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Tickborne relapsing fever outbreak after a family gathering--New Mexico, August 2002.

On August 2, 2002, the New Mexico Department of Health (NMDOH) and the Indian Health Service (IHS) were notified of a tickborne relapsing fever (TBRF) outbreak after a 1-day family gathering held in late July at a remote, previously uninhabited cabin located in a mountainous region of northern New Mexico (elevation: approximately 8,000 feet). Approximately 40 persons attended the event; at least half slept overnight in the cabin. This report summarizes the investigation of this outbreak, which indicates that prompt diagnosis and collaboration among clinicians and public health authorities can reduce morbidity associated with TBRF. Persons living in areas where TBRF is endemic should avoid sleeping in rodent-infested buildings, rodent-proof susceptible buildings, and consider fumigation of buildings that harbor rodents.

Adolescent↗

Non-ceremonial tobacco use among southwestern rural American Indians: the New Mexico American Indian Behavioural Risk Factor Survey.

OBJECTIVES: To ascertain non-ceremonial tobacco use among rural American Indians in New Mexico (United States). DESIGN: A geographically targeted telephone survey. SETTING: Rural New Mexico. PARTICIPANTS: American Indian residents aged 18 years and older. MAIN OUTCOME MEASURES: Prevalence of ever-smokers and current smokers of cigarettes and ever-users and current users of smokeless tobacco, number of cigarettes smoked, and prevalence of cigarette smoking quitting behaviour. RESULTS: Of the 1266 respondents, 38.5% (95% confidence interval (CI) = 34.5% to 42.1%) reported ever smoking, and 16.3% (95% CI = 13.5% to 19.0%) reported being current smokers. Current smokers averaged 7.6 (95% CI = 6.0 to 9.3) cigarettes per day. Current smoking prevalence was highest among men and lowest among college graduates. Prevalence of smokeless tobacco use was 24.1% for ever-use and 7.2% for current use and showed a strong male predominance of use. CONCLUSIONS: The prevalence of current smokers among rural American Indians in New Mexico was lower than among American Indians of other regions in the United States, all New Mexicans, and the national population as a whole. Although smoking prevalence was lower among American Indians in New Mexico, variation by sex and education followed the same patterns as reported among American Indians of other regions.

Adolescent↗

Respiratory diseases and cigarette smoking in a Hispanic population in New Mexico.

We have conducted a cross-sectional study of Hispanic residents of a community in New Mexico. A total of 2,111 subjects were recruited from 733 households; the overall participation rates were 68.1% for males and 78.9% for females. For all subjects, a standardized respiratory symptoms questionnaire was completed, spirometric testing was performed, and saliva and end-tidal breath samples were obtained. As in other populations, chronic respiratory symptoms were uncommon in children, and asthma was more prevalent in boys than in girls. In adults, physician-diagnosed chronic bronchitis and emphysema were less prevalent in this population than in a previously studied sample of non-Hispanic whites in New Mexico. Spirometric testing was confirmatory; less than 1% of the Hispanic males and females had chronic air-flow obstruction. The prevalence of cigarette usage in the Hispanics was comparable to data from non-Hispanic whites in New Mexico and from nationwide surveys. However, daily cigarette consumption by the Hispanics in this sample tended to be low, as found in previous studies in New Mexico and elsewhere.

Adolescent↗

Cervical cancer incidence and mortality in New Mexico's Hispanics, American Indians, and non-Hispanic whites.

