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Background: Some personal care products (PCPs) contain endocrine-disrupting chemicals that may affect breast cancer (BC) risk. Patterns of use vary by race and ethnicity. Use often starts in adolescence, when rapidly developing breast tissue may be more susceptible to environmental carcinogens. Few studies have examined associations of BC with PCP use during this susceptible window. Objectives: We characterized race and ethnicity-specific patterns of PCP use at 10-13 years of age and estimated associations of use with incident BC. Methods: At enrollment (2003-2009), Sister Study participants (n = 4,049 Black, 2,104 Latina, and 39,312 White women) 35-74 years of age reported use of 37 'everyday' PCPs during the ages of 10-13 y (did not use, sometimes, or frequently used). We conducted race and ethnicity-specific latent class analyses to separately identify groups of women with similar patterns of beauty, hair, and skincare/hygiene product use. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations of identified PCP classes and single products with incident BC using Cox proportional hazards regression. Results: During a mean follow-up time of 10.8 y, 280 Black, 128 Latina, and 3,137 White women were diagnosed with BC. Classes of adolescent PCP use were not clearly associated with BC diagnosis among Black, Latina, or White women. HRs were elevated but imprecise for frequent nail product and perfume use in Black women (HR= 1.34; 95% CI: 0.85, 2.12) and greater hair product use in Black (HR= 1.28; 95% CI: 0.91, 1.80) and Latina (HR = 1.42; 95% CI: 0.81, 2.48) women compared with lighter use. In single-product models, we observed higher BC incidence associated with frequent use of lipstick, nail products, pomade, perfume, makeup remover, and acne/blemish products in at least one group. Discussion: This work provides some support for the hypothesis that PCP use during puberty is associated with BC risk. More research is needed to confirm these novel findings. https://doi.org/10.1289/EHP13882, Introduction Many personal care products (PCPs) contain endocrine-disrupting chemicals (EDCs), including phthalates, parabens, and phenols, (1-4) that may affect breast cancer (BC) risk. (5-7) Although many EDCs used in PCPs [...]

Objectives To determine whether affluent-born White mother's descending neighborhood income is associated with infant mortality rates (< 365 day, IMR). Methods Stratified and multilevel logistic regression analyses were completed on the Illinois transgenerational dataset of singleton births (1989-1991) to non-Latina White mothers (1956-1976) with an early-life residence in affluent neighborhoods (defined as the fourth quartile of income distribution). The breadth of descending neighborhood income was defined by mother's neighborhood income at the time of delivery. Results Infants of White mothers (n = 4890) who did not suffer descending neighborhood income by the time of delivery had a first-year mortality rate of 5.1/1,000. Infants of White mothers who experienced minor (n = 5112), modest (n = 2158), or extreme (n = 339) descending neighborhood income had IMR of 6.5/1,000, 14.4/1,000, and 11.8/1,000, respectively; RR [95% CI] = 1.3 [0.8, 2.1], 2.8 [1.7, 4.8], and 2.3 [0.8, 6.6], respectively. The incidence of young maternal age, inadequate prenatal care utilization, and cigarette smoking rose as descending neighborhood income increased, p < 0.01. In multilevel logistic regression models, the adjusted (controlling for selected individual-level co-variates) OR [95% CI] of infant mortality for White women with an early-life residence in affluent neighborhoods who subsequently experienced minor or modest to extreme (versus absent) descending neighborhood income equaled 1.0 [0.6, 1.8] and 2.1 [1.1, 3.8] respectively. Conclusions White mother's modest to extreme descending neighborhood income from early-life residence in affluent neighborhoods is associated with a twofold greater risk of infant mortality independent of selected biologic, medical, and behavioral characteristics., Author(s): James W. Jr. Collins [sup.1] [sup.3] , Jennifer Colgan [sup.1] , Kristin M. Rankin [sup.2] , Carla Desisto [sup.2] Author Affiliations: (Aff1) 0000 0004 0388 2248, grid.413808.6, Department of [...]

Introduction Black women in the United States are more likely to develop breast cancer at a younger age and to be diagnosed with more aggressive subtypes and more advanced stage [...]

