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Older women on the U.S.-Mexico border: exploring the health of Hispanics and non-Hispanics Whites.

Research on ethnicity and socioeconomic status (SES) suggests that Hispanics are more likely than non-Hispanic Whites to experience poverty and low levels of education, which may relate to poorer health status. This study used a health survey to examine income, education, ethnicity, birthplace, and age on self-reported health factors of women age 60 and older on the U.S.-Mexico border. Results show that income, age, and education were significantly associated with several health factors (Physical Health, Emotional Health, General Health, Energy Level, and Activity Potential). Older women with lower SES, regardless of ethnicity, reported poorer health than younger-old women with higher SES.

Aged↗

Cigarette use among Hispanic and non-Hispanic white school children, Albuquerque, New Mexico.

We conducted a survey of cigarette usage among Hispanic and non-Hispanic White school children in Albuquerque, New Mexico. The distributions of current, experimental, and never smokers were similar in the two groups. Among smokers, the average weekly cigarette consumption was 19 for Hispanic White males, 14 for non-Hispanic White males, 16 for non-Hispanic White females, and nine for Hispanic White females. Educational programs are needed to maintain the low-risk status of Southwestern Hispanics for cigarette-related diseases.

Adolescent↗

Mortality from lung cancer and chronic obstructive pulmonary disease in New Mexico, 1958-82.

We examined mortality from lung cancer and from chronic obstructive pulmonary disease in Hispanic White, Other White, and Native American residents of New Mexico during the period 1958-82. Age-specific mortality was calculated by combining death certificate data with population estimates based on the 1960, 1970, and 1980 censuses that were adjusted for inconsistencies in the designation of race and ethnicity. In Other Whites, age-adjusted mortality rates from lung cancer and from chronic obstructive pulmonary disease increased progressively in males and females. Mortality rates for both diseases also increased in Hispanics during the study period, but the most recent rates for Hispanics were well below those for Other Whites. Age-specific mortality rates for lung cancer declined for more recently born Hispanic women at older ages. In Native Americans, rates for both diseases were low throughout the study period and did not show consistent temporal trends.

Age Factors↗

Prediction of type 2 diabetes using simple measures of insulin resistance: combined results from the San Antonio Heart Study, the Mexico City Diabetes Study, and the Insulin Resistance Atherosclerosis Study.

To determine and formally compare the ability of simple indexes of insulin resistance (IR) to predict type 2 diabetes, we used combined prospective data from the San Antonio Heart Study, the Mexico City Diabetes Study, and the Insulin Resistance Atherosclerosis Study, which include well-characterized cohorts of non-Hispanic white, African-American, Hispanic American, and Mexican subjects with 5-8 years of follow-up. Poisson regression was used to assess the ability of each candidate index to predict incident diabetes at the follow-up examination (343 of 3,574 subjects developed diabetes). The areas under the receiver operator characteristic (AROC) curves for each index were calculated and statistically compared. In pooled analysis, Gutt et al.'s insulin sensitivity index at 0 and 120 min (ISI(0,120)) displayed the largest AROC (78.5%). This index was significantly more predictive (P < 0.0001) than a large group of indexes (including those by Belfiore, Avignon, Katz, and Stumvoll) that had AROC curves between 66 and 74%. These findings were essentially similar both after adjustment for covariates and when analyses were conducted separately by glucose tolerance status and ethnicity/study subgroups. In conclusion, we found substantial differences between published IR indexes in the prediction of diabetes, with ISI(0,120) consistently showing the strongest prediction. This index may reflect other aspects of diabetes pathogenesis in addition to IR, which might explain its strong predictive abilities despite its moderate correlation with direct measures of IR.

Adult↗

Inhalant abuse and juvenile delinquency: a control study in Albuquerque, New Mexico.

This paper examines the relationship between inhalant abuse and delinquency among juveniles in Albuquerque, New Mexico. The arrest records of 100 juvenile delinquents identified as chronic inhalant abusers are compared with two control groups (N = 100 each) of other delinquents from Albuquerque. One control group was stratified on age, sex, and ethnicity, and the other was a simple random sample. The demographic characteristics of inhalant abusers indicated an overrepresentation of young, male Hispanics from large, poor, disrupted families where siblings were involved in both the abuse of inhalants and a variety of other delinquent activities. The inhalant abusers were much more likely to be arrested for virtually every type and category of delinquent activity. Specifically, inhalant abusers are considerably more criminal regarding total offenses committed, status offenses, crimes against property, crimes against persons, and criminal and violent offenses. Therefore, this study has indicated a strong relationship between inhalant abuse and juvenile delinquency.

