RESUMO
PURPOSE: Previous comparisons of coronary heart disease mortality between Mexican Americans and non-Hispanic whites have given paradoxic results: despite their adverse cardiovascular risk profiles, especially a greater prevalence of diabetes, Mexican Americans are reported to have lower rates of mortality from coronary heart disease. SUBJECTS AND METHODS: We performed a community-based surveillance among all residents of Nueces County, Texas, aged 25 to 74 years, from 1990 to 1994. All death certificates were obtained and coded, and deaths potentially related to coronary heart disease were selected and validated by standardized methods blinded to ethnicity. Validated in-hospital and out-of-hospital coronary heart disease mortality was compared between 785 Mexican Americans and 862 non-Hispanic white women and men. RESULTS: Validated coronary heart disease mortality in Mexican Americans exceeded that for non-Hispanic whites in the same community. Among women, definite coronary heart disease mortality was 40% greater among Mexican Americans (rate ratio [RR] 1.43, 95% confidence interval [CI]: 1.12 to 1.82), as was all coronary heart disease mortality (RR, 1.32, 95% CI: 1.08 to 1.63). Among men, Mexican Americans had greater rates of all (RR, 1.11; 95% CI: 0.96 to 1.28) and definite coronary heart disease mortality (RR, 1.16; 95% CI: 0.91 to 1.47), but the associations were not statistically significant. CONCLUSIONS: When community-wide mortality rates from coronary heart disease are properly validated, Mexican Americans have rates equal to or higher than those of non-Hispanic whites. Community-based surveillance with validation of coronary heart disease as the cause of death is necessary to avoid the errors that occur with the use of death certificates alone.
Assuntos
Doença das Coronárias/etnologia , Doença das Coronárias/mortalidade , Americanos Mexicanos/estatística & dados numéricos , População Branca/estatística & dados numéricos , Adulto , Idoso , Feminino , Mortalidade Hospitalar/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Texas/epidemiologiaRESUMO
The authors performed a prospective, community-based pilot stroke surveillance project in Nueces County, TX. Mexican-Americans showed a trend toward higher completed ischemic stroke hospitalization rates compared with non-Hispanic whites. Mexican-Americans were more commonly uninsured (p = 0.007) and were less likely to receive neuroimaging (p = 0.001). Additional studies are needed to confirm this finding and to determine the role of stroke risk factors and access to care variables.
Assuntos
Hospitalização/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Acidente Vascular Cerebral/etnologia , População Branca , Idoso , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Vigilância da População , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Texas/epidemiologiaRESUMO
BACKGROUND: The determination of hypertension in a given population depends on the knowledge of population norms for blood pressure. This is true for both casual blood pressure (CBP) measurements and the newest and most promising technology of ambulatory blood pressure monitoring (ABPM). OBJECTIVE: To design an ambitious multinational co-operative study to determine normal blood pressure data in Brazilian children. METHODS: The study was designed to determine normative data for CBP, using the Task Force technical recommendations for age-, sex- and height-percentile-specific blood pressure values. The proposed procedure is as follows. ABPM will be studied in a random subgroup of individuals, to develop similar normative data. These data will be correlated to CBP measurements and to echocardiographic findings as a measure of end-organ damage. All patients who are diagnosed by CBP measurement to be hypertensive will also be studied by ABPM, and studies of target-organ damage will be performed. Family and medical histories will be evaluated by questionnaire and first-degree relatives will be evaluated for CBP measurement. Hypertensive patients will form a cohort for long-term follow-up. These data will be the foundation for studies of hypertension in Brazilian children.
