Eosinophilia-myalgia syndrome and L-tryptophan-containing products--New Mexico, Minnesota, Oregon, and New York, 1989.
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Case-Control Studies↗
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Clues to positive birth outcomes in New Mexico.
Childbearing women in New Mexico possess several characteristics known to be associated with poor pregnancy outcomes: late entry into prenatal care and few visits, a high rate of teen pregnancy, low family income, and ethnic and minority group membership. Despite these, rates of low birth weight and infant mortality in New Mexico remain at or below those for all American women. Data from the 1988 National Maternal and Infant Health Survey were used to compare characteristics of New Mexico women with women in the southwest and with all American women to identify factors that may contribute to favorable pregnancy outcomes in New Mexico. Observed differences that warrant further study were: a high proportion of births for Hispanic women, greater gestational weight gain, and a high rate of participation in the Special Supplemental Food Program for Women, Infants, and Children.
Adolescent↗
Health promotion mini-grants: grassroots implementation in New Mexico.
The populations of New Mexico are ethnically diverse, with large Hispanic and Native American components, and live in communities that are geographically dispersed and economically challenged. The University of New Mexico is located in Albuquerque, the state's only major urban area, and houses the state's only academic health sciences center. In 1986, the University received a grant from the W.K. Kellogg Foundation to establish health promotion/disease prevention curricula for health science students and create two Wellness Centers on campus. The Wellness Centers train students to be providers of health information and learn how to counsel and assist people with changing health-related behaviors. A campus-wide employee health promotion program was also implemented. Most of the instructional and service programs initiated by the grant have continued with stable institutional support. A later phase of the project was to encourage other agencies and organizations throughout New Mexico to adopt or expand their own health promotion initiatives. An operating premise of this phase was that local initiatives should respond to locally perceived priorities. To accomplish this, a program of mini-grants was designed to assist in creating health promotion programs within a variety of topic areas. Thirteen mini-grants were awarded to agencies representing diverse groups and cultures throughout New Mexico. Our experience with the mini-grants and the ability of organizations to sustain the activities past the period of grant support are described. The successful use of mini-grants has been reported elsewhere in the literature.
Health Planning Support↗
Medications obtained in Mexico by patients in southern New Mexico.
Many health care providers practicing near the border between the United States and Mexico have serious concerns about their patients' using medications obtained in Mexico. Despite these concerns, the extent of this problem is not known. A survey administered in a publicly funded rural clinic and an urban private practice in southern New Mexico assessed this problem. The survey revealed that 87% of the rural clinic patients and 6% of the urban private practice patients had purchased medications in Mexico within the past two months. Further, 91% of the clinic patients and 56% of the private practice patients stated that they had, at some time, used medications from Mexico. Although many of these medications are fairly innocuous, their easy accessibility and lack of regulation can lead to serious health hazards.
Adult↗
Trends in motor vehicle traffic fatalities among Hispanics, non-Hispanic whites and American Indians in New Mexico, 1958-1990.
OBJECTIVE: New Mexico has had the highest motor vehicle fatality rate in the nation for many years. Our objective was to examine ethnic differences and trends in motor vehicle fatality rates. DESIGN: Using death certificate data from the New Mexico Bureau of Vital Records and Health Statistics, we compiled age-adjusted motor vehicle-related mortality rates from 1958-1990 among the three major ethnic groups in New Mexico--Hispanics, white non-Hispanics and American Indians. RESULTS: Over the 33-year study period, American Indians of both sexes had two to three times higher mortality rates than white non-Hispanics. Hispanic males also had higher motor vehicle death rates than white non-Hispanic males. During the 1970s fatality rates peaked, with age-adjusted death rates of 233/100,000 for American Indian males, 74.7 for Hispanic males and 49.3 for white non-Hispanics for the period 1973-1977. Evaluation of successive 5-year birth cohorts showed highest mortality rates for ages 15-29 years for each ethnic group and both sexes, and a dramatic decline in most ethnic, sex and age-specific rates during the last eight years of the study period. CONCLUSION: Although the recent trends indicate favorable changes in motor vehicle fatality rates, our data highlight the need for ethnic and age-specific interventions to further reduce rates of motor vehicle-related mortality in this state.
Accidents, Traffic↗
Polygenis martinezbaezi (Siphonaptera: Rhopalopsyllidae) reared from a rodent nest found in the Peloncillo Mountains of southwestern New Mexico.
