Long-Term Change in Underage Drinking and Impaired Driving After the Establishment of Drinking Age Laws in New York State

This study depicts the long-term change in youths' alcohol use and impaired driving behaviors associated with the establishment of the drinking age laws. Five telephone surveys were conducted with youths aged 16 to 24 in 10 sampled New York State counties in 1982, 1983, 1985, 1986, and 1996. Analysis of the self-reported data showed that, 10 years after the enactment of the 21 drinking age law, alcohol use among la-, 19-, and 20-year-olds decreased by up to 58%. Alcohol purchase rates of 19- and 20-year-olds were reduced by ∼70% from 1985 to 1996. Although impaired driving rates declined over the survey years for each age group, ∼25% of all underage respondents in 1996 reported that they had ridden in a vehicle with an impaired driver. Findings from this research indicate that alcohol purchase, alcohol use, and impaired driving have declined among the targeted youth groups as a result of the 21 drinking age law. However, continued efforts need to focus on both underage drinking and impaired driving/riding with impaired drivers, because they remain serious public health risks among the youth population.     

Relationship of Ethnic Origin, Gender, and Age to Blood Creatine Kinase Levels

Background

Creatine kinase is expressed at high levels in muscle, where it plays a central role in energy metabolism. Highly elevated creatine kinase levels in blood may indicate muscle trauma or disease. However, it is known that baseline creatine kinase levels are higher in African Americans than in whites and that they are higher in men than in women. This analysis explores the relationship of ethnic origin, gender, and age to baseline blood creatine kinase levels in a large group of adults with hypercholesterolemia.

Methods

Data from the screening phases of 4 North American trials of statins, which included large numbers of specific racial/ethnic populations, were combined for analysis. The pooled population (N = 11,346) included 2760 African Americans, 3301 whites, 2930 Hispanics, and 2355 South Asians.

Results

Creatine kinase levels varied according to ethnic origin, gender, and age. African American participants had higher median creatine kinase levels than did individuals of the 3 other ethnicities. Within each ethnic group, men had higher median creatine kinase levels than women: African Americans, 135 versus 73 U/L; whites, 64 versus 42 U/L; Hispanics, 69 versus 48 U/L; and South Asians, 74 versus 50 U/L. An age-dependent decrease in creatine kinase levels was noted among men, but no such trend was seen among women. The median creatine kinase levels for younger African American men exceeded the standard upper limit of normal.

Conclusion

Physicians should use caution when interpreting creatine kinase levels that seem elevated, particularly when treating African American patients and younger men.     

Alcohol Use and Sexual Risk Behavior among College Students: Understanding Gender and Ethnic Differences

Objectives: The purpose of the current study was to assess the role of gender and ethnicity in the relationship between alcohol use and risky sexual behavior. Method: Sexually active college students (n = 425) reported on alcohol expectancies, perceived risk of HIV, and drinking and sexual behavior in the context of a larger health behavior survey. Results: Approximately one-third of participants reported binge drinking 3 or more times in the past two weeks. African-American women reported less drinking and less positive alcohol expectancies than other women. Older men engaged more often than younger men in binge drinking and reported more sexual partners in the past year. Younger age and greater perceived risk for HIV were positively associated with condom use for both women and men. Conclusion: Collectively, these findings suggest that alcohol abuse and HIV prevention efforts among young adults need to consider gender, ethnicity, and age.     