High rates of cervical cancer were reported in New Mexico in the early 1970s, with especially high rates for minority women. We examined data collected from 1970 to 1987 for invasive cervical cancer and cervical carcinoma in situ for New Mexico's Hispanic, American Indian, and non-Hispanic white women to determine whether changes had occurred in cervical cancer rates since earlier reports. To further characterize the epidemiology of cervical cancer in New Mexico, we reviewed state vital statistics for cervical cancer deaths occurring between 1958 and 1987. From 1970 to 1987, the incidence for invasive cervical cancer among Hispanic (18.9 per 100,000 person-years) and American Indian women (22.0 per 100,000 person-years) was about double that for non-Hispanic white women (10.3 per 100,000). The incidence in each ethnic group decreased over time for both invasive cancer and carcinoma in situ when the data were examined by 2 time periods (1970 to 1978 and 1979 to 1987). These decreases were most dramatic for invasive cervical cancer. Cervical cancer-related death rates for Hispanics and non-Hispanic whites also decreased from 1958 to 1987. Although our data reflect declines in cervical cancer rates during the study period, further rate decreases, especially for minority women, remain an important public health goal in New Mexico.

Adult↗

Occupational injury mortality in New Mexico.

STUDY OBJECTIVE: To examine specific risks for occupational injury deaths in New Mexico. DESIGN: Retrospective review of state medical investigator reports from 1980 through 1991 with regard to industry, agent of death, gender, ethnicity, location, and alcohol and other drug involvement. PARTICIPANTS: New Mexico residents who were fatally injured while on the job. RESULTS: We identified 613 deaths: 87.1% unintentional, 10.6% homicides, and 2.3% suicides. Industries with the most fatalities were construction (11.8%), oil/gas (10.6%), and farming (8.6%). The primary agents of death were motor vehicles (41.7%), firearms (10.1%), and falling objects (10.0%). Almost all (95.6%) of the decedents were male. However, females were overrepresented among homicide deaths (P < .0001). Most unintentional injuries occurred in rural areas (69.1%), whereas most homicides (73.4%) and suicides (71.4%) occurred in urban areas. Drug or alcohol use was evident in 19.4% of cases. CONCLUSION: New Mexico has a high rate of occupational injury death, which appears to be associated with rural location and use of motor vehicles and alcohol.

Accidents, Occupational↗

Cultural self-efficacy of licensed registered nurses in New Mexico.

This study determined the level of cultural self-efficacy of licensed Registered Nurses caring for multiethnic patients (White non-Hispanic, Hispanic, African American Native American and Asian American) in New Mexico, and the level of influence of various background and demographic variables. The sample consisted of 1000 randomly selected New Mexico licensed RNs. The Cultural Self-Efficacy Scale, developed by Bernal and Froman (1987), was modified and used to measure the confidence level of the licensed Registered Nurses. It is a 25-item Likert-type scale that groups cultural self-efficacy ratings into three categories: (a) knowledge of cultural concepts; (b) self-efficacy in performing cultural nursing skills; and (c) knowledge of cultural life patterns for specific ethnic groups. The data show that RNs in New Mexico are moderately efficacious in caring for patients/clients of cultures other than their own. Few demographic variables (age, number ofyears an RN) correlated with higher cultural self-efficacy levels. This study provided information on practicing nurses in New Mexico which, to date, was non-existent. Licensed Registered Nurses in New Mexico are moderately efficacious in caring for patients of five cultural/ethnic groups.

Adult↗

Ischemic heart disease mortality in Hispanics, American Indians, and non-Hispanic whites in New Mexico, 1958-1982.

To describe trends in mortality from ischemic heart disease in New Mexico's Hispanic, American Indian, and non-Hispanic white populations, we used vital records data collected from 1958 through 1982. We calculated age-adjusted and age-specific mortality rates for ischemic heart disease for each of the state's principal ethnic groups. Death certificate data were used in combination with population estimates based on the censuses of 1960, 1970, and 1980. Age-adjusted mortality rates for ischemic heart disease among Hispanics, American Indians, and non-Hispanic white men were consistent with nationwide patterns of rising mortality rates during the 1960s followed by declining rates. Mortality rates from ischemic heart disease in all three ethnic groups in New Mexico were lower than national rates for whites. Rates for Hispanics in New Mexico were lower than for non-Hispanic whites; rates for American Indians were the lowest among the three groups. These data support previous observations that Hispanics and American Indians in the Southwest are at decreased risk for mortality from ischemic heart disease in comparison with U.S. whites.

