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Food preferences play a central role in food choices and consumption. The primary objective of this study was to examine the relationship between children's preferences for fruits and vegetables and their weight status. A total of 341 black children (43% boys; 68% fourth graders) attending low-income, public elementary schools in southeastern Louisiana volunteered to participate. Children were measured for height and weight and completed a survey that sought their preferences for 38 different fruits and vegetables during the fall of 2005. Results indicated that children preferred fruits more than vegetables and that there was a negative association between children's mean fruit and vegetable preference score and their body mass index for age percentile (r=-0.26; P=0.01). Children who reported a very low preference for fruits and vegetables were 5.5 times more likely to be categorized as at risk for overweight or overweight than were those who reported a high preference for fruits and vegetables (odds ratio: 5.5; confidence interval: 1.97 to 15.44; P<0.01). It is believed that food preferences are established early in life; therefore, nutritionists and other health care professionals should promote children's acceptance and intake of fruits and vegetables as a measure to reduce the prevalence of overweight among children.

A study was conducted to test the hypothesis that high consumption of soft drinks, relative to milk and 100% fruit juice, is a risk factor for dental caries in low-income African-American children in Detroit. Findings show that children who changed from being low consumers of soft drinks at baseline to high consumers after two years had a 1.75 times higher mean number of new decayed, missing, and filled tooth surfaces.

The key factors that determine the frequency of preventive dental care visits made by low-income African-American children to dental care providers are examined. Child's age, caregiver's qualification and the type of children's dental insurance are significant driving elements.

Objectives. We estimated racial/ethnic differences in overweight and obesity in a national sample of 3-year-olds from urban, low-income families and assessed possible determinants of differences. Methods. Survey, in-home observation, and interview data were collected at birth, 1 year, and 3 years. We used logistic regression analyses and adjusted for a range of covariates in examining overweight and obesity differentials according to race/ethnicity. Results. Thirty-five percent of the study children were overweight or obese. Hispanic children were twice as likely as either Black or White children to be overweight or obese. Although we controlled for a wide variety of characteristics, we were unable to explain either White-Hispanic or Black-Hispanic differences in overweight and obesity. However, birthweight, taking a bottle to bed, and mother's weight status were important predictors of children's overweight or obesity at age 3 years. Conclusions. Children's problems with overweight and obesity begin as early as age 3, and Hispanic children and those with obese mothers are especially at risk. (Am J Public Health. 2007;97:298-305. doi:10.2105/AJPH.2005.080812)

This study investigates the geography of racial disparities in low birthweight in New York City by focusing on racial residential segregation and its effect on the risk of low birthweight among African-American infants and mothers. This cross-sectional multilevel analysis uses birth records at the individual level (n = 96,882) and racial isolation indices at the census tract or neighborhood level (n = 2095) to measure their independent and cross-level effects on low birthweight. This study found that residential segregation and neighborhood poverty operate at different scales to increase the risk of low birthweight. At the neighborhood scale residential segregation is positively and significantly associated with low birthweight, after controlling for individual-level risk factors and neighborhood poverty. Residential segregation explains neighborhood variation in low birthweight means and race effects across census tracts, which cannot be accounted for by neighborhood poverty alone. At the individual scale-increasing levels of residential segregation does not significantly reduce or exacerbate individual-level risk factors for low birthweight; whereas increasing levels of neighborhood poverty significantly eliminates the race effect and reduces the protective effect of being foreign-born on low birthweight, after controlling for other individual-level risk factors and residential segregation. These findings are contradictory to previous health research that shows protective mechanisms associated with ethnic density in local areas. It is likely that structural factors underlying residential segregation, i.e., racial isolation, impose additional stressors on African-American women that may offset or disguise positive attributes associated with ethnic density. However, as poverty is concentrated within these neighborhoods, differences between races in low birthweight cease to exist. This study demonstrates that residential segregation and neighborhood poverty are important determinants of racial disparity in low birthweight in New York City. Keywords: Racial disparities; Birthweight; Residential segregation; Multilevel modelling; African-American; USA

