Socioeconomic Factors at the Intersection of Race and Ethnicity Influencing Health Risks for People with Disabilities.

PubMed

Courtney-Long, Elizabeth A; Romano, Sebastian D; Carroll, Dianna D; Fox, Michael H

2017-04-01

People with disabilities are known to experience disparities in behavioral health risk factors including smoking and obesity. What is unknown is how disability, race/ethnicity, and socioeconomic status combine to affect prevalence of these health behaviors. We assessed the association between race/ethnicity, socioeconomic factors (income and education), and disability on two behavioral health risk factors. Data from the 2007-2010 Behavioral Risk Factor Surveillance System were used to determine prevalence of cigarette smoking and obesity by disability status, further stratified by race and ethnicity as well as income and education. Logistic regression was used to determine associations of income and education with the two behavioral health risk factors, stratified by race and ethnicity. Prevalence of disability by race and ethnicity ranged from 10.1 % of Asian adults to 31.0 % of American Indian/Alaska Native (AIAN) adults. Smoking prevalence increased with decreasing levels of income and education for most racial and ethnic groups, with over half of white (52.4 %) and AIAN adults (59.3 %) with less than a high school education reporting current smoking. Education was inversely associated with obesity among white, black, and Hispanic adults with a disability. Smoking and obesity varied by race and ethnicity and socioeconomic factors (income and education) among people with disabilities. Our findings suggest that disparities experienced by adults with disabilities may be compounded by disparities associated with race, ethnicity, and socioeconomic factors. This knowledge may help programs in formulating health promotion strategies targeting people at increased risk for smoking and obesity, inclusive of those with disabilities.

Socioeconomic Factors at the Intersection of Race and Ethnicity Influencing Health Risks for People with Disabilities

PubMed Central

Romano, Sebastian D.; Carroll, Dianna D.; Fox, Michael H.

2016-01-01

Objectives People with disabilities are known to experience disparities in behavioral health risk factors including smoking and obesity. What is unknown is how disability, race/ethnicity, and socioeconomic status combine to affect prevalence of these health behaviors. We assessed the association between race/ethnicity, socio-economic factors (income and education), and disability on two behavioral health risk factors. Methods Data from the 2007–2010 Behavioral Risk Factor Surveillance System were used to determine prevalence of cigarette smoking and obesity by disability status, further stratified by race and ethnicity as well as income and education. Logistic regression was used to determine associations of income and education with the two behavioral health risk factors, stratified by race and ethnicity. Results Prevalence of disability by race and ethnicity ranged from 10.1 % of Asian adults to 31.0 % of American Indian/ Alaska Native (AIAN) adults. Smoking prevalence increased with decreasing levels of income and education for most racial and ethnic groups, with over half of white (52.4 %) and AIAN adults (59.3 %) with less than a high school education reporting current smoking. Education was inversely associated with obesity among white, black, and Hispanic adults with a disability. Conclusion Smoking and obesity varied by race and ethnicity and socioeconomic factors (income and education) among people with disabilities. Our findings suggest that disparities experienced by adults with disabilities may be compounded by disparities associated with race, ethnicity, and socioeconomic factors. This knowledge may help programs in formulating health promotion strategies targeting people at increased risk for smoking and obesity, inclusive of those with disabilities. PMID:27059052

Working Class Matters: Socioeconomic Disadvantage, Race/Ethnicity, Gender, and Smoking in NHIS 2000

PubMed Central

Barbeau, Elizabeth M.; Krieger, Nancy; Soobader, Mah-Jabeen

2004-01-01

Objectives. We sought to describe the burden of smoking on the US population, using diverse socioeconomic measures. Methods. We analyzed data from the 2000 National Health Interview Survey. Results. Overall, the prevalence of current smoking was greatest among persons in—and independently associated with—working class jobs, low educational level, and low income. Attempts to quit showed no socioeconomic gradient, while success in quitting was greatest among those with the most socioeconomic resources. These patterns held in most but not all race/ethnicity–gender groups. Finer resolution of smoking patterns was obtained using a relational UK occupational measure, compared to the skill-based measure commonly used in US studies. Conclusions. Reducing social disparities in smoking requires attention to the complexities of class along with race/ethnicity and gender. PMID:14759942

Race/Ethnicity, Life-Course Socioeconomic Position, and Body Weight Trajectories Over 34 years: The Alameda County Study

PubMed Central

Baltrus, Peter T.; Lynch, John W.; Everson-Rose, Susan; Raghunathan, Trivellore E.; Kaplan, George A.

2005-01-01

Objectives. We investigated whether race differences in weight gain over 34 years were because of socioeconomic position (SEP) and psychosocial and behavioral factors (physical activity, cigarette smoking, alcohol consumption, depression, marital status, number of children). We used a life-course approach to SEP with 4 measures of SEP (childhood SEP, education, occupation, income) and a cumulative measure of SEP. Methods. We used mixed models and data collected from the Alameda County Study to examine the association between race and weight change slopes and baseline weight in men (n=1186) and women (n=1375) aged 17 to 40 years at baseline (in 1965). Results. All subjects gained weight over time. African American women weighed 4.96 kg (P < .001) more at baseline and gained 0.10 kg/year (P = .043) more weight than White women. Black men weighed 2.41 kg (P= .006) more at baseline but did not gain more weight than White men. The association of race with weight gain in women was largely because of cumulative SEP score. Conclusions. Interventions to prevent overweight and obesity should begin early in life and target the socioeconomically disadvantaged. PMID:16051936

Short and Long Sleep Duration Associated with Race/Ethnicity, Sociodemographics, and Socioeconomic Position

PubMed Central

Whinnery, Julia; Jackson, Nicholas; Rattanaumpawan, Pinyo; Grandner, Michael A.

2014-01-01

Study Objectives: Short and/or long sleep duration are associated with cardiometabolic disease risk and may be differentially experienced among minorities and the socioeconomically disadvantaged. The present study examined nationally representative data along multiple dimensions of race/ ethnicity and socioeconomic status. Design: Cross-sectional. Setting: Survey. Patients or Participants: 2007-2008 NHANES (N = 4,850). Interventions: None. Measurements and Results: Self-reported sleep duration was classified as very short (< 5 h), short (5-6 h), normative (7-8 h) and long (≥ 9 h). Population-weighted multinomial logistic regression analyses examined race/ ethnicity, country of origin, language, income, education, health insurance, and food security, controlling for all others as well as age, sex, marital-status, and overall self-rated health. Outcome was self-reported sleep duration, relative to normative sleep duration. Blacks/African Americans were more likely than whites to report very short (OR = 2.34, P < 0.001) and short (OR = 1.85, P < 0.001) sleep. Mexican Americans reported less long sleep (OR = 0.36, P = 0.032). Other Hispanics/ Latinos reported more very short sleep (OR = 2.69, P = 0.025). Asians/ Others reported more very short (OR = 3.99, P = 0.002) and short (OR = 2.08, P = 0.002) sleep. Mexico-born adults reported less short sleep (OR = 0.63, P = 0.042). Spanish-only speakers reported less very short sleep (OR = 0.32, P = 0.030). Lower income groups reported more very short sleep versus > $75,000. Compared to college graduates, increased very short sleep was seen among all lower education levels. Those with public insurance reported more very short (OR = 1.67, P = 0.31) and long (OR = 1.83, P = 0.011) sleep versus uninsured. Very low food security was associated with very short (OR = 1.86, P = 0.036) and short (OR = 1.44, P = 0.047) sleep. Conclusions: Minority status and lower socioeconomic position were associated with shorter self-reported sleep

Who is Most Susceptible to Movie Smoking Effects? Exploring the Impacts of Race and Socioeconomic Status

PubMed Central

Soneji, Samir; Lewis, Valerie; Tanski, Susanne; Sargent, James D.

2012-01-01

Aims This study assesses how race/ethnicity and socioeconomic status (SES) modify the relationship between exposure to movie smoking and having tried smoking in adolescents. Design Data come from a cross-sectional telephone survey and were analyzed using logistic regression models. A respondent reporting ever having tried smoking was regressed on exposure to movie smoking, race, socioeconomic status, the interactions of these variables, and family and background characteristics. Setting National sample of US adolescents. Participants 3653 respondents aged 13–18 years. Measurements Outcome was if subjects reported ever having tried smoking. Movie smoking exposure was assessed through respondents’ reporting having watched a set of movie titles, which were coded for smoking instances. Findings The proportion having tried smoking was lower for Blacks (0.32) compared to Hispanics (0.41) and Whites (0.38). The relationship between movie smoking and having tried smoking varied by race/ethnicity. Among Whites and Hispanics exposure to movie smoking positively predicted smoking behavior, but movie smoking had no impact on Blacks. SES further modified the relation among Whites; high SES white adolescents were more susceptible to movie smoking than low SES white adolescents. Conclusions Exposure to movie smoking is not uniformly experienced as a risk factor for having ever tried smoking among U.S. adolescents. Whites and Hispanics are more likely to try smoking as a function of increased exposure to movie smoking. In addition, higher socioeconomic status increases susceptibility to movie smoking among Whites. Youth with fewer risk factors may be more influenced by media messages on smoking. PMID:22724674

The link between body dissatisfaction and self-esteem in adolescents: similarities across gender, age, weight status, race/ethnicity, and socioeconomic status.

PubMed

van den Berg, Patricia A; Mond, Jonathan; Eisenberg, Marla; Ackard, Diann; Neumark-Sztainer, Dianne

2010-09-01

The present study examined whether the cross-sectional association between body dissatisfaction and low self-esteem varies across gender, age, body weight status, race/ethnicity, and socioeconomic status (SES). We also examined the association longitudinally. A school-based survey of eating, weight, and related attitudes was conducted with a diverse sample of adolescents aged 11-18 years (N = 4,746). Height and weight were measured in the schools at Time 1. Participants were resurveyed through mails 5 years later (Time, 2; N = 2,516). The relationship between body dissatisfaction and self-esteem was strong and significant in both boys and girls (all p values < .0001), and did not differ significantly between genders (p = .16), or between the middle school and high school cohorts in either boys (p = .79) or girls (p = .80). Among girls, the relationship between body dissatisfaction and self-esteem was strong, but did vary across weight status, race/ethnicity, and SES (all p values = .0001-.03). The relationship was nonsignificant in underweight girls (p = .36), and weaker but still significant among black, Asian, and low SES group girls (all p values < .0001) in comparison to white and high SES group girls. Among boys, the association did not differ significantly across demographic groups (all p values = .18-.79). In longitudinal analyses, the strength of the association did not change significantly as adolescents grew older. Findings indicate that body dissatisfaction and self-esteem are strongly related among nearly all groups of adolescents. This suggests the importance of addressing body image concerns with adolescents of all backgrounds and ages.

Race, Age, and Neighborhood Socioeconomic Status in Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry.

PubMed

Coley, Sheryl L; Nichols, Tracy R

2016-01-01

Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers. Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial status, age, and neighborhood socioeconomic status (as defined by census-tract median household income) and low birth weight outcomes across census tracts. Significant racial differences were identified in which African-American adolescents had greater odds of low birth weight outcomes than Caucasian adolescents (OR=1.88, 95% CI 1.64, 2.15). Although racial disparities in low birth weight outcomes remained significant in context of maternal age and neighborhood socioeconomic status, the greatest disparities were found between African-American and Caucasian adolescents that lived in areas of higher socioeconomic status (p<.001). Maternal age was not significantly associated with racial differences in low birth weight outcomes. These findings indicate that racial disparities in low birth weight outcomes among adolescent mothers can vary by neighborhood socioeconomic status. Further investigations using intersectional frameworks are needed for examining the relationships between neighborhood socioeconomic status and birth outcome disparities among infants born to adolescent mothers.

Older Adults' Internet Use for Health Information: Digital Divide by Race/Ethnicity and Socioeconomic Status.

PubMed

Yoon, Hyunwoo; Jang, Yuri; Vaughan, Phillip W; Garcia, Michael

2018-04-01

Building upon literature suggesting low Internet use among racial/ethnic minorities and socioeconomically disadvantaged groups, this study examined how race/ethnicity and socioeconomic status (SES) influence the Internet use for health information, addressing both independent and interactive effects. Using data from 17,704 older adults in the California Health Interview Survey, logistic regression models were estimated with race/ethnicity (Whites, African Americans, Latinos, and Asians), SES index, and the interaction between race/ethnicity and SES index. Overall, approximately 40% of participants were Internet-users for health information. Direct effects of race/ethnicity and SES-and their interactions-were all found to be significant. Minority status combined with the lowest levels of SES substantially reduced the odds of using Internet for health information. Findings suggest the combination of racial/ethnic minority status and low SES as a source of digital divide, and provide implications for Internet technology training for the target population.

Late life socioeconomic status and hypertension in an aging cohort: the Atherosclerosis Risk in Communities Study.

PubMed

McDoom, M Maya; Palta, Priya; Vart, Priya; Juraschek, Stephen P; Kucharska-Newton, Anna; Diez Roux, Ana V; Coresh, Josef

2018-06-01

To investigate the association between individual and area-level socioeconomic status and hypertension risk among individuals later in life. We used Cox proportional hazards models to examine the association of socioeconomic status with incident hypertension using race-specific neighborhood socioeconomic status, median household income, and education among 3372 participants (mean age, 61 years) from the Atherosclerosis Risk in Communities Study at Visit 4 (1996-1998). Incident hypertension was defined as self-reported diagnosis or reported use of antihypertensive medications. Over a median follow-up time of 9.4 years, there were 1874 new cases of hypertension (62.1 per 1000 person-years). Overall, being in high as compared with low socioeconomic status categories was associated with a lower risk of developing hypertension in late life, with hazard ratios (95% confidence intervals) of 0.87 (0.77-0.98) for high neighborhood socioeconomic status tertile, 0.79 (0.69-0.90) for high individual income, and 0.75 (0.63-0.89) for college education after adjustment for traditional risk factors. These findings were consistent and robust whenever accounting for competing risks of all-cause mortality. No significant interactions by race and age (dichotomized at age 65) were observed. Among participants free of hypertension in midlife, high neighborhood and individual socioeconomic status are associated with a decreased risk of incident hypertension. Our findings support population-level interventions, such as blood pressure screening at senior centers and faith-based organizations, that are tailored to shift the distribution of blood pressure and reduce hypertension health inequalities among older adults.

Mind the gap: race/ethnic and socioeconomic disparities in obesity.

PubMed

Krueger, Patrick M; Reither, Eric N

2015-11-01

Race/ethnic and socioeconomic status (SES) disparities in obesity are substantial and may widen in the future. We review nine potential mechanisms that recent research has used to explain obesity disparities. Those nine mechanisms fall into three broad groups-health behaviors, biological factors, and the social environment-which incorporate both proximate and upstream determinants of obesity disparities. Efforts to reduce the prevalence of obesity in the US population and to close race/ethnic and SES disparities in obesity will likely require the use of multifaceted interventions that target multiple mechanisms simultaneously. Unfortunately, relatively few of the mechanisms reviewed herein have been tested in an intervention framework.

Mind the Gap: Race\\Ethnic and Socioeconomic Disparities in Obesity

PubMed Central

Reither, Eric N.

2016-01-01

Race/ethnic and socioeconomic status (SES) disparities in obesity are substantial and may widen in the future. We review seven potential mechanisms that recent research has used to explain obesity disparities. Those seven mechanisms fall into three broad groups—health behaviors, biological and developmental factors, and the social environment—which incorporate both proximate and upstream determinants of obesity disparities. Efforts to reduce the prevalence of obesity in the U.S. population and to close race/ethnic and SES disparities in obesity will likely require the use of multifaceted interventions that target multiple mechanisms simultaneously. Unfortunately, relatively few of the mechanisms reviewed herein have been tested in an intervention framework. PMID:26377742

Socioeconomic Status, Not Race, Is Associated With Reduced Survival in Esophagectomy Patients.

PubMed

Erhunmwunsee, Loretta; Gulack, Brian C; Rushing, Christel; Niedzwiecki, Donna; Berry, Mark F; Hartwig, Matthew G

2017-07-01

Black patients with esophageal cancer have worse survival than white patients. This study examines this racial disparity in conjunction with socioeconomic status (SES) and explores whether race-based outcome differences exist using a national database. The associations between race and SES with overall survival of patients treated with esophagectomy for stages I to III esophageal cancer between 2003 and 2011 in the National Cancer Data Base were investigated using the Kaplan-Meier method and proportional hazards analyses. Median income by zip code and proportion of the zip code residents without a high school diploma were grouped into income and education quartiles, respectively and used as surrogates for SES. The association between race and overall survival stratified by SES is explored. Of 11,599 esophagectomy patients who met study criteria, 3,503 (30.2%) were in the highest income quartile, 2,847 (24.5%) were in the highest education quartile, and 610 patients (5%) were black. Before adjustment for SES, black patients had worse overall survival than white patients (median survival 23.0 versus 34.7 months, log rank p < 0.001), and overall, survival times improved with increasing income and education (p < 0.001 for both). After adjustment for putative prognostic factors, SES was associated with overall survival, whereas race was not. Prior studies have suggested that survival of esophageal cancer patients after esophagectomy is associated with race. Our study suggests that race is not significantly related to overall survival when adjusted for other prognostic variables. Socioeconomic status, however, remains significantly related to overall survival in our model. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

TV Viewing and BMI by Race/Ethnicity and Socio-Economic Status

PubMed Central

Shuval, Kerem; Gabriel, Kelley Pettee; Leonard, Tammy

2013-01-01

Objective To assess the association between TV viewing and obesity by race/ethnicity and socio-economic status. Design Cross-sectional analysis of 5,087 respondents to the Health Information National Trends Survey (HINTS), a nationally representative sample of US adults. Multivariate regression models were computed to assess the association between quartiles of TV viewing and BMI, stratified by race/ethnicity, educational attainment, employment and health insurance status. Results Findings indicate that increased TV viewing was associated with higher odds for being overweight/obese in the entire sample, while adjusting for physical activity and other confounders. After stratification by race/ethnicity, increased odds for overweight/obesity in the 3rd and 4th quartiles of TV viewing (e.g., 3rd quartile- cumulative OR = 1.43, 95%CI 1.07–1.92) was observed in non-Hispanic whites, with statistical significance. In non-Hispanic blacks and Hispanics, the odds were similar to whites, but did not reach statistical significance. Significant relations between greater TV viewing and increased BMI were observed in college graduates and non-graduates, those with health insurance and the employed. Conclusions This study extends previous research by examining potential inconsistencies in this association between various racial/ethnic groups and some socio-economic variables, which primarily were not found. PMID:23691070

Differential trends in weight-related health behaviors among American young adults by gender, race/ethnicity, and socioeconomic status: 1984-2006.

PubMed

Clarke, Philippa J; O'Malley, Patrick M; Johnston, Lloyd D; Schulenberg, John E; Lantz, Paula

2009-10-01

We investigated temporal patterns from 1984 to 2006 in 6 weight-related health behaviors by using longitudinal data for multiple cohorts of young adults (aged 19-26 years) from the nationally representative Monitoring the Future Study. We used growth curve models to examine historical trends in 6 health behaviors: frequency of eating breakfast, eating green vegetables, eating fruit, exercising, watching television, and sleeping 7 hours each night. Variations across gender, race/ethnicity, and socioeconomic status were investigated. Frequency of exercising was consistently lower among young adult women than young adult men over this 23-year period. Compared with White women, Hispanic women, and women from other race/ethnic groups, Black women showed declines in the frequency of exercise since 1984. In general, young adult women showed a marked increase in the frequency of eating breakfast over this period, although Black women did not show any net gains. Social disparities in body weight may increase because Black women, Hispanic women, and men with lower socioeconomic status show declining trends in positive weight-related health behaviors compared with White young adults with higher socioeconomic status.

A National Study of the Effect of Race, Socioeconomic Status, and Gender on Burn Outcomes.

PubMed

Bedri, Hala; Romanowski, Kathleen S; Liao, Junlin; Al-Ramahi, Ghassan; Heard, Jason; Granchi, Thomas; Wibbenmeyer, Lucy

Age, burn size, and inhalation injury are the major contributing variables related to burn mortality. While the female gender has been linked to higher mortality, the impact of socioeconomic status has not been well studied. The interplay between these three factors is also unknown. This study sought to clarify the effects of these variables on outcomes in a national sample of patients with burns. A retrospective review of 172,640 patient records of the National Burn Repository (version 8, 2002-2011) data was conducted. Of those records, 36,960 (21.4%) patient entries were excluded for duplicate entries, follow-up visits, readmissions, nonburn injuries, skin diseases, and incompleteness (missing date of admission, date of discharge, race, or TBSA of burn or TBSA). Univariate and multivariate analyses were performed to compare outcomes by race (Caucasian, African-American, and other minority groups). P < .05 was considered significant. The study group included 135,680 patients and was predominately Caucasian (59.0% Caucasian, 19.0% African-American, and 22.0% other minority groups). The African-American race had more females, operations, longer length of stay, ventilator days, septicemia (all P < .001), and urinary tract infections (UTIs, P < .01). Caucasians had the largest burns (9.27 ± 13.22, P <.001) and were more likely to be older, to be intubated, and to have longer intensive care unit stays and higher mortality (all P < .001). Other non-African-American minorities (other minority group) had the second largest burn sizes, most uninsured members, and lowest mortality (P < .001). On multivariate analysis, mortality was related to African-American race, female gender, TBSA, full-thickness burn injury, inhalation injury, uninsured status, and burn mechanism. African-Americans were 50% more likely to have complications (P < .001), 30% more likely to have UTIs (P = .002), and 41% more likely to get septicemia (P < .001). Other racial minority groups had more

Concurrent Social Disadvantages and Chronic Inflammation: The Intersection of Race and Ethnicity, Gender, and Socioeconomic Status.

PubMed

Richman, Aliza D

2017-08-28

Disadvantaged social statuses, such as being female, poor, or a minority, are associated with increased psychosocial stress and elevated circulating concentrations of C-reactive protein, a biomarker of chronic inflammation and indicator of cardiovascular health. Individuals' experience of embodying psychosocial stress revolves around the multiplicative effects of concurrent gender, socioeconomic, and racial and ethnic identities. This study expands on prior research by examining chronic inflammation at the intersection of race and ethnicity, gender, socioeconomic status, and age group to understand which demographic subgroups in society are most vulnerable to the cumulative effects of social disadvantage. Using data from the National Health and Nutrition Examination Survey 2007-2010, the findings reveal inflammation disparities between non-poor whites and the following demographic subgroups, net of sociodemographic and biological factors: young poor Hispanic women, young poor white men, young poor and non-poor Hispanic men, middle-aged poor and non-poor black women, middle-aged poor and non-poor black men, and middle-aged poor Hispanic men. Disparities in inflammation on account of social disadvantage are most evident among those aged 45-64 years and diminish for those 65 and older in both men and women.

Prenatal attitudes toward vaginal delivery and actual delivery mode: Variation by race/ethnicity and socioeconomic status.

PubMed

Attanasio, Laura B; Hardeman, Rachel R; Kozhimannil, Katy B; Kjerulff, Kristen H

2017-12-01

Researchers documenting persistent racial/ethnic and socioeconomic status disparities in chances of cesarean delivery have speculated that women's birth attitudes and preferences may partially explain these differences, but no studies have directly tested this hypothesis. We examined whether women's prenatal attitudes toward vaginal delivery differed by race/ethnicity or socioeconomic status, and whether attitudes were differently related to delivery mode depending on race/ethnicity or socioeconomic status. Data were from the First Baby Study, a cohort of 3006 women who gave birth to a first baby in Pennsylvania between 2009 and 2011. We used regression models to examine (1) predictors of prenatal attitudes toward vaginal delivery, and (2) the association between prenatal attitudes and actual delivery mode. To assess moderation, we estimated models adding interaction terms. Prenatal attitudes toward vaginal delivery were not associated with race/ethnicity or socioeconomic status. Positive attitudes toward vaginal delivery were associated with lower odds of cesarean delivery (AOR=0.60, P < .001). However, vaginal delivery attitudes were only related to delivery mode among women who were white, highly educated, and privately insured. There are racial/ethnic differences in chances of cesarean delivery, and these differences are not explained by birth attitudes. Furthermore, our findings suggest that white and high-socioeconomic status women may be more able to realize their preferences in childbirth. © 2017 Wiley Periodicals, Inc.

Short and long sleep duration associated with race/ethnicity, sociodemographics, and socioeconomic position.

PubMed

Whinnery, Julia; Jackson, Nicholas; Rattanaumpawan, Pinyo; Grandner, Michael A

2014-03-01

Short and/or long sleep duration are associated with cardiometabolic disease risk and may be differentially experienced among minorities and the socioeconomically disadvantaged. The present study examined nationally representative data along multiple dimensions of race/ ethnicity and socioeconomic status. Cross-sectional. Survey. 2007-2008 NHANES (N = 4,850). None. Self-reported sleep duration was classified as very short (< 5 h), short (5-6 h), normative (7-8 h) and long (≥ 9 h). Population-weighted multinomial logistic regression analyses examined race/ ethnicity, country of origin, language, income, education, health insurance, and food security, controlling for all others as well as age, sex, marital-status, and overall self-rated health. Outcome was self-reported sleep duration, relative to normative sleep duration. Blacks/African Americans were more likely than whites to report very short (OR = 2.34, P < 0.001) and short (OR = 1.85, P < 0.001) sleep. Mexican Americans reported less long sleep (OR = 0.36, P = 0.032). Other Hispanics/ Latinos reported more very short sleep (OR = 2.69, P = 0.025). Asians/ Others reported more very short (OR = 3.99, P = 0.002) and short (OR = 2.08, P = 0.002) sleep. Mexico-born adults reported less short sleep (OR = 0.63, P = 0.042). Spanish-only speakers reported less very short sleep (OR = 0.32, P = 0.030). Lower income groups reported more very short sleep versus > $75,000. Compared to college graduates, increased very short sleep was seen among all lower education levels. Those with public insurance reported more very short (OR = 1.67, P = 0.31) and long (OR = 1.83, P = 0.011) sleep versus uninsured. Very low food security was associated with very short (OR = 1.86, P = 0.036) and short (OR = 1.44, P = 0.047) sleep. Minority status and lower socioeconomic position were associated with shorter self-reported sleep durations.

Socioeconomic Status and Race Outperform Concussion History and Sport Participation in Predicting Collegiate Athlete Baseline Neurocognitive Scores.

PubMed

Houck, Zac; Asken, Breton; Clugston, James; Perlstein, William; Bauer, Russell

2018-01-01

The purpose of this study was to assess the contribution of socioeconomic status (SES) and other multivariate predictors to baseline neurocognitive functioning in collegiate athletes. Data were obtained from the Concussion Assessment, Research and Education (CARE) Consortium. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baseline assessments for 403 University of Florida student-athletes (202 males; age range: 18-23) from the 2014-2015 and 2015-2016 seasons were analyzed. ImPACT composite scores were consolidated into one memory and one speed composite score. Hierarchical linear regressions were used for analyses. In the overall sample, history of learning disability (β=-0.164; p=.001) and attention deficit-hyperactivity disorder (β=-0.102; p=.038) significantly predicted worse memory and speed performance, respectively. Older age predicted better speed performance (β=.176; p<.001). Black/African American race predicted worse memory (β=-0.113; p=.026) and speed performance (β=-.242; p<.001). In football players, higher maternal SES predicted better memory performance (β=0.308; p=.007); older age predicted better speed performance (β=0.346; p=.001); while Black/African American race predicted worse speed performance (β=-0.397; p<.001). Baseline memory and speed scores are significantly influenced by history of neurodevelopmental disorder, age, and race. In football players, specifically, maternal SES independently predicted baseline memory scores, but concussion history and years exposed to sport were not predictive. SES, race, and medical history beyond exposure to brain injury or subclinical brain trauma are important factors when interpreting variability in cognitive scores among collegiate athletes. Additionally, sport-specific differences in the proportional representation of various demographic variables (e.g., SES and race) may also be an important consideration within the broader biopsychosocial attributional model. (JINS, 2018

Menu labels, for better, and worse? Exploring socio-economic and race-ethnic differences in menu label use in a national sample.

PubMed

Feng, Wenhui; Fox, Ashley

2018-06-09

Menu calorie labeling aims to empower customers to make healthier food choices, but researchers have questioned whether labels will empower those with greater health literacy, literacy or numeracy more, possibly reinforcing race-ethnic or socioeconomic inequalities in obesity. The goal of this study was to investigate differences in seeing and using restaurant menu calorie labels and whether differences have compounded over time. Using data from three rounds of the National Health and Nutrition Examination Survey covering the period 2007-2014, we investigate race-ethnic and socio-economic differences in menu label usage over time adjusting for sex, age and body weight. While menu label usage increased over time, not all groups increased their use equally. While we find that Blacks and Hispanics use labels more than Whites in sit-down restaurants, more educated individuals, higher income groups and Whites each increased the degree to which they saw and/or used labels in certain settings compared with other groups. This study reinforces concerns that menu-calorie labeling may exacerbate socio-economic and certain race-ethnic obesity differences. As menu labeling policy moves forward to be implemented federally, more attention may need to be diverted to educational campaigns accompanying the implementation and improving the labels so the information is easier to use. Copyright © 2018 Elsevier Ltd. All rights reserved.

Race/Ethnicity, Socioeconomic Status, and Satisfaction With Health Care

PubMed Central

Haviland, Mark G.; Morales, Leo S.; Dial, Thomas H.; Pincus, Harold Alan

2006-01-01

The purpose of the present study was to evaluate the effects of race/ethnicity and socioeconomic status on consumer health care satisfaction ratings. The authors analyzed national data from the 2001 National Research Corporation Healthcare Market Guide Survey (N = 99 102). Four global and 3 composite ratings were examined. In general, satisfaction ratings were high across all global and composite measures; however, Asian/Pacific Islanders and Hispanics gave lower ratings than did whites, and African Americans gave a mix of higher and lower ratings (vs whites). Among the lowest ratings were those given by American Indians/Alaska Natives living in poverty. Race/ethnicity effects were independent of education and income. These findings are consistent with reports of continuing racial/ethnic disparities in both coverage and care. Programs to improve quality of care must specifically address these well-documented, severe, and persistent disparities. PMID:16020676

Understanding associations among race, socioeconomic status, and health: Patterns and prospects.

PubMed

Williams, David R; Priest, Naomi; Anderson, Norman B

2016-04-01

Race/ethnicity and socioeconomic status (SES) are social categories that capture differential exposure to conditions of life that have health consequences. Race/ethnicity and SES are linked to each other, but race matters for health even after SES is considered. This commentary considers the complex ways in which race combines with SES to affect health. There is a need for greater attention to understanding how risks and resources in the social environment are systematically patterned by race, ethnicity and SES, and how they combine to influence cardiovascular disease and other health outcomes. Future research needs to examine how the levels, timing and accumulation of institutional and interpersonal racism combine with other toxic exposures, over the life-course, to influence the onset and course of illness. There is also an urgent need for research that seeks to build the science base that will identify the multilevel interventions that are likely to enhance the health of all, even while they improve the health of disadvantaged groups more rapidly than the rest of the population so that inequities in health can be reduced and ultimately eliminated. We also need sustained research attention to identifying how to build the political support to reduce the large shortfalls in health. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The Relationship of Pressure Ulcers, Race, and Socioeconomic Conditions After Spinal Cord Injury

PubMed Central

Saunders, Lee L; Krause, James S; Peters, Bridget A; Reed, Karla S

2010-01-01

Objective: To identify risks factors associated with pressure ulcers (PrU) after spinal cord injury (SCI) by examining race and indicators of socioeconomic status (measured by income and education). We hypothesize African Americans will have a greater risk for PrUs than whites, but this relationship will be mediated by the 2 socioeconomic status indicators. Design: Cohort study. Setting: A large rehabilitation hospital in the southeastern US. Participants: 1,466 white and African American adults at least 1-year post-traumatic SCI. Outcome Measures: (a) PrUs in the past year, (b) current PrU, (c) surgery to repair a PrU since injury. Results: In preliminary analyses, race was significantly associated with having a current PrU and with having surgery to repair a PrU since injury. In multivariable analyses, the relationships of PrU with having a current PrU and with having surgery to repair a PrU were both mediated by income and education such that the relationships were no longer significant. Lower income was associated with increased odds of each PrU outcome. After controlling for other variables in the model, education was associated with increased odds of having a current PrU. Conclusion: These findings help clarify the relationships between race and socioeconomic status with PrUs after SCI. Specifically, a lack of resources, both financial and educational, is associated with worse PrU outcomes. These results can be used by both providers and policy makers when considering prevention and intervention strategies for PrUs among people with SCI. PMID:21061898

Life-span socioeconomic trajectory, nativity, and cognitive aging in Mexican Americans: the Sacramento Area Latino Study on Aging.

PubMed

Haan, Mary N; Zeki Al-Hazzouri, Adina; Aiello, Allison E

2011-07-01

Early life circumstances influence health across the life span. Migration and ethnicity may modify the lifetime trajectory of socioeconomic status (SES) and lead to heterogeneity in cognitive aging in later life. We examined the effects of both lifetime socioeconomic trajectory and cumulative disadvantage from childhood through adulthood on late life cognitive performance in a 9-year cohort of 1,789 Mexican Americans aged 60-100 years in 1998-1999. Compared with those with low SES sustained over the life course, we found that those with more advantaged lifetime SES trajectories experienced fewer declines on a test of global cognitive function and a short-term verbal memory test. These associations are larger in first- and second-generation immigrant families. Heterogeneity of cognitive aging among diverse race/ethnic groups may be influenced by intergenerational changes in SES, cultural norms, and behaviors and changes in health related to changes in the social and physical environment.

Life-span Socioeconomic Trajectory, Nativity, and Cognitive Aging in Mexican Americans: The Sacramento Area Latino Study on Aging

PubMed Central

Zeki Al-Hazzouri, Adina; Aiello, Allison E.

2011-01-01

Objectives. Early life circumstances influence health across the life span. Migration and ethnicity may modify the lifetime trajectory of socioeconomic status (SES) and lead to heterogeneity in cognitive aging in later life. Methods. We examined the effects of both lifetime socioeconomic trajectory and cumulative disadvantage from childhood through adulthood on late life cognitive performance in a 9-year cohort of 1,789 Mexican Americans aged 60–100 years in 1998–1999. Results. Compared with those with low SES sustained over the life course, we found that those with more advantaged lifetime SES trajectories experienced fewer declines on a test of global cognitive function and a short-term verbal memory test. These associations are larger in first- and second-generation immigrant families. Discussion. Heterogeneity of cognitive aging among diverse race/ethnic groups may be influenced by intergenerational changes in SES, cultural norms, and behaviors and changes in health related to changes in the social and physical environment. PMID:21743044

Race, Socioeconomic Status and Health: Complexities, Ongoing Challenges and Research Opportunities

PubMed Central

Williams, David R.; Mohammed, Selina A.; Leavell, Jacinta; Collins, Chiquita

2012-01-01

This paper provides an overview of racial variations in health and shows that differences in socioeconomic status (SES) across racial groups are a major contributor to racial disparities in health. However, race reflects multiple dimensions of social inequality and individual and household indicators of SES capture relevant but limited aspects of this phenomenon. Research is needed that will comprehensively characterize the critical pathogenic features of social environments and identify how they combine with each other to affect health over the life course. Migration history and status are also important predictors of health and research is needed that will enhance understanding of the complex ways in which race, SES, and immigrant status combine to affect health. Fully capturing the role of race in health also requires rigorous examination of the conditions under which medical care and genetic factors can contribute to racial and SES differences in health. The paper identifies research priorities in all of these areas. PMID:20201869

Race, socioeconomic status, and health: complexities, ongoing challenges, and research opportunities.

PubMed

Williams, David R; Mohammed, Selina A; Leavell, Jacinta; Collins, Chiquita

2010-02-01

This paper provides an overview of racial variations in health and shows that differences in socioeconomic status (SES) across racial groups are a major contributor to racial disparities in health. However, race reflects multiple dimensions of social inequality and individual and household indicators of SES capture relevant but limited aspects of this phenomenon. Research is needed that will comprehensively characterize the critical pathogenic features of social environments and identify how they combine with each other to affect health over the life course. Migration history and status are also important predictors of health and research is needed that will enhance understanding of the complex ways in which race, SES, and immigrant status combine to affect health. Fully capturing the role of race in health also requires rigorous examination of the conditions under which medical care and genetic factors can contribute to racial and SES differences in health. The paper identifies research priorities in all of these areas.

Race/Ethnicity, Socioeconomic Status, and Healthcare Intensity at the End of Life.

PubMed

Brown, Crystal E; Engelberg, Ruth A; Sharma, Rashmi; Downey, Lois; Fausto, James A; Sibley, James; Lober, William; Khandelwal, Nita; Loggers, Elizabeth T; Curtis, J Randall

2018-06-12

Although racial/ethnic minorities receive more intense, nonbeneficial healthcare at the end of life, the role of race/ethnicity independent of other social determinants of health is not well understood. Examine the association between race/ethnicity, other key social determinants of health, and healthcare intensity in the last 30 days of life for those with chronic, life-limiting illness. We identified 22,068 decedents with chronic illness cared for at a single healthcare system in Washington State who died between 2010 and 2015 and linked electronic health records to death certificate data. Binomial regression models were used to test associations of healthcare intensity with race/ethnicity, insurance status, education, and median income by zip code. Path analyses tested direct and indirect effects of race/ethnicity with insurance, education, and median income by zip code used as mediators. We examined three measures of healthcare intensity: (1) intensive care unit admission, (2) use of mechanical ventilation, and (3) receipt of cardiopulmonary resuscitation. Minority race/ethnicity, lower income and educational attainment, and Medicaid and military insurance were associated with higher intensity care. Socioeconomic disadvantage accounted for some of the higher intensity in racial/ethnic minorities, but most of the effects were direct effects of race/ethnicity. The effects of minority race/ethnicity on healthcare intensity at the end of life are only partly mediated by other social determinants of health. Future interventions should address the factors driving both direct and indirect effects of race/ethnicity on healthcare intensity.

Comparison of ischemic stroke outcomes and patient and hospital characteristics by race/ethnicity and socioeconomic status.

PubMed

Hanchate, Amresh D; Schwamm, Lee H; Huang, Wei; Hylek, Elaine M

2013-02-01

Current literature provides mixed evidence on disparities by race/ethnicity and socioeconomic status in discharge outcomes after hospitalization for acute ischemic stroke. Using comprehensive data from 8 states, we sought to compare inpatient mortality and length of stay by race/ethnicity and socioeconomic status. We examined all 2007 hospitalizations for acute ischemic stroke in all nonfederal acute care hospitals in Arizona, California, Florida, Maine, New Jersey, New York, Pennsylvania, and Texas. Population was stratified by race/ethnicity (non-Hispanic whites, non-Hispanic blacks, and Hispanics) and socioeconomic status, measured by median income of patient zip code. For each stratum, we estimated risk-adjusted rates of inpatient mortality and longer length of stay (greater than median length of stay). We also compared the hospitals where these subpopulations received care. Hispanic and black patients accounted for 14% and 12% of all ischemic stroke admissions (N=147 780), respectively, and had lower crude inpatient mortality rates (Hispanic=4.5%, blacks=4.4%; all P<0.001) compared with white patients (5.8%). Hispanic and black patients were younger and fewer had any form of atrial fibrillation. Adjusted for patient risk, inpatient mortality was similar by race/ethnicity, but was significantly higher for low-income area patients than that for high-income area patients (odds ratio, 1.08; 95% confidence interval, 1.02-1.15). Risk-adjusted rates of longer length of stay were higher among minority and low-income area populations. Risk-adjusted inpatient mortality was similar among patients by race/ethnicity but higher among patients from lower income areas. However, this pattern was not evident in sensitivity analyses, including the use of mechanical ventilation as a partial surrogate for stroke severity.

Association between Race, Household Income and Grip Strength in Middle- and Older-Aged Adults.

PubMed

Thorpe, Roland J Jr; Simonsick, Eleanor; Zonderman, Alan; Evans, Michelle K

2016-10-20

Poor grip strength is an indicator of frailty and a precursor to functional limitations. Although poor grip strength is more prevalent in older disabled African American women, little is known about the association between race and poverty-related disparities and grip strength in middle-aged men and women. We examined the cross-sectional relationship between race, socioeconomic status as assessed by household income, and hand grip strength in men and women in the Healthy Aging in Neighborhoods of Diversity across the Life Span study. General linear models examined grip strength (maximum of two trials on both sides) by race and household income adjusted for age, weight, height, hand pain, education, insurance status, family income, and two or more chronic conditions. Of 2,091 adults, 422(45.4%) were male, 509(54.8%) were African American, and 320 (34.5%) were living in households with incomes below 125% of the federal poverty level (low SES). In adjusted models, African American women had greater grip strength than White women independent of SES (low income household: 29.3 vs 26.9 kg and high income household: 30.5 vs. 28.3kg; P<.05 for both); whereas in men, only African Americans in the high income household group had better grip strength than Whites (46.3 vs. 43.2; P<.05). The relationship between grip strength, race and SES as assessed by household income varied in this cohort. Efforts to develop grip strength norms and cut points that indicate frailty and sarcopenia may need to be race- and income-specific.

Collective Pedagogical Teacher Culture and Mathematics Achievement: Differences by Race, Ethnicity, and Socioeconomic Status

ERIC Educational Resources Information Center

Moller, Stephanie; Mickelson, Roslyn Arlin; Stearns, Elizabeth; Banerjee, Neena; Bottia, Martha Cecilia

2013-01-01

Scholars have not adequately assessed how organizational cultures in schools differentially influence students' mathematics achievement by race and socioeconomic status (SES). We focus on what we term "collective pedagogical teacher culture", highlighting the role of professional communities and teacher collaboration in influencing…

Surgery for Otitis Media in a Universal Health Care Model: Socioeconomic Status and Race/Ethnicity Effects.

PubMed

Ambrosio, Art; Brigger, Matthew T

2014-07-01

(1) To determine the association between socioeconomic status (SES), race/ethnicity, and other demographic risk factors in surgically managed otitis media within a model of universal health care. 2) To determine quality of life (QOL) outcomes of surgically managed otitis media in this model. Tertiary academic medical center. Prospective cohort study. A prospective study was conducted between June 2011 and December 2012 with dependent children of military families. TRICARE provides equal access to care among all beneficiaries regardless of a wide range of annual incomes. Caretakers of children scheduled for bilateral myringotomy and tympanostomy tube (BMT) placement were administered a demographic survey, as well as OM-6 QOL instrument preoperatively and 6 weeks postoperatively. A control group who did not undergo BMT was also administered both the survey and OM-6 for comparison. Two hundred forty patients were enrolled (120 surgical patients and 120 controls). Logistic regression demonstrated age younger than 6 years old (P < .001), day care attendance (P < .001), and non-Hispanic Caucasian race (P = .022) to be associated with surgery. Surgical QOL outcomes demonstrated a significant improvement in otitis media-6 (OM-6) scores after surgical management from 3.00 (95% confidence interval [CI], 2.79-3.20) to 1.35 (95% CI, 1.22-1.47). In a universal health care model serving more than 2 million children, previously reported proxies of low SES as well as minority race/ethnicity were not associated with surgically managed otitis media contrary to reported literature. Caucasian race, young age, and day care attendance were associated with surgery. Surgery improved QOL outcomes 6 weeks postoperatively. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Changes in prenatal care timing and low birth weight by race and socioeconomic status: implications for the Medicaid expansions for pregnant women.

PubMed

Dubay, L; Joyce, T; Kaestner, R; Kenney, G M

2001-06-01

To conduct the first national study that assesses whether the Medicaid expansions for pregnant women, legislated by Congress over a decade ago, met the policy objectives of improved access to care and birth outcomes for poor and near-poor women. Data on 8.1 million births using the 1980, 1986, and 1993 National Natality Files. We use births from all areas of the United States except California, Texas, Washington, and upstate New York. We conduct a before and after analysis that compares obstetrical outcomes by race and socioeconomic status for the periods 1980-86 and 1986-93. We examine whether women of low socioeconomic status showed greater improvements in outcomes during the 1986-93 period compared to the 1980-86 period. We analyze two obstetrical outcomes: the rate of late initiation of prenatal care and the rate of low birth weight. Natality data were aggregated to race, socioeconomic status, age, and parity groups. During the 1986-93 period, rates of late initiation of prenatal care decreased by 6.0 to 7.8 percentage points beyond changes estimated for the 1980-86 period for both white and African American women of low socioeconomic status. For some white women of low socioeconomic status, the rate of low birth weight was reduced by 0.26 to 0.37 percentage points between 1986 and 1993 relative to the earlier period. Other white women of low socioeconomic status and all African American women of low socioeconomic status showed no relative improvement in the rate of low birth weight during the 1986-93 period. The expansions in Medicaid lead to significant improvements in prenatal care utilization among women of low socioeconomic status. The emerging lesson from the Medicaid expansions, however, is that increased access to primary care is not adequate if the goal is to narrow the gap in newborn health between poor and nonpoor populations.

Math Growth Trajectories of Students with Disabilities: Disability Category, Gender, Racial, and Socioeconomic Status Differences from Ages 7 to 17

ERIC Educational Resources Information Center

Wei, Xin; Lenz, Keith B.; Blackorby, Jose

2013-01-01

This study examined math growth trajectories by disability category, gender, race, and socioeconomic status using a nationally representative sample of students ages 7 to 17. The students represented 11 federal disability categories. Compared with the national norming sample, students in all 11 disability categories had lower math achievement…

Absolute and Relative Socioeconomic Health Inequalities across Age Groups

PubMed Central

van Zon, Sander K. R.; Bültmann, Ute; Mendes de Leon, Carlos F.; Reijneveld, Sijmen A.

2015-01-01

Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender. Methods The study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender. Results Absolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups. Conclusions Absolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of

Race/Ethnic and Nativity Disparities in Later Life Physical Performance: The Role of Health and Socioeconomic Status Over the Life Course

PubMed Central

Krueger, Patrick M.; Rohlfsen, Leah

2012-01-01

Objectives. We examine race/ethnic and nativity differences in objective measures of physical performance (i.e., peak expiratory flow, grip strength, and gait speed) in a nationally representative sample of older Whites, Blacks, and Hispanics. We also examine whether detailed measures of childhood and adult health and socioeconomic status (SES) mediate race/ethnic differences in physical performance. Method. We use data from the Health and Retirement Study, a population-based sample of older Americans born before 1947, and 3 measures of physical performance. Nested ordinary least squares models examine whether childhood and adult health and SES mediate race/ethnic differences in performance. Results. We find large and significant race/ethnic and nativity differences in lung function, grip strength, and gait speed. Adjusting for childhood and current adult health and SES reduces race/ethnic differences in physical performance but does not eliminate them entirely. Childhood health and SES as well as more proximal levels of SES are important determinants of race/ethnic disparities in later life physical performance. Discussion. The analysis highlights that a large proportion of race/ethnic and nativity disparities result from health and socioeconomic disadvantages in both early life and adulthood and thus suggests multiple intervention points at which disparities can be reduced. PMID:22391749

Changes in Transportation-Related Air Pollution Exposures by Race-Ethnicity and Socioeconomic Status: Outdoor Nitrogen Dioxide in the United States in 2000 and 2010

PubMed Central

Clark, Lara P.; Millet, Dylan B.

2017-01-01

Background: Disparities in exposure to air pollution by race-ethnicity and by socioeconomic status have been documented in the United States, but the impacts of declining transportation-related air pollutant emissions on disparities in exposure have not been studied in detail. Objective: This study was designed to estimate changes over time (2000 to 2010) in disparities in exposure to outdoor concentrations of a transportation-related air pollutant, nitrogen dioxide (NO2), in the United States. Methods: We combined annual average NO2 concentration estimates from a temporal land use regression model with Census demographic data to estimate outdoor exposures by race-ethnicity, socioeconomic characteristics (income, age, education), and by location (region, state, county, urban area) for the contiguous United States in 2000 and 2010. Results: Estimated annual average NO2 concentrations decreased from 2000 to 2010 for all of the race-ethnicity and socioeconomic status groups, including a decrease from 17.6 ppb to 10.7 ppb (−6.9 ppb) in nonwhite [non-(white alone, non-Hispanic)] populations, and 12.6 ppb to 7.8 ppb (−4.7 ppb) in white (white alone, non-Hispanic) populations. In 2000 and 2010, disparities in NO2 concentrations were larger by race-ethnicity than by income. Although the national nonwhite–white mean NO2 concentration disparity decreased from a difference of 5.0 ppb in 2000 to 2.9 ppb in 2010, estimated mean NO2 concentrations remained 37% higher for nonwhites than whites in 2010 (40% higher in 2000), and nonwhites were 2.5 times more likely than whites to live in a block group with an average NO2 concentration above the WHO annual guideline in 2010 (3.0 times more likely in 2000). Conclusions: Findings suggest that absolute NO2 exposure disparities by race-ethnicity decreased from 2000 to 2010, but relative NO2 exposure disparities persisted, with higher NO2 concentrations for nonwhites than whites in 2010. https://doi.org/10.1289/EHP

Changes in Transportation-Related Air Pollution Exposures by Race-Ethnicity and Socioeconomic Status: Outdoor Nitrogen Dioxide in the United States in 2000 and 2010.

PubMed

Clark, Lara P; Millet, Dylan B; Marshall, Julian D

2017-09-14

Disparities in exposure to air pollution by race-ethnicity and by socioeconomic status have been documented in the United States, but the impacts of declining transportation-related air pollutant emissions on disparities in exposure have not been studied in detail. This study was designed to estimate changes over time (2000 to 2010) in disparities in exposure to outdoor concentrations of a transportation-related air pollutant, nitrogen dioxide (NO2), in the United States. We combined annual average NO2 concentration estimates from a temporal land use regression model with Census demographic data to estimate outdoor exposures by race-ethnicity, socioeconomic characteristics (income, age, education), and by location (region, state, county, urban area) for the contiguous United States in 2000 and 2010. Estimated annual average NO2 concentrations decreased from 2000 to 2010 for all of the race-ethnicity and socioeconomic status groups, including a decrease from 17.6 ppb to 10.7 ppb (-6.9 ppb) in nonwhite [non-(white alone, non-Hispanic)] populations, and 12.6 ppb to 7.8 ppb (-4.7 ppb) in white (white alone, non-Hispanic) populations. In 2000 and 2010, disparities in NO2 concentrations were larger by race-ethnicity than by income. Although the national nonwhite-white mean NO2 concentration disparity decreased from a difference of 5.0 ppb in 2000 to 2.9 ppb in 2010, estimated mean NO2 concentrations remained 37% higher for nonwhites than whites in 2010 (40% higher in 2000), and nonwhites were 2.5 times more likely than whites to live in a block group with an average NO2 concentration above the WHO annual guideline in 2010 (3.0 times more likely in 2000). Findings suggest that absolute NO2 exposure disparities by race-ethnicity decreased from 2000 to 2010, but relative NO2 exposure disparities persisted, with higher NO2 concentrations for nonwhites than whites in 2010. https://doi.org/10.1289/EHP959.

Family Socioeconomic Status at Birth and Youth Impulsivity at Age 15; Blacks' Diminished Return.

PubMed

Assari, Shervin; Caldwell, Cleopatra Howard; Mincy, Ron

2018-05-01

Minorities’ Diminished Return theory suggests that health effects of socioeconomic status (SES) are systemically smaller for racial and ethnic minorities compared to Whites. To test the relevance of Minorities’ Diminished Return theory for youth impulsivity, we investigated Black⁻White differences in the effects of family SES at birth on subsequent youth impulsivity at age 15. Data came from the Fragile Families and Child Wellbeing Study (FFCWS), 1998⁻2016, a 15-year longitudinal study of urban families from the birth of their children to age 15. This analysis included 1931 families who were either White ( n = 495) or Black ( n = 1436). The independent variables of this study were family income, maternal education, and family structure at birth. Youth impulsivity at age 15 was the dependent variable. Gender was the covariate and race was the focal moderator. We ran linear regressions in the overall sample and specific to each race. In the overall sample, higher household income (b = −0.01, 95% CI = −0.01 to 0.00) and maternal education (b = −0.24, 95% CI = −0.44 to −0.04) at birth were associated with lower youth impulsivity at age 15, independent of race, gender, and family structure. A significant interaction was found between race and household income at birth (b = 0.01, 95% CI = 0.00 to 0.02) on subsequent youth impulsivity, which was indicative of a stronger protective effect for Whites compared to Blacks. Blacks’ diminished return exists for the long-term protective effects of family income at birth against subsequent youth impulsivity. The relative disadvantage of Blacks in comparison to Whites is in line with a growing literature showing that Black families gain less from high SES, which is possibly due to the existing structural racism in the US.

School-Based Health Centers and Adolescent Substance Use: Moderating Effects of Race/Ethnicity and Socioeconomic Status

ERIC Educational Resources Information Center

Bersamin, Melina; Paschall, Mallie J.; Fisher, Deborah A.

2017-01-01

Background: School-based health centers (SBHCs) have been associated with many positive health and academic outcomes. The current study extends previous research and examines possible differences in the association between SBHC exposure and adolescent alcohol, tobacco, and other drug use by race/ethnicity, sex, and socioeconomic status (SES).…

Medical student socio-demographic characteristics and attitudes toward patient centered care: do race, socioeconomic status and gender matter? A report from the Medical Student CHANGES study.

PubMed

Hardeman, Rachel R; Burgess, Diana; Phelan, Sean; Yeazel, Mark; Nelson, David; van Ryn, Michelle

2015-03-01

To determine whether attitudes toward patient-centered care differed by socio-demographic characteristics (race, gender, socioeconomic status) among a cohort of 3191 first year Black and White medical students attending a stratified random sample of US medical schools. This study used baseline data from Medical Student CHANGES, a large national longitudinal cohort study of medical students. Multiple logistic regression was used to assess the association of race, gender and SES with attitudes toward patient-centered care. Female gender and low SES were significant predictors of positive attitudes toward patient-centered care. Age was also a significant predictor of positive attitudes toward patient-centered care such that students older than the average age of US medical students had more positive attitudes. Black versus white race was not associated with attitudes toward patient-centered care. New medical students' attitudes toward patient-centered care may shape their response to curricula and the quality and style of care that they provide as physicians. Some students may be predisposed to attitudes that lead to both greater receptivity to curricula and the provision of higher-quality, more patient-centered care. Medical school curricula with targeted messages about the benefits and value of patient-centered care, framed in ways that are consistent with the beliefs and world-view of medical students and the recruitment of a socioeconomically diverse sample of students into medical schools are vital for improved care. Published by Elsevier Ireland Ltd.

Age and Race Differences in the Trajectories of Self-Esteem

PubMed Central

Shaw, Benjamin A.; Liang, Jersey; Krause, Neal

2010-01-01

The purpose of this research was to assess age- and race-based variation in within-persons changes in self-esteem over a 16-year period. We used hierarchical linear modeling with data from 3,617 adults aged 25 and older who were interviewed up to four times. Self-esteem increased, on average, over the course of the study period. At the same time, significant age variations around this trend were observed, with younger adults experiencing increases in self-esteem and older adults experiencing decreases. In general, race differences were not evident with respect to average levels or rates of change in self-esteem. However, a significant age by race interaction suggested that late life declines in self-esteem were steeper for blacks compared to whites. These findings suggest the presence of age- and race-based stratification with respect to self-esteem. Future work in this area should examine the health and well-being effects of declining self-esteem during old age. PMID:20230130

Blinded to Science: Gender Differences in the Effects of Race, Ethnicity, and Socioeconomic Status on Academic and Science Attitudes among Sixth Graders

ERIC Educational Resources Information Center

Perry, Brea L.; Link, Tanja; Boelter, Christina; Leukefeld, Carl

2012-01-01

Little research has examined whether the effects of race or socioeconomic status (SES) on educational attitudes differ by gender, limiting knowledge of unique vulnerabilities occurring at the intersection of multiple social statuses. Using data from 182 sixth-graders, interactions between gender, race/ethnicity, and SES in predicting educational…

Motherhood, Fatherhood and Midlife Weight Gain in a US Cohort: Associations differ by race/ethnicity and socioeconomic position.

PubMed

Brown, Daniel M; Barbara, Abrams; Cohen, Alison K; Rehkopf, David H

2017-12-01

While there is an association of greater short-term weight gain with childbearing among women, less is known about longer-term weight gain, whether men have similar gains, and how this varies by race/ethnicity and socioeconomic position. Our cohort consisted of a nationally representative sample of 7,356 Americans with oversampling of Black and Hispanic populations. We estimated the associations between number of biological children and parental weight, measured as both change in self-reported body mass index (BMI) from age 18 and overweight/obese status (BMI ≥ 25) at age 40. We performed multivariate linear and logistic regression analysis and tested for effect modification by gender. For change in BMI, men gained on average 0.28 BMI (95% CI: (0.01, 0.55)) units per child, while women gained 0.13 units per child (95% CI: (-0.22, 0.48)). The adjusted odds ratios for overweight/obesity associated with each child were 1.32 (95% CI: (1.11, 1.58)) for men and 1.15 (95% CI: (1.01, 1.31)) for women. Stratified analyses by race/ethnicity and socioeconomic position suggested that the observed full-cohort differences were driven primarily by gendered differences in low-income Hispanics and Whites - with the greatest associations among Hispanic men. For example, among low-income Hispanic men we observed a positive relationship between the number of children and weight change by age 40, with average weight change of 0.47 units per child (95%CI: (-0.65, 1.59 For low-income Hispanic women, however, the average weight change was -0.59 units per child (95%CI: (-1.70, 0.47), and the P-value for the test of interaction between gender and number of children was P < 0.001. Our findings suggest that the shared social and economic aspects of raising children play an important role in determining parental weight at mid-life.

Race, socioeconomic status, and health. The added effects of racism and discrimination.

PubMed

Williams, D R

1999-01-01

Higher disease rates for blacks (or African Americans) compared to whites are pervasive and persistent over time, with the racial gap in mortality widening in recent years for multiple causes of death. Other racial/ethnic minority populations also have elevated disease risk for some health conditions. This paper considers the complex ways in which race and socioeconomic status (SES) combine to affect health. SES accounts for much of the observed racial disparities in health. Nonetheless, racial differences often persist even at "equivalent" levels of SES. Racism is an added burden for nondominant populations. Individual and institutional discrimination, along with the stigma of inferiority, can adversely affect health by restricting socioeconomic opportunities and mobility. Racism can also directly affect health in multiple ways. Residence in poor neighborhoods, racial bias in medical care, the stress of experiences of discrimination and the acceptance of the societal stigma of inferiority can have deleterious consequences for health.

Socioeconomic status, psychosocial factors, race and nocturnal blood pressure dipping in a Hispanic cohort.

PubMed

Rodriguez, Carlos J; Jin, Zhezhen; Schwartz, Joseph E; Turner-Lloveras, Daniel; Sacco, Ralph L; Di Tullio, Marco R; Homma, Shunichi

2013-05-01

Little information is available about the relationship of socioeconomic status (SES) to blunted nocturnal ambulatory blood pressure (ABP) dipping among Hispanics and whether this relationship differs by race. We sought to characterize ABP nondipping and its determinants in a sample of Hispanics. We enrolled 180 Hispanic participants not on antihypertensive medications. SES was defined by years of educational attainment. All participants underwent 24-hour ABP monitoring. A decrease of <10% in the ratio between average awake and average asleep systolic BP was considered nondipping. The mean age of the cohort was 67.1 ± 8.7, mean educational level was 9.4 ± 4.4 years, and 58.9% of the cohort was female. The cohort was comprised of 78.3% Caribbean Hispanics with the rest from Mexico and Central/South America; 41.4% self-identified as white Hispanic, 34.4% self-identified as black Hispanic, and 24.4% did not racially self- identify. The percentage of nondippers was 57.8%. Educational attainment (10.5 years vs. 8.6 years; P <0.01) was significantly higher among dippers than nondippers. In multivariable analyses, each 1-year increase in education was associated with a 9% reduction in the likelihood of being a nondipper (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.84-0.98; P = 0.01). There were significantly greater odds of being a nondipper for black Hispanics than for white Hispanics (OR, 2.83, 95% CI, 1.29-6.23; P = 0.005). Higher SES was significantly protective of nondipping in white Hispanics but not black Hispanics. These results document a substantial prevalence of nondipping in a cohort of predominantly normotensive Hispanics. Dipping status varied significantly by race. Lower SES is significantly associated with nondipping status, and race potentially impacts on this relation.

