Race and socioeconomic status as confounding variables in the accurate diagnosis of alcoholism

Utilized two psychologists as actors in making four videotapes to depict background information and verbal modes of communication for alcoholics according to black-white race differences and high-low socioeconomic status. Forty graduate psychology students (10 per group) then were shown randomly one of the four recordings and asked to make a diagnosis. A significant difference was found for the effects of race, socioeconomic status, and race X socioeconomic status interaction on the correct diagnosis of alcoholism. Results were interpreted as suggesting that a clinician's personal biases and/or prejudices might extend into the clinical diagnosis and treatment of clients.     

Sex,race, age,and education variables in Shipley-Hartford scores of alcoholic inpatients

Administered the Shipley-Hartford Institute of Living Scale to 376 inpatients at a municipal hospital for the treatment of alcoholism. The results indicate that all of the independent variables under study--sex, race, age, and education--have a significant effect on one or more of the Shipley-Hartford scores. As these are considered extraneous variables whether the test is used to measure intelligence or organicity, group means are provided as rough approximations to correct for bias. The results also Provide some support for the validity of the Conceptual Quotient as an indication of organic impairment.     

Longitudinal predictors of adult socioeconomic attainment: the roles of socioeconomic status, academic competence, and mental health

Educational attainment and occupational status are key markers of success in adulthood. We expand upon previous research that focused primarily on the contributions of academic competence and family socioeconomic status (SES) by investigating the role of mental health in predicting adult SES. In a longitudinal study spanning 30 years, we used structural equation modeling to examine how parental mental health in early childhood and family SES, offspring academic competence, and offspring mental health in adolescence relate to occupational and educational attainment at age 30. Results were that adolescent academic competence predicted adult educational attainment, and that educational attainment then predicted occupational attainment. The pathways between academic competence and occupational attainment, family SES and educational attainment, and family SES and occupational attainment were not significant. In contrast, adolescent mental health not only predicted educational attainment, but was also directly related to adult occupational attainment. Finally, early maternal mental health was associated with offspring's adult socioeconomic attainment through its relations with adolescent academic competence and mental health. These results highlight the importance of mental health to adult socioeconomic attainment.     

Race/ethnicity, socioeconomic status and the health of pregnant women

We examined how traditional (income, education) and nontraditional (public assistance, material deprivation, subjective social standing) socioeconomic status (SES) indicators were associated with self-rated health, physical functioning, and depression in ethnically diverse pregnant women. Using multiple regression, we estimated the association of race/ethnicity (African American, Latino, Asian/Pacific Islander (PI) and white) and sets of SES measures on each health measure. Education, material deprivation, and subjective social standing were independently associated with all health measures. After adding all SES variables, race/ethnic disparities in depression remained for all minority groups; disparities in self-rated health remained for Asian/Pacific Islanders. Few race/ethnic differences were found in physical functioning. Our results contribute to a small literature on how SES might interact with race/ethnicity in explaining health.     

Activity pattern,smoking habits,and somatometric variables of the Czechoslovakian population

Summary A total of 3762 subjects of both sexes, natives of Czechoslovakia, ranging in age from 12–55 years, were examined. Both anamnestic data and selected anthropometric variables were evaluated. The proportion of non-smokers for adult males was 47–56%, and for adult females was 54–74% of the population. The proportion of subjects not engaged in any type of physical activity decreases in boys between 12 and 18 years from 28 to 16%, in girls between 12 and 15 years from 25 to 22%; from then on the trend reverses and the percentage rises up to 42% in men and 65% in women. The number of subjects participating in competitive sporting activity reaches its peak at 18 years, when 46% of boys and 43% of girls compete, but than decreases quickly. 12 year old girls are taller and heavier than boys but at 15 years the relationship is reversed. The LBM at the age of 12 is equal in boys and girls, but from then till 18 years the increase is larger in boys. The LBM weight in adults remains steady, women attaining 77% of the value found in men. The skinfold increases with age similarly in both sexes, except for an interval between 12 and 18 years, when girls show a steeper increase. Adult women attain 121–160% of the values characteristic for men. The grip strength of the right hand equals about 50 kp in adult men and 30 kp in adult women. Within the age range followed, it remains unaffected by age.More than 50 specialists assisted in gathering the pertinent data     

The effects of life events on cardiovascular reactivity to behavioral stressors as a function of socioeconomic status, ethnicity, and sex

