J Natl Med Assoc
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The Evans County, Georgia, cohort of the Hypertension Detection and Follow-up Program (HDFP) was reexamined seven years after termination of the trial in 1979. Of the 510 survivors, 91 percent of the black and 91 percent of the white hypertensive subjects were evaluated by blood pressure (BP) levels, electrocardiograms (ECG), height-weight measurements, and questionnaire. The HDFP had treated a randomly selected half of the patients in an intensive stepped care (SC) program and the other half was referred to usual care (RC). ⋯ Weight loss of 15 lb was associated with normotension. Weight gain of 9 to 10 lb over seven years was associated with hypertensive BP levels. The supportive or detrimental effect of weight loss or weight gain on BP levels was thus reconfirmed in this biracial cohort.
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In order to provide national data on the epidemiology of sarcoidosis in the United States, data from the National Center for Health Statistics were examined for the period 1968 to 1984. Sarcoidosis appeared among the diagnoses of over 20,000 hospital discharges in recent years. It was mentioned on 605 death certificates in 1982, and as underlying cause of death on 339. ⋯ Race-specific hospital discharge rates must be interpreted with caution in this survey. Nevertheless, patterns were generally consistent with studies of prevalence and incidence. Further descriptive and analytic studies of the epidemiology of sarcoidosis are needed to help identify modifiable risk factors and possible causes.
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As of the end of September 1988, 16,600 cases of acquired immunodeficiency syndrome (AIDS) have been reported in New York City, including 5,248 cases among blacks, 32 percent of the total. Of these, 4,220 (80 percent of adults) are men, 1,028 (19 percent of adults) are women, and 195 are children. The major source of the spread of human immunodeficiency virus (HIV) infection within the black community is the intravenous (IV) drug user. ⋯ AIDS education efforts must be increased, and legislation to protect against unauthorized disclosures of confidential health records must be supported. Comprehensive education programs must destigmatize AIDS among health care workers. To keep up with the epidemic, a national prevention strategy must consist of a massive national public health education program; voluntary, confidential counseling and HIV antibody testing expanded into every public and private clinical facility; and major efforts to curtail AIDS transmission by the IV drug user.
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The status of dental health in the American population has significantly improved during the past 15 years. The prevalence of dental diseases is similar in children when racial comparisons are made. ⋯ Therefore, true differences between races may be even more marked when jobless adults are included. This omission is especially significant for blacks, where unemployment rates are twice those of whites, and this subgroup has not been included in the most recent national survey.
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To analyze Afro-American ethnomedical beliefs and practices concerning disease and health care, the author investigated the health-care-seeking behavior among 285 Afro-Americans and 178 Euro-Americans in the Detroit metropolitan area with respect to hypertension. Hypertension was chosen because more than 60 million individuals in the United States have elevated blood pressure (140/90 mmHg or greater). ⋯ In addition to these ethnohealth and ethnocaring modes, the decisive sociocultural factors in the utilization of the health screening were (1) the health beliefs of the extended lay network, (2) the type of health facility, (3) the lifestyle and behavioral patterns of Detroiters from 1910 to the present, and (4) the adherence to traditional Afro-American cultural beliefs. Once health care professionals recognize the multitude of factors that affect health-care-seeking behavior among Afro-Americans, many health care issues can be resolved.