Background. This study examined the racial differences in probabilities of transitioning across three disability levels of walking 1/2 mile in a community-dwelling population of older women. Methods. The sample comprised 436 community-dwelling older women who were among the two-third least disabled women in Baltimore, Maryland. The levels of disability status of walking 1/2 mile included high functioning defined as reporting no difficulty, preclinical disability defined as reports of task modification but no reported difficulty, and disability defined as reported difficulty. First-order Markov transition models were specified to determine whether race influences the types of individual-level transitions between difficulty levels of walking 1/2 mile. Results. Among high-functioning women, African Americans were more likely to be disabled at the next round than their White counterparts. African American women who began with preclinical disability were more likely to die before the next round. After adjusting for age, education, and perceived income inadequacy, African American women tended to have an increased risk of becoming disabled if preclinically disabled than White women. Conclusions. Prevention through identification of individuals at an early phase of decline appears to be key to addressing racial disparities in physical disability even in later life. Key Words: Racial disparities--Preclinical disability--Mobility disability--Walking.

In 2004, we conducted qualitative interviews with 29 White women diagnosed with cardiovascular disease (CVD) living in Southwest Virginia, aged 69 to 92 years (M age = 79.2 years; SD = 6.8); time since diagnosis ranged from 1 to 50 years (M = 14.3; SD = 11.2). We explored the women's initial illness episode and the influence of CVD on their current daily functioning, family activities and relationships, and social engagement. The women were slow to seek help for CVD symptoms. Postrecovery, 62% of women perceived their heart disease as influencing change in their daily lives. The influence of CVD varied depending on how congruent behavior changes were with their sense of self. KEYWORDS older women, aging, cardiovascular disease, family, social activities, daily life, life-course

Objective. We examined whether African American women were as likely as White women to receive the results of a recent mammogram and to self-report results that matched the mammography radiology report (i.e., were adequately communicated). We also sought to determine whether the adequacy of communication was the same for normal and abnormal results. Methods. From a prospective cohort study of mammography screening, we compared self-reported mammogram results, which were collected by telephone interview, to results listed in the radiology record of 411 African American and 734 White women who underwent screening in 5 hospital-based facilities in Connecticut between October 1996 and January 1998. Using multivariate Iogistic regression, we identified independent predictors of inadequate communication of mammography results. Results. It was significantly more common for African American women to experience inadequate communication of screening mammography results compared with White women, after adjustment for sociodemographic, access-tocare, biomedical, and psychosocial factors. Abnormal mammogram results resulted in inadequate communication for African American women but not White women (P< .001 ). Conclusions. African American women may not be receiving the full benefit of screening mammograms because of inadequate communication of results, particularly when mammography results are abnormal. doi:10.2105/AJPH.2005.076349

Objectives. We estimate the extent to which upward socioeconomic mobility limits the probability that Black and White women who spent their childhoods in or near poverty will give birth to a low-birthweight baby. Methods. Data from the National Longitudinal Survey of Youth 1979 and the 1970 US Census were used to complete a series of logistic regression models. We restricted multivariate analyses to female survey respondents who, at 14 years of age, were living in households in which the income-to-needs ratio did not exceed 200% of poverty. Results. For White women, the probability of giving birth to a low-birthweight baby decreases by 48% for every 1 unit increase in the natural logarithm of adult family income, once the effects of all other covariates are taken into account. For Black women, the relation between adult family income and the probability of low birthweight is also negative; however, this association fails to reach statistical significance. Conclusions. Upward socioeconomic mobility contributes to improved birth outcomes among infants born to White women who were poor as children, but the same does not hold true for their Black counterparts.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2006.04.020 Byline: Mina C. Mojtahedi, Karen L. Plawecki, Karen M. Chapman-Novakofski, Edward McAuley, Ellen M. Evans Abstract: Racial disparity in osteoporosis between older black and white women is well established; however, less is known regarding daily dietary and supplemental calcium intake in these populations. Moreover, racial differences in calcium intake are confounded by differences in socioeconomic status (SES). The objective of this study was to assess calcium intake and source in older black women (n=33) and white women (n=33), matched in age and SES. Calcium intake and source were evaluated by interview using a 46-item calcium food frequency questionnaire including all food groups and supplements. Black and white women were identical in SES and matched on age (black women 66.9[+ or -]6.2 years vs white women 67.1[+ or -]5.5 years [mean[+ or -]standard deviation], P=0.85). No significant difference existed for dietary calcium intake between black and white women (974[+ or -]524 vs 1,070[+ or -]600 mg/day; P=0.65) or total calcium intake between black and white women (1,485[+ or -]979 vs 1,791[+ or -]887 mg/day; P=0.15). Dairy foods contributed most to dietary calcium intake in black and white women and differed by race (black women 402[+ or -]269 mg/day, white women, 603[+ or -]376 mg/day; P=0.02). Calcium intake from grains differed by race (black women 205[+ or -]201 mg/day vs white women 130[+ or -]234 mg/day; P=0.010) and fortified cereals were a major source of calcium for black women. Calcium supplementation contributed substantially to total calcium intake in both groups, with more white women (n=23, 70%) using supplements than black women did (n=19, 58%). However, no racial difference existed in supplemented calcium intake (black women, n=19; 889[+ or -]605 vs white women, n=23; 1,034[+ or -]460 mg/day; P=0.20). Our data suggest that total daily dietary and supplemental calcium intakes do not differ, but calcium intake from dairy foods and from grains differ in older black and white women matched in age and SES.