A 3rd species of the flea genus Polygenis Jordan was added to the U.S. fauna by extension of known range from Mexico into New Mexico. Eleven males and 24 females of P. martinezbaezi Vargas were reared from a rodent nest, probably that of a yellow-nosed cotton rat, Sigmodon ochrognathus Bailey.
Animals↗
Survey for coccidia and haemosporidia in the lesser prairie-chicken (Tympanuchus pallidicinctus) from New Mexico with description of a new Eimeria species.
Blood films and fecal samples of the lesser prairie-chicken (Tympanuchus pallidicinctus) were examined for parasites when we surveyed specimens captured during a radio-tracking study conducted in Chaves County, New Mexico (USA). All birds were captured on the Caprock Wildlife Habitat Management Area, administered by the Bureau of Land Management. Samples were collected in late March, April, and early May 1998-2000. Oocysts were detected in five of 64 (8%) birds sampled and, upon sporulation, were determined to be an Eimeria species. This is the first eimerian reported from the lesser prairie-chicken and is described here as a new species. Sporulated oocysts are ellipsoidal, 27.1 x 22.7 (22-32 x 18-26) microns, with micropyle absent, but oocyst residuum and polar granule present. Sporocysts are ovoidal, 11.9 x 7.8 (10-14 x 6-10); a Stieda body, and sporocyst residuum are present, as is a small, indistinct substieda body. Inspection of blood smears revealed four cases of Plasmodium infection of 32 (13%) individuals sampled. The characteristics of this plasmodiid are consistent with the description of Plasmodium (Giovannolaia) pedioecetii, previously found in T. pallidicinctus (Stabler, 1978).
Animals↗
Unintentional prescription drug overdose deaths in New Mexico, 1994-2003.
BACKGROUND: New Mexico has the highest rate of drug-induced mortality in the United States. The contribution of prescription drugs to the total overdose death rate has not been adequately described. METHODS: A total of 1,906 unintentional drug overdose deaths occurring in 1994 to 2003 in New Mexico were analyzed. Unintentional drug overdose death was defined as death caused by prescription, illicit, or a combination of drugs, as determined by a pathologist. Deaths were investigated annually by the medical examiner and data were analyzed in 2004-2005. Rates and trends of total and prescription drug overdose death were calculated, decedent characteristics were analyzed, and common drug combinations causing death were described. RESULTS: The rate of unintentional prescription drug overdose death increased by 179% (1.9 to 5.3/100,000) from 1994 to 2003. A high percentage of prescription drug overdose decedents were white non-Hispanic (63.2%) and female (43.9%). These decedents were older and less frequently had alcohol listed as an additional cause of death than decedents of other drug overdose categories. Of all deaths caused by prescription drug(s) (n =765), 590 (77.1%) were caused by opioid painkillers, 263 (34.4%) by tranquilizers, and 196 (25.6%) by antidepressants. CONCLUSIONS: The rate of prescription drug overdose death in New Mexico increased significantly over the 10-year study period. Comprehensive surveillance of drug overdose deaths is recommended to describe their occurrence in the context of both medical and diverted use of prescription drugs. Understanding decedent profiles and the potential risk factors for prescription drug overdose death is crucial for effective drug overdose prevention education among healthcare providers.
Adult↗
Illegal sales of cigarettes to minors--Ciudad Juárez, Mexico; El Paso, Texas; and Las Cruces, New Mexico, 1999.
In 1996, the United States-Mexico Binational Commission (US-MBC) Health Working Group identified prevention of tobacco use, particularly among adolescents, as a priority and subsequently recommended joint efforts toward reducing illegal sales of cigarettes to minors. A 1997 survey of 561 commercial cigarette outlets in Mexico City found that 79% of retailers sold cigarettes to minors. To assess the illegal sale of cigarettes to minors in other regions of Mexico and on both sides of the U.S.-Mexico border, during January-February 1999 the General Directorate of Epidemiology in Mexico, the Chihuahua State Department of Health Services (CDH), the Ciudad Juarez Department of Health (CJDH), the Texas Department of Health (TDH), and the New Mexico Department of Health (NMDH) surveyed cigarette outlets in Ciudad Juarez, Mexico; El Paso, Texas; and Las Cruces, New Mexico. This report summarizes the results of these surveys, which indicate that almost all retailers in the surveyed outlets in Ciudad Juarez sold cigarettes to minors and that sales rates to minors were substantially lower in El Paso and Las Cruces.