Age Factors↗

Stomach cancer among New Mexico's American Indians, Hispanic whites, and non-Hispanic whites.

Stomach cancer incidence rates vary by ethnic group in New Mexico, with American Indians and Hispanic Whites at higher risk than the state's non-Hispanic White population. To further characterize the descriptive epidemiology of this disease in New Mexico, we investigated temporal trends in stomach cancer mortality and incidence rates. Stomach cancer mortality rates declined over a 25-year period (1958-1982) among New Mexico's Hispanic and non-Hispanic Whites. Birth cohort analysis suggests that much of the decline was achieved prior to 1968. Stomach cancer mortality rates did not drop among American Indians during the same period. Stomach cancer incidence rates remained constant for Hispanic Whites, non-Hispanic Whites, and American Indian males over a 13-year period (1969-1982), but more than doubled among American Indian females. Although environmental factors have been implicated in the etiology of stomach cancer, little is currently known about the distribution of such risk factors among the ethnic groups described in this report. The environmental and biological correlates of sex, ethnicity, and socioeconomic status that determine stomach cancer risk merit further investigation in New Mexico.

Adult↗

Mercury poisoning associated with beauty cream--Texas, New Mexico, and California, 1995-1996.

The Texas Department of Health (TDH), New Mexico Department of Health (NMDH), and San Diego County Health Department (SDCHD) recently investigated three cases of mercury poisoning among persons who had used a beauty cream produced in Mexico. The investigations implicated the beauty cream as the source of the mercury. The cream, marketed as "Crema de Belleza--Manning," lists "calomel" (mercurous chloride) as an ingredient and was found to contain 6%-8% mercury by weight. This report summarizes the ongoing investigation of these and other possible cases.

Adolescent↗

Hear early: New Mexico's universal newborn hearing screening program.

Hear Early, New Mexico's newborn screening program, was established in 1996. Thirty-one of the state's 32 birthing hospitals participate in the Hear Early program that now screens 95% of New Mexico's 27, 500 births. The authors' experience in developing this statewide system is described and the critical components and the rationale behind this program are addressed. The development of Hear Early required input from a wide variety of professionals and consumers. Screening is only the first step in a comprehensive state program, which must also include assessment and intervention. Systems development, equipment issues, follow-up procedures, data management, and a tracking system are all pertinent factors. The various accomplishments and challenges that Hear Early has encountered are discussed.

Child Health Services↗

Health-related quality of life for rural American Indians in New Mexico.

OBJECTIVES: To determine health-related quality of life for rural American Indians using an economical telephone surveillance system. DESIGN: We interviewed 618 American Indians by telephone about health-related quality of life using an adaptation of the Behavioral Risk Factor Surveillance System questionnaire. RESULTS: A smaller proportion of rural New Mexico American Indians (50.7%) reported their general health as 'excellent' or 'very good' compared to the overall New Mexico (58.2%) and US populations (57.9%). American Indians reported a mental health limitation more frequently than the New Mexico and the US populations. However, 13% fewer rural New Mexico American Indians reported a limitation in usual activities. Most limitations were due to musculoskeletal conditions or diabetes mellitus. Survey respondents were found to be representative of the rural American Indian population as reported by the 1990 US Census Bureau by tribal group affiliation and age, but were not representative by income, education, and gender. CONCLUSIONS: Health-related quality of life for rural American Indians differs little from that of other New Mexicans and the general US population; however, when physical and mental health was rated as poor, fewer American Indians reported a limitation in usual activities. A telephone survey focusing on New Mexico American Indians is an efficient method by which to conduct surveillance of health-related quality of life.

Adolescent↗

Echinococcosis in Arizona and New Mexico. Survey of hospital records, 1969-1974.

