Pulmonary function of children aged 6-18 years is described based on 82,462 annual measurements of forced vital capacity (FVC), forced expired volume in 1 second (FEV1), and forced expiratory flow between 25% and 75% of FVC (FEF25-75%) from 11,630 white children and 989 black children. Median height, FVC, FEV1, FEV1/FVC, and FEF25-75% for each 3 months of age are compared among race and sex subgroups. Race- and sex-specific percentile distributions of FVC, FEV1, FEV1/FVC, and FEF25-75% are presented for each centimeter of height (growth curves). For the same height, boys have greater lung function values than girls, and whites have greater ones than blacks. Lung function increases linearly with age until the adolescent growth spurt at about age 10 years in girls and 12 in boys. The pulmonary function vs. height relationship shifts with age during adolescence. Thus, a single equation or the pulmonary function-height growth chart alone does not completely describe growth during the complex adolescent period. Nevertheless, race- and sex-specific growth curves of pulmonary function vs. height make it easy to display and evaluate repeated measures of pulmonary function for an individual child. Race-, sex-, and age-specific regression equations based on height are provided, which permit the evaluation of growth during adolescence with improved accuracy and, more importantly, in comparison with previous observations for the same child.

To understand whether neighborhood contexts contribute to the onset or maintenance of mental health problems independently of individual characteristics requires the use of multilevel study designs and analytical strategies. This study used a multilevel analytical framework to examine the relation between neighborhood context and risk of depressive symptoms, using data from the New Haven component of the Established Populations for Epidemiologic Studies of the Elderly, a community-based sample of noninstitutionalized men and women aged 65 years or older and living in the city of New Haven, Connecticut, in 1982. Neighborhoods were characterized by census-based characteristics and also by measures of the neighborhood service environment using data abstracted from the New Haven telephone book Yellow Pages. Living in a poor neighborhood was associated with higher levels of depressive symptoms in older adults, above and beyond individual vulnerabilities. In addition, the presence of more elderly people in the neighborhood was associated with better mental health among older adults. The authors found no evidence that access to services hypothesized to promote social engagement, to provide health services, or to affect the reputation of a neighborhood explained (i.e., mediated) neighborhood variations in depressive symptoms.

Background and Purpose-This study assesses the effect of socioeconomic status on stroke incidence in the elderly, and the contribution of risk factors to stroke disparities. Methods-Data comprised a sample of 2812 men and women aged 65 years and over from the New Haven cohort of the Established Populations for the Epidemiologic Studies of the Elderly. Individuals provided baseline information on demographics, functioning, cardiovascular and psychosocial risk factors in 1982 and were followed for 12 years. Proportional hazard models were used to model survival from initial interview to first fatal or nonfatal stroke. Results-Two hundred and seventy subjects developed incident stroke. At ages 65 to 74, lower socioeconomic status was associated with higher stroke incidence for both education (HR lowest/highest ϭ2.07, 95% CI, 1.04 to 4.13) and income (HR lowest/highest ϭ2.08, 95% CI, 1.01 to 4.27). Adjustment for race, diabetes, depression, social networks and functioning attenuated hazard ratios to a nonsignificant level, whereas other risk factors did not change associations significantly. Beyond age 75, however, stroke rates were higher among those with the highest education (HR lowest/highest ϭ0.42, 95% CI, 0.22 to 0.79) and income (HR lowest/highest ϭ0.43, 95% CI, 0.22 to 0.86), which remained largely unchanged after adjustment for risk factors. Conclusions-We observed substantial socioeconomic disparities in stroke at ages 65 to 74, whereas a crossover of the association occurred beyond age 75. Policies to improve social and economic resources at early old age, and interventions to improve diabetes management, depression, social networks and functioning in the disadvantaged elderly can contribute to reduce stroke disparities.