Adolescent↗
A new species of Vexillata (Nemata: Ornithostrongylidae) from the coarse-haired pocket mouse Chaetodipus hispidus in New Mexico.
Individuals of a new species of trichostrongyloid nematode of the genus Vexillata were collected from the intestines of the coarse-haired pocket mouse Chaetodipus hispidus from eastern New Mexico. This new species possesses general features of the genus Vexillata but may be recognized as distinct from all other species by unique features of the dorsal ray of the caudal bursa and the synlophe.
Animals↗
Decreasing rates of cervical cancer among American Indians and Hispanics in New Mexico (United States).
Minority women in New Mexico (United States)--including American Indian and Hispanic women--have shown disproportionately high incidence rates of invasive cervical cancer during the 1960s and 1970s. Several public health programs in New Mexico were directed toward early detection of cervical cellular abnormalities, particularly targeting the state's minority women. To evaluate the effectiveness of these programs, we examined the New Mexico Surveillance, Epidemiology, and End Results (SEER) data collected from 1969-92, and calculated average annual, age-specific, and age-adjusted incidence rates by ethnic group (American Indian, Hispanic, and non-Hispanic White) for five-year time intervals. We also calculated age-adjusted mortality rates for cervical cancer in the same ethnic groups using state vital records. Age-adjusted incidence rates for invasive cervical cancer show substantial temporal decreases, especially for minority women in the state. The age-adjusted incidence rate decreased by 66 percent, from 30.3 to 10.3 per 100,000 for American Indian women, and by 61 percent, from 26.1 to 10.2 per 100,000 for Hispanic women. A stage shift to earlier stages of cervical neoplasia occurred over the study period, with a substantially higher proportion of in situ compared with invasive cancers diagnosed in the most recent cf the most remote time period. The ratio of incidence rates of in situ to invasive cancers changed dramatically for both American Indian and Hispanic women. Cervical cancer mortality rates decreased steadily among Hispanic women from 1958 to 1992; the decrease among American Indian women was less stable and fluctuated due to small numbers. Ongoing targeted screening programs should help to reduce cervical cancer incidence and mortality further in New Mexico.
Adult↗
Child and adolescent suicide deaths in New Mexico, 1990-1994.
The suicide death rate in New Mexico is consistently higher than the national rate. Among adolescents, suicide is the third leading cause of death nationally, but in New Mexico it is the second leading cause of death. This study describes the pattern of adolescent suicide deaths in New Mexico. We conducted a retrospective review of all medical examiner autopsies for adolescent suicides (ages 20 years and younger) in New Mexico from 1990-1994. Records were reviewed for demographics and possible contributing factors such as depression, previous attempts, and alcohol and drug use. We identified 184 suicide deaths among children and adolescents ages 9-20 years for an overall rate of 12.9 per 100,000. Our rates for ages 5-9 years (0.2), 10-14 years (3.8), and 15-19 years (22.3) are over twice the U. S. rates. Suicide deaths resulted primarily from firearms (67%), hanging (16%), poisoning (6%), inhalation (4%), and other methods (7%). Method varied by ethnicity (p = .01) and gender (p = .03); males and non-Hispanic Whites were overrepresented among firearm deaths. Firearm ownership was known in 60 (48%) of the firearm deaths. Of these, 53% of the firearms belonged to a family member, 25% to the decedent, and 22% to a friend. Over one-third of decedents (41%) experienced mental disorders, primarily depressed mood and clinical depression. Previous suicide attempts were noted for 15% of the decedents. Some 50% of the decedents had alcohol or drugs present at the time of death; among American Indians/Alaska Natives, 74% had drugs or alcohol present (p = .003). Targeted interventions are needed to reduce adolescent suicide in New Mexico. We suggest raising awareness about acute and chronic contributing factors to suicide; training physicians to look for behavioral manifestations of depression; and involving physicians, teachers, and youth activity leaders in efforts to limit firearm accessibility, such as advising parents to remove firearms from their households.
Adolescent↗
A study of the conversion from paid to altruistic blood donors in New Mexico.
