Race/Ethnicity/Nativity Differentials and Changes in Cause-Specific Infant Deaths in the Context of Declining Infant Mortality in the U.S.: 1989–2001

Using data from the national linked birth/infant death cohort files, we examined race/ethnicity/nativity disparities and changes in infant mortality due to the five leading causes of infant death between 1989 and 2001. Our results indicate substantial decreases in infant mortality from three causes (congenital anomalies, sudden infant death syndrome, and respiratory distress syndrome) for which specific perinatal health innovations emerged or were expanded. However, for these three causes, the relative disparities in infant mortality between infants born to U.S.-born black women as compared to infants of U.S.-born white women increased following the introduction (or expansion) of beneficial interventions. Among infants of U.S.-born Mexican American mothers, the findings differed. In the static comparisons, our results show the often-reported similarity in the risk of death of these babies compared to those born to non-Hispanic white mothers. However, when changes over time were modeled, there was an erosion of the relatively favorable survival chances of Mexican American infants. Our models show little change in the relative risk of death for infants of immigrant women. Regarding the other two causes (disorders relating to short gestation and unspecified low birth weight and maternal complications) for which no efficacious innovations occurred, either little change or actual increases in risks were observed. Future studies and health policy efforts should be geared toward further understanding and aggressively working to close infant mortality gaps, especially for infants of U.S.-born black mothers—an effort that will be facilitated by research focused on cause-specific infant mortality.     

Spanish Surname and Anglo Infant Mortality: Differentials Over a Half-Century

Using a half-century of death records from San Antonio/Bexar County, Texas, we examine the timing and cause structure of Spanish surname and Anglo infant mortality. Our findings show that despite the substantial disparities between ethnic-specific infant mortality rates in the early years of the study, there have been consistent declines in overall, neonatal, and postneonatal mortality for both groups, as well as a major convergence of mortality rates between Spanish surname and Anglo infants. Further, we demonstrate that the convergence is of relatively recent origin and is due primarily to shifts in postneonatal mortality. Finally, we examine the transition reflected in the cause structure of ethnic-specific infant mortality and show that the convergence was largely the result of reductions in deaths from exogenous causes. Implications for research into the "epidemiologic paradox" are discussed.     

Gambling participation in the U.S.--results from a national survey

Demographic patterns of gambling participation in the U.S. were examined. A national telephone survey was conducted with 2,630 representative U.S. residents aged 18 or older. The sample as weighted for analysis was 48% male, 12% black, and 11% Hispanic. Respondents were questioned on 15 types of gambling: how often they played and how much they won or lost. Eighty-two percent gambled in the past year. Lottery was the most commonly played game, while casino gambling accounted for the largest extent of gambling involvement. Men and women were equally likely to gamble in the past year, but men gambled more frequently and had larger wins and losses, particularly on sports betting and games of skill. Blacks were less likely to have gambled in the past year, but blacks who gambled did so more heavily than other racial groups. Blacks and Hispanics were more likely than average to be pathological gamblers. The rate of past year gambling declined with age, but extent of gambling involvement among gamblers did not vary with age. Rates of participation in most forms of gambling increased with socioeconomic status, but higher socioeconomic status gamblers had lower rates of pathological gambling, and lower extent of gambling involvement, particularly for lottery. New Englanders gambled more heavily than other Americans. Comparison with past studies showed an increase in overall gambling participation in the U.S., and large increases in rates of participation in lottery and casino gambling.     

The effect of unions on labor markets and economic growth: An analysis of state data

Despite voluminous research on unions, there still is no consensus on how unions affect a state's economy. Using a panel of 48 U.S. states for the 1978–1994 period, we estimate a series of simultaneous equations to analyze how unions affect various economic barometers. This provides measures for the partial correlations between unions and performance. The model is then re-estimated using regional dummies to capture fixed effects and to highlight regional differences in the slope of the Phillips curve. We find that unions adversely affect unemployment rates and the growth rates of gross state product (GSP), productivity, and population, while increasing the rate of wage inflation. The impact on the employment growth rate is negative but not significant. A test for fixed effects reveals regional differences in GSP growth. Regional differences in popu-lation growth are not significant. Also, the slope of the Phillips curve is significantly dif-ferent across regions.     

Religiosity and preferences for life-prolonging medical treatments in African-American and white elders: a mediation study

Research on end-of-life treatment preferences has documented robust racial differences, with African-Americans preferring more life-prolonging treatment than Whites. Although little research has attempted to explain these racial differences systematically, speculation has centered on religiosity. We examined a dimension of religiosity frequently invoked in end-of-life research-guidance by God's will-as a potential mediator of racial differences in such treatment preferences. Three hundred African-American and White men and women aged 60 or older participated in a 35-minute telephone interview that elicited preferences for four common life-prolonging treatments in each of nine health scenarios. The questionnaire included the five-item God's will (GW) scale, a health conditions checklist, a depression measure, and sociodemographic questions. GW mediated racial differences at least partially for most treatments and in most health scenarios. Implications are discussed for understanding end-of-life treatment preferences and why races tend to differ.