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Aboriginal Canadians (i.e., First Nations, Inuit and Métis) are disproportionately affected by HIV/AIDS, and experience greater social and economic marginalization and poorer housing conditions. This study sought to understand the differences in the determinants of health and housing-related characteristics between samples of Aboriginal and Caucasian adults living with HIV/AIDS in Ontario. We analyzed baseline demographic, socio-economic, health, and housing-related data from 521 individuals (79 Aboriginal and 442 Caucasian) living with HIV/AIDS and enrolled in the Positive Spaces, Healthy Placesstudy. We compared the characteristics of Aboriginal and Caucasian participants to identify determinants of health and housing-related characteristics independently associated with Aboriginal ethnicity. Compared to Caucausian participants living with HIV, Aboriginal participants were more likely to be younger, female or transgender women, less educated, unemployed, and homeless or unstably housed. They were also more likely to have low incomes and to have experienced housing-related discrimination. In a multivariate model, gender, income, and experiences of homelessness were independently associated with Aboriginal ethnicity. Aboriginal individuals living with HIV/AIDS in our sample are coping with significantly worse social and economic conditions and are more likely to experience challenging housing situations than a comparison group of Caucasian individuals living with HIV/AIDS. To develop effective care, treatment and support strategies for Aboriginal peoples with HIV, it is critical to address and improve their socio-economic and housing conditions. Les Canadiens autochtones (Premières Nations, Inuits et Métis) sont démesurément touchés par le VIH et le sida; ils sont aussi plus marginalisés sur le plan socioéconomique et ont des conditions de logement inférieures. Nous avons cherché à comprendre les différences dans les déterminants de la santé et les caractéristiques de l’habitat d’échantillons d’adultes autochtones et blancs vivant avec le VIH ou le sida en Ontario. Nous avons analysé les données de base (démographiques, socioéconomiques, sanitaires et liées au logement) de 521 sujets (79 Autochtones, 442 Blancs) vivant avec le VIH ou le sida et participant à l’étude Positive Spaces, Healthy Places. Les caractéristiques des participants autochtones et blancs ont été comparées afin de cerner les déterminants de la santé et les caractéristiques de l’habitat présentant une association indépendante avec l’ethnicité autochtone. Comparativement aux participants blancs vivant avec le VIH, les participants autochtones étaient plus susceptibles d’être des jeunes, des femmes ou des femmes transgenre, d’être moins scolarisés, sans emploi, sans abri ou de vivre dans un logement précaire. Ils étaient aussi plus susceptibles d’avoir un faible revenu et d’avoir été victimes de discrimination liée au logement. Dans notre modèle multivarié, le sexe, le revenu et les expériences d’itinérance présentaient des associations indépendantes avec l’ethnicité autochtone. Les sujets autochtones vivant avec le VIH ou le sida dans notre échantillon composent avec des conditions socioéconomiques beaucoup plus difficiles et sont plus susceptibles d’éprouver des problèmes à se loger que le groupe témoin de sujets blancs vivant avec le VIH et le sida. Pour élaborer des stratégies de soins, de traitement et de soutien efficaces pour les Autochtones atteints du VIH, il est essentiel d’aborder et d’améliorer leurs conditions socioéconomiques et de logement.

Objective:To evaluate for Indigenous Australians the agreement between a fasting plasma glucose (FPG) criterion of 7.0 mmol/L and diabetes test results using a two‐hour oral glucose tolerance test (OGTT), comparing relationships between test agreement and prevalence to similar studies. Methods:Screening was undertaken in 25 remote settlements. Agreement between FPG and OGTT results was evaluated using the kappa coefficient (chance‐corrected agreement). Results:Participants (n=3,249) ranged from 15–94 years. Kappa ranged from 0.70‐0.77 for diabetes prevalence of 5–30%, with overall agreement of 0.76. In comparison studies, the relationship between kappa and diabetes prevalence was similar, but with kappa 0.21‐0.48. Conclusions and Implications:A FPG test with a 7.0 mmol/L cut‐off is a reliable screening method, relative to the OGTT, for remote Indigenous settlements. The level of agreement between the FPG test and the OGTT for the Indigenous population surveyed is superior by far to agreement reported for non‐Indigenous samples.

