Surgical Sterilization, Regret, and Race: Contemporary Patterns*

PubMed Central

Shreffler, Karina M.; McQuillan, Julia; Greil, Arthur L.; Johnson, David R.

2014-01-01

Surgical sterilization is a relatively permanent form of contraception that has been disproportionately used by Black, Hispanic, and Native American women in the United States in the past. We use a nationally representative sample of 4,609 women ages 25 to 45 to determine whether sterilization continues to be more common and consequential by race for reproductive-age women. Results indicate that Native American and Black women are more likely to be sterilized than non-Hispanic White women, and Hispanic and Native American women are more likely than non-Hispanic White women to report that their sterilization surgeries prevent them from conceiving children they want. Reasons for sterilization differ significantly by race. These findings suggest that stratified reproduction has not ended in the United States and that the patterns and consequences of sterilization continue to vary by race. PMID:25592919

Surgical sterilization, regret, and race: contemporary patterns.

PubMed

Shreffler, Karina M; McQuillan, Julia; Greil, Arthur L; Johnson, David R

2015-03-01

Surgical sterilization is a relatively permanent form of contraception that has been disproportionately used by Black, Hispanic, and Native American women in the United States in the past. We use a nationally representative sample of 4592 women ages 25-45 to determine whether sterilization continues to be more common and consequential by race for reproductive-age women. Results indicate that Native American and Black women are more likely to be sterilized than non-Hispanic White women, and Hispanic and Native American women are more likely than non-Hispanic White women to report that their sterilization surgeries prevent them from conceiving children they want. Reasons for sterilization differ significantly by race. These findings suggest that stratified reproduction has not ended in the United States and that the patterns and consequences of sterilization continue to vary by race. Copyright © 2014 Elsevier Inc. All rights reserved.

Ethnic Traditions and the Family: Asian, Black, Greek, Native American, Polynesian and Hispanic Culture. Proceedings of a Symposium (Salt Lake City, Utah, April 30, May 1, 7-8 and 14-15, 1980).

ERIC Educational Resources Information Center

Lewy, Rafael, Ed.; Henry, Alberta, Ed.

Presentations from a symposium series sponsored by the Salt Lake City School District and the Utah Endowment for the Humanities in the spring of 1980 describe the family customs and ethnic traditions of Asians, Blacks, Greeks, Native Americans, Polynesians, and Hispanics. The first presentation notes the differences between Asians who have been in…

Variation in Birth Outcomes by Mother’s Country of Birth Among Non-Hispanic Black Women in the United States

PubMed Central

Vang, Zoua; Culhane, Jennifer F.

2014-01-01

Rates of prematurity (PTB) and small-for-gestational age (SGA) were compared between US-born and foreign-born non-Hispanic black women. Comparisons were also made between Sub-Saharan African-born and Caribbean-born black women and by maternal country of birth within the two regions. Comparisons were adjusted for sociodemographic, health behavioral and medical risk factors available on the birth record. Birth record data (2008) from all states (n = 27) where mother’s country of birth was recorded were used. These data comprised 58 % of all singleton births to non-Hispanic black women in that year. Pearson Chi square and logistic regression were used to investigate variation in the rates of PTB and SGA by maternal nativity. Foreign-born non-Hispanic black women had significantly lower rates of PTB (OR 0.727; CI 0. 726, 0.727) and SGA (OR 0.742; CI 0.739–0.745) compared to US-born non-Hispanic black women in a fully adjusted model. Sub-Saharan African-born black women compared to Caribbean-born black women had significantly lower rates of PTB and SGA. Within each region, the rates of PTB and SGA varied by mother’s country of birth. These differences could not be explained by adjustment for known risk factors obtained from vital records. Considerable heterogeneity in rates of PTB and SGA among non-Hispanic black women in the US by maternal nativity was documented and remained unexplained after adjustment for known risk factors. PMID:24756226

Female Sterilization and Poor Mental Health: Rates and Relatedness among American Indian and Alaska Native Women.

PubMed

Cackler, Christina J J; Shapiro, Valerie B; Lahiff, Maureen

2016-01-01

To describe the reproductive and mental health of American Indian and Alaska Native (AI/AN) women, an understudied population. Data from the 2004 Behavioral Risk Factor Surveillance System survey were analyzed to determine the 1) prevalence of female sterilization among a nationally representative sample of reproductive age AI/AN women and 2) the association of female sterilization and poor mental health among AI/AN women compared with non-Hispanic White, non-Hispanic Black, and Hispanic women. Nearly 25% of AI/AN women reported female sterilization, a prevalence higher than the comparison racial/ethnic groups (p < .005). Adjusting for sociodemographic characteristics, AI/AN women reporting female sterilization had nearly 2.5 times the odds of poor mental health compared with AI/AN women not reporting female sterilization (p = .001). The same magnitude of relationship between female sterilization and poor mental health was not found for non-Hispanic White, non-Hispanic Black, and Hispanic women. The prevalence of female sterilization is greater among AI/AN women compared with non-Hispanic White, non-Hispanic Black, and Hispanic women, and AI/AN women reporting female sterilization have higher odds of reporting poor mental health. Common cultural experiences, such as a shared ancestral history of forced sterilizations, may be relevant, and could be considered when providing reproductive and mental health services to AI/AN women. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

State-specific prevalence of selected health behaviors, by race and ethnicity--Behavioral Risk Factor Surveillance System, 1997.

PubMed

Bolen, J C; Rhodes, L; Powell-Griner, E E; Bland, S D; Holtzman, D

2000-03-24

In the United States, disparities in risks for chronic disease (e.g., diabetes, cardiovascular disease, and cancer) and injury exist among racial and ethnic groups. This report summarizes findings from the 1997 Behavioral Risk Factor Surveillance System (BRFSS) of the distribution of access to health care, health-status indicators, health-risk behaviors, and use of clinical preventive services across five racial and ethnic groups (i.e., whites, blacks, Hispanics, American Indians or Alaska Natives, and Asians or Pacific Islanders) and by state. 1997. The BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (i.e., persons aged > or = 18 years) population. In 1997, all 50 states, the District of Columbia, and Puerto Rico participated in the BRFSS. Variations in risk for chronic disease and injury among racial and ethnic groups exist both within states and across states. For example, in Arizona, 11.0% of whites, 26.2% of Hispanics, and 50.5% of American Indians or Alaska Natives reported having no health insurance. Across states, the median percentage of adults who reported not having this insurance ranged from 10.8% for whites to 24.5% for American Indians or Alaska Natives. Other findings are as follows. Blacks, Hispanics, American Indians or Alaska Natives, and Asians or Pacific Islanders were more likely than whites to report poor access to health care (i.e., no health-care coverage and cost as a barrier to obtaining health care). Blacks, Hispanics, and American Indians or Alaska Natives were more likely than whites and Asians or Pacific Islanders to report fair or poor health status, obesity, diabetes, and no leisure-time physical activity. Blacks were substantially more likely than other racial or ethnic groups to report high blood pressure. Among all groups, American Indians or Alaska Natives were the most likely to report cigarette smoking. Except for Asians or Pacific Islanders, the median percentage of adults who reported not always wearing a safety belt while driving or riding in a car was > or = 30%. The Papanicolaou test was the most commonly reported screening measure: > or = 81% of white, black, and Hispanic women with an intact uterine cervix reported having had one in the past 3 years. Among white, black, and Hispanic women aged > or = 50 years, > or = 63% reported having had a mammogram in the past 2 years. Approximately two thirds of white, black, and Hispanic women aged > or = 50 years reported having had both a mammogram and a clinical breast examination in the past 2 years; this behavior was least common among Hispanics and most common among blacks. Screening for colorectal cancer was low among whites, blacks, and Hispanics aged > or = 50 years: in each racial or ethnic group, < or = 20% reported having used a home-kit blood stool test in the past year, and < or = 30% reported having had a sigmoidoscopy within the last 5 years. Differences in median percentages between racial and ethnic groups, as well as between states within each racial and ethnic group, are likely mediated by various factors. According to published literature, socioeconomic factors (e.g., age distribution, educational attainment, employment status, and poverty), lifestyle behaviors (e.g., lack of physical activity, alcohol intake, and cigarette smoking), aspects of the social environment (e.g., educational and economic opportunities, neighborhood and work conditions, and state and local laws enacted to discourage high-risk behaviors), and factors affecting the health-care system (e.g., access to health care, and cost and availability of screening for diseases and health-risk factors) may be associated with these differences. ACTION TAKEN: States will continue to use the BRFSS to collect information about health-risk behaviors among various racial and ethnic groups. (ABSTRACT TRUNCATED)

Autism Spectrum Disorders and Race, Ethnicity, and Nativity: A Population-Based Study

PubMed Central

Becerra, Tracy A.; von Ehrenstein, Ondine S.; Heck, Julia E.; Olsen, Jorn; Arah, Onyebuchi A.; Jeste, Shafali S.; Rodriguez, Michael

2014-01-01

OBJECTIVE: Our understanding of the influence of maternal race/ethnicity and nativity and childhood autistic disorder (AD) in African Americans/blacks, Asians, and Hispanics in the United States is limited. Phenotypic differences in the presentation of childhood AD in minority groups may indicate etiologic heterogeneity or different thresholds for diagnosis. We investigated whether the risk of developing AD and AD phenotypes differed according to maternal race/ethnicity and nativity. METHODS: Children born in Los Angeles County with a primary AD diagnosis at ages 3 to 5 years during 1998–2009 were identified and linked to 1995–2006 California birth certificates (7540 children with AD from a cohort of 1 626 354 births). We identified a subgroup of children with AD and a secondary diagnosis of mental retardation and investigated heterogeneity in language and behavior. RESULTS: We found increased risks of being diagnosed with AD overall and specifically with comorbid mental retardation in children of foreign-born mothers who were black, Central/South American, Filipino, and Vietnamese, as well as among US-born Hispanic and African American/black mothers, compared with US-born whites. Children of US African American/black and foreign-born black, foreign-born Central/South American, and US-born Hispanic mothers were at higher risk of exhibiting an AD phenotype with both severe emotional outbursts and impaired expressive language than children of US-born whites. CONCLUSIONS: Maternal race/ethnicity and nativity are associated with offspring’s AD diagnosis and severity. Future studies need to examine factors related to nativity and migration that may play a role in the etiology as well as identification and diagnosis of AD in children. PMID:24958588

Autism spectrum disorders and race, ethnicity, and nativity: a population-based study.

PubMed

Becerra, Tracy A; von Ehrenstein, Ondine S; Heck, Julia E; Olsen, Jorn; Arah, Onyebuchi A; Jeste, Shafali S; Rodriguez, Michael; Ritz, Beate

2014-07-01

Our understanding of the influence of maternal race/ethnicity and nativity and childhood autistic disorder (AD) in African Americans/blacks, Asians, and Hispanics in the United States is limited. Phenotypic differences in the presentation of childhood AD in minority groups may indicate etiologic heterogeneity or different thresholds for diagnosis. We investigated whether the risk of developing AD and AD phenotypes differed according to maternal race/ethnicity and nativity. Children born in Los Angeles County with a primary AD diagnosis at ages 3 to 5 years during 1998-2009 were identified and linked to 1995-2006 California birth certificates (7540 children with AD from a cohort of 1,626,354 births). We identified a subgroup of children with AD and a secondary diagnosis of mental retardation and investigated heterogeneity in language and behavior. We found increased risks of being diagnosed with AD overall and specifically with comorbid mental retardation in children of foreign-born mothers who were black, Central/South American, Filipino, and Vietnamese, as well as among US-born Hispanic and African American/black mothers, compared with US-born whites. Children of US African American/black and foreign-born black, foreign-born Central/South American, and US-born Hispanic mothers were at higher risk of exhibiting an AD phenotype with both severe emotional outbursts and impaired expressive language than children of US-born whites. Maternal race/ethnicity and nativity are associated with offspring's AD diagnosis and severity. Future studies need to examine factors related to nativity and migration that may play a role in the etiology as well as identification and diagnosis of AD in children. Copyright © 2014 by the American Academy of Pediatrics.

12 CFR 202.13 - Information for monitoring purposes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Latino, and not Hispanic or Latino; and race, using the categories American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White; (ii) Sex; (iii...

Two-Year Colleges for Women and Minorities: Enabling Access to the Baccalaureate. Garland Studies in Higher Education. Garland Reference Library of Social Science.

ERIC Educational Resources Information Center

Townsend, Barbara, Ed.

This book focuses on approximately 250 nonprofit, two-year colleges with a student body that is entirely female or at least 25% Black, Hispanic, or Native American. These special-focus colleges include two-year colleges, historically black colleges (HBC), Hispanic-serving institutions (HIS), and tribal colleges, with some of the schools being…

Diversity by race, Hispanic ethnicity, and sex of the United States medical oncology physician workforce over the past quarter century.

PubMed

Deville, Curtiland; Chapman, Christina H; Burgos, Ramon; Hwang, Wei-Ting; Both, Stefan; Thomas, Charles R

2014-09-01

To assess the medical oncology (MO) physician workforce diversity by race, Hispanic ethnicity, and sex, with attention to trainees. Public registries were used to assess 2010 differences among MO practicing physicians, academic faculty, and fellows; internal medicine (IM) residents; and the US population, using binomial tests with P < .001 significance adjusting for multiple comparisons. Significant changes in fellow representation from 1986 to 2011 were assessed. Female representation as MO fellows (45.0%) was significantly increased compared with faculty (22.4%) and practicing physicians (27.4%); was no different than IM residents (44.7%, P = .853); and increased significantly, by 1.0% per year. Women were significantly underrepresented as practicing physicians, faculty, and fellows compared with the US population (50.8%). Traditionally underrepresented minorities in medicine (URM) were significantly underrepresented as practicing physicians (7.8%), faculty (5.7%), and fellows (10.9%), versus US population (30.0%). Hispanic MO fellows (7.5%) were increased compared with faculty (3.9%) and practicing physicians (4.1%); Black fellows (3.1%) were no different than faculty (1.8%, P = .0283) or practicing physicians (3.5%, P = .443). When comparing MO fellows versus IM residents, there were no differences for American Indians/Alaska Natives/Native Hawaiians/Pacific Islanders (0.3%, 0.6%, respectively, P = .137) and Hispanics (7.5%, 8.7%, P = .139), unlike Blacks (3.1%, 5.6%, P < .001). There has been no significant change in URM representation, with negligible changes every 5 years for American Indians/Alaska Natives/Native Hawaiians/Pacific Islanders (-0.1%), Blacks (-0.3%), and Hispanics (0.3%). Female fellow representation increased 1% per year over the quarter century indicating historical gains, whereas URM diversity remains unchanged. For Blacks alone, representation as MO fellows is decreased compared with IM residents, suggesting greater disparity in MO training. Copyright © 2014 by American Society of Clinical Oncology.

Allostatic load in foreign-born and US-born blacks: evidence from the 2001-2010 National Health and Nutrition Examination Survey.

PubMed

Doamekpor, Lauren A; Dinwiddie, Gniesha Y

2015-03-01

We tested whether the immigrant health advantage applies to non-Hispanic Black immigrants and examined whether nativity-based differences in allostatic load exist among non-Hispanic Blacks. We used pooled data from the 2001-2010 National Health and Nutrition Examination Survey to compare allostatic load scores for US-born (n = 2745) and foreign-born (n = 152) Black adults. We used multivariate logistic regression techniques to assess the association between nativity and high allostatic load scores, controlling for gender, age, health behaviors, and socioeconomic status. For foreign-born Blacks, length of stay and age were powerful predictors of allostatic load scores. For older US-born Blacks and those who were widowed, divorced, or separated, the risk of high allostatic load was greater. Foreign-born Blacks have a health advantage in allostatic load. Further research is needed that underscores a deeper understanding of the mechanisms driving this health differential to create programs that target these populations differently.

24 CFR 570.416 - Hispanic-serving institutions work study program.

Code of Federal Regulations, 2012 CFR

2012-04-01

... to, students with disabilities and students who are Black, American Indian/Alaska Native, Hispanic... establish recruitment procedures that identify eligible economically disadvantaged and minority students... providing assistance to economically disadvantaged and minority students who participate in a work study...

24 CFR 570.416 - Hispanic-serving institutions work study program.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to, students with disabilities and students who are Black, American Indian/Alaska Native, Hispanic... establish recruitment procedures that identify eligible economically disadvantaged and minority students... providing assistance to economically disadvantaged and minority students who participate in a work study...

24 CFR 570.416 - Hispanic-serving institutions work study program.

Code of Federal Regulations, 2013 CFR

2013-04-01

... to, students with disabilities and students who are Black, American Indian/Alaska Native, Hispanic... establish recruitment procedures that identify eligible economically disadvantaged and minority students... providing assistance to economically disadvantaged and minority students who participate in a work study...

24 CFR 570.416 - Hispanic-serving institutions work study program.

Code of Federal Regulations, 2014 CFR

2014-04-01

... to, students with disabilities and students who are Black, American Indian/Alaska Native, Hispanic... establish recruitment procedures that identify eligible economically disadvantaged and minority students... providing assistance to economically disadvantaged and minority students who participate in a work study...

Disparities in infant mortality and effective, equitable care: are infants suffering from benign neglect?

PubMed

Rowley, Diane L; Hogan, Vijaya

2012-04-01

Quality care for infant mortality disparity elimination requires services that improve health status at both the individual and the population level. We examine disparity reduction due to effective care and ask the following question: Has clinical care ameliorated factors that make some populations more likely to have higher rates of infant mortality compared with other populations? Disparities in postneonatal mortality due to birth defects have emerged for non-Hispanic black and Hispanic infants. Surfactant and antenatal steroid therapy have been accompanied by growing disparities in respiratory distress syndrome mortality for black infants. Progesterone therapy has not reduced early preterm birth, the major contributor to mortality disparities among non-Hispanic black and Puerto Rican infants. The Back to Sleep campaign has minimally reduced SIDS disparities among American Indian/Alaska Native infants, but it has not reduced disparities among non-Hispanic black infants. In general, clinical care is not equitable and contributes to increasing disparities.

Ethnic identity, acculturation and the prevalence of lifetime psychiatric disorders among black, Hispanic, and Asian adults in the U.S.

PubMed

Burnett-Zeigler, Inger; Bohnert, Kipling M; Ilgen, Mark A

2013-01-01

Past research has asserted that racial/ethnic minorities are more likely to develop psychiatric disorders due to their increased exposure to stressors; however most large epidemiologic studies have found that individuals who are Black or Hispanic are less likely to have most psychiatric disorders than those who are White. This study examines the associations between ethnic identity, acculturation, and major psychiatric disorders among Black, Hispanic, and Asian adults in the U.S. The sample included Wave 2 respondents to the National Epidemiologic Survey on Alcohol Related Conditions (NESARC), a large population-based survey, who self-identified as Black (N = 6219), Asian/Native Hawaiian/Other pacific islander (N = 880), and Hispanic (N = 5963). Multivariable regression analyses were conducted examining the relationships between ethnic identity, acculturation, and the prevalence of psychiatric disorders. Higher scores on the ethnic identity measure were associated with decreased odds of having any lifetime psychiatric diagnoses for those who were Black (AOR = 0.978; CI = 0.967-0.989), Hispanic (AOR = 0.974; CI = 0.963-0.985), or Asian (AOR = 0.96; CI = 0.936-0.984). Higher levels of acculturation were associated with an increased odds of having any lifetime psychiatric diagnosis for those who were Black (AOR = 1.027; CI = 1.009-1.046), Hispanic (AOR = 1.033; CI = 1.024-1.042), and Asian (AOR = 1.029; CI = 1.011-1.048). These findings suggest that a sense of pride, belonging, and attachment to one's racial/ethnic group and participating in ethnic behaviors may protect against psychopathology; alternatively, losing important aspects of one's ethnic background through fewer opportunities to use one's native language and socialize with people of their ethnic group other may be a risk factor for psychopathology. Copyright © 2012 Elsevier Ltd. All rights reserved.

34 CFR 648.9 - What definitions apply?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Alaskan Native, American Indian, Asian-American, Black (African-American), Hispanic American, Native... institution of higher education in which the students are enrolled; and (vi) Has necessary research resources not otherwise readily available in the institutions in which students are enrolled. Fees mean non...

34 CFR 648.9 - What definitions apply?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Alaskan Native, American Indian, Asian-American, Black (African-American), Hispanic American, Native... institution of higher education in which the students are enrolled; and (vi) Has necessary research resources not otherwise readily available in the institutions in which students are enrolled. Fees mean non...

34 CFR 648.9 - What definitions apply?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Alaskan Native, American Indian, Asian-American, Black (African-American), Hispanic American, Native... institution of higher education in which the students are enrolled; and (vi) Has necessary research resources not otherwise readily available in the institutions in which students are enrolled. Fees mean non...

34 CFR 648.9 - What definitions apply?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Alaskan Native, American Indian, Asian-American, Black (African-American), Hispanic American, Native... institution of higher education in which the students are enrolled; and (vi) Has necessary research resources not otherwise readily available in the institutions in which students are enrolled. Fees mean non...

Alcoholism and Minority Populations.

ERIC Educational Resources Information Center

Watts, Thomas D.; Wright, Roosevelt, Jr.

1991-01-01

Briefly discusses some aspects of the role of the state and the position of minorities in respect to alcoholism policies and services. Includes case study of a Black alcoholic. Refers readers to studies on Black alcoholism, Native American alcoholism, Hispanic alcoholism, and Asian-American alcoholism. (Author/NB)

Does the Hispanic Paradox in U.S. Adult Mortality Extend to Disability?

PubMed Central

Hummer, Robert A.; Chiu, Chi-Tsun; González-González, César; Wong, Rebeca

2015-01-01

Studies consistently document a Hispanic paradox in U.S. adult mortality, whereby Hispanics have similar or lower mortality rates than non-Hispanic whites despite lower socioeconomic status. This study extends this line of inquiry to disability, especially among foreign-born Hispanics, since their advantaged mortality seemingly should be paired with health advantages more generally. We also assess whether the paradox extends to U.S.-born Hispanics to evaluate the effect of nativity. We calculate multistate life tables of life expectancy with disability to assess whether racial/ethnic and nativity differences in the length of disability-free life parallel differences in overall life expectancy. Our results document a Hispanic paradox in mortality for foreign-born and U.S.-born Hispanics. However, Hispanics’ low mortality rates are not matched by low disability rates. Their disability rates are substantially higher than those of non-Hispanic whites and generally similar to those of non-Hispanic blacks. The result is a protracted period of disabled life expectancy for Hispanics, both foreign- and U.S.-born. PMID:25821283

Are Hispanic Women Happier About Unintended Births?

PubMed Central

Hartnett, Caroline Sten

2014-01-01

Reducing unintended pregnancies – particularly among Hispanic and Black women, who have relatively high rates – is a key public health goal in the United States. However, descriptive literature has suggested that Hispanic women are happier about these pregnancies compared with White and Black women, which could mean that there is variation across groups in the consequences of the resulting births. The purpose of this study was to examine variations in happiness about unintended births by race-ethnicity and to assess possible explanations for these differences. Using data from the National Survey of Family Growth (n=1,462 births) I find that Hispanic women report being happier about unintended births compared with White and Black women. Higher happiness among Hispanics was particularly pronounced among a subgroup of women: those who were foreign-born and very religious. Overall, results confirm previous findings that intention status alone is incomplete for capturing pregnancy experiences. Happiness offers complementary information that is important when making comparisons by race-ethnicity and nativity. PMID:25339786

Racial/Ethnic Differences in Treatment for Substance Use Disorders among U.S. Adolescents

ERIC Educational Resources Information Center

Cummings, Janet R.; Wen, Hefei; Druss, Benjamin G.

2011-01-01

Objective: This study examined differences in treatment rates for substance use disorders (SUD) among adolescents of white, black, Hispanic, Asian, Native American/Alaska Native, and Native Hawaiian/Pacific Islander race/ethnicity. Method: Eight years of cross-sectional data (2001-2008) were pooled from the National Survey on Drug Use and Health…

28 CFR 42.302 - Application.

Code of Federal Regulations, 2011 CFR

2011-07-01

... responsibility in compliance matters in agencies of the kind mentioned in this paragraph rests with the... Black, not of Hispanic origin; Asian or Pacific Islanders; American Indians or Alaskan Native; or...

28 CFR 42.302 - Application.

Code of Federal Regulations, 2014 CFR

2014-07-01

... responsibility in compliance matters in agencies of the kind mentioned in this paragraph rests with the... Black, not of Hispanic origin; Asian or Pacific Islanders; American Indians or Alaskan Native; or...

28 CFR 42.302 - Application.

Code of Federal Regulations, 2012 CFR

2012-07-01

... responsibility in compliance matters in agencies of the kind mentioned in this paragraph rests with the... Black, not of Hispanic origin; Asian or Pacific Islanders; American Indians or Alaskan Native; or...

28 CFR 42.302 - Application.

Code of Federal Regulations, 2013 CFR

2013-07-01

... responsibility in compliance matters in agencies of the kind mentioned in this paragraph rests with the... Black, not of Hispanic origin; Asian or Pacific Islanders; American Indians or Alaskan Native; or...

Race/ethnicity and all-cause mortality in US adults: revisiting the Hispanic paradox.

PubMed

Borrell, Luisa N; Lancet, Elizabeth A

2012-05-01

We examined the association between race/ethnicity and all-cause mortality risk in US adults and whether this association differs by nativity status. We used Cox proportional hazards regression to estimate all-cause mortality rates in 1997 through 2004 National Health Interview Survey respondents, relating the risk for Hispanic subgroup, non-Hispanic Black, and other non-Hispanic to non-Hispanic White adults before and after controlling for selected characteristics stratified by age and gender. We observed a Hispanic mortality advantage over non-Hispanic Whites among women that depended on nativity status: US-born Mexican Americans aged 25 to 44 years had a 90% (95% confidence interval [CI] = 0.03, 0.31) lower death rate; island- or foreign-born Cubans and other Hispanics aged 45 to 64 years were more than two times less likely to die than were their non-Hispanic White counterparts. Island- or foreign-born Puerto Rican and US-born Mexican American women aged 65 years and older exhibited at least a 25% lower rate of dying than did their non-Hispanics White counterparts. The "Hispanic paradox" may not be a static process and may change with this population growth and its increasing diversity over time.

Higher Education: Gaps in Access and Persistence Study. Statistical Analysis Report. NCES 2012-046

ERIC Educational Resources Information Center

Ross, Terris; Kena, Grace; Rathbun, Amy; KewalRamani, Angelina; Zhang, Jijun; Kristapovich, Paul; Manning, Eileen

2012-01-01

Numerous studies, including those of the National Center for Education Statistics (NCES), have documented persistent gaps between the educational attainment of White males and that of Black, Hispanic, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander males. Further, there is evidence of growing gaps by sex within these…

Prevalence and Disparities in Tobacco Product Use Among American Indians/Alaska Natives - United States, 2010-2015.

PubMed

Odani, Satomi; Armour, Brian S; Graffunder, Corinne M; Garrett, Bridgette E; Agaku, Israel T

2017-12-22

An overarching goal of Healthy People 2020 is to achieve health equity, eliminate disparities, and improve health among all groups.* Although significant progress has been made in reducing overall commercial tobacco product use, † disparities persist, with American Indians or Alaska Natives (AI/ANs) having one of the highest prevalences of cigarette smoking among all racial/ethnic groups (1,2). Variations in cigarette smoking among AI/ANs have been documented by sex and geographic location (3), but not by other sociodemographic characteristics. Furthermore, few data exist on use of tobacco products other than cigarettes among AI/ANs (4). CDC analyzed self-reported current (past 30-day) use of five tobacco product types among AI/AN adults from the 2010-2015 National Survey on Drug Use and Health (NSDUH); results were compared with six other racial/ethnic groups (Hispanic; non-Hispanic white [white]; non-Hispanic black [black]; non-Hispanic Native Hawaiian or other Pacific Islander [NHOPI]; non-Hispanic Asian [Asian]; and non-Hispanic multirace [multirace]). Prevalence of current tobacco product use was significantly higher among AI/ANs than among non-AI/ANs combined for any tobacco product, cigarettes, roll-your-own tobacco, pipes, and smokeless tobacco. Among AI/ANs, prevalence of current use of any tobacco product was higher among males, persons aged 18-25 years, those with less than a high school diploma, those with annual family income <$20,000, those who lived below the federal poverty level, and those who were never married. Addressing the social determinants of health and providing evidence-based, population-level, and culturally appropriate tobacco control interventions could help reduce tobacco product use and eliminate disparities in tobacco product use among AI/ANs (1).

Risk of Stress Fracture Varies by Race/Ethnic Origin in a Cohort Study of 1.3 Million US Army Soldiers.

PubMed

Bulathsinhala, Lakmini; Hughes, Julie M; McKinnon, Craig J; Kardouni, Joseph R; Guerriere, Katelyn I; Popp, Kristin L; Matheny, Ronald W; Bouxsein, Mary L

2017-07-01

Stress fractures (SF) are common and costly injuries in military personnel. Risk for SF has been shown to vary with race/ethnicity. Previous studies report increased SF risk in white and Hispanic Soldiers compared with black Soldiers. However, these studies did not account for the large ethnic diversity in the US military. We aimed to identify differences in SF risk among racial/ethnic groups within the US Army. A retrospective cohort study was conducted using data from the Total Army Injury and Health Outcomes Database from 2001 until 2011. SF diagnoses were identified from ICD-9 codes. We used Cox-proportional hazard models to calculate time to SF by racial/ethnic group after adjusting for age, education, and body mass index. We performed a sex-stratified analysis to determine whether the ethnic variation in SF risk depends on sex. We identified 21,549 SF cases in 1,299,332 Soldiers (more than 5,228,525 person-years of risk), revealing an overall incidence rate of 4.12 per 1000 person-years (7.47 and 2.05 per 1000 person-years in women and men, respectively). Using non-Hispanic blacks as the referent group, non-Hispanic white women had the highest risk of SF, with a 92% higher risk of SF than non-Hispanic black women (1.92 [1.81-2.03]), followed by American Indian/Native Alaskan women (1.72 [1.44-1.79]), Hispanic women (1.65 [1.53-1.79]), and Asian women (1.32 [1.16-1.49]). Similarly, non-Hispanic white men had the highest risk of SF, with a 59% higher risk of SF than non-Hispanic black men (1.59 [1.50-1.68]), followed by Hispanic men (1.19 [1.10-1.29]). When examining the total US Army population, we found substantial differences in the risk of stress fracture among racial/ethnic groups, with non-Hispanic white Soldiers at greatest risk and Hispanic, American Indian/Native Alaskan, and Asian Soldiers at an intermediate risk. Additional studies are needed to determine the factors underlying these race- and ethnic-related differences in stress fracture risk. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.

Living with a Grandparent and Parent in Early Childhood: Associations with School Readiness and Differences by Demographic Characteristics

PubMed Central

Pilkauskas, Natasha V.

2016-01-01

Despite the increasing prevalence of three-generation family households (grandparent, parent, child), relatively little research has studied these households during early childhood. Using nationally representative data from the Early Childhood Longitudinal Study – Birth Cohort (N∼6,550), this study investigates the associations between three-generation coresidence in early childhood and school readiness, and how the associations differ by maternal age, race/ethnicity, nativity, relationship status and poverty. For the full sample of children, no associations between three-generation coresidence and school readiness were found. Analyses by demographic characteristics found that race/ethnicity and nativity moderate the associations; whereas maternal age, relationship status and poverty do not. The findings suggest that three-generation coresidence was associated with lower levels of expressive language for White, Asian and Black children, but more expressive language for Hispanic children. Coresidence was also associated with more externalizing behavior for White and American Indian/Alaskan Native children but less externalizing behavior for Hispanic and Black children. Analyses by maternal nativity found that for children of immigrant mothers, three-generation coresidence was associated with more expressive language and less externalizing and internalizing behavior. Interactions between race/ethnicity and nativity found that the positive associations for Hispanic children were concentrated among children of immigrant parents. No differences were found between grandmother-only and grandmother/grandfather three-generation family households. Overall the findings suggest there may be heterogeneity by race/ethnicity and nativity in the associations between three-generation coresidence and school readiness. PMID:25365124

Understanding your breast cancer risk

MedlinePlus

... more often than African American/Black, Hispanic/Latina, Asian/Pacific Islander, or American Indian/Alaska Native women. ... reduce radiation from imaging tests, especially during puberty. Breastfeeding, if possible, may decrease your risk. Talk with ...

Hispanic Fathers and Risk for Maltreatment in Father-Involved Families of Young Children

PubMed Central

Lee, Shawna J.; Altschul, Inna; Shair, Sarah R.; Taylor, Catherine A.

2011-01-01

The Hispanic population is the fastest growing segment of U.S. population. However, risks for child maltreatment in the foreign-born and native-born Hispanic populations are largely understudied. To address this knowledge gap, we explore the association of sociodemographic factors, psychosocial parenting factors, and nativity status with Hispanic fathers’ aggression toward their young children (3 to 5 years). Using the Fragile Families and Child Wellbeing Study and the follow-up In-Home Longitudinal Study of Pre-School Aged Children, we examine data for 372 foreign-born (FB; n = 155) and native-born (NB; n = 217) Hispanic biological fathers residing in the home when the study target child was 3 years old. Results of analysis at the bivariate level show FB Hispanic fathers engage in fewer aggressive behaviors than NB Hispanic, White, or Black fathers. Time-lagged path models of Hispanic fathers show FB Hispanic fathers use less aggression than NB Hispanic fathers. Length of time in the United States was not associated with parenting aggression. Path models also examine paternal psychosocial factors such as alcohol use, depression, parenting stress, and involvement in caregiving, and control for the child’s aggressive behavior. Results suggest one reason Hispanic children do not face heightened risk for child welfare involvement, despite socioeconomic risks, is that FB Hispanic fathers use less aggression toward their young children. An implication of this finding is that socioeconomic and parenting behavior risks must be considered separately when practitioners are considering issues related to the representation of minority children in the child welfare system. PMID:22624074

Knocking at the College Door: Projections of High School Graduates by State and Race/Ethnicity, 1992-2022. Wyoming

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2008

2008-01-01

The 7th edition of this publication provides updated projections of high school graduates for each year and each state (plus the District of Columbia) through 2022. The profile breaks down the projections by major racial and ethnic groups: (1) American Indian/Alaska Native; (2) Asian/Pacific Islander; (3) Black, non-Hispanic; (4) Hispanic; and (5)…

Knocking at the College Door: Projections of High School Graduates by State and Race/Ethnicity, 1992-2022. Alaska

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2008

2008-01-01

The 7th edition of this publication provides updated projections of high school graduates for each year and each state (plus the District of Columbia) through 2022. The profile breaks down the projections by major racial and ethnic groups: (1) American Indian/Alaska Native; (2) Asian/Pacific Islander; (3) Black, non-Hispanic; (4) Hispanic; and (5)…

Knocking at the College Door: Projections of High School Graduates by State and Race/Ethnicity, 1992-2022. Louisiana

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2008

2008-01-01

The 7th edition of this publication provides updated projections of high school graduates for each year and each state (plus the District of Columbia) through 2022. The profile breaks down the projections by major racial and ethnic groups: (1) American Indian/Alaska Native; (2) Asian/Pacific Islander; (3) Black, non-Hispanic; (4) Hispanic; and (5)…

Knocking at the College Door: Projections of High School Graduates by State and Race/Ethnicity, 1992-2022. Mississippi

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2008

2008-01-01

The 7th edition of this publication provides updated projections of high school graduates for each year and each state (plus the District of Columbia) through 2022. The profile breaks down the projections by major racial and ethnic groups: (1) American Indian/Alaska Native; (2) Asian/Pacific Islander; (3) Black, non-Hispanic; (4) Hispanic; and (5)…

The prevalence, burden, and treatment of severe, frequent, and migraine headaches in US minority populations: statistics from National Survey studies.

PubMed

Loder, Stephen; Sheikh, Huma U; Loder, Elizabeth

2015-02-01

The prevalence and burden of migraine and other severe headaches in the US population as a whole is well documented. Prevalence and treatment patterns in US racial and ethnic minorities, however, have received less attention. We sought to assemble and compare this information as identified in large, nationally representative studies. We searched for summary statistics from studies performed in the United States between 1989 and 2014. Included studies had to provide population-based, nationally or broadly representative information on the prevalence, burden, or treatment of severe or frequent headache or migraine in adult US Blacks, Hispanics, Native Americans, or Asians. Nine studies were included in the review. Prevalence data from the National Health Interview Survey (NHIS) provide the most comprehensive information for major racial and ethnic groups. The average prevalence of severe headache or migraine from 2005 to 2012 NHIS was 17.7% for Native Americans, 15.5% for Whites, 14.5% for Hispanics, 14.45% for Blacks, and 9.2% for Asians. Severe headache or migraine prevalence was higher in females of all races and ethnic groups compared with males and across all included studies. Female to male prevalence ratios from the 2005-2012 NHIS were 2.1 for Whites, 2.5 for Hispanics, 2.1 for Blacks, and 2.0 for Asians. Among those with chronic migraine (≥15 days of headache per month), prevalence data from the American Migraine Prevalence and Prevention study showed that the prevalence of chronic migraine was highest in Hispanic women (2.26% compared with 1.2% for White females), whereas White males had the lowest prevalence at 0.46%. Data from the National Hospital Ambulatory Care Survey and National Ambulatory Care Survey show that Hispanics make only 89.5 annual ambulatory care visits per 10,000 population at which they receive a diagnosis of migraine, compared with 176.3 for Whites and 133.2 for Blacks. In contrast, visit rates resulting in a diagnosis of nonspecific headache were more comparable across all groups. Only one study obtained information on selected subgroups within Hispanic and Asian populations. This showed that differences among these subgroups, which suggest composite prevalence estimates for broadly defined racial and ethnic groups such as Asians, may conceal meaningful differences in subgroups, such as Vietnamese or Filipinos. In the United States, migraine prevalence is highest among Native Americans, then Whites, followed closely by Hispanics and Blacks. Asians have the lowest prevalence of severe, frequent headache or migraine of the major racial or ethnic groups. Differences in diagnosis and treatment of headache and migraine may indicate racial and ethnic disparities in access and quality of care for minority patients. © 2015 American Headache Society.

Epidemiology of syphilis among Hispanic women and associations with congenital syphilis, Maricopa county, Arizona.

PubMed

Kirkcaldy, Robert D; Su, John R; Taylor, Melanie M; Koumans, Emilia; Mickey, Tom; Winscott, Michelle; Kenney, Kerry; Weinstock, Hillard S

2011-07-01

We investigated factors associated with high rates of congenital syphilis among Hispanic infants in Maricopa County, AZ. Using 2004-2008 syphilis case report data from the state and county health departments, we examined characteristics of pregnant and nonpregnant women with syphilis and their male partners. During 2004-2008, 970 women were reported to have syphilis: 49% were Hispanic (of whom 49% were non-US citizens), 27% were white, 13% were black, and 8% were American Indian/Alaskan Native. Although 16% of Hispanic noncitizens reported drug use or high-risk sexual behaviors, 64% of these women had a male sex partner who reported drug use or anonymous sex. Hispanic women with syphilis were more likely to be pregnant (37%) than white (15%) or black women (13%) (P < 0.05), and were overrepresented among pregnant women with syphilis. Pregnant Hispanic noncitizens were treated later than pregnant Hispanic citizens (median 28 weeks gestation vs. 21 weeks, P = 0.01). Innovative congenital syphilis prevention strategies that are relevant to Hispanic women are warranted. Strategies should address the reproductive health and prenatal care needs of Hispanic women, and may include interventions for their male partners.

Premature death rates diverge in the United States

Cancer.gov

An NCI press release on a study that shows premature death rates have declined in the United States among Hispanics, blacks, and Asian/Pacific Islanders but increased among whites and American Indian/Alaska Natives.

School Segregation, Charter Schools, and Access to Quality Education*

PubMed Central

Logan, John R.; Burdick-Will, Julia

2015-01-01

Race, class, neighborhood, and school quality are all highly inter-related in the American educational system. In the last decade a new factor has come into play, the option of attending a charter school. We offer a comprehensive analysis of the disparities among public schools attended by white, black, Hispanic, Asian, and Native American children in 2010–2011, including all districts in which charter schools existed. We compare schools in terms of poverty concentration, racial composition, and standardized test scores, and we also examine how attending a charter or non-charter school affects these differences. Black and Hispanic (and to a lesser extent Native American and Asian) students attend elementary and high schools with higher rates of poverty than white students. Especially for whites and Asians, attending a charter school means lower exposure to poverty. Children’s own race and the poverty and charter status of their schools affect the test scores and racial isolation of schools that children attend in complex combinations. Most intriguing, attending a charter school means attending a better performing school in high-poverty areas but a lower performing school in low-poverty areas. Yet even in the best case the positive effect of attending a charter school only slightly offsets the disadvantages of black and Hispanic students. PMID:27616813

Knocking at the College Door: Projections of High School Graduates by State and Race/Ethnicity, 1992-2022. District of Columbia

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2008

2008-01-01

The 7th edition of this publication provides updated projections of high school graduates for each year and each state (plus the District of Columbia) through 2022. The profile breaks down the projections by major racial and ethnic groups: (1) American Indian/Alaska Native; (2) Asian/Pacific Islander; (3) Black, non-Hispanic; (4) Hispanic; and (5)…

Knocking at the College Door: Projections of High School Graduates by State and Race/Ethnicity, 1992-2022. South Dakota

ERIC Educational Resources Information Center

Western Interstate Commission for Higher Education, 2008

2008-01-01

The 7th edition of this publication provides updated projections of high school graduates for each year and each state (plus the District of Columbia) through 2022. The profile breaks down the projections by major racial and ethnic groups: (1) American Indian/Alaska Native; (2) Asian/Pacific Islander; (3) Black, non-Hispanic; (4) Hispanic; and (5)…

Prevalence of victimization and exposure to violence in a sample of Hispanic Americans: a research note.

PubMed

Miller, Holly Ventura; Lopez, Kristina M

2015-05-01

Research on the growing U.S. Hispanic population has increased in recent years, although much of this work has examined differences between the foreign- and native-born or between Hispanics and non-Hispanics. Fewer studies have explored within-group differences (Mexican vs. Puerto Rican vs. Cuban, etc.) and none have assessed variability in the prevalence of victimization across these diverse groups. Unfortunately, the available evidence is somewhat inconclusive regarding the prevalence of victimization among Hispanics and relative to other demographic groups such as Whites and Blacks. This study first aims to provide clarification as to the prevalence of Hispanic victimization relative to non-Hispanic Whites (NHW) and non-Hispanic Blacks (NHB). Then, we assess within-group differences for the Hispanic subsample for each of the victimization measures. Using Wave IV of the National Longitudinal Study of Adolescent Health (Add Health), we estimate the prevalence of various forms of criminal victimization and exposure to violence for Hispanics, NHW, and NHB. Results suggest that significant differences exist between Hispanics and both NHW and NHB. More specifically, Hispanics were less likely to report most of the victimization outcomes than either group. Significant differences in victimization were also observed between Hispanic subgroups. Generally, Mexicans and Puerto Ricans were most likely to report victimization whereas Cubans and Chicanos (with the exception of property crime) were least likely to report victimization. © The Author(s) 2014.

78 FR 72677 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-03

..., Black, Hispanic, Native Hawaiian or other Pacific Islander, mixed race, or those that do not meet the 25... graduate school. These institutions comprise a mix of 2-year and 4-year colleges, public and private...

29 CFR 1602.20 - Records to be made or kept.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the applicant's identification as “White,” “Black,” “Hispanic,” “Asian or Pacific Islander” or “American Indian or Alaskan Native.” The methods of making such identification are set forth in the...

Maternal ratings of child health and child obesity, variations by mother's race/ethnicity and nativity.

PubMed

Baker, Elizabeth H; Altman, Claire E

2015-05-01

We examined whether indicators of child health, focusing on obesity, are associated with maternal ratings of child health (MRCH) and its variation by mother's ethnicity/nativity, focusing on Hispanics. The early childhood longitudinal study, kindergarten cohort kindergarten-eighth grade waves (n = 48,814) and nested general linear mixed modeling are used to examine excellent MRCH. The only indicator of child health that varies by mother's ethnicity/nativity for MRCH is child obesity. Child obesity did not influence MRCH for foreign-born Hispanic mothers, especially among less acculturated mothers, though significant differences among immigrants by acculturation were not found. However, among native-born white, black, and Hispanic mothers child obesity was associated with a lower likelihood of excellent MRCH even after controls for socioeconomic characteristics, family characteristics, and other indicators of child health are included. MRCH reflect not only child's actual health, but also the mother's perception of what contributes to poor child health. Our findings suggest that less acculturated foreign-born Hispanic mothers are less likely to associate child obesity with poor child health. Cultural orientations that prefer heavier children or are unlikely to associate child obesity with poor child health may contribute to the higher levels of obesity found among their children.

Culture and ethnicity influence outcomes of the Scoliosis Research Society Instrument in adolescent idiopathic scoliosis.

PubMed

Morse, Lee Jae; Kawakami, Noriaki; Lenke, Lawrence G; Sucato, Daniel J; Sanders, James O; Diab, Mohammad

2012-05-20

Retrospective comparative study. To report preoperative differences in the Scoliosis Research Society Outcomes Instrument (SRS-30) between multiple US ethnicities and native Japanese and Korean children with adolescent idiopathic scoliosis (AIS). The SRS-24 was developed in a US cohort with AIS. Comparative studies using the SRS-24 between US and Japanese patients showed differences, suggesting that culture might affect functional outcome. Preoperative SRS-30 outcomes were collected from 1853 children with AIS from 6 different ethnic groups: US white (1234), black (213), Hispanic (78), and Asian (29), as well as native Japanese (192) and Koreans (107). Analysis of covariance of 4 SRS-30 domains (pain, appearance, activity, and mental) was compared between groups adjusting for differences in age, sex, major curve magnitude, and body mass index. Pairwise comparisons of the 4 SRS-30 domains were adjusted for multiple comparisons, using Bonferroni correction. A P value of less than 0.05 was considered significant. Significant differences between ethnicities were found in all domains (P < 0.001). Whites reported more pain than Japanese or Koreans (Japanese = 4.52, Korean = 4.47, white = 4.04). Korean and Japanese patients had the lowest appearance scores (Japanese = 2.89, Korean = 2.73, US Asian = 3.55, Hispanic = 3.11, black = 3.47, white = 3.29). Koreans also had the lowest activity (Korean = 3.64, Japanese = 4.24, US Asian = 4.07, Hispanic = 4.02, black = 4.06, white = 4.16), mental (Korean = 3.70, Japanese = 4.23, US Asian = 4.05, Hispanic = 3.75, black = 4.03, white = 3.94), and total scores (Korean = 3.63, Japanese = 3.92, US Asian = 4.02, Hispanic = 3.75, black = 3.92, and white = 3.84). Culture and ethnicity influence SRS-30 outcomes in AIS. Whites reported more pain than Japanese and Koreans. Japanese and Koreans had the lowest appearance scores. Koreans additionally were distinguished by the lowest activity, mental, and total scores. These cultural and ethnic differences must be taken into account when counseling patients with AIS and studying functional outcomes.

The Contributions of Selected Diseases to Disparities in Death Rates and Years of Life Lost for Racial/Ethnic Minorities in the United States, 1999–2010

PubMed Central

Peace, Frederick; Howard, Virginia J.

2014-01-01

Introduction Differences in risk for death from diseases and other causes among racial/ethnic groups likely contributed to the limited improvement in the state of health in the United States in the last few decades. The objective of this study was to identify causes of death that are the largest contributors to health disparities among racial/ethnic groups. Methods Using data from WONDER system, we measured the relative (age-adjusted mortality ratio [AAMR]) and absolute (difference in years of life lost [dYLL]) differences in mortality risk between the non-Hispanic white population and the black, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander populations for the 25 leading causes of death. Results Many causes contributed to disparities between non-Hispanic whites and blacks, led by assault (AAMR, 7.56; dYLL, 4.5 million). Malignant neoplasms were the second largest absolute contributor (dYLL, 3.8 million) to black–white disparities; we also found substantial relative and absolute differences for several cardiovascular diseases. Only assault, diabetes, and diseases of the liver contributed substantially to disparities between non-Hispanic whites and Hispanics (AAMR ≥ 1.65; dYLL ≥ 325,000). Many causes of death, led by assault (AAMR, 3.25; dYLL, 98,000), contributed to disparities between non-Hispanic whites and American Indians/Alaska Natives; Asian/Pacific Islanders did not have a higher risk than non-Hispanic whites for death from any disease. Conclusion Assault was a substantial contributor to disparities in mortality among non-Asian racial/ethnic minority populations. Research and intervention resources need to target diseases (such as diabetes and diseases of the liver) that affect certain racial/ethnic populations. PMID:25078566

Self-Reported Cognitive Impairment Across Racial/Ethnic Groups in the United States, National Health Interview Survey, 1997-2015.

PubMed

Luo, Huabin; Yu, Gary; Wu, Bei

2018-01-11

The primary objectives of this study were 1) to examine trends of self-reported cognitive impairment among 5 major racial/ethnic groups during 1997-2015 in the United States and 2) to examine differences in the trends across these groups. Data were from the National Health Interview Survey (NHIS). The sample consisted of 155,682 people aged 60 or older. Respondents were asked to report whether any family member was "limited in any way because of difficulty remembering or because of experiencing periods of confusion." Race/ethnicity categories were non-Hispanic white, non-Hispanic black, Native American, Hispanic, and Asian. We applied hierarchical age-period-cohort cross-classified random-effects models for the trend analysis. All analyses accounted for the complex survey design of NHIS. The overall rate of self-reported cognitive impairment increased from 5.7% in 1997 to 6.7% in 2015 (P for trend <.001). Among non-Hispanic white respondents, the rate increased from 5.2% in 1997 to 6.1% in 2015 (slope = 0.14, P for trend <.001). We observed no significant trend in rate of cognitive impairment in other groups. After we controlled for covariates, we found that Asian (B = 0.31), non-Hispanic black (B = 0.37), Hispanic (B = 0.25), and Native American (B = 0.87) respondents were more likely than non-Hispanic white respondents to report cognitive impairment (P <.001 for all). We found an increased rate of self-reported cognitive impairment in older adults of 5 major racial/ethnic groups from 1997 through 2015 in the United States. However, the rate of self-reported cognitive impairment was low, which may suggest underreporting. There is a need to further promote awareness of the disease among individuals, family members, and health care providers.

The role of income in reducing racial and ethnic disparities in emergency room and urgent care center visits for asthma-United States, 2001-2009.

PubMed

Law, Huay-Zong; Oraka, Emeka; Mannino, David M

2011-05-01

To examine racial/ethnic disparities and associated factors in asthma-related emergency room (ER) and urgent care center (UCC) visits among US adults and determine whether disparities vary across increasing income strata. We analyzed data from 238,678 adult respondents from the 2001 to 2009 National Health Interview Survey and calculated the weighted annual prevalence of an ER/UCC visit for persons with current asthma. We used logistic regression to calculate adjusted odds ratios (AORs) for asthma-related ER/UCC visits by race/ethnicity and income, adjusting for demographics, socioeconomic, and other health-related factors. The average annual prevalence of asthma-related ER/UCC visits among adults with current asthma was highest for Puerto Ricans (24.8%, 95% confidence interval [CI]: 20.3-29.9) followed by non-Hispanic American Indian/Alaskan Natives (22.1%, 95% CI: 14.4-32.4), non-Hispanic blacks (20.4%, 95% CI: 18.5-22.4), other Hispanics (17.3%, 95% CI: 15.0-19.9), Asians (11.0%, 95% CI: 7.8-15.4), and non-Hispanic whites (10.1%, 95% CI: 9.4-10.9). Puerto Ricans (AOR: 2.01; 95% CI: 1.54-2.62), non-Hispanic blacks (AOR: 1.72; 95% CI: 1.46-2.03), and other Hispanics (AOR: 1.55; 95% CI: 1.25-1.92) with current asthma had significantly higher odds of an asthma-related ER/UCC visit than non-Hispanic whites. Lower socioeconomic status, obesity, and serious psychological distress were also associated with higher odds of asthma-related ER/UCC visits. Puerto Ricans with the lowest income (AOR: 3.52; 95% CI: 2.27-5.47), non-Hispanic American Indian/Alaskan Natives with the highest income (AOR: 5.71; 95% CI: 1.48-22.13), and non-Hispanic blacks in every income stratum had significantly higher odds of asthma-related ER/UCC visits compared to non-Hispanic whites in the highest income stratum. Racial/ethnic disparities in asthma-related ER/UCC visits persist after accounting for income and other socioeconomic factors. Further research is needed to identify modifiable risk factors directly associated to race/ethnicity to decrease the asthma burden on minority populations.

