Exploring Alcohol-Use Behaviors Among Heterosexual and Sexual Minority Adolescents: Intersections With Sex,Age, and Race/Ethnicity

Objectives. We examined sexual orientation status differences in alcohol use among youths aged 13 to 18 years or older, and whether differences were moderated by sex, age, or race/ethnicity.Methods. We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys and conducted weighted analyses, adjusting for complex design effects. We operationalized sexual orientation status with items assessing sexual orientation identity, sexual behavior, sexual attraction, or combinations of these.Results. Compared with exclusively heterosexual youths, sexual-minority youths were more likely to report each of the primary study outcomes (i.e., lifetime and past-month alcohol use, past-month heavy episodic drinking, earlier onset of drinking, and more frequent past-month drinking). Alcohol-use disparities were larger and more robust for (1) bisexual youths than lesbian or gay youths, (2) girls than boys, and (3) younger than older youths. Few differences in outcomes were moderated by race/ethnicity.Conclusions. Bisexual youths, sexual-minority girls, and younger sexual-minority youths showed the largest alcohol-use disparities. Research is needed that focuses on identifying explanatory or mediating mechanisms, psychiatric or mental health comorbidities, and long-term consequences of early onset alcohol use, particularly frequent or heavy use, among sexual-minority youths.Although alcohol consumption by youths has declined in recent years, it remains a major public health problem.1 Underage drinking is associated with a range of physical, academic, and social problems. Youths who drink, especially those who drink heavily, are more likely to engage in delinquent behavior, experience violence and victimization, and commit suicide.1,2 Of great concern is that alcohol consumption is a leading contributor to injury, the main cause of death for people younger than 21 years.1 Early onset drinking is also associated with increased risk for developing an alcohol-use disorder during the lifespan.3Despite the fact that almost all US youths grow up in a culture permeated by alcohol, the prevalence of early and heavy drinking and its consequences vary across demographic groups. For example, considerable variation exists in alcohol consumption between White and racial/ethnic–minority youths; data consistently show the highest rates of drinking and drinking-related problems among White and American Indian or Alaska Native youths, followed by Hispanic/Latino, Black/African American, and Asian youths.4–6 Non-Hispanic White youths generally start drinking at younger ages than their racial/ethnic minority counterparts. Greater percentages of racial/ethnic minority youths abstain or drink very little,7 and significant differences exist in levels of drinking between racial/ethnic minority boys and girls.7 Generally, across racial/ethnic groups, prevalence rates of drinking for boys and girls tend to be similar in younger age groups2; among older adolescents, however, more boys than girls engage in frequent and heavy drinking,2 and boys show higher rates of drinking-related consequences.8Alcohol use and heavy drinking are more prevalent among lesbian, gay, and bisexual (LGB) youths and adults than among their heterosexual counterparts, and this is especially true for LGB girls and women.9–12 Because most research on alcohol use among youths has focused on heterosexual youths or has not assessed sexual orientation, little is known about how sexual orientation interacts with other demographic characteristics to influence drinking patterns. Studies comparing sexual-minority and heterosexual adults suggest that drinking patterns of sexual minorities differ in substantial ways from those of the general population. For example, differences in alcohol-use patterns between lesbian or bisexual women and gay or bisexual men are much smaller than those between heterosexual women and men.12–18 Also, rates and patterns of drinking may be more similar among sexual minorities across racial/ethnic minority statuses, compared with their heterosexual counterparts.19Few studies have examined alcohol-use disparities among subgroups of sexual-minority youths (SMYs; < 18 years). In a meta-analysis, Marshal et al.20 found that SMYs had more than twice the odds of ever drinking alcohol, and 3 of the 4 studies that examined alcohol-related effects for boys and girls separately reported larger alcohol-use disparities among girls than among boys.21–23 Moreover, although studies analyzed by Marshal et al.20 included racially and ethnically diverse samples, none examined the intersecting influences of sexual-minority and racial/ethnic status on substance-use outcomes.The current analyses build on existing literature in 2 ways. First, previous studies with SMYs have examined a limited number of alcohol-use outcomes (e.g., any lifetime drinking).21,22,24 Second, researchers have typically combined subgroups of SMYs25–31 in analyses—often because of small subgroup sample sizes. Because alcohol-use patterns appear to differ on the basis of how sexual orientation is defined—that is, whether data are analyzed on the basis of sexual identity, behavior, attraction, or some combination of these17,32–34—we extended previous work25,35 by examining a variety of sexual-orientation subgroup differences. In addition to our primary goal of examining sexual-orientation differences in alcohol-use patterns, we conducted moderation analyses to determine whether relations between sexual orientation and drinking patterns varied on the basis of sex, age, or race/ethnicity.     