Socioeconomic Status, Psychosocial Factors, Race and Nocturnal Blood Pressure Dipping in a Hispanic Cohort

PubMed Central

2013-01-01

BACKGROUND Little information is available about the relationship of socioeconomic status (SES) to blunted nocturnal ambulatory blood pressure (ABP) dipping among Hispanics and whether this relationship differs by race. We sought to characterize ABP nondipping and its determinants in a sample of Hispanics. METHODS We enrolled 180 Hispanic participants not on antihypertensive medications. SES was defined by years of educational attainment. All participants underwent 24-hour ABP monitoring. A decrease of <10% in the ratio between average awake and average asleep systolic BP was considered nondipping. RESULTS The mean age of the cohort was 67.1 ± 8.7, mean educational level was 9.4 ± 4.4 years, and 58.9% of the cohort was female. The cohort was comprised of 78.3% Caribbean Hispanics with the rest from Mexico and Central/South America; 41.4% self-identified as white Hispanic, 34.4% self-identified as black Hispanic, and 24.4% did not racially self- identify. The percentage of nondippers was 57.8%. Educational attainment (10.5 years vs. 8.6 years; P <0.01) was significantly higher among dippers than nondippers. In multivariable analyses, each 1-year increase in education was associated with a 9% reduction in the likelihood of being a nondipper (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.84–0.98; P = 0.01). There were significantly greater odds of being a nondipper for black Hispanics than for white Hispanics (OR, 2.83, 95% CI, 1.29–6.23; P = 0.005). Higher SES was significantly protective of nondipping in white Hispanics but not black Hispanics. CONCLUSIONS These results document a substantial prevalence of nondipping in a cohort of predominantly normotensive Hispanics. Dipping status varied significantly by race. Lower SES is significantly associated with nondipping status, and race potentially impacts on this relation. PMID:23547037

Classes within a Class: The Discourses of Race, Ethnicity, Gender, and Socioeconomic Status in a Preschool Classroom

ERIC Educational Resources Information Center

Maldonado, Camilo, III

2013-01-01

Over the course of 12 months, I conducted an ethnographic study in an urban preschool classroom in the northeastern Unites States. Employing a sociocultural perspective of early childhood development, I investigated the various social and academic discourses related to race and ethnicity, gender, and socioeconomic status (SES) presented in a…

Maternal Black Race and Persistent Wheezing Illness in Former Extremely Low Gestational Age Newborns: Secondary Analysis of a Randomized Trial.

PubMed

Wai, Katherine C; Hibbs, Anna M; Steurer, Martina A; Black, Dennis M; Asselin, Jeanette M; Eichenwald, Eric C; Ballard, Philip L; Ballard, Roberta A; Keller, Roberta L

2018-04-04

To evaluate the relationship between maternal self-reported race/ethnicity and persistent wheezing illness in former high-risk, extremely low gestational age newborns, and to quantify the contribution of socioeconomic, environmental, and biological factors on this relationship. We assessed persistent wheezing illness determined at 18-24 months corrected (for prematurity) age in survivors of a randomized trial. Parents/caregivers were surveyed for wheeze and inhaled asthma medication use quarterly to 12 months, and at 18 and 24 months. We used multivariable analysis to evaluate the relationship of maternal race to persistent wheezing illness, and identified mediators for this relationship via formal mediation analysis. Of 420 infants (25.2 ± 1.2 weeks of gestation and 714 ± 166 g at birth, 57% male, 34% maternal black race), 189 (45%) had persistent wheezing illness. After adjustment for gestational age, birth weight, and sex, infants of black mothers had increased odds of persistent wheeze compared with infants of nonblack mothers (OR = 2.9, 95% CI 1.9, 4.5). Only bronchopulmonary dysplasia, breast milk diet, and public insurance status were identified as mediators. In this model, the direct effect of race accounted for 69% of the relationship between maternal race and persistent wheeze, whereas breast milk diet, public insurance status, and bronchopulmonary dysplasia accounted for 8%, 12%, and 10%, respectively. Among former high-risk extremely low gestational age newborns, infants of black mothers have increased odds of developing persistent wheeze. A substantial proportion of this effect is directly accounted for by race, which may reflect unmeasured environmental influences, and acquired and innate biological differences. ClinicalTrials.gov: NCT01022580. Copyright © 2018 Elsevier Inc. All rights reserved.

Multiple-Component Remediation for Developmental Reading Disabilities: IQ, Socioeconomic Status, and Race as Factors in Remedial Outcome

ERIC Educational Resources Information Center

Morris, Robin D.; Lovett, Maureen W.; Wolf, Maryanne; Sevcik, Rose A.; Steinbach, Karen A.; Frijters, Jan C.; Shapiro, Marla B.

2012-01-01

Results from a controlled evaluation of remedial reading interventions are reported: 279 young disabled readers were randomly assigned to a program according to a 2 x 2 x 2 factorial design (IQ, socioeconomic status [SES], and race). The effectiveness of two multiple-component intervention programs for children with reading disabilities (PHAB +…

Limited English Proficiency, Race/Ethnicity and Socio-Economic Status as Influences on Scores in Large-Scale Assessments

ERIC Educational Resources Information Center

Terwilliger, James S.; Magnuson, Paul

2005-01-01

The purpose of this study was to examine the effects of three basic demographic variables on reading test scores for students in the middle elementary grades. Limited English proficiency (LEP), race/ethnicity and socio-economic status (SES) were studied to determine their influence individually and in combination on performance in large-scale…

The effect of age on the racing speed of Thoroughbred racehorses

PubMed Central

TAKAHASHI, Toshiyuki

2015-01-01

ABSTRACT The running performance of Thoroughbred racehorses has been reported to peak when they are between 4 and 5 years old. However, changes in their racing speed by month or season have not been reported. The purposes of this study were to reveal the average racing speed of Thoroughbreds, and observe changes in their average speed with age. The surveyed races were flat races on turf and dirt tracks with firm or standard track conditions held by the Japan Racing Association from January 1st, 2002 to December 31st, 2010. The racing speed of each horse was calculated by dividing the race distance (m) by the horse’s final time (sec). Average speeds per month for each age and distance condition were calculated for each gender group when there were 30 or more starters per month for each age and distance condition for each gender group. The common characteristic change for all conditions was an average speed increase up until the first half of the age of 4 years old. The effect of increased carry weight on average speed was small, and average speed increased with the growth of the horse. After the latter half of the age of 4 years old, the horses’ average speed remained almost constant, with little variation. It is speculated that decreases in the weight carried; and the retirement of less well performing horses; are responsible for the maintenance of average speed. PMID:26170760

Epidemiology and Disparities in Care: The Impact of Socioeconomic Status, Gender, and Race on the Presentation, Management, and Outcomes of Patients Undergoing Ventral Hernia Repair.

PubMed

Cherla, Deepa V; Poulose, Benjamin; Prabhu, Ajita S

2018-06-01

More research is needed with regards to gender, race, and socioeconomic status on ventral hernia presentation, management, and outcomes. The role of culture and geography in hernia-related health care remains unknown. Currently existing nationwide registries have thus far yielded at best a modest overview of disparities in hernia care. The significant variation in care relative to gender, race, and socioeconomic status suggests that there is room for improvement in providing consistent care for patients with hernias. Copyright © 2018 Elsevier Inc. All rights reserved.

76 FR 80966 - Agency Information Collection Activities; Proposed Collection: Age, Sex, and Race of Persons...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... Collection Activities; Proposed Collection: Age, Sex, and Race of Persons Arrested 18 Years of Age and Over; Age, Sex, and Race of Persons Arrested Under 18 Years of Age; Revision of a Currently Approved..., Sex, and Race of Persons Arrested 18 Years of Age and Over; Age, Sex, and Race of Persons Arrested...

The Influence of Race/Ethnicity and Socioeconomic Status on End-of-Life Care in the ICU

PubMed Central

Muni, Sarah; Engelberg, Ruth A.; Treece, Patsy D.; Dotolo, Danae

2011-01-01

Background: There is conflicting evidence about the influence of race/ethnicity on the use of intensive care at the end of life, and little is known about the influence of socioeconomic status. Methods: We examined patients who died in the ICU in 15 hospitals. Race/ethnicity was assessed as white and nonwhite. Socioeconomic status included patient education, health insurance, and income by zip code. To explore differences in end-of-life care, we examined the use of (1) advance directives, (2) life-sustaining therapies, (3) symptom management, (4) communication, and (5) support services. Results: Medical charts were abstracted for 3,138/3,400 patients of whom 2,479 (79%) were white and 659 (21%) were nonwhite (or Hispanic). In logistic regressions adjusted for patient demographics, socioeconomic factors, and site, nonwhite patients were less likely to have living wills (OR, 0.41; 95% CI, 0.32-0.54) and more likely to die with full support (OR, 1.59; 95% CI, 1.30-1.94). In documentation of family conferences, nonwhite patients were more likely to have documentation that prognosis was discussed (OR, 1.47; 95% CI, 1.21-1.77) and that physicians recommended withdrawal of life support (OR, 1.57; 95% CI, 1.11-2.21). Nonwhite patients also were more likely to have discord documented among family members or with clinicians (OR, 1.49; 95% CI, 1.04-2.15). Socioeconomic status did not modify these associations and was not a consistent predictor of end-of-life care. Conclusions: We found numerous racial/ethnic differences in end-of-life care in the ICU that were not influenced by socioeconomic status. These differences could be due to treatment preferences, disparities, or both. Improving ICU end-of-life care for all patients and families will require a better understanding of these issues. Trial registry: ClinicalTrials.gov; No.: NCT00685893; URL: www.clinicaltrials.gov PMID:21292758

Retinal Thickness Analysis by Race, Gender, and Age Using Stratus OCT™

PubMed Central

Kashani, Amir H.; Zimmer-Galler, Ingrid E.; Shah, Syed Mahmood; Dustin, Laurie; Do, Diana V.; Eliott, Dean; Haller, Julia A.; Nguyen, Quan Dong

2010-01-01

PURPOSE To detect differences in retinal thickness among patients of different race, gender and age using Stratus OCT™. DESIGN Cross-sectional study. METHODS In a multicenter, university-based study, 126 patients with no history of ocular disease were enrolled (78 diabetics without retinopathy and 48 nondiabetics). Optical coherence tomography measurements were performed using Stratus OCT™. Statistical comparisons of centerpoint foveal thickness and mean foveal thickness were made using generalized estimating equations adjusting for diabetic status, race, age, and gender. RESULTS The study population consisted of 36% males, 39% Caucasians, 33% African Americans, and 28% Hispanics. Mean foveal thickness was 191.6±2.7µm and 194.5±2.7µm for diabetics and nondiabetics, respectively (P=0.49). Mean foveal thickness in males was significantly larger than in females (201.8±2.7µm and 186.9±2.6µm, respectively; P<0.001). Mean foveal thickness was 200.2±2.7µm for Caucasians, 181.0±3.7µm for African Americans, and 194.7±3.9µm for Hispanics. Mean foveal thickness was significantly less for African Americans than Caucasians (P <0.0001) or Hispanics (P=0.005). Centerpoint foveal thickness and mean foveal thickness showed a significant increase with age. CONCLUSIONS There are statistically significant differences in retinal thickness between subjects of different race, gender, and age. When compared to Caucasians and Hispanics, African-American race is a predictor of decreased mean foveal thickness; and male sex (regardless of race) is a significant predictor of increased mean foveal thickness. Mean foveal thickness is similar among diabetics and nondiabetics when data are controlled for age, race, and sex. These results suggest that studies comparing OCT measurements should carefully control for age, race, and gender-based variations in retinal thickness. PMID:20042179

Influence of socioeconomic factors and race on birth outcomes in urban Milwaukee.

PubMed

Ward, Trina C Salm; Mori, Naoyo; Patrick, Timothy B; Madsen, Mary K; Cisler, Ron A

2010-10-01

A national study found that infants born in low socioeconomic areas had the worst infant mortality rates (IMRs) and the highest racial disparity. Racial disparities in birth outcomes are also evident in the city of Milwaukee, with African American infants at 3 times greater the risk than white infants. This study was conducted to examine the influence of socioeconomic status (SES) and race on birth outcomes in the city of Milwaukee. Milwaukee ZIP codes were stratified into lower, middle, and upper SES groups. IMR, low birth weight, and preterm birth rates by race were analyzed by SES group for the years 2003 to 2007. The overall IMR for the lower, middle, and upper SES groups were 12.4, 10.7, and 7.7, respectively. The largest racial disparity in IMR (3.1) was in the middle SES group, versus lower (1.6) and upper (1.8) SES groups. The overall percent of low birth weight infants for the lower, middle, and upper SES groups was 10.9%, 9.5%, and 7.5%, respectively. Racial disparity ratios in low birth weight were 2.0, 1.9, and 1.9 for lower, middle and upper SES groups. The overall percent of preterm birth was 15.4%, 13.2%, and 10.6% of births within the lower, middle, and upper SES groups, respectively, with a disparity ratio of 1.6 across all SES groups. For all outcomes, African American infants born in the upper SES group fared the same or worse than white infants born in the lower SES group. Although higher SES appeared to have a protective effect for whites in Milwaukee, it did not have the same protective effect for African Americans.

Sex Differences in the Age of Peak Marathon Race Time.

PubMed

Nikolaidis, Pantelis T.; Rosemann, Thomas; Knechtle, Beat

2018-04-30

Recent studies showed that women were older than men when achieving their fastest marathon race time. These studies, however, investigated a limited sample of athletes. We investigated the age of peak marathon performance in a large sample of female and male marathon finishers by using data from all finishers. We analyzed the age of peak marathon performance in 1-year and 5-year age intervals of 451,637 runners (i.e. 168,702 women and 282,935 men) who finished the ‘New York City Marathon’ between 2006 and 2016, using analysis of variance and non-linear regression analysis. During these 11 years, men were faster and older than women, the participation of women increased disproportionately to that of men resulting in a decrease of the male-to-female ratio, and relatively more women participated in the younger age groups. Most women were in the age group 30-34 years and most men in the age group 40-44 years. The fastest race time was shown at 29.7 years in women and 34.8 years in men in the 1-year age intervals, and in age group 30-34 years in women and 35-39 years in men in the 5-year age intervals. In contrast to existing findings reporting a higher age of peak marathon performance in women compared to men, we found that women achieved their best marathon race time ~5 years earlier in life than men in both 1-year and 5-year age intervals. Female athletes and their coaches should plan to achieve their fastest marathon race time at the age of ~30 years.

Does the association between early life growth and later obesity differ by race/ethnicity or socioeconomic status? A systematic review.

PubMed

Andrea, Sarah B; Hooker, Elizabeth R; Messer, Lynne C; Tandy, Thomas; Boone-Heinonen, Janne

2017-09-01

Rapid growth during infancy predicts higher risk of obesity later in childhood. The association between patterns of early life growth and later obesity may differ by race/ethnicity or socioeconomic status (SES), but prior evidence syntheses do not consider vulnerable subpopulations. We systemically reviewed published studies that explored patterns of early life growth (0-24 months of age) as predictors of later obesity (>24 months) that were either conducted in racial/ethnic minority or low-SES study populations or assessed effect modification of this association by race/ethnicity or SES. Literature searches were conducted in PubMed and SocINDEX. Ten studies met the inclusion criteria. Faster growth during the first 2 years of life was consistently associated with later obesity irrespective of definition and timing of exposure and outcome measures. Associations were strongest in populations composed of greater proportions of racial/ethnic minority and/or low-SES children. For example, ORs ranged from 1.17 (95% CI: 1.11, 1.24) in a heterogeneous population to 9.24 (95% CI: 3.73, 22.9) in an entirely low-SES nonwhite population. The impact of rapid growth in infancy on later obesity may differ by social stratification factors such as race/ethnicity and family income. More robust and inclusive studies examining these associations are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Race/ethnic disparities in reproductive age: an examination of ovarian reserve estimates across four race/ethnic groups of healthy, regularly cycling women.

PubMed

Bleil, Maria E; Gregorich, Steven E; Adler, Nancy E; Sternfeld, Barbara; Rosen, Mitchell P; Cedars, Marcelle I

2014-01-01

To determine whether reproductive age, as indexed by a validated marker of ovarian reserve (antimüllerian hormone [AMH]), varies among women of different race/ethnic backgrounds. Cross-sectional study. Community-based sample. Multiethnic sample of 947 (277 white, 237 African American, 220 Latina, and 213 Chinese) healthy and regularly cycling premenopausal women, ages 25-45. None. AMH level. A multivariate model was fit examining race/ethnicity, covariates, nonlinear terms for age (age(2), age(3)), and body mass index (BMI(2), BMI(3)), and two-way interactions between race/ethnicity and each of the other predictor variables in relation to AMH. After backward elimination, significant effects included race/ethnicity (F = 8.45), age (F = 349.94), race/ethnicity-by-linear age interaction (F = 4.67), age(2) (F = 31.61), and BMI (F = 10.69). Inspection of the significant race/ethnicity-by-linear age interaction showed AMH levels were consistently lower among Latina women compared with white women across all ages, whereas AMH levels were lower among African American and Chinese women compared with the white women at younger and middle ages, respectively. The AMH levels were higher among African American compared with Latina and Chinese women at older ages. Although the results must be considered preliminary, the findings are twofold: African American women may have lower AMH levels at younger ages but experience less of a reduction in AMH with advancing age, and Latina and Chinese women compared with white women may have lower AMH levels, marking a lower ovarian reserve and a possibly increased risk for earlier menopause. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Career profile of the Canadian Standardbred. II. Influence of age, gait and sex upon number of races, money won and race times.

PubMed Central

Physick-Sheard, P W

1986-01-01

The objective of the study was to examine the career profile of the average racehorse in order to establish normal values for performance. Records of race performance for a population of 762 horses randomly-selected from the 1972 registrations of the Canadian Standardbred Horse Society were summarized to provide annual statistics for number of races, money won, and times for the mile (race times) over the period 1974 to 1983 inclusive. Results were analyzed to determine the influence of sex, gait, age, and year of the first race. The transformation log (1 + X) was used to achieve normality where necessary. The 95% confidence interval for the mean (mean range) for career total for number of races was 21.8 to 69.6. Of the horses which raced, 30% raced 20 or fewer times, 29% raced more than 100 times. Females raced significantly less often than either males or geldings (p less than 0.001), pacers significantly more often than trotters (p less than 0.01). Regardless of the age at which they first competed all horses were raced lightly in their first race year. Mean range for career total for money won was $2,212 to $2,798 (n = 507). Of 507 horses which raced, 65.8% earned less than $10,000, 6.3% more than $50,000. Trotting geldings had the highest mean money won, mean range $2,448 to $38,105. Mean range for money won per race for all horses racing was $67.77 to $74.51. Overall, 58% of horses earned less than $100 per race, 4.5% over $500. Only 4.5% of horses racing met their immediate training expenses. Increase in age at first race was associated with highly significant and progressive reductions in career races, money won, and money won per race. Of 507 horses which raced, 409 or 80% won at least one race and thus acquired an official winning time or mark. Population mean for career mark was 2.126 min (2.07.3.). Population trend in mean mark was for progressive improvement over the ten year racing period amounting to 0.0968 min or 5.81 s. The average horse achieved

Alcohol advertising at Boston subway stations: an assessment of exposure by race and socioeconomic status.

PubMed

Gentry, Elisabeth; Poirier, Katie; Wilkinson, Tiana; Nhean, Siphannay; Nyborn, Justin; Siegel, Michael

2011-10-01

We investigated the frequency of alcohol ads at all 113 subway and streetcar stations in Boston and the patterns of community exposure stratified by race, socioeconomic status, and age. We assessed the extent of alcohol advertising at each station in May 2009. We measured gross impressions and gross rating points (GRPs) for the entire Greater Boston population and for Boston public school student commuters. We compared the frequency of alcohol advertising between neighborhoods with differing demographics. For the Greater Boston population, alcohol advertising at subway stations generated 109 GRPs on a typical day. For Boston public school students in grades 5 to 12, alcohol advertising at stations generated 134 GRPs. Advertising at stations in low-poverty neighborhoods generated 14.1 GRPs and at stations in high-poverty areas, 63.6 GRPs. Alcohol ads reach the equivalent of every adult in the Greater Boston region and the equivalent of every 5th- to 12th-grade public school student each day. More alcohol ads were displayed in stations in neighborhoods with high poverty rates than in stations in neighborhoods with low poverty rates.

Understanding how race/ethnicity and gender define age-trajectories of disability: an intersectionality approach.

PubMed

Warner, David F; Brown, Tyson H

2011-04-01

A number of studies have demonstrated wide disparities in health among racial/ethnic groups and by gender, yet few have examined how race/ethnicity and gender intersect or combine to affect the health of older adults. The tendency of prior research to treat race/ethnicity and gender separately has potentially obscured important differences in how health is produced and maintained, undermining efforts to eliminate health disparities. The current study extends previous research by taking an intersectionality approach (Mullings & Schulz, 2006), grounded in life course theory, conceptualizing and modeling trajectories of functional limitations as dynamic life course processes that are jointly and simultaneously defined by race/ethnicity and gender. Data from the nationally representative 1994-2006 US Health and Retirement Study and growth curve models are utilized to examine racial/ethnic/gender differences in intra-individual change in functional limitations among White, Black and Mexican American Men and Women, and the extent to which differences in life course capital account for group disparities in initial health status and rates of change with age. Results support an intersectionality approach, with all demographic groups exhibiting worse functional limitation trajectories than White Men. Whereas White Men had the lowest disability levels at baseline, White Women and racial/ethnic minority Men had intermediate disability levels and Black and Hispanic Women had the highest disability levels. These health disparities remained stable with age-except among Black Women who experience a trajectory of accelerated disablement. Dissimilar early life social origins, adult socioeconomic status, marital status, and health behaviors explain the racial/ethnic disparities in functional limitations among Men but only partially explain the disparities among Women. Net of controls for life course capital, Women of all racial/ethnic groups have higher levels of functional

The Association Between Family Violence and Adolescent Dating Violence Onset: Does it Vary by Race, Socioeconomic Status, and Family Structure?

ERIC Educational Resources Information Center

Foshee, Vangie A.; Ennett, Susan T.; Bauman, Karl E.; Benefield, Thad; Suchindran, Chirayath

2005-01-01

The authors determine if the associations between family violence (corporal punishment, violence against the child with the intention of harm, and witnessing violence between parents) and adolescent dating violence vary by subgroups based on race, socioeconomic status, and family structure. This study is guided by the theoretical propositions of…

Age trends in rates of substance use disorders across ages 18-90: Differences by gender and race/ethnicity.

PubMed

Vasilenko, Sara A; Evans-Polce, Rebecca J; Lanza, Stephanie T

2017-11-01

Although research has documented age differences in substance use, less is known about how prevalence of substance use disorders (SUDs) vary across age and differ by gender and race/ethnicity. Time-varying effect models (TVEMs) were estimated on data from the National Epidemiologic Survey of Alcohol and Related Conditions-III (NESARC III; N=36,309), a nationally representative survey of the adult population. The sample was 44% male; 53% White, 21% Black, 19% Hispanic/Latino, 6% other race/ethnicity. Prevalence of four SUDs (alcohol, tobacco, cannabis and opioid use disorders) were flexibly estimated across ages 18-90 by gender and race/ethnicity. Estimated SUD prevalences were generally higher for men compared to women at most ages until the 70s. However, disparities by race/ethnicity varied with age, such that for most SUDs, estimated prevalences were higher for White participants at younger ages and Black participants at older ages. Results suggest relatively constant disparities by gender across age, and a crossover effect for Black and White participants. Findings demonstrate that Black individuals in midlife may be an important target of intervention programs for some substances. Copyright © 2017 Elsevier B.V. All rights reserved.

Extended family households among children in the United States: Differences by race/ethnicity and socio-economic status.

PubMed

Cross, Christina J

2018-07-01

This study uses nationally representative longitudinal data from the Panel Study of Income Dynamics, to examine the prevalence and predictors of extended family households among children in the United States and to explore variation by race/ethnicity and socio-economic status (SES). Findings suggest that extended family households are a common living arrangement for children, with 35 per cent of youth experiencing this family structure before age 18. Racial/ethnic and SES differences are substantial: 57 per cent of Black and 35 per cent of Hispanic children ever live in an extended family, compared with 20 per cent of White children. Further, 47 per cent of children whose parents did not finish high school spend time in an extended family, relative to 17 per cent of children whose parents earned a bachelor's degree or higher. Models of predictors show that transitions into extended families are largely a response to social and economic needs.

A Closer Look at Gender in NAEP Mathematics Achievement and Affect Data: Intersections with Achievement, Race/Ethnicity, and Socioeconomic Status

ERIC Educational Resources Information Center

McGraw, Rebecca; Lubienski, Sarah Theule; Strutchens, Marilyn E.

2006-01-01

In this article we describe gender gaps in mathematics achievement and attitude as measured by the U.S. National Assessment of Educational Progress (NAEP) from 1990 to 2003. Analyzing relationships among achievement and mathematical content, student proficiency and percentile levels, race, and socioeconomic status (SES), we found that gender gaps…

18 CFR 1300.106 - Harassment on the basis of race, color, religion, age, or disability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of race, color, religion, age, or disability. 1300.106 Section 1300.106 Conservation of Power and... AUTHORITY § 1300.106 Harassment on the basis of race, color, religion, age, or disability. It is TVA policy... basis of race, color, religion, age, or disability. Accordingly, all employees must avoid any action or...

18 CFR 1300.106 - Harassment on the basis of race, color, religion, age, or disability.

Code of Federal Regulations, 2011 CFR

2011-04-01

... of race, color, religion, age, or disability. 1300.106 Section 1300.106 Conservation of Power and... AUTHORITY § 1300.106 Harassment on the basis of race, color, religion, age, or disability. It is TVA policy... basis of race, color, religion, age, or disability. Accordingly, all employees must avoid any action or...

18 CFR 1300.106 - Harassment on the basis of race, color, religion, age, or disability.

Code of Federal Regulations, 2013 CFR

2013-04-01

... of race, color, religion, age, or disability. 1300.106 Section 1300.106 Conservation of Power and... AUTHORITY § 1300.106 Harassment on the basis of race, color, religion, age, or disability. It is TVA policy... basis of race, color, religion, age, or disability. Accordingly, all employees must avoid any action or...

18 CFR 1300.106 - Harassment on the basis of race, color, religion, age, or disability.

Code of Federal Regulations, 2014 CFR

2014-04-01

... of race, color, religion, age, or disability. 1300.106 Section 1300.106 Conservation of Power and... AUTHORITY § 1300.106 Harassment on the basis of race, color, religion, age, or disability. It is TVA policy... basis of race, color, religion, age, or disability. Accordingly, all employees must avoid any action or...

18 CFR 1300.106 - Harassment on the basis of race, color, religion, age, or disability.

Code of Federal Regulations, 2012 CFR

2012-04-01

... of race, color, religion, age, or disability. 1300.106 Section 1300.106 Conservation of Power and... AUTHORITY § 1300.106 Harassment on the basis of race, color, religion, age, or disability. It is TVA policy... basis of race, color, religion, age, or disability. Accordingly, all employees must avoid any action or...

Using Multiple-hierarchy Stratification and Life Course Approaches to Understand Health Inequalities: The Intersecting Consequences of Race, Gender, SES, and Age.

PubMed

Brown, Tyson H; Richardson, Liana J; Hargrove, Taylor W; Thomas, Courtney S

2016-06-01

This study examines how the intersecting consequences of race-ethnicity, gender, socioeconomics status (SES), and age influence health inequality. We draw on multiple-hierarchy stratification and life course perspectives to address two main research questions. First, does racial-ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial-ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the Health and Retirement Study (N = 12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks, and Mexican Americans. Findings indicate that the effects of racial-ethnic, gender, and SES stratification are interactive, resulting in the greatest racial-ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial-ethnic/gender/SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses. © American Sociological Association 2016.

Using Multiple-hierarchy Stratification and Life Course Approaches to Understand Health Inequalities: The Intersecting Consequences of Race, Gender, SES, and Age

PubMed Central

Brown, Tyson H.; Richardson, Liana J.; Hargrove, Taylor W.; Thomas, Courtney S.

2016-01-01

This study examines how the intersecting consequences of race-ethnicity, gender, socioeconomics status (SES), and age influence health inequality. We draw on multiple-hierarchy stratification and life course perspectives to address two main research questions. First, does racial-ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial-ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the Health and Retirement Study (N = 12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks, and Mexican Americans. Findings indicate that the effects of racial-ethnic, gender, and SES stratification are interactive, resulting in the greatest racial-ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial-ethnic/gender/SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses. PMID:27284076

Race/ethnicity disparities in dysglycemia among U.S. women of childbearing age found mainly in the nonoverweight/nonobese.

PubMed

Marcinkevage, Jessica A; Alverson, C J; Narayan, K M Venkat; Kahn, Henry S; Ruben, Julia; Correa, Adolfo

2013-10-01

To describe the burden of dysglycemia-abnormal glucose metabolism indicative of diabetes or high risk for diabetes-among U.S. women of childbearing age, focusing on differences by race/ethnicity. Using U.S. National Health and Nutrition Examination Survey data (1999-2008), we calculated the burden of dysglycemia (i.e., prediabetes or diabetes from measures of fasting glucose, A1C, and self-report) in nonpregnant women of childbearing age (15-49 years) by race/ethnicity status. We estimated prevalence risk ratios (PRRs) for dysglycemia in subpopulations stratified by BMI (measured as kilograms divided by the square of height in meters), using predicted marginal estimates and adjusting for age, waist circumference, C-reactive protein, and socioeconomic factors. Based on data from 7,162 nonpregnant women, representing>59,000,000 women nationwide, 19% (95% CI 17.2-20.9) had some level of dysglycemia, with higher crude prevalence among non-Hispanic blacks and Mexican Americans vs. non-Hispanic whites (26.3% [95% CI 22.3-30.8] and 23.8% [19.5-28.7] vs. 16.8% [14.4-19.6], respectively). In women with BMI<25 kg/m2, dysglycemia prevalence was roughly twice as high in both non-Hispanic blacks and Mexican Americans vs. non-Hispanic whites. This relative increase persisted in adjusted models (PRRadj 1.86 [1.16-2.98] and 2.23 [1.38-3.60] for non-Hispanic blacks and Mexican Americans, respectively). For women with BMI 25-29.99 kg/m2, only non-Hispanic blacks showed increased prevalence vs. non-Hispanic whites (PRRadj 1.55 [1.03-2.34] and 1.28 [0.73-2.26] for non-Hispanic blacks and Mexican Americans, respectively). In women with BMI>30 kg/m2, there was no significant increase in prevalence of dysglycemia by race/ethnicity category. Our findings show that dysglycemia affects a significant portion of U.S. women of childbearing age and that disparities by race/ethnicity are most prominent in the nonoverweight/nonobese.

Race, socioeconomic status, and return migration to New Orleans after Hurricane Katrina

PubMed Central

Sastry, Narayan; VanLandingham, Mark

2010-01-01

Hurricane Katrina struck New Orleans on the 29th of August 2005 and displaced virtually the entire population of the city. Soon after, observers predicted the city would become whiter and wealthier as a result of selective return migration, although challenges related to sampling and data collection in a post-disaster environment have hampered evaluation of these hypotheses. In this article, we investigate return to the city by displaced residents over a period of approximately 14 months following the storm, describing overall return rates and examining differences in return rates by race and socioeconomic status. We use unique data from a representative sample of pre-Katrina New Orleans residents collected in the Displaced New Orleans Residents Pilot Survey. We find that black residents returned to the city at a much slower pace than white residents even after controlling for socioeconomic status and demographic characteristics. However, the racial disparity disappears after controlling for housing damage. We conclude that blacks tended to live in areas that experienced greater flooding and hence suffered more severe housing damage which, in turn, led to their delayed return to the city. The full-scale survey of displaced residents being fielded in 2009–2010 will show whether the repopulation of the city was selective over a longer period. PMID:20440381

Socioeconomic disadvantage and change in blood pressure associated with aging.

PubMed

Diez Roux, Ana V; Chambless, Lloyd; Merkin, Sharon Stein; Arnett, Donna; Eigenbrodt, Marsha; Nieto, F Javier; Szklo, Moyses; Sorlie, Paul

2002-08-06

Few studies have examined how the longitudinal change in blood pressure associated with aging differs across social groups within industrialized countries. Data from the Atherosclerosis Risk In Communities Study were used to investigate differences in the incidence of hypertension and in aging-related changes in blood pressure by neighborhood and individual socioeconomic factors over a 9-year follow-up. Disadvantage in multiple socioeconomic dimensions was associated with the greatest risk of developing hypertension (age- and sex-adjusted hazard ratio [HR] and 95% CI: HR 1.95, 95% CI 1.38 to 2.75 in whites and HR 1.43, 95% CI 0.96 to 2.13 in blacks). Aging-related increases in systolic blood pressure were inversely associated with socioeconomic position in whites (mean [SEM] 5-year increase in systolic blood pressure 7 [0.7] mm Hg in the most disadvantaged category and 5.4 [0.4] mm Hg in the most advantaged category). In whites, low socioeconomic position was also associated with more rapid declines in diastolic blood pressure after 50 years of age. Socioeconomic differences in hypertension incidence and changes in systolic blood pressure were reduced after adjustment for baseline blood pressure. The change in blood pressure associated with aging varies by social groups within the United States.

Age, sex and (the) race: gender and geriatrics in the ultra-endurance age.

PubMed

Whyte, Greg

2014-01-01

Ultra-endurance challenges were once the stuff of legend isolated to the daring few who were driven to take on some of the greatest physical endurance challenges on the planet. With a growing fascination for major physical challenges during the nineteenth century, the end of the Victorian era witnessed probably the greatest ultra-endurance race of all time; Scott and Amundsen's ill-fated race to the South Pole. Ultra-endurance races continued through the twentieth century; however, these events were isolated to the elite few. In the twenty-first century, mass participation ultra-endurance races have grown in popularity. Endurance races once believed to be at the limit of human durability, i.e. marathon running, are now viewed as middle-distance races with the accolade of true endurance going to those willing to travel significantly further in a single effort or over multiple days. The recent series of papers in Extreme Physiology & Medicine highlights the burgeoning research data from mass participation ultra-endurance events. In support of a true 'mass participation' ethos Knetchtle et al. reported age-related changes in Triple and Deca Iron-ultra-triathlon with an upper age of 69 years! Unlike their shorter siblings, the ultra-endurance races appear to present larger gender differences in the region of 20% to 30% across distance and modality. It would appear that these gender differences remain for multi-day events including the 'Marathon des Sables'; however, this gap may be narrower in some events, particularly those that require less load bearing (i.e. swimming and cycling), as evidenced from the 'Ultraman Hawaii' and 'Swiss Cycling Marathon', and shorter (a term I used advisedly!) distances including the Ironman Triathlon where differences are similar to those of sprint and endurance distances i.e. c. 10%. The theme running through this series of papers is a continual rise in participation to the point where major events now require selection races to remain

Social disparities in BMI trajectories across adulthood by gender, race/ethnicity and lifetime socio-economic position: 1986-2004.

PubMed

Clarke, Philippa; O'Malley, Patrick M; Johnston, Lloyd D; Schulenberg, John E

2009-04-01

The prevalence of obesity and overweight is rapidly increasing in industrialized countries, with long-term health and social consequences. There is also a strong social patterning of obesity and overweight, with a higher prevalence among women, racial/ethnic minorities and those from a lower socio-economic position (SEP). Most of the existing work in this area, however, is based on cross-sectional data or single cohort studies. No national studies to date have examined how social disparities in obesity and overweight differ by age and historical period using longitudinal data with repeated measures. We used panel data from the nationally representative Monitoring the Future Study (1986-2004) to examine social disparities in trajectories of body mass index (BMI) over adulthood (age 18-45). Self-reported height and weight were collected in this annual US survey of high-school seniors, followed biennially since 1976. Using growth curve models, we analysed BMI trajectories over adulthood by gender, race/ethnicity and lifetime SEP (measured by parents' education and respondent's education). BMI trajectories exhibit a curvilinear rate of change from age 18 to 45, but there was a strong period effect, such that weight gain was more rapid for more recent cohorts. As a result, successive cohorts become overweight (BMI>25) at increasingly earlier points in the life course. BMI scores were also consistently higher for women, racial/ethnic minority groups and those from a lower SEP. However, BMI scores for socially advantaged groups in recent cohorts were actually higher than those for their socially disadvantaged counterparts who were born 10 years earlier. Results highlight the importance of social status and socio-economic resources for maintaining optimal weight. Yet, even those in advantaged social positions have experienced an increase in BMI in recent years.

Perceived Socioeconomic Status: A New Type of Identity which Influences Adolescents’ Self Rated Health

PubMed Central

Goodman, Elizabeth; Huang, Bin; Schafer-Kalkhoff, Tara; Adler, Nancy E.

2007-01-01

Purpose The cognitive, social, and biological transitions of adolescence suggest that subjective perceptions of social position based on the socioeconomic hierarchy may undergo important changes during this period, yet how such perceptions develop is poorly understood and no studies assess if changes in such perceptions influence adolescents’ health. This study describes adolescents’ subjective perceptions of familial socioeconomic status (SSS), how SSS changes over time, and how age, race, and objective socioeconomic status (SES) indicators influence SSS. In addition, the study determines if SSS independently influences adolescents’ self-rated health, an important predictor of morbidity and health service utilization. Methods 1179 non-Hispanic black and white baseline 7–12th graders from a Midwestern public school district completed a validated, teen-specific measure of SSS annually for 4 consecutive years. A parent provided information on SES. Markov modeling assessed transitions in SSS over time. Results SSS declined with age (p=.001) and stabilized among older teens. In addition to age, SES and race, but not gender, were significant correlates of SSS, but the relationships between these factors were complex. In cross-sectional and longitudinal analyses, black teens from families with low parent education had higher SSS than white teens from similarly educated families, while white teens from highly educated families had higher SSS than black teens from highly educated families. Lower SSS and changes in SSS predicted poor self rated health even when adjusting for race and objective SES measures. Conclusion Subjective evaluations of socioeconomic status predict adolescents’ global health ratings even when adjusting for the sociodemographic factors which shape them. PMID:17950168

Racial residential segregation, socioeconomic disparities, and the White-Black survival gap.

PubMed

Popescu, Ioana; Duffy, Erin; Mendelsohn, Joshua; Escarce, José J

2018-01-01

To evaluate the association between racial residential segregation, a prominent manifestation of systemic racism, and the White-Black survival gap in a contemporary cohort of adults, and to assess the extent to which socioeconomic inequality explains this association. This was a cross sectional study of White and Black men and women aged 35-75 living in 102 large US Core Based Statistical Areas. The main outcome was the White-Black survival gap. We used 2009-2013 CDC mortality data for Black and White men and women to calculate age-, sex- and race adjusted White and Black mortality rates. We measured segregation using the Dissimilarity index, obtained from the Manhattan Institute. We used the 2009-2013 American Community Survey to define indicators of socioeconomic inequality. We estimated the CBSA-level White-Black gap in probability of survival using sequential linear regression models accounting for the CBSA dissimilarity index and race-specific socioeconomic indicators. Black men and women had a 14% and 9% lower probability of survival from age 35 to 75 than their white counterparts. Residential segregation was strongly associated with the survival gap, and this relationship was partly, but not fully, explained by socioeconomic inequality. At the lowest observed level of segregation, and with the Black socioeconomic status (SES) assumed to be at the White SES level scenario, the survival gap is essentially eliminated. White-Black differences in survival remain wide notwithstanding public health efforts to improve life expectancy and initiatives to reduce health disparities. Eliminating racial residential segregation and bringing Black socioeconomic status (SES) to White SES levels would eliminate the White-Black survival gap.

Alcohol Advertising at Boston Subway Stations: An Assessment of Exposure by Race and Socioeconomic Status

PubMed Central

Poirier, Katie; Wilkinson, Tiana; Nhean, Siphannay; Nyborn, Justin; Siegel, Michael

2011-01-01

Objectives. We investigated the frequency of alcohol ads at all 113 subway and streetcar stations in Boston and the patterns of community exposure stratified by race, socioeconomic status, and age. Methods. We assessed the extent of alcohol advertising at each station in May 2009. We measured gross impressions and gross rating points (GRPs) for the entire Greater Boston population and for Boston public school student commuters. We compared the frequency of alcohol advertising between neighborhoods with differing demographics. Results. For the Greater Boston population, alcohol advertising at subway stations generated 109 GRPs on a typical day. For Boston public school students in grades 5 to 12, alcohol advertising at stations generated 134 GRPs. Advertising at stations in low-poverty neighborhoods generated 14.1 GRPs and at stations in high-poverty areas, 63.6 GRPs. Conclusions. Alcohol ads reach the equivalent of every adult in the Greater Boston region and the equivalent of every 5th- to 12th-grade public school student each day. More alcohol ads were displayed in stations in neighborhoods with high poverty rates than in stations in neighborhoods with low poverty rates. PMID:21852632

Do Mothers' Educational Expectations Differ by Race and Ethnicity, or Socioeconomic Status?

ERIC Educational Resources Information Center

Kim, Youngmi; Sherraden, Michael; Clancy, Margaret

2013-01-01

Research has linked parents' educational expectations to children's educational attainment, but findings are inconsistent regarding differences in educational expectations by race and ethnicity. In addition, existing studies have focused on school-age children and their parents. In this study, we use a state representative sample to examine…

Cross-sectional relations of race and poverty status to cardiovascular risk factors in the Healthy Aging in Neighborhoods of Diversity across the Lifespan (HANDLS) study.

PubMed

Waldstein, Shari R; Moody, Danielle L Beatty; McNeely, Jessica M; Allen, Allyssa J; Sprung, Mollie R; Shah, Mauli T; Al'Najjar, Elias; Evans, Michele K; Zonderman, Alan B

2016-03-14

Examine interactive relations of race and poverty status with cardiovascular disease (CVD) risk factors in a socioeconomically diverse sample of urban-dwelling African American (AA) and White adults. Participants were 2,270 AAs and Whites (57% AA; 57% female; ages 30-64 years) who completed the first wave of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. CVD risk factors assessed included body mass index (BMI), waist circumference (WC), total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C, LDL-C), triglycerides (TG), glycated hemoglobin (HbA1c), high-sensitivity C-reactive protein (CRP), and systolic, diastolic, and pulse pressure (SBP, DBP, PP). Interactive and independent relations of race, poverty status, and sex were examined for each outcome via ordinary least squares regression adjusted for age, education, literacy, substance use, depressive symptoms, perceived health care barriers, medical co-morbidities, and medications. Significant interactions of race and poverty status (p's < .05) indicated that AAs living in poverty had lower BMI and WC and higher HDL-C than non-poverty AAs, whereas Whites living in poverty had higher BMI and WC and lower HDL-C than non-poverty Whites. Main effects of race revealed that AAs had higher levels of HbA1c, SBP, and PP, and Whites had higher levels of TC, LDL-C and TG (p's < .05). Poverty status moderated race differences for BMI, WC, and HDL-C, conveying increased risk among Whites living in poverty, but reduced risk in their AA counterparts. Race differences for six additional risk factors withstood extensive statistical adjustments including SES indicators.

The Kinesiology of Race

ERIC Educational Resources Information Center

McAfee, Myosha

2014-01-01

In this research article, Myosha McAfee presents findings from her grounded theory and microethnographical study of math instruction in a racially and socioeconomically diverse public school. Her analysis puts forth a new theory-the kinesiology of race-which conceptualizes race as a verb rather than a noun. It centrally considers how racial…

Sleep and Cognitive Functioning in Childhood: Ethnicity, Socioeconomic Status, and Sex as Moderators

ERIC Educational Resources Information Center

Philbrook, Lauren E.; Hinnant, J. Benjamin; Elmore-Staton, Lori; Buckhalt, Joseph A.; El-Sheikh, Mona

2017-01-01

We examined children's sleep at age 9 as a predictor of developmental trajectories of cognitive performance from ages 9 to 11 years. The effects of sleep on cognition are not uniform and thus we tested race/ethnicity, socioeconomic status (SES), and sex as moderators of these associations. At the first assessment, 282 children aged 9.44 years (52%…

Age and Race Differences in Racial Stereotype Awareness and Endorsement

PubMed Central

Copping, Kristine E.; Kurtz-Costes, Beth; Rowley, Stephanie J.; Wood, Dana

2012-01-01

Age and race differences in race stereotype awareness and endorsement were examined in 382 Black and White fourth, sixth, and eighth graders. Youth reported their own beliefs and their perceptions of adults’ beliefs about racial differences in ability in two domains: academics and sports. Children’s own endorsement of race stereotypes was highly correlated with their perceptions of adults’ race stereotypes. Blacks reported stronger traditional sports stereotypes than Whites, and fourth- and sixth-grade Blacks reported roughly egalitarian academic stereotypes. At every grade level, Whites reported academic stereotypes that favored Whites, and sixth and eighth grade Whites reported sports stereotypes that favored Blacks. Results support the tenets of status theory and have implications for identity development and achievement motivation in adolescents. PMID:23729837

Maternal age, birth order, and race: differential effects on birthweight

PubMed Central

Swamy, Geeta K; Edwards, Sharon; Gelfand, Alan; James, Sherman A; Miranda, Marie Lynn

2014-01-01

Background Studies examining the influence of maternal age and birth order on birthweight have not effectively disentangled the relative contributions of each factor to birthweight, especially as they may differ by race. Methods A population-based, cross-sectional study of North Carolina births from 1999 to 2003 was performed. Analysis was restricted to 510 288 singleton births from 28 to 42 weeks’ gestation with no congenital anomalies. Multivariable linear regression was used to model maternal age and birth order on birthweight, adjusting for infant sex, education, marital status, tobacco use and race. Results Mean birthweight was lower for non-Hispanic black individuals (NHB, 3166 g) compared with non-Hispanic white individuals (NHW, 3409 g) and Hispanic individuals (3348 g). Controlling for covariates, birthweight increased with maternal age until the early 30s. Race-specific modelling showed that the upper extremes of maternal age had a significant depressive effect on birthweight for NHW and NHB (35+ years, p<0.001), but only age less than 25 years was a significant contributor to lower birthweights for Hispanic individuals, p<0.0001. Among all racial subgroups, birth order had a greater influence on birthweight than maternal age, with the largest incremental increase from first to second births. Among NHB, birth order accounted for a smaller increment in birthweight than for NHW and Hispanic women. Conclusion Birth order exerts a greater influence on birthweight than maternal age, with signficantly different effects across racial subgroups. PMID:21081308

Racial differences in colorectal cancer mortality. The importance of stage and socioeconomic status.

PubMed

Marcella, S; Miller, J E

2001-04-01

This investigation studies racial and socioeconomic differences in mortality from colorectal cancer, and how they vary by stage and age at diagnosis. Cox proportional hazards models were used to estimate the hazard ratio of dying from colorectal cancer, controlling for tumor characteristics and sociodemographic factors. Black adults had a greater risk of death from colorectal cancer, especially in early stages. The gender gap in mortality is wider among blacks than whites. Differences in tumor characteristics and socioeconomic factors each accounted for approximately one third of the excess risk of death among blacks. Effects of socioeconomic factors and race varied significantly by age. Higher stage-specific mortality rates and more advanced stage at diagnosis both contribute to the higher case-fatality rates from colorectal cancer among black adults, only some of which is due to socioeconomic differences. Socioeconomic and racial factors have their most significant effects in different age groups.

Health, Aging and Childhood Socio-Economic Conditions in Mexico

PubMed Central

Grimard, Franque; Laszlo, Sonia; Lim, Wilfredo

2015-01-01

We investigate the long-term effect of childhood socio-economic conditions on the health of the elderly in Mexico. We utilize a panel of individuals aged 50 and above from the Mexican Health and Aging Survey and find that the conditions under which the individual lived at the age of 10 affect health in old age, even accounting for education and income. This paper contributes to the literature of the long-term effects of childhood socio-economic status by being the first, to our knowledge, to consider exclusively the case of the elderly in a developing country. PMID:20688405

Infectious episodes before and after a marathon race.

PubMed

Ekblom, B; Ekblom, O; Malm, C

2006-08-01

The aim of this study was to investigate the incidence of self-reported infectious episodes (IE) during 3 weeks before (pre-IE) and 3 weeks after (post-IE) a marathon race and relate these figures to training status, running time, socioeconomic and demographic factors. Two questionnaires, including questions about important factors for IE incidence, were given to a representative cohort of 1694 runners (17% of all finishers) in the Stockholm Marathon 2000. Pre-IE incidence in the cohort was 17% with no difference between women and men. Post-IE incidence in the whole cohort was 19% with no significant (P>0.05) difference between women and men. The post-IE incidence in runners without a pre-IE was 16% (P>0.05 to pre-IE incidence). In the group of runners with pre-IE, 33% experienced an IE after the race also (P<0.05 to Pre-IE incidence). A logistic regression analysis showed that younger age and pre race health status and, for men only, experienced nausea during and after the race were depended factors explaining post-IE incidence. Younger runners were more prone to experience IE both before and after the race. There was no relation between training volume 6 months before the race, finishing time and socioeconomic and demographic factors and pre-IE or post-IE. This study does not support the theory of increased infection rate after exhaustive long-distance running ("The Open Window Theory") in recreational runners, but suggests that the sometimes experienced increased rate of infections among athletes can be caused by strenuous exercise too soon after an infection.

Population-based study on the effect of socioeconomic factors and race on management and outcomes of 35,535 inpatient ectopic pregnancies.

PubMed

Papillon-Smith, Jessica; Imam, Basel; Patenaude, Valerie; Abenhaim, Haim Arie

2014-01-01

To evaluate whether socioeconomic variables influence the management and outcomes of ectopic pregnancies. Retrospective cohort study (Canadian Task Force classification II-2). Hospitals in the United States participating in the Health Care Cost and Utilization Project. Women (n = 35 535) with a primary discharge diagnosis of ectopic pregnancy. Effect of socioeconomic factors and race/ethnicity on management and adverse outcomes of ectopic pregnancy. During the 9-year study, 35 535 ectopic pregnancies were identified. The development of hemoperitoneum in 8706 patients (24.50%) was the most common complication. Asian race was the sociodemographic variable most predictive of hemoperitoneum (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.24-1.61; p < .01) and transfusion (OR, 1.62; 95% CI, 1.39-1.89; p < .01), and Medicare status was most influential on prolonged hospitalization (OR, 1.83; 95% CI, 1.36-2.47; p < .01). Major complications were not affected by socioeconomic factors. Laparotomy in 25 075 patients (70.6%) was the most common treatment option. Patients of Asian or Pacific Islander descent were least likely to be treated non-surgically (OR, 0.62; 95% CI, 0.51-0.76; p < .01), whereas Medicare recipients were most likely to be treated non-surgically (OR, 1.70; 95% CI, 1.32-2.18; p < .01). All non-white groups were less likely to undergo a laparoscopic approach. Major complications from ectopic pregnancy are not influenced by socioeconomic variables; however, less serious complications and management approaches are persistently affected. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

Socioeconomic status and age at menarche in indigenous and non-indigenous Chilean adolescents.

PubMed

Amigo, Hugo; Vásquez, Sofía; Bustos, Patricia; Ortiz, Guillermo; Lara, Macarena

2012-05-01

The objective was to analyze the relationship between socioeconomic status and age at menarche among indigenous and non-indigenous girls in the Araucanía Region of Chile, controlling for nutritional status and mother's age at menarche. A total of 8,624 randomly selected girls from 168 schools were screened, resulting in the selection of 207 indigenous and 200 non-indigenous girls who had recently experienced menarche. Age at menarche was 149.6 ± 10.7 months in the indigenous group and 146.6 ± 10.8 months in the non-indigenous group. Among the non-indigenous, the analysis showed no significant association between age at menarche and socioeconomic status. In the indigenous group, age at menarche among girls with low socioeconomic status was 5.4 months later than among those with higher socioeconomic status. There were no differences in nutritional status according to socioeconomic level. Obesity was associated with earlier menarche. Menarche occurred earlier than in previous generations. An inverse relationship between socioeconomic status and age at menarche was seen in the indigenous group only; low socioeconomic status was associated with delayed menarche, regardless of nutritional status or mother's age at menarche.

Development of Preferences for Differently Aged Faces of Different Races.

PubMed

Heron-Delaney, Michelle; Quinn, Paul C; Damon, Fabrice; Lee, Kang; Pascalis, Olivier

2018-02-01

Children's experiences with differently aged faces changes in the course of development. During infancy, most faces encountered are adult, however as children mature, exposure to child faces becomes more extensive. Does this change in experience influence preference for differently aged faces? The preferences of children for adult versus child, and adult versus infant faces were investigated. Caucasian 3- to 6-year-olds and adults were presented with adult/child and adult/infant face pairs which were either Caucasian or Asian (race consistent within pairs). Younger children (3 to 4 years) preferred adults over children, whereas older children (5 to 6 years) preferred children over adults. This preference was only detected for Caucasian faces. These data support a "here and now" model of the development of face age processing from infancy to childhood. In particular, the findings suggest that growing experience with peers influences age preferences and that race impacts on these preferences. In contrast, adults preferred infants and children over adults when the faces were Caucasian or Asian, suggesting an increasing influence of a baby schema, and a decreasing influence of race. The different preferences of younger children, older children, and adults also suggest discontinuity and the possibility of different mechanisms at work during different developmental periods.

Dental services utilization by women of childbearing age by socioeconomic status.

PubMed

Kaylor, Mary B; Polivka, Barbara J; Chaudry, Rosemary; Salsberry, Pamela; Wee, Alvin G

2010-04-01

For women of childbearing age, oral health not only affects their physical and psychological well-being but also that of their children. This study used the 2003-2004 Ohio Family Health Survey (N = 9,819) to examine dental need and utilization by women in Ohio. Predisposing, enabling, and need variables were examined as they effect dental health service utilization by women of childbearing age at different socioeconomic status (SES) levels. The proportion of women in the low SES group self reporting a dental need (18%) was 3 times that of the proportion of women in the higher SES group with a self reported need (6%). Results of bivariate analysis showed that having a dental visit in the past year varied significantly by SES, race, insurance status, provider density, and need. A racial disparity in dental service utilization was noted in the bivariate analysis of the middle SES group. While dental need and type of dental coverage varied by SES, both were significantly associated with utilization of dental services within all 3 SES categories in the logistic regressions. These results suggest that measures need to be implemented to meet the goal of increasing access and utilization of dental health services by low-income populations.

The link between body dissatisfaction and self-esteem in adolescents: Similarities across gender, age, weight status, race/ethnicity, and socioeconomic status

PubMed Central

van den Berg, Patricia A.; Mond, Jonathan; Eisenberg, Marla; Ackard, Diann; Neumark-Sztainer, Dianne

2010-01-01

Purpose The present study examined whether the cross-sectional association between body dissatisfaction and low self-esteem varies across gender, age, body weight status, race/ethnicity, and SES. We also examined the association longitudinally. Methods A school-based survey of eating, weight, and related attitudes was conducted with a diverse sample of adolescents aged 11–18 years (N = 4,746). Height and weight were measured in the schools at Time 1. Participants was resurveyed by mail five years later (Time 2, N = 2,516). Results The body dissatisfaction/self-esteem association was strong and significant in both boys and girls (p’s<.0001), and did not differ significantly between genders (p =.16), nor between the middle school and high school cohorts in either boys (p=.79) or girls (p=.80). Among girls, the body dissatisfaction/self-esteem relationship was strong, but did vary across weight status, race/ethnicity, and SES (p’s .0001–.03). The relationship was non-significant in underweight girls (p=.36), and weaker but still significant among black, Asian, and low SES girls (all p’s <.0001) in comparison to white and high SES group girls. Among boys, the association did not differ significantly across demographic groups (p’s .18–.79). In longitudinal analyses, the strength of the association did not change significantly as adolescents grew older. Conclusions Findings indicate that body dissatisfaction and self-esteem are strongly related among nearly all groups of adolescents. This suggests the importance of addressing body image concerns with adolescents of all backgrounds and ages. PMID:20708569

Comparison of Ischemic Stroke Outcomes and, Patient and Hospital Characteristics by Race/Ethnicity and Socioeconomic Status

PubMed Central

Hanchate, Amresh D.; Schwamm, Lee H.; Huang, Wei-Jie; Hylek, Elaine

2013-01-01

Background and Purpose Current literature provides mixed evidence on disparities by race/ethnicity and socioeconomic status (SES) in discharge outcomes following hospitalization for acute ischemic stroke. Using comprehensive data from eight states, we sought to compare inpatient mortality and length of stay (LOS) by race/ethnicity and SES. Methods We examined all 2007 hospitalizations for acute ischemic stroke in all non-Federal acute care hospitals in AZ, CA, FL, MA, NJ, NY, PA and TX. Population was stratified by race/ethnicity (non-Hispanic Whites, non-Hispanic Blacks and Hispanics) and SES, measured by median income of patient zip code. For each stratum we estimated risk-adjusted rates of inpatient mortality and longer LOS (> median LOS). We also compared the hospitals where these subpopulations received care. Results Hispanic and Black patients accounted for 14 and 12 percent of all ischemic stroke admissions (N=147,780) respectively and had lower crude inpatient mortality rates (Hispanic=4.5%, Blacks=4.4%; all p-values < 0.001) compared to White patients (5.8%). Hispanic and Black patients were younger and fewer had any form of atrial fibrillation. Adjusted for patient risk, inpatient mortality was similar by race/ethnicity, but was significantly higher for low area-income patients than that for high area-income patients (Odds Ratio=1.08, 95% confidence interval=[1.02, 1.15]). Risk-adjusted rates of longer LOS were higher among minority and low area-income populations. Conclusions Risk adjusted inpatient mortality was similar among patients by race/ethnicity but higher among patients from lower income areas. However, this pattern was not evident in sensitivity analyses including the use of mechanical ventilation as a partial surrogate for stroke severity. PMID:23306327

Are Differences in Disability-Free Life Expectancy by Gender, Race, and Education Widening at Older Ages?

PubMed Central

Solé-Auró, Aïda; Beltrán-Sánchez, Hiram; Crimmins, Eileen M.

2018-01-01

To examine change from 1991 to 2001 in disability-free life expectancy in the age range 60–90 by gender, race, and education in the United States. Mortality is estimated over two 10-year follow-up periods for persons in the National Health Interview Surveys of 1986/1987 and 1996/1997. Vital status is ascertained through the National Death Index. Disability prevalence is estimated from the National Health and Nutrition Examination Surveys of 1988–1994 and 1999–2002. Disability is defined as ability to perform four activities of daily living without difficulty. Disability-free life expectancy increased only among white men. Disabled life expectancy increased for all groups—black and white men and women. Racial differences in disability-free life expectancy widened among men; gender differences were reduced among whites. Expansion of socioeconomic differentials in disability-free life at older ages occurred among white men and women and black women. The 1990s was a period where the increased years of life between ages 60 and 90 were concentrated in disabled years for most population groups. PMID:29681672

Relationship between age and elite marathon race time in world single age records from 5 to 93 years

PubMed Central

2014-01-01

Background The aims of the study were (i) to investigate the relationship between elite marathon race times and age in 1-year intervals by using the world single age records in marathon running from 5 to 93 years and (ii) to evaluate the sex difference in elite marathon running performance with advancing age. Methods World single age records in marathon running in 1-year intervals for women and men were analysed regarding changes across age for both men and women using linear and non-linear regression analyses for each age for women and men. Results The relationship between elite marathon race time and age was non-linear (i.e. polynomial regression 4th degree) for women and men. The curve was U-shaped where performance improved from 5 to ~20 years. From 5 years to ~15 years, boys and girls performed very similar. Between ~20 and ~35 years, performance was quite linear, but started to decrease at the age of ~35 years in a curvilinear manner with increasing age in both women and men. The sex difference increased non-linearly (i.e. polynomial regression 7th degree) from 5 to ~20 years, remained unchanged at ~20 min from ~20 to ~50 years and increased thereafter. The sex difference was lowest (7.5%, 10.5 min) at the age of 49 years. Conclusion Elite marathon race times improved from 5 to ~20 years, remained linear between ~20 and ~35 years, and started to increase at the age of ~35 years in a curvilinear manner with increasing age in both women and men. The sex difference in elite marathon race time increased non-linearly and was lowest at the age of ~49 years. PMID:25120915

Socioeconomic (SES) differences in language are evident in female infants at 7months of age.

PubMed

Betancourt, Laura M; Brodsky, Nancy L; Hurt, Hallam

2015-12-01

Language skills, strongly linked to academic success, are known to differ by socioeconomic status (SES), with lower SES individuals performing less well than higher SES. To examine the effect of SES on infant language at 7months of age and the relationship between maternal vocabulary skills and infant language function. To determine if the relationships between SES and infant language are mediated by maternal vocabulary skills. Longitudinal follow-up of healthy term female African American infants born to mothers in two SES groups: Low SES (income-to-needs≤1, no education beyond high school) and Higher SES (Income-to-Needs >1, at least a high school diploma). 54 infants tested at 7months of age; 54 mothers tested at infant age 7months. Preschool Language Scale-5 (PLS-5), Vocabulary and Matrix Reasoning subtests of the Wechsler Adult Intelligence Scale-IV. Low SES infants (n=29) performed less well than Higher SES (n=25) on PLS-5 Total Language, Auditory Comprehension, and Expressive Communication (p≤0.012). Maternal Vocabulary subtest scores were lower in Low SES than Higher SES (p=0.002), but not related to infant PLS Language scores (p≥0.17). Maternal vocabulary did not mediate the relationship between SES and infant language skills at age 7months. In this single sex and race cohort of healthy, term, female infants, lower SES exerted negative effects on infant language by 7months of age. While maternal vocabulary scores showed no relation with infant language skills at 7months, continued study of the relations between SES, infant outcomes and maternal characteristics is needed to determine how low SES conditions impact early language. These findings underscore the importance of early interventions, as well as policies designed to improve socioeconomic conditions for infants and families. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Understanding How Race/Ethnicity and Gender Define Age-Trajectories of Disability: An Intersectionality Approach

PubMed Central

Warner, David F.; Brown, Tyson H.