OBJECTIVE: The purposes of this study were 1) to examine the effects of stressful life events on cardiovascular reactivity to acute laboratory stressors in youth and 2) to determine whether these effects varied as a function of socioeconomic status, ethnicity, and/or sex. METHODS: Four hundred eighty-three youths (mean age = 16.7 years; 249 Caucasian Americans [126 males, 123 females] and 234 African Americans [109 males, 125 females]) completed the Adolescent Resources Challenge Scale (ARCS), a measure of stressful life events, and underwent two laboratory stressors (a car-driving simulation and the Social Competence Interview) during which blood pressure, heart rate, cardiac output, and total peripheral resistance were assessed. RESULTS: Youths who reported high levels of stressful life events showed smaller increases in blood pressure (both systolic and diastolic) and heart rate to the car-driving simulation but larger increases in cardiac output in response to the Social Competence Interview than did youths who reported low levels of stressful life events. The effect of stressful life events on cardiovascular reactivity was not moderated by sex, ethnicity, or socioeconomic status. Higher family socioeconomic status was associated with greater blood pressure, heart rate, and cardiac output increases in response to the Social Competence Interview. CONCLUSIONS: The attenuating effects of stressful life events on cardiovascular reactivity in response to car-driving simulation in youths are consistent with an inoculation effect, whereas the potentiating impact of stressful life events on reactivity observed during the social stressor interview is compatible with a possible cost of coping effect.     

Effects of home environment, socioeconomic status, and health status on cognitive functioning in children with HIV-1 infection

OBJECTIVE: To investigate the effects of the home environment, socioeconomic status (SES), and health status on cognitive functioning in a sample of children with HIV-1 infection in a cross-sectional study. METHODS: Forty-three caregivers and their children (2.5 to 12 years) participated. Caregivers completed two self-report measures of the home environment that included questions regarding the organization of the environment, play materials, parental involvement, variety of stimulation, and parental attitudes toward the provision of a cognitively stimulating environment. Cognitive functioning was assessed using a standardized intelligence (IQ) test. Children's medical charts were reviewed for HIV-1 classification status (CDC, 1994), CD4 cell counts, and current medication. RESULTS: This study revealed two primary findings. First, measures of the home environment mediated the association between SES and child IQ. Second, measures of the home environment had a stronger association with child IQ during the advanced stages of disease than earlier stages of disease. CONCLUSIONS: The home environment is associated with cognitive functioning among children with HIV-1 infection. Moreover, interventions aimed at enhancing the quality of the home environment may have a positive impact on these children's cognitive development.     

Cardiovascular reactivity in adolescent boys of low socioeconomic status previously characterized as anxious, disruptive, anxious-disruptive or normal during childhood

BACKGROUND: The purpose of the study was to compare cardiovascular reactivity, a potential mechanism underlying the development of cardiovascular disease (CVD), in boys with different behavioral characteristics. METHOD: Eighty-nine adolescent boys with low socioeconomic status who were classified as anxious, disruptive, anxious-disruptive or boys without these characteristics (i.e. control) during childhood were observed during a laboratory stress experiment. RESULT: No significant group differences were found for resting levels of diastolic or systolic blood pressure (SBP). Anxious and anxious-disruptive boys exhibited greater SBP reactivity to the social stressor (Social Competence Interview) compared to the disruptive and control boys. The disruptive boys tended to engage in compromising behaviors which are associated with health problems. The anxious boys were significantly more likely to have a positive family history of hypertension. CONCLUSIONS: Boys with different behavioral problems (anxiety, disruptiveness) may be at risk for CVD via different mechanisms.     

Low socioeconomic status as a risk factor for asthma, rhinitis and sensitization at 4 years in a birth cohort