In 1974, seven cases of human echinococcosis were diagnosed in Arizona and New Mexico. A retrospective survey of Arizona and New Mexico hospitals obtained data on ten additional cases reported for the 5-year period 1969 through 1973. Sixteen cases were diagnosed as Echinococcus granulosus infections and one as E. multilocularis infection. The latter infection was in an Eskimo from Alaska, where E. multilocularis is endemic. All of the 16 E. granulosus cases were probably acquired autochthonously; 14 were diagnosed in American Indians of the Navajo (8 cases), Zuni (4 cases), and Santo Domingo (2 cases) tribes; the remaining 2 cases were diagnosed in non-Indian women. This is the first published account of echinococcosis autochthonous to Arizona and New Mexico. Evidence suggests that the infection may have been introduced only relatively recently to the areas populated by the American Indians and that parasite transmission to humans is increasing.

Adolescent↗

Effectiveness of bans and laws in reducing traffic deaths: legalized Sunday packaged alcohol sales and alcohol-related traffic crashes and crash fatalities in New Mexico.

We determined the relative risk of alcohol-related motor vehicle accidents and fatalities after New Mexico lifted its ban on Sunday packaged alcohol sales. We extracted all alcohol-related crashes from New Mexico police reports for 3652 days between July 1, 1990, and June 30, 2000, and found a 29% increase in alcohol-related crashes and a 42% increase in alcohol-related crash fatalities on Sundays after the ban on Sunday packaged alcohol sales was lifted. There was an estimated excess of 543.1 alcohol-related crashes and 41.6 alcohol-related crash fatalities on Sundays after the ban was lifted. Repealing the ban on Sunday packaged alcohol sales introduced a public health and safety hazard in New Mexico.

Accidents, Traffic↗

Lower extremity amputation episodes among persons with diabetes--New Mexico, 2000.

Lower extremity amputation (LEA) is one of the most disabling complications of diabetes. Lower extremity problems tend to recur among persons because of underlying complications, including the loss of "protective" sensation. To define the burden of LEA among persons with diabetes in New Mexico, the New Mexico Diabetes Prevention and Control Program (DPCP) analyzed data from the Hospital Inpatient Discharge Database (HIDD) and the Santa Fe Indian Hospital (SFIH) from 2000 by linking hospital discharges to persons to create "episodes" of LEA. This report summarizes the findings of that analysis, which indicated that the age-adjusted rate of LEA by episode was approximately 3.5 times higher for American Indians (AIs) (11.4 per 1,000 persons with diabetes) than for non-Hispanic whites (3.3). To address this disparity, DPCP is collaborating with the Indian Health Service (IHS) to determine the needs for foot-care resources and education in AI communities.

Adult↗

Diabetes mortality among New Mexico's American Indian, Hispanic, and non-Hispanic white populations, 1958-1987.

OBJECTIVE: To determine the diabetes-related mortality rates among New Mexico's American Indians, Hispanics, and non-Hispanic whites over a 30-yr period. RESEARCH DESIGN AND METHODS: Death certificates were used to identify diabetes as an underlying cause of death by ethnic group in New Mexico during each 5-yr period from 1958 through 1987. The age-adjusted rates were calculated by ethnic group and sex, and temporal trends were examined. Comparison was made to U.S. white age-adjusted rates during the same time period. RESULTS: Age-adjusted diabetes mortality rates for American Indians and Hispanics increased throughout the 30-yr period, and far exceeded rates for New Mexico non-Hispanic whites and U.S. whites by the 1983-1987 time period. The rates increased most dramatically among the state's American Indians, increasing 550% among women and 249% among men. Hispanic women and men experienced increases of 112 and 140%, respectively. CONCLUSIONS: New Mexico's American Indian and Hispanic populations have higher diabetes mortality rates than non-Hispanic whites, and American Indian mortality rates have risen dramatically over the 30-yr period included in our study. Although the high prevalence of diabetes in American Indians and Hispanics is a major contributor to these rates, other factors may also influence the reported mortality rates.

