Erectile dysfunction prevalence in the United States: report from the 2021 National Survey of Sexual Wellbeing.

BACKGROUND: There has been a great deal of public speculation regarding a surge in erectile dysfunction (ED) in younger men despite data consistently indicating that the ED prevalence rates increase with age. AIM: In this study we sought to assess the prevalence and risk of experiencing ED in a nationally representative sample of men in the United States across various social groups, describe comorbidities, and examine barriers to treatment. METHODS: Data from the 2021 National Survey of Sexual Wellbeing were analyzed by utilizing the Ipsos KnowledgePanel®, a probability-based online panel, for the purpose of obtaining US nationally representative data of adults aged 18 years and older. The analytic sample consisted of 1822 cisgender men ranging in age from 18 to 87 years, with a mean age of 47.5 years. OUTCOMES: Study outcomes were ED as measured by the 5-item version of the International Index of Erectile Function (IIEF-5), as well as self-reported diagnosis by a medical professional, comorbidities with other health issues, medications taken for ED, and barriers to treatment. RESULTS: The ED prevalence rate based on IIEF-5 scores was 24.2%. Prevalence increased with age: 52.2% of the 75+ age group, and 48.0% of the 65-74 age group meeting diagnostic criteria for ED. Diagnostic criteria were met for more participants in the 18-24 age group (17.9%) than the 25-34 (13.3%) or 35-44 (12.7%) age groups, but less than the 45-54 (25.3%) or 55-64 (33.9%) age groups. Only 7.7% (n = 141) of the sample reported having been diagnosed by a provider (n = 4 in 25-34, n = 6 in 35-44, n = 13 in 45-54, n = 39 in 55-64, n = 44 in 65-74, and n = 34 in ≥75-year olds), indicating a gap in access to treatment. The most common reason selected for not accessing care for ED concerns was a lack of need to see a provider in the past year. CLINICAL IMPLICATIONS: The discrepancy between ED self-report and medical diagnosis is critical, given that ED can be an indication of underlying health risks. STRENGTHS AND LIMITATIONS: This study is the first nationally representative update to information regarding the prevalence of ED in almost 2 decades. Standard administration of the IIEF-5 is limited to participants who have had sex in the last 6 months, so these rates do not include those men with ED who have been avoiding penetrative sex for a significant time. CONCLUSION: The results indicate that ED prevalence and severity remain highest in older age groups and that most individuals who meet criteria for ED have not sought medical care related to this concern.

Oxygen quenching of structurally characterized [5,10,15,20-tetrakis(4-fluoro-2,6-dimethylphenyl)porphyrinato]platinum(II).

The compound [5,10,15,20-tetrakis(4-fluoro-2,6-dimethylphenyl)porphyrinato]platinum(II), [Pt(C52H40F4N4)] or Pt(II)TFP, has been synthesized and structurally characterized by single-crystal X-ray crystallography. The Pt porphyrin exhibits a long-lived phosphorescent excited state (τ0 = 66 µs), which has been characterized by transient absorption and emission spectroscopy. The phosphorescence is extremely sensitive to oxygen, as reflected by a quenching rate constant of 5.0 × 108 M-1 s-1, and as measured by Stern-Volmer quenching analysis.

Comparison of Imine- and Phosphinimine-Supported Indium Complexes: Tuning the Reactivity for the Sequential and Simultaneous Copolymerization of Lactide and ε-Caprolactone.

Imine- and phosphinimine-supported indium complexes were used as catalysts in the polymerization of racemic lactide and ε-caprolactone as well as their copolymerization by the sequential and simultaneous addition of monomers. Tuning the electronics and sterics of the indium centers by either (i) changing the nature of the nitrogen donors and (ii) coordinating a hemilabile side group had a significant effect on the reactivity of the complexes, their stability, and their control in the synthesis of block copolymers. Specifically, the imine-supported complex (5) showed the highest activity in the homo- and copolymerization of the cyclic esters, in contrast to the phosphinimine-supported complex (7), which was significantly slower and less stable. The presence of morpholine and thiomorpholine hemilabile side groups either reduced the activity or prevented the formation of alkoxide complexes.

Health Care Reform: A Caucus of Asian American Health Workers' Perspective.