2011-01-01

A number of studies have demonstrated wide disparities in health among racial/ethnic groups and by gender, yet few have examined how race/ethnicity and gender intersect or combine to affect the health of older adults. The tendency of prior research to treat race/ethnicity and gender separately has potentially obscured important differences in how health is produced and maintained, undermining efforts to eliminate health disparities. The current study extends previous research by taking an intersectionality approach (Mullings & Schulz, 2006), grounded in life course theory, conceptualizing and modeling trajectories of functional limitations as dynamic life course processes that are jointly and simultaneously defined by race/ethnicity and gender. Data from the nationally representative 1994–2006 US Health and Retirement Study and growth curve models are utilized to examine racial/ethnic/gender differences in intra-individual change in functional limitations among White, Black and Mexican American Men and Women, and the extent to which differences in life course capital account for group disparities in initial health status and rates of change with age. Results support an intersectionality approach, with all demographic groups exhibiting worse functional limitation trajectories than White Men. Whereas White Men had the lowest disability levels at baseline, White Women and racial/ethnic minority Men had intermediate disability levels and Black and Hispanic Women had the highest disability levels. These health disparities remained stable with age—except among Black Women who experience a trajectory of accelerated disablement. Dissimilar early life social origins, adult socioeconomic status, marital status, and health behaviors explain the racial/ethnic disparities in functional limitations among Men but only partially explain the disparities among Women. Net of controls for life course capital, Women of all racial/ethnic groups have higher levels of functional

Can Socioeconomic Status Substitute for Race in Affirmative Action College Admissions Policies? Evidence from a Simulation Model. CEPA Working Paper No. 15-04

ERIC Educational Resources Information Center

Reardon, Sean F.; Baker, Rachel; Kasman, Matt; Klasik, Daniel; Townsend, Joseph

2017-01-01

This paper simulates a system of socioeconomic status (SES)-based affirmative action in college admissions and examines the extent to which it can produce racial diversity in selective colleges. Using simulation models, we investigate the potential relative effects of race- and/or SES-based affirmative action policies, alongside targeted,…

Age and executive ability impact the neural correlates of race perception

PubMed Central

Lee, Eunice J.; Krendl, Anne C.

2016-01-01

Decreased executive ability elicits racial bias. We clarified the neural correlates of how executive ability contributes to race perception by comparing young adults (YA) to a population with highly variable executive ability: older adults (OA). After replicating work showing higher race bias in OA vs YA and a negative association between bias and executive ability, a subsample of White YA and OA perceived Black and White faces and cars during functional magnetic resonance imaging. YA had higher executive ability than OA, and OA had higher variability in executive ability. When perceiving Black vs White faces, YA exhibited more dorsolateral prefrontal cortex recruitment—a region previously implicated in regulating prejudiced responses—than OA. Moreover, OA with relatively impaired executive ability had more amygdala activity toward Black faces vs OA with relatively intact executive ability, whereas responses to White faces did not differ. Both YA and OA with relatively intact executive ability had stronger amygdala-ventrolateral prefrontal cortex connectivity when perceiving Black vs White faces. These findings are the first to disentangle age from executive ability differences in neural recruitment when perceiving race, potentially informing past behavioral work on aging and race perception. PMID:27330185

Peer Collaboration in Childhood According to Age, Socioeconomic Context and Task

ERIC Educational Resources Information Center

Castellaro, Mariano A.; Roselli, Néstor D.

2015-01-01

From a socio-constructivist approach, this work aimed to analyze the characteristics of peer collaboration in dyads of children according to age (4, 8, and 12 years old), socioeconomic context (advantaged socioeconomic context and disadvantaged socioeconomic context), and task (block construction task and free drawing). Eighty-two children (41…

Socioeconomic and race/ethnic disparities in observed park quality.

PubMed

Engelberg, Jessa K; Conway, Terry L; Geremia, Carrie; Cain, Kelli L; Saelens, Brian E; Glanz, Karen; Frank, Lawrence D; Sallis, James F

2016-05-12

Though park presence and access disparities are well studied for their associations with physical activity (PA), disparities in the availability and quality of amenities and facilities within parks have been infrequently examined. Five hundred forty-three parks from 472 block groups in the Seattle, WA and Baltimore, MD regions were audited using the Environmental Assessment of Public Recreation Spaces (EAPRS) to assess presence and quality (e.g., condition, cleanliness) of amenities (e.g., restrooms, seating) and facilities (e.g., fields, courts). General linear model regressions investigated Census 2000-derived neighborhood race/ethnicity and income main effect and interactive relationships with 7 park quality summary scores: 1) trails, 2) open space, 3) sports facilities, 4) PA facilities count, 5) PA facilities quality, 6) aesthetics, and 7) overall amenities, controlling for park size. The regions were analyzed separately due to differing race/ethnicity distributions. In the Seattle region, neighborhood income was significantly negatively associated with sports quality score (p < .043), PA facilities total count (p < .015) and the overall amenities quality score (p < .004) (unexpected direction). In the Baltimore region, neighborhood race/ethnicity (percent White/non-Hispanic) was significantly positively related to the open spaces quality score (p < .011) (expected direction). A significant income-by-race/ethnicity interaction was found for PA facilities quality (p = .014), with high-percent minority neighborhoods having higher quality parks in high- vs. low-income neighborhoods, yet was opposite in mostly White/non-Hispanic neighborhoods. The other income-by-race/ethnicity interaction was for overall amenities quality score (p = .043), where scores in high-percent minority neighborhoods were best in high- vs. low-income neighborhoods. There was little difference in scores within mostly White or mixed neighborhoods by income. Patterns

An Overview of Methods for Monitoring Social Disparities in Cancer with an Example Using Trends in Lung Cancer Incidence by Area-Socioeconomic Position and Race-Ethnicity, 1992–2004

PubMed Central

Harper, Sam; Lynch, John; Meersman, Stephen C.; Breen, Nancy; Davis, William W.; Reichman, Marsha E.

2008-01-01

The authors provide an overview of methods for summarizing social disparities in health using the example of lung cancer. They apply four measures of relative disparity and three measures of absolute disparity to trends in US lung cancer incidence by area-socioeconomic position and race-ethnicity from 1992 to 2004. Among females, measures of absolute and relative disparity suggested that area-socioeconomic and race-ethnic disparities increased over these 12 years but differed widely with respect to the magnitude of the change. Among males, the authors found substantial disagreement among summary measures of relative disparity with respect to the magnitude and the direction of change in disparities. Among area-socioeconomic groups, the index of disparity increased by 47% and the relative concentration index decreased by 116%, while for race-ethnicity the index of disparity increased by 36% and the Theil index increased by 13%. The choice of a summary measure of disparity may affect the interpretation of changes in health disparities. Important issues to consider are the reference point from which differences are measured, whether to measure disparity on the absolute or relative scale, and whether to weight disparity measures by population size. A suite of indicators is needed to provide a clear picture of health disparity change. PMID:18344513

Socioeconomic status and lifetime risk for workplace eye injury reported by a us population aged 50 years and over.

PubMed

Luo, Huabin; Beckles, Gloria L A; Fang, Xiangming; Crews, John E; Saaddine, Jinan B; Zhang, Xinzhi

2012-04-01

To examine whether socioeconomic status, as measured by educational attainment and annual household income, is associated with lifetime risk for workplace eye injury in a large US population. In analyses of data from the Behavioral Risk Factor Surveillance System (2005-2007, N = 43,510), we used logistic regression analysis and propensity score matching to assess associations between socioeconomic measures and lifetime risk for workplace eye injury among those aged ≥50 years. The lifetime prevalence of self-reported workplace eye injury was significantly higher among men (13.5%) than women (2.6%) (P < 0.001). After adjusting for age, race/ethnicity, eye care insurance, health status, and risk-taking behaviors, men with less than high school education (adjusted odds ratio [OR] = 2.24, 95% CI: 1.74-2.87) or high school education (adjusted OR = 1.92, 95% CI: 1.57-2.33) were more likely to report having had a lifetime workplace eye injury than those with more than a high school education. Men with an annual household income <$15,000 were also more likely to report having had a lifetime workplace eye injury than those whose income was >$50,000 (adjusted OR = 1.44, 95% CI: 1.07-1.95). After adjusting for other factors, no statistically significant associations between education, income, and lifetime workplace eye injury were found among women. Socioeconomic status was associated with lifetime risk for workplace eye injury among men but not women. Greater public awareness of individual and societal impacts of workplace eye injuries, especially among socioeconomically disadvantaged men, could help support efforts to develop a coordinated prevention strategy to minimize avoidable workplace eye injuries.

Media Representations of Bullying toward Queer Youth: Gender, Race, and Age Discrepancies

ERIC Educational Resources Information Center

Paceley, Megan S.; Flynn, Karen

2012-01-01

In 2010, media coverage on the bullying of queer youth increased dramatically. This study examined online news media's portrayal of the gender, race, and age of bullying victims. Content analyses of ten sources were compared to research on the dynamics of sexuality-based bullying. Discrepancies were found for gender and race (with White males…

Race by Gender Group Differences in the Protective Effects of Socioeconomic Factors Against Sustained Health Problems Across Five Domains.

PubMed

Assari, Shervin; Nikahd, Amirmasoud; Malekahmadi, Mohammad Reza; Lankarani, Maryam Moghani; Zamanian, Hadi

2016-10-17

Despite the existing literature on the central role of socioeconomic status (SES; education and income) for maintaining health, less is known about group differences in this effect. Built on the intersectionality approach, this study compared race by gender groups for the effects of baseline education and income on sustained health problems in five domains: depressive symptoms, insomnia, physical inactivity, body mass index (BMI), and self-rated health (SRH). Data came from waves 7, 8, and 10 of the Health and Retirement Study (HRS), which were collected in 2004, 2006, and 2010, respectively. The study followed 37,495 white and black men and women above age 50 for up to 6 years. This number included 12,495 white men, 15,581 white women, 3839 black men, and 5580 black women. Individuals reported their depressive symptoms (Center for Epidemiological Studies-Depression (CES-D) 11), insomnia, physical inactivity, BMI, and SRH across all waves. Multigroup structural equation modeling (SEM) was used to compare black men, black women, white men, and white women for the effects of education and income in 2004 on sustained health problems from 2004 to 2010. In the pooled sample, higher education and income at baseline were associated with lower sustained health problems across all five domains. However, race by gender group differences were found in the effects of education and income on sustained insomnia, physical inactivity, and BMI, but not depressive symptoms and SRH. The protective effects of education against insomnia, physical inactivity, and BMI were not found for black men. For black women, the effect of education on BMI was not found. Income had a protective effect against sustained high BMI among white and black women but not white and black men. The intersection of race and gender alters the protective effects of social determinants on sustained health problems such as insomnia, physical inactivity, and BMI. Social groups particularly vary in the operant

Age and executive ability impact the neural correlates of race perception.

PubMed

Cassidy, Brittany S; Lee, Eunice J; Krendl, Anne C

2016-11-01

Decreased executive ability elicits racial bias. We clarified the neural correlates of how executive ability contributes to race perception by comparing young adults (YA) to a population with highly variable executive ability: older adults (OA). After replicating work showing higher race bias in OA vs YA and a negative association between bias and executive ability, a subsample of White YA and OA perceived Black and White faces and cars during functional magnetic resonance imaging. YA had higher executive ability than OA, and OA had higher variability in executive ability. When perceiving Black vs White faces, YA exhibited more dorsolateral prefrontal cortex recruitment-a region previously implicated in regulating prejudiced responses-than OA. Moreover, OA with relatively impaired executive ability had more amygdala activity toward Black faces vs OA with relatively intact executive ability, whereas responses to White faces did not differ. Both YA and OA with relatively intact executive ability had stronger amygdala-ventrolateral prefrontal cortex connectivity when perceiving Black vs White faces. These findings are the first to disentangle age from executive ability differences in neural recruitment when perceiving race, potentially informing past behavioral work on aging and race perception. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Who’s not driving among U.S. high school seniors: A closer look at race/ethnicity, socioeconomic factors, and driving status

PubMed Central

Shults, Ruth A.; Banerjee, Tanima; Perry, Timothy

2017-01-01

Objectives We examined associations among race/ethnicity, socioeconomic factors, and driving status in a nationally representative sample of >26,000 U.S. high school seniors. Methods Weighted data from the 2012 and 2013 Monitoring the Future surveys were combined and analyzed. We imputed missing values using fully conditional specification multiple imputation methods. Multivariate logistic regression modeling was conducted to explore associations among race/ethnicity, socioeconomic factors, and driving status, while accounting for selected student behaviors and location. Lastly, odds ratios were converted to prevalence ratios. Results 23% of high school seniors did not drive during an average week; 14% of white students were nondrivers compared to 40% of black students. Multivariate analysis revealed that minority students were 1.8 to 2.5 times more likely to be nondrivers than their white counterparts, and students who had no earned income were 2.8 times more likely to be nondrivers than those earning an average of ≥$36 a week. Driving status also varied considerably by student academic performance, number of parents in the household, parental education, census region, and urbanicity. Conclusions Our findings suggest that resources—both financial and time—influence when or whether a teen will learn to drive. Many young people from minority or lower socioeconomic families who learn to drive may be doing so after their 18th birthday and therefore would not take advantage of the safety benefits provided by graduated driver licensing. Innovative approaches may be needed to improve safety for these young novice drivers. PMID:27064697

Sexual Problems Among Older Women by Age and Race.

PubMed

Hughes, Anne K; Rostant, Ola S; Pelon, Sally

2015-08-01

The purpose of our study was to examine the prevalence of sexual problems by age and race among older women in the United States and to examine quality of life correlates to sexual dysfunction among non-Hispanic white and African American older women. A cross-sectional study using self-report surveys was conducted among community-dwelling U.S. women, aged 60 years and over. A total of 807 women aged 61-89 years were included. Self-administered questionnaires assessed sexual dysfunction, satisfaction with life, depressive symptomatology, and self-rated health. Analyses included multivariate logistic regression. The mean age of the sample was 66 years. Two-thirds of the sample had at least one sexual dysfunction; the most common for both African American and non-Hispanic white women were lack of interest in sex and vaginal dryness. Prevalence varied by age for each of the sexual dysfunctions. The odds of experiencing sexual dysfunction varied with age and race. Compared with non-Hispanic white women, African American women had lower odds of reporting lack of interest in sex or vaginal dryness. Poor self-rated health, depressive symptomatology, and lower satisfaction with life were associated with higher odds of having some sexual dysfunction. Improved understanding of how sexual dysfunction affects women across multiple age ranges and racial/ethnic groups can assist providers in making recommendations for care that are patient centered. The associations that we identified with quality of life factors highlight the need to assess sexual health care in the aging female population.

Sexual Problems Among Older Women by Age and Race

PubMed Central

Rostant, Ola S.; Pelon, Sally

2015-01-01

Abstract Background: The purpose of our study was to examine the prevalence of sexual problems by age and race among older women in the United States and to examine quality of life correlates to sexual dysfunction among non-Hispanic white and African American older women. Methods: A cross-sectional study using self-report surveys was conducted among community-dwelling U.S. women, aged 60 years and over. A total of 807 women aged 61–89 years were included. Self-administered questionnaires assessed sexual dysfunction, satisfaction with life, depressive symptomatology, and self-rated health. Analyses included multivariate logistic regression. Results: The mean age of the sample was 66 years. Two-thirds of the sample had at least one sexual dysfunction; the most common for both African American and non-Hispanic white women were lack of interest in sex and vaginal dryness. Prevalence varied by age for each of the sexual dysfunctions. The odds of experiencing sexual dysfunction varied with age and race. Compared with non-Hispanic white women, African American women had lower odds of reporting lack of interest in sex or vaginal dryness. Poor self-rated health, depressive symptomatology, and lower satisfaction with life were associated with higher odds of having some sexual dysfunction. Conclusions: Improved understanding of how sexual dysfunction affects women across multiple age ranges and racial/ethnic groups can assist providers in making recommendations for care that are patient centered. The associations that we identified with quality of life factors highlight the need to assess sexual health care in the aging female population. PMID:26061291

Sexual Orientation Disparities in Adolescent Cigarette Smoking: Intersections With Race/Ethnicity, Gender, and Age

PubMed Central

Corliss, Heather L.; Rosario, Margaret; Birkett, Michelle A.; Newcomb, Michael E.; Buchting, Francisco O.; Matthews, Alicia K.

2014-01-01

Objectives. We examined sexual orientation differences in adolescent smoking and intersections with race/ethnicity, gender, and age. Methods. We pooled Youth Risk Behavior Survey data collected in 2005 and 2007 from 14 jurisdictions; the analytic sample comprised observations from 13 of those jurisdictions (n = 64 397). We compared smoking behaviors of sexual minorities and heterosexuals on 2 dimensions of sexual orientation: identity (heterosexual, gay–lesbian, bisexual, unsure) and gender of lifetime sexual partners (only opposite sex, only same sex, or both sexes). Multivariable regressions examined whether race/ethnicity, gender, and age modified sexual orientation differences in smoking. Results. Sexual minorities smoked more than heterosexuals. Disparities varied by sexual orientation dimension: they were larger when we compared adolescents by identity rather than gender of sexual partners. In some instances race/ethnicity, gender, and age modified smoking disparities: Black lesbians–gays, Asian American and Pacific Islander lesbians–gays and bisexuals, younger bisexuals, and bisexual girls had greater risk. Conclusions. Sexual orientation, race/ethnicity, gender, and age should be considered in research and practice to better understand and reduce disparities in adolescent smoking. PMID:24825218

Normal reference ranges for and variability in the levels of blood manganese and selenium by gender, age, and race/ethnicity for general U.S. population.

PubMed

Jain, Ram B; Choi, Y Sammy

2015-04-01

Data from National Health and Nutrition Examination Survey for the period 2011-2012 were used to determine normal reference ranges and percentile distributions for manganese (Mn) and selenium (Se) in blood by gender, age, race/ethnicity, socioeconomic status as determined by annual family income, and smoking status. The effect of gender, age, race/ethnicity, family income, and smoking status on the levels of Mn and Se was also determined by fitting regression models. Males had lower adjusted levels of Mn and higher adjusted levels of Se than females. Adjusted levels of Mn decreased with increase in age but adjusted levels of Se were lower in adolescents aged 12-19 years than adults aged 20-64 years. Non-Hispanic black (NHB) had the lowest levels of both Mn and Se and non-Hispanic Asians (NHAS) had the highest levels of both Mn and Se. Non-Hispanic white (NHW) and NHB had lower levels of Mn than Hispanics (HISP) and NHAS. NHB and HISP had lower levels of Se than NHW and NHAS. Low annual income (<$20,000) was associated with lower levels of Se than high annual income (≥$55,000). Smoking negatively affected the adjusted levels of Se among seniors aged ≥65 years but this was not observed in other age groups. Mn levels were not affected by smoking. Published by Elsevier GmbH.

DNA methylation levels associated with race and childhood asthma severity.

PubMed

Chan, Marcia A; Ciaccio, Christina E; Gigliotti, Nicole M; Rezaiekhaligh, Mo; Siedlik, Jacob A; Kennedy, Kevin; Barnes, Charles S

2017-10-01

Asthma is a common chronic childhood disease worldwide. Socioeconomic status, genetic predisposition and environmental factors contribute to its incidence and severity. A disproportionate number of children with asthma are economically disadvantaged and live in substandard housing with potential indoor environmental exposures such as cockroaches, dust mites, rodents and molds. These exposures may manifest through epigenetic mechanisms that can lead to changes in relevant gene expression. We examined the association of global DNA methylation levels with socioeconomic status, asthma severity and race/ethnicity. We measured global DNA methylation in peripheral blood of children with asthma enrolled in the Kansas City Safe and Healthy Homes Program. Inclusion criteria included residing in the same home for a minimum of 4 days per week and total family income of less than 80% of the Kansas City median family income. DNA methylation levels were quantified by an immunoassay that assessed the percentage of 5-methylcytosine. Our results indicate that overall, African American children had higher levels of global DNA methylation than children of other races/ethnicities (p = 0.029). This difference was more pronounced when socioeconomic status and asthma severity were coupled with race/ethnicity (p = 0.042) where low-income, African American children with persistent asthma had significantly elevated methylation levels relative to other races/ethnicities in the same context (p = 0.006, Hedges g = 1.14). Our study demonstrates a significant interaction effect among global DNA methylation levels, asthma severity, race/ethnicity, and socioeconomic status.

Race/ethnicity, socioeconomic status, and lifetime morbidity burden in the women's health initiative: a cross-sectional analysis.

PubMed

Gold, Rachel; Michael, Yvonne L; Whitlock, Evelyn P; Hubbell, F Allan; Mason, Ellen D; Rodriguez, Beatriz L; Safford, Monika M; Sarto, Gloria E

2006-12-01

We sought to assess the extent to which race/ethnicity and socioeconomic status (SES) are independently and jointly related to lifetime morbidity burden by comparing the impact of SES on lifetime morbidity among women of different racial/ethnic groups: white, black, Hispanic, American Indian/Alaska Native (AIAN), and Asian/Pacific Islander (API). Using baseline data from the Women's Health Initiative (WHI), a national study of 162,000 postmenopausal women, we measured lifetime morbidity burden using a modified version of the Charlson Index, and measured SES with educational attainment and household income. In multivariable simple polytomous logistic regression models, we first assessed the effect of SES on lifetime morbidity burden among women of each racial/ethnic group, then assessed the combined effect of race/ethnicity and SES. Five percent of all women in the study population had high lifetime morbidity burden. Women with high lifetime morbidity were more likely to be AIAN or black; poor; less educated; divorced, separated, or widowed; past or current smokers; obese; uninsured or publicly insured. Lower SES was associated with higher morbidity among most women. The extent to which morbidity was higher among lower SES compared to higher SES women was about the same among Hispanic women and white women, but was substantially greater among black and AIAN women compared with white women. This study demonstrates the importance of considering race/ethnicity and class together in relation to health outcomes.

Race/Ethnicity, Socioeconomic Status, Residential Segregation, and Spatial Variation in Noise Exposure in the Contiguous United States.

PubMed

Casey, Joan A; Morello-Frosch, Rachel; Mennitt, Daniel J; Fristrup, Kurt; Ogburn, Elizabeth L; James, Peter

2017-07-25

Prior research has reported disparities in environmental exposures in the United States, but, to our knowledge, no nationwide studies have assessed inequality in noise pollution. We aimed to a ) assess racial/ethnic and socioeconomic inequalities in noise pollution in the contiguous United States; and b ) consider the modifying role of metropolitan level racial residential segregation. We used a geospatial sound model to estimate census block group–level median (L 50 ) nighttime and daytime noise exposure and 90th percentile (L 10 ) daytime noise exposure. Block group variables from the 2006–2010 American Community Survey (ACS) included race/ethnicity, education, income, poverty, unemployment, homeownership, and linguistic isolation. We estimated associations using polynomial terms in spatial error models adjusted for total population and population density. We also evaluated the relationship between race/ethnicity and noise, stratified by levels of metropolitan area racial residential segregation, classified using a multigroup dissimilarity index. Generally, estimated nighttime and daytime noise levels were higher for census block groups with higher proportions of nonwhite and lower-socioeconomic status (SES) residents. For example, estimated nighttime noise levels in urban block groups with 75% vs. 0% black residents were 46.3 A-weighted decibels (dBA) [interquartile range (IQR): 44.3–47.8 dBA] and 42.3 dBA (IQR: 40.4–45.5 dBA), respectively. In urban block groups with 50% vs. 0% of residents living below poverty, estimated nighttime noise levels were 46.9 dBA (IQR: 44.7–48.5 dBA) and 44.0 dBA (IQR: 42.2–45.5 dBA), respectively. Block groups with the highest metropolitan area segregation had the highest estimated noise exposures, regardless of racial composition. Results were generally consistent between urban and suburban/rural census block groups, and for daytime and nighttime noise and robust to different spatial weight and neighbor

Race/Ethnicity, Socioeconomic Status, Residential Segregation, and Spatial Variation in Noise Exposure in the Contiguous United States

PubMed Central

Morello-Frosch, Rachel; Mennitt, Daniel J.; Fristrup, Kurt; Ogburn, Elizabeth L.; James, Peter

2017-01-01

Background: Prior research has reported disparities in environmental exposures in the United States, but, to our knowledge, no nationwide studies have assessed inequality in noise pollution. Objectives: We aimed to a) assess racial/ethnic and socioeconomic inequalities in noise pollution in the contiguous United States; and b) consider the modifying role of metropolitan level racial residential segregation. Methods: We used a geospatial sound model to estimate census block group–level median (L50) nighttime and daytime noise exposure and 90th percentile (L10) daytime noise exposure. Block group variables from the 2006–2010 American Community Survey (ACS) included race/ethnicity, education, income, poverty, unemployment, homeownership, and linguistic isolation. We estimated associations using polynomial terms in spatial error models adjusted for total population and population density. We also evaluated the relationship between race/ethnicity and noise, stratified by levels of metropolitan area racial residential segregation, classified using a multigroup dissimilarity index. Results: Generally, estimated nighttime and daytime noise levels were higher for census block groups with higher proportions of nonwhite and lower-socioeconomic status (SES) residents. For example, estimated nighttime noise levels in urban block groups with 75% vs. 0% black residents were 46.3 A-weighted decibels (dBA) [interquartile range (IQR): 44.3–47.8 dBA] and 42.3 dBA (IQR: 40.4–45.5 dBA), respectively. In urban block groups with 50% vs. 0% of residents living below poverty, estimated nighttime noise levels were 46.9 dBA (IQR: 44.7–48.5 dBA) and 44.0 dBA (IQR: 42.2–45.5 dBA), respectively. Block groups with the highest metropolitan area segregation had the highest estimated noise exposures, regardless of racial composition. Results were generally consistent between urban and suburban/rural census block groups, and for daytime and nighttime noise and robust to

The ARIC-PET amyloid imaging study: Brain amyloid differences by age, race, sex, and APOE.

PubMed

Gottesman, Rebecca F; Schneider, Andrea L C; Zhou, Yun; Chen, Xueqi; Green, Edward; Gupta, Naresh; Knopman, David S; Mintz, Akiva; Rahmim, Arman; Sharrett, A Richey; Wagenknecht, Lynne E; Wong, Dean F; Mosley, Thomas H

2016-08-02

To evaluate differences in amyloid deposition in a community-based cohort without dementia by age, sex, race, education, and APOE ε4 allele status. Recruited from the longitudinal Atherosclerosis Risk in Communities study, 329 participants without dementia, ages 67-88 years, were imaged using florbetapir PET at 3 US community sites (Washington County, Maryland; Forsyth County, North Carolina; and Jackson, Mississippi). Standardized uptake value ratios (SUVRs) were calculated; global cortical SUVR >1.2 was evaluated as the primary outcome. Age, race, sex, education level, and number of APOE ε4 alleles were evaluated in multivariable models including vascular risk factors, brain white matter hyperintensity and total intracranial volume, and cognitive status. A total of 141 of the participants (43%) were black. In multivariable models, odds of elevated SUVR was increased in participants with increasing age (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.01-2.65 per 10 years of age) and black race (OR 2.08, 95% CI 1.23-3.51) but did not differ by educational level. Each ε4 allele was associated with increased odds of elevated SUVR (OR 2.65, 95% CI 1.61-4.39). In this community-based cohort without dementia, florbetapir uptake is associated with older age and APOE genotype. Black race was associated with higher SUVR, after adjusting for demographics, vascular risk factors, cognitive status, white matter hyperintensity volume, and APOE genotype, with effect sizes nearing those seen for APOE ε4. Replication of these findings is needed in other cohorts, and reasons for and consequences of these observed differences by race warrant further study. © 2016 American Academy of Neurology.

The temperament profiles of school-age children.

PubMed

McClowry, Sandra Graham

2002-02-01

Maternal reports of child temperament were used to develop temperament profiles of school-age children. The subjects were 883 children who were between 4 and 12 years of age. The children's families varied substantially in their socioeconomic status and race/ethnicity. To develop the profiles, the dimensions derived from the School-Age Temperament Inventory were subjected to a second order principal factor analysis with varimax rotation. Pearson chi-squares were used to determine whether sociodemographic variables were proportionally represented among the profiles. Forty-two percent of the children were classified into four temperament profiles. High maintenance and cautious/slow to warm up were deemed as challenging temperaments. Industrious and social/eager to try were mirror images of those profiles and were labeled easy. Some children were both types of challenging or easy profiles. The generalizability of the profiles in relation to the sociodemographic variables of gender, age, race/ethnicity, and socioeconomic status was also examined. Challenging temperament profiles were disproportionately represented by boys, Hispanic children, and those from lower socioeconomic families. Girls were over represented in the group that included both types of easy temperaments. Social/eager to try children were more often from higher rather than lower socioeconomic status families. Clinical applications and research implications for the profiles are discussed. The profiles can be used as exemplars that parents can use to recognize their child's temperament. Further research is needed to explore whether different developmental outcomes are associated with the profiles. Copyright 2002, Elsevier Science (USA).

Interrelationships of added sugars intake, socioeconomic status, and race/ethnicity in adults in the United States: National Health Interview Survey, 2005.

PubMed

Thompson, Frances E; McNeel, Timothy S; Dowling, Emily C; Midthune, Douglas; Morrissette, Meredith; Zeruto, Christopher A

2009-08-01

The consumption of added sugars (eg, white sugar, brown sugar, and high-fructose corn syrup) displaces nutrient-dense foods in the diet. The intake of added sugars in the United States is excessive. Little is known about the predictors of added sugar intake. To examine the independent relationships of socioeconomic status and race/ethnicity with added sugar intake, and to evaluate the consistency of relationships using a short instrument to those from a different survey using more precise dietary assessment. Cross-sectional, nationally representative, interviewer-administered survey. Adults (aged > or = 18 years) participating in the 2005 US National Health Interview Survey Cancer Control Supplement responding to four added sugars questions (n=28,948). The intake of added sugars was estimated using validated scoring algorithms. Multivariate analysis incorporating sample weights and design effects was conducted. Least squares means and confidence intervals, and significance tests using Wald F statistics are presented. Analyses were stratified by sex and controlled for potential confounders. The intake of added sugars was higher among men than women and inversely related to age, educational status, and family income. Asian Americans had the lowest intake and Hispanics the next lowest intake. Among men, African Americans had the highest intake, although whites and American Indians/Alaskan Natives also had high intakes. Among women, African Americans and American Indians/Alaskan Natives had the highest intakes. Intake of added sugars was inversely related to educational attainment in whites, African Americans, Hispanic men, and American Indians/Alaskan Native men, but was unrelated in Asian Americans. These findings were generally consistent with relationships in National Health and Nutrition Examination Survey 2003-2004 (using one or two 24-hour dietary recalls). Race/ethnicity, family income, and educational status are independently associated with intake of added

Is Decedent Race an Independent Predictor of Organ Donor Consent, or Merely a Surrogate Marker of Socioeconomic Status?

PubMed Central

DuBay, Derek A.; Redden, David; Haque, Akhlaque; Gray, Stephen; Fouad, Mona; Siminoff, Laura A.; Holt, Cheryl; Kohler, Connie; Eckhoff, Devin

2013-01-01

Background Studies have demonstrated that African American race is a strong predictor of non-donation. However, it is often and correctly argued that African American race is a crude explanatory variable that is a surrogate marker of socioeconomic status (SES), education and access to health care. We hypothesized that when controlling for these factors, African American race would cease to be a predictor of organ donation. Methods A retrospective review was performed of 1292 Alabama decedents approached for organ donation between 2006 and 2009. Multivariable logistic regression models were constructed to identify the most parsimonious model that could explain the variation in the log-odds of obtaining consent. Results Consent for donation was obtained from 49% of the decedent's families. Household income was a predictor of organ donor consent only in Caucasians. Surprisingly, household income was not statistically different between consented and non-consented African American decedents ($25,147 vs. $26,137; p=0.90). On multivariable analysis, education, urban residence and shorter distance between the decedent residence and donor hospital were significantly associated with obtaining consent for organ donation. On univariate analysis, the odds of donor consent in Caucasians compared to African Americans was 2.76 (95% CI 2.17 – 3.57). When controlling for SES and access to healthcare variables, the odds of donor consent increased to 4.36 (95% CI 2.88 – 6.61). Conclusions We interpret this result to indicate that there remains unknown but important factor(s) associated with both race and obtaining organ donor consent. Further studies are required to isolate and determine whether this factor(s) is modifiable. PMID:23018878

Effects of age, socioeconomic status, and menstrual cycle on pulmonary response to ozone

DOE Office of Scientific and Technical Information (OSTI.GOV)

Seal, E. Jr.; McDonnell, W.F.; House, D.E.

The purpose of this study was to investigate the effects of age, socioeconomic status, and menstrual cycle phase on the pulmonary response to ozone exposure. Three hundred seventy-two healthy white and black young adults, between the ages of 18 and 35 y, were exposed only once to 0.0, 0.12, 0.18, 0.24, 0.30, or 0.40 ppm ozone for 2.3 h. Prior to and after exposure, pulmonary function tests were obtained. Prior to exposure, each subject completed a personal and family-history questionnaire. The response to this questionnaire were used to investigate age, socioeconomic status, and menstrual cycle phase effects on pulmonary responsivenessmore » to ozone. We concluded that the ages of subjects, within the age range studied, had an effect on responsiveness (i.e., decrements in forced expiratory volume in 1 s decreased as the subjects` ages decreased). Socioeconomic status, as reflected by education of fathers, also appeared to affect forced expiratory volume in 1-s responsiveness to ozone, with the middle socioeconomic group being the most responsive. The phase of menstrual cycle did not have an impact on individual responsiveness to ozone. 14 refs., 4 figs.« less

Socioeconomic and Demographic Predictors of Missed Opportunities to Provide Advanced Imaging Services.

PubMed

Glover, McKinley; Daye, Dania; Khalilzadeh, Omid; Pianykh, Oleg; Rosenthal, Daniel I; Brink, James A; Flores, Efrén J

2017-11-01

The extent to which racial and socioeconomic disparities exist in accessing clinically appropriate, advanced diagnostic imaging has not been well studied. This study assesses the relationship between demographic and socioeconomic factors and the incidence of imaging missed care opportunities (IMCOs). We performed a retrospective review of outpatient CT and MRI appointments at a quaternary academic medical center and affiliated outpatient facilities during a 12-month period. Missed appointments not rescheduled in advance were classified as IMCOs. Appropriateness criteria scores and demographics were also obtained. Univariate and multivariate analyses were performed to determine if demographic and socioeconomic factors were predictive of IMCOs. Overall, 57,847 patients met inclusion criteria, representing 89,943 scheduled unique imaging appointments of which 5,840 (6.1%) were IMCOs; 0.8% of IMCO appointments had low appropriateness scores compared with 1.2% of completed appointments (P < .01). Appointments covered by commercial insurance (5.2%) had a significantly lower rate of IMCOs than other payers: Medicare = 6.3%, Medicaid = 14.5%, self-pay = 12.0% (P < .05). The following factors were independent predictors of a patient having ≥ 1 IMCO: noncommercial insurance [odds ratio (OR) = 1.7-2.6], African American (OR = 1.8), Hispanic (OR = 1.2), other race (OR = 1.1), language other than English or Spanish (OR = 1.2), male gender (OR = 1.2), age ≥ 65 (OR = 0.71), and median household income of patient home zip code <$50,000 (OR = 1.4). Race and socioeconomic status are independent predictors of IMCOs. In efforts to enhance patient engagement, radiologists should be aware of the impact of race and socioeconomic status on access to clinically appropriate advanced diagnostic imaging. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Joint Attention and Toddler Characteristics: Race, Sex and Socioeconomic Status.

ERIC Educational Resources Information Center

Saxon, Terrill F.; Reilly, John T.

1999-01-01

Investigated the relationship between joint attention and toddler's race, sex, and SES. Found that joint attention related to a "persisting" mother, whether or not the toddler accepted the initial maternal bid. Females engaged in joint attention bouts and nonpersistent maternal responses after the bid was accepted more often than males. Race and…

Impact of IQ, Age, SES, Gender, and Race on Autistic Symptoms

ERIC Educational Resources Information Center

Mayes, Susan Dickerson; Calhoun, Susan L.

2011-01-01

The purpose of our study was to determine differences in autism severity and symptoms as a function of IQ, age, SES, gender, and race while simultaneously controlling these variables in 777 children with autism using a comprehensive measure evaluating 30 core and associated symptoms of autism. The children were 1-17 years of age with IQs from 9 to…

Seeing through Race, Gender and Socioeconomic Status.

ERIC Educational Resources Information Center

Gundi, Kirmanj

This paper discusses the history of discrimination in the United States and the length of time it took to abolish the legal support of racism. The paper then discusses the problems of diversity in the United States. Acknowledging and accepting U.S. diversity in terms of race, ethnicity, gender, religious background, and national origin would…

Disability Prevalence According to a Class, Race, and Sex (CSR) Hypothesis.

PubMed

Siordia, Carlos

2015-09-01

Disability has been shown to be related in definite ways to social class. In modern industrial societies, disability is influenced by and has the potential to contribute to the production and reproduction of social inequality. However, markers of social stratification processes are sometimes ignored determinants of health. A Class, Race, Sex (CRS) hypothesis is presented to argue that a "low-education disadvantage"; "racial-minority disadvantage"; and "female disadvantage" will compound to affect the risks for being disable. In particular, the CRS hypothesis posits that class is more important than race and the latter more than sex when predicting presence or severity of disability. The cross-sectional study of community-dwelling adults between the ages of 45 and 64 uses data from the American Community Survey (ACS) Public Use Microdata Sample (PUMS) 2008-2012 file. By using 3,429,523 individuals-which weighted equal to 61,726,420-the results of the study suggest the CRS hypothesis applies to both Non-Latino-Blacks and Non-Latino-Whites. There is a "male disadvantage" exception for Non-Latino-Whites. Decreasing between-group differences in health may be achieved by making the age-health association at lower socioeconomic stratum similar to that of the upper socioeconomic strata.

Racial/ethnic variations in associations between socioeconomic factors and tooth loss.

PubMed

Jimenez, Monik; Dietrich, Thomas; Shih, Mei-Chiung; Li, Yi; Joshipura, Kaumudi J

2009-06-01

To compare the associations between socioeconomic factors and tooth loss among White, Black, and Mexican-American people. Analyses were conducted on 16,821 adults, using data from the National Health and Nutrition Examination Survey-III. Age- and multivariate-adjusted negative binomial regressions were used to explore the relation of socioeconomic factors, region of residence, gender, and foreign birth with the number of missing teeth. Effect modification by race/ethnicity was assessed by the inclusion of interaction terms. In multivariate-adjusted analyses, non-Hispanic White people with 9-12 years of education exhibited 71% higher mean number of missing teeth than those with >12 years of education [incidence rate ratio (IRR) = 1.71, 95% confidence interval (CI): 1.52-1.92]. Education was unrelated to the number of teeth among non-Hispanic Black people (IRR = 1.16; 95% CI: 1.00-1.35) or Mexican-Americans (IRR = 1.10, 95% CI: 0.93-1.31). The poorest White people exhibited 39% more missing teeth, on average, than the most affluent White people, but no association between poverty and number of teeth was observed among Black or Mexican-American people. The associations between socioeconomic factors and tooth loss vary across race/ethnicity. This suggests that the health benefits associated with high socioeconomic status are not equally shared across racial/ethnic groups.

Race, embodiment and later life: Re-animating aging bodies of color.

PubMed

Rajan-Rankin, Sweta

2018-06-01

This theoretical essay examines the intersections between race, ethnicity and old age from an inter-disciplinary lens. Drawing on cultural gerontology (especially embodied aging studies) and post-colonial perspectives on aging, it explores how an emphasis on the body and embodiment can serve as a conceptual lens for understanding racialized aging bodies. A tentative framework for analysis is proposed. The concept of exile explores how bodies of color and older bodies are denigrated through the hegemonic (white, youth-centered, masculinist) gaze. Re-animation can take place by transcending double-consciousness: 'seeing beyond' the dominant gaze. Othering and otherness are explored in relation to both raced and aging bodies. The limits of ethnic aging are scrutinized at an epistemic level, simultaneously informing, and obscuring the understanding of lived experiences of racialized ethnic minorities in old age. Visible and invisible difference provide a way of unpacking the simultaneous hypervisibility of older (female) bodies of color, and their invisibility in institutional and policy discourses. De-coloniality is considered, by exploring ways to resist hegemonic power through embodied ways of knowing. This article concludes by exploring how recent methodological innovations - especially the visual and sensory turn - can offer new ways of understanding the lived experiences of aging bodies of color. Copyright © 2018 The Author. Published by Elsevier Inc. All rights reserved.

Race and weight change in US women: the roles of socioeconomic and marital status.

PubMed

Kahn, H S; Williamson, D F; Stevens, J A

1991-03-01

The prevalence of overweight among Black women in the US is higher than among White women, but the causes are unknown. We examined the weight change for 514 Black and 2,770 White women who entered the first Health and Nutrtion Examination Survey (1971-75) at ages 25-44 years and were weighed again a decade later. We used multivariate analyses to estimate the weight-change effectgs associated with race, family income, education, and marital change. After multiple adjustments, Black race, education below college level, and becoming married during the follow-up interval were each independently associated with an increased mean weight change. Using multivariate logistic analyses, Black race was not independently associated with an increased risk of major weight gain (change greater than or equal to +13 kg), but it was associated with a reduced likelihood of major weight loss (change less than or equal to -7 kg) (odds ratio - 0.64 [95% CI -0.41, 0.97])]. Very low family income was independently associated with the likelihood of both major weight gain (OR - 1.71 [95% CI - 1.15, 2.55]) and major weight loss (OR - 1.86 [95% CI - 1.18, 2.95]). Amont US women, Black race is independently associated with a reduced likelihood of major weight loss, but not with major weight gain. Women at greatest risk of weight gain are those with education below college level, those entering marriage, and those with very low family income.

Comparing Diabetes Prevalence Between African Americans and Whites of Similar Socioeconomic Status

PubMed Central

Signorello, Lisa B.; Schlundt, David G.; Cohen, Sarah S.; Steinwandel, Mark D.; Buchowski, Maciej S.; McLaughlin, Joseph K.; Hargreaves, Margaret K.; Blot, William J.

2007-01-01

Objectives. We investigated whether racial disparities in the prevalence of type 2 diabetes exist beyond what may be attributable to differences in socioeconomic status (SES) and other modifiable risk factors. Methods. We analyzed data from 34331 African American and 9491 White adults aged 40 to 79 years recruited into the ongoing Southern Community Cohort Study. Participants were enrolled at community health centers and had similar socioeconomic circumstances and risk factor profiles. We used logistic regression to estimate the association between race and prevalence of self-reported diabetes after taking into account age, SES, health insurance coverage, body mass index, physical activity, and hypertension. Results. Multivariate analyses accounting for several diabetes risk factors did not provide strong support for higher diabetes prevalence rates among African Americans than among Whites (men: odds ratio [OR]=1.07; 95% confidence interval [CI]=0.95, 1.20); women: OR=1.13, 95% CI=1.04, 1.22). Conclusions. Our findings suggest that major differences in diabetes prevalence between African Americans and Whites may simply reflect differences in established risk factors for the disease, such as SES, that typically vary according to race. PMID:17971557

Age, class and race discrimination: their interactions and associations with mental health among Brazilian university students.

PubMed

Bastos, João Luiz; Barros, Aluisio J D; Celeste, Roger Keller; Paradies, Yin; Faerstein, Eduardo

2014-01-01

Although research on discrimination and health has progressed significantly, it has tended to focus on racial discrimination and US populations. This study explored different types of discrimination, their interactions and associations with common mental disorders among Brazilian university students, in Rio de Janeiro in 2010. Associations between discrimination and common mental disorders were examined using multiple logistic regression models, adjusted for confounders. Interactions between discrimination and socio-demographics were tested. Discrimination attributed to age, class and skin color/race were the most frequently reported. In a fully adjusted model, discrimination attributed to skin color/race and class were both independently associated with increased odds of common mental disorders. The simultaneous reporting of skin color/race, class and age discrimination was associated with the highest odds ratio. No significant interactions were found. Skin color/race and class discrimination were important, but their simultaneous reporting, in conjunction with age discrimination, were associated with the highest occurrence of common mental disorders.

Not just smoking and high-tech medicine: socioeconomic inequities in US mortality rates, overall and by race/ethnicity, 1960–2006

PubMed Central

Krieger, Nancy; Chen, Jarvis T.; Kosheleva, Anna; Waterman, Pamela D.

2011-01-01

Recent research on the post-1980 widening of US socioeconomic mortality inequalities has emphasized the contribution of smoking and high-tech medicine, with some studies treating the growing inequalities as effectively inevitable. No studies, however, have analyzed long-term trends in US mortality rates and inequities unrelated to smoking or due to lack of basic medical care, even as a handful have shown that US socioeconomic inequalities in overall mortality shrank between the mid-1960s and 1980. We accordingly analyzed US mortality data for 1960–2006, stratified by county income quintile and race/ethnicity, for mortality unrelated to smoking and preventable by 1960s standards of medical care. Key findings were that relative and absolute socioeconomic inequalities in US mortality unrelated to smoking and preventable by 1960s medical care standards shrank between the 1960s and 1980 and then increased and stagnated, with absolute rates on par with several leading causes of death, and with the burden worst for US populations of color. None of these findings can be attributed to trends in smoking-related deaths and access to high-tech medicine, and they also demonstrate that socioeconomic inequities in mortality can shrink and need not inevitably rise. PMID:22611656

Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity.

PubMed

Townsend, J; Roderick, P; Cooper, J

1994-10-08

To assess effects of price, income, and health publicity on cigarette smoking by age, sex, and socioeconomic group. Econometric multiple regression analysis of data on cigarette smoking from the British general household survey. Random sample of adult population in Britain interviewed for biennial general household surveys 1972-90. Changes in cigarette consumption and prevalence of smoking. Price elasticities of demand for cigarettes (percentage change in cigarette consumption for a 1% change in price) were significant at -0.5 (95% confidence interval -0.8 to -0.1) for men and -0.6 (-0.9 to -0.3) for women, were highest in socioeconomic group V (-1.0 for men and -0.9 for women), and lowest (not significantly different from zero) in socioeconomic groups I and II. The gradient in price elasticities by socioeconomic group was significant for men (F = 5.6, P = 0.02) and for women (F = 6.1, P = 0.02). Price was a significant factor in cigarette consumption by age for women in every age group and for men aged 25-34. Cigarette consumption by young men aged 16-34 increased with income. There was a significant decrease in smoking over time by women in socioeconomic groups I and II and by men in all age and social groups except socioeconomic group V attributable to health publicity. Price significantly affected smoking prevalence in socioeconomic group V (-0.6 for men and -0.5 for women) and for all women (-0.2). Men and women in lower socioeconomic groups are more responsive than are those in higher socioeconomic groups to changes in the price of cigarettes and less to health publicity. Women of all ages, including teenagers, appear to have been less responsive to health publicity than have men but more responsive to price. Response to health publicity decreased linearly with age. Real price increases in cigarettes could narrow differences between socioeconomic groups in smoking and the related inequalities in health, but specific measures would be necessary to ameliorate

Motor Performance Age and Race Differences between Black and Caucasian Boys Six to Nine Years of Age.

ERIC Educational Resources Information Center

DiNucci, James M.

This study was undertaken to compare the motor performance age and race differences between black and caucasian boys ages six to nine. One hundred and twenty subjects were administered 25 test items which measured (a) muscular strength, (b) muscular endurance, (c) cardio-respiratory endurance, (d) speed, (e) power, (f) agility, (g) balance, and…

The development of the own-race advantage in school-age children: A morphing face paradigm

PubMed Central

Tai, Chu-Lik; Yang, Shu-Fei

2018-01-01

Previous studies examining the other-race effect in school-age children mostly focused on recognition memory performance. Here we investigated perceptual discriminability for Asian-like versus Caucasian-like morph faces in school-age Taiwanese children and adults. One-hundred-and-two 5- to 12-year-old children and twenty-three adults performed a sequential same/different face matching task, where they viewed an Asian- or a Caucasian-parent face followed by either the same parent face or a different morphed face (containing 15%, 30%, 45%, or 60% contribution from the other parent face) and judged if the two faces looked the same. We computed the d’ as the sensitivity index for each age groups. We also analyzed the group mean rejection rates as a function of the morph level and fitted with a cumulative normal distribution function. Results showed that the adults and the oldest 11-12-year-old children exhibited a greater sensitivity (d’) and a smaller discrimination threshold (μ) in the Asian-parent condition than those in the Caucasian-parent condition, indicating the presence of an own-race advantage. On the contrary, 5- to 10-year-old children showed an equal sensitivity and similar discrimination thresholds for both conditions, indicating an absence of the own-race advantage. Moreover, a gradual development in enhancing the discriminability for the Asian-parent condition was observed from age 5 to 12; however, the progression in the Caucasian-parent condition was less apparent. In sum, our findings suggest that expertise in face processing may take the entire childhood to develop, and supports the perceptual learning view of the other-race effect—the own-race advantage seen in adulthood likely reflects a result of prolonged learning specific to faces most commonly seen in one’s visual environment such as own-race faces. PMID:29634731

Race and socioeconomic disparities in national stoma reversal rates.

PubMed

Zafar, Syed Nabeel; Changoor, Navin R; Williams, Kibileri; Acosta, Rafael D; Greene, Wendy R; Fullum, Terrence M; Haider, Adil H; Cornwell, Edward E; Tran, Daniel D

2016-04-01

Many temporary stomas are never reversed leading to significantly worse quality of life. Recent evidence suggests a lower rate of reversal among minority patients. Our study aimed to elucidate disparities in national stoma closure rates by race, medical insurance status, and household income. Five years of data from the Nationwide Inpatient Sample (2008 to 2012) was used to identify the annual rates of stoma formation and annual rates of stoma closure. Stomas labeled as "permanent" or those created secondary to colorectal cancers were excluded. Temporary stoma closure rates were calculated, and differences were tested with the chi-square test. Separate analyses were performed by race/ethnicity, insurance status, and household income. Nationally representative estimates were calculated using discharge-level weights. The 5-year average annual rate of temporary stoma creation was 76,551 per year (46% colostomies and 54% ileostomies). The annual rate of stoma reversal was 50,155 per year that equated to an annual reversal rate of 65.5%. Reversal rates were higher among white patients compared with black patients (67% vs 56%, P < .001) and among privately insured patients compared with uninsured patients (88% vs 63%, P < .001). Reversal rates increased as the household income increased from 61% in the lowest income quartile to 72% in the highest quartile (P < .001). Stark disparities exist in national rates of stoma closure. Stoma closure is associated with race, insurance, and income status. This study highlights the lack of access to surgical health care among patients of minority race and low-income status. Copyright © 2016 Elsevier Inc. All rights reserved.

Peripapillary Choroidal Thickness Variation With Age and Race in Normal Eyes

PubMed Central

Rhodes, Lindsay A.; Huisingh, Carrie; Johnstone, John; Fazio, Massimo A.; Smith, Brandon; Wang, Lan; Clark, Mark; Downs, J. Crawford; Owsley, Cynthia; Girard, Michael J. A.; Mari, Jean Martial; Girkin, Christopher A.

2015-01-01

Purpose. This study examined the association between peripapillary choroidal thickness (PCT) with age and race in a group of African descent (AD) and European descent (ED) subjects with normal eyes. Methods. Optic nerve head images from enhanced depth imaging spectral-domain optical coherence tomography of 166 normal eyes from 84 subjects of AD and ED were manually delineated to identify the principal surfaces of Bruch's membrane (BM), Bruch's membrane opening (BMO), and anterior sclera (AS). Peripapillary choroidal thickness was measured between BM and AS at increasing distance away from BMO. The mean PCT was compared between AD and ED subjects and generalized estimating equation (GEE) regression analysis was used to examine the association between race and PCT overall, in each quadrant, and by distance from BMO. Models were adjusted for age, BMO area, and axial length in the regression analysis. Results. Overall, the mean PCT increased from 63.9 μm ± 18.1 at 0 to 250 μm to 170.3 μm ± 56.7 at 1500 to 2000 μm from BMO. Individuals of AD had a greater mean PCT than those of ED at all distances from BMO (P < 0.05 at each distance) and in each quadrant (P < 0.05 in each quadrant). Results from multivariate regression indicate that ED subjects had significantly lower PCT compared to AD overall and in all quadrants and distances from BMO. Increasing age was also significantly associated with a lower PCT in both ED and AD participants. Conclusions. Peripapillary choroidal thickness varies with race and age, as individuals of AD have a thicker peripapillary choroid than those of ED. (ClinicalTrials.gov number, NCT00221923.) PMID:25711640

Socioeconomic status and the incidence of atrial fibrillation in whites and blacks: the Atherosclerosis Risk in Communities (ARIC) study.

PubMed

Misialek, Jeffrey R; Rose, Kathryn M; Everson-Rose, Susan A; Soliman, Elsayed Z; Clark, Cari J; Lopez, Faye L; Alonso, Alvaro

2014-08-20

No previous studies have examined the interplay among socioeconomic status, sex, and race with the risk of atrial fibrillation (AF). We prospectively followed 14 352 persons (25% black, 75% white, 55% women, mean age 54 years) who were free of AF and participating in the Atherosclerosis Risk in Communities (ARIC) study. Socioeconomic status was assessed at baseline (1987-1989) through educational level and total family income. Incident AF through 2009 was ascertained from electrocardiograms, hospitalizations, and death certificates. Cox regression was used to estimate hazard ratios and 95% CIs of AF for education and family income. Interactions were tested between socioeconomic status and age, race, or sex. Over a median follow-up of 20.6 years, 1794 AF cases occurred. Lower family income was associated with higher AF risk (hazard ratio 1.45, 95% CI 1.27 to 1.67 in those with income less than $25 000 per year compared with those with $50 000 or more per year). The association between education and AF risk varied by sex (P=0.01), with the lowest education group associated with higher AF risk in women (hazard ratio 1.88, 95% CI 1.55 to 2.28) but not in men (hazard ratio 1.15, 95% CI 0.97 to 1.36) compared with the highest education group. Adjustment for cardiovascular risk factors attenuated the associations. There were no interactions with race or age. Blacks had lower AF risk than whites in all income and education groups. Lower family income was associated with a higher AF risk overall, whereas the impact of education on AF risk was present only in women. Differences in socioeconomic status do not explain the lower risk of AF in blacks compared with whites. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Neural correlates of socioeconomic status in the developing human brain.

PubMed

Noble, Kimberly G; Houston, Suzanne M; Kan, Eric; Sowell, Elizabeth R

2012-07-01

Socioeconomic disparities in childhood are associated with remarkable differences in cognitive and socio-emotional development during a time when dramatic changes are occurring in the brain. Yet, the neurobiological pathways through which socioeconomic status (SES) shapes development remain poorly understood. Behavioral evidence suggests that language, memory, social-emotional processing, and cognitive control exhibit relatively large differences across SES. Here we investigated whether volumetric differences could be observed across SES in several neural regions that support these skills. In a sample of 60 socioeconomically diverse children, highly significant SES differences in regional brain volume were observed in the hippocampus and the amygdala. In addition, SES × age interactions were observed in the left superior temporal gyrus and left inferior frontal gyrus, suggesting increasing SES differences with age in these regions. These results were not explained by differences in gender, race or IQ. Likely mechanisms include differences in the home linguistic environment and exposure to stress, which may serve as targets for intervention at a time of high neural plasticity. © 2012 Blackwell Publishing Ltd.

Age, gender, and race/ethnic differences in total body and subregional bone density1

PubMed Central

Looker, Anne C; Melton, L. Joseph; Harris, Tamara; Borrud, Lori; Shepherd, John; McGowan, Joan

2011-01-01

Introduction Total body dual-energy x-ray absorptiometry (DXA) data offer the opportunity to compare bone density of demographic groups across the entire skeleton. Methods The present study uses total body DXA data (Hologic QDR 4500A, Hologic Inc, Bedford MA) from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 to examine bone mineral density (BMD) of the total body and selected skeletal subregions in a wide age range of adult men and women from three race/ethnic groups. Total body, lumbar spine, pelvis, right leg, and left arm BMD and lean mass from 13,091 adults age 20 years and older were used. The subregions were chosen to represent sites with different degrees of weight bearing. Results Mean BMD varied in expected ways for some demographic characteristics (men>women and non-Hispanic blacks>non-Hispanic whites) but not others (non-Hispanic whites>Mexican Americans). Differences in age patterns in BMD also emerged for some characteristics (sex) but not others (race/ethnicity). Differences in cross-sectional age patterns in BMD and lean mass by degree of weight-bearing in older adults were observed for the pelvis, leg and arm. Conclusion This information may be useful for generating hypotheses about age, race, and sex differences in fracture risk in the population. PMID:19048179

Age, Race, and Gender Differences in Depressive Symptoms: A Lifespan Developmental Investigation

ERIC Educational Resources Information Center

Bracken, Bruce A.; Reintjes, Cristina

2010-01-01

This study considered depressive symptoms among a normative sample of 1,900 children, adolescents, and adults (950 males and 950 females) divided across four age-levels to investigate the developmental progression of depressive symptoms by age, race/ethnicity, and gender. The national normative sample of the Clinical Assessment of Depression (CAD)…

Low-Income Students and the Socioeconomic Composition of Public High Schools

ERIC Educational Resources Information Center

Crosnoe, Robert

2009-01-01

Increasing constraints placed on race-based school diversification have shifted attention to socioeconomic desegregation. Although past research suggests that socioeconomic desegregation can produce heightened achievement, the "frog pond" perspective points to potential problems with socioeconomic desegregation in nonachievement domains.…

Trends in birth across high-parity groups by race/ethnicity and maternal age.

PubMed Central

Aliyu, Muktar H.; Salihu, Hamisu M.; Keith, Louis G.; Ehiri, John E.; Islam, M. Aminul; Jolly, Pauline E.

2005-01-01

BACKGROUND: The changing racial and ethnic diversity of the U.S. population along with delayed childbearing suggest that shifts in the demographic composition of gravidas are likely. It is unclear whether trends in the proportion of births to parous women in the United States have changed over the decades by race and ethnicity, reflecting parallel changes in population demographics. METHODS: Singleton deliveries > or = 20 weeks of gestation in the United States from 1989 through 2000 were analyzed using data from the "Natality data files" assembled by the National Center for Health Statistics (NCHS). We classified maternal age into three categories; younger mothers (aged < 30 years), mature mothers (30-39 years) and older mothers (> or = 40 years) and maternal race/ethnicity into three groups: blacks (non-Hispanic), Hispanics and whites (non-Hispanic). We computed birth rates by period of delivery across the entire population and repeated the analysis stratified by age and maternal race. Chi-squared statistics for linear trend were utilized to assess linear trend across three four-year phases: 1989-1992, 1993-1996 and 1997-2000. In estimating the association between race/ethnicity and parity status, the direct method of standardization was employed to adjust for maternal age. RESULTS: Over the study period, the total number of births to blacks and whites diminished consistently (p for trend < 0.001), whereas among Hispanics a progressive increase in the total number of deliveries was evident (p for trend < 0.001). Black and white women experienced a reduction in total deliveries equivalent to 10% and 9.3%, respectively, while Hispanic women showed a substantial increment in total births (25%). Regardless of race or ethnicity, birth rate was associated with increase in maternal age in a dose-effect fashion among the high (5-9 previous live births), very high (10-14 previous live births) and extremely high (> or = 15 previous live births) parity groups (p for trend

Race and weight change in US women: the roles of socioeconomic and marital status.

PubMed Central

Kahn, H S; Williamson, D F; Stevens, J A

1991-01-01

BACKGROUND. The prevalence of overweight among Black women in the US is higher than among White women, but the causes are unknown. METHODS. We examined the weight change for 514 Black and 2,770 White women who entered the first Health and Nutrtion Examination Survey (1971-75) at ages 25-44 years and were weighed again a decade later. We used multivariate analyses to estimate the weight-change effectgs associated with race, family income, education, and marital change. RESULTS. After multiple adjustments, Black race, education below college level, and becoming married during the follow-up interval were each independently associated with an increased mean weight change. Using multivariate logistic analyses, Black race was not independently associated with an increased risk of major weight gain (change greater than or equal to +13 kg), but it was associated with a reduced likelihood of major weight loss (change less than or equal to -7 kg) (odds ratio - 0.64 [95% CI -0.41, 0.97])]. Very low family income was independently associated with the likelihood of both major weight gain (OR - 1.71 [95% CI - 1.15, 2.55]) and major weight loss (OR - 1.86 [95% CI - 1.18, 2.95]). CONCLUSIONS. Amont US women, Black race is independently associated with a reduced likelihood of major weight loss, but not with major weight gain. Women at greatest risk of weight gain are those with education below college level, those entering marriage, and those with very low family income. PMID:2036117

Changing disparities in invasive pneumococcal disease by socioeconomic status and race/ ethnicity in Connecticut, 1998-2008.

PubMed

Soto, Kristen; Petit, Susan; Hadler, James L

2011-01-01

We compared invasive pneumococcal disease (IPD) incidence by race/ethnicity and neighborhood poverty level and assessed their relative utility to describe disparities in IPD in 1998-1999 and again in 2007-2008, after introduction of the 7-valent pneumococcal conjugate vaccine (PCV7). We conducted laboratory surveillance for pneumococcal isolates from sterile body sites and serotyped the isolates. Home address was geocoded to the census-tract level. Census-tract data on the percentage of people below poverty were grouped into three categories. The difference in the magnitude of incidence by race/ethnicity and by census-tract socioeconomic status (SES) (high poverty minus low poverty) was compared for 1998-1999 and 2007-2008 for PCV7 and non-PCV7 serotypes. In 1998-1999, incidence difference (all per 100,000 population) for PCV7 serotypes for black people compared with white people was 14.3 and by poverty level was 13.9. The highest rate was among white people in high-poverty tracts (77.3). By 2007-2008, there were only slight differences between rates for black and white people (0.7) and SES (1.4). In 1998-1999, the incidence difference for non-PCV7 serotypes was 4.7 between black and white people and 6.0 by SES. By 2007-2008, the differences were 11.6 and 11.7, respectively. Among those living in the highest-poverty tracts, white people had the highest rate (42.9). In the absence of vaccine, IPD incidence is higher among people living in higher-poverty census tracts and among black people. Emerging serotypes also follow this trend. Differences in neighborhood poverty levels reveal disparities in rates of IPD as large as those seen by race/ethnicity and could be used to routinely describe disparities and target prevention.

