Health - Behaviors That Threaten Health

Cigarette Smoking

Nicotine is the drug in tobacco that causes addiction; cigarette smoking is the most popular method of taking nicotine in the United States. Tobacco use is the leading cause of preventable death in the United States. Smoking during pregnancy causes an increased risk of stillborn, premature birth, and low birth weight. The tar in cigarettes increases the user's risk of lung cancer, emphysema, and other bronchial diseases, while the carbon monoxide in the smoke increases the chance of cardiovascular diseases.

In 2004 Native Americans and Alaska Natives were more likely to smoke than any other group: 33.8% FIGURE 6.8 Adults with diabetes who had all five recommended diabetic services in the past year, by race, ethnicity, and income, 2000–01 "Figure 2.2. Adults with Diabetes Who Had All Five Recommended Diabetic Services in the Past Year, by Race, Ethnicity, and Income, 2000–2001," in 2004 National Healthcare Disparities Report, U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, December 2004, http://qualitytools.ahrq.gov/disparitiesreport/documents/nhdr2004.pdf (accessed January 25, 2006). Data from Medical Expenditure Panel Survey, 2000–2001.reported smoking in the past month, 41.5% in the past year, and 83.1% had smoked at some point in their lifetime. Non-Hispanic whites were the next most likely to smoke. African-Americans were slightly more likely than Hispanics to smoke: 27.3% had smoked in the past month, compared with 23.3% of Hispanics; 31.6% had smoked in the past year, compared with 29.8% of Hispanics; and 62.1% had smoked in their lifetime, compared with 55.8% of Hispanics. Asian-Americans were least likely to smoke; only 11.7% reported smoking in the past month, 15.9% in the past year, and 44.9% in their lifetime. (See Table 6.15.)

Cigarette smoking is most likely among those ages eighteen to twenty-five, regardless of race or ethnic group. Among this age group, whites are overwhelmingly more likely to smoke than their African-American or Hispanic counterparts. In 2004, 45.1% of eighteen- to twenty-five-year-old whites smoked, compared with 31.7% of Hispanics and 28.8% of African-Americans. However, the race and ethnic difference leveled off among smokers age twenty-six and older. In 2004, 25.7% of African-Americans in this age group smoked, as did 25% of whites and 20.9% of Hispanics. (See Figure 6.9.)

Diet and Nutrition

One reason that Asians and Pacific Islanders enjoy better health than other racial and ethnic groups is their diet. The typical Asian and Pacific Islander diet is low in fat and cholesterol. The staple food for many Asian-Americans is rice. Consumption of vegetables is relatively high; pork and fish are also commonly eaten. Dairy products are used less frequently. The traditional sources of calcium are soybean curd, sardines, and green, leafy vegetables, all healthy sources of nutrients.

The Healthy Eating Index is computed periodically by the U.S. Department of Agriculture, and its most recent publication is the Report Card on the Diet Quality of African Americans (July 1998, http://www.usda.gov/cnpp/ INSIGHT6c.PDF). This report finds that of various population subgroups, African-Americans have particularly poor diets. Between 1994 and 1996, the period of the study, 28% of African-Americans had poor diets, compared with 16% of whites. Fewer than 50% of African-Americans met the dietary recommendations for consumption of grains, vegetables, fruits, milk, meat, total fat, saturated fat, or sodium.

Native American diets have been negatively affected by the introduction of nonnative foods. Although there are considerable tribal variations in diet, studies show that the less Native Americans eat of their traditional foods, the greater their levels of obesity and adult-onset diabetes. High carbohydrate, sodium, and saturated fat contents can characterize most current Native American diets. Also, Native American diets are relatively low in meat and dairy products. Factors contributing to these eating habits include food availability, preference for nonnative food, and place of residence.

Drug Abuse

ALCOHOL

Alcohol depresses the central nervous system. Consumption of small amounts of alcohol can actually have a beneficial affect on the body. However, when consumed in larger amounts, alcohol impairs judgment and increases reaction time, can interfere with prescription and nonprescription medications in adverse ways, and can cause serious damage to developing fetuses. Chronic health consequences of excessive drinking include increased risk of liver cirrhosis, pancreatitis, certain types of cancer, high blood pressure, and psychological disorders. Addiction to alcohol is a chronic disease that is often progressive and sometimes fatal.

In 2004 Asian-Americans, Native Americans and Alaska Natives, Hispanics, and African-Americans were all less likely to report having used alcohol in the past month than were non-Hispanic whites. The rate of binge alcohol use, defined as five or more drinks on one TABLE 6.11 Estimated numbers of persons living with HIV/AIDS, by year and selected characteristics, 2001–04 "Table 8. Estimated Numbers of Persons Living with HIV/AIDS, by Year and Selected Characteristics, 2001–2004—35 Areas with Confidential Name-Based HIV Infection Reporting," in HIV/AIDS Surveillance Report, 2004, vol. 16, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2005, http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2004report/default.htm (accessed January 26, 2006)occasion in at least one day in the previous month, was lowest among Asian-Americans (13%) and African-Americans (18%), while Hispanics (24%) and Native Americans and Alaska Natives (25%) had rates comparable to that of whites (23%). (See Figure 6.10.)

ILLICIT DRUG USE

According to the CDC, illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens (including LSD and PCP), inhalants, or any prescription-type psychotherapeutic drug used nonmedically. Illicit drug use is a particular problem in the Native American and Alaska Native community, where rates of use in the past month, past year, and lifetime use were highest. In 2004 the rate of illicit drug use in the past month was highest for Native Americans and Alaska Natives (12.3%) and lowest for Asian-Americans (3.1%). African-Americans (8.7%), non-Hispanic TABLE 6.12 Estimated number of AIDS cases in children less than 13 years of age, by year of diagnosis and transmission category, 2000–04 "Table 4. Estimated Numbers of AIDS Cases in Children 13 Years of Age, by Year of Diagnosis and Transmission Category, 2000–2004—United States," in HIV/AIDS Surveillance Report, 2004, vol. 16, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2005, http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2004report/default.htm (accessed January 26, 2006)whites (8.1%), and Hispanics (7.2%) reported similar rates of illicit drug use in the past month. (See Table 6.16.)