不同年龄段ST段抬高型心肌梗死男女患者院内病死率的性别差异

目的研究不同年龄段ST段抬高型心肌梗死(STEMI)患者不同性别院内病死率的差异。方法入选1994年1月1日至2006年12月31日首都医科大学宣武医院心脏科收治住院的STEMI患者1189例,其中男性869例,女性320例,年龄23~91岁。根据年龄分为3组:A组(65岁)571例;B组(65~74岁)419例;C组(≥75岁)199例。收集患者年龄、性别、2型糖尿病、血脂、血压等方面的临床资料。结果 A组中,与男性STEMI患者比较,女性(3.1%vs.8.3%)院内病死率升高,差异具有统计学意义(P0.05)。在B组中,与男性STEMI患者比较,女性院内病死率升高(11.9%vs.20.1%)。C组中,男性与女性STEMI患者病死率差异无统计学意义(P0.05)。三组中,随着年龄增长,女性对男性院内病死率的优势比(OR)亦呈逐步下降趋势(2.861 vs.1.875 vs.1.143)。通过多因素分析,校正混杂因素后,在A组,年龄(OR=1.154,95%CI:1.052~1.264),高血压(OR=7.685,95%CI:2.276~25.946)为STEMI患者院内病死的独立危险因素,急诊再灌注治疗(OR=7.685,95%CI:0.007~0.098)为STEMI患者院内病死的保护因素。在B组,女性(OR=1.875,95%CI:1.088~3.232)是STEMI患者院内病死的独立危险因素。结论女性STEMI患者院内病死率较男性高,年龄越大其差异越小。在65岁人群中,年龄,高血压为STEMI患者院内病死的危险因素,急诊再灌注治疗为保护因素;在65~74岁人群中,女性为STEMI患者院内病死的危险因素。     

Drinking,Alcohol Use Disorder,and Treatment Access and Utilization Among U.S. Racial/Ethnic Groups

Data from approximately 140 articles and reports published since 2000 on drinking, alcohol use disorder (AUD), correlates of drinking and AUD, and treatment needs, access, and utilization were critically examined and summarized. Epidemiological evidence demonstrates alcohol‐related disparities across U.S. racial/ethnic groups. American Indians/Alaska Natives generally drink more and are disproportionately affected by alcohol problems, having some of the highest rates for AUD. In contrast, Asian Americans are less affected. Differences across Whites, Blacks, and Hispanics are more nuanced. The diversity in drinking and problem rates that is observed across groups also exists within groups, particularly among Hispanics, Asian Americans, and American Indians/Alaska Natives. Research findings also suggest that acculturation to the United States and nativity affect drinking. Recent studies on ethnic drinking cultures uncover the possible influence that native countries’ cultural norms around consumption still have on immigrants’ alcohol use. The reasons for racial/ethnic disparities in drinking and AUD are complex and are associated with historically rooted patterns of racial discrimination and persistent socioeconomic disadvantage. This disadvantage is present at both individual and environmental levels. Finally, these data indicate that admission to alcohol treatment is also complex and is dependent on the presence and severity of alcohol problems but also on a variety of other factors. These include individuals’ sociodemographic characteristics, the availability of appropriate services, factors that may trigger coercion into treatment by family, friends, employers, and the legal system, and the overall organization of the treatment system. More research is needed to understand facilitators and barriers to treatment to improve access to services and support. Additional directions for future research are discussed.     

Ethnic differences in driving after drinking and riding with drinking drivers among adolescents

BACKGROUND: This study examined the relationship between ethnicity and driving after drinking (DD) and riding with drinking drivers (RWDD) while controlling for drinking patterns, driving practices, and background demographic characteristics including age and gender. METHODS: Using random-digit dialing procedures, 1534 young adults ranging from 15- to 20-years of age(mean = 17.6) living in California were recruited to participate in a telephone survey. Latinos, African Americans, and Asian Americans were oversampled to allow cross-group comparisons. RESULTS: Rates of DD were lower for females than for males and were also lower for African Americans and Asian Americans than for whites. However, after we controlled for drinking patterns and driving practices, the results showed Latinos at greater risk for DD than white adolescents. Compared with whites and males, Asian American and female adolescents were less likely to report RWDD. When drinking patterns and driving practices were taken into account, Latino adolescents were nearly twice as more likely to ride with drinking drivers than whites. CONCLUSIONS: These findings indicate a greater need for directing prevention efforts to target Latino youth and youth at risk. Moreover, research aimed at elucidating the social and environmental factors involved in the low prevalence rates of DD and RWDD among Asian American youth may indicate possible protective factors to DD and RWDD operating within the Asian American community.     

