Gerardo Marín

Behavioral risk factors: a comparison of Latinos and non-Latino whites in San Francisco.

OBJECTIVES The purpose of the study was to evaluate differences between Latino and non-Latino White adults in health-related behavioral risk factors. METHODS Telephone interviews were conducted with 652 Latinos and 584 non-Latino Whites in San Francisco selected by random-digit dialing. RESULTS Latino men and women, compared with their non-Latino White counterparts, were less likely to have consumed any alcoholic beverage in the previous month (59% and 29% vs 77% and 75%, respectively), consumed fewer drinks per week (6.6 and 3.0 vs 8.9 and 5.1, respectively), and were more likely to be sedentary (40% and 46% vs 17% and 23%). Latina women were less likely than non-Latina Whites to smoke cigarettes (8% vs 29%), to have ever had a Pap smear (76% vs 93%), and to have ever had a clinical breast examination (81% vs 96%). Multivariate analyses adjusting for sex, age, education, and employment confirmed univariate findings. CONCLUSIONS Behavioral risk factor profiles by ethnicity help emphasize priorities of health promotion programs for a community. Latino needs include maintenance of limited consumption of alcohol and cigarettes, promotion of regular physical activity, and increasing use of low-cost cervical and breast cancer screening tests.

Apparent underreporting of cigarette consumption among Mexican American smokers.

To determine the accuracy of self-report of cigarette consumption among Mexican American smokers, we compared self-reported cigarette use and serum cotinine concentrations in a sample of 547 participants in the Hispanic Health and Nutrition Examination Survey (HHANES). We defined underreporting of cigarette use as a cotinine to cigarette-per-day ratio of greater than 0.142 microM/l which represented a substantial discrepancy between self-reported consumption and serum cotinine. Of the 98 men and 97 women who reported smoking one to nine cigarettes/day, 20.4 percent and 24.7 percent, respectively, underreported their cigarette consumption. Underreporting was less common among men and women smoking 10 to 19 cigarettes/day (8.3 percent and 10.8 percent, respectively) and 20 or more cigarettes/day (2.2 percent and 2.9 percent, respectively). Comparison of underreporters to other smokers by demographic characteristics within sex and cigarettes/day categories showed no differences. Differences in cotinine metabolism and extremely efficient smoking are alternative explanations that can not be ruled out with these data. We believe, however, that a proportion of Mexican American light smokers may underreport the quantity of cigarettes smoked per day, and may truly be moderate or heavy smokers.

Depressive symptoms and cigarette smoking among Latinos in San Francisco.

We administered the Center for Epidemiological Studies Depression (CES-D) Scale to 547 San Francisco Latinos as part of a random digit dialing telephone survey to evaluate smoking behavior. Both men and women current smokers had the highest mean CES-D levels (9.7 and 14.3, respectively). Logistic regression analysis adjusting for gender, acculturation, education, age, and employment showed that current smokers had an odds ratio of 1.7 (95% CI = 1.3, 2.2) for significant depressive symptoms compared to former smokers (OR = 1.1;95% CI = .8, 1.6) and never smokers (OR = 1).

Feasibility of a telephone survey to study a minority community: Hispanics in San Francisco.

In two random digit dialing surveys conducted among Hispanics using a modified Mitofsky-Waksberg procedure, we found low refusal rates (4.7% and 3.1%), low assumed noncontact rate (14.0% and 18.3%), and high response rates (88.6% and 88.4%) with limited investment in time (1.58 hours and 1.66 hours per completed interview). These results suggest that Hispanics are willing to participate in telephone surveys and that this method may be feasible and useful for research and evaluation purposes.

Health Care Utilization by Low-Income Clients of a Community Clinic: An Archival Study:

An archival study was done of 500 medical records from a community clinic serving a low-income predominantly Hispanic area of Los Angeles. Data collected included demographic characteristics and presenting symptoms or reasons for visit, as well as diagnoses and treatment. Patients tended to be young, poor, female Hispanics. The majority of patient visits were for family planning services, with smaller proportions for pediatric, general medical, or pregnancy testing services. Return rates for family planning and other services were not as high as desirable, with more than half of the sample having made only one clinic visit. A careful analysis of the demographic characteristics of oral contraceptive acceptors who returned or did not return for services indicated that the two groups were similar to each other except that married women were more likely to return than single women. One quarter of positive pregnancy tests were done on women who were more than 12 weeks pregnant, while another quarter of positive tests were referred for abortion. The data highlighted certain changes needed in service delivery, such as the need for a pre- and postnatal care component of service and a need to attract more older and male patients. In the future, collection of archival data from this same clinic could facilitate the evaluation of certain policy changes, since those data could be compared with the present findings. Se llevó a cabo un estudio de 500 expedientes médicos de una clínica comunitaria que sirve a un área predominantemente Hispana de bajos recursos económicos de la ciudad de Los Angeles. Los datos recogidos incluyeron características demográficas, síntomas o razones para la visita, así como diagnóstico y tratamiento. Los pacientes generalmente eran jóvenes, de bajos recursos económicos y del sexo femenino. La mayoría de las visitas estaban relacionadas con planificación familiar, con proporciones mas bajas relacionadas con ciudados pediátricos, de medicina general y exámenes de gravidez. Visitas subsecuentes a la inicial no fueron muy frecuentes con la mayoría de los pacientes habiendo visitado la clínica una sola vez. Un análisis cuidadoso de las caracteristicas demográficas de las personas que utilizaban anticonceptivos orales que retornaron o no retornaron indicó que los dos grupos de pacientes eran similares excepto que las mujeres casadas tenian mayor probabilidad de retornar que las mujeres solteras. Una cuarta parte de los exámenes de gravidez fueron llevados a cabo en mujeres que tenian ya mas de 12 semanas desde el momento de la concepción mientras que la cuarta parte de los exámenes positivos de gravidez fueron referidos para abortos. Los datos demuestran ciertos cambios necesarios en la entrega de servicios tales como la necesidad de componentes pre- y post-natal y la necesidad de atraer mas pacientes masculinos y de pacientes de mayor edad. En el futuro, la recolección de datos de esta misma clínica puede facilitar la evaluación de ciertas políticas y cambios en las mismas ya que esos datos pueden ser comparados con los aquí presentados.