Sleep duration partially accounts for race differences in diurnal cortisol dynamics.

PubMed

Peterson, Laurel M; Miller, Karissa G; Wong, Patricia M; Anderson, Barbara P; Kamarck, Thomas W; Matthews, Karen A; Kirschbaum, Clemens; Manuck, Stephen B

2017-05-01

Emerging research demonstrates race differences in diurnal cortisol slope, an indicator of hypothalamic-pituitary-adrenocortical (HPA)-axis functioning associated with morbidity and mortality, with African Americans showing flatter diurnal slopes than their White counterparts. Sleep characteristics are associated with both race and with HPA-axis functioning. The present report examines whether sleep duration may account for race differences in cortisol dynamics. Participants were 424 employed African American and White adults (mean age = 42.8 years, 84.2% White, 53.6% female) with no cardiovascular disease (Adult Health and Behavior Project-Phase 2 [AHAB-II] cohort, University of Pittsburgh). Cortisol slope was calculated using 4 salivary cortisol readings, averaged over each of 4 days. Demographic (age, sex), psychosocial (socioeconomic status [SES], affect, discrimination), and health behaviors (smoking, alcohol use, physical activity) variables were used as covariates, and sleep (self-report and accelerometry) was also assessed. African Americans had flatter slopes than Whites (F(1, 411) = 10.45, B = .02, p = .001) in models adjusting for demographic, psychosocial, and health behavior covariates. Shorter actigraphy-assessed total sleep time was a second significant predictor of flatter cortisol slopes (F(1, 411) = 25.27, B = -.0002, p < .0001). Total sleep time partially accounted for the relationship between race and diurnal slope [confidence interval = .05 (lower = .014, upper .04)]. African Americans have flatter diurnal cortisol slopes than their White counterparts, an effect that may be partially attributable to race differences in nightly sleep duration. Sleep parameters should be considered in further research on race and cortisol. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Age, training, and previous experience predict race performance in long-distance inline skaters, not anthropometry.

PubMed

Knechtle, Beat; Knechtle, Patrizia; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald

2012-02-01

The association of characteristics of anthropometry, training, and previous experience with race time in 84 recreational, long-distance, inline skaters at the longest inline marathon in Europe (111 km), the Inline One-eleven in Switzerland, was investigated to identify predictor variables for performance. Age, duration per training unit, and personal best time were the only three variables related to race time in a multiple regression, while none of the 16 anthropometric variables were related. Anthropometric characteristics seem to be of no importance for a fast race time in a long-distance inline skating race in contrast to training volume and previous experience, when controlled with covariates. Improving performance in a long-distance inline skating race might be related to a high training volume and previous race experience. Also, doing such a race requires a parallel psychological effort, mental stamina, focus, and persistence. This may be reflected in the preparation and training for the event. Future studies should investigate what motivates these athletes to train and compete.

Jocks, gender, race, and adolescent problem drinking.

PubMed

Miller, Kathleen E; Hoffman, Joseph H; Barnes, Grace M; Farrell, Michael P; Sabo, Don; Melnick, Merrill J

2003-01-01

Alcohol remains the drug of choice for many adolescents; however, the nature of the relationship between athletic involvement and alcohol misuse remains ambiguous. In this article, we used a longitudinal sample of over 600 Western New York adolescents and their families to explore the gender-specific and race-specific relationships between identification with the "jock" label and adolescent alcohol consumption, specifically problem drinking. Operationalization of problem drinking included frequency measures of heavy drinking, binge drinking, and social problems related to alcohol (e.g., trouble with family, friends, school officials over drinking). Self-identified adolescent "jocks" were more likely to engage in problem drinking than their non-jock counterparts, even after controlling for gender, age, race, socioeconomic status, physical maturity, social maturity, and frequency of athletic activity. Jock identity was strongly associated with higher binge drinking frequency in Black adolescent girls. This study underscores the need to distinguish between objective and subjective meanings of athletic involvement when assessing the relationship between sport and adolescent health-risk behavior.

Age/race differences in HER2 testing and in incidence rates for breast cancer triple subtypes: a population-based study and first report.

PubMed

Lund, Mary Jo; Butler, Ebonee N; Hair, Brionna Y; Ward, Kevin C; Andrews, Judy H; Oprea-Ilies, Gabriella; Bayakly, A Rana; O'Regan, Ruth M; Vertino, Paula M; Eley, J William

2010-06-01

Although US year 2000 guidelines recommended characterizing breast cancers by human epidermal growth factor receptor 2 (HER2), national cancer registries do not collect HER2, rendering a population-based understanding of HER2 and clinical "triple subtypes" (estrogen receptor [ER] / progesterone receptor [PR] / HER2) largely unknown. We document the population-based prevalence of HER2 testing / status, triple subtypes and present the first report of subtype incidence rates. Medical records were searched for HER2 on 1842 metropolitan Atlanta females diagnosed with breast cancer during 2003-2004. HER2 testing/status and triple subtypes were analyzed by age, race/ethnicity, tumor factors, socioeconomic status, and treatment. Age-adjusted incidence rates were calculated. Over 90% of cases received HER2 testing: 12.6% were positive, 71.7% negative, and 15.7% unknown. HER2 testing compliance was significantly better for women who were younger, of Caucasian or African-American descent, or diagnosed with early stage disease. Incidence rates (per 100,000) were 21.1 for HER2+ tumors and 27.8 for triple-negative tumors, the latter differing by race (36.3 and 19.4 for black and white women, respectively). HER2 recommendations are not uniformly adhered to. Incidence rates for breast cancer triple subtypes differ by age/race. As biologic knowledge is translated into the clinical setting eg, HER2 as a biomarker, it will be incumbent upon national cancer registries to report this information. Incidence rates cautiously extrapolate to an annual burden of 3000 and 17,000 HER2+ tumors for black and white women, respectively, and triple-negative tumors among 5000 and 16,000 respectively. Testing, rate, and burden variations warrant population-based in-depth exploration and clinical translation. (c) 2010 American Cancer Society.

Regional Variation in Disparities in Breast Cancer Specific Mortality Due to Race/Ethnicity, Socioeconomic Status, and Urbanization.

PubMed

Parise, Carol A; Caggiano, Vincent

2017-08-01

Disparities in breast cancer mortality due to race/ethnicity, area socioeconomic status (SES), and urbanization have been documented. This study examined if disparities in the risk of breast cancer specific mortality due to race/ethnicity, SES, and urbanization varied within diverse regions of California. We identified 163,569 cases of first primary female invasive breast cancer from the California Cancer Registry diagnosed between January, 2000 and December, 2013. Cox regression was used to compute hazard ratios (HR) and 95 % confidence intervals for race/ethnicity, SES, and urbanization within eight regions of California. Blacks had an increased risk of mortality in the San Francisco Bay Area (SFBA) (HR = 1.37; 1.22-1.55), Desert Sierra (HR = 1.27; 1.08-1.49), San Diego/Orange (HR = 1.43; 1.19-1.71), and Los Angeles (LA) (HR = 1.31; 1.20-1.44). Japanese (HR = 0.62; 0.47-0.81), Chinese (HR = 0.71; 0.58-0.87), and Filipino (HR = 0.81; 0.69-0.95) women had a decreased risk of mortality in LA. Southeast Asians had a decreased risk in San Diego/Orange (HR = 0.72; 0.57-0.90) and in the SFBA (HR = 0.81; 0.67-0.98). Hispanics had a decreased risk (HR = 0.73; 0.57-0.93) and American Indians had an increased risk (HR = 2.32; 1.08-4.98) in the Tri-County region. SES was a significant risk factor for mortality in all regions except the North and Tri-County. Urbanization was a statistically significant factor for mortality only in LA (HR = 1.32; 1.08-1.60). Disparities in breast cancer mortality, due to race/ethnicity, SES, and urbanization vary by region which suggests that further research is warranted concerning the role of geographic regions and neighborhoods in cancer outcomes.

Bladder Cancer Mortality in the United States: A Geographic and Temporal Analysis of Socioeconomic and Environmental Factors.

PubMed

Smith, Norm D; Prasad, Sandip M; Patel, Amit R; Weiner, Adam B; Pariser, Joseph J; Razmaria, Aria; Maene, Chieko; Schuble, Todd; Pierce, Brandon; Steinberg, Gary D

2016-02-01

We assessed the association of temporal, socioeconomic and environmental factors with bladder cancer mortality in the United States. Our hypothesis was that bladder cancer mortality is associated with distinct environmental and socioeconomic factors with effects varying by region, race and gender. NCI (National Cancer Institute) age adjusted, county level bladder cancer mortality data from 1950 to 2007 were analyzed to identify clusters of increased bladder cancer death using the Getis-Ord Gi* statistic. Socioeconomic, clinical and environmental data were assessed using geographically weighted spatial regression analysis adjusting for spatial autocorrelation. County level socioeconomic, clinical and environmental data were obtained from national databases, including the United States Census, CDC (Centers for Disease Control and Prevention), NCHS (National Center for Health Statistics) and County Health Rankings. Bladder cancer mortality hot spots and risk factors for bladder cancer death differed significantly by gender, race and geographic region. From 1996 to 2007 smoking, unemployment, physically unhealthy days, air pollution ozone days, percent of houses with well water, employment in the mining industry and urban residences were associated with increased rates of bladder cancer mortality (p <0.05). Model fit was significantly improved in hot spots compared to all American counties (R(2) = 0.20 vs 0.05). Environmental and socioeconomic factors affect bladder cancer mortality and effects appear to vary by gender and race. Additionally there were temporal trends of bladder cancer hot spots which, when persistent, should be the focus of individual level studies of occupational and environmental factors. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Adolescent Self-Esteem: Differences by Race/Ethnicity, Gender, and Age

PubMed Central

Bachman, Jerald G.; O’Malley, Patrick M.; Freedman-Doan, Peter; Trzesniewski, Kali H.; Donnellan, M. Brent

2012-01-01

Large-scale representative surveys of 8th-, 10th-, and 12th-grade students in the United States show high self-esteem scores for all groups. African-American students score highest, Whites score slightly higher than Hispanics, and Asian Americans score lowest. Males score slightly higher than females. Multivariate controls for grades and college plans actually heighten these race/ethnic/gender differences. A truncated scoring method, designed to counter race/ethnic differences in extreme response style, reduced but did not eliminate the subgroup differences. Age differences in self-esteem are modest, with 12th graders reporting the highest scores. The findings are highly consistent across 18 annual surveys from 1991 through 2008, and self-esteem scores show little overall change during that period. PMID:22279425

Age, gender, and race/ethnic differences in total body and subregional bone density.

PubMed

Looker, A C; Melton, L J; Harris, T; Borrud, L; Shepherd, J; McGowan, J

2009-07-01

Total body bone density of adults from National Health and Nutrition Examination Survey (NHANES) 1999-2004 differed as expected for some groups (men>women and blacks>whites) but not others (whites>Mexican Americans). Cross-sectional age patterns in bone mineral density (BMD) of older adults differed at skeletal sites that varied by degree of weight-bearing. Total body dual-energy X-ray absorptiometry (DXA) data offer the opportunity to compare bone density of demographic groups across the entire skeleton. The present study uses total body DXA data (Hologic QDR 4500A, Hologic, Bedford MA, USA) from the NHANES 1999-2004 to examine BMD of the total body and selected skeletal subregions in a wide age range of adult men and women from three race/ethnic groups. Total body, lumbar spine, pelvis, right leg, and left arm BMD and lean mass from 13,091 adults aged 20 years and older were used. The subregions were chosen to represent sites with different degrees of weight-bearing. Mean BMD varied in expected ways for some demographic characteristics (men>women and non-Hispanic blacks>non-Hispanic whites) but not others (non-Hispanic whites>Mexican Americans). Differences in age patterns in BMD also emerged for some characteristics (sex) but not others (race/ethnicity). Differences in cross-sectional age patterns in BMD and lean mass by degree of weight-bearing in older adults were observed for the pelvis, leg, and arm. This information may be useful for generating hypotheses about age, race, and sex differences in fracture risk in the population.

Race, Ethnicity, and Self-Rated Health Among Immigrants in the United States.

PubMed

Alang, Sirry M; McCreedy, Ellen M; McAlpine, Donna D

2015-12-01

Previous work has not fully explored the role of race in the health of immigrants. We investigate race and ethnic differences in self-rated health (SRH) among immigrants, assess the degree to which socio-economic characteristics explain race and ethnic differences, and examine whether time in the USA affects racial and ethnic patterning of SRH among immigrants. Data came from the 2012 National Health Interview Survey (N = 16, 288). Using logistic regression, we examine race and ethnic differences in SRH controlling for socio-economic differences and length of time in the country. Hispanic and non-Hispanic Black immigrants were the most socio-economically disadvantaged. Asian immigrants were socio-economically similar to non-Hispanic White immigrants. Contrary to U.S. racial patterning, Black immigrants had lower odds of poor SRH than did non-Hispanic White immigrants when socio-demographic factors were controlled. When length of stay in the USA was included in the model, there were no racial or ethnic differences in SRH. However, living in the USA for 15 years and longer was associated with increased odds of poor SRH for all immigrants. Findings have implications for research on racial and ethnic disparities in health. Black-White disparities that have received much policy attention do not play out when we examine self-assessed health among immigrants. The reasons why non-Hispanic Black immigrants have similar self-rated health than non-Hispanic White immigrants even though they face greater socio-economic disadvantage warrant further attention.

Effects of age, gender, education and race on two tests of language ability in community-based older adults.

PubMed

Snitz, Beth E; Unverzagt, Frederick W; Chang, Chung-Chou H; Bilt, Joni Vander; Gao, Sujuan; Saxton, Judith; Hall, Kathleen S; Ganguli, Mary

2009-12-01

Neuropsychological tests, including tests of language ability, are frequently used to differentiate normal from pathological cognitive aging. However, language can be particularly difficult to assess in a standardized manner in cross-cultural studies and in patients from different educational and cultural backgrounds. This study examined the effects of age, gender, education and race on performance of two language tests: the animal fluency task (AFT) and the Indiana University Token Test (IUTT). We report population-based normative data on these tests from two combined ethnically divergent, cognitively normal, representative population samples of older adults. Participants aged > or =65 years from the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) and from the Indianapolis Study of Health and Aging (ISHA) were selected based on (1) a Clinical Dementia Rating (CDR) score of 0; (2) non-missing baseline language test data; and (3) race self-reported as African-American or white. The combined sample (n = 1885) was 28.1% African-American. Multivariate ordinal logistic regression was used to model the effects of demographic characteristics on test scores. On both language tests, better performance was significantly associated with higher education, younger age, and white race. On the IUTT, better performance was also associated with female gender. We found no significant interactions between age and sex, and between race and education. Age and education are more potent variables than are race and gender influencing performance on these language tests. Demographically stratified normative tables for these measures can be used to guide test interpretation and aid clinical diagnosis of impaired cognition.

Differences in surgical outcomes for patients with craniosynostosis in the US: impact of socioeconomic variables and race.

PubMed

Shweikeh, Faris; Foulad, David; Nuño, Miriam; Drazin, Doniel; Adamo, Matthew A

2016-01-01

OBJECT Craniosynostosis is often treated with neurosurgical intervention. The aim of this study was to report and analyze the clinical and socioeconomic characteristics of patients with craniosynostosis and to present current national trends. METHODS Using the Kids' Inpatient Database for the years 2000, 2003, 2006, and 2009, the authors identified patients with craniosynostosis using International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes and their associated procedure codes. Clinical features, demographics, inpatient procedures, outcomes, and charges were collected and analyzed. RESULTS Of the 3415 patients identified, 65.8% were White, 21.4% were Hispanic, and 3.2% were Black. More than 96% were treated at urban teaching hospitals and 54.2% in southern or western regions. White patients were younger (mean 6.1 months) as compared with Blacks (mean 10.9 months) and Hispanics (mean 9.1 months; p < 0.0001) at the time of surgery. A higher fraction of Whites had private insurance (70.3%) compared with nonwhites (34.0%-41.6%; p < 0.001). Approximately 12.2% were nonelective admissions, more so among Blacks (16.9%). Mean hospital length of stay (LOS) was 3.5 days with no significant differences among races. Following surgical treatment, 12.1% of patients developed complications, most commonly pulmonary/respiratory (4.8%), wound infection (4.4%), and hydrocephalus (1.4%). The mean overall hospital charges were significantly lower for Whites than nonwhites ($34,527 vs $44,890-$48,543, respectively; p < 0.0001). CONCLUSIONS The findings of this national study suggest a higher prevalence of craniosynostosis in Hispanics. The higher predisposition among males was less evident in Hispanics and Blacks. There was a significant percentage of nonelective admissions, more commonly among Blacks. Additionally, Hispanics and Blacks were more likely to receive surgery at an older age, past the current recommendation of the optimum age for

Age Stereotypes as a Function of Sex, Race, and Vocational Preference.

ERIC Educational Resources Information Center

Crew, James C.

1983-01-01

Examined the influence of race, age, sex, and vocational preference on attitudes toward older workers in a study of 125 business students. Results showed Blacks rated a younger worker more favorably and an older worker less favorably than Whites on three of four work-related dimensions. (JAC)

Probability of an Abnormal Screening PSA Result Based on Age, Race, and PSA Threshold

PubMed Central

Espaldon, Roxanne; Kirby, Katharine A.; Fung, Kathy Z.; Hoffman, Richard M.; Powell, Adam A.; Freedland, Stephen J.; Walter, Louise C.

2014-01-01

Objective To determine the distribution of screening PSA values in older men and how different PSA thresholds affect the proportion of white, black, and Latino men who would have an abnormal screening result across advancing age groups. Methods We used linked national VA and Medicare data to determine the value of the first screening PSA test (ng/mL) of 327,284 men age 65+ who underwent PSA screening in the VA healthcare system in 2003. We calculated the proportion of men with an abnormal PSA result based on age, race, and common PSA thresholds. Results Among men age 65+, 8.4% had a PSA >4.0ng/mL. The percentage of men with a PSA >4.0ng/mL increased with age and was highest in black men (13.8%) versus white (8.0%) or Latino men (10.0%) (P<0.001). Combining age and race, the probability of having a PSA >4.0ng/mL ranged from 5.1% of Latino men age 65–69 to 27.4% of black men age 85+. Raising the PSA threshold from >4.0ng/mL to >10.0ng/mL, reclassified the greatest percentage of black men age 85+ (18.3% absolute change) and the lowest percentage of Latino men age 65–69 (4.8% absolute change) as being under the biopsy threshold (P<0.001). Conclusions Age, race, and PSA threshold together affect the pre-test probability of an abnormal screening PSA result. Based on screening PSA distributions, stopping screening among men whose PSA < 3ng/ml means over 80% of white and Latino men age 70+ would stop further screening, and increasing the biopsy threshold to >10ng/ml has the greatest effect on reducing the number of older black men who will face biopsy decisions after screening. PMID:24439009

Racial and Socioeconomic Variation in Genetic Markers of Telomere Length: A Cross-Sectional Study of U.S. Older Adults.

PubMed

Hamad, Rita; Tuljapurkar, Shripad; Rehkopf, David H

2016-09-01

Shorter telomere length (TL) has been associated with stress and adverse socioeconomic conditions, yet U.S. blacks have longer TL than whites. The role of genetic versus environmental factors in explaining TL by race and socioeconomic position (SEP) remains unclear. We used data from the U.S. Health and Retirement Study (N=11,934) to test the hypothesis that there are differences in TL-associated SNPs by race and SEP. We constructed a TL polygenic risk score (PRS) and examined its association with race/ethnicity, educational attainment, assets, gender, and age. U.S. blacks were more likely to have a lower PRS for TL, as were older individuals and men. Racial differences in TL were statistically accounted for when controlling for population structure using genetic principal components. The GWAS-derived SNPs for TL, however, may not have consistent associations with TL across different racial/ethnic groups. This study showed that associations of race/ethnicity with TL differed when accounting for population stratification. The role of race/ethnicity for TL remains uncertain, however, as the genetic determinants of TL may differ by race/ethnicity. Future GWAS samples should include racially diverse participants to allow for better characterization of the determinants of TL in human populations. Copyright © 2016 Forschungsgesellschaft für Arbeitsphysiologie und Arbeitschutz e.V. Published by Elsevier B.V. All rights reserved.

Inter-Observer Agreement on Subjects' Race and Race-Informative Characteristics

PubMed Central

Edgar, Heather J. H.; Daneshvari, Shamsi; Harris, Edward F.; Kroth, Philip J.

2011-01-01

Health and socioeconomic disparities tend to be experienced along racial and ethnic lines, but investigators are not sure how individuals are assigned to groups, or how consistent this process is. To address these issues, 1,919 orthodontic patient records were examined by at least two observers who estimated each individual's race and the characteristics that influenced each estimate. Agreement regarding race is high for African and European Americans, but not as high for Asian, Hispanic, and Native Americans. The indicator observers most often agreed upon as important in estimating group membership is name, especially for Asian and Hispanic Americans. The observers, who were almost all European American, most often agreed that skin color is an important indicator of race only when they also agreed the subject was European American. This suggests that in a diverse community, light skin color is associated with a particular group, while a range of darker shades can be associated with members of any other group. This research supports comparable studies showing that race estimations in medical records are likely reliable for African and European Americans, but are less so for other groups. Further, these results show that skin color is not consistently the primary indicator of an individual's race, but that other characteristics such as facial features add significant information. PMID:21897865

The contribution of social and environmental factors to race differences in dental services use.

PubMed

Eisen, Colby H; Bowie, Janice V; Gaskin, Darrell J; LaVeist, Thomas A; Thorpe, Roland J

2015-06-01

Dental services use is a public health issue that varies by race. African Americans are less likely than whites to make use of these services. While several explanations exist, little is known about the role of segregation in understanding this race difference. Most research does not account for the confounding of race, socioeconomic status, and segregation. Using cross-sectional data from the Exploring Health Disparities in Integrated Communities Study, we examined the relationship between race and dental services use. Our primary outcome of interest was dental services use within 2 years. Our main independent variable was self-identified race. Of the 1408 study participants, 59.3% were African American. More African Americans used dental services within 2 years than whites. After adjusting for age, gender, marital status, income, education, insurance, self-rated health, and number of comorbidities, African Americans had greater odds of having used services (odds ratio = 1.48, 95% confidence interval 1.16, 1.89) within 2 years. Within this low-income racially integrated sample, African Americans participated in dental services more than whites. Place of living is an important factor to consider when seeking to understand race differences in dental service use.

A Life Course Approach to Inequality: Examining Racial/Ethnic Differences in the Relationship between Early Life Socioeconomic Conditions and Adult Health Among Men.

PubMed

Hargrove, Taylor W; Brown, Tyson H

2015-08-07

Previous research has documented a relationship between childhood socioeconomic conditions and adult health, but less is known about racial/ethnic differences in this relationship, particularly among men. This study utilizes a life course approach to investigate racial/ethnic differences in the relationships among early and later life socioeconomic circumstances and health in adulthood among men. Panel data from the Health and Retirement Study and growth curve models are used to examine group differences in the relationships among childhood and adult socioeconomic factors and age-trajectories of self-rated health among White, Black and Mexican American men aged 51-77 years (N=4147). Multiple measures of childhood socioeconomic status (SES) predict health in adulthood for White men, while significantly fewer measures of childhood SES predict health for Black and Mexican American men. Moreover, the health consequences of childhood SES diminish with age for Black and Mexican American men. The childhood SES-adult health relationship is largely explained by measures of adult SES for White men. The life course pathways linking childhood SES and adult health differ by race/ethnicity among men. Similar to arguments that the universality of the adult SES-health relationship should not be assumed, results from our study suggest that scholars should not assume that the significance and nature of the association between childhood SES and health in adulthood is similar across race/ethnicity among men.

An Analysis of the Effect of Race, Socioeconomic Status and Center Size on Unrelated NMDP Donor Outcomes: Donor Toxicities are More Common at Low Volume Bone Marrow Collection Centers

PubMed Central

Shaw, Bronwen E.; Logan, Brent R.; Kiefer, Deidre M.; Chitphakdithai, Pintip; Pedersen, Tanya L.; Abdel-Azim, Hisham; Abidi, Muneer H.; Akpek, Gorgun; Diaz, Miguel A.; Artz, Andrew S.; Dandoy, Christopher; Gajewski, James L.; Hematti, Peiman; Kamble, Rammurti T.; Kasow, Kimberley A.; Lazarus, Hillard M.; Liesveld, Jane L.; Majhail, Navneet S.; O’Donnell, Paul V.; Olsson, Richard F.; Savani, Bipin N.; Schears, Raquel M.; Stroncek, David F.; Switzer, Galen E.; Williams, Eric P.; Wingard, John R.; Wirk, Baldeep M.; Confer, Dennis L.; Pulsipher, Michael A.

2015-01-01

Previous studies have shown that risks of collection-related pain and symptoms are associated with sex, body mass index (BMI), and age in unrelated donors undergoing collection at National Marrow Donor Program (NMDP) centers. We hypothesized that other important factors (race, socioeconomic status (SES), and number of procedures at the collection center) might affect symptoms in donors. We assessed outcomes in 2,726 bone marrow (BM) and 6,768 peripheral blood stem cell (PBSC) donors collected between 2004 and 2009. Pain/symptoms are reported as maximum levels over mobilization and collection (PBSC) or within 2 days of collection (BM) and at 1 week after collection. For PBSC donors, race and center volumes were not associated with differences in pain/symptoms at any time. PBSC donors with high SES levels reported higher maximum symptom levels 1 week post donation (p=0.017). For BM donors, black males reported significantly higher levels of pain (OR=1.90, CI=1.14-3.19, p=0.015). No differences were noted by SES groups. BM donors from low volume centers reported more toxicity (OR=2.09, CI=1.26-3.46, p=0.006). In conclusion, race and SES have a minimal effect on donation associated symptoms. However, donors from centers performing ≤1 BM collection every 2 months have more symptoms following BM donation. Approaches should be developed by registries and low volume centers to address this issue. PMID:26116089

Early changes in socioeconomic status do not predict changes in body mass in the first decade of life.

PubMed

Starkey, Leighann; Revenson, Tracey A

2015-04-01

Many studies link childhood socioeconomic status (SES) to body mass index (BMI), but few account for the impact of socioeconomic mobility throughout the lifespan. This study aims to investigate the impact of socioeconomic mobility on changes in BMI in childhood. Analyses tested whether [1] socioeconomic status influences BMI, [2] changes in socioeconomic status impact changes in BMI, and [3] timing of socioeconomic status mobility impacts BMI. Secondary data spanning birth to age 9 were analyzed. SES and BMI were investigated with gender, birth weight, maternal race/ethnicity, and maternal nativity as covariates. Autoregressive structural equation modeling and latent growth modeling were used. Socioeconomic status in the first year of life predicted body mass index. Child covariates were consistently associated with body mass index. Rate of change in socioeconomic status did not predict change in body mass index. The findings suggest that early socioeconomic status may most influence body mass in later childhood.

Body mass index and depressive symptoms in older adults: the moderating roles of race, sex, and socioeconomic status.

PubMed

Sachs-Ericsson, Natalie; Burns, Andrea B; Gordon, Kathryn H; Eckel, Lisa A; Wonderlich, Steven A; Crosby, Ross D; Blazer, Dan G

2007-09-01

Although the long-term health risks associated with obesity in older adults have been well documented, less is known about the psychological consequences. The current study examined the relationship between body mass index (BMI) and subsequent depressive symptoms. The authors anticipated that BMI would predict depressive symptoms, and that this relationship would be greater among women, individuals of higher socioeconomic status (SES), and white subjects. A three-year longitudinal epidemiological design was employed. Participants were obtained from a biracial sample of community-dwelling older adults (N = 2,406) and were interviewed in their home by trained interviewers. A comprehensive survey assessed age, gender, race, SES (education and income), and health functioning variables. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. BMI was derived from self-reported weight and height. BMI was found to predict depressive symptoms. Contrary to predictions, the influence of BMI on depressive symptoms was greater for African Americans than whites and, in particular, African Americans with less education. There were no sex differences. Among older adults, BMI was associated with depressive symptoms although the effect size was small. Factors contributing to this relationship may differ from those observed in younger populations, for example, health functioning may play a larger role. Obesity appears to have the most adverse impact on those who are most likely to be overweight, lower SES African Americans.

Socioeconomic inequalities in health after age 50: Are health risk behaviors to blame?

PubMed Central

Shaw, Benjamin A.; McGeever, Kelly; Grubert, Elizabeth; Agahi, Neda; Fors, Stefan

2013-01-01

Recent studies indicate that socioeconomic inequalities in health extend into the elderly population, even within the most highly developed welfare states. One potential explanation for socioeconomic inequalities in health focuses on the role of health behaviors, but little is known about the degree to which health behaviors account for health inequalities among older adults, in particular. Using data from the Health and Retirement Study (N=19,245), this study examined the degree to which four behavioral risk factors – smoking, obesity, physical inactivity, and heavy drinking – are associated with socioeconomic position among adults aged 51 and older, and whether these behaviors mediate socioeconomic differences in mortality, and the onset of disability among those who were disability-free at baseline, over a 10-year period from 1998–2008. Results indicate that the odds of both smoking and physical inactivity are higher among persons with lower wealth, with similar stratification in obesity, but primarily among women. The odds of heavy drinking decrease at lower levels of wealth. Significant socioeconomic inequalities in mortality and disability onset are apparent among older men and women; however, the role that health behaviors play in accounting for these inequalities differs by age and gender. For example, these health behaviors account for between 23–45% of the mortality disparities among men and middle aged women, but only about 5% of the disparities found among women over 65 years. Meanwhile, these health behaviors appear to account for about 33% of the disparities in disability onset found among women survivors, and about 9–14% among men survivors. These findings suggest that within the U.S. elderly population, behavioral risks such as smoking and physical inactivity contribute moderately to maintaining socioeconomic inequalities in health. As such, promoting healthier lifestyles among the socioeconomically disadvantaged older adults should help

Attitudes toward victims of rape: effects of gender, race, religion, and social class.

PubMed

Nagel, Barbara; Matsuo, Hisako; McIntyre, Kevin P; Morrison, Nancy

2005-06-01

Although previous literature focusing on perceptions of victims of rape has examined how gender, race, and culture influence the attitudes one holds toward victims, these studies have yielded mixed results. This study compared perceptions of victims of rape across a wide range of ages, educational backgrounds, religions, and income levels, while focusing on gender and racial differences. Results indicate (N = 220) that victims of rape are generally viewed more sympathetically by females than by males and by Whites than by African Americans. However, the effect of race disappears when socioeconomic variables are controlled, suggesting a more complex relationship. Also, a hierarchical regression indicates that age, sex, education, and income are significant predictors of attitudes toward victims. This study builds on existing research that examines such attitudes from a cultural perspective and extends this literature by examining the interactive effects of several demographic variables within a community sample.

Nativity status and access to care in Canada and the U.S.: factoring in the roles of race/ethnicity and socioeconomic status.

PubMed

Lebrun, Lydie A; Shi, Leiyu

2011-08-01

We conducted cross-country comparisons of Canada and the U.S., and assessed the extent to which access to care varies by nativity status overall, as well as in conjunction with race/ethnicity and socioeconomic status. Data came from the Joint Canada-U.S. Survey of Health (n=6,620 non-elderly adults). Access measures included having a regular medical doctor, consultation with a health professional in the past year, dentist visit in the past year, Pap test in the past three years, and any unmet health care needs in the past year. Logistic regression was employed to estimate the relative odds of access to care, adjusting for potential confounders. Disparities in access to care based on nativity status overall, as well as nativity-by-race joint effects, were found in both countries. There was also a dose-response effect of education on access to care among the native-born but not among the foreign-born; there were few nativity-by-income joint effects.

The late-stage diagnosis of colorectal cancer: demographic and socioeconomic factors.

PubMed Central

Mandelblatt, J; Andrews, H; Kao, R; Wallace, R; Kerner, J

1996-01-01

OBJECTIVES: This study described factors related to colorectal cancer stage at diagnosis. METHODS: Logistic regression analyses were used on data from the New York State Tumor Registry and US Census area-level social class indicators. RESULTS: After the effects of other predictors were controlled for, the odds of late-stage cancer increased as age decreased; women and African Americans were significantly more likely to have late stage than men and Whites; and individuals living in areas of low socioeconomic status (SES) were significantly more likely to be diagnosed at late stage than those living in higher SES areas. Stratified analyses showed that living in a low SES area was the most important determinant of stage for all age, race, gender and source-of-care groups. CONCLUSIONS: While all populations would benefit from the systematic use of screening socioeconomically disadvantaged groups may also benefit from targeted screening. PMID:9003140

A Multilevel Analysis of Neighborhood Socioeconomic Disadvantage and Transactional Sex with Casual Partners Among Young Men Who Have Sex with Men Living in Metro Detroit.

PubMed

Bauermeister, José; Eaton, Lisa; Stephenson, Rob

2016-01-01

The role of structural factors when evaluating the vulnerability of human immunodeficiency virus/sexually transmitted infection (HIV/STI) risks among young gay, bisexual, and other men who have sex with men is an important area of focus for HIV prevention. Using cross-sectional data from young men living in Metro Detroit (N = 319; aged 18-29 years; 50% black, 25% white, 15% Latino, 9% other race/ethnicity; 9% HIV-positive), we examined whether transactional sex with casual partners was associated with neighborhood-level socioeconomic disadvantage and individual-level factors (race/ethnicity and sexual identity, socioeconomic status, HIV/STI diagnoses, and substance use). Youth living in greater socioeconomic disadvantage reported more transactional sex (b = 0.11; SE = 0.04; p ≤ 0.01). This relationship was mitigated once individual-level correlates were entered into the model. Multilevel efforts to counteract socioeconomic deficits through community and individual level strategies may alleviate youth's exposure to transactional sex and reduce their vulnerability to HIV/STI risks.

The Role of Coping and Race in Healthy Children’s Experimental Pain Responses

PubMed Central

Evans, Subhadra; Lu, Qian; Tsao, Jennie C. I.; Zelter, Lonnie K.

2009-01-01

This study examined the relationship between race, laboratory-based coping strategies and anticipatory anxiety and pain intensity for cold, thermal (heat) and pressure experimental pain tasks. Participants were 123 healthy children and adolescents, including 33 African Americans (51% female; mean age =13.9 years) and 90 Caucasians (50% female; mean age = 12.6 years). Coping in response to the cold task was assessed with the Lab Coping Style interview; based on their interview responses, participants were categorized as ‘attenders’ (i.e., those who focused on the task) vs. ‘distractors’ (i.e., those who distracted themselves during the task). Analysis of covariance (ANCOVA) revealed significant interactions between race (African-American vs. Caucasian) and lab-based coping style after controlling for sex, age and socioeconomic status. African-American children classified as attenders reported less anticipatory anxiety for the cold task and lower pain intensity for the cold, heat and pressure tasks compared to those categorized as distractors. For these pain outcomes, Caucasian children classified as distractors reported less anticipatory anxiety and lower pain intensity relative to those categorized as attenders. The findings point to the moderating effect of coping in the relationship between race and experimental pain sensitivity. PMID:20352035

Diet quality of Americans differs by age, sex, race/ethnicity, income, and education level.

PubMed

Hiza, Hazel A B; Casavale, Kellie O; Guenther, Patricia M; Davis, Carole A

2013-02-01

An index that assesses the multidimensional components of the diet across the lifecycle is useful in describing diet quality. The purpose of this study was to use the Healthy Eating Index-2005, a measure of diet quality in terms of conformance to the 2005 Dietary Guidelines for Americans, to describe the diet quality of Americans by varying sociodemographic characteristics in order to provide insight as to where diets need to improve. The Healthy Eating Index-2005 scores were estimated using 1 day of dietary intake data provided by participants in the 2003-2004 National Health and Nutrition Examination Survey. Mean daily intakes of foods and nutrients, expressed per 1,000 kilocalories, were estimated using the population ratio method and compared with standards that reflect the 2005 Dietary Guidelines for Americans. Participants included 3,286 children (2 to 17 years), 3,690 young and middle-aged adults (18 to 64 years), and 1,296 older adults (65+ years). Results are reported as percentages of maximum scores and tested for significant differences (P ≤ 0.05) by age, sex, race/ethnicity, income, and education levels. Children and older adults had better-quality diets than younger and middle-aged adults; women had better-quality diets than men; Hispanics had better-quality diets than blacks and whites; and diet quality of adults, but not children, generally improved with income level, except for sodium. The diets of Americans, regardless of socioeconomic status, are far from optimal. Problematic dietary patterns were found among all sociodemographic groups. Major improvements in the nutritional health of the American public can be made by improving eating patterns. Published by Elsevier Inc.

Projections of the Population of the United States, by Age, Sex, and Race: 1983 to 2080.

ERIC Educational Resources Information Center

Spencer, Gregory

1984-01-01

Based on assumptions about fertility, mortality, and net immigration trends, statistical tables depict the future U.S. population by age, sex, and race. Figures are based on the July 1, 1982, population estimates and race definitions and are projected using the cohort-component method with alternative assumptions for future fertility, mortality,…

Duty, Honor, Country, Disparity: Race/Ethnic Differences in Health and Disability among Male Veterans

PubMed Central

Sheehan, Connor M.; Hummer, Robert A.; Moore, Brenda L.; Huyser, Kimberly R.; Butler, John Sibley

2015-01-01

Given their unique occupational hazards and sizable population, military veterans are an important population for the study of health. Yet veterans are by no means homogeneous, and there are unanswered questions regarding the extent of, and explanations for, racial and ethnic differences in veterans’ health. Using the 2010 National Survey of Veterans, we first documented race/ethnic differences in self-rated health and limitations in Activities of Daily Living among male veterans aged 30–84. Second, we examined potential explanations for the disparities, including socioeconomic and behavioral differences, as well as differences in specific military experiences. We found that Black, Hispanic, and other/multiple race veterans reported much worse health than White veterans. Using progressively adjusted regression models, we uncovered that the poorer self-rated health and higher levels of activity limitations among minority veterans compared to Whites was partially explained by differences in their socioeconomic status and by their military experiences. Minority veterans are a vulnerable population for poor health; future research and policy efforts should attempt to better understand and ameliorate their health disadvantages relative to White veterans. PMID:26783376

[Comparative study of height and age at menarche according to the socioeconomic level in Venezuela].

PubMed

López Contreras, M; Tovar Escobar, G; Farid Coupal, N; Landaeta Jiménez, M; Méndez Castellano, H

1981-12-01

This is a retrospective study based on growth and development data published in Venezuela by various authors in the period 1936-1978. The data on height for males of the middle and high socioeconomic strata show growth curves which are very similar to the standards for British children. Likewise, the girls of the same socioeconomic condition follow the British standards, but only up to about 10-12 years of age. After that age, the girls studied by the Venezuelan authors, show a pattern of early maturation with a corresponding lower adult height compared with their British counterparts. There were differences in the growth curves according to the socioeconomic strata. These differences were more marked in the girls data. A secular increase for height was discerned, from the published data, in all socioeconomic strata and in both sexes. The data on sexual maturation showed a tendency for progressively early menarche in Venezuelan girls. These changes in growth in height and age of menarche were more notorious and came about at an earlier age in the upper socioeconomic strata. They were less marked, not constant, and came about later in the lower socioeconomic groups. The secular changes in height and sexual maturation apparent from these data, could be explained by an improvement in the environmental conditions, especially nutrition and hygiene of the population, and also be genetic heterosis from European immigration and with improvement in communications.

Race, Genetic Ancestry and Response to Antidepressant Treatment for Major Depression

PubMed Central

Murphy, Eleanor; Hou, Liping; Maher, Brion S; Woldehawariat, Girma; Kassem, Layla; Akula, Nirmala; Laje, Gonzalo; McMahon, Francis J

2013-01-01

The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study revealed poorer antidepressant treatment response among black compared with white participants. This racial disparity persisted even after socioeconomic and baseline clinical factors were taken into account. Some studies have suggested genetic contributions to this disparity, but none have attempted to disentangle race and genetic ancestry. Here we used genome-wide single-nucleotide polymorphism (SNP) data to examine independent contributions of race and genetic ancestry to citalopram response. Secondary data analyses included 1877 STAR*D participants who completed an average of 10 weeks of citalopram treatment and provided DNA samples. Participants reported their race as White (n=1464), black (n=299) or other/mixed (n=114). Genetic ancestry was estimated by multidimensional scaling (MDS) analyses of about 500 000 SNPs. Ancestry proportions were estimated by STRUCTURE. Structural equation modeling was used to examine the direct and indirect effects of observed and latent predictors of response, defined as change in the Quick Inventory of Depressive Symptomatology (QIDS) score from baseline to exit. Socioeconomic and baseline clinical factors, race, and anxiety significantly predicted response, as previously reported. However, direct effects of race disappeared in all models that included genetic ancestry. Genetic African ancestry predicted lower treatment response in all models. Although socioeconomic and baseline clinical factors drive racial differences in antidepressant response, genetic ancestry, rather than self-reported race, explains a significant fraction of the residual differences. Larger samples would be needed to identify the specific genetic mechanisms that may be involved, but these findings underscore the importance of including more African-American patients in drug trials. PMID:23827886

Cross race comparisons between SES health gradients among African-American and white women at mid-life

PubMed Central

Salsberry, Pamela J.

2014-01-01

This study explored how multiple indicators of socioeconomic status (SES) inform understanding of race differences in the magnitude of health gains associated with higher SES. The study sample, 1268 African-American women and 2066 white women, was drawn from the National Longitudinal Surveys of Youth 1979. The outcome was the Physical Components Summary from the SF-12 assessed at age 40. Ordinary least squares regressions using education, income and net worth fully interacted with race were conducted. Single measure gradients tended to be steeper for whites than African-Americans, partly because “sheepskin” effects of high school and college graduation were higher for whites and low income and low net worth whites had worse health than comparable African-Americans. Conditioning on multiple measures of SES eliminated race disparities in health benefits of education and net worth, but not income. A discussion of current public policies that affect race disparities in levels of education, income and net wealth is provided. PMID:24632052

Adolescent physical activity participation and motivational determinants across gender, age, and race.

PubMed

Butt, Joanne; Weinberg, Robert S; Breckon, Jeff D; Claytor, Randal P

2011-11-01

Physical activity (PA) declines as adolescents get older, and the motivational determinants of PA warrant further investigation. The purposes of this study were to investigate the amount of physical and sedentary activity that adolescents participated in across age, gender, and race, and to investigate adolescents' attraction to PA and their perceived barriers and benefits across age, gender, and race. High school students (N = 1163) aged between 13 and 16 years completed questionnaires on minutes and intensity of physical and sedentary activity, interests in physical activity, and perceived benefits and barriers to participating in PA. A series of multivariate analyses of variance were conducted and followed up with discriminant function analysis. PA participation decreased in older females. In addition, fun of physical exertion was a primary attraction to PA for males more than females. Body image as an expected outcome of participating in PA contributed most to gender differences. There is a need to determine why PA drops-off as females get older. Findings underscore the importance of structuring activities differently to sustain interest in male and female adolescents, and highlights motives of having a healthy body image, and making PA fun to enhance participation.

Association of Childhood Blood Lead Levels With Cognitive Function and Socioeconomic Status at Age 38 Years and With IQ Change and Socioeconomic Mobility Between Childhood and Adulthood.

PubMed

Reuben, Aaron; Caspi, Avshalom; Belsky, Daniel W; Broadbent, Jonathan; Harrington, Honalee; Sugden, Karen; Houts, Renate M; Ramrakha, Sandhya; Poulton, Richie; Moffitt, Terrie E

2017-03-28

Many children in the United States and around the world are exposed to lead, a developmental neurotoxin. The long-term cognitive and socioeconomic consequences of lead exposure are uncertain. To test the hypothesis that childhood lead exposure is associated with cognitive function and socioeconomic status in adulthood and with changes in IQ and socioeconomic mobility between childhood and midlife. A prospective cohort study based on a population-representative 1972-1973 birth cohort from New Zealand; the Dunedin Multidisciplinary Health and Development Study observed participants to age 38 years (until December 2012). Childhood lead exposure ascertained as blood lead levels measured at age 11 years. High blood lead levels were observed among children from all socioeconomic status levels in this cohort. The IQ (primary outcome) and indexes of Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed (secondary outcomes) were assessed at age 38 years using the Wechsler Adult Intelligence Scale-IV (WAIS-IV; IQ range, 40-160). Socioeconomic status (primary outcome) was assessed at age 38 years using the New Zealand Socioeconomic Index-2006 (NZSEI-06; range, 10 [lowest]-90 [highest]). Of 1037 original participants, 1007 were alive at age 38 years, of whom 565 (56%) had been lead tested at age 11 years (54% male; 93% white). Mean (SD) blood lead level at age 11 years was 10.99 (4.63) µg/dL. Among blood-tested participants included at age 38 years, mean WAIS-IV score was 101.16 (14.82) and mean NZSEI-06 score was 49.75 (17.12). After adjusting for maternal IQ, childhood IQ, and childhood socioeconomic status, each 5-µg/dL higher level of blood lead in childhood was associated with a 1.61-point lower score (95% CI, -2.48 to -0.74) in adult IQ, a 2.07-point lower score (95% CI, -3.14 to -1.01) in perceptual reasoning, and a 1.26-point lower score (95% CI, -2.38 to -0.14) in working memory. Associations of childhood blood lead level with deficits in

Socioeconomic Status and Lung Cancer: Unraveling the Contribution of Genetic Admixture

PubMed Central

Selvin, Steve; Wrensch, Margaret R.; Sison, Jennette D.; Hansen, Helen M.; Quesenberry, Charles P.; Seldin, Michael F.; Barcellos, Lisa F.; Buffler, Patricia A.; Wiencke, John K.

2013-01-01

Objectives. We examined the relationship between genetic ancestry, socioeconomic status (SES), and lung cancer among African Americans and Latinos. Methods. We evaluated SES and genetic ancestry in a Northern California lung cancer case–control study (1998–2003) of African Americans and Latinos. Lung cancer case and control participants were frequency matched on age, gender, and race/ethnicity. We assessed case–control differences in individual admixture proportions using the 2-sample t test and analysis of covariance. Logistic regression models examined associations among genetic ancestry, socioeconomic characteristics, and lung cancer. Results. Decreased Amerindian ancestry was associated with higher education among Latino control participants and greater African ancestry was associated with decreased education among African lung cancer case participants. Education was associated with lung cancer among both Latinos and African Americans, independent of smoking, ancestry, age, and gender. Genetic ancestry was not associated with lung cancer among African Americans. Conclusions. Findings suggest that socioeconomic factors may have a greater impact than genetic ancestry on lung cancer among African Americans. The genetic heterogeneity and recent dynamic migration and acculturation of Latinos complicate recruitment; thus, epidemiological analyses and findings should be interpreted cautiously. PMID:23948011

What Levels of Racial Diversity Can Be Achieved with Socioeconomic-Based Affirmative Action? Evidence from a Simulation Model

ERIC Educational Resources Information Center

Reardon, Sean F.; Baker, Rachel; Kasman, Matt; Klasik, Daniel; Townsend, Joseph B.

2018-01-01

This paper investigates to what extent socioeconomic status (SES)-based affirmative action in college admissions can produce racial diversity. Using simulation models, we investigate the racial and socioeconomic distribution of students among colleges under the use of race- or SES-based affirmative action policies, or targeted, race-based…

The rules of implicit evaluation by race, religion, and age.

PubMed

Axt, Jordan R; Ebersole, Charles R; Nosek, Brian A

2014-09-01

The social world is stratified. Social hierarchies are known but often disavowed as anachronisms or unjust. Nonetheless, hierarchies may persist in social memory. In three studies (total N > 200,000), we found evidence of social hierarchies in implicit evaluation by race, religion, and age. Participants implicitly evaluated their own racial group most positively and the remaining racial groups in accordance with the following hierarchy: Whites > Asians > Blacks > Hispanics. Similarly, participants implicitly evaluated their own religion most positively and the remaining religions in accordance with the following hierarchy: Christianity > Judaism > Hinduism or Buddhism > Islam. In a final study, participants of all ages implicitly evaluated age groups following this rule: children > young adults > middle-age adults > older adults. These results suggest that the rules of social evaluation are pervasively embedded in culture and mind. © The Author(s) 2014.

Racing performance of Standardbred trotting horses undergoing surgery of the carpal flexor sheath and age- and sex-matched control horses.

PubMed

Carmalt, James L; Johansson, Bengt C; Zetterström, Sandra M; McOnie, Rebecca C

2017-07-01

OBJECTIVE To determine factors affecting race speed in Swedish Standardbred horses undergoing surgery of the carpal flexor sheath (CFS), to investigate whether preoperative racing speed was associated with specific intraoperative findings and whether horses returned to racing, and to compare the performance of horses undergoing surgery of the CFS with that of age- and sex-matched control horses. ANIMALS 149 Swedish Standardbred trotters undergoing surgery of the CFS and 274 age- and sex-matched control horses. PROCEDURES Medical records of CFS horses were examined. Racing data for CFS and control horses were retrieved from official online records. Generalizing estimating equations were used to examine overall and presurgery racing speeds and the association of preoperative clinical and intraoperative findings with preoperative and postoperative speeds. Multivariable regression analysis was used to examine career earnings and number of career races. Kaplan-Meier survival analysis was used to compare career longevity between CFS and control horses. RESULTS CFS horses were significantly faster than control horses. The CFS horses that raced before surgery were slower as they approached the surgery date, but race speed increased after surgery. There were 124 of 137 (90.5%) CFS horses that raced after surgery. No intrathecal pathological findings were significantly associated with preoperative racing speed. Career longevity did not differ between CFS and control horses. CONCLUSIONS AND CLINICAL RELEVANCE Horses undergoing surgery of the CFS had a good prognosis to return to racing after surgery. Racing careers of horses undergoing surgery of the CFS were not significantly different from racing careers of control horses.

Analysis of the Effect of Race, Socioeconomic Status, and Center Size on Unrelated National Marrow Donor Program Donor Outcomes: Donor Toxicities Are More Common at Low-Volume Bone Marrow Collection Centers.

PubMed

Shaw, Bronwen E; Logan, Brent R; Kiefer, Deidre M; Chitphakdithai, Pintip; Pedersen, Tanya L; Abdel-Azim, Hisham; Abidi, Muneer H; Akpek, Gorgun; Diaz, Miguel A; Artz, Andrew S; Dandoy, Christopher; Gajewski, James L; Hematti, Peiman; Kamble, Rammurti T; Kasow, Kimberley A; Lazarus, Hillard M; Liesveld, Jane L; Majhail, Navneet S; O'Donnell, Paul V; Olsson, Richard F; Savani, Bipin N; Schears, Raquel M; Stroncek, David F; Switzer, Galen E; Williams, Eric P; Wingard, John R; Wirk, Baldeep M; Confer, Dennis L; Pulsipher, Michael A

2015-10-01

Previous studies have shown that risks of collection-related pain and symptoms are associated with sex, body mass index, and age in unrelated donors undergoing collection at National Marrow Donor Program centers. We hypothesized that other important factors (race, socioeconomic status [SES], and number of procedures at the collection center) might affect symptoms in donors. We assessed outcomes in 2726 bone marrow (BM) and 6768 peripheral blood stem cell (PBSC) donors collected between 2004 and 2009. Pain/symptoms are reported as maximum levels over mobilization and collection (PBSC) or within 2 days of collection (BM) and at 1 week after collection. For PBSC donors, race and center volumes were not associated with differences in pain/symptoms at any time. PBSC donors with high SES levels reported higher maximum symptom levels 1 week after donation (P = .017). For BM donors, black males reported significantly higher levels of pain (OR, 1.90; CI, 1.14 to 3.19; P = .015). No differences were noted by SES group. BM donors from low-volume centers reported more toxicity (OR, 2.09; CI, 1.26 to 3.46; P = .006). In conclusion, race and SES have a minimal effect on donation-associated symptoms. However, donors from centers performing ≤ 1 BM collection every 2 months have more symptoms after BM donation. Approaches should be developed by registries and low-volume centers to address this issue. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Endometrial cancer: socioeconomic status and racial/ethnic differences in stage at diagnosis, treatment, and survival.

PubMed

Madison, Terri; Schottenfeld, David; James, Sherman A; Schwartz, Ann G; Gruber, Stephen B

2004-12-01

We evaluated the association between socioeconomic status and racial/ ethnic differences in endometrial cancer stage at diagnosis, treatment, and survival. We conducted a population-based study among 3656 women. Multivariate analyses showed that either race/ethnicity or income, but not both, was associated with advanced-stage disease. Age, stage at diagnosis, and income were independent predictors of hysterectomy. African American ethnicity, increased age, aggressive histology, poor tumor grade, and advanced-stage disease were associated with increased risk for death; higher income and hysterectomy were associated with decreased risk for death. Lower income was associated with advanced-stage disease, lower likelihood of receiving a hysterectomy, and lower rates of survival. Earlier diagnosis and removal of barriers to optimal treatment among lower-socioeconomic status women will diminish racial/ethnic differences in endometrial cancer survival.

Relationship of Echocardiographic Z Scores Adjusted for Body Surface Area to Age, Sex, Race, and Ethnicity: The Pediatric Heart Network Normal Echocardiogram Database.

PubMed

Lopez, Leo; Colan, Steven; Stylianou, Mario; Granger, Suzanne; Trachtenberg, Felicia; Frommelt, Peter; Pearson, Gail; Camarda, Joseph; Cnota, James; Cohen, Meryl; Dragulescu, Andreea; Frommelt, Michele; Garuba, Olukayode; Johnson, Tiffanie; Lai, Wyman; Mahgerefteh, Joseph; Pignatelli, Ricardo; Prakash, Ashwin; Sachdeva, Ritu; Soriano, Brian; Soslow, Jonathan; Spurney, Christopher; Srivastava, Shubhika; Taylor, Carolyn; Thankavel, Poonam; van der Velde, Mary; Minich, LuAnn

2017-11-01

Published nomograms of pediatric echocardiographic measurements are limited by insufficient sample size to assess the effects of age, sex, race, and ethnicity. Variable methodologies have resulted in a wide range of Z scores for a single measurement. This multicenter study sought to determine Z scores for common measurements adjusted for body surface area (BSA) and stratified by age, sex, race, and ethnicity. Data collected from healthy nonobese children ≤18 years of age at 19 centers with a normal echocardiogram included age, sex, race, ethnicity, height, weight, echocardiographic images, and measurements performed at the Core Laboratory. Z score models involved indexed parameters (X/BSA α ) that were normally distributed without residual dependence on BSA. The models were tested for the effects of age, sex, race, and ethnicity. Raw measurements from models with and without these effects were compared, and <5% difference was considered clinically insignificant because interobserver variability for echocardiographic measurements are reported as ≥5% difference. Of the 3566 subjects, 90% had measurable images. Appropriate BSA transformations (BSA α ) were selected for each measurement. Multivariable regression revealed statistically significant effects by age, sex, race, and ethnicity for all outcomes, but all effects were clinically insignificant based on comparisons of models with and without the effects, resulting in Z scores independent of age, sex, race, and ethnicity for each measurement. Echocardiographic Z scores based on BSA were derived from a large, diverse, and healthy North American population. Age, sex, race, and ethnicity have small effects on the Z scores that are statistically significant but not clinically important. © 2017 American Heart Association, Inc.

Methods of Suicide by Age: Sex and Race Differences among the Young and Old.

ERIC Educational Resources Information Center

McIntosh, John L.; Santos, John F.

1986-01-01

Annual official statistics for specific methods of suicide (firearms, hanging, poisons) by age for different sex and racial groups (Whites, Blacks, non-Whites excluding Black) were examined from 1960 to 1978. Comparisons among the age-sex-race groups, along with trends over time and differences in the methods employed, were noted. (Author/ABL)

The Effect of Age, Race, and Sex on Social Cognitive Performance in Individuals With Schizophrenia.

PubMed

Pinkham, Amy E; Kelsven, Skylar; Kouros, Chrystyna; Harvey, Philip D; Penn, David L

2017-05-01

Age, race, and sex are linked to social cognitive performance among healthy individuals, but whether similar effects are evident in schizophrenia is unknown. Data from 170 individuals with schizophrenia or schizoaffective disorder and 98 healthy controls were used to examine relations between these demographic factors and performance across multiple domains and measures of social cognition. Sex was not related to performance on any domain, but older age was related to poorer emotion recognition from dynamic stimuli in both patients and controls. In patients, older age was also associated with better abilities to decipher hints. Both Caucasian patients and controls performed better than African American individuals on emotion recognition and mental state attribution tasks that use only Caucasian individuals as visual stimuli. Findings suggest rather limited influences of demographic factors but do demonstrate normative age and race effects among patients. Findings also highlight important methodological considerations for measurement of social cognition.

Socioeconomic disadvantage across the life-course and oral health in older age: findings from a longitudinal study of older British men.

PubMed

Ramsay, Sheena E; Papachristou, Efstathios; Watt, Richard G; Lennon, Lucy T; Papacosta, A Olia; Whincup, Peter H; Wannamethee, S Goya

2018-04-19

The influence of life-course socioeconomic disadvantage on oral health at older ages is not well-established. We examined the influence of socioeconomic factors in childhood, middle-age and older age on oral health at older ages, and tested conceptual life-course models (sensitive period, accumulation of risk, social mobility) to determine which best described observed associations. A representative cohort of British men aged 71-92 in 2010-12 included socioeconomic factors in childhood, middle-age and older age. Oral health assessment at 71-92 years (n = 1622) included tooth count, periodontal disease and self-rated oral health (excellent/good, fair/poor) (n = 2147). Life-course models (adjusted for age and town of residence) were compared with a saturated model using Likelihood-ratio tests. Socioeconomic disadvantage in childhood, middle-age and older age was associated with complete tooth loss at 71-92 years-age and town adjusted odds ratios (95% CI) were 1.39 (1.02-1.90), 2.26 (1.70-3.01), 1.83 (1.35-2.49), respectively. Socioeconomic disadvantage in childhood and middle-age was associated with poor self-rated oral health; adjusted odds ratios (95% CI) were 1.48 (1.19-1.85) and 1.45 (1.18-1.78), respectively. A sensitive period for socioeconomic disadvantage in middle-age provided the best model fit for tooth loss, while accumulation of risk model was the strongest for poor self-rated oral health. None of the life-course models were significant for periodontal disease measures. Socioeconomic disadvantage in middle-age has a particularly strong influence on tooth loss in older age. Poor self-rated oral health in older age is influenced by socioeconomic disadvantage across the life-course. Addressing socioeconomic factors in middle and older ages are likely to be important for better oral health in later life.

On causal interpretation of race in regressions adjusting for confounding and mediating variables

PubMed Central

VanderWeele, Tyler J.; Robinson, Whitney R.

2014-01-01

We consider several possible interpretations of the “effect of race” when regressions are run with race as an exposure variable, controlling also for various confounding and mediating variables. When adjustment is made for socioeconomic status early in a person’s life, we discuss under what contexts the regression coefficients for race can be interpreted as corresponding to the extent to which a racial inequality would remain if various socioeconomic distributions early in life across racial groups could be equalized. When adjustment is also made for adult socioeconomic status, we note how the overall racial inequality can be decomposed into the portion that would be eliminated by equalizing adult socioeconomic status across racial groups and the portion of the inequality that would remain even if adult socioeconomic status across racial groups were equalized. We also discuss a stronger interpretation of the “effect of race” (stronger in terms of assumptions) involving the joint effects of race-associated physical phenotype (e.g. skin color), parental physical phenotype, genetic background and cultural context when such variables are thought to be hypothetically manipulable and if adequate control for confounding were possible. We discuss some of the challenges with such an interpretation. Further discussion is given as to how the use of selected populations in examining racial disparities can additionally complicate the interpretation of the effects. PMID:24887159

The Effect of Race and Ethnicity on Outcomes Among Patients in the Intensive Care Unit: A Comprehensive Study Involving Socioeconomic Status and Resuscitation Preferences

PubMed Central

Erickson, Sara E.; Vasilevskis, Eduard E.; Kuzniewicz, Michael W.; Cason, Brian A.; Lane, Rondall K.; Dean, Mitzi L.; Rennie, Deborah J.; Dudley, R. Adams

2013-01-01

Objective We sought to determine whether race or ethnicity is independently associated with mortality or intensive care unit (ICU) length of stay (LOS) among critically ill patients after accounting for patients' clinical and demographic characteristics including socioeconomic status and resuscitation preferences. Design Historical cohort study of patients hospitalized in intensive care units. Setting Adult intensive care units in 35 California hospitals during the years 2001-2004. Patients A total of 9,518 ICU patients (6334 white, 655 black, 1917 Hispanic and 612 Asian/Pacific Islander patients). Measurements and Main Results The primary outcome was risk-adjusted mortality and a secondary outcome was risk-adjusted ICU LOS. Crude hospital mortality was 15.9% among the entire cohort. Asian patients had the highest crude hospital mortality at 18.6% and black patients had the lowest at 15.0%. After adjusting for age and gender, Hispanic and Asian patients had a higher risk of death compared to white patients, but these differences were not significant after additional adjustment for severity of illness. Black patients had more acute physiologic derangements at ICU admission and longer unadjusted ICU LOS. ICU LOS was not significantly different among racial/ethnic groups after adjustment for demographic, clinical, socioeconomic factors and do-not-resuscitate status. In an analysis restricted only to those who died, decedent black patients averaged 1.1 additional days in the ICU (95% CI – 0.26 to 2.6) compared to white patients who died, although this was not statistically significant. Conclusions Hospital mortality and ICU LOS did not differ by race or ethnicity among this diverse cohort of critically ill patients after adjustment for severity of illness, resuscitation status, SES, insurance status and admission type. Black patients had more acute physiologic derangements at ICU admission and were less likely to have a DNR order. These results suggest that among ICU

Socioeconomic status discrimination and C-reactive protein in African-American and White adults.