Objective:To evaluate for Indigenous Australians the agreement between a fasting plasma glucose (FPG) criterion of 7.0 mmol/L and diabetes test results using a two‐hour oral glucose tolerance test (OGTT), comparing relationships between test agreement and prevalence to similar studies.

OBJECTIVE To determine whether maternal depressive symptoms, reported when infants are 2 to 4 months old, are associated with mothers' early parenting practices. DESIGN Secondary data analyses collected from the National Evaluation of Healthy Steps for Young Children. Data sources included newborn enrollment questionnaires and parent interviews when infants were 2 to 4 months old. Maternal depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. SETTING Twenty-four pediatric practices across the United States. PARTICIPANTS A total of 5565 families enrolled in Healthy Steps; 4874 mothers (88%) completed 2- to 4-month interviews and provided Center for Epidemiologic Studies Depression Scale data; 17.8% of mothers reported having depressive symptoms. MAIN OUTCOME MEASURES Ten parenting practices assessed in 3 domains: safety (sleep position and lowering water temperature), feeding (cereal, water, or juice; continuing breastfeeding), and practices to promote child development (showing books, playing with infant, talking to infant, and following 2 or more routines). RESULTS Mothers with and without depressive symptoms reported similar uses of safety and feeding practices. Mothers with depressive symptoms had reduced odds of continuing breastfeeding (adjusted odds ratio [AOR], 0.73; 95% confidence interval [CI], 0.61-0.88), showing books (AOR, 0.81; 95% CI, 0.68-0.97), playing with the infant (AOR, 0.70; 95% CI, 0.54-0.90), talking to the infant (AOR, 0.74; 95% CI, 0.63-0.86), and following routines (AOR, 0.61; 95% CI, 0.52-0.72). CONCLUSION Maternal depressive symptoms are common in early infancy and contribute to unfavorable parenting practices.--

Persistent unmet preventive and developmental health care needs of children in low-income families are a national concern. Recently, there have been efforts to promote developmental services as part of primary care for all young children. However, there is limited research to determine whether the neediest families are well in universal interventions. In our study, we assessed if disparities persist in utilization of developmental services, well child care, and satisfaction with care among low-, middle-, and high-income families participating in Healthy Steps for Young Children. Healthy Steps is a national experiment that incorporated developmental services into primary care for children from birth to 3 years of age. In the United States, 15 pediatric practices participated in this prospective study. At birth, 2,963 children were enrolled between September 1996 and November 1998 and followed through 33 months of age. The utilization of developmental services, satisfaction with care, and receipt of age-appropriate well child visits were measured at 30–33 months and adjusted for demographic and economic covariates. We found that the adjusted odds of low-income families did not differ from high-income families in receipt of four or more Healthy Steps services, a home visit, or discussing five or more child rearing topics. Low- and middle-income families had reduced adjusted odds of receiving a developmental assessment and books to read. The adjusted odds of low- and middle-income families did not differ from high-income families in being very satisfied with care provided or receiving age-appropriate well child visits. A universal practice-based intervention such as Healthy Steps has the potential to reduce income disparities in the utilization of preventive services, timely well child care, and satisfaction with care.Persistent unmet preventive and developmental health care needs of children in low-income families are a national concern. Recently, there have been efforts to promote developmental services as part of primary care for all young children. However, there is limited research to determine whether the neediest families are well in universal interventions. In our study, we assessed if disparities persist in utilization of developmental services, well child care, and satisfaction with care among low-, middle-, and high-income families participating in Healthy Steps for Young Children. Healthy Steps is a national experiment that incorporated developmental services into primary care for children from birth to 3 years of age. In the United States, 15 pediatric practices participated in this prospective study. At birth, 2,963 children were enrolled between September 1996 and November 1998 and followed through 33 months of age. The utilization of developmental services, satisfaction with care, and receipt of age-appropriate well child visits were measured at 30–33 months and adjusted for demographic and economic covariates. We found that the adjusted odds of low-income families did not differ from high-income families in receipt of four or more Healthy Steps services, a home visit, or discussing five or more child rearing topics. Low- and middle-income families had reduced adjusted odds of receiving a developmental assessment and books to read. The adjusted odds of low- and middle-income families did not differ from high-income families in being very satisfied with care provided or receiving age-appropriate well child visits. A universal practice-based intervention such as Healthy Steps has the potential to reduce income disparities in the utilization of preventive services, timely well child care, and satisfaction with care.