Racial/ethnic disparities in self-reported short sleep duration among US-born and foreign-born adults.

PubMed

Cunningham, Timothy J; Wheaton, Anne G; Ford, Earl S; Croft, Janet B

2016-12-01

Racial/ethnic health disparities are infrequently considered by nativity status in the United States, although the immigrant population has practically doubled since 1990. We investigated the modifying role of nativity status (US- vs. foreign-born) on racial/ethnic disparities in short sleep duration (<7 h), which has serious health consequences. Cross-sectional data from 23,505 US-born and 4,326 foreign-born adults aged ≥ 18 years from the 2012 National Health Interview Survey and multivariable log-linear regression were used to estimate prevalence ratios (PR) for reporting short sleep duration and their corresponding 95% confidence intervals (CI). After controlling for sociodemographic covariates, short sleep was more prevalent among blacks (PR 1.29, 95% CI: 1.21-1.37), Hispanics (PR 1.18, 95% CI: 1.08, 1.29), and Asians (PR 1.37, 95% CI: 1.16-1.61) than whites among US-born adults. Short sleep was more prevalent among blacks (PR 1.71, 95% CI: 1.38, 2.13) and Asians (PR 1.23, 95% CI: 1.02, 1.47) than whites among the foreign-born. Among both US- and foreign-born adults, blacks and Asians had a higher likelihood of short sleep compared to whites. US-born Hispanics, but not foreign-born Hispanics, had a higher likelihood than their white counterparts. Future research should aim to uncover mechanisms underlying these disparities.

12 CFR 906.11 - Who may participate in the outreach program?

Code of Federal Regulations, 2010 CFR

2010-01-01

... ORGANIZATION AND OPERATIONS OPERATIONS Contractor Outreach Program for Businesses Owned by Minorities, Women..., women, and individuals with disabilities, and businesses unconditionally owned by them, may participate... 1630.3. (b) Minority means Black or African American, American Indian or Alaska Native, Hispanic or...

12 CFR 906.11 - Who may participate in the outreach program?

Code of Federal Regulations, 2011 CFR

2011-01-01

... ORGANIZATION AND OPERATIONS OPERATIONS Contractor Outreach Program for Businesses Owned by Minorities, Women..., women, and individuals with disabilities, and businesses unconditionally owned by them, may participate... 1630.3. (b) Minority means Black or African American, American Indian or Alaska Native, Hispanic or...

The Need to Increase or Maintain Enrollment at Current Levels.

ERIC Educational Resources Information Center

Davidson, David W.

1987-01-01

A serious decline in the optometry schools' applicant pool argues forcefully for increased and aggressive student recruitment, particularly of black, Hispanic, and native Americans, who are underrepresented in the profession. Financial aid and financial management assistance for these groups are also needed. (MSE)

Racial and ethnic variations in incidence and survival of cutaneous melanoma in the United States, 1999-2006.

PubMed

Wu, Xiao-Cheng; Eide, Melody J; King, Jessica; Saraiya, Mona; Huang, Youjie; Wiggins, Charles; Barnholtz-Sloan, Jill S; Martin, Nicolle; Cokkinides, Vilma; Miller, Jacqueline; Patel, Pragna; Ekwueme, Donatus U; Kim, Julian

2011-11-01

Most melanoma studies use data from the National Cancer Institute Surveillance, Epidemiology, and End Results Program or individual cancer registries. Small numbers of melanoma cases have limited in-depth analyses for all racial and ethnic groups. We sought to describe racial and ethnic variations in melanoma incidence and survival. Incidence for invasive melanoma and 5-year melanoma-specific survival were calculated for whites, blacks, American Indians/Alaskan Natives, Asians/Pacific Islanders (API), and Hispanics using data from 38 population-based cancer registries. Incidence rates of melanoma were significantly higher for females than males among whites and Hispanics under 50 years of age and APIs under 40 years of age. White and black patients were older (median age: 59-63 years) compared with Hispanics, American Indians/Alaskan Natives, and API (median age: 52-56 years). The most common histologic type was acral lentiginous melanoma among blacks and superficial spreading melanoma among all other racial and ethnic groups. Hispanics had the highest incidence rate of acral lentiginous melanoma, significantly higher than whites and API. Nonwhites were more likely to have advanced and thicker melanomas at diagnosis and lower melanoma-specific survival compared with whites. Over 50% of melanoma cases did not have specified histology. The numbers of nonwhite patients were still relatively small despite broad population coverage (67% of United States). Racial and ethnic differences in age at melanoma diagnosis, anatomic sites, and histologic types suggest variations in etiologic pathways. The high percentages of advanced and thicker melanomas among nonwhites highlight the need to improve melanoma awareness for all race and ethnicity in the United States. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

A Meta-Analysis of Gifted and Talented Identification Practices

ERIC Educational Resources Information Center

Hodges, Jaret; Tay, Juliana; Maeda, Yukiko; Gentry, Marcia

2018-01-01

Researchers consider the underrepresentation of Black, Hispanic, and Native American students is largely due to the use of traditional methods of identification (i.e., IQ and standardized achievement tests). To address this concern, researchers created novel nontraditional identification methods (e.g., nonverbal tests, student portfolios,…

Understanding Minority Aging: Perspectives and Sources.

ERIC Educational Resources Information Center

Cuellar, Jose B.; And Others

The monograph presents state-of-the-art assessments of available research pertaining to the American Indian/Alaska Native, Pacific Asian, Hispanic, and Black elderly. These assessments, prepared by five prominent minority gerontologists (John Red Horse, Sharon Y. Moriwaki, Sylvia Yuen Schwitters, Jean Keith Crawford, and Maurice Jackson), reflect…

Minority Health in Michigan: Closing the Gap.

ERIC Educational Resources Information Center

Michigan State Dept. of Public Health, Lansing.

The wide and growing discrepancy in mortality rates between the minority populations of Blacks, Hispanics, Arab Americans, Asian/Pacific Islanders, and Native Americans and the White population of the State of Michigan make improving minority health status a matter of simple justice. Section I, "Introduction and Overview," comprises…

Homicides - United States, 2007 and 2009.

PubMed

Logan, Joseph E; Hall, Jeffrey; McDaniel, Dawn; Stevens, Mark R

2013-11-22

According to 1981-2009 data, homicide accounts for 16,000-26,000 deaths annually in the United States and ranks within the top four leading causes of death among U.S. residents aged 1-40 years. Homicide can have profound long-term emotional consequences on families and friends of victims and on witnesses to the violence, as well as cause excessive economic costs to residents of affected communities. For years, homicide rates have been substantially higher among certain populations. Previous reports have found that homicides are higher among males, adolescents and young adults, and certain racial/ethnic groups, such as non-Hispanic blacks, non-Hispanic American Indian/Alaska Natives (AI/ANs), and Hispanics. The 2011 CDC Health Disparities and Inequalities Report (CHDIR) described similar findings for the year 2007. For example, the 2011 report showed that the 2007 homicide rate was highest among non-Hispanic blacks (23.1 deaths per 100,000), followed by AI/ANs (7.8 deaths per 100,000), Hispanics (7.6 deaths per 100,000), non-Hispanic whites (2.7 deaths per 100,000), and Asian/Pacific Islanders (A/PIs) (2.4 deaths per 100,000). In addition, non-Hispanic black men aged 20-24 years were at greatest risk for homicide in 2007, with a rate that exceeded 100 deaths per 100,000 population. Other studies have reported that community factors such as poverty and economic inequality and individual factors such as unemployment and involvement in criminal activities can play a substantial role in these persistent disparities in homicide rates. Public health strategies are needed in communities at high risk for homicide to prevent violence and save lives.

From Tradition to Diversity: Educational Transition of American Higher Education

ERIC Educational Resources Information Center

Yang, Jack Fei; Hu, Yu-Ning; Lin, Nick Chao-Ming; Hsiao, Ching-Mei

2006-01-01

The United States is extremely diverse in the racial and ethnic backgrounds of its citizens, which include whites, blacks, Native Americans, Alaskans, Asians, Pacific Islanders, and Hispanics. Such a diverse combination of different racial populations makes the characteristics of accessibility and diversity in American higher education important.…

A Guide to Minority Aging References.

ERIC Educational Resources Information Center

Cuellar, Jose B.; Stanford, E. Percil

The approximately l500 references in this document comprise a comprehensive list of the published and unpublished material on aging minorities in the United States and its territories. The bibliography is divided into six major parts. The first four are ethnic-specific, dealing with American Indian/Alaska Native, Hispanic, Black and Pacific/Asian…

MESA/MEP at American River College: Year One Evaluation Report.

ERIC Educational Resources Information Center

Lee, Beth S.; And Others

In 1989, the Mathematics, Engineering, and Science Achievement (MESA)/Minority Engineering Program (MEP) was initiated at American River College. The MESA/MEP program recruits Black, Hispanic, and Native American students and provides assistance, encouragement, and enrichment programs to help them succeed in the fields of mathematics, engineering,…

24 CFR 570.415 - Community Development Work Study Program.

Code of Federal Regulations, 2013 CFR

2013-04-01

... assistance, including, but not limited to, students who are Black, American Indian/Alaskan Native, Hispanic... disabilities means a student who meets the definition of “person with disabilities” in the Americans with... students who participate in a work study program while enrolled in full-time graduate programs in community...

24 CFR 570.415 - Community Development Work Study Program.

Code of Federal Regulations, 2014 CFR

2014-04-01

... assistance, including, but not limited to, students who are Black, American Indian/Alaskan Native, Hispanic... disabilities means a student who meets the definition of “person with disabilities” in the Americans with... students who participate in a work study program while enrolled in full-time graduate programs in community...

Minority Access to Higher Education

ERIC Educational Resources Information Center

Jackson, Nathaniel

2012-01-01

Blacks, Hispanics, Native Americans, and Asian Americans are entitled to equal access to all institutions of higher education. Ensuring greater access and participation by minorities in higher education is one of the most practical ways of moving America closer to the ideal of equal opportunity, which is the actualization of the American dream.…

24 CFR 570.415 - Community Development Work Study Program.

Code of Federal Regulations, 2012 CFR

2012-04-01

... assistance, including, but not limited to, students who are Black, American Indian/Alaskan Native, Hispanic... disabilities means a student who meets the definition of “person with disabilities” in the Americans with... students who participate in a work study program while enrolled in full-time graduate programs in community...

Competent Communities: A Critical Analysis of Theories and Public Policy.

ERIC Educational Resources Information Center

Padilla, Amado M.

Blacks, Native Americans, Mexicans, Asians, Hispanics, and other minority groups have managed to survive many consequences of racial/ethnic bias and discrimination in the United States. However, certain theoretical models that social scientists apply to studies of social problems reflect majority group biases that tend to perpetuate discrimination…

Outcomes of Vocational Education for Women, Minorities, the Handicapped, and the Poor.

ERIC Educational Resources Information Center

Campbell, Paul B.; And Others

A study investigated interrelationships between educational background and membership in "groups of special interest"--women, blacks, Hispanics, Native Americans, Asians, persons of low socioeconomic status (SES), handicapped individuals, and persons with limited English proficiency. Data were from the High School and Beyond sample and the sample…

Teaching Ethnic Psychology to Undergraduates: Course Development, Delivery, and Evaluation.

ERIC Educational Resources Information Center

Romero, Dan; And Others

This paper discusses the development, delivery, and evaluation of university undergraduate courses in ethnic psychology, which is defined as research and literature about four major racial/ethnic minority groups, Asian American/Pacific Islanders, Black Americans, Hispanic Americans, and Native Americans. Following a brief history of the role of…

Maternal Birthplace is Associated with Low Birth Weight Within Racial/Ethnic Groups.

PubMed

Wartko, Paige D; Wong, Eva Y; Enquobahrie, Daniel A

2017-06-01

Introduction While disparities in low birth weight (LBW) incidence by racial/ethnic group are well known, differences in LBW incidence by maternal birthplace within racial/ethnic groups, and particularly, differences after adjustment for pregnancy complications, are less clear. Methods We conducted a population-based study of LBW using 113,760 singleton, live birth records from King County, Washington (2008-2012), a region in the Pacific Northwest with a large immigrant population. Study participants were Asian, non-Hispanic black, Hispanic, Native Hawaiian/Other Pacific Islander (NHOPI), and non-Hispanic white women. Using multivariable logistic regression models, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) to estimate relative risk of LBW (<2500 g) related to maternal race/ethnicity and birthplace (defined by the Millennium Development Goals Regional Groupings). Results Compared with non-Hispanic white women, non-Hispanic black, Asian Indian, Filipino, Japanese, and Vietnamese women had 1.57-2.23-fold higher, statistically significant, risk of having a LBW infant, and NHOPI and Mexican women had 1.30-1.33-fold, statistically significant, higher risk. LBW risk was lower for Asian women from Eastern Asia (OR 0.68, 95% CI 0.55-0.85), non-Hispanic black women from Sub-Saharan Africa (OR 0.58, 95% CI 0.47-0.73), and non-Hispanic white women from other developed countries (OR 0.83, 95% CI 0.69-1.00), as compared with their US-born racial/ethnic counterparts. Results were, in general, similar after adjustment for pregnancy complications. Conclusions Compared with most other racial/ethnic groups, non-Hispanic whites had lower risk of LBW. Foreign-born women had lower risk of LBW compared with their US-born counterparts in the majority of racial/ethnic groups. Pregnancy complications had minimal effect on the associations.

Underrepresentation of Women and Minorities in the United States IR Academic Physician Workforce.

PubMed

Higgins, Mikhail C S S; Hwang, Wei-Ting; Richard, Chase; Chapman, Christina H; Laporte, Angelique; Both, Stefan; Thomas, Charles R; Deville, Curtiland

2016-12-01

To assess the United States interventional radiology (IR) academic physician workforce diversity and comparative specialties. Public registries were used to assess demographic differences among 2012 IR faculty and fellows, diagnostic radiology (DR) faculty and residents, DR subspecialty fellows (pediatric, abdominal, neuroradiology, and musculoskeletal), vascular surgery and interventional cardiology trainees, and 2010 US medical school graduates and US Census using binomial tests with .001 significance level (Bonferroni adjustment for multiple comparisons). Significant trends in IR physician representation were evaluated from 1992 to 2012. Women (15.4%), blacks (2.0%), and Hispanics (6.2%) were significantly underrepresented as IR fellows compared with the US population. Women were underrepresented as IR (7.3%) versus DR (27.8%) faculty and IR fellows (15.4%) versus medical school graduates (48.3%), DR residents (27.8%), pediatric radiology fellows (49.4%), and vascular surgery trainees (27.7%) (all P < .001). IR ranked last in female representation among radiologic subspecialty fellows. Blacks (1.8%, 2.1%, respectively, for IR faculty and fellows); Hispanics (1.8%, 6.2%); and combined American Indians, Alaska Natives, Native Hawaiians, and Pacific Islanders (1.8%, 0) showed no significant differences in representation as IR fellows compared with IR faculty, DR residents, other DR fellows, or interventional cardiology or vascular surgery trainees. Over 20 years, there was no significant increase in female or black representation as IR fellows or faculty. Women, blacks, and Hispanics are underrepresented in the IR academic physician workforce relative to the US population. Given prevalent health care disparities and an increasingly diverse society, research and training efforts should address IR physician workforce diversity. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

A resolution supporting national minority health awareness in order to bring attention to the severe health disparities faced by minority populations such as American Indians and Alaska Natives, Asians, Blacks or African Americans, Hispanics or Latinos, and Native Hawaiians and other Pacific Islanders.

THOMAS, 112th Congress

Sen. Cardin, Benjamin L. [D-MD

2011-05-17

Senate - 05/17/2011 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Influence of experiences of racial discrimination and ethnic identity on prenatal smoking among urban black and Hispanic women.

PubMed

Nguyen, Kim Hanh; Subramanian, S V; Sorensen, Glorian; Tsang, Kathy; Wright, Rosalind J

2012-04-01

Although the prevalence of prenatal smoking among minority women exceeds the projected 2010 national objective, data on the determinants of prenatal smoking among minorities remain sparse. We examined associations between self-reported experiences of racial discrimination on prenatal smoking among urban black and Hispanic women aged 18-44 years (n=677). Our main independent variable was created from the Experiences of Discrimination (EOD) scale. Multivariable logistic regression models were estimated to examine the relationship between EOD (moderate EOD as the referent group) and smoking for the entire sample and then separately by race/ethnicity adjusted for sociodemographic variables. We also examined the role of ethnic identity (EI) as a buffer to racial discrimination (n=405). The prevalence of smoking was 18.1% versus 10% for black and Hispanic women, respectively (p=0.002). There were no significant differences in the level of EOD based on race. In multivariate regressions, compared to those reporting moderate EOD, women reporting high discrimination (OR 2.64, 95% CI 1.25 to 5.60) had higher odds of smoking. In stratified analyses, this relationship remained significant only in black women. Results suggest that foreign-born Hispanic women with higher EI were less likely to smoke compared to their low-EI counterparts (3.5 vs 10.1%; p=0.08). These are the first data in pregnant minority women showing an association between discrimination and increased risk of smoking particularly among black women. Ethnic identity and nativity status were also associated with smoking risk. Smoking cessation programmes should consider such factors among childbearing minority women.

Occupational Analysis of Colorado Homemakers Utilizing the DACUM Approach. Publication Number OA10.

ERIC Educational Resources Information Center

Abt, Phyllis J., Comp.; And Others

A project was conducted to identify the commonalities and uniqueness of tasks performed by homemakers throughout Colorado. Initial data was collected from ten subgroups of the Colorado homemaking population: rural, low income, male, single/before children, couple/during children, single parent, after children, Hispanic, Black, and Native American.…

Ethnicity and Aging: A Bibliography. Checklists in the Humanities and Education: Series Number Eight.

ERIC Educational Resources Information Center

Murguia, Edward, Comp.; And Others

Literature on ethnicity and aging is listed in this bibliography, which is intended to assist researchers, teachers, and policymakers. The bibliography is divided into seven categories: (1) multiethnic and general studies; (2) Black Americans; (3) Hispanic Americans; (4) Native Americans; (5) Asian and Pacific Americans; (6) European origin ethnic…

Racial/Ethnic Minorities in Rural Areas: Progress and Stagnation, 1980-90.

ERIC Educational Resources Information Center

Swanson, Linda L., Ed.

Rural minorities lag behind rural Whites and urban minorities on many crucial economic and social measures. This collection of 10 papers examines rural Black, Hispanic, Native American, and Asian and Pacific Islander populations and their economic well-being in the 1980s, an economically difficult decade for rural areas. Results show minimal…

Minority Health in Michigan: Closing the Gap. Executive Summary.

ERIC Educational Resources Information Center

Michigan State Dept. of Public Health, Lansing.

This document summarizes a report on the health status of minority groups in Michigan. Mortality rates and health problems are analyzed for the following groups: (1) Blacks; (2) Hispanics: (3) Arab Americans; (4) Asian and Pacific Islanders; and (5) Native Americans. The following problem areas are discussed: (1) nutrition and hunger; (2)…

Professional Leadership Practices and Diversity Issues in the U.S. Higher Education System: A Research Synthesis

ERIC Educational Resources Information Center

Karkouti, Ibrahim Mohamad

2016-01-01

This paper examines the effects of negligence toward diversity issues on campus racial climate, describes how exclusionary practices affect minority students' (i.e., Asian American, Hispanic, Black, and Native American) educational experiences, and addresses faculty issues relevant to diversity. In addition, the paper identifies the factors that…

Implementation of an Entry-Level Retention Program for High-Risk College Freshmen.

ERIC Educational Resources Information Center

Zanoni, Candido

The specially funded program described in this report was implemented at the University of Minnesota's General College in Fall 1979 to promote the academic improvement and long-range retention of high-risk Black, Hispanic, and Native American students. After introductory material discussing the process involved in securing program funds from the…

75 FR 49484 - Office of Postsecondary Education; Asian American and Native American Pacific Islander-Serving...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

...), Hispanic Serving Institutions-STEM and Articulation (HSI-STEM), and Predominantly Black Institutions (PBI... application for eligibility for AANAPISI, NASNTI, HSI-STEM, and PBI fiscal year (FY) 2010 competitions... competitions to be announced this fall under the AANAPISI, NASNTI, HSI- STEM, and PBI programs. This limited...

40 CFR 33.203 - How does an entity qualify as an MBE or WBE under EPA's 10% statute?

Code of Federal Regulations, 2010 CFR

2010-07-01

... disadvantaged individuals, and the management and daily business operations of the business concern must be... of 1990, 42 U.S.C. 7601 note, Black Americans, Hispanic Americans, Native Americans, Asian Americans, Women and Disabled Americans are presumed to be socially and economically disadvantaged individuals. In...

Can universal coverage eliminate health disparities? Reversal of disparate injury outcomes in elderly insured minorities.

PubMed

Ramirez, Michelle; Chang, David C; Rogers, Selwyn O; Yu, Peter T; Easterlin, Molly; Coimbra, Raul; Kobayashi, Leslie

2013-06-15

Health outcome disparities in racial minorities are well documented. However, it is unknown whether such disparities exist among elderly injured patients. We hypothesized that such disparities might be reduced in the elderly owing to insurance coverage under Medicare. We investigated this issue by comparing the trauma outcomes in young and elderly patients in California. A retrospective analysis of the California Office of Statewide Health Planning and Development hospital discharge database was performed for all publicly available years from 1995 to 2008. Trauma admissions were identified by International Classification of Disease, Ninth Revision, primary diagnosis codes from 800 to 959, with certain exclusions. Multivariate analysis examined the adjusted risk of in-hospital mortality in young (<65 y) and elderly (≥65 y) patients, controlling for age, gender, injury severity as measured by the survival risk ratio, Charlson comorbidity index, insurance status, calendar year, and teaching hospital status. A total of 1,577,323 trauma patients were identified. Among the young patients, the adjusted odds ratio of death relative to non-Hispanic whites for blacks, Hispanics, Asians, and Native Americans/others was 1.2, 1.2, 0.90, and 0.78, respectively. The corresponding adjusted odds ratios of death for elderly patients were 0.78, 0.87, 0.92, and 0.61. Young black and Hispanic trauma patients had greater mortality risks relative to non-Hispanic white patients. Interestingly, elderly black and Hispanic patients had lower mortality risks compared with non-Hispanic whites. Copyright © 2013 Elsevier Inc. All rights reserved.

Familial Influences on Poverty Among Young Children in Black Immigrant, U.S.-born Black, and Nonblack Immigrant Families

PubMed Central

Thomas, Kevin J. A.

2014-01-01

This study examines how familial contexts affect poverty disparities between the children of immigrant and U.S.-born blacks, and among black and nonblack children of immigrants. Despite lower gross child poverty rates in immigrant than in U.S.-born black families, accounting for differences in family structure reveals that child poverty risks among blacks are highest in single-parent black immigrant families. In addition, within two-parent immigrant families, child poverty declines associated with increasing assimilation are greater than the respective declines in single-parent families. The heads of black immigrant households have more schooling than those of native-black households. However, increased schooling has a weaker negative association with child poverty among the former than among the latter. In terms of racial disparities among the children of immigrants, poverty rates are higher among black than nonblack children. This black disadvantage is, however, driven by the outcomes of first-generation children of African and Hispanic-black immigrants. The results also show that although children in refugee families face elevated poverty risks, these risks are higher among black than among nonblack children of refugees. In addition, the poverty-reducing impact associated with having an English-proficient household head is about three times lower among black children of immigrants than among non-Hispanic white children of immigrants. PMID:21491186

A resolution promoting minority health awareness and supporting the goals and ideals of National Minority Health Month in April 2013 to bring attention to the health disparities faced by minority populations such as American Indians and Alaska Natives, Asians, Blacks or African Americans, Hispanics or Latinos, and Native Hawaiians and other Pacific Islanders.

THOMAS, 113th Congress

Sen. Cardin, Benjamin L. [D-MD

2013-05-16

Senate - 05/16/2013 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

The Role of Race/Ethnicity in Alcohol-attributable Injury in the United States

PubMed Central

Keyes, Katherine M.; Liu, Xianfang C.; Cerda, Magdalena

2012-01-01

A substantial proportion of injuries worldwide are attributable to alcohol consumption, and US estimates indicate that the drinking patterns of racial/ethnic groups vary considerably. The authors reviewed evidence from 19 publications regarding racial/ethnic differences in overall alcohol-attributable injury as well as percent blood alcohol content positivity for injury deaths in the United States. They found that Native Americans evidence higher rates of alcohol-attributable motor vehicle crash fatality, suicide, and falls compared with other racial/ethnic groups; conversely, Asians evidence lower rates of alcohol-attributable injury than other racial/ethnic groups. The rate of alcohol positivity and intoxication among Hispanics is disproportionately high relative to estimates of alcohol use. Black subgroups also evidence higher rates of alcohol positivity than would be expected given estimates of alcohol use, including for alcohol positivity among drivers of fatally injured black children and homicide. These findings highlight the continued need for public health focus on Native American populations with respect to alcohol consumption and injury. Further, the disparity in alcohol-attributable injury mortality among black and Hispanic groups relative to their reported rates of alcohol consumption is an overlooked area of research. The authors review potential social determinants of racial/ethnic disparities in alcohol-attributable injuries and identify directions for further research on these patterns. PMID:21930592

The Role of Race/Ethnicity in Alcohol-attributable Injury in the United States

PubMed Central

Keyes, Katherine M.; Liu, Xianfang C.; Cerda, Magdalena

2017-01-01

A substantial proportion of injuries worldwide are attributable to alcohol consumption, and US estimates indicate that the drinking patterns of racial/ethnic groups vary considerably. The authors reviewed evidence from 19 publications regarding racial/ethnic differences in overall alcohol-attributable injury as well as percent blood alcohol content positivity for injury deaths in the United States. They found that Native Americans evidence higher rates of alcohol-attributable motor vehicle crash fatality, suicide, and falls compared with other racial/ethnic groups; conversely, Asians evidence lower rates of alcohol-attributable injury than other racial/ethnic groups. The rate of alcohol positivity and intoxication among Hispanics is disproportionately high relative to estimates of alcohol use. Black subgroups also evidence higher rates of alcohol positivity than would be expected given estimates of alcohol use, including for alcohol positivity among drivers of fatally injured black children and homicide. These findings highlight the continued need for public health focus on Native American populations with respect to alcohol consumption and injury. Further, the disparity in alcohol-attributable injury mortality among black and Hispanic groups relative to their reported rates of alcohol consumption is an overlooked area of research. The authors review potential social determinants of racial/ethnic disparities in alcohol-attributable injuries and identify directions for further research on these patterns. PMID:23441581

Minority American Women Physicists Achieving at the Intersection of Race and Gender

NASA Astrophysics Data System (ADS)

Horton, K. Renee

2005-10-01

As minority women physicists, we stand at the intersection of race and gender. We are physicists to be sure, but we are also women of Native, African, Hispanic, and Asian descent. We are colleagues, mothers, sisters, friends and wives, as are our white counterparts, but our experiences cannot be distilled to only gender or race. As Prudence Carter (2005 Annual Meeting of the American Educational Research Association) and Scott Page (``The Logic of Diversity,'' private communication, 2004) remind us, women of color emerge from the interaction between race and gender. This distinction is important because most researchers who study American women's participation in science focus exclusively on the participation of white American women. Of those who acknowledge the existence of non-white women, most do so by disclaiming the exclusion of women of color because the numbers are so small or the experiences are different from white American women. There are some important differences, however. While American women are 15% of all scientists and engineers, black American women are 60% of all black scientists and engineers. Yet an average of less than 3 black women and less than 3 Hispanic women earn PhDs in the U.S. each year, out of about 1100. As Rachel Ivie and Kim Nies Ray point out in AIP Publication R-430.02, ``Minority women especially represent a great, untapped resource that could be drawn on to increase the size of the scientific workforce in the U.S.'' Donna Nelson's (University of Oklahoma) study of diversity in science and engineering faculties further finds that (with the exception of one black woman in astronomy) there are no female black or Native American full professors. In physics, there are no black women professors and no Native American women professors. Despite such a bleak picture, there is hope. Of the 18 departments that award at least 40% of bachelors degrees to women, 7 are in Historically Black Colleges and Universities (HBCUs). Black women are earning degrees from HBCUs at rates above equity, and many singles and firsts at predominantly white institutions continue to persevere despite the obstacles.

A private sector view of health, surveillance, and communities of color.

PubMed Central

Rabin, S A

1994-01-01

The U.S. population is fast evolving into a patchwork of health behaviors, incomes, and ethnic backgrounds. Simple cultural labeling will not do. A growing number of Americans, now numbering about 10 million, cannot or will not describe their race in any one of the Census Bureau's standard categories--white, black, American Indian, Eskimo, Aleut, Asian Pacific, or Hispanic. They group themselves as a multicultural population rather than a single racial or ethnic category. To guide health interventions, the private sector now relies more on statistical clusters based on geography, lifestyle, behavior, financial status, and attitudes instead of on race. In marketing, the challenge is to reach diverse markets without stereotyping the product as one designed for only a certain ethnic group. The emphasis on athletics instead of on race is one example of how some marketers solve this problem of reaching minorities without giving the impression that specific products are only for blacks, or Hispanics, or Asians. Surveillance professionals can expand the way data are collected and publicized. Blacks, Hispanics, Asians, and Native Americans should not be categorized simply by race; other variables of health, such as income and age, should be given careful attention. PMID:8303013

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.

Health of the Disadvantaged. Chart Book-II.

ERIC Educational Resources Information Center

Health Resources Administration (DHHS/PHS), Hyattsville, MD.

The tables and charts in this book act as resources for information on the health status of racial and ethnic minorities and the poor. The four minority groups referred to are blacks, Hispanic Americans, Native Americans, and Asian Americans. The poor are defined as those whose income falls below the poverty line specified by the Census Bureau.…

The Role of Minority Serving Institutions in Transforming Teacher Education and Diversifying the Teaching Profession: A Literature Review and Research Agenda

ERIC Educational Resources Information Center

Ginsberg, Alice; Gasman, Marybeth; Samayoa, Andrés Castro

2017-01-01

Background: Teacher education programs at Minority Serving Institutions--which include Historically Black Colleges and Universities, Native American and Tribal Colleges, Asian American and Pacific Islander Serving Institutions, and Hispanic Serving Institutions--are an under-researched resource. Purpose: Our aim is to provide a foundation and set…

Status and Trends in the Education of Racial and Ethnic Groups 2016. NCES 2016-007

ERIC Educational Resources Information Center

Musu-Gillette, Lauren; Robinson, Jennifer; McFarland, Joel; KewalRamani, Angelina; Zhang, Anlan; Wilkinson-Flicker, Sidney

2016-01-01

"Status and Trends in the Education of Racial and Ethnic Groups" examines the educational progress and challenges students face in the United States by race/ethnicity. This report shows that, over time, students in the racial/ethnic groups of White, Black, Hispanic, Asian, Native Hawaiian or Other Pacific Islander, American Indian/Alaska…

The Disproportionate Use of Discipline: An Investigation of the Potential Impact of School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Guardino, David Matthew

2013-01-01

Over the last 35 years, the disproportionate use of discipline by gender, race/ethnicity, and disability status has been consistently documented. Specifically, Black males receive the majority of suspensions and expulsions. Discipline for Native American and Hispanic students, while often showing overrepresentation, is less consistent. There is…

Status and Trends in the Education of Racial and Ethnic Groups 2017. NCES 2017-051

ERIC Educational Resources Information Center

Musu-Gillette, Lauren; de Brey, Cristobal; McFarland, Joel; Hussar, William; Sonnenberg, William; Wilkinson-Flicker, Sidney

2017-01-01

This report uses statistics to examine current conditions and changes over time in education activities and outcomes for different racial/ethnic groups in the United States. This report shows that over time, students in the racial/ethnic groups of White, Black, Hispanic, Asian, Native Hawaiian or Other Pacific Islander, American Indian/Alaska…

BLACK PRETERM BIRTH RISK IN NON-BLACK NEIGHBORHOODS: EFFECTS OF HISPANIC, ASIAN, AND NON-HISPANIC WHITE ETHNIC DENSITIES

PubMed Central

Mason, Susan M.; Kaufman, Jay S.; Daniels, Julie L.; Emch, Michael E.; Hogan, Vijaya K.; Savitz, David A.

2013-01-01

Purpose Studies of ethnic density and health in the United States have documented poorer health outcomes in black compared to non-black neighborhoods, but few studies have considered the identities of the non-black populations. Methods New York City birth records from 1995 through 2003 and a spatial measure of ethnic density were used to examine preterm birth risks among non-Hispanic black women associated with non-Hispanic white, Hispanic, Asian, and non-Hispanic black neighborhood densities. Logistic regression models were used to estimate the effect on black preterm birth risks of replacing white neighbors with Hispanic, Asian, and black neighbors. Risk differences were computed for changes from the 10th to the 90th percentiles of ethnic density. Results Increasing Hispanic density was associated with reduced preterm birth risks among non-Hispanic black women, especially if the black women were foreign-born (RD=−19.1 per 1,000 births; 95% CI: −28.6, −9.5). Estimates for increasing Asian density were null. Increasing black density was associated with increasing black preterm birth risk, with a threshold at higher levels of black density. Conclusions The low risks of preterm birth among foreign-born non-Hispanic black women in majority-Hispanic neighborhoods may be related to protective psychosocial or nutritional factors in Hispanic neighborhoods. PMID:21737050

A Comparison of Birth Outcomes Among Black, Hispanic, and Black Hispanic Women

PubMed Central

BeLue, Rhonda; Hillemeier, Marianne M.

2015-01-01

Background While non-Hispanic Black populations tend to be disproportionately affected by adverse reproductive outcomes, Hispanic populations tend to demonstrate healthier birth outcomes, regardless of socioeconomic background. Little is known about birth outcomes for women who are both Black and Hispanic. We examined whether birth outcomes and risk factors for women who are both Black and Hispanic most closely resemble those of women who are only Black or Hispanic and also compared these outcomes to those for Whites. Methods Using the 2013 US natality files, we examined 2,970,315 singleton births to Black Hispanic, Hispanic, Black, and White mothers. We used logistic regression to calculate predicted probabilities of low birth weight (LBW), preterm birth (PTB), or small for gestational age (SGA). Race-stratified regression analysis was used to identify the factors that significantly predicted risk for each outcome for each racial/ethnic group. Results Black mothers had the highest prevalence and predicted probabilities of experiencing all three outcomes. Black Hispanic mothers were less likely than Black mothers and more likely than Hispanic mothers to experience each of the adverse outcomes. We also found support for racial variation in risk and protective factors for mothers in the different groups. Factors like age and education inconsistently predicted risk of experiencing the birth outcomes for all groups. Overall, Black Hispanic mothers had birth outcomes and risk factor profiles like Hispanic mothers, although they had sociodemographic characteristics and health behaviors like Black mothers. Conclusions Patterning of birth outcomes among Black Hispanic women suggest an intersection of risk and protective factors associated with their respective racial and ethnic identities. Additional information about sociodemographic context is needed to develop a more complete picture of how factors related to race and ethnic group membership influence Black Hispanic women’s birth outcomes. PMID:26561541

Nativity and language preference as drivers of health information seeking: examining differences and trends from a U.S. population-based survey.

PubMed

Massey, Philip M; Langellier, Brent A; Sentell, Tetine; Manganello, Jennifer

2017-12-01

To examine differences in health information seeking between U.S.-born and foreign-born populations in the U.S. Data from 2008 to 2014 from the Health Information National Trends Survey were used in this study (n = 15,249). Bivariate analyses, logistic regression, and predicted probabilities were used to examine health information seeking and sources of health information. Findings demonstrate that 59.3% of the Hispanic foreign-born population reported looking for health information, fewer than other racial/ethnic groups in the sample. Compared with non-Hispanic White, non-Hispanic Black (OR = 0.62) and Hispanic foreign-born individuals (OR = 0.31) were the least likely to use the internet as a first source for health information. Adjustment for language preference explains much of the disparity in health information seeking between the Hispanic foreign-born population and Whites; controlling for nativity, respondents who prefer Spanish have 0.25 the odds of using the internet as a first source of health information compared to those who prefer English. Foreign-born nativity and language preference are significant determinants of health information seeking. Further research is needed to better understand how information seeking patterns can influence health care use, and ultimately health outcomes. To best serve diverse racial and ethnic minority populations, health care systems, health care providers, and public health professionals must provide culturally competent health information resources to strengthen access and use by vulnerable populations, and to ensure that all populations are able to benefit from evolving health information sources in the digital age.

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

America's Churning Races: Race and Ethnicity Response Changes Between Census 2000 and the 2010 Census.

PubMed

Liebler, Carolyn A; Porter, Sonya R; Fernandez, Leticia E; Noon, James M; Ennis, Sharon R

2017-02-01

A person's racial or ethnic self-identification can change over time and across contexts, which is 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 United States and among all federally recognized race/ethnic groups. We use internal U.S. Census Bureau data from the 2000 and 2010 censuses in which responses have been linked at the individual level (N = 162 million). Approximately 9.8 million people (6.1 %) 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 %, respectively, changed). We found a variety of response change patterns, which we detail. In many race/Hispanic response groups, we see 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 racial/ethnic categories. Researchers should address the implications of race and Hispanic-origin response change when designing analyses and interpreting results.

Reconstructing a Pregnancy Cohort to Examine Potential Selection Bias in Studies on Racial Disparities in Preterm Delivery.

PubMed

Sapra, Katherine J; Chaurasia, Ashok K; Hutcheon, Jennifer A; Ahrens, Katherine A

2017-01-01

Epidemiologic studies examining preconception risk factors on perinatal outcomes are typically restricted to livebirths. By including only non-terminated pregnancies, estimates for the underlying pregnancy cohort may be subject to selection bias. We examined if potential selection bias due to induced termination by maternal race may result in different estimates of the non-Hispanic black - non-Hispanic white risk ratio (RR) for preterm delivery (PTD) among a reconstructed pregnancy cohort ('pseudo-pregnancy cohort'). Using New York City registries of 1.6 million livebirths, spontaneous terminations, and induced terminations among non-Hispanic black and non-Hispanic white women (2000-12), we multiply imputed PTD (<37 weeks) and early PTD (<32 weeks) outcomes for induced terminations based on maternal race, age, parity, marital status, nativity, and medical care payer to construct the pseudo-pregnancy cohort. Among non-Hispanic black and non-Hispanic white women, 55% and 19% of pregnancies ended in induced termination and 13% and 8% resulted in PTD, respectively. Although several factors were associated with both PTD and induced termination, PTD RRs in the birth (RR 1.64, 95% confidence interval (CI) 1.62, 1.66) and pseudo-pregnancy (RR 1.63, 95% CI 1.56, 1.71) cohorts were similar. However, early PTD RR was somewhat larger in the birth (RR 2.80, 95% CI 2.71, 2.89) than pseudo-pregnancy (RR 2.47, 95% CI 2.23, 2.73) cohort. Using birth certificate data - thereby excluding induced terminations - to estimate the PTD racial disparity did not produce biased estimates. Our data suggest observed PTD disparities likely are not artefacts of selection bias due to induced termination. © 2016 John Wiley & Sons Ltd.

Association of birthplace and self-reported hypertension by racial/ethnic groups among US adults--National Health Interview Survey, 2006-2010.

PubMed

Fang, Jing; Ayala, Carma; Loustalot, Fleetwood

2012-12-01

Over the past few decades, the proportion of US adults who were foreign-born has been increasing, as has the overall prevalence of hypertension. Here, we compared the prevalence of self-reported hypertension among native-born adults with that among foreign-born adults, classified by racial/ethnic group. Using 2006-2010 data from the National Health Interview Survey (NHIS), we compared the age-adjusted prevalence of hypertension among native-born adults to foreign-born adults, specified by continent of birthplace and race/ethnicity. Results are expressed as unadjusted odds ratios (ORs) and three sets of adjusted odds ratios (AORs) adjusted for selected sociodemographic, behavioral and health-related characteristics. All results accounted for NHIS sampling design variables. The analytic sample was 124,260 with 16.3% foreign-born adults. Among the foreign-born adults, 56% were from Central or South America, 22% from Asia, 13% from Europe, and 4% from Africa. Overall and after adjustment, hypertension prevalence was significantly higher among US-born adults than among foreign-born adults (AOR: 1.28, 95% CI: 1.21-1.36). By race/ethnicity, hypertension prevalence was higher among US-born non-Hispanic blacks than either foreign-born non-Hispanic blacks (AOR: 1.24, 95%CI: 1.02-1.50) or all Africa-born immigrants of any race/ethnicity [AOR: 1.45, 95% confidence interval (CI): 1.07-1.97]. Among foreign-born adults, duration of US residence was positively associated with the likelihood of hypertension. Hypertension prevalence was higher among US-born adults than among foreign-born adults and higher among US-born non-Hispanic blacks than in any other group. Among foreign-born adults, hypertension risk increased with the number of years they had lived in the United States.

Racial/Ethnic Differences in Use of Health Care Services for Diabetes Management.

PubMed

Chandler, Raeven Faye; Monnat, Shannon M

2015-12-01

Research demonstrates consistent racial/ethnic disparities in access to and use of health care services for a variety of chronic conditions. Yet we know little about whether these disparities exist for use of health care services for diabetes management. Racial/ethnic minorities disproportionately suffer from diabetes, complications from diabetes, and diabetes-related mortality. Proper diabetes management can reduce the risk of complications and premature mortality. Using a large national data set (N = 37,705) of White, Black, Hispanic, Asian, and Native American U.S. adults aged 65 years and older who have been diagnosed with diabetes, we examine three specific types of health care provider (HCP) use for diabetes management: number of times seen by a health care professional for diabetes, number of times feet have been checked by a health care professional, and number of visits for a glycosylated hemoglobin check. We found that net of controls for a variety of demographic and socioeconomic characteristics, Blacks and Hispanics had significantly more visits to a HCP for their diabetes and significantly more glycosylated hemoglobin checks than Whites, and Blacks and Native Americans had significantly more HCP feet checks than Whites. Our results suggest that the reduced access to health care services traditionally found among racial/ethnic minorities does not hold for access to health care services for diabetes management, where racial/ethnic minority diabetics are actually more likely to use care than are White diabetics. Future research should examine whether higher use of health care services for diabetes among racial/ethnic minorities is due to greater disease severity among racial/ethnic minorities than among non-Hispanic Whites. © 2015 Society for Public Health Education.

Racial and socioeconomic disparities in access to mechanical revascularization procedures for acute ischemic stroke.

PubMed

Attenello, Frank J; Adamczyk, Peter; Wen, Ge; He, Shuhan; Zhang, Katie; Russin, Jonathan J; Sanossian, Nerses; Amar, Arun P; Mack, William J

2014-02-01

Mechanical revascularization procedures performed for treatment of acute ischemic stroke have increased in recent years. Data suggest association between operative volume and mortality rates. Understanding procedural allocation and patient access patterns is critical. Few studies have examined these demographics. Data were collected from the 2008 Nationwide Inpatient Sample database. Patients hospitalized with ischemic stroke and the subset of individuals who underwent mechanical thrombectomy were characterized by race, payer source, population density, and median wealth of the patient's zip code. Demographic data among patients undergoing mechanical thrombectomy procedures were examined. Stroke admission demographics were analyzed according to thrombectomy volume at admitting centers and patient demographics assessed according to the thrombectomy volume at treating centers. Significant allocation differences with respect to frequency of mechanical thrombectomy procedures among stroke patients existed according to race, expected payer, population density, and wealth of the patient's zip code (P < .0001). White, Hispanic, and Asian/Pacific Islander patients received endovascular treatment at higher rates than black and Native American patients. Compared with the white stroke patients, black (P < .001), Hispanic (P < .001), Asian/Pacific Islander (P < .001), and Native American stroke patients (P < .001) all demonstrated decreased frequency of admission to hospitals performing mechanical thrombectomy procedures at high volumes. Among treated patients, blacks (P = .0876), Hispanics (P = .0335), and Asian/Pacific Islanders (P < .001) demonstrated decreased frequency in mechanical thrombectomy procedures performed at high-volume centers when compared with whites. While present, socioeconomic disparities were not as consistent or pronounced as racial differences. We demonstrate variances in endovascular acute stroke treatment allocation according to racial and socioeconomic factors in 2008. Efforts should be made to monitor and address potential disparities in treatment utilization. Published by Elsevier Inc.

Low-Income and Minority Serving Institutions: Education Has Taken Steps to Improve Monitoring and Assistance, but Further Progress Is Needed--Statement of George A. Scott, Director Education, Workforce and Income Security Issues. Testimony before the Subcommittee on Higher Education, Lifelong Learning, and Competitiveness, Committee on Education and Labor, House of Representatives. GAO-07-926T

ERIC Educational Resources Information Center

Scott, George A.

2007-01-01

Institutions that may receive funding under Titles III and V include Historically Black Colleges and Universities (HBCUs), Tribal Colleges, Hispanic Serving Institutions, Alaska Native Serving Institutions, Native Hawaiian Serving Institutions, and other postsecondary institutions that serve low-income students. In fiscal year 2006, these programs…

Underrepresented groups

NASA Technical Reports Server (NTRS)

Peters, David A.

1990-01-01

The problem with the shortage of under represented groups in science and engineering is absolutely crucial, especially considering that U.S. will experience a shortage of 560,000 science and engineering personnel by the year 2010. Most studies by the National Science Foundation also concluded that projected shortages cannot be alleviated without significant increases in the involvement of Blacks, Hispanics, Native Americans, handicapped persons, and women.

The Impact of Race and Ethnicity on the Identification Process for Giftedness in Utah

ERIC Educational Resources Information Center

Warne, Russell T.; Anderson, Braydon; Johnson, Alyce O.

2013-01-01

Many gifted education experts have found that Black, Hispanic, and Native American students are less likely to be identified for gifted programs than Asian American and White students. A study was conducted to ascertain the degree of underrepresentation of these groups in gifted programs in Utah. Using state-collected data from 14,781 students in…

Ethnicity and Authenticity, or How Black (Hispanic, Native American, etc.) Do I Gotta Be?

ERIC Educational Resources Information Center

Salle, Ellen

1994-01-01

Considers the authenticity of the works of children's and juvenile authors who write about cultures or sexes other than their own. Examples are provided, including the works of Scott O'Dell, and limitations placed on authors, including minority authors, who are expected to write only from their own experiences are discussed. (36 references) (LRW)

48 CFR 52.212-3 - Offeror Representations and Certifications-Commercial Items.

Code of Federal Regulations, 2011 CFR

2011-10-01

... which are, or are based on, established catalog or market prices (see FAR 22.1003-4(c)(2)(ii)) for the... furnished at prices that are, or are based on, established catalog or market prices (see FAR 22.1003-4(d)(2... disadvantaged in paragraph (c)(4) or (c)(10) of this provision.) _Black American. _Hispanic American. _Native...

Internal validity of an anxiety disorder screening instrument across five ethnic groups.

PubMed

Ritsher, Jennifer Boyd; Struening, Elmer L; Hellman, Fred; Guardino, Mary

2002-08-30

We tested the factor structure of the National Anxiety Disorder Screening Day instrument (n=14860) within five ethnic groups (White, Black, Hispanic, Asian, Native American). Conducted yearly across the US, the screening is meant to detect five common anxiety syndromes. Factor analyses often fail to confirm the validity of assessment tools' structures, and this is especially likely for minority ethnic groups. If symptoms cluster differently across ethnic groups, criteria for conventional DSM-IV disorders are less likely to be met, leaving significant distress unlabeled and under-detected in minority groups. Exploratory and confirmatory factor analyses established that the items clustered into the six expected factors (one for each disorder plus agoraphobia). This six-factor model fit the data very well for Whites and not significantly worse for each other group. However, small areas of the model did not appear to fit as well for some groups. After taking these areas into account, the data still clearly suggest more prevalent PTSD symptoms in the Black, Hispanic and Native American groups in our sample. Additional studies are warranted to examine the model's external validity, generalizability to more culturally distinct groups, and overlap with other culture-specific syndromes.

Use of complementary and alternative medical therapies among racial and ethnic minority adults: results from the 2002 National Health Interview Survey.

PubMed Central

Graham, Robert E.; Ahn, Andrew C.; Davis, Roger B.; O'Connor, Bonnie B.; Eisenberg, David M.; Phillips, Russell S.

2005-01-01

PURPOSE: Complementary and alternative medicine (CAM) use among ethnic minority populations is poorly understood. We sought to examine CAM use in Hispanics, non-Hispanic blacks and non-Hispanic whites. METHODS: We analyzed data from the Alternative Health Supplement to the 2002 National Health Interview Survey (NHIS), including information on 19 different CAM therapies used in the past 12 months. RESULTS: An estimated 34% of Hispanic, non-Hispanic black and non-Hispanic white adults in the United States used at least one CAM therapy (excluding prayer) during the prior 12 months (2002). CAM use was highest for non-Hispanic whites (36%), followed by Hispanics (27%) and non-Hispanic blacks (26%). Non-Hispanic whites were more likely to use herbal medicine, relaxation techniques and chiropractic more frequently than Hispanics and non-Hispanic blacks. After controlling for other sociodemographic factors, Hispanic and non-Hispanic black races/ethnicities were associated with less CAM use, with adjusted odds ratios (95% confidence intervals) of 0.78 (0.70, 0.87) and 0.71 (0.65, 0.78), respectively. Hispanics cited using CAM because conventional medical treatments were too expensive more frequently than non-Hispanic blacks or whites. Hispanics had the highest provider nondisclosure rates (68.5%), followed by non-Hispanic blacks (65.1%) and non-Hispanic whites (58.1%). CONCLUSIONS: Excluding prayer, Hispanics and non-Hispanic blacks used CAM less frequently than non-Hispanic whites and were less likely to disclose their use to their healthcare provider. Further research is needed to improve our understanding of the disparities in CAM use. PMID:15868773

Are There Racial-Ethnic Disparities in Time to Pressure Ulcer Development and Pressure Ulcer Treatment in Older Adults After Nursing Home Admission?

PubMed Central

Bliss, Donna Z.; Gurvich, Olga; Savik, Kay; Eberly, Lynn E.; Harms, Susan; Mueller, Christine; Wyman, Jean F.; Garrard, Judith; Virnig, Beth

2017-01-01

Objective The objective of this study was to assess whether there are racial and ethnic disparities in the time to development of a pressure ulcer and number of pressure ulcer treatments in individuals aged 65 and older after nursing home admission. Method Multi-level predictors of time to a pressure ulcer from three national surveys were analyzed using Cox proportional hazards regression for White Non-Hispanic residents. Using the Peters–Belson method to assess for disparities, estimates from the regression models were applied to American Indians/Alaskan Natives, Asians/ Pacific Islanders, Blacks, and Hispanics separately resulting in estimates of expected outcomes as if they were White Non-Hispanic, and were then compared with their observed outcomes. Results More Blacks developed pressure ulcers sooner than expected. No disparities in time to a pressure ulcer disadvantaging other racial/ethnic groups were found. There were no disparities in pressure ulcer treatment for any group. Discussion Reducing disparities in pressure ulcer development offers a strategy to improve the quality of nursing home care. PMID:25260648

Are there racial-ethnic disparities in time to pressure ulcer development and pressure ulcer treatment in older adults after nursing home admission?

PubMed

Bliss, Donna Z; Gurvich, Olga; Savik, Kay; Eberly, Lynn E; Harms, Susan; Mueller, Christine; Wyman, Jean F; Garrard, Judith; Virnig, Beth

2015-06-01

The objective of this study was to assess whether there are racial and ethnic disparities in the time to development of a pressure ulcer and number of pressure ulcer treatments in individuals aged 65 and older after nursing home admission. Multi-level predictors of time to a pressure ulcer from three national surveys were analyzed using Cox proportional hazards regression for White Non-Hispanic residents. Using the Peters-Belson method to assess for disparities, estimates from the regression models were applied to American Indians/Alaskan Natives, Asians/Pacific Islanders, Blacks, and Hispanics separately resulting in estimates of expected outcomes as if they were White Non-Hispanic, and were then compared with their observed outcomes. More Blacks developed pressure ulcers sooner than expected. No disparities in time to a pressure ulcer disadvantaging other racial/ethnic groups were found. There were no disparities in pressure ulcer treatment for any group. Reducing disparities in pressure ulcer development offers a strategy to improve the quality of nursing home care. © The Author(s) 2014.