Purpose: This study examined the relation between African American preschoolers&apos; use of African American English (AAE) and their language and emergent literacy skills in an effort to better understand the perplexing and persistent difficulties many African American children experience learning to read proficiently. Method: African American preschoolers&apos; (n = 63) vocabulary skills were assessed in the fall and their language and emergent literacy skills were assessed in the spring. The relation between students&apos; AAE use and their vocabulary and emergent literacy skills was examined using hierarchical linear modeling (HLM), controlling for fall vocabulary and other child, family, and school variables. Children&apos;s use of AAE was examined across two contexts--sentence imitation and oral narrative using a wordless storybook prompt. Results: There was a significant U-shaped relation between the frequency with which preschoolers used AAE features and their language and emergent literacy skills. Students who used AAE features with greater or lesser frequency demonstrated stronger sentence imitation, letter-word recognition, and phonological awareness skills than did preschoolers who used AAE features with moderate frequency, controlling for fall vocabulary skills. Fewer preschoolers used AAE features during the sentence imitation task with explicit expectations for Standard American English (SAE) or School English than they did during an oral narrative elicitation task with implicit expectations for SAE. Conclusions: The nonlinear relation between AAE use and language and emergent literacy skills, coupled with systematic differences in AAE use across contexts, indicates that some preschoolers may be dialect switching between AAE and SAE, suggesting emerging pragmatic/metalinguistic awareness. KEY WORDS: children, literacy, metalinguistic awareness, phonological awareness, dialects, African American English, There is a well-documented and long-standing disparity between the reading levels of African American children and their European American peers. Sixty-one percent of African American children failed to achieve basic [...]

Abstract Renal involvement is one of the major determinants of the outcome in patients with systemic lupus erythematosus. Although African-American ethnicity has been suggested to be a poor prognostic factor [...]

In 2002, over 12 million children in the United States, more than 16%, lived below the official poverty line. (1) Importantly, some of these children will experience poverty briefly, while […]

Substantial racial and ethnic disparities continue to exist for many health outcomes in children. Research about perceived health status, disability, and specific medical conditions document worse health in African American […]

This study examined the effectiveness of a unique extracurricular after-school initiative designed to promote healthy diets and exercise in urban African Americans. The Students and Parents Actively Involved in Being Fit after-school program was offered for 12 weeks to students and their parents/guardians at an urban middle school. Specific aims of the intervention were to increase participants' vegetable and fruit intake by using established 5 A Day for Better Health educational resource materials/activities and to affect their health-related fitness through dance, games, and fitness activities. Fifty-six children and 25 parents/guardians completed a standard battery of evaluations before and after the program. Pre-post pairwise t test revealed that both children and their parents/guardians showed an increase in fruit consumption and a reduction in diastolic blood pressure (P<.05). Moreover, children showed improvements in systolic blood pressure and fruit juice, salad, and nonfried potato consumption while parents/guardians showed a decrease in body fat, body mass index, and endurance walk/run time (P<.05). Overall, findings indicate that children tended to gain more diet-related benefits while parents/guardians tended to derive more fitness-related benefits. After-school programs like the Students and Parents Actively Involved in Being Fit initiative can potentially contribute to improved health levels in urban African Americans. J Am Diet Assoc. 2005;105:455-459.

Eliminating racial/ethnic disparities in children's health is one of the nation's most important public health objectives. (1,2) Many pediatric clinicians and researchers have focused on asthma as one of the […]

Black children with acute lymphoblastic leukemia (ALL) should have the same good outcome as white children with this type of leukemia provided they receive the same treatment, according to a study of 412 children and teenager with ALL. About 80% of the children survived for at least five years after treatment, regardless of their race. This was true even though the black children were more sick when they began treatment.

