Mississippi CHAMPS: Decreasing Racial Inequities in Breastfeeding.

Mississippi CHAMPS addressed racial inequities in breastfeeding by implementing community and hospital-based practice changes in accordance with the BFHI and by parallel community work.

Perceived Susceptibility to Cervical Cancer among African American Women in the Mississippi Delta: Does Adherence to Screening Matter?

BACKGROUND: Although preventive measures have greatly decreased the national burden of cervical cancer, racial/ethnic and geographic disparities remain, including the disproportionate incidence and mortality among African American women in the Mississippi Delta. Along with structural barriers, health perceptions and cultural beliefs influence participation in cervical screening. This study examined perceived susceptibility to cervical cancer among African American women in the Delta across three groups: 1) women attending screening appointments (screened), 2) women attending colposcopy clinic following an abnormal Papanicolaou test (colposcopy), and 3) women with no screening in 3 years or longer (unscreened/underscreened). METHODS: Data were collected during a study assessing the feasibility/acceptability of self-collected sampling for human papillomavirus (HPV) testing as a cervical screening modality. A questionnaire assessed demographics, health care access, and cervical cancer knowledge and beliefs (including perceived susceptibility). Participants were asked, "Do you think you are at risk for cervical cancer?", and responses included yes, no, and I don't know. Multinomial logistic regression models compared variables associated with answers among each group. RESULTS: Of 524 participants, one-half did not know if they were at risk of cervical cancer (50%) or HPV exposure (53%). Between the unscreened/underscreened (n = 160), screened (n = 198), and colposcopy (n = 166) groups, age (p < .001), education (p = .02), and perceived risk of HPV exposure (p < .01) differed. Older age and younger age at first intercourse (unscreened/underscreened), family history and screening recommendations (screened), and family history and perceived risk of HPV exposure (colposcopy) were associated with perceived susceptibility to cervical cancer. CONCLUSIONS: Differences in the perceived susceptibility to cervical cancer exist between African American women in the Delta. Understanding these variations can help in developing strategies to promote screening among this population with a high burden of disease.

The BP oil spill and the bounty of Plaquemines Parish.

The source of 25 to 30 percent of America's seafood, the Mississippi River Delta's cornucopian world is now uncertain. And yet, even if shrimp, oysters, and finfish are unaffected by the BP Oil Spill - a big if - one can already reflect on the passing of the culture once built upon gathering them. For almost three centuries, levees made life possible along the riverbanks and in the wetlands beyond. Those same levees also ensured the wetlands would eventually melt away into the Gulf. Cutting off the silt left behind during annual river inundations subjected the fragile land to erosion. Sulfur, natural gas, and oil production companies dug twenty thousand miles of canals to gain more direct routes to their fields and to pump out their mineral wealth. This caused salt-water intrusion that killed off plant life and caused more erosion. The world that sustained my Plaquemines ancestors was less subject to collapse following disasters not only because the ecosystem before the wetlands' ongoing loss was then more vibrant, complex, and robust; but also because their lives, especially their culinary lives, were more vibrant, complex, and robust. Life was hard, but when it came to putting food on the table, life followed the seasons.

Hurricane Katrina and mental health: a research note on Mississippi Gulf Coast residents.

Katrina was the most devastating and deadliest hurricane in recent U.S. history. The storm was particularly destructive for residents of the Mississippi Gulf Coast where sustained winds of 135 mph and a storm surge of 32 feet literally obliterated the built and modified environments. Limited research exists on the chronic (32 months) mental health impacts of survivors in this geographical area. Random-digit dialing telephone surveys were administered in Harrison and Hancock counties (Mississippi) in April and May 2008 and data were collected on a number of mental health outcomes. The results of the calculation of Oridinary Least Squares (OLS) regression models revealed that females, African Americans, and less-educated residents manifested the most severe mental health impacts. Most important, consistent findings for depression and Katrina-related psychological stress indicate that residents who were separated from family members, had maximum residential damage, and suffered severe financial problems remained significantly impacted 32 months after Katrina's landfall. A secondary stressor, in the form of having applications to the Mississippi State Grant Program denied or not processed also predicted personal depression. The implications of these findings are discussed.

Chronic disease and disasters medication demands of Hurricane Katrina evacuees.

BACKGROUND: Preparing for natural disasters has historically focused on treatment for acute injuries, environmental exposures, and infectious diseases. Many disaster survivors also have existing chronic illness, which may be worsened by post-disaster conditions. The relationship between actual medication demands and medical relief pharmaceutical supplies was assessed in a population of 18,000 evacuees relocated to San Antonio TX after Hurricane Katrina struck the Gulf Coast in August 2005. METHODS: Healthcare encounters from day 4 to day 31 after landfall were monitored using a syndromic surveillance system based on patient chief complaint. Medication-dispensing records were collected from federal disaster relief teams and local retail pharmacies serving evacuees. Medications dispensed to evacuees during this period were quantified into defined daily doses and classified as acute or chronic, based on their primary indications. RESULTS: Of 4,229 categorized healthcare encounters, 634 (15%) were for care of chronic medical conditions. Sixty-eight percent of all medications dispensed to evacuees were for treatment of chronic diseases. Cardiovascular medications (39%) were most commonly dispensed to evacuees. Thirty-eight percent of medication doses dispensed by federal relief teams were for chronic care, compared to 73% of doses dispensed by retail pharmacies. Federal disaster relief teams supplied 9% of all chronic care medicines dispensed. CONCLUSIONS: A substantial demand for drugs used to treat chronic medical conditions was identified among San Antonio evacuees, as was a reliance on retail pharmacy supplies to meet this demand. Medical relief pharmacy supplies did not consistently reflect the actual demands of evacuees.

Impact of body mass index on changes in common carotid artery wall thickness.

OBJECTIVE: To examine associations between changes in body mass index (BMI) and changes in carotid artery intima-media thickness (IMT) in a community-based sample. RESEARCH METHODS AND PROCEDURES: Carotid artery IMT and BMI were assessed at baseline (between 1987 and 1990) and in three subsequent examinations at 3-year intervals in participants in the Atherosclerosis Risk in Communities cohort. The 9,316 African-American and white men and women in the analysis were 45 to 64 years of age at baseline. Cross-sectional associations between BMI and IMT were assessed using general linear models. Longitudinal associations were examined using mixed models analysis. RESULTS: Cross-sectional associations between BMI and IMT were confirmed. At baseline, a 1-kg/m(2) increase in BMI was associated with an increase in IMT that ranged from 2.5 to 7.5 micro m among the ethnic-gender groups examined. Changes in BMI were not associated with changes in IMT in models that adjusted for aging and other covariates. Results were similar across ethnic-gender groups. DISCUSSION: Among free-living, 45- to 64-year-old adults, changes in common carotid artery IMT associated with changes in BMI are either very small or absent.