Examination of contraceptive perceptions and usage among Los Angeles County women

This paper examines the contraceptive perceptions and usage of 583 currently married Los Angeles County women between the ages of 18 and 49. The respondents perceived surgical sterilization as the most positive form of birth control in terms of effectiveness, safety, interference with enjoyment, convenience, and overall desirability. The Pill was rated second in positivity, followed by the IUD and the diaphragm. The Pill was the most widely used method followed by vasectomy, IUD, and the diaphragm. Generally, women who had at sometime used a method perceived it more favorably than those who had never used it, and those who were currently using a method perceived it most favorably. Only a small portion of the variance in contraceptive usage could be accounted for by the particular method's perceived attributes.     

Drug use among homeless young people in Los Angeles and Melbourne

PURPOSE: To examine the effect of time spent homeless on young people's substance use and use of drug and alcohol services in two countries with contrasting policy and service environments. METHODS: A crossnational survey was conducted of recently homeless and experienced homeless young people in Melbourne (N = 674) and Los Angeles (N = 620). Questions were asked about alcohol and drug use in the past 3 months, frequency of use, injecting drug use, drug dependency, and perceived need for, and use of, drug and alcohol services. Data were analyzed using logistic regression. RESULTS: Substantial numbers of young people reported use of alcohol and drugs. More Australians than Americans and more experienced than newly homeless reported drug use, although there were no differences in frequency of use in the past 3 months. Polydrug use was common, as were injecting drugs and responses that signified drug dependency. All were more common among Australians and experienced homeless young people. A substantial number of young people had "ever" taken part in a drug or alcohol program, but only a minority believed that they needed help from services. Of these, only a minority had sought help. This was particularly so among those who were classified as drug dependent. Reasons for failure to seek help varied. CONCLUSION: Substance use is alarmingly high compared to national samples of young people, especially among those who had been homeless for longer periods. Programs to reduce substance use must take account of the prevailing drug cultures, as well as different subgroups of the population.     

Effective birth control use among women at risk for unintended pregnancy in Los Angeles, California

ContextIdentifying sociodemographic and health-related risk factors associated with more effective versus less effective birth control use can help to identify barriers to effective birth control use and decrease risk for unintended pregnancy.MethodsData used were from the 2007 Los Angeles County Health Survey. More effective birth control use was assessed among women ages 18 to 49, who were at risk for unintended pregnancy, residing in Los Angeles County. The study population consisted of 849 women. Multivariate associations of more effective birth control use with sociodemographic and health factors were assessed in logistic regression models. All analyses used weighted data.ResultsWomen who used a more effective birth control method at last act of coitus were less likely to be Black (odds ratio [OR], 0.33) or Asian/Pacific Islander (OR, 0.49), have less than a high school education (OR, 0.33), be a smoker (OR, 0.52), and have public insurance (OR, 0.47) than women using a less effective birth control method. They were more likely to have received a pap test (OR, 2.66), describe their health as fair or poor (OR, 2.39), and have a household income of 200% to 299% of the federal poverty level (OR, 2.25) than women using a less effective birth control method.ConclusionsSociodemographic factors, some of which underlie cultural diversity, predict the use of more effective birth control methods and should be considered when providing family planning services and preconception health counseling to unique populations.     

Knowledge and use of preventive health practices among Korean women in Los Angeles county

BACKGROUND: The aims of this study are to determine (1) knowledge and use of preventive health practices, and (2) the relationship between acculturation and preventive health practices, in Korean women. METHODS: The data came from the 2000 Korean American Health Survey (KAHS), which includes 656 women. The dependent variables included use of pap smears, physical examinations and mammograms, and use and knowledge of self-breast examinations. Independent variables included demographic and acculturation variables. Logistic regression modeling was used to assess the role of acculturation on dependent variables. RESULTS: Some of the acculturation variables significantly predicted preventive practices. Being married (P < 0.0001) and insured (P < 0.05) were significantly associated with receipt of preventive services. A married Korean woman was more likely than an unmarried Korean woman to have a pap smear within 2 years (P < 0.0001), physical exam within 1 year (P < 0.0001), and perform self-breast examinations (P < 0.05). CONCLUSIONS: Factors related to acculturation influence use of preventive health practices by Korean American women, highlighting the need to consider cultural background in developing systems of care.     