Assuntos
Monitorização Ambulatorial da Pressão Arterial , Pressão Sanguínea , Adolescente , Fatores Etários , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Fatores SexuaisRESUMO
BACKGROUND AND PURPOSE: This study compared the risk for stroke during acute myocardial infarction (AMI), percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) between Mexican Americans (MAs) and non-Hispanic whites. METHODS: We examined the age-specific rate ratios (RR) of acute stroke during hospitalization for AMI, CABG and PTCA in a population-based study in Corpus Christi, Tex. by searching the cardiac surveillance data for ICD-9 codes for stroke (430-437). ICD-9 stroke codes were validated by comparing medical chart abstraction with ICD-9 discharge diagnoses. RESULTS: Stroke codes were found in 220 of the 5,697 admissions for AMI, CABG and PTCA. In the 45- to 59-year age-group MAs had a RR of 2.66 (95% CI 1.36-5.23) relative to non-Hispanic whites. In the 60- to 74-year age-group the RR was 1.52 (95% CI 1.11-2.08). There were no significant differences in the 25- to 44-year age-group. These ethnic relationships were found in nondiabetics but not in diabetics. Women in the 45- to 59-year age-group had a RR of 1.88 (95% CI 1.09-3.25) compared with men, but there were no significant sex differences in the 25- to 44- or 59- to 74-year age-groups. Stroke ICD-9 codes have a poor positive predictive value for acute stroke ranging from 10 to 76%. The stroke misclassifications were nondifferential with respect to ethnicity or sex. CONCLUSIONS: MAs have a higher stroke rate complicating acute heart disease in Corpus Christi. A rigorous stroke surveillance project is needed to study the burden of stroke in MAs, the United States' largest Hispanic population.
Assuntos
Hospitalização/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Infarto do Miocárdio/etnologia , Acidente Vascular Cerebral/etnologia , População Branca , Adulto , Idoso , Comparação Transcultural , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Texas/epidemiologiaRESUMO
BACKGROUND: Information concerning differences in cardiovascular disease risk factors between Mexican-American and non-Hispanic white children is limited. We conducted a study to determine if there were ethnic differences in cardiovascular disease risk factors in children and whether such differences were explained by differences in body mass index. METHODS AND RESULTS: Fasting glucose, insulin, and blood lipid concentrations, blood pressure, weight, and height were measured in a cross-sectional survey among 403 third-grade children in Corpus Christi, Tex. We found significantly higher fasting insulin and glucose concentrations among Mexican-American than among non-Hispanic white children. Mexican-American boys had slightly lower levels of HDL cholesterol and higher systolic blood pressure than non-Hispanic white boys. Ethnic differences in insulin and glucose were not explained by body mass index. CONCLUSIONS: These results provide preliminary evidence that ethnic differences in insulin, glucose, body mass index, and other risk factors occur as early as age 8 to 10 years. Additional research is warranted on differences in risk factors in Mexican-American and non-Hispanic white children and the potential importance of insulin in influencing the natural history of these characteristics.
Assuntos
Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/etiologia , Americanos Mexicanos , Glicemia , Pressão Sanguínea , Doenças Cardiovasculares/sangue , Criança , Feminino , Humanos , Insulina/sangue , Lipídeos/sangue , Masculino , Fatores de RiscoRESUMO
Age-adjusted rates of percutaneous transluminal coronary angioplasty (PTCA) and aortocoronary bypass surgery (ACBS) were determined for Mexican American (MA) and non-Hispanic white (NHW) patients hospitalized for coronary heart disease. Hypotheses of equal receipt of procedures between gender and ethnic groups were tested. Following myocardial infarction (MI), women were less likely than men to receive either procedure (22 versus 32%, p < 0.01), and MA were less likely than NHW to receive PTCA (13 versus 23%, p < 0.01) but not ACBS. After adjustment for extent of disease and other potential confounders, ethnic groups differed marginally in receipt of PTCA but not ACBS, while gender differences were not significant. Although women received revascularization procedures less frequently than men, this difference did not persist after controlling for extent of coronary artery disease by angiography: therefore, these observed differences in delivery of health care services may be appropriate. Mexican Americans received PTCA, but not ACBS, less frequently than NHW. This selective ethnic difference in receipt of PTCA does not appear to be associated with the extent of disease or other medical characteristics, and may represent inappropriate bias in delivery of health care services.