This article reviews the literature on the conflicts and presenting problems of mid-life single women wishing to marry and addresses the clinical issues in their treatment. Methodology and findings of a research project conducted by the authors with 49 African-American and White women who married after the age of 35 are reported. There is a review of the sociological and historical context for African-American women, which accounts for the different findings for the two subgroups studied. The paper concludes with recommendations to the clinician working with this population. KEY WORDS: African-American; marriage; mid-life; single women.

Objectives. We examined age, period, and cohort (APC) effects on temporal trends in stillbirths among Black and White women in the United States. Methods. We conducted a cohort study of Black and White women who delivered a singleton live-born or stillborn infant during 1981 through 2000. We analyzed stillbirth rates at 20 or more weeks of gestation within 7 age groups, 4 periods, and 10 'central' birth cohorts after adjusting for confounders. Results. In both racial groups, women younger than 20 years or 35 years or older were at increased risk of stillbirth; risks decreased over successive periods in all age groups. Birth cohort had no impact on stillbirth trends among Blacks and only a small, nonsignificant effect among Whites. Analyses of various APC combinations showed that Blacks were at a 1.2- to 2.9-fold increased risk for stillbirth relative to Whites. Attributable fractions for stillbirth because of age, period, and cohort effects were 16.5%, 24.9%, and 0.1%, respectively, among Black women and 14.5%, 36.2%, and 2.1%, respectively, among White women. Conclusions. Strong effects of age and period were observed in stillbirth trends, but these factors do not explain the persistent stillbirth disparity between Black and White women. (Am J Public Health. 2005;95:2213-2217. doi:10.2105/AJPH. 2004.043885)

A study was conducted to compare ethnic differences in dietary and health behaviors between African American and Caucasian female college students. The study's findings identify three areas of concern such as, increased dissatisfaction with body image among the Caucasian women, cultural influences on food choices of the African American subjects, and lack of physical activity in both groups.

Objective: The purpose of this study was to develop an understanding of body weight from emic perspectives of limited-income overweight and obese white women. Design: In-depth individual interviews, including the use of contour drawings and body dissatisfaction parameters. Setting: All methods were conducted in the homes of the research participants. Participants: A purposeful sample of limited-income white women (N = 25), ages 19 to 44 years. Phenomena of Interest: Personal perceptions of attractiveness, health, body weight, and body dissatisfaction. Analysis: Transcripts were analyzed using content analysis. Triangulation of data was achieved by comparing data elicited by different methods in different sections of the interview. Results: Disordered eating habits were common and considered consequences of social, economic, and familial pressures. Food was often used as a means of coping with life pressures. Social and economic barriers were identified as impeding the adoption of more healthful lifestyles. Weight loss was a low priority owing to financial, emotional, familial, and health care constraints. Conclusions and Implications: Multidisciplinary programs addressing financial, emotional, and nutritional concerns may be the most effective for weight management among white limited-income women. Additional research is necessary to verify the results of this study with larger samples. KEY WORDS: obesity, limited income, women, body dissatisfaction