Age Factors↗

Motorcycle fatalities in New Mexico: the association of helmet nonuse with alcohol intoxication.

STUDY OBJECTIVE: To determine the relationship among helmet use, alcohol use, and ethnicity in people killed on motorcycles. DESIGN: Retrospective review of all motorcycle fatalities in New Mexico from 1984 through 1988. SETTING: Office of the Medical Investigator, State of New Mexico. TYPE OF PARTICIPANTS: All decedents of motorcycle crashes in New Mexico from 1984 through 1988. INTERVENTIONS: Review of all autopsies, medical investigator reports, traffic fatality reports, and toxicological studies on fatally injured motorcyclists. RESULTS: Nine of the helmeted drivers (18%) were legally intoxicated compared with 67 of the nonhelmeted drivers (51%) (chi 2 = 15.7, P less than .0001); 42 of the white nonHispanic decedents (37%), ten of Hispanic decedents (12%), and none of the Native-American decedents were wearing helmets. The head and neck region was the most severely injured body region in 42 of the nonhelmeted cases (84%) and in eight of the helmeted cases (50%) (Fisher's exact test, P less than .02). CONCLUSION: There is an association between nonuse of helmets and alcohol intoxication in fatally injured motorcyclists in New Mexico. Strategies for preventing motorcycle fatalities should address alcohol abuse and ethnicity in conjunction with helmet use.

Abbreviated Injury Scale↗

Mental health in the United States: health risk behaviors and conditions among persons with depression--new Mexico, 2003.

Studies have demonstrated relationships between physical health and mental health. Chronic disease has been associated with depression, which, in the absence of intervention, also can assume a chronic course. To determine the prevalence of depression among adults in New Mexico and examine the association between depression and selected health risk behaviors and health conditions, the New Mexico Department of Health and CDC analyzed data from the 2003 New Mexico Behavioral Risk Factor Surveillance System (BRFSS) survey. This report describes the results of that analysis, which determined that 3.8% of adults in New Mexico had current symptoms of depression and that these adults were significantly more likely to have engaged in certain health risk behaviors (e.g., smoking and binge drinking) and to have certain health conditions (e.g., high blood pressure, high blood cholesterol, arthritis, and asthma) than persons without depression. Public health programs that promote mental health and timely diagnosis and treatment of depression might also help reduce morbidity and risk behaviors related to chronic diseases.

Adult↗

Breast cancer survival among New Mexico Hispanic, American Indian, and non-Hispanic white women (1973-1992).

A study of breast cancer survival was conducted among New Mexico Hispanic and non-Hispanic white women and New Mexico and Arizona American Indian women diagnosed between 1973 and 1992. The goals were to determine whether, after adjusting for first treatment and the extent of disease at diagnosis, American Indian and Hispanic women had poorer survival than non-Hispanic whites and, if survival had improved over time, whether comparable improvements had been made for the three racial/ethnic groups. Five-year relative survival rates were calculated, and a Cox proportional hazards model was constructed to compare survival between races/ethnicities, adjusting for first treatment and the extent of disease at diagnosis. Findings indicate that during 1983-1992, breast cancer was more commonly detected at a local stage for all three groups compared to 1973-1982. Five-year relative survival improved for non-Hispanic white and American Indian women with local or regional disease, but the improvement was statistically significant only for non-Hispanic white women and for American Indian women with local disease. Despite earlier stages at diagnosis, Hispanic females showed less improvement in overall or stage-specific survival than non-Hispanic whites. The Cox model indicated that American Indian women experienced poorer survival than non-Hispanic whites during both time periods. Survival of Hispanic women with breast cancer was comparable to non-Hispanic whites during 1973-1982 but was significantly worse during 1983-1992. The significance of this lower survival is amplified by increasing breast cancer incidence among New Mexico Hispanics and American Indians.

Breast Neoplasms↗