Heart disease risk factor prevalence and profiles in a randomized community sample of Canadian women

This study examined the prevalence and profiles of behavioural and biomedical risk factors of heart disease in a randomized community sample of 843 Canadian women. Sociodemographic characteristics were also examined to determine their association with women who have multiple primary risk factors versus risk factor-free women. A greater proportion of high-risk women (n = 81) reported to have less education, lower income and employment levels and were more likely to live without a partner than women with no primary risk factors (n = 135). These findings contribute to the understanding of the growing complexity of addressing heart health beyond lifestyle behaviours as articulated by the Victoria (1992), Catelonia (1995), Singapore (1998) and Women's International (2000) Declarations on Heart Health. Public health planning should continue to address physical activity, smoking and dietary behaviours across age groups with a concentrated effort to target high-risk, socio-economically disadvantaged women. Risk assessment for heart disease must also include sociodemographic characteristics for tailoring heart health programs in the community.     

Overweight among children and adolescents in a Native Canadian community: prevalence and associated factors

BACKGROUND: The prevalence of pediatric obesity in North America is increasing. Native American children are at especially high risk. OBJECTIVES: The objective was to evaluate the prevalence of pediatric overweight and associated behavioral factors in a Native Canadian community with high rates of adult obesity and type 2 diabetes mellitus. DESIGN: Height and weight were measured in 445 children and adolescents aged 2-19 y. Fitness level, television viewing, body image concepts, and dietary intake were assessed in 242 subjects aged 10-19 y. Overweight was defined as a body mass index > or =85th percentile value for age- and sex-specific reference data from the third National Health and Nutrition Examination Survey (NHANES III). Multiple logistic regression was used to examine factors associated with overweight, with adjustment for age and sex. RESULTS: The overall prevalence of overweight in subjects aged 2-19 y was significantly higher than NHANES III reference data [boys: 27. 7% (95% CI: 21.8, 34.5); girls: 33.7% (95% CI: 27.9, 40.1)]. In the subset aged 10-19 y, > or =5 h television viewing/d was associated with a significantly higher risk of overweight than was < or =2 h/d [odds ratio (OR) = 2.52; 95% CI: 1.06, 5.98]. Subjects in the third and fourth quartiles of fitness had a substantially lower risk of overweight than did those in the first quartile [third quartile compared with first quartile: OR = 0.24 (95% CI: 0.09, 0.66); fourth quartile compared with first quartile: OR = 0.13 (95% CI: 0.03, 0. 48)]. Fiber consumption on the previous day was associated with a decreased risk of overweight (OR = 0.69; 95% CI: 0.47, 0.99 for each 0.77 g/MJ increase in fiber intake). CONCLUSIONS: Pediatric overweight is a harbinger of future diabetes risk and indicates a need for programs targeting primary prevention of obesity in children and adolescents.     

Injection drug use among street-involved youth in a Canadian setting

Background  

Street-involved youth contend with an array of health and social challenges, including elevated rates of blood-borne infections and mortality. In addition, there has been growing concern regarding high-risk drug use among street-involved youth, in particular injection drug use. We undertook this study to examine the prevalence of injection drug use and associated risks among street-involved youth in Vancouver, Canada.     

Patterns of drug use among a sample of drug users and injecting drug users attending a General Practice in Iran

Aim  

This study aimed to examine drug use, drug treatment history and risk behaviour among a sample of Iranian drug users seeking treatment through a general practice clinic in Iran.     

Cigar smoking among college students: prevalence and correlates.

BACKGROUND: Cigar smoking is deleterious to health and point prevalence estimates suggest that rates of cigar smoking among young adults may be high. Little is known, however, about the reasons for the popularity of cigar smoking among young adults or the relationship of cigar smoking to cigarette smoking. This study documents the prevalence of cigar smoking in two samples of college students, examines the association between cigar and cigarette smoking, and investigates the hypothesis that cigar smoking is associated with a positive image of the typical cigar smoker. METHODS: Two cross-sectional surveys of college students were conducted (sample sizes = 745 and 167). RESULTS: Current cigar smoking was reported by 7 and 19% of the respondents in Studies One and Two, respectively. In both studies, cigar smoking was far more likely among men and among either former or current cigarette smokers. In Study Two, cigar smoking was associated with a positive image of the typical cigar smoker. CONCLUSIONS: The results suggest that the popularity of cigar smoking among college students is of sufficient magnitude to be a public health concern and may be related to a positive image of the typical cigar smoker.     