Assuntos
Angioplastia Coronária com Balão/estatística & dados numéricos , Ponte de Artéria Coronária/estatística & dados numéricos , Doença das Coronárias/etnologia , Doença das Coronárias/terapia , Americanos Mexicanos , População Branca , Adulto , Idoso , Feminino , Pesquisa sobre Serviços de Saúde , Hospitalização , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Inquéritos e Questionários , TexasRESUMO
BACKGROUND: Since Mexican Americans have adverse patterns of risk factors for myocardial infarction relative to non-Hispanic whites, the incidence of myocardial infarction should be greater among Mexican Americans than among non-Hispanic whites. This expectation conflicts with reports generated from death certificate registries. METHODS AND RESULTS: Data regarding myocardial infarction attacks and incident events were collected for a 4-year period in the Corpus Christi Heart Project, a population-based surveillance project for hospitalized coronary heart disease events. For both women and men, Mexican Americans experienced greater hospitalization rates for both attacks and incident events than non-Hispanic whites. Age-adjusted attack rate ratios comparing Mexican Americans with non-Hispanic whites were 1.59 (95% CI, 1.05 to 2.41) and 1.31 (95% CI, 1.18 to 1.45) among women and men, respectively. Corresponding incidence ratios were 1.52 (95% CI, 1.28 to 1.80) and 1.25 (95% CI, 1.10 to 1.42). CONCLUSIONS: This is the first report documenting greater incidence of hospitalized myocardial infarction among Mexican Americans than among non-Hispanic whites, a biologically plausible finding given the risk factor patterns observed in the Mexican-American population. Public health planners and clinicians should be aware of the importance of myocardial infarction as a health problem in the Mexican-American population. Culturally appropriate prevention strategies should be developed for and tested in Mexican-American populations.
Assuntos
Hospitalização , Americanos Mexicanos , Infarto do Miocárdio/etnologia , Infarto do Miocárdio/epidemiologia , População Branca , Adulto , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/fisiopatologia , Vigilância da População , Distribuição por Sexo , Texas/epidemiologia , Texas/etnologiaRESUMO
BACKGROUND: Mexican-American (MA) adults are known to have a greater burden of diabetes and insulin resistance than non-Hispanic white (NHW) people. In this report, we examined data obtained from MA and NHW third-grade children for evidence of a pattern consistent with the insulin resistance syndrome. In addition, we developed two summary measures characterizing insulin resistance syndrome to compare measures of this syndrome among our population. METHODS AND RESULTS: Data regarding fasting insulin, triglycerides, HDL cholesterol, systolic blood pressure, and body mass index (BMI) were available for 403 third-grade children. Median levels of insulin and glucose were significantly higher in MA boys and girls than in NHW boys and girls. Risk factors characterizing insulin resistance, including levels of insulin, triglycerides, systolic blood pressure, HDL cholesterol, and BMI were categorized as above or below the total population median. MA children were more likely than NHW children to have three or more adverse risk factors (55% versus 37%). When risk factors were converted to Z scores, and the five Z scores were summed for each individual, MA boys and girls had higher mean scores than NHW boys and girls (means for boys, 0.65 versus -0.97, P<.0001; girls, 0.52 versus -0.30, P<.04). Principal components analysis was used to create a summary score or index representing the insulin resistance syndrome. This summary score was significantly higher among MA boys and girls than NHW boys and girls (means for boys, 0.34 versus -0.72, P<.0001; girls, 0.35 versus -0.04, P=.056). CONCLUSIONS: Our results support the hypothesis that MA children exhibit a greater degree of the insulin resistance syndrome than NHW children, especially among boys. We conclude that some of the factors responsible for the increased risk of NIDDM seen among MA adults are demonstrable in childhood.