Original Research: Racial/Ethnic Patterns of HIV Sexual Risk Behaviors Among Young Men Who Have Sex with Men

Objectives: Not enough is known about the HIV high-risk sexual behaviors of young men who have sex with men (YMSM), and this is especially the case among ethnic minorities. This study examined racial/ethnic differences in the prevalence of HIV risk behaviors among YMSM across the United States. Design: Face-to-face interviews were conducted among randomly selected participants in venues identified with large samples of ethnic minority YMSM. Methods: Participants (N = 2612) were systematically sampled from venues in 13 U.S. cities representing four ethnic strata (African American, Asian/Pacific Islander, Hispanic, and mixed ethnicity). Results: Twenty-two percent of the sample reported that their last sexual contact with their main sexual partner, someone other than a main sexual partner, or both involved unprotected anal intercourse. Participants from Asian/Pacific Islander sites, mixed sites, and Hispanic sites were more likely than participants from African American sites to report unprotected anal intercourse. Moreover, within the mixed sites, Hispanic participants, followed by Asian/Pacific Islander and White participants, were more likely than African American participants to report unprotected anal intercourse. Conclusions: Interventions are needed that are responsive to the racial/ethnic differences in HIV risk behaviors of YMSM throughout urban American cities.     

A Comparison of Maternal Health Status and Weight-Related Cognitions,Behaviors, and Home Environments by Race/Ethnicity

This cross-sectional study compared weight-related cognitions, behaviors, and home environments of 568 mothers of young children (ages 2 to <9 years) by racial/ethnic group. Maternal health status was good and did not differ by race/ethnicity. Mothers were somewhat confident in their ability to promote healthy physical activity and eating behaviors in their children, with White and Asian mothers having greater confidence than Hispanic mothers. Mothers had low physical activity, with Hispanic mothers getting more sedentary screentime than White and Asian mothers. Mothers’ dietary intake did not differ. Modeling of healthful behaviors was more frequent in White than Hispanic mothers. Asian mothers tended to use non-recommended feeding patterns more than White, Hispanic, and Black mothers. Children’s physical activity and screentime did not differ by race/ethnicity. Asian children tended to drink less sugar-sweetened beverages and more milk than counterparts. All reported frequent family meals, with Hispanic mothers reporting more family meals eaten in less healthful locations. Household food environments did not differ. However, White mothers reported greater access to physical activity space and supports than Hispanic mothers. Race/ethnicity may link with maternal weight-related cognitions, behaviors, and home environments and thus can help inform the development of interventions tailored by race/ethnicity.     

浅析人种和种族因素在医疗器械设计开发中的考虑

对于医疗器械,其疗效和安全性在不同人种和种族群体中可能存在具有临床意义的亚组差异.医疗器械设计开发过程中产生的各种数据在不同区域和国家监管机构递交的可接受性面临巨大的挑战.针对人种和种族因素在医疗器械设计开发中应予以的考虑进行讨论,以期在一个框架下提高安全性和有效性数据的质量及可利用性.     