Adolescent↗

Surgery in elderly patients in Mexico. Portal hypertension surgery as an example.

Although people older than 65 years represent less than 5% of Mexico's registered population, medical care for elderly patients requires a multidisciplinary approach. In our academic university hospital, they are managed by a team of specialists. As an example of this approach, we evaluated the surgical treatment of bleeding portal hypertension in a highly selected elderly population. A retrospective study was done reviewing the files of 25 patients older than 65 years. All had good liver function (Child-Pugh class A and B) and had undergone elective surgery. Sixteen of them were women. The mean age was 68.8 years (age range, 65-76 years), and most had a diagnosis of cirrhosis. All patients were treated with portal blood flow-preserving procedures (selective shunts or Sugiura-Futagawa procedures). The operative mortality was 8%. Eight later deaths were recorded, with a mean follow-up of 25 months (range, 2-110 months). Survival (Kaplan-Meier) was 87% at 12 months, 54% at 60 months, and 45% at 110 months. Two rebleeding incidents were recorded as well as 3 cases of postoperative encephalopathy. We concluded that well-selected elderly patients, undergoing elective surgery with portal blood flow-preserving procedures, have a good postoperative outcome.

Age Factors↗

Annual rotavirus epidemic patterns in North America. Results of a 5-year retrospective survey of 88 centers in Canada, Mexico, and the United States. Rotavirus Study Group.

Rotavirus is the major cause of severe diarrhea in children. A recent study of hospitalizations for diarrhea in the United States suggested that the annual rotavirus epidemic may follow a regional sequence from west to east. As part of a program to establish active surveillance of rotavirus prior to the introduction of vaccines, we obtained 5 years of retrospective data on rotavirus detections from 88 centers throughout North America. Analysis of 34,644 detections indicates that the peak of the annual rotavirus epidemic occurs first in Mexico and the Southwest of the United States in late fall, goes systematically across the continent in the winter, and ends in the Northeast United States and the Maritime Provinces of Canada in the spring. When detections are grouped by region, onset of the epidemic follows the same regional sequence as the peak. To our knowledge, this is the only description of a repetitive geographic sequence for the seasonal epidemic activity of a viral agent. Further studies are indicated to determine whether climate, features of the virus itself, or other factors are responsible for this apparently unique pattern. A system of active surveillance can use this pattern to detect natural alterations in the epidemic behavior of rotavirus and to assess the impact of vaccines.

Canada↗

Study on occurrence of human calicivirus (Mexico strain) as cause of sporadic cases and outbreaks of calicivirus-associated diarrhoea in the United Kingdom, 1983-1995.

The use of a recently developed EIA using antisera raised against purified baculovirus expressed recombinant Mexico virus (rMx) capsid protein is described for screening for human calicivirus in stools. The results show that MX-like viruses have been circulating in the UK periodically since 1983 and were an occasional cause of sporadic cases of diarrhoea in infants and outbreaks of infection among elderly patients in hospitals and old people's homes. Further evidence is presented that some strains of caliciviruses with characteristic surface morphology (HuCVs) and some with an indistinct appearance, small round structured viruses (SRSVs) are antigenically related to MxV. Tests on SRSVs from four unrelated outbreaks typed as UK3 failed to react in the Mx EIA or recombinant Norwalk virus (rNV) EIA. A 2-month survey of 206 children treated in two London hospitals for diarrhoea showed that only one was positive for MxV, a child known to be infected with HIV-1. None of the samples reacted in the rNV EIA.

Adult↗

Incidence of malignant neoplasms in children attending Social Security Hospitals in Mexico City.

