Knowledge and care of chronic illness in three ethnic minority groups.

BACKGROUND AND OBJECTIVES: Despite advances in medical approaches to the management of chronic illnesses, relatively little is known about how older members of ethnic minority groups view their chronic illnesses or how they manage them in daily life. METHODS: We recruited 35 African-Americans, 61 Latinos, and 55 Filipino-Americans, all over age 50. Criteria for entry into the study was the presence of one or more chronic illnesses. Findings are based on structured and semi-structured questions in one in-depth interview. Qualitative data on transcribed interviews with 151 respondents was analyzed. RESULTS: Comparison of the three groups revealed social and cultural differences and similarities that affected the management of chronic illness. The extent to which respondents demonstrated an understanding of their illnesses as chronic varied considerably, with discernible differences among groups about knowledge of illness and self-care practices. CONCLUSIONS: Our findings showed that although major chronic illnesses were, for the most part, the same for all three groups, each group differed in its response to and management of its illnesses. These findings have implications for the education of physicians in training.

High attack rates and case fatality during a measles outbreak in groups with religious exemption to vaccination.

Beginning in October, 1990, a large measles outbreak involving predominantly unvaccinated preschool age children occurred in Philadelphia. By June, 1991, 938 measles cases had been reported to the Philadelphia Health Department. In addition to these cases, 486 cases and 6 measles-associated deaths occurred between November 4, 1990, and March 24, 1991, among members of 2 Philadelphia church groups that do not accept vaccination. We identified measles cases and collected information on symptoms and potential risk factors for complications. Telephone interviews were conducted to collect demographic and clinical information on measles cases in church member households. We identified 486 measles cases among 892 mostly unvaccinated church members. Age-specific attack rates were highest among children 1 to 4 years of age (94%) and 5 to 14 years of age (91%). Five (83%) of the 6 deaths occurred in females, 3 of whom had underlying illnesses. The overall case-fatality rate was 1.2%. The case-fatality rate was 2% for females, 0.4% for males (P = 0.22), 1.7% for primary cases and 0.7% for secondary household cases (P = 0.67). Only one of the children who died had received medical care. Measles spread rapidly in this group, sparing few susceptible individuals. Lack of medical care and underlying disease appear to have contributed to the high case-fatality rate in the church communities.

Patients' attitudes toward screening for gestational diabetes mellitus in the Illawarra area, Australia.

OBJECTIVE: To examine the attitudes toward screening of a group of women who have had GDM compared with a group who were screened but did not have GDM. RESEARCH DESIGN AND METHODS: We surveyed 90 women with GDM and 100 control women with a postal questionnaire. They were asked to mark on a six-point Likert scale their responses to statements about certain aspects of screening for diabetes in pregnancy. RESULTS: No significant differences were found in mean responses between the two groups. The method of screening was found to be convenient (GDM group, 5.02; control group, 4.77). A strong belief that all women should be screened in pregnancy (GDM group, 5.76; control group, 5.66) and a personal desire for screening in any future pregnancy (GDM group, 5.73; control group, 5.62) were expressed. CONCLUSIONS: Both groups of women surveyed in this study were extremely positive about the convenience of the screening method used, the need for all women to be screened in pregnancy, and their desire for screening in future pregnancies.