Variations in the relationship between maternal depression, maternal sensitivity, and child attachment by race/ethnicity and nativity: findings from a nationally representative cohort study.

PubMed

Huang, Zhihuan Jennifer; Lewin, Amy; Mitchell, Stephanie J; Zhang, Jin

2012-01-01

This study uses data from the nationally representative Early Childhood Longitudinal Study-Birth Cohort to examine the relationship between maternal depression, maternal sensitivity, and child attachment, specifically among Hispanic and Asian American mothers and their young children, and to explore the role of cultural variation and nativity in the associations between these variables. Data used in this study were collected from biological mothers on two occasions, when their children were approximately 9 and 24 months of age. Trained observers completed a direct assessment of child attachment security and an observational measure of maternal sensitivity, data on maternal depression was obtained via maternal report. Hierarchical logistic regression models were used to predict odds of child insecure attachment. The risk of child insecure attachment associated with chronic maternal depression was found to be much higher for Hispanic mothers than for Asians. In contrast, mothers' foreign-born status was a stronger risk factor than depression for insecure child attachment among Asian Americans. Maternal sensitivity significantly reduced the odds of Asian American children being insecurely attached by more than half. Among the full sample of mothers, which included U.S.-born non-Hispanic White mothers and U.S.-born non-Hispanic Black mothers, decreased maternal sensitivity mediated the association between chronic depression and child insecure attachment. However, this mediation was not found in stratified analyses of Hispanic and Asian mothers. Finally, mothers' nativity did not influence the extent to which maternal depression or sensitivity was associated with child attachment. These findings suggest that the associations between maternal depression, sensitivity, and child attachment are culturally specific, and that mothers' immigrant status may be a risk factor in some racial/ethnic groups but protective in others.

Race/Ethnic Variations in Quitline Use Among US Adult Tobacco Users in 45 States, 2011-2013.

PubMed

Marshall, LaTisha L; Zhang, Lei; Malarcher, Ann M; Mann, Nathan H; King, Brian A; Alexander, Robert L

2017-11-07

State quitlines provide free telephone-based cessation services and are available in all states. However, quitlines presently reach 1% of US cigarette smokers. We assessed variations in quitline reach by race/ethnicity across 45 US states included in the National Quitline Data Warehouse, a repository on non-identifiable data reported by state quitlines. During 2011 to 2013, we analyzed 1 220 171 records from the National Quitline Data Warehouse. Annual quitline reach was defined as the proportion of cigarette smokers and smokeless tobacco users who utilized quitline services during each year, and was calculated by dividing the number of state-specific quitline registrants in each year by the number of adult cigarette smokers and smokeless tobacco users in the state. Average annual reach ranged from: 0.08% (Tennessee) to 3.42% (Hawaii) among non-Hispanic whites; 0.17% (Tennessee) to 3.85% (Delaware) among non-Hispanic blacks; 0.27% (Nevada) to 9.98% (Delaware) among non-Hispanic American Indians/Alaska Native; 0.03% (Alabama) to 2.43% (Hawaii) among non-Hispanic Asian/Pacific Islanders; and from 0.08% (Tennessee) to 3.18% (Maine) among Hispanics. Average annual reach was highest among non-Hispanic American Indians/Alaska Native in 27 states, non-Hispanic blacks in 14 states, and non-Hispanic whites in four states. Quitlines appear to be reaching minority populations; however, overall reach remains low and variations in quitline reach exist by race/ethnicity. Opportunities exist to increase the utilization of quitlines and other effective cessation treatments among racial/ethnic minority populations. Some studies have assessed quitline reach across demographic groups in individual states; however, no studies have provided multistate data about quitline reach across race/ethnic groups. Ongoing monitoring of the use of state quitlines can help guide targeted outreach to particular race/ethnic groups with the goal of increasing the overall proportion and number of tobacco users that use quitlines. These efforts should be complemented by comprehensive tobacco control initiatives that increase cessation including mass media campaigns, smoke-free policies, increased tobacco prices, expansion of health insurance coverage, and health systems change. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Assessment of the ability of the triglyceride to high density lipoprotein cholesterol ratio to discriminate insulin resistance among Caribbean-born black persons with and without Hispanic ethnicity.

PubMed

Tull, E S

2013-02-01

The objective of this research was to determine if the triglyceride (TG) to high density lipoprotein (HDL) cholesterol (TG/HDL) ratio has similar utility for discriminating insulin resistance in Caribbean-born black persons with and without Hispanic ethnicity. Serum lipids, glucose and insulin were determined and compared for 144 Hispanic blacks and 655 non-Hispanic blacks living in the US Virgin Islands. Area under the receiver operating characteristics (AUROC) curve statistics were used to evaluate the ability of the TG/HDL ratio to discriminate insulin resistance in the two ethnic groups. Hispanic blacks had significantly higher levels of triglycerides and insulin resistance and a lower level of HDL cholesterol than non-Hispanic blacks. The AUROC curve for the ability of the TG/HDL to discriminate insulin resistance was 0.71 (95% CI = 0.62, 0.79) for Hispanic blacks and 0.64 (95% CI = 0.59, 0.69) for non-Hispanic blacks. Among Caribbean-born black persons living in the US Virgin Islands, the TG/HDL ratio is a useful screening measure for discriminating insulin resistance in those with Hispanic ethnicity but not in those without Hispanic ethnicity.

Ethnic Identity as a Predictor of Microaggressions Toward Blacks, Whites, and Hispanic LGBs by Blacks, Whites, and Hispanics.

PubMed

Elias, Troy; Jaisle, Alyssa; Morton-Padovano, Cynthia

2017-01-01

Results of the study suggest racial differences still exist when it comes to attitudes toward homosexuality in the United States. Findings indicate Black individuals hold significantly less favorable attitudes toward lesbian/gay/bisexual (LGB) individuals than non-Hispanic White individuals but not Hispanics, after controlling for demographics. Hispanic individuals' attitudes toward LGBs were not significantly different from those of non-Hispanic Whites. Despite less favorable attitudes toward LGBs, however, Black Americans display a significantly lower likelihood of engaging in LGB-directed microaggressions than both non-Hispanic Whites and Hispanics. Finally, the results of the study indicate that as non-Hispanic White individuals' ethnic identity gets stronger, their likelihood of engaging in microaggressions toward LGBs increases, more so than Black or Hispanic individuals.

Racial diversity in American oral and maxillofacial surgery.

PubMed

Aziz, Shahid R

2010-08-01

Health care disparity in the United States is a significant problem. Part of the solution is to improve the diversity of health care providers. The purpose of this study is to review the racial demographic of American oral and maxillofacial surgery as it compares with the racial demographic of the United States. Additionally, the racial demographic of the American dental and medical professions are reviewed. Databases from the American Association of Oral and Maxillofacial Surgeons, American Dental Association, and Association of American Medical Colleges were analyzed, specifically reviewing racial demographic data of academic oral and maxillofacial surgery, dentistry, and medicine. Of the 349 full-time faculty, 248 were white (71.1%), 24 black (6.9%), 18 Hispanic (5.1%), 30 Asian (8.6%), and 29 other/unknown (8.3%); there were no full-time faculty of American Indian or Alaska Native descent. Of the 991 oral and maxillofacial surgery residents, whites comprised 701 (70.7%), blacks 43 (4.3%), Hispanics 42 (4.2%), Asians 197 (19.9%), and unknown 8 (0.8%). There are currently no residents of American Indian/Alaska Native origin. A 2006 American Dental Association survey of the distribution of race among the 179,594 professionally active dentists in the United States revealed 86.2% white, 3.4% black, 3.4% Hispanic, 6.9% Asian, and 0.12% American Indian. In 2004, whites comprised 36.7% (344,821) of US physicians, blacks 3.3% (30,598), Hispanics 2.8% (26,094), and Asians 5.7% (53,799); 27.6% (258,950) of US physicians were listed as unknown, and 23.6% (221,633) were listed as international medical graduates without demographic information. American oral and maxillofacial surgery's racial demographic (just as dentistry and medicine) does not remotely resemble the racial demographic of the United States. To improve health care disparity in this nation, diversifying the health care professional workforce is essential. Oral and maxillofacial surgery, a unique surgical specialty connecting medicine to dentistry, is positioned to make an impact on the oral health care disparity in this nation and as such should make a concerted effort to improve the racial diversity of the specialty. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Variation in child body mass index patterns by race/ethnicity and maternal nativity status in the United States and England.

PubMed

Martinson, Melissa L; McLanahan, Sara; Brooks-Gunn, Jeanne

2015-02-01

This paper examines body mass index (BMI) trajectories among children from different race/ethnic and maternal nativity backgrounds in the United States and England from early- to middle-childhood. This study is the first to examine race/ethnic and maternal nativity differences in BMI trajectories in both countries. We use two longitudinal birth cohort studies-The Fragile Families and Child Wellbeing Study (n = 3,285) for the United States and the Millennium Cohort Study (n = 6,700) for England to estimate trajectories in child BMI by race/ethnicity and maternal nativity status using multilevel growth models. In the United States our sample includes white, black, and Hispanic children; in England the sample includes white, black, and Asian children. We find significant race/ethnic differences in the initial BMI and BMI trajectories of children in both countries, with all non-white groups having significantly steeper BMI growth trajectories than whites. Nativity differences in BMI trajectories vary by race/ethnic group and are only statistically significantly higher for children of foreign-born blacks in England. Disparities in BMI trajectories are pervasive in the United States and England, despite lower overall BMI among English children. Future studies should consider both race/ethnicity and maternal nativity status subgroups when examining disparities in BMI in the United States and England. Differences in BMI are apparent in early childhood, which suggests that interventions targeting pre-school age children may be most effective at stemming childhood disparities in BMI.

Smoking Trends and Disparities Among Black and Non-Hispanic Whites in California

PubMed Central

Felicitas, Jamie; Fagan, Pebbles; Gruder, Charles L.; Blanco, Lyzette; Cappelli, Christopher; Trinidad, Dennis R.

2015-01-01

Objectives: The current study examined disparities in smoking trends across Blacks and non-Hispanic Whites in California. Methods: Data from the 1996 to 2008 California Tobacco Survey were analyzed to examine trends in smoking behaviors and cessation across Blacks and non-Hispanic Whites. Results: A decrease in overall ever and current smoking was observed for both Black and non-Hispanic Whites across the 12-year time period. A striking decrease in proportions of heavy daily smokers for both Black and non-Hispanic Whites were observed. Proportions of light and intermittent smokers and moderate daily smokers displayed modest increases for Blacks, but large increases for non-Hispanic Whites. Increases in successful cessation were also observed for Blacks and, to a lesser extent, for non-Hispanic Whites. Discussion: Smoking behavior and cessation trends across Blacks and non-Hispanic Whites were revealing. The decline in heavy daily and former smokers may demonstrate the success and effectiveness of tobacco control efforts in California. However, the increase in proportions of light and intermittent smokers and moderate daily smokers for both Blacks and non-Hispanic Whites demonstrates a need for tobacco cessation efforts focused on lighter smokers. PMID:25666813

The Validity of Race and Hispanic-origin Reporting on Death Certificates in the United States: An Update.

PubMed

Arias, Elizabeth; Heron, Melonie; Hakes, Jahn

2016-08-01

Objectives This report presents the findings of an updated study of the validity of race and Hispanic-origin reporting on death certificates in the United States, and its impact on race- and Hispanic origin-specific death rates. Methods The latest version of the National Longitudinal Mortality Study (NLMS) was used to evaluate the classification of race and Hispanic origin on death certificates for deaths occurring in 1999–2011 to decedents in NLMS. To evaluate change over time, these results were compared with those of a study based on an earlier version of NLMS that evaluated the quality of race and ethnicity classification on death certificates for 1979–1989 and 1990–1998. NLMS consists of a series of annual Current Population Survey files (1973 and 1978–2011) and a sample of the 1980 decennial census linked to death certificates for 1979–2011. Pooled 2009–2011 vital statistics mortality data and 2010 decennial census population data were used to estimate and compare observed and corrected race- and Hispanic origin-specific death rates. Results Race and ethnicity reporting on death certificates continued to be highly accurate for both white and black populations during the 1999–2011 period. Misclassification remained high at 40% for the American Indian or Alaska Native (AIAN) population. It improved, from 5% to 3%, for the Hispanic population, and from 7% to 3% for the Asian or Pacific Islander (API) population. Decedent characteristics such as place of residence and nativity affected the quality of reporting on the death certificate. Effects of misclassification on death rates were large for the AIAN population but not significant for the Hispanic or API populations.

Black Hispanics have a worse cardiovascular risk profile than mixed Hispanics in Venezuela.

PubMed

Ryder, Elena; Silva, Eglee; Sulbarán, Tulio; Fernández, Virginia; Campos, Gilberto; Calmon, Gustavo; Clavell, Emilio; Raleigh, Xiomara; Florez, Hermes

2007-03-01

In order to characterize components of the metabolic syndrome (MS) in Venezuelan black Hispanics and compare these metabolic abnormalities with those found in the predominant mixed Hispanic population, 2336 mixed Hispanics (69% women) and 281 black Hispanics (60% women), aged 20-78 years, without prior history of diabetes and/or cardiovascular disease were evaluated in a population-based study in Zulia State, Venezuela. Blood pressure (BP), waist circumference, as well as fasting insulin, fasting blood glucose (FBG), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) levels were measured. The criteria proposed by the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) to identify those with metabolic abnormalities were used. We found that black Hispanics showed higher frequency of age-adjusted elevated BP than mixed Hispanics in both men (66.9% vs. 52.3%, p < 0.01) and women (39.3% vs. 30.4%, p < 0.05). In men, elevated FBG was also more frequent in black Hispanics (32.7%) than in mixed Hispanics (22.3%), despite the lack of significant differences in fasting insulin, HOMA-insulin resistance and HOMA-beta cell function values. In women low HDL-C and higher abdominal obesity were more common in black Hispanics (71.8% and 54.1%, respectively) than in mixed Hispanics (56.2% and 44.5%, respectively), despite the greater frequency of high TG in mixed Hispanics (22.6%) when compared to black Hispanics (13.3%). Furthermore, in logistic regression analysis black Hispanic race was independently associated with higher risk for hypertension, fasting hyperglycemia, and low HDL-C. These results suggest that black Hispanics have worse cardiovascular risk profile than mixed Hispanics in Zulia State, with higher BP, higher FBG, more abdominal obesity, and lower HDL-C. Identification and intervention of these high-risk subjects are important strategies for diabetes and cardiovascular disease prevention in Venezuela.

Explaining racial/ethnic differences in adolescent substance abuse treatment completion in the United States: a decomposition analysis.

PubMed

Saloner, Brendan; Carson, Nicholas; Lê Cook, Benjamin

2014-06-01

To identify contributors to racial/ethnic differences in completion of alcohol and marijuana treatment among adolescents at publicly funded providers. The 2007 Treatment Episode Data Set provided substance use history, treatment setting, and treatment outcomes for youth aged 12-17 years from five racial/ethnic groups (N = 67,060). Individual-level records were linked to variables measuring the social context and service system characteristics of the metropolitan area. We implemented nonlinear regression decomposition to identify variables that explained minority-white differences. Black and Hispanic youth were significantly less likely than whites to complete treatment for both alcohol and marijuana. Completion rates were similar for whites, Native Americans, and Asian-Americans, however. Differences in predictor variables explained 12.7% of the black-white alcohol treatment gap and 7.6% of the marijuana treatment gap. In contrast, predictors explained 57.4% of the Hispanic-white alcohol treatment gap and 19.8% of the marijuana treatment gap. While differences in the distribution of individual-level variables explained little of the completion gaps, metropolitan-level variables substantially contributed to Hispanic-white gaps. For example, racial/ethnic composition of the metropolitan area explained 41.0% of the Hispanic-white alcohol completion gap and 23.2% of the marijuana completion gap. Regional differences in addiction treatment financing (particularly use of Medicaid funding) explained 13.7% of the Hispanic-white alcohol completion gap and 9.8% of the Hispanic-white marijuana treatment completion gap. Factors related to social context are likely to be important contributors to white-minority differences in addiction treatment completion, particularly for Hispanic youth. Increased Medicaid funding, coupled with culturally tailored services, could be particularly beneficial. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

One size does not fit all: an examination of low birthweight disparities among a diverse set of racial/ethnic groups.

PubMed

Johnelle Sparks, P

2009-11-01

To examine disparities in low birthweight using a diverse set of racial/ethnic categories and a nationally representative sample. This research explored the degree to which sociodemographic characteristics, health care access, maternal health status, and health behaviors influence birthweight disparities among seven racial/ethnic groups. Binary logistic regression models were estimated using a nationally representative sample of singleton, normal for gestational age births from 2001 using the ECLS-B, which has an approximate sample size of 7,800 infants. The multiple variable models examine disparities in low birthweight (LBW) for seven racial/ethnic groups, including non-Hispanic white, non-Hispanic black, U.S.-born Mexican-origin Hispanic, foreign-born Mexican-origin Hispanic, other Hispanic, Native American, and Asian mothers. Race-stratified logistic regression models were also examined. In the full sample models, only non-Hispanic black mothers have a LBW disadvantage compared to non-Hispanic white mothers. Maternal WIC usage was protective against LBW in the full models. No prenatal care and adequate plus prenatal care increase the odds of LBW. In the race-stratified models, prenatal care adequacy and high maternal health risks are the only variables that influence LBW for all racial/ethnic groups. The race-stratified models highlight the different mechanism important across the racial/ethnic groups in determining LBW. Differences in the distribution of maternal sociodemographic, health care access, health status, and behavior characteristics by race/ethnicity demonstrate that a single empirical framework may distort associations with LBW for certain racial and ethnic groups. More attention must be given to the specific mechanisms linking maternal risk factors to poor birth outcomes for specific racial/ethnic groups.

Racial and ethnic differences in advance care planning among patients with cancer: impact of terminal illness acknowledgment, religiousness, and treatment preferences.

PubMed

Smith, Alexander K; McCarthy, Ellen P; Paulk, Elizabeth; Balboni, Tracy A; Maciejewski, Paul K; Block, Susan D; Prigerson, Holly G

2008-09-01

Despite well-documented racial and ethnic differences in advance care planning (ACP), we know little about why these differences exist. This study tested proposed mediators of racial/ethnic differences in ACP. We studied 312 non-Hispanic white, 83 non-Hispanic black, and 73 Hispanic patients with advanced cancer in the Coping with Cancer study, a federally funded multisite prospective cohort study designed to examine racial/ethnic disparities in ACP and end-of-life care. We assessed the impact of terminal illness acknowledgment, religiousness, and treatment preferences on racial/ethnic differences in ACP. Compared with white patients, black and Hispanic patients were less likely to have an ACP (white patients, 80%; black patients, 47%; Hispanic patients, 47%) and more likely to want life-prolonging care even if he or she had only a few days left to live (white patients, 14%; black patients, 45%; Hispanic patients, 34%) and to consider religion very important (white patients, 44%; black patients, 88%; Hispanic patients, 73%; all P < .001, comparison of black or Hispanic patients with white patients). Hispanic patients were less likely and black patients marginally less likely to acknowledge their terminally ill status (white patients, 39% v Hispanic patients, 11%; P < .001; white v black patients, 27%; P = .05). Racial/ethnic differences in ACP persisted after adjustment for clinical and demographic factors, terminal illness acknowledgment, religiousness, and treatment preferences (has ACP, black v white patients, adjusted relative risk, 0.64 [95% CI, 0.49 to 0.83]; Hispanic v white patients, 0.65 [95% CI, 0.47 to 0.89]). Although black and Hispanic patients are less likely to consider themselves terminally ill and more likely to want intensive treatment, these factors did not explain observed disparities in ACP.

Health disparities between Black Hispanic and Black non-Hispanic cervical cancer cases in the USA.

PubMed

Khan, Hafiz Mohammad Rafiqullah; Gabbidon, Kemesha; Abdool-Ghany, Faheema; Saxena, Anshul; Gomez, Esneider; Stewart, Tiffanie Shauna-Jeanne

2014-01-01

Globally, cervical cancer is a major public health concern. Cervical cancer is the second most common cancer among women, resulting in approximately 500,000 cases per year. The purpose of this study is to compare disease characteristics between Black Hispanic (BH) and Black non-Hispanic (BNH) women in the US. We used stratified random sampling to select cervical cancer patient records from the SEER database (1973-2009). We used Chi-square and independent samples t-test to examine differences in proportions and means. The sample included 2,000 cervical cancer cases of Black non-Hispanic and 91 Black Hispanic women. There were statistically significant differences between black Hispanic and black non- Hispanics in mean age at diagnosis (p<0.001), mean survival time (p<0.001), marital status (p<0.001), primary site of cancer (p<0.001); lymph node involvement (p<0.001); grading and differentiation (p<0.0001); and tumor behavior (p<0.001). Black women were more likely to develop cervical cancer and to have the highest mortality rates from the disease. Findings from this study show clear racial and ethnic disparities in cervical cancer incidence and prognosis that should be addressed.

Adolescent Pornography Use and Dating Violence among a Sample of Primarily Black and Hispanic, Urban-Residing, Underage Youth

PubMed Central

Rothman, Emily F.; Adhia, Avanti

2015-01-01

This cross-sectional study was designed to characterize the pornography viewing preferences of a sample of U.S.-based, urban-residing, economically disadvantaged, primarily Black and Hispanic youth (n = 72), and to assess whether pornography use was associated with experiences of adolescent dating abuse (ADA) victimization. The sample was recruited from a large, urban, safety net hospital, and participants were 53% female, 59% Black, 19% Hispanic, 14% Other race, 6% White, and 1% Native American. All were 16–17 years old. More than half (51%) had been asked to watch pornography together by a dating or sexual partner, and 44% had been asked to do something sexual that a partner saw in pornography. Adolescent dating abuse (ADA) victimization was associated with more frequent pornography use, viewing pornography in the company of others, being asked to perform a sexual act that a partner first saw in pornography, and watching pornography during or after marijuana use. Approximately 50% of ADA victims and 32% of non-victims reported that they had been asked to do a sexual act that their partner saw in pornography (p = 0.15), and 58% did not feel happy to have been asked. Results suggest that weekly pornography use among underage, urban-residing youth may be common, and may be associated with ADA victimization. PMID:26703744

Heightened risk of preterm birth and growth restriction after a first-born son.

PubMed

Bruckner, Tim A; Mayo, Jonathan A; Gould, Jeffrey B; Stevenson, David K; Lewis, David B; Shaw, Gary M; Carmichael, Suzan L

2015-10-01

In Scandinavia, delivery of a first-born son elevates the risk of preterm delivery and intrauterine growth restriction of the next-born infant. External validity of these results remains unclear. We test this hypothesis for preterm delivery and growth restriction using the linked California birth cohort file. We examined the hypothesis separately by race and/or ethnicity. We retrieved data on 2,852,976 births to 1,426,488 mothers with at least two live births. Our within-mother tests applied Cox proportional hazards (preterm delivery, defined as less than 37 weeks gestation) and linear regression models (birth weight for gestational age percentiles). For non-Hispanic whites, Hispanics, Asians, and American Indian and/or Alaska Natives, analyses indicate heightened risk of preterm delivery and growth restriction after a first-born male. The race-specific hazard ratios for preterm delivery range from 1.07 to 1.18. Regression coefficients for birth weight for gestational age percentile range from -0.73 to -1.49. The 95% confidence intervals for all these estimates do not contain the null. By contrast, we could not reject the null for non-Hispanic black mothers. Whereas California findings generally support those from Scandinavia, the null results among non-Hispanic black mothers suggest that we do not detect adverse outcomes after a first-born male in all racial and/or ethnic groups. Copyright © 2015 Elsevier Inc. All rights reserved.

Revisiting the Hispanic health paradox: the relative contributions of nativity, country of origin, and race/ethnicity to childhood asthma.

PubMed

Camacho-Rivera, Marlene; Kawachi, Ichiro; Bennett, Gary G; Subramanian, S V

2015-06-01

This study examined the relationship between race and Hispanic ethnicity, maternal and child nativity, country of origin and asthma among 2,558 non-Hispanic white and Hispanic children across 65 Los Angeles neighborhoods. A series of two-level multilevel models were estimated to examine the independent effects of race, ethnicity, and country of origin on childhood asthma. Lifetime asthma prevalence was reported among 9% of children, with no significant differences between Hispanics and non-Hispanic whites overall. However, in fully adjusted models, Hispanic children of non-Mexican origin reported higher odds of asthma compared to non-Hispanic white children. A protective nativity effect was also observed among children of foreign born mothers compared to US born mothers. Our study provides evidence in support of the heterogeneity of childhood asthma by Hispanic ethnicity and maternal nativity. These findings suggest moving beyond solely considering racial/ethnic classifications which could mask subgroups at increased risk of childhood asthma.

Is Heart Disease or Cancer the Leading Cause of Death in United States Women?

PubMed

Pathak, Elizabeth B

This paper compares the mortality burden of heart disease versus cancer among women by age, race, and ethnicity. U.S. death and population data for the years 2000 through 2013 were used to calculate heart disease and cancer death rates. Detailed analyses focused on age (15-19 years old to ≥100 years old) and race and ethnicity (Whites, Blacks, Hispanics, Asians and Pacific Islanders (A/PIs), and American Indians and Alaska Natives (AI/ANs)). Among women aged 15 years and older, there were 289,467 heart disease deaths and 276,716 cancer deaths in 2013. The majority of heart disease deaths (51.6%) occurred among women 85 years or older, compared with 18.9% of female cancer deaths. The age-adjusted death rates (per 100,000 population) were 171 (95% confidence interval [CI], 170-171) for heart disease versus 177 (95% CI, 176-178) for cancer. For all racial and ethnic groups, cancer mortality was significantly higher than heart disease mortality among women younger than 80 years of age. For all ages combined, cancer deaths exceeded heart disease deaths among Hispanics, A/PIs, and AI/ANs. Black non-Hispanic women were the only racial/ethnic group who had a higher age-adjusted death rate for heart disease than for cancer: 224 (95% CI, 222-226) versus 207 (95% CI, 205-209). Heart disease remains the leading cause of death among all women combined in the United States by a narrow margin. However, cancer predominantly kills middle-aged and young women, whereas heart disease predominantly kills the very old. New research on the overreporting of heart disease on death certificates for elderly women is needed. National summary statistics obscure the fact that cancer is already the overall leading cause of death for Hispanic women, Asian and Pacific Islander women, and American Indian and Alaska Native women. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Prostate cancer risk profiles of Asian-American men: disentangling the effects of immigration status and race/ethnicity.

PubMed

Lichtensztajn, Daphne Y; Gomez, Scarlett Lin; Sieh, Weiva; Chung, Benjamin I; Cheng, Iona; Brooks, James D

2014-04-01

Asian-American men with prostate cancer have been reported to present with higher grade and later stage disease than white American men. However, Asian-American men comprise a heterogeneous population with distinct health outcomes. We compared prostate cancer risk profiles among the diverse racial and ethnic groups in California. We used data from the California Cancer Registry on 90,845 nonHispanic white, nonHispanic black and Asian-American men diagnosed with prostate cancer between 2004 and 2010. Patients were categorized into low, intermediate and high risk groups based on clinical stage, Gleason score and prostate specific antigen at diagnosis. Using polytomous logistic regression we estimated adjusted ORs for the association of race/ethnicity and nativity with risk group. In addition to the nonHispanic black population, 6 Asian-American groups (United States born Chinese, foreign born Chinese, United States born Japanese, foreign born Japanese, foreign born Filipino and foreign born Vietnamese) were more likely to have an unfavorable risk profile compared to nonHispanic white men. The OR for high vs intermediate risk disease ranged from 1.23 (95% CI 1.02-1.49) for United States born Japanese men to 1.45 (95% CI 1.31-1.60) for foreign born Filipino men. These associations appeared to be driven by higher grade and prostate specific antigen rather than by advanced clinical stage at diagnosis. In this large, ethnically diverse, population based cohort Asian-American men were more likely to have an unfavorable risk profile at diagnosis. This association varied by racial/ethnic group and nativity, and was not attributable to later stage at diagnosis. This suggests that Asian men may have biological differences that predispose to more severe disease. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Maternal employment and overweight among Hispanic children of immigrants and children of natives.

PubMed

Baker, Elizabeth; Balistreri, Kelly Stamper; Van Hook, Jennifer

2009-06-01

This research examines the relationship between maternal employment and child overweight among fifth grade Hispanic and non-Hispanic white children. Data from the Early Childhood Longitudinal Study Kindergarten (ECLS-K) cohort fifth grade sample (N = 4,360) were analyzed. OLS regression models were estimated predicting percentile BMI as a function of maternal employment, ethnicity, parental nativity status, income, and the interactions of employment, ethnicity/nativity, and income. Among Hispanic children of immigrants, maternal employment is associated with lower percentile BMI and this association strengthens at higher levels of income. Among Hispanic children of natives and non-Hispanic whites, maternal employment is beneficial (i.e. associated with lower percentile BMI) among low-income children but detrimental among high-income children, but this pattern is significantly greater in strength for Hispanics than non-Hispanic whites. Thus, maternal employment is associated with worse health outcomes only in the case of Hispanic children of natives, and maternal employment is associated with the best outcomes for Hispanic children of mothers from high-income families. We speculate that among children of immigrants, maternal employment may signify and/or accelerate assimilation towards middle- or upper-class American values of healthy weight and body size. Diet, meal regularity and supervision, and childcare did not mediate the relationship between maternal employment and overweight.

Maternal Employment and Overweight Among Hispanic Children of Immigrants and Children of Natives

PubMed Central

Balistreri, Kelly Stamper; Van Hook, Jennifer

2012-01-01

This research examines the relationship between maternal employment and child overweight among fifth grade Hispanic and non-Hispanic white children. Data from the Early Childhood Longitudinal Study Kindergarten (ECLS-K) cohort fifth grade sample (N = 4,360) were analyzed. OLS regression models were estimated predicting percentile BMI as a function of maternal employment, ethnicity, parental nativity status, income, and the interactions of employment, ethnicity/nativity, and income. Among Hispanic children of immigrants, maternal employment is associated with lower percentile BMI and this association strengthens at higher levels of income. Among Hispanic children of natives and non-Hispanic whites, maternal employment is beneficial (i.e. associated with lower percentile BMI) among low-income children but detrimental among high-income children, but this pattern is significantly greater in strength for Hispanics than non-Hispanic whites. Thus, maternal employment is associated with worse health outcomes only in the case of Hispanic children of natives, and maternal employment is associated with the best outcomes for Hispanic children of mothers from high-income families. We speculate that among children of immigrants, maternal employment may signify and/or accelerate assimilation towards middle- or upper-class American values of healthy weight and body size. Diet, meal regularity and supervision, and childcare did not mediate the relationship between maternal employment and overweight. PMID:17963041

Other- and Self-Directed Forms of Violence and Their Relationship With Number of Substance Use Disorder Criteria Among Youth Ages 12–17: Results From the National Survey on Drug Use and Health

PubMed Central

Harford, Thomas C.; Chen, Chiung M.; Grant, Bridget F.

2016-01-01

Objective: The purpose of this study was to examine the associations between the number of substance use disorder (SUD) criteria as listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and other- and self-directed forms of violence among youth ages 12–17 in the general population. Method: Data were obtained from the National Survey on Drug Use and Health pooled across survey years 2008–2013, with a combined sample of 108,560 respondents ages 12–17. Violence categories defined by suicide attempt (self-directed) and attacking someone with the intent for serious injury (other-directed) were categorized as follows: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression estimated odds ratios of the increased number of criteria for alcohol, marijuana, and other illicit drug use, and nicotine dependence for each violence category, by controlling for sociodemographics and criminal justice involvement. Results: The multivariable model indicates that increased number of SUD criteria confers significantly higher odds for each violence category versus no violence. For combined violence versus self-directed violence, male gender, non-Hispanic Black and mixed race (with non-Hispanic White as referent), nicotine dependence, increased number of alcohol use disorder criteria, and other drug use disorder criteria have significantly higher odds, whereas Native Hawaiian/Pacific Islander and age have significantly lower odds. For combined violence versus other-directed violence, non-Hispanic mixed race and the increased number of other drug use disorder criteria have significantly higher odds, whereas male gender, non-Hispanic Black and Native Hawaiian/Pacific Islander, and Hispanic have significantly lower odds. Conclusions: The identification of the combined self-/other-directed violence in the general population provides additional support for clinical studies that established associations between self- and other-directed violent behaviors. Prevention and treatment programs need to address both instances of violence and suicidality. PMID:26997186

Measuring success: Results from a national survey of recruitment and retention initiatives in the nursing workforce

PubMed Central

Carthon, J. Margo Brooks; Nguyen, Thai-Huy; Chittams, Jesse; Park, Elizabeth; Guevara, James

2015-01-01

Objectives The purpose of this study was to identify common components of diversity pipeline programs across a national sample of nursing institutions and determine what effect these programs have on increasing underrepresented minority enrollment and graduation. Design Linked data from an electronic survey conducted November 2012 to March 2013 and American Association of Colleges of Nursing baccalaureate graduation and enrollment data (2008 and 2012). Participants Academic and administrative staff of 164 nursing schools in 26 states, including Puerto Rico in the United States. Methods Chi-square statistics were used to (1) describe organizational features of nursing diversity pipeline programs and (2) determine significant trends in underrepresented minorities’ graduation and enrollment between nursing schools with and without diversity pipeline programs Results Twenty percent (n = 33) of surveyed nursing schools reported a structured diversity pipeline program. The most frequent program measures associated with pipeline programs included mentorship, academic, and psychosocial support. Asian, Hispanic, and Native Hawaiian/Pacific Islander nursing student enrollment increased between 2008 and 2012. Hispanic/Latino graduation rates increased (7.9%–10.4%, p = .001), but they decreased among Black (6.8%–5.0%, p = .004) and Native American/Pacific Islander students (2.1 %–0.3%, p ≥ .001). Conclusions Nursing diversity pipeline programs are associated with increases in nursing school enrollment and graduation for some, although not all, minority students. Future initiatives should build on current trends while creating targeted strategies to reverse downward graduation trends among Black, Native American, and Pacific Island nursing students. PMID:24880900

Measuring success: results from a national survey of recruitment and retention initiatives in the nursing workforce.

PubMed

Brooks Carthon, J Margo; Nguyen, Thai-Huy; Chittams, Jesse; Park, Elizabeth; Guevara, James

2014-01-01

The purpose of this study was to identify common components of diversity pipeline programs across a national sample of nursing institutions and determine what effect these programs have on increasing underrepresented minority enrollment and graduation. Linked data from an electronic survey conducted November 2012 to March 2013 and American Association of Colleges of Nursing baccalaureate graduation and enrollment data (2008 and 2012). Academic and administrative staff of 164 nursing schools in 26 states, including Puerto Rico in the United States. Chi-square statistics were used to (1) describe organizational features of nursing diversity pipeline programs and (2) determine significant trends in underrepresented minorities' graduation and enrollment between nursing schools with and without diversity pipeline programs Twenty percent (n = 33) of surveyed nursing schools reported a structured diversity pipeline program. The most frequent program measures associated with pipeline programs included mentorship, academic, and psychosocial support. Asian, Hispanic, and Native Hawaiian/Pacific Islander nursing student enrollment increased between 2008 and 2012. Hispanic/Latino graduation rates increased (7.9%-10.4%, p = .001), but they decreased among Black (6.8%-5.0%, p = .004) and Native American/Pacific Islander students (2.1 %-0.3%, p ≥ .001). Nursing diversity pipeline programs are associated with increases in nursing school enrollment and graduation for some, although not all, minority students. Future initiatives should build on current trends while creating targeted strategies to reverse downward graduation trends among Black, Native American, and Pacific Island nursing students. Copyright © 2014 Elsevier Inc. All rights reserved.

Her earnings: Exploring variation in wives' earning contributions across six major Asian groups and Whites.

PubMed

Kulkarni, Veena S

2015-07-01

Previous research on understanding race-ethnic differentials in employment and economic contributions by married women has primarily focused on Blacks, Hispanics, or Whites. This study investigates variations in wives' earning contributions as measured by wives earnings as a proportion of total annual household earnings among six Asian groups, Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese relative to native born non-Hispanic White. I disaggregate the six Asian groups by their ethnicity and nativity status. Using pooled data from 2009-2011 American Community Survey, the findings show significance of human capital, hours of paid labor market engagement and nativity status. There is strong and negative association between husbands' human capital and labor supply with wives' earning contributions suggesting near universality of male-breadwinner status. Notwithstanding the commonalities, there is significant intergroup diversity. While foreign born and native born Filipina wives despite their spouses' reasonably high human capital and work hours, contribute one of the highest shares, the same cannot be said for the Asian Indians and Japanese. For foreign born Asian Indian and to some extent Japanese women, their high human capital is not translated to high earning contribution after controlling for husband's human capital. Further, nativity status impacts groups differentially. Native born Vietnamese wives contribute the greatest. Overall, the findings underscore the relevance of employing multiple conceptual frameworks in understanding earning contributions of foreign and native born Asian wives belonging to the six Asian groups, Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese. Copyright © 2015 Elsevier Inc. All rights reserved.

Hypertension in the Hispanic and Black Population in New York City

PubMed Central

Barrios, Eugene; Iler, Elizabeth; Mulloy, Katherine; Goldstein, Jonathan; Chalfin, Donald; Muñoz, Eric

1987-01-01

Little data have been accumulated on the health care problems of underserved, urban Hispanic-Americans. The purpose of this study was to determine the prevalence of hypertension and the adequacy of treatment for Hispanic-Americans (predominately Puerto Ricans) and blacks living in the South Bronx section of New York City. Almost three fourths (74.5 percent) of the study subjects (n = 145) knew what hypertension was, and 40.7 percent said they had hypertension. However, 52.3 percent of subjects (Hispanic, 49.2 percent and black, 61.5 percent) who responded that they were not hypertensive had hypertension. Of those who said they had hypertension, only 55.9 percent were taking medication (Hispanic, 57.5 percent and black, 57.1 percent). For those taking medication, the majority did not have their hypertension controlled (Hispanic, 78.2 percent and black, 100 percent). These data suggest that for urban Hispanics and blacks, both hypertensive awareness and control is poor. This population thus appears likely to suffer excess morbidity and mortality from hypertension. Public policy programs for surveillance and control of hypertension in urban Hispanic and black populations may decrease the rate of morbidity and mortality from this treatable disease. PMID:3498048

Hispanic and Black American Adolescents' Beliefs Relating to Sexuality and Contraception.

ERIC Educational Resources Information Center

Scott, Clarissa S.; And Others

1988-01-01

Explored the level of scientific knowledge regarding sexuality and contraception of Black and Hispanic inner-city adolescents. Results indicated that Hispanic males were the most knowledgeable, Hispanic females the least, and Black males and females were intermediate. A cultural basis for this difference is considered, and the need to design…

Personality Differences among Black, White, and Hispanic-American Male Heroin Addicts on MMPI Content Scales.

ERIC Educational Resources Information Center

Dolan, M. P.; And Others

1983-01-01

Assessed personality differences among Black, White, and Hispanic-American heroin addicts (N=423). Results confirmed the hypotheses that minority group heroin addicts (Blacks and Hispanics) would show better adjustment than White heroin addicts and that Hispanic-American heroin addicts would evidence personality characteristics unlike those of…

Osteoinvasive subungual melanoma: a case and review.

PubMed

Kleinerman, Rebecca; Kriegel, David; Amir, Imran; Emanuel, Patrick O; Markinson, Bryan C

2010-02-01

Subungual melanoma is a relatively rare variant of melanoma, accounting for 0.7-3.5% of all melanoma cases in the Caucasian population. Curiously, it occurs in 8-33% of cases in black, Asian, Native American and Hispanic populations, which generally face a substantially lower risk of melanoma. Herein the authors report the case of a 69-year-old Hispanic female with a subungual melanoma of the acral lentiginous type that directly invaded the periosteum, cortex and medulla of the distal phalanx. In addition, we review published reports of acral lentiginous melanoma with osseous invasion and discuss the evidence, on a molecular level, for this entity's aggressive pattern of invasion. The review of cases is limited to those found through the PubMed search engine.

Variation in participation in health care settings associated with race and ethnicity.

PubMed

Bliss, Erika B; Meyers, David S; Phillips, Robert L; Fryer, George E; Dovey, Susan M; Green, Larry A

2004-09-01

To use the ecology model of health care to contrast participation of black, non-Hispanics (blacks); white, non-Hispanics (whites); and Hispanics of any race (Hispanics) in 5 health care settings and determine whether disparities between those individuals exist among places where they receive care. 1996 Medical Expenditure Panel Survey data were used to estimate the number of black, white, and Hispanic people per 1,000 receiving health care in each setting. Physicians' offices, outpatient clinics, hospital emergency departments, hospitals, and people's homes. Number of people per 1,000 per month who had at least one contact in a health care setting. Fewer blacks and Hispanics than whites received care in physicians' offices (154 vs 155 vs 244 per 1,000 per month, respectively) and outpatient clinics (15 vs 12 vs 24 per 1,000 per month, respectively). There were no significant differences in proportions hospitalized or receiving care in emergency departments. Fewer Hispanics than blacks or whites received home health care services (7 vs 14 vs 14 per 1,000 per month, respectively). After controlling for 7 variables, blacks and Hispanics were less likely than whites to receive care in physicians' offices (odds ratio [OR], 0.65, 95% confidence interval [CI], 0.60 to 0.69 for blacks and OR, 0.79, 95% CI, 0.73 to 0.85 for Hispanics), outpatient clinics (OR, 0.73, 95% CI, 0.60 to 0.90 for blacks and OR, 0.71, 95% CI, 0.58 to 0.88 for Hispanics), and hospital emergency departments (OR, 0.80, 95% CI, 0.69 to 0.94 for blacks and OR, 0.80, 95% CI, 0.68 to 0.93 for Hispanics) in a typical month. The groups did not differ in the likelihood of receiving care in the hospital or at home. Fewer blacks and Hispanics than whites received health care in physicians' offices, outpatient clinics, and emergency departments in contrast to hospitals and home care. Research and programs aimed at reducing disparities in receipt of care specifically in the outpatient setting may have an important role in the quest to reduce racial and ethnic disparities in health.

Race/Ethnicity and Adoption of a Population Health Management Approach to Colorectal Cancer Screening in a Community-Based Healthcare System.

PubMed

Mehta, Shivan J; Jensen, Christopher D; Quinn, Virginia P; Schottinger, Joanne E; Zauber, Ann G; Meester, Reinier; Laiyemo, Adeyinka O; Fedewa, Stacey; Goodman, Michael; Fletcher, Robert H; Levin, Theodore R; Corley, Douglas A; Doubeni, Chyke A

2016-11-01

Screening outreach programs using population health management principles offer services uniformly to all eligible persons, but racial/ethnic colorectal cancer (CRC) screening patterns in such programs are not well known. To examine the association between race/ethnicity and the receipt of CRC screening and timely follow-up of positive results before and after implementation of a screening program. Retrospective cohort study of screen-eligible individuals at the Kaiser Permanente Northern California community-based integrated healthcare delivery system (2004-2013). A total of 868,934 screen-eligible individuals 51-74 years of age at cohort entry, which included 662,872 persons in the period before program implementation (2004-2006), 654,633 during the first 3 years after implementation (2007-2009), and 665,268 in the period from 4 to 7 years (2010-2013) after program implementation. A comprehensive system-wide long-term effort to increase CRC that included leadership alignment, goal-setting, and quality assurance through a PHM approach, using mailed fecal immunochemical testing (FIT) along with offering screening at office visits. Differences over time and by race/ethnicity in up-to-date CRC screening (overall and by test type) and timely follow-up of a positive screen. Race/ethnicity categories included non-Hispanic white, non-Hispanic black, Hispanic/Latino, Asian/Pacific Islander, Native American, and multiple races. From 2004 to 2013, age/sex-adjusted CRC screening rates increased in all groups, including 35.2 to 81.1 % among whites and 35.6 to 78.0 % among blacks. Screening rates among Hispanics (33.1 to 78.3 %) and Native Americans (29.4 to 74.5 %) remained lower than those for whites both before and after program implementation. Blacks, who had slightly higher rates before program implementation (adjusted rate ratio [RR] = 1.04, 99 % CI: 1.02-1.05), had lower rates after program implementation (RR for period from 4 to 7 years = 0.97, 99 % CI: 0.96-0.97). There were also substantial improvements in timely follow-up of positive screening results. In this screening program using core PHM principles, CRC screening increased markedly in all racial/ethnic groups, but disparities persisted for some groups and developed in others, which correlated with levels of adoption of mailed FIT.

Perceptions of Stress among Native American and Hispanic K-5 Teachers

ERIC Educational Resources Information Center

Lotz-Drlik, Jane Elizabeth

2012-01-01

Within the context of a nationwide shortage of teachers of color, stable enrollment of Native American students, and increasing enrollments of Hispanic students, the purpose of this study was to examine self-reported stress among Native American, Hispanic, and Caucasian K-5 teachers. This was a mixed-methods study, with both quantitative and…

Mandated Coverage of Preventive Care and Reduction in Disparities: Evidence From Colorectal Cancer Screening

PubMed Central

Kapinos, Kandice A.

2015-01-01

Objectives. We identified correlates of racial/ethnic disparities in colorectal cancer screening and changes in disparities under state-mandated insurance coverage. Methods. Using Behavioral Risk Factor Surveillance System data, we estimated a Fairlie decomposition in the insured population aged 50 to 64 years and a regression-adjusted difference-in-difference-in-difference model of changes in screening attributable to mandates. Results. Under mandated coverage, blood stool test (BST) rates increased among Black, Asian, and Native American men, but rates among Whites also increased, so disparities did not change. Endoscopic screening rates increased by 10 percentage points for Hispanic men and 3 percentage points for non-Hispanic men. BST rates fell among Hispanic relative to non-Hispanic men. We found no changes for women. However, endoscopic screening rates improved among lower income individuals across all races and ethnicities. Conclusions. Mandates were associated with a reduction in endoscopic screening disparities only for Hispanic men but may indirectly reduce racial/ethnic disparities by increasing rates among lower income individuals. Findings imply that systematic differences in insurance coverage, or health plan fragmentation, likely existed without mandates. These findings underscore the need to research disparities within insured populations. PMID:25905835

Sex and Race Differences in the Association Between Statin Use and the Incidence of Alzheimer Disease.

PubMed

Zissimopoulos, Julie M; Barthold, Douglas; Brinton, Roberta Diaz; Joyce, Geoffrey

2017-02-01

To our knowledge, no effective treatments exist for Alzheimer disease, and new molecules are years away. However, several drugs prescribed for other conditions have been associated with reducing its risk. To analyze the association between statin exposure and Alzheimer disease incidence among Medicare beneficiaries. We examined the medical and pharmacy claims of a 20% sample of Medicare beneficiaries from 2006 to 2013 and compared rates of Alzheimer disease diagnosis for 399 979 statin users 65 years of age or older with high or low exposure to statins and with drug molecules for black, Hispanic, and non-Hispanic white people, and men and women of Asian, Native American, or unkown race/ethnicity who are referred to as "other." The main outcome was incident diagnosis of Alzheimer disease based on the International Classification of Diseases, Ninth Revision, Clinical Modification. We used Cox proportional hazard models to analyze the association between statin exposure and Alzheimer disease diagnosis for different sexes, races and ethnicities, and statin molecules. The 399 979 study participants included 7794 (1.95%) black men, 24 484 (6.12%) black women, 11 200 (2.80%) Hispanic men, 21 458 (5.36%) Hispanic women, 115 059 (28.77%) white men, and 195 181 (48.80%) white women. High exposure to statins was associated with a lower risk of Alzheimer disease diagnosis for women (hazard ratio [HR], 0.85; 95% CI, 0.82-0.89; P<.001) and men (HR, 0.88; 95% CI, 0.83-0.93; P<.001). Simvastatin was associated with lower Alzheimer disease risk for white women (HR, 0.86; 95% CI, 0.81-0.92; P<.001), white men (HR, 0.90; 95% CI, 0.82-0.99; P=.02), Hispanic women (HR, 0.82; 95% CI, 0.68-0.99; P=.04), Hispanic men (HR, 0.67; 95% CI, 0.50-0.91; P=.01), and black women (HR, 0.78; 95% CI, 0.66-0.93; P=.005). Atorvastatin was associated with a reduced risk of incident Alzheimer disease diagnosis for white women (HR, 0.84, 95% CI, 0.78-0.89), black women (HR, 0.81, 95% CI, 0.67-0.98), and Hispanic men (HR, 0.61, 95% CI, 0.42-0.89) and women (HR, 0.76, 95% CI, 0.60-0.97). Pravastatin and rosuvastatin were associated with reduced Alzheimer disease risk for white women only (HR, 0.82, 95% CI, 0.70-0.95 and HR, 0.81, 95% CI, 0.67-0.98, respectively). High statin exposure was not associated with a statistically significant lower Alzheimer disease risk among black men. The reduction in Alzheimer disease risk varied across statin molecules, sex, and race/ethnicity. Clinical trials that include racial and ethnic groups need to confirm these findings. Because statins may affect Alzheimer disease risk, physicians should consider which statin is prescribed to each patient.

Cigarette smoking and lesbian and bisexual women in the Bronx.

PubMed

Sanchez, John P; Meacher, Peter; Beil, Robert

2005-02-01

This study investigated the prevalence of cigarette smoking, smoking patterns, and smoking cessation efforts of Black and Hispanic lesbian and bisexual women from a poor, urban community. One-on-one interviews were conducted with a convenience sample of 130 self-identified Black and Hispanic lesbian and bisexual women from the Bronx, NY. Bivariate statistics were used to determine differences between Black and Hispanic respondents in smoking prevalence, frequency, desire to quit, and impact on family unit. Fifty-five percent of Black respondents and sixty-two percent of Hispanic respondents were current smokers. Hispanics were more likely than Blacks to have a partner (p < 0.04), 2 or more children (p < 0.05), and an asthmatic in their household (p < 0.02). Hispanics were less likely than Blacks to have ever attempted to quit (p < 0.04) and to have made a serious attempt to quit in the past year (p < 0.02). Culturally sensitive interventions are needed to help Hispanic lesbian and bisexual women move from the pre-contemplative to action stage of quitting. The large proportion of current smokers requires greater access to effective smoking cessation tools.

Racial/Ethnic Differences in Primary Care Experiences in Patient-Centered Medical Homes among Veterans with Mental Health and Substance Use Disorders.

PubMed

Jones, Audrey L; Mor, Maria K; Cashy, John P; Gordon, Adam J; Haas, Gretchen L; Schaefer, James H; Hausmann, Leslie R M

2016-12-01

Patient-Centered Medical Homes (PCMH) may be effective in managing care for racial/ethnic minorities with mental health and/or substance use disorders (MHSUDs). How such patients experience care in PCMH settings is relatively unknown. We aimed to examine racial/ethnic differences in experiences with primary care in PCMH settings among Veterans with MHSUDs. We used multinomial regression methods to estimate racial/ethnic differences in PCMH experiences reported on a 2013 national survey of Veterans Affairs patients. Veterans with past-year MHSUD diagnoses (n = 65,930; 67 % White, 20 % Black, 11 % Hispanic, 1 % American Indian/Alaska Native[AI/AN], and 1 % Asian/Pacific Island[A/PI]). Positive and negative experiences from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) PCMH Survey. Veterans with MHSUDs reported the lowest frequency of positive experiences with access (22 %) and the highest frequency of negative experiences with self-management support (30 %) and comprehensiveness (16 %). Racial/ethnic differences (as compared to Whites) were observed in all seven healthcare domains (p values < 0.05). With access, Blacks and Hispanics reported more negative (Risk Differences [RDs] = 2 .0;3.6) and fewer positive (RDs = -2 .3;-2.3) experiences, while AI/ANs reported more negative experiences (RD = 5.7). In communication, Blacks reported fewer negative experiences (RD = -1.3); AI/ANs reported more negative (RD = 3.6) experiences; and AI/ANs and APIs reported fewer positive (RD = -6.5, -6.7) experiences. With office staff, Hispanics reported fewer positive experiences (RDs = -3.0); AI/ANs and A/PIs reported more negative experiences (RDs =  3.4; 3.7). For comprehensiveness, Blacks reported more positive experiences (RD = 3.6), and Hispanics reported more negative experiences (RD = 2.7). Both Blacks and Hispanics reported more positive (RDs = 2.3; 4.2) and fewer negative (RDs = -1.8; -1.9) provider ratings, and more positive experiences with decision making (RDs = 2.4; 3.0). Blacks reported more positive (RD = 3.9) and fewer negative (RD = -5.1) experiences with self-management support. In a national sample of Veterans with MHSUDs, potential deficiencies were observed in access, self-management support, and comprehensiveness. Racial/ethnic minorities reported worse experiences than Whites with access, comprehensiveness, communication, and office staff helpfulness/courtesy.