We investigated the recent conversion of the New Mexico blood supply from a donor recruitment base which depended almost entirely upon paid, responsibility fee, and insured donors to 100 per cent reliance upon altruistic donors. Blood Services of New Mexico (BSNM) effected this change. The local Red Cross played a key role in interpreting the change to the community and in providing entree for BSNM recruiters to the right places in the community, resulting in the enlistment of an almost entirely new group of donors who had never been asked to give blood before. The sequence of decision making is identified in relation to the detailed results during the transition. Altruistically donated blood did not significantly alter the incidence of HBsAg in the New Mexico blood supply. The supply of blood was not interrupted or diminished, the range and quality of blood services improved and the cost of blood service to the patient was reduced. The New Mexico community responded magnificently, although focal responsibility for the success of this project rests with a small number of key individuals. New Mexico now has an altruistically donated blood supply.
Blood Donors↗
The impact on rural New Mexico of a family medicine residency.
PURPOSE: To determine the impact on rural New Mexico of the large, decentralized University of New Mexico (UNM) family medicine residency. METHOD: A cross-sectional study was conducted of all 317 residency's graduates from 1974 to 2004. Location of current practice was correlated with the residents' gender, ethnicity, medical school of origin, and whether most training took place in the urban program or one of three rural programs. The residency's impact on rural communities was assessed. RESULTS: There was no significant gender difference between graduates who went into urban or rural practice. Compared with non-minority graduates, a significantly greater percentage of ethnic minority graduates were in rural and urban New Mexico practices and fewer in out-of-state practices. A greater percentage of graduates who had been medical students in New Mexico practiced in both rural and urban New Mexico areas compared with graduates of out of state medical schools. Finally, a greater percentage of graduates from the three rural family medicine residencies remained in the state and practiced in rural areas compared with graduates from the urban program. The graduates' contributions to the school of medicine and to rural New Mexico are described. CONCLUSIONS: Graduates of UNM's family medicine residency have contributed significantly to the state's rural health workforce. Ethnic minority status, graduation from New Mexico's medical school, and training in one of the three rurally based residencies favored in-state and rural retention, while gender had no significant effect. The rural orientation of the residencies offered rural communities economic benefits.
Career Choice↗
L-tryptophan and eosinophilia-myalgia syndrome in New Mexico.
On Oct 30, 1989, the New Mexico Health and Environment Department learned of 3 patients with eosinophilia and severe myalgia who had been taking L-tryptophan. Further review of these and similar cases led to the initial recognition of the eosinophilia-myalgia syndrome (EMS) epidemic. To elucidate the apparent association between L-tryptophan-containing products (LTCPs) and EMS a case-control study was done. The case definition was unexplained peripheral eosinophilia (2000/microliters or more) and incapacitating myalgia. Cases were found through review of white blood cell counts from May 1 to Oct 31, 1989, in nine medical laboratories in New Mexico. 11 cases and 22 matched controls were interviewed for information on symptoms and other clinical findings, on the use of LTCPs, and on potential confounding factors. All 11 cases (100%) used LTCPs compared with only 2 controls. These findings led to a ban on the sale of LTCPs in New Mexico, followed by a nationwide recall of such preparations in the United States.
Adult↗
Violent death in the West: suicide and homicide in New Mexico, 1958-1987.
We examined New Mexico vital statistics data for suicides and homicides among the state's Hispanics, Native Americans, and non-Hispanic whites collected from 1958 to 1987. We found high age-adjusted rates for both suicides and homicides among Hispanic and Native American males, in comparison with rates for non-Hispanic white males. Suicide rates among Native American women were comparatively low, contrasting with their high homicide rates. Homicide rates for males in all three ethnic groups increased substantially over the 30-year study period. We conclude that death from violent causes, both suicide and homicide, is a major public health problem in New Mexico, and disproportionately affects minority males.
Adolescent↗
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.
Accidents, Traffic↗
Providers and staff respond to Medicaid managed care: the unintended consequences of reform in New Mexico.
In 1997 a new Medicaid managed care (MMC) program called Salud! was implemented by the State of New Mexico. This article serves as an introduction to a special issue of Medical Anthropology Quarterly that assesses the unintended consequences of this reform and its impact on providers and staff who work in clinics, physician offices, and emergency rooms where Medicaid patients are served. MMC fused state and corporate bureaucracies, creating a complex system where enrollment and access was difficult. The special issue focuses on providers' responses to these new structures, including ways in which staff buffer the impact of reform and the role of the discourses of medical necessity and accountability in shaping the way in which MMC functions.
Attitude of Health Personnel↗