Correlates of daily smoking among female arrestees in New York City and Los Angeles, 1997

OBJECTIVES: I sought to determine correlates of daily smoking among recently arrested women involved in the Drug Use Forecasting Program (DUF), many of whom are illicit drug users. Also, I compared smoking rates among DUF women, who were illicit drug users, with rates among women taking part in the Behavioral Risk Factor Surveillance System (BRFSS) survey, who do not have high levels of drug use, to determine if drug use accounts for heavy smoking. METHODS: I compared daily smoking, illicit drug use, and selected demographic characteristics in 2 DUF cities: New York, with the highest rate of smoking among DUF cities in 1997, and Los Angeles, with the lowest. I also compared DUF and BRFSS daily smoking rates. RESULTS: Although rates of illicit drug use were similar in New York and Los Angeles (69.7% and 61.8%, respectively), the daily smoking rate was higher in New York (90.9% vs 41.7%). DUF smoking rates were higher than BRFSS rates; both rates were higher than the general population (23%). CONCLUSIONS: Illicit drug use does not, in all cases, explain high rates of daily smoking. Future efforts to shape tobacco-related public health policies in New York and elsewhere should involve collaboration with criminal justice transitional health programs.     

Physical inactivity and overweight among Los Angeles County adults

OBJECTIVES: The present study examines sociodemographic, health status, health behavioral, and health-related self-perception correlates of physical inactivity in a large, multiethnic urban population. METHODS: A random-digit-dialed telephone survey of a representative sample of 8353 Los Angeles County adults aged >/= 18 years was conducted between September 17, 1999 and December 31, 2000. Data were analyzed to assess the prevalence and identify independent correlates of physical inactivity, defined as <10 minutes of continuous physical activity weekly ("sedentary"). RESULTS: Overall, the prevalence of sedentary adults was 41%. Lower educational attainment, female gender, advancing age, non-U.S. birthplace, poorer self-perceived health status, self-perceived depression, smoking, leisure-time television watching/computer use, and receiving a diabetes diagnosis were significantly related to sedentariness in both bivariate and multivariate analyses. CONCLUSIONS: Mental and physical health status were prominent correlates of sedentariness. Lower socioeconomic class was also associated with sedentary behavior. Further research is needed to understand the relationship between self-perceived overweight and sedentary behavior.     

A trial to increase mammography utilization among Los Angeles Hispanic women

The objective of this program was to increase mammography screening rates among Hispanic women through a series of targeted community-wide interventions. A diverse array of outreach efforts was offered by the program to increase awareness and use of screening mammography. Before the program, 12 percent of the Hispanic women surveyed in the intervention community had been screened, compared with 27 percent after the program. There was no change in screening among Hispanic women in the control community (23 percent before and 24 percent after the program). The program demonstrated that the awareness and behavior of "hard-to-reach" underscreened Hispanic women can be changed through intensive targeted outreach and that a church-based cancer control program can play an effective role in the process. This finding has national health policy implications.     

Acute illnesses among Los Angeles County lifeguards according to worksite exposures

Due to public concern regarding the potential adverse health effects of exposure to Santa Monica Bay waters, a case-control study of acute illnesses among Los Angeles County lifeguards was conducted. Workers' compensation claimants (N = 112) were matched to healthy lifeguards working in the same year and having the same job classification. Conditional logistic regression showed that the southernmost worksites of the bay were associated with all acute illnesses (OR = 14.4, 95% CI = 4.7, 44.8) and with ear infections (OR = 12.5, 95% CI = 2.9, 53.4).     

