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.     

Recruitment and retention of nursing students in Kuwait

Occupational and toxicological studies have demonstrated adverse health effects from exposure to toxic air contaminants. Data on outdoor levels of toxic air contaminants have not been available for most communities in the United States, making it difficult to assess the potential for adverse human health effects from general population exposures. Emissions data from stationary and mobile sources are used in an atmospheric dispersion model to estimate outdoor concentrations of 148 toxic air contaminants for each of the 60,803 census tracts in the contiguous United States for 1990. Outdoor concentrations of air toxics were compared to previously defined benchmark concentrations for cancer and noncancer health effects. Benchmark concentrations are based on standard toxicological references and represent air toxic levels above which health risks may occur. The number of benchmark concentrations exceeded by modeled concentrations ranged from 8 to 32 per census tract, with a mean of 14. Estimated concentrations of benzene, formaldehyde, and 1,3-butadiene were greater than cancer benchmark concentrations in over 90% of the census tracts. Approximately 10% of all census tracts had estimated concentrations of one or more carcinogenic HAPs greater than a 1-in-10,000 risk level. Twenty-two pollutants with chronic toxicity benchmark concentrations had modeled concentrations in excess of these benchmarks, and approximately 200 census tracts had a modeled concentration 100 times the benchmark for at least one of these pollutants. This comprehensive assessment of air toxics concentrations across the United States indicates hazardous air pollutants may pose a potential public health problem.     

Has the health profile and pregnant Ethiopian immigrants changed in the Ashkelon region in the past years?]

There are about 6500 births yearly in the Ashkelon District. 6% of the mothers are Ethiopians, most of whom immigrated to Israel since the early 90's. Our data are from 3 sources: birth certificates, infant death certificates, and the national population register. Birth rates in single mothers and rates of low-birth-weight births have declined over the years. Infant mortality and still-birth rates have also shown remarkable and consistent declines between 1990-1995. We conclude that improvement in life conditions of Ethiopian immigrants and better use of health services have had a great impact on birth outcomes and pregnancy patterns. The gap between Ethiopian immigrants and other Jewish communities in Israel is closing fast.     

Successful management of right coronary air embolus after intracoronary administration of verapamil

The incidence of classic Kaposi's sarcoma (CKS) has been reported to be high in Jewish populations living in Israel and in immigrants originating from the Mediterranean basin. No population-based reports are available on the incidence of CKS in Israeli Arabs. We analyzed the incidence of CKS cases occurring between 1970 and 1993 among Arabs living in Israel. Reporting systems were the Israel Cancer Registry, the medical documentation of all-Kaposi's sarcoma cases and the registry of human immunodeficiency virus-seropositive patients. Population figures were derived for census surveys (1972 and 1983) and inter-census data based on annual updating of demographic characteristics. Age-standardized incidence rates (ASR) were 6.87 per million in men and 2.18 per million in women. The ASR did not increase between 1970 and 1993 in either men or women. The age-adjusted male to female ratio was 2.0 below 50 years of age and 3.5 above it. The observation of a stable and relatively high incidence of CKS in Israel-born Arabs, comparable to other populations living in the Mediterranean basin, suggests that risk is related to geographical origin. CKS incidence, however, is lower than that in Israel-born Jews.     

Parent–child role reversal and psychological adjustment among immigrant youth in Israel.

Parent–child role reversal and its relation to psychological adjustment was investigated in Israel among immigrants from the former Soviet Union. Study 1 examined immigrant and Israeli-born college students (n = 184), and Study 2 examined adolescents (n = 180) by means of self-report questionnaires. Two major factors of role reversal emerged: child dominance and family support. The results of both studies clearly showed that immigrants assume more dominant roles and parental responsibilities in their families and receive less support from their parents than their Israeli-born peers. Role reversal dimensions had differential relations with adjustment. Child dominance was mostly not related to adjustment, except for a positive correlation with psychological distress among immigrants. Familial support appeared to be the most important factor related to better adjustment among all studied groups, immigrants included. It is interesting that language brokering (i.e., translating for parents), although associated with child dominance, was negatively related to self-perceptions. Possible explanations within the Israeli context are suggested for negative language brokering correlates, with support from the interviews conducted among the immigrants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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.     

Long-term behavioral sequelae of prematurity

Between the end of 1989 and June 1992, 380,152 Russian Jews left the former Soviet Union for Israel, swelling Israel's Jewish population by nearly 10%. Absorbing great waves of immigrants was not new to Israel. Since its establishment in 1948 and the enactment of its Law of Return, large population groups from dozens of different ethnic and cultural backgrounds had immigrated into the country. In 1992 Israel's Jewish population totaled 4,242,500. Of that number, 360,949 had been born in Asian countries, 458,009 in Africa, 1,252,131 in Europe, and 184,317 in America and Oceana.     