Benzodiazepine anti-anxiety agents: prevalence and correlates of use in a southern community.

BACKGROUND: Benzodiazepine anti-anxiety agents are the most widely prescribed psychotherapeutic drugs in the United States today. Recent evidence, however, suggests that their use may be decreasing. METHODS: We examine the population prevalence and correlates of use of benzodiazepine anxiolytics at the Duke site of the NIMH-sponsored Epidemiologic Catchment Area project. RESULTS: Bivariate analysis of use patterns for the drugs revealed demographic predictors similar to those reported in previous studies: increased likelihood of use by the elderly, Whites, women, the less educated, and the separated or divorced. Use is also associated with symptoms of psychic distress, negative life events, use of health care services, and diagnoses of affective disorder, agoraphobia with panic, and panic disorder. Age, sex, race, education, and marital status remain associated with non-hypnotic benzodiazepine use in a logistic regression analysis. CONCLUSIONS: Multivariate analyses of these data indicate that when potential confounding factors are controlled, age, sex, race, education, and marital status are significantly related to benzodiazepine anxiolytic use but the effects of sex and education are mediated by intervening variables. Implications of these findings are discussed particularly in relation to high levels of use in the elderly.     

Validity of drug use reporting in a high-risk community sample: a comparison of cocaine and heroin survey reports with hair tests.

Hair specimens were collected from 322 subjects and analyzed as part of an experimental study administering household surveys during 1997 to a high-risk community sample of adults from Chicago, Illinois. Toxicologic results were compared with survey responses about recent and lifetime drug use. About 35% of the sample tested positive for cocaine, and 4% tested positive for heroin. Sample prevalence estimates of cocaine use based on toxicologic results were nearly five times the survey-based estimates of past month use and nearly four times the survey-based estimates of past year use. With the hair test results as the standard, cocaine and heroin use were considerably underreported in the survey. Underreporting was more of a problem for cocaine than for heroin. Among those who tested positive, survey disclosure of cocaine use was associated with higher levels of cocaine detected in hair. In general, when recent drug use was reported, it was usually detected in hair. When a drug was detected in hair, use was usually not reported in the survey. When heroin was detected in hair, cocaine was almost always detected as well.     

Health behaviours among adolescents: towards a hypothesis of two dimensions

Most previous studies addressing the issue of inter-relationshipsbetween health behaviours have shown that such behaviours areinter-correlated. No consensus has yet emerged, however, regardingthe number and nature of underlying dimensions. If health behaviourscan be shown to reflect a small number of underlying dimensions,it would indicate that various fields of health education areconfronted with similar challenges, and it would call for amore integrated and holistic approach to health behaviour change.A recent series of exploratory principal components analysesof health behaviours among 15 year olds in nine countries leadsto a hypothesis of bidimensionality of such behaviours. Thepresent article sets out to test this hypothesis. In the presentreport a series of LISREL-based confirmatory factor analyseslend support to the hypothesis of bidimensionality. The twofactors are labelled (1) addictive behaviours and (2) healthenhancing behaviours. Some of the methodological problems associatedwith factor analysis of health behaviour variables are discussed.Possible explanations of the patterns of inter-correlation betweenhealth behaviours are suggested. The data stem from the EuropeanCross-National Study of Health Behaviour in School-Age Children.     

Social determinants and health service use among racial and ethnic minorities: findings from a community sample

Multiple models conceptualizing the relationship between social determinants and health exist, but little research has examined the relationship between social determinants and health service use. Using previously collected survey data from racial and linguistic minorities from high-crime communities in a Midwestern urban area, this study uses the Commission on Social Determinants of Health framework to test the structural and intermediary determinants of health service use. The results indicate that perceived discrimination and neighborhood cohesion increase the likelihood of a person using health services. Implications for social work practice, advocacy, and research to address intermediary social determinants are discussed.     

