Children & Young Adults(2)

Rural Black Teens Have Riskier Sex Than Urban Counterparts

     By Becky Ham, Staff Writer
     Health Behavior News Service

A new nationwide study of black teens concludes that those living in
rural areas engage in more risky sexual behaviors than their counterparts
in urban areas.

Based on responses to a nationwide survey of high school students,
rural black teens are more likely to have sex and to not use condoms,
according to Robin R. Millhausen, M.Sc. of the Rural Center for AIDS/STD
Prevention and colleagues.

Compared with their city counterparts, rural black girls and boys are
46 percent and 65 percent more likely, respectively, to report ever
having sex. Rural black girls are 34 percent more likely to say that they
did not use a condom the last time they had sex, while boys are 96
percent more likely to have unprotected sex.

Rural black girls were also more likely than urban girls to report
other risky sexual behaviors, including having more than three sexual
partners in their life and more than one sex partner in the past three
months.

The study was published in the American Journal of Health Behavior.

The researchers acknowledge that their study may not be representative
of all black teens living in rural areas, since it included only those
enrolled in school and did not consider differences in income or social
status.

In areas where sexually transmitted diseases and HIV prevalence is
high, risky sexual behavior “may easily foster STD/HIV outbreaks and
epidemics,” Milhausen says.

The survey was conducted among more than 4,000 teenagers. They were
considered to be rural residents if they lived in a county with less than
50,000 people.

Milhausen and colleagues suggest that rural teens may not be as aware
of the risks of sexually transmitted disease as urban teens or may even
think that diseases like HIV/AIDS are urban problems only.

“If rural youth deny the possibility of HIV risk, they may be less
likely to engage in protective behaviors,” Milhausen says.

The study was supported by the Rural Center for AIDS/STD Prevention, a
joint project of Indiana University, Purdue University and Texas A&M
University, the Centers for Disease Control and Prevention and the
Association of Teachers of Preventive Medicine.

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FOR MORE INFORMATION
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Interviews: Contact William Yarber at yarber@indiana.edu.
American Journal of Health Behavior: Visit www.ajhb.org or e-mail
eglover@hsc.wvu.edu.

 

 Race Gap Remains in Infant Survival Rates

By Marie Love Darbouze

New study findings show that from 1989 to 1997 there was a 30% decrease in the death rate of premature white infants in the United States.  By contrast, among black infants,  the death rate decreased by only 14%.

Whites also had the greatest improvement in overall infant mortality rates--34% versus 24% among blacks.

The reason for this discrepancy between blacks and whites is unknown.  It may largely be due to accessibility to care, particularly to neonatal intensive care units, study lead author Dr. Kitaw Demissie of the University of Medicine and Dentistry of New Jersey, speculated in an interview with Reuters Health.

``Blacks have less access to those kinds of services in comparison to whites,'' he said. ``We have to do more...to narrow that gap.''

Demissie's findings are based on an analysis of data obtained from the National Center for Health Statistics in Maryland.

Rates of premature delivery, a leading predictor of infant death, also varied widely between blacks and whites, Demissie's team reports in the August 15th issue of the American Journal of Epidemiology.

Among whites, the rate of preterm births increased more than 15%, but preterm births among blacks decreased 7%. For both groups, preterm birth rates increased among women carrying more than one child, yet the increase was greater among whites than blacks.

The main factors associated with the increased rates among whites were preterm induction of labor and preterm cesarean delivery, both of which also increased during the study period, the report indicates.

Other findings indicate that rates of pregnancy-induced high blood pressure and diabetes increased in both ethnic groups, although more so among blacks.

``Reduction of race disparities in infant mortality is an important public health objective in the United States and is reflected in the new national Health Objectives for the Year 2010,'' Demissie and colleagues conclude.

SOURCE: American Journal of Epidemiology 2001;154:307-315. ; Reuters Health

Black and Hispanic Children Are more Insulin-Resistant than White Kids, Study Says

By Marie Love Darbouze

In a study of 57 healthy children living in Los Angeles, black and Hispanic children were shown to be at greater risk for developing insulin resistance than white kids, according to researchers at the University of Southern California.  This loss of sensitivity to insulin -- a hormone that regulates the levels of blood sugar (glucose) in the body --i seems to indicate that ethnicity and genetics may be  contributing factors to the development of type 2 diabetes in these segments of the U.S. population.

Researchers at the Keck School of Medicine at USC performed tests on 14 white children, 15 African Americans and 28 Hispanics who ranged in age from 8 to 12. The researchers adjusted for the effect of total body fat, because this is the leading contributor to insulin sensitivity.  Intravenous injections of glucose were given to the children, to measure their insulin response to the glucose injection. 

The researchers found that the black and Hispanic children were more insulin-resistant than whites, meaning the tissues of the body become less responsive to the action of insulin. With reduced sensitivity to insulin, the body usually compensates by having the pancreas secrete more insulin. Type 2 diabetes develops when the pancreas fails to sustain the increased need for insulin secretion, and glucose builds up in the bloodstream.

The researchers found that Hispanic and black children had high levels of insulin in the bloodstream. They believed though these insulin elevations were from different mechanisms.  Hispanic children tended to have more insulin circulating in their bloodstream because their bodies responded to resistance by pumping out lots of insulin, while  in the black children the researchers believed  the children's livers were removing less of the insulin from the blood circulation.

The researchers said it was important to consider these differences when developing therapies to treat the disease.

Type 2 diabetes is twice as common among blacks and Hispanics compared to whites, according to the American Diabetes Association. More and more teenagers are now being diagnosed with the illness.

SOURCE: Diabetes Care 2002;25:2184-2190

Reviewed by Carl Gilbert, M.D.

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