification did not have a consistent positive correlation with salary. Results indicate that the salaries of hospital librarians are, on the average, roughly comparable to those of academic librarians in Southern California and Arizona.

Age Factors↗