American journal of preventive medicine
-
Occupational medicine (OM) training programs apparently vary more in content and practice skills than other medical special training programs. This variation appears to exist both within programs, in that individual trainees in some programs may engage in very different experiences, and between programs. Some variation is not necessarily undesirable, considering the multiplicity of professional roles, the eclectic backgrounds of many residents, and the diversity of points of view in each of the specialties. ⋯ A consensus would help physicians to judge their own level of preparation in order to decide to participate in further training and continuing education programs. I prepared a model set of objectives for occupational medicine under the auspices and with the endorsement of the American College of Preventive Medicine. Further evaluation can refine the objectives, implement use of the objectives in formal training programs, and assess the utility of the format for other preventive medicine specialties.
-
We report patterns of prenatal smoking cessation and postpartum relapse for a large urban population of pregnant women. We examined associations between sociodemographic factors and prepregnancy, pregnancy, and early postpartum smoking behavior. Forty-one percent of women smoking before pregnancy quit smoking during pregnancy. ⋯ Early postpartum smoking relapse rates differed by ethnicity. Twenty-eight percent of white women and 46% of black women who had quit during pregnancy relapsed within 6-12 weeks postpartum. Using logistic regression, we found formula feeding to be the most important predictor of early postpartum smoking relapse for both white and black women.
-
Cardiovascular disease rates illustrate the excess morbidity and mortality associated with race and social class. However, while prevalence and deaths from heart disease are greater among black and lower socioeconomic status (SES) populations, researchers rarely consider possible confounds between race and SES. In a longitudinal study of 246 older myocardial infarction (MI) patients, differences appeared in both morbid events and death for black and lower SES patients. ⋯ Low SES black subjects ranked last in physical functioning and cardiac symptomatology, whereas high SES white subjects ranked first in preventive health opportunities. We also considered the potential race-SES confound as an interaction term in multiple regression analysis, and three recovery outcomes were significantly predicted by the joint effects of these variables. These findings demonstrate that failure to consider SES of black and white patients jointly, as well as individually, can lead to erroneous conclusions about health.