Byline: Kathleen R. Moum (1), Gregory S. Holzman (2), Todd S. Harwell (3), Sherri L. Parsons (1), Sandra D. Adams (1), Carrie S. Oser (3), Michael R. Spence (3), Steven D. Helgerson (2,3), Dorothy Gohdes (3) Keywords: diabetes mellitus; gestational diabetes mellitus; longitudinal studies; North American/Indian Abstract: Objectives: The purpose of this study was to assess trends in diabetes in pregnancy in American Indian and whites mothers in Montana and North Dakota. Methods: Montana and North Dakota birth records were utilized to assess trends in any diabetes in pregnancy in American Indians and whites from 1989 to 2000. Results: From 1989 through 2000, there were 133,991 and 102,232 births in Montana and North Dakota, respectively. The majority of mothers were American Indian (11%) or white (87%). The rate of any diabetes in pregnancy increased significantly in Montana Indian (3.1--4.1%, p = 0.04) and white mothers (1.8--2.6%, p &lt 0.001) from 1989--1991 to 1998--2000. The rate also increased significantly in white North Dakota mothers (1.6--3.2%, p &lt 0.001), but the increase in rate for Indian mothers in North Dakota did not reach statistical significance (3.8--4.8%, p=0.06) during this time period. In each time period, Montana and North Dakota Indian mothers were more likely than white mothers to have any diabetes in pregnancy. Conclusions: The rate of diabetes in pregnancy has increased in American Indian and white mothers. Thus public health programs are now facing an increasing number of women with a history of GDM at future risk of type 2 diabetes and an increasing number of offspring of diabetic pregnancies at risk for becoming overweight and developing type 2 diabetes at a young age. Author Affiliation: (1) North Dakota Diabetes Prevention and Control Program, North Dakota Department of Health, Bismarck, North Dakota (2) Department of Community Medicine, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota (3) Montana Diabetes Project, Montana Department of Public Health and Human Services, Helena, Montana Article History: Registration Date: 18/10/2004

Byline: Manfred Wildner (1,2,4), Andrea Peters (1), Vibhavendra S. Raghuvanshi (1), Jorg Hohnloser (1), Uwe Siebert (1,3) Keywords: Osteoporosis; Risk factor; Prediction model; Bone mineral density; Screening Abstract: Identification of women at risk for osteoporosis is of great importance for the prevention of osteoporotic fractures. Routine BMD measurement of all women is not feasible for most populations, hence identification of a high-risk subset of women is an important element of effective preventive strategies. Methods: We identified 959 postmenopausal non-Hispanic women aged 51 years and above from the NHANES III study to assess the relative contribution of risk predictors for low BMD at the whole proximal femur and the femoral neck regions. Based on recognized risk factors for osteoporosis identified by a systematic literature search, we ran several multiple linear regression models based on the results of preceding bivariate analyses. We show several models based on their explanatory ability assessed by adjusted r .sup.2, ROC, and C-value analyses rather than on the coefficients and P values. We furthermore examined the sensitivity, specificity, and predictive values of our preferred models for various cutoff T-scores--the choice of which will vary depending on different study goals and population characteristics. Results: Age and weight were by far the most informative predictors for low bone mineral density out of a list of 20 candidate risk predictors. Our preferred prediction models for the two regions hence contained only two variables: i.e., age and measured weight. The resulting parsimonious model to predict BMD at whole proximal femur had an adjusted r .sup.2 of 0.43, an area under the ROC curve of 0.85, and a C-value of 0.70. Similarly, prediction for BMD at the femoral neck had adjusted r .sup.2, area under the curve, and C-value of 0.39, 0.83, and 0.66, respectively. Conclusions: The model equations, predicted T-score = -1.332-0.0404 x (age) + 0.0386 x (measured weight) and predicted T-score = -1.318-0.0360 x (age) + 0.0314 x (measured weight) for whole proximal femur and femoral neck, respectively, can be used in field conditions for screening purposes. More complex prediction equations add little explanatory power. Based on the study goals and the population characteristics, specific cutoff T-scores have to be decided before using these equations. Author Affiliation: (1) Bavarian Public Health Research Center and Institute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilian University, Munich, Germany (2) Harvard Injury Control Research Center, Boston, Massachusetts, USA (3) Harvard Center for Risk Analysis, Boston, Massachusetts, USA (4) Bavarian Health and Food Safety Authority, Veterinarstr. 2, 85762, Oberschleissheim, Germany Article History: Received Date: 28/11/2002 Accepted Date: 22/07/2003 Online Date: 16/09/2003