PubMed

Van Dyke, Miriam E; Vaccarino, Viola; Dunbar, Sandra B; Pemu, Priscilla; Gibbons, Gary H; Quyyumi, Arshed A; Lewis, Tené T

2017-08-01

We examined the association between socioeconomic status (SES) discrimination and C-reactive protein (CRP) in a biracial cohort of middle-aged adults using an intersectionality framework. Participants were 401 African-American and White adults from a population-based cohort in the Southeastern United States. SES discrimination was self-reported with a modified Experiences of Discrimination Scale, and CRP levels were assayed from blood samples. Linear regression analyses were used to examine the associations among SES discrimination, race, education, and CRP after controlling for age, gender, racial and gender discrimination, financial and general stress, body mass index, smoking, sleep quality, and depressive symptoms. Intersectional effects were tested using race×SES discrimination, education×SES discrimination and race×education×SES discrimination interactions. Adjusting for sociodemographics, racial discrimination, gender discrimination, and all relevant two-way interaction terms, we observed a significant race×education×SES discrimination interaction (p=0.019). In adjusted models stratified by race and education, SES discrimination was associated with elevated CRP among higher educated African-Americans (β=0.29, p=0.018), but not lower educated African-Americans (β=-0.13, p=0.32); or lower educated (β=-0.02, p=0.92) or higher educated (β=-0.01, p=0.90) Whites. Findings support the relevance of SES discrimination as an important discriminatory stressor for CRP specifically among higher educated African-Americans. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neighborhood socioeconomic index and stroke incidence in a national cohort of blacks and whites

PubMed Central

McClure, Leslie A.; Kleindorfer, Dawn O.; Cunningham, Solveig A.; Thrift, Amanda G.; Diez Roux, Ana V.; Howard, George

2016-01-01

Objective: To assess the relationship between neighborhood socioeconomic characteristics and incident stroke in a national cohort of black and white participants. Methods: The study comprised black (n = 10,274, 41%) and white (n = 14,601) stroke-free participants, aged 45 and older, enrolled in 2003–2007 in Reasons for Geographic and Racial Differences in Stroke (REGARDS), a national population-based cohort. A neighborhood socioeconomic score (nSES) was constructed using 6 neighborhood variables. Incident stroke was defined as first occurrence of stroke over an average 7.5 (SD 3.0) years of follow-up. Proportional hazards models were used to estimate associations between nSES score and incident stroke, adjusted for demographics (age, race, sex, region), individual socioeconomic status (SES) (education, household income), and other risk factors for stroke. Results: After adjustment for demographics, compared to the highest nSES quartile, stroke incidence increased with each decreasing nSES quartile. The hazard ratio (95% confidence interval) ranged from 1.28 (1.05–1.56) in quartile 3 to 1.38 (1.13–1.68) in quartile 2 to 1.56 (1.26–1.92) in quartile 1 (p < 0.0001 for linear trend). After adjustment for individual SES, the trend remained marginally significant (p = 0.085). Although there was no evidence of a differential effect by race or sex, adjustment for stroke risk factors attenuated the association between nSES and stroke in both black and white participants, with greater attenuation in black participants. Conclusions: Risk of incident stroke increased with decreasing nSES but the effect of nSES is attenuated through individual SES and stroke risk factors. The effect of neighborhood socioeconomic characteristics that contribute to increased stroke risk is similar in black and white participants. PMID:27742815

Neighborhood socioeconomic index and stroke incidence in a national cohort of blacks and whites.

PubMed

Howard, Virginia J; McClure, Leslie A; Kleindorfer, Dawn O; Cunningham, Solveig A; Thrift, Amanda G; Diez Roux, Ana V; Howard, George

2016-11-29

To assess the relationship between neighborhood socioeconomic characteristics and incident stroke in a national cohort of black and white participants. The study comprised black (n = 10,274, 41%) and white (n = 14,601) stroke-free participants, aged 45 and older, enrolled in 2003-2007 in Reasons for Geographic and Racial Differences in Stroke (REGARDS), a national population-based cohort. A neighborhood socioeconomic score (nSES) was constructed using 6 neighborhood variables. Incident stroke was defined as first occurrence of stroke over an average 7.5 (SD 3.0) years of follow-up. Proportional hazards models were used to estimate associations between nSES score and incident stroke, adjusted for demographics (age, race, sex, region), individual socioeconomic status (SES) (education, household income), and other risk factors for stroke. After adjustment for demographics, compared to the highest nSES quartile, stroke incidence increased with each decreasing nSES quartile. The hazard ratio (95% confidence interval) ranged from 1.28 (1.05-1.56) in quartile 3 to 1.38 (1.13-1.68) in quartile 2 to 1.56 (1.26-1.92) in quartile 1 (p < 0.0001 for linear trend). After adjustment for individual SES, the trend remained marginally significant (p = 0.085). Although there was no evidence of a differential effect by race or sex, adjustment for stroke risk factors attenuated the association between nSES and stroke in both black and white participants, with greater attenuation in black participants. Risk of incident stroke increased with decreasing nSES but the effect of nSES is attenuated through individual SES and stroke risk factors. The effect of neighborhood socioeconomic characteristics that contribute to increased stroke risk is similar in black and white participants. © 2016 American Academy of Neurology.

Interaction between age and race alters predicted survival in colorectal cancer.

PubMed

Phatak, Uma R; Kao, Lillian S; Millas, Stefanos G; Wiatrek, Rebecca L; Ko, Tien C; Wray, Curtis J

2013-10-01

Racial disparities in colorectal cancer persist. Late stage at presentation and lack of stage-specific treatment may be contributing factors. We sought to evaluate the magnitude of disparity remaining after accounting for gender, stage, and treatment using predicted survival models. We used institutional tumor registries from a public health system (two hospitals) and a not-for-profit health system (nine hospitals) from 1995 to 2011. Demographics, stage at diagnosis, treatment, and survival were recorded. Hazard ratios (HRs) and predicted HRs were determined by Cox regression and postestimation analyses. There were 6,990 patients: 55.7 % white, 23.6 % African American, 15.1 % Hispanic, and 5.6 % Asian/other. Predictors of survival were surgery (HR 0.57, 95 % confidence interval [CI] 0.46-0.70), chemotherapy (HR 0.7, 95 % CI 0.62-0.79), female gender (HR 0.87, 95 % CI 0.83-0.90), age (HR 1.04, 95 % CI 1.03-1.05), and African American race (HR 3.6, 95 % CI 1.5-8.4). Balancing for stage, gender, and treatment reduced the predicted HRs for African Americans by 28 % and Hispanics by 17 %. In this model, African American and Hispanics still had the worst predicted HRs at younger ages, but whites had the worst predicted HR after age 75. Gender, stage, and treatment partially accounted for worsened survival in African Americans and Hispanics at all ages. At younger ages, race-related disparities remained which may reflect tumor biology or other unknown factors. Once gender, stage, and treatment are balanced at older ages, the increased mortality observed in whites may be due to factors such as comorbidities. Further system- and patient-level study is needed to investigate reasons for colorectal cancer survival disparities.

Influence of age, sex, and race on college students' exercise motivation of physical activity.

PubMed

Egli, Trevor; Bland, Helen W; Melton, Bridget F; Czech, Daniel R

2011-01-01

The authors examined differences in exercise motivation between age, sex, and race for college students. Students from 156 sections of physical activity classes at a midsize university were recruited (n = 2,199; 1,081 men, 1,118 women) in 2005-2006 and volunteered to complete the Exercise Motivation Inventory. Quantitative, cross-sectional descriptive research design was employed. Significant differences were found in 3 of 14 exercise motivational subscales by age (affiliation, health pressures, and ill health avoidance) (p < .05). Males were motivated by intrinsic factors (strength, competition, and challenge) (p < .05) and females by extrinsic factors (ie, weight management and appearance) (p < .05); only 2 subscales proved not to be significant by sex. Race differences provided 8 significant differences by exercise motivations (p < .05). Significant differences for exercise motivations in college-aged population by demographics were documented. Understanding these differences is important for college health professionals for programming strategies and promoting physical activity.

Accelerated ageing and renal dysfunction links lower socioeconomic status and dietary phosphate intake.

PubMed

McClelland, Ruth; Christensen, Kelly; Mohammed, Suhaib; McGuinness, Dagmara; Cooney, Josephine; Bakshi, Andisheh; Demou, Evangelia; MacDonald, Ewan; Caslake, Muriel; Stenvinkel, Peter; Shiels, Paul G

2016-05-01

We have sought to explore the impact of dietary Pi intake on human age related health in the pSoBid cohort (n=666) to explain the disparity between health and deprivation status in this cohort. As hyperphosphataemia is a driver of accelerated ageing in rodent models of progeria we tested whether variation in Pi levels in man associate with measures of biological ageing and health. We observed significant relationships between serum Pi levels and markers of biological age (telomere length (p=0.040) and DNA methylation content (p=0.028), gender and chronological age (p=0.032). When analyses were adjusted for socio-economic status and nutritional factors, associations were observed between accelerated biological ageing (telomere length, genomic methylation content) and dietary derived Pi levels among the most deprived males, directly related to the frequency of red meat consumption. Accelerated ageing is associated with high serum Pi levels and frequency of red meat consumption. Our data provide evidence for a mechanistic link between high intake of Pi and age-related morbidities tied to socio-economic status.

Premature mortality in the U.S.-- trends by race, ethnicity, age, and region

Cancer.gov

DCEG scientists are spearheading the Premature Mortality Project—an interdisciplinary, multi-institutional effort to characterize U.S. trends in premature mortality. In the process, the team has uncovered distinct mortality trends by race, ethnicity, age, and region, and provided crucial information about the ongoing,

The relationship between lifetime health trajectories and socioeconomic attainment in middle age.

PubMed

Lee, Dohoon; Jackson, Margot

2015-11-01

A large literature demonstrates the direct and indirect influence of health on socioeconomic attainment, and reveals the ways in which health and socioeconomic background simultaneously and dynamically affect opportunities for attainment and mobility. Despite an increasing understanding of the effects of health on social processes, research to date remains limited in its conceptualization and measurement of the temporal dimensions of health, especially in the presence of socioeconomic circumstances that covary with health over time. Guided by life course theory, we use data from the British National Child Development Study, an ongoing panel study of a cohort born in 1958, to examine the association between lifetime health trajectories and socioeconomic attainment in middle age. We apply finite mixture modeling to identify distinct trajectories of health that simultaneously account for timing, duration and stability. Moreover, we employ propensity score weighting models to account for the presence of time-varying socioeconomic factors in estimating the impact of health trajectories. We find that, when poor health is limited to the childhood years, the disadvantage in socioeconomic attainment relative to being continuously healthy is either insignificant or largely explained by time-varying socioeconomic confounders. The socioeconomic impact of continuously deteriorating health over the life course is more persistent, however. Our results suggest that accounting for the timing, duration and stability of poor health throughout both childhood and adulthood is important for understanding how health works to produce social stratification. In addition, the findings highlight the importance of distinguishing between confounding and mediating effects of time-varying socioeconomic circumstances. Copyright © 2015 Elsevier Inc. All rights reserved.

The Relationship between Lifetime Health Trajectories and Socioeconomic Attainment in Middle Age

PubMed Central

Lee, Dohoon; Jackson, Margot

2015-01-01

A large literature demonstrates the direct and indirect influence of health on socioeconomic attainment, and reveals the ways in which health and socioeconomic background simultaneously and dynamically affect opportunities for attainment and mobility. Despite an increasing understanding of the effects of health on social processes, research to date remains limited in its conceptualization and measurement of the temporal dimensions of health, especially in the presence of socioeconomic circumstances that covary with health over time. Guided by life course theory, we use data from the British National Child Development Study, an ongoing panel study of a cohort born in 1958, to examine the association between lifetime health trajectories and socioeconomic attainment in middle age. We apply finite mixture modeling to identify distinct trajectories of health that simultaneously account for timing, duration and stability. Moreover, we employ propensity score weighting models to account for the presence of time-varying socioeconomic factors in estimating the impact of health trajectories. We find that, when poor health is limited to the childhood years, the disadvantage in socioeconomic attainment relative to being continuously healthy is either insignificant or largely explained by time-varying socioeconomic confounders. The socioeconomic impact of continuously deteriorating health over the life course is more persistent, however. Our results suggest that accounting for the timing, duration and stability of poor health throughout both childhood and adulthood is important for understanding how health works to produce social stratification. In addition, the findings highlight the importance of distinguishing between confounding and mediating effects of time-varying socioeconomic circumstances. PMID:26463537

The relationship of race to women's use of health information resources.

PubMed

Nicholson, Wanda K; Grason, Holly A; Powe, Neil R

2003-02-01

The purpose of this study was to examine, among the general public, the independent effect of race on women's use of health information resources. A population-based random-digit dialing survey of adult women, aged 18 to 64 years, was conducted between October 1999 and January 2000. Subjects included 509 women (341 white women, 135 black women, and 33 women of other races). The response rate was 66%. The main outcome variable was the use of health information resources (print health or news media, broadcast media, computer resources [Internet], health organizations, organized health events). Logistic regression was used to determine the independent effect of race/ethnicity on the use of different information resources, with an adjustment for age, income, education, and marital status. After the adjustment for socioeconomic factors, black women had <50% odds of using print news media (odds ratio, 0.5; 95% CI, 0.4-0.8), <60% odds of using computer-based resources (odds ratio, 0.4; 95% CI, 0.2-0.6), and <70% odds of using health policy organizations (odds ratio, 0.3; 95% CI, 0.2-0.7), compared with white women. There is a large racial disparity in women's use of health information resources. Traditional sources that are used to provide patient information may not be effective in certain populations.

Socioeconomic and Clinical Factors Are Key To Uncovering Disparity in Accrual Onto Therapeutic Trials for Breast Cancer

PubMed Central

Behrendt, Carolyn E.; Hurria, Arti; Tumyan, Lusine; Niland, Joyce C.; Mortimer, Joanne E.

2015-01-01

To monitor and address disparity in accrual, patient participation in cancer clinical trials is routinely summarized by race/ethnicity. To investigate whether confounding obscures racial/ethnic disparity in participation, all women with breast cancer treated by medical oncologists at City of Hope Comprehensive Cancer Center from 2004 through 2009 were classified by birthplace and self-reported race/ethnicity, and followed for accrual onto therapeutic trials through 2010. Undetectable on univariate analysis, significantly reduced participation by subjects of African, Asian, Eastern European, Latin American, and Middle Eastern ancestries was revealed after accounting for age, socioeconomic factors, tumor and oncologist characteristics, and intrapractice clustering of patients. PMID:25361805

Sex-specific suicide mortality in the South African urban context: the role of age, race, and geographical location.

PubMed

Burrows, Stephanie; Vaez, Marjan; Laflamme, Lucie

2007-01-01

This study investigates the importance of sociodemographic and geographical characteristics for suicide risks in the South African urban context. Suicide epidemiology is under-researched in low- and middle-income countries, and such knowledge is important not only for local and national policy, but also for a global understanding of the phenomenon. Sex-specific crude and adjusted odds ratios (95% confidence intervals) for suicide by age, race, and city are assessed using logistic regression. Cases aged 45+ years, classified as "Coloured" (a category denoting mixed racial origin), and living in Cape Town are used as reference groups. Additionally, the proportion of leading suicide methods within groups was estimated (95% confidence intervals). For males, compared with each reference group, the odds of suicide are significantly higher during middle adulthood, among Asians and particularly among Whites, and among residents of all but one city. Patterns for women differ in magnitude and distribution. Suicide odds are significantly higher in all age groups, particularly 15-24 years, among Whites, and among residents of all other cities, particularly Nelson Mandela or Buffalo City. Males living in Tshwane and Black females have lower odds of suicide. The distribution of methods across age, race, and city groups varies little for males but substantially for females. Age, race, and city play independent roles in sex-specific suicide rates. As for high-income settings, age, race, method and city are important in sex-specific suicide in the urban South African context. Possible underlying mechanisms deserve greater attention for context-relevant preventive efforts.

The spectre of race in American medicine.

PubMed

Fofana, Mariam O

2013-12-01

Controversies and debates surrounding race have long been a fixture in American medicine. In the past, the biological concept of race-the idea that race is biologically determined and meaningful-has served to justify the institution of slavery and the conduct of unethical research trials. Although these days may seem far behind, contemporary debates over the race-specific approval of drugs and the significance of genetic differences are evidence that race still yields tremendous influence on medical research and clinical practice. In many ways, the use of race in medicine today reflects the internalisation of racial hierarchies borne out of the history of slavery and state-mandated segregation, and there is still much uncertainty over its benefits and harms. Although using race in research can help elucidate disparities, the reflexive use of race as a variable runs the risk of reifying the biological concept of race and blinding researchers to important underlying factors such as socioeconomic status. Similarly, in clinical practice, the use of race in assessing a patient's risk of certain conditions (eg, sickle cell) turns harmful when the heuristic becomes a rule. Through selected historical and contemporary examples, I aim to show how the biological concept of race that gave rise to past abuses remains alive and harmful, and propose changes in medical education as a potential solution. By learning from the past, today's physicians will be better armed to discern-and correct-the ways in which contemporary medicine perpetuates historical injustices.

Extended Household Transitions, Race/Ethnicity, and Early Childhood Cognitive Outcomes*

PubMed Central

Mollborn, Stefanie; Fomby, Paula; Dennis, Jeff A.

2012-01-01

Beyond mothers’ union status transitions, other adults’ transitions into and out of the household contribute to family instability, particularly in early childhood. Using the Early Childhood Longitudinal Study-Birth Cohort (N≅8,550), this study examines associations between extended household transitions and age 2 cognitive development. A substantial minority of toddlers experiences these transitions, and their consequences vary by household member type, entry versus exit, and race/ethnicity. Extended household transitions predict lower cognitive scores for white children, but the selection of low-socioeconomic status families into extended households explains these disparities. Grandparent transitions predict significantly higher cognitive scores for African American and Latino children than whites, and some “other adult” transitions predict higher scores for Latinos than African Americans and whites. Extended household transitions’ consequences are independent of co-occurring residential moves and partner transitions. Findings suggest that studying extended household transitions is useful for understanding children’s early development, and their consequences vary by race/ethnicity. PMID:23017924

Effects of race and socioeconomic status on the relative influence of education and literacy on cognitive functioning.

PubMed

Dotson, Vonetta M; Kitner-Triolo, Melissa H; Evans, Michele K; Zonderman, Alan B

2009-07-01

Previous research has shown that reading ability is a stronger predictor of cognitive functioning than years of education, particularly for African Americans. The current study was designed to determine whether the relative influence of literacy and education on cognitive abilities varies as a function of race or socioeconomic status (SES). We examined the unique influence of education and reading scores on a range of cognitive tests in low- and higher-SES African Americans and Whites. Literacy significantly predicted scores on all but one cognitive measure in both African American groups and low-SES Whites, while education was not significantly associated with any cognitive measure. In contrast, both education and reading scores predicted performance on many cognitive measures in higher-SES Whites. These findings provide further evidence that reading ability better predicts cognitive functioning than years of education and suggest that disadvantages associated with racial minority status and low SES affect the relative influence of literacy and years of education on cognition.

Intersectionality and Disability Harassment: The Interactive Effects of Disability, Race, Age, and Gender

ERIC Educational Resources Information Center

Shaw, Linda R.; Chan, Fong; McMahon, Brian T.

2012-01-01

A possible interaction among the characteristics of disability, race, gender, and age was examined with respect to formal allegations of disability harassment. Using data from the National Equal Employment Opportunity Commission (EEOC) Americans With Disabilities Act (ADA) Research Project, the authors examined whether there was an interaction…

Age at menarche in urban Argentinian girls: association with biological and socioeconomic factors.

PubMed

Orden, Alicia B; Vericat, Agustina; Apezteguía, Maria C

2011-01-01

Age at menarche is regarded as a sensitive indicator of physical, biological, and psychosocial environment. The aim of this study was to determine the age at menarche and its association with biological and socioeconomic factors in girls from Santa Rosa (La Pampa, Argentina). An observational cross-sectional study was carried out on 1,221 schoolgirls aged 9-15 years. Menarche data were obtained by the status-quo method. Height, sitting height, weight, arm circumference, tricipital and subscapular skinfolds were measured. We also calculated body mass index, measures of body composition and proportions, and fat distribution. To assess socioeconomic factors, parents completed a self-administered questionnaire about their occupation and education, family size, household, and other family characteristics. The median age at menarche - estimated by the logit method--was 12.84 years (95% CI: 12.71, 12.97). Compared with their premenarcheal age peers, postmenarcheal girls had greater anthropometric dimensions through age 12. After this age, only height was higher in the latter group. Data were processed by fitting two logistic regressions, both including age. The first model included anthropometric variables and birth weight, while the second model included the socioeconomic variables. The significant variables derived from each model were incorporated into a new regression: height, sitting height ratio (first model), and maternal education (second model). These three variables remained significantly associated with menarche. The results suggest a relationship between linear growth and menarche and agree with those found in other populations where the advancement of menarche is associated with improved living conditions. In relatively uniform urban contexts, maternal education may be a good proxy for the standard of living.

Trends in Breast Cancer Stage and Mortality in Michigan (1992–2009) by Race, Socioeconomic Status, and Area Healthcare Resources

PubMed Central

Akinyemiju, Tomi F.; Soliman, Amr S.; Copeland, Glenn; Banerjee, Mousumi; Schwartz, Kendra; Merajver, Sofia D.

2013-01-01

The long-term effect of socioeconomic status (SES) and healthcare resources availability (HCA) on breast cancer stage of presentation and mortality rates among patients in Michigan is unclear. Using data from the Michigan Department of Community Health (MDCH) between 1992 and 2009, we calculated annual proportions of late-stage diagnosis and age-adjusted breast cancer mortality rates by race and zip code in Michigan. SES and HCA were defined at the zip-code level. Joinpoint regression was used to compare the Average Annual Percent Change (AAPC) in the median zip-code level percent late stage diagnosis and mortality rate for blacks and whites and for each level of SES and HCA. Between 1992 and 2009, the proportion of late stage diagnosis increased among white women [AAPC = 1.0 (0.4, 1.6)], but was statistically unchanged among black women [AAPC = −0.5 (−1.9, 0.8)]. The breast cancer mortality rate declined among whites [AAPC = −1.3% (−1.8,−0.8)], but remained statistically unchanged among blacks [AAPC = −0.3% (−0.3, 1.0)]. In all SES and HCA area types, disparities in percent late stage between blacks and whites appeared to narrow over time, while the differences in breast cancer mortality rates between blacks and whites appeared to increase over time. PMID:23637921

Endometrial Cancer: Socioeconomic Status and Racial/Ethnic Differences in Stage at Diagnosis, Treatment, and Survival

PubMed Central

Madison, Terri; Schottenfeld, David; James, Sherman A.; Schwartz, Ann G.; Gruber, Stephen B.

2004-01-01

Objective. We evaluated the association between socioeconomic status and racial/ ethnic differences in endometrial cancer stage at diagnosis, treatment, and survival. Methods. We conducted a population-based study among 3656 women. Results. Multivariate analyses showed that either race/ethnicity or income, but not both, was associated with advanced-stage disease. Age, stage at diagnosis, and income were independent predictors of hysterectomy. African American ethnicity, increased age, aggressive histology, poor tumor grade, and advanced-stage disease were associated with increased risk for death; higher income and hysterectomy were associated with decreased risk for death. Conclusions. Lower income was associated with advanced-stage disease, lower likelihood of receiving a hysterectomy, and lower rates of survival. Earlier diagnosis and removal of barriers to optimal treatment among lower-socioeconomic status women will diminish racial/ethnic differences in endometrial cancer survival. PMID:15569961

Lifecourse socioeconomic position and 16 year body mass index trajectories: differences by race and sex.

PubMed

Insaf, Tabassum Z; Shaw, Benjamin A; Yucel, Recai M; Chasan-Taber, Lisa; Strogatz, David S

2014-10-01

The aim of this study is to evaluate the association between lifecourse socioeconomic position (SEP) and changes in body mass index (BMI), and assess disparities in these associations across racial/ethnic groups. With longitudinal data from 4 waves of the Americans' Changing Lives Study (1986-2002), we employed mixed-effects modeling to estimate BMI trajectories for 1174 Blacks and 2323 White adults. We also estimated associations between these trajectories and lifecourse SEP variables, including father's education, perceived childhood SEP, own education, income, wealth, and financial security. Blacks had higher baseline BMIs, and steeper increases in BMI, compared to Whites. Childhood SEP, as measured by high father's education, was associated with lower baseline BMI among Whites. High education was associated with a lower baseline BMI within both race and sex categories. Income had contrasting effects among men and women. Higher income was associated with higher BMI only among males. Associations between indicators of SEP and BMI trajectories were only found for Whites. Our study demonstrates that lifecourse SEP may influence adult BMI differently within different racial and sex groups. Copyright © 2014 Elsevier Inc. All rights reserved.

LIFECOURSE SOCIOECONOMIC POSITION AND 16 YEAR BODY MASS INDEX TRAJECTORIES : DIFFERENCES BY RACE AND SEX

PubMed Central

Insaf, Tabassum Z; Shaw, Benjamin A; Yucel, Recai M; Chasan-Taber, Lisa; Strogatz, David S

2014-01-01

Objective To evaluate the association between lifecourse socioeconomic position (SEP) and changes in body mass index (BMI), and assess disparities in these associations across racial/ethnic groups. Methods With longitudinal data from 4 waves of the Americans Changing Lives Study (1986–2002), we employed mixed-effects modeling to estimate BMI trajectories for 1,174 Blacks and 2,323 White adults. We also estimated associations between these trajectories and lifecourse SEP variables, including father’s education, perceived childhood SEP, own education, income, wealth, and financial security. Results Blacks had higher baseline BMI’s, and steeper increases in BMI, compared to Whites. Childhood SEP, as measured by high father’s education, was associated with lower baseline BMI among Whites. High education was associated with a lower baseline BMI within both race and sex categories. Income had contrasting effects among men and women. Higher income, was associated with higher BMI only among males Associations between indicators of SEP and BMI trajectories were only found for Whites. Conclusions Our study demonstrates that lifecourse SEP may influence adult BMI differently within different racial and sex groups. PMID:24967954

Racial, gender, and socioeconomic status bias in senior medical student clinical decision-making: a national survey.

PubMed

Williams, Robert L; Romney, Crystal; Kano, Miria; Wright, Randy; Skipper, Betty; Getrich, Christina M; Sussman, Andrew L; Zyzanski, Stephen J

2015-06-01

Research suggests stereotyping by clinicians as one contributor to racial and gender-based health disparities. It is necessary to understand the origins of such biases before interventions can be developed to eliminate them. As a first step toward this understanding, we tested for the presence of bias in senior medical students. The purpose of the study was to determine whether bias based on race, gender, or socioeconomic status influenced clinical decision-making among medical students. We surveyed seniors at 84 medical schools, who were required to choose between two clinically equivalent management options for a set of cardiac patient vignettes. We examined variations in student recommendations based on patient race, gender, and socioeconomic status. The study included senior medical students. We investigated the percentage of students selecting cardiac procedural options for vignette patients, analyzed by patient race, gender, and socioeconomic status. Among 4,603 returned surveys, we found no evidence in the overall sample supporting racial or gender bias in student clinical decision-making. Students were slightly more likely to recommend cardiac procedural options for black (43.9 %) vs. white (42 %, p = .03) patients; there was no difference by patient gender. Patient socioeconomic status was the strongest predictor of student recommendations, with patients described as having the highest socioeconomic status most likely to receive procedural care recommendations (50.3 % vs. 43.2 % for those in the lowest socioeconomic status group, p < .001). Analysis by subgroup, however, showed significant regional geographic variation in the influence of patient race and gender on decision-making. Multilevel analysis showed that white female patients were least likely to receive procedural recommendations. In the sample as a whole, we found no evidence of racial or gender bias in student clinical decision-making. However, we did find evidence of bias with regard to the

Trends in SSBs and snack consumption among children by age, body weight and race/ethnicity

PubMed Central

Bleich, Sara N.; Wolfson, Julia A.

2015-01-01

Objective To describe national trends in discretionary calories from sugar sweetened beverage (SSB) and snacks by age-specific body weight categories and by age- and weight-specific race/ethnicity groups. Examining these sub-populations is important as population averages may mask important differences. Design and Methods We used 24-hour dietary recall data obtained from the National Health and Nutrition Examination Survey 2003–2010 among children aged 2 to 19 (N=14,092). Logistic and linear regression methods were used to adjust for multiple covariates and survey design. Results The number of calories from SSBs declined significantly for nearly all age-specific body weight groups. Among overweight or obese children, significant declines in the number of calories from SSBs were observed among Hispanic children aged 2 to 5 (117 kcal vs. 174 kcal) and white adolescents aged 12 to 19 (299 kcal vs. 365 kcal). Significant declines in the number of calories from salty snacks were observed among white children aged 2 to 5 (192 kcal to 134 kcal) and 6 to 11 (273 kcal vs. 200 kcal). Conclusions The decrease in SSB consumption and increase in snack consumption observed in prior research are not uniform when children are examined within sub-groups accounting for age, weight and race/ethnicity. PMID:25919923

Age and Socioeconomic Gradients of Health of Indian Adults: An Assessment of Self-Reported and Biological Measures of Health.

PubMed

Arokiasamy, Perianayagam; Uttamacharya; Kowal, Paul; Chatterji, Somnath

2016-06-01

This paper describes overall socioeconomic gradients and the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multiple aspects of health. Cross-sectional data on 11,230 Indians aged 18 years and older from the WHO-SAGE India Wave 1, 2007 were analyzed. Multivariate logit models were estimated to examine effects of socioeconomic status (education and household wealth) and age on four health domains: self-rated health, self-reported functioning, chronic diseases, and biological health measures. Results show that socioeconomic status (SES) was negatively associated with prevalence of each health measure but with considerable heterogeneity across age groups. Results for hypertension and COPD were inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for biological markers. Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum.

Associations between race, lifecourse socioeconomic position and prevalence of diabetes among US women and men: results from a population-based panel study.

PubMed

Insaf, T Z; Strogatz, D S; Yucel, R M; Chasan-Taber, L; Shaw, B A

2014-04-01

Few studies have examined the degree to which racial disparities in the development of diabetes are accounted by differences in lifecourse socioeconomic position (SEP). We assessed the association between race, lifecourse SEP measures and prevalence of diabetes in a representative US sample of black and white adults. A generalised estimating equations approach was used with a sample of 3497 adults from the Americans' Changing Lives study. Sex-specific models were calculated to compute prevalence ratios (PR) for associations of race and SEP with self-reported diagnoses of diabetes. For men, childhood and adult SEP were unrelated to diabetes, and adjustment for lifecourse SEP had little effect on the excess diabetes in blacks (PR=1.56, 95% CI 1.11 to 2.21). Adjustment for measures of lifecourse SEP reduced the PR for the association between race and diabetes in women from 1.96 (95% CI 1.52 to 2.54) to 1.40 (95% CI 1.04 to 1.87) with the respondent's education responsible for most of the reduction in the association. However, diabetes was also inversely associated with father's education, and low SEP throughout the lifecourse was associated with a nearly threefold increase in diabetes (PR=2.89, 95% CI 2.10 to 3.99). Racial disparities in diabetes existed among both men and women, but lifecourse SEP was related to diabetes only among women. The pathway and cumulative hypotheses for lifecourse SEP effects on diabetes may be especially salient for women.

Maternal education and excessive gestational weight gain in New York city, 1999-2001: the effect of race/ethnicity and neighborhood socioeconomic status.

PubMed

Huynh, Mary; Borrell, Luisa N; Chambers, Earle C

2014-01-01

To examine the association between maternal education and excessive gestational weight gain (EGWG) and whether this association differs by maternal race/ethnicity and neighborhood socio-economic status (SES). A sample of 56,911 New York City births between 1999 and 2001 was used. Self-reported EGWG was defined as gaining >40 pounds. Maternal education and race/ethnicity were obtained from birth record data. Neighborhood SES was determined from 2000 US Census data. Women with a high school [prevalence ratio (PR) = 1.21; 95 % CI 1.10-1.32] and some college (PR = 1.33; 95 % CI 1.21-1.47) education were more likely to gain excessive weight during pregnancy than their counterparts with less than a high school education. Having a college or more education was associated with a decreased EGWG for non-Hispanic white women (PR = 0.81; 95 % CI 0.67-0.96) but an increased EGWG for Hispanic women (PR = 1.25; 95 % CI 1.12-1.44). EGWG increased for women with a college or more education in medium and low SES neighborhoods (1.26; 95 % CI 1.04-1.53 and 1.20; 95 % CI 1.10-1.30, respectively); whereas a college or more education was not significant in the high SES neighborhoods. Our findings suggest that maternal education is associated with EGWG. However, this association depends on race/ethnicity and SES of the neighborhood of residence.

Socioeconomic disparities in colorectal cancer mortality in the United States, 1990-2007.

PubMed

Enewold, Lindsey; Horner, Marie-Josèphe; Shriver, Craig D; Zhu, Kangmin

2014-08-01

United States colorectal cancer mortality rates have declined; however, disparities by socioeconomic status and race/ethnicity persist. The objective of this study was to describe the temporal association between colorectal cancer mortality and socioeconomic status by sex and race/ethnicity. Cancer mortality rates in the United States from 1990 to 2007, which were generated by the National Center for Health Statistics, and county-level socioeconomic status, which was estimated as the proportion of county residents living below the national poverty line based on 1990 US Census Bureau data, were obtained from the Surveillance, Epidemiology, and End Results program. The Kunst-Mackenbach relative index of inequality, which considers data across all poverty levels when comparing risks in the poorest (≥ 20%) and richest counties (<10%), was calculated as the measure of association. The study found that colorectal cancer mortality rates were significantly lower in the poorest counties than the richest counties during 1990-1992 among non-Hispanic whites, non-Hispanic black women and non-Hispanic API men. Over time though the tendency was for the poorest counties to have higher mortality rates. By 2003-2007 colorectal cancer mortality rates were significantly higher in the poorest than the richest counties among all sex-race/ethnicity groups. This disparity was most noticeable and appeared to be increasing most among Hispanic men. This suggests that socioeconomic disparities in colorectal cancer mortality were apparent after stratifying by sex and race/ethnicity and reversed over time. Further studies into the causes of these disparities would provide a basis for targeted cancer control interventions and allocation of public health resources.

Meta-analytic review of the development of face discrimination in infancy: Face race, face gender, infant age, and methodology moderate face discrimination.

PubMed

Sugden, Nicole A; Marquis, Alexandra R

2017-11-01

Infants show facility for discriminating between individual faces within hours of birth. Over the first year of life, infants' face discrimination shows continued improvement with familiar face types, such as own-race faces, but not with unfamiliar face types, like other-race faces. The goal of this meta-analytic review is to provide an effect size for infants' face discrimination ability overall, with own-race faces, and with other-race faces within the first year of life, how this differs with age, and how it is influenced by task methodology. Inclusion criteria were (a) infant participants aged 0 to 12 months, (b) completing a human own- or other-race face discrimination task, (c) with discrimination being determined by infant looking. Our analysis included 30 works (165 samples, 1,926 participants participated in 2,623 tasks). The effect size for infants' face discrimination was small, 6.53% greater than chance (i.e., equal looking to the novel and familiar). There was a significant difference in discrimination by race, overall (own-race, 8.18%; other-race, 3.18%) and between ages (own-race: 0- to 4.5-month-olds, 7.32%; 5- to 7.5-month-olds, 9.17%; and 8- to 12-month-olds, 7.68%; other-race: 0- to 4.5-month-olds, 6.12%; 5- to 7.5-month-olds, 3.70%; and 8- to 12-month-olds, 2.79%). Multilevel linear (mixed-effects) models were used to predict face discrimination; infants' capacity to discriminate faces is sensitive to face characteristics including race, gender, and emotion as well as the methods used, including task timing, coding method, and visual angle. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Association of race and age with treatment attendance and completion among adult marijuana users in community-based substance abuse treatment.

PubMed

Peters, Erica N; Hendricks, Peter S; Clark, C Brendan; Vocci, Frank J; Cropsey, Karen L

2014-01-01

African American youth who use marijuana are less likely to attend and complete treatment than white youth. Limited information is available on racial and age variation in treatment attendance and completion among adults who use marijuana. The current research examined differences in community-based substance abuse treatment attendance and completion between adult African American and white marijuana users in 2 independent samples from the US southeastern (N = 160; 70.6% African American) and mid-Atlantic (N = 450; 34.7% African American) regions. Attended at least 3 treatment sessions, successful treatment completion, number of days in treatment, and percentage of positive urine drug screens. Adjusted regression models examined the association of race, age, and the interaction of race and age with treatment attendance and completion. In the southeastern sample, successful treatment completion was significantly associated with the interaction of race and age (adjusted odds ratio = 1.35, 95% confidence interval = 1.08-1.69); whereas younger African Americans were less likely to complete treatment than older African Americans, age was unrelated to treatment completion among whites. In the mid-Atlantic sample, African Americans were significantly less likely to attend at least 3 treatment sessions (adjusted odds ratio = 0.37, 95% confidence interval = 0.23-0.58), and younger adult marijuana users were retained for fewer days in treatment (adjusted β = 0.13, 95% confidence interval = 0.27-2.48). Among African Americans, 37.9% (SD = 38.0) of urine drug screens tested positive for at least 1 illicit drug, and among whites, 34.2% (SD = 37.8%) tested positive; the percentage of positive urine drug screens was not associated with race or age. Among marijuana-using adults, treatment attendance and completion differ by race and age, and improvements in treatment completion may occur as some African Americans mature out of young adulthood.

There is a Positive Correlation Between Socioeconomic Status and Ovarian Reserve in Women of Reproductive Age.

PubMed

Barut, Mert Ulas; Agacayak, Elif; Bozkurt, Murat; Aksu, Tarık; Gul, Talip

2016-11-16

BACKGROUND The purpose of this study was to investigate the potential association between socioeconomic status and ovarian reserve, anti-Mullerian hormone level, antral follicle count, and follicle stimulating hormone level in women of reproductive age. MATERIAL AND METHODS A total of 101 married women between 20-35 years of age who presented to the Department of Obstetrics and Gynecology, Health Research System In Vitro Fertilization (HRS IVF) Center between October 2014 and November 2015 and met the inclusion criteria were included in this study. The participants were divided into three socioeconomic groups using Kuppuswamy's socioeconomic status scale. Thirty-one participants were assigned to the low socioeconomic status group, 37 to the middle socioeconomic status group, and 33 to the high socioeconomic status group. On days 3-6 of the menstrual cycle, 10 mL of blood was collected from the participants for follicle stimulating hormone and anti-Mullerian hormone measurements. Transvaginal ultrasonography was performed for both ovaries for the purpose of counting antral follicles measuring 2-10 mm in diameter. RESULTS Both ovarian reserve parameters, namely anti-Mullerian hormone level and antral follicle count, exhibited a significant association with socioeconomic status (p=0.000 and p=0.000, respectively). The association between follicle stimulating hormone level and socioeconomic status was also significant (p=0.000). CONCLUSIONS A low socioeconomic status aggravated by sources of stress such as undernutrition and financial hardships affects ovarian reserve, which should be remembered in approaching infertile patients.

[Race and inequality among women: an example in southern Brazil].

PubMed

Olinto, M T; Olinto, B A

2000-01-01

This study uses epidemiological data to investigate socioeconomic proportions of distinctions raised by "racism" in Brazilian society. A population-based cross-sectional study was conducted with a sample of 2,779 women ages 14 through 49, living in a southern Brazilian city. Black and mixed-race women had less schooling, lower family income, and worse housing conditions than white women. They also used contraceptive methods less frequently, had more children, and had higher spontaneous abortion and stillbirth rates than white women. Virtually all of the results show a linear relationship between such categories, i.e., the "darker" the woman's skin color, the worse her socioeconomic and reproductive conditions. We also observed that black women were either separated, divorced, or widowed, another apparent factor for black women's impoverishment, related mainly to their limited employment opportunities. The results of the current study indicate that racial relations among women are an issue that should foster a discussion concerning citizenship in Brazil.

Race/Ethnic Differences in Birth Size, Infant Growth, and Body Mass Index at Age Five Years in Children in Hawaii.

PubMed

Oshiro, Caryn E S; Novotny, Rachel; Grove, John S; Hurwitz, Eric L

2015-12-01

Factors at birth and infancy may increase risk of being overweight in childhood. The aim of this study was to examine the relationship of birth size and infant growth (2-24 months) with BMI at age 5 years in a multiethnic population. This was a retrospective study (using electronic medical records of a health maintenance organization in Hawaii) of singleton children born in 2004-2005, with linked maternal and birth information, infant weights (n = 597) and lengths (n = 473) in the first 2 years, and BMI measures at age 5 years (n = 894). Multiple regression models were used to estimate the association of BMI at age 5 years with birth size and infant growth. Birth weight was positively associated with BMI at age 5 years, adjusting for gestational age, sex, race/ethnicity, and maternal prepregnancy weight, age, education, and smoking. A greater change in infant weight was associated with a higher BMI at age 5 years, though the effect of birth weight on BMI was neither mediated nor modified by infant growth rate. Birth weight, change in infant weight, and BMI at age 5 years varied by race/ethnicity. Change in infant BMI in the first 2 years was higher in other Pacific Islanders and whites (Δ = 0.966; confidence interval [CI] = 0.249-1.684; p = 0.02) than in Asian, other, and part Native Hawaiian race/ethnic groups. Early biological measures of birth weight and infant weight gain varied by race/ethnicity and positively predicted BMI at age 5 years.

Prejudices in Cultural Contexts: Shared Stereotypes (Gender, Age) Versus Variable Stereotypes (Race, Ethnicity, Religion).

PubMed

Fiske, Susan T

2017-09-01

Some prejudices share cross-cultural patterns, but others are more variable and culture specific. Those sharing cross-cultural patterns (sexism, ageism) each combine societal status differences and intimate interdependence. For example, in stereotypes of sex and age, lower status groups-women and elders-gain stereotypic warmth (from their cooperative interdependence) but lose stereotypic competence (from their lower status); men and middle-aged adults show the opposite trade-off, stereotypically more competent than warm. Meta-analyses support these widespread ambivalent (mixed) stereotypes for gender and age across cultures. Social class stereotypes often share some similarities (cold but competent rich vs. warm but incompetent poor). These compensatory warmth versus competence stereotypes may function to manage common human dilemmas of interacting across societal and personal positions. However, other stereotypes are more variable and culture specific (ethnicity, race, religion). Case studies of specific race/ethnicities and religions reveal much more cultural variation in their stereotype content, supporting their being responses to particular cultural contexts, apparent accidents of history. To change stereotypes requires understanding their commonalities and differences, their origins and patterns across cultures.

Living Conditions, Low Socioeconomic Position, and Mortality in the Ibadan Study of Aging.

PubMed

Ojagbemi, Akin; Bello, Toyin; Luo, Zhehui; Gureje, Oye

2017-07-01

Very little is known about socioeconomic differentials in mortality among persons surviving to old age in sub-Saharan Africa. We report on the impact of low socioeconomic position (SEP) on mortality over a 5-year observation period among community-dwelling older adults living in southwestern Nigeria. Data are from a household multistage probability sample of 2,149 Yoruba Nigerians aged 65 years or older. We collected information on indices related to health and well-being at baseline (2003/2004). Socioeconomic positions were estimated using asset-based measures relevant to low income settings. Information on mortality was obtained by research supervisors in multiple waves (2007, 2008, and 2009). Associations between baseline covariates and mortality were explored using discrete time survival models and life tables. We recorded 357 deaths over 5 years, or an annual mortality rate of 4.7% (95% CI = 4.2-5.2). Being 80 years or older (HR = 1.6, 95% CI = 1.1-2.5) and belonging to the lowest SEP (HR = 1.5, 95% CI = 1.1-2.1) were the main predictors of mortality. The significant effect of lowest SEP on mortality risk over the study period was independent of age, gender, education, rural or urban residence, weight, physical activity level, and social engagement. In this sample of older persons living in an economically disadvantaged context, we found persistent socioeconomic differentials in mortality estimated, conservatively, over 5 years. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Neighbourhood socioeconomic inequalities in incidence of acute myocardial infarction: a cohort study quantifying age- and gender-specific differences in relative and absolute terms.

PubMed

Koopman, Carla; van Oeffelen, Aloysia A M; Bots, Michiel L; Engelfriet, Peter M; Verschuren, W M Monique; van Rossem, Lenie; van Dis, Ineke; Capewell, Simon; Vaartjes, Ilonca

2012-08-07

Socioeconomic status has a profound effect on the risk of having a first acute myocardial infarction (AMI). Information on socioeconomic inequalities in AMI incidence across age-gender-groups is lacking. Our objective was to examine socioeconomic inequalities in the incidence of AMI considering both relative and absolute measures of risk differences, with a particular focus on age and gender. We identified all patients with a first AMI from 1997 to 2007 through linked hospital discharge and death records covering the Dutch population. Relative risks (RR) of AMI incidence were estimated by mean equivalent household income at neighbourhood-level for strata of age and gender using Poisson regression models. Socioeconomic inequalities were also shown within the stratified age-gender groups by calculating the total number of events attributable to socioeconomic disadvantage. Between 1997 and 2007, 317,564 people had a first AMI. When comparing the most deprived socioeconomic quintile with the most affluent quintile, the overall RR for AMI was 1.34 (95 % confidence interval (CI): 1.32-1.36) in men and 1.44 (95 % CI: 1.42-1.47) in women. The socioeconomic gradient decreased with age. Relative socioeconomic inequalities were most apparent in men under 35 years and in women under 65 years. The largest number of events attributable to socioeconomic inequalities was found in men aged 45-74 years and in women aged 65-84 years. The total proportion of AMIs that was attributable to socioeconomic inequalities in the Dutch population of 1997 to 2007 was 14 % in men and 18 % in women. Neighbourhood socioeconomic inequalities were observed in AMI incidence in the Netherlands, but the magnitude across age-gender groups depended on whether inequality was expressed in relative or absolute terms. Relative socioeconomic inequalities were high in young persons and women, where the absolute burden of AMI was low. Absolute socioeconomic inequalities in AMI were highest in

Neighborhood socioeconomic status at the age of 40 years and ischemic stroke before the age of 50 years: A nationwide cohort study from Sweden.

PubMed

Carlsson, Axel C; Li, Xinjun; Holzmann, Martin J; Ärnlöv, Johan; Wändell, Per; Gasevic, Danijela; Sundquist, Jan; Sundquist, Kristina

2017-10-01

Objective We aimed to study the association between neighborhood socioeconomic status at the age of 40 years and risk of ischemic stroke before the age of 50 years. Methods All individuals in Sweden were included if their 40th birthday occurred between 1998 and 2010. National registers were used to categorize neighborhood socioeconomic status into high, middle, and low and to retrieve information on incident ischemic strokes. Hazard ratios and their 95% confidence intervals were estimated. Results A total of 1,153,451 adults (women 48.9%) were followed for a mean of 5.5 years (SD 3.5 years), during which 1777 (0.30%) strokes among men and 1374 (0.24%) strokes among women were recorded. After adjustment for sex, marital status, education level, immigrant status, region of residence, and neighborhood services, there was a lower risk of stroke in residents from high-socioeconomic status neighborhoods (hazard ratio 0.87, 95% confidence interval 0.78-0.96), and an increased risk of stroke in adults from low-socioeconomic status neighborhoods (hazard ratio 1.16, 95% confidence interval 1.06-1.27), compared to their counterparts living in middle-socioeconomic status neighborhoods. After further adjustment for hospital diagnoses of hypertension, diabetes, heart failure, and atrial fibrillation prior to the age of 40, the higher risk in neighborhoods with low socioeconomic status was attenuated, but remained significant (hazard ratio 1.12, 95% confidence interval 1.02-1.23). Conclusions In a nationwide study of individuals between 40 and 50 years, we found that the risk of ischemic stroke differed depending on neighborhood socioeconomic status, which calls for increased efforts to prevent cardiovascular diseases in low socioeconomic status neighborhoods.

The Influence of Patient Race and Socioeconomic Status and Resident Physician Gender and Specialty on Preventive Screening

PubMed Central

Baig, Arshiya A.; Heisler, Michele

2009-01-01

Objective Health care disparities remain largely unexplained and need to be better understood to be addressed. Little is known about whether resident physicians screen patients differently based on race or socioeconomic status (SES). The objective of this study was to assess whether residents' preventive screening practices are influenced by patient race or SES or by resident gender, specialty, minority status, or years of training. Design Cross-sectional survey. Methods Residents from 6 specialties at a large academic medical center participated in an online survey to gauge their knowledge, attitudes, and practices pertaining to primary care screening. The survey consisted of 1 of 4 clinical vignettes that varied by patient race and SES (African-American or Caucasian; high income or low income), followed by questions pertaining to 9 routine screening areas. Resident demographics and patient race and SES were compiled, and bivariate and multivariate analyses were used to assess associations between patient and/or resident characteristics and residents' reported importance of screening as well as intention to screen the vignette patient for the 9 specified health risks. Results Of 309 residents sent the online survey, 167 responded (response rate, 54%). Four of the 9 screening areas (sexual behavior, physical activity, depression, diet) were reported by residents as both “very important” (versus “not very important”) and “would definitely ask about during an office visit” (versus “would not definitely ask about”). In the adjusted odds models, residents showed no racial preference in intention to screen for depression, diet, physical activity, or sexual behavior. Residents were less likely to report that they would screen the high-income patient for sexual behavior compared with the low-income patient (adjusted odds ratio [OR], 0.46 [95% confidence interval {CI}, 0.21–0.99]). Female residents were more likely than male residents to report that they

Stage-specific incidence rates and trends of prostate cancer by age, race, and ethnicity, United States, 2004-2014.

PubMed

Li, Jun; Siegel, David A; King, Jessica B

2018-05-01

Current literature shows different findings on the contemporary trends of distant-stage prostate cancer incidence, in part, due to low study population coverage and wide age groupings. This study aimed to examine the stage-specific incidence rates and trends of prostate cancer by age (5-year grouping), race, and ethnicity using nationwide cancer registry data. Data on prostate cancer cases came from the 2004-2014 United States Cancer Statistics data set. We calculated stage-specific incidence and 95% confidence intervals by age (5-year age grouping), race, and ethnicity. To measure the changes in rates over time, we calculated annual percentage change (APC). We identified 2,137,054 incident prostate cancers diagnosed during 2004-2014, with an age-adjusted incidence rate of 453.8 per 100,000. Distant-stage prostate cancer incidence significantly decreased during 2004-2010 (APC = -1.2) and increased during 2010-2014 (APC = 3.3). Significant increases in distant prostate cancer incidence also occurred in men aged older than or equal to 50 years except men aged 65-74 and older than or equal to 85 years, in men with white race (APC = 3.9), and non-Hispanic ethnicity (APC = 3.5). Using data representing over 99% of U.S. population, we found that incidence rates of distant-stage prostate cancer significantly increased during 2010-2014 among men in certain ages, in white, and with non-Hispanic ethnicity. Published by Elsevier Inc.

Socioeconomic and clinical factors are key to uncovering disparity in accrual onto therapeutic trials for breast cancer.

PubMed

Behrendt, Carolyn E; Hurria, Arti; Tumyan, Lusine; Niland, Joyce C; Mortimer, Joanne E

2014-11-01

To monitor and address disparity in accrual, patient participation in cancer clinical trials is routinely summarized by race/ethnicity. To investigate whether confounding obscures racial/ethnic disparity in participation, all women with breast cancer treated by medical oncologists at City of Hope Comprehensive Cancer Center from 2004 through 2009 were classified by birthplace and self-reported race/ethnicity, and followed for accrual onto therapeutic trials through 2010. Undetectable on univariate analysis, significantly reduced participation by subjects of African, Asian, Eastern European, Latin American, and Middle Eastern ancestries was revealed after accounting for age, socioeconomic factors, tumor and oncologist characteristics, and intrapractice clustering of patients. Copyright © 2014 by the National Comprehensive Cancer Network.

Race and Gender Differences in Perceived Caregiver Availability for Community-Dwelling Middle-Aged and Older Adults

ERIC Educational Resources Information Center

Roth, David L.; Haley, William E.; Wadley, Virginia G.; Clay, Olivio J.; Howard, George

2007-01-01

Purpose: Informal family caregivers are increasingly recognized as critical for meeting the needs of individuals with chronic diseases associated with aging. This study examined race and gender differences in perceived informal caregiver availability for participants aged 45 and older in a large national epidemiological study. Design and Methods:…

Effects of Age, Sex, and Race on the Safety and Pharmacokinetics of Single and Multiple Doses of Azilsartan Medoxomil in Healthy Subjects.

PubMed

Harrell, Robert E; Karim, Aziz; Zhang, Wencan; Dudkowski, Caroline

2016-05-01

Azilsartan medoxomil (AZL-M) is an angiotensin II receptor blocker approved to treat hypertension. After oral dosing, AZL-M is quickly hydrolyzed to azilsartan (AZL). The aims of this study were to assess the effects of age, sex, and race on the pharmacokinetics of AZL-M in healthy subjects, as well as safety and tolerability. Sixty-one healthy adults were enrolled in this phase I, single-blind, randomized placebo-controlled study (placebo control was for assessment of safety/tolerability only). Subjects were stratified by age (18-45 vs. 65-85 years), sex, and race (black vs. white) and given oral AZL-M 60 mg (3 × 20 mg capsules) or placebo as a single dose (Day 1) and consecutive daily doses (Days 4-8) (6:2 ratio for AZL-M:placebo per group). Pharmacokinetics were evaluated (AZL-M patients only) on Days 1-3 and 8-9 and safety/tolerability was monitored. Age, sex, and race had no clinically meaningful effect on AZL exposures after single or multiple dosing. Pharmacokinetic parameters remained similar between Days 1 and 8 for each age, sex, and race subgroup. The frequency of adverse events was similar for AZL-M (32%) and placebo (29%). No discontinuations or serious adverse events occurred. Based on these pharmacokinetic and safety/tolerability findings, no AZL-M dose adjustments are required based on age, sex, or race (black/white).

Physical Fitness, Academic Achievement, and Socioeconomic Status in School-Aged Youth

ERIC Educational Resources Information Center

Coe, Dawn P.; Peterson, Thomas; Blair, Cheryl; Schutten, Mary C.; Peddie, Heather

2013-01-01

Background: This study examined the association between physical fitness and academic achievement and determined the influence of socioeconomic status (SES) on the association between fitness and academic achievement in school-aged youth. Methods: Overall, 1,701 third-, sixth-, and ninth-grade students from 5 school districts participated in the…

The Spectre of Race in American Medicine

PubMed Central

Fofana, Mariam O.

2014-01-01

Controversies and debates surrounding race have long been a fixture in American medicine. In the past, the biological concept of race—the idea that race is biologically determined and meaningful—has served to justify the institution of slavery and the conduct of unethical research trials. Although these days may seem far behind, contemporary debates over the race-specific approval of drugs and the significance of genetic differences are evidence that race still yields tremendous influence on medical research and clinical practice. In many ways, the use of race in medicine today reflects the internalization of racial hierarchies borne out of the history of slavery and state-mandated segregation, and there is still much uncertainty over its benefits and harms. Although using race in research can help elucidate disparities, the reflexive use of race as a variable runs the risk of reifying the biological concept of race and blinding researchers to important underlying factors such as socioeconomic status. Similarly, in clinical practice, the use of race in assessing a patient’s risk of certain conditions (e.g., sickle cell) turns harmful when the heuristic becomes a rule. Through selected historical and contemporary examples, I aim to show how the biological concept of race that gave rise to past abuses remains alive and harmful and propose changes in medical education as a potential solution. By learning from the past, today’s physicians will be better armed to discern—and correct—the ways in which contemporary medicine perpetuates historical injustices. PMID:23988563

Associations between poor sleep quality and psychosocial stress with obesity in reproductive-age women of lower socioeconomic status.

PubMed

Tom, Sarah E; Berenson, Abbey B

2013-01-01

Prior studies have not examined the role of psychosocial stress in the relationship between poor sleep quality and obesity among women of lower socioeconomic status (SES). We tested the following hypotheses in a sample of reproductive-age women of lower SES: 1) Poor sleep quality is related to increased risk of obesity, and 2) psychosocial stress confounds this association between poor sleep quality and obesity. A total of 927 women age 16 to 40 years attending public health clinics in Southeastern Texas provided information on the Pittsburgh Sleep Quality Index and sociodemographic and health characteristics, including the Perceived Stress Scale. Height, weight, and waist circumference (WC) were measured in clinic. A series of models examined the associations between sleep disturbance, perceived stress, and weight outcomes, accounting for potential confounding factors. Nearly 30% of women were overweight, and 35% were obese. Half of women had a WC of greater than 35 inches. Most women had poor sleep quality and high levels of stress. Sleep quality and perceived stress were not related to body mass index category or WC in models that adjusted for age and race/ethnicity. Adjusting for potential confounding factors did not alter results. Perceived stress did not modify the association between sleep quality and weight outcomes. Poor sleep quality and psychosocial stress were not related to weight in reproductive-aged women of lower SES. However, poor sleep quality, high stress, overweight, and obesity were common in this group. Copyright © 2013 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Eight Americas: investigating mortality disparities across races, counties, and race-counties in the United States.

PubMed

Murray, Christopher J L; Kulkarni, Sandeep C; Michaud, Catherine; Tomijima, Niels; Bulzacchelli, Maria T; Iandiorio, Terrell J; Ezzati, Majid

2006-09-01

The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the "eight Americas," to explore the causes of the disparities that can inform specific public health intervention policies and programs. The eight Americas were defined based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate. Data sources for population and mortality figures were the Bureau of the Census and the National Center for Health Statistics. We estimated life expectancy, the risk of mortality from specific diseases, health insurance, and health-care utilization for the eight Americas. The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 y for males (Asians versus high-risk urban blacks) and 12.8 y for females (Asians versus low-income southern rural blacks). Mortality disparities among the eight Americas were largest for young (15-44 y) and middle-aged (45-59 y) adults, especially for men. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the ordering of life expectancy among the eight Americas and the absolute difference between the advantaged and disadvantaged groups remained largely unchanged. Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations. Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The

Age at menarche and its socioeconomic determinants among female students in an urban area in Bangladesh.

PubMed

Islam, Md Serajul; Hussain, Md Altaf; Islam, Saimul; Mahumud, Rashidul Alam; Biswas, Tuhin; Islam, Sheikh Mohammed Shariful

2017-06-01

This cross-sectional study aimed to determine the age at menarche and its socioeconomic determinants among urban female students (n=680) in Bangladesh. The mean age of the respondents was 14±1.43years. Majority of the respondents were unmarried (98.4%). The mean age at menarche was 11.6±3.6years, median 12years. Almost one-third (35.7%) of the participants had menarche at the age of 12years. There was no statistically significant difference between age at menarche before and after 12years with the socio-economic characteristics, except education (p=<0.001). In the multivariate model, only higher education was statistically significant predictor of age at menarche. Copyright © 2017 Elsevier B.V. All rights reserved.

The Vicious Circle: Effects of Race and Class on University Entrance in Brazil

ERIC Educational Resources Information Center

Valente, Rubia R.

2017-01-01

Brazil has high levels of socio-economic inequality and an inequitable distribution of access to higher education. How much of this inequality is associated with race or class is an important question in light of the current debate over affirmative action and the suitability of race and social targeted policies. There are those who claim that…

Association of socioeconomic stratification with plasmatic markers of lipoperoxidation and antioxidants in Venezuelan school-age children.

PubMed

Ruiz-Fernández, Nelina; Bosch, Virgilio; Giacopini, Maria Isabel

2016-12-30

To establish association between socioeconomic status and plasmatic markers of lipoperoxidation and antioxidants in Venezuelan school-age children from the middle-class and in critical poverty. Cross-sectional study with a sample of 114 school-age children (aged 7-9). The socioeconomic status, dietary intake of macro and micro-nutrients, weight, height, lipid profile, indicators of lipid peroxidation and enzymatic and non-enzymatic antioxidants were determined. The daily average intake of energy, carbohydrates and vitamin A, and the percentage of energy obtained from carbohydrates was significantly higher in middle-class children compared to critical poverty children ( p <0.05). The circulating oxidized low density lipoprotein ( p <0.001) and the susceptibility of low density lipoproteins and very low density lipoproteins to oxidation in vitro ( p <0.05) were significantly higher in middle-class children, while the critical poverty children showed significantly lower levels of Vitamin C and E in plasma ( p <0.05). Non-enzymatic antioxidant levels were frequently deficient in both strata. The concentrations of circulating oxidized low density lipoprotein (OR: 1.09, CI 95% : 1.016-1.179; p = 0.017) and Vitamin C (OR: 3.21, CI 95% : 1.104-9.938; p = 0.032) were associated to the socioeconomic status independently of gender, family history of premature coronary artery disease, triglicerides, Vitamin C and E dietary intake and count of white blood cells. The socioeconomic status was associated to circulating oxidized low density lipoprotein and Vitamin C in Venezuelan school-age children, The results suggested the need to improve the dietary intake of antioxidants in both studied socioeconomic groups.

Green and lean: Is neighborhood park and playground availability associated with youth obesity? Variations by gender, socioeconomic status, and race/ethnicity.

