Firearms in New Mexico.

To determine the prevalence of firearm ownership and storage practices in New Mexico, we did a random-digit-dialing survey of New Mexico residents in October 1991. Of 200 households surveyed, 79 (40%) had 1 or more firearms in the home. Rural households were more likely than urban households to have firearms (44% versus 30%), and households with annual incomes of greater than $25,000 were more likely to have a firearm than households with incomes of $25,000 or less (41% versus 33%). Household firearm ownership did not vary with the presence of young (< 15 years old) children (38% with children versus 41% without). Handguns were generally owned for self-protection, and rifles were owned for hunting. Of households with firearms, 24% stored them unsafely (unlocked and loaded or unloaded but with ammunition nearby), including 21% of households with young children. Of the households with handguns only, 40% stored these firearms unsafely compared with 13% of those with rifles only. The prevalence of gun ownership in New Mexico is similar to that reported in national surveys; handguns are stored less safely than rifles; and the presence of young children in the home does not appear to improve firearm storage safety.

Trends in anthropometric measurements among Mescalero Apache Indian preschool children. 1968 through 1988.

OBJECTIVE: To determine if there were trends in underweight, short stature, and obesity among 1- through 5-year-old Mescalero (NM) Apache Indian children from 1968 through 1988. DESIGN: Cross-sectional review of hospital clinic charts for five cohorts. SETTING: General pediatric outpatient clinic at the Mescalero Indian Health Service Hospital. PARTICIPANTS: Sixty-nine patients aged 1 through 5 years in 1968, 1973, 1978, 1983, or 1988 for whom weight and height were recorded during a well-child visit that occurred in the respective year. SELECTION PROCEDURES: Approximately half the charts were screened for eligibility through systematic sampling for all years except 1988; for 1988 all available charts were screened for eligibility for the study. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: We found trends of decreasing prevalence of both underweight (defined as weight-for-height below the fifth percentile) and short stature (defined as height-for-age below the fifth percentile) based on the Centers for Disease Control/World Health Organization growth reference. We found no secular trends in obesity (weight-for-height above the 95th percentile), although the prevalences throughout the 21-year period were as much as two to four times higher than expected when compared with the Centers for Disease Control/World Health Organization reference. There has been an upward shift in both weight-for-height and height-for-age distributions since 1968, indicating that Mescalero children today are, on average, heavier and taller. CONCLUSIONS: Underweight and short stature decreased among Mescalero preschool children from 1968 through 1988, suggesting nutritional improvements. However, given the current high prevalence of obesity, it is recommended that surveillance of nutritional status be continued and appropriate interventions be developed to treat and prevent obesity in this population.

Pedestrian and hypothermia deaths among Native Americans in New Mexico. Between bar and home.

OBJECTIVE: To determine the nature of excess injury mortality among Native Americans in New Mexico. DESIGN: Retrospective review of death certificates for deaths from unintentional injuries. SETTING: The state of New Mexico. SUBJECTS: New Mexico residents who died of unintentional injuries between January 1, 1980, and December 31, 1989. MAIN OUTCOME MEASURE: Cause-specific mortality rates. RESULTS: Over half of the excess mortality from all unintentional injuries among Native Americans resulted from hypothermia and from pedestrian-motor vehicle crashes. New Mexico Native Americans were nearly eight times more likely to die in pedestrian--motor vehicle crashes and were 30 times more likely to die of hypothermia compared with other New Mexico residents. At death, 90% of those Native Americans tested were highly intoxicated (median blood alcohol concentrations of 0.24 and 0.18 g/dL [corrected] for pedestrian and hypothermia deaths, respectively). Despite the fact that most Native Americans in New Mexico live on reservations, most deaths occurred at off-reservation sites in border towns and on roads leading back to the reservation. CONCLUSIONS: The possession and sale of alcohol is illegal on many Native American reservations. This policy forces Native Americans who want to drink to travel long distances to obtain alcohol. These data suggest that this policy is also the likely explanation for the markedly increased risk of death from hypothermia and pedestrian-motor vehicle crashes in this population.

Obesity among Mescalero preschool children. Association with maternal obesity and birth weight.