BACKGROUND: The relation between socioeconomic status and allergic diseases in childhood is controversial. Some studies have proposed childhood asthma to be more common in families with low socioeconomic status, while sensitization to airborne allergens seems to be more frequent in individuals with higher socioeconomic status in childhood. OBJECTIVE: To assess the relation between socioeconomic status and asthma, rhinitis and sensitization in an unselected prospective birth cohort. METHODS: Four thousand and eighty-nine families with children born 1994-1996 in predefined areas of Stockholm answered questionnaires on environmental factors, socioeconomic status (parental occupation), and symptoms of allergic disease at birth, 1, 2 and 4 years of age. Blood samples taken at 4 years from 2614 children were analysed for specific IgE to common airborne and food allergens. Odds ratios (OR) and 95% confidence intervals (CI) for various outcomes in relation to socioeconomic status were estimated with a multiple logistic regression model, adjusting for potential confounders such as heredity for allergic diseases, maternal smoking, short duration of breastfeeding and house construction. RESULTS: There was a decreasing risk of asthma and rhinitis with increasing socioeconomic status. The OR for asthma was 0.33 (95% CI 0.17-0.66) and for rhinitis 0.50 (0.32-0.79) comparing the highest and the lowest socioeconomic groups, with a tendency to stronger effects in those with heredity for allergic disease. The risk of sensitization to food allergens also decreased with increasing socioeconomic status; OR 0.65 (0.41-1.02) in the highest socioeconomic group (Ptrend=0.03), which was not clearly seen for airborne allergens. CONCLUSION: Asthma, rhinitis and sensitization is more common in lower than in higher socioeconomic groups after adjustment for traditional risk factors. This may be related to additional uncontrolled differences in life style and environmental exposures between the groups, and calls for further studies.     

The comparability of the WRAT-R reading test and NAART as estimates of premorbid intelligence in neurologically impaired patients.

A study by Wiens, Bryan, and Crossen (1993) suggests the Wide Range Achievement Test-Revised (WRAT-R) Reading subtest and North American Adult Reading Test (NAART) are adequate predictors of Wechsler Adult Intelligence Scale-Revised (WAIS-R) IQ scores for a normal population. Although it is common practice to use reading scores to estimate premorbid IQ in clinical populations, the WRAT-R and NAART have not been compared using individuals with brain dysfunction. The current study cross-validated the Wiens et al. (1993) study using neurologically impaired populations: traumatic brain injury (n = 118), dementia (n = 37), and other neurologic impairments (n = 77). The results were generally consistent across all three groups: (a) the WRAT-R and NAART were equivalent and accurate estimates of average VIQ levels; (b) the WRAT-R and NAART were equivalent but underestimates of higher intelligence ranges; and (c) the WRAT-R is a more accurate estimate for lower VIQ ranges, although both are overestimates. This third finding is in contrast to Wiens et al.'s (1993) results that suggest the WRAT-R is an accurate estimate of lower IQ ranges for normals. It is concluded that the WRAT-R is the preferred measure of premorbid verbal intelligence for psychometric and clinical reasons.     

Dietary pattern and growth of 10–12-year-old Bolivian girls and boys: Relation between altitude and socioeconomic status

The purpose of the study was to determine the impact of nutrition and physical activity on growth and health of 228 native Bolivian prepubertal girls and boys 10–12 years of age, from high socioeconomic status (HSES) and low socioeconomic status (LSES), living at high altitude (HA) in La Paz (∼4,000 m) and at low altitude (LA) in St. Cruz (∼400 m). In the 4 years of the study, dietary information and daily physical activities were obtained with the 24-hour recall method by interviewing the child and mother. All food items were converted into grams, and nutrients were calculated by using food composition tables for Latin America. Physical activities were estimated in four intensity levels and calculated in terms of energy output. The results show that nutritional intake is influenced by socioeconomic status, but not by altitude. Overall, the energy and nutrient intake of the HSES girls and boys was significantly higher (P ≤ 0.01) than the intake of the LSES children at both altitudes; no sex effect was evident. HSES girls and boys consumed greater amounts of nutrients, especially protein and fat; they were taller but also fatter. The physical activity of LSES children was higher than that of HSES children. The lower energy intake and the higher energy expenditure of LSES children were reflected in their smaller body size. Am. J. Hum. Biol. 9:51–62 © 1997 Wiley-Liss, Inc.     