An increase in neoplasms in Mexican children has been reported. In 1991, the incidence in children from Mexico City (MC) was 70 (x 10(6) child/year), although this rate might be underestimated. The aim of the present study was to estimate the incidence of malignant neoplasms in children resident in MC attending Social Security (SS) hospitals. This study was a retrospective hospital survey. All records of childhood malignant neoplasms diagnosed between 1992 and 1993 in the two SS hospitals which attend childhood neoplasms in MC were reviewed. Histopathological diagnoses were reevaluated and incidence rates (x 10(6) child/ year) in terms of age, sex, and place of residence were estimated. A total of 667 cases were found for the period of study, of which 199 corresponded to residents of MC. The neoplasms with highest prevalence were leukemias (39.2%), lymphomas (17.6%), and central nervous system tumors (12.6%). A general incidence of 94.3 was found, which was highest in children under 5 years of age. Leukemias had an incidence of 36.4, lymphomas of 15.2, and central nervous system tumors of 12.0. Prevalence was higher in boys (male/female ratio of 1.6). As for the place of residence, the highest incidence corresponded to children living in the southern areas of MC. Eighty percent of the leukemias were acute lymphoblastic, while 54% of solid neoplasms were classified as stages III and IV. In conclusion, the incidence of malignant neoplasms in children resident in MC treated at SS hospitals is consistent with that found worldwide, and also with the Latin American pattern.

Adolescent↗

Trends in incidence and treatment for ductal carcinoma in situ in Hispanic, American Indian, and non-Hispanic white women in New Mexico, 1973-1994.

BACKGROUND: Incidence rates of ductal carcinoma in situ (DCIS) breast carcinoma and the use of breast-conserving surgery (BCS) for its treatment show substantial geographic and ethnic variations nationwide. To the authors' knowledge, few studies have investigated incidence rates and treatment patterns in Hispanics and American Indians. METHODS: The authors used data from the population-based New Mexico Tumor Registry to describe trends in DCIS incidence rates between 1973-1994 and investigate patient and physician characteristics related to BCS in a multiethnic population between 1985-1994. Multiple logistic regression was used to evaluate patient and physician factors related to receiving BCS. RESULTS: Incidence rates for DCIS in Hispanics were approximately 50% lower compared with non-Hispanic whites. American Indians had the lowest incidence rate. Beginning in 1985, incidence rates for Hispanics and non-Hispanic whites showed a 21% annual increase. Between 1990-1994, incidence rates in American Indians increased more than twofold. BCS increased 5.8% per year between 1985-1994, with 50% of Hispanic and non-Hispanic white patients treated with BCS in 1994. The strongest factor associated with receiving BCS was geographic location of treatment (P < 0.001). The odds of receiving BCS were 5.8 times higher in the northern third of the state compared with the southern third. No significant variation in BCS was found by ethnicity, rural/urban residency, socioeconomic status, or physician characteristics. CONCLUSIONS: Incidence rates for DCIS increased substantially in all three ethnic groups. The use of BCS was associated most strongly with the location of treatment, most likely reflecting differences in physician practices and treatment recommendations. Further research is needed to investigate the increasing incidence rates of DCIS and the determinants of BCS for the treatment of DCIS.

Adolescent↗

Has the use of pap smears reduced the risk of invasive cervical cancer in Guadalajara, Mexico?

In Mexico, cervical cancer is the leading cause of death due to cancer among women 35 years of age and older. Although cytologic screening for cervical cancer was introduced as a national program 24 years ago, the mortality rate for this disease has been increasing. A case-control study was undertaken. Cases were women younger than 70, with newly diagnosed invasive cervical cancer (ICC), who had been residing for at least the past year in the metropolitan area of Guadalajara. They were selected from 5 hospitals belonging to the Mexican National Health System. Controls were women without cervical cancer who were treated in the same health center as the corresponding case. Analysis included 143 cases and 311 controls. Information on risk factors for cervical cancer and prior cervical cytologic screening was obtained through a standardized personal interview. Overall, 54% of the cases reported having had a cervical cytology compared with 82% of controls. When compared with unscreened women, those who had ever had a Pap smear had a significantly lower risk of cervical cancer (OR = 0.3, 95% CI 0.2-0.4), and the protective effect persisted for over 5 years. Utilization of Pap smears in the metropolitan area of Guadalajara exerted a protective effect on ICC. Of the 65 women who reported a negative history of Pap smears, 45 would not have contracted cancer if they had ever had a Pap smear.