Race/ethnic differences in obstructive sleep apnea risk in patients with acute ischemic strokes in south Florida.

PubMed

Ramos, Alberto R; Guilliam, Daniela; Dib, Salim I; Koch, Sebastian

2014-03-01

Obstructive sleep apnea (OSA) is a risk factor for ischemic stroke, but it may differ between race/ethnic groups. The goal of our study was to examine the pre-stroke risk of OSA between three race/ethnic groups admitted for acute ischemic stroke in a tertiary urban hospital in South Florida. Our sample was composed of patients with acute ischemic strokes evaluated at a teaching hospital over a 3-year period. Race/ethnicity was defined by self-identification, modeled after the US census and categorized into non-Hispanic whites, non-Hispanic blacks, and Hispanics. Pre-stroke risk of OSA was assessed with the Berlin questionnaire and categorized into high- or low-risk categories. We performed binary logistic regression to evaluate the pre-stroke risk of OSA in Hispanics and non-Hispanic blacks with non-Hispanic whites as the reference, adjusting for age, body mass index, hypertension, diabetes, and smoking. There were 176 patients with acute ischemic strokes of which 44 % were Hispanics, 44 % non-Hispanic Blacks, and 12 % non-Hispanic whites. A higher frequency of patients at high risk for OSA was seen in 60 % of Hispanics, 54 % of non-Hispanic blacks, and 33 % of non-Hispanic whites. Hispanics (OR, 2.6; 95 % CI 1.1-6.4) had a higher frequency of patients at high risk for OSA compared to non-Hispanic whites, adjusting for covariates. There were no differences between non-Hispanic blacks (OR, 1.2; 0.5-2.9 and non-Hispanic whites. We observed higher frequency of patients at high risk for OSA in Hispanics with acute ischemic strokes in South Florida.

The effect of body mass index on blood pressure varies by race among obese children.

PubMed

Hannon, Tamara S; Gupta, Sandeep; Li, Zhuokai; Eckert, George; Carroll, Aaron E; Pratt, J Howard; Tu, Wanzhu

2015-05-01

Previous studies have shown that the effect of adiposity on blood pressure (BP) intensifies as children become increasingly obese. Black children tend to have greater body mass index (BMI) and higher BP than age-matched white children. It is unclear whether the BP effects of BMI are race-specific among black and white children, and data on obese Hispanic children are sparse. We compared the BP effect of BMI in obese white, black, and Hispanic children. We examined the medical records of children enrolled in a pediatric obesity clinic. Height, weight, BP, and fasting insulin were assessed as part of routine clinical care. The concurrent effects of age and BMI on BP percentile values were examined using semiparametric regression, which allows the accommodation of nonlinear effects. The study included 873 children (338 male; 354 black, 447 white, 72 Hispanic; 11.7±3.5 years, BMI 36.2±8.5 kg/m2). While BMI Z-scores were similar among the groups, systolic BP (SBP) was higher in black children and Hispanic children (white: 107 mm Hg; black: 112 mm Hg; Hispanic: 112 mm Hg; p=0.0001). Age, sex, and height-adjusted SBP percentiles were significantly different among the three groups (white: 50; black: 59; Hispanic: 59; p=0.0006). In children of the same age, BP was higher at any given BMI in black children and Hispanic children. Among children referred for treatment of obesity, black children and Hispanic children are at a greater risk for having elevated BP when compared to white children of similar age and BMI.

Harnessing Data to Assess Equity of Care by Race, Ethnicity and Language

PubMed Central

Gracia, Amber; Cheirif, Jorge; Veliz, Juana; Reyna, Melissa; Vecchio, Mara; Aryal, Subhash

2015-01-01

Objective: Determine any disparities in care based on race, ethnicity and language (REaL) by utilizing inpatient (IP) core measures at Texas Health Resources, a large, faith-based, non-profit health care delivery system located in a large, ethnically diverse metropolitan area in Texas. These measures, which were established by the U.S. Centers for Medicare and Medicaid Services (CMS) and The Joint Commission (TJC), help to ensure better accountability for patient outcomes throughout the U.S. health care system. Methods: Sample analysis to understand the architecture of race, ethnicity and language (REaL) variables within the Texas Health clinical database, followed by development of the logic, method and framework for isolating populations and evaluating disparities by race (non-Hispanic White, non-Hispanic Black, Native American/Native Hawaiian/Pacific Islander, Asian and Other); ethnicity (Hispanic and non-Hispanic); and preferred language (English and Spanish). The study is based on use of existing clinical data for four inpatient (IP) core measures: Acute Myocardial Infarction (AMI), Congestive Heart Failure (CHF), Pneumonia (PN) and Surgical Care (SCIP), representing 100% of the sample population. These comprise a high number of cases presenting in our acute care facilities. Findings are based on a sample of clinical data (N = 19,873 cases) for the four inpatient (IP) core measures derived from 13 of Texas Health’s wholly-owned facilities, formulating a set of baseline data. Results: Based on applied method, Texas Health facilities consistently scored high with no discernable race, ethnicity and language (REaL) disparities as evidenced by a low percentage difference to the reference point (non-Hispanic White) on IP core measures, including: AMI (0.3%–1.2%), CHF (0.7%–3.0%), PN (0.5%–3.7%), and SCIP (0–0.7%). PMID:26703665

The Coming Black/Hispanic Coalition. A Black View and An Hispanic View.

ERIC Educational Resources Information Center

Calhoun, Lillian; Arias, Ron

1980-01-01

Two journalists discuss political, economic, and social issues which unite Blacks and Hispanics and consider the problems which impede the formation of a formal political coalition between the two groups. Among the common issues identified are police brutality, voter registration, unemployment, health, housing, and the media. (GC)

Drinking in different social contexts among white, black, and Hispanic men.

PubMed Central

Caetano, R.; Herd, D.

1988-01-01

This paper describes alcohol use by White, Black, and Hispanic men in eight different social settings. Data were obtained from a multi-stage probability sample of the household population of White, Black, and Hispanic adults aged 18 years and over, residing in the 48 contiguous United States. The response rate was 73 percent for Whites, 76 percent for Blacks, and 72 percent for Hispanics. Results show that Whites go more frequently and drink more frequently than Blacks and Hispanics at restaurants, in clubs or organizational meetings, and in bars. Blacks go more frequently than Whites and Hispanics to public settings such as parks, streets, and parking lots; however, the mean number of drinks consumed in these public places and the proportion of men drinking five or more drinks is higher for Hispanics than for Whites and Blacks. Other places where heavier drinking is common in all three ethnic groups are bars, taverns and cocktail lounges, and parties. In all three ethnic groups, men who are younger and those who are single go more frequently than other men to bars or public places such as streets, parks, and parking lots. Men who are younger and those who are single also have a higher rate of heavy drinking and of drunkenness than other men. PMID:3176527

Racial disparities in mortality among infants with Dandy-Walker syndrome.

PubMed

Salihu, Hamisu M; Kornosky, Jennifer L; Alio, Amina P; Druschel, Charlotte M

2009-05-01

Congenital malformations are the major cause of infant mortality in the United States, but their contribution to overall racial disparity--a major public health concern--is poorly understood. We sought to estimate the contribution of a congenitally acquired central nervous system lesion, Dandy-Walker Syndrome (DWS), to black-white disparity in infant mortality. Data were obtained from the New York State Congenital Malformations Registry, an ongoing population-based validated surveillance system. We compared black to white infants with respect to infant, neonatal, and postneonatal mortality using Cox proportional hazards regression models. A total of 196 live-born neonates were diagnosed with DWS in the state from 1992 to 2005 inclusive. Of these, 53 were non-Hispanic black and 76 were non-Hispanic white. Neonatal mortality was similar for non-Hispanic blacks and non-Hispanic whites (adjusted hazards ratio [AHR], 1.42; 95% CI, 0.52-3.82), but non-Hispanic blacks had an 8-fold increased risk for postneonatal mortality (AHR, 8.26; 95% CI, 2.08-32.72). Adjustment for fetal growth and other maternal and infant characteristics resulted in a 10-fold increased risk of mortality for non-Hispanic black infants as compared to non-Hispanic whites. By contrast, adjustment for preterm birth attenuated the risk, but non-Hispanic black infants were still more than 6 times as likely to die during the postneonatal period than non-Hispanic whites (AHR, 6.36, 95% CI, 1.52-26.60). DWS has one of the largest black-white disparities in postneonatal survival. This underscores the importance of evaluating racial disparities in infant mortality by specific conditions in order to formulate targeted interventions to reduce disparities.

Contrasting Portraits: Integrating Materials about the Afro-Hispanic Woman Into the Traditional Curriculum. Working Paper No. 120.

ERIC Educational Resources Information Center

Jimenez, Marilyn

Images of Black women in Hispanic literature tend to be the work of White authors or Black male authors who, however well-intentioned, cannot articulate the direct, lived experience of the black, Hispanic woman. Moreover, the image of the Black woman in Spain and Latin America is the result of a slavocratic, patriarchal system and, therefore,…

Explaining low mortality among US immigrants relative to native-born Americans: the role of smoking.

PubMed

Blue, Laura; Fenelon, Andrew

2011-06-01

In many developed countries, immigrants live longer-that is, have lower death rates at most or all ages-than native-born residents. This article tests whether different levels of smoking-related mortality can explain part of the 'healthy immigrant effect' in the USA, as well as part of the related 'Hispanic paradox': the tendency for US Hispanics to outlive non-Hispanic Whites. With data from vital statistics and the national census, we calculate lung cancer death rates in 2000 for four US subpopulations: foreign-born, native-born, Hispanic and non-Hispanic White. We then use three different methods-the Peto-Lopez method, the Preston-Glei-Wilmoth method and a novel method developed in this article-to generate three alternative estimates of smoking-related mortality for each of the four subpopulations, extrapolating from lung cancer death rates. We then measure the contribution of smoking-related mortality to disparities in all-cause mortality. Taking estimates from any of the three methods, we find that smoking explains >50% of the difference in life expectancy at 50 years between foreign- and native-born men, and >70% of the difference between foreign- and native-born women; smoking explains >75% of the difference in life expectancy at 50 years between US Hispanic and non-Hispanic White men, and close to 75% of the Hispanic advantage among women. Low smoking-related mortality was the main reason for immigrants' and Hispanics' longevity advantage in the USA in 2000.

Nativity and neighborhood characteristics and cervical cancer stage at diagnosis and survival outcomes among Hispanic women in California.

PubMed

Gomez, Nicole; Guendelman, Sylvia; Harley, Kim G; Gomez, Scarlett Lin

2015-03-01

We examined stage of diagnosis and survival after cervical cancer among Hispanic women, and their associations with Hispanic nativity, and explored whether neighborhood socioeconomic status (SES) and residence in a Hispanic enclave modify the association of nativity with stage and survival. We used California Cancer Registry data (1994-2009) to identify 7958 Hispanic women aged 21 years and older with invasive cervical cancer. We used logistic and Cox proportional hazards models to estimate the associations between stage and mortality with nativity, neighborhood factors, and other covariates. Foreign-born women had similar adjusted relative odds of being diagnosed with stages II through IV (vs stage I) cervical cancer compared with US-born Hispanic women. However, among foreign-born women, those in low-SES-low-enclave neighborhoods were more likely to have late-stage disease than those in high-SES-low-enclave neighborhoods (adjusted odds ratio=1.91; 95% confidence interval=1.18, 3.07). Foreign-born women had lower cervical cancer mortality (adjusted hazard ratio=0.67; 95% confidence interval=0.58, 0.76) than US-born women, but only in high enclaves. Among Hispanic women, nativity, neighborhood enclaves, and SES interact in their influence on stage and survival of cervical cancer.

Vital Signs: Leading Causes of Death, Prevalence of Diseases and Risk Factors, and Use of Health Services Among Hispanics in the United States — 2009–2013

PubMed Central

Dominguez, Kenneth; Penman-Aguilar, Ana; Chang, Man-Huei; Moonesinghe, Ramal; Castellanos, Ted; Rodriguez-Lainz, Alfonso; Schieber, Richard

2015-01-01

Background Hispanics and Latinos (Hispanics) are estimated to represent 17.7% of the U.S. population. Published national health estimates stratified by Hispanic origin and nativity are lacking. Methods Four national data sets were analyzed to compare Hispanics overall, non-Hispanic whites (whites), and Hispanic country/region of origin subgroups (Hispanic origin subgroups) for leading causes of death, prevalence of diseases and associated risk factors, and use of health services. Analyses were generally restricted to ages 18–64 years and were further stratified when possible by sex and nativity. Results Hispanics were on average nearly 15 years younger than whites; they were more likely to live below the poverty line and not to have completed high school. Hispanics showed a 24% lower all-cause death rate and lower death rates for nine of the 15 leading causes of death, but higher death rates from diabetes (51% higher), chronic liver disease and cirrhosis (48%), essential hypertension and hypertensive renal disease (8%), and homicide (96%) and higher prevalence of diabetes (133%) and obesity (23%) compared with whites. In all, 41.5% of Hispanics lacked health insurance (15.1% of whites), and 15.5% of Hispanics reported delay or nonreceipt of needed medical care because of cost concerns (13.6% of whites). Among Hispanics, self-reported smoking prevalences varied by Hispanic origin and by sex. U.S.-born Hispanics had higher prevalences of obesity, hypertension, smoking, heart disease, and cancer than foreign-born Hispanics: 30% higher, 40%, 72%, 89%, and 93%, respectively. Conclusion Hispanics had better health outcomes than whites for most analyzed health factors, despite facing worse socioeconomic barriers, but they had much higher death rates from diabetes, chronic liver disease/cirrhosis, and homicide, and a higher prevalence of obesity. There were substantial differences among Hispanics by origin, nativity, and sex. Implications for Public Health Differences by origin, nativity, and sex are important considerations when targeting health programs to specific audiences. Increasing the proportions of Hispanics with health insurance and a medical home (patient-centered, team-based, comprehensive, coordinated health care with enhanced access) is critical. A feasible and systematic data collection strategy is needed to reflect health diversity among Hispanic origin subgroups, including by nativity. PMID:25950254

Vital signs: leading causes of death, prevalence of diseases and risk factors, and use of health services among Hispanics in the United States - 2009-2013.

PubMed

Dominguez, Kenneth; Penman-Aguilar, Ana; Chang, Man-Huei; Moonesinghe, Ramal; Castellanos, Ted; Rodriguez-Lainz, Alfonso; Schieber, Richard

2015-05-08

Hispanics and Latinos (Hispanics) are estimated to represent 17.7% of the U.S. population. Published national health estimates stratified by Hispanic origin and nativity are lacking. Four national data sets were analyzed to compare Hispanics overall, non-Hispanic whites (whites), and Hispanic country/region of origin subgroups (Hispanic origin subgroups) for leading causes of death, prevalence of diseases and associated risk factors, and use of health services. Analyses were generally restricted to ages 18-64 years and were further stratified when possible by sex and nativity. Hispanics were on average nearly 15 years younger than whites; they were more likely to live below the poverty line and not to have completed high school. Hispanics showed a 24% lower all-cause death rate and lower death rates for nine of the 15 leading causes of death, but higher death rates from diabetes (51% higher), chronic liver disease and cirrhosis (48%), essential hypertension and hypertensive renal disease (8%), and homicide (96%) and higher prevalence of diabetes (133%) and obesity (23%) compared with whites. In all, 41.5% of Hispanics lacked health insurance (15.1% of whites), and 15.5% of Hispanics reported delay or nonreceipt of needed medical care because of cost concerns (13.6% of whites). Among Hispanics, self-reported smoking prevalences varied by Hispanic origin and by sex. U.S.-born Hispanics had higher prevalences of obesity, hypertension, smoking, heart disease, and cancer than foreign-born Hispanics: 30% higher, 40%, 72%, 89%, and 93%, respectively. Hispanics had better health outcomes than whites for most analyzed health factors, despite facing worse socioeconomic barriers, but they had much higher death rates from diabetes, chronic liver disease/cirrhosis, and homicide, and a higher prevalence of obesity. There were substantial differences among Hispanics by origin, nativity, and sex. Differences by origin, nativity, and sex are important considerations when targeting health programs to specific audiences. Increasing the proportions of Hispanics with health insurance and a medical home (patientcentered, team-based, comprehensive, coordinated health care with enhanced access) is critical. A feasible and systematic data collection strategy is needed to reflect health diversity among Hispanic origin subgroups, including by nativity.

Race and Ethnic Differences in Religious Involvement: African Americans, Caribbean Blacks and Non-Hispanic Whites

PubMed Central

Chatters, Linda M.; Taylor, Robert Joseph; Bullard, Kai McKeever; Jackson, James S.

2010-01-01

This study examined differences in religious participation and spirituality among African Americans, Caribbean Blacks (Black Caribbeans) and non-Hispanic Whites. Data are taken from the National Survey of American Life, a nationally representative study of African Americans, Black Caribbeans and non-Hispanic Whites. Selected measures of organizational, nonorganizational and subjective religious participation were examined. African American and Caribbean Blacks were largely similar in their reports of religious involvement; both groups generally indicated higher levels of religious participation than non-Hispanic Whites. African Americans were more likely than Black Caribbeans to be official members of their places of worship, engage in activities (choirs, church clubs) at their place of worship and request prayer from others. Black Caribbeans reported reading religious materials more frequently than African Americans. The discussion notes the importance of examining ethnic differences within the black American population of the United States. PMID:20975850

Discharge destination's effect on bounce-back risk in Black, White, and Hispanic acute ischemic stroke patients.

PubMed

Kind, Amy J H; Smith, Maureen A; Liou, Jinn-Ing; Pandhi, Nancy; Frytak, Jennifer R; Finch, Michael D

2010-02-01

To determine whether racial and ethnic effects on bounce-back risk (ie, movement to settings of higher care intensity within 30 d of hospital discharge) in acute stroke patients vary depending on initial posthospital discharge destination. Retrospective analysis of administrative data. Four hundred twenty-two hospitals, southern/eastern United States. All Medicare beneficiaries 65 years or more with hospitalization for acute ischemic stroke within one of the 422 target hospitals during the years 1999 or 2000 (N=63,679). Not applicable. Adjusted predicted probabilities for discharge to and for bouncing back from each initial discharge site (ie, home, home with home health care, skilled nursing facility [SNF], or rehabilitation center) by race (ie, black, white, and Hispanic). Models included sociodemographics, comorbidities, stroke severity, and length of stay. Blacks and Hispanics were significantly more likely to be discharged to home health care (blacks=21% [95% confidence interval (CI), 19.9-22.8], Hispanic=19% [17.1-21.7] vs whites=16% [15.5-16.8]) and less likely to be discharged to SNFs (blacks=26% [95% CI, 23.6-29.3], Hispanics=28% [25.4-31.6] vs whites=33% [31.8-35.1]) than whites. However, blacks and Hispanics were significantly more likely to bounce back when discharged to SNFs than whites (blacks=26% [95% CI, 24.2-28.6], Hispanics=28% [24-32.6] vs whites=21% [20.3-21.9]). Hispanics had a lower risk of bouncing back when discharged home than either blacks or whites (Hispanics=14% [95% CI, 11.3-17] vs blacks=20% [18.4-22.2], whites=18% [16.8-18.3]). Patients discharged to home health care or rehabilitation centers demonstrated no significant differences in bounce-back risk. Racial/ethnic bounce-back risk differs depending on initial discharge destination. Additional research is needed to fully understand this variation in effect. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Disparities in Infant Mortality by Race Among Hispanic and Non-Hispanic Infants.

PubMed

Rice, Whitney S; Goldfarb, Samantha S; Brisendine, Anne E; Burrows, Stevie; Wingate, Martha S

2017-07-01

U.S.-born Hispanic infants have a well-documented health advantage relative to other minority groups. However, little published research has examined racial heterogeneity within the Hispanic population, in relation to health outcomes. The current study aims to explore possible implications of racial identification for the health of U.S. born Hispanic compared to non-Hispanic infants. Methods Data were drawn from 2007 to 2008 NCHS Cohort Linked Live Birth-Infant Death Files, restricted to deliveries of Hispanic black, Hispanic white, non-Hispanic black (NHB) and non-Hispanic white mothers (NHW) (n = 7,901,858). Adjusted odds ratios for first week mortality, neonatal, postneonatal, and overall infant mortality were calculated for each group, using NHW as the reference group. A distinct health gradient was observed in which NHB infants (n = 1,250,222) had the highest risk of first week (aOR 2.29, CI 2.21-2.37), neonatal (aOR 2.23, CI 2.17-2.30), postneonatal (aOR 1.74, CI 1.68-1.81), and infant mortality (aOR 2.05, CI 2.00-2.10) compared to NHW infants (n = 4,578,150). Hispanic black infants (n = 84,377) also experienced higher risk of first-week (aOR 1.28 (1.12-1.47), neonatal (aOR .27, CI 1.13-1.44), postneonatal (aOR 1.34, CI 1.15-1.56), and infant mortality (aOR 1.30, CI 1.18-1.43) compared to both NHW and Hispanic white infants (n = 1,989,109). Conclusions for Practice: Risk of infant mortality varies among Hispanic infants by race, with poorer outcomes experienced by Hispanic black infants. Compared to non-Hispanic infants of the same race, Hispanic black infants experience a smaller health disadvantage and Hispanic white infants have better or similar infant health outcomes. Our findings suggest implications of racial heterogeneity on infant health outcomes, and provide insight into the role of race as a social construct.

Race, Ethnicity, and Self-Reported Hypertension: Analysis of Data From the National Health Interview Survey, 1997–2005

PubMed Central

2009-01-01

Objective. I estimated the association between race and self-reported hypertension among Hispanics and non-Hispanics and determined whether this association was stronger among non-Hispanics. Methods. With data from the 1997–2005 National Health Interview Survey, I used logistic regression to estimate the strength of the association between race/ethnicity and self-reported hypertension among US adults. Results. The overall prevalence of self-reported hypertension was 24.5%, with lower prevalence among Hispanics (16.7%) than among non-Hispanics (25.2%; P < .01). Blacks, regardless of ethnicity, had the highest prevalence. Compared with non-Hispanic Whites, non-Hispanic Blacks had 48% (odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.41, 1.55) greater odds of reporting hypertension; Hispanic Whites had 23% (OR = 0.81; 95% CI = 0.76, 0.88) lower odds. There was no difference in the strength of the association between race and self-reported hypertension observed among non-Hispanics (OR for Blacks = 1.47) and among Hispanics (OR for Blacks = 1.20; for interaction, P = 0.43). Conclusions. The previously reported hypertension advantage of Hispanics holds for Hispanic Whites only. As Hispanics continue their rapid growth in the United States, race may have important implications on their disease burden, because most US health disparities are driven by race and its socially patterned experiences. PMID:19059869

Separate and Unequal: The Neighborhood Gap for Blacks and Hispanics in Metropolitan America.

ERIC Educational Resources Information Center

Logan, John R.

This study used data from the Census of Population 1990 and 2000 to investigate economic inequalities between racial and ethnic groups, particularly blacks and Hispanics. It examined people's household incomes and the quality of their neighborhoods. Non-Hispanic Blacks remained the lowest-income minority group, with household incomes only 63.7…

The Influence of Hispanic Ethnicity and Nativity Status on 2009 H1N1 Pandemic Vaccination Uptake in the United States.

PubMed

Burger, Andrew E; Reither, Eric N; Hofmann, Erin Trouth; Mamelund, Svenn-Erik

2018-06-01

Previous research suggests Hispanic vaccination rates for H1N1 were similar to non-Hispanic whites. These previous estimates do not take into account nativity status. Using the 2010 National Health Interview Survey, we estimate adult H1N1 vaccination rates for non-Hispanic whites (n = 8780), U.S.-born Hispanics (n = 1142), and foreign-born Hispanics (n = 1912). To test Fundamental Cause Theory, we estimate odds of H1N1 vaccination while controlling for flexible resources (e.g., educational and economic capital), ethnicity, and nativity status. Foreign-born Hispanics experienced the lowest rates of H1N1 vaccination (15%), followed by U.S.-born Hispanics (18%) and non-Hispanic whites (21%). Regression models show odds of H1N1 vaccination did not differ among these three groups after controlling for sociodemographic characteristics. Insufficient access to flexible resources and healthcare coverage among foreign-born Hispanics was responsible for relatively low rates of H1N1 vaccination. Addressing resource disparities among Hispanics could increase vaccination uptake in the future, reducing inequities in disease burden.

Disparities in the Use of Radiation Therapy in Patients With Local-Regionally Advanced Breast Cancer

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

Martinez, Steve R., E-mail: steve.martinez@ucdmc.ucdavis.ed; Beal, Shannon H.; Chen, Steven L.

2010-11-01

Background: Radiation therapy (RT) is indicated for the treatment of local-regionally advanced breast cancer (BCa). Hypothesis: We hypothesized that black and Hispanic patients with local-regionally advanced BCa would receive lower rates of RT than their white counterparts. Methods: The Surveillance Epidemiology and End Results database was used to identify white, black, Hispanic, and Asian patients with invasive BCa and {>=}10 metastatic lymph nodes diagnosed between 1988 and 2005. Univariate and multivariate logistic regression evaluated the relationship of race/ethnicity with use of RT. Multivariate models stratified for those undergoing mastectomy or lumpectomy. Results: Entry criteria were met by 12,653 patients. Approximatelymore » half of the patients did not receive RT. Most patients were white (72%); the remainder were Hispanic (10.4%), black (10.3%), and Asian (7.3%). On univariate analysis, Hispanics (odd ratio [OR] 0.89; 95% confidence interval [CI], 0.79-1.00) and blacks (OR 0.79; 95% CI, 0.70-0.89) were less likely to receive RT than whites. On multivariate analysis, blacks (OR 0.76; 95% CI, 0.67-0.86) and Hispanics (OR 0.80; 95% CI, 0.70-0.90) were less likely than whites to receive RT. Disparities persisted for blacks (OR 0.74; 95% CI, 0.64-0.85) and Hispanics (OR 0.77; 95% CI, 0.67-0.89) who received mastectomy, but not for those who received lumpectomy. Conclusions: Many patients with local-regionally advanced BCa do not receive RT. Blacks and Hispanics were less likely than whites to receive RT. This disparity was noted predominately in patients who received mastectomy. Future efforts at improving rates of RT are warranted. Efforts at eliminating racial/ethnic disparities should focus on black and Hispanic candidates for postmastectomy RT.« less

Association between workplace psychosocial factors and mental health in Black, Hispanic, and White women: Cross-sectional findings from the National Health Interview Survey.

PubMed

Mutambudzi, Miriam

2017-01-01

Research evaluating the relation of workplace psychosocial factors to mental health among U.S. women of different racial/ethnic backgrounds is limited. This study investigated the relationship between work-related psychosocial factors and mental health among non-Hispanic Black, Hispanic, and non-Hispanic White women using data from the 2010 National Health Interview Survey. Independent variables of interest included job insecurity, workplace harassment, and work-family conflict (WFC). Multiple Poisson regression models were used to examine the associations between the outcome and independent variables. The prevalence of unfavorable mental health was highest among non-Hispanic Black women (36%) compared to Hispanic (34%) and non-Hispanic White (30%) women. A higher proportion of non-Hispanic Black women reported WFC compared to Hispanics and non-Hispanic Whites (χ 2 = 15.50, p < .01), while more Hispanics reported job insecurity (χ 2 = 116.81, p < .01). Prevalence of workplace harassment did not differ significantly by race/ethnicity. Odds of unfavorable mental health were significantly higher for women reporting psychosocial work factors. Unexpectedly, a greater association between psychosocial work factors and unfavorable mental health was observed among non-Hispanic White women compared to non-White women; however, caution should be taken in interpreting these cross-sectional results. Future studies should investigate temporal associations and additional psychosocial variables that were not available for use in the current study.

Exploring opinions and beliefs about cord blood donation among Hispanic and non-Hispanic black women.

PubMed

Rucinski, Dianne; Jones, Risé; Reyes, Brenda; Tidwell, Lawon; Phillips, RoiAnn; Delves, Denise

2010-05-01

Despite higher birth rates among non-Hispanic blacks and Hispanics, the availability of umbilical cord blood from these groups is lower due to lower donation rates than that of non-Hispanic whites. Similar racial and ethnic disparities in donation rates have been found for blood and organ donation. This study is among the first to explore beliefs and attitudes toward umbilical cord blood donation among Hispanic and non-Hispanic black women. Five focus groups composed of Hispanic and non-Hispanic black women were conducted to explore how women conceptualize information needs about umbilical cord blood donation and from whom women want to receive information about donation. Participants were adult women who had given birth within the past year or were pregnant. Lack of basic information regarding umbilical cord blood, its harvesting and use, and the steps and conditions necessary to donate were primary barriers to donation. Women expressed confusion over the differences between "donation" and "banking." The social value of donation was explicitly weighed in terms of the cost of the donation effort. Doctors were viewed as critical sources for information about donation, although women expressed skepticism about doctors' ability to convey sufficient information during short office visits. Efforts to increase donation rates among Hispanic and non-Hispanic black women should include information about both the technical aspects and the social value of donation. The specific terms "umbilical" and "donation" should be used consistently to prevent misunderstanding. Information should be provided by physicians with follow-up by other health providers.

Direct and mediated effects of nativity and other indicators of acculturation on Hispanic mothers' use of physical aggression.

PubMed

Altschul, Inna; Lee, Shawna J

2011-11-01

This study used data from 845 foreign-born (n = 328) and native-U.S. born (n = 517) Hispanic mothers who participated in the Fragile Families and Child Wellbeing Study (FFCWS) to examine four indicators of acculturation--nativity, years lived in the United States, religious attendance, and endorsement of traditional gender norms--as predictors of maternal physical aggression directed toward young children. The authors also examined whether psychosocial risk factors associated with child maltreatment and acculturation--maternal alcohol use, depression, parenting stress, and intimate partner aggression and violence--mediate relationships between acculturation and maternal aggression. Foreign-born Hispanic mothers had significantly lower rates of physical aggression than native-born Hispanic mothers. In path modeling results, U.S. nativity, along with maternal alcohol use, parenting stress, and child aggressive behavior, emerged as the strongest risk factors for maternal physical aggression. Among the four acculturation indicators, only foreign birth was directly associated with lower maternal aggression. Study findings suggest immigrant status is a unique protective factor that contributes to lower levels of physical aggression among Hispanic mothers.

CKD in Hispanics: Baseline Characteristics From the CRIC (Chronic Renal Insufficiency Cohort) and Hispanic-CRIC Studies

PubMed Central

Fischer, Michael J.; Go, Alan; Lora, Claudia M.; Ackerson, Lynn; Cohan, Janet; Kusek, John; Mercado, Alejandro; Ojo, Akinlolu; Ricardo, Ana C.; Rosen, Leigh; Tao, Kelvin; Xie, Dawei; Feldman, Harold; Lash, James P.

2012-01-01

Background Little is known regarding chronic kidney disease (CKD) in Hispanics. We compared baseline characteristics of Hispanic participants in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC (H-CRIC) Studies with non-Hispanic CRIC participants. Study Design Cross-sectional analysis Setting and Participants Participants were aged 21–74 years with CKD using age-based glomerular filtration rate (eGFR) at enrollment into the CRIC/H-CRIC Studies. H-CRIC included Hispanics recruited at the University of Illinois from 2005–2008 while CRIC included Hispanics and non-Hispanics recruited at seven clinical centers from 2003–2007. Factor Race/ethnicity Outcomes Blood pressure, angiotensin-converting enzyme (ACE) inhibitor/angiotensin receptor blocker (ARB) use, CKD-associated complications Measurements Demographic characteristics, laboratory data, blood pressure, and medications were assessed using standard techniques and protocols Results Among H-CRIC/ CRIC participants, 497 were Hispanic, 1650 non-Hispanic Black, and 1638 non-Hispanic White. Low income and educational attainment were nearly twice as prevalent in Hispanics compared with non-Hispanics (p<0.01). Hispanics had self-reported diabetes (67%) more frequently than non-Hispanic Blacks (51%) and Whites (40%) (p<0.01). Blood pressure > 130/80 mmHg was more common in Hispanics (62%) compared with Blacks (57%) and Whites (35%) (p<0.05), and abnormalities in hematologic, metabolic, and bone metabolism parameters were more prevalent in Hispanics (p<0.05), even after stratifying by entry eGFR. Hispanics had the lowest receipt of ACE inhibitor/ARB among high-risk subgroups, including participants with diabetes, proteinuria, and blood pressure > 130/80 mmHg. Mean eGFR (ml/min/m2) was lower in Hispanics (39.6) than in Blacks (43.7) and Whites (46.2), while median proteinuria was higher in Hispanics (0.72 g/d) than in Blacks (0.24 g/d) and Whites (0.12 g/d) (p<0.01). Limitations Generalizability; observed associations limited by residual bias and confounding Conclusions Hispanics with CKD in CRIC/H-CRIC Studies are disproportionately burdened with lower socioeconomic status, more frequent diabetes mellitus, less ACE inhibitor/ARB use, worse blood pressure control, and more severe CKD and associated complications than their non-Hispanic counterparts. PMID:21705121

CKD in Hispanics: Baseline characteristics from the CRIC (Chronic Renal Insufficiency Cohort) and Hispanic-CRIC Studies.

PubMed

Fischer, Michael J; Go, Alan S; Lora, Claudia M; Ackerson, Lynn; Cohan, Janet; Kusek, John W; Mercado, Alejandro; Ojo, Akinlolu; Ricardo, Ana C; Rosen, Leigh K; Tao, Kaixiang; Xie, Dawei; Feldman, Harold I; Lash, James P

2011-08-01

Little is known regarding chronic kidney disease (CKD) in Hispanics. We compared baseline characteristics of Hispanic participants in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC (H-CRIC) Studies with non-Hispanic CRIC participants. Cross-sectional analysis. Participants were aged 21-74 years with CKD using age-based estimated glomerular filtration rate (eGFR) at enrollment into the CRIC/H-CRIC Studies. H-CRIC included Hispanics recruited at the University of Illinois in 2005-2008, whereas CRIC included Hispanics and non-Hispanics recruited at 7 clinical centers in 2003-2007. Race/ethnicity. Blood pressure, angiotensin-converting enzyme (ACE)-inhibitor/angiotensin receptor blocker (ARB) use, and CKD-associated complications. Demographic characteristics, laboratory data, blood pressure, and medications were assessed using standard techniques and protocols. Of H-CRIC/CRIC participants, 497 were Hispanic, 1,650 were non-Hispanic black, and 1,638 were non-Hispanic white. Low income and educational attainment were nearly twice as prevalent in Hispanics compared with non-Hispanics (P < 0.01). Hispanics had self-reported diabetes (67%) more frequently than non-Hispanic blacks (51%) and whites (40%; P < 0.01). Blood pressure >130/80 mm Hg was more common in Hispanics (62%) than blacks (57%) and whites (35%; P < 0.05), and abnormalities in hematologic, metabolic, and bone metabolism parameters were more prevalent in Hispanics (P < 0.05), even after stratifying by entry eGFR. Hispanics had the lowest use of ACE inhibitors/ARBs among the high-risk subgroups, including participants with diabetes, proteinuria, and blood pressure >130/80 mm Hg. Mean eGFR was lower in Hispanics (39.6 mL/min/1.73 m(2)) than in blacks (43.7 mL/min/1.73 m(2)) and whites (46.2 mL/min/1.73 m(2)), whereas median proteinuria was higher in Hispanics (protein excretion, 0.72 g/d) than in blacks (0.24 g/d) and whites (0.12 g/d; P < 0.01). Generalizability; observed associations limited by residual bias and confounding. Hispanics with CKD in the CRIC/H-CRIC Studies are disproportionately burdened with lower socioeconomic status, more frequent diabetes mellitus, less ACE-inhibitor/ARB use, worse blood pressure control, and more severe CKD and associated complications than their non-Hispanic counterparts. Published by Elsevier Inc.

Willingness to Participate in Cancer Screenings: Blacks vs Whites vs Puerto Rican Hispanics

PubMed Central

Katz, Ralph V.; Claudio, Cristina; Kressin, Nancy R.; Green, B. Lee; Wang, Min Qi; Russell, Stefanie Luise

2009-01-01

Background In the United States, blacks and Hispanics have lower cancer screening rates than whites have. Studies on the screening behaviors of minorities are increasing, but few focus on the factors that contribute to this discrepancy. This study presents the self-reported willingness by blacks, Puerto Rican Hispanics, and non-Hispanic whites to participate in cancer screenings in differing cancer screening situations. Methods The Cancer Screening Questionnaire (CSQ), a 60-item questionnaire, was administered via random-digit-dial telephone interviews to adults in three cities: Baltimore, Maryland; New York, New York; and, San Juan, Puerto Rico. Results The 1,148 participants in the CSQ study sample consisted of 355 blacks, 311 Puerto Rican Hispanics, and 482 non-Hispanic whites. Response rates ranged from 45% to 58% by city. Multivariable logistic regression analyses revealed that blacks and Puerto Ricans were often more likely (OR 2.0-3.0) and never less likely than whites to self-report willingness to participate in cancer screenings regardless of who conducted the cancer screening, what one was asked to do in the cancer screening, or what type of cancer was involved (with the exception of skin cancer where blacks, compared with whites, had an OR of 0.5). Conclusions The findings from this study provide evidence that blacks and Hispanics self-report that they are either as willing or more willing than whites to participate in cancer screening programs. PMID:18813201

Predictors of the Nicotine Dependence Behavior Time to the First Cigarette in a Multiracial Cohort.

PubMed

Branstetter, Steven A; Mercincavage, Melissa; Muscat, Joshua E

2015-07-01

The time to first cigarette of the day (TTFC) is a strong indicator of nicotine dependence behaviors such as nicotine uptake and quit success in young and older smokers. There are substantial differences in levels of nicotine dependence by race and ethnic group. Data from Wave III of the multiracial National Longitudinal Study of Adolescent Health were analyzed for young smokers between the ages of 21 and 28 (N = 1,425). Time to first cigarette data was compared between Hispanic, White, Black, Native American, and Asian smokers. Black smokers were significantly more likely to smoke within 5min of waking than White, Hispanic, and Asian smokers. Lower personal income predicted smoking within 5min of waking for both White and Black smokers. For White smokers, increased number of cigarettes per day and increased years of smoking also predicted smoking within 5min of waking. The number of days smoked or number of cigarettes per day did not predict smoking within 5min of waking among smokers. The higher prevalence of early TTFC among Blacks indicates increased nicotine and carcinogen exposure, and may help explain the increased lung cancer rates and failed cessation attempts among Black smokers. TTFC may be an important screening item, independent of cigarettes per day, for clinicians and interventions to identify those at highest risk for cessation failure and disease risk. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Association between a Community College's Teacher Education Program and the 4-Year Graduation Rates of Black and Hispanic Teacher Education Students

ERIC Educational Resources Information Center

Perkins, Britine; Arvidson, Cody

2017-01-01

In response to a shortage of qualified Black and Hispanic teachers, community colleges (CC) have developed certificate programs and Associate of Arts degrees in teacher education to address shortages of minority teachers in the nation's classrooms. We examined one CC's effectiveness in transferring Black and Hispanic students to university teacher…

Closed Labor Markets: Underrepresentation of Blacks, Hispanics and Women in New York City's Core Industries and Jobs.

ERIC Educational Resources Information Center

Stafford, Walter W.

Federal and State employment data were examined in a study of the industrial, occupational, and job segmentation of Blacks, Hispanics, and Whites by sex in New York City's private sector. Primary focus was placed on the effects of the city's growing service-oriented economy on the employment patterns of Blacks and Hispanics. The study found that…

A Prospective, Longitudinal Examination of the Influence of Childhood Home and School Contexts on Psychopathic Characteristics in Adolescence.

PubMed

Fisher, Jacqueline Horan; Brown, Joshua L

2018-05-28

Much of the existing research examining etiological contributors to psychopathic characteristics considers only biological and physiological deficits, with little consideration given to contextual factors that may play a role in their development. This prospective, longitudinal study examined the influence of childhood home and school environments on adolescent psychopathic characteristics among 390 youth (50.5% female; 46.2% Black/African American, 44.9% Hispanic/Latino, 6.9% Asian or Native American/Alaska Native, and 2.1% Non-Hispanic White). Specifically, this study examined (1) the effect of home chaos and poor parental monitoring on adolescent primary and secondary psychopathy and callous-unemotional traits through the lens of multiple reporters, and (2) whether classroom climate quality across three years of childhood moderated these relationships. The results indicated that delinquency and home chaos in childhood were related to primary psychopathy in adolescence and that exposure to higher quality classroom climates across childhood acted as a buffer by mitigating the negative relationship between parental monitoring in childhood and secondary psychopathy in adolescence. These findings have implications for designing interventions to mitigate the manifestation of youth psychopathy.

Adverse birth outcomes among native-born and immigrant women: replicating national evidence regarding Mexicans at the local level.

PubMed

Cervantes, A; Keith, L; Wyshak, G

1999-06-01

For almost two decades, the literature has consistently described an epidemiologic paradox relating to better birth outcomes among high-risk groups, particularly new immigrants from Mexico and Southeast Asia. We hypothesize that regardless of their sociodemographic profile, Mexican immigrants will exhibit lower rates of low birth weight and preterm deliveries than native-(U.S.) born women of Mexican origin, non-Hispanic White and Black women, and Puerto Rican Women. We studied 57,324 live-born singleton infants born to residents in the city of Chicago in a linked data set of 1994 birth-death records. Multivariate logistic regression was used to analyze race/ethnicity differentials in two pregnancy outcome measures, low birth weight and preterm birth. Overall better birth outcome is related to maternal immigrant status regardless of race/ethnic groups. Immigrant Mexican women had a significantly lower risk of both low birth weight [adjusted odds ratio (AOR): 0.78, 95% confidence interval (CI) 0.66-0.91] and preterm births (AOR: 0.75, 95% CI 0.65-0.86) and were at 28% and 33% lower risks of delivering a low birth weight infant or a premature infant, respectively, than non-Hispanic White women.

Comparing genetic ancestry and self-reported race/ethnicity in a multiethnic population in New York City.

PubMed

Lee, Yin Leng; Teitelbaum, Susan; Wolff, Mary S; Wetmur, James G; Chen, Jia

2010-12-01

Self-reported race/ethnicity is frequently used in epidemiological studies to assess an individual's background origin. However, in admixed populations such as Hispanic, self-reported race/ethnicity may not accurately represent them genetically because they are admixed with European, African and Native American ancestry. We estimated the proportions of genetic admixture in an ethnically diverse population of 396 mothers and 188 of their children with 35 ancestry informative markers (AIMs) using the STRUCTURE version 2.2 program. The majority of the markers showed significant deviation from Hardy-Weinberg equilibrium in our study population. In mothers self-identified as Black and White, the imputed ancestry proportions were 77.6% African and 75.1% European respectively, while the racial composition among self-identified Hispanics was 29.2% European, 26.0% African, and 44.8% Native American. We also investigated the utility of AIMs by showing the improved fitness of models in paraoxanase-1 genotype-phenotype associations after incorporating AIMs; however, the improvement was moderate at best. In summary, a minimal set of 35 AIMs is sufficient to detect population stratification and estimate the proportion of individual genetic admixture; however, the utility of these markers remains questionable.

Socioeconomic Status and Body Mass Index Among Hispanic Children of Immigrants and Children of Natives

PubMed Central

Van Hook, Jennifer

2009-01-01

Objectives. We examined how Hispanic parents' income and education, combined with their nativity status, influenced the body mass index (BMI) of their children, compared with non-Hispanic White children and their parents. Methods. We used data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998–99 to estimate linear growth curve models of children's initial BMI in kindergarten and change in BMI through fifth grade. Socioeconomic status was measured by logged household income and parental educational attainment (less than high school, high school graduate, some college, college graduate or higher). Results. Parental education was negatively associated with children's BMI (baseline and growth) for non-Hispanic White children. Among Hispanic children, the association of parental education with growth in BMI was negative but much weaker. The weak effect of parental education was not explained by the presence of immigrants in the Hispanic population. Income was strongly negatively associated with children's BMI in kindergarten among children of Hispanic and White natives, but positively associated among Hispanic immigrant families. Conclusions. The positive income–BMI association among Hispanic immigrant children might reflect cultural differences that immigrant parents carry with them from their countries of origin. PMID:19846690

Racial and Ethnic Disparities in the Pregnancies of Women With Systemic Lupus Erythematosus.

PubMed

Clowse, Megan E B; Grotegut, Chad

2016-10-01

Both systemic lupus erythematosus (SLE; lupus) and pregnancy individually have significant racial disparities, with black women experiencing higher rates of complications, yet no large studies have focused on the impact of race/ethnicity on pregnancy outcomes among women with lupus. Using the Nationwide Inpatient Sample (NIS) for 2008-2010, pregnancy delivery discharges were identified and pregnancy outcomes were compared for women with lupus by maternal race/ethnicity. Adjusted odds ratios were used to compare pregnancy outcomes between black and white or Hispanic and white women with lupus. In this period, the NIS included 13,553 deliveries with lupus and 12,510,565 deliveries without lupus. Compared to white women with lupus, black and Hispanic women had higher rates of chronic hypertension, chronic renal failure, pneumonia, and acute renal failure. There was a high degree of pregnancy complication in all women with lupus, but especially in black and Hispanic women, with more than 40% cesarean-section delivery; preterm labor in 14.3% of white, 24.7% of black (odds ratio [OR] 1.97), and 20.6% of Hispanic (OR 1.56) deliveries; and preeclampsia and gestational hypertension in almost 20% of black and Hispanic pregnancies. After adjustment for predictors of pregnancy outcomes and racial differences in nonlupus pregnancy, black and Hispanic women with lupus had higher than expected rates of preeclampsia, preterm labor, and fetal growth restriction. Black and Hispanic women with lupus have disproportionately poor pregnancy outcomes. This study suggests that identifying the key causes of these differences and targeting interventions to the women of greatest need is an essential next step. © 2016, American College of Rheumatology.

Panic disorder among African Americans, Caribbean blacks and non-Hispanic whites

PubMed Central

Himle, Joseph A.; Taylor, Robert Joseph; Abelson, Jamie M.; Matusko, Niki; Muroff, Jordana; Jackson, James

2014-01-01

Introduction This study investigated co-morbidities, level of disability, service utilization and demographic correlates of panic disorder (PD) among African Americans, Caribbean blacks and non-Hispanic white Americans. Methods Data are from the National Survey of American Life (NSAL) and the National Comorbidity Survey-Replication (NCS-R). Results Non-Hispanic whites are the most likely to develop PD across the lifespan compared to the black subgroups. Caribbean blacks were found to experience higher levels of functional impairment. There were no gender differences found in prevalence of PD in Caribbean blacks, indicating that existing knowledge about who is at risk for developing PD (generally more prevalent in women) may not be true among this subpopulation. Furthermore, Caribbean blacks with PD were least likely to use mental health services compared to African Americans and non-Hispanic whites. Conclusion This study demonstrates that PD may affect black ethnic subgroups differently, which has important implications for understanding the nature and etiology of the disorder. PMID:22983664

QuickStats: Age-Adjusted Death Rates,* by Race/Ethnicity† - National Vital Statistics System, United States, 2014-2015.

PubMed

2017-04-07

From 2014 to 2015, the age-adjusted death rate for the total U.S. population increased 1.2% from 724.6 to 733.1 per 100,000 population. The rate increased 0.6% from 870.7 to 876.1 for non-Hispanic blacks and 1.4% from 742.8 to 753.2 for non-Hispanic whites. The rate for Hispanic persons did not change significantly. The highest rate was recorded for the non-Hispanic black population, followed by the non-Hispanic white and Hispanic populations.

Racial and Ethnic Trends in Sudden Unexpected Infant Deaths: United States, 1995-2013.

PubMed

Parks, Sharyn E; Erck Lambert, Alexa B; Shapiro-Mendoza, Carrie K

2017-06-01

Immediately after the 1994 Back-to-Sleep campaign, sudden unexpected infant death (SUID) rates decreased dramatically, but they have remained relatively stable (93.4 per 100 000 live births) since 2000. In this study, we examined trends in SUID rates and disparities by race/ethnicity since the Back-to-Sleep campaign. We used 1995-2013 US period-linked birth-infant death data to evaluate SUID rates per 100 000 live births by non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander racial/ethnic groupings. To examine racial/ethnic disparities, we calculated rate ratios with NHWs as the referent group. Unadjusted linear regression was used to evaluate trends ( P < .05) in rates and rate ratios. The distribution and rates of SUID by demographic and birth characteristics were compared for 1995-1997 and 2011-2013, and χ 2 tests were used to evaluate significance. From 1995 to 2013, SUID rates were consistently highest for American Indian/Alaska Natives, followed by NHBs. The rate for NHBs decreased significantly, whereas the rate for NHWs also declined, but not significantly. As a result, the disparity between NHWs and NHBs narrowed slightly. The SUID rates for Hispanics and Asian/Pacific Islanders were lower than the rates for NHWs and showed a significant decrease, resulting in an increase in their advantage over NHWs. Each racial/ethnic group showed a unique trend in SUID rates since the Back-to-Sleep campaign. When implementing risk-reduction strategies, it is important to consider these trends in targeting populations for prevention and developing culturally appropriate approaches for racial/ethnic communities. Copyright © 2017 by the American Academy of Pediatrics.

Racial and Ethnic Trends in Sudden Unexpected Infant Deaths: United States, 1995–2013

PubMed Central

Parks, Sharyn E.; Erck Lambert, Alexa B.; Shapiro-Mendoza, Carrie K.