The prevalence of obesity among native American children ranks with the highest in the United States. However, little is known about associated risk factors for obesity among these children. We conducted a medical record review of 261 preschool children enrolled in the Mescalero Apache tribe to determine the prevalence of obesity and associated risk factors. The prevalence of obesity (weight for height greater than 95th percentile) in this population was 19.5%. The prevalence of obesity (body mass index greater than 95th percentile) in their mothers was 23%. Children with obese mothers were more than twice as likely to be obese than children of nonobese mothers. Children with a high birth weight were three times as likely to be obese as children of low or normal birth weight. The high prevalence of obesity may be due to both life-style and dietary patterns on the reservation. Family-based interventions are needed to prevent obesity and its long-term consequences in this population.

Effects of the 65-mph speed limit on rural interstate fatalities in New Mexico.

As a result of federal legislation passed in April 1987, New Mexico was the first state to resume a 65-mph speed limit on rural Interstate highways. We compared the rates of fatal crashes before and after the speed limit change. The rate of fatal crashes in the 1 year after the speed limit was increased was 2.9 per 100 million vehicle-miles traveled, compared with a predicted rate of 1.5 per 100 million vehicle-miles based on the trend of the 5 previous years. When fatal crashes that occurred after the speed limit change were compared with fatal crashes in the 5 previous years, there was no difference in the mean age and sex of the at-fault drivers, mean age and sex of the victims, seat belt use by the victims, or alcohol involvement of the crashes. The increase in fatal crashes can be attributed to an increase in fatal single-vehicle crashes. Vehicles on rural Interstates are traveling at greater rates of speed and a larger proportion of vehicles are exceeding the 65-mph speed limit. The benefits associated with the 65-mph speed limit should be weighed against the increased loss of lives.

Cryptosporidiosis and surface water.

In the period July through October, 1986, 78 laboratory-confirmed cases of cryptosporidiosis were identified in New Mexico. To determine possible risk factors for development of this disease, we conducted a case-control study; 24 case-patients and 46 neighborhood controls were interviewed. Seventeen (71 per cent) of the 24 case-patients were females, seven (29%) were males; their ages ranged from 4 months to 44 years, median 3 years. There was a strong association between drinking surface water and illness: five of the 24 case-patients, but none of the 46 controls drank untreated surface water. Among children, illness was also associated with attending a day care center where other children were ill (odds ratio = 13.1).

Comparison of HIV-antibody prevalence in patients consenting to and declining HIV-antibody testing in an STD clinic.

All patients attending a sexually transmitted disease (STD) clinic were offered voluntary, anonymous human immunodeficiency virus (HIV)-antibody testing and counseling as part of routine clinical evaluation. During a three-month evaluation period, 82% of patients accepted HIV testing. Testing was accepted equally by men and women and by heterosexual and homosexual men. Black men were more likely to refuse testing than men from other ethnic groups. Eight (0.7%) of 1146 STD clinic patients tested were infected with HIV. A blinded study of 237 patients who refused testing identified nine (3.8%) additional HIV-infected patients. Men who refused testing were 5.3 times more likely to be infected than men who accepted testing. Male homosexuals and black and Hispanic men who refused testing were 7.3 and 8.8 times, respectively, more likely to be infected with HIV than were their counterparts who accepted testing. Human immunodeficiency virus testing and counseling should be routinely offered to STD clinic patients. Male STD clinic patients, especially homosexual or minority men, who refuse voluntary HIV testing should be counseled regarding reducing their risk for HIV transmission.

KIE: Results of voluntary, anonymous human immunodeficiency virus (HIV) antibody testing and counseling offered to all patients attending a sexually transmitted disease (STD) clinic showed that men who refused testing were 5.3 times more likely to be infected than men who accepted testing, and that male homosexuals and black and Hispanic men who refused testing were even more likely to be infected than their counterparts who accepted testing. The prevalence of HIV infection in persons refusing HIV testing was determined in a retrospective, blinded study using stored serum specimens originally drawn for syphilis testing. It is recommended that HIV testing and counseling should be routinely offered to STD clinic patients; male STD clinic patients who refuse voluntary HIV testing should be counseled about reducing their risk for HIV transmission.