Race/Ethnicity Differences in the Relationship Between Obesity and Gait Speed Among Older Americans

Projections indicate that the older American population will become more racially diverse in the future. Therefore, eliminating health disparities among older adults should be a public health priority. Using data from the 1999–2002 National Health and Nutrition Examination Survey, we examined the relationship between obesity, measured by BMI and waist circumference, and gait speed, a performance-based measure of physical function, in 2,285 older adults (≥60 y) in order to determine whether this relationship varies by race/ethnicity. Overweight and obesity, indicated by a BMI ≥ 25 kg/m² and a waist circumference in quartiles 3 (male: 102.4–109.9 cm; female: 97.3–106.3 cm) and 4 (male: 110.2–156.6 cm; female: 106.4–147.5 cm), were associated with slower gait speed in non-Hispanic Whites. Among non-Hispanic Blacks, only extreme obesity, indicated by a BMI ≥ 35 kg/m² and a waist circumference in quartile 4 (male: 110.2–149.6 cm; female: 106.4–137.7 cm), was associated with a slower gait speed. Among Mexican Americans, only extreme obesity, indicated by a BMI ≥ 35 kg/m², was associated with a slower gait speed. Thus we found the relationship between obesity and gait speed differed by race/ethnicity. The goal of eliminating health disparities in access to and quality of health care is only possible when differences in the associations between possible risk factors and physical function are identified.     

Menstrual and Oral Contraceptive Use Patterns Among Deployed Military Women by Race and Ethnicity

Menstrual cycle patterns and concerns and oral contraceptive use in the combat environment were examined in Caucasian, Asian, Hispanic, and African American women to guide the development of educational resources for women soldiers. An anonymous, questionnaire was completed by 455 U.S. Army women—Caucasian (CA: n = 141); Asian (AS: n = 67); Hispanic (HIS: n = 67); and African American (AA: n = 184) to compare menstrual patterns and concerns, dysmenorrhea, and oral contraceptive patterns. Total menstrual concerns were significantly lower among African Americans relative to Caucasians, Asians, or Hispanics; Asians and Hispanics reported the greatest concern. Overall, secondary amenorrhea was noted by 14.9% of women. Severe dysmenorrhea rates were significantly lower in African American (6.1%) compared to Caucasian (11.6%), Asian (20.9%) and Hispanic (19.7%) women. Asian women reported missing less work—only 9.3% with moderate to severe dysmenorrhea missed work compared to 25.1% of all other women. Only 9.2% of women with mild, compared to 25.8% with moderate to severe (OR = 3.44; p ≤ 0.0001) dysmenorrhea sought health care. Less than 50% of women took oral contraceptive, and less than half of those women took oral contraceptive continuously. African Americans seemed to experience menstruation as less bothersome than others, despite no difference in the proportion with menstrual irregularities, mean duration of menses, and/or mean time between cycles.     

Processed Food Contributions to Energy and Nutrient Intake Differ among US Children by Race/Ethnicity

This study determined and compared the mean daily intake of energy and nutrients from processed foods by level of processing (minimally processed; processed for preservation, nutrient enhancement, and freshness; mixtures of combined ingredients; ready-to-eat processed foods; and prepared foods/meals) among non-Hispanic white, non-Hispanic black, and Mexican American US children. Data from participants 2–18 years old (n = 10,298) of the nationally representative cross-sectional National Health and Nutrition Examination Survey 2003–2008 with a complete one day, 24-h dietary recall were used to determine mean intake of energy and nutrients recommended for increase and decrease, as per the 2010 Dietary Guidelines for Americans, among child race/ethnic groups by category of food processing. Regression analysis was used to estimate and compare covariate-adjusted (gender, age, and poverty-income-level) least square means (p < 0.05/3 race/ethnic groups). All children, regardless of race or ethnicity consumed processed foods. Approximately 66% to 84% of total daily energy, saturated fat, cholesterol, fiber, total sugar, added sugars, calcium, vitamin D, potassium, and sodium intake are contributed by one of the five categories of processed foods. Clinicians and policy should primarily advise consideration of the energy and nutrient composition of foods, rather than the processing level, when selecting a healthy diet for children.