2017-01-01

BACKGROUND AND OBJECTIVES Immediately after the 1994 Back-to-Sleep campaign, sudden unexpected infant death (SUID) rates decreased dramatically, but they have remained relatively stable (93.4 per 100 000 live births) since 2000. In this study, we examined trends in SUID rates and disparities by race/ethnicity since the Back-to-Sleep campaign. METHODS We used 1995–2013 US period-linked birth-infant death data to evaluate SUID rates per 100 000 live births by non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander racial/ethnic groupings. To examine racial/ethnic disparities, we calculated rate ratios with NHWs as the referent group. Unadjusted linear regression was used to evaluate trends (P < .05) in rates and rate ratios. The distribution and rates of SUID by demographic and birth characteristics were compared for 1995–1997 and 2011–2013, and χ2 tests were used to evaluate significance. RESULTS From 1995 to 2013, SUID rates were consistently highest for American Indian/Alaska Natives, followed by NHBs. The rate for NHBs decreased significantly, whereas the rate for NHWs also declined, but not significantly. As a result, the disparity between NHWs and NHBs narrowed slightly. The SUID rates for Hispanics and Asian/Pacific Islanders were lower than the rates for NHWs and showed a significant decrease, resulting in an increase in their advantage over NHWs. CONCLUSIONS Each racial/ethnic group showed a unique trend in SUID rates since the Back-to-Sleep campaign. When implementing risk-reduction strategies, it is important to consider these trends in targeting populations for prevention and developing culturally appropriate approaches for racial/ethnic communities. PMID:28562272

Ethnic Disparities in Emergency Severity Index Scores among U.S. Veteran’s Affairs Emergency Department Patients

PubMed Central

Vigil, Jacob M.; Alcock, Joe; Coulombe, Patrick; McPherson, Laurie; Parshall, Mark; Murata, Allison; Brislen, Heather

2015-01-01

Background The goal of these analyses was to determine whether there were systematic differences in Emergency Severity Index (ESI) scores, which are intended to determine priority of treatment and anticipate resource needs, across categories of race and ethnicity, after accounting for patient-presenting vital signs and examiner characteristics, and whether these differences varied among male and female Veterans Affairs (VA) ED patients. Methods and Findings We used a large national database of electronic medical records of ED patients from twenty-two U.S. Department of Veterans Affairs ED stations to determine whether ESI assignments differ systematically by race or ethnicity. Multi-level, random effects linear modeling was used to control for demographic characteristics and patient’s vital signs (heart rate, respiratory rate, and pain level), as well as age, gender, and experience of triage nurses. The dataset included 129,991 VA patients presenting for emergency care between 2008 and 2012 (91% males; 61% non-Hispanic White, 28% Black, 7% Hispanic, 2% Asian, <1% American Indian/Alaska Native, 1% mixed ethnicity) and 774 nurses for a total of 359,642 patient/examiner encounters. Approximately 13% of the variance in ESI scores was due to patient characteristics and 21% was due to the nurse characteristics. After controlling for characteristics of nurses and patients, Black patients were assigned less urgent ESI scores than White patients, and this effect was more prominent for Black males compared with Black females. A similar interaction was found for Hispanic males. It remains unclear how these results may generalize to EDs and patient populations outside of the U.S. VA Health Care system. Conclusions The findings suggest the possibility that subgroups of VA patients receive different ESI ratings in triage, which may have cascading, downstream consequences for patient treatment quality, satisfaction with care, and trust in the health equity of emergency care. PMID:26024515

Success in Undergraduate Engineering Programs: A Comparative Analysis by Race and Gender

NASA Astrophysics Data System (ADS)

Lord, Susan

2010-03-01

Interest in increasing the number of engineering graduates in the United States and promoting gender equality and diversification of the profession has encouraged considerable research on women and minorities in engineering programs. Drawing on a framework of intersectionality theory, this work recognizes that women of different ethnic backgrounds warrant disaggregated analysis because they do not necessarily share a common experience in engineering education. Using a longitudinal, comprehensive data set of more than 79,000 students who matriculated in engineering at nine universities in the Southeastern United States, this research examines how the six-year graduation rates of engineering students vary by disaggregated combinations of gender and race/ethnicity. Contrary to the popular opinion that women drop out of engineering at higher rates, our results show that Asian, Black, Hispanic, Native American, and White women who matriculate in engineering are as likely as men to graduate in engineering in six years. In fact, Asian, Black, Hispanic, and Native American women engineering matriculants graduate at higher rates than men and there is a small difference for white students. 54 percent of White women engineering matriculants graduate in six-years compared with 53 percent of white men. For male and female engineering matriculants of all races, the most likely destination six years after entering college is graduation within engineering. This work underscores the importance of research disaggregated by race and gender and points to the critical need for more recruitment of women into engineering as the low representation of women in engineering education is primarily a reflection of their low representation at matriculation.

White-black and white-Hispanic differences on fluid and crystallized abilities by age across the 11- to 94-year range.

PubMed

Kaufman, J C; McLean, J E; Kaufman, A S; Kaufman, N L

1994-12-01

Standardization data for the Kaufman Adolescent and Adult Intelligence Test (KAIT) were used to examine white-black and white-Hispanic differences on the Horn-Cattell crystallized and fluid constructs at several age groups across the broad 11- to 94-year span. Samples included 1,547 white, 241 black, and 140 Hispanic persons. Multivariate analyses with educational attainment covaried yielded only one significant finding: the white-black difference on the Crystallized Famous Faces subtest became smaller with increasing age.

Methods for recruiting white, black, and hispanic working-class women and men to a study of physical and social hazards at work: the United for Health study.

PubMed

Barbeau, Elizabeth M; Hartman, Cathy; Quinn, Margaret M; Stoddard, Anne M; Krieger, Nancy

2007-01-01

Despite research on work and health having a long-standing concern about unjust exposures and inequitable burdens of disease, there are few studies that document the joint distribution and health effects of physical and psychosocial hazards (e.g., noise, dusts, fumes, and job strain) and social hazards (e.g., racial discrimination and gender harassment) encountered at work. Also, there is a paucity of data on how these exposures, singly and combined, are distributed in relation to sociodemographic characteristics including race/ethnicity, gender, socioeconomic position, and nativity. This article presents a conceptual model for redressing these knowledge gaps and describes recruitment strategies and the characteristics of study participants in the United for Health study. Working with labor unions, the authors recruited 14 (67%) of 21 worksites from manufacturing, meat processing, retail, and transportation, and 1,282 workers (72% response rate), of whom 62 percent were men, 36 percent were women, 39 percent were black, 23 percent were Hispanic, 25 percent were white, 31% earned less than a living wage, 40 percent were below the poverty level, and 23 percent had less than a high school education.

Excess frequent insufficient sleep in American Indians/Alaska natives.

PubMed

Chapman, Daniel P; Croft, Janet B; Liu, Yong; Perry, Geraldine S; Presley-Cantrell, Letitia R; Ford, Earl S

2013-01-01

Frequent insufficient sleep, defined as ≥14 days/past 30 days in which an adult did not get enough rest or sleep, is associated with adverse mental and physical health outcomes. Little is known about the prevalence of frequent insufficient sleep among American Indians/Alaska Natives (AI/AN). We assessed racial/ethnic differences in the prevalence of frequent insufficient sleep from the combined 2009-2010 Behavioral Risk Factor Surveillance Survey among 810,168 respondents who self-identified as non-Hispanic white (NHW, n = 671,448), non-Hispanic black (NHB, n = 67,685), Hispanic (n = 59,528), or AI/AN (n = 11,507). We found significantly higher unadjusted prevalences (95% CI) of frequent insufficient sleep among AI/AN (34.2% [32.1-36.4]) compared to NHW (27.4% [27.1-27.6]). However, the age-adjusted excess prevalence of frequent insufficient sleep in AI/AN compared to NHW was decreased but remained significant with the addition of sex, education, and employment status; this latter relationship was further attenuated by the separate additions of obesity and lifestyle indicators, but was no longer significant with the addition of frequent mental distress to the model (PR  =  1.05; 95% CI : 0.99-1.13). This is the first report of a high prevalence of frequent insufficient sleep among AI/AN. These results further suggest that investigation of sleep health interventions addressing frequent mental distress may benefit AI/AN populations.

Distribution of hepatitis C virus genotypes in a diverse US integrated health care population.

PubMed

Manos, M Michele; Shvachko, Valentina A; Murphy, Rosemary C; Arduino, Jean Marie; Shire, Norah J

2012-11-01

Hepatitis C virus (HCV) genotypes influence response to therapy, and recently approved direct-acting antivirals are genotype-specific. Genotype distribution information can help to guide antiviral development and elucidate infection patterns. HCV genotype distributions were studied in a diverse cross-section of patients in the Northern California Kaiser Permanente health plan. Associations between genotype and race/ethnicity, age, and sex were assessed with multivariate logistic regression models. The 10,256 patients studied were median age 56 years, 62% male, 55% White non-Hispanic. Overall, 70% were genotype 1, 16% genotype 2, 12% genotype 3, 1% genotype 4, <1% genotype 5, and 1% genotype 6. Blacks (OR 4.5 [3.8-5.5]) and Asians (OR 1.2 [1.0-1.4]) were more likely to have genotype 1 than 2/3 versus non-Hispanic Whites. Women less likely had genotype 1 versus 2/3 than did men (OR 0.86 [0.78-0.94]). Versus non-Hispanic Whites, Asians (OR 0.38 [0.31-0.46]) and Blacks (OR 0.73 [0.63-0.84]) were less likely genotype1a than 1b; Hispanics (OR 1.3 [1.1-1.5]) and Native Americans (OR 1.9 [1.2-2.8]) more likely had genotype 1a than 1b. Patients age ≥65 years less likely had genotype 1a than 1b versus those age 45-64 (OR 0.34 [0.29-0.41]). The predominance of genotype 1 among all groups studied reinforces the need for new therapies targeting this genotype. Racial/ethnic variations in HCV genotype and subtype distribution must be considered in formulating new agents and novel strategies to successfully treat the diversity of hepatitis C patients. Copyright © 2012 Wiley Periodicals, Inc.

Effects of pre-pregnancy obesity, race/ethnicity and prematurity.

PubMed

de Jongh, B E; Paul, D A; Hoffman, M; Locke, R

2014-04-01

To investigate the association between maternal pre-pregnancy obesity, race/ethnicity and prematurity. Retrospective cohort study of maternal deliveries at a single regional center from 2009 to 2010 time period (n = 11,711). Generalized linear models were used for the analysis to estimate an adjusted odds ratio with 95% confidence interval of the association between maternal pre-pregnancy obesity, race/ethnicity and prematurity. Analysis controlled for diabetes, chronic hypertension, previous preterm birth, smoking and insurance status. The demographics of the study population were as follows, race/ethnicity had predominance in the White/Non-Hispanic population with 60.1%, followed by the Black/Non-Hispanic population 24.2%, the Hispanic population with 10.3% and the Asian population with 5.4%. Maternal pre-pregnancy weight showed that the population with a normal body mass index (BMI) was 49.4%, followed by the population being overweight with 26.2%, and last, the population which was obese with 24.4%. Maternal obesity increased the odds of prematurity in the White/Non-Hispanic, Hispanic and Asian population (aOR 1.40, CI 1.12-1.75; aOR 2.20, CI 1.23-3.95; aOR 3.07, CI 1.16-8.13, respectively). Although the Black/Non-Hispanic population prematurity rate remains higher than the other race/ethnicity populations, the Black/Non-Hispanic population did not have an increased odds of prematurity in obese mothers (OR 0.87; CI 0.68-1.19). Unlike White/Non-Hispanic, Asian and Hispanic mothers, normal pre-pregnancy BMI in Black/Non-Hispanic mothers was not associated with lower odds for prematurity. The odds for mothers of the White/Non-Hispanic, Hispanic and Asian populations, for delivering a premature infant, were significantly increased when obese. Analysis controlled for chronic hypertension, diabetes, insurance status, prior preterm birth and smoking. Obesity is a risk factor for prematurity in the White/Non-Hispanic, Asian and Hispanic population, but not for the Black/Non-Hispanic population. The design and evaluation of weight-based maternal health programs that aggregate race/ethnicity may not be sufficient. The optimal method to address maternal pre-pregnancy and intra-pregnancy weight-related health disorders may need to be stratified along race/ethnicity adjusted strategies and goals. However, a more global preventative strategy that encompasses the social determinants of health may be needed to reduce the higher rates of prematurity among the Black/Non-Hispanic population.

QuickStats: Age-Adjusted Death Rates* for Top Five Causes of Cancer Death,(†) by Race/Hispanic Ethnicity - United States, 2014.

PubMed

2016-09-16

In 2014, the top five causes of cancer deaths for the total population were lung, colorectal, female breast, pancreatic, and prostate cancer. The non-Hispanic black population had the highest age-adjusted death rates for each of these five cancers, followed by non-Hispanic white and Hispanic groups. The age-adjusted death rate for lung cancer, the leading cause of cancer death in all groups, was 42.1 per 100,000 standard population for the total population, 45.4 for non-Hispanic white, 45.7 for non-Hispanic black, and 18.3 for Hispanic populations.

Impact of Menthol Smoking on Nicotine Dependence for Diverse Racial/Ethnic Groups of Daily Smokers

PubMed Central

Soulakova, Julia N.; Danczak, Ryan R.

2017-01-01

Introduction: The aims of this study were to evaluate whether menthol smoking and race/ethnicity are associated with nicotine dependence in daily smokers. Methods: The study used two subsamples of U.S. daily smokers who responded to the 2010–2011 Tobacco Use Supplement to the Current Population Survey. The larger subsample consisted of 18,849 non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic (HISP) smokers. The smaller subsample consisted of 1112 non-Hispanic American Indian/Alaska Native (AIAN), non-Hispanic Asian (ASIAN), non-Hispanic Hawaiian/Pacific Islander (HPI), and non-Hispanic Multiracial (MULT) smokers. Results: For larger (smaller) groups the rates were 45% (33%) for heavy smoking (16+ cig/day), 59% (51%) for smoking within 30 min of awakening (Sw30), and 14% (14%) for night-smoking. Overall, the highest prevalence of menthol smoking corresponded to NHB and HPI (≥65%), followed by MULT and HISP (31%–37%), and then by AIAN, NHW, and ASIAN (22%–27%) smokers. For larger racial/ethnic groups, menthol smoking was negatively associated with heavy smoking, not associated with Sw30, and positively associated with night-smoking. For smaller groups, menthol smoking was not associated with any measure, but the rates of heavy smoking, Sw30, and night-smoking varied across the groups. Conclusions: The diverse associations between menthol smoking and nicotine dependence maybe due to distinction among the nicotine dependence measures, i.e., individually, each measure assesses a specific smoking behavior. Menthol smoking may be associated with promoting smoking behaviors. PMID:28085040

Racial and ethnic disparities in maternal morbidity and obstetric care.

PubMed

Grobman, William A; Bailit, Jennifer L; Rice, Madeline Murguia; Wapner, Ronald J; Reddy, Uma M; Varner, Michael W; Thorp, John M; Leveno, Kenneth J; Caritis, Steve N; Iams, Jay D; Tita, Alan T N; Saade, George; Rouse, Dwight J; Blackwell, Sean C; Tolosa, Jorge E; VanDorsten, J Peter

2015-06-01

To evaluate whether racial and ethnic disparities exist in obstetric care and adverse outcomes. We analyzed data from a cohort of women who delivered at 25 hospitals across the United States over a 3-year period. Race and ethnicity was categorized as non-Hispanic white, non-Hispanic black, Hispanic, or Asian. Associations between race and ethnicity and severe postpartum hemorrhage, peripartum infection, and severe perineal laceration at spontaneous vaginal delivery as well as between race and ethnicity and obstetric care (eg, episiotomy) relevant to the adverse outcomes were estimated by univariable analysis and multivariable logistic regression. Of 115,502 studied women, 95% were classified by one of the race and ethnicity categories. Non-Hispanic white women were significantly less likely to experience severe postpartum hemorrhage (1.6% non-Hispanic white compared with 3.0% non-Hispanic black compared with 3.1% Hispanic compared with 2.2% Asian) and peripartum infection (4.1% non-Hispanic white compared with 4.9% non-Hispanic black compared with 6.4% Hispanic compared with 6.2% Asian) than others (P<.001 for both). Severe perineal laceration at spontaneous vaginal delivery was significantly more likely in Asian women (2.5% non-Hispanic white compared with 1.2% non-Hispanic black compared with 1.5% Hispanic compared with 5.5% Asian; P<.001). These disparities persisted in multivariable analysis. Many types of obstetric care examined also were significantly different according to race and ethnicity in both univariable and multivariable analysis. There were no significant interactions between race and ethnicity and hospital of delivery. Racial and ethnic disparities exist for multiple adverse obstetric outcomes and types of obstetric care and do not appear to be explained by differences in patient characteristics or by delivery hospital. II.

Racial and Ethnic Disparities in Maternal Morbidity and Obstetric Care

PubMed Central

Grobman, William A.; Bailit, Jennifer L.; Rice, Madeline Murguia; Wapner, Ronald J.; Reddy, Uma M.; Varner, Michael W.; Thorp, John M.; Leveno, Kenneth J.; Caritis, Steve N.; Iams, Jay D.; Tita, Alan T. N.; Saade, George; Rouse, Dwight J.; Blackwell, Sean C.; Tolosa, Jorge E.; VanDorsten, J. Peter

2015-01-01

Objective To evaluate whether racial and ethnic disparities exist in obstetric care and adverse outcomes. Methods We analyzed data from a cohort of women who delivered at 25 hospitals across the United States over a 3-year period. Race and ethnicity was categorized as Non-Hispanic white, Non-Hispanic black, Hispanic, or Asian. Associations between race and ethnicity and severe postpartum hemorrhage (PPH), peripartum infection, and severe perineal laceration at spontaneous vaginal delivery, as well as between race and ethnicity and obstetric care (eg, episiotomy) relevant to the adverse outcomes, were estimated by univariable analysis and multivariable logistic regression. Results Of 115,502 studied women, 95% were classified by one of the race and ethnicity categories. Non-Hispanic white women were significantly less likely to experience severe PPH (1.6% non-Hispanic white vs. 3.0% Non-Hispanic black vs. 3.1% Hispanic vs. 2.2%Asian) and peripartum infection (4.1% non-Hispanic white vs. 4.9% Non-Hispanic black vs. 6.4% Hispanic vs. 6.2% Asian) than others (P < 0.001 for both). Severe perineal laceration at spontaneous vaginal delivery was significantly more likely in Asian women (2.5% non-Hispanic white vs. 1.2% Non-Hispanic black vs. 1.5% Hispanic vs. 5.5% Asian) P< 0.001). These disparities persisted in multivariable analysis. Many types of obstetric care examined also were significantly different according to race and ethnicity in both univariable and multivariable analysis. There were no significant interactions between race and ethnicity and hospital of delivery. Conclusion Racial and ethnic disparities exist for multiple adverse obstetric outcomes and types of obstetric care, and do not appear to be explained by differences in patient characteristics or by delivery hospital. PMID:26000518

Body image and eating disordered behavior in a community sample of Black and Hispanic women.

PubMed

Hrabosky, Joshua I; Grilo, Carlos M

2007-01-01

The current study examined body image concerns and eating disordered behaviors in a community sample of Black and Hispanic women. In addition, this study explored whether there are ethnic differences in the correlates or in the prediction of body image concerns. Participants were 120 (67 Black and 53 Hispanic) women who responded to advertisements to participate in a study of women and health. Participants completed a battery of established self-report measures to assess body image, eating disordered behaviors, and associated psychological domains. Black and Hispanic women did not differ significantly in their self-reports of body image, eating disordered behaviors, or associated psychological measures. Comparisons performed separately within both ethnic groups revealed significant differences by weight status, with a general graded patterning of greater concerns in obese than overweight than average weight groups. In terms of predicting body image, multiple regression analyses testing a number of variables, including BMI, performed separately for Black and Hispanic women revealed that eating concern and depressive affect were significant predictors of body image concern for both groups. Overall, Black and Hispanic women differed little in their self-reports of body image, eating-disordered features, and depressive affect. Higher weight was associated with a general pattern of increased body image concerns and features of eating disorders in both groups and with binge eating in Black women. Eating concerns and depressive affect emerged as significant independent predictors of body image for both ethnic groups.

Do Sexual Networks of Men Who Have Sex with Men in New York City Differ by Race/Ethnicity?

PubMed Central

Nandi, Vijay; Hoover, Donald R.; Lucy, Debbie; Stewart, Kiwan; Frye, Victoria; Cerda, Magdalena; Ompad, Danielle; Latkin, Carl; Koblin, Beryl A.

2016-01-01

Abstract The United States HIV epidemic disproportionately affects black and Hispanic men who have sex with men (MSM). This disparity might be partially explained by differences in social and sexual network structure and composition. A total of 1267 MSM in New York City completed an ACASI survey and egocentric social and sexual network inventory about their sex partners in the past 3 months, and underwent HIV testing. Social and sexual network structure and composition were compared by race/ethnicity of the egos: black, non-Hispanic (N = 365 egos), white, non-Hispanic (N = 466), and Hispanic (N = 436). 21.1% were HIV-positive by HIV testing; 17.2% reported serodiscordant and serostatus unknown unprotected anal/vaginal intercourse (SDUI) in the last 3 months. Black MSM were more likely than white and Hispanic MSM to report exclusively having partners of same race/ethnicity. Black and Hispanic MSM had more HIV-positive and unknown status partners than white MSM. White men were more likely to report overlap of social and sex partners than black and Hispanic men. No significant differences by race/ethnicity were found for network size, density, having concurrent partners, or having partners with ≥10 years age difference. Specific network composition characteristics may explain racial/ethnic disparities in HIV infection rates among MSM, including HIV status of sex partners in networks and lack of social support within sexual networks. Network structural characteristics such as size and density do not appear to have such an impact. These data add to our understanding of the complexity of social factors affecting black MSM and Hispanic MSM in the U.S. PMID:26745143

Breast cancer incidence patterns among California Hispanic women: Differences by nativity and residence in an enclave

PubMed Central

Keegan, Theresa H.M.; John, Esther M.; Fish, Kari M.; Alfaro-Velcamp, Theresa; Clarke, Christina A.; Gomez, Scarlett L.

2010-01-01

Background Breast cancer incidence is higher in US-born Hispanic women than foreign-born Hispanics, but no studies have examined how these rates have changed over time. To better inform cancer control efforts, we examined incidence trends by nativity and incidence patterns by neighborhood socioeconomic status (SES) and Hispanic enclave (neighborhoods with high proportions of Hispanics or Hispanic immigrants). Methods Information regarding all Hispanic women diagnosed with invasive breast cancer between 1988 and 2004 were obtained from the California Cancer Registry. Nativity was imputed from Social Security number for the 27% of cases with missing birthplace information. Neighborhood variables were developed from Census data. Results From 1988 to 2004, incidence rates for US-born Hispanics were parallel, but lower than, those of non-Hispanic whites, showing an annual 6% decline from 2002 to 2004. Foreign-born Hispanics had an annual 4% increase in incidence rates from 1995 to 1998 and a 1.4% decline thereafter. Rates were 38% higher for US- than foreign-born Hispanics, with elevations more pronounced for localized than regional/distant disease, and for women > 50 years of age. Residence in higher SES and lower Hispanic enclave neighborhoods were independently associated with higher incidence, with Hispanic enclave having a stronger association than SES. Conclusions Compared to foreign-born, US-born Hispanic women in California had higher prevalence of breast cancer risk factors, suggesting that incidence patterns largely reflects these differences in risk factors. Impact Further research is needed to separate the effects of individual- and neighborhood-level factors that impact incidence in this large and growing population. PMID:20447917

Race-based differences in length of stay among patients undergoing pancreatoduodenectomy.

PubMed

Schneider, Eric B; Calkins, Keri L; Weiss, Matthew J; Herman, Joseph M; Wolfgang, Christopher L; Makary, Martin A; Ahuja, Nita; Haider, Adil H; Pawlik, Timothy M

2014-09-01

Race-based disparities in operative morbidity and mortality have been demonstrated for various procedures, including pancreatoduodenectomy (PD). Race-based differences in hospital length-of-stay (LOS), especially related to provider volume at the surgeon and hospital level, remain poorly defined. Using the 2003-2009 Nationwide Inpatient Sample, we determined year-specific PD volumes for surgeons and hospitals and grouped them into terciles. Patient race (white, black, or Hispanic), age, sex, and comorbidities were examined. Median length of stay was calculated, and multivariable logistic regression was used to examine factors associated with increased LOS. Among 4,319 eligible individuals, 3,502 (81.1%) were white, 423 (9.8%) were black, and 394 (9.1%) were Hispanic. Overall median LOS was 12 days (range, 0-234). Median annual surgeon volume was 8 (interquartile range [IQR], 2-19; range, 1-54). Annual hospital volume ranged from 1 to 129 (median, 19; IQR, 7-55). White patients were more likely to have been treated at medium- to high-volume hospitals (odds ratio [OR] 1.53, P < .001) and by medium- to high-volume surgeons (OR 1.62, P < .001) than black or Hispanic patients. After PD, white, black, and Hispanic patients demonstrated similar in-hospital mortality (5.1%, 5.7% and 7.2% respectively P = .250). After adjustment, black (OR 1.36, P = .010) and Hispanic (OR 1.68, P < .001) patients were more likely to have a greater LOS after PD. Black and Hispanic PD patients were less likely than white patients to be treated at higher-volume hospitals and by higher-volume surgeons. Proportional mortality and LOS after PD were greater among black and Hispanic patients. Copyright © 2014 Mosby, Inc. All rights reserved.

Biking practices and preferences in a lower income, primarily minority neighborhood: Learning what residents want.

PubMed

Lusk, Anne C; Anastasio, Albert; Shaffer, Nicholas; Wu, Juan; Li, Yanping

2017-09-01

This paper examines if, in a lower-income minority neighborhood, bicycling practices and bicycle-environment preferences of Blacks and Hispanics were different from Whites. During the summer of 2014, surveys were mailed to 1537 households near a proposed cycle track on Malcolm X Boulevard in Roxbury, MA. On the Boulevard, intercept surveys were distributed to cyclists and observations noted about passing cyclist's characteristics. Data were analyzed from 252 returned-mailed surveys, 120 intercept surveys, and 709 bicyclists. White (100%), Hispanic (79%), and Black (76%) bicyclists shown pictures of 6 bicycle facility types in intercept surveys perceived the cycle track as safest. More White mailed-survey respondents thought bikes would not be stolen which may explain why more Hispanics (52%) and Blacks (47%) preferred to park their bikes inside their home compared with Whites (28%), with H/W B/W differences statistically significant ( p  < 0.05). More Hispanic (81%) and Black (54%) mailed-survey respondents thought they would bicycle more if they could bicycle with family and friends compared with Whites (40%). Bicyclists observed commuting morning and evening included Blacks (55%), Whites (36%) and Hispanics (9%). More Whites (68%) wore helmets compared with Hispanics (21%) and Blacks (17%) ( p  < 0.001). More Blacks (94%) and Hispanics (94%) rode a mountain bike compared with Whites (75%). Minority populations are biking on roads but prefer cycle tracks. They also prefer to park bikes inside their homes and bicycle with family and friends. Wide cycle tracks (bicycling with family/friends) and home bike parking should be targeted as capital investments in lower-income minority neighborhoods.

Differences in fruit and vegetable intake by race/ethnicity and by Hispanic origin and nativity among women in the Special Supplemental Nutrition Program for Women, Infants, and Children, 2015

USDA-ARS?s Scientific Manuscript database

The objective of this exploratory study was to determine whether fruit and vegetable consumption differed by race/ethnicity, by origin and nativity among Hispanics, and by language preference (as an indicator of acculturation) among foreign-born Hispanics. We recruited 723 women enrolled in the Spec...

The Tuskegee Legacy Project: willingness of minorities to participate in biomedical research.

PubMed

Katz, Ralph V; Kegeles, S Steven; Kressin, Nancy R; Green, B Lee; Wang, Min Qi; James, Sherman A; Russell, Stefanie Luise; Claudio, Cristina

2006-11-01

The broad goal of the Tuskegee Legacy Project (TLP) study was to address, and understand, a range of issues related to the recruitment and retention of Blacks and other minorities in biomedical research studies. The specific aim of this analysis was to compare the self-reported willingness of Blacks, Hispanics, and Whites to participate as research subjects in biomedical studies, as measured by the Likelihood of Participation (LOP) Scale and the Guinea Pig Fear Factor (GPFF) Scale. The Tuskegee Legacy Project Questionnaire, a 60 item instrument, was administered to 1,133 adult Blacks, Hispanics, and non-Hispanic Whites in 4 U.S. cities. The findings revealed no difference in self-reported willingness to participate in biomedical research, as measured by the LOP Scale, between Blacks, Hispanics, and Whites, despite Blacks being 1.8 times as likely as Whites to have a higher fear of participation in biomedical research on the GPFF Scale.

The Tuskegee Legacy Project: Willingness of Minorities to Participate in Biomedical Research

PubMed Central

Katz, Ralph V.; Russell, Stefanie L.; Kegeles, S. Steven; Kressin, Nancy R.; Green, B. Lee; Wang, Min Qi; James, Sherman A.; Claudio, Cristina

2006-01-01

The broad goal of the Tuskegee Legacy Project (TLP) study was to address, and understand, a range of issues related to the recruitment and retention of Blacks and other minorities in biomedical research studies. The specific aim of this analysis was to compare the self-reported willingness of Blacks, Hispanics, and Whites to participate as research subjects in biomedical studies, as measured by the Likelihood of Participation (LOP) Scale and the Guinea Pig Fear Factor (GPFF) Scale. The Tuskegee Legacy Project Questionnaire, a 60 item instrument, was administered to 1,133 adult Blacks, Hispanics, and non-Hispanic Whites in 4 U.S. cities. The findings revealed no difference in self-reported willingness to participate in biomedical research, as measured by the LOP Scale, between Blacks, Hispanics, and Whites, despite Blacks being 1.8 times as likely as Whites to have a higher fear of participation in biomedical research on the GPFF Scale. PMID:17242525

Racial Disparities in Survival Among Injured Drivers

PubMed Central

Haskins, Amy E.; Clark, David E.; Travis, Lori L.

2013-01-01

Prior studies on racial and ethnic disparities in survival after motor vehicle crashes have examined only population-based death rates or have been restricted to hospitalized patients. In the current study, we examined 3 components of crash survival by race/ethnicity: survival overall, survival to reach a hospital, and survival among those hospitalized. Nine years of data (from 2000 through 2008) from the National Automotive Sampling System Crashworthiness Data System were used to examine white non-Hispanic, black non-Hispanic, and Hispanic drivers aged ≥15 years with serious injuries (injury severity scores of ≥9). By using multivariable logistic regression, we found that a driver's race/ethnicity was not significantly associated with overall survival after being injured in a crash (for blacks, odds ratio (OR) = 0.69, 95% confidence interval (CI): 0.36, 1.32; for Hispanics, OR = 1.00, 95% CI: 0.59, 1.72), and blacks and Hispanics were equally likely to survive to be treated at a hospital compared with whites (for blacks, OR = 1.00, 95% CI: 0.52, 1.93; for Hispanics, OR = 1.13, 95% CI: 0.71, 1.79). However, among patients who were treated at a hospital, blacks were 50% less likely to survive 30 days compared with whites (OR = 0.50, 95% CI: 0.33, 0.76). The disparity in survival after serious traffic injuries among blacks appears to occur after hospitalization, not in prehospital survival. PMID:23371352

34 CFR 628.32 - What funding priorities does the Secretary use in evaluating an application for an endowment...

Code of Federal Regulations, 2013 CFR

2013-07-01

..., Special Needs, Hispanic-Serving Institutions, Strengthening Historically Black Colleges and Universities, or Strengthening Historically Black Graduate Institutions Program. (Total: 20 points) The Secretary... Institutions, Special Needs, Hispanic-Serving Institutions, Strengthening Historically Black Colleges and...

34 CFR 628.32 - What funding priorities does the Secretary use in evaluating an application for an endowment...

Code of Federal Regulations, 2014 CFR

2014-07-01

..., Special Needs, Hispanic-Serving Institutions, Strengthening Historically Black Colleges and Universities, or Strengthening Historically Black Graduate Institutions Program. (Total: 20 points) The Secretary... Institutions, Special Needs, Hispanic-Serving Institutions, Strengthening Historically Black Colleges and...

34 CFR 628.32 - What funding priorities does the Secretary use in evaluating an application for an endowment...

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Special Needs, Hispanic-Serving Institutions, Strengthening Historically Black Colleges and Universities, or Strengthening Historically Black Graduate Institutions Program. (Total: 20 points) The Secretary... Institutions, Special Needs, Hispanic-Serving Institutions, Strengthening Historically Black Colleges and...

34 CFR 628.32 - What funding priorities does the Secretary use in evaluating an application for an endowment...

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Special Needs, Hispanic-Serving Institutions, Strengthening Historically Black Colleges and Universities, or Strengthening Historically Black Graduate Institutions Program. (Total: 20 points) The Secretary... Institutions, Special Needs, Hispanic-Serving Institutions, Strengthening Historically Black Colleges and...

34 CFR 628.32 - What funding priorities does the Secretary use in evaluating an application for an endowment...

Code of Federal Regulations, 2012 CFR

2012-07-01

..., Special Needs, Hispanic-Serving Institutions, Strengthening Historically Black Colleges and Universities, or Strengthening Historically Black Graduate Institutions Program. (Total: 20 points) The Secretary... Institutions, Special Needs, Hispanic-Serving Institutions, Strengthening Historically Black Colleges and...

Video tool to promote knowledge of syphilis among black and Hispanic men recruited from clinical and non-clinical settings.

PubMed

Sánchez, John P; Guilliames, Conair; Sánchez, Nelson F; Calderon, Yvette; Burton, William B

2010-06-01

Recent syphilis outbreaks in metropolitan cities are attributed to men who have sex with men (MSM) with a significant proportion of Black or Hispanic identity. However, there are few syphilis interventions that are tailored to minority MSM. We conducted a randomized controlled trial to assess whether Black and Hispanic MSM recruited from various venues who viewed the "Syphilis and Men" video showed an increase in syphilis knowledge, regardless of self-reported characteristics associated with increased risk for syphilis infection. Of the 168 participants, 91.1% were Black or Hispanic and 64.9% had a male partner in the past 6 months. The video intervention group had a significant increase of 19.5-20.9 percentage points on the post-test survey, depending on the venue. This difference was present irrespective of participant socio-demographic and health-related characteristics. The "Syphilis and Men" video is a brief, cost-limited intervention to promote syphilis knowledge among Black and Hispanic MSM that can potentially be implemented in various venues.

Belief in AIDS origin conspiracy theory and willingness to participate in biomedical research studies: findings in whites, blacks, and Hispanics in seven cities across two surveys.

PubMed

Russell, Stefanie L; Katz, Ralph V; Wang, Min Qi; Lee, Ryan; Green, B Lee; Kressin, Nancy R; Claudio, Cristina

2011-01-01

The purpose of this study was to determine whether a belief in the AIDS origin conspiracy theory is related to likelihood or fear of participation in research studies. The Tuskegee Legacy Project Questionnaire was administered via random-digit-dialed telephone interview to black, white, and Hispanic participants in 4 cities in 1999 and 2000 (n = 1,133) and in 3 cities in 2003 (n = 1,162). In 1999, 27.8% of blacks, 23.6% of Hispanics, and 8% of whites (P ≤ .001) reported that it was "very or somewhat likely" that AIDS is "the result of a government plan to intentionally kill a certain group of people by genocide." In 2003, 34.1% of blacks, 21.9% of Hispanics, and 8.4% of whites (P ≤ .001) reported the same. Whereas blacks and Hispanics were more than 3 times more likely than whites to believe in this AIDS origin conspiracy theory, holding this belief was not associated with a decreased likelihood of participation in, or increased fear of participation in, biomedical research.

Racial/ethnic disparities in hepatocellular carcinoma treatment and survival in California, 1988-2012.

PubMed

Stewart, Susan L; Kwong, Sandy L; Bowlus, Christopher L; Nguyen, Tung T; Maxwell, Annette E; Bastani, Roshan; Chak, Eric W; Chen, Moon S

2016-10-14

To describe racial/ethnic differences in treatment and survival among liver cancer patients in a population-based cancer registry. Invasive cases of primary hepatocellular carcinoma, n = 33270, diagnosed between January 1, 1988-December 31, 2012 and reported to the California Cancer Registry were analyzed by race/ethnicity, age, gender, geographical region, socio-economic status, time period of diagnosis, stage, surgical treatment, and survival. Patients were classified into 15 racial/ethnic groups: non-Hispanic White (White, n = 12710), Hispanic ( n = 8500), Chinese ( n = 2723), non-Hispanic Black (Black, n = 2609), Vietnamese ( n = 2063), Filipino ( n = 1479), Korean ( n = 1099), Japanese ( n = 658), American Indian/Alaskan Native (AIAN, n = 281), Laotian/Hmong ( n = 244), Cambodian ( n = 233), South Asian ( n = 190), Hawai`ian/Pacific Islander ( n = 172), Thai ( n = 95), and Other Asian ( n = 214). The main outcome measures were receipt of surgical treatment, and cause-specific and all-cause mortality. After adjustment for socio-demographic characteristics, time period, and stage of disease, compared to Whites, Laotian/Hmong [odds ratio (OR) = 0.30, 95%CI: 0.17-0.53], Cambodian (OR = 0.65, 95%CI: 0.45-0.96), AIAN (OR = 0.66, 95%CI: 0.46-0.93), Black (OR = 0.76, 95%CI: 0.67-0.86), and Hispanic (OR = 0.78, 95%CI: 0.72-0.84) patients were less likely, whereas Chinese (OR = 1.58, 95%CI: 1.42-1.77), Koreans (OR = 1.45, 95%CI: 1.24-1.70), Japanese (OR = 1.41, 95%CI: 1.15-1.72), and Vietnamese (OR = 1.26, 95%CI: 1.12-1.42) were more likely to receive surgical treatment. After adjustment for the same covariates and treatment, cause-specific mortality was higher for Laotian/Hmong [(hazard ratio (HR) = 1.50, 95%CI: 1.29-1.73)], Cambodians (HR = 1.35, 95%CI: 1.16-1.58), and Blacks (HR = 1.07, 95%CI: 1.01-1.13), and lower for Chinese (HR = 0.82, 95%CI: 0.77-0.86), Filipinos (HR = 0.84, 95%CI: 0.78-0.90), Vietnamese (HR = 0.85, 95%CI: 0.80-0.90), Koreans (HR = 0.90, 95%CI: 0.83-0.97), and Hispanics (HR = 0.91, 95%CI: 0.88-0.94); results were similar for all-cause mortality. Disaggregated data revealed substantial racial/ethnic differences in liver cancer treatment and survival, demonstrating the need for development of targeted interventions to mitigate disparities.

Racial disparities in BRCA testing and cancer risk management across a population-based sample of young breast cancer survivors.

PubMed

Cragun, Deborah; Weidner, Anne; Lewis, Courtney; Bonner, Devon; Kim, Jongphil; Vadaparampil, Susan T; Pal, Tuya

2017-07-01

Breast cancer (BC) disparities may widen with genomic advances. The authors compared non-Hispanic white (NHW), black, and Hispanic BC survivors for 1) cancer risk-management practices among BRCA carriers and 2) provider discussion and receipt of genetic testing. A population-based sample of NHW, black, and Hispanic women who had been diagnosed with invasive BC at age 50 years or younger from 2009 to 2012 were recruited through the state cancer registry. Multiple logistic regression was used to compare cancer risk-management practices in BRCA carriers and associations of demographic and clinical variables with provider discussion and receipt of testing. Of 1622 participants, 159 of 440 (36.1%) black women, 579 of 897 (64.5%) NHW women, 58 of 117 (49.6%) Spanish-speaking Hispanic women, and 116 of 168 (69%) English-speaking Hispanic women underwent BRCA testing, of whom 90 had a pathogenic BRCA mutation identified. Among BRCA carriers, the rates of risk-reducing mastectomy and risk-reducing salpingo-oophorectomy were significantly lower among black women compared with Hispanic and NHW women after controlling for clinical and demographic variables (P = .025 and P = .008, respectively). Compared with NHW women, discussion of genetic testing with a provider was 16 times less likely among black women (P < .0001) and nearly 2 times less likely among Spanish-speaking Hispanic women (P = .04) after controlling for clinical and sociodemographic factors. The current results suggest that the rates of risk-reducing salpingo-oophorectomy are lower among black BRCA carriers compared with their Hispanic and NHW counterparts, which is concerning because benefits from genetic testing arise from cancer risk-management practice options. Furthermore, lower BRCA testing rates among blacks may partially be because of a lower likelihood of provider discussion. Future studies are needed to improve cancer risk identification and management practices across all populations to prevent the widening of disparities. Cancer 2017;123:2497-05. © 2017 American Cancer Society. © 2017 American Cancer Society.

Determinants of Usual Source of Care Disparities among African American and Caribbean Black Men: Findings from the national Survey of american life

PubMed Central

Hammond, Wizdom Powell; Mohottige, Dinushika; Chantala, Kim; Hastings, Julia F.; Neighbors, Harold W.; Snowden, Lonnie

2011-01-01

Purpose The Aday-Andersen model was used as a framework for investigating the contribution of immigration status (i.e., nativity and acculturation), socioeconomic factors, health care access, health status, and health insurance to usual source of health care (USOC) in a nationally representative sample of African American (n5551) and Caribbean Black men (n51,217). Methods We used the 2001–2003 National Survey of American Life, a nationally representative household survey of non-institutionalized U.S. Blacks to conduct descriptive and logistic regression analyses. Results Older age, more health conditions, neighborhood medical clinic access, and health insurance were associated with higher odds of reporting a USOC. Odds were lower for men with lower-middle incomes and poorer mental health status. Having health insurance was associated with higher odds of reporting a USOC for African American men but lower odds among Caribbean Black men. Odds were higher in the presence of more health conditions for African American men than for Caribbean Black men. Conclusions Health care reform policies aimed solely at increasing health insurance may not uniformly eliminate USOC disparities disfavoring U.S. and foreign-born non-Hispanic Black men. PMID:21317513

Low sensitivity for the metabolic syndrome to detect uric acid elevations in females and non-Hispanic-black male adolescents: an analysis of NHANES 1999-2006.

PubMed

DeBoer, Mark D; Gurka, Matthew J

2012-02-01

Uric acid is tightly linked to the metabolic syndrome (MetS) and among adults higher uric acid levels are associated with future risk for diabetes, cardiovascular disease, hypertension and renal disease. Evaluate the sensitivity of MetS to identify adolescents with elevated uric acid levels on a race/ethnicity and gender-specific basis. We evaluated 3296 male and female adolescents 12-19 y participating in the National Health and Nutrition Evaluation Survey 1999-06, comprised of 67.6% non-Hispanic whites, 15.1% non-Hispanic blacks, and 17.3% Hispanics. We used a definition of MetS modified for use in adolescents and evaluated the sensitivity of a diagnosis of MetS to identify individuals with uric acid elevations (approximately the 95th percentile of uric acid by gender among normal-weight adolescents). When used as a screening test to identify individuals with uric acid elevations MetS performed more poorly among females (18.0%) than among males (37.0%) (p<0.001). Among males, MetS exhibited a lower sensitivity among non-Hispanic blacks (17.8%) compared to Hispanics (45.9%) (p<0.01) and non-Hispanic whites (37.4%) (p<0.05). There were no race/ethnicity differences in detecting elevated uric acid levels among females (non-Hispanic-white 15.5%, non-Hispanic-black 19.4%, Hispanic 26.5%, p>0.05). Current criteria to diagnose MetS exhibit racial/ethnic and gender differences in the ability to identify adolescents with elevated uric acid levels, performing poorly among non-Hispanic-black males and among females. Given emerging data regarding the ability of uric acid elevations for predicting future disease, these data may have implications regarding the use of MetS as a marker of risk among all gender and racial/ethnic groups. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Racial Differences in the Surgical Care of Medicare Beneficiaries With Localized Prostate Cancer.

PubMed

Schmid, Marianne; Meyer, Christian P; Reznor, Gally; Choueiri, Toni K; Hanske, Julian; Sammon, Jesse D; Abdollah, Firas; Chun, Felix K H; Kibel, Adam S; Tucker-Seeley, Reginald D; Kantoff, Philip W; Lipsitz, Stuart R; Menon, Mani; Nguyen, Paul L; Trinh, Quoc-Dien

2016-01-01

There is extensive evidence suggesting that black men with localized prostate cancer (PCa) have worse cancer-specific mortality compared with their non-Hispanic white counterparts. To evaluate racial disparities in the use, quality of care, and outcomes of radical prostatectomy (RP) in elderly men (≥ 65 years) with nonmetastatic PCa. This retrospective analysis of outcomes stratified according to race (black vs non-Hispanic white) included 2020 elderly black patients (7.6%) and 24,462 elderly non-Hispanic white patients (92.4%) with localized PCa who underwent RP within the first year of PCa diagnosis in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database between 1992 and 2009. The study was performed in 2014. Process of care (ie, time to treatment, lymph node dissection), as well as outcome measures (ie, complications, emergency department visits, readmissions, PCa-specific and all-cause mortality, costs) were evaluated using Cox proportional hazards regression. Multivariable conditional logistic regression and quantile regression were used to study the association of racial disparities with process of care and outcome measures. The proportion of black patients with localized prostate cancer who underwent RP within 90 days was 59.4% vs 69.5% of non-Hispanic white patients (P <  001). In quantile regression of the top 50% of patients, blacks had a 7-day treatment delay compared with non-Hispanic whites. (P <  001). Black patients were less likely to undergo lymph node dissection (odds ratio [OR], 0.76 [95% CI, 0.66-0.80]; P < .001) but had higher odds of postoperative visits to the emergency department (within 30 days: OR, 1.48 [95% CI, 1.18-1.86]); after 30 days or more (OR, 1.45 [95% CI, 1.19-1.76]) and readmissions (within 30 days: OR, 1.28 [95% CI, 1.02-1.61]); ≥ 30 days (OR, 1.27 [95% CI, 1.07-1.51]) compared with non-Hispanic whites. The surgical treatment of black patients was associated with a higher incremental annual cost (the top 50% of blacks spent $1185.50 (95% CI , $804.85-1 $1566.10; P < .001) more than the top 50% of non-Hispanic whites). There was no difference in PCa-specific mortality (P = .16) or all-cause mortality (P = .64) between black and non-Hispanic white men. Blacks treated with RP for localized PCa are more likely to experience adverse events and incur higher costs compared with non-Hispanic white men; however, this does not translate into a difference in PCa-specific or all-cause mortality.

Socioeconomic Status and Self-Rated Oral Health; Diminished Return among Hispanic Whites.

PubMed

Assari, Shervin

2018-04-24

Background. An extensive body of knowledge has documented weaker health effects of socio-economic status (SES) for Blacks compared to Whites, a phenomenon also known as Blacks’ diminished return. It is, however, unknown whether the same diminished return also holds for other ethnic minorities such as Hispanics or not. Aim. Using a nationally representative sample, the current study aimed to compare Non-Hispanic and Hispanic Whites for the effects of SES on self-rated oral health. Methods. For the current cross-sectional study, we used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001⁻2003. With a nationally representative sampling, CPES included 11,207 adults who were either non-Hispanic Whites ( n = 7587) or Hispanic Whites ( n = 3620. The dependent variable was self-rated oral health, treated as dichotomous measure. Independent variables were education, income, employment, and marital status. Ethnicity was the focal moderator. Age and gender were covariates. Logistic regressions were used for data analysis. Results. Education, income, employment, and marital status were associated with oral health in the pooled sample. Although education, income, employment, and marital status were associated with oral health in non-Hispanic Whites, none of these associations were found for Hispanic Whites. Conclusion. In a similar pattern to Blacks’ diminished return, differential gain of SES indicators exists between Hispanic and non-Hispanic Whites, with a disadvantage for Hispanic Whites. Diminished return of SES should be regarded as a systemically neglected contributing mechanism behind ethnic oral health disparities in the United States. Replication of Blacks’ diminished return for Hispanics suggests that these processes are not specific to ethnic minority groups, and non-White groups gain less because they are not enjoying the privilege and advantage of Whites.

The effect of race and gender on pediatric surgical outcomes within the United States.

PubMed

Stone, Matthew L; Lapar, Damien J; Kane, Bartholomew J; Rasmussen, Sara K; McGahren, Eugene D; Rodgers, Bradley M

2013-08-01

The purpose of this study was to examine risk-adjusted associations between race and gender on postoperative morbidity, mortality, and resource utilization in pediatric surgical patients within the United States. 101,083 pediatric surgical patients were evaluated using the U.S. national KID Inpatient Database (2003 and 2006): appendectomy (81.2%), pyloromyotomy (9.8%), intussusception (6.2%), decortication (1.9%), congenital diaphragmatic hernia repair (0.7%), and colonic resection for Hirschsprung's disease (0.2%). Patients were stratified according to gender (male: 63.1%, n=63,783) and race: white (n=58,711), Hispanic (n=26,118), black (n=9,103), Asian (n=1,582), Native American (n=474), and other (n=5,096). Multivariable logistic regression modeling was utilized to evaluate risk-adjusted associations between race, gender, and outcomes. After risk adjustment, race was independently associated with in-hospital death (p=0.02), with an increased risk for black children. Gender was not associated with mortality (p=0.77). Postoperative morbidity was significantly associated with gender (p<0.001) and race (p=0.01). Gender (p=0.003) and race (p<0.001) were further associated with increased hospital length of stay. Importantly, these results were dependent on operation type. Race and gender significantly affect postoperative outcomes following pediatric surgery. Black patients are at disproportionate risk for postoperative mortality, while black and Hispanic patients have increased morbidity and hospital resource utilization. While gender does not affect mortality, gender is a determinant of both postoperative morbidity and increased resource utilization. Copyright © 2013 Elsevier Inc. All rights reserved.

THE IMPACT OF HISPANIC POPULATION GROWTH ON THE OUTLOOK OF AFRICAN AMERICANS

PubMed Central

Taylor, Marylee C.; Schroeder, Matthew B.

2014-01-01

We know too little about the effects of immigration on black Americans. If prior research yields mixed evidence about immigration’s consequences for the objective well-being of African Americans, it is silent about effects of immigration on blacks’ subjective well-being. To fill that void, this paper assesses the impact of the expanding Hispanic population on black Americans from a social psychological perspective. We ask whether blacks’ self-reported distress, social distrust, or attitudes toward Hispanics and immigrants are affected by the size of the local Hispanic population or by the percentage growth in local Hispanic residents. Answers come from responses of non-Hispanic black participants in the 1998–2002 General Social Surveys, linked to 1990 and 2000 census data. Contrary to pessimistic claims, most social psychological outcomes, including measures of economic distress, manifest no impact of local Hispanic numbers. The four exceptions, significant effects of local Hispanic population share or percentage growth evenly split in valence, underscore the complexity of recent immigration’s effects on African Americans. PMID:25242830

Can school income and racial/ethnic composition explain the racial/ethnic disparity in adolescent physical activity participation?

PubMed

Richmond, Tracy K; Hayward, Rodney A; Gahagan, Sheila; Field, Alison E; Heisler, Michele

2006-06-01

Our goal was to determine if racial/ethnic disparities in adolescent boys' and girls' physical activity participation exist and persist once the school attended is considered. We performed a cross-sectional analysis of 17,007 teens in the National Longitudinal Study of Adolescent Health. Using multivariate linear regression, we examined the association between adolescent self-reported physical activity and individual race/ethnicity stratified by gender, controlling for a wide range of sociodemographic, attitudinal, behavioral, and health factors. We used multilevel analyses to determine if the relationship between race/ethnicity and physical activity varied by the school attended. Participants attended racially segregated schools; approximately 80% of Hispanic and black adolescent boys and girls attended schools with student populations that were <66% white, whereas nearly 40% of the white adolescents attended schools that were >94% white. Black and Hispanic adolescent girls reported lower levels of physical activity than white adolescent girls. There were more similar levels of physical activity reported in adolescent boys, with black boys reporting slightly more activities. Although black and Hispanic adolescent girls were more likely to attend poorer schools with overall lower levels of physical activity in girls; there was no difference within schools between black, white, and Hispanic adolescent girls' physical activity levels. Within the same schools, both black and Hispanic adolescent boys had higher rates of physical activity when compared with white adolescent boys. In this nationally representative sample, lower physical activity levels in Hispanic and black adolescent girls were largely attributable to the schools they attended. In contrast, black and Hispanic males had higher activity levels than white males when attending the same schools. Future research is needed to determine the mechanisms through which school environments contribute to racial/ethnic disparities in adolescent physical activity and will need to consider gender differences in these racial/ethnic disparities.

Revitalizing Hispanic and Native American Communities: Four Examples.

ERIC Educational Resources Information Center

Robinson, Paul; And Others

1989-01-01

Describes locally controlled economic development strategies used by Native American and Hispanic cooperatives and organizations: Ganados del Valle, Madera Forest Products Association, Seventh Generation Fund, and Ramah Navajo Weavers Association. Discusses the issues of cultural and economic survival in isolated rural communities. (SV)

A Comparative Analysis of the Wages of Hispanic, Black, and Anglo Men.

ERIC Educational Resources Information Center

Reimers, Cordelia

This paper details the factors contributing to the wage structure of Hispanic men and compares the wages of Black and Anglo men. The major finding is that controlling for differences in observable personal characteristics--such as education and work experience--substantially reduces the wage differences between Hispanics and Anglos. For example,…

Examination of the Association between Insufficient Sleep and Cardiovascular Disease and Diabetes by Race/Ethnicity.

