Acculturation and cigarette smoking among Korean American men

This study examined the prevalence and correlated factors of cigarette smoking in a cross-sectional, epidemiological survey of Korean American men living in Maryland (n=333). In this sample, 26.1% were current smokers and 42.3% were former smokers. The older age group (> or = 40 years) was more likely to have quit smoking than the younger age group (< 40 years). In multiple logistic regression analysis, acculturation was associated with smoking status; those who stayed more than 20 years in the U.S. were less likely to be current smokers (OR=0.32, 95% CI 0.13-0.77) than those who stayed less than 10 years. Alcohol use was associated with smoking status; those who consumed alcohol were more likely to be current smokers (OR=5.24, 95% CI 2.33-11.79) or former smokers (OR=5.45, 95% CI=2.69-11.04) than those did not. Those with hypertension were more likely to have quit smoking (OR=3.11, 95% CI=1.33-7.24). The results suggest that the role of acculturation in smoking status among Korean American men deserves further attention by researchers as well as by health professionals who develop smoking prevention and cessation programs.     

Influence of Information Sources on Hepatitis B Screening Behavior and Relevant Psychosocial Factors Among Asian Immigrants

This study examines how different information sources relate to Health Belief Model constructs, hepatitis B virus (HBV) knowledge, and HBV screening. The Maryland Asian American Liver Cancer Education Program administered a survey of 877 Asian immigrants. The most common sources of information identified by the multiple-answer questions were newspapers (39.8 %), physicians (39.3 %), friends (33.8 %), TV (31.7 %), and the Internet (29.5 %). Path analyses—controlling for age, sex, educational level, English proficiency, proportion of life in U.S., health insurance coverage, and family history of HBV infection—showed that learning about HBV from physicians had the strongest direct effect; friends had a marginal indirect effect. Perceived risk, benefits, and severity played limited roles in mediation effects. Path analysis results differed by ethnicity. Physician-based HBV screening intervention would be effective, but should be complemented with community health campaigns through popular information sources for the uninsured.     

Patterns and Factors Associated with Health Care Utilization among Korean American Elderly

OBJECTIVE: To examine patterns and factors associated with the utilization of health care services among Korean American elderly (KAE). DATA SOURCES/STUDY SETTING: Data collected from a survey of face­to­face interviews with 205 KAE, aged 60 years and older, residing in the Greater Baltimore Metropolitan area in 1999. STUDY DESIGN: We employed a cross-sectional design, based on the behavioral model of health service utilization for vulnerable populations. Poisson regression was used to estimate parameters associated with physician visits, the utilization of Oriental medicine, and hospitalization. DATA COLLECTION: Data were collected using face-to-face interviews with 205 KAE. PRINCIPAL FINDINGS: About 60% of respondents reported that they could not get care when needed, and the majority (86%) had experienced difficulty getting care. About 71% of respondents visited a physician, and 25% used Oriental medicine at least once during the previous 6 months. Only 8% visited an emergency room. Enabling factors such as public insurance and having a regular physician were important to the utilization of physician care and hospitalization, whereas perceived or evaluated needs were crucial to the utilization of Oriental medicine. The level of acculturation was not significant. CONCLUSIONS: Korean American elderly grossly underutilized ambulatory health facilities, a finding which suggests that this vulnerable population needs culturally effective interventions and policies. KEY WORDS: Korean American, Elderly, Health Service Utilization, Behavioral Model for Vulnerable Population     

Cancer screening behaviors among Korean-American women

The goals of this study were to evaluate breast and cervical cancer screening tests and to examine the correlates of cancer screening behaviors. A cross-sectional face-to-face survey of 438 Korean-American women residing in Maryland was conducted. About 50% of women age 18 and older had had a Pap smear and 46.6% of these women age 40 and older had had a mammogram in the past 2 years. In multiple logistic regression analyses, the strongest correlate of screening behaviors was having a regular medical checkup. Age and acculturation were found to be important correlates of cancer screening tests: Women less than 50 years of age were more likely to have cancer screening tests than those 50 years and older. English language proficiency was associated with having a mammogram and the proportion of life spent in the United States was associated with having a Pap smear. Employment interacted with marital status for a Pap smear, with those married and unemployed being less likely to have a Pap smear than women who were both married and employed. For strategies to increase cancer-screening tests among Korean-American women, we need to aim at developing culturally appropriate educational programs about cancer for less acculturated and recent immigrants.     