Adult↗

Women who quit maquiladora work on the U.S.-Mexico border: assessing health, occupation, and social dimensions in two transnational electronics plants.

This cohort study of 725 women examined the health, occupational, and social factors that contribute to quitting work in two transnational electronics maquiladoras (assembly plants) in Tijuana, Mexico. The estimated cumulative probabilities of quitting were 68% and 81% by 1 and 2 years of employment. After adjusting for other factors, women who had a history of smoking or surgery and those who returned to work after a paid leave due to illness were more likely to quit. In contrast, women with a history of chronic illness had lower quitting rates. The nationality of the company and the work shift also significantly influenced quitting rates, but demographic characteristics and health care visits did not have a significant effect. Women selectively leave maquiladora employment, often due to health-related events. The healthy worker effect is difficult to measure in a mobile population with high turnover.

Adult↗

Feeding and general activity patterns of a howler monkey (Alouatta palliata) troop living in a forest fragment at Los Tuxtlas, Mexico.

The feeding behavior and general activity patterns of a howler monkey troop living in a 3.6 ha forest fragment were studied at Los Tuxtlas, Mexico, for an annual cycle. Monthly samples of their feeding behavior indicated that they used 52 species of 24 plant families as sources of food. Of these, 67% were trees, which accounted for 96% of total feeding time recorded. Ten species of Moraceae, Cecropiaceae, Anacrdiaceae. and Sapotaceae contributed to 70% of the trees used and to almost 90% of feeding time. The number of plant species used per monthly record varied from 7 to 31 with an average of 19.9 species. Young leaves and ripe fruit were the principal items in the monthly diet of howlers and average percent of time spent consuming these plant parts was 46.7% and 34.8%, respectively. The use of tree species was found to be associated to their importance value and to their pattern of spatial dispersal in the study site. Availability of young leaves was fairly constant from month to month, but it presented a seasonal pattern, and there was a significantly lower number of tree species bearing ripe fruit through the year with brief pulses of production. The monthly activity pattern was found to be related to variations in the availability of young leaves and ripe fruit as well as to the values of the intermonthly overlap in plant species used. Resting and feeding presented a bimodal pattern of occurrence throughout the day that seemed to be related to variations in maximum ambient temperatures. Results are discussed in light of the small size and shape of the forest fragment inhabited by the howler troop.

Alouatta↗

Multiple primary cancers: relative risk in New Mexico's triethnic population.

A review of the population-based New Mexico Tumor Registry data identified 446 patients with nonsimultaneous multiple primary cancers, excluding non-melanoma skin cancers and carcinomas in situ of the uterine cervix. Expected numbers of cases were established by observing the person-years of exposure to the risk of developing a second or subsequent primary cancer and then applying the appropriate locally determined age-, sex-, ethnic-, and site-specific cancer incidence rates. The relative risk (observed/expected) of developing a second primary cancer was elevated for "Anglo" and Spanish American cancer patients in comparison with the risk of developing a first primary cancer in persons who have never had one. Only six cases of nonsimultaneous multiple primary cancer were observed (6.39 expected) in the region's American Indian population. There were differences in site-site associations among the three ethnic groups, but in many categories there were too few cases for analysis.

Ethnicity↗

Survival of children and adolescents with acute lymphoid leukemia. A study of American Indians and Hispanic and non-Hispanic whites treated in New Mexico (1969 to 1986).

During the period 1969 to 1986, 196 American Indian and Hispanic and non-Hispanic white children and adolescents (ages, 0 to 19 years) were treated for acute lymphoid leukemia (ALL) at the University of New Mexico affiliated institutions. There were 28 American Indians (14%), 91 Hispanic whites (46%), and 77 non-Hispanic whites (39%). Median survivals for patients undergoing antileukemic therapy ranged from 8 months for American Indian boys to 140 months for non-Hispanic white girls. American Indian boys had the highest initial median leukocyte count (WBC) at 23.8 X 10(9)/l. Compliance problems occurred most commonly among American Indian children of both genders. Other clinical and pathologic features evaluated in this study were distributed similarly among the ethnic gender groups. Multi-variate analysis revealed that independent prognostic variables for survival included initial WBC, age, and gender. Ethnicity and compliance problems were possible, but confounded, prognostic variables. To the authors' knowledge this represents the most comprehensive study to date of ALL in American Indian patients.