Oral squamous cell carcinoma, socioeconomic status and history of exposure to alcohol and tobacco

Oral squamous cell carcinoma, traditionally a disease of elderly men with a history of chronic exposure to the carcinogenic effects of tobacco and alcohol, is presently being more frequently diagnosed both in a younger patient population and in those not exposed to these carcinogenic substances. At our center, most patients with oral squamous cell carcinoma are not involved in the use of tobacco or alcoholic beverages and are mainly of a low socioeconomic class. This hospital-based case-control study was designed to assess if the risk of developing intraoral squamous cell carcinoma in Ibadan, Nigeria, was associated with the use of tobacco, alcohol, or socioeconomic status. Medical records of patients with histological diagnosis of squamous cell carcinoma of the oral cavity at the University College Hospital, Ibadan, between January 1990 and December 2008 were analyzed. Only 26% of patients gave a positive history of exposure to tobacco, alcohol, or both; of this number, 20.3% used tobacco, while 18.8% consumed alcohol and 13% used both. Although 24.6% of the cases were of high socioeconomic class, there was no significant difference in the distribution of oral cancer patients in the 2 socioeconomic classes. This study revealed an important deviation from expected amongst the oral squamous cell carcinoma patients diagnosed at Ibadan, thus raising the possibility of a different etiology for oral cancer in our population and the need for research focused on identifying possible risk factors.     

The Epworth Sleepiness Scale: influence of age, ethnicity, and socioeconomic deprivation. Epworth Sleepiness scores of adults in New Zealand

STUDY OBJECTIVES: To examine possible relationships between excessive sleepiness (Epworth Sleepiness Scale score >10), and age, sex, ethnicity, socioeconomic deprivation, usual sleep, and self-reported symptoms of obstructive sleep apnea. DESIGN: Mail-out survey to a stratified random sample of 10,000 people aged 30 to 60 years, selected from the electoral roll. Setting: Nationwide survey of adults in New Zealand (71% response rate). PARTICIPANTS: The sample design aimed for equal numbers of M?ori and non-M?ori participants, men and women, and participants in each age decade. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Two-page questionnaire. M?ori participants had higher mean Epworth Sleepiness Scale scores than non-M?ori (7.5 versus 6.0) and were more likely to have an Epworth Sleepiness Scale score of more than 10. Logistic multiple regression modeling identified the following significant independent risk factors for having an Epworth Sleepiness Scale score >10: being M?ori, male, older, reporting more or less than 7.5 to 8.0 hours usual sleep, never or rarely getting enough sleep, never or rarely waking refreshed, larger neck circumference, observed apneas, and not drinking alcohol (compared with moderate alcohol consumption). CONCLUSIONS: The relationships between an Epworth Sleepiness Scale score >10 and sleep habits and risk factors for obstructive sleep apnea are as expected. The relationships between an ESS score > 10 and being M?ori, a man, older, or more socioeconomically deprived could be related to a higher prevalence of sleep disorders in these groups. However, more research is needed to understand possible differences not only in pathophysiologic processes, but also in the wider societal trends and pressures that may impact differentially on sleep and sleepiness.     

Maternal depression, assessment methods, and physical symptoms affect estimates of depressive symptomatology among children with cancer.

Investigated the incidence of depressive symptoms and their covariates in a sample of 99 children undergoing treatment for cancer and their mothers. Although the prevalence of depressive symptoms falling within the clinical range was low (7 to 8%), classification of these children was highly dependent upon the informant and instrument used. Interrater reliabilities did not differ from chance levels. Separate multiple regression analyses of the mother's and nurse's ratings of the child's level of depression, the child's self-report on the Child Depression Inventory, and the mother's responses to the Child Behavior Checklist depression scales revealed different statistical models for each method of assessment. However, increased severity of the mother's self-report of depressive symptoms on the Beck Depression Inventory, which was predicted by low perceived social support and hospitalization of her child, was associated with higher levels of child depression on all child- and parent-report measures. Parental adjustment, sociodemographic, and medical factors as well as methods of assessment must be addressed by models explaining the etiology of depressive symptoms among pediatric oncology patients.     

Independent association of hygiene, socioeconomic status, and circumcision with reduced risk of HIV infection among Kenyan men

Among Kenyan men recruited as sex partners of women with genital symptoms, 22 of 150 were HIV seropositive. Because male HIV infection and male hygiene were unexpectedly found to be associated with each other, we examined the relationship of 5 hygiene variables with HIV infection in the men in a principal components analysis, controlling for socioeconomic status and other potential confounders. By multivariate analyses, HIV infection in men was not only independently associated with previous illness (odds ratio [OR], 5.1; 95% confidence interval [CI], 1.4-19.1) and inversely associated with being circumcised (OR, 0.12; 95% CI, 0.02-0.91), but also independently associated with a combined measure of hygiene (OR, 0.41; 95% CI, 0.19-0.90).