Classic Kaposi's sarcoma in Jews living in Israel, 1961-1989: a population-based incidence study

BACKGROUND: The incidence of classic Kaposi's sarcoma (CKS) has been reported to be high in Jewish populations, mostly born in Eastern Europe. OBJECTIVE: To describe the incidence on CKS in Israeli Jews and to determine differences in incidence according to their geography origin. DESIGN: We analysed data on 1098 incident CKS cases with known country of origin occurring between 1961 and 1989 in the Jewish Israeli population. Reporting systems were the Israel Cancer Registry, the medical documentation of all-Kaposi's sarcoma cases and the registry of HIV-seropositive patients. Patients who were seropositive for HIV were excluded from the study population. Population figures for groups of migrants and natives were derived from census surveys (1961, 1972, 1983) and inter-census estimates based on the population registry. RESULTS: The overall age-standardized rate of CKS was 16.9 per million in men and 6.3 per million in women. The ratio between genders remained stable during the study period. In both genders, there was a steep increase in CKS incidence between the late 1960s (age-standardized rates per million: 8.0 in men and 2.2 in women) and the early 1970s (17.9 in men and 6.7 in women). No further increase was present after 1971. Overall, immigrants experienced a relative risk (RR) of 1.17 [95% confidence interval (CI) 0.90-1.521 compared with Jews born in Israel. Immigrants from Morocco, Algeria and Tunisia had the highest incidence (RR 2.01; 95% CI 1.52-2.65) compared with Jews born in Israel, followed by those born in Iraq (RR 1.74; CI 95% 1.27-2.37). The lowest incidence was experienced by immigrants from Iran (RR 0.37; CI 95% 0.18-0.77) and from Central European countries (RR 0.45; CI 95% 0.30-0.66). Immigrants from other countries in Asia, Africa, the Americas and Europe had similar rates as Jews born in Israel. CONCLUSIONS: Israeli Jews present one of the highest incidences of CKS reported from developed countries. The incidence varies according to geographical origin. Countries surrounding the Mediterranean sea represent the area of highest CKS incidence.     

Toward an Understanding of Jewish Identity: A Phenomenological Study.

To begin mapping the landscape of contemporary Jewish identity from a phenomenological perspective, the authors conducted a qualitative analysis of semistructured interviews of 10 Jewish adults in the northeastern United States. Coding resulted in 6 universal themes (dynamic nature of self-identification, early formative experiences, desire to increase religious practice, generativity, feeling marginalized, and awareness of discrimination). Most of the other 18 typical and variant themes reflected a congruence between cultural identification and religious observance. Whereas only the religiously unaffiliated participants expressed shame or embarrassment about being Jewish, the observant Jews described a sense of pride, the importance of Jewish marriage, and a connection to Israel. The Conservative and Orthodox Jews were most clear about their identity as Jews; they discussed the importance of Jewish texts, heritage, values, search for meaning, and relation to God. All but the most Orthodox participants valued interpersonal relations with Gentiles; for them, Jewish identity predominates regardless of the social context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Ashkenazic Jewish Bloom syndrome mutation blmAsh is present in non-Jewish Americans of Spanish ancestry

Bloom syndrome (BS) is more frequent in the Ashkenazic Jewish population than in any other. There the predominant mutation, referred to as "blmAsh," is a 6-bp deletion and 7-bp insertion at nucleotide position 2281 in the BLM cDNA. Using a convenient PCR assay, we have identified blmAsh on 58 of 60 chromosomes transmitted by Ashkenazic parents to persons with BS. In contrast, in 91 unrelated non-Ashkenazic persons with BS whom we examined, blmAsh was identified only in 5, these coming from Spanish-speaking Christian families from the southwestern United States, Mexico, or El Salvador. These data, along with haplotype analyses, show that blmAsh was independently established through a founder effect in Ashkenazic Jews and in immigrants to formerly Spanish colonies. This striking observation underscores the complexity of Jewish history and demonstrates the importance of migration and genetic drift in the formation of human populations.     

Basic characteristics of radiology groups in the United States: results of a 1991-1992 census