PubMed

Vishnu, Abhishek; Shankar, Anoop; Kalidindi, Sita

2011-01-01

Background. We examined the association between insufficient rest/sleep and cardiovascular disease or diabetes mellitus separately among non-Hispanic whites, non-Hispanic blacks, Hispanic Americans, and other races in a contemporary sample of US adults. Methods. Multiethnic, nationally representative, cross-sectional survey (2008 BRFSS) participants who were >20 years of age (n = 369, 217; 50% women). Self-reported insufficient rest/sleep in the previous month was categorized into: zero, 1-13, 14-29, and all 30 days. Outcomes were: (1) any CVD, (2) coronary artery disease (CHD), (3) stroke, and (4) diabetes mellitus. Results. Insufficient rest/sleep was found to be positively associated with (1) any CVD, (2) CHD, and (3) stroke among all race-ethnicities. In contrast, insufficient rest/sleep was positively associated with diabetes mellitus in all race-ethnicities except non-Hispanic blacks. The odds ratio of diabetes association with insufficient rest/sleep for all 30 days was 1.37 (1.26-1.48) among non-Hispanic whites, 1.11 (0.90-1.36) among non-Hispanic blacks, 1.88 (1.46-2.42) among Hispanic Americans, and 1.48 (1.10-2.00) among other race/ethnicities. Conclusion. In a multiethnic sample of US adults, perceived insufficient rest/sleep was associated with CVD, among all race-ethnicities. However, the association between insufficient rest/sleep and diabetes mellitus was present among all race-ethnicities except non-Hispanic blacks.

Haemoglobin concentration and the risk of death in older adults: differences by race/ethnicity in the NHANES III follow-up.

PubMed

Patel, Kushang V; Longo, Dan L; Ershler, William B; Yu, Binbing; Semba, Richard D; Ferrucci, Luigi; Guralnik, Jack M

2009-05-01

Mildly low haemoglobin concentration is associated with increased mortality in older adults. However, this relationship has not been well characterized in racial/ethnic minorities. Therefore, this study determined the haemoglobin threshold below which risk of death is significantly increased in older non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Data on 4089 participants of the 1988-94 US National Health and Nutrition Examination Survey who were > or =65 years of age were analyzed with mortality follow-up through December 31, 2000. Mean haemoglobin in non-Hispanic whites (n = 2686) and Mexican Americans (n = 663) was 140 g/l, while in non-Hispanic blacks (n = 740) the mean was 10 g/l lower. A total of 1944 (47.5%) participants died. Among non-Hispanic whites and Mexican Americans, age- and sex-adjusted models showed that the haemoglobin thresholds below which mortality risk was significantly increased were 4 and 2 g/l respectively, above the World Health Organization (WHO) cut-off points for anaemia. In contrast, the threshold for non-Hispanic blacks was 7 g/l below the WHO criteria. Similar threshold effects were observed when analyzing haemoglobin in categories and adjusting for multiple confounders. In conclusion, the haemoglobin threshold below which mortality rises significantly is a full g/dl lower in non-Hispanic blacks than in non-Hispanic whites and Mexican Americans.

Preterm Birth and Prenatal Maternal Occupation: The Role of Hispanic Ethnicity and Nativity in a Population-Based Sample in Los Angeles, California

PubMed Central

Wilhelm, Michelle; Wang, Anthony; Ritz, Beate

2014-01-01

Objectives. We investigated preterm birth (PTB) in relation to maternal occupational exposure and whether effect measures were modified by Hispanic ethnicity and nativity in a population-based sample with high proportion of Hispanics. Methods. We used a case-control study (n = 2543) nested within a cohort of 58 316 births in Los Angeles County, California, in 2003. We categorized prenatal occupations using the US Census Occupation Codes and Classification System and developed a job exposure matrix. Odds ratios for PTB were estimated using logistic regression. Results. Odds ratios for PTB were increased for all women in health care practitioner and technical occupations, but the 95% confidence intervals included the null value; effects were more pronounced among Hispanics. We estimated elevated odds ratios for foreign-born Hispanic women in building and grounds cleaning and maintenance occupations. Shift work and physically demanding work affected births among US-born but not foreign-born Hispanics. Conclusions. Hispanic women are at particular risk for PTB related to adverse prenatal occupational exposure. Nativity may moderate these effects on PTB. Maternal occupational exposures likely contribute to ethnic disparities in PTB. PMID:24354840

Perceived Discrimination and Nocturnal Blood Pressure Dipping Among Hispanics: The Influence of Social Support and Race.

PubMed

Rodriguez, Carlos Jose; Gwathmey, TanYa M; Jin, Zhezhen; Schwartz, Joseph; Beech, Bettina M; Sacco, Ralph L; Di Tullio, Marco R; Homma, Shunichi

2016-09-01

Little is known about the relationship of perceived racism to ambulatory blood pressure (ABP) in Hispanics. We explored possible associations between ABP nocturnal dipping and perceived racism in a Hispanic cohort. Participants included 180 community-dwelling Hispanics from the Northern Manhattan Study. Measures included perceived racism, socioeconomic status, social support, and ABP monitoring. Nocturnal ABP nondipping was defined as a less than 10% decline in the average asleep systolic blood pressure relative to the awake systolic blood pressure. Overall, 77.8% of participants reported some form of perceived racism (Perceived Ethnic Discrimination Questionnaire scores >1.0). Greater social support was associated with less perceived discrimination (Spearman r = -0.54, p < .001). Those with higher perceived discrimination scores reported more depressive symptoms (r = 0.25, p < .001). Those with higher Perceived Ethnic Discrimination Questionnaire scores were less likely to show nocturnal ABP nondipping in multivariate models (odds ratio = 0.40, confidence interval = 0.17-0.98, p = .045). Among those with low perceived racism, black Hispanic participants were more likely to have nocturnal ABP nondipping (82.6%) compared with white Hispanics (53.9%; p = .02). Among those with high perceived racism, no associations between race and the prevalence of ABP nondipping was found (black Hispanic = 61.5% versus white Hispanic = 51.4%, p = .39; p interaction = .89). Perceived racism is relatively common among US Hispanics and is associated with ABP. Nondipping of ABP, a potential cardiovascular risk factor, was more common in black Hispanic participants with low perceived racism. This finding may reflect different coping mechanisms between black versus white Hispanics and related blood pressure levels during daytime exposures to discrimination.

Perceived Discrimination and Nocturnal Blood Pressure Dipping Among Hispanics: the Influence of Social Support and Race

PubMed Central

Rodriguez, Carlos J.; Gwathmey, TanYa M.; Jin, Zhezhen; Schwartz, Joseph; Beech, Bettina M.; Sacco, Ralph L.; Di Tullio, Marco R.; Homma, Shunichi

2016-01-01

Objective Little is known about the relationship of perceived racism to ambulatory blood pressure (ABP) in Hispanics. We explored possible associations between ABP nocturnal dipping and perceived racism in a Hispanic cohort. Methods Participants included 180 community-dwelling Hispanics from the Northern Manhattan Study. Measures included perceived racism, socioeconomic status, social support, and ABP monitoring. Nocturnal ABP non-dipping was defined as a less than 10% decline in the average asleep systolic BP (SBP) relative to the awake SBP. Results Overall, 77.8% of participants reported some form of perceived racism [Perceived Ethnic Discrimination Questionnaire (PEDQ) scores >1.0]. Greater social support was associated with less perceived discrimination (Spearman r =−0.54; p<0.001). Those with higher perceived discrimination scores reported more depressive symptoms (r =0.25; p<0.001). Those with higher PEDQ scores were less likely to show nocturnal ABP non-dipping in multivariate models (OR=0.40, CI=0.17–0.98; p=0.045). Among those with low perceived racism, black Hispanic participants were more likely to have nocturnal ABP non-dipping (82.6%) compared to white Hispanics (53.9%; p=0.02). Among those with high perceived racism, no associations between race and the prevalence of ABP non-dipping was found (black Hispanic=61.5% vs. white Hispanic=51.4%, p=0.39; p interaction=0.89). Conclusions Perceived racism is relatively common among US Hispanics and is associated with ABP. Non-dipping of ABP, a potential cardiovascular risk factor, was more common in black-Hispanic participants with low perceived racism. This finding may reflect different coping mechanisms between black versus white Hispanics and related blood pressure levels during daytime exposures to discrimination. PMID:27136505

Hispanic Men in the United States: Acculturation and Recent Sexual Behaviors With Female Partners, 2006-2010.

PubMed

Haderxhanaj, Laura T; Rhodes, Scott D; Romaguera, Raul A; Bloom, Fred R; Leichliter, Jami S

2015-08-01

We examined Hispanic men's recent risky and protective sexual behaviors with female partners by acculturation. Using the 2006-2010 National Survey of Family Growth, we performed bivariate analyses to compare acculturation groups (Hispanic Spanish-speaking immigrants, Hispanic English-speaking immigrants, Hispanic US natives, and non-Hispanic White men) by demographics and recent sexual behaviors with women. Multivariable logistic regression models for sexual behaviors by acculturation group were adjusted for demographics. Compared with Hispanic Spanish-speaking immigrants, non-Hispanic White men were less likely to report exchange of money or drugs for sex (adjusted odds ratio [AOR] = 0.3; 95% confidence interval [CI] = 0.1, 0.9), but were also less likely to report condom use at last vaginal (AOR = 0.6; 95% CI = 0.4, 0.8) and anal sex (AOR = 0.4; 95% CI = 0.3, 0.7). Hispanic US natives were less likely to report condom use at last vaginal sex than were Spanish-speaking immigrants (AOR = 0.6; 95% CI = 0.4, 0.8). English- and Spanish-speaking immigrants did not differ in risky or protective sexual behaviors. Our findings suggest that targeted interventions focusing on unique sexual risks and sociodemographic differences by acculturation level, particularly nativity, may be helpful for preventing sexually transmitted infections.

Hispanic Men in the United States: Acculturation and Recent Sexual Behaviors With Female Partners, 2006–2010

PubMed Central

Rhodes, Scott D.; Romaguera, Raul A.; Bloom, Fred R.; Leichliter, Jami S.

2015-01-01

Objectives. We examined Hispanic men’s recent risky and protective sexual behaviors with female partners by acculturation. Methods. Using the 2006–2010 National Survey of Family Growth, we performed bivariate analyses to compare acculturation groups (Hispanic Spanish-speaking immigrants, Hispanic English-speaking immigrants, Hispanic US natives, and non-Hispanic White men) by demographics and recent sexual behaviors with women. Multivariable logistic regression models for sexual behaviors by acculturation group were adjusted for demographics. Results. Compared with Hispanic Spanish-speaking immigrants, non-Hispanic White men were less likely to report exchange of money or drugs for sex (adjusted odds ratio [AOR] = 0.3; 95% confidence interval [CI] = 0.1, 0.9), but were also less likely to report condom use at last vaginal (AOR = 0.6; 95% CI = 0.4, 0.8) and anal sex (AOR = 0.4; 95% CI = 0.3, 0.7). Hispanic US natives were less likely to report condom use at last vaginal sex than were Spanish-speaking immigrants (AOR = 0.6; 95% CI = 0.4, 0.8). English- and Spanish-speaking immigrants did not differ in risky or protective sexual behaviors. Conclusions. Our findings suggest that targeted interventions focusing on unique sexual risks and sociodemographic differences by acculturation level, particularly nativity, may be helpful for preventing sexually transmitted infections. PMID:26066961

Color Vision Deficiency in Preschool Children

PubMed Central

Xie, John Z.; Tarczy-Hornoch, Kristina; Lin, Jesse; Cotter, Susan A.; Torres, Mina; Varma, Rohit

2016-01-01

Purpose To determine the sex- and ethnicity-specific prevalence of color vision deficiency (CVD) in black, Asian, Hispanic, and non-Hispanic white preschool children. Design Population-based, cross-sectional study. Participants The Multi-Ethnic Pediatric Eye Disease Study is a population-based evaluation of the prevalence of vision disorders in children in Southern California. A total of 5960 subjects 30 to 72 months of age were recruited for the study, of whom 4177 were able to complete color vision testing (1265 black, 812 Asian, 1280 Hispanic, and 820 non-Hispanic white). Methods Color vision testing was performed using Color Vision Testing Made Easy color plates (Home Vision Care, Gulf Breeze, FL), and diagnostic confirmatory testing was performed using the Waggoner HRR Diagnostic Test color plates (Home Vision Care). Main Outcome Measures Testability of color vision in preschool children between 30 and 72 months of age and prevalence of CVD stratified by age, sex, and ethnicity. Results Testability was 17% in children younger than 37 months of age, increasing to 57% in children 37 to 48 months of age, 89% in children 49 to 60 months of age, and 98% in children 61 to 72 months of age. The prevalence of CVD among boys was 1.4% for black, 3.1% for Asian, 2.6% for Hispanic, and 5.6% for non-Hispanic white children; the prevalence in girls was 0.0% to 0.5% for all ethnicities. The ethnic difference in CVD was statistically significant between black and non-Hispanic white children (P = 0.0003) and between Hispanic and non-Hispanic white children (P = 0.02). In boys, most CVD cases were either deutan (51%) or protan (34%); 32% were classified as mild, 15% as moderate, and 41% as severe. Conclusions Testability for CVD in preschool children is high by 4 years of age. The prevalence of CVD in preschool boys varies by ethnicity, with the highest prevalence in non-Hispanic white and lowest in black children. PMID:24702753

Selected cancers with increasing mortality rates by educational attainment in 26 states in the United States, 1993-2007.

PubMed

Jemal, Ahmedin; Simard, Edgar P; Xu, Jiaquan; Ma, Jiemin; Anderson, Robert N

2013-03-01

Mortality rates continue to increase for liver, esophagus, and pancreatic cancers in non-Hispanic whites and for liver cancer in non-Hispanic blacks. However, the extent to which trends vary by socioeconomic status (SES) is unknown. We calculated age-standardized death rates for liver, esophagus, and pancreas cancers for non-Hispanic whites and non-Hispanic blacks aged 25-64 years by sex and level of education (≤12, 13-15, and ≥16 years, as a SES proxy) during 1993-2007 using mortality data from 26 states with consistent education information on death certificates. Temporal trends were evaluated using log-linear regression, and rate ratios (RRs) with 95 % confidence intervals (CIs) compared death rates in persons with ≤12 versus ≥16 years of education. Generally, death rates increased for cancers of the liver, esophagus, and pancreas in non-Hispanic whites and non-Hispanic blacks (liver cancer only) with ≤12 and 13-15 years of education, with steeper increases in the least educated group. In contrast, rates remained stable in persons with ≥16 years of education. During 1993-2007, the RR (rates in ≤12 versus ≥16 years of education) increased for all three cancers, particularly for liver cancer among men which increased from 1.76 (95 % CI, 1.38-2.25) to 3.23 (95 % CI, 2.78-3.75) in non-Hispanic whites and from 1.28 (95 % CI, 0.71-2.30) to 3.64 (95 % CI, 2.44-5.44) in non-Hispanic blacks. The recent increase in mortality rates for liver, esophagus, and pancreatic cancers in non-Hispanic whites and for liver cancer in non-Hispanic blacks reflects increases among those with lower education levels.

Racial/ethnic disparities in the lifetime risk of Chlamydia trachomatis diagnosis and adverse reproductive health outcomes among women in King County, Washington.

PubMed

Chambers, Laura C; Khosropour, Christine M; Katz, David A; Dombrowski, Julia C; Manhart, Lisa E; Golden, Matthew R

2018-02-06

Chlamydia trachomatis is the most common reportable infection in the US and can cause pelvic inflammatory disease (PID) and tubal factor infertility (TFI). We created lifetables to estimate the "lifetime" risk of chlamydia diagnosis among women age 15-34 in King County, Washington, US, 1992-2014. We estimated the lifetime risk of chlamydia-associated PID and TFI, incorporating published estimates of the risk of sequelae by chlamydia testing history. From 1992-2014, 51,464 first chlamydia diagnoses were reported among women age 15-34 in King County. For women born 1980-1984, the lifetime risk of chlamydia diagnosis was 19.8% overall and 14.0% for non-Hispanic white, 64.9% for non-Hispanic black, and 32.6% for Hispanic women. The cumulative risk of chlamydia by age 24 increased overall from 13.9% to 17.3% among birth cohorts born 1975-1994 but declined among non-Hispanic black women, among whom risk by age 24 peaked at 57.3% among women born 1980-1984 and declined to 38.6% among women born 1990-1994. The overall lifetime risk of chlamydia-associated PID among women born 1980-1984 ranged from 0.33-1.14%. Among non-Hispanic white, non-Hispanic black, and Hispanic women, the lifetime risk of chlamydia-associated TFI was 0.04%, 0.20%, and 0.10%, respectively. The lifetime risk of chlamydia varies dramatically by race/ethnicity, with over 60% of non-Hispanic black women diagnosed with at least one infection by age 34 in the birth cohorts most affected, a risk almost five times that in non-Hispanic whites. An estimated one in 500 non-Hispanic black women develops chlamydia-associated TFI. More effective control measures are needed. © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Racial and Ethnic Differences in Total Knee Arthroplasty in the Veterans Affairs Health Care System, 2001-2013.

PubMed

Hausmann, Leslie R M; Brandt, Cynthia A; Carroll, Constance M; Fenton, Brenda T; Ibrahim, Said A; Becker, William C; Burgess, Diana J; Wandner, Laura D; Bair, Matthew J; Goulet, Joseph L

2017-08-01

To examine black-white and Hispanic-white differences in total knee arthroplasty from 2001 to 2013 in a large cohort of patients diagnosed with osteoarthritis (OA) in the Veterans Affairs (VA) health care system. Data were from the VA Musculoskeletal Disorders cohort, which includes data from electronic health records of more than 5.4 million veterans with musculoskeletal disorders diagnoses. We included white (non-Hispanic), black (non-Hispanic), and Hispanic (any race) veterans, age ≥50 years, with an OA diagnosis from 2001-2011 (n = 539,841). Veterans were followed from their first OA diagnosis until September 30, 2013. As a proxy for increased clinical severity, analyses were also conducted for a subsample restricted to those who saw an orthopedic or rheumatology specialist (n = 148,844). We used Cox proportional hazards regression to examine racial and ethnic differences in total knee arthroplasty by year of OA diagnosis, adjusting for age, sex, body mass index, physical and mental diagnoses, and pain intensity scores. We identified 12,087 total knee arthroplasty procedures in a sample of 473,170 white, 50,172 black, and 16,499 Hispanic veterans. In adjusted models examining black-white and Hispanic-white differences by year of OA diagnosis, total knee arthroplasty rates were lower for black than for white veterans diagnosed in all but 2 years. There were no Hispanic-white differences regardless of when diagnosis occurred. These patterns held in the specialty clinic subsample. Black-white differences in total knee arthroplasty appear to be persistent in the VA, even after controlling for potential clinical confounders. © 2016, American College of Rheumatology.

Racial-Ethnic Disparities in Maternal Parenting Stress: The Role of Structural Disadvantages and Parenting Values

PubMed Central

Nomaguchi, Kei; House, Amanda N.

2013-01-01

Although researchers contend that racial-ethnic minorities experience more stress than whites, knowledge of racial-ethnic disparities in parenting stress is limited. Using a pooled time-series analysis of data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998–99 (n = 11,324), we examine racial-ethnic differences in maternal parenting stress, with a focus on structural and cultural explanations and variations by nativity and child age. In kindergarten, black mothers, albeit U.S.-born only, report more parenting stress than white mothers due to structural disadvantages and authoritarian parenting values. The black-white gap increases from kindergarten to third grade, and in third grade, U.S.-born black mothers’ higher stress than white mothers’ persists after controlling for structural and parenting factors. Hispanic and Asian mothers, albeit foreign-born only, report more stress than white mothers at both ages due to structural disadvantages and authoritarian values. Despite structural disadvantages, American Indian mothers report less stress. PMID:24026535

Racial-ethnic disparities in maternal parenting stress: the role of structural disadvantages and parenting values.

PubMed

Nomaguchi, Kei; House, Amanda N

2013-01-01

Although researchers contend that racial-ethnic minorities experience more stress than whites, knowledge of racial-ethnic disparities in parenting stress is limited. Using a pooled time-series analysis of data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (n = 11,324), we examine racial-ethnic differences in maternal parenting stress, with a focus on structural and cultural explanations and variations by nativity and child age. In kindergarten, black mothers, albeit U.S.-born only, report more parenting stress than white mothers due to structural disadvantages and authoritarian parenting values. The black-white gap increases from kindergarten to third grade, and in third grade, U.S.-born black mothers' higher stress than white mothers' persists after controlling for structural and parenting factors. Hispanic and Asian mothers, albeit foreign-born only, report more stress than white mothers at both ages due to structural disadvantages and authoritarian values. Despite structural disadvantages, American Indian mothers report less stress.

Religious Coping among African Americans, Caribbean Blacks and Non-Hispanic Whites

ERIC Educational Resources Information Center

Chatters, Linda M.; Taylor, Robert Joseph; Jackson, James S.; Lincoln, Karen D.

2008-01-01

This study examined demographic predictors of attitudes regarding religious coping (i.e., prayer during stressful times and look to God for support, strength and guidance) within a national sample of African Americans, Caribbean Blacks, and non-Hispanic Whites (National Survey of American Life). The findings demonstrate significant Black-White…

Experiences of Successful Black Males at a Hispanic Serving Community College

ERIC Educational Resources Information Center

Knox, Jonelle B. A.

2017-01-01

The purpose of this qualitative collective case study was to understand experiences of Black males who successfully graduated from a northeast Hispanic serving community college. The overarching question that guided this study was: How do the experiences of Black male students who participated in a male initiative program at Pinewood Community…

Knowledge and Attitudes About Tuberculosis Among U.S.-Born Blacks and Whites with Tuberculosis.

PubMed

Howley, Meredith M; Rouse, Chaturia D; Katz, Dolores J; Colson, Paul W; Hirsch-Moverman, Yael; Royce, Rachel A

2015-10-01

Non-Hispanic blacks represent 13% of the U.S.-born population but account for 37% of tuberculosis (TB) cases reported in U.S.-born persons. Few studies have explored whether this disparity is associated with differences in TB-related knowledge and attitudes. Interviews were conducted with U.S.-born, non-Hispanic blacks and whites diagnosed with TB from August 2009 to December 2010 in cities and states that accounted for 27% of all TB cases diagnosed in these racial groups in the U.S. during that time period. Of 477 participants, 368 (77%) were non-Hispanic black and 109 (23%) were non-Hispanic white. Blacks had significantly less knowledge and more misconceptions about TB transmission and latent TB infection than whites. Most TB patients in both groups recalled being given TB information; having received such information was strongly correlated with TB knowledge. Providing information to U.S.-born TB patients significantly increased their knowledge and understanding of TB. More focused efforts are needed to provide TB information to U.S.-born black TB patients.

Belief in AIDS Origin Conspiracy Theory and Willingness to Participate in Biomedical Research Studies: Findings in Whites, Blacks, and Hispanics in Seven Cities Across Two Surveys

PubMed Central

Russell, Stefanie L.; Katz, Ralph V.; Wang, Min Qi; Lee, Ryan; Green, B. Lee; Kressin, Nancy R.; Claudio, Cristina

2013-01-01

Purpose The purpose of this study was to determine whether a belief in the AIDS origin conspiracy theory is related to likelihood or fear of participation in research studies. Methods The Tuskegee Legacy Project Questionnaire was administered via random-digit-dialed telephone interview to black, white, and Hispanic participants in 4 cities in 1999 and 2000 (n = 1,133) and in 3 cities in 2003 (n = 1,162). Results In 1999, 27.8% of blacks, 23.6% of Hispanics, and 8% of whites (P ≤ .001) reported that it was “very or somewhat likely” that AIDS is “the result of a government plan to intentionally kill a certain group of people by genocide.” In 2003, 34.1% of blacks, 21.9% of Hispanics, and 8.4% of whites (P ≤ .001) reported the same. Conclusions Whereas blacks and Hispanics were more than 3 times more likely than whites to believe in this AIDS origin conspiracy theory, holding this belief was not associated with a decreased likelihood of participation in, or increased fear of participation in, biomedical research. PMID:21388939

Cannabis use disorders are comparatively prevalent among nonwhite racial/ethnic groups and adolescents: a national study.

PubMed

Wu, Li-Tzy; Brady, Kathleen T; Mannelli, Paolo; Killeen, Therese K

2014-03-01

The racial/ethnic composition of the US population is shifting, with the nonwhite population growing faster than whites. We examined cannabis use disorder (CUD) prevalences and correlates in seven racial/ethnic groups. We included cannabis use (CU) prevalence as a comparison. Data were from the 2005-2011 National Surveys on Drug Use and Health (N = 394,400). Substance use among respondents aged ≥12 years was assessed by computer-assisted, self-interviewing methods. The following were included as control variables: age, sex, family income, government assistance, county type, residential stability, major depressive episode history, arrest history, nicotine dependence, alcohol disorder, and survey year. Past-year CU prevalence increased significantly from 10.45% in 2005 to 11.41-11.54% during 2009-2011. Compared with whites, mixed-race individuals had higher odds of CU; Asian Americans and Hispanics had lower odds of CU. There were no significant yearly changes in CUD prevalence in the sample during 2005-2011 (1.58-1.73%). Compared with whites, individuals who were mixed-race, black, and Native American had higher odds of CUD; Asian Americans had lower odds. In aggregate, 15.35% of past-year cannabis users met criteria for a CUD in the 12-month period. Past-year cannabis users who were black, Native American, Hispanic, or Asian American had higher odds of CUD than white users. In each racial/ethnic group, adolescent cannabis users generally showed greater odds of CUD than adult users. Behavioral health indicators (major depressive episode, arrest history, nicotine dependence, alcohol disorder) were associated with CU and CUD. In conclusion, CUD disproportionally affects nonwhite groups and youth. Copyright © 2013 Elsevier Ltd. All rights reserved.

Moral objections to suicide and suicidal ideation among mood disordered Whites, Blacks, and Hispanics.

PubMed

Richardson-Vejlgaard, Randall; Sher, Leo; Oquendo, Maria A; Lizardi, Dana; Stanley, Barbara

2009-01-01

Understanding the beliefs that protect individuals against suicide can help to enhance suicide prevention strategies. One measure of suicide non-acceptability is the moral objections to suicide (MOS) sub-scale of the reasons for living inventory (RFLI). This study examined the MOS and suicidal ideation of White, Black, and Hispanic individuals with mood disorders. We expected minority individuals to have stronger objections to suicide. Eight hundred and four, White (588), Black (122) and Hispanic (94) participants with DSM-IV diagnoses of MDD or bipolar disorder were administered the scale for suicide ideation, the reasons for living inventory and several measures of clinical distress. Higher suicidal ideation was modestly correlated with lower MOS scores overall (r=0.15, p=0.001). Among Blacks however the relationship was inverted: despite having higher suicidal ideation than Whites or Hispanics, Blacks reported the least accepting attitudes toward suicide. These results suggest that attitudes regarding the acceptability of suicide may be independent of suicidal ideation.

Measuring racial/ethnic disparities across the distribution of health care expenditures.

PubMed

Cook, Benjamin Lê; Manning, Willard G

2009-10-01

To assess whether black-white and Hispanic-white disparities increase or abate in the upper quantiles of total health care expenditure, conditional on covariates. Nationally representative adult population of non-Hispanic whites, African Americans, and Hispanics from the 2001-2005 Medical Expenditure Panel Surveys. We examine unadjusted racial/ethnic differences across the distribution of expenditures. We apply quantile regression to measure disparities at the median, 75th, 90th, and 95th quantiles, testing for differences over the distribution of health care expenditures and across income and education categories. We test the sensitivity of the results to comparisons based only on health status and estimate a two-part model to ensure that results are not driven by an extremely skewed distribution of expenditures with a large zero mass. Black-white and Hispanic-white disparities diminish in the upper quantiles of expenditure, but expenditures for blacks and Hispanics remain significantly lower than for whites throughout the distribution. For most education and income categories, disparities exist at the median and decline, but remain significant even with increased education and income. Blacks and Hispanics receive significantly disparate care at high expenditure levels, suggesting prioritization of improved access to quality care among minorities with critical health issues.

Racial Variation in the Use of Life-Sustaining Treatments among Patients Who Die After Major Elective Surgery

PubMed Central

Hernandez, Roland A.; Hevelone, Nathanael D.; Lopez, Lenny; Finlayson, Samuel R.G.; Chittenden, Eva; Cooper, Zara

2015-01-01

Background Although various studies have documented increased Life-Sustaining Treatments (LST) among racial minorities in medical patients, whether similar disparities exist in surgical patients is unknown. Methods Retrospective cohort study using the Nationwide Inpatient Sample (2006–2011) examining patients >39 years who died following elective colectomy. Primary predictor variable was race and main outcome was use of LST. Results In univariate analysis, significant differences existed in use of CPR (Black-35.9%, Hispanic-29.0%, Other-24.5%, White-11.7%, p = 0.002) and re-intubation (Hispanic-75.0%, Other-69.0%, Black-52.3%, White-45.2%, p = 0.01). In multivariate analysis, Black (OR3.67, p=0.01) and Hispanic (4.21, p=0.03) patients were more likely to have undergone CPR, and Hispanic patients (4.24, p=0.01) were more likely to have been re-intubated (reference: White). Conclusions Blacks and Hispanics had increased odds of experiencing CPR, and Hispanics were more likely to have been re-intubated before death following a major elective operation. These variations may imply worse quality of death and increased associated costs. PMID:25465749

Cystic fibrosis newborn screening programs: implications of the CFTR variant spectrum in nonwhite patients.

PubMed

Pique, Lynn; Graham, Steve; Pearl, Michelle; Kharrazi, Martin; Schrijver, Iris

2017-01-01

Cystic fibrosis newborn screening (CFNBS) has been offered across the United States since 2010. However, as compared with white patients with CF, CFTR variant identification in nonwhite populations remains inequitable. Utilizing the recent characterization of the nonwhite CF variant spectrum, we examined the effectiveness of current CFNBS molecular panels in identifying affected nonwhite newborns. Based on a cross-sectional evaluation of genotyping data from the CF Foundation Patient Registry that compared 3,496 nonwhite with 22,206 white CF patients, the current CFNBS algorithms used in the 50 states and the District of Columbia were analyzed. We assessed the percentage of CF patients of Hispanic, African, Asian, and Native American heritage who would not be identified by the molecular panels most commonly used. Compared with whites, variant detection was significantly lower in Hispanic, black, and Asian newborns (P ≤ 0.0001 each), as well as in Native American newborns (P values ranged from 0.001 to 0.0003), for the most common CFNBS panels. This study provides a perspective on the applicability of current panels to a diverse population and enables CFNBS programs to consider more inclusive test approaches to facilitate diagnosis, timely clinical intervention, and enhanced prognosis for CF patients of nonwhite and mixed ethnicities.Genet Med 19 1, 36-44.

Racial differences in natriuretic peptide levels: the Dallas Heart Study

PubMed Central

Gupta, Deepak K.; de Lemos, James A.; Ayers, Colby R.; Berry, Jarett D.; Wang, Thomas J.

2015-01-01

Background Natriuretic peptides (NP) are hormones with natriuretic, diuretic, and vasodilatory effects. Experimental NP deficiency promotes salt-sensitive hypertension and cardiac hypertrophy, conditions that are more common among black individuals. We hypothesized that black individuals have lower N-terminal pro B-type natriuretic peptide (Nt-proBNP) levels than white and Hispanic individuals. Objectives To assess whether Nt-proBNP levels differ according to race/ethnicity. Methods We examined plasma Nt-proBNP levels according to race/ethnicity in 3,148 individuals (51% black, 31% white, 18% Hispanic) free of prevalent cardiovascular disease in the Dallas Heart Study. Nt-proBNP values in the bottom sex-specific quartile were defined as low. Multivariable linear and logistic regression analyses were performed adjusting for clinical covariates and MRI measurements of cardiac structure and function. Results Hypertension was present in 41%, 25%, and 16% of black, white, and Hispanic individuals, respectively. Unadjusted Nt-proBNP levels were lowest in blacks (median 24 pg/ml; IQR 10, 52) as compared with Hispanic (30 pg/ml; IQR 14, 59) and white individuals (32 pg/ml; IQR 16, 62), P < 0.0001. In multivariable-adjusted models, black individuals still had significantly lower Nt-proBNP levels (-39% [95%CI -46%, -31%]; P < 0.0001) and greater odds of having low Nt-proBNP (OR: 2.46, [95% CI 1.86, 3.26]), compared with whites. In contrast, Nt-proBNP levels did not significantly differ between Hispanic and white individuals (P = 0.28). The finding of lower Nt-proBNP levels in blacks was similar when analyses were restricted to healthy participants without cardiovascular risk factors. Conclusions In this multi-ethnic cohort, Nt-proBNP levels differ substantially according to race/ethnicity. Despite a higher prevalence of hypertension, blacks had significantly lower NP levels than white and Hispanic individuals. A relative NP “deficiency” among black individuals may lead to greater susceptibility to salt retention and hypertension. PMID:26071618

The Association of Age, Insomnia, and Self-Efficacy with Continuous Positive Airway Pressure Adherence in Black, White, and Hispanic US Veterans

PubMed Central

Wallace, Douglas M.; Shafazand, Shirin; Aloia, Mark S.; Wohlgemuth, William K.

2013-01-01

Study Objectives: Studies of continuous positive airway pressure (CPAP) adherence in multi-ethnic samples are lacking. This study explores previously described factors associated with therapeutic CPAP use in South Florida veterans with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: We performed a retrospective, cross-sectional analysis of CPAP adherence comparing white, black, and Hispanic veterans returning to the Miami VA sleep clinic over a 4-month period. Participants had CPAP use download and completed questionnaires on demographics, sleepiness, insomnia, and social cognitive measures related to adherence. Linear regression modeling was used to explore the impact of measured variables and potential interactions with race-ethnicity on mean daily CPAP use. Results: Participants (N = 248) were 94% male with mean age of 59 ± 11 years and included 95 blacks (38%), 91 whites (37%), and 62 Hispanic (25%) veterans. Blacks had less mean daily CPAP use than whites (-1.6 h, p < 0.001) and Hispanics (-1.3 h, p < 0.01). Blacks reported worse sleep onset insomnia symptoms compared to whites. In the final multivariable regression model, black race-ethnicity (p < 0.01), insomnia symptoms (p < 0.001), and self-efficacy (p < 0.001) were significantly associated with mean daily CPAP use. In addition, the black race by age interaction term showed a trend towards significance (p = 0.10). Conclusions: In agreement with recent studies, we found that mean daily CPAP use in blacks was 1 hour less than whites after adjusting for covariates. No CPAP adherence differences were noted between whites and Hispanics. Further investigations exploring sociocultural barriers to regular CPAP use in minority individuals with OSAHS are needed. Citation: Wallace DM; Shafazand S; Aloia MS; Wohlgemuth WK. The association of age, insomnia, and self-efficacy with continuous positive airway pressure adherence in black, white, and Hispanic US veterans. J Clin Sleep Med 2013;9(9):885-895. PMID:23997701

Drinking, Alcohol Use Disorder, and Treatment Access and Utilization Among U.S. Racial/Ethnic Groups.

PubMed

Vaeth, Patrice A C; Wang-Schweig, Meme; Caetano, Raul

2017-01-01

Data from approximately 140 articles and reports published since 2000 on drinking, alcohol use disorder (AUD), correlates of drinking and AUD, and treatment needs, access, and utilization were critically examined and summarized. Epidemiological evidence demonstrates alcohol-related disparities across U.S. racial/ethnic groups. American Indians/Alaska Natives generally drink more and are disproportionately affected by alcohol problems, having some of the highest rates for AUD. In contrast, Asian Americans are less affected. Differences across Whites, Blacks, and Hispanics are more nuanced. The diversity in drinking and problem rates that is observed across groups also exists within groups, particularly among Hispanics, Asian Americans, and American Indians/Alaska Natives. Research findings also suggest that acculturation to the United States and nativity affect drinking. Recent studies on ethnic drinking cultures uncover the possible influence that native countries' cultural norms around consumption still have on immigrants' alcohol use. The reasons for racial/ethnic disparities in drinking and AUD are complex and are associated with historically rooted patterns of racial discrimination and persistent socioeconomic disadvantage. This disadvantage is present at both individual and environmental levels. Finally, these data indicate that admission to alcohol treatment is also complex and is dependent on the presence and severity of alcohol problems but also on a variety of other factors. These include individuals' sociodemographic characteristics, the availability of appropriate services, factors that may trigger coercion into treatment by family, friends, employers, and the legal system, and the overall organization of the treatment system. More research is needed to understand facilitators and barriers to treatment to improve access to services and support. Additional directions for future research are discussed. Copyright © 2016 by the Research Society on Alcoholism.

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.

Racial residential segregation and risky sexual behavior among non-Hispanic blacks, 2006-2010.

PubMed

Lutfi, Khaleeq; Trepka, Mary Jo; Fennie, Kristopher P; Ibanez, Gladys; Gladwin, Hugh

2015-09-01

Sexually transmitted infections (STIs) including human immunodeficiency virus (HIV) have disproportionately affected the non-Hispanic black population in the United States. A person's community can affect his or her STI risk by the community's underlying prevalence of STIs, sexual networks, and social influences on individual behaviors. Racial residential segregation-the separation of racial groups in a residential context across physical environments-is a community factor that has been associated with negative health outcomes. The objective of this study was to examine if non-Hispanic blacks living in highly segregated areas were more likely to have risky sexual behavior. Demographic and sexual risk behavior data from non-Hispanic blacks aged 15-44 years participating in the National Survey of Family Growth were linked to Core-Based Statistical Area segregation data from the U.S. Census Bureau. Five dimensions measured racial residential segregation, each covering a different concept of spatial variation. Multilevel logistic regressions were performed to test the effect of each dimension on sexual risk behavior controlling for demographics and community poverty. Of the 3643 participants, 588 (14.5%) reported risky sexual behavior as defined as two or more partners in the last 12 months and no consistent condom use. Multilevel analysis results show that racial residential segregation was associated with risky sexual behavior with the association being stronger for the centralization [aOR (95% CI)][2.07 (2.05-2.08)] and concentration [2.05 (2.03-2.07)] dimensions. This suggests risky sexual behavior is more strongly associated with neighborhoods with high concentrations of non-Hispanic blacks and an accumulation of non-Hispanic blacks in an urban core. Findings suggest racial residential segregation is associated with risky sexual behavior in non-Hispanic blacks 15-44 years of age with magnitudes varying by dimension. Incorporating additional contextual factors may lead to the development of interventions that promote healthier behaviors and lower rates of HIV and other STIs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sexual health among U.S. black and Hispanic men and women: a nationally representative study.

PubMed

Dodge, Brian; Reece, Michael; Herbenick, Debby; Schick, Vanessa; Sanders, Stephanie A; Fortenberry, J Dennis

2010-10-01

Little is known about the prevalence of sexual behaviors among the black and Hispanic populations in the United States outside the context of sexual risk and disease transmission in "high-risk" samples. This study sought to establish current rates of sexual behaviors, sexual health care practices (i.e., experiences with testing and diagnosis of sexually transmitted infections [STIs]), and condom use in a probability sample of black and Hispanic adult men and women in the United States. Sexual behaviors including solo masturbation, partnered masturbation, receiving oral sex and giving oral sex, vaginal intercourse, and anal intercourse were assessed. Self-reported rates of HIV and other STI testing, and self-reported history of STI diagnosis were examined. Also assessed were rates of condom use during most recent and past 10 vaginal intercourse events. Data from a probability sample of 1246 black and Hispanic adults were analyzed to explore sexual behaviors, condom use, and STI testing and diagnosis trends. Masturbation, oral sex, and vaginal intercourse were prevalent among black and Hispanic men and women throughout the life course. Anal intercourse and same-gender sexual activities were less common. Self-reported rates of HIV testing were relatively high but varied by gender across age groups. Similarly, rates of testing for other STI were high and differed by gender across age groups. Overall rates of condom use among black and Hispanic men and women were relatively high and did not appear to be related to a variety of situational factors including location of sexual encounter, relationship status, other contraceptive use, and substance use during sexual activity. These data provide a foundation for understanding diverse sexual behaviors, sexual health-care practices, and condom use among the general population of black and Hispanic men and women in the United States. © 2010 International Society for Sexual Medicine.

Racial/ethnic disparities in emergency department waiting time for stroke patients in the United States.

PubMed

Karve, Sudeep J; Balkrishnan, Rajesh; Mohammad, Yousef M; Levine, Deborah A

2011-01-01

Emergency department waiting time (EDWT), the time from arrival at the ED to evaluation by an emergency physician, is a critical component of acute stroke care. We assessed racial/ethnic differences in EDWT in a national sample of patients with ischemic or hemorrhagic stroke. We identified 543 ED visits for ischemic stroke (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 433.x1, 434.xx, and 436.xx) and hemorrhagic stroke (ICD-9-CM codes 430.xx, 431.xx, and 432.xx) in persons age ≥ 18 years representing 2.1 million stroke-related ED visits in the United States using the National Hospital Ambulatory Medical Care Survey for years 1997-2000 and 2003-2005. Using linear regression (outcome, log-transformed EDWT) and logistic regression (outcome, EDWT > 10 minutes, based on National Institute of Neurological Disorders and Stroke guidelines), we adjusted associations between EDWT and race/ethnicity (non-Hispanic whites [designated whites herein], non-Hispanic blacks [blacks], and Hispanics) for age, sex, region, mode of transportation, insurance, hospital characteristics, triage status, hospital admission, stroke type, and survey year. Compared with whites, blacks had a longer EDWT in univariate analysis (67% longer, P = .03) and multivariate analysis (62% longer, P = .03), but Hispanics had a similar EDWT in both univariate analysis (31% longer, P = .65) and multivariate analysis (5% longer, P = .91). Longer EDWT was also seen with nonambulance mode of arrival, urban hospitals, or nonemergency triage. Race was significantly associated with EDWT > 10 minutes (whites, 55% [referent]; blacks, 70% [P = .03]; Hispanics, 62% [P = .53]). These differences persisted after adjustment (blacks: odds ratio [OR] = 2.08, 95% confidence interval [CI] = 1.05-4.09; Hispanics: OR = 1.07, 95% CI = 0.52-2.22). Blacks, but not Hispanics, had significantly longer EDWT than whites. The longer EDWT in black stroke patients may lead to treatment delays and sub-optimal stroke care. Published by Elsevier Inc.

Continued Declines in Teen Births in the United States, 2015.

PubMed

Hamilton, Brady E; Mathews, T J

2016-09-01

•The teen birth rate declined to another historic low for the United States in 2015, down 8% from 2014 to 22.3 births per 1,000 females aged 15-19. •The birth rates for teenagers aged 15-17 and 18-19 declined in 2015 to 9.9 and 40.7, respectively, which are record lows for both groups. •In 2015, birth rates declined to 6.9 for Asian or Pacific Islander, 16.0 for non-Hispanic white, 25.7 for American Indian or Alaska Native, 31.8 for non-Hispanic black, and 34.9 for Hispanic female teenagers aged 15-19. •Birth rates fell to record lows for nearly all race and Hispanic-origin groups of females aged 15-19, 15-17, and 18-19 in 2015. The birth rate for teenagers aged 15-19 has fallen almost continuously since 1991, reaching historic lows for the nation every year since 2009 (1-4). Despite declines in all racial and ethnic groups, teen birth rates continue to vary considerably by race and ethnicity. Moreover, the U.S. teen birth rate remains higher than in other industrialized countries (5). Childbearing by teenagers continues to be a matter of public concern. This report presents the recent and long-term trends and disparity in teen childbearing by race and Hispanic origin. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Population frequencies of the Triallelic 5HTTLPR in six Ethnicially diverse samples from North America, Southeast Asia, and Africa.

PubMed

Haberstick, Brett C; Smolen, Andrew; Williams, Redford B; Bishop, George D; Foshee, Vangie A; Thornberry, Terence P; Conger, Rand; Siegler, Ilene C; Zhang, Xiaodong; Boardman, Jason D; Frajzyngier, Zygmunt; Stallings, Michael C; Brent Donnellan, M; Halpern, Carolyn T; Harris, Kathleen Mullan

2015-03-01

Genetic differences between populations are potentially an important contributor to health disparities around the globe. As differences in gene frequencies influence study design, it is important to have a thorough understanding of the natural variation of the genetic variant(s) of interest. Along these lines, we characterized the variation of the 5HTTLPR and rs25531 polymorphisms in six samples from North America, Southeast Asia, and Africa (Cameroon) that differ in their racial and ethnic composition. Allele and genotype frequencies were determined for 24,066 participants. Results indicated higher frequencies of the rs25531 G-allele among Black and African populations as compared with White, Hispanic and Asian populations. Further, we observed a greater number of 'extra-long' ('XL') 5HTTLPR alleles than have previously been reported. Extra-long alleles occurred almost entirely among Asian, Black and Non-White Hispanic populations as compared with White and Native American populations where they were completely absent. Lastly, when considered jointly, we observed between sample differences in the genotype frequencies within racial and ethnic populations. Taken together, these data underscore the importance of characterizing the L-G allele to avoid misclassification of participants by genotype and for further studies of the impact XL alleles may have on the transcriptional efficiency of SLC6A4.

Racial/Ethnic Variations in Colorectal Cancer Screening Self-Efficacy, Fatalism and Risk Perception in a Safety-Net Clinic Population: Implications for Tailored Interventions.

PubMed

Lumpkins, Cy; Cupertino, P; Young, K; Daley, C; Yeh, Hw; Greiner, Ka

2013-01-25

Ethnic and racial minority groups in the U.S. receive fewer colorectal cancer (CRC) screening tests and are less likely to be up-to-date with CRC screening than the population as a whole. Access, limited awareness of CRC and barriers may, in part, be responsible for inhibiting widespread adoption of CRC screening among racial and ethnic minority groups. The purpose of this study was to examine the role of self-efficacy, fatalism and CRC risk perception across racial and ethnic groups in a diverse sample. This study was a cross-sectional analysis from baseline measures gathered on a group of patients recruited into a trial to track colorectal cancer screening in underserved adults over 50. Out of 470 Participants, 42% were non-Hispanic; 27% Hispanic and 28% non-Hispanic White. Hispanic and non-Hispanic Blacks were more likely to have fatalistic beliefs about CRC than non-Hispanic Whites. Non-Hispanic Blacks perceived higher risk of getting colon cancer. Self-efficacy for completing CRC screening was higher among Non-Hispanic Blacks than among Hispanics. Racial and ethnic differences in risk perceptions, fatalism and self-efficacy should be taken into consideration in future CRC interventions with marginalized and uninsured populations.

Hemoglobin Concentration and the Risk of Death in Older Adults: Differences by Race/Ethnicity in the NHANES III Follow-up

PubMed Central

Patel, Kushang V.; Longo, Dan L.; Ershler, William B.; Yu, Binbing; Semba, Richard D.; Ferrucci, Luigi; Guralnik, Jack M.

2009-01-01

Summary Mildly low hemoglobin concentration is associated with increased mortality in older adults. However, this relationship has not been well characterized in racial/ethnic minorities. Therefore, this study determined the hemoglobin threshold below which risk of death is significantly increased in older non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Data on 4,089 participants of the 1988-1994 US National Health and Nutrition Examination Survey who were ≥65 years of age were analyzed with mortality follow-up through December 31, 2000. Mean hemoglobin in non-Hispanic whites (n=2,686) and Mexican Americans (n=663) was 140 g/L, while in non-Hispanic blacks (n=740) the mean was 10 g/L lower. A total of 1,944 (47.5%) participants died. Among non-Hispanic whites and Mexican Americans, age- and sex-adjusted models showed that the hemoglobin thresholds below which mortality risk was significantly increased were 4 g/L and 2 g/L, respectively, above the World Health Organization (WHO) cutoffs for anaemia. In contrast, the threshold for non-Hispanic blacks was 7 g/L below the WHO criteria. Similar threshold effects were observed when analyzing hemoglobin in categories and adjusting for multiple confounders. In conclusion, the hemoglobin threshold below which mortality rises significantly is a full g/dL lower in non-Hispanic blacks than in non-Hispanic whites and Mexican Americans. PMID:19344387

Improved Survival in Pediatric Heart Transplant Recipients: Have White, Black and Hispanic Children Benefited Equally?

PubMed Central

Singh, T. P.; Almond, C. S.; Gauvreau, K.

2014-01-01

We assessed whether the improvement in post-transplant survival in pediatric heart transplant (HT) recipients during the last 2 decades has benefited the major racial groups in the US equally. We analyzed all children <18 years of age who underwent their first HT in the US during 1987–2008. We compared trends in graft loss (death or re-transplant) in white, black and Hispanic children in 5 successive cohorts (1987–1992, 1993–1996, 1997–2000, 2001–2004, 2005–2008). The primary endpoint was early graft loss within 6 months post-transplant. Longer-term survival was assessed in recipients who survived the first 6 months. The improvement in early post-transplant survival was similar (hazard ratio [HR] for successive eras 0.80, 95% confidence interval [CI] 0.7, 0.9, P=0.24 for black-era interaction, P=0.22 for Hispanic-era interaction) in adjusted analysis. Longer-term survival was worse in black children (HR 2.2, CI 1.9, 2.5) and did not improve in any group with time (HR 1.0 for successive eras, CI 0.9, 1.1, P=0.57; P=0.19 for black-era interaction, P=0.21 for Hispanic-era interaction). Thus, the improvement in early post-HT survival during the last 2 decades has benefited white, black and Hispanic children equally. Disparities in longer-term survival have not narrowed with time; the survival remains worse in black recipients. PMID:21199352

Pathways to the Future: A Longitudinal Study of Young Americans. Preliminary Report: Youth and the Labor Market--1979.

ERIC Educational Resources Information Center

Borus, Michael E.; And Others

This monograph presents preliminary cross-tabulation analyses of the 1979 National Longitudinal Survey of Youth Labor Market Experience of 12,693 youth of ages 14-21 who will be interviewed annually for at least five years. (Hispanic; non-Hispanic black; and non-Hispanic, non-black, poor youth were oversampled.) Each of the twenty-four topics…

Hispanic Adolescent Fertility.

ERIC Educational Resources Information Center

Darabi, Katherine F.; And Others

1986-01-01

Discusses fertility of Hispanic adolescents in the United States. Summarizes what is known about sexuality, contraception, pregnancy, and childbearing among male and female Hispanics of various countries of origin. Indicates Hispanic adolescent birthrates fall between those of non-Hispanic Whites and Blacks, but there is considerable within-group…

Racial-ethnic disparities in acute blood pressure after intracerebral hemorrhage.

PubMed

Koch, Sebastian; Elkind, Mitchell S V; Testai, Fernando D; Brown, W Mark; Martini, Sharyl; Sheth, Kevin N; Chong, Ji Y; Osborne, Jennifer; Moomaw, Charles J; Langefeld, Carl D; Sacco, Ralph L; Woo, Daniel

2016-08-23

To assess race-ethnic differences in acute blood pressure (BP) following intracerebral hemorrhage (ICH) and the contribution to disparities in ICH outcome. BPs in the field (emergency medical services [EMS]), emergency department (ED), and at 24 hours were compared and adjusted for group differences between non-Hispanic black (black), non-Hispanic white (white), and Hispanic participants in the Ethnic Racial Variations of Intracerebral Hemorrhage case-control study. Outcome was obtained by modified Rankin Scale (mRS) score at 3 months. We analyzed race-ethnic differences in good outcome (mRS ≤ 2) and mortality after adjusting for baseline differences and included BP recordings in this model. Of 2,069 ICH cases enrolled, 30% were white, 37% black, and 33% Hispanic. Black and Hispanic patients had higher EMS and ED systolic and diastolic BPs compared with white patients (p = 0.0001). Although attenuated, at 24 hours after admission, black patients had higher systolic and diastolic BPs. After adjusting for baseline differences, significant race/ethnic differences persisted for EMS systolic, ED systolic and diastolic, and 24-hours diastolic BP. Only ED systolic and diastolic BP was associated with poor functional outcome, and no BP predicted mortality. We found no race-ethnic differences in 3-month functional outcome or mortality after adjusting for group differences, including acute BPs. Although black and Hispanic patients had higher BPs than white patients at presentation, we did not find race-ethnic disparities in 3-month functional outcome or mortality. ED systolic and diastolic BP was associated with poor functional outcome, but not mortality, in this race-ethnically diverse population. © 2016 American Academy of Neurology.

MS Sunshine Study: Sun Exposure But Not Vitamin D Is Associated with Multiple Sclerosis Risk in Blacks and Hispanics.

