Differences in Occupational Injuries, Illnesses, and Fatalities among Hispanic and Non-Hispanic Construction Workers

The U.S. Census Bureau estimates that one in four persons in the United States will be of Hispanic origin by 2050, up from one in eight in 2002. Driven by immigration, this dramatic growth in the Hispanic population will present unique challenges in the workplace. In construction, the increase in the Hispanic population has enabled the industry to meet its workforce demands. Unfortunately, this has occurred with costs in the health and safety of Hispanic construction workers. Using data from the U.S. Bureau of Labor Statistics’ current population survey, current employment survey, survey of occupational injuries and illnesses, and census of fatal occupational injuries, this study examines relative differences in injuries, illnesses, and fatalities between Hispanic and non-Hispanic construction workers by occupation. The findings show that differences in injuries, illnesses, and fatalities exist between Hispanic and non-Hispanic construction workers, although not always unfavorably toward Hispanics, and the difference does vary by occupation. The implication of the increasing size of the Hispanic construction workforce with respect to construction safety and health training needs is discussed.     

Adjustment of cancer incidence rates for ethnic misclassification

Although ethnic population counts measured by the United States Census are based on self-identification, the same is not necessarily true of cases reported to cancer registries. The use of different ethnic classification methods for numerators and denominators may therefore lead to biased estimates of cancer incidence rates. The extent of such misclassification may be assessed by conducting an ethnicity survey of cancer patients and estimating the proportion misclassified using double sampling models that account for sample stratification. For two ethnic categories, logistic regression may be used to model self-identified ethnicity as a function of demographic variables and the fallible classification method. Incidence rates then may be adjusted for misclassification using regression results to estimate the number of cancer cases of a given age, sex, and site in each self-identified ethnic group. An example is given using this method to estimate ethnic misclassification of San Francisco Bay area Hispanic cancer patients diagnosed in 1990. Results suggest that the number of cancer cases reported as Hispanic is an underestimate of the number of cases self-identified as Hispanic, resulting in an underestimate of Hispanic cancer rates.     

Increasing diversity of the U.S. population

Demographic changes have shaped the nation's past and will continue to shape its future. During the first half of the 1990s, the U.S. population grew, on average, by 2.7 million people each year, reaching 262.8 million in 1995. Population growth is projected to continue for the next 50 years, although at a slower rate. The forecast is for more than 390 million Americans by the year 2050. As the U.S. population grows, it will increasingly become more diverse along many socioeconomic dimensions. This increasing diversity will represent an historic shift in America's racial and ethnic composition with long-range implications for how we view racial issues, how we define racial categories and how the political landscape will be refashioned. By the middle of the 21st century the "minority" population will almost equal the size of the non-Hispanic white population. The minority population grew 14 percent during the first half of the 1990s compared with a 3 percent growth in the non-Hispanic white population. But even within the minority population, growth rates varied. Between 1990 and 1995, the Asian population grew 23 percent, the Hispanic population 20 percent and the African American population increased their numbers by 8 percent. Hispanics are projected to outnumber African Americans within the next 15 years. In part, these demographic changes are shifting because of U.S. immigration policies. Until the early 1960s, immigrants to the United States were primarily of white, European stock. Nowadays, Europeans account for about 20 percent of the immigrants. Three-quarters of legal immigrants in the mid-1990s now come from Latin America, the Caribbean and Asia. The increasing racial and ethnic diversity in the United States will create both challenges and opportunities for U.S. schools and businesses in the future. The magnitude of these numbers and their geographic location will be important factors to consider as we prepare for the 21st century.     

Are we maintaining the ratio of private practicing pediatric dentists to the number of children?

Using recent ADA and Bureau of the Census reports, national, region and state ratios of pediatric dentists per 100,000 children are provided for the mid-1990s. While national averages continue to improve, there are wide variations at more local levels.     