Perception of contraceptive counseling and contraceptive use among systemic lupus erythematosus patients

Objectives(1) To evaluate the perception of contraceptive counseling and knowledge regarding the impact of unintended pregnancy and (2) examine the prevalence of, and predictors for contraceptive use among systemic lupus erythematosus (SLE) patients.Study designA cross-sectional survey was conducted at the Rheumatology Clinic of a university hospital. SLE patients who attended the clinic from April 2018 to January 2019 and at risk for unintended pregnancy and were invited to be interviewed. The structured interview guide consisted of three parts: personal and obstetric information, perception of contraceptive counseling and knowledge about the impact of unintended pregnancy, and contraceptive use.ResultsThe mean age of the 137 patients who gave informed consents was 34 ± 8 years, with 47 patients (34%) stating that they had received contraceptive counseling. Seventy-five patients (52%) reported practicing contraception. The intention to not become pregnant (Odds Ratio; 95% CI = 7.28; 1.75–30.27), perception of adequate contraceptive counseling (2.77; 1.06–7.20) and discussion with partners and physicians about contraception (3.95; 1.64–9.50) were predictors for contraceptive use (p < 0.05).ConclusionMost patients reported no contraceptive counseling with approximately half of the patients using contraceptive methods within the past three months. Desire to avoid pregnancy, perception of adequate contraceptive counseling, and the influence of partners and physicians were significant predictors for contraceptive use.ImplicationsContraceptive counseling should be routinely included in discussions about disease processes and treatment plans, including access issues. Best practices for contraceptive counseling and integrated, multi-disciplinary team services should be developed and provided in clinical settings.     

Sexual behavior and condom practices among Los Angeles women.

BACKGROUND: The sociodemographic correlates of the number of recent sexual partners and condom use are investigated in a population-based sample of 1,178 unmarried women living in Los Angeles County. RESULTS: Asian Americans, foreign born, and older women are less likely to be sexually active and that more educated and previously married women are more likely. Among the sexually active (n = 909), Hispanic women and older women are less likely to have multiple partners, and younger and previously married women more are more likely. African-American women and younger women are more likely to use condoms; older and previously married women are less likely. CONCLUSIONS: Results from this study indicate that women-centered primary and secondary prevention efforts may benefit from targeting women not previously considered, such as women of post-reproductive age and divorced women.     

Screening mammography rates and barriers to use: a Los Angeles County survey

The use of screening mammography among women 40 years of age and older in Los Angeles County was assessed through a random digit dial telephone interview. The sample of 802 women represents a large urban population with substantial proportions of blacks, Hispanics, and Asians. The survey obtained information regarding adherence to the ACS/NCI screening mammography guidelines, perceived benefits of early detection and mammography, perceived threat of developing breast cancer, and barriers to utilization. The results showed that 71% of the women had had at least one mammogram, with 49% having received a screening mammogram according to the guidelines for their age. Less than half the respondents knew the screening guidelines for their age, with women ages 40-49 years being less knowledgeable than women greater than or equal to 50 years old (29 vs 58% answering correctly). A logistic regression analysis predicting the likelihood of having obtained a screening mammogram according to the guidelines found the following to be predictive: concern over radiation (negative association), age (negative association), family history, knowledge of guidelines, and cost of a mammogram (negative association). Other demographic factors and beliefs were not significantly related to this dependent variable.     

Solvent use and time to pregnancy among female personnel in biomedical laboratories in Sweden