Health status and health outcomes differ by race in the United States, (1) as does access to health car (2,3) and the quality of care received. (4) Infant mortality rates, […]

Byline: Paul A. Buescher (1), Stephanie J. Horton (1), Barbara L. Devaney (2), Sarah J. Roholt (3), Alice J. Lenihan (3), J. Timothy Whitmire (1), Jonathan B. Kotch (4) Keywords: race; children; Medicaid; health service use; health care expenditures Abstract: Objectives: Racial differences in health status and use of health services persist in the United States and are not completely explained by differences in socioeconomic status. This study examines differences in use of health services between White and African American children enrolled in Medicaid, controlling for other factors that affect service use. We make comparisons for use of primary preventive services, diagnosis and treatment of selected common childhood illnesses, and Medicaid expenditures. Methods: We linked Medicaid enrollment records, Medicaid paid claims data, and data on use of child WIC services to birth certificates for NorthCarolina children born in 1992 to measure use of health services and Medicaid expenditures by race for children ages 1, 2, 3, and 4. Logistic and Tobit regression models were used to estimate the independent effect ofrace, controlling for other variables such as low birth weight, WICparticipation, and mother&apos;s age, education, and marital status. Since allchildren enrolled in Medicaid are in families of relatively low income, racial differences in socioeconomic status are partially controlled.Results: African American children had consistently lower Medicaidexpenditures and lower use of health servicesthan did White children,after statistically controlling for other maternal and infantcharacteristics that affect health service use, including child WICparticipation. For example, total annual Medicaid expenditures were $207--303 less for African American children than for White children,controlling for other variables. African America children were significantly less likely to receive well-child and dental services than were White children. Conclusions: African American children enrolled in Medicaid use healthservices much less than White children, even when controlling forsocioeconomic status and other factors that affect service use. Linkingstate administrative databases can be a cost-effective way of addressingimportant issues such as racial disparities in health service use. Author Affiliation: (1) North Carolina Division of Public Health, State Center for Health Statistics, Raleigh, North Carolina (2) Mathematica Policy Research, Inc., Princeton, New Jersey (3) Nutrition Services Branch, North Carolina Division of Public Health, Raleigh, North Carolina (4) Department of Maternal and Child Health, University of North Carolina School of Public Health, Chapel Hill, North Carolina Article History: Registration Date: 07/10/2004

The current article examines literature relevant to understanding the impact of community violence on African American women and children, with a focus on witnessing violence and injury, and the loss of close others. Survivors may report psychological distress, increased rates of aggression, diminished physical health, and additional challenges in their parental roles. Despite these challenges, they have developed a variety of coping strategies. Individual and community level interventions, based on the more successful coping mechanisms of violence survivors, are discussed. KEYWORDS. Community violence, Blacks, violence, urban environments, aggression

The authors examine the psychosocial aspects of African American children told that a parent is HIV positive versus those children with whom the information is not shared. Topics include mother and child relationships, behavior problems in children, and pre- to post disclosure relationships.

