American journal of preventive medicine
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The population of uninsured and underinsured individuals in the United States continues to grow, compounding problems of adequate access to medical care. Some of the medical needs of this population are met by community health centers (CHCs). However, CHCs often have difficulty recruiting and retaining physicians, especially those with skills in community medicine. ⋯ Thus far, all graduates have remained involved in community-based medical care and preventive medicine activities for medically underserved populations. This training arrangement can serve as a model for other preventive medicine residency programs and for CHCs interested in enhancing physician recruitment and retention. Medical Subject Headings (MeSH): community-oriented preventive medicine, medically uninsured, preventive medicine residency training, community health centers.
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During the last decade, the decline in cardiovascular disease mortality slowed among African Americans, compared to the general population. Hypertension control is likely to play an important role in determining these trends. The Maywood Cardiovascular Survey provides estimates of the prevalence, awareness, treatment, and control of hypertension among African Americans. ⋯ Rates of hypertension awareness, pharmacologic treatment, and control on pharmacologic treatment are higher in this sample of African Americans than among African Americans in NHANES II and are comparable to those in NHANES III. The impact of nonpharmacologic treatments on control needs further consideration. Medical Subject Headings (MeSH): hypertension, nonpharmacologic treatment, African-American males.
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In the majority of episodes of fatal interpersonal violence, the weapon used is a firearm. Amid frequent reports of youths carrying weapons, including firearms, we conducted a case-control study to identify risk factors for being charged with gun-carrying and gun-carrying, per se, among adolescents in Jefferson Parish, Louisiana. Cases were defined as incidents of gun-carrying among adolescents < 19 years of age, legally charged in the Jefferson Parish, Louisiana, juvenile court from January 1, 1992, through April 15, 1993. ⋯ Gun-carrying control subjects were significantly more likely than non-gun-carrying control subjects to report their school not safe, having seen a shooting, using marijuana, and having fired a gun (OR = 9, 95% CI = 1, 82.1; OR = 7, 95% CI = 1.3, 38.2; OR = 6.8, 95% CI = 1.8, 25.5; and OR = 17, 95% CI = 1.8, 156.6, respectively). We found that gun-carrying was very common, and that adolescent youths who carry guns were more likely to have familiarity with guns and experience with or perception of an unsafe environment. Together, these lead to the conclusion that gun-carrying is a common response of youths who live in a risky environment, who do not have the social support to learn how to deal effectively with that risk, and who have access to guns, which they think may provide them with some protection.
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This study describes the patterns and predictors of smokeless tobacco (ST) use in a large sample of urban public school students in Los Angeles and San Diego. The use of ST is more common among men than women and among Caucasians than African Americans, Hispanics, and others. Approximately 20% of the male respondents and 5% of the female respondents reported use of ST at least once, and 10.1% of male students and 3.1% of female students who had never tried ST by seventh grade started to use it by eighth grade. ⋯ This study supports a problem-prone behavior perspective of ST use and cigarette smoking. We suggest that both products be targeted because the same programs are likely to apply to both products to counteract problem-prone type variables. Medical Subject Headings (MeSH): tobacco, smokeless chewing tobacco, adolescent behavior.
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Reduction of cigarette smoking among Southeast Asian men is a national health promotion objective for the year 2000. Early onset of cigarette smoking is known to be a risk factor for later nicotine addiction, yet little is known about tobacco patterns among Southeast Asian youths. Using questionnaire items from the Youth Risk Behavior Survey (YRBS) translated into Vietnamese and Spanish, this article reports such data on a school-based sample of Vietnamese adolescents in Worcester, Massachusetts, and compares smoking and other tobacco use among Caucasian, African-American, and Hispanic adolescents. ⋯ The prevalence of smokeless tobacco use among Vietnamese boys (12.0%) was similar to that among other minority boys but was rare among Vietnamese girls. This study is the first to document the rates of tobacco use among Vietnamese adolescents, and the findings suggest that Vietnamese boys should be targeted in efforts to achieve the goal of reducing smoking among Southeast Asian men. Medical Subject Headings (MeSH): adolescent behavior, health surveys, smoking, health promotion, tobacco, smokeless, Asians, Asian Americans, Vietnam.