PubMed

Morgan Hughey, S; Kaczynski, Andrew T; Child, Stephanie; Moore, Justin B; Porter, Dwayne; Hibbert, James

2017-02-01

Parks and park features are important for promoting physical activity and healthy weight, especially for low-income and racial/ethnic minority youth who have disproportionately high obesity rates. This study 1) examined associations between neighborhood park and playground availability and youth obesity, and 2) assessed whether these associations were moderated by youth race/ethnicity and socioeconomic status (SES). In 2013, objectively measured height and weight were collected for all 3rd-5th grade youth (n=13.469) in a southeastern US county to determine body mass index (BMI) percentiles. Enumeration and audits of the county's parks (n=103) were concurrently conducted. Neighborhood park and playground availability were calculated as the number of each facility within or intersecting each youth's Census block group. Multilevel linear regression models were utilized to examine study objectives. For boys, no main effects were detected; however, SES moderated associations such that higher park availability was associated with lower BMI percentile for low-SES youth but higher BMI percentile for high-SES youth. For girls, the number of parks and playgrounds were significantly associated with lower BMI (b=-2.2, b=-1.1, p<0.05, respectively) and race/ethnicity and SES moderated associations between playground availability and BMI percentile. Higher playground availability was associated with lower BMI percentile for White and high-SES girls but higher BMI percentile for African American and low-SES girls. Considerable variation was detected in associations between park and playground availability and youth obesity by SES and race/ethnicity, highlighting the importance of studying the intersection of these characteristics when exploring associations between built environment features and obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

Relationships of Race and Socioeconomic Status to Postpartum Depressive Symptoms in Rural African American and Non-Hispanic White Women

PubMed Central

Dolbier, Christyn L.; Rush, Taylor E.; Sahadeo, Latoya S.; Shaffer, Michele L.; Thorp, John

2012-01-01

This study examines the potential racial disparity in postpartum depression (PPD) symptoms among a cohort of non-Hispanic white and African American women after taking into consideration the influence of socioeconomic status (SES). Participants (N = 299) were recruited from maternity clinics serving rural counties, with over-sampling of low SES and African Americans. The Edinburgh Postnatal Depression Scale (EPDS) was administered 1 and 6 months postpartum, and subjective SES scale at 6 months postpartum. Demographic information was collected during enrollment and 1 month postpartum, with updates at 6 months postpartum. Separate logistic regressions were conducted for 1 and 6 month time points for minor-major PPD (EPDS ≥ 10) and major PPD (EPDS > 12); with marital status, poverty, education, subjective SES, and race predictors entered in block sequence. After including all other predictors, race was not a significant predictor of minor-major or major PPD at 1 or 6 months postpartum. Subjective SES was the most consistent predictor of PPD, being significantly associated with minor-major PPD and major PPD at 6 months postpartum, with higher subjective SES indicating lower odds of PPD, even after accounting for all other predictors. This study shows that significant racial disparities were not observed for minor-major or major PPD criteria at 1 or 6 months postpartum. The most consistent and significant predictor of PPD was subjective SES. Implications of these findings for future research, as well as PPD screening and intervention are discussed. PMID:22961387

Impact of socioeconomic status and medical conditions on health and healthcare utilization among aging Ghanaians.

PubMed

Saeed, Bashiru Ii; Xicang, Zhao; Yawson, Alfred Edwin; Nguah, Samuel Blay; Nsowah-Nuamah, Nicholas N N

2015-03-20

This study attempts to examine the impact of socioeconomic and medical conditions in health and healthcare utilization among older adults in Ghana. Five separate models with varying input variables were estimated for each response variable. Data (Wave 1 data) were drawn from the World Health Organization Global Ageing and Adult Health (SAGE) conducted during 2007-2008 and included a total of 4770 respondents aged 50+ and 803 aged 18-49 in Ghana. Ordered logits was estimated for self-rated health, and binary logits for functional limitation and healthcare utilization. Our results show that the study provides enough grounds for further research on the interplay between socioeconomic and medical conditions on one hand and the health of the aged on the other. Controlling for socioeconomic status substantially contributes significantly to utilization. Also, aged women experience worse health than men, as shown by functioning assessment, self-rated health, chronic conditions and functional limitations. Women have higher rates of healthcare utilization, as shown by significantly higher rates of hospitalization and outpatient encounters. Expansion of the national health insurance scheme to cover the entire older population--for those in both formal and informal employments--is likely to garner increased access and improved health states for the older population.

Socioeconomic and Behavioral Characteristics Associated With Metabolic Syndrome Among Overweight/Obese School-age Children.

PubMed

Ham, Ok Kyung

Obesity in children comprises a significant public health concern in Korea. As with increased prevalence of overweight and obesity among children, risk factors for metabolic syndrome (MetS) have also increased in this population. The purpose was to examine behavioral and socioeconomic factors that were associated with biomarkers of MetS among overweight/obese school-age children. A cross-sectional study was conducted, and a convenience sample of 75 overweight/obese school-age children participated. Socioeconomic and behavioral characteristics, anthropometric measurements, and physiologic examinations were studied. The data were analyzed using an analysis of covariance and logistic regression. Metabolic syndrome was diagnosed in 27.8% of our population. Severe stress was significantly associated with elevated systolic blood pressure (P < .05). Among the family characteristics, children's perception of family income (wealthy and very wealthy) and mother's education level (high school or less) were associated with diagnoses of MetS in children (P < .05). The results indicated that certain socioeconomic and behavioral characteristics were associated with risk factors of MetS, and therefore, interventions to modify these risk factors are needed to promote the healthy development of overweight/obese school-age children.

The two worlds of race revisited: a meditation on race in the age of Obama.

PubMed

Early, Gerald

2011-01-01

Nearly fifty years ago, the American Academy organized a conference and two issues of its journal "Daedalus" on the topic of "The Negro American." The project engaged top intellectuals and policy-makers around the conflicts and limitations of mid-1960s liberalism in dealing with race. Specifically, they grappled with the persistent question of how to integrate a forced-worker population that had been needed but that was socially undesirable once its original purpose no longer existed. Today, racism has been discredited as an idea and legally sanctioned segregation belongs to the past, yet the question the conference participants explored -- in essence, how to make the unwanted wanted -- still remains. Recent political developments and anticipated demographic shifts, however, have recast the terms of the debate. Gerald Early, guest editor for the present volume, uses Barack Obama's election to the presidency as a pretext for returning to the central question of "The Negro American" project and, in turn, asking how white liberalism will fare in the context of a growing minority population in the United States. Placing his observations alongside those made by John Hope Franklin in 1965, Early positions his essay, and this issue overall, as a meditation on how far we have come in America to reach "the age of Obama" and at the same time how far we have to go before we can overcome "the two worlds of race."

Serum levels of the immune activation marker neopterin change with age and gender and are modified by race, BMI, and percentage of body fat.

PubMed

Spencer, Monique E; Jain, Alka; Matteini, Amy; Beamer, Brock A; Wang, Nae-Yuh; Leng, Sean X; Punjabi, Naresh M; Walston, Jeremy D; Fedarko, Neal S

2010-08-01

Neopterin, a GTP metabolite expressed by macrophages, is a marker of immune activation. We hypothesize that levels of this serum marker alter with donor age, reflecting increased chronic immune activation in normal aging. In addition to age, we assessed gender, race, body mass index (BMI), and percentage of body fat (%fat) as potential covariates. Serum was obtained from 426 healthy participants whose age ranged from 18 to 87 years. Anthropometric measures included %fat and BMI. Neopterin concentrations were measured by competitive ELISA. The paired associations between neopterin and age, BMI, or %fat were analyzed by Spearman's correlation or by linear regression of log-transformed neopterin, whereas overall associations were modeled by multiple regression of log-transformed neopterin as a function of age, gender, race, BMI, %fat, and interaction terms. Across all participants, neopterin exhibited a positive association with age, BMI, and %fat. Multiple regression modeling of neopterin in women and men as a function of age, BMI, and race revealed that each covariate contributed significantly to neopterin values and that optimal modeling required an interaction term between race and BMI. The covariate %fat was highly correlated with BMI and could be substituted for BMI to yield similar regression coefficients. The association of age and gender with neopterin levels and their modification by race, BMI, or %fat reflect the biology underlying chronic immune activation and perhaps gender differences in disease incidence, morbidity, and mortality.

Neighbourhood socioeconomic inequalities in incidence of acute myocardial infarction: a cohort study quantifying age- and gender-specific differences in relative and absolute terms

PubMed Central

2012-01-01

Background Socioeconomic status has a profound effect on the risk of having a first acute myocardial infarction (AMI). Information on socioeconomic inequalities in AMI incidence across age- gender-groups is lacking. Our objective was to examine socioeconomic inequalities in the incidence of AMI considering both relative and absolute measures of risk differences, with a particular focus on age and gender. Methods We identified all patients with a first AMI from 1997 to 2007 through linked hospital discharge and death records covering the Dutch population. Relative risks (RR) of AMI incidence were estimated by mean equivalent household income at neighbourhood-level for strata of age and gender using Poisson regression models. Socioeconomic inequalities were also shown within the stratified age-gender groups by calculating the total number of events attributable to socioeconomic disadvantage. Results Between 1997 and 2007, 317,564 people had a first AMI. When comparing the most deprived socioeconomic quintile with the most affluent quintile, the overall RR for AMI was 1.34 (95 % confidence interval (CI): 1.32 – 1.36) in men and 1.44 (95 % CI: 1.42 – 1.47) in women. The socioeconomic gradient decreased with age. Relative socioeconomic inequalities were most apparent in men under 35 years and in women under 65 years. The largest number of events attributable to socioeconomic inequalities was found in men aged 45–74 years and in women aged 65–84 years. The total proportion of AMIs that was attributable to socioeconomic inequalities in the Dutch population of 1997 to 2007 was 14 % in men and 18 % in women. Conclusions Neighbourhood socioeconomic inequalities were observed in AMI incidence in the Netherlands, but the magnitude across age-gender groups depended on whether inequality was expressed in relative or absolute terms. Relative socioeconomic inequalities were high in young persons and women, where the absolute burden of AMI was low. Absolute

Women's preferences for vaginal antimicrobial contraceptives. II. Preferred characteristics according to women's age and socioeconomic status.

PubMed

Hardy, E; de Pádua, K S; Jiménez, A L; Zaneveld, L J

1998-10-01

A study was carried out to identify characteristics that women would want for an idealized vaginal contraceptive, and the possible association of these characteristics with age and socioeconomic status. The study was done in Campinas, São Paulo State, Brazil. A total of 635 women were selected by age and socioeconomic status, using the "social network" technique. Almost half were adolescents (15-19 years old) and the rest were adults (20-45 years old). Half were of low socioeconomic status and the rest of medium-high status. The data were analyzed with SPSS-PC and EPI-INFO 6.0. Logistic regression and chi 2 were used for the analysis. Despite some differences found between age and socioeconomic status in regard to the characteristics desired for the idealized method, most of the participants expressed the same preferences. The results indicate that women would like the idealized method to be a cream, rather than a suppository, with no odor or flavor, to be colorless, to be placed in the vagina with an applicator well before coitus, and to offer protection against sexually transmitted diseases including AIDS.

Perceived interpersonal mistreatment among obese Americans: do race, class, and gender matter?

PubMed

Carr, Deborah; Jaffe, Karen J; Friedman, Michael A

2008-11-01

We examine the extent to which body weight affects three types of perceived interpersonal mistreatment, and evaluate whether these patterns vary by race, social class, and gender in a large sample of American men and women. We use data from the first wave (1995) of the Midlife Development in the United States (N = 3,511), a survey of persons aged 25-74, to contrast underweight, normal weight, overweight, obese I, and obese II/III persons' reports of three types of perceived interpersonal mistreatment: disrespectful treatment; harassment/teasing; and being treated as if one has a character flaw. We assess whether these relationships are contingent upon one's gender, race, and occupational status. We control for possible confounding influences, including physical and mental health. In the total sample, obese I and obese II/III persons report significantly higher levels of all three types of perceived mistreatment (compared to normal weight persons), even when demographic, socioeconomic status, and health characteristics are controlled. Among black men, however, obese II/III persons report significantly lower levels of all three types of perceived mistreatment, compared to their normal weight peers. Among both men and women, obese professional workers report significantly more perceived interpersonal mistreatment, compared to obese persons of lower socioeconomic status. These findings reveal the ways that intersecting social identities may shape obese Americans' perceptions of stigmatizing interpersonal encounters.

High school seniors by race and SES

NASA Astrophysics Data System (ADS)

White, Susan C.

2015-12-01

In September, we looked at participation in high school physics by race and ethnicity, and we have provided two different views of physics in high school by socioeconomic status (SES). This month, we consider the proportion of seniors attending schools by race and SES. About half of the Hispanics and almost 45% of the African-Americans among high school seniors in 2013 attended a school where the students were determined to be "worse off" economically than their peers in the local area. The converse is true for Asians and Whites with the vast majority attending schools where students are seen as "better off" than their peers.

Sex, race, and age distributions of mean aortic wall thickness in a multiethnic population-based sample.

PubMed

Rosero, Eric B; Peshock, Ronald M; Khera, Amit; Clagett, Patrick; Lo, Hao; Timaran, Carlos H

2011-04-01

Reference values and age-related changes of the wall thickness of the abdominal aorta have not been described in the general population. We characterized age-, race-, and gender-specific distributions, and yearly rates of change of mean aortic wall thickness (MAWT), and associations between MAWT and cardiovascular risk factors in a multi-ethnic population-based probability sample. Magnetic resonance imaging measurements of MAWT were performed on 2466 free-living white, black, and Hispanic adult subjects. MAWT race/ethnicity- and gender-specific percentile values across age were estimated using regression analyses. MAWT was greater in men than in women and increased linearly with age in all the groups and across all the percentiles. Hispanic women had the thinnest and black men the thickest aortas. Black men had the highest and white women the lowest age-related MAWT increase. Age, gender, ethnicity, smoking status, systolic blood pressure, low-density lipoprotein-cholesterol levels, high-density lipoprotein-cholesterol levels, and fasting glucose levels were independent predictors of MAWT. Age, gender, and racial/ethnic differences in MAWT distributions exist in the general population. Such differences should be considered in future investigations assessing aortic atherosclerosis and the effects of anti-atherosclerotic therapies. Published by Mosby, Inc.

Seasonal Dynamics of Academic Achievement Inequality by Socioeconomic Status and Race/Ethnicity

ERIC Educational Resources Information Center

Quinn, David M.; Cooc, North; McIntyre, Joe; Gomez, Celia J.

2016-01-01

Early studies examining seasonal variation in academic achievement inequality generally concluded that socioeconomic test score gaps grew more over the summer than the school year, suggesting schools served as "equalizers." In this study, we analyze seasonal trends in socioeconomic status (SES) and racial/ethnic test score gaps using…

Race and Gender Matter: A Multidimensional Approach to Conceptualizing and Measuring Stress in African American Women

PubMed Central

Woods-Giscombé, Cheryl L.; Lobel, Marci

2008-01-01

Based on prior research and theory, the authors constructed a multidimensional model of stress in African American women comprised of race-related, gender-related, and generic stress. Exposure to and appraisal of these three types of stress were combined into a higher-order global stress factor. Using structural equation modeling, the fit of this stress factor and its ability to predict distress symptoms were examined in 189 socioeconomically diverse African American women aged 21 to 78. Results support the multidimensional conceptualization and operationalization of stress. Race-related, gender-related, and generic stress contributed equally to the global stress factor, and global stress predicted a significant amount of variance in distress symptoms and intensity. This model exhibited better fit than a model without a global stress factor, in which each stress component predicted distress directly. Furthermore, race-related, gender-related, and generic stress did not contribute to distress beyond their representation in the global stress factor. These findings illustrate that stress related to central elements of identity, namely race and gender, cohere with generic stress to define the stress experience of African American women. PMID:18624581

Race and gender matter: a multidimensional approach to conceptualizing and measuring stress in African American women.

PubMed

Woods-Giscombé, Cheryl L; Lobel, Marci

2008-07-01

Based on prior research and theory, the authors constructed a multidimensional model of stress in African American women comprised of race-related, gender-related, and generic stress. Exposure to and appraisal of these three types of stress were combined into a higher-order global stress factor. Using structural equation modeling, the fit of this stress factor and its ability to predict distress symptoms were examined in 189 socioeconomically diverse African American women aged 21 to 78. Results support the multidimensional conceptualization and operationalization of stress. Race-related, gender-related, and generic stress contributed equally to the global stress factor, and global stress predicted a significant amount of variance in distress symptoms and intensity. This model exhibited better fit than a model without a global stress factor, in which each stress component predicted distress directly. Furthermore, race-related, gender-related, and generic stress did not contribute to distress beyond their representation in the global stress factor. These findings illustrate that stress related to central elements of identity, namely race and gender, cohere with generic stress to define the stress experience of African American women. Copyright (c) 2008 APA, all rights reserved.

Socioeconomic gradient in consumption of whole fruit and 100% fruit juice among US children and adults.

PubMed

Drewnowski, Adam; Rehm, Colin D

2015-01-05

The consumption of fruit is generally associated with better health, but also higher socioeconomic status (SES). Most previous studies evaluating consumption of fruits have not separated 100% fruit juice and whole fruit, which may conceal interesting patterns in consumption. To estimate demographic and socioeconomic correlates of whole fruit versus 100% juice consumption among children and adults in the United States. Secondary analyses of two cycles of the nationally representative National Health and Nutrition Examination Survey (NHANES) from 2007-2010, by gender, age group, race/ethnicity and SES among 16,628 children and adults. Total fruit consumption (population average of 1.06 cup equivalents/d) fell far short of national goals. Overall, whole fruit provided about 65% of total fruit, while 100% juice provided the remainder. Whereas 100% juice consumption was highest among children and declined sharply with age, whole fruit consumption was highest among older adults. Total fruit and whole fruit consumption was generally higher among those with higher incomes or more education. By contrast, the highest 100% juice consumption was found among children, racial/ethnic minorities and lower-income groups. Consumption patterns for whole fruit versus 100% fruit juice showed different gradients by race/ethnicity, education, and income. The advice to replace 100% juice with whole fruit may pose a challenge for the economically disadvantaged and some minority groups, whose fruit consumption falls short of national goals.

Association of socioeconomic stratification with plasmatic markers of lipoperoxidation and antioxidants in Venezuelan school-age children

PubMed Central

Bosch, Virgilio; Giacopini, Maria Isabel

2016-01-01

Abstract Objetive: To establish association between socioeconomic status and plasmatic markers of lipoperoxidation and antioxidants in Venezuelan school-age children from the middle-class and in critical poverty. Methods: Cross-sectional study with a sample of 114 school-age children (aged 7-9). The socioeconomic status, dietary intake of macro and micro-nutrients, weight, height, lipid profile, indicators of lipid peroxidation and enzymatic and non-enzymatic antioxidants were determined. Results: The daily average intake of energy, carbohydrates and vitamin A, and the percentage of energy obtained from carbohydrates was significantly higher in middle-class children compared to critical poverty children (p <0.05). The circulating oxidized low density lipoprotein (p <0.001) and the susceptibility of low density lipoproteins and very low density lipoproteins to oxidation in vitro (p <0.05) were significantly higher in middle-class children, while the critical poverty children showed significantly lower levels of Vitamin C and E in plasma (p <0.05). Non-enzymatic antioxidant levels were frequently deficient in both strata. The concentrations of circulating oxidized low density lipoprotein (OR: 1.09, CI 95%: 1.016-1.179; p= 0.017) and Vitamin C (OR: 3.21, CI 95%: 1.104-9.938; p= 0.032) were associated to the socioeconomic status independently of gender, family history of premature coronary artery disease, triglicerides, Vitamin C and E dietary intake and count of white blood cells. Conclusion: The socioeconomic status was associated to circulating oxidized low density lipoprotein and Vitamin C in Venezuelan school-age children, The results suggested the need to improve the dietary intake of antioxidants in both studied socioeconomic groups. PMID:28293041

[Socioeconomic differences in physical activity in the middle-aged working population: The role of education, occupation, and income].

PubMed

Hoebel, Jens; Finger, Jonas D; Kuntz, Benjamin; Lampert, Thomas

2016-02-01

Regular physical activity has positive effects on health at all ages. This study aims to investigate how far physical activity and regular sports engagement, as a more specific type of physical activity, are associated with socioeconomic factors in the middle-aged working population. Data were obtained from 21,699 working men and women aged between 30 and 64 years who participated in the 2009 and 2010 population-based national German Health Update (GEDA) surveys conducted by the Robert Koch Institute. Besides a multi-dimensional index of socioeconomic status (SES), three single dimensions of SES (education, occupation, and income) were used to analyse socioeconomic differences in total physical activity and regular sports engagement. While the prevalence of total physical activity increased with lower SES, the proportion of people with regular sports engagement decreased with lower SES. These associations remained after adjusting for age in men and women. After mutual adjustment of the three single socioeconomic dimensions, physical activity was independently associated with lower education and lower occupational status. Regular sports engagement was observed to be independently associated with higher education, higher occupational status, as well as higher income after mutual adjustment. This study demonstrates significant socioeconomic differences in physical and sports activity in the middle-aged working population. Education, occupation, and income show varying independent associations with physical activity behaviour. Such differences need to be considered when identifying target groups for health-enhancing physical activity interventions.

Parent’s Socioeconomic Status, Adolescents’ Disposable Income, and Adolescents’ Smoking Status in Massachusetts

PubMed Central

Soteriades, Elpidoforos S.; DiFranza, Joseph R.

2003-01-01

Objectives. This study examined the association between parental socioeconomic status (SES) and adolescent smoking. Methods. We conducted telephone interviews with a probability sample of 1308 Massachusetts adolescents aged 12 to 17 years. We used multiple-variable-adjusted logistic regression models. Results. The risk of adolescent smoking increased by 28% with each step down in parental education and increased by 30% for each step down in parental household income. These associations persisted after adjustment for age, sex, race/ethnicity, and adolescent disposable income. Parental smoking status was a mediator of these associations. Conclusions. Parental SES is inversely associated with adolescent smoking. Parental smoking is a mediator but does not fully explain the association. PMID:12835202

Street connectivity and obesity in Glasgow, Scotland: impact of age, sex and socioeconomic position.

PubMed

Ball, Kylie; Lamb, Karen; Travaglini, Noemi; Ellaway, Anne

2012-11-01

This study investigated associations of street connectivity with body mass index (BMI), and whether these associations varied by sex, age and socioeconomic position, amongst adults in Glasgow, Scotland. Data on socio-demographic variables, height and weight were collected from 1062 participants in the Greater Glasgow Health and Well-being Study, and linked with neighbourhood-level census and geo-referenced data on area level deprivation and street connectivity. Results of multilevel models showed that, after adjustment for individual level covariates, street connectivity was not significantly associated with either BMI or BMI category; nor were there any significant interactions between age, sex or socioeconomic position and street connectivity. Copyright © 2012 Elsevier Ltd. All rights reserved.

Influence of Age, Sex, and Race on College Students' Exercise Motivation of Physical Activity

ERIC Educational Resources Information Center

Egli, Trevor; Bland, Helen W.; Melton, Bridget F.; Czech, Daniel R.

2011-01-01

Objective: The authors examined differences in exercise motivation between age, sex, and race for college students. Participants: Students from 156 sections of physical activity classes at a midsize university were recruited (n = 2,199; 1,081 men, 1,118 women) in 2005-2006 and volunteered to complete the Exercise Motivation Inventory. Methods:…

Socioeconomic status and bone mineral density in adults by race/ethnicity and gender: the Louisiana osteoporosis study.

PubMed

Du, Y; Zhao, L-J; Xu, Q; Wu, K-H; Deng, H-W

2017-05-01

Low bone mineral density (BMD) and osteoporosis have become a public health problem. We found that non-Hispanic white, black, and Asian adults with extremely low education and personal income are more likely to have lower BMD. This relationship is gender-specific. These findings are valuable to guide bone health interventions. The evidence is limited regarding the relationship between socioeconomic status (SES) and bone mineral density (BMD) for minority populations in the USA, as well as the relationship between SES and BMD for men. This study explored and examined the relationship between SES and BMD by race/ethnicity and gender. Data (n = 6568) from the Louisiana Osteoporosis Study (LOS) was examined, including data for non-Hispanic whites (n = 4153), non-Hispanic blacks (n = 1907), and non-Hispanic Asians (n = 508). General linear models were used to estimate the relationship of SES and BMD (total hip and lumbar spine) stratified by race/ethnicity and gender. Adjustments were made for physiological and behavioral factors. After adjusting for covariates, men with education levels below high school graduate experienced relatively low hip BMD than their counterparts with college or graduate education (p < 0.05). In addition, women reporting a personal annual income under $20,000 had relatively low hip and spine BMD than their counterparts with higher income level(s) (p < 0.05). Establishing a conclusive positive or negative association between BMD and SES proved to be difficult. However, individuals who are at an extreme SES disadvantage are the most vulnerable to have relatively low BMD in the study population. Efforts to promote bone health may benefit from focusing on men with low education levels and women with low individual income.

Body composition and blood pressure in children based on age, race, and sex.

PubMed

Brandon, L J; Fillingim, J

1993-01-01

We evaluated 675 nine- and twelve-year-old children for body composition and circulatory differences based on age, race, and sex. The specific variables measured included height, weight, triceps and subscapula skinfolds, body mass index, percentage fat, fat-free weight, and systolic, diastolic, and mean arterial blood pressures. A 2 x 2 x 2 factorial multiple analysis of variance (MANOVA) test of significance showed body composition and blood pressure differences (P < .01) for race, age, and sex. The univariate test of the specific variables within the factors showed that black children had higher fat-free weights and lower fat levels but higher blood pressure values (P < .05) than white children. Boys had lower fat levels than girls, and the older children had higher values on the body composition variables but not on blood pressure. Zero order correlations between body composition and blood pressure ranged from 0.14 to 0.55; systolic blood pressure and body weight shared the highest correlation. These data show that, although black children have less body fat than white children, they are heavier and have higher blood pressure. We hypothesize that some aspect of fat-free body weight may contribute to hypertension in black individuals.

Socioeconomic inequalities in life and health expectancies around official retirement age in 10 Western-European countries.

PubMed

Majer, I M; Nusselder, W J; Mackenbach, J P; Kunst, A E

2011-11-01

Discussions on raising pension eligibility age focus more on improvement in life expectancy (LE) and health expectancy measures than on socioeconomic differences in these measures. Therefore, this study assesses the level of socioeconomic differences in these two measures in Western-Europe. Data from seven annual waves (1995-2001) of the European Community Household Panel were used. Health and socioeconomic information was collected using standardised questionnaires. Health was measured in terms of disability in daily activities. Socioeconomic status was determined as education level at baseline. Multi-state Markov modelling was applied to obtain age-specific transition rates between health states for every country, educational level and gender. The multi-state life table method was used to estimate LE and disability free life expectancy (DFLE) according to country, educational level and gender. When comparing high and low educational levels, differences in partial DFLE between the ages 50 and 65 years were 2.1 years for men and 1.9 years for women. At age 65 years, for LE the difference between high and low educated groups was 3 years for men and 1.9 years for women, and for DFLE the difference between high and low educated groups was 4.6 years for men and 4.4 years for women. Similar patterns were observed in all countries, although inequalities tended to be greater in the southern countries. Educational inequalities, favouring the higher educated, exist on both sides of the retirement eligibility age. Higher educated persons live longer in good health before retirement and can expect to live longer afterwards.

Socio-economic variables influencing mean age at marriage in Karnataka and Kerala.

PubMed

Prakasam, C P; Upadhyay, R B

1985-01-01

"In this paper an attempt was made to study the influence of certain socio-economic variables on the male and the female age at marriage in Karnataka and Kerala [India] for the year 1971. Step-wise regression method has been used to select the predictor variables influencing mean age at marriage. The results reveal that percent female literate...and percent female in labour force...are found to influence female mean age at marriage in Kerala, while the variables for Karnataka were percent female literate..., percent male literate..., and percent urban male population...." excerpt

Oral narrative skills: Explaining the language-emergent literacy link by race/ethnicity and SES.

PubMed

Gardner-Neblett, Nicole; Iruka, Iheoma U

2015-07-01

Although children's early language skills have been found to predict literacy outcomes, little is known about the role of preschool oral narrative skills in the pathway between language and emergent literacy or how these associations differ by race/ethnicity and socioeconomic status. The current study uses the Early Childhood Longitudinal Study to explore how language at age 2 is associated with narrative skills at age 4 and emergent literacy outcomes at age 5 for a nationally representative sample of children. Findings demonstrate that early language is associated with narrative skills for most children. Oral narrative skills were found to mediate the pathway between early language and kindergarten emergent literacy for poor and nonpoor African American children. Implications for children's literacy development and future research are discussed. (c) 2015 APA, all rights reserved).

Socioeconomic factors and mortality in emergency general surgery: trends over a 20-year period.

PubMed

Armenia, Sarah J; Pentakota, Sri Ram; Merchant, Aziz M

2017-05-15

Socioeconomic factors such as race, insurance, and income quartiles have been identified as independent risk factors in emergency general surgery (EGS), but this impact has not been studied over time. We sought to identify trends in disparities in EGS-related operative mortality over a 20-y period. The National Inpatient Sample was used to identify patient encounters coded for EGS in 1993, 2003, and 2013. Logistic regression models were used to examine the adjusted relationship between race, primary payer status, and median income quartiles and in-hospital mortality after adjusting for patients' age, gender, Elixhauser comorbidity score, and hospital region, size, and location-cum-teaching status. We identified 391,040 patient encounters. In 1993, Black race was associated with higher odds of in-hospital mortality (odds ratio [95% confidence interval]: 1.35 [1.20-1.53]) than White race, although this difference dissipated in subsequent years. Medicare, Medicaid, and underinsured patients had a higher odds of mortality than those with private insurance for the entire 20-y period; only the disparity in the underinsured decreased over time (1993, 1.63 [1.35-1.98]; 2013, 1.41 [1.20-1.67]). In 2003 (1.23 [1.10-1.38]) and 2013 (1.23 [1.11-1.37]), patients from the lowest income quartile were more likely to die after EGS than patients from the highest income quartile. Socioeconomic disparities in EGS-related operative morality followed inconsistent trends. Over time, while gaps in in-hospital mortality among Blacks and Whites have narrowed, disparities among patients belonging to lowest income quartile have worsened. Medicare and Medicaid beneficiaries continued to experience higher odds of in-hospital mortality relative to those with private insurance. Copyright © 2017 Elsevier Inc. All rights reserved.

Gifted Students' Perceptions of Parenting Styles: Associations with Cognitive Ability, Sex, Race, and Age

ERIC Educational Resources Information Center

Rudasill, Kathleen Moritz; Adelson, Jill L.; Callahan, Carolyn M.; Houlihan, Deanna Vogt; Keizer, Benjamin M.

2013-01-01

Children whose parents are warm and responsive yet also set limits and have reasonable expectations for their children tend to have better outcomes than their peers whose parents show less warmth and responsiveness, have low expectations, or both. Parenting behavior is related to family race and children's sex, age, and cognitive ability. However,…

Impact of Tobacco-Related Health Warning Labels across Socioeconomic, Race and Ethnic Groups: Results from a Randomized Web-Based Experiment

PubMed Central

Cantrell, Jennifer; Vallone, Donna M.; Thrasher, James F.; Nagler, Rebekah H.; Feirman, Shari P.; Muenz, Larry R.; He, David Y.; Viswanath, Kasisomayajula

2013-01-01

Background The U.S. Family Smoking Prevention and Tobacco Control Act of 2009 requires updating of the existing text-only health warning labels on tobacco packaging with nine new warning statements accompanied by pictorial images. Survey and experimental research in the U.S. and other countries supports the effectiveness of pictorial health warning labels compared with text-only warnings for informing smokers about the risks of smoking and encouraging cessation. Yet very little research has examined differences in reactions to warning labels by race/ethnicity, education or income despite evidence that population subgroups may differ in their ability to process health information. The purpose of the present study was to evaluate the potential impact of pictorial warning labels compared with text-only labels among U.S. adult smokers from diverse racial/ethnic and socioeconomic subgroups. Methods/Findings Participants were adult smokers recruited from two online research panels (n = 3,371) into a web-based experimental study to view either the new pictorial warnings or text-only warnings. Participants viewed the labels and reported their reactions. Adjusted regression models demonstrated significantly stronger reactions for the pictorial condition for each outcome salience (b = 0.62, p<.001); perceived impact (b = 0.44, p<.001); credibility (OR = 1.41, 95% CI = 1.22−1.62), and intention to quit (OR = 1.30, 95% CI = 1.10−1.53). No significant results were found for interactions between condition and race/ethnicity, education, or income. The only exception concerned the intention to quit outcome, where the condition-by-education interaction was nearly significant (p = 0.057). Conclusions Findings suggest that the greater impact of the pictorial warning label compared to the text-only warning is consistent across diverse racial/ethnic and socioeconomic populations. Given their great reach, pictorial health warning labels may be one of

Role of Sex, Socioeconomic Status, and Emotional Support in Predicting Aging Perception Among Older Adults.

PubMed

Yaghoobzadeh, Ameneh; Sharif Nia, Hamid; Pahlevan Sharif, Saeed; Hosseinigolafshani, Seyedeh Zahra; Mohammadi, Fatemeh; Oveisi, Sonia; Allen, Kelly A

2017-01-01

Self-perception is found to be a central predictive factor in experiencing successful aging. The aim of this study was to explore the role of sex, socioeconomic status, and emotional support in elders' aging perception. A cross-sectional design was used with 300 older aged participants recruited from 23 clinics and health centers in Qazvin, Iran. Data were collected included questions to elicit demographic information and Barker's aging perception questionnaire. Exploratory multiple linear regression showed that the level of emotional support (β: -12.10; 95% CI: [-20.72, -3.48]), socioeconomic status (β: 2.84; 95% CI: [0.25, 5.43]), and women (β: -4.34; 95% CI: [-6.91, -1.77]) were associated with aging perception among elders. Educational level and marital status did not significantly contribute to the variance of AP. Findings revealed that aging perception was related to individual differences as well as social and emotional factors. Researchers, health-care professionals, and elders may benefit from thinking about old age as an inevitable life stage.

Education, socio-economic status and age-related macular degeneration in Asians: the Singapore Malay Eye Study.

PubMed

Cackett, P; Tay, W T; Aung, T; Wang, J J; Shankar, A; Saw, S M; Mitchell, P; Wong, T Y

2008-10-01

Low socio-economic status is increasingly being identified as a risk marker for chronic diseases, but few studies have investigated the link between socio-economic factors and age-related macular degeneration (AMD). The present study aimed to assess the association between socio-economic status and the prevalence of AMD. A population-based cross-sectional study of 3280 (78.7% response rate) Malay adults aged 40-80 years residing in 15 south-western districts of Singapore. AMD was graded from retinal photographs at a central reading centre using the modified Wisconsin AMD scale. Early and late AMD signs were graded from retinal photographs following the Wisconsin grading system. Socio-economic status including education, housing type and income were determined from a detailed interview. Of the participants, 3265 had photographs of sufficient quality for grading of AMD. Early AMD was present in 168 (5.1%) and late AMD in 21 (0.6%). After adjusting for age, gender, smoking, hypertension, diabetes and body mass index, participants with lower educational levels were significantly more likely to have early AMD (multivariate OR 2.2, 95% CI 1.2 to 4.0). This association was stronger in persons who had never smoked (multivariate OR 3.6, 95% confidence CI 1.4 to 9.4). However, no association with housing type or income was seen. Low educational level is associated with a higher prevalence of early AMD signs in our Asian population, independent of age, cardiovascular risk factors and cigarette smoking.

Effects of infants' birth order, maternal age, and socio-economic status on birth weight.

PubMed

Ghaemmaghami, Seyed J; Nikniaz, Leila; Mahdavi, Reza; Nikniaz, Zeinab; Razmifard, Farzad; Afsharnia, Farzaneh

2013-09-01

To determine the effects of infants' birth order, maternal age, and socioeconomic status (SES) on birth weight. This cross-sectional study included a sample of 858 mothers recruited over a 6-month period in 2010, in a defined population of 9 urban health centers, and who were admitted for their infants' first vaccination. Maternal clinical data, demographic data, and infants' birth weight were obtained from the interview and maternal hospital files. Multiple regression and analysis of variance were used for data analysis. First and fourth births had lower birth weights compared with second and third births in all maternal ages in controlling parity, birth weight increases with maternal age up to the early 24, and then tends to level off. Male gender, maternal age 20-24 years, second and third births had a significant positive effect on birth weight. Lower family economic status and higher educational attainment were significantly associated with lower birth weight. For women in the 15-19 and 40-44 years age groups, the second birth order was associated with the most undesirable effect on birth weight. Accessibility of health care services, parity, maternal age, and socioeconomic factors are strongly associated with infants' birth weight.

Associating socioeconomic position and maternal depression with the health of children: an evaluation of the 2008 Brazilian household survey.

PubMed

Leivas, Pedro Henrique Soares; Tejada, Cesar Augusto Oviedo; Bertoldi, Andréa Dâmaso; Santos, Anderson Moreira Aristides Dos; Jacinto, Paulo de Andrade

2018-05-01

The study analyzed the association between socioeconomic position (income), maternal depression and the health of children in Brazil, using information from the 2008 National Household Survey (PNAD/IBGE). The analysis considered the sampling design for the research and included 46,874 individuals up to the age of nine. The Poisson models were estimated for three health outcomes for children: health as reported by the parents or the responsible person, restrictions on habitual activities for health reasons and periods when they were confined to bed two weeks before the interviews in the study. The results showed an association between the mothers' depression and the three health outcomes, even after taking into account the following: socioeconomic position, maternal characteristics (health self-referral, age, level of education and smoking), age, gender, the child's race, geographical region, the situation as noted in the census and the number of residents in a household. It was found that there still exists an association between maternal depression and children's health irrespective of socioeconomic position. Therefore public policies that aim to reduce the adverse effects of maternal depression on the health of children need to also take into account the higher income segments of society.

Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States

PubMed Central

Murray, Christopher J. L; Kulkarni, Sandeep C; Michaud, Catherine; Tomijima, Niels; Bulzacchelli, Maria T; Iandiorio, Terrell J; Ezzati, Majid

2006-01-01

Background The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the “eight Americas,” to explore the causes of the disparities that can inform specific public health intervention policies and programs. Methods and Findings The eight Americas were defined based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate. Data sources for population and mortality figures were the Bureau of the Census and the National Center for Health Statistics. We estimated life expectancy, the risk of mortality from specific diseases, health insurance, and health-care utilization for the eight Americas. The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 y for males (Asians versus high-risk urban blacks) and 12.8 y for females (Asians versus low-income southern rural blacks). Mortality disparities among the eight Americas were largest for young (15–44 y) and middle-aged (45–59 y) adults, especially for men. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the ordering of life expectancy among the eight Americas and the absolute difference between the advantaged and disadvantaged groups remained largely unchanged. Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations. Conclusions Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans

Maturity status influences the relative age effect in national top level youth alpine ski racing and soccer

PubMed Central

Müller, Lisa; Gonaus, Christoph; Perner, Christoph; Müller, Erich; Raschner, Christian

2017-01-01

Since the relative age effect (RAE) characterizes a problem in all age categories of alpine ski racing and soccer and the fact that, yet, to date the underlying factors have not been well investigated, the aim of the present study was to assess the influence of the biological maturity status on the RAE among youth alpine ski racers (YSR) and soccer players (SP). In total, 183 male and female YSR selected for national final races and 423 male SP selected for Elite Youth Development Centres were investigated. Additionally, a comparison group of 413 non-athletes was evaluated. The birth months were split into four relative age quarters. The biological maturity status was assessed by the age at peak height velocity (APHV) method; according to the M±SD of the comparison group, the athletes were divided into normal, early and late maturing. Chi2-tests indicated a significant RAE among YSR (χ2(3,N = 183) = 18.0; p<0.001; ω = 0.31) and SP (χ2(3,N = 423) = 33.1; p<0.001; ω = 0.28). In total, only a small number of late maturing athletes were present (0.5–2.3%). Among relatively younger athletes, high percentages of early maturing athletes were found (43.1–43.3%). The findings indicate that relatively younger and less mature athletes are marginalized or totally excluded in alpine ski racing and soccer. Thus, selection criteria in both sports are effectively based on early biological development and relatively older age, both of which should be considered in future in the talent selection process. In this context, the easy feasible method of assessing the APHV can be used. PMID:28759890

A Quarter Century of Participation in School-Based Extracurricular Activities: Inequalities by Race, Class, Gender and Age?

PubMed

Meier, Ann; Hartmann, Benjamin Swartz; Larson, Ryan

2018-06-01

Extracurricular activity participation is linked to positive development, but it is also a setting for inequality. Using a quarter century of data from Monitoring the Future (N = 593,979; 51% female; 65% non-Hispanic white; 13% non-Hispanic black; 12% Hispanic; 4% non-Hispanic Asian/Pacific Islander; 7% other race), this article documents patterns and trends in school-based extracurricular participation by race, social class, gender, and age, and their links to academic and substance use outcomes. Findings reveal differences by race and confirm a division by social class that has worsened over time. Further, girls are gaining on boys and surpass them in some types of school-based activities. Participation is linked to better academic outcomes and less substance use, affirming the importance of redressing the inequalities revealed.

Examining the inter-correlated effects of low income, life stress, and race on birth outcomes: A representative state study.

PubMed

Lefmann, Tess; Combs-Orme, Terri; Orme, John G

2017-07-01

Programming of the stress response system during gestation has lifelong effects that put the infant at risk for multiple stress-related pathologies. Populations most vulnerable to prenatal stress are African-Americans and individuals of low socioeconomic status. The Pregnancy Risk Assessment Monitoring System (PRAMS) research project, a collaboration between the Centers for Disease Control and Prevention and individual state health departments, was employed for this study. Tennessee data from 2009 were compiled from individual birth certificates and PRAMS questionnaire responses to examine the influence of maternal stressors, race and low income on birth outcomes. The number of stressors was only a significant predictor of having an infant small for gestational age when moderated by Medicaid status. Medicaid status was a positive predictor of both problematic birth and preterm delivery, but did not predict small or large for gestational age. The relationship between race and birth outcomes overall was moderated by age, with young African-American mothers less likely than European-Americans and older African-American mothers to have adverse birth outcomes.

Perceived Interpersonal Mistreatment Among Obese Americans: Do Race, Class, and Gender Matter?

PubMed Central

Carr, Deborah; Jaffe, Karen J.; Friedman, Michael A.

2010-01-01

Objective: We examine the extent to which body weight affects three types of perceived interpersonal mistreatment, and evaluate whether these patterns vary by race, social class, and gender in a large sample of American men and women. Methods and Procedures: We use data from the first wave (1995) of the Midlife Development in the United States (N = 3,511), a survey of persons aged 25–74, to contrast underweight, normal weight, overweight, obese I, and obese II/III persons' reports of three types of perceived interpersonal mistreatment: disrespectful treatment; harassment/teasing; and being treated as if one has a character flaw. We assess whether these relationships are contingent upon one's gender, race, and occupational status. We control for possible confounding influences, including physical and mental health. Results: In the total sample, obese I and obese II/III persons report significantly higher levels of all three types of perceived mistreatment (compared to normal weight persons), even when demographic, socioeconomic status, and health characteristics are controlled. Among black men, however, obese II/III persons report significantly lower levels of all three types of perceived mistreatment, compared to their normal weight peers. Among both men and women, obese professional workers report significantly more perceived interpersonal mistreatment, compared to obese persons of lower socioeconomic status. Discussion: These findings reveal the ways that intersecting social identities may shape obese Americans' perceptions of stigmatizing interpersonal encounters. PMID:18978765

Risk Factors for Learning-Related Behavior Problems at 24 Months of Age: Population-Based Estimates

ERIC Educational Resources Information Center

Morgan, Paul L.; Farkas, George; Hillemeier, Marianne M.; Maczuga, Steven

2009-01-01

We used a large sample of singleton children to estimate the effects of socioeconomic status (SES), race/ethnicity, gender, additional socio-demographics, gestational and birth factors, and parenting on children's risk for learning-related behavior problems at 24 months of age. We investigated to what extent these factors increased a child's risk…

Racial and Socioeconomic Differences Manifest in Process Measure Adherence for Enhanced Recovery After Surgery Pathway.

PubMed

Leeds, Ira L; Alimi, Yewande; Hobson, Deborah R; Efron, Jonathan E; Wick, Elizabeth C; Haut, Elliott R; Johnston, Fabian M

2017-10-01

Adherence to care processes and surgical outcomes varies by population subgroups for the same procedure. Enhanced recovery after surgery pathways are intended to standardize care, but their effect on process adherence and outcomes for population subgroups is unknown. This study aims to demonstrate the association between recovery pathway implementation, process measures, and short-term surgical outcomes by population subgroup. This study is a pre- and post-quality improvement implementation cohort study. This study was conducted at a tertiary academic medical center. A modified colorectal enhanced recovery after surgery pathway was implemented. Patients were included who had elective colon and rectal resections before (2013) and following (2014-2016) recovery pathway implementation. Thirty-day outcomes by race and socioeconomic status were analyzed using a difference-in-difference approach with correlation to process adherence. We identified 639 cases (199 preimplementation, 440 postimplementation). In these cases, 75.2% of the patients were white, and 91.7% had a high socioeconomic status. Groups were similar in terms of other preoperative characteristics. Following pathway implementation, median lengths of stay improved in all subgroups (-1.0 days overall, p ≤ 0.001), but with no statistical difference by race or socioeconomic status (p = 0.89 and p = 0.29). Complication rates in both racial and socioeconomic groups were no different (26.4% vs 28.8%, p = 0.73; 27.3% vs 25.0%, p = 0.86) and remained unchanged with implementation (p = 0.93, p = 0.84). By race, overall adherence was 31.7% in white patients and 26.5% in nonwhite patients (p = 0.32). Although stratification by socioeconomic status demonstrated decreased overall adherence in the low-status group (31.8% vs 17.1%, p = 0.05), white patients were more likely to have regional pain therapy (57.1% vs 44.1%, p = 0.02) with a similar trend seen with socioeconomic status. Data were collected primarily for

Race, life course socioeconomic position, racial discrimination, depressive symptoms and self-rated health.

PubMed

Hudson, Darrell L; Puterman, Eli; Bibbins-Domingo, Kirsten; Matthews, Karen A; Adler, Nancy E

2013-11-01

Greater levels of socioeconomic position (SEP) are generally associated with better health. However results from previous studies vary across race/ethnicity and health outcomes. Further, the majority of previous studies do not account for the effects of life course SEP on health nor the effects of racial discrimination, which could moderate the effects of SEP on health. Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, we examined the relationship between a life course SEP measure on depressive symptoms and self-rated health. A life course SEP was constructed for each participant, using a framework that included parental education and occupation along with respondents' highest level of education and occupation. Interaction terms were created between life course SEP and racial discrimination to determine whether the association between SEP and health was moderated by experiences of racial discrimination. Analyses revealed that higher levels of life course SEP were inversely related to depressive symptoms. Greater life course SEP was positively associated with favorable self-rated health. Racial discrimination was associated with more depressive symptoms and poorer self-rated health. Analyses indicated a significant interaction between life course SEP and racial discrimination on depressive symptoms in the full sample. This suggested that for respondents with greater levels of SEP, racial discrimination was associated with reports of more depressive symptoms. Future research efforts should be made to examine whether individuals' perceptions and experiences of racial discrimination at the interpersonal and structural levels limits their ability to acquire human capital as well as their advancement in education and occupational status. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cancer in relation to socioeconomic status: stage at diagnosis in Texas, 2004-2008.

PubMed

Risser, David R; Miller, Eric A

2012-10-01

To determine whether stage of cancer diagnosis was associated with the socioeconomic status (SES) of the census tract where the patient resides, and to assess whether this is modified by race, ethnicity, or urban/rural residence, other factors known to affect cancer diagnosis stage. Using 2004-2008 data from the Texas Cancer Registry, we examined the distribution of stage at diagnosis in Texas residents for 15 cancer sites by the SES of the census tract of residence. Stage at diagnosis was categorized into the summary stage categories of early (in situ [preinvasive disease] and localized) and late stage (regional and distant spread). Age-adjusted odds ratios for late-stage versus early-stage cancer diagnosis in low versus high SES census tracts were evaluated by cancer site, race, ethnicity, and urban versus rural residence. For most cancer sites, late-stage cancer diagnosis increased with decreasing SES. These findings were consistent by cancer site, race, ethnicity, and in urban and rural areas of the state. For most cancer sites, particularly those likely to have patients diagnosed early by screening, late-stage cancer diagnosis is increased in Texas populations residing in lower SES census tracts compared with higher SES census tracts.

Body weight, perceived weight stigma and mental health among women at the intersection of race/ethnicity and socioeconomic status: insights from the modified labelling approach.

PubMed

Ciciurkaite, Gabriele; Perry, Brea L

2018-01-01

With increasing rates of obesity in the United States, attention to life chances and psychological consequences associated with weight stigma and weight-based discrimination has also intensified. While research has demonstrated the negative effects of weight-based discrimination on mental health, little is known about whether different social groups are disproportionately vulnerable to these experiences. Drawing on the modified labelling theory, the focus of this paper is to investigate the psychological correlates of body weight and self-perceived weight-based discrimination among American women at the intersection of race/ethnicity and socioeconomic status (SES). Analyses use data from the National Health Measurement Study (NHMS), a national multi-stage probability sample of non-institutional, English-speaking adults, ages 35 to 89 in 2005-2006. Our findings demonstrate that the effect of weight-based discrimination on psychological well-being is highly contingent on social status. Specifically, the psychological consequences of discrimination on Hispanic women and women in the lowest household income group is significantly greater relative to White women and women with higher household income, controlling for obesity status and self-rated health. These results suggest that higher social status has a buffering effect of weight stigma on psychological well-being. © 2017 Foundation for the Sociology of Health & Illness.

Race, income, and education: associations with patient and family ratings of end-of-life care and communication provided by physicians-in-training.

PubMed

Long, Ann C; Engelberg, Ruth A; Downey, Lois; Kross, Erin K; Reinke, Lynn F; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W; Back, Anthony L; Curtis, J Randall

2014-04-01

Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families.

Neighborhood socioeconomic status is associated with violent reinjury.

PubMed

Chong, Vincent E; Lee, Wayne S; Victorino, Gregory P

2015-11-01

Measures of individual socioeconomic status correlate with recurrent violent injury; however, neighborhood socioeconomic status may also matter. We conducted a review of victims of interpersonal violence treated at our trauma center, hypothesizing that the percent of the population living under the poverty level in their neighborhood is associated with recurrent violent victimization. We identified victims of interpersonal violence, ages 12-24, in our trauma registry from 2005-2010. Recurrent episodes of violent injury were identified through 2012. The percentage of the population living under the poverty level for the patient's zip code of residence was derived from United States census estimates and divided into quartiles. Multivariable logistic regression was conducted to evaluate predictors of violent injury recidivism. Our cohort consisted of 1890 patients. Multivariable logistic regression confirmed the following factors as independent predictors of violent injury recidivism: male sex (odds ratio [OR] = 2 [1.06-3.80]; P = 0.03), black race (OR = 2.1 [1.44-3.06]; P < 0.001), injury due to firearms (OR = 1.67 [1.12-2.50]; P = 0.01), and living in the lowest zip code socioeconomic quartile (OR = 1.59 [1.12-2.25]; P = 0.01). For young patients injured by violence, the socioeconomic position of their neighborhood of residence is independently correlated with their risk of violent reinjury. Low neighborhood socioeconomic status may be associated with a disrupted sense of safety after injury and also may alter a person's likelihood of engaging in behaviors correlated with recurrent violent injury. Programs aimed at reducing violent injury recidivism should address needs at the individual and neighborhood level. Copyright © 2015 Elsevier Inc. All rights reserved.

Association between socioeconomic status, sex, and age at death from cystic fibrosis in England and Wales (1959 to 2008): cross sectional study.

PubMed

Barr, Helen L; Britton, John; Smyth, Alan R; Fogarty, Andrew W

2011-08-23

To determine the trend in the association between socioeconomic status and sex and median age at death from cystic fibrosis in England and Wales, over the past 50 years. Series of annual cross sectional studies of all registered deaths with a diagnosis of cystic fibrosis in England and Wales, from 1959 to 2008. We obtained national mortality data for cystic fibrosis from the Office for National Statistics. From 1959 to 2000, the Registrar General's Social Class coded socioeconomic status as manual or non-manual. From 2001 onwards, the National Statistics Socioeconomic Classification was implemented and socioeconomic status was split into three groups: professional and managerial, intermediate, and routine and manual. We calculated median age at death for every study year. We calculated the effects of sex and socioeconomic status on the odds of death above the median age at death for every study decade using logistic regression. From 1959 to 2008, 6750 deaths were attributed to cystic fibrosis in England and Wales. Males were more likely to die above the annual median age at death than females (from 1959 to 1999, adjusted odds ratio for socioeconomic status 1.28, 95% confidence intervals 1.13 to 1.45; from 2000 to 2008, 1.57, 1.18 to 2.08). Individuals in the highest socioeconomic class were also more likely to die above the median age of death than those in the lowest socioeconomic class (from 1959 to 2000, adjusted odds ratio for sex 2.50, 2.16 to 2.90; from 2001 to 2008, 1.89, 1.20 to 2.97). Socioeconomic status and sex remain strong determinants of survival from cystic fibrosis in England and Wales, and the magnitude of these effects does not appear to have substantially reduced over time.

Coronary calcium predicts events better with absolute calcium scores than age-sex-race/ethnicity percentiles: MESA (Multi-Ethnic Study of Atherosclerosis).

PubMed

Budoff, Matthew J; Nasir, Khurram; McClelland, Robyn L; Detrano, Robert; Wong, Nathan; Blumenthal, Roger S; Kondos, George; Kronmal, Richard A

2009-01-27

In this study, we aimed to establish whether age-sex-specific percentiles of coronary artery calcium (CAC) predict cardiovascular outcomes better than the actual (absolute) CAC score. The presence and extent of CAC correlates with the overall magnitude of coronary atherosclerotic plaque burden and with the development of subsequent coronary events. MESA (Multi-Ethnic Study of Atherosclerosis) is a prospective cohort study of 6,814 asymptomatic participants followed for coronary heart disease (CHD) events including myocardial infarction, angina, resuscitated cardiac arrest, or CHD death. Time to incident CHD was modeled with Cox regression, and we compared models with percentiles based on age, sex, and/or race/ethnicity to categories commonly used (0, 1 to 100, 101 to 400, 400+ Agatston units). There were 163 (2.4%) incident CHD events (median follow-up 3.75 years). Expressing CAC in terms of age- and sex-specific percentiles had significantly lower area under the receiver-operating characteristic curve (AUC) than when using absolute scores (women: AUC 0.73 versus 0.76, p = 0.044; men: AUC 0.73 versus 0.77, p < 0.001). Akaike's information criterion indicated better model fit with the overall score. Both methods robustly predicted events (>90th percentile associated with a hazard ratio [HR] of 16.4, 95% confidence interval [CI]: 9.30 to 28.9, and score >400 associated with HR of 20.6, 95% CI: 11.8 to 36.0). Within groups based on age-, sex-, and race/ethnicity-specific percentiles there remains a clear trend of increasing risk across levels of the absolute CAC groups. In contrast, once absolute CAC category is fixed, there is no increasing trend across levels of age-, sex-, and race/ethnicity-specific categories. Patients with low absolute scores are low-risk, regardless of age-, sex-, and race/ethnicity-specific percentile rank. Persons with an absolute CAC score of >400 are high risk, regardless of percentile rank. Using absolute CAC in standard groups performed

A Way Forward: Nurturing the Imagination at the Intersection of Race, Class, Gender, and Age

ERIC Educational Resources Information Center

Lockhart-Gilroy, Annie A.

2016-01-01

Those who are oppressed often find themselves internalizing voices that limit their ability. This article focuses on a population that falls on the non-hegemonic side of the intersection of race, class, gender, and age: Black girls from poor and working-class backgrounds. From my work with youth, I have noticed that internalizing these limiting…

How does race/ethnicity influence pharmacological response to asthma therapies?

PubMed

Cazzola, Mario; Calzetta, Luigino; Matera, Maria Gabriella; Hanania, Nicola A; Rogliani, Paola

2018-04-01

Our understanding of whether and/or how ethnicity influences pharmacological response to asthma therapies is still very scarce. A possible explanation for the increased asthma treatment failures observed in ethnic and racial minorities receiving asthma therapies is that some of these groups may have a pharmacogenomic predisposition to either nonresponse or to adverse response with a specific class of drugs. However, the effects of ethnicity on pharmacological response to asthma therapies are also, and mainly, determined by socioeconomic and environmental factors to a varying extent, depending on the ethnic groups. Areas covered: Genetic, socioeconomic and environmental factors that can affect the pharmacotherapeutic responses to asthma medications and their link(s) to race/ethnicity have been examined and critically discussed. Expert opinion: Differences in genetic ancestry are definitely non-modifiable factors, but socioeconomic and environmental disadvantages are all factors that can be modified. It is likely that improved outcomes may be achieved when tailored and multifaceted approaches that include home, school, and clinician-based interventions are implemented. Consequently, it is critical to determine if a clinical intervention programme combined with implementation strategies that attempt to reduce inequalities can reduce asthma disparities, including the influence of ethnicity and race on pharmacological response to asthma therapies.

A Model of Aging Perception in Iranian Elders With Effects of Hope, Life Satisfaction, and Socioeconomic Status: A Path Analysis.

PubMed

Yaghoobzadeh, Ameneh; Gorgulu, Ozkan; Yee, Bit-Lian; Wibisono, Ahmad Hasyim; Pahlevan Sharif, Saeed; Sharif Nia, Hamid; Allen, Kelly A

2018-01-01

Aging perception plays a central role in the experience of healthy aging by older people. Research identified that factors such as hope, life satisfaction, and socioeconomic status influence the perception of aging in older populations. This study sought to test a hypothetical model to quantitatively evaluate the relationship between hope, life satisfaction, and socioeconomic status with aging perception. A cross-sectional design was used with 504 older aged participants who live in Qazvin, Iran. Data were collected using the Barker's Aging Perception Questionnaire, Life Satisfaction Index-Z, and Herth Hope Index. The results of path analysis showed that hope was the most important factor affecting aging perception. Results drawn from correlation analysis indicated that there was a positive significant correlation ( r = .383, p < .001) between hope and aging perception. Further analysis found that hope had the strongest impact on aging perception compared with the other variables analyzed (e.g., life satisfaction and socioeconomic status). A model of aging perception in Iranian elders is presented. The findings suggested that hope had a significant and positive impact on aging perception. Implications for clinical practice and research are discussed.

Is the Risk of Autism in Younger Siblings of Affected Children Moderated by Sex, Race/Ethnicity, or Gestational Age?

PubMed

Xie, Fagen; Peltier, Morgan; Getahun, Darios

2016-10-01

To evaluate the recurrence risk of autism spectrum disorders (ASD) in younger siblings of affected children and determine how it is modified by race/ethnicity and sex. Medical records of children born in a large health maintenance organization (Kaiser Permanent Southern California) hospitals from January 1, 2001, through December 31, 2010, and who remained in our system until 2 to 11 years of age were used to assess the risk of recurrence of ASD in younger siblings. Children born at <28 or >42 weeks gestation, multiple births, or those who were not active members for ≥3 months were excluded. ASD diagnosis was ascertained from DSM-IV codes, and the magnitude of the association was estimated using adjusted relative risks (aRRs). Among eligible younger siblings, 592 (1.11%) had the diagnosis of ASD. The ASD rates were 11.30% and 0.92% for younger siblings of older affected and unaffected siblings, respectively (aRR: 14.27; 95% confidence interval, 11.41-17.83). This association remained after adjusting for potential confounding factors. Race/ethnicity- and gestational age-specific analyses revealed a positive association of similar magnitude across groups. Risk remained higher in younger boys than girls regardless of the sex of affected older siblings. The findings of this study suggest that the risk of ASD in younger siblings is higher if the older sibling has ASD. The risk of ASD in younger siblings of older affected siblings was comparable across gestational age at birth and child's race/ethnicity groups. However, risk remains higher for boys. This study contributes to a better understanding of the influence of race/ethnicity, sex, and gestational age at birth in identifying children at higher risk of ASD.

Children with Autism Spectrum Disorder scan own-race faces differently from other-race faces.

PubMed

Yi, Li; Quinn, Paul C; Fan, Yuebo; Huang, Dan; Feng, Cong; Joseph, Lisa; Li, Jiao; Lee, Kang

2016-01-01

It has been well documented that people recognize and scan other-race faces differently from faces of their own race. The current study examined whether this cross-racial difference in face processing found in the typical population also exists in individuals with Autism Spectrum Disorder (ASD). Participants included 5- to 10-year-old children with ASD (n=29), typically developing (TD) children matched on chronological age (n=29), and TD children matched on nonverbal IQ (n=29). Children completed a face recognition task in which they were asked to memorize and recognize both own- and other-race faces while their eye movements were tracked. We found no recognition advantage for own-race faces relative to other-race faces in any of the three groups. However, eye-tracking results indicated that, similar to TD children, children with ASD exhibited a cross-racial face-scanning pattern: they looked at the eyes of other-race faces longer than at those of own-race faces, whereas they looked at the mouth of own-race faces longer than at that of other-race faces. The findings suggest that although children with ASD have difficulty with processing some aspects of faces, their ability to process face race information is relatively spared. Copyright © 2015 Elsevier Inc. All rights reserved.