OBJECTIVES—To elucidate possible effects on fecundability from chemical, biological, and physical agents in laboratories, a retrospective study based on a questionnaire was conducted among female personnel who worked in Swedish biomedical research laboratories. Female personnel in non-laboratory departments were used as a reference group. The maximum number of women included in the analyses was 560. This corresponded to 2519 menstrual cycles. These women had given birth at least once during the period 1990-4.
METHODS—Time to pregnancy was used to estimate the fecundability—that is, probability of conception of a clinically detectable pregnancy per cycle. The fecundability ratio (FR) between exposed and unexposed cycles was calculated with a discrete time analogue of the Cox's proportional-hazards model. The FR estimates below unity indicate subfecundity.
RESULTS—Work with organic solvents in general in laboratory work, gave a decreased adjusted fecundability ratio (FR) of 0.79 (95% confidence interval (95 % CI) 0.68 to 0.93). Moreover, work with acetone and use of viruses also showed decreased FRs, 0.72 (0.53 to 0.97) and 0.66 (0.49 to 0.90), respectively.
CONCLUSIONS—The results of the present study give some indications of reduced fecundability for work with specific agents in laboratories, and support previously reported findings of a negative influence of organic solvents on fecundity among female laboratory personnel.


Keywords: laboratory work; organic solvents; time to pregnancy     

Blood lead level and blood pressure during pregnancy in South Central Los Angeles

In many studies in which the relationship between blood pressure and blood lead level has been examined, investigators have found significant--but small--associations. There was only one previous report of a significant association of blood lead with blood pressure in pregnant women. We measured blood lead level and sitting blood pressure of 1,627 women in their third trimester of pregnancy. We eliminated subjects with known causes of hypertension. Most women (98.4%) were normotensive. We controlled for body mass index, age, and stress--among other factors--and constructed multiple-regression models of lead association with diastolic and systolic blood pressures. Immigrants (73% of total) had significantly higher blood lead levels and different blood pressures than nonimmigrants, suggesting that analysis be stratified by "immigrant, nonimmigrant" status. Positive relationships between blood lead level and blood pressure were found only for immigrants (p < or = .001). From the 5th to 95th blood-lead percentiles (0.9-6.2 microg/dl) in immigrants, systolic blood pressure increased 2.8 mm Hg, and diastolic blood pressure increased 2.4 mm Hg. Higher prior lead exposure of immigrants (97.7% from Latin countries) than nonimmigrants might explain the differential effect of these low levels of blood lead on blood pressure in nonimmigrants. Perhaps some immigrants are at higher risk than nonimmigrants for lead-associated elevated blood pressure during pregnancy, despite blood lead levels within the currently considered acceptable range.     

Maternal blood lead level during pregnancy in South Central Los Angeles.

Twenty-five years of public health efforts produced a striking reduction in lead exposure; the blood lead average in the United States has decreased to less than 20% of levels measured in the 1970s. However, poor minority groups that live in large urban centers are still at high risk for elevated lead levels. In this study, our data showed that pregnant immigrants (n = 1,428) who live in South Central Los Angeles--one of the most economically depressed regions of California--have significantly higher (p < .0001) blood lead levels (geometric mean = 2.3 microg/dl [0.11 micromol/l]) than 504 pregnant nonimmigrants (geometric mean = 1.9 microg/dl [0.09 micromol/l]). The most important factors associated with lower blood lead levels in both groups were younger age; more-recent date of blood sampling (i.e., decreasing secular trend); and blood sampling in mid-autumn, instead of mid-spring (i.e., seasonal trend). Blood lead levels of immigrants were strongly dependent on time elapsed since immigration to the United States; each natural log increase in years of residence was associated with an approximately 19% decrease in blood lead levels. Although blood lead means for both groups were almost the same as the estimated national average, 25 of the 30 cases of elevated blood lead (i.e., > or = 10 microg/dl [0.48 micromol/l) occurred in the immigrant group. The odds ratio (95% confidence intervals within parentheses) for having elevated blood lead levels (a) was 9.3 (1.9, 45.8) if the immigrant engaged in pica; (b) was 3.8 (1.4, 10.5) if the immigrant had low dietary calcium intake during pregnancy; and (c) was .65 (.43, .98) for every natural log unit increase of years of residence in the United States. The control of pica and dietary calcium intake may offer a means of reducing lead exposure in immigrants.     