Mechanisms of normal and abnormal neurulation: evidence from embryo culture studies

In this paper we estimate the size of several categories of "Israeli" immigrants in the United States. According to the 1990 U.S. census, there were about 95,000 Israeli-born immigrants in the United States in that year. Using the language and ancestry information available in the Public Use Microdata Sample (PUMS) of the 1990 census, we estimate that of this total, about 80,000 are Jews and 15,000 are Palestinian Arabs born in Israel. In addition to the Israeli-born, we present a range for the number of Jewish immigrants from Israel who are not Israeli-born (about 30,000-56,000). Thus our estimate for the total number of Jewish immigrants from Israel in the United States in 1990 is between 110,000 and 135,000. Fertility information available in the PUMS, also enable us to provide estimates for the number of second-generation Israelis in the United States in the 1990 (about 42,000). Finally, using both the 1980 and 1990 PUMS, we provide estimates for the rate of return migration among Israeli-born Jewish immigrants in the United States.     

The growth in noncitizen SSI caseloads 1979-1996: aging versus new immigrant effects

OBJECTIVES: The goal of this research is to assess the degree to which the recent growth in the rate of Supplemental Security Income (SSI) usage is concentrated among recently arrived elderly immigrants or among earlier arriving immigrants who have "aged in place" and thus become eligible for benefits. METHODS: We use 1980 and 1990 Census data and 1997 Current Population Survey (CPS) data to examine whether the growth in the elderly noncitizen caseload during the 1980s and 1990s may be attributed to increases in rates of receipt among newly arrived elderly immigrants, to increases in rates of receipt among "settled" immigrants who have aged into categories that allow them to obtain SSI benefits, or to increases in the number of persons in each of these groups. RESULTS: We find that the major contribution to the growth in the noncitizen elderly SSI caseload has been the significant increase in the rate of receipt among those who have lived in the United States for more than 10 years (a smaller increase occurred among recent arrivals). This factor accounts for about half of the total growth in the caseload and cannot be explained by increases in poverty among noncitizens. DISCUSSION: The idea that the availability of SSI for elderly immigrants has acted as a magnet for poor elderly immigrants, thereby accounting for the growth in the elderly immigrant SSI caseloads during the 1980s and 1990s, does not receive much support in the findings of this research.     

Declines in teenage birth rates, 1991-97: national and state patterns

This report presents data on the numbers of teenage births and teenage birth rates for the United States for the period 1950-97 and State-specific birth rates for teenagers for 1991-96. After increasing sharply in the late 1980's, birth rates declined for American teenagers from 1991 through 1997. Rates fell overall by 16 percent for teenagers 15-17 years and by 11 percent for teenagers 18-19 years. Declines were reported for all race and ethnic origin groups, with the largest declines found for black teenagers, especially those aged 15-17 years. Particularly noteworthy has been the 21-percent decline in the rate of second births for teenagers who have had one child. Rates have fallen for first births as well, but the reductions are more modest, about 6 percent. Teenage mothers and their babies continue to be at greater risk of adverse health consequences compared with older mothers, including higher rates of preterm birth and low birthweight. While teenage birth rates vary considerably by State, rates fell in all States in the 1990's with nearly all declines statistically significant. Rates for black and non-Hispanic white teenagers dropped in most States from 1991 to 1996. Birth rate trends for Hispanic teenagers by State were not consistent. The proportion of second and higher order births among all teenage births declined substantially in most States. Data are from the National Center for Health Statistics' (NCHS) National Vital Statistics System.     

