Our findings suggest that the risk of coronary heart disease morbidity and mortality attributable to diabetes may be increasing over time. Therefore, clinicians need to take extra care in the management of MIs in diabetic individuals, and public health efforts to reduce diabetes prevalence are warranted.

Energy expenditure in leisure-time physical activity (LTPA) was measured using the Minnesota LTPA Questionnaire in 35- to 74-year-old black and white residents of Minneapolis-St. Paul, Minnesota. Estimates of the geometric mean LTPA energy expenditure were 129 and 204 kcal per day for black and white men (p less than .05) and 91 and 123 kcal per day for black and white women (p less than .05). The percentage of individuals expending 2000 kcal or more per week in LTPA was significantly lower in black men than white men (25 vs. 35%; p = .01) but was not different in black versus white women (18 vs. 17%). Although black men and women reported greater occupational physical activity than their white counterparts, LTPA and job activity were unrelated in all race and sex groups. In both races, LTPA energy expenditure declined with age. LTPA increased with level of formal education, and the largest LTPA difference between blacks and whites was observed in those who had a high-school diploma or less. Blacks had lower participation rates than whites in most of the individually assessed physical activities. Additional research is needed on the determinants and promoters of LTPA in population subgroups.

Systematic, simultaneous surveillance of cardiovascular disease risk factors, morbidity, and mortality is ongoing in the Minnesota Heart Survey. Risk factors for cardiovascular disease were measured in population-based surveys of Twin Cities metropolitan area residents aged 25-74 years in 1980-1982 and 1985-1987. During this period, age-adjusted, average systolic blood pressure declined nonsignificantly in men and significantly in women, and average, age-adjusted diastolic blood pressure declined 1.1 mmHg in men and 0.9 mmHg in women. Between 1980-1982 and 1985-1987, serum total cholesterol declined significantly, 5.2 and 5.8 mg/dl in men and women, respectively. Serum high density lipoprotein cholesterol decreased 1.6 mg/dl in men and 0.9 mg/dl in women. The prevalence of cigarette smoking declined by 14% in men and 18% in women. In contrast, the average body mass index increased 0.6 kg/m2 in men and 1.2 kg/m2 in women. Systematic hospital and death certificate surveillance found that mortality rates for coronary heart disease in the Twin Cities metropolitan area declined 20.1% in men and 12.9% in women from 1981 to 1986. Despite difficulties in interpretation of ecologic studies, it appears likely that improvements in population risk factor levels played a role in the decline in disease rates and could influence future mortality trends in this population.

No abstract

We surveyed 1,000 randomly selected state-licensed pesticide appliers to improve our understanding of pesticide use and its potential health effects. Participants were stratified by pesticide class (herbicides, insecticides, fungicides, fumigants) to determine potential differences in health characteristics among different pesticide groups. A subset of 60 applicators, divided by pesticide class used, were studied for exposure-related cholinesterase (ChE) depression. ChE depression in excess of 20% was most frequent in fumigant applicators who did enclosed-space application, in addition to other pesticide application procedures (p < .05). Survey data demonstrated that the prevalence of all common chronic diseases considered together was significantly increased (p = .015) in fumigant appliers, compared with all other pesticide use groups. The frequency of chronic lung disease was also significantly increased in the fumigant applier group (p = .027). Curiously, two cases of a rare hematopoietic neoplasm--hairy cell leukemia--were identified in our study group (annual incidence 0.67/100,000 in Minnesota). Whether there is an association between this unique tumor and agricultural work is uncertain, and further study is needed in this regard.