Disparities of Shigellosis Rates among California Children by Race/Ethnicity and Census Tract Poverty Level, 2000-2010.

PubMed

Jackson, Rebecca; Smith, Daniel; Tabnak, Farzaneh; Vugia, Duc

2015-08-01

We examined surveillance data for disparities in shigellosis rates among children by census tract (CT) poverty level and race/ethnicity in California. We geocoded addresses of 9740 children younger than 15 years of age from 2000-2010 California shigellosis surveillance data and calculated incidence rate (IR) per 100,000 population by age group and race/ethnicity. We linked geocoded cases to 2006-2010 American Community Survey CT-level poverty data and used IR ratios to compare children in the most impoverished CTs with those in the least impoverished CTs. The contribution of socioeconomic inequalities to age-standardized racial and ethnic disparities was explored using Poisson regression. Per 100,000 population, shigellosis IR was highest among California children less than 5 years old (16.4) and of Hispanic ethnicity (15.2). The age-standardized IR was 22.3 per 100,000 person-years in CTs with more than 40% of the population below the poverty line and 4.1 per 100,000 person-years in CTs with less than 5% of the population below the poverty line, an IR ratio of 5.8 (95% confidence interval: 5.2, 6.5). Shigellosis rates among California children were highest among Hispanics and increased with CT poverty.

Relationship of race and poverty to lower extremity function and decline: findings from the Women's Health and Aging Study.

PubMed

Thorpe, Roland James; Kasper, Judith D; Szanton, Sarah L; Frick, Kevin D; Fried, Linda P; Simonsick, Eleanor M

2008-02-01

Race- and poverty-related disparities in physical function are well documented, though little is known about effects of race and poverty on functional decline and the progression of disability. We examined cross-sectional and longitudinal relationships between race, poverty and lower extremity function using data from moderately to severely disabled women in the U.S. Women's Health and Aging Study. Severity of lower extremity functional limitation was determined from scaled responses of reported difficulty walking (1/4) mile, walking across a room, climbing stairs, and stooping, crouching or kneeling. Usual walking speed assessed over 4m was our objective measure of function. Of the 996 women who described themselves as black or white, 284 (29%) were black and 367 (37%) were living at or below 100% of the federal poverty level. Independent of demographic and health-related factors, among white women, the poor exhibited consistently worse lower extremity function than the non-poor; this association, however, was not observed in black women. Among the non-poor, black women had slower walking speeds, and reported more limitation in lower extremity function than their non-poor white counterparts, even after adjusting for demographic variables and health-related characteristics. After 3 years, accounting for baseline function, demographic and health-related factors, race and poverty status were unrelated to functional decline. Thus, while race and poverty status were associated with functional deficits in old age, they do not appear to impact the rate of functional decline or progression of disability over 3 years.

Recognition of own-race and other-race faces by three-month-old infants.

PubMed

Sangrigoli, Sandy; De Schonen, Scania

2004-10-01

People are better at recognizing faces of their own race than faces of another race. Such race specificity may be due to differential expertise in the two races. In order to find out whether this other-race effect develops as early as face-recognition skills or whether it is a long-term effect of acquired expertise, we tested face recognition in 3-month-old Caucasian infants by conducting two experiments using Caucasian and Asiatic faces and a visual pair-comparison task. We hypothesized that if the other race effect develops together with face processing skills during the first months of life, the ability to recognize own-race faces will be greater than the ability to recognize other-race faces: 3-month-old Caucasian infants should be better at recognizing Caucasian faces than Asiatic faces. If, on the contrary, the other-race effect is the long-term result of acquired expertise, no difference between recognizing own- and other-race faces will be observed at that age. In Experiment 1, Caucasian infants were habituated to a single face. Recognition was assessed by a novelty preference paradigm. The infants' recognition performance was better for Caucasian than for Asiatic faces. In Experiment 2, Caucasian infants were familiarized with three individual faces. Recognition was demonstrated with both Caucasian and Asiatic faces. These results suggest that (i) the representation of face information by 3-month-olds may be race-experience-dependent (Experiment 1), and (ii) short-term familiarization with exemplars of another race group is sufficient to reduce the other-race effect and to extend the power of face processing (Experiment 2).

A Meta-analysis of the Association of Estimated GFR, Albuminuria, Age, Race, and Sex With Acute Kidney Injury

PubMed Central

Grams, Morgan E.; Sang, Yingying; Ballew, Shoshana H.; Gansevoort, Ron T.; Kimm, Heejin; Kovesdy, Csaba P.; Naimark, David; Oien, Cecilia; Smith, David H.; Coresh, Josef; Sarnak, Mark J.; Stengel, Benedicte; Tonelli, Marcello

2015-01-01

Background Acute kidney injury (AKI) is a serious global public health problem. We aimed to quantify the risk of AKI associated with estimated glomerular filtration rate (eGFR), albuminuria (albumin-creatinine ratio [ACR]), age, sex, and race (African American and Caucasian). Study Design Collaborative meta-analysis. Setting & Population 8 general population cohorts (1,285,049 participants) and 5 chronic kidney disease (CKD) cohorts (79,519 participants). Selection Criteria for Studies Available eGFR, ACR, and ≥50 AKI events. Predictors Age, sex, race, eGFR, urine ACR, and interactions. Outcome Hospitalized with or for AKI, using Cox proportional hazards models to estimate HRs of AKI and random effects meta-analysis to pool results. Results 16,480 (1.3%) general population cohort participants had AKI over a mean follow-up of 4 years; 2,087 (2.6%) CKD participants had AKI over mean follow-up of 1 year. Lower eGFR and higher ACR were strongly associated with AKI. Compared with eGFR 80 ml/min/1.73 m2, the adjusted HR of AKI at eGFR 45 ml/min/1.73 m2 was 3.35 (95% CI, 2.75–4.07). Compared with ACR 5 mg/g, the risk of AKI at ACR 300 mg/g was 2.73 (95% CI, 2.18–3.43). Older age was associated with higher risk of AKI, but this effect was attenuated in lower eGFR or higher ACR. Male sex was associated with higher risk of AKI, with a slight attenuation in lower eGFR but not in higher ACR. African Americans had higher AKI risk at higher levels of eGFR and most levels of ACR. Limitations Only 2 general population cohorts could contribute to analyses by race; AKI identified by diagnostic code. Conclusions Reduced eGFR and increased ACR are consistent, strong risk factors for AKI whereas the associations of AKI with age, sex, and race may be weaker in more advanced stages of CKD. PMID:25943717

A Meta-analysis of the Association of Estimated GFR, Albuminuria, Age, Race, and Sex With Acute Kidney Injury.

PubMed

Grams, Morgan E; Sang, Yingying; Ballew, Shoshana H; Gansevoort, Ron T; Kimm, Heejin; Kovesdy, Csaba P; Naimark, David; Oien, Cecilia; Smith, David H; Coresh, Josef; Sarnak, Mark J; Stengel, Benedicte; Tonelli, Marcello

2015-10-01

Acute kidney injury (AKI) is a serious global public health problem. We aimed to quantify the risk of AKI associated with estimated glomerular filtration rate (eGFR), albuminuria (albumin-creatinine ratio [ACR]), age, sex, and race (African American and white). Collaborative meta-analysis. 8 general-population cohorts (1,285,049 participants) and 5 chronic kidney disease (CKD) cohorts (79,519 participants). Available eGFR, ACR, and 50 or more AKI events. Age, sex, race, eGFR, urine ACR, and interactions. Hospitalized with or for AKI, using Cox proportional hazards models to estimate HRs of AKI and random-effects meta-analysis to pool results. 16,480 (1.3%) general-population cohort participants had AKI over a mean follow-up of 4 years; 2,087 (2.6%) CKD participants had AKI over a mean follow-up of 1 year. Lower eGFR and higher ACR were strongly associated with AKI. Compared with eGFR of 80mL/min/1.73m(2), the adjusted HR of AKI at eGFR of 45mL/min/1.73m(2) was 3.35 (95% CI, 2.75-4.07). Compared with ACR of 5mg/g, the risk of AKI at ACR of 300mg/g was 2.73 (95% CI, 2.18-3.43). Older age was associated with higher risk of AKI, but this effect was attenuated with lower eGFR or higher ACR. Male sex was associated with higher risk of AKI, with a slight attenuation in lower eGFR but not in higher ACR. African Americans had higher AKI risk at higher levels of eGFR and most levels of ACR. Only 2 general-population cohorts could contribute to analyses by race; AKI identified by diagnostic code. Reduced eGFR and increased ACR are consistent strong risk factors for AKI, whereas associations of AKI with age, sex, and race may be weaker in more advanced stages of CKD. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Impact of County-Level Socioeconomic Status on Oropharyngeal Cancer Survival in the United States.

PubMed

Megwalu, Uchechukwu C

2017-04-01

Objective To evaluate the impact of county-level socioeconomic status on survival in patients with oropharyngeal cancer in the United States. Study Design Retrospective cohort study via a large population-based cancer database. Methods Data were extracted from the SEER 18 database (Surveillance, Epidemiology, and End Results) of the National Cancer Institute. The study cohort included 18,791 patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012. Results Patients residing in counties with a low socioeconomic status index had worse overall survival (56.5% vs 63.0%, P < .001) and disease-specific survival (62.7% vs 70.3%, P < .001) than patients residing in counties with a high socioeconomic status index. On multivariable analysis, residing in a county with a low socioeconomic status index was associated with worse overall survival (hazard ratio, 1.21; 95% CI, 1.14-1.29; P < .001) and disease-specific survival (hazard ratio, 1.21; 95% CI, 1.12-1.30; P < .001), after adjusting for race, age, sex, marital status, year of diagnosis, site, American Joint Committee on Cancer stage group, presence of distant metastasis, presence of unresectable tumor, histologic grade, surgical resection of primary site, treatment with neck dissection, and radiation therapy. Conclusion Residing in a county with a low socioeconomic status index is associated with worse survival. Further research is needed to elucidate the mechanism by which socioeconomic status affects survival in oropharyngeal cancer.

Impact of socioeconomic status on survival for patients with anal cancer.

PubMed

Lin, Daniel; Gold, Heather T; Schreiber, David; Leichman, Lawrence P; Sherman, Scott E; Becker, Daniel J

2018-04-15

Although outcomes for patients with squamous cell carcinoma of the anus (SCCA) have improved, the gains in benefit may not be shared uniformly among patients of disparate socioeconomic status. In the current study, the authors investigated whether area-based median household income (MHI) is predictive of survival among patients with SCCA. Patients diagnosed with SCCA from 2004 through 2013 in the Surveillance, Epidemiology, and End Results registry were included. Socioeconomic status was defined by census-tract MHI level and divided into quintiles. Multivariable Cox proportional hazards models and logistic regression were used to study predictors of survival and radiotherapy receipt. A total of 9550 cases of SCCA were included. The median age of the patients was 58 years, 63% were female, 85% were white, and 38% were married. In multivariable analyses, patients living in areas with lower MHI were found to have worse overall survival and cancer-specific survival (CSS) compared with those in the highest income areas. Mortality hazard ratios for lowest to highest income were 1.32 (95% confidence interval [95% CI], 1.18-1.49), 1.31 (95% CI, 1.16-1.48), 1.19 (95% CI, 1.06-1.34), and 1.16 (95% CI, 1.03-1.30). The hazard ratios for CSS similarly ranged from 1.34 to 1.22 for lowest to highest income. Older age, black race, male sex, unmarried marital status, an earlier year of diagnosis, higher tumor grade, and later American Joint Committee on Cancer stage of disease also were associated with worse CSS. Income was not found to be associated with the odds of initiating radiotherapy in multivariable analysis (odds ratio of 0.87 for lowest to highest income level; 95% CI, 0.63-1.20). MHI appears to independently predict CSS and overall survival in patients with SCCA. Black race was found to remain a predictor of SCCA survival despite controlling for income. Further study is needed to understand the mechanisms by which socioeconomic inequalities affect cancer care and

The association of socio-economic position across the life course and age at menopause: the British Women's Heart and Health Study.

PubMed

Lawlor, Debbie A; Ebrahim, Shah; Smith, George Davey

2003-12-01

To assess the association of indicators of adverse socio-economic position from across the life course with age at menopause. Cross sectional study as part of the British Women's Heart and Health Study. 23 British towns. Three thousand and five hundred and thirteen women aged 60-79 years from a total cohort of 4286. Women who underwent a hysterectomy or oophorectomy prior to their 'natural' menopause or who were taking hormone replacement therapy around the perimenopausal period and for whom a biological age at menopause could not be calculated were excluded from this study. Age at menopause. Most of the 10 indicators of adverse socio-economic position from childhood through to adulthood were linearly associated with a younger age at menopause. In age adjusted analyses, women from manual social classes in childhood began their menopause on average 0.68 years (95% confidence interval [CI] 0.11, 1.3) earlier than those from non-manual social classes. Those who lived in a house as a child without a bathroom began their menopause 0.47 years (95% CI 0.12, 0.82) earlier than those with a bathroom. Those who shared a bedroom began 0.36 years (95% CI 0.03, 0.70) earlier than those who had their own bedroom and finally those who lived in a household with no access to a car as a child began their menopause 0.47 years (95% CI 0.02, 0.95) earlier than those with access to a car. Adult indicators of adverse socio-economic position were similarly associated with earlier age at menopause. Age at completing full time education was not substantively associated with age at menopause. The inverse associations between each of the indicators of both childhood and adult socio-economic position and age at menopause were not importantly affected by adjustment for other reproductive factors but they attenuated by between 6% and 21% with adjustment for adult smoking and body mass index. The inverse associations between each of the childhood indicators of socio-economic position only and age

Race, Income, and Education: Associations with Patient and Family Ratings of End-of-Life Care and Communication Provided by Physicians-in-Training

PubMed Central

Engelberg, Ruth A.; Downey, Lois; Kross, Erin K.; Reinke, Lynn F.; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W.; Back, Anthony L.; Curtis, J. Randall

2014-01-01

Abstract Background: Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. Objective: To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. Methods: As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Results: Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Conclusions: Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families. PMID:24592958

Do physicians' attitudes toward implantable cardioverter defibrillator therapy vary by patient age, gender, or race?

PubMed

Al-Khatib, Sana M; Sanders, Gillian D; O'Brien, Sean M; Matlock, Daniel; Zimmer, Louise O; Masoudi, Frederick A; Peterson, Eric

2011-01-01

Implantable cardioverter defibrillator (ICD) therapy improves survival of patients with systolic heart failure. We assessed whether physicians' recommendation for ICD therapy varies as a function of patient age, gender, race, and physician's specialty. We surveyed a random sample (n = 9969) of U.S. physicians who are active members of the American College of Cardiology (ACC). We asked participants about their likelihood to recommend ICD therapy in 4 clinical scenarios that randomly varied patient age, gender, race, and ICD indication (guideline Class I, Class IIa, Class III, and Class I in a noncompliant patient). Responses were received from 1210 physicians (response rate 12%), of whom 1127 met the study inclusion criteria. Responders and nonresponders had similar demographics. In responding to hypothetical clinical scenarios, physicians were less likely to recommend an ICD to older patients (≥80 vs 50 years) (P < 0.01) but were unaffected by gender or race for all class indications. Compared with non-electrophysiologists (EPs), EPs were significantly more likely to recommend an ICD for a Class I indication (92.4% vs 81.4%; P < 0.01), but they were not more likely to offer an ICD for a Class III indication (0.4% vs 0.6%; P = 0.95). Based on survey responses, physicians were equally willing to offer an ICD to men and women and to whites and blacks, but were less likely to offer an ICD to an older patient even when indicated by practice guidelines. Electrophysiologists (EPs) more often adhered to practice guideline recommendations on ICD therapy compared with non-EPs. ©2011, Wiley Periodicals, Inc.

Socioeconomic disparities in gait speed and associated characteristics in early old age.

PubMed

Plouvier, S; Carton, M; Cyr, D; Sabia, S; Leclerc, A; Zins, M; Descatha, A

2016-04-23

A few studies have documented associations between socioeconomic position and gait speed, but the knowledge about factors from various domains (personal factors, lifestyle, occupation…) which contribute to these disparities is limited. Our objective was to assess socioeconomic disparities in usual gait speed in a general population in early old age in France, and to identify potential contributors to the observed disparities, including occupational factors. The study population comprised 397 men and 339 women, aged 55 to 69, recruited throughout France for the field pilot of the CONSTANCES cohort. Gait speed was measured in meters/second. Socioeconomic position was based on self-reported occupational class. Information on personal characteristics, lifestyle, comorbidities and past or current occupational physical exposure came either from the health examination, from interview or from self-administered questionnaire. Four groups were considered according to sex-specific distributions of speed (the two slowest thirds versus the fastest third, for each gender). Logistic regression models adjusted for health screening center and age allowed to the study of cross-sectional associations between: 1- slower speed and occupational class; 2- slower speed and each potential contributor; 3- occupational class and selected potential contributors. The association between speed and occupational class was then further adjusted for the factors significantly associated both with speed and occupational class, in order to assess the potential contribution of these factors to disparities. With reference to managers/executives, gait speed was reduced in less skilled categories among men (OR 1.21 [0.72-2.05] for Intermediate/Tradesmen, 1.95 [0.80-4.76] for Clerks, Sale/service workers, 2.09 [1.14-3.82] for Blue collar/Craftsmen) and among women (OR 1.12 [0.55-2.28] for Intermediate/Tradesmen, 2.33 [1.09-4.97] for Clerks, 2.48 [1.18-5.24] for Sale/service workers/Blue collar

Socioeconomic status and overweight prevalence in polish adolescents: the impact of single factors and a complex index of socioeconomic status in respect to age and sex.

PubMed

Kowalkowska, Joanna; Wadolowska, Lidia; Weronika Wuenstel, Justyna; Słowińska, Małgorzata Anna; Niedźwiedzka, Ewa

2014-07-01

The aim of this study was to analyze the association between overweight prevalence and socioeconomic status (SES) measured by complex SES index and single SES factors in Polish adolescents in respect to age and sex. This cross-sectional study was conducted in 2010-2011. A total of 1,176 adolescents aged 13.0-18.9 years were included. The respondents were students of junior-high and high schools from northern, eastern and central Poland. Quota sampling by sex and age was used. The SES was determined by: place of residence, self-declared economic situation, and parental education level. Respondents with low, average or high SES index (SESI) were identified. The level of overweight was assessed using Polish and international standards. The odds ratio (OR) for overweight prevalence in the oldest girls (aged 17.0-18.9 years) with high SESI was 0.34 (95%CI:0.13-0.92; P < 0.05) by Polish standards and 0.22 (95%CI:0.05-0.95; P < 0.05) by international standards, in comparison to the reference group (low SESI). In total girls who had mothers with higher education level, the OR adjusted for age was 0.44 (95%CI:0.21-0.90; P <0.05) by Polish standards and 0.35 (95%CI:0.15-0.81; P < 0.05) by international standards, in comparison to the reference group (maternal elementary education). The other single SES factors were not significant for overweight prevalence. The relationship between socioeconomic status and prevalence of overweight was related to sex and age. The high socioeconomic status strongly lowered the risk of overweight prevalence in the oldest girls, but not in boys, irrespective of age. Maternal education level lowered risk of overweight prevalence in girls.

Socioeconomic Status and Overweight Prevalence in Polish Adolescents: The Impact of Single Factors and a Complex Index of Socioeconomic Status in Respect to Age and Sex

PubMed Central

KOWALKOWSKA, Joanna; WADOLOWSKA, Lidia; WERONIKA WUENSTEL, Justyna; SŁOWIŃSKA, Małgorzata Anna; NIEDŹWIEDZKA, Ewa

2014-01-01

Abstract Background The aim of this study was to analyze the association between overweight prevalence and socioeconomic status (SES) measured by complex SES index and single SES factors in Polish adolescents in respect to age and sex. Methods This cross-sectional study was conducted in 2010-2011. A total of 1,176 adolescents aged 13.0-18.9 years were included. The respondents were students of junior-high and high schools from northern, eastern and central Poland. Quota sampling by sex and age was used. The SES was determined by: place of residence, self-declared economic situation, and parental education level. Respondents with low, average or high SES index (SESI) were identified. The level of overweight was assessed using Polish and international standards. Results The odds ratio (OR) for overweight prevalence in the oldest girls (aged 17.0-18.9 years) with high SESI was 0.34 (95%CI:0.13-0.92; P < 0.05) by Polish standards and 0.22 (95%CI:0.05-0.95; P < 0.05) by international standards, in comparison to the reference group (low SESI). In total girls who had mothers with higher education level, the OR adjusted for age was 0.44 (95%CI:0.21-0.90; P <0.05) by Polish standards and 0.35 (95%CI:0.15-0.81; P < 0.05) by international standards, in comparison to the reference group (maternal elementary education). The other single SES factors were not significant for overweight prevalence Conclusions The relationship between socioeconomic status and prevalence of overweight was related to sex and age. The high socioeconomic status strongly lowered the risk of overweight prevalence in the oldest girls, but not in boys, irrespective of age. Maternal education level lowered risk of overweight prevalence in girls. PMID:25909059

The influence of sex, race, and age on pain assessment and treatment decisions using virtual human technology: a cross-national comparison.

PubMed

Torres, Calia A; Bartley, Emily J; Wandner, Laura D; Alqudah, Ashraf F; Hirsh, Adam T; Robinson, Michael E

2013-01-01

Studies in the United States have found that patients' sex, race, and age influence the pain assessment and treatment decisions of laypeople and medical professionals. However, there is limited research as to whether people of other nationalities make pain management decisions differently based on demographic characteristics. Therefore, the purpose of the following study was to compare pain assessment and treatment decisions of undergraduate students in Jordan and the United States as a preliminary examination of nationality as a potential proxy for cultural differences in pain decisions. Virtual human (VH) technology was used to examine the influences of patients' sex (male or female), race (light-skinned or dark-skinned), and age (younger or older) on students' pain management decisions. Seventy-five American and 104 Jordanian undergraduate students participated in this web-based study. American and Jordanian students rated pain intensity higher in females and older adults and were more likely to recommend medical help to these groups, relative to males and younger adults. Furthermore, Jordanian participants rated pain intensity higher and were more likely to recommend medical help for all patient demographic groups (ie, sex, race, age) than American participants. This is the first cross-national study that compares pain decisions between undergraduate students. The results suggest that sex, race, and age cues are used in pain assessment and treatment by both Americans and Jordanians, with Jordanians more likely to rate pain higher and recommend medical help to patients. Additional research is needed to determine the cultural determinants of these differences.

The Effects of Prediction on the Perception for Own-Race and Other-Race Faces

PubMed Central

Ran, Guangming; Zhang, Qi; Chen, Xu; Pan, Yangu

2014-01-01

Human beings do not passively perceive important social features about others such as race and age in social interactions. Instead, it is proposed that humans might continuously generate predictions about these social features based on prior similar experiences. Pre-awareness of racial information conveyed by others' faces enables individuals to act in “culturally appropriate” ways, which is useful for interpersonal relations in different ethnicity groups. However, little is known about the effects of prediction on the perception for own-race and other-race faces. Here, we addressed this issue using high temporal resolution event-related potential techniques. In total, data from 24 participants (13 women and 11 men) were analyzed. It was found that the N170 amplitudes elicited by other-race faces, but not own-race faces, were significantly smaller in the predictable condition compared to the unpredictable condition, reflecting a switch to holistic processing of other-race faces when those faces were predictable. In this respect, top-down prediction about face race might contribute to the elimination of the other-race effect (one face recognition impairment). Furthermore, smaller P300 amplitudes were observed for the predictable than for unpredictable conditions, which suggested that the prediction of race reduced the neural responses of human brains. PMID:25422892

Decomposing race and gender differences in underweight and obesity in South Africa.

PubMed

Averett, Susan L; Stacey, Nicholas; Wang, Yang

2014-12-01

Using data from the National Income Dynamics Study, we document differentials in both underweight and obesity across race and gender in post-Apartheid South Africa. Using a nonlinear decomposition method, we decompose these differences across gender within race and then across race within gender. Less than one third of the differences in obesity and underweight across gender are explained by differences in covariates. In contrast, at least 70% of the obesity differences across race are explained by differences in covariates. Behavioral variables such as smoking and exercise explain the largest part of the bodyweight differentials across gender. For bodyweight differentials across race within gender, however, socioeconomic status and background variables have the largest explanatory power for obesity differentials, while background variables play the key role in explaining the underweight differentials. These results indicate that eradicating obesity and underweight differentials will require targeting policies to specific groups. Copyright © 2014 Elsevier B.V. All rights reserved.

Race Differences in the Association of Spiritual Experiences and Life Satisfaction in Older Age

PubMed Central

Skarupski, Kimberly A.; Fitchett, George; Evans, Denis A.; de Leon, Carlos F. Mendes

2013-01-01

Objectives The primary objective of this study was to examine an African American ‘faith advantage’ in life satisfaction. Specifically, we sought to test the hypothesis that the positive relationship between spiritual experiences and life satisfaction is stronger among older African Americans than among older Whites. Method The data came from 6,864 community-dwelling persons aged 65+ (66% African American) who participated in the Chicago Health and Aging Project. Life satisfaction was measured using a five-item composite and we used a five-item version of the Daily Spiritual Experiences scale. Results In a regression model adjusting for age, sex, marital status, education, income, and worship attendance, we found that African American race was associated with lower life satisfaction. We also found a positive association between spiritual experiences and life satisfaction. In an additional model, a significant race × spiritual experiences interaction term indicates that spiritual experiences are more positively associated with life satisfaction among African Americans. Conclusion The data suggest that at higher levels of spiritual experiences, racial differences in life satisfaction are virtually non-existent. However, at lower levels of spiritual experiences, older African Americans show modestly lower levels of life satisfaction than do older Whites. This pattern suggests that spiritual experiences are a positive resource - distinct from worship attendance- that enable older African Americans to overcome decrements in life satisfaction and in fact, that lower spiritual experiences may be especially harmful for older African American’s life satisfaction. PMID:23627686

Age, Ethnicity, and Socioeconomic Factors Impacting Infant and Toddler Fall-Related Trauma.

PubMed

Shimony-Kanat, Sarit; Benbenishty, Julie

2016-10-04

To characterize trauma-related falls in infants and toddlers aged 0 to 3 years over a 4-year period and develop a risk stratification model of causes of fall injuries. Data on falls of 0 to 3 year olds from 2009 to 2012 were identified from a Jerusalem tertiary hospital trauma registry (N = 422) and the National Trauma Registry of Israel (N = 4,131). Almost half of falls occurred during the first year of life, and 57% of the children were Jewish. The majority of the children lived in low socioeconomic environments, both in the Jewish (59.2%) and Arab (97.6%) samples. Most (74%) of the falls resulted in head injury. A classification and regression tree analysis indicated that falls from furniture were the leading cause of injury in 0 to 12 month olds (estimated probability of 37.9%), whereas slipping is the leading cause in 13 to 36 month olds (estimated probability of 38.4%). Age and ethnicity emerged as the leading predictors of the nature of a fall; Injury Severity Score and the child's sex were secondary. Compared with the national data, Jerusalem children had a higher incidence of falls from buildings (9.3%; 2.4%), a higher moderate-severe Injury Severity Score (>16), a higher incidence of traumatic brain injury, and a longer hospital length of stay (P < 0.001). The leading determinants of fall injuries in children below the age of 3 years are age, ethnicity, and low socioeconomic status. Future outreach community interventions should target these risk groups and be tailored to their defining characteristics.

Racial/Ethnic, socioeconomic, and geographic disparities of cervical cancer advanced-stage diagnosis in Texas.

PubMed

Zhan, F Benjamin; Lin, Yan

2014-01-01

Advanced-stage diagnosis is among the primary causes of mortality among cervical cancer patients. With the wide use of Pap smear screening, cervical cancer advanced-stage diagnosis rates have decreased. However, disparities of advanced-stage diagnosis persist among different population groups. A challenging task in cervical cancer disparity reduction is to identify where underserved population groups are. Based on cervical cancer incidence data between 1995 and 2008, this study investigated advanced-stage cervical cancer disparities in Texas from three social domains: Race/ethnicity, socioeconomic status (SES), and geographic location. Effects of individual and contextual factors, including age, tumor grade, race/ethnicity, as well as contextual SES, spatial access to health care, sociocultural factors, percentage of African Americans, and insurance expenditures, on these disparities were examined using multilevel logistic regressions. Significant variations by race/ethnicity and SES were found in cervical cancer advanced-stage diagnosis. We also found a decline in racial/ethnic disparities of advanced cervical cancer diagnosis rate from 1995 to 2008. However, the progress was slower among African Americans than Hispanics. Geographic disparities could be explained by age, race/ethnicity, SES, and the percentage of African Americans in a census tract. Our findings have important implications for developing effective cervical cancer screening and control programs. We identified the location of underserved populations who need the most assistance with cervical cancer screening. Cervical cancer intervention programs should target Hispanics and African Americans, as well as individuals from communities with lower SES in geographic areas where higher advanced-stage diagnosis rates were identified in this study. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Gender-, age-, and race/ethnicity-based differential item functioning analysis of the movement disorder society-sponsored revision of the Unified Parkinson's disease rating scale.

PubMed

Goetz, Christopher G; Liu, Yuanyuan; Stebbins, Glenn T; Wang, Lu; Tilley, Barbara C; Teresi, Jeanne A; Merkitch, Douglas; Luo, Sheng

2016-12-01

Assess MDS-UPDRS items for gender-, age-, and race/ethnicity-based differential item functioning. Assessing differential item functioning is a core rating scale validation step. For the MDS-UPDRS, differential item functioning occurs if item-score probability among people with similar levels of parkinsonism differ according to selected covariates (gender, age, race/ethnicity). If the magnitude of differential item functioning is clinically relevant, item-score interpretation must consider influences by these covariates. Differential item functioning can be nonuniform (covariate variably influences an item-score across different levels of parkinsonism) or uniform (covariate influences an item-score consistently over all levels of parkinsonism). Using the MDS-UPDRS translation database of more than 5,000 PD patients from 14 languages, we tested gender-, age-, and race/ethnicity-based differential item functioning. To designate an item as having clinically relevant differential item functioning, we required statistical confirmation by 2 independent methods, along with a McFadden pseudo-R 2 magnitude statistic greater than "negligible." Most items showed no gender-, age- or race/ethnicity-based differential item functioning. When differential item functioning was identified, the magnitude statistic was always in the "negligible" range, and the scale-level impact was minimal. The absence of clinically relevant differential item functioning across all items and all parts of the MDS-UPDRS is strong evidence that the scale can be used confidently. As studies of Parkinson's disease increasingly involve multinational efforts and the MDS-UPDRS has several validated non-English translations, the findings support the scale's broad applicability in populations with varying gender, age, and race/ethnicity distributions. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

Physical Disability Trajectories in Older Americans with and without Diabetes: The Role of Age, Gender, Race or Ethnicity, and Education

ERIC Educational Resources Information Center

Chiu, Ching-Ju; Wray, Linda A.

2011-01-01

Purpose: This research combined cross-sectional and longitudinal data to characterize age-related trajectories in physical disability for adults with and without diabetes in the United States and to investigate if those patterns differ by age, gender, race or ethnicity, and education. Design and Methods: Data were examined on 20,433 adults aged 51…

Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race.

PubMed

Stepanikova, Irena; Oates, Gabriela R

2017-01-01

This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). The sample consisted of white, black, and Native American respondents to the Behavioral Risk Factor Surveillance System (2005-2013) who had sought health care in the past 12 months. Multiple logistic regression models of perceived racial privilege and perceived discrimination were estimated. Analyses were performed in 2016. Perceptions of racial privilege were less common among blacks and Native Americans compared with whites, while perceptions of racial discrimination were more common among these minorities. In whites, higher income and education contributed to increased perceptions of privileged treatment and decreased perceptions of discrimination. The pattern was reversed in blacks, who reported more discrimination and less privilege at higher income and education levels. Across racial groups, respondents who reported foregone medical care due to cost had higher risk of perceived racial discrimination. Health insurance contributed to less perceived racial discrimination and more perceived privilege only among whites. SES is an important social determinant of perceived privilege and perceived discrimination in health care, but its role varies by indicator and racial group. Whites with low education or no health insurance, well-educated blacks, and individuals who face cost-related barriers to care are at increased risk of perceived discrimination. Policies and interventions to reduce these perceptions should target structural and systemic factors, including society-wide inequalities in income, education, and healthcare access, and should be tailored to account for racially specific healthcare experiences. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Socioeconomic factors are associated with frequency of repeat emergency department visits for closed pediatric fractures

PubMed Central

Dy, Christopher J.; Lyman, Stephen; Do, Huong T.; Fabricant, Peter D.; Marx, Robert G.; Green, Daniel W.

2014-01-01

Background Previous research has demonstrated both greater difficulty in obtaining follow-up appointments and increased likelihood of return visits to the emergency department (ED) for patients with government-funded insurance plans. The purpose of the current study is to determine whether socioeconomic factors, such as race and insurance type, are associated with the frequency of repeat ED visits in pediatric patients with closed fractures. Methods A review of ED visit data over a 2-year period from a statewide hospital discharge database in New York was conducted. Discharges for patients with a unique person identifier in the database age 17 and younger were examined for an ICD-9 diagnosis of closed upper or lower extremity fracture. Age, sex, race, and insurance type for patients with a return ED visit within 8 weeks for the same fracture diagnosis were compared to those without a return visit using standard univariate statistical tests and logistic regression analyses. Results Of the 68,236 visits reviewed, the revisit rate was 0.85%. Patients of non-white or unidentified race were significantly more likely to have a revisit than white patients (OR 1.27; p=0.006). Patients with government-funded insurance were significantly more likely to have a revisit than those without government-funded insurance (OR 1.55; p<0.001). Patients with private insurance were significantly less likely to have a revisit than those without private insurance (OR 0.72; p=0.001). Conclusions Our analysis revealed that non-white patients are more likely to return to the ED within 8 weeks for the same fracture diagnosis. Patients with government insurance are 55% more likely to have a revisit, while patients with private insurance are 28% less likely to have a revisit. Our results suggest that socioeconomic disparities exist in access to orthopaedic care for closed fractures in a pediatric population. Physicians and policy makers should be mindful of these health care disparities when

Career Aspirations of Youth: Untangling Race/Ethnicity, SES, and Gender

ERIC Educational Resources Information Center

Howard, Kimberly A. S.; Carlstrom, Aaron H.; Katz, Andrew D.; Chew, Aaronson Y.; Ray, G. Christopher; Laine, Lia; Caulum, David

2011-01-01

This study examined the influence of gender, socioeconomic status, and race/ethnicity on the career aspirations of over 22,000 8th and 10th grade youth. The top five occupations identified by youth as aspirations included artist, lawyer, musician, FBI agent, and actor/actress. Top occupations were also reported for each gender x socioeconomic…

The impact of age at diagnosis on socioeconomic inequalities in adult cancer survival in England.

PubMed

Nur, Ula; Lyratzopoulos, Georgios; Rachet, Bernard; Coleman, Michel P

2015-08-01

Understanding the age at which persistent socioeconomic inequalities in cancer survival become apparent may help motivate and support targeting of cancer site-specific interventions, and tailoring guidelines to patients at higher risk. We analysed data on more than 40,000 patients diagnosed in England with one of three common cancers in men and women, breast, colon and lung, 2001-2005 with follow-up to the end of 2011. We estimated net survival for each of the five deprivation categories (affluent, 2, 3, 4, deprived), cancer site, sex and age group (15-44, 45-54, 55-64, and 65-74 and 75-99 years). The magnitude and pattern of the age specific socioeconomic inequalities in survival was different for breast, colon and lung. For breast cancer the deprivation gap in 1-year survival widened with increasing age at diagnosis, whereas the opposite was true for lung cancer, with colon cancer having an intermediate pattern. The 'deprivation gap' in 1-year breast cancer survival widened steadily from -0.8% for women diagnosed at 15-44 years to -4.8% for women diagnosed at 75-99 years, and was the widest for women diagnosed at 65-74 years for 5- and 10-year survival. For colon cancer in men, the gap was widest in patients diagnosed aged 55-64 for 1-, 5- and 10-year survival. For lung cancer, the 'deprivation gap' in survival in patients diagnoses aged 15-44 years was more than 10% for 1-year survival in men and for 1- and 5-year survival in women. Our findings suggest that reduction of socioeconomic inequalities in survival will require updating of current guidelines to ensure the availability of optimal treatment and appropriate management of lung cancer patients in all age groups and older patients in deprived groups with breast or colon cancer. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

A Connected Generation? Digital Inequalities in Elementary and High School Students According to Age and Socioeconomic Level

ERIC Educational Resources Information Center

Collin, Simon; Karsenti, Thierry; Ndimubandi, Alexis; Saffari, Hamid

2016-01-01

The objective of this article was to better understand the relationship between students' age and socioeconomic level, and its influence on students' digital uses. We conducted a quantitative study of 401 elementary and high school students in Quebec. Four independent variables were initially selected: two related to age (actual age and education…

Socioeconomic and Physician Supply Determinants of Racial Disparities in Colorectal Cancer Screening

PubMed Central

Soneji, Samir; Armstrong, Katrina; Asch, David A.

2012-01-01

Purpose: Causes of racial disparities in colorectal cancer (CRC) screening may extend beyond individual-level characteristics. We examined how physician density, beyond socioeconomic factors, affected observed racial disadvantages in recent CRC screening for blacks and Hispanics. Methods: We obtained socioeconomic and CRC screening information on adults age ≥ 50 years from the Behavioral Risk Factor Surveillance System (1997 to 2008) and information on the number of primary care physicians and gastroenterologists from the American Medical Association Masterfile (1997 to 2008). We used fixed-effect multivariate logistic regression to model the probability of receiving a fecal occult blood test within the past year or endoscopic screening within the past 5 years as a function of individual-level socioeconomic factors and state-level physician supply. Results: In 2008, 60.6% of whites were current on CRC screening (95% CI, 60.6% to 61.0%) compared with 57.9% of blacks (95% CI, 56.7% to 59.2%) and 42.9% of Hispanics (95% CI, 41.0% to 44.8%). Inclusion of socioeconomic variables reversed black-white disparities (odds ratio [OR], 1.17; 95% CI, 1.15 to 1.19) but did not explain disadvantage for Hispanics (OR, 0.89; 95% CI, 0.87 to 0.92). Once interaction of race and physician supply was considered, likelihood of recent CRC screening became statistically indistinguishable for Hispanics and whites of similar socioeconomic status residing in states with high physician supplies. Conclusion: Socioeconomic factors and physician supply are key predictors of CRC screening. Adjustment for socioeconomic determinants explained black-white disparities; further adjustment for physician supply explained Hispanic-white disparities. Physician distribution is a potentially remediable contributor to ethnic/racial disparities in CRC screening. Whether the United States is able to equitably meet future demand for screening may depend on access, physician supply, and organization of the

Socioeconomic and physician supply determinants of racial disparities in colorectal cancer screening.

PubMed

Soneji, Samir; Armstrong, Katrina; Asch, David A

2012-09-01

Causes of racial disparities in colorectal cancer (CRC) screening may extend beyond individual-level characteristics. We examined how physician density, beyond socioeconomic factors, affected observed racial disadvantages in recent CRC screening for blacks and Hispanics. We obtained socioeconomic and CRC screening information on adults age ≥ 50 years from the Behavioral Risk Factor Surveillance System (1997 to 2008) and information on the number of primary care physicians and gastroenterologists from the American Medical Association Masterfile (1997 to 2008). We used fixed-effect multivariate logistic regression to model the probability of receiving a fecal occult blood test within the past year or endoscopic screening within the past 5 years as a function of individual-level socioeconomic factors and state-level physician supply. In 2008, 60.6% of whites were current on CRC screening (95% CI, 60.6% to 61.0%) compared with 57.9% of blacks (95% CI, 56.7% to 59.2%) and 42.9% of Hispanics (95% CI, 41.0% to 44.8%). Inclusion of socioeconomic variables reversed black-white disparities (odds ratio [OR], 1.17; 95% CI, 1.15 to 1.19) but did not explain disadvantage for Hispanics (OR, 0.89; 95% CI, 0.87 to 0.92). Once interaction of race and physician supply was considered, likelihood of recent CRC screening became statistically indistinguishable for Hispanics and whites of similar socioeconomic status residing in states with high physician supplies. Socioeconomic factors and physician supply are key predictors of CRC screening. Adjustment for socioeconomic determinants explained black-white disparities; further adjustment for physician supply explained Hispanic-white disparities. Physician distribution is a potentially remediable contributor to ethnic/racial disparities in CRC screening. Whether the United States is able to equitably meet future demand for screening may depend on access, physician supply, and organization of the health care system.

Can social policy influence socioeconomic disparities? Korean War GI Bill eligibility and markers of depression.

PubMed

Vable, Anusha M; Canning, David; Glymour, M Maria; Kawachi, Ichiro; Jimenez, Marcia P; Subramanian, Subu V

2016-02-01

The Korean War GI Bill provided socioeconomic benefits to veterans; however, its association with health is unclear; we hypothesize GI Bill eligibility is associated with fewer depressive symptoms and smaller disparities. Data from 246 Korean War GI Bill eligible veterans and 240 nonveterans from the Health and Retirement Study were matched on birth year, southern birth, race, height, and childhood health using coarsened exact matching. Number of depressive symptoms in 2010 (average age = 78 years) was assessed using a modified, validated Center for Epidemiologic Studies-Depression Scale, dichotomized to reflect elevated depressive symptoms. Regression analyses were stratified into low (at least one parent < 8 years schooling/missing data, n = 167) or high (both parents ≥ 8 years schooling, n = 319) childhood socioeconomic status (cSES) groups. Korean War GI Bill eligibility predicted fewer depressive symptoms among individuals from low cSES backgrounds [β = -0.64, 95% confidence interval (CI) = (-1.18, -0.09), P = .022]. Socioeconomic disparities were smaller among veterans than nonveterans for number of depressive symptoms [β = -0.76, 95% CI = (-1.33, -0.18), P = .010] and elevated depressive symptoms [β = -11.7, 95% CI = (-8.2, -22.6), P = .035]. Korean War GI Bill eligibility predicted smaller socioeconomic disparities in depression markers. Copyright © 2016 Elsevier Inc. All rights reserved.

Biometric gonioscopy and the effects of age, race, and sex on the anterior chamber angle

PubMed Central

Congdon, N G; Foster, P J; Wamsley, S; Gutmark, J; Nolan, W; Seah, S K; Johnson, G J; Broman, A T

2002-01-01

Aim: To utilise a novel method for making measurements in the anterior chamber in order to compare the anterior chamber angles of people of European, African, and east Asian descent aged 40 years and over. Methods: A cross sectional study on 15 people of each sex from each decade from the 40s to the 70s, from each of three racial groups—black, white, and Chinese Singaporeans. Biometric gonioscopy (BG) utilises a slit lamp mounted reticule to make measurements from the apparent iris insertion to Schwalbe's line through a Goldmann one mirror goniolens. The main outcome measures were BG measurements of the anterior chamber angle as detailed above. Results: There was no significant difference in angle measurement between black, white, and Chinese races in this study. However, at younger ages people of Chinese race appeared to have deeper angles than white or black people, whereas the angles of older Chinese were significantly narrower (p = 0.004 for the difference in slope of BG by age between Chinese and both black and white people). Conclusion: The failure to detect a difference in angle measurements between these groups was surprising, given the much higher prevalence of angle closure among Chinese. It appears that the overall apparent similarity of BG means between Chinese and Western populations may mask very different trends with age. The apparently more rapid decline in angle width measurements with age among Chinese may be due to the higher prevalence of cataract or “creeping angle closure.” However, longitudinal inferences from cross sectional data are problematic, and this may represent a cohort phenomenon caused by the increasing prevalence of myopia in the younger Singaporean population. PMID:11801496

Health care expenditures associated with overweight and obesity among US adults: importance of age and race.

PubMed

Wee, Christina C; Phillips, Russell S; Legedza, Anna T R; Davis, Roger B; Soukup, Jane R; Colditz, Graham A; Hamel, Mary Beth

2005-01-01

We estimated health care expenditures associated with overweight and obesity and examined the influence of age, race, and gender. Using 1998 Medical Expenditure Panel Survey data, we employed 2-stage modeling to estimate annual health care expenditures associated with high body mass index (BMI) and examine interactions between demographic factors and BMI. Overall, the mean per capita annual health care expenditure (converted to December 2003 dollars) was $3338 before adjustment. While the adjusted expenditure was $2127 (90% confidence interval [CI]=$1927, $2362) for a typical normal-weight White woman aged 35 to 44 years, expenditures were $2358 (90% CI=$2128, $2604) for women with BMIs of 25 to 29.9 kg/m(2), $2873 (90% CI=$2530, $3236) for women with BMIs of 30 to 34.9 kg/m(2), $3058 (90% CI=$2529, $3630) for women with BMIs of 35 to 39.9 kg/m(2), and $3506 (90% CI=$2912, $4228) for women with BMIs of 40 kg/m(2) or higher. Expenditures related to higher BMI rose dramatically among White and older adults but not among Blacks or those younger than 35 years. We found no interaction between BMI and gender. Health care costs associated with overweight and obesity are substantial and vary according to race and age.

Attractiveness of own-race, other-race, and mixed-race faces.

PubMed

Rhodes, Gillian; Lee, Kieran; Palermo, Romina; Weiss, Mahi; Yoshikawa, Sakiko; Clissa, Peter; Williams, Tamsyn; Peters, Marianne; Winkler, Chris; Jeffery, Linda

2005-01-01

Averaged face composites, which represent the central tendency of a familiar population of faces, are attractive. If this prototypicality contributes to their appeal, then averaged composites should be more attractive when their component faces come from a familiar, own-race population than when they come from a less familiar, other-race population. We compared the attractiveness of own-race composites, other-race composites, and mixed-race composites (where the component faces were from both races). In experiment 1, Caucasian participants rated own-race composites as more attractive than other-race composites, but only for male faces. However, mixed-race (Caucasian/Japanese) composites were significantly more attractive than own-race composites, particularly for the opposite sex. In experiment 2, Caucasian and Japanese participants living in Australia and Japan, respectively, selected the most attractive face from a continuum with exaggerated Caucasian characteristics at one end and exaggerated Japanese characteristics at the other, with intervening images including a Caucasian averaged composite, a mixed-race averaged composite, and a Japanese averaged composite. The most attractive face was, again, a mixed-race composite, for both Caucasian and Japanese participants. In experiment 3, Caucasian participants rated individual Eurasian faces as significantly more attractive than either Caucasian or Asian faces. Similar results were obtained with composites. Eurasian faces and composites were also rated as healthier than Caucasian or Asian faces and composites, respectively. These results suggest that signs of health may be more important than prototypicality in making average faces attractive.

Socioeconomic position, psychosocial work environment and disability in an ageing workforce: a longitudinal analysis of SHARE data from 11 European countries.

PubMed

Reinhardt, Jan D; Wahrendorf, Morten; Siegrist, Johannes

2013-03-01

Prevention of disability in the ageing workforce is essential for sustaining economic growth in Europe. In order to provide information on entry points for preventive measures, it is important to better understand sociodemographic, socioeconomic and work-related determinants of disability in older employees. We aimed to test the hypothesis that low socioeconomic position and exposure to a stressful psychosocial work environment at baseline contribute to later disability. We further assumed that the association of socioeconomic position with disability is partly mediated by exposure to adverse working conditions. We studied longitudinal data from the first two waves of the Survey on Health, Ageing and Retirement in Europe comprising 11 European countries. Sociodemographic, socioeconomic and work-related factors (low control, effort-reward imbalance) and baseline disability of 2665 male and 2209 female employees aged between 50 and 64 years were used to predict disability 2 years later. Following the International Classification of Functioning (ICF), disability was subdivided into the components 'impairment' and 'restriction in activities and participation'. Two multilevel Poisson regressions were fitted to the data. After adjusting for baseline disability and relevant confounding variables, low socioeconomic position and chronic stress at work exerted significant effects on disability scores 2 years later. We found some support for the hypothesis that the association of socioeconomic position with disability is partly mediated by work stress. Investing in reduction of work stress and reducing social inequalities in health functioning are relevant entry points of policies that aim at maintaining work ability in early old age.

Lower Neighborhood Socioeconomic Status Associated with Reduced Diversity of the Colonic Microbiota in Healthy Adults.

PubMed

Miller, Gregory E; Engen, Phillip A; Gillevet, Patrick M; Shaikh, Maliha; Sikaroodi, Masoumeh; Forsyth, Christopher B; Mutlu, Ece; Keshavarzian, Ali

2016-01-01

In the United States, there are persistent and widening socioeconomic gaps in morbidity and mortality from chronic diseases. Although most disparities research focuses on person-level socioeconomic-status, mounting evidence suggest that chronic diseases also pattern by the demographic characteristics of neighborhoods. Yet the biological mechanisms underlying these associations are poorly understood. There is increasing recognition that chronic diseases share common pathogenic features, some of which involve alterations in the composition, diversity, and functioning of the gut microbiota. This study examined whether socioeconomic-status was associated with alpha-diversity of the colonic microbiota. Forty-four healthy adults underwent un-prepped sigmoidoscopy, during which mucosal biopsies and fecal samples were collected. Subjects' zip codes were geocoded, and census data was used to form a composite indicator of neighborhood socioeconomic-status, reflecting household income, educational attainment, employment status, and home value. In unadjusted analyses, neighborhood socioeconomic-status explained 12-18 percent of the variability in alpha-diversity of colonic microbiota. The direction of these associations was positive, meaning that as neighborhood socioeconomic-status increased, so did alpha-diversity of both the colonic sigmoid mucosa and fecal microbiota. The strength of these associations persisted when models were expanded to include covariates reflecting potential demographic (age, gender, race/ethnicity) and lifestyle (adiposity, alcohol use, smoking) confounds. In these models neighborhood socioeconomic-status continued to explain 11-22 percent of the variability in diversity indicators. Further analyses suggested these patterns reflected socioeconomic variations in evenness, but not richness, of microbial communities residing in the sigmoid. We also found indications that residence in neighborhoods of higher socioeconomic-status was associated with a

Race and health in Guyana: an empirical assessment from survey data.

PubMed

Wilson, Leon C; Wilson, Colwick M; Johnson, Bridgette M

2010-01-01

This paper examines racial differences in physical health and mental well-being in Guyana, South America: a country with cultural ties to the Caribbean. It explores the complex relationship among race, socioeconomic status and health outcomes which in developed societies continues to be of significant research interest. Utilizing a random probability sample of over 900 adults, the analyses provide information on the general physical and mental health status of this population and examine the differences by racial groups when other factors are controlled. The results indicate significant age-specific racial differences in physical and mental health in Guyana. Higher rates of diabetes, arthritis or rheumatism, back and breathing problems among Indo-Guyanese when compared to other groups were noted. Racial differences in physical health were attenuated when gender and educational levels were controlled.

Beyond education and income: Identifying novel socioeconomic correlates of cigarette use in U.S. young adults.

PubMed

Villanti, Andrea C; Johnson, Amanda L; Rath, Jessica M

2017-11-01

Young adulthood is defined by transitions in family life, living situations, educational settings, and employment. As a result, education and income may not be appropriate measures of socioeconomic status (SES) in young people. Using a national sample of young adults aged 18-34 (n=3364; collected February 2016), we explored novel socioeconomic correlates of ever cigarette use, past 30-day cigarette use, and daily cigarette use, weighted to account for non-response. Measures of SES assessed current education, household income, employment status, and subjective financial situation (SFS) and childhood SES (maternal and paternal education, SFS during childhood, parental divorce before age 18). Parental smoking during childhood was examined in sensitivity analyses. The highest prevalence of ever cigarette use was in young adults whose parents divorced before age 18 (57% vs. 47% overall). In general, current education, subjective financial status, and parental education were inversely correlated with past 30-day and daily cigarette use in bivariate analyses. In multivariable Poisson regression models controlling for age, gender, race/ethnicity, and other SES measures, lower education and poorer SFS were most strongly correlated with ever and past 30-day cigarette use. Lower maternal education emerged as the strongest correlate of daily smoking, conferring a twofold higher prevalence of daily smoking compared to maternal education of a Bachelor's degree or greater. Current household income was not a strong predictor of any cigarette use outcome. Novel measures like SFS may improve estimates of socioeconomic disadvantage during this developmental stage. Copyright © 2017. Published by Elsevier Inc.

Umbilical cord blood bilirubins, gestational age, and maternal race predict neonatal hyperbilirubinemia.

PubMed

Castillo, Adrian; Grogan, Tristan R; Wegrzyn, Grace H; Ly, Karrie V; Walker, Valencia P; Calkins, Kara L

2018-01-01

No validated biomarker at birth exists to predict which newborns will develop severe hyperbilirubinemia. This study's primary aim was to build and validate a prediction model for severe hyperbilirubinemia using umbilical cord blood bilirubins (CBB) and risk factors at birth in neonates at risk for maternal-fetal blood group incompatibility. This study's secondary aim was to compare the accuracy of CBB to the direct antigen titer. Inclusion criteria for this prospective cohort study included: ≥35 weeks gestational age, mother with blood type O and/or Rh negative or positive antibody screen, and <24 hours of age. The primary outcome was severe hyperbilirubinemia, defined as phototherapy during the initial hospital stay. Secondary outcomes were a total serum bilirubin concentration >95th and >75th percentile during the initial hospital stay. The predictive performance and accuracy of the two tests (CBB and direct antigen titer) for each outcome was assessed using area under a receiver-operating characteristic curve (AUC), sensitivity, and specificity. When compared to neonates who did not receive phototherapy (n = 463), neonates who received phototherapy (n = 36) had a greater mean CBB ± standard deviation (2.5 ± 0.7 vs. 1.6 ± 0.4 mg/dL, p<0.001). For every 0.3 mg/dL increase in CBB, a neonate was 3.20 (95% confidence interval, 2.31-4.45), 2.10 (1.63-2.70), and 3.12 (2.44-3.99) times more likely to receive phototherapy or have a total serum bilirubin concentration >95th and >75th percentile, respectively. The AUC ± standard error (95% confidence interval) for CBB for phototherapy and a total serum bilirubin concentration >95th and >75th percentile was 0.89 ± 0.03 (0.82-0.95), 0.81 ± 0.04 (0.73-0.90), and 0.84 ± 0.02 (0.80-0.89), respectively. However, the AUC for gestational age and maternal Asian race for these outcomes was only 0.55 ± 0.05 (0.45-0.66), 0.66 ± 0.05 (0.56-0.76), and 0.57 ± 0.04 (0.05-0.64), respectively. When the CBB was combined with

Age, BMI, and race are less important than random plasma glucose in identifying risk of glucose intolerance: the Screening for Impaired Glucose Tolerance Study (SIGT 5).

PubMed

Ziemer, David C; Kolm, Paul; Weintraub, William S; Vaccarino, Viola; Rhee, Mary K; Caudle, Jane M; Irving, Jade M; Koch, David D; Narayan, K M Venkat; Phillips, Lawrence S

2008-05-01

Age, BMI, and race/ethnicity are used in National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and American Diabetes Association (ADA) guidelines to prompt screening for pre-diabetes and diabetes, but cutoffs have not been evaluated rigorously. Random plasma glucose (RPG) was measured and 75-g oral glucose tolerance tests were performed in 1,139 individuals without known diabetes. Screening performance was assessed by logistic regression and area under the receiver operating characteristic curve (AROC). NIDDK/ADA indicators age >45 years and BMI >25 kg/m(2) provided significant detection of both diabetes and dysglycemia (both AROCs 0.63), but screening was better with continuous-variable models of age, BMI, and race and better still with models of age, BMI, race, sex, and family history (AROC 0.78 and 0.72). However, screening was even better with RPG alone (AROCs 0.81 and 0.72). RPG >125 mg/dl could be used to prompt further evaluation with an OGTT. Use of age, BMI, and race/ethnicity in guidelines for screening to detect diabetes and pre-diabetes may be less important than evaluation of RPG. RPG should be investigated further as a convenient, inexpensive screen with good predictive utility.

Race Matters: Analyzing the Relationship between Colorectal Cancer Mortality Rates and Various Factors within Respective Racial Groups.

PubMed

Veach, Emma; Xique, Ismael; Johnson, Jada; Lyle, Jessica; Almodovar, Israel; Sellers, Kimberly F; Moore, Calandra T; Jackson, Monica C

2014-01-01

Colorectal cancer (CRC) is the third leading cause of mortality due to cancer (with over 50,000 deaths annually), representing 9% of all cancer deaths in the United States (1). In particular, the African-American CRC mortality rate is among the highest reported for any race/ethnic group. Meanwhile, the CRC mortality rate for Hispanics is 15-19% lower than that for non-Hispanic Caucasians (2). While factors such as obesity, age, and socio-economic status are known to associate with CRC mortality, do these and other potential factors correlate with CRC death in the same way across races? This research linked CRC mortality data obtained from the National Cancer Institute with data from the United States Census Bureau, the Centers for Disease Control and Prevention, and the National Solar Radiation Database to examine geographic and racial/ethnic differences, and develop a spatial regression model that adjusted for several factors that may attribute to health disparities among ethnic/racial groups. This analysis showed that sunlight, obesity, and socio-economic status were significant predictors of CRC mortality. The study is significant because it not only verifies known factors associated with the risk of CRC death but, more importantly, demonstrates how these factors vary within different racial groups. Accordingly, education on reducing risk factors for CRC should be directed at specific racial groups above and beyond creating a generalized education plan.

Sex differences in US mortality rates for stroke and stroke subtypes by race/ethnicity and age, 1995-1998.

PubMed

Ayala, Carma; Croft, Janet B; Greenlund, Kurt J; Keenan, Nora L; Donehoo, Ralph S; Malarcher, Ann M; Mensah, George A

2002-05-01

Ischemic stroke accounts for 70% to 80% of all strokes, but intracerebral and subarachnoid hemorrhagic strokes have greater fatality. Age-standardized death rates from overall stroke are higher among men than women, but little is known about sex differences in stroke subtype mortality by race/ethnicity. We analyzed 1995 to 1998 national death certificate data to compare sex-specific age-standardized death rates (per 100 000) for ischemic stroke (n=507 256), intracerebral hemorrhagic stroke (n=98 709), and subarachnoid hemorrhagic stroke (n=27 334) among whites, blacks, American Indians/Alaska Natives, Asians/Pacific Islanders, and Hispanics. We calculated rate ratios and 95% CIs comparing women with men within age and racial/ethnic groups. Age-specific rates of ischemic and intracerebral hemorrhagic stroke deaths were lower for women than for men aged 25 to 44 and 45 to 64 years but were higher for ischemic stroke among older women, aged > or =65 years. Only among whites did women have higher age-standardized rates of ischemic stroke. Age-standardized death rates for intracerebral hemorrhagic stroke among women were lower than or similar to those among men in all racial/ethnic groups. Women had higher risk of death from subarachnoid hemorrhagic; this sex differential increased with age. The female-to-male mortality ratio differs for stroke subtypes by race/ethnicity and age. A primary public health effort should focus on increasing the awareness of stroke symptoms, particularly among people at high risk, to decrease delay in early detection and effective stroke treatment.

Trends in colorectal cancer incidence among younger adults-Disparities by age, sex, race, ethnicity, and subsite.

PubMed

Crosbie, Amanda B; Roche, Lisa M; Johnson, Linda M; Pawlish, Karen S; Paddock, Lisa E; Stroup, Antoinette M

2018-06-22

Millennials (ages 18-35) are now the largest living generation in the US, making it important to understand and characterize the rising trend of colorectal cancer incidence in this population, as well as other younger generations of Americans. Data from the New Jersey State Cancer Registry (n = 181 909) and Surveillance, Epidemiology, and End Results program (n = 448 714) were used to analyze invasive CRC incidence trends from 1979 to 2014. Age, sex, race, ethnicity, subsite, and stage differences between younger adults (20-49) and screening age adults (≥50) in New Jersey (NJ) were examined using chi-square; and, we compared secular trends in NJ to the United States (US). Whites, men, and the youngest adults (ages 20-39) are experiencing greater APCs in rectal cancer incidence. Rates among younger black adults, overall, were consistently higher in both NJ and the US over time. When compared to older adults, younger adults with CRC in NJ were more likely to be: diagnosed at the late stage, diagnosed with rectal cancer, male, non-white, and Hispanic. Invasive CRC incidence trends among younger adults were found to vary by age, sex, race, ethnicity, and subsite. Large, case-level, studies are needed to understand the role of genetics, human papillomavirus (HPV), and cultural and behavioral factors in the rise of CRC among younger adults. Provider and public education about CRC risk factors will also be important for preventing and reversing the increasing CRC trend in younger adults. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

The Impact of the ACA Medicaid Expansions on Health Insurance Coverage through 2015 and Coverage Disparities by Age, Race/Ethnicity, and Gender.

PubMed

Wehby, George L; Lyu, Wei

2018-04-01

Examine the ACA Medicaid expansion effects on Medicaid take-up and private coverage through 2015 and coverage disparities by age, race/ethnicity, and gender. 2011-2015 American Community Survey for 3,137,989 low-educated adults aged 19-64 years. Difference-in-differences regressions accounting for national coverage trends and state fixed effects. Expansion effects doubled in 2015 among low-educated adults, with a nearly 8 percentage-point increase in Medicaid take-up and 6 percentage-point decline in uninsured rate. Significant coverage gains were observed across virtually all examined groups by age, gender, and race/ethnicity. Take-up and insurance declines were strongest among younger adults and were generally close by gender and race/ethnicity. Despite the increased take-up however, coverage disparities remained sizeable, especially for young adults and Hispanics who had declining but still high uninsured rates in 2015. There was some evidence of private coverage crowd-out in certain subgroups, particularly among young adults aged 19-26 years and women, including in both individually purchased and employer-sponsored coverage. The ACA Medicaid expansions have continued to increase coverage in 2015 across the entire population of low-educated adults and have reduced age disparities in coverage. However, there is still a need for interventions that target eligible young and Hispanic adults. © Health Research and Educational Trust.