Geographic variation in the decline of stroke mortality in the United States

BACKGROUND AND PURPOSE: This study examines the geographic variation in the decline of stroke mortality rates in the United States. METHODS: National Center for Health Statistics and Bureau of the Census data were used to assess regional and state level temporal trends of stroke mortality in the United States for 1970 to 1989. RESULTS: Underlying- and multiple-cause stroke mortality rates have declined fairly steadily in all regions of the United States and for all race/sex groups, although the rates of decline were greater during 1970 to 1978 than during 1979 to 1989. The declines in underlying-cause rates could not be attributed to a shift toward reporting stroke as a contributing rather than underlying cause of death, since both underlying- and multiple-cause rates declined similarly. There was significant regional variation in the rate of decline, particularly during 1979 to 1989. The South initially had the highest rates, but it experienced the most rapid decline, so that by 1989 the South no longer had the highest rates. States with the most rapid rates of decline were significantly clustered in the South and particularly the Southeast. Most of the decline in overall stroke mortality was due to declines in ischemic stroke mortality. CONCLUSIONS: During 1970 to 1989 there was significant geographic variation in the rate of decline of stroke mortality rates, with the most rapid rates of decline concentrated in the high-rate areas of the South and particularly the Southeast. As a result, there has been a decrease in interregional and interstate variation in stroke mortality rates, which is apparently not due to an artifact of changing reporting patterns.     

Hispanic and Non-Hispanic Wage Differentials: Implications for United States Construction Industry

The shortage of skilled construction workers is considered to be one of the greatest challenges facing the United States construction industry. To meet workforce demands, the industry is increasingly relying on Hispanic construction workers. The result has been a strong increase in Hispanic construction workers, especially in the Western and Southern United States where Hispanics already comprise 31 and 24% of the total construction workforce, respectively. Using data from the U.S. Bureau of Labor Statistic’s Current Population Survey (CPS), this study examines relative differences in hourly wages between Hispanic and non-Hispanic construction workers. The finding suggests that Hispanic workers earn less than their non-Hispanic counterparts controlling for experience, occupation, schooling, and geographical location. The implication of the increasing size of the Hispanic construction workforce with respect to industry real wages and education needs is discussed, along with the workforce’s ability to adopt future technologies and workforce strategies.     

Diabetic nephropathy and end-stage renal disease in Mexican Americans

Hispanics are the second largest minority group in the United States. Mexican Americans (MAs) are the largest subgroup at 14 million in 1990. MAs have a two- to threefold increased prevalence of non-insulin-dependent diabetes mellitus. Population-based studies of MAs with non-insulin-dependent diabetes have shown that these patients may be more likely than non-Hispanic whites to develop proteinuria and are more likely to develop end-stage renal disease. The reasons for this excess risk are yet to be completely elucidated, but may be due to worse glycemic control, worse blood pressure control when hypertension does occur, worse access to medical care, and/or genetics. When MAs are treated for diabetic end-stage renal disease, they have better survival. Much less data are available for other Hispanic subgroups. From a public health perspective, higher incidence and longer survival as well as relatively young and rapidly growing population predict an increasing burden for MAs if prevention measures are not instituted soon.     

Reviewing acculturation and Asian Americans: How acculturation affects health, adjustment, school achievement, and counseling.

The minority population in the United States is larger than the total population of all but 11 countries with Asian Americans comprising the third largest group. This review will be a useful resource for researchers or practitioners seeking information on why acculturation is important. The review will confirm how acculturation has outcomes for Asian American’s physical health, adjustment, school performance, and response to counseling or psychotherapy. The review will also suggest implications that various research findings have for future research as well as implications for practitioners working with Asian American clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perspectives on ethical practice with people who have disabilities.

An estimated 49.7 million people in the United States live with one or more disabilities, representing nearly 20% of the 257.2 million individuals ages 5 and older in the civilian population (U.S. Census Bureau, 2003). Most psychologists are likely to have the opportunity to work with clients who have disabilities (R. Olkin, 2002) and need the competencies to provide ethical services to this growing proportion of the population. What constitutes ethical practice with people with disabilities? First, the ethical issues involved in providing services for people with disabilities are outlined, and 2 vignettes and a number of questions for practitioners and educators are presented. Then, 3 invited experts provide commentaries that address these issues, raise additional questions, and provide important resources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hip fracture incidence among elderly Hispanics

OBJECTIVES: This study estimated hip fracture incidence for elderly Hispanics in the United States. METHODS: A cohort of Spanish-surnamed 1992 Medicare enrollees was followed for 2 years. Hip fractures were identified by inpatient diagnostic code. RESULTS: For Hispanic women, the national age-adjusted hip fracture rate was 7.3 per 1000 person-years; for men, the rate was 3.3. Rates varied markedly, with higher rates for the predominantly Mexican-American southwestern states than for Puerto Ricans. CONCLUSIONS: Nationally, the Hispanic population is at intermediate risk of hip fracture between Blacks and Whites, but geographic variation suggests that Mexican Americans are at higher risk than Puerto Ricans.     