Byline: Natalie P. So (1), Alexies V. Osorio (1), Stephen D. Simon (2), U. S. Alon (1) Keywords: KeywordsaUrinary calcium; Urinary sodium; Urinary potassium; Urinary creatinine; Children; Race Abstract: A random urine calcium/creatinine ratio (UCa/Cr) is of practical use in screening for hypercalciuria. However, due to worldwide variations, reference values for the pediatric population are not yet well established. Furthermore, no study has been conducted to establish normal UCa/Cr values in young African-American (AA) children. It has also been previously reported that an elevated UCa/Cr is related to a high urine Na/K ratio (UNa/K). The objectives of the present study were: (1) to set normal values of random UCa/Cr by age and race in the pediatric population of Metropolitan Kansas City, (2) to identify potential racial differences in UCa/Cr between Caucasian (CS) and AA children, and (3) to determine the relationship between UCa/Cr and UNa/K in healthy children.A total of 368 healthy children of both genders were enrolled in the study. They were divided into four age groups as follows: (1) &lt 7 months, (2) 8--18 months, (3) 19 months to 6 years, and (4) 7--16 years. Each group was subdivided into AA and CS. A non-fasting random urine specimen from each subject was analyzed for Ca, Na, K and creatinine.The median UCa/Cr values for AA were: (1) 0.13, (2) 0.09, (3) 0.06, and (4) 0.04 and for CS they were (1) 0.26, (2) 0.11, (3) 0.10, and (4) 0.09. The data showed a strong inverse relationship between UCa/Cr and age, the youngest children demonstrating the highest UCa/Cr. In each age group, UCa/Cr in CS exceeded the corresponding value in AA. The age-dependent 95th percentiles of UCa/Cr values for CS were (1) 0.70, (2) 0.50, (3) 0.28, and (4) 0.20 and for AA they were (1) 0.38 and (3) 0.24. Due to outliers, the 95th percentile could not be established for the other two AA subgroups. The relationship between UCa/Cr and UNa/K was found to be extremely weak in both AA (r .sup.2=0.00005) and CS (r .sup.2=0.02). On the other hand, a strong linear correlation was observed between UNa/K and age (CS r .sup.2=0.23, P&lt 0.001, AA r .sup.2=0.19, P&lt 0.001), explaining in part the lack of correlation between UNa/K and UCa/Cr.We conclude that the child&apos;s age, ethnicity and geographic location should be taken into consideration when assessing UCa/Cr ratio. Contrary to what has previously been reported in hypercalciuric children, no significant relationship was found between UCa/Cr and UNa/K in healthy children. Author Affiliation: (1) Section of Pediatric Nephrology, The Children&apos;s Mercy Hospital, University of Missouri at Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA e-mail: ualon@cmh.edu Tel.: +1-816-2343010, Fax: +1-816-2343494, US (2) Office of Medical Research, The Children&apos;s Mercy Hospital, University of Missouri at Kansas City, Missouri, USA, US Article note: Received: 7 June 2000 / Revised: 21 September 2000 / Accepted: 23 September 2000

Evidence is mounting regarding the multiple benefits of exercise and good nutrition (1-4). Physical activity and healthful eating may protect against a number of adolescent and adult public health concerns […]

Poor and minority children have substantially more dental decay than advantaged children. Using data from the Third National Health and Nutrition Examination Survey (NHANES III) on the health of 10,332 children, researchers determined that 79% of teeth were decayed in the poorest children with some tooth decay, while 45% were decayed in children from households earning three or more times the federal poverty level of income. Untreated tooth decay was also more common in black and Mexican-American children than in white children and those from higher-income families.

Many inner-city children with asthma may not receive appropriate and effective medical therapy. Researchers surveyed the families of 392 urban asthmatic children to determine which medications were used to treat and manage asthma. Twenty percent of children used no medications or only used over-the-counter medication. Many older children supervised their own medication use. Only 11% of children used an antiinflammatory drug every day, despite national guidelines which recommend it. Urban asthmatic children may be undermedicated, and they require more supervision of care., Objective. The purpose of the study was to examine medication use reported by families participating in an urban school-based community intervention program and to relate this use to other social and medical variables. Design. The design of the study was a cross-sectional questionnaire survey. Setting. Patients and their families recruited from elementary schools in a community setting were interviewed between December 1991 and January 1992. Participants. A total of 508 children with asthma were identified by school health records and teacher surveys. Their families confirmed the diagnosis and agreed to enter the study. Questionnaires were completed by 392 families. Intervention. The 392 families participated in a controlled trial of asthma education after providing the data that are the basis of this report. Results. More than half of the children took two or more medications for asthma. Thirty-one percent took theophylline alone or in combination with an adrenergic agent, 11% took some form of daily antiinflammatory medication, either cromolyn (8%) or inhaled steroids (3%). The pattern of medication use related to measures of severity and to regular visits to physicians or nurses. In general, however, children were undermedicated. A total of 78 children (20%) reported no medication or over-the-counter medication use, although 370% reported asthma severe enough to be associated with [is greater than or equal to] 20 days of school missed per month, and 37% had had an emergency room visit for asthma in the past 6 months. More than half of children [is greater than or equal to] 9 years old supervised their own medication. Conclusions. We concluded that undermedication is common in poor children with asthma living in urban areas. Antiinflammatory medications are used less commonly than in the general population, and theophylline is used more often. School children may be likely to supervise their own medication. Pediatrics 1998; 101:349-354; asthma, medications, minorities, epidemiology., Medication recommendations for the treatment of chronic asthma have changed a great deal in the past decade. Currently, national and international guidelines for asthma therapyl[1,2] include daily antiinflammatory medications such [...]