PubMed

Langer-Gould, Annette; Lucas, Robyn; Xiang, Anny H; Chen, Lie H; Wu, Jun; Gonzalez, Edlin; Haraszti, Samantha; Smith, Jessica B; Quach, Hong; Barcellos, Lisa F

2018-02-27

Multiple sclerosis (MS) incidence and serum 25-hydroxyvitamin D (25OHD) levels vary by race/ethnicity. We examined the consistency of beneficial effects of 25OHD and/or sun exposure for MS risk across multiple racial/ethnic groups. We recruited incident MS cases and controls (blacks 116 cases/131 controls; Hispanics 183/197; whites 247/267) from the membership of Kaiser Permanente Southern California into the MS Sunshine Study to simultaneously examine sun exposure and 25OHD, accounting for genetic ancestry and other factors. Higher lifetime ultraviolet radiation exposure (a rigorous measure of sun exposure) was associated with a lower risk of MS independent of serum 25OHD levels in blacks (adjusted OR = 0.53, 95% CI = 0.31-0.83; p = 0.007) and whites (OR = 0.68, 95% CI = 0.48-0.94; p = 0.020) with a similar magnitude of effect that did not reach statistical significance in Hispanics (OR = 0.66, 95% CI = 0.42-1.04; p = 0.071). Higher serum 25OHD levels were associated with a lower risk of MS only in whites. No association was found in Hispanics or blacks regardless of how 25OHD was modeled. Lifetime sun exposure appears to reduce the risk of MS regardless of race/ethnicity. In contrast, serum 25OHD levels are not associated with MS risk in blacks or Hispanics. Our findings challenge the biological plausibility of vitamin D deficiency as causal for MS and call into question the targeting of specific serum 25OHD levels to achieve health benefits, particularly in blacks and Hispanics.

Perceptions matter: beliefs about influenza vaccine and vaccination behavior among elderly white, black and Hispanic Americans.

PubMed

Wooten, Karen G; Wortley, Pascale M; Singleton, James A; Euler, Gary L

2012-11-06

Knowledge and beliefs about influenza vaccine that differ across racial or ethnic groups may promote racial or ethnic disparities in vaccination. To identify associations between vaccination behavior and personal beliefs about influenza vaccine by race or ethnicity and education levels among the U.S. elderly population. Data from a national telephone survey conducted in 2004 were used for this study. Responses for 3875 adults ≥ 65 years of age were analyzed using logistic regression methods. Racial and ethnic differences in beliefs were observed. For example, whites were more likely to believe influenza vaccine is very effective in preventing influenza compared to blacks and Hispanics (whites, 60%; blacks, 47%, and Hispanics, 51%, p<0.01). Among adults who believed the vaccine is very effective, self-reported vaccination was substantially higher across all racial/ethnic groups (whites, 93%; blacks, 76%; Hispanics, 78%) compared to adults who believed the vaccine was only somewhat effective (whites 67%; blacks 61%, Hispanics 61%). Also, vaccination coverage differed by education level and personal beliefs of whites, blacks, and Hispanics. Knowledge and beliefs about influenza vaccine may be important determinants of influenza vaccination among racial/ethnic groups. Strategies to increase coverage should highlight the burden of influenza disease in racial and ethnic populations, the benefits and safety of vaccinations and personal vulnerability to influenza disease if not vaccinated. For greater effectiveness, factors associated with the education levels of some communities may need to be considered when developing or implementing new strategies that target specific racial or ethnic groups. Published by Elsevier Ltd.

Sun-Earth Scientists and Native Americans Collaborate on Sun-Earth Day

NASA Astrophysics Data System (ADS)

Ng, C. Y.; Lopez, R. E.; Hawkins, I.

2004-12-01

Sun-Earth Connection scientists have established partnerships with several minority professional societies to reach out to the blacks, Hispanics and Native American students. Working with NSBP, SACNAS, AISES and NSHP, SEC scientists were able to speak in their board meetings and national conferences, to network with minority scientists, and to engage them in Sun-Earth Day. Through these opportunities and programs, scientists have introduced NASA research results as well indigenous views of science. They also serve as role models in various communities. Since the theme for Sun-Earth Day 2005 is Ancient Observatories: Timeless Knowledge, scientists and education specialists are hopeful to excite many with diverse backgrounds. Sun-Earth Day is a highly visible annual program since 2001 that touches millions of students and the general public. Interviews, classroom activities and other education resources are available on the web at sunearthday.nasa.gov.

Racial and Ethnic Differences in the Polycystic Ovary Syndrome (PCOS) Metabolic Phenotype

PubMed Central

Engmann, Lawrence; Jin, Susan; Sun, Fangbai; Legro, Richard S; Polotsky, Alex J.; Hansen, Karl R; Coutifaris, Christos; Diamond, Michael P; Eisenberg, Esther; Zhang, Heping; Santoro, Nanette

2017-01-01

Background Women with polycystic ovarian syndrome have a high prevalence of metabolic syndrome and type 2 diabetes mellitus. Blacks and Hispanics have a high morbidity and mortality due to cardiovascular disease and diabetes mellitus in the general population. Since metabolic syndrome is a risk factor for development of type 2 diabetes and cardiovascular disease, understanding any racial and ethnic differences in metabolic syndrome amongst women with polycystic ovarian syndrome is important for prevention strategies. However, data regarding racial/ethnic differences in metabolic phenotype amongst women with polycystic ovary syndrome is inconsistent. Objective To determine if there are racial/ethnic differences in insulin resistance, metabolic syndrome and hyperandrogenemia in women with polycystic ovarian syndrome. Study Design Secondary data analysis of a prospective multicenter, double blind controlled clinical trial, the Pregnancy in Polycystic Ovary Syndrome II study, conducted in 11 academic health centers. Data on 702 women with polycystic ovarian syndrome aged 18-40 years who met modified Rotterdam criteria for the syndrome and wished to conceive were included in the study. Women were grouped into racial/ethnic categories Non-Hispanic Whites, non-Hispanic Blacks and Hispanic. The main outcomes were the prevalence of insulin resistance, metabolic syndrome and hyperandrogenemia in the different racial/ethnic groups. Results BMI (35.1 ± 9.8 vs. 35.7 ± 7.9 vs. 36.4 ± 7.9 kg/m2) and waist circumference (106.5 ± 21.6 vs. 104.9 ± 16.4 vs. 108.7 ± 7.3 cm) did not differ significantly between non-Hispanic White, non-Hispanic Black and Hispanic women. Hispanic women with PCOS had a significantly higher prevalence of hirsutism (93.8 vs. 86.8%), abnormal free androgen index (FAI) (75.8 vs. 56.5%), abnormal homeostasis model assessment (HOMA) (52.3 vs. 38.4%) and hyperglycemia (14.8 vs. 6.5%), as well as lower sex hormone binding globulin compared to non-Hispanic Whites. Non-Hispanic Black women had a significantly lower prevalence of metabolic syndrome (24.5 vs. 42.2%) compared with Hispanic women, and lower serum triglyceride levels compared to both Hispanics and non-Hispanic Whites (85.7 ± 37.3 vs. 130.2 ± 57.0 vs. 120.1 ± 60.5 vs. mg/dL, p<0.01), with a markedly lower prevalence of hypertriglyceridemia (5.1 vs. 28.3 vs. 30.5%, p<0.01) compared to the other two groups. Comment Hispanic women with PCOS have the most severe phenotype, both in terms of hyperandrogenism and metabolic criteria. Non-Hispanic Black women have an overall milder polycystic ovarian syndrome phenotype than Hispanics and in some respects, than Non-Hispanic White women. PMID:28104402

Racial and ethnic differences in the polycystic ovary syndrome metabolic phenotype.

PubMed

Engmann, Lawrence; Jin, Susan; Sun, Fangbai; Legro, Richard S; Polotsky, Alex J; Hansen, Karl R; Coutifaris, Christos; Diamond, Michael P; Eisenberg, Esther; Zhang, Heping; Santoro, Nanette

2017-05-01

Women with polycystic ovarian syndrome have a high prevalence of metabolic syndrome and type 2 diabetes mellitus. Blacks and Hispanics have a high morbidity and mortality due to cardiovascular disease and diabetes mellitus in the general population. Since metabolic syndrome is a risk factor for development of type 2 diabetes and cardiovascular disease, understanding any racial and ethnic differences in metabolic syndrome among women with polycystic ovarian syndrome is important for prevention strategies. However, data regarding racial/ethnic differences in metabolic phenotype among women with polycystic ovary syndrome are inconsistent. We sought to determine if there are racial/ethnic differences in insulin resistance, metabolic syndrome, and hyperandrogenemia in women with polycystic ovarian syndrome. We conducted secondary data analysis of a prospective multicenter, double-blind controlled clinical trial, the Pregnancy in Polycystic Ovary Syndrome II study, conducted in 11 academic health centers. Data on 702 women with polycystic ovarian syndrome aged 18-40 years who met modified Rotterdam criteria for the syndrome and wished to conceive were included in the study. Women were grouped into racial/ethnic categories: non-Hispanic whites, non-Hispanic blacks, and Hispanic. The main outcomes were the prevalence of insulin resistance, metabolic syndrome, and hyperandrogenemia in the different racial/ethnic groups. Body mass index (35.1 ± 9.8 vs 35.7 ± 7.9 vs 36.4 ± 7.9 kg/m 2 ) and waist circumference (106.5 ± 21.6 vs 104.9 ± 16.4 vs 108.7 ± 7.3 cm) did not differ significantly between non-Hispanic white, non-Hispanic black, and Hispanic women. Hispanic women with polycystic ovarian syndrome had a significantly higher prevalence of hirsutism (93.8% vs 86.8%), abnormal free androgen index (75.8% vs 56.5%), abnormal homeostasis model assessment (52.3% vs 38.4%), and hyperglycemia (14.8% vs 6.5%), as well as lower sex hormone binding globulin compared to non-Hispanic whites. Non-Hispanic black women had a significantly lower prevalence of metabolic syndrome (24.5% vs 42.2%) compared with Hispanic women, and lower serum triglyceride levels compared to both Hispanics and non-Hispanic whites (85.7 ± 37.3 vs 130.2 ± 57.0 vs 120.1 ± 60.5 mg/dL, P < .01), with a markedly lower prevalence of hypertriglyceridemia (5.1% vs 28.3% vs 30.5%, P < .01) compared to the other 2 groups. Hispanic women with polycystic ovarian syndrome have the most severe phenotype, both in terms of hyperandrogenism and metabolic criteria. Non-Hispanic black women have an overall milder polycystic ovarian syndrome phenotype than Hispanics and in some respects, than non-Hispanic white women. Copyright © 2017 Elsevier Inc. All rights reserved.

Are Blacks and Hispanics Disproportionately Incarcerated Relative to Their Arrests? Racial and Ethnic Disproportionality Between Arrest and Incarceration

PubMed Central

Steffensmeier, Darrell; Ulmer, Jeffrey T.; Painter-Davis, Noah

2014-01-01

Do large racial and ethnic disparities in prison populations reflect systematic racial and policy discrimination in the criminal justice system, or do they reflect disproportionate involvement of blacks and Hispanics in “serious” or street crime? Our investigation of this question keys off the approach initiated by Alfred Blumstein is his pioneering studies on the topic. While yielding important findings, there are, however, substantial gaps in the empirical literature on the racial disproportionality issue. We attempt to fill those gaps by (1) using both data on prison admission as well as in-stock prison populations, (2) presenting more recent racially and ethnically disaggregated arrest and incarceration data from Pennsylvania for 2003–2007, and (3) including Hispanic offenders in our racial and ethnic disproportionality comparisons. Our results indicate, first, that the representation of blacks, whites, and Hispanics among offenders admitted to state prison and in the prison population corresponds closely to their representation in arrest statistics. Second, using arrests as a marker of violent offending, the overrepresentation of blacks among offenders admitted to state prisons occurs because they commit a disproportionate number of frequently imprisoned (i.e., violent) crimes. Third, for those offenses where there is a within-race difference between arrest and incarceration representation, Hispanics experience the greatest disadvantage. Fourth, failing to account for Hispanics in white and black estimates tends to inflate white proportions and deflate black proportions of arrests, admissions, and prison population estimates, masking the “true” black and white racial disproportionality. We conclude that while there is a need for continued concern with possible racial discrimination in justice system processing, this concern should not distract attention from what arguably is the more important matter—ameliorating the social environmental conditions that foster disproportionate minority (especially black) involvement in violent crime. PMID:25067960

#Me_Who: Anatomy of Scholastic, Leadership, and Social Isolation of Underrepresented Minority Women in Academic Medicine.

PubMed

Albert, Michelle A

2018-05-22

In academic medicine, under-represented minority women physician-scientists (URMWP)* are uncommon, particularly in leadership positions. Data from the American Association of Medical Colleges (AAMC) show that among internal medicine chairs, there are 12 Asian males, 10 African/American (blacks; 9 men), 7 Hispanics (2 females) and 137 whites (21 females). In the top 40 ranked cardiology programs, there are no female cardiology chiefs, whereas there are at least 10, 2, 1 and 24 Asian, black, Hispanic and white males respectively. There are more URMWP than URM males, yet URMWP are less likely to be professors and occupy leadership positions in academia. Specifically, among United States medical school faculty, relative proportions at assistant, associate and full professor levels according to race/ethnicity and gender have remained essentially unchanged over the past 20 years. AAMC information demonstrates that only 11%, 9%, 11% and 24% of Asian, black, Hispanic and white women are full professors compared with 21%, 18%, 19% and 36% of Asian, black, Hispanic and white men. Additionally, while there are representative proportions of women and Asians at the lowest faculty levels, they have not equitably progressed in academic medicine, likely reflecting discrimination and structural/organizational barriers that are also applicable to black and Hispanic females 1 .

Racial and ethnic disparities in universal cervical length screening with transvaginal ultrasound

PubMed Central

Haviland, Miriam J; Shainker, Scott A; Hacker, Michele R; Burris, Heather H

2016-01-01

Objective Determine if race or ethnicity is associated with missed or late transvaginal cervical length screening in a universal screening program. Methods Retrospective cohort study of nulliparous women with singleton gestations and a fetal anatomical ultrasound from 16-24 weeks' gestation from January, 2012 through November, 2013. We classified women into mutually exclusive racial and ethnic groups: non-Hispanic black (black), Hispanic, Asian, non-Hispanic white (white), and other or unknown race. We used log-binomial regression to calculate the risk ratio (RR) and 95% confidence interval (CI) of missed or late (≥ 20 weeks' gestation) screening vs. optimally-timed screening between the different racial and ethnic groups. Results Among the 2 967 women in our study population, 971 (32.7%) had either missed or late cervical length screening. Compared to white women, black (RR: 1.3; 95% CI:1.1-1.5) and Hispanic (RR:1.2; 95% CI:1.01-1.5) women were more likely to have missed or late screening. Among women screened, black (vs. white) women were more likely to be screened late (RR: 2.2; 95% CI: 1.6-3.1). Conclusions Black and Hispanic women may be more likely to have missed or late cervical length screenings. PMID:26987873

Weight Misperceptions and Racial and Ethnic Disparities in Adolescent Female Body Mass Index

PubMed Central

Krauss, Ramona C.; Powell, Lisa M.; Wada, Roy

2012-01-01

This paper investigated weight misperceptions as determinants of racial/ethnic disparities in body mass index (BMI) among adolescent females using data from the National Survey of Youth 1997. Compared to their white counterparts, higher proportions of black and Hispanic adolescent females underperceived their weight status; that is, they misperceived themselves to have lower weight status compared to their clinically defined weight status. Compared to their black counterparts, higher proportions of white and Hispanic adolescent females misperceived themselves to be heavier than their clinical weight status. Oaxaca-Blinder decomposition analysis showed that accounting for weight misperceptions, in addition to individual and contextual factors, increased the total explained portion of the black-white female BMI gap from 44.7% to 54.3% but only slightly increased the total explained portion of the Hispanic-white gap from 62.8% to 63.1%. Weight misperceptions explained 13.0% of the black-white female BMI gap and 3.3% of the Hispanic-white female BMI gap. The regression estimates showed that weight underperceptions were important determinants of adolescent female BMI, particularly among black and Hispanic adolescents. Education regarding identification and interpretation of weight status may play an important role to help reduce the incidence and racial disparity of female adolescent obesity. PMID:22701166

National and State-Specific Attitudes toward Smoke-Free Parks among U.S. Adults

PubMed Central

Kruger, Judy; Jama, Amal; Kegler, Michelle; Marynak, Kristy; King, Brian

2016-01-01

Outdoor places, such as parks, remain a source of secondhand smoke (SHS) exposure. We assessed attitudes toward smoke-free parks among U.S. adults. Data came from the 2009–2010 National Adult Tobacco Survey, a landline and cellular telephone survey of noninstitutionalized adults aged ≥18 in the 50 U.S. states and D.C. Descriptive statistics and logistic regression were used to assess the prevalence and sociodemographic correlates of attitudes toward smoke-free parks, overall and by current tobacco use. Overall, 38.5% of adults reported favorable attitudes toward complete smoke-free parks; prevalence ranged from 29.2% in Kentucky to 48.2% in Maine. Prevalence of favorable attitudes toward smoke-free parks was higher among nonusers of tobacco (44.6%) and noncombustible-only users (30.0%) than any combustible users (21.3%). The adjusted odds of having a favorable attitude were higher among: women; Hispanics and Black non-Hispanics, American Indian and Alaska Native non-Hispanics, and other non-Hispanics; those with an unspecified sexual orientation; and those with children aged ≤17 in the household, relative to each characteristics respective referent group. Odds were lower among: any combustible tobacco and noncombustible-only tobacco users; adults aged 45–64; and those with some college or an undergraduate degree. Opportunities exist to educate the public about the benefits of smoke-free outdoor environments. PMID:27589779

National and State-Specific Attitudes toward Smoke-Free Parks among U.S. Adults.

PubMed

Kruger, Judy; Jama, Amal; Kegler, Michelle; Marynak, Kristy; King, Brian

2016-08-31

Outdoor places, such as parks, remain a source of secondhand smoke (SHS) exposure. We assessed attitudes toward smoke-free parks among U.S. adults. Data came from the 2009-2010 National Adult Tobacco Survey, a landline and cellular telephone survey of noninstitutionalized adults aged ≥18 in the 50 U.S. states and D.C. Descriptive statistics and logistic regression were used to assess the prevalence and sociodemographic correlates of attitudes toward smoke-free parks, overall and by current tobacco use. Overall, 38.5% of adults reported favorable attitudes toward complete smoke-free parks; prevalence ranged from 29.2% in Kentucky to 48.2% in Maine. Prevalence of favorable attitudes toward smoke-free parks was higher among nonusers of tobacco (44.6%) and noncombustible-only users (30.0%) than any combustible users (21.3%). The adjusted odds of having a favorable attitude were higher among: women; Hispanics and Black non-Hispanics, American Indian and Alaska Native non-Hispanics, and other non-Hispanics; those with an unspecified sexual orientation; and those with children aged ≤17 in the household, relative to each characteristics respective referent group. Odds were lower among: any combustible tobacco and noncombustible-only tobacco users; adults aged 45-64; and those with some college or an undergraduate degree. Opportunities exist to educate the public about the benefits of smoke-free outdoor environments.

Is 30-day Posthospitalization Mortality Lower Among Racial/Ethnic Minorities?: A Reexamination.

PubMed

Lin, Meng-Yun; Kressin, Nancy R; Paasche-Orlow, Michael K; Kim, Eun Ji; López, Lenny; Rosen, Jennifer E; Hanchate, Amresh D

2018-06-05

Multiple studies have reported that risk-adjusted rates of 30-day mortality after hospitalization for an acute condition are lower among blacks compared with whites. To examine if previously reported lower mortality for minorities, relative to whites, is accounted for by adjustment for do-not-resuscitate status, potentially unconfirmed admission diagnosis, and differential risk of hospitalization. Using inpatient discharge and vital status data for patients aged 18 and older in California, we examined all admissions from January 1, 2010 to June 30, 2011 for acute myocardial infarction, heart failure, pneumonia, acute stroke, gastrointestinal bleed, and hip fracture and estimated relative risk of mortality for Hispanics, non-Hispanic blacks, non-Hispanic Asians, and non-Hispanic whites. Multiple mortality measures were examined: inpatient, 30-, 90-, and 180 day. Adding census data we estimated population risks of hospitalization and hospitalization with inpatient death. Across all mortality outcomes, blacks had lower mortality rate, relative to whites even after exclusion of patients with do-not-resuscitate status and potentially unconfirmed diagnosis. Compared with whites, the population risk of hospitalization was 80% higher and risk of hospitalization with inpatient mortality was 30% higher among blacks. Among Hispanics and Asians, disparities varied with mortality measure. Lower risk of posthospitalization mortality among blacks, relative to whites, may be associated with higher rate of hospitalizations and differences in unobserved patient acuity. Disparities for Hispanics and Asians, relative to whites, vary with the mortality measure used.

Black, Hispanic, and White Girls' Perceptions of Environmental and Social Support and Enjoyment of Physical Activity

PubMed Central

Grieser, Mira; Neumark-Sztainer, Dianne; Saksvig, Brit I.; Lee, Jung-Sun; Felton, Gwen M.; Kubik, Martha Y.

2009-01-01

Background This study examines the differences among black, Hispanic, and white adolescent girls in their perceptions surrounding physical activity (PA), including support within the school climate, friend and family social support, and personal enjoyment. Methods Participants included 1466 sixth-grade girls from 36 middle schools across the United States. Participants were 20% black, 21% Hispanic, 47% white, and 12% of other or mixed races. Multivariate analyses were performed on each scale, adjusting for body mass index and free and reduced-price lunch status. Results Results showed racial differences on several variables. Black girls, compared with white girls, perceived significantly lower PA enjoyment (p < .001) and teacher support for PA (p = .004). Hispanic girls experienced less PA enjoyment (p = .003) and perceived less support for PA from boys (p = .001) and their families (p = .008) than white girls. Black girls reported significantly higher levels of physical education (PE) enjoyment than did white girls (p = .003). Conclusions Differences in perceived PA support and enjoyment across race raise questions about why these differences exist and how best to address disparities within interventions. PMID:18489464

Race/ethnicity, educational attainment, and pregnancy complications in New York City women with pre-existing diabetes.

PubMed

James-Todd, Tamarra; Janevic, Teresa; Brown, Florence M; Savitz, David A

2014-03-01

More women are entering pregnancy with pre-existing diabetes. Disease severity, glycaemic control, and predictors of pregnancy complications may differ by race/ethnicity or educational attainment, leading to differences in adverse pregnancy outcomes. We used linked New York City hospital record and birth certificate data for 6291 singleton births among women with pre-existing diabetes between 1995 and 2003. We defined maternal race/ethnicity as non-Hispanic white, non-Hispanic black, Hispanic, South Asian, and East Asian, and education level as <12, 12, and >12 years. Our outcomes were pre-eclampsia, preterm birth (PTB) (<37 weeks gestation and categorised as spontaneous or medically indicated), as well as small-for-gestational age (SGA) and large-for-gestational age (LGA). Using multivariable binomial regression, we estimated the risk ratios for pre-eclampsia, SGA, and LGA. We used multivariable multinomial regression to estimate odds ratios (OR) for PTB. Compared with non-Hispanic white women with pre-existing diabetes, non-Hispanic black and Hispanic women with pre-existing diabetes had a 1.50-fold increased risk of pre-eclampsia compared with non-Hispanic whites with pre-existing diabetes, after full adjustment. Non-Hispanic black and Hispanic women with pre-existing diabetes had adjusted ORs of 1.72 [adj. 95% confidence interval (CI) 1.38, 2.15] and 1.65 [adj.95% CI 1.32, 2.05], respectively, for medically indicated PTB. South Asian women with pre-existing diabetes had the highest risk for having an SGA infant [adj. OR: 2.29; adj. 95% CI 1.73, 3.03]. East Asian ethnicity was not associated with these pregnancy complications. Non-Hispanic black, Hispanic, and South Asian women with pre-existing diabetes may benefit from targeted interventions to improve pregnancy outcomes. © 2013 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.

High Risk Behaviors but Low Injury-Related Mortality Among Hispanic Teens in Missouri.

PubMed

Yun, Shumei; Kayani, Noaman; Geiger, Sarah; Homan, Sherri; Wilson, Janet

2016-11-01

Our objective was to examine racial/ethnic disparities in injury-related risk behaviors and deaths among teens in Missouri, with a focus on Hispanic people-the fastest-growing racial/ethnic group in the state. We used data from the 2013 Missouri Youth Risk Behavior Survey, which included 1616 students in grades 9 through 12 from 32 public and charter high schools. The overall response rate was 69%. We compared the prevalence of 10 injury-related risk behaviors among racial/ethnic groups and used multivariate logistic regression models to control for respondent age and sex. Using data from the 2000-2014 Missouri death records, we also compared injury-related death rates among racial/ethnic groups of teens aged 15 to 19 years. Hispanic students had a significantly higher prevalence than non-Hispanic white students for 9 of 10 risk behaviors and a significantly higher prevalence than non-Hispanic black students for 6 of the 10 risk behaviors included in the study. However, Hispanic teens aged 15 to 19 years had a significantly lower death rate from suicide, homicide, and unintentional injury combined (39.8 per 100000 population, 95% confidence interval [CI], 32.2-48.5) when compared with their non-Hispanic white (54.3 per 100000 population, 95% CI, 52.3-54.6) or non-Hispanic black (94.1 per 100000 population, 95% CI, 87.9-100.3) counterparts. Injury-related risk behaviors were more prevalent among Hispanic students than non-Hispanic white or non-Hispanic black students. Further efforts are needed to understand risk behaviors among Hispanic teens to guide intervention efforts.

Correlates of Spirituality among African Americans and Caribbean Blacks in the United States: Findings from the National Survey of American Life

PubMed Central

Taylor, Robert Joseph; Chatters, Linda M.; Jackson, James S.

2010-01-01

The present study examined differences in reports of spirituality among African Americans, Caribbean Blacks (Black Caribbeans), and non-Hispanic whites using data from the National Survey of American Life (NSAL). Bivariate analyses indicated that African Americans were most likely to endorse statements regarding the importance of spirituality in their lives (“How important is spirituality in your life?”) and self-assessments of spirituality (“How spiritual would you say you are?”), followed by Caribbean Blacks and non-Hispanic whites. Regression analyses indicated that African Americans and Caribbean Blacks had significantly higher levels of spirituality than did non-Hispanic whites. However, there were no significant differences in spirituality between African Americans and Caribbean Blacks. Separate regression analyses for African Americans and Caribbean Blacks indicated distinctive patterns of sociodemographic and denominational correlates of spiritual sentiments. Findings are discussed in relation to available survey and ethnographic data on self-assessments of spirituality. PMID:21031157

Color vision deficiency in preschool children: the multi-ethnic pediatric eye disease study.

PubMed

Xie, John Z; Tarczy-Hornoch, Kristina; Lin, Jesse; Cotter, Susan A; Torres, Mina; Varma, Rohit

2014-07-01

To determine the sex- and ethnicity-specific prevalence of color vision deficiency (CVD) in black, Asian, Hispanic, and non-Hispanic white preschool children. Population-based, cross-sectional study. The Multi-Ethnic Pediatric Eye Disease Study is a population-based evaluation of the prevalence of vision disorders in children in Southern California. A total of 5960 subjects 30 to 72 months of age were recruited for the study, of whom 4177 were able to complete color vision testing (1265 black, 812 Asian, 1280 Hispanic, and 820 non-Hispanic white). Color vision testing was performed using Color Vision Testing Made Easy color plates (Home Vision Care, Gulf Breeze, FL), and diagnostic confirmatory testing was performed using the Waggoner HRR Diagnostic Test color plates (Home Vision Care). Testability of color vision in preschool children between 30 and 72 months of age and prevalence of CVD stratified by age, sex, and ethnicity. Testability was 17% in children younger than 37 months of age, increasing to 57% in children 37 to 48 months of age, 89% in children 49 to 60 months of age, and 98% in children 61 to 72 months of age. The prevalence of CVD among boys was 1.4% for black, 3.1% for Asian, 2.6% for Hispanic, and 5.6% for non-Hispanic white children; the prevalence in girls was 0.0% to 0.5% for all ethnicities. The ethnic difference in CVD was statistically significant between black and non-Hispanic white children (P = 0.0003) and between Hispanic and non-Hispanic white children (P = 0.02). In boys, most CVD cases were either deutan (51%) or protan (34%); 32% were classified as mild, 15% as moderate, and 41% as severe. Testability for CVD in preschool children is high by 4 years of age. The prevalence of CVD in preschool boys varies by ethnicity, with the highest prevalence in non-Hispanic white and lowest in black children. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Teaching Hispanic Linguistics: Strategies to Engage Learners

ERIC Educational Resources Information Center

Knouse, Stephanie M.; Gupton, Timothy; Abreau, Laurel

2015-01-01

Even though many post-secondary institutions offer a variety of Hispanic linguistics classes (Hualde 2006; Lipski 2006), research on the pedagogy of Hispanic linguistics is an underdeveloped or non-existent area of the discipline. Courses in Hispanic linguistics can present not only linguistic challenges for non-native speakers of Spanish, but…

Non-Hispanic Black-White disparities in pain and pain management among newly admitted nursing home residents with cancer.

PubMed

Mack, Deborah S; Hunnicutt, Jacob N; Jesdale, Bill M; Lapane, Kate L

2018-01-01

Racial disparities in pain management persist across health care settings and likely extend into nursing homes. No recent studies have evaluated racial disparities in pain management among residents with cancer in nursing homes at time of admission. Using a cross-sectional study design, we compared reported pain and pain management between non-Hispanic White and non-Hispanic Black newly admitted nursing home residents with cancer (n=342,920) using the de-identified Minimum Data Set version 3.0. Pain management strategies included the use of scheduled analgesics, pro re nata analgesics, and non-pharmacological methods. Presence of pain was based on self-report when residents were able, and staff report when unable. Robust Poisson models provided estimates of adjusted prevalence ratios (aPR) and 95% CIs for reported pain and pain management strategies. Among nursing home residents with cancer, ~60% reported pain with non-Hispanic Blacks less likely to have both self-reported pain (aPR [Black versus White]: 0.98, 95% CI: 0.97-0.99) and staff-reported pain (aPR: 0.89, 95% CI: 0.86-0.93) documentation compared with Non-Hispanic Whites. While most residents received some pharmacologic pain management, Blacks were less likely to receive any compared with Whites (Blacks: 66.6%, Whites: 71.1%; aPR: 0.98, 95% CI: 0.97-0.99), consistent with differences in receipt of non-pharmacologic treatments (Blacks: 25.8%, Whites: 34.0%; aPR: 0.98, 95 CI%: 0.96-0.99). Less pain was reported for Black compared with White nursing home residents and White residents subsequently received more frequent pain management at admission. The extent to which unequal reporting and management of pain persists in nursing homes should be further explored.

Racial/ethnic variation in devices used to access patient portals.

PubMed

Chang, Eva; Blondon, Katherine; Lyles, Courtney R; Jordan, Luesa; Ralston, James D

2018-01-01

We examined racial/ethnic variation in the devices used by patients to access medical records through an online patient portal. Retrospective, cross-sectional analysis. Using data from 318,700 adults enrolled in an integrated delivery system between December 2012 and November 2013, we examined: 1) online patient portal use that directly engages the electronic health record and 2) portal use over desktops/laptops only, mobile devices only, or both device types. The primary covariate was race/ethnicity (non-Hispanic white, black, Hispanic, and Asian). Other covariates included age, sex, primary language, and neighborhood-level income and education. Portal use and devices used were assessed with multiple and multinomial logistic models, respectively. From December 2012 to November 2013, 56% of enrollees used the patient portal. Of these portal users, 62% used desktops/laptops only, 6% used mobile devices only, and 32% used both desktops/laptops and mobile devices. Black, Hispanic, and Asian enrollees had significantly lower odds of portal use than whites. Black and Hispanic portal users also were significantly more likely to use mobile devices only (relative risk ratio, 1.73 and 1.44, respectively) and both device types (1.21 and 1.07, respectively) than desktops/laptops only compared with whites. Although racial/ethnic minority enrollees were less likely to access the online patient portal overall, a greater proportion of black and Hispanic users accessed the patient portal with mobile devices than did non-Hispanic white users. The rapid spread of mobile devices among racial/ethnic minorities may help reduce variation in online patient portal use. Mobile device use may represent an opportunity for healthcare organizations to further engage black and Hispanic enrollees in online patient portal use.

Identifying the Tuskegee Syphilis Study: implications of results from recall and recognition questions

PubMed Central

2009-01-01

Background This analysis assessed whether Blacks, Whites and Puerto-Rican (PR) Hispanics differed in their ability to identify the Tuskegee Syphilis Study (TSS) via open-ended questions following lead-in recognition and recall questions. Methods The Tuskegee Legacy Project (TLP) Questionnaire was administered via a Random-Digit Dial (RDD) telephone survey to a stratified random sample of Black, White and PR Hispanic adults in three U.S. cities. Results The TLP Questionnaire was administered to 1,162 adults (356 African-Americans, 313 PR Hispanics, and 493 non-Hispanic Whites) in San Juan, PR, Baltimore, MD and New York City, NY. Recall question data revealed: 1) that 89% or more of Blacks, Whites, and PR Hispanics were not able to name or definitely identify the Tuskegee Syphilis Study by giving study attributes; and, 2) that Blacks were the most likely to provide an open-ended answer that identified the Tuskegee Syphilis Study as compared to Whites and PR Hispanics (11.5% vs 6.3% vs 2.9%, respectively) (p ≤ 0.002). Even when probed by a recognition question, only a minority of each racial/ethnic group (37.1%, 26.9%, and 8.6%, for Blacks, Whites and PR Hispanics, respectively) was able to clearly identify the TSS (p < 0.001). Conclusions The two major implications of these findings for health disparity researchers are 1) that it is unlikely that detailed knowledge of the Tuskegee Syphilis Study has any current widespread influence on the willingness of minorities to participate in biomedical research, and 2) that caution should be applied before assuming that what community leaders 'know and are aware of' is equally 'well known' within their community constituencies. PMID:20015361

Identifying the Tuskegee Syphilis Study: implications of results from recall and recognition questions.

PubMed

Katz, Ralph V; Jean-Charles, Germain; Green, B Lee; Kressin, Nancy R; Claudio, Cristina; Wang, Minqi; Russell, Stefanie L; Outlaw, Jason

2009-12-16

This analysis assessed whether Blacks, Whites and Puerto-Rican (PR) Hispanics differed in their ability to identify the Tuskegee Syphilis Study (TSS) via open-ended questions following lead-in recognition and recall questions. The Tuskegee Legacy Project (TLP) Questionnaire was administered via a Random-Digit Dial (RDD) telephone survey to a stratified random sample of Black, White and PR Hispanic adults in three U.S. cities. The TLP Questionnaire was administered to 1,162 adults (356 African-Americans, 313 PR Hispanics, and 493 non-Hispanic Whites) in San Juan, PR, Baltimore, MD and New York City, NY. Recall question data revealed: 1) that 89% or more of Blacks, Whites, and PR Hispanics were not able to name or definitely identify the Tuskegee Syphilis Study by giving study attributes; and, 2) that Blacks were the most likely to provide an open-ended answer that identified the Tuskegee Syphilis Study as compared to Whites and PR Hispanics (11.5% vs 6.3% vs 2.9%, respectively) (p

A multi-group path analysis of the relationship between perceived racial discrimination and self-rated stress: how does it vary across racial/ethnic groups?

PubMed

Yang, Tse-Chuan; Chen, Danhong

2018-04-01

The objective of this study was to answer three questions: (1) Is perceived discrimination adversely related to self-rated stress via the social capital and health care system distrust pathways? (2) Does the relationship between perceived discrimination and self-rated stress vary across race/ethnicity groups? and (3) Do the two pathways differ by one's race/ethnicity background? Using the Philadelphia Health Management Corporation's Southeastern Pennsylvania Household Survey, we classified 9831 respondents into 4 race/ethnicity groups: non-Hispanic White (n = 6621), non-Hispanic Black (n = 2359), Hispanic (n = 505), and non-Hispanic other races (n = 346). Structural equation modeling was employed to simultaneously estimate five sets of equations, including the confirmatory factor analysis for both social capital and health care distrust and both direct and indirect effects from perceived discrimination to self-rated stress. The key findings drawn from the analysis include the following: (1) in general, people who experienced racial discrimination have higher distrust and weaker social capital than those without perceived discrimination and both distrust and social capital are ultimately related to self-rated stress. (2) The direct relationship between perceived discrimination and self-rated stress is found for all race/ethnicity groups (except non-Hispanic other races) and it does not vary across groups. (3) The two pathways can be applied to non-Hispanic White and Black, but for Hispanic and non-Hispanic other races, we found little evidence for the social capital pathway. For non-Hispanic White, non-Hispanic Black, and Hispanic, perceived discrimination is negatively related to self-rated stress. This finding highlights the importance of reducing interpersonal discriminatory behavior even for non-Hispanic White. The health care system distrust pathway can be used to address the racial health disparity in stress as it holds true for all four race/ethnicity groups. On the other hand, the social capital pathway seems to better help non-Hispanic White and Black to mediate the adverse effect of perceived discrimination on stress.

Positive association between high-sensitivity C-reactive protein level and diabetes mellitus among US non-Hispanic black adults.

PubMed

Shankar, A; Li, J

2008-08-01

Previous epidemiologic studies have demonstrated a positive association between serum C-reactive protein (CRP) level and diabetes mellitus. However among US race-ethnicities, the putative association between CRP and diabetes mellitus in non-Hispanic Blacks is not clear. We specifically examined the association between high-sensitivity CRP level and diabetes mellitus in a representative sample of US non-Hispanic blacks. Cross-sectional study among 1,479 National Health and Nutrition Examination Survey 1999-2002 non-Hispanic black participants aged > or = 20 years. Main outcome-of-interest was the presence of diabetes mellitus (fasting plasma glucose > or = 126 mg/dL, non-fasting plasma glucose > or = 200 mg/dL, or self-reported current use of oral hypoglycemic medication or insulin) (n=204). Higher CRP levels were positively associated with diabetes mellitus, independent of smoking, waist circumference, hypertension, and other confounders. Multivariable odds ratio (OR) [95% confidence intervals (CI)] comparing elevated CRP level (>3 mg/L) to low CRP level (<1 mg/L) was 3.12 (1.77-5.48), p-trend<0.0001. This association persisted in separate analysis among men and women. The results were consistent in subgroup analyses by categories of age, smoking, body mass index, and hypertension status. In nonparametric models, the positive association between serum CRP and diabetes mellitus appeared to be present across the full range of CRP, without any threshold effect. Higher serum high-sensitivity CRP levels are positively associated with diabetes mellitus in a sample of US non-Hispanic blacks. Inflammatory processes previously shown to be related to diabetes mellitus in other race-ethnicities may be involved in non-Hispanic blacks also.

Body mass index and mobility limitations: An analysis of middle-aged and older Black, Hispanic, and White women in the U.S.

PubMed

Sharma, Andy

2018-06-16

While the Body Mass Index (BMI) did not change significantly for men from 2005 to 2014 in the United States, women exhibited an upward linear trend. Hispanic and Black women, in particular, showed a dramatic increase. Therefore, the objective of this study was to examine the association between BMI and mobility limitations for non-institutionalised middle-aged and older Black, Hispanic, and White women. The International Classification of Functioning, Disability, and Health model was applied to a sample of 2865 Black, 1846 Hispanic, and 9721 White women categorised as middle-aged and older (i.e., at least 50 years of age) from the 2010 and 2014 Rand Health and Retirement Study. A random effects ordered logit was employed. After accounting for personal/activity characteristics, the analyses revealed Black women with greater BMI were associated with a higher likelihood for mobility limitations with an odds ratio of 1.11 [1.06-1.16, 95% CI]. A significant association was also found for Hispanic women with an odds ratio of 1.16 [1.11-1.23, 95% CI] and White women with an odds ratio of 1.16 [1.13-1.19, 95% CI]. Even after accounting for the possibility of endogeneity, BMI remained robust. Higher-levels of BMI were associated with an increased probability for mobility limitations for Black, Hispanic, and White middle-aged and older women. Those with a vigorous exercise regimen were less likely to be in this category across all ranges of BMI. These results are useful for prioritising minority health policy, particularly given the limited amount of existing research in this specific area. Copyright © 2018 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study.

PubMed

White, Halina; Boden-Albala, Bernadette; Wang, Cuiling; Elkind, Mitchell S V; Rundek, Tanja; Wright, Clinton B; Sacco, Ralph L

2005-03-15

Stroke incidence is greater in blacks than in whites; data on Hispanics are limited. Comparing subtype-specific ischemic stroke incidence rates may help to explain race-ethnic differences in stroke risk. The aim of this population-based study was to determine ischemic stroke subtype incidence rates for whites, blacks, and Hispanics living in one community. A comprehensive stroke surveillance system incorporating multiple overlapping strategies was used to identify all cases of first ischemic stroke occurring between July 1, 1993, and June 30, 1997, in northern Manhattan. Ischemic stroke subtypes were determined according to a modified NINDS scheme, and age-adjusted, race-specific incidence rates calculated. The annual age-adjusted incidence of first ischemic stroke per 100,000 was 88 (95% CI, 75 to 101) in whites, 149 (95% CI, 132 to 165) in Hispanics, and 191 (95% CI, 160 to 221) in blacks. Among blacks compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.85 (95% CI, 1.82 to 18.73); extracranial atherosclerotic stroke, 3.18 (95% CI, 1.42 to 7.13); lacunar stroke, 3.09 (95% CI, 1.86 to 5.11); and cardioembolic stroke, 1.58 (95% CI, 0.99 to 2.52). Among Hispanics compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.00 (95% CI, 1.69 to 14.76); extracranial atherosclerotic stroke, 1.71 (95% CI, 0.80 to 3.63); lacunar stroke, 2.32 (95% CI, 1.48 to 3.63); and cardioembolic stroke, 1.42 (95% CI, 0.97 to 2.09). The high ischemic stroke incidence among blacks and Hispanics compared with whites is due to higher rates of all ischemic stroke subtypes.

Racial and Ethnic Disparities in Parental Refusal of Consent in a Large, Multisite Pediatric Critical Care Clinical Trial.

PubMed

Natale, Joanne E; Lebet, Ruth; Joseph, Jill G; Ulysse, Christine; Ascenzi, Judith; Wypij, David; Curley, Martha A Q

2017-05-01

To evaluate whether race or ethnicity was independently associated with parental refusal of consent for their child's participation in a multisite pediatric critical care clinical trial. We performed a secondary analyses of data from Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE), a 31-center cluster randomized trial of sedation management in critically ill children with acute respiratory failure supported on mechanical ventilation. Multivariable logistic regression modeling estimated associations between patient race and ethnicity and parental refusal of study consent. Among the 3438 children meeting enrollment criteria and approached for consent, 2954 had documented race/ethnicity of non-Hispanic White (White), non-Hispanic Black (Black), or Hispanic of any race. Inability to approach for consent was more common for parents of Black (19.5%) compared with White (11.7%) or Hispanic children (13.2%). Among those offered consent, parents of Black (29.5%) and Hispanic children (25.9%) more frequently refused consent than parents of White children (18.2%, P < .0167 for each). Compared with parents of White children, parents of Black (OR 2.15, 95% CI 1.56-2.95, P < .001) and Hispanic (OR 1.44, 95% CI 1.10-1.88, P = .01) children were more likely to refuse consent. Parents of children offered participation in the intervention arm were more likely to refuse consent than parents in the control arm (OR 2.15, 95% CI 1.37-3.36, P < .001). Parents of Black and Hispanic children were less likely to be approached for, and more frequently declined consent for, their child's participation in a multisite critical care clinical trial. Ameliorating this racial disparity may improve the validity and generalizability of study findings. ClinicalTrials.gov: NCT00814099. Copyright © 2017 Elsevier Inc. All rights reserved.

Trends in Childhood Leukemia Incidence Over Two Decades from 1992–2013

PubMed Central

Barrington-Trimis, Jessica L.; Cockburn, Myles; Metayer, Catherine; Gauderman, W. James; Wiemels, Joseph; McKean-Cowdin, Roberta

2017-01-01

Incidence rates of childhood leukemia in the United States have steadily increased over the last several decades, but only recently have disparities in the increase in incidence been recognized. In the current analysis, Surveillance, Epidemiology and End Results (SEER) data were used to evaluate recent trends in the incidence of childhood leukemia diagnosed at age 0–19 years from 1992–2013, overall and by age, race/ethnicity, gender, and histologic subtype. Hispanic White children were more likely than non-Hispanic White, non-Hispanic Black or non-Hispanic Asian children to be diagnosed with acute lymphocytic leukemia (ALL) from 2009–2013. From 1992–2013, a significant increase in ALL incidence was observed for Hispanic White children (annual percent change (APC)Hispanic=1.08, 95%CI:0.59, 1.58); no significant increase was observed for non-Hispanic White, Black or Asian children. ALL incidence increased by about 3% per year from 1992–2013 for Hispanic White children diagnosed from 15–19 years (APC=2.67; 95%CI:0.88, 4.49), and by 2% for those 10–14 years (APC=2.09; 95%CI:0.57, 3.63), while no significant increases in incidence were observed in non-Hispanic White, Black, or Asian children of the same age. Acute myeloid leukemia (AML) incidence increased among non-Hispanic White children under 1 year at diagnosis, and among Hispanic White children diagnosed at age 1–4. The increase in incidence rates of childhood ALL appears to be driven by rising rates in older Hispanic children (10–14, and 15–19 years). Future studies are needed to evaluate reasons for the increase in ALL among older Hispanic children. PMID:27778348

Gallbladder carcinoma: An analysis of the national cancer data base to examine hispanic influence.

PubMed

Liu, Chrissy; Berger, Nicholas G; Rein, Lisa; Tarima, Sergey; Clarke, Callisia; Mogal, Harveshp; Christians, Kathleen K; Tsai, Susan; Gamblin, T Clark

2018-05-01

Gallbladder cancer (GBC) is a lethal disease with high incidence among Hispanics. Overall survival (OS) among races/ethnicities has not been described using the most recent National Cancer Database. This study hypothesized that prognosis is worse for Hispanics compared to similar non-Hispanic populations. Patients with GBC were identified from the National Cancer Database and categorized as White, Black, Hispanic, and Other. Descriptive statistics, OS, and Cox regression were examined. The study identified 12 952 patients. Median age was 71 years and 68.8% were female. The study characterized 69.8% White, 13.9% Black, 11.0% Hispanic, and 5.4% other patients. A 5-year OS curves differed, with survival highest in Hispanic patients (27% vs 23% Other, 18% White, and 17% Black, P < 0.001). Hispanics presented at younger ages (67 vs 72 years, P < 0.001), were more likely to be uninsured (17.3% vs 3.9% P < 0.001), had lower income (P < 0.001), and education levels (P < 0.001) compared to Whites. Following multivariable modeling, treatment at an academic facility (HR 0.90, 95%CI 0.84-0.97) and year of diagnosis (HR 0.90, 95%CI 0.88-0.92) related to survival. Hispanic ethnicity did not show significance (P = 0.207). Hispanic ethnicity exhibits the highest OS for GBC, but after adjusting for covariates, this influence is not significant. © 2018 Wiley Periodicals, Inc.

Epilepsy by the Numbers: Epilepsy deaths by age, race/ethnicity, and gender in the United States significantly increased from 2005 to 2014.

PubMed

Greenlund, Sujay F; Croft, Janet B; Kobau, Rosemarie

2017-04-01

To inform public health efforts to prevent epilepsy-related deaths, we used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (WONDER; Wonder.cdc.gov) to examine any-listed epilepsy deaths for the period 2005-2014 by age groups (≤24, 25-44, 45-64, 65-84, ≥85years), sex, and race/ethnicity (non-Hispanic White, non-Hispanic African American, Hispanic, Asian/Pacific Islander, or American Indian/Alaska Native). Epilepsy deaths were defined by the International Classification of Diseases, Tenth Revision (ICD-10) codes G40.0-G40.9. The total number of deaths per year with epilepsy as any listed cause ranged from 1760 in 2005 to 2962 in 2014. Epilepsy was listed as the underlying cause of death for about 54% of all deaths with any mention of epilepsy in 2005 and for 43% of such deaths in 2014. Age-adjusted epilepsy mortality rates (as any-listed cause of death) per 100,000 significantly increased from 0.58 in 2005 to 0.85 in 2014 (47% increase). In 2014, deaths among the non-Hispanic Black population (1.42 deaths per 100,000) were higher than among non-Hispanic White (0.86 deaths per 100,000) and Hispanic populations (0.70 deaths per 100,000). Males had a higher mortality rate than females (1.01 per 100,000 versus 0.74 per 100,000 in 2014), and those aged 85years or older had the highest mortality among age groups. Results highlight the need for heightened action to prevent and monitor epilepsy-associated mortality. Published by Elsevier Inc.

The Role of Perceived Peer Prejudice and Teacher Discrimination on Adolescent Substance Use: A Social Determinants Approach

PubMed Central

Respress, Brandon N.; Small, Eusebius; Francis, Shelley A.; Cordova, David

2013-01-01

Although Black adolescents have reported a lower prevalence of substance use relative to non-Hispanic Whites, Black youth are disproportionately affected by adverse social outcomes. Social scientists have highlighted that using a framework that includes perceived peer prejudice and teacher discrimination as social determinants of adolescent risk behaviors is essential to fully understanding substance use behaviors in adolescents. However, this area of research remains underdeveloped. This study examined whether and to what extent perceived peer prejudice and teacher discrimination affect binge drinking and marijuana use by Black (n = 514) and non-Hispanic White (n = 2,818) adolescents using data from the National Longitudinal Study of Adolescent Health, Wave 2, Public Use dataset. Findings suggest that peer prejudice increased the risk of substance use in non-Hispanic White youth only, whereas experiences of teacher discrimination increased the risk of substance use in both Black and non-Hispanic White youth. The study’s limitations are noted, and implications for future research are discussed. PMID:24215222

Racial and Ethnic Disparities in Diabetes Screening Between Asian Americans and Other Adults: BRFSS 2012-2014.

PubMed

Tung, Elizabeth L; Baig, Arshiya A; Huang, Elbert S; Laiteerapong, Neda; Chua, Kao-Ping

2017-04-01

Although Asian Americans are at high risk for type 2 diabetes, it is not known whether they are appropriately screened for this disease. To assess racial and ethnic disparities in diabetes screening between Asian Americans and other adults. Analysis of pooled cross-sectional data from 45 U.S. states and territories using the 2012-2014 Behavioral Risk Factor Surveillance System. We calculated the weighted proportions of adults in each racial and ethnic group who received recommended diabetes screening. To assess for racial and ethnic disparities, we used multivariable logistic regression to model receipt of recommended diabetes screening as a function of race and ethnicity, adjusting for demographics, healthcare access, survey year, and state. A total of 526,000 adults who were eligible to receive diabetes screening according to American Diabetes Association guidelines from 2012 to 2014 (age ≥ 45 years or age < 45 years with a body mass index [BMI] ≥ 25 kg/m 2 ). Self-reported receipt of diabetes screening (defined as a test for high blood sugar or diabetes within the past 3 years) and self-reported race/ethnicity (non-Hispanic white, non-Hispanic Asian, non-Hispanic Pacific Islander, non-Hispanic American Indian or Alaskan Native, non-Hispanic black, Hispanic or Latino, and non-Hispanic multiracial or other). Asian Americans were the least likely racial and ethnic group to receive recommended diabetes screening. Overall, Asian Americans had 34% lower adjusted odds of receiving recommended diabetes screening compared to non-Hispanic whites (95 % CI: 0.60, 0.73). In subgroup analyses by age and weight status, disparities were widest among obese Asian Americans ≥ 45 years (AOR = 0.56; 95 % CI: 0.39, 0.81). Disparities persisted among Asian Americans who completed other types of preventive cancer screening. Despite their high risk of diabetes, Asian Americans were the least likely racial and ethnic group to receive recommended diabetes screening.

