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Hypertension and related health issues among Asians and Pacific Islanders in California.

The prevalence of controlled and uncontrolled hypertension in the United States is lower for persons ethnically classified as Asian, particularly Japanese and excepting Filipinos, than for the general population. In this study, measurements of blood pressure were taken of 8,353 adults living in California, including 1,757 Asians and Pacific Islanders, and the subjects were asked six questions concerning high blood pressure. The results show that Asians and Pacific Islanders with hypertension, in comparison with hypertensive persons of other races, were less likely to be aware of their hypertension, to be under treatment with medication, and to be controlling their blood pressure; similarly, they had their blood pressure measured less frequently and visited physicians less often. Compared with the general population, Asians and Pacific Islanders were less knowledgeable about hypertension. In relation to health care, they recorded lower frequencies of hospital stays, days of bed disabilities, and days of not feeling well than persons of other races. Asians and Pacific Islanders' lower treatment rates and knowledge level concerning hypertension may be related to the fact that a high percentage are foreign-born. Consequently, they have been taught less about hypertension, rely more on traditional methods of medicine, and are hampered by the lack of availability of health care providers of their own ethnic background. In addition, Filipinos have experienced high levels of poverty and lack of education. These factors require additional study as part of efforts to help improve health care for these ethnic groups in the United States.

Adolescent↗

Why are Polynesian children admitted to hospital for asthma more frequently than European children?

Polynesian children have higher hospital admission rates than European children. This study compared 156 Polynesian children with 199 European children admitted to hospital for asthma. After controlling for socioeconomic status Polynesian children were similar to European children for many variables, but there were a number of important differences. The number of previous hospital admissions for asthma was higher in Polynesians than Europeans (mean (SD), 3.9 (4.6) v 2.8 (3.8) respectively p = 0.028). Despite this, 33% of Polynesian children were not receiving any asthma drugs in the 24 hours prior to admission to hospital compared with 14% of Europeans (relative risk (RR) = 1.94, 95% confidence interval (CI) = 1.25-3.00) and fewer were taking sympathomimetics and cromoglycate. A similar trend in asthma drug usage was seen six months later. Polynesian children were less likely to be referred to hospital by a general practitioner than European children (42% v 64% respectively, RR = 0.72 95% CI = 0.58-0.89). The differences in hospital admission rates are not explained by genetic or socioeconomic factors but seem to be related more to patterns of medical management.

Adolescent↗

Distribution of orosomucoid (ORM1) phenotypes in Cook Islanders: analysis by six-band patterns.

The polymorphism of the orosomucoid (ORM) system was analysed in 318 Cook Islanders. Modified isoelectric focusing revealed six-band patterns in thin-layer polyacrylamide gel followed by immunofixation. The first ORM locus showed four-band patterns with variations, while the second locus revealed two-band patterns without variation. ORM1*1 and ORM1*2 gene frequencies were 0.7893 and 0.2107 respectively. ORM1*3 allele was not detected.

Alleles↗

Admission of geriatric patients to hospital on Niue Island 1977-1982.

This report analyses the admission to hospital of people aged 65 years or more on Niue Island in the years 1977-1982. Geriatric admissions, of which 59% were female, comprised 8% of all admissions, equalling the proportion of old people in the community. There were no significant differences by age and or sex for admission rates, reasons for admission, length of stay or disposition. Acute illnesses, particularly respiratory problems, accounted for the majority of geriatric admissions although chronic degenerative disorders, usually cardio-vascular in nature, also played a role. The median hospital stay was 10.5 days, with 81% of all geriatric patients being discharged within one month. The majority (79%) of patients are discharged back into the community. Longest hospital stays resulted from potentially preventable accidents and injury, which constitute a leading cause of death for elderly men, from infectious/parasitic diseases, and from nonspecific nursing care admissions.

Aged↗

Alpha-globin gene haplotypes in Polynesians: their relationships to population groups and gene rearrangements.

Five hundred two alpha-globin gene haplotypes were established in three Polynesian populations, Samoans, Maoris, and Niueans. Limited diversity of haplotypes was found in Polynesians, in whom six common haplotypes (Ia, IIa, IId, IIe, IIIa, and IVa) predominate. Haplotypes Ia and IIa enable Polynesians to be distinguished from Melanesians. Differences in haplotype profiles between the above Polynesian populations support their separate clustering on the basis of previous globin gene analyses and proposed theories of migration. The -alpha/, alpha alpha alpha/, -zeta/, and zeta zeta zeta/rearrangements are each associated exclusively with a particular haplotype, providing evidence of a single evolutionary origin for each. Therefore, a minimum of four DNA crossover events account for the separate origins of these rearrangements in the Polynesians.

Chromosome Mapping↗

Primary and secondary dapsone resistance of M. leprae in Martinique, Guadeloupe, New Caledonia, Tahiti, Senegal, and Paris between 1980 and 1985.

