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Prenatal Exposure to Organophosphate Pesticides and IQ in 7-Year Old Children
No full textContext: Organophosphate (OP) pesticides are neurotoxic at high doses. Few studies have examined whether chronic exposure at lower levels could adversely impact children’s cognitive development.
Objective: To examine associations between prenatal and postnatal exposure to OP pesticides and cognitive abilities in school-age children.
Methods: We conducted a birth-cohort study (CHAMACOS) among predominantly Latino farmworker families from an agricultural community in California. We assessed exposure to OP pesticides by measuring dialkyl phosphate (DAP) metabolites in urine collected during pregnancy and from children at age 6 months and 1, 2, 3½ and 5 years. We administered the Wechsler Intelligence Scale for Children-IV to 329 seven-year old children. Analyses were adjusted for maternal education and intelligence, HOME score, and language of cognitive assessment.
Results: Urinary DAP concentrations measured during the 1st and 2nd half of pregnancy had similar relations to cognitive scores, thus we used the average of concentrations measured during pregnancy in further analyses. Averaged maternal DAP concentrations were associated with poorer scores for Working Memory, Processing Speed, Verbal Comprehension, Perceptual Reasoning, and Full Scale IQ. Children in the highest quintile of maternal DAP concentrations had an average deficit of 7.0 IQ-points compared with those in the lowest quintile. However, children’s urinary DAP concentrations were not consistently associated with cognitive scores.
Conclusions: Prenatal but not postnatal urinary DAP concentrations were associated with poorer intellectual development in 7-year-old children. Maternal urinary DAP concentrations in the present study were higher, but nonetheless within the range of levels measured in the general U.S. population
Recruitment and Retention Strategies for Minority or Poor Clinical Research Participants: Lessons From the Healthy Aging in Neighborhoods of Diversity Across the Life Span Study
Get PDFPURPOSE OF THE STUDY: Investigating health disparities requires studies designed to recruit and retain racially and socioeconomically diverse cohorts. It is critical to address the barriers that disproportionately affect participation in clinical research by minorities and the socioeconomically disadvantaged. This study sought to identify and rectify these barriers to recruit and retain a biracial (African American and non-Hispanic White) and socioeconomically diverse cohort for a longitudinal study.
DESIGN AND METHOD: The Healthy Aging in Neighborhoods of Diversity across the Life Span study is a 20-year longitudinal examination of how race and socioeconomic status influence the development of age-related health disparities. One goal was to create a multifactorial recruitment and retention strategy. The recruitment paradigm targeted known barriers and identified those unique to the study's urban environment. The retention paradigm mirrored the recruitment plan but was based on specifically developed approaches.
RESULTS: This cohort recruitment required attention to developing community partnerships, designing the research study to meet the study hypotheses and to provide benefit to participants, providing a safe community-based site for the research and creating didactics to develop staff cultural proficiency. These efforts facilitated study implementation and enhanced recruitment resulting in accrual of a biracial and socioeconomically diverse cohort of 3,722 participants.
IMPLICATIONS: Recruiting and retaining minority or poor research participants is challenging but possible. The essential facets include clear communication of the research hypothesis, focus on providing a direct benefit for participants, and selection of a hypothesis that is directly relevant to the community studied
2010 National Healthcare Quality & Disparities Reports
No full textFor the eighth year in a row, the Agency for Healthcare Research and Quality (AHRQ) has produced the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care. New this year are chapters on care coordination, health system infrastructure. The reports present, in chart form, the latest available findings on quality of and access to health care.
The National Healthcare Quality Report tracks the health care system through quality measures, such as the percentage of heart attack patients who received recommended care when they reached the hospital or the percentage of children who received recommended vaccinations. The National Healthcare Disparities Report summarizes health care quality and access among various racial, ethnic, and income groups and other priority populations, such as residents of rural areas and people with disabilities.
The reports have been revised based on recommendations from the Institute of Medicine that can be found in their report, Future Directions for the National Healthcare Quality and Disparities Reports
Maryland Infant Mortality Epidemiology Work Group Findings from Data Analysis and Overall Recommendations
Get PDFThe Infant Mortality Epidemiology Workgroup was charged to examine the risk factors associated with infant mortality in Maryland and to identify interventions that were most likely to enhance the state’s ability to achieve the goal of 10% reduction in infant mortality and to reduce the health disparities gap in infant mortality rates.
The Workgroup examined linked birth and infant death data from the Maryland Vital Statistics Administration, and data from the Maryland Pregnancy Risk Assessment Monitoring System
State and Local Policy Initiatives To Reduce Health Disparities - Workshop Summary
No full textAbstract available at publisher's web site
Death Rate Higher in Minorities with Acute Leukemia
No full textBlacks and Hispanics have fewer cases of acute leukemia compared to whites but they die at a substantially higher rate, according to study results presented at the Fourth AACR Conference on The Science of Cancer Health Disparities, held here Sept. 18-21, 2011.
From 1998 to 2008, blacks had a 17 percent increased risk of dying from acute leukemia and Hispanics had a 12 percent increased risk compared to white patients.
When separated into the two forms of acute leukemia – acute lymphoblastic leukemia (ALL) and acute myelogenous leukemia (AML) – the difference in mortality was even more striking. Blacks and Hispanics diagnosed
Help on the Horizon: How the Recession Has Left Millions of Workers Without Health Insurance, and How Health Reform Will Bring Relief
No full textUsing data from The Commonwealth Biennial Health Insurance Survey of 2010 and
prior years, this report examines the effect of the recession on the health insurance coverage of
adults between the ages of 19 and 64 and the implications for their finances and access to
health care. The survey finds that in the last two years a majority (57%) of men and women who
lost a job that had health benefits became uninsured. Both insured and uninsured Americans
struggled to pay medical bills and faced cost-related barriers to getting needed care. When fully
implemented in 2014, the Affordable Care Act will bring relief: nearly all of the 52 million
working-age adults who were without health insurance for a time in 2010 will be covered, most
with subsidized premiums and reduced cost-sharing. No one who is legally present will have to
go without insurance when they lose their job, and no one will be charged a higher premium
because of a health problem, have a problem excluded from coverage, or be denied coverage
Stress May Factor Into Breast Tumor Aggressiveness
No full textHigher levels of stress may partially account for aggressive tumor growth in African American and Hispanic women with breast cancer, according to Garth H. Rauscher, Ph.D., of the University of Illinois at Chicago.
This is one of the first studies to look closely at the potential role of psychosocial stress on tumor progression in breast cancer, said Dr. Rauscher, an associate professor of epidemiology at the university’s School of Public Health. However, he acknowledged that the study is “flawed” because it is cross-sectional and has other limitations. “This is definitely an exploratory study,” Dr. Rauscher said at the American Association
The Corporate Role In Reducing Disparities: Initiatives Under Way At Verizon
No full textAbstract available at publisher's web site
Understanding Social Capital and HIV Risk in Rural African American Communities
No full textAbstract available at publisher's web site