Randomized controlled trial of mammography intervention in insured very low-income women.

Background: The expectation that insurance coverage mitigates health disparities and equalizes use of healthcare assumes that services are equally accessed; however, the insured low-income target population in this research had a mammography rate of 23.4%, well below the general population. Our objective was to determine the most effective intervention to improve mammography use in low-income women insured by a managed care organization (MCO).

Breast cancer knowledge and barriers to mammography in a low-income managed care population.

Background: Low-income women experience multiple barriers to screening mammography. This study explored cancer knowledge as a point of intervention to reduce overall barriers.

Methods: A survey of breast cancer knowledge and barriers was obtained from 173 low-income female residents of Middle Tennessee, > or =40 years, enrolled in the state managed care organization and nonadherent to mammography.

Impact of a two-city community cancer prevention intervention on African Americans.

We report the first multisite, multicomponent community intervention trial to focus on cancer prevention in African Americans. The project explored the potential of historically black medical schools to deliver health information to their local communities and used a community-based participatory research approach. The intervention consisted of culturally sensitive messages at appropriate educational levels delivered over an 18-month period and tested in predominantly black census tracts in Nashville, TN and Atlanta, GA.

Prevalence and correlates of initiation of smoking behavior among preteen black and white children.

This study estimated smoking prevalence and identified factors associated with initiation among preteens in Nashville, TN. An anonymous, self-administrated questionnaire was given to 238 fifth- and sixth-graders in a middle-class neighborhood school. The mean age at initiation was 8.

Intergenerational effects of high socioeconomic status on low birthweight and preterm birth in African Americans.

As socioeconomic status (SES) increases, the incidence of low birthweight and preterm birth decreases irrespective of social class. However, low birthweight remains twice as high for African-American women as for white women even when SES is controlled. This study examines to what extent second generation high SES African-American women experience improvement in birthweight and gestational age.

Difficulty in reaching low-income women for screening mammography.

Low-income women have a high mortality from breast cancer. Yet, they participate in breast cancer early detection screening programs less than women in the general population. An intervention study to improve screening mammography rates of low-income women participating in Tennessee's TennCare program (state Medicaid and Medicare program) revealed significant barriers to reaching these women.

Cancer rate differentials between blacks and whites in three metropolitan areas: a 10-year comparison.

This article compares cancer rate differentials for 1989-1993 and 1979-1981 between black and whites in Los Angeles, Nashville, and Atlanta, In Los Angeles and Atlanta, the black/white relative risk of lung cancer incidence has increased. While the relative risk for prostate cancer has decreased, blacks still show an excess incidence. White women still show a higher incidence of breast cancer, but the risk is closer to one.

Low birthweight in African Americans: does intergenerational well-being improve outcome?

The primary antecedent of infant mortality is low birthweight. Vital statistics data have shown that women of low socioeconomic status, regardless of race, are at greater risk for delivering low birthweight infants; however, prevailing data show that black women of the same socioeconomic status as white women have a twofold higher risk of giving birth to an infant weighing < 2500 g and a threefold risk of delivering a very low birthweight infant weighing < 1500 g. There is also evidence that intergenerational effects on birth outcome exist.

Parental hypertension as a predictor of hypertension in black physicians: the Meharry Cohort Study.

Parental histories were obtained for a cohort of black medical students in a longitudinal study of hypertension precursors. At follow-up, 25 to 30 years later, initial and current parental histories for hypertension were compared with other precursor characteristics as well as resulting cohort hypertension. The number of participants having no positive parental history for hypertension as parents aged declined from 55% to 24%.

Depression in black women of low socioeconomic status: psychosocial factors and nursing diagnosis.

This study examines the relationship between depressive symptomatology and selected psychosocial variables in a sample of low socioeconomic status of Black women. The purpose of the investigation was to determine if a study of attribution style, interpersonal style, and racial identity within this sample of Black women might yield results that would lead to the development of treatment strategies with specific applicability to this population of people. Findings indicated a significant disproportionate prevalence of depressive symptomatology in sample of 101 Black women.

Cancer rate differentials between blacks and whites of three metropolitan areas.