African-American children appear to use emergency departments and inpatient services for asthma more often than white children, regardless of family income and type of medical insurance. Medicaid claims data from 1988 to 1992 for 576 African-American children and 1,369 white children, all enrolled in Aid to Families with Dependent Children, were analyzed. Total per capita charges paid for asthmatic African-American children were 24% higher than for white children. The higher cost was attributed to greater use of costly emergency departments and hospitalization. White children made office visits for asthma and tended to been seen by a private physician, while African-American children were likely to visit publicly funded clinics. African-American children were prescribed theophylline more often than were white children, although 1991 National Institutes of Health asthma guidelines recommend inhaled beta-agonists and anti-inflammatory medications. African-American children may be receiving substandard care for asthma., Objective.--To determine whether African-American children with asthma use more emergency department (ED) and inpatient medical services and fewer preventive services than white children with similar insurance coverage and family income. Design.--Historical cohort study using Medicaid claims data. Setting.--Aid to Families With Dependent Children enrollees aged 3 through 17 years in the Seattle-Tacoma, Wash, metropolitan area. Patients.--All 576 African-American children and 1369 white children receiving services for asthma between June 1988 and December 1992. Main Outcome Measures.--Utilization of asthma services (ED, inpatient, office visits, and pharmacy) and well-child services and associated Medicaid reimbursements. Results.--African-American children were more likely than white children to make ED visits or to be hospitalized for ashthma; adjusted odds ratios (ORs) were 1.70 (95% confidence interval [CI], 1.34 to 2.15) and 1.42 (95% CI, 1.03 to 1.96), respectively. African-American children were less likely to have made an office visit for asthma; the adjusted OR was 0.48 (95% CI, 0.26 to 0.85). The two groups were similarly likely to have filled a prescription for an asthma medication and to have made a well-child visit. Per capita payments for asthma services were 24% higher for African-American children: $436 vs $350 per child-year. Conclusions.--Higher use of ED and inpatient services for asthma among African-American children using Medicaid (compared with white children) cannot be fully explained by poverty or inadequate health insurance. Furthermore, these children appear to make disproportionately few office visits for asthma, suggesting suboptimal use of preventive services for asthma. In contrast, the comparable use of well-child visits in the two groups suggests the problem may not be in access to care in general, but there may be specific problems in the successful management of chronic diseases such as asthma among African-American children. (JAMA. 1995; 274:469-473)

Discriminatory practices are depriving African-American children of a hopeful future. The country's criminal justice system, housing practices, schools, and employment overwhelmingly favor whites. More than 40% of people arrested for drug possession are African-American, although only 12% of drug users are African-American. African-American males are six times more apt to die of homicide than whites. Pregnancy is eight times higher among African-American females than whites. Because of the hopelessness and the shortage of opportunities, African-American children often grow up without a clear sense of direction. Pediatricians should become involved in public policy to foster the healthy development of all children. Adequate public school funding, affirmative action programs in universities, urban renewal, and multiculturism should be promoted., Key words: adolescents, advocacy, African-Americans, alienation, prevention. ABBREVIATIONS. HIV, human immunodeficiecy virus; STDs, sexually transmitted diseases. Increasingly, the most urgent problems in pediatrics are the result of complex sociopolitical and [...]