Contraceptive use and sterilization among Puerto Rican women.

A comparison of contraceptive use in the early to mid-1980s among married Puerto Rican women aged 15-49 in the New York City area reveals that island-born Puerto Rican women living in New York rely on female sterilization to nearly the same extent as do women living in Puerto Rico (45% and 41%, respectively) and that mainland-born Puerto Rican women use sterilization as much as do all women in the United States (19% for both groups). Puerto Rican women in New York use reversible methods to a greater extent than do women in Puerto Rico (22% v. 16%), but to a lesser extent than do all women in the United States (37%). Although mainland-born Puerto Rican women in New York use reversible methods more than do island-born women in New York (42% v. 23%), they tend not to adopt these methods to the same extent as do all U.S. women during the early reproductive years, when education and employment are critical to socioeconomic attainment.

PIP: Researchers compared data from 1985 on 1998 15-49 year old Puerto Rican women living in the greater New York City area with data from 1982 on 3174 15-49 year old women living in Puerto Rico and with data from 1982 on 7969 15-44 year old women living in the US to examine their contraceptive practices. Women who were born in Puerto Rico and later lived in New York City had almost the same sterilization rate as those women still living in Puerto Rico (44.7% vs. 40.5%). On the other hand, about the same proportion of Puerto Rican women born and raised in New York City used reversible methods (42.1%), especially oral contraceptives (18.5%) and the IUD (11%). Only 18.5% of the US-born Puerto Rican women had undergone female sterilization which basically equalled that for all US women (18.7%). A higher proportion of Puerto Ricans in New York City used reversible methods than did those in Puerto Rico (21.7% vs. 15.7%), but not as high a proportion as all US women (36.8%). US-born Puerto Ricans did not accept reversible methods as early in the reproductive years as did all US women (42.2% vs. 58.4% for 15-24 year olds). Puerto Rican women, regardless of residence or place of birth, reported fewer male sterilizations and less condom use by their partners than all US women (0% male sterilizations for all Puerto Rican women in New York City, 4.6% for those in Puerto Rico vs. 10.8% and 2.8% of partners using condoms for island-born Puerto Ricans, 5.1% for US-born Puerto Ricans, and 4.4% for those in Puerto Rico vs. 9.8%). These findings on partner responsibility for contraception may reflect the cultural definition of women as rearers of children. The researchers hoped that the results of this descriptive study would motivate others to conduct further research to determine socioeconomic correlates of contraceptive practice and cultural and religious variables.

Long-term follow-up of a cohort of children with alpha-1-antitrypsin deficiency.

We assessed lung function, liver function, and smoking attitudes and behavior in 22 adolescents with homozygous alpha 1-antitrypsin deficiency whose condition had been detected through neonatal screening in the early 1970s. All subjects had normal lung volumes, expiratory flow rates, and diffusing capacity except for two siblings with mild asthma whose values reverted to the normal range after administration of an inhaled bronchodilator. Liver function was normal in all subjects with the exception of one boy who had an isolated elevation of alkaline phosphatase activity. Smoking attitudes, as determined by questionnaire, did not differ from those of 130 control subjects, but smoking initiation rates were significantly lower (p = 0.02). We believe that the issue of neonatal screening for alpha 1-antitrypsin deficiency should be reexamined because augmentation therapy for adults with emphysema is now available, and screening followed by family-based smoking intervention may lead to a nonsmoking life-style. The latter is especially important because the current weight of epidemiologic evidence strongly suggests that in nonsmokers with this condition, severe emphysema may never develop or, if it does, it will do so at a much later age than in smokers.