Adolescent↗

Primary thrombophilia in Mexico. V. A comprehensive prospective study indicates that most cases are multifactorial.

Over a 36-month period, 46 consecutive Mexican mestizos with a clinical marker associated with a primary hypercoagulable state were prospectively assessed by searching for the sticky platelet syndrome (SPS), the activated protein C resistance (aPCR) phenotype, coagulation protein C activity and antigen, coagulation protein S, antithrombin III, plasminogen, tissue-type plasminogen activator activity, plasminogen activator inhibitor activity, plasminogen activator inhibitor type 1, IgG and IgM isotypes of antiphospholipid antibodies, homocysteine levels, the factor V gene Leiden, Cambridge, Hong Kong, and Liverpool mutations, the 677 C-->T mutation in the 5,10-methylenetetrahydrofolatereductase (MTHFR), and the G20210A polymorphism in the 3'-untranslated region of the prothrombin gene. Of the 46 consecutive patients prospectively accrued in the study, only 12 (26%) were males, the median age being 38 years (range 10-63 years). In only four individuals (8%) could we not record any abnormality. In 5/42 patients with abnormal results (12%), a single abnormality was recorded, whereas in the remaining 37, two to five co-existing abnormalities were identified. We found 22 (48%) patients with the SPS, 11 (24%) with the aPCR phenotype, 5 (11%) with the factor V Leiden mutation, 7 (15%) with the prothrombin gene mutation, 29 (63%) with the MTHFR gene mutation, 11 (24%) with the factor V HR2 haplotype, 11 (24%) with antiphospholipid antibodies, 4 (9%) with PS deficiency, 6 (13%) with PC deficiency, one with the FV Hong Kong mutation, and one with AT-III deficiency. The results are consonant with the idea that most cases of thrombophilia in Mexico are multifactorial.

Adolescent↗

Prothrombin "Mexico City," an asymptomatic autosomal dominant prothrombin variant.

A functionally normal but structurally abnormal prothrombin variant was found in a Mexican family. Immunoisoelectricfocusing studies revealed that this variant has a more acidic isoelectric point (4.01) than normal prothrombin (4.29), but it proved to have a normal molecular weight as assessed by sodium-dodecyl-sulphate polyacrylamide gel electrophoresis. Two-dimensional immunoelectrophoresis studies showed an abnormal cleavage of the prothrombin molecule by factor Xa and Echis carinatus venom as well, despite the fact that both yield functionally normal thrombin molecules. Finally, the ability of the molecule to bind calcium ions as well as its overall antigenic structure were investigated and found to be normal. These results taken together suggest a simple (substitution or translocation) mutation at the fragment 2 level. Since this prothrombin variant is different from others described previously, the name "Mexico City" is proposed to identify it.

Adult↗

Urban-rural contrasts in the physical fitness of school children in Oaxaca, Mexico.

The physical fitness of school children resident in an urban colonia and in a rural indigenous community in Oaxaca, southern Mexico, was compared. Two measures of performance-related fitness (standing long jump, 35-yard dash [32 m]) and four measures of health-related fitness (grip strength, sit and reach, timed sit-ups, distance run) were taken on 355 rural (175 boys, 184 girls) and 324 urban (163 boys, 161 girls) school children, 6-13 years of age. Urban children were significantly taller and heavier than rural children. Absolute grip strength did not consistently differ between rural and urban children, but when adjusted for age and body size, strength was greater in rural children. Explosive power (standing long jump) and abdominal strength and endurance (timed sit-ups) were better in urban than in rural children without and with adjustment for age and body size. Urban-rural differences in running speed (dash) and flexibility (sit and reach) varied by age group and sex. Younger rural children and older urban girls performed better in the distance run, whereas older rural and urban boys did not differ in endurance. The size advantage of urban children does not necessarily translate into better levels of performance- and health-related physical fitness. The observed differences may be related to activity habits associated with school physical education and lifestyle in the respective communities.

Adolescent↗