Trends and Ethnic Differences in COPD Hospitalization and Mortality in Singapore

Study Objective. COPD mortality alone among major causes of diseases continues to rise in most countries worldwide. We examine trends, and gender and ethnic differences in COPD hospitalization and mortality in Singapore from 1991 to 1998, and examine possible explanations. Design. Analysis of population‐based health administrative data. Setting. Multi‐ethnic (Chinese, Malay and Indian) population of Singapore (3 million population). Method. Data on hospitalizations and deaths due to COPD as the underlying cause (ICD codes 491, 492, 496), extracted from national databases, were used to calculate age‐specific and standardized rates for the population aged 55 + years. COPD accounted for 4.6% of total deaths (5.8% in those aged 55 +), and 1.02% of all hospitalizations (3.1% in those aged 55 +). Results. COPD mortality in 1998 decreased steeply by ? 43.7% from 1991 (a decline that continued a steady trend since 1970), while hospitalization showed little significant change (? 3.3%). Men had 4 and 5 times higher mortality and hospitalization, and also showed less favorable trends than women. Malays, especially males, showed the highest level and least favorable decline of mortality. Conclusion. Exceptionally steady declines in COPD mortality rates, and stable rates of hospitalization are observed in Singapore in the 1990s. Differing levels and trends of hospitalization and mortality by gender and ethnicity are related to known demographic variations and trends of smoking prevalence in the country.     

原发性高血压超声心动图的性别差异

目的研究高血压病人超声心动图的性别差异.方法1～2级原发性高血压病人108例,其中女性病例组(PGf) 52例,男性病例组(PGm)56例;正常血压者42例作对照,其中女性对照组(CGf) 20例,男性对照组(CGm)22例.所有受试者用Aspen电脑声像仪行超声心动图检查.检测受试者左心房和左心室结构和功能的相关指标,测值取5个心动周期测值的平均值.指标数据以(-x±s)表示,以t检验进行统计学分析.结果与PGm相比,PGf的超声心动图具有以下特点LAID、MVa较大[(37.24±5.88 vs 32.14±3.80)mm,P＜0.01和(84.18±12.13 vs 81.71±12.30)cm/s,P＜0.05];LV-MI[(119.26±22.33)g/m2vs(128.17±27.00)g/m2,P＜0.05]、EF(75.13%±6.69%vs 83.00%±3.68%,P＜0.01)、FS(41.67%±7.99%vs 49.03%±7.35%,P＜0.01)、MVe[(68.28±8.66)cm/s vs(73.73±11.46)cm/s,P＜0.05]和MVe/a(0.83±0.08 vs 0.93±0.11,P＜0.01)均较小.CGf和CGm之间的上述指标差别无显著性.结论高血压病人的超声心动图存在性别差异,女性高血压病人较男性更易出现心脏结构和功能损害.     

原发性高血压超声心动图的性别差异

目的研究高血压病人超声心动图的性别差异。方法1～2级原发性高血压病人108例,其中女性病例组(PGf)52例,男性病例组(PGm)56例;正常血压者42例作对照,其中女性对照组(CGf)20例,男性对照组(CGm)22例。所有受试者用Aspen电脑声像仪行超声心动图检查。检测受试者左心房和左心室结构和功能的相关指标,测值取5个心动周期测值的平均值。指标数据以(x±s)表示,以t检验进行统计学分析。结果与PGm相比,PGf的超声心动图具有以下特点:LAID、MVa较大[(37.24±5.88vs32.14±3.80)mm,P<0.01和(84.18±12.13vs81.71±12.30)/s,P<0.05];LVMI[(119.26±22.33)g/m2vs(128.17±27.00)g/m2,P<0.05]、EF(75.13%±6.69%vs83.00%±3.68%,P<0.01)、FS(41.67%±7.99%vs49.03%±7.35%,P<0.01)、MVe[(68.28±8.66)/svs(73.73±11.46)/s,P<0.05]和MVe/a(0.83±0.08vs0.93±0.11,P<0.01)均较小。CGf和CGm之间的上述指标差别无显著性。结论高血压病人的超声心动图存在性别差异,女性高血压病人较男性更易出现心脏结构和功能损害。     