Primary and secondary dapsone resistance were studied among lepromatous patients living in Martinique, Guadeloupe, New Caledonia, Tahiti, Senegal, and Paris. Four hundred fifteen biopsies were taken from clinically active and bacteriologically positive (bacterial index greater than 2) patients in the 6-year period of 1980-1985. Among these, 280 biopsies that contained 5 x 10(4) acid-fast bacilli per ml with a morphological index of at least 0.10 were inoculated into the mouse foot pad, and 229 harbored infective Mycobacterium leprae. Among the 129 infective M. leprae isolated from new cases, 54% had some degree of dapsone resistance, a low degree being prominent in all cases. Among the 100 infective M. leprae isolated from relapsed cases, 79% had a high or an intermediate degree of dapsone resistance. The annual incidence of secondary dapsone resistance was estimated to be about 0.55% in Guadeloupe.

Dapsone↗

Fertility and contraception in the Marshall Islands.

Data on fertility and contraception in Micronesian women in the Marshall Islands were collected during a women's health survey in 1985. High total fertility rates were found. The reproductive pattern of many Marshallese women is one that has been associated with adverse health consequences: pregnancies in teenagers and in women over 39 years, high parities of four or more births, and short birth intervals. The practice of breastfeeding is declining in younger women. The prevalence of contraceptive use is low, and the availability of reversible methods is limited. Most contraceptive nonusers would like to practice contraception, but are inhibited by the lack of information about family planning. It is suggested that more attention needs to be given to family planning services in the Marshall Islands, in particular to improving the availability of reversible methods of contraception and of information about family planning. Further research is also needed on how family planning services might best be organized to maximize participation by women and their partners who wish to use such services.

Adolescent↗

Health in Niue.

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Child↗

[Carriage of HBs antigen in New Caledonia. Study according to ethnic group].

Owing to 2,772 New Caledonian blood donors and pregnant women, a study was made of the salient features of the H. B. s. antigen carrier state; percentages of carriers showed no difference according to the age and a slight difference between sexes. These percentages proved to be quite different according to ethnic groups. Smaller rates of carriers were found among Europeans (1.1%) than among Melanesians (7.6%) as well as Polynesians (7.7%). There is a relation between H. B. s. carrier state and positive treponema serology, the latter occurring more frequently among melanesian and polynesian groups.

Adolescent↗

Diabetes in young New Zealanders: results of national survey 1978-82.

Over a four-year period, 1 August 1978-31 July 1982, a national survey attempted to record all newly diagnosed cases of diabetes in persons under the age of 20 years, by seeking voluntary reporting from paediatricians and physicians. There were 282 cases reported--an annual incidence of 5.74 per 100,000. There was an excess of males in the 0-4 years and 15-17 year age groups, and the incidence among Maoris was significantly lower than among nonMaoris. Diabetes was significantly less common among mothers of diabetic children than among their fathers. The peak age at onset was 11 years for girls and 12 years for boys. A threefold geographical variation was noted, but underreporting may have contributed to this variation. Seasonal variation was apparent, but this was statistically significant in only one of the four years of the study. Symptoms were present in all but 3% of the cases, and the median duration of these symptoms was three weeks. More than half of the children who were treated with insulin were given more than one injection per day. It is suggested that better quality information could come from a compulsory national register.

Adolescent↗

Diabetic patient discharges from Middlemore Hospital in 1983.

Diabetes mellitus is a significant health problem in south Auckland. A retrospective case note review of all diabetic admissions to Middlemore Hospital in 1983 was performed to establish a database to identify current problem areas and permit ongoing analysis. Three hundred and seventeen admissions from 225 patients using 6086 hospital days were reviewed: 204 diabetes-related admissions occupied 4040 days. One hundred and nine patients were male. One hundred and fifty-seven patients were European, 45 were Maori and 21 were Polynesian. European patients were older (mean age 64 years) and lighter (mean weight 69kg) than the non-European patients (mean age 56 years, mean weight 83kg). One hundred and eighty patients had noninsulin dependent diabetes mellitus: European patients were discharged on insulin treatment in 38% of admissions compared with 17% for nonEuropean patients. The patterns of admission were similar for all racial groups except for admissions for chronic renal failure where 21 of 22 admissions were by nonEuropean patients. A comparative cost analysis was performed: admissions for peripheral vascular disease contributed 34% to the calculated total cost of diabetes-related admissions despite only accounting for 17% of admissions. Further research, especially in the nutritional field, is necessary before realistic cost-benefit interventions can be devised and implemented.

Adult↗

New Zealand contraception and health study: design and preliminary report. New Zealand Contraception and Health Study Group.

The New Zealand contraception and health study is investigating the potential health risks associated with oral contraceptives, intrauterine contraceptive devices and injectable medroxy-progesterone acetate. This prospective observational study, begun as a pilot study in 1980, will record for at least six years the health of approximately 7500 women divided into three groups of equal size according to contraceptive method at entry. A major objective is to compare the incidence of dysplasia, carcinoma in situ and invasive carcinoma of the cervix in each group. This paper describes the design of the study and reports its progress.

Adult↗