The influence of patterns of welfare receipt during the child-rearing years on later physical and psychological health.

This study examined interrelations among welfare receipt, social integration, and later physical and mental health in a cohort of African American mothers from the Woodlawn neighborhood on the south side of Chicago. These women (N = 681) have been followed prospectively from 1966-67 to 1997-98. Findings indicate that receiving welfare during the child-rearing stage of life is related to both social integration and later health, with those who had received welfare in young to middle adulthood being more socially isolated and having more health problems twenty to thirty years later. Findings provided no support for the hypothesis that social integration mediated the relationship between welfare receipt and later physical and psychological health problems. Welfare receipt had a direct detrimental effect on later health outcomes. Attending church regularly was protective for later physical and psychological health. The relationship between early welfare and later health remained even when the women's current poverty was added to the model.     

Strahlenüberempfindlichkeit nach generalisierter Dermatitis infolge einer Salvarsan- und Hg-Kur

Ohne ZusammenfassungMit 1 Textabbildung.     

Cancer Prevention Behaviors in Low-Income Urban Whites: An Understudied Problem

Low-income urban whites in the United States have largely gone unexamined in health disparities research. In this study, we explored cancer prevention behaviors in this population. We compared data on whites with low socioeconomic status (SES) from the 2003 Exploring Health Disparities in Integrated Communities Study in Southwest Baltimore, Maryland (EHDIC-SWB) with nationally representative data for low SES white respondents from the 2003 National Health Interview Survey (NHIS). Rates for health behaviors and health indicators for whites from the EHDIC-SWB study as compared to NHIS prevalence estimates were as follows: current cigarette smoking, 59% (31% nationally); current regular drinking, 5% (5% nationally); overweight, 26% (32% nationally); obesity, 30% (22% nationally); mammography in the past 2 years, 50% (57% nationally); Pap smear in the past 2 years, 64% (68% nationally); screening for colon cancer in the past 2 years, 41% (30% nationally); and fair or poor self-reported health, 37% (22% nationally). Several cancer prevention behaviors and health indicators for white EHDIC-SWB respondents were far from the Healthy People 2010 objectives. This study provides rare estimates of cancer-related health and health care measures in an understudied population in the United States. Findings illustrate the need for further examination of health behaviors in low SES white urban populations who may share health risks with their poor minority urban counterparts.     

Maternal psychological distress: adult sons' and daughters' mental health and educational attainment

BACKGROUND: Offspring of depressed women have high rates of depressive symptoms and other psychopathology. The authors examined the relationship of mothers' symptoms of depression and anxiety reported during their offspring's childhood and adolescence on depressive disorder and educational achievement of their adult children. METHOD: The data come from a longitudinal cohort study of first graders from Woodlawn, a neighborhood in Chicago, followed from age 6 to 32 years (N = 879). Adult children's depression and educational attainment are regressed on earlier self-reports of mothers' psychological distress. Using multiple logistic regression, the authors controlled for the relationships of poverty, mothers' education, mobility, family structure, mothers' illness, and children's first grade classroom behavior and psychological symptoms. RESULTS: Daughters of mothers with persistent maternal psychological distress had two and a half times the risk of lifetime depressive disorder, but no increased risk of high school dropout. For sons, mothers' psychological distress was not related to depression but was related to poorer educational attainment. CONCLUSIONS: Mothers' depressed feelings during the childrearing years relate to their children's depression and educational attainment as measured in adulthood. The patterns differ for sons and daughters.