Hematologic disorders in children from southeast Asia

The overall laboratory features of the common RBC disorders occurring in Southeast Asians is summarized in Table 4. These erythrocyte disorders will continue to be important public health issues, and it has been predicted that most new cases of thalassemia in the United States will occur in this population group. The fertility rate in Southeast Asian families is very high, with an average of more than five children delivered by each married woman. This number of children is consistent with perceptions of ideal family size, and, to date, no evidence suggests any change in the size of Southeast Asian families who now reside in the United States. Moreover, attitudes about health care, reasons why one seeks medical attention, and a variety of other cultural issues may impair the effectiveness of genetic counseling and other preventive measures designed to reduce the incidence of serious blood diseases. Genetic screening and prenatal diagnosis clearly have led to a markedly decreased incidence of homozygous thalassemia disorders in high-risk Mediterranean populations throughout the world. With further assimilation into Western culture, a similar disease may occur in the Southeast Asian population also.     

Sociodemographic factors and the variation in syphilis rates among US counties, 1984 through 1993: an ecological analysis

OBJECTIVES: Syphilis in the United States is focally distributed, with high incidence rates in the South and in metropolitan areas nationwide. In this study an ecological analysis, using the county as the unit of analysis, was performed to generate hypotheses about community-level determinants of syphilis rates. METHODS: Bivariate rank correlations and multivariate, backward stepwise elimination linear regressions were performed. Mean annual incidence of primary- and secondary-stage syphilis in a county was the dependent variable, and county sociodemographic characteristics (from census data) were the independent variables. RESULTS: In the multivariate regression model, sociodemographic characteristics accounted for 71% of the variation in syphilis rates among counties. With other factors accounted for, the most highly correlated characteristics were percentage non-Hispanic Black population, county location in the South, percentage of the population that was urban, percentage Hispanic population, and percentage of births to women younger than 20 years. CONCLUSIONS: Most of the variation in syphilis rates among counties is accounted for by sociodemographic characteristics. Identification and remediation of modifiable health determinants for which these factors are markers are needed to improve the health status of these populations.     

Health education lessons learned: the H.A.P.I. Kids Program

Challenges exist for effective health communication and health education within diverse populations of the United States. This article addresses the development process for educational materials and lessons learned from the Healthy Asian and Pacific Islander (H.A.P.I.) Kids Program, a vaccination demonstration project funded by the Centers for Disease Control and Prevention to promote catch-up hepatitis B vaccination for older American Asian and Pacific Islander children. Simplicity and a common message were incorporated in multiple strategies to disseminate information to a diverse population. Community representatives from the Cambodian, Hmong, Filipino, Lao, and Vietnamese communities were instrumental in the material development process, which included needs assessment, design, and translation. By making the target community part of the development process, important health messages can be disseminated effectively, carrying great impact to an otherwise hard-to-reach community.     

Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States

OBJECTIVE: To provide a single source for the best available estimates of the national prevalence of arthritis in general and of selected musculoskeletal disorders (osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, the spondylarthropathies, systemic lupus erythematosus, scleroderma, polymyalgia rheumatica/giant cell arteritis, gout, fibromyalgia, and low back pain). METHODS: The National Arthritis Data Workgroup reviewed data from available surveys, such as the National Health and Nutrition Examination Survey series. For overall national estimates, we used surveys based on representative samples. Because data based on national population samples are unavailable for most specific musculoskeletal conditions, we derived data from various smaller survey samples from defined populations. Prevalence estimates from these surveys were linked to 1990 US Bureau of the Census population data to calculate national estimates. We also estimated the expected frequency of arthritis in the year 2020. RESULTS: Current national estimates are provided, with important caveats regarding their interpretation, for self-reported arthritis and selected conditions. An estimated 15% (40 million) of Americans had some form of arthritis in 1995. By the year 2020, an estimated 18.2% (59.4 million) will be affected. CONCLUSION: Given the limitations of the data on which they are based, this report provides the best available prevalence estimates for arthritis and other rheumatic conditions overall, and for selected musculoskeletal disorders, in the US population.     