Health risk behaviours, awareness, treatment and control of hypertension among rural community people in Thailand

This cross-sectional study aimed to assess health risk behaviours, prevalence, awareness, treatment, and control of hypertension and associated factors among Thai rural community people. 527 people, aged 35-60 years, were randomly sampled and interviewed. Two blood pressure (BP) measurements were assessed by standardized protocol. Hypertension was defined as a mean systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg. 76.9% lacked regular exercise, 28.5% were current alcohol drinkers, and 23.7% were current smokers. The prevalence of hypertension was 17.8%. Among the hypertensive cases, 64.9% (61/94) were aware of their high BP, 42.6% (26/61) were treated, and 42.3% (11/26) achieved BP control (< 140/ 90 mmHg). Multiple logistic regression analysis indicated four variables significantly associated with hypertension: age > 40 years (adjusted OR = 4.20, 95% CI 1.93-9.11), married status (adjusted OR = 0.48, 95% CI 0.26-0.89), family history of hypertension (adjusted OR = 2.39, 95% CI 1.40-4.07), and BMI > 23.0 kg/m2 (adjusted OR = 3.41, 95% CI 1.80-6.45). Lifestyle modification programs are needed to prevent hypertension.     

The prevalence and risk behaviours associated with the transmission of blood-borne viruses among ethnic-Vietnamese injecting drug users

OBJECTIVE: To measure the prevalence and determinants of blood-borne virus (BBV) transmission in ethnic Vietnamese injecting drug users (IDUs). METHODS:The study was conducted in Melbourne, Australia, in 2003. It was a cross-sectional design with participants recruited from street-based illicit drug markets predominately using a snowball technique. One hundred and twenty-seven participants completed a questionnaire that asked about illicit drug use and participants' blood samples were tested for HIV, HCV and HBV. RESULTS: One hundred and three (81.1%) ethnic Vietnamese IDU study participants were HCV positive and three (2.4%) were HIV positive. More than 60% had evidence of being infected with HBV (either in the past, acute infection or chronic infection). Almost 60% had injected daily over the past 12 months. Fifty-nine participants had recently travelled to Vietnam; 24 (41%) had injected drugs in Vietnam; and three (12.5%) reported sharing injecting equipment in Vietnam. CONCLUSION: The prevalence of BBVs was higher in this study's IDU population compared with IDUs in Australia generally, despite the fact that the injecting risk behaviours were similar to IDUs more generally. IMPLICATIONS: Culturally sensitive drug treatment and education programs need to be developed in Australia for both ethnic Vietnamese IDUs and their families to reduce this group's risk of contracting a BBV.     

Disease prevalence and use of health care among a national sample of black and white male state prisoners

U.S. prisons have a court-affirmed mandate to provide health care to prisoners. Given this mandate, we sought to determine whether use of prison health care was equitable across race using a nationally-representative sample of Black and White male state prisoners. We first examined the prevalence of health conditions by race. Then, across all health conditions and for each of 15 conditions, we compared the proportion of Black and White male prisoners with the condition who received health care. For most conditions including cancer, heart disease, and liver-related disorders, the age-adjusted prevalence of disease among Blacks was lower than among Whites (p<.05). Blacks were also modestly more likely than Whites to use health care for existing conditions (p<.05), particularly hypertension, cerebral vascular accident/brain injury, cirrhosis, flu-like illness, and injury. The observed racial disparities in health and health care use are different from those among non-incarcerated populations.     

Health care utilization in a sample of Canadian lesbian women: predictors of risk and resilience

This study was designed to test an exploratory path model predicting health care utilization by lesbian women. Using structural equation modeling we examined the joint influence of internalized homophobia, feminism, comfort with health care providers (HCPs), education, and disclosure of sexual identity both in one's life and to one's HCP on health care utilization. Surveys were completed by 254 Canadian lesbian women (54% participation rate) recruited through snowball sampling and specialized media. The majority (95%) of women were White, 3% (n = 7) were women of colour, and the remaining six women did not indicate ethnicity. Participants ranged in age from 18 to 67 with a mean age of 38.85 years (SD = 9.12). In the final path model, higher education predicted greater feminism, more disclosure to HCPs, and better utilization of health services. Feminism predicted both decreased levels of internalized homophobia and increased disclosure across relationships. Being more open about one's sexual identity was related to increased disclosure to HCPs, which in turn, led to better health care utilization. Finally, the more comfortable women were with their HCP the more likely they were to seek preventive care. All paths were significant at p < .01. The path model offers insight into potential target areas for intervention with the goal of improving health care utilization in lesbian women.     

Drug use and risk behaviours among injecting drug users: a comparison between sex workers and non-sex workers in Sydney,Australia

Background  

This paper examines the differences in demographics, drug use patterns and self reported risk behaviours between regular injecting drug users (IDU) who report engaging in sex work for money or drugs and regular injecting drug users who do not.