Synopsis for February 11, 2005

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Racial/Ethnic and Socioeconomic Disparities in Multiple Risks Factors for Heart Disease and Stroke ― United States, 2003
2. Disparities in Screening for and Awareness of High Blood Cholesterol― United States, 1999 and 2002
3. Racial/Ethnic Differences in the Prevalence and Impact of Doctor-Diagnosed Arthritis ― United States, 2002
4. Japanese Encephalitis in a U.S. Traveler Returning from Thailand, 2004

Racial/Ethnic and Socioeconomic Disparities in Multiple Risks Factors for Heart Disease and Stroke ― United States, 2003

To decrease the disproportionate burden of multiple risk factors on minority populations, public health programs should focus on improving identification and treatment of affected persons and promote policy and lifestyle changes conducive to cardiovascular health.

Heart disease and stroke are among the leading causes of death in the U.S. but can be reduced by controlling modifiable risk factors (high blood pressure, high cholesterol, diabetes, smoking, obesity, and physical inactivity). This CDC study shows a large proportion of the population has two or more of these risk factors with significant disparities among socioeconomic and racial/ethnic groups. Those who were older, less educated, unemployed, and lower income were more likely to have multiple risk factors. Blacks and Native Americans were also at increased risk, compared to whites. To decrease the disproportionate burden of multiple risk factors on minority populations, public health programs should focus on improving identification and treatment of affected persons and promote policy and lifestyle changes conducive to cardiovascular health.

Disparities in Screening for and Awareness of High Blood Cholesterol ― United States, 1999 and 2002

Only 63 percent of the US population has had a cholesterol screening in the proceeding five years. This is still far from the Healthy People 2010 objective of 80 percent. Greater public health efforts are needed to raise awareness of the importance of cholesterol screening and maintaining healthy cholesterol levels especially among minorities, younger adults and women. Overall, early detection and control of high blood cholesterol will reduce risk of heart attacks and other cardiovascular events.

The prevalence of high blood cholesterol levels (>240 mg/dL) among US adults aged 20 to 74 years has been decreasing from 1970s to 2002 due to increased awareness of and improved action to control levels. However, in 1999-2002, blacks and Mexican Americans were less likely to be screened and aware of their high cholesterol than whites. Younger people were less likely than older people to be screened for and aware of a high cholesterol level. Women were less likely to be aware of the high cholesterol condition than were men.

Racial/Ethnic Differences in the Prevalence and Impact of Doctor-Diagnosed Arthritis ― United States, 2002

Arthritis is a frequent problem with a large impact on all racial/ethnic groups, but the disabling effects of arthritis (arthritis-attributable activity limitations, work limitations, and severe pain) affect racial/ethnic minorities more severely.

Nearly 43 million U.S. adults (almost 21percent) have self-reported, doctor-diagnosed arthritis (an additional 23 million have possible arthritis). Among those with doctor-diagnosed arthritis more than a third (16 million) having arthritis-attributable activity limitations and nearly a third (8.2 million) of working age adults with arthritis having arthritis-attributable work limitations. Compared with non-Hispanic whites, non-Hispanic blacks had a similar population prevalence of doctor-diagnosed arthritis but those with arthritis had higher proportion of arthritis-attributable activity limitation (44 percent vs. 34 percent), work limitation (39 percent vs. 28 percent), and severe joint pain (34 percent vs. 23 percent). Hispanics had lower population prevalence with arthritis but those with arthritis had a higher proportion of arthritis-attributable work limitation (39 percent vs. 28 percent) and severe joint pain (33 percent vs. 23 percent). Physical activity, weight reduction, and arthritis self management can reduce the disabling effects of arthritis; existing programs should be made more available and accessible to all people with arthritis, and especially to black and Hispanic populations with arthritis, who are more likely to suffer the disabling effects of arthritis.

Japanese Encephalitis in a U.S. Traveler Returning from Thailand, 2004

Travelers to JE endemic countries, especially those visiting rural areas with irrigated rice land and/or large-scale pig husbandry, should discuss their need for JE vaccine with a health care provider with experience in travel or tropical medicine.

A student traveling in Thailand returned to the United States with encephalopathy and fever. The student stayed approximately 3 days in the rural Chang Mai Valley and one month in Chang Mai City, and reported being bitten by mosquitoes in both places. Japanese encephalitis (JE) is a leading cause of viral encephalitis in Asia and predominantly affects children. It has a very high mortality (estimated at up to 30 percent) and, among survivors, a high rate of persistent neurological abnormalities (up to 50 percent). JE among travelers from the United States or Western Europe has rarely been reported. A vaccine is available and is recommended for travelers visiting Asia, particularly to JE endemic countries.

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