Socio-economic determinants of health behaviours across age groups: results of a cross-sectional survey.

PubMed

Dorner, T E; Stronegger, W J; Hoffmann, K; Stein, K Viktoria; Niederkrotenthaler, T

2013-05-01

The aim of this study was to analyse the impact of different socio-economic variables on the lifestyle factors, like lack of physical activity, diet rich in meat, and smoking, across sex and age groups in the general Austrian population to formulate more targeted public health measures. The Austrian Health Interview Survey 2006-07 contains data of 15,474 people, representative for the general population. Statistical analyses included linear and logistic regression models. Lack of physical activity was more prevalent in women, while unhealthy nutrition and daily smoking were more prevalent in men. Overall, profession was the strongest predictor for health behaviour in men, while the educational level played the most significant role in women. Subjects in higher age groups had a more healthy nutrition and were less likely to smoke, but had a higher chance for lack of physical activity. Socio-economic factors predict lifestyle choices differently in different age groups. For example, in men, the highest percentage of daily smokers was found in the middle age, while the youngest age group was the one that smoked the most in women. Furthermore, the educational level had a reverse effect on women in the oldest age group, where those with tertiary education smoked three times more than those with less education. Our results emphasise the importance of taking a holistic approach towards health, including educational, cultural and age-specific policies to improve the overall health status and health equality of a population.

Race influences warfarin dose changes associated with genetic factors

PubMed Central

Brown, Todd M.; Yan, Qi; Thigpen, Jonathan L.; Shendre, Aditi; Liu, Nianjun; Hill, Charles E.; Arnett, Donna K.; Beasley, T. Mark

2015-01-01

Warfarin dosing algorithms adjust for race, assigning a fixed effect size to each predictor, thereby attenuating the differential effect by race. Attenuation likely occurs in both race groups but may be more pronounced in the less-represented race group. Therefore, we evaluated whether the effect of clinical (age, body surface area [BSA], chronic kidney disease [CKD], and amiodarone use) and genetic factors (CYP2C9*2, *3, *5, *6, *11, rs12777823, VKORC1, and CYP4F2) on warfarin dose differs by race using regression analyses among 1357 patients enrolled in a prospective cohort study and compared predictive ability of race-combined vs race-stratified models. Differential effect of predictors by race was assessed using predictor-race interactions in race-combined analyses. Warfarin dose was influenced by age, BSA, CKD, amiodarone use, and CYP2C9*3 and VKORC1 variants in both races, by CYP2C9*2 and CYP4F2 variants in European Americans, and by rs12777823 in African Americans. CYP2C9*2 was associated with a lower dose only among European Americans (20.6% vs 3.0%, P < .001) and rs12777823 only among African Americans (12.3% vs 2.3%, P = .006). Although VKORC1 was associated with dose decrease in both races, the proportional decrease was higher among European Americans (28.9% vs 19.9%, P = .003) compared with African Americans. Race-stratified analysis improved dose prediction in both race groups compared with race-combined analysis. We demonstrate that the effect of predictors on warfarin dose differs by race, which may explain divergent findings reported by recent warfarin pharmacogenetic trials. We recommend that warfarin dosing algorithms should be stratified by race rather than adjusted for race. PMID:26024874

Race influences warfarin dose changes associated with genetic factors.

PubMed

Limdi, Nita A; Brown, Todd M; Yan, Qi; Thigpen, Jonathan L; Shendre, Aditi; Liu, Nianjun; Hill, Charles E; Arnett, Donna K; Beasley, T Mark

2015-07-23

Warfarin dosing algorithms adjust for race, assigning a fixed effect size to each predictor, thereby attenuating the differential effect by race. Attenuation likely occurs in both race groups but may be more pronounced in the less-represented race group. Therefore, we evaluated whether the effect of clinical (age, body surface area [BSA], chronic kidney disease [CKD], and amiodarone use) and genetic factors (CYP2C9*2, *3, *5, *6, *11, rs12777823, VKORC1, and CYP4F2) on warfarin dose differs by race using regression analyses among 1357 patients enrolled in a prospective cohort study and compared predictive ability of race-combined vs race-stratified models. Differential effect of predictors by race was assessed using predictor-race interactions in race-combined analyses. Warfarin dose was influenced by age, BSA, CKD, amiodarone use, and CYP2C9*3 and VKORC1 variants in both races, by CYP2C9*2 and CYP4F2 variants in European Americans, and by rs12777823 in African Americans. CYP2C9*2 was associated with a lower dose only among European Americans (20.6% vs 3.0%, P < .001) and rs12777823 only among African Americans (12.3% vs 2.3%, P = .006). Although VKORC1 was associated with dose decrease in both races, the proportional decrease was higher among European Americans (28.9% vs 19.9%, P = .003) compared with African Americans. Race-stratified analysis improved dose prediction in both race groups compared with race-combined analysis. We demonstrate that the effect of predictors on warfarin dose differs by race, which may explain divergent findings reported by recent warfarin pharmacogenetic trials. We recommend that warfarin dosing algorithms should be stratified by race rather than adjusted for race. © 2015 by The American Society of Hematology.

Disparities in alcohol use: does race matter as much as place?

PubMed

Fesahazion, Ruth G; Thorpe, Roland J; Bell, Caryn N; LaVeist, Thomas A

2012-11-01

National estimates of race differences in alcohol use suggest that whites are more likely to be current and binge users of alcohol. These findings fail to account for race differences in the social and environmental context where people live. This study aims to determine whether race disparities persist in alcohol use among individuals who share similar social and environmental conditions. We compared race disparities between individuals living in a low-income racially integrated urban community without race differences in socioeconomic status (EHDIC-SWB) to individuals from the National Health Interview Survey (NHIS 2003) to determine if race disparities in alcohol use were attenuated in the integrated environment. In the NHIS 2003 sample, compared to whites, African Americans had lower odds of being a current drinker (OR=0.56, 95% CI=0.49-0.64) and binge drinker (OR=0.68, 95% CI=0.58-0.80) independent of covariates. However in the EHDIC-SWB sample, African Americans had similar odds of being a current drinker (OR=0.94, 95% CI=0.67-1.33) and binge drinker (OR=1.02, 95% CI=0.77-1.35) compared to whites. Among individuals who share similar social and environmental risk exposures, race group differences in alcohol use patterns are similar. Copyright © 2012 Elsevier Inc. All rights reserved.

Race/Ethnicity and Health-Related Quality of Life Among LGBT Older Adults

PubMed Central

Kim, Hyun-Jun; Jen, Sarah; Fredriksen-Goldsen, Karen I.

2017-01-01

Purpose of the Study: Few existing studies have addressed racial/ethnic differences in the health and quality of life of lesbian, gay, bisexual, and transgender (LGBT) older adults. Guided by the Health Equity Promotion Model, this study examines health-promoting and health risk factors that contribute to racial/ethnic health disparities among LGBT adults aged 50 and older. Design and Methods: We utilized weighted survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study. By applying multiple mediator models, we analyzed the indirect effects of race/ethnicity on health-related quality of life (HRQOL) via demographics, lifetime LGBT-related discrimination, and victimization, and socioeconomic, identity-related, spiritual, and social resources. Results: Although African Americans and Hispanics, compared with non-Hispanic Whites, reported lower physical HRQOL and comparable psychological HRQOL, indirect pathways between race/ethnicity and HRQOL were observed. African Americans and Hispanics had lower income, educational attainment, identity affirmation, and social support, which were associated with a decrease in physical and psychological HRQOL. African Americans had higher lifetime LGBT-related discrimination, which was linked to a decrease in their physical and psychological HRQOL. African Americans and Hispanics had higher spirituality, which was associated with an increase in psychological HRQOL. Implications: Findings illustrate the importance of identifying both health-promoting and health risk factors to understand ways to maximize the health potential of racially and ethnically diverse LGBT older adults. Interventions aimed at health equity should be tailored to bolster identity affirmation and social networks of LGBT older adults of color and to support strengths, including spiritual resources. PMID:28087793

Socioeconomic Status Discrimination is Associated with Poor Sleep in African-Americans, but not Whites

PubMed Central

Van Dyke, Miriam E.; Vaccarino, Viola; Quyyumi, Arshed A.; Lewis, Tené T.

2016-01-01

Rationale Research on self-reported experiences of discrimination and health has grown in recent decades, but has largely focused on racial discrimination or overall mistreatment. Less is known about reports of discrimination on the basis of socioeconomic status (SES), despite the fact that SES is one of the most powerful social determinants of health. Objective We sought to examine the cross-sectional association between self-reported SES discrimination and subjective sleep quality, an emerging risk factor for disease. We further examined whether associations differed by race or SES. Methods We used logistic and linear regression to analyze data from a population-based cohort of 425 African-American and White middle-aged adults (67.5% female) in the Southeastern United States. SES discrimination was assessed with a modified Experiences of Discrimination Scale and poor subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. Results In logistic regression models adjusted for age, gender, and education, reports of SES discrimination were associated with poor sleep quality among African-Americans (OR=2.39, 95% CI =1.35, 4.24), but not Whites (OR=1.03, 95% CI= 0.57, 1.87), and the race × SES discrimination interaction was significant at p=0.04. After additional adjustments for reports of racial and gender discrimination, other psychosocial stressors, body mass index and depressive symptoms, SES discrimination remained a significant predictor of poor sleep among African-Americans, but not Whites. In contrast to findings by race, SES discrimination and sleep associations did not significantly differ by SES. Conclusion Findings suggest that reports of SES discrimination may be an important risk factor for subjective sleep quality among African-Americans and support the need to consider the health impact of SES-related stressors in the context of race. PMID:26896878

Socioeconomic status discrimination is associated with poor sleep in African-Americans, but not Whites.

PubMed

Van Dyke, Miriam E; Vaccarino, Viola; Quyyumi, Arshed A; Lewis, Tené T

2016-03-01

Research on self-reported experiences of discrimination and health has grown in recent decades, but has largely focused on racial discrimination or overall mistreatment. Less is known about reports of discrimination on the basis of socioeconomic status (SES), despite the fact that SES is one of the most powerful social determinants of health. We sought to examine the cross-sectional association between self-reported SES discrimination and subjective sleep quality, an emerging risk factor for disease. We further examined whether associations differed by race or SES. We used logistic and linear regression to analyze data from a population-based cohort of 425 African-American and White middle-aged adults (67.5% female) in the Southeastern United States. SES discrimination was assessed with a modified Experiences of Discrimination Scale and poor subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. In logistic regression models adjusted for age, gender, and education, reports of SES discrimination were associated with poor sleep quality among African-Americans (OR = 2.39 95%, CI = 1.35, 4.24), but not Whites (OR = 1.03, 95% CI = 0.57, 1.87), and the race × SES discrimination interaction was significant at p = 0.04. After additional adjustments for reports of racial and gender discrimination, other psychosocial stressors, body mass index and depressive symptoms, SES discrimination remained a significant predictor of poor sleep among African-Americans, but not Whites. In contrast to findings by race, SES discrimination and sleep associations did not significantly differ by SES. Findings suggest that reports of SES discrimination may be an important risk factor for subjective sleep quality among African-Americans and support the need to consider the health impact of SES-related stressors in the context of race. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Transmission of Values to School-Age and Young Adult Offspring: Race and Gender Differences in Parenting

ERIC Educational Resources Information Center

Pagano, Maria E.; Hirsch, Barton J.; Deutsch, Nancy L.; McAdams, Dan P.

2003-01-01

The current study explores parental socialization practices and the values transmitted to school-aged and young adult off-spring, focusing on race and gender issues involved in parental teachings. A community sample of 187 black and white mothers and fathers were interviewed with regards to their parenting practices using both quantitative and…

Incidence of Parkinson's disease: variation by age, gender, and race/ethnicity.

PubMed

Van Den Eeden, Stephen K; Tanner, Caroline M; Bernstein, Allan L; Fross, Robin D; Leimpeter, Amethyst; Bloch, Daniel A; Nelson, Lorene M

2003-06-01

The goal of this study was to estimate the incidence of Parkinson's disease by age, gender, and ethnicity. Newly diagnosed Parkinson's disease cases in 1994-1995 were identified among members of the Kaiser Permanente Medical Care Program of Northern California, a large health maintenance organization. Each case met modified standardized criteria/Hughes diagnostic criteria as applied by a movement disorder specialist. Incidence rates per 100,000 person-years were calculated using the Kaiser Permanente membership information as the denominator and adjusted for age and/or gender using the direct method of standardization. A total of 588 newly diagnosed (incident) cases of Parkinson's disease were identified, which gave an overall annualized age- and gender-adjusted incidence rate of 13.4 per 100,000 (95% confidence interval (CI): 11.4, 15.5). The incidence rapidly increased over the age of 60 years, with only 4% of the cases being under the age of 50 years. The rate for men (19.0 per 100,000, 95% CI: 16.1, 21.8) was 91% higher than that for women (9.9 per 100,000, 95% CI: 7.6, 12.2). The age- and gender-adjusted rate per 100,000 was highest among Hispanics (16.6, 95% CI: 12.0, 21.3), followed by non-Hispanic Whites (13.6, 95% CI: 11.5, 15.7), Asians (11.3, 95% CI: 7.2, 15.3), and Blacks (10.2, 95% CI: 6.4, 14.0). These data suggest that the incidence of Parkinson's disease varies by race/ethnicity.

Age group athletes in inline skating: decrease in overall and increase in master athlete participation in the longest inline skating race in Europe - the Inline One-Eleven.

PubMed

Teutsch, Uwe; Knechtle, Beat; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald

2013-01-01

Participation and performance trends in age group athletes have been investigated in endurance and ultraendurance races in swimming, cycling, running, and triathlon, but not in long-distance inline skating. The aim of this study was to investigate trends in participation, age, and performance in the longest inline race in Europe, the Inline One-Eleven over 111 km, held between 1998 and 2009. The total number, age distribution, age at the time of the competition, and race times of male and female finishers at the Inline One-Eleven were analyzed. Overall participation increased until 2003 but decreased thereafter. During the 12-year period, the relative participation in skaters younger than 40 years old decreased while relative participation increased for skaters older than 40 years. The mean top ten skating time was 199 ± 9 minutes (range: 189-220 minutes) for men and 234 ± 17 minutes (range: 211-271 minutes) for women, respectively. The gender difference in performance remained stable at 17% ± 5% across years. To summarize, although the participation of master long-distance inline skaters increased, the overall participation decreased across years in the Inline One-Eleven. The race times of the best female and male skaters stabilized across years with a gender difference in performance of 17% ± 5%. Further studies should focus on the participation in the international World Inline Cup races.

Socioeconomic Disadvantage and Other Risk Factors for Using Higher-Nicotine/Tar-Yield (Regular Full-Flavor) Cigarettes.

PubMed

Higgins, Stephen T; Redner, Ryan; Priest, Jeff S; Bunn, Janice Y

2017-11-07

Use of machine-estimated higher nicotine/tar yield (regular full-flavor) cigarettes is associated with increased risk of nicotine dependence. The present study examined risk factors for using full-flavor versus other cigarette types, including socioeconomic disadvantage and other risk factors for tobacco use or tobacco-related adverse health impacts. Associations between use of full-flavor cigarettes and risk of nicotine dependence were also examined. Data were obtained from nationally representative samples of adult cigarette smokers from the US National Survey on Drug Use and Health. Logistic regression and classification and regression tree modeling were used to examine associations between use of full-flavor cigarettes and educational attainment, poverty, race/ethnicity, age, sex, mental illness, alcohol abuse/dependence, and illicit drug abuse/dependence. Logistic regression was used to examine risk for nicotine dependence. Each of these risk factors except alcohol abuse/dependence independently predicted increased odds of using full-flavor cigarettes (p < .001), with lower educational attainment the strongest predictor, followed by poverty, male sex, younger age, minority race/ethnicity, mental illness, and drug abuse/dependence, respectively. Use of full-flavor cigarettes was associated with increased odds of nicotine dependence within each of these risk factor groupings (p < .01). Cart modeling identified how prevalence of full-flavor cigarette use can vary from a low of 25% to a high of 66% corresponding to differing combinations of these independent risk factors. Use of full-flavor cigarettes is overrepresented in socioeconomically disadvantaged and other vulnerable populations, and associated with increased risk of nicotine dependence. Greater regulation of this cigarette type may be warranted. Greater regulation of commercially available Regular Full-Flavor Cigarettes may be warranted. Use of this type of cigarette is overrepresented in

The influence of ethnicity and adverse life experiences during adolescence on young adult socioeconomic attainment: the moderating role of education.

PubMed

Wickrama, K A S; Simons, Leslie Gordon; Baltimore, Diana

2012-11-01

Previous research has documented that adverse life experiences during adolescence, particularly for ethnic minorities, have a long-term influence on income and asset attainment and that this relationship is largely mediated by educational achievement. We extend prior research by investigating three research questions. First, we investigate the extent to which community disadvantage, family factors and race/ethnicity each exert an independent influence on young adult socioeconomic attainment. Second, we examine whether youths' educational attainment mediates these independent influences on socioeconomic attainment. Third, we test whether educational attainment ameliorates the negative influences of disadvantaged community and family conditions and race/ethnicity on socioeconomic attainment. We address these questions using multilevel modeling with longitudinal, prospective data from Waves 1 and 4 of National Longitudinal Study of Adolescent Health, which has a nationally representative sample of adolescents (N = 13, 450; 53 % females). Regarding our first research question, our results indicated that African Americans, youth from disadvantaged communities, lower SES families achieve significantly lower levels of earnings, assets, and job quality during young adulthood. Second, we found that young adults' educational level only partially mediate the influences of family and race/ethnicity influences on young adults' socioeconomic attainment. Third, we found that young adults' educational level buffered the influence of early socioeconomic adversities and accentuated the positive influences of family resources. Findings highlight the importance of social context as well as educational opportunities during childhood and adolescence for economic stability in early adulthood.

Race/ethnicity and income in relation to the home food environment in US youth aged 6 to 19 years.

PubMed

Masters, Melissa A; Stanek Krogstrand, Kaye L; Eskridge, Kent M; Albrecht, Julie A

2014-10-01

The home food environment is complex and has the potential to influence dietary habit development in young people. Several factors may influence the home food environment, including income and race/ethnicity. To examine the relationship of income and race/ethnicity with three home food environment factors (ie, food availability frequency, family meal patterns [frequency of family and home cooked meals], and family food expenditures). A cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES). A total of 5,096 youth aged 6 to 19 years from a nationally representative sample of US individuals participating in NHANES 2007-10. Prevalence of food availability frequency was assessed for the entire sample, race/ethnicity, poverty income ratio (PIR), and race/ethnicity stratified by PIR. Mean values of family meal patterns and food expenditures were calculated based on race/ethnicity, PIR, and race/ethnicity stratified by PIR using analysis of variance and least squares means. Tests of main effects were used to assess differences in food availability prevalence and mean values of family meal patterns and food expenditures. Non-Hispanic whites had the highest prevalence of salty snacks (51.1%±1.5%) and fat-free/low-fat milk (39.2%±1.7%) always available. High-income homes had the highest prevalence of fruits (75.4%±2.4%) and fat-free/low-fat milk (38.4%±2.1%) always available. Differences were found for prevalence of food availability when race/ethnicity was stratified by PIR. Non-Hispanic blacks had the lowest prevalence of fat-free/low-fat milk always available across PIR groups. Differences in mean levels of family meal patterns and food expenditures were found for race/ethnicity, PIR, and race/ethnicity stratified by PIR. Race/ethnicity and PIR appear to influence food availability, family meal patterns, and family food expenditures in homes of youth. Knowledge of factors that influence the home food environment could assist in

Temporal Trends and the Impact of Race, Insurance, and Socioeconomic Status in the Management of Localized Prostate Cancer.

PubMed

Gray, Phillip J; Lin, Chun Chieh; Cooperberg, Matthew R; Jemal, Ahmedin; Efstathiou, Jason A

2017-05-01

Numerous management options exist for patients with prostate cancer; however, recent trends and their influencing factors are not well described. To describe modern patterns of care and factors associated with management choice using the National Cancer Database. Patients with localized prostate cancer diagnosed between 2004 and 2012 were included and grouped according to National Comprehensive Cancer Network guidelines into low, intermediate, or high risk. Trend analyses and multivariate logistic regression was used to identify factors associated with management. There were 598 640 patients who met the study criteria; 36.3% were classified as low risk, 43.8% intermediate risk, and 20.0% high risk. Over the study period, among low-risk patients, observation increased from 9.2% to 21.3%, while radical prostatectomy (RP) increased from 29.5% to 51.1% (p<0.001 for both). In contrast, external beam radiotherapy decreased from 24.3% to 14.5%, while brachytherapy decreased from 31.7% to 11.1%. A similar pattern was seen for patients with intermediate-risk or high-risk disease. Among high-risk patients, RP increased from 25.1% to 43.4% replacing external beam radiotherapy as the dominant therapy. On multivariate analysis, racial minorities, the uninsured, and low-income patients were less likely to receive RP. Low-risk patients in similar subgroups were significantly more likely to be observed. Limitations include potential miscoding or misclassification of variables. Patterns of care in localized prostate cancer are changing rapidly. While use of observation is increasing in low-risk groups, the use of RP is increasing across all risk groups with a concomitant decline in use of radiotherapy. Socioeconomic factors appear to influence management choice. In this report we identify a recent significant increase in the use of radical prostatectomy for prostate cancer patients. Socioeconomic factors such as race, insurance type, and income may affect treatments offered to and

Influence of socioeconomic factors on hospital readmissions for heart failure and acute myocardial infarction in patients 65 years and older: evidence from a systematic review

PubMed Central

Damiani, Gianfranco; Salvatori, Eleonora; Silvestrini, Giulia; Ivanova, Ivana; Bojovic, Luka; Iodice, Lanfranco; Ricciardi, Walter

2015-01-01

Purpose Cardiovascular diseases are the leading cause of death and disability worldwide. Among these diseases, heart failure (HF) and acute myocardial infarction (AMI) are the most common causes of hospitalization. Therefore, readmission for HF and AMI is receiving increasing attention. Several socioeconomic factors could affect readmissions in this target group, and thus, a systematic review was conducted to identify the effect of socioeconomic factors on the risk for readmission in people aged 65 years and older with HF or AMI. Methods The search was carried out by querying an electronic database and hand searching. Studies with an association between the risk for readmission and at least one socioeconomic factor in patients aged 65 years or older who are affected by HF or AMI were included. A quality assessment was conducted independently by two reviewers. The agreement was quantified by Cohen’s Kappa statistic. The outcomes of studies were categorized in the short-term and the long-term, according to the follow-up period of readmission. A positive association was reported if an increase in the risk for readmission among disadvantaged patients was found. A cumulative effect of socioeconomic factors was computed by considering the association for each study and the number of available studies. Results A total of eleven articles were included in the review. They were mainly published in the United States. All the articles analyzed patients who were hospitalized for HF, and four of them also analyzed patients with AMI. Seven studies (63.6%) were found for the short-term outcome, and four studies (36.4%) were found for the long-term outcome. For the short-term outcome, race/ethnicity and marital status showed a positive cumulative effect on the risk for readmission. Regarding the educational level of a patient, no effect was found. Conclusion Among the socioeconomic factors, mainly race/ethnicity and marital status affect the risk for readmission in elderly people

Influence of socioeconomic factors on hospital readmissions for heart failure and acute myocardial infarction in patients 65 years and older: evidence from a systematic review.

PubMed

Damiani, Gianfranco; Salvatori, Eleonora; Silvestrini, Giulia; Ivanova, Ivana; Bojovic, Luka; Iodice, Lanfranco; Ricciardi, Walter

2015-01-01

Cardiovascular diseases are the leading cause of death and disability worldwide. Among these diseases, heart failure (HF) and acute myocardial infarction (AMI) are the most common causes of hospitalization. Therefore, readmission for HF and AMI is receiving increasing attention. Several socioeconomic factors could affect readmissions in this target group, and thus, a systematic review was conducted to identify the effect of socioeconomic factors on the risk for readmission in people aged 65 years and older with HF or AMI. The search was carried out by querying an electronic database and hand searching. Studies with an association between the risk for readmission and at least one socioeconomic factor in patients aged 65 years or older who are affected by HF or AMI were included. A quality assessment was conducted independently by two reviewers. The agreement was quantified by Cohen's Kappa statistic. The outcomes of studies were categorized in the short-term and the long-term, according to the follow-up period of readmission. A positive association was reported if an increase in the risk for readmission among disadvantaged patients was found. A cumulative effect of socioeconomic factors was computed by considering the association for each study and the number of available studies. A total of eleven articles were included in the review. They were mainly published in the United States. All the articles analyzed patients who were hospitalized for HF, and four of them also analyzed patients with AMI. Seven studies (63.6%) were found for the short-term outcome, and four studies (36.4%) were found for the long-term outcome. For the short-term outcome, race/ethnicity and marital status showed a positive cumulative effect on the risk for readmission. Regarding the educational level of a patient, no effect was found. Among the socioeconomic factors, mainly race/ethnicity and marital status affect the risk for readmission in elderly people with HF or AMI. Multidisciplinary

Diabetes and work: 12-year national follow-up study of the association of diabetes incidence with socioeconomic group, age, gender and country of origin.

PubMed

Poulsen, Kjeld; Cleal, Bryan; Willaing, Ingrid

2014-12-01

To investigate the extent and socioeconomic distribution of incident diabetes among the Danish working-age population. The Danish National Diabetes Register was linked with socioeconomic and population-based registers covering the entire population. We analysed the 12-year diabetes incidence using multivariate Poisson regression for 2,086,682 people, adjusting for gender, 10-year age groups, main population groups defined by country of origin, and seven socioeconomic groups: professionals, managers, technicians, workers skilled at basic level, unskilled workers, unemployed and pensioners. The crude 12-year incidence of diabetes was 5.8%. The saturated multivariate model, adjusted for gender, age, country of origin and socioeconomic status; showed a relative risk (RR) for diabetes incidence of 1.44 for male (reference: female), 3.95 for the age range of 50-59 years (reference: 30-39 years), 2.07 for unskilled workers (reference: professionals) and 2.15 for people from countries of 'non-Western origin' (reference: Danish origin). Diabetes incidence increases with age, male gender and low socioeconomic status; and also among people from countries of 'non-Western origin'. The results indicate that getting a more senior workforce will substantially increase the proportion of workers with diabetes, especially among already vulnerable groups. © 2014 the Nordic Societies of Public Health.

Obesity and Overweight Among Brazilian Early Adolescents: Variability Across Region, Socioeconomic Status, and Gender.

PubMed

Fradkin, Chris; Valentini, Nadia C; Nobre, Glauber C; Dos Santos, João O L

2018-01-01

As with most emerging nations, Brazil lacks up-to-date data on the prevalence of obesity and overweight among its children. Of particular concern is the lack of data on children in early adolescence, considered by many to be the crucial stage for weight-related healthcare. To assess regional, socioeconomic, and gender differences in the prevalence of obesity and overweight among Brazilian early adolescents. A cross-sectional study was conducted on a racially diverse sample of students aged 10-13 years, from schools in three geographic regions (north, northeast, south) ( N  = 1,738). Data on gender, age, race, socioeconomic status (SES), weight, and height were obtained. Weight class was calculated from age- and gender-adjusted body mass index, based on children's weight and height. Bivariate and multivariable analyses, with post hoc tests, were conducted to estimate differences between groups and were corrected for multiple comparisons. Procedures were approved by institutional review boards at study sites. Analyses revealed a higher prevalence of obesity and/or overweight among: (1) children of higher SES; (2) children in southern Brazil; (3) males; and (4) Black females. The most salient predictor of weight risk among Brazilian early adolescents is higher SES. This finding is consistent with previous findings of an inverse social gradient, in weight risk, among emerging-nation population groups.

The association between life course socioeconomic position and life satisfaction in different welfare states: European comparative study of individuals in early old age

PubMed Central

Niedzwiedz, Claire L.; Katikireddi, Srinivasa Vittal; Pell, Jill P.; Mitchell, Richard

2014-01-01

Background: whether socioeconomic position over the life course influences the wellbeing of older people similarly in different societies is not known. Objective: to investigate the magnitude of socioeconomic inequalities in life satisfaction among individuals in early old age and the influence of the welfare state regime on the associations. Design: comparative study using data from Wave 2 and SHARELIFE, the retrospective Wave of the Survey of Health, Ageing, and Retirement in Europe (SHARE), collected during 2006–07 and 2008–09, respectively. Setting: thirteen European countries representing four welfare regimes (Southern, Scandinavian, Post-communist and Bismarckian). Subjects: a total of 17,697 individuals aged 50–75 years. Methods: slope indices of inequality (SIIs) were calculated for the association between life course socioeconomic position (measured by the number of books in childhood, education level and current wealth) and life satisfaction. Single level linear regression models stratified by welfare regime and multilevel regression models, containing interaction terms between socioeconomic position and welfare regime type, were calculated. Results: socioeconomic inequalities in life satisfaction were present in all welfare regimes. Educational inequalities in life satisfaction were narrowest in Scandinavian and Bismarckian regimes among both genders. Post-communist and Southern countries experienced both lower life satisfaction and larger socioeconomic inequalities in life satisfaction, using most measures of socioeconomic position. Current wealth was associated with large inequalities in life satisfaction across all regimes. Conclusions: Scandinavian and Bismarckian countries exhibited narrower socioeconomic inequalities in life satisfaction. This suggests that more generous welfare states help to produce a more equitable distribution of wellbeing among older people. PMID:24476800

Adolescent work intensity, school performance, and substance use: links vary by race/ethnicity and socioeconomic status.

PubMed

Bachman, Jerald G; Staff, Jeremy; O'Malley, Patrick M; Freedman-Doan, Peter

2013-11-01

High school students who spend long hours in paid employment during the school year are at increased risk of lower grades and higher substance use, although questions remain about whether these linkages reflect causation or prior differences (selection effects). Questions also remain about whether such associations vary by socioeconomic status (SES) and race/ethnicity. This study examines those questions using nationally representative data from two decades (1991-2010) of annual Monitoring the Future surveys involving about 600,000 students in 10th and 12th grades. White students are consistently more likely than minority students to hold paid employment during the school year. Among White and Asian American students, paid work intensity is negatively related to parental education and grade point averages (GPA) and is positively related to substance use. Also among Whites and Asian Americans, students with the most highly educated parents show the strongest negative relations between work intensity and GPA, whereas the links are weaker for those with less educated parents (i.e., lower SES levels). All of these relations are less evident for Hispanic students and still less evident for African American students. It thus appears that any costs possibly attributable to long hours of student work are most severe for those who are most advantaged--White or Asian American students with highly educated parents. Working long hours is linked with fewer disadvantages among Hispanic students and especially among African American students. Youth employment dropped in 2008-2010, but the relations described above have shown little change over two decades.

The Subtlety of Age, Gender, and Race Barriers: A Case Study of Early Career African American Female Principals

ERIC Educational Resources Information Center

Jean-Marie, Gaetane

2013-01-01

While all educational leaders face challenges in achieving success, African American female principals often face a unique set of challenges associated with the complexity of their gender, race, and, as examined in this study, age. This case study investigates the experiences of two highly visible, early career African American female principals…

The relationship between selected socioeconomic factors and thinness among Polish school-aged children and adolescents.

PubMed

Gurzkowska, Beata; Kułaga, Zbigniew; Grajda, Aneta; Góźdź, Magdalena; Wojtyło, Małgorzata; Litwin, Mieczysław

2017-06-01

The analysis was performed on a database including 17,427 records of subjects aged 7-18 years, randomly sampled from a population of Polish students. Thinness was determined using international cut-off points, defined to pass through body mass index of 18.5 kg/m 2 at the age of 18. The weighted prevalence of thinness and odds ratios with 95% confidence interval were estimated for gender, birth weight, level of schooling and school location, gross domestic product (GDP) per inhabitant, family income and maternal education. Body height was analysed according to body mass and birth weight categories. The prevalence of thinness was higher among children with low birth weight and among girls. The prevalence of thinness decreased with increasing GDP per inhabitant. In analysis by level of schooling: primary-middle-secondary, prevalence of thinness decreased among boys and increased among girls. Thin students were significantly shorter than other students, and thin girls less likely participated in physical education. Gender and socioeconomic factors are important determinants of thinness among Polish children and adolescents. Public health strategies should address family eating practices to prevent negative effects of weight deficit, especially among girls/children from low GDP regions. What is Known: • Socioeconomic factors and gender influence weight status of children and adolescents. What is New: • The first time the prevalence and determinants of thinness based on data from a nationally representative, weighted sample of Polish children aged 7-18 years were presented. • The analysis shows how gender and socioeconomics determinants influence the prevalence of thinness among children and adolescent in post-transformation country and can be used to international comparisons.

Sources of variation in emotional awareness: Age, gender, and socioeconomic status

PubMed Central

Mankus, Annette M.; Boden, Matthew Tyler; Thompson, Renee J.

2015-01-01

The present study examined associations between emotional awareness facets (type clarity, source clarity, negative emotion differentiation, voluntary attention, involuntary attention) and sociodemographic characteristics (age, gender, and socioeconomic status (SES)) in a large US sample (N = 919). Path analyses—controlling for variance shared between sociodemographic variables and allowing emotional awareness facets to correlate—demonstrated that (a) age was positively associated with type clarity and source clarity, and inversely associated with involuntary attention; (b) gender was associated with all facets but type clarity, with higher source clarity, negative emotion differentiation, voluntary attention, and involuntary attention reported by women then men; and (c) SES was positively associated with type clarity with a very small effect. These findings extend our understanding of emotional awareness and identify future directions for research to elucidate the causes and consequences of individual differences in emotional awareness. PMID:26500384

Digit Sucking, Age, Sex, and Socioeconomic Status as Determinants of Oral Hygiene Status and Gingival Health of Children in Suburban Nigeria.

PubMed

Agbaje, Hakeem O; Kolawole, Kikelomo A; Folayan, Morenike O; Onyejaka, Nneka K; Oziegbe, Elizabeth O; Oyedele, Titus A; Chukwumah, Nneka M; Oshomoji, Olusegun V

2016-09-01

This study determines prevalence of digit sucking and gingivitis, and association among age, sex, socioeconomic status, presence of digit-sucking habits, oral hygiene status (OHS), and gingivitis among a group of Nigerian children. Data of 992 children aged 1 to 12 years recruited through a household survey conducted in Osun State, Nigeria were analyzed. Information on age, sex, socioeconomic status, and history of digit-sucking habits were collected. Children were assessed for OHS and severity of gingivitis using the simplified oral hygiene index and the gingival index, respectively. Predictors of presence of gingivitis and poor oral hygiene were determined using multivariate logistic regression. One (0.2%) and 454 (93.0%) children aged 1 to 5 years had poor oral hygiene and mild gingivitis, respectively. Twenty-two (4.4%) and 361 (72.9%) children aged 6 to 12 years had poor oral hygiene and mild gingivitis, respectively. The odds of having poor oral hygiene (adjusted odds ratio [AOR]: 0.26; 95% confidence interval [CI]: 0.20 to 0.35; P <0.001) and gingivitis (AOR: 0.21; 95% CI: 0.14 to 0.31; P <0.001) was significantly reduced for children aged 1 to 5 years. The odds of having gingivitis was increased in children with low socioeconomic status (AOR: 2.09; 95% CI: 1.32 to 3.31; P = 0.002). There was no significant relationship among sex, digit sucking, OHS, and presence of gingivitis. A digit-sucking habit did not increase chances of having poor oral hygiene and gingivitis. Increasing age and low socioeconomic status were factors that significantly increased chances of having poor oral hygiene and gingivitis.

Analysing the socioeconomic determinants of hypertension in South Africa: a structural equation modelling approach

PubMed Central

2014-01-01

Background Epidemiological research has long observed a varying prevalence of hypertension across socioeconomic strata. However, patterns of association and underlying causal mechanisms are poorly understood in sub-Saharan Africa. Using education and income as indicators, we investigated the extent to which socioeconomic status is linked to blood pressure in the first wave of the National Income Dynamics Study — a South African longitudinal study of more than 15000 adults – and whether bio-behavioural risk factors mediate the association. Methods In a cross-sectional analysis, structural equation modelling was employed to estimate the effect of socioeconomic status on systolic and diastolic blood pressure and to assess the role of a set of bio-behavioural risk factors in explaining the observed relationships. Results After adjustment for age, race and antihypertensive treatment, higher education and income were independently associated with higher diastolic blood pressure in men. In women higher education predicted lower values of both diastolic and systolic blood pressure while higher income predicted lower systolic blood pressure. In both genders, body mass index was a strong mediator of an adverse indirect effect of socioeconomic status on blood pressure. Together with physical exercise, alcohol use, smoking and resting heart rate, body mass index therefore contributed substantially to mediation of the observed relationships in men. By contrast, in women unmeasured factors played a greater role. Conclusion In countries undergoing epidemiological transition, effects of socioeconomic status on blood pressure may vary by gender. In women, factors other than those listed above may have substantial role in mediating the association and merit investigation. PMID:24885860

Patterns and Trends in Elder Homicide Across Race and Ethnicity, 1985-2009

PubMed Central

Feldmeyer, Ben; Steffensmeier, Darrell

2014-01-01

In this report, we assess total and race/ethnicity-disaggregated patterns and temporal trends in elderly homicide (age 55-74) compared with younger age groups for the 1985-to-2009 period. To do this, we use California arrest statistics that provide annual homicide figures by race and ethnicity (including a Hispanic identifier) and by age. Major aims of our analysis are to establish whether (a) elderly homicide rates are different/similar across race/ethnic comparisons; (b) the elderly share of homicide and age-homicide distributions more generally differ across race/ethnicity; and (c) elderly rates of homicide and the share of elderly homicide relative to younger age groups is similar or different now as compared with 20 to 30 years ago. Our analysis is important and timely because some commentators have suggested that elderly homicide levels have been rising over the past one to two decades and because there is a virtual absence of research of any sort on elderly homicide trends that involve comparisons by race and ethnicity. Key findings are that elderly shares of homicide offending relative to younger ages have not increased (or decreased), that elder homicides continue to account for a small fraction of all homicides, and that these patterns persist across race/ethnicity comparisons. PMID:25598653

Poverty, race, and the contexts of achievement: Examining educational experiences of children in the U.S. south.

PubMed

Fram, Maryah Stella; Miller-Cribbs, Julie E; Van Horn, Lee

2007-10-01

This article considers issues of educational inequality in the U.S. South from a social work/ social justice perspective. After a review of existing literature and discussion of cultural versus structural explanations for race and socioeconomic status gaps in academic achievement, findings are presented from a study examining child-, classroom-, and school-level factors that influence academic achievement among public school children in the South. Although a sizeable minority of southern children attend schools that are segregated along racial and socioeconomic lines, and although these schools are different in various aspects of educational environment, once family structure, parental characteristics, the use of ability grouping, and rural school location were taken into account, no influence of race on achievement remained. Implications for social work policy and practice are discussed.

Vitamin D intakes of children differ by race/ethnicity, sex, age, and income in the United States, 2007 to 2010.

PubMed

Moore, Carolyn E; Radcliffe, John D; Liu, Yan

2014-06-01

The 2007-2010 National Health and Nutrition Examination Survey was used to estimate vitamin D intakes of children 1 to 18 years old in the United States by race/ethnicity, sex, age, and family using 24-hour dietary intake recalls and dietary supplement use questionnaires. We hypothesized that total, dietary, and supplemental vitamin D intakes of children would differ by race/ethnicity, sex, age, and income. Statistical analyses of weighted data were performed using Statistical Analysis Software (V 9.2) to estimate means ± SE. Race and ethnic intake differences controlling for poverty income ratio (PIR), sex, and age were assessed by analysis of covariance. Total (dietary and supplement) vitamin D intake was greater in the high (7.9 ± 0.3 μg/d) vs the medium (6.5 ± 0.3 μg/d) income group, but not the low (7.2 ± 0.2 μg/d) PIR group. Total vitamin D intake of non-Hispanic (NH) white children (8.1 ± 0.2 μg/d) was greater than Hispanic (7.0 ± 0.2 μg/d) and NH black (5.9 ± 0.2 μg/d) children. Total vitamin D intake declined with age, and intake by boys was higher than girls. Only 17.4% of the children consumed supplements containing vitamin D. Overall, mean intake of vitamin D by all children in each age and ethnic group was lower than the estimated average requirement for vitamin D. Public health efforts should encourage consumption of foods high in vitamin D, expand the number of foods fortified, and target health messages to parents to increase use of vitamin D supplements by children. Copyright © 2014 Elsevier Inc. All rights reserved.

Perceptual Training Prevents the Emergence of the Other Race Effect during Infancy

PubMed Central

Heron-Delaney, Michelle; Anzures, Gizelle; Herbert, Jane S.; Quinn, Paul C.; Slater, Alan M.; Tanaka, James W.; Lee, Kang; Pascalis, Olivier

2011-01-01

Experience plays a crucial role in the development of the face processing system. At 6 months of age infants can discriminate individual faces from their own and other races. By 9 months of age this ability to process other-race faces is typically lost, due to minimal experience with other-race faces, and vast exposure to own-race faces, for which infants come to manifest expertise [1]. This is known as the Other Race Effect. In the current study, we demonstrate that exposing Caucasian infants to Chinese faces through perceptual training via picture books for a total of one hour between 6 and 9 months allows Caucasian infants to maintain the ability to discriminate Chinese faces at 9 months of age. The development of the processing of face race can be modified by training, highlighting the importance of early experience in shaping the face representation. PMID:21625638

Prevalence of overweight and obesity in Canadian children, 2004 to 2013: Impact of socioeconomic determinants.

PubMed

Rodd, Celia; Sharma, Atul K

2017-06-01

We recently reported an encouraging decline in the prevalence of overweight (OW) or obesity (OB) in Canadian children from 31% to 27% with stabilization in OB rates at ~13% using national survey data between 2004 and 2013. Although rates were lower for toddlers, girls and those of European (White) race-ethnicity, secular trends persisted after adjustment. In this follow-up study, we explored the ability of socioeconomic status to explain or modify these relationships using the same data set. We analyzed a decade of anthropometric data from 14,014 children aged 3 to 19 years. We explored the influence of income adequacy, education, immigration status, family type (e.g., single-parent) and geographic region by multivariable logistic regression. Data sets included Canadian Community Health Survey cycle 2.2 and Canadian Health Measures Surveys cycles 2 and 3. Children from higher-income families fared better than their lower-income counterparts in each survey era and demonstrated a significant decline in OW/OB from 29.1% (95% confidence interval [CI]: 27.3 to 30.8) in 2004 to 2005 to 22.2% (95% CI: 19.8 to 24.6) in 2012 to 2013, P<0.001. Regression models confirmed the effects of time, age, sex, race, income, education, immigration and region. Although single-parent families did less well in univariate analyses, this effect vanished after adjustment for other socioeconomic status variables, such as income and education. Regional variations persisted, with lower rates of OB and OW/OB in British Columbia and higher rates in Atlantic Canada. These results confirm that progress is possible against this important public health challenge, underline the need to better understand sociodemographic risk factors and identify groups at higher risk for possible interventions.

Perceived discrimination, socioeconomic disadvantage and refraining from seeking medical treatment in Sweden.

PubMed

Wamala, Sarah; Merlo, Juan; Boström, Gunnel; Hogstedt, Christer

2007-05-01

To analyse the association between perceived discrimination and refraining from seeking required medical treatment and the contribution of socioeconomic disadvantage. Data from the Swedish National Survey of Public Health 2004 were used for analysis. Respondents were asked whether they had refrained from seeking required medical treatment during the past 3 months. Perceived discrimination was based on whether respondents reported that they had been treated in a way that made them feel humiliated (due to ethnicity/race, religion, gender, sexual orientation, age or disability). The Socioeconomic Disadvantage Index (SDI) was developed to measure economic deprivation (social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves). Swedish population-based survey of 14,736 men and 17,115 women. Both perceived discrimination and socioeconomic disadvantage were independently associated with refraining from seeking medical treatment. Experiences of frequent discrimination even without any socioeconomic disadvantage were associated with three to nine-fold increased odds for refraining from seeking medical treatment. A combination of both frequent discrimination and severe SDI was associated with a multiplicative effect on refraining from seeking medical treatment, but this effect was statistically more conclusive among women (OR = 11.6, 95% CI 8.1 to 16.6; Synergy Index (SI) = 2.0 (95% CI 1.2 to 3.2)) than among men (OR = 12, 95% CI 7.7 to 18.7; SI = 1.6 (95% CI 1.3 to 2.1)). The goal of equitable access to healthcare services cannot be achieved without public health strategies that confront and tackle discrimination in society and specifically in the healthcare setting.

Race, ethnicity, concentrated poverty, and low birth weight disparities.

PubMed

Sims, Mario; Sims, Tammy L; Bruce, Marino A

2008-07-01

This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (< 2500 grams) rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in neighborhoods with 40% or more poverty in metropolitan areas. The results showed that the relationship between concentrated poverty and LBW varied by race and ethnicity. Concentrated poverty was significant for Latinos, even when controlling for maternal health and MSA-level factors. By contrast, maternal health characteristics, such as pre-term birth, teen birth and tobacco use, explained much of the variance in African-American and White LBW These findings extend the discussion about race, class, and health disparities to include Latinos and shows how the relationship between SEP and LBW can vary within an ethnic group.

Race, Ethnicity, Concentrated Poverty, and Low Birth Weight Disparities

PubMed Central

Sims, Mario; Sims, Tammy L.; Bruce, Marino A.

2016-01-01

This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (< 2500 grams) rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in neighborhoods with 40% or more poverty in metropolitan areas. The results showed that the relationship between concentrated poverty and LBW varied by race and ethnicity. Concentrated poverty was significant for Latinos, even when controlling for maternal health and MSA-level factors. By contrast, maternal health characteristics, such as pre-term birth, teen birth and tobacco use, explained much of the variance in African-American and White LBW. These findings extend the discussion about race, class, and health disparities to include Latinos and shows how the relationship between SEP and LBW can vary within an ethnic group. PMID:18807774

Socioeconomic factors and adolescent pregnancy outcomes: distinctions between neonatal and post-neonatal deaths?

PubMed Central

Markovitz, Barry P; Cook, Rebeka; Flick, Louise H; Leet, Terry L

2005-01-01

Background Young maternal age has long been associated with higher infant mortality rates, but the role of socioeconomic factors in this association has been controversial. We sought to investigate the relationships between infant mortality (distinguishing neonatal from post-neonatal deaths), socioeconomic status and maternal age in a large, retrospective cohort study. Methods We conducted a population-based cohort study using linked birth-death certificate data for Missouri residents during 1997–1999. Infant mortality rates for all singleton births to adolescent women (12–17 years, n = 10,131; 18–19 years, n = 18,954) were compared to those for older women (20–35 years, n = 28,899). Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for all potential associations. Results The risk of infant (OR 1.95, CI 1.54–2.48), neonatal (1.69, 1.24–2.31) and post-neonatal mortality (2.47, 1.70–3.59) were significantly higher for younger adolescent (12–17 years) than older (20–34 years) mothers. After adjusting for race, marital status, age-appropriate education level, parity, smoking status, prenatal care utilization, and poverty status (indicated by participation in WIC, food stamps or Medicaid), the risk of post-neonatal mortality (1.73, 1.14–2.64) but not neonatal mortality (1.43, 0.98–2.08) remained significant for younger adolescent mothers. There were no differences in neonatal or post-neonatal mortality risks for older adolescent (18–19 years) mothers. Conclusion Socioeconomic factors may largely explain the increased neonatal mortality risk among younger adolescent mothers but not the increase in post-neonatal mortality risk. PMID:16042801

Trends in participation rates for wildlife-associated outdoor recreation activities by age and race/ethnicity: implications for cohort-component projection models

Treesearch

John F. Dwyer; Allan Marsinko

1998-01-01

Cohort-component projection models have been used to explore the implications of increased aging and growth of racial/ethnic minority groups on number of participants in outdoor recreation activities in the years ahead. Projections usually assume that participation rates by age and race/ethnicity remain constant over time. This study looks at trends in activity...

Association of childhood blood-lead levels with cognitive function and socioeconomic status at age 38 years and with IQ change and socioeconomic mobility between childhood and adulthood

PubMed Central

Reuben, Aaron; Caspi, Avshalom; Belsky, Daniel W.; Broadbent, Jonathan; Harrington, Honalee; Sugden, Karen; Houts, Renate M.; Ramrakha, Sandhya; Poulton, Richie; Moffitt, Terrie E.

2017-01-01

Importance Many children in the US and around the world are exposed to lead, a developmental neurotoxin. The long-term cognitive and socioeconomic consequences of lead exposure are uncertain. Objective To test the hypothesis that childhood lead exposure is associated with cognitive function and socioeconomic status in adulthood and with changes in IQ and socioeconomic mobility between childhood and midlife. Design, Setting, and Participants Prospective cohort study based on a population-representative 1972–73 birth cohort from New Zealand, the Dunedin Multidisciplinary Health and Development Study, followed to age 38 years (December, 2012). Exposure Childhood lead exposure ascertained as blood-lead levels measured at 11 years. High blood-lead levels were observed among children from all socioeconomic status levels in this cohort. Main Outcomes and Measures The IQ (primary outcome) and indexes of Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed (secondary outcomes) were assessed at 38 years using the Wechsler Adult Intelligence Scale–IV (WAIS-IV; IQ range 40–160). Socioeconomic status (primary outcome) was assessed at 38 years using the New Zealand Socioeconomic Index-2006, (NZSEI-06; range 10=lowest-90=highest). Results Of 1037 original participants, 1007 were alive at 38 years, of whom 565 (56%) had been lead tested at 11 years (54% male; 93% white). Mean blood-lead level at 11 years was 10.99μg/dL (SD=4.63). Among blood-tested participants included at 38 years, mean WAIS-IV score was 101.16 (SD=14.82) and mean NZSEI-06 score was 49.75 (SD=17.12). After adjusting for maternal IQ, childhood IQ, and childhood socioeconomic status, each 5μg/dL higher level of blood-lead in childhood was associated with a 1.61-point lower score (95%CI:−2.48, −0.74) in adult IQ, a 2.07-point lower score (95%CI: −3.14, −1.01) in Perceptual Reasoning, and a 1.26-point lower score (95%CI: −2.38, −0.14) in Working Memory. Lead

America’s Churning Races: Race and Ethnic Response Changes between Census 2000 and the 2010 Census

PubMed Central

Liebler, Carolyn A.; Porter, Sonya R.; Fernandez, Leticia E.; Noon, James M.; Ennis, Sharon R.

2017-01-01

Race and ethnicity responses can change over time and across contexts – a component of population change not usually considered in studies that use race and ethnicity as variables. To facilitate incorporation of this aspect of population change, we show patterns and directions of individual-level race and Hispanic response change throughout the U.S. and among all federally recognized race/ethnic groups. We use internal Census Bureau data from the 2000 and 2010 censuses in which responses have been linked at the individual level (N = 162 million). About 9.8 million people (6.1 percent) in our data have a different race and/or Hispanic origin response in 2010 than they did in 2000. Race response change was especially common among those reported as American Indian, Alaska Native, Native Hawaiian, Other Pacific Islander, in a multiple-race response group, or Hispanic. People reported as non-Hispanic white, black, or Asian in 2000 usually had the same response in 2010 (3%, 6% and 9% of responses changed, respectively). Hispanic/non-Hispanic ethnicity responses were also usually consistent (13% and 1% changed). There were a variety of response change patterns, which we detail. In many race/Hispanic response groups, there is population churn in the form of large countervailing flows of response changes that are hidden in cross-sectional data. We find that response changes happen across ages, sexes, regions, and response modes, with interesting variation across race/ethnic categories. Researchers should think through and discuss the implications of race and Hispanic origin response change when designing analyses and interpreting results. PMID:28105578

Epidemiology of fractures in the United Kingdom 1988-2012: Variation with age, sex, geography, ethnicity and socioeconomic status.

PubMed

Curtis, Elizabeth M; van der Velde, Robert; Moon, Rebecca J; van den Bergh, Joop P W; Geusens, Piet; de Vries, Frank; van Staa, Tjeerd P; Cooper, Cyrus; Harvey, Nicholas C

2016-06-01

Rates of fracture worldwide are changing. Using the Clinical Practice Research Datalink (CPRD), age, and gender, geographical, ethnic and socioeconomic trends in fracture rates across the United Kingdom were studied over a 24-year period 1988-2012. Previously observed patterns in fracture incidence by age and fracture site were evident. New data on the influence of geographic location, ethnic group and socioeconomic status were obtained. With secular changes in age- and sex-specific fracture incidence observed in many populations, and global shifts towards an elderly demography, it is vital for health care planners to have an accurate understanding of fracture incidence nationally. We aimed to present up to date fracture incidence data in the UK, stratified by age, sex, geographic location, ethnicity and socioeconomic status. The Clinical Practice Research Datalink (CPRD) contains anonymised electronic health records for approximately 6.9% of the UK population. Information comes from General Practitioners, and covers 11.3 million people from 674 practices across the UK, demonstrated to be representative of the national population. The study population consisted of all permanently registered individuals aged ≥18years. Validated data on fracture incidence were obtained from their medical records, as was information on socioeconomic deprivation, ethnicity and geographic location. Age- and sex-specific fracture incidence rates were calculated. Fracture incidence rates by age and sex were comparable to those documented in previous studies and demonstrated a bimodal distribution. Substantial geographic heterogeneity in age- and sex adjusted fracture incidence was observed, with rates in Scotland almost 50% greater than those in London and South East England. Lowest rates of fracture were observed in black individuals of both sexes; rates of fragility fracture in white women were 4.7 times greater than in black women. Strong associations between deprivation and fracture

Trends in state/territorial obesity prevalence by race/ethnicity among U.S. low-income, preschool-aged children.

PubMed

Pan, L; Grummer-Strawn, L M; McGuire, L C; Park, S; Blanck, H M

2016-10-01

Understanding state/territorial trends in obesity by race/ethnicity helps focus resources on populations at risk. This study aimed to examine trends in obesity prevalence among low-income, preschool-aged children from 2008 through 2011 in U.S. states and territories by race/ethnicity. We used measured weight and height records of 11.1 million children aged 2-4 years who participated in federally funded health and nutrition programmes in 40 states, the District of Columbia and two U.S. territories. We used logistic regression to examine obesity prevalence trends, controlling for age and sex. From 2008 through 2011, the aggregated obesity prevalence declined among all racial/ethnic groups (decreased by 0.4-0.9%) except American Indians/Alaska Natives (AI/ANs); the largest decrease was among Asians/Pacific Islanders (A/PIs). Declines were significant among non-Hispanic whites in 14 states, non-Hispanic blacks in seven states/territories, Hispanics in 13 states, A/PIs in five states and AI/ANs in one state. Increases were significant among non-Hispanic whites in four states, non-Hispanic blacks in three states, Hispanics in two states and A/PIs in one state. The majority of the states/territories had no change in obesity prevalence. Our findings indicate slight reductions in obesity prevalence and variations in obesity trends, but disparities exist for some states and racial/ethnic groups. © 2015 World Obesity.

Socioeconomic status inconsistency and risk of stroke among Japanese middle-aged women.

PubMed

Honjo, Kaori; Iso, Hiroyasu; Inoue, Manami; Sawada, Norie; Tsugane, Shoichiro

2014-09-01

Little research has been conducted to examine the effect of inconsistencies in socioeconomic status on cardiovascular health. In particular, no studies have been reported in Asian countries, including Japan, which is thought to have high socioeconomic status inconsistency among women. We examined the effect of status inconsistency between education level and occupation on stroke risk in a prospective 20-year study of 14 742 middle-aged Japanese women included in the prospective Japan Public Health Center-based (JPHC) Study Cohort I in 1990. Status inconsistency between education level and occupation was determined (qualified, overqualified, and underqualified), and the association with risk of stroke was examined. Cox proportional regression analysis was used to determine hazard ratios, which were adjusted for age, marital status, and geographical area. Adjusted hazard ratio for stroke in overqualified compared with qualified women was 2.06 (95% confidence interval, 1.13-3.78). Adjusted hazard ratios for stroke among highly educated manual workers and workers in service industry were 3.47 (95% confidence interval, 1.54-7.84) and 3.21 (95% confidence interval, 1.49-6.90), respectively, when compared with highly educated professionals/managers. High academic qualifications without an appropriate job could be a risk factor for stroke among Japanese women. Our result suggests that status inconsistency could be a potential explanation for the increased stroke risk among highly educated women. © 2014 American Heart Association, Inc.

Can Social Policy Influence Socio-Economic Disparities? Korean War GI Bill Eligibility and Markers of Depression

PubMed Central

Vable, Anusha M.; Canning, David; Glymour, M. Maria; Kawachi, Ichiro; Jimenez, Marcia P.; Subramanian, S. V.

2017-01-01

Background The Korean War GI Bill provided socio-economic benefits to veterans, however its association with health is unclear; we hypothesize GI Bill eligibility is associated with fewer depressive symptoms and smaller disparities. Methods Data from 246 Korean War GI Bill eligible veterans and 240 non-veterans from the Health and Retirement Study were matched on birth year, southern birth, race, height, and childhood health using coarsened exact matching. Number of depressive symptoms in 2010 (average age=78) were assessed using a modified, validated Center for Epidemiologic Studies-Depression Scale, dichotomized to reflect elevated depressive symptoms. Regression analyses were stratified into low (at least one parent < 8 years schooling / missing data, N=167) or high (both parents ≥ 8 years schooling, N=319) childhood socio-economic status (cSES) groups. Results Korean War GI Bill eligibility predicted fewer depressive symptoms among individuals from low cSES backgrounds [β=-0.64, 95% Confidence Interval (CI):(-1.18, -0.09), p=0.022]. Socio-economic disparities were smaller among veterans than non-veterans for number of depressive symptoms [β=-0.76, 95% (CI):(-1.33, -0.18), P = 0.010] and elevated depressive symptoms [β=-11.7, 95%CI:(-8.2, -22.6), P = 0.035]. Conclusions Korean War GI Bill eligibility predicted smaller socio-economic disparities in depression markers. PMID:26778285

Same-sex cohabitors and health: the role of race-ethnicity, gender, and socioeconomic status.

PubMed

Liu, Hui; Reczek, Corinne; Brown, Dustin

2013-03-01

A legacy of research finds that marriage is associated with good health. Yet same-sex cohabitors cannot marry in most states in the United States and therefore may not receive the health benefits associated with marriage. We use pooled data from the 1997 to 2009 National Health Interview Surveys to compare the self-rated health of same-sex cohabiting men (n = 1,659) and same-sex cohabiting women (n = 1,634) with that of their different-sex married, different-sex cohabiting, and unpartnered divorced, widowed, and never-married counterparts. Results from logistic regression models show that same-sex cohabitors report poorer health than their different-sex married counterparts at the same levels of socioeconomic status. Additionally, same-sex cohabitors report better health than their different-sex cohabiting and single counterparts, but these differences are fully explained by socioeconomic status. Without their socioeconomic advantages, same-sex cohabitors would report similar health to nonmarried groups. Analyses further reveal important racial-ethnic and gender variations.

Compliance with therapy for cervical dysplasia among women of low socioeconomic status.

PubMed

Laedtke, T W; Dignan, M

1992-01-01

This paper reports results of a project designed to examine factors related to compliance with referral for follow-up and treatment of cervical dysplasia. Women studied had cervical dysplasia diagnosed by Pap smear between May 1989 and April 1990. These women had regular follow-up at the gynecology clinic of the Reynolds Health Center in Winston-Salem or at one of 14 county health departments in northwestern North Carolina. Data were collected by chart review, and included age, race, place of residence, marital status, parity/gravidity, education, previous papillomavirus infections, method of payment, and previous Pap smear results. Patients were traced through the treatment protocol, and compliance was assessed at each appointment. In these women of low socioeconomic status, approximately one third of those referred for treatment of dysplasia were noncompliant with referral.

Age group athletes in inline skating: decrease in overall and increase in master athlete participation in the longest inline skating race in Europe – the Inline One-Eleven

PubMed Central

Teutsch, Uwe; Knechtle, Beat; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald

2013-01-01

Background Participation and performance trends in age group athletes have been investigated in endurance and ultraendurance races in swimming, cycling, running, and triathlon, but not in long-distance inline skating. The aim of this study was to investigate trends in participation, age, and performance in the longest inline race in Europe, the Inline One-Eleven over 111 km, held between 1998 and 2009. Methods The total number, age distribution, age at the time of the competition, and race times of male and female finishers at the Inline One-Eleven were analyzed. Results Overall participation increased until 2003 but decreased thereafter. During the 12-year period, the relative participation in skaters younger than 40 years old decreased while relative participation increased for skaters older than 40 years. The mean top ten skating time was 199 ± 9 minutes (range: 189–220 minutes) for men and 234 ± 17 minutes (range: 211–271 minutes) for women, respectively. The gender difference in performance remained stable at 17% ± 5% across years. Conclusion To summarize, although the participation of master long-distance inline skaters increased, the overall participation decreased across years in the Inline One-Eleven. The race times of the best female and male skaters stabilized across years with a gender difference in performance of 17% ± 5%. Further studies should focus on the participation in the international World Inline Cup races. PMID:23690697