OBJECTIVE: The American College of Radiology (ACR), the principal professional organization of United States radiologists, receives numerous requests for information on the characteristics of radiology groups. This report describes the basic characteristics of radiology groups in the United States. We defined radiology groups as any practice with two or more radiologists or radiation oncologists, including academic departments, units in multispecialty groups, and staff of government facilities. MATERIALS AND METHODS: To collect basic information on radiology groups, the ACR conducted a mail census of all identified radiology groups in the United States during late 1991 and early 1992. Follow-up was conducted by mail and telephone. To make the responses accurately representative of all radiology groups, we weighted the approximately 2000 responses to correspond to known control totals for the number of groups of each of seven size categories in each of the four census regions (Northeast, Midwest, South, and West). These control totals were obtained from the ACR's 1990 Manpower Survey, which showed a total of approximately 3200 radiology groups. RESULTS: Approximately one fourth of all groups have two radiologists, one fourth have three or four radiologists, one fourth have five to seven radiologists, and one fourth have eight or more radiologists. Academic groups were relatively large; almost 50% had 11 or more radiologists. Nonmetropolitan areas had very few large groups, and metropolitan center cities had relatively few small groups. Ninety-two percent of all groups practiced at hospitals, and 73% of all groups practiced at nonhospital offices or centers. The median number of practice sites for all groups was three, including both hospital and nonhospital sites. Eighty-eight percent of all groups provided diagnostic radiology services, 23% provided radiation oncology, 12% offered both, and 11% were oncology-only groups. Relatively many academic groups (25%) were oncology-only groups; very few radiology groups (2%) in multispecialty practices were oncology-only groups. The diagnostic radiology techniques available from the largest percentages of groups were general radiography (plain film), sonography, mammography, and CT. One eighth of academic groups that provided diagnostic services did not report providing mammography, compared with only a few percent of all groups in the United States that provided diagnostic services. CONCLUSION: Half of all groups have two to four radiologists, and this has not changed since at least 1986. A substantial percentage of groups that perform diagnostic radiology do not provide MR, interventional, or nuclear medicine services. This is particularly true of relatively small groups. These characteristics may become the source of some problems as managed care becomes more prominent and larger groups, offering a full range of services and practicing at several sites, are favored by managed care organizations that seek to contract with one group for all their radiology services.     

Dental caries, restoration and tooth conditions in U.S. adults, 1988-1991. Selected findings from the Third National Health and Nutrition Examination Survey

This article provides estimates of dental caries experience and selected restorative and tooth conditions among U.S. adults, obtained from Phase 1 (1988-1991) of the Third National Health and Nutrition Examination Survey. Between 1988 and 1991, 94 percent of adults in the United States showed evidence of past or present coronal caries. Based on the data collected, the authors estimate that about 40.5 percent, or 61.6 million, dentate adults had at least one tooth or tooth space that could potentially benefit from professional treatment. Minimally, it is estimated that 135.6 million tooth or tooth spaces among U.S. adults may benefit from professional treatment. These estimates supplement information available from the DMF index to provide a broader profile of the impact of dental caries on permanent tooth of U.S. adults.     

Analysis of factors affecting U.S. emergency physician workforce projections. SAEM Workforce Task Force

OBJECTIVES: To use existing data sources to refine prior estimates of the U.S. emergency medicine (EM) workforce and to estimate effects of proposed changes in the U.S. health care system on the EM workforce. METHODS: Relevant data were extracted from the American College of Emergency Physicians (ACEP) 1995 Membership Activity Report, the American Medical Association (AMA) publication "1995/96 Physician Characteristics and Distribution in the U.S.," the American Hospital Association (AHA) 1994 hospital directory, a written survey of each state's medical licensing board and state medical society, and the American Board of Emergency Medicine (ABEM) annual activity report for 1995. These data were used to project workforce supply and demand estimates applicable to workforce models. RESULTS: None of the available information sources had complete data on the number and distribution of emergency physicians (EPs) currently practicing in the United States. Extrapolating the limited reliable statewide EP numbers to make nationwide projections reveals a shortage of EPs needed to fully staff the nation's existing EDs. At least 22 states had an average ratio of < 5 EPs per existing ED. Additional national projections incorporating a decreasing number of U.S. EDs indicate that the current annual number of EM residency graduates will not eliminate the deficit of EPs for at least several decades, given that projected numbers of retiring EPs annually will soon equal the total annual EM residency graduate production. CONCLUSIONS: Although the current data on EPs in practice in the United States are incomplete, the authors project a relative shortage of EPs. More accurate and complete information on the numbers and distribution of EPs in America is needed to improve workforce projections.     

A more diversified America: state and local population changes, 1990-1997

Recently, the U.S. Bureau of the Census released state and county population estimates with age, gender, race and Hispanic origin detail for 1990-1997. These estimates illustrate the changing demographics of the United States. The 1997 state population estimates show that both Texas and Georgia experienced notable population growth since 1990. Texas replaced New York as the second largest state; Georgia bumped North Carolina from the list of top 10 most populous states to become the state with the 10th largest population. In both Texas and Georgia, migration flows have contributed to the population change. Texas is one of the most popular "intended states of residence" for international migrants, many coming from Latin American countries. On the other hand, Georgia's growth has largely been influenced by "rustbelt" to "sunbelt" domestic migration. At the county level, the largest total population increases again occurred in western and southern states. Population estimates for Asian and Pacific Islanders show that this population remained concentrated in the West in 1997. Similarly, the Hispanic population is primarily concentrated in southwestern states. However, as the Asian and Pacific Islander and Hispanic populations continue to grow, there is spillover into other regions, primarily the larger metropolitan areas in the South, including Washington, DC, and Atlanta, GA. The population projections produced by the Census Bureau indicate that racial and ethnic diversity will continue to increase in the United States well into the next century.     