Assuntos
Resistência à Insulina , Americanos Mexicanos , População Branca , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Criança , HDL-Colesterol/sangue , Estudos Transversais , Diabetes Mellitus Tipo 2/etiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Insulina/sangue , Resistência à Insulina/fisiologia , Masculino , Fatores de Risco , Caracteres Sexuais , Síndrome , Triglicerídeos/sangueRESUMO
Mortality following myocardial infarction (MI) is greater among women than men and among Mexican Americans than non-Hispanic whites. Because therapy can affect mortality following MI, we examined differences in discharge therapy among these groups. Data regarding discharge therapy of 982 patients in the Corpus Christi Heart Project showed that women received fewer cardiovascular drugs than men, and Mexican Americans received fewer cardiovascular drugs than non-Hispanic whites. In multivariate analysis adjusting for age, cigarettes smoking, diabetes, hypertension, congestive heart failure, and serum cholesterol, the odds ratio for receipt of cardiovascular medications was 0.51 (95% CI: 0.28-0.93) for women versus men and 0.62 (0.3-1.15) for Mexican Americans versus non-Hispanic whites. Beta-blockers were prescribed rarely. Thus, treatment differences between ethnic and gender groups were observed following MI. Further research is needed to determine both the reasons for these differences and the extent to which these differences contribute to the observed survival patterns following MI.
Assuntos
Fármacos Cardiovasculares/uso terapêutico , Americanos Mexicanos/estatística & dados numéricos , Infarto do Miocárdio/prevenção & controle , Mulheres , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Alta do Paciente , Fatores Sexuais , TexasRESUMO
The effect of diabetes on survival after myocardial infarction (MI) was examined in a prospective population-based study of individuals hospitalized with MI in a bi-ethnic community of Mexican-Americans and non-Hispanic whites. Among Mexican-Americans, 54% (331 of 610) had diabetes compared with 33% (192 of 589) of non-Hispanic whites (P < 0.001). Among those with diabetes, the prevalence of a history of a cardiac event before the index admission was significantly higher (odds ratio = 1.4, 95% confidence interval [CI] 1.1-1.8) than among nondiabetic subjects. During the index hospitalization, diabetic subjects received cardiac catheterization less frequently than did nondiabetic subjects (45.1 vs. 51.5%, P = 0.03). Diabetic subjects had lower estimated ejection fractions, and the number of coronary arteries with significant obstruction (> 75%) was higher (P < 0.001). The peak creatine phosphokinase and creatine phosphokinase myocardial isoenzyme (CK-MB) levels were similar in diabetic and nondiabetic subjects. Despite a similar infarct size, diabetic subjects had a higher incidence of congestive heart failure (relative ratio = 2.2, 95% CI 1.7-2.8), more adverse indexes of short-term and long-term prognosis, and a longer average hospital stay (12.1 vs. 8.9 days, P < 0.01). After adjustment for age, sex, and ethnicity, the cumulative risk for total mortality, over 44 months of follow-up, was 37.4% among diabetic compared with 23.3% among nondiabetic subjects (P < 0.001). Diabetic subjects had a higher 28-day case-fatality rate post-MI as well as higher long-term mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Diabetes Mellitus/fisiopatologia , Americanos Mexicanos , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/fisiopatologia , População Branca , Adulto , Idoso , Creatina Quinase/sangue , Complicações do Diabetes , Feminino , Insuficiência Cardíaca/epidemiologia , Hospitalização , Humanos , Incidência , Isoenzimas , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Prognóstico , Estudos Prospectivos , Caracteres Sexuais , Fatores Sexuais , Taxa de Sobrevida , Texas , Fatores de TempoRESUMO
Age-adjusted 28-day case-fatality rates were higher among Mexican Americans than among non-Hispanic whites and higher among women than among men hospitalized for definite or possible myocardial infarction in Corpus Christi, Nueces County, Texas, from May 1, 1988, through April 30, 1990. The authors therefore examined whether these higher case-fatality rates were associated with greater prevalence of previously diagnosed coronary heart disease or diabetes; with greater age, frequency of definite myocardial infarction, or congestive heart failure; with higher values of indicators of severity of infarction, including peak creatine phosphokinase levels and scales prognostic of early mortality after myocardial infarction; and with differences in receipt of in-hospital therapy. The overall 28-day case-fatality rate among 1,228 patients hospitalized for myocardial infarction during a 24-month period was 7.3%. After adjustment for age; diabetes; myocardial infarction class (definite vs. possible); congestive heart failure; the Norris and Peel severity indices; peak total creatine phosphokinase; and receipt of thrombolytic therapy, aspirin, calcium channel blockers, beta-blockers, anticoagulants, angioplasty, and bypass surgery, the risk of 28-day case-fatality for Mexican Americans in relation to non-Hispanic whites was 1.49 (95% confidence interval 0.92-2.40). The corresponding risk for women in relation to men was 1.80 (95% confidence interval 1.12-2.89). These findings should alert clinicians to the high-risk status of these groups of patients.