Purpose: Few empirical studies have compared the efficacy between psychoeducational (skill-building) approaches for reducing caregivers' psychological distress and interventions modeled after typical community-based support groups. We compare the impact of two distinct interventions on Anglo and Latino caregivers of elderly relatives with dementia. Design and Methods: The change from preassessment to postassessment (baseline to 3 months) for 213 female caregivers (122 Anglo and 91 Latino) is presented. They were seen weekly for 10 weeks in either the Coping With Caregiving psychoeducational program (instruction and practice in small groups to learn specific cognitive and behavioral skills) or in the Enhanced Support Group condition (guided discussion and empathic listening to develop reciprocal support within the group). Both programs were tailored to be sensitive to the cultural concerns of Anglo and Latino caregivers, and they were delivered in either English or Spanish by trained interventionists. Results: Overall, participants in the Coping With Caregiving condition reported a significant reduction in depressive symptoms, increased use of adaptive coping strategies, and a trend toward decreased use of negative coping strategies when compared with those in the Enhanced Support Group condition. Results were similar for both ethnic groups: there were no main effects for ethnicity, and no significant ethnicity by treatment interaction effects. Implications: This study provides empirical support that female caregivers benefit more from a skill-building approach to managing their distress than from support group membership alone. We find it very encouraging that the Latino caregivers responded well on key outcome variables, suggesting that Latinos will participate in clinical research and will benefit from their involvement when services are provided to meet their specific needs. Key Words: Alzheimer's caregiving, Interventions, Latino issues, Coping

Byline: K. L. Cobb (1), J. L. Kelsey (1), S. Sidney (2), B. Ettinger (2), C. E. Lewis (3) Keywords: Key words:Bone mineral density -- Estrogen -- Ethinyl estradiol -- Oral contraceptives -- Osteoporosis Abstract: To examine whether exposure to oral contraceptives (OCs) is associated with bone mineral density (BMD) in young women, we studied, cross-sectionally and longitudinally, 216 white and 260 black women enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Spine, hip and whole body BMDs were measured by dual-energy X-ray absorptiometry (DXA) when the women were aged 25--37 years, and whole body BMD was remeasured in 369 of the women 3 years later. A comprehensive history of OC use, including dose of ethinyl estradiol (estrogen) and duration of use, was determined from an interviewer-administered questionnaire. After adjustment for other relevant variables, we found that cumulative estrogen from OCs (mg) explained 4.0% of the variation in spine BMD (p = 0.024) among white women, but did not explain any of the variance in BMD in black women. Cumulative OC estrogen was associated with a decreased risk for low bone density (lowest quartile) at the spine, hip and whole body in white women. The odds ratios (95% CIs) comparing women in the highest quartile of cumulative OC estrogen with those in the lowest quartile were, at the spine: 0.08 (0.02, 0.46) at the hip: 0.23 (0.06, 0.87) and at the whole body: 0.37 (0.11, 1.26). OC exposure was not related to low bone density in black women. OCs did not predict longitudinal changes in whole body BMD in either race. These results suggest that exposure to the estrogen from OCs during the premenopausal years may have a small beneficial effect on the skeleton in white women. Benefit is proportional to the cumulative estrogen exposure, suggesting that previous cross-sectional studies that considered OC use as a dichotomous variable may have lacked the power to detect an association. Author Affiliation: (1) Division of Epidemiology, Department of Health Research and Policy, Stanford University, Stanford, California, US (2) Division of Research, Kaiser Permanente Medical Core Program, Oakland, California, US (3) Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA, US Article note: Received: 22 January 2002 / Accepted: 25 April 2002 Correspondence and offprint requests to: Kristin L. Cobb, Division of Epidemiology, HRP Redwood Building, Stanford University, Stanford, CA 94305, USA. Tel: +1 (650) 498 6784. Fax: +1 (650) 725 6951. e-mail: kcobb@stanford.edu

Physical activity is an important aspect of health promotion and disease prevention. However, women often have lower rates of physical activity than men. The purpose of this study was to identify environmental and policy determinants to physical activity among rural white women. Six focus groups were conducted with women aged 20-50 years who were not currently regular exercisers. Women reported that the social environment had a strong impact on physical activity level. Factors of the social environment included guilt, family responsibility, and social support. Environmental and policy barriers such as lack of access to places to exercise and safety concerns were also discussed. Intervention suggestions included family exercise and work-site programs. Information gained from this study can be used to fuel further research and inform future physical activity interventions. KEYWORDS. Environment, physical activity, women's health, rural, exercise