Effects of Gender and Comorbidity on Problem Drinking in a Community Sample

We investigated the influence of gender, comorbidity, drinking history, and age on the clinical manifestations of DSM-III alcohol abuse and/or dependence in men and women. The sample was drawn from the National Institute of Mental Health Epidemiologic Catchment Area study, a large-scale, multicenter survey to investigate psychiatric disorders in the community. The results showed that gender and comorbidity had independent effects on problem drinking after drinking history and age had been taken into account. Gender contributed to the age of onset of problem drinking and the rate of its development. Comorbidity, drinking history, and age contributed independently to its severity. The effects of these variables in this community sample paralleled those reported in treatment samples.     

Gender, age and the marriage market: Evidence on marriage in late adulthood in Russia

In this paper I explore one specific type of informal support, marital unions, and the ways in which patterns suggest differential access to this support mechanism based on age and sex. Through an examination of marriage patterns in the Russian Federation I show that women may be disadvantaged by low levels of access to marital unions past the age of 50 due to high differential mortality and age differentials at marriage. For both sexes, the probability of marital entrance is negatively related to age, but the negative influence of age follows different paths for men and women. In spite of high sex differentials in mortality, findings indicate that men, over 50 and outside of marital unions, are far more likely to marry than their female counterparts regardless of residence or age.Department of Sociology, University of Texas at Austin     

Gender Differences in Comorbidly Depressed Alcohol-Dependent Outpatients

Clinical profiles of alcohol-dependent male and female outpatients were evaluated at treatment entry to compare the level of clinical severity in alcoholics with a coexistent comorbid depressive disorder to alcoholics who have never been depressed. Due to a higher proportion of females than males in the depressed alcoholic population, selected patient groups were oversampled to create a study group with equivalent number of males and females with and without comorbid depression. Clinical severity was assessed by examining both the extent of alcohol problems, and depressive symptomatology at treatment entry with respect to gender differences (unrelated to depression), effects of comorbid depression (unrelated to gender), and effects from the interaction of gender and depression. There were 93 DSM-III-R alcohol-dependent outpatients (SO males, 43 females), half of whom had a current or lifetime DSM-III-R depressive disorder. The amount of drinking in the 90 days before treatment entry, the degree of alcohol severity, and the number of lifetime drinking-related consequences were collected in the first week after detoxification. Diagnoses of lifetime and current depression were determined via the Structured Clinical Interview for DSM-III-R, and depressive symptoms were evaluated with rating scales 1 week after detoxification. In most cases, a depressive disorder was diagnosed only if sometime in the patient's history depressive symptoms had either predated problem drinking or been present during a 6-month abstinent period. Results: depressed males had a more severe clinical profile with respect to their alcoholism (i.e., more drinking, drinking-related problems, and alcohol severity than depressed females and never-depressed males). Surprisingly, females who had never been depressed (also no family history of depression) reported drinking the same quantities of alcohol in the 90 days before treatment and had comparable alcohol severity and number of consequences as males who had never been depressed. Depressed females, however, were more severely depressed (i.e., reported more intensive depressive symptoms than depressed male alcoholics). Thus, determining the type and extent of clinical severity at treatment entry in comorbidly depressed alcoholics depends on the gender of the patient. The significant interaction between gender and the presence of comorbid depression that was found in this study may have important implications for predicting success in treatment.