Assuntos
Americanos Mexicanos , Infarto do Miocárdio/etnologia , Infarto do Miocárdio/mortalidade , Saúde da Mulher , Adulto , Idoso , Diabetes Mellitus/epidemiologia , Feminino , Insuficiência Cardíaca/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/fisiopatologia , Infarto do Miocárdio/terapia , Prognóstico , Fatores de Risco , Fatores Sexuais , Texas/epidemiologia , População BrancaRESUMO
We compared short- and long-term mortality among 334 Mexican Americans and 348 non-Hispanic whites hospitalized for myocardial infarction in the Corpus Christi Heart Project. Age-adjusted 28-day case fatality rates were 37% and 68% greater among Mexican-American women (6.7%) and men (6.2%) than among their non-Hispanic white counterparts (4.9% and 3.7%). Age-adjusted all-cause mortality rates over the next 25-month period, among those who survived the initial 28 days, were similar among Mexican-American and non-Hispanic white women (17.8% and 18.1%), but were 70% higher among Mexican-American men than among non-Hispanic white men (17.4% and 10.2%, respectively). Age-adjusted 25-month coronary mortality rates among initial 28-day survivors were 40% greater among Mexican-American women than among non-Hispanic white women (12.5% vs 9.0%), and 129% greater among Mexican-American men than among non-Hispanic white men (11.4% vs 5.0%, respectively). Thus, nearly all measures of post-myocardial infarction mortality indicated a survival disadvantage for Mexican Americans compared to non-Hispanic whites.
Assuntos
Infarto do Miocárdio/mortalidade , Adulto , Idoso , Feminino , Hospitalização , Humanos , Masculino , Americanos Mexicanos , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etnologia , Vigilância da População , Fatores de Risco , Taxa de Sobrevida , Texas/epidemiologia , População BrancaRESUMO
We calculated acute myocardial infarction and chronic coronary heart disease mortality rates for Mexican Americans and non-Hispanic whites in Texas for the 10-year period from 1980 through 1989 in an examination of ethnicity-related differences in death rates and trends according to vital statistics for the state of Texas. During the study period, acute myocardial infarction mortality decreased significantly in all four sex-ethnic groups, between 5.1% and 7.4% per year. Chronic coronary heart disease mortality rates decreased less, but significantly, for women in both ethnic groups, decreasing 3.4% and 1.8% per year for Mexican-American and non-Hispanic white women, respectively. We found no significant trend of changes in chronic coronary heart disease mortality rate among men in either ethnic group. For both acute myocardial infarction and chronic coronary heart disease mortality, rates were significantly lower among Mexican-American men than among non-Hispanic white men. Age-adjusted rate ratios for Mexican-American men in relation to non-Hispanic white men were 0.78 (95% CI: 0.65-0.93) and 0.75 (0.65-0.86) for acute myocardial infarction and chronic coronary heart disease mortality, respectively. No significant ethnicity-related mortality difference was seen among women. This previously observed interaction of ethnicity and sex in relation to coronary heart disease mortality remains unexplained. Despite apparently adverse cardiovascular risk factor profiles, Mexican Americans have acute myocardial infarction and chronic coronary heart disease mortality rates equal to or lower than their non-Hispanic white counterparts on the basis of death certificate data. This paradox deserves further attention.