Background. The objective of this study was to determine the prevalence of lower back pain and associated leg pain/ numbness in postmenopausal Caucasian women and the relationship of these symptoms to health status and function. Methods. A convenience sample of 573 white women enrolled in the Observational Study of the Women's Health Initiative (WHI) in Pittsburgh completed a questionnaire on low back pain (LBP) and leg pain (LP) and its impact on their daily activity. For data analysis, this information was merged with that obtained under the standard WHI protocol. Results. Almost half of the women (49%) reported having had LBP during the previous month: 8% had LBP only, while 41% had both LBP and LP. In 9% of women, the leg and back symptoms were alleviated by sitting. Among women with LBP during the previous month, those who also had leg pain were five times more likely to have had functional limitations, two to four times more likely to have consulted a clinician or taken medications, and more likely to have had prior spinal surgery or hospitalization than the women with no LP. Based on the Short Form-36, women with LBP/LP had significantly lower scores for physical function, physical role, and bodily pain than women with no LBP or with LBP alone. Conclusions. Low back pain that radiates into the hip, buttock, or leg is relatively common in postmenopausal Caucasian women living in the community and is associated with decreased physical health status and with physical limitations.

Similarities and differences are presented between European American and Japanese American women entering menopause, both biologically and culturally. Although both groups view the midlife transition as a woman's final identity shift, the event is interpreted very differently within the two cultures.

This article examines the cumulative effects of multiple stressors on women's health, by race and area of residence. Specifically, we examine socioeconomic status, experiences of unfair treatment and acute life events by race and residential location, and their cumulative effects on the health status of African American and white women living within the city of Detroit and in the surrounding metropolitan area. African American women, regardless of whether they live inside or outside the city, report more frequent encounters with everyday unfair treatment than white women. African American women who live in the city report a greater number of acute life events than white women who live outside the city. Regression analyses used to examine the cumulative effects of exposure to these stressors by race and area of residence show that: (1) socioeconomic status, everyday experiences with unfair treatment and acute life events each make a significant contribution to differences in health status; and (2) the contribution of each of these variables to explaining variations in health status varies by area of residence. We suggest that differences in socioeconomic status, exposure to unfair treatment or discrimination and experiences of acute life events make significant contributions to racial differences in women's health status. Keywords: Self-reported health; Social inequality; Women; African American; Stress; USA

This article examines the relationships between subjective and objective measures of social status and health indicators in Caucasian women. Results indicate that perceptions of social status are more closely associated with health indicators like heart rate, body fat, and stress than objective measures of status like education or income level.

A sample of African-American, Latina and White women in LA were surveyed to analyse the links between economic, social and structural factors and HIV-related risk taking. The findings show distinct differences in the ethnic communities influenced by the nature of the family and the economic position of the women. African-American women faced increased risk because of economic instability which led them to sex outside their primary relationships. Latina women in committed relationships faced risk influenced by the sexual history of their partners. The sexual practices of White women increased their risk.

Ethnographic interviewing methods were used to explore women's explanatory models (EMs) of overweight and the congruence of these models with professional models and professionally recommended treatments for overweight Through community-based snowball and theoretical sampling, 40 African American, 40 Euro-American, and 40 Mexican American women of varying social status and weight participated in multiple ethnographic interviews, which were subsequently interpreted using domain analysis and constant comparison. Study participants' EMs of overweight ranged from simple to complex, were generally similar across the three study groups, and only partially congruent with professional EMs of obesity. Major differences in EMs between the study groups were found in the dimensions of etiologies and consequences of overweight. There was partial congruence between participants' EMs and professionally recommended treatments for overweight., Overweight and obesity are major health problems among women across the lifespan. Despite the well-publicized health and psychological consequences of obesity, a flourishing weight-loss industry, and a high rate of [...]