PURPOSE OF THE PAPER: The purpose of this paper is to offer an American Public Health Association (APHA)/Caucus of Asian American Health Workers' (CAAHW) perspective on health care reform. Dr. William Chen, the CAAHW Chair had asked the author, a Caucus member to present the Caucus' perspective on health care reform as part of a special session that was held during the 1993 APHA annual meeting in San Francisco. This paper is based on the oral presentation made. SUMMARY OF METHODS UTILIZED: The author reviewed the September 7, 1993 draft of the President's Health Care Reform proposal, other related papers, and the literature on Asian and Pacific Islander American health care needs. This was followed by a discussion of major issues and concerns with the CAAHW Chair and key members. This paper has undergone review by the Caucus chair and his reviewers whom he selected and thus is endorsed as the CAAHW's perspective on health care reform. PRINCIPAL FINDINGS: The CAAHW applauds President Clinton for his leadership in introducing much­needed reform in the U.S. health care system. However, the CAAHW wants to point out that access to medical care is not equivalent to utilizing and benefiting from services. Three issues of special concern to Asian Pacific Islander Americans are: (1) cultural sensitivity and relevancy of health services; (2) adequacy of racial/ethnic specific health data; and (3) due representation and input to key health policy­making and administrative bodies. CONCLUSIONS: The CAHW supports universal health insurance for all Americans and is particularly concerned that cultural sensitivity and appropriateness be assured for all populations. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: This paper calls attention to Asian Pacific Islander Americans as the nation's fastest growing minority that is largely foreign­born and extremely heterogenous and the need for culturally sensitive services. KEY WORDS: Asian Pacific Islander Americans; health care reform; health policy; cultural sensitivity.

Asian and Pacific Islander Americans: An Overview of Demographic Characteristics and Health Care Issues.

PURPOSE: To review the demographic characteristics of Asian and Pacific Islander Americans (APIAs) and their health care needs. METHODS: The author reviewed the 1990 Census data, later Current Population Surveys, monographs, books, and the medical literature on APIAs based on MEDLINE and other sources. FINDINGS: APIAs are the fastest growing minority in the U.S. They are mostly foreign­born, highly diversified, heterogeneous, bipolar in socioeconomic status, and concentrated in the West and metropolitan areas. APIAs have many health care needs: lack of health data, ethnocultural barriers, and high frequency of hepatitis B and tuberculosis and certain genetic disorders such as thalassemia and lactase deficiency. It is also questionable whether some U.S. norms and standards based on non­APIA subjects are appropriate for APIAs. CONCLUSIONS: APIAs are a fast growing minority whose many unmet health care needs have been overshadowed by the myth of a model minority. The health care system should address these needs and assure equal access to health services for all minorities. KEY WORDS: Asian Americans, Culture, Ethnicity, Health Services Accessibility, Health Education, Health Policy, Hepatitis B, Minority Groups, Thalassemia, Tuberculosis

Special health concerns of ethnic minority women.

Ethnic minorities have become an increasingly greater part of the U.S. population. From 1970 to 1980, minorities (American Indian and Native Alaskan, Asian and Pacific Islanders, Black, and Hispanic) rose from 16.7 percent to 20.4 percent of the population. Their rate of increase was more than three times that of the population as a whole (36 percent versus 11.5 percent). In 1980, there were 23.8 million minority females who accounted for 20.1 percent of the U.S. female population.As a group, minority women suffer disproportionately from socioeconomic disadvantages and discrimination that impact on their health. Many must also overcome ethnocultural barriers in gaining access to the health care system. In addition to sharing these common obstacles, each minority has its special problems and needs. Today, minority women bear a disproportionate share of diseases, homicides, and unintentional injuries. Their special health care needs present an important challenge to persons in all facets and at all levels of the health care system. Becoming aware of and sensitive to the plight of minority women is a crucial first step for policymakers and service providers. There should be a concerted effort to educate both health service providers and consumers about ways to break down ethnocultural barriers. Also needed is the collection of better health statistics through accurate racial and ethnic identification in surveys and vital records and abandonment of labels such as "others" and "nonwhites." Lastly, there should also be a sincere effort to increase participation by minority women in all aspects of health care.