Recall of traumatic life events at the time of national socialism in (former) Jewish emigrants and concentration camp prisoners]

Semi-structured interviews with 248 (former) Jewish emigrants and extermination camp survivors in Germany and three destination countries of Jewish emigration (Argentina, Israel, United States) indicate that reminiscence of traumatic experiences suffered from National Socialist Germany occurs in numerous daily contexts. In later life, traumatic memories do not only occur spontaneously and unexpectedly; moreover, they are an essential part of the people's frame of reference for questions about personal identity, perceptions of social relationships, society and societal development, and coping with specific themes. Following a pilot study on subjective reconstruction of the life course in (former) Jewish emigrants and extermination camp survivors, different phases of post-holocaust development are distinguished. Self-ratings for intensity of traumatic reminiscence for these phases of personal development support the hypothesis that traumatic reminiscence increased in old age. People highly differ in coping with stressful reminiscence. Some study participants react with depression, anxiety, feelings of survivor guilt, and withdrawal from social relationships. Others, however, are highly engaged in social relationships, especially with the following generations. They want to give a contribution to the educational work of their society and to prevent discrimination, racism, and xenophobia.     

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.     

Attributional style and depression in pregnant teenagers

Among industrialized countries, the United States has the highest rates of firearm suicide and homicide, as well as the highest rate of gun ownership. The present study compares the differential impact of gun availability on firearm suicides and homicides in the U.S. Using data from the NCHS Mortality Detail Files (1989-1991), the 1990 U.S. census population estimates, and the General Social Surveys (1989-1991) for nine geographic divisions, we computed rates of firearm and non-firearm suicides and homicides as well as rates of gun ownership for four gender-race groups. We tested the strength of the associations between gun availability and firearm suicide and homicide rates by computing the Spearman correlation coefficients. To help elucidate the role of method substitution, we conducted similar analyses on non-firearm suicide and homicide. The results show that gun ownership has a stronger impact on firearm suicides than homicides. These findings held up after stratifying by gender and race. The study suggests that reducing the aggregate level of gun availability may decrease the risk of firearm-related deaths.     

Approval of new drugs in the United States. Comparison with the United Kingdom, Germany, and Japan

In a study reported herein, the marketing approval dates of 214 drugs newly introduced into the world market from January 1990 through December 1994 were compared in 4 countries. The analysis reveals that the United States and the United Kingdom have similar patterns of drug availability, although the United States has a number of therapies with significant public health benefits that are not yet available in the United Kingdom. The findings also show that the United States outpaces both Germany and Japan in approving important new drugs. Various strategies adopted by the Food and Drug Administration to expedite its pharmaceutical review process, including the use of industry user fees, are described.     

Computerised biofeedback games: a new method for teaching stress management and its use in irritable bowel syndrome

OBJECTIVE: To examine the characteristics of foreign-born people with tuberculosis (TB) in Southern Florida, their contribution to the total number of TB cases, and available data on their HIV status as well as to determine the number of cases detected by the overseas medical screening of immigrants and refugees. METHODS: The authors reviewed TB cases reported by Broward, Dade, and Palm Beach counties in 1995. Case records were matched against the CDC Division of Quarantine database of immigrants and refugees suspected to have TB at the time of visa application overseas. RESULTS: Nearly half (49%) of TB cases in the three counties were among people born outside the United States--34% in Broward County, 58% in Dade County, and 40% in Palm Beach County. A high percentage (26%) were co-infected with HIV. Of those with known date of arrival, 68% had been in the United States for five or more years. Only three cases had been identified by overseas immigrant screening. CONCLUSIONS: A low percentage of TB cases in foreign-born people were identified through the overseas screening system. Controlling TB in South Florida will require efforts targeted toward high risk populations, including people with HIV infection.     

Scientific and regulatory aspects of nutraceutical products in the United States

Within the past decade, the so-called health food industry has experienced a tremendous growth such that these products are commonplace in most community pharmacies within the United States. These products have since been defined, by those in the industry, as nutraceuticals. Passage of the Nutrition Labeling and Education Act of 1990 and the Dietary Supplement Health and Education Act of 1994 has had a significant impact on the information available to the consumers to enable them to make educated decisions when "self-medicating" with this class of products. This paper is an attempt to summarize the current state of scientific and regulatory issues that are relevant to nutraceutical products.