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At least 145 records · Page 8Linked to original sources
PubMed2001

Urban renal disease: reflections of an urban nephrologist.

On completion of a Nephrology fellowship, I went back to the inner city community where I was raised to begin my practice. Filled with idealism, I believed that, by returning, I could slow the devastation that hypertension was imparting on the black community, and in doing so, prevent end-stage renal disease (ESRD). It was soon obvious that this view was naive. Although the government is willing to spend $60,000 per dialysis patient per year, there is no adequate system for, nor funding of, prevention. Social factors impact on prevention as well. Black physicians are often not readily accepted on staffs of hospitals in their own communities. The community itself often values medical care more highly from others not of their own race. Medical schools, located in inner city neighborhoods, rarely encourage their graduates to practice in the local communities. Economic issues result in varying access to care, with the poorest, who often have the highest needs, receiving the least. Effective change will occur only when there is a concerted multidisciplinary approach, led by respected leaders in the black community (nurses, physicians, preachers, social workers, teachers, and politicians) to create an atmosphere of empowerment within the community residents.

Attitude of Health Personnel↗
PubMed1999

Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time.

Using the data resources of the Rochester Epidemiology Project, we carried out a descriptive study of fracture incidence among the residents of Olmsted County, Minnesota. During the 3-year period 1989-91, 2901 County residents > or = 35 years of age experienced 3665 separate fractures. The age- and sex-adjusted (to 1990 United States whites) incidence of any fracture was 2205 per 100,000 person-years (95% CI, 2123 to 2286) and that of all fractures was 2797 per 100,000 (95% CI, 2705 to 2889). Age-adjusted fracture rates were 40% greater among women. Incidence rates increased with age in both sexes. One-third of the fractures involved the hip, spine or distal forearm - the skeletal sites traditionally associated with osteoporosis. The age- and sex-adjusted incidence of fractures due to moderate trauma (2205 per 100,000 person-years; 95% CI, 2106 to 2303) was twice that of fractures due to more severe trauma (1164 per 100,000; 95% CI, 1106 to 1223) and 12 times that of pathological fractures (178 per 100,000; 95% CI, 133 to 222). Overall fracture rates were 15% greater among residents of the central city of Rochester compared with the rural portion of Olmsted County. The incidence of limb fractures among Rochester residents was 14% higher than comparable rates documented for this community 20 years earlier in 1969-71, due mainly to a substantial increase in the incidence of leg fractures.

Adult↗