Assuntos
Doença das Coronárias/mortalidade , Americanos Mexicanos , Infarto do Miocárdio/mortalidade , Doença Crônica , Doença das Coronárias/epidemiologia , Doença das Coronárias/etnologia , Feminino , Humanos , Masculino , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etnologia , Estudos Retrospectivos , Texas/epidemiologia , População BrancaRESUMO
The rate of hospitalization for myocardial infarction was examined in the Corpus Christi Heart Project (CCHP), a prospective population-based surveillance program in a biethnic community of Mexican-Americans and non-Hispanic whites. During 12 months of ascertainment, a total of 740 patients hospitalized with definite (217) or possible (523) myocardial infarction were identified. Of the 740 subjects, 334 were Mexican-Americans (150 females and 184 males), 348 were non-Hispanic whites (138 females and 210 males), and 58 were of other ethnic backgrounds. The 1-year age-adjusted rates of hospitalization per 100,000 population were 427.4 and 276.9 among Mexican-American and non-Hispanic white females, respectively, and 721.4 and 502.6 among Mexican-American and non-Hispanic white males, respectively. The age-adjusted hospitalization rate ratios for Mexican-Americans in relation to non-Hispanic whites were 1.55 (95% confidence interval [CI]: 1.23 to 1.95) and 1.40 (95% CI: 1.15 to 1.70) for females and males, respectively. These results suggest that Mexican-Americans may have a greater burden of coronary disease than non-Hispanic whites.
Assuntos
Hospitalização/estatística & dados numéricos , Americanos Mexicanos , Infarto do Miocárdio/etnologia , Adulto , Idoso , Comparação Transcultural , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Vigilância da População , Estudos Prospectivos , Texas/epidemiologia , População BrancaRESUMO
Blood pressure rises in adolescence and its increase appears to be more closely related to body size than to age. This cross-sectional study assessed the relationship between selected anthropometric and demographic factors and blood pressure during early adolescence in a sample of 233 females aged 10-12 years enrolled in public and private primary schools in Tlalpan, Mexico. Standardized measurements of blood pressure, arm circumference and length, height, weight, body mass index, and triceps skinfold were obtained. All anthropometric attributes were strong univariate correlates of blood pressure. Multiple regression analyses suggest positive associations between both body mass index and arm length and systolic blood pressure early in adolescence. When cross-cultural comparisons were made of blood pressure levels in the Blood Pressure Study in Mexican Children (BPSMC) with results in other countries, the BPSMC mean blood pressure levels were found to be the lowest. Possible explanations are discussed.
Assuntos
Pressão Sanguínea , Adolescente , Antropometria , Estatura , Peso Corporal , Criança , Comparação Transcultural , Estudos Transversais , Feminino , Humanos , MéxicoRESUMO
Panama's black citizens are culturally and historically divisible into two groups, the Spanish-speaking coloniales and the English-speaking anglos or afro-antillanos. Until recently these groups have been geographically as well as culturally isolated one from the other, although both are predominantly of West and Southwest African origin. Assessment of the genetic diversity within-villages and within language groups reveals as much, possibly somewhat more, diversity in 15 inherited biochemical markers within villages and language groups as that which obtains between villages and language groups. A number of rare variants at the 6-phosphogluconate dehydrogenase, lactate dehydrogenase, and esterase D loci were encountered and are described.
Assuntos
População Negra , Variação Genética , Adulto , Proteínas Sanguíneas/genética , Enzimas/genética , Frequência do Gene , Humanos , Masculino , Panamá , Fenótipo , Fosfogluconato Desidrogenase/genéticaRESUMO
Based on Texas vital statistics for 1969-71, patterns of lung cancer mortality in three ethnic groups are examined. Among males, the risk of lung cancer for Mexican Americans is considerably lower than for Blacks and Anglos for ages under 75 and slightly higher for older ages. Among females, Mexican American exhibit a distinct excess of lung cancer mortality for ages 70 and over and a deficit for younger ages. The excess among Mexican American females is confined mainly to the older foreign-born women and the excess is reduced for ages 45-60 and diminishes for younger immigrants. This suggests that the excess risk among Mexican Americans will completely disappear within a generation and a general deficit pattern will emerge for all ages. The implications of the diminishing excess and the emerging deficit lung cancer mortality among Mexican Americans clearly call for further study in exploring the effect of cultural change on mortality patterns, particularly for cancer.