By the year 2050, the population of the United States is projected to be approximately half white and half non-white. Yet the knowledge of child development within ethnic minority groups lags markedly behind knowledge of child development for white Americans, and it is increasingly clear that the rich diversity within minority groups is masked by studies focusing on between-group comparisons. Children of Color: Research, Health, and Public Policy Issues, a collection of original essays, brings together researchers from the fields of education, family and child ecology, nursing, psychology, sociology, pediatrics, anthropology, and social work to explore the rich cultural, familial, and individual diversity of all ethnic minority groups. The essays were generated by round table discussions sponsored by the Society for Research in Child Development and the Irving Harris Foundation, and they cover a broad range of topics including immigration policy, social policy, health status of immigrant infants, children and families, and educational policies related to minority children.

Background & Aims: Gastrin is a putative promoter of colorectal carcinomas. The aim of this study was to evaluate the temporal relationship between gastrinemia and development of colorectal malignancy.

Methods: We conducted a nested case-control study among 128,992 subscribers to a health maintenance program who had participated in a multiphasic health checkup between 1964 and 1969. Serum had been frozen since the checkup and the cohort followed up for cancer. Of 1881 incident colorectal carcinoma cases, 250 were randomly selected; 1 control without cancer was matched to each case by age, sex, education, and date of serum collection. Stored sera were tested for Helicobacter pylori immunoglobulin G and for gastrin and glycine-extended gastrin.

Results: Verified cases included 166 colon cancers, 58 rectal cancers, and 9 with cancer in both locations. A mean of 15.3 years had elapsed between serum collection and diagnosis of cancer. Median gastrin levels were similar in cases and controls (41.7 vs. 40.7 pg/mL). However, a gastrin level above normal was associated with increased risk for colorectal malignancy (odds ratio, 3.9; 95% confidence interval, 1.5-9.8). If this association is causal, 8.6% of colorectal cancers could be attributed to high serum gastrin level.

Conclusions: Hypergastrinemia is associated with an increased risk of colorectal carcinoma.

Does government spend too little or too much on child care? How can education dollars be spent more efficiently? Should government's role in medical care increase or decrease? In this volume, social scientists, lawyers, and a physician explore the political, social, and economic forces that shape policies affecting human services.

Four in-depth studies of human-service sectors - child care, education, medical care, and long-term care for the elderly - are followed by six cross-sector studies that stimulate new ways of thinking about human services through the application of economic theory, institutional analysis, and the history of social policy.

This timely study sheds important light on the tension between individual and social responsibility, and will appeal to economists and other social scientists and policymakers concerned with social policy issues.

Abstract

Although economic research has not yet produced accurate estimates of the total cost of prenatal substance exposure, there is growing evidence that this exposure may result in large short-term expenditures for newborn medical intensive care and probably even larger long-term medical, social, and educational expenditures. The annual short-term economic costs due to maternal smoking are estimated to be from $332 million to $652 million (in 1986 dollars). Long-term costs due to maternal smoking are estimated at $351 million to $852 million (in 1986 dollars) per year. In comparison, the short-term economic costs for perinatal cocaine exposure are estimated at $33 million to $650 million (in 1989 dollars). The cost estimates for cocaine vary widely because accurate estimates of the number of infants born exposed to this drug each year are not available.

Programs aimed at reducing the number of women who use drugs during pregnancy, and thus reducing the overall rate of low birth weight and the need for neonatal intensive care, may be extremely cost-effective. Because of the high cost of neonatal intensive care, even moderately effective programs that address maternal substance abuse may be cost-effective and may rapidly yield savings. Substantial long-term costs may also be saved by avoiding the need for subsequent medical care and for social and special education services that may be consequences of prenatal substance exposure.