Sexually transmitted diseases: United States, 1995

Over the past two decades, the United States has experienced some dramatic changes in the rates of three "classic" sexually transmitted diseases (STDs) as well as the introduction of a variety of newer and more complex STD organisms. Rates of primary and secondary syphilis increased through the mid-1980s to a record high of 20.3 cases per 100,000 population in 1990. Since then, rates have dropped 69 percent to 6.3, the lowest rate in 35 years. Gonorrhea rates increased steadily between 1950 and 1975, plateaued between 1975 and 1978, before beginning a gradual but quite steady decline. In 1995 the rate of gonorrhea reached a 30-year low of 149.5 per 100,000. Rates of chlamydial infections, however, have increased more than 55 since 1984 as screening programs proliferated and reporting improved. These infections are commonly found in sexually active adolescents and young adults, and for every case detected in men, there are approximately six detected in women. Rates of syphilis (primary and secondary) and gonorrhea are concentrated primarily in southern states, while chlamydial infections appear to be more widespread geographically. Despite the availability of diagnostic tests and effective treatment regimens for many infectious diseases, STDs continue to target certain populations. They disproportionately affect the poor, inner-city residents and minority groups. The consequences of the diseases are many and varied, and risk of sterility, ectopic pregnancy, fetal death and/or blindness are markedly increased among women with STDs. In addition, risk of HIV infection appears to be increased among persons with a history of having an STD.     

Would you say you "had sex" if...?

CONTEXT: The current public debate regarding whether oral sex constitutes having "had sex" or sexual relations has reflected a lack of empirical data on how Americans as a population define these terms. OBJECTIVE: To determine which interactions individuals would consider as having "had sex." METHODS: A question was included in a survey conducted in 1991 that explored sexual behaviors and attitudes among a random stratified sample of 599 students representative of the undergraduate population of a state university in the Midwest. PARTICIPANTS: The participants originated from 29 states, including all 4 US Census Bureau geographic regions. Approximately 79% classified themselves as politically moderate to conservative. MAIN OUTCOME MEASURE: Percentage of respondents who believed the interaction described constituted having "had sex." RESULTS: Individual attitudes varied regarding behaviors defined as having "had sex": 59% (95% confidence interval, 54%-63%) of respondents indicated that oral-genital contact did not constitute having "had sex" with a partner. Nineteen percent responded similarly regarding penile-anal intercourse. CONCLUSIONS: The findings support the view that Americans hold widely divergent opinions about what behaviors do and do not constitute having "had sex."     

In search of value: an international comparison of cost, access, and outcomes

The United States spent the most resources on health care of all the twenty-nine industrialized countries in 1996 by a wide margin. Managed care and other recent initiatives have been credited with slowing the rate of increase in the U.S. health care spending in recent years. Although the rate of increase slowed, it was still more rapid than the rate in most other industrialized countries between 1990 and 1996. Among the twenty-nine industrialized countries, the United states had the lowest percentage of its population eligible for publicly mandated insurance in 1995. Since 1960 Greece, Korea, and Mexico have surpassed the United States on this measure. AMong the twenty-nine industrialized countries, only the United States had less than half of its population eligible for publicly mandated health insurance in 1995. The United States appears to be comparable to the other G7 countries in terms of access to physicians, in-patient hospital services, and pharmaceuticals. However, on outcomes indicators such as life expectancy and infant mortality, the United States is frequently in the bottom quartile among the twenty-nine industrialized countries, and its relative ranking has been declining since 1960.