Racial and ethnic differences in the use of invasive cardiac procedures among cardiac patients in Los Angeles County, 1986 through 1988.

OBJECTIVES. The purpose of the study was to compare use of invasive cardiovascular procedures among Latino, Asian, African-American, and White patients. METHODS. In a cross-sectional study of hospital discharge data, multiple logistic regression was used to model use of coronary artery angiography, bypass graft surgery, and angioplasty among adult Los Angeles County residents discharged from California hospitals between 1986 and 1988 with primary diagnoses consistent with possible ischemic heart disease. RESULTS. After potential demographic, socioeconomic, and clinical confounders, including hospital procedure volume, were controlled, Latinos were less likely than Whites to undergo angiography (odds ratio [OR] = 0.90) and bypass graft surgery (OR = 0.87). African Americans were less likely to receive bypass graft surgery (OR = 0.62) and angioplasty (OR = 0.80). Asians were as likely as Whites to receive each procedure. The impact of adjustment for hospital procedure volume was greater for Latinos and Asians than for African Americans. CONCLUSIONS. Administrative data suggest that disparities in use of invasive cardiovascular procedures are not limited to African Americans. Hospital procedure volume appears to be an important factor related to such disparities. The causes of racial/ethnic differences in reported procedure rates remain unclear.     

Factors associated with major depression among mothers in Los Angeles.

PURPOSE: The aim of this study was to identify factors associated with major depression among a sample of diverse mothers in Los Angeles while paying special attention to racial and ethnic as well as immigration status differences. METHODS: Using logistic regression models, we examined the association between major depression and race and ethnicity, immigration status, and other key covariates. Major depression was measured using the Comprehensive International Diagnostic Interview Short Form. This study was based on 1,856 racially and ethnically diverse mothers who participated in Wave 1 of the Los Angeles Family and Neighborhood Survey, which was fielded in 65 census tracts. MAIN FINDINGS: After controlling for key covariates, we found that non-Hispanic white mothers had 1.67 times the odds of having major depression than Hispanic mothers (95% confidence interval [CI], 0.99-2.80). In addition, single mothers had elevated rates of major depression compared with married mothers (odds ratio [OR], 1.54; 95% CI, 1.00-2.37). Mothers with a college degree or higher had significantly lower odds of being depressed compared with mothers without a college degree (OR, 0.50; 95% CI, 0.29-0.86); mothers with only adolescents in the home had significantly higher odds of major depression than mothers with at least one preadolescent child in the home (OR, 1.73; 95% CI, 1.11-2.70). CONCLUSION: Given the links between depressed mothers and child outcomes, our results have important implication for mothers with adolescent children, particularly those who are white, single, or less educated.     

Perceived discrimination as a risk factor for depressive symptoms and substance use among Hispanic adolescents in Los Angeles

Objectives: Discrimination has been associated with adverse psychological and physical health outcomes, but few studies have examined the effects of discrimination on Hispanic adolescents. This study assessed the relation of perceived discrimination with depressive symptoms and drug use. Covariates included immigrant generation status (GS). A second objective was to examine the potentially moderating effect of neighborhoods' ethnic composition as suggested by Mair et al.

Design: Secondary data analyses of a longitudinal survey examined self-reports of Hispanic adolescents in 9th grade (the first year of high school) and 11th grade at seven high schools in Los Angeles.

Results: (1) Perceiving discrimination in 9th grade significantly predicted depressive symptoms (β=0.23, p<0.01) and drug use (β=0.12, p<0.01) in 11th grade, even after controlling for socioeconomic status, gender, acculturation, and GS in the USA. The third GS group reported significantly higher perceptions of discrimination compared to newer immigrants. (2) Neighborhoods' ethnic composition was included as a moderator of the association between perceived discrimination and the outcomes, but did not moderate the relation.

Conclusion: Teaching Hispanic adolescents effective strategies for coping with discrimination, such as increasing their sense of belongingness in the American mainstream, may prove useful in preventing drug use and depressive symptoms.