Keywords: Racial differences; blacks; whites; women; perceived barriers to prenatal care Abstract: Objectives: It is well known that black women are less likely to receive adequate prenatal care than white women. This study examines whether there are differences in barriers to prenatal care reported by black and white mothers. Method: Data from the 1988 National Maternal and Infant Health Survey were used to measure relationships between race and reported financial, service, and personal barriers to prenatal care use, adjusting for maternal age, parity, education, poverty level, and insurance coverage during pregnancy. All analyses were stratified by marital status because of substantial effect modification. Results: Among married women, 12.1% of black women reported at least one barrier to prenatal care compared to 9.8% of white women. However, after adjustment for demographic and socioeconomic factors, black women were less likely to report a barrier odds ratio [OR] of 0.8 0.6--1.0). Unmarried black women were less likely to report any barriers to care than white unmarried women (17.9% vs. 25.6%). After adjustment, the OR was 0.4 (0.3--0.5). Conclusions: This study suggests that though black women are less likely to receive prenatal care than white women, they are less likely to report barriers to such care. This may be due to differing expectations from the health system. The investigation of perceived barriers to care is important to the consequent understanding of what steps must be taken to assure that pregnant women do not experience obstacles to the receipt of prenatal care. Article History: Registration Date: 23/10/2004

Objectives. Time trends in breast cancer mortality were analyzed from 1970 to 1992 among White and Black US women aged 25 and over. Methods. Mortality data from the National Center for Health Statistics were summarized within three periods: 1970 to 1979, 1980 to 1988, and 1989 to 1992. The annual change was calculated as the average yearly percentage of change based on the logistic model. Results. For White women of all ages, breast cancer mortality decreased by 1.6% (95% confidence interval = - 2.0%, - 1.1%) per year on average during 1989 to 1992, in contrast to the flat mortality rates observed during the 1970s and a 0.5% average annual increase during 1980 to 1988. The decline was observed for White women under age 60, among whom breast cancer mortality had been decreasing, and for White women aged 60 to 79, among whom breast cancer mortality had been increasing, but it was not observed among Black women. Conclusions. The long-awaited decline in US breast cancer mortality has finally appeared, although only among White women. The possible contributions are changes in inherent risk of disease, changes in treatment effectiveness, and increased use of screening mammography. (Am J Public Health 1997;87:775-781)

Objectives. This investigated racial differences in mammography use and their association with physicians' recommendations and other factors. Methods. The study used 1988 survey data for 948 women 50 years of age and older from the New Hanover Breast Cancer Screening Program. Racial differences in terms of physician recommendation, personal characteristics, health characteristics, and attitudes toward breast cancer and mammography were examined. Factors at least minimally associated with race and use were included in multivariate logistic regression analyses to examine the effect of race while controlling for other factors. Results. In comparison with White women, Black women were half as likely to report ever having had a mammogram (27% vs 52%) and having a mammogram in the past year (17% vs 36%). Black women also significantly less often reported physician recommendation (25% vs 52%). Although Black and White women differed significantly in other characteristics, multivariate logistic regression analyses indicated that physician recommendation accounted for 60% to 75% of the initial racial differences in mammography use. Conclusions. Understanding physicians' recommendations for breast cancer screening is a critical first step to increasing mammography use in disadvantaged populations. (Am J Public Health. 1997;87: 782-786)

A survey of 190 black and white James Madison University students of both genders revealed a higher prevalence of eating disorders in white women as a consequence of their obsession with their perceived ideal, thin body shapes. White women faced societal pressures in the form of white men's disregard for heavier body shapes in women, thereby forcing them to be more concerned about their weight and dieting.

Hispanics of Mexican origin constitute the largest minority population in the Southwestern United States, yet little is known about their reproductive health. This study assessed ethnic differentials in fetal mortality at 20 or more weeks gestation and identified the social and behavioral predictors associated with this outcome among low-income Hispanic, black non-Hispanic and white non-Hispanic women. Records were used of 80,431 patients attending federally funded prenatal care clinics in California from 1984 through 1989. The fetal death rate per 1,000 live births and fetal deaths was 7.8 for Hispanic, 8.4 for white non-Hispanic and 20.5 for black non-Hispanic women. These rates indicated favorable reproductive outcomes for Mexican Americans despite their social risk profile. An analysis of still-births by gestational age showed that Hispanic women stood a significantly lower risk of short-gestational stillbirths than non-Hispanics. In contrast, Hispanic women had a higher proportion of term stillbirths. Hispanic acculturation was a significant predictor of short-term gestation fetal deaths only. The inability to pay for health care was a strong predictor of fetal deaths for all ethnic groups, underscoring the need to ensure adequate access to maternity care for low-income women.