This article presents a comparison of the cancer incidence and mortality rates for the populations of the metropolitan areas of Los Angeles, Atlanta, and Nashville. The results reveal that cancer of the lung, prostate, breast, and cervix should be of major concern to all, but especially to blacks and residents of Nashville. The findings have specific implications for the prevention of cancer in the black population of the United States.

Failure of the cold pressor test to predict hypertension in black physicians: the Meharry Cohort Study.

As part of a longitudinal study of precursors for hypertension and atherosclerosis in a cohort of 315 black physicians, the predictive values of cold pressor reactivity were assessed. At initial evaluation, cold pressor tests were performed on all members of the cohort. At the 23- to 30- year follow-up, the participants were again examined and tho cumulative incidence of hypertension was analyzed by the Kaplan-Meier curves in relationship to cold pressor reactivity.

Type A behavior and black physicians: the Meharry Cohort Study.

A group of 261 black, male physicians was examined for the prevalence of Type A behavior and other sociomedical correlates.Type A behavior, as measured by the Jenkins Activity Survey (JAS), was collected together with type of practice specialty, blood pressure, weight, and height. Type A behavior tended to vary by physician practice specialty.

Tests of small airway function in black smokers and nonsmokers.

Tests of small airway function (closing volume, forced expiratory flow in the middle half of the vital capacity, specific airway conductance, and peak expiratory flow) and routine spirometric tests (forced vital capacity, forced expiratory volume in one second, and residual volume) were performed in 848 adult black subjects of both sexes. The group included 422 smokers and 426 nonsmokers. No significant difference was found between smokers and nonsmokers for any of the tests, although some values were higher for men than for women.

Precursors of hypertension in black compared to white medical students.

Data were collected on 433 black medical students at Meharry Medical College (MMC) and 573 white medical students at The Johns Hopkins University School of Medicine (JHMS) during the period of 1958 through 1965 consisting of baseline measurement of some possible precursors of hypertension. Similar methods were employed in both cohorts. Comparison as to prevalence and significance of hypertension precursors revealed the following: Black males had significantly higher casual and resting blood pressures than whites (p less than 0.

Plasma sialic acid alterations in neoplastic diseases.

The several types of neoplastic transformations are accompanied by alterations in the composition of cell glycoproteins, which are major structural components of cell surfaces. One such observed alteration is in the level of sialic acid on the cell surface. In the present investigation, plasma sialic acid levels were measured in normal volunteers and neoplastic patients using thiobarbituric acid spectrophotometric methods.

Obesity and hypertension in a longitudinal study of black physicians: the Meharry Cohort Study.

Obesity has been considered a risk factor among the precursors of essential hypertension for many years. Most related studies were general population surveys or predominantly white, male cohorts. This paper reports results of a longitudinal study of former black medical students, now practicing physicians for an average of 22.

Risk factors and the incidence of hypertension in black physicians: the Meharry Cohort Study.

A prospective longitudinal study of black medical students was conducted to determine the predictive value of hypertension precursors. Follow-up examinations, averaging 22.5 years later, were performed on 341 subjects (78.

Longitudinal study of three views of mandibular third molar eruption in males.

A longitudinal study, using three views simultaneously, was conducted on twenty North American black males to investigate mandibular third molar eruption. Each subject had two third molars present. Forty third molars were studied.

Precursors of hypertension in black medical students: the Meharry cohort study.

Data were collected on a cohort of 435 black medical students whose attendance at Meharry Medical College fell within the period 1958 to 1965, providing baseline measurements on multiple possible hypertension precursors. Relevant family history, sociodemographic, and clinical characteristics were obtained. Fifty percent of the students had at least one of the following possible precursors of hypertension: systolic blood pressure >120 mmHg; diastolic blood pressure >80 mmHg; pulse >80 beats/min; and relative body weight >120 percent of ideal body weight.

Precursors of hypertension: a review.

Recent advances in hypertension therapy have been remarkable; however, much less is known about those precursors that facilitate preventive and early intervention measures. This review of the literature indicates that relevant precursors are early elevated casual systolic blood pressures, positive family history, and obesity in females. Additional predisposing or enhancing factors point to high sodium ingestion, heavy smoking, and high socioecologic stress.