Trends in Alcohol Services Utilization from 1991-1992 to 2001-2002: Ethnic Group Differences in the U.S. Population

PubMed Central

Chartier, Karen G.; Caetano, Raul

2011-01-01

Background During the early 1990s in the U.S., changes to the provision and financing of alcohol treatment services included reductions in inpatient treatment services and in private sector spending for treatment. We investigated trends in alcohol services utilization over the 10-year period from 1991-1992 to 2001-2002 among U.S. Whites, Blacks and Hispanics. Method Data come from two household surveys of the U.S. adult population. The 1991-1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES) and the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) conducted face-to-face interviews with a multistage cluster sample of individuals 18 years of age and older in the continental United States. Treatment utilization represented both total utilization and the use of alcohol services. Data analyses were prevalence rates and multivariate logistic regressions for lifetime utilization with drinkers and individuals with alcohol use disorders (AUD). Results From 1991-1992 to 2001-2002, drinking-related emergency room and human services use increased for drinkers, while total utilization and the use of private health professional services and mutual aid decreased for individuals with AUDs. In drinkers and individuals with AUDs, Blacks and Hispanics were less likely than Whites to use private health professional care. Hispanics with AUDs were less likely than Whites with AUDs to use alcohol or drug programs. Ethnicity interacted with alcohol severity to predict alcohol services utilization. At higher levels of alcohol severity, Blacks and Hispanics were less likely than Whites to ever use treatment and to use alcohol services (i.e., human services for Hispanic drinkers, mental health services for Blacks with AUDs, and mutual aid for Hispanics with AUDs). Conclusions Our findings showed increases from 1991-1992 to 2001-2002 in alcohol services utilization for drinkers, but reductions in utilization for individuals with AUDs. Blacks and Hispanics, particularly those at higher levels of alcohol severity, underutilized treatment services compared to Whites. These utilization trends for Blacks and Hispanics may reflect underlying disparities in health care access for minority groups, and language and logistical barriers to utilizing services. PMID:21575015

Cancer incidence among Arab Americans in California, Detroit, and New Jersey SEER registries.

PubMed

Bergmans, Rachel; Soliman, Amr S; Ruterbusch, Julie; Meza, Rafael; Hirko, Kelly; Graff, John; Schwartz, Kendra

2014-06-01

We calculated cancer incidence for Arab Americans in California; Detroit, Michigan; and New Jersey, and compared rates with non-Hispanic, non-Arab Whites (NHNAWs); Blacks; and Hispanics. We conducted a study using population-based data. We linked new cancers diagnosed in 2000 from the Surveillance, Epidemiology, and End Results Program (SEER) to an Arab surname database. We used standard SEER definitions and methodology for calculating rates. Population estimates were extracted from the 2000 US Census. We calculated incidence and rate ratios. Arab American men and women had similar incidence rates across the 3 geographic regions, and the rates were comparable to NHNAWs. However, the thyroid cancer rate was elevated among Arab American women compared with NHNAWs, Hispanics, and Blacks. For all sites combined, for prostate and lung cancer, Arab American men had a lower incidence than Blacks and higher incidence than Hispanics in all 3 geographic regions. Arab American male bladder cancer incidence was higher than that in Hispanics and Blacks in these regions. Our results suggested that further research would benefit from the federal recognition of Arab Americans as a specified ethnicity to estimate and address the cancer burden in this growing segment of the population.

Racial Residential Segregation and Risky Sexual Behavior Among Non-Hispanic Blacks, National Survey of Family Growth, 2006 – 2010

PubMed Central

Lutfi, Khaleeq; Trepka, Mary Jo; Fennie, Kristopher P.; Ibanez, Gladys; Gladwin, Hugh

2015-01-01

Sexually transmitted infections (STIs) including human immunodeficiency virus (HIV) have disproportionately affected the non-Hispanic black population in the United States. A person’s community can affect his or her STI risk by the community’s underlying prevalence of STIs, sexual networks, and social influences on individual behaviors. Racial residential segregation—the separation of racial groups in a residential context across physical environments—is a community factor that has been associated with negative health outcomes. The objective of this study was to examine if non-Hispanic blacks living in highly segregated areas were more likely to have risky sexual behavior. Demographic and sexual risk behavior data from non-Hispanic blacks aged 15 – 44 years participating in the National Survey of Family Growth were linked to Core-Based Statistical Area segregation data from the U.S. Census Bureau. Five dimensions measured racial residential segregation, each covering a different concept of spatial variation. Multilevel logistic regressions were performed to test the effect of each dimension on sexual risk behavior controlling for demographics and community poverty. Of the 3,643 participants, 588 (14.5%) reported risky sexual behavior as defined as two or more partners in the last 12 months and no consistent condom use. Multilevel analysis results show that racial residential segregation was associated with risky sexual behavior with the association being stronger for the centralization [aOR (95% CI)][2.07 (2.05 – 2.08)] and concentration [2.05 (2.03 – 2.07)] dimensions. This suggests risky sexual behavior is more strongly associated with neighborhoods with high concentrations of non-Hispanic blacks and an accumulation of non-Hispanic blacks in an urban core. Findings suggest racial residential segregation is associated with risky sexual behavior in non-Hispanic blacks 15 – 44 years of age with magnitudes varying by dimension. Incorporating additional contextual factors may lead to the development of interventions that promote healthier behaviors and lower rates of HIV and other STIs. PMID:26210657

Race and trust in the health care system.

PubMed

Boulware, L Ebony; Cooper, Lisa A; Ratner, Lloyd E; LaVeist, Thomas A; Powe, Neil R

2003-01-01

A legacy of racial discrimination in medical research and the health care system has been linked to a low level of trust in medical research and medical care among African Americans. While racial differences in trust in physicians have been demonstrated, little is known about racial variation in trust of health insurance plans and hospitals. For the present study, the authors analyzed responses to a cross-sectional telephone survey to assess the independent relationship of self-reported race (non-Hispanic black or non-Hispanic white) with trust in physicians, hospitals, and health insurance plans. Respondents ages 18-75 years were asked to rate their level of trust in physicians, health insurance plans, and hospitals. Items from the Medical Mistrust Index were used to assess fear and suspicion of hospitals. Responses were analyzed for 49 (42%) non-Hispanic black and 69 (58%) non-Hispanic white respondents (N=118; 94% of total survey population). A majority of respondents trusted physicians (71%) and hospitals (70%), but fewer trusted their health insurance plans (28%). After adjustment for potential confounders, non-Hispanic black respondents were less likely to trust their physicians than non-Hispanic white respondents (adjusted absolute difference 37%; p=0.01) and more likely to trust their health insurance plans (adjusted absolute difference 28%; p=0.04). The difference in trust of hospitals (adjusted absolute difference 13%) was not statistically significant. Non-Hispanic black respondents were more likely than non-Hispanic white respondents to be concerned about personal privacy and the potential for harmful experimentation in hospitals. Patterns of trust in components of our health care system differ by race. Differences in trust may reflect divergent cultural experiences of blacks and whites as well as differences in expectations for care. Improved understanding of these factors is needed if efforts to enhance patient access to and satisfaction with care are to be effective.

Racial and ethnic differences in outcomes in older patients with acute ischemic stroke.

PubMed

Qian, Feng; Fonarow, Gregg C; Smith, Eric E; Xian, Ying; Pan, Wenqin; Hannan, Edward L; Shaw, Benjamin A; Glance, Laurent G; Peterson, Eric D; Eapen, Zubin J; Hernandez, Adrian F; Schwamm, Lee H; Bhatt, Deepak L

2013-05-01

Little is known as to whether long-term outcomes of acute ischemic stroke (AIS) vary by race/ethnicity. Using the American Heart Association Get With The Guidelines-Stroke registry linked with Medicare claims data set, we examined whether 30-day and 1-year outcomes differed by race/ethnicity among older patients with AIS. We analyzed 200 900 patients with AIS >65 years of age (170 694 non-Hispanic whites, 85.0%; 20 514 non-Hispanic blacks, 10.2%; 6632 Hispanics, 3.3%; 3060 non-Hispanic Asian Americans, 1.5%) from 926 US centers participating in the Get With The Guidelines-Stroke program from April 2003 through December 2008. Compared with whites, other racial and ethnic groups were on average younger and had a higher median score on the National Institutes of Health Stroke Scale. Whites had higher 30-day unadjusted mortality than other groups (white versus black versus Hispanic versus Asian=15.0% versus 9.9% versus 11.9% versus 11.1%, respectively). Whites also had higher 1-year unadjusted mortality (31.7% versus 28.6% versus 28.1% versus 23.9%, respectively) but lower 1-year unadjusted all-cause rehospitalization (54.7% versus 62.5% versus 60.0% versus 48.6%, respectively). After risk adjustment, Asian American patients with AIS had lower 30-day and 1-year mortality than white, black, and Hispanic patients. Relative to whites, black and Hispanic patients had higher adjusted 1-year all-cause rehospitalization (black: adjusted odds ratio, 1.28 [95% confidence interval, 1.21-1.37]; Hispanic: adjusted odds ratio, 1.22 [95% confidence interval, 1.11-1.35]), whereas Asian patients had lower odds (adjusted odds ratio, 0.83 [95% confidence interval, 0.74-0.94]). Among older Medicare beneficiaries with AIS, there were significant differences in long-term outcomes by race/ethnicity, even after adjustment for stroke severity, other prognostic variables, and hospital characteristics.

Hodgkin lymphoma incidence in California Hispanics: Influence of nativity and tumor Epstein–Barr virus

PubMed Central

Clarke, C. A.; Chang, E. T.; Yang, J.; Gomez, S. L.; Keegan, T. H.

2017-01-01

Purpose For classical Hodgkin lymphoma (HL), migrant studies could elucidate contributions of environmental factors (including Epstein–Barr virus (EBV)) to the lower rates in non-whites. Given the well-described etiologic complexity of HL, this research requires a large, immigrant population, such as California Hispanics. Methods With 1988–2004 California Cancer Registry data (2,595 Hispanic, 8,637 white HL cases) and tumor cell EBV status on a subset (218 Hispanics, 656 whites), we calculated ethnicity- and nativity-specific HL incidence rates simultaneously by age, sex, and histologic subtype, and tumor cell EBV prevalence. Results Compared with white rates, Hispanic HL rates were lower overall (70 %) and for nodular sclerosis HL, particularly among young adults (60–65 % for females). However, they were higher among children (200 %) and older adults, and for mixed cellularity HL. Compared with rates in foreign-born Hispanics, rates in US-born Hispanics were higher among young adults (>threefold in females), lower for children and adults over age 70, and consistently intermediate compared with rates in whites. EBV tumor prevalence was 67, 32, and 23 % among foreign-born Hispanics, US-born Hispanics, and whites, respectively, although with variation by age, sex, and histology. Conclusions Findings strongly implicate environmental influences, such as nativity-related sociodemographic differences, on HL occurrence. In addition, lower young adult rates and higher EBV prevalence in US-born Hispanics than in whites raise questions about the duration/extent of environmental change for affecting HL rates and also point to ethnic differences in genetic susceptibility. Lesser variation in mixed cellularity HL rates and greater variation in rates for females across groups suggest less modifiable factors interacting with environmental influences. PMID:24722952

Racial Variation in End-of-Life Intensive Care Use: A Race or Hospital Effect?

PubMed Central

Barnato, Amber E; Berhane, Zekarias; Weissfeld, Lisa A; Chang, Chung-Chou H; Linde-Zwirble, Walter T; Angus, Derek C

2006-01-01

Objective To determine if racial and ethnic variations exist in intensive care (ICU) use during terminal hospitalizations, and, if variations do exist, to determine whether they can be explained by systematic differences in hospital utilization by race/ethnicity. Data Source 1999 hospital discharge data from all nonfederal hospitals in Florida, Massachusetts, New Jersey, New York, and Virginia. Design We identified all terminal admissions (N =192,705) among adults. We calculated crude rates of ICU use among non-Hispanic whites, blacks, Hispanics, and those with “other” race/ethnicity. We performed multivariable logistic regression on ICU use, with and without adjustment for clustering of patients within hospitals, to calculate adjusted differences in ICU use and by race/ethnicity. We explored both a random-effects (RE) and fixed-effect (FE) specification to adjust for hospital-level clustering. Data Collection The data were collected by each state. Principal Findings ICU use during the terminal hospitalization was highest among nonwhites, varying from 64.4 percent among Hispanics to 57.5 percent among whites. Compared to white women, the risk-adjusted odds of ICU use was higher for white men and for nonwhites of both sexes (odds ratios [ORs] and 95 percent confidence intervals: white men =1.16 (1.14–1.19), black men =1.35 (1.17–1.56), Hispanic men =1.52 (1.27–1.82), black women =1.31 (1.25–1.37), Hispanic women =1.53 (1.43–1.63)). Additional adjustment for within-hospital clustering of patients using the RE model did not change the estimate for white men, but markedly attenuated observed differences for blacks (OR for men =1.12 (0.96–1.31), women =1.10 (1.03–1.17)) and Hispanics (OR for men =1.19 (1.00–1.42), women =1.18 (1.09–1.27)). Results from the FE model were similar to the RE model (OR for black men =1.10 (0.95–1.28), black women =1.07 (1.02–1.13) Hispanic men =1.17 (0.96–1.42), and Hispanic women =1.14 (1.06–1.24)) Conclusions The majority of observed differences in terminal ICU use among blacks and Hispanics were attributable to their use of hospitals with higher ICU use rather than to racial differences in ICU use within the same hospital. PMID:17116117

Prevalence of Healthy Sleep Duration among Adults--United States, 2014.

PubMed

Liu, Yong; Wheaton, Anne G; Chapman, Daniel P; Cunningham, Timothy J; Lu, Hua; Croft, Janet B

2016-02-19

To promote optimal health and well-being, adults aged 18-60 years are recommended to sleep at least 7 hours each night (1). Sleeping <7 hours per night is associated with increased risk for obesity, diabetes, high blood pressure, coronary heart disease, stroke, frequent mental distress, and all-cause mortality (2-4). Insufficient sleep impairs cognitive performance, which can increase the likelihood of motor vehicle and other transportation accidents, industrial accidents, medical errors, and loss of work productivity that could affect the wider community (5). CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) to determine the prevalence of a healthy sleep duration (≥ 7 hours) among 444,306 adult respondents in all 50 states and the District of Columbia. A total of 65.2% of respondents reported a healthy sleep duration; the age-adjusted prevalence of healthy sleep was lower among non-Hispanic blacks, American Indians/Alaska Natives, Native Hawaiians/Pacific Islanders, and multiracial respondents, compared with non-Hispanic whites, Hispanics, and Asians. State-based estimates of healthy sleep duration prevalence ranged from 56.1% in Hawaii to 71.6% in South Dakota. Geographic clustering of the lowest prevalence of healthy sleep duration was observed in the southeastern United States and in states along the Appalachian Mountains, and the highest prevalence was observed in the Great Plains states. More than one third of U.S. respondents reported typically sleeping <7 hours in a 24-hour period, suggesting an ongoing need for public awareness and public education about sleep health; worksite shift policies that ensure healthy sleep duration for shift workers, particularly medical professionals, emergency response personnel, and transportation industry personnel; and opportunities for health care providers to discuss the importance of healthy sleep duration with patients and address reasons for poor sleep health.

Nativity, language spoken at home, length of time in the United States, and race/ethnicity: associations with self-reported hypertension.

PubMed

Yi, Stella; Elfassy, Tali; Gupta, Leena; Myers, Christa; Kerker, Bonnie

2014-02-01

Characterization of health conditions in recent immigrant subgroups, including foreign-born whites and Asians, is limited but important for identifying emerging health disparities. Hypertension, a major modifiable risk factor for cardiovascular disease, has been shown to be associated with acculturation, but the acculturative experience varies for different racial/ethnic groups. Assessing the impact of race/ethnicity on the relationship between acculturation-related factors and hypertension is therefore of interest. Data from the 2005-2008 waves (n = 36,550) of the NYC Community Health Survey were combined to estimate self-reported hypertension prevalence by nativity, language spoken at home, and time spent in the United States. Multivariable analyses were used to assess (i) the independent associations of acculturation-related factors and hypertension and (ii) potential effect modification by race/ethnicity. Sensitivity analysis recalibrating self-reported hypertension using measured blood pressures from a prior NYC population-based survey was performed. Prevalence was also explored by country of origin. Being foreign vs. US born was associated with higher self-reported hypertension in whites only. Speaking Russian vs. English at home was associated with a 2-fold adjusted odds of self-reported hypertension. Living in the United States for ≥10 years vs. less time was associated with higher self-reported hypertension prevalence in blacks and Hispanics. Hypertension prevalence in Hispanics was slightly lower when using a recalibrated definition, but other results did not change substantively. Race/ethnicity modifies the relationship between acculturation-related factors and hypertension. Consideration of disease prevalence in origin countries is critical to understanding health patterns in immigrant populations. Validation of self-reported hypertension in Hispanic populations is indicated.

Geographic variation in trends and characteristics of teen childbearing among American Indians and Alaska Natives, 1990-2007.

PubMed

Wingo, Phyllis A; Lesesne, Catherine A; Smith, Ruben A; de Ravello, Lori; Espey, David K; Arambula Solomon, Teshia G; Tucker, Myra; Thierry, Judith

2012-12-01

To study teen birth rates, trends, and socio-demographic and pregnancy characteristics of AI/AN across geographic regions in the US. The birth rate for US teenagers 15-19 years reached a historic low in 2009 (39.1 per 1,000) and yet remains one of the highest teen birth rates among industrialized nations. In the US, teen birth rates among Hispanic, non-Hispanic black, and American Indian/Alaska Native (AI/AN) youth are consistently two to three times the rate among non-Hispanic white teens. Birth certificate data for females younger than age 20 were used to calculate birth rates (live births per 1,000 women) and joinpoint regression to describe trends in teen birth rates by age (<15, 15-17, 18-19) and region (Aberdeen, Alaska, Bemidji, Billings, California, Nashville, Oklahoma, Portland, Southwest). Birth rates for AI/AN teens varied across geographic regions. Among 15-19-year-old AI/AN, rates ranged from 24.35 (California) to 123.24 (Aberdeen). AI/AN teen birth rates declined from the early 1990s into the 2000s for all three age groups. Among 15-17-year-olds, trends were approximately level during the early 2000s-2007 in six regions and declined in the others. Among 18-19-year-olds, trends were significantly increasing during the early 2000s-2007 in three regions, significantly decreasing in one, and were level in the remaining regions. Among AI/AN, cesarean section rates were lower in Alaska (4.1%) than in other regions (16.4-26.6%). This is the first national study to describe regional variation in AI/AN teen birth rates. These data may be used to target limited resources for teen pregnancy intervention programs and guide research.

Place matters: variation in the black/white very preterm birth rate across U.S. metropolitan areas, 2002-2004.

PubMed

Kramer, Michael R; Hogue, Carol R

2008-01-01

We reported on the distribution of very preterm (VPT) birth rates by race across metropolitan statistical areas (MSAs). Rates of singleton VPT birth for non-Hispanic white, non-Hispanic black, and Hispanic women were calculated with National Center for Health Statistics 2002-2004 natality files for infants in 168 MSAs. Subanalysis included stratification by parity, age, smoking, maternal education, metropolitan size, region, proportion of MSA that was black, proportion of black population living below the poverty line, and indices of residential segregation. The mean metropolitan-level VPT birth rate was 12.3, 34.8, and 15.7 per 1,000 live births for white, black, and Hispanic women, respectively. There was virtually no overlap in the white and black distributions. The variation in mean risk across cities was three times greater for black women compared with white women. The threefold disparity in mean rate, and two- to threefold increased variation as indicated by standard deviation, was maintained in all subanalyses. Compared with white women, black women have three times the mean VPT birth risk, as well as three times the variance in city-level rates. The racial disparity in VPT birth rates was composed of characteristics that were constant across MSAs, as well as factors that varied by MSA. The increased sensitivity to place for black women was unexplained by measured maternal and metropolitan factors. Understanding determinants of differences in both the mean risk and the variation of risk among black and white women may contribute to reducing the disparity in risk between races.

The Political Consequences of Latino Prejudice against Blacks

PubMed Central

Krupnikov, Yanna; Piston, Spencer

2016-01-01

A good deal of scholarship examines the effects of prejudice against blacks on public opinion and vote choice in the United States. Despite producing valuable insights, this research largely ignores the attitudes of Latinos—a critical omission, since Latinos constitute a rapidly growing share of the population. Using two nationally representative survey data sets, we find that the level of racial prejudice is comparable for Latinos and non-Hispanic whites. Equally comparable are associations between prejudice and political preferences: policy opinion and support for Obama in the 2008 presidential election. Our findings suggest that despite demographic changes, efforts to enact policies intended to assist blacks and elect black candidates will continue to be undermined by prejudice. That said, Latinos are more likely than non-Hispanic whites to support policies intended to assist blacks, because Latinos are more Democratic than non-Hispanic whites, more egalitarian, and less committed to the value of limited government. PMID:27274574

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.

Racial and Ethnic Differences in Patient Navigation: Results from the Patient Navigation Research Program

PubMed Central

Ko, Naomi Y; Snyder, Frederick R; Raich, Peter C; Paskett, Electra D.; Dudley, Donald; Lee, Ji-Hyun; Levine, Paul H.; Freund, Karen M

2016-01-01

Purpose Patient navigation was developed to address barriers to timely care and reduce cancer disparities. This study explores navigation and racial and ethnic differences in time to diagnostic resolution of a cancer screening abnormality. Patients and Methods We conducted an analysis of the multi-site Patient Navigation Research Program. Participants with an abnormal cancer screening test were allocated to either navigation or control. Unadjusted median time to resolution was calculated for each racial and ethnic group by navigation and control. Multivariable Cox proportional hazards models were fit, adjusting for sex, age, cancer abnormality type, and health insurance, stratifying by center of care. Results Among a sample of 7,514 participants, 29% were Non-Hispanic White, 43% Hispanic, and 28% Black. In the control group Blacks had a longer median time to diagnostic resolution (108 days) than Non-Hispanic Whites (65 days) or Hispanics (68 days) (p< .0001). In the navigated groups, Blacks had a reduction in median time to diagnostic resolution (97 days) (p <.0001). In the multivariable models, among controls, Black race was associated with increased delay to diagnostic resolution (HR=0.77; 95% CI: 0.69, 0.84) compared to the Non-Hispanic Whites, which was reduced in the navigated arm (HR=0.85; 95% CI: 0.77, 0.94). Conclusion Patient navigation had its greatest impact for Black patients who had the greatest delays in care. PMID:27227342

Racial and ethnic disparities in meeting MTM eligibility criteria among patients with asthma.

PubMed

Lu, Degan; Qiao, Yanru; Johnson, Karen C; Wang, Junling

2017-06-01

Asthma is one of the most frequently targeted chronic diseases in the medication therapy management (MTM) programs of the Medicare prescription drug (Part D) benefits. Although racial and ethnic disparities in meeting eligibility criteria for MTM services have been reported, little is known about whether there would be similar disparities among adults with asthma in the United States. Adult patients with asthma (age ≥ 18) from Medical Expenditure Panel Survey (2011-2012) were analyzed. Bivariate analyses were conducted to compare the proportions of patients who would meet Medicare MTM eligibility criteria between non-Hispanic Blacks (Blacks), Hispanics and non-Hispanic Whites (Whites). Survey-weighted logistic regression was performed to adjust for patient characteristics. Main and sensitivity analyses were conducted to cover the entire range of the eligibility thresholds used by Part D plans in 2011-2012. The sample included 4,455 patients with asthma, including 2,294 Whites, 1,218 Blacks, and 943 Hispanics. Blacks and Hispanics had lower proportions of meeting MTM eligibility criteria than did Whites (P < 0.001). According to the main analysis, Blacks and Hispanics had 36% and 32% lower, respectively, likelihood of MTM eligibility than Whites (odds ratio [OR]: 0.64, 95% confidence interval [CI]: 0.45-0.90; OR: 0.68, 95% CI: 0.47-0.98, respectively). Similar results were obtained in sensitivity analyses. There are racial and ethnic disparities in meeting Medicare Part D MTM eligibility criteria among adult patients with asthma. Future studies should examine the implications of such disparities on health outcomes of patients with asthma and explore alternative MTM eligibility criteria.

Acute infection contributes to racial disparities in stroke mortality.

PubMed

Levine, Deborah A; Langa, Kenneth M; Rogers, Mary A M

2014-03-18

It is unknown whether racial differences in exposure to acute precipitants of stroke, specifically infection, contribute to racial disparities in stroke mortality. Among participants in the nationally representative Health and Retirement Study with linked Medicare data (1991-2007), we conducted a case-crossover study employing within-person comparisons to study racial/ethnic differences in the risks of death and hospitalization from ischemic stroke following acute infection. There were 964 adults hospitalized for ischemic stroke. Acute infection increased the 30-day risks of ischemic stroke death (5.82-fold) and ischemic stroke hospitalization (1.87-fold). Acute infection was a more potent trigger of acute ischemic stroke death in non-Hispanic blacks (odds ratio [OR] 39.21; 95% confidence interval [CI] 9.26-166.00) than in non-Hispanic whites (OR 4.50; 95% CI 3.14-6.44) or Hispanics (OR 5.18; 95% CI 1.34-19.95) (race-by-stroke interaction, p = 0.005). When adjusted for atrial fibrillation, infection remained more strongly associated with stroke mortality in blacks (OR 34.85) than in whites (OR 3.58) and Hispanics (OR 3.53). Acute infection increased the short-term risk of incident stroke similarly across racial/ethnic groups. Infection occurred often before stroke death in non-Hispanic blacks, with 70% experiencing an infection in the 30 days before stroke death compared to a background frequency of 15%. Acute infection disproportionately increases the risk of stroke death for non-Hispanic blacks, independently of atrial fibrillation. Stroke incidence did not explain this finding. Acute infection appears to be one factor that contributes to the black-white disparity in stroke mortality.

Prevalence of transportation and leisure walking among U.S. adults.

PubMed

Kruger, Judy; Ham, Sandra A; Berrigan, David; Ballard-Barbash, Rachel

2008-09-01

This paper aims to contrast the demographic correlates of leisure and transportation walking. Using data from the 2005 National Health Interview Survey (n=31,482), this paper reports on the prevalence of transportation walking and leisure walking for U.S. adults and examines the variation in prevalence across different socio-demographic groups. The prevalence of transportation walking and leisure walking for U.S. adults (> or =5 days/week for > or =30 min/day) was calculated using data from the 2005 National Health Interview Survey. In the United States, 41.5% of adults walked for leisure and 28.2% walked for transportation in intervals of at least 10 min. The highest prevalence of transportation walking was among black non-Hispanic men (36.0%) and Asian/Native Hawaiian/Pacific Islander women (40.5%). The highest prevalence of leisure walking was among Asian/Native Hawaiian/Pacific Islander men (42.0%) and white non-Hispanic women (46.6%). Leisure walking was most prevalent among respondents with higher incomes and education levels, whereas transportation walking increased in prevalence with education level but decreased with income level. Based on the findings, 6% of U.S. adults were considered regularly active (> or =5 days/week for > or =30 min/day) by walking for transportation and 9% were regularly active by walking for leisure. Leisure and transportation walking have distinctly different demographic correlates. These differences should guide interventions aimed at influencing walking for different purposes.

Racial and ethnic disparities in discharge to rehabilitation following traumatic brain injury.

PubMed

Meagher, Ashley D; Beadles, Christopher A; Doorey, Jennifer; Charles, Anthony G

2015-03-01

Disparities in access to inpatient rehabilitation services after traumatic brain injury (TBI) have been identified, but less well described is the likelihood of discharge to a higher level of rehabilitation for Hispanic or black patients compared with non-Hispanic white patients. The authors investigate racial disparities in discharge destination (inpatient rehabilitation vs skilled nursing facility vs home health vs home) following TBI by using a nationwide database and methods to address racial differences in prehospital characteristics. Analysis of discharge destination for adults with moderate to severe TBI was performed using National Trauma Data Bank data for the years 2007-2010. The authors performed propensity score weighting followed by ordered logistic regression in their analytical sample and in a subgroup analysis of older adults with Medicare. Likelihood of discharge to a higher level of rehabilitation based on race/ethnicity accounting for prehospital and in-hospital variables was determined. The authors identified 299,205 TBI incidents: 232,392 non-Hispanic white, 29,611 Hispanic, and 37,202 black. Propensity weighting resulted in covariate balance among racial groups. Hispanic (adjusted OR 0.71, 95% CI 0.68-0.75) and black (adjusted OR 0.94, 95% CI 0.91-0.97) populations were less likely to be discharged to a higher level of rehabilitation than were non-Hispanic whites. The subgroup analysis indicated that Hispanic (adjusted OR 0.79, 95% CI 0.71-0.86) and black (OR 0.87, 95% CI 0.81-0.94) populations were still less likely to receive a higher level of rehabilitation, despite uniform insurance coverage (Medicare). Adult Hispanic and black patients with TBI are significantly less likely to receive intensive rehabilitation than their non-Hispanic white counterparts; notably, this difference persists in the Medicare population (age ≥ 65 years), indicating that uniform insurance coverage alone does not account for the disparity. Given that insurance coverage and a wide range of prehospital characteristics do not eliminate racial disparities in discharge destination, it is crucial that additional unmeasured patient, physician, and institutional factors be explored to eliminate them.

Identifying the ‘Vulnerables’ in Biomedical Research: the vox populis from the Tuskegee Legacy Project

PubMed Central

Wiley, John

2011-01-01

Objectives This report presents, for the first time, findings on the vox populis as to who constitutes the ‘vulnerables in biomedical research’. Methods The 3-City Tuskegee Legacy Project (TLP) study used the TLP Questionnaire as administered via RDD telephone interviews to 1,162 adult Blacks, non-Hispanic Whites, and two Puerto Rican (PR) Hispanic groups: Mainland U.S. and San Juan (SJ) in 3 cities. The classification schema was based upon respondents’ answers to an open-ended question asking which groups of people were the most vulnerable when participating in biomedical research. Results Subjects provided 749 valid open-ended responses which were grouped into 29 direct response categories, leading to a 4 tier classification schema for vulnerability traits. Tier 1, the summary tier, had five vulnerability categories: 1) Race/ethnicity; 2) Age; 3) SES; 4) Health; and, 5) Gender. Blacks and Mainland U.S. PR Hispanics most frequently identified Race/Ethnicity as a vulnerability trait (42.1% of Blacks and 42.6% of Mainland U.S. PR Hispanics vs. 15.4% of Whites and 16.7% of San Juan R Hispanics) (p<.007), while Whites and SJ PR Hispanics most frequently identified Age (48.3% and 29.2%) as a vulnerability trait. Conclusions The response patterns on ‘who was vulnerable’ were similar for the two minority groups (Blacks and Mainland U.S. PR Hispanics), and notably different from the response patterns of the two majority groups (Whites and SJPR Hispanics). Further, the vox populis definition of vulnerables differed from the current official definitions as used by the U.S. federal government. PMID:21972462

Identifying the "vulnerables" in biomedical research: the vox populis from the Tuskegee Legacy Project.

PubMed

Chiu, Christopher T; Katz, Ralph V

2011-01-01

This report presents, for the first time, findings on the vox populis as to who constitutes the "vulnerables in biomedical research" The 3-City Tuskegee Legacy Project (TLP) study used the TLP questionnaire as administered via random-digit-dial telephone interviews to 1162 adult Black people, non-Hispanic White people, and two Puerto Rican (PR) Hispanic groups: Mainland United States and San Juan (SJ) in three cities. The classification schema was based upon respondents' answers to an open-ended question asking which groups of people were the most vulnerable when participating in biomedical research. Subjects provided 749 valid open-ended responses, which were grouped into 29 direct response categories, leading to a four-tier classification schema for vulnerability traits. Tier 1, the summary tier, had five vulnerability categories: (1) Race/ ethnicity; (2) Age; (3) SES; (4) Health; and, (5) Gender. Black people and Mainland United States PR Hispanics most frequently identified Race/Ethnicity as a vulnerability trait (42.1 percent of Black people and 42.6 percent of Mainland United States. PR Hispanics versus 15.4 percent of White people and 16.7 percent of SJ R Hispanics) (P < 0.007), while White people and SJ PR Hispanics most frequently identified Age (48.3 percent and 29.2 percent) as a vulnerability trait. The response patterns on "who was vulnerable" were similar for the two minority groups (Black people and Mainland US PR Hispanics), and notably different from the response patterns of the two majority groups (White people and SJ PR Hispanics). Further, the vox populis definition of vulnerables differed from the current official definitions as used by the U.S. federal government.

Disproportionate Placement of Black and Hispanic Students in Special Education Programs.

ERIC Educational Resources Information Center

Goodale, Ronda; Soden, Marcia

The paper examines practices and procedures that are seen as contributory to disproportionate placement of Black and Hispanic students in special education programs and discusses various components of the Boston Public School's Remedial Plan. Practices and procedures critical in disproportionate placement are seen to include biased assessment,…

Blacks and Hispanics in High School Economics Texts.

ERIC Educational Resources Information Center

Ellington, Lucien

1986-01-01

An analysis of 12 secondary economics textbooks revealed that the economic issues of poverty, unemployment, and labor as they relate to Blacks and Hispanics are often ignored. Economics texts would be greatly improved if critical work led to the inclusion of even such rudimentary information as race-specific employment data. (RM)

Black-Brown Relations and Stereotypes.

ERIC Educational Resources Information Center

Mindiola, Tatcho Jr.; Niemann, Yolanda Flores; Rodriguez, Nestor

This book analyzes how African and Hispanic Americans perceive and interact with one another, highlighting black-brown relations in Houston, Texas, one of the largest cities with a majority ethnic population and one in which Hispanic Americans outnumber African Americans. Using results from several sociological studies, the book examines: how each…

Successful Teaching Strategies: Instruction for Black and Hispanic Students in the California Community Colleges.

ERIC Educational Resources Information Center

Mercado, Olivia; And Others

In response to the growing concern over the significant underrepresentation, underpreparation, and enrollment decline of minority students, the chancellor's office of the California Community Colleges prepared this report to identify community college instructional programs designed specifically for Blacks and Hispanics. Sections 1 through 3…

Comparing Black, Hispanic, and White Mothers with a National Standard of Parenting

ERIC Educational Resources Information Center

Strom, Robert D.; Strom, Paris S.; Beckert, Troy E.

2008-01-01

Black, Hispanic, and White mothers (N = 739) and adolescents (N = 806) completed a Parent Success Indicator to assess maternal behavior related to Communication, Use of Time, Teaching, Frustration, Satisfaction, and Information Needs. Comparisons between each ethnic group and a previously established national parenting standard revealed that both…

Recruitment of Hispanic and Black Students.

ERIC Educational Resources Information Center

Rivera, Manuel G.

The issue of recruitment of community college minority students who are underrepresented in higher education (Hispanics and Blacks) is complex and needs various programs which are unique and fit within the framework of the institution. Historical elements in Texas make it difficult to implement recruitment efforts. Recent statistics illustrate the…

The sexual and reproductive health of foreign-born women in the United States.

PubMed

Tapales, Athena; Douglas-Hall, Ayana; Whitehead, Hannah

2018-02-14

To explore the sexual and reproductive health (SRH) behaviors, health insurance coverage and use of SRH services of women in the United States (U.S.) by nativity, disaggregated by race and ethnicity. We analyzed publicly available and restricted data from the National Survey of Family Growth to assess differences and similarities between foreign-born and U.S.-born women, both overall and within Hispanic, non-Hispanic (NH) white, NH black and NH Asian groups. A larger proportion of foreign-born women than U.S.-born women lacked health insurance coverage. Foreign-born women utilized SRH services at lower rates than U.S.-born women; this effect diminished at the multivariate level, although race and ethnicity differences remained. Overall, foreign-born women were less likely to pay for SRH services with private insurance than U.S.-born women. Foreign-born women were less likely to use the most effective contraceptive methods than U.S.-born women, with some variation across race and ethnicity: NH white and NH black foreign-born women were less likely to use highly effective contraceptive methods than their U.S.-born counterparts, but among Hispanic women, the reverse was true. Our findings demonstrate that the SRH behaviors, needs and outcomes of foreign-born women differ from those of U.S-born women within the same race/ethnic group. This paper contributes to the emergent literature on immigrants in the U.S. by laying the foundation for further research on the SRH of the foreign-born population in the country, which is critical for developing public health policies and programs to understand better and serve this growing and diverse population. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Different yet similar: Examining race and ethnicity in treatment-seeking adults with binge eating disorder.

PubMed

Lydecker, Janet A; Grilo, Carlos M

2016-01-01

This study examined racial/ethnic differences in demographic variables and the clinical presentation of treatment-seeking adults with binge eating disorder (BED) who participated in treatment research at a medical school-based program. Participants were 775 (n = 195 men, n = 560 women) treatment-seeking adults with DSM-IV-defined BED who self-identified as Black (n = 121), Hispanic (n = 54), or White (n = 580). Doctoral-level research clinicians assessed participants for BED and for eating disorder psychopathology using the Structured Clinical Interview for DSM-IV Disorders and the Eating Disorder Examination (EDE) interview, and measured height and weight. Participants also completed established self-report measures. Black participants had a greater proportion of women than White participants and White participants had higher education than Black and Hispanic participants. Black participants had higher body mass index (BMI) and reported more frequent binge eating episodes than White participants but eating-disorder psychopathology (EDE scales and Global Severity) did not significantly differ across racial/ethnic groups. Black participants had lower levels of depression than Hispanic and White participants. These differences in clinical presentation remained unchanged after adjusting for age, education, sex, and BMI. White participants had younger ages of onset for dieting, binge eating, and obesity, but not BED, than Black and Hispanic participants. There are some racial/ethnic differences in the developmental trajectories and clinical presentation of treatment-seeking adults with BED that remain unchanged after adjusting for demographic differences. Black participants presented for treatment with higher BMI and binge eating frequency than White participants and with lower depression than White and Hispanic groups, but associated eating disorder psychopathology levels were similar across racial/ethnic groups. (c) 2015 APA, all rights reserved).

Native American and Hispanic Students: Recruitment, Enrollment, Retention and Graduation Trends; Institutional Performance Measures and Targets; Institutional Action Plans

ERIC Educational Resources Information Center

New Mexico Higher Education Department, 2005

2005-01-01

New Mexicans of Native American and Hispanic ancestry participate less often and less successfully in the higher education system than do other groups. This fact has been demonstrated repeatedly in various studies and is exacerbated by a cycle of poverty, inadequate academic and financial preparation for college, and other issues related to…

School Characteristics and Experiences of African American, Hispanic/Latino, and Native American Youth in Rural Communities: Relation to Educational Aspirations

ERIC Educational Resources Information Center

Irvin, Matthew J.; Byun, Soo-yong; Meece, Judith L.; Reed, Karla S.; Farmer, Thomas W.

2016-01-01

The primary purpose of this study was to examine differences in the school characteristics and experiences of African American, Hispanic/Latino, and Native American youth in rural high schools as well as their relation to educational aspirations. We also investigated the characteristics and experiences of students and their families given that…

Racial/Ethnic Differences in Cardiovascular Risk Factors Among Women Veterans

DTIC Science & Technology

2013-01-01

at all?” with respondents who indicated they smoke every day designat- ed as daily smokers . For physical activity, we asked, “On average, how many...ethnic categories were created: Hispanic, Non -Hispanic White (White), Non -Hispanic Black (Black), and Other. Logistic regressions were conducted for each...likely than White women Veterans to report diabetes (OR: 4.20, 95 % CI: 1.15, 15.39) and daily smoking (OR: 3.38, 95 % CI: 1.01, 11.30), but less

Genetic ancestry and lower extremity peripheral artery disease in the Multi-Ethnic Study of Atherosclerosis.

PubMed

Allison, Matthew A; Peralta, Carmen A; Wassel, Christina L; Aboyans, Victor; Arnett, Donna K; Cushman, Mary; Eng, John; Ix, Joachim; Rich, Stephen S; Criqui, Michael H

2010-10-01

Using self-report of race/ethnicity, African Americans consistently have a higher prevalence of peripheral artery disease (PAD) compared to other ethnic groups. We aimed to determine the associations between estimated genetic admixture and PAD among African and Hispanic Americans. We studied the association between genetic ancestry and PAD among 1417 African and Hispanic American participants in the Multi-Ethnic Study of Atherosclerosis who were genotyped for ancestry informative markers (AIMs). PAD was defined as an ankle-brachial index (ABI) < 0.90. The overall prevalence of PAD among the 712 self-identified African American subjects was 15.2% and 4.6% among the 705 self-identified Hispanic Americans. A one standard deviation increment in European ancestry was associated with non-significant reductions in the odds for PAD among African (OR: 0.96 [95% CI: 0.78-1.18]) and Hispanic Americans (0.84 [0.58-1.23]), while the same increment in Native American ancestry was significantly associated with a lower odds of PAD in Hispanic Americans (0.56 [0.36-0.96]). Adjustment for demographic variables, field center, cardiovascular disease (CVD) risk factors and inflammatory markers strengthened the odds for European ancestry among African (0.85 [0.66-1.10]) and Hispanic Americans (0.68 [0.41-1.11]). The magnitude of the association for Native American ancestry among Hispanic Americans did not materially change (0.56 [0.29-1.09]). In conclusion, a higher percent Native American ancestry in Hispanics is associated with a lower odds of PAD while in both Hispanics and African Americans, greater European ancestry does not appear to be associated with lower odds for PAD.

Disparities in survival improvement for metastatic colorectal cancer by race/ethnicity and age in the United States.

PubMed

Sineshaw, Helmneh M; Robbins, Anthony S; Jemal, Ahmedin

2014-04-01

Previous studies documented significant increase in overall survival for metastatic colorectal cancer (CRC) since the late 1990s coinciding with the introduction and dissemination of new treatments. We examined whether this survival increase differed across major racial/ethnic populations and age groups. We identified patients diagnosed with primary metastatic colorectal cancer during 1992-2009 from 13 population-based cancer registries of the National Cancer Institute's Surveillance, Epidemiology, and End Results Program, which cover about 14 % of the US population. The 5-year cause-specific survival rates were calculated using SEER*Stat software. From 1992-1997 to 2004-2009, 5-year cause-specific survival rates increased significantly from 9.8 % (95 % CI 9.2-10.4) to 15.7 % (95 % CI 14.7-16.6) in non-Hispanic whites and from 11.4 % (95 % CI 9.4-13.6) to 17.7 % (95 % CI 15.1-20.5) in non-Hispanic Asians, but not in non-Hispanic blacks [from 8.6 % (95 % CI 7.2-10.1) to 9.8 % (95 % CI 8.1-11.8)] or Hispanics [from 14.0 % (95 % CI 11.8-16.3) to 16.4 % (95 % CI 14.0-19.0)]. By age group, survival rates increased significantly for the 20-64-year age group and 65 years or older age group in non-Hispanic whites, although the improvement in the older non-Hispanic whites was substantially smaller. Rates also increased in non-Hispanic Asians for the 20-64-year age group although marginally nonsignificant. In contrast, survival rates did not show significant increases in both younger and older age groups in non-Hispanic blacks and Hispanics. Non-Hispanic blacks, Hispanics, and older patients diagnosed with metastatic CRC have not equally benefitted from the introduction and dissemination of new treatments.

Diabetes and RACE A Historical Perspective

PubMed Central

2011-01-01

Today, US government sources inform us that Native Americans, Blacks, and Hispanics/Latinos run the greatest risk of developing type 2 diabetes. One hundred years ago, however, Jews were thought to be the population most likely to develop this disease. I evaluated the evidence that the medical and public health communities provided to support the purported link between diabetes and Jews. Diabetes was conceptualized as a Jewish disease not necessarily because its prevalence was high among this population, but because medicine, science, and culture reinforced each other, helping to construct narratives that made sense at the time. Contemporary narratives are as problematic as the erstwhile depiction of diabetes as a disease of Jews. PMID:21148711

Dietary and urinary metabonomic factors possibly accounting for higher blood pressure of black compared with white Americans: results of International Collaborative Study on macro-/micronutrients and blood pressure.

PubMed

Stamler, Jeremiah; Brown, Ian J; Yap, Ivan K S; Chan, Queenie; Wijeyesekera, Anisha; Garcia-Perez, Isabel; Chadeau-Hyam, Marc; Ebbels, Timothy M D; De Iorio, Maria; Posma, Joram; Daviglus, Martha L; Carnethon, Mercedes; Holmes, Elaine; Nicholson, Jeremy K; Elliott, Paul

2013-12-01

Black compared with non-Hispanic white Americans have higher systolic and diastolic blood pressure and rates of prehypertension/hypertension. Reasons for these adverse findings remain obscure. Analyses here focused on relations of foods/nutrients/urinary metabolites and higher black blood pressure for 369 black compared with 1190 non-Hispanic white Americans aged 40 to 59 years from 8 population samples. Multiple linear regression, standardized data from four 24-hour dietary recalls per person, two 24-hour urine collections, and 8 blood pressure measurements were used to quantitate the role of foods, nutrients, and metabolites in higher black blood pressure. Compared with non-Hispanic white Americans, blacks' average systolic/diastolic pressure was higher by 4.7/3.4 mm Hg (men) and 9.0/4.8 mm Hg (women). Control for higher body mass index of black women reduced excess black systolic/diastolic pressure to 6.8/3.8 mm Hg. Lesser intake of vegetables, fruits, grains, vegetable protein, glutamic acid, starch, fiber, minerals, and potassium, and higher intake of processed meats, pork, eggs, and sugar-sweetened beverages, along with higher cholesterol and higher Na/K ratio, related to in higher black blood pressure. Control for 11 nutrient and 10 non-nutrient correlates reduced higher black systolic/diastolic pressure to 2.3/2.3 mm Hg (52% and 33% reduction in men) and to 5.3/2.8 mm Hg (21% and 27% reduction in women). Control for foods/urinary metabolites had little further influence on higher black blood pressure. Less favorable multiple nutrient intake by blacks than non-Hispanic white Americans accounted, at least in part, for higher black blood pressure. Improved dietary patterns can contribute to prevention/control of more adverse black blood pressure levels.

Race-ethnicity and poverty after spinal cord injury.

PubMed

Krause, J S; Dismuke, C E; Acuna, J; Sligh-Conway, C; Walker, E; Washington, K; Reed, K S

2014-02-01

Secondary analysis of existing data. Our objective was to examine the relationship between race-ethnicity and poverty status after spinal cord injury (SCI). A large specialty hospital in the southeastern United States. Participants were 2043 adults with traumatic SCI in the US. Poverty status was measured using criteria from the US Census Bureau. Whereas only 14% of non-Hispanic White participants were below the poverty level, 41.3% of non-Hispanic Blacks were in poverty. Logistic regression with three different models identified several significant predictors of poverty, including marital status, years of education, level of education, age and employment status. Non-Hispanic Blacks had 2.75 greater odds of living in poverty after controlling for other factors, including education and employment. We may need to consider quality of education and employment to better understand the elevated risk of poverty among non-Hispanic Blacks in the US.

Racial/ethnic disparities in history of incarceration, experiences of victimization, and associated health indicators among transgender women in the U.S.

PubMed

Reisner, Sari L; Bailey, Zinzi; Sevelius, Jae

2014-01-01

Limited national data document the prevalence of incarceration among transgender women, experiences of victimization while incarcerated, and associations of transgender status with health. Data were from the National Transgender Discrimination Survey (NTDS), a large convenience sample of transgender adults in the U.S., collected between September 2008 and March 2009. Respondents who indicated a transfeminine gender identity were included in the current study (n = 3,878). Multivariable logistic regression was used to model ever being incarcerated and experiencing victimization while incarcerated as a function of race/ethnicity and health-related indicators. Overall, 19.3% reported having ever been incarcerated. Black and Native American/Alaskan Native transgender women were more likely to report a history of incarceration than White (non-Hispanic) respondents, and those with a history of incarceration were more likely to report negative health-related indicators, including self-reporting as HIV-positive. Among previously incarcerated respondents, 47.0% reported victimization while incarcerated. Black, Latina, and mixed race transgender women were more likely to report experiences of victimization while incarcerated. Transgender women reported disproportionately high rates of incarceration and victimization while incarcerated, as well as associated negative health-related indicators. Interventions and policy changes are needed to support transgender women while incarcerated and upon release.

Racial/ethnic disparities in obesity among US-born and foreign-born adults by sex and education.

PubMed

Barrington, Debbie S; Baquero, Maria C; Borrell, Luisa N; Crawford, Natalie D

2010-02-01

This study examines sex and education variations in obesity among US- and foreign-born whites, blacks, and Hispanics utilizing 1997-2005 data from the National Health Interview Survey on 267,585 adults aged > or =18 years. After adjusting for various demographic, health, and socioeconomic factors via logistic regression, foreign-born black men had the lowest odds for obesity relative to US-born white men. The largest racial/ethnic disparity in obesity was between US-born black and white women. High educational attainment diminished the US-born black-white and Hispanic-white disparities among women, increased these disparities among men, and had minimal effect on foreign-born Hispanic-white disparities among women and men. Comprehension of these relationships is vital for conducting effective obesity research and interventions within an increasingly diverse United States.

Religious Media Use Among African Americans, Black Caribbeans, and Non-Hispanic Whites

PubMed Central

Chatters, Linda M.

2014-01-01

The purpose of this study was to examine the correlates of watching religious television programs and listening to religious radio programs. Data are taken from the National Survey of American Life, a nationally representative study of African Americans, Black Caribbeans, and non-Hispanic Whites. Several significant findings were noted. Both African Americans and Black Caribbeans watched religious television programs and listened to religious radio programs significantly more frequently than non-Hispanic whites. These differences in electronic religious media consumption were particularly large, especially listening to religious radio programming. Among African Americans and Black Caribbeans, several significant demographic differences in frequency of consuming religious programming (e.g., age, gender, region, marital status, immigration status) emerged. Lastly, our analysis found that consuming electronic religious programming did not substitute for attending church service but, instead, complemented weekly service attendance. PMID:26045698

Association of race and ethnicity with management of abdominal pain in the emergency department.

PubMed

Johnson, Tiffani J; Weaver, Matthew D; Borrero, Sonya; Davis, Esa M; Myaskovsky, Larissa; Zuckerbraun, Noel S; Kraemer, Kevin L

2013-10-01

To determine if race/ethnicity-based differences exist in the management of pediatric abdominal pain in emergency departments (EDs). Secondary analysis of data from the 2006-2009 National Hospital Ambulatory Medical Care Survey regarding 2298 visits by patients ≤ 21 years old who presented to EDs with abdominal pain. Main outcomes were documentation of pain score and receipt of any analgesics, analgesics for severe pain (defined as ≥ 7 on a 10-point scale), and narcotic analgesics. Secondary outcomes included diagnostic tests obtained, length of stay (LOS), 72-hour return visits, and admission. Of patient visits, 70.1% were female, 52.6% were from non-Hispanic white, 23.5% were from non-Hispanic black, 20.6% were from Hispanic, and 3.3% were from "other" racial/ethnic groups; patients' mean age was 14.5 years. Multivariate logistic regression models adjusting for confounders revealed that non-Hispanic black patients were less likely to receive any analgesic (odds ratio [OR]: 0.61; 95% confidence interval [CI]: 0.43-0.87) or a narcotic analgesic (OR: 0.38; 95% CI: 0.18-0.81) than non-Hispanic white patients (referent group). This finding was also true for non-Hispanic black and "other" race/ethnicity patients with severe pain (ORs [95% CI]: 0.43 [0.22-0.87] and 0.02 [0.00-0.19], respectively). Non-Hispanic black and Hispanic patients were more likely to have a prolonged LOS than non-Hispanic white patients (ORs [95% CI]: 1.68 [1.13-2.51] and 1.64 [1.09-2.47], respectively). No significant race/ethnicity-based disparities were identified in documentation of pain score, use of diagnostic procedures, 72-hour return visits, or hospital admissions. Race/ethnicity-based disparities exist in ED analgesic use and LOS for pediatric abdominal pain. Recognizing these disparities may help investigators eliminate inequalities in care.

Health disparities in awareness of physical activity and cancer prevention: findings from the National Cancer Institute's 2007 Health Information National Trends Survey (HINTS).

PubMed

Oh, April; Shaikh, Abdul; Waters, Erika; Atienza, Audie; Moser, Richard P; Perna, Frank

2010-01-01

This national study examines differences between racial/ethnic groups on awareness of physical activity and reduced cancer risk and explores correlates of awareness including trust, demographic, and health characteristics within racial/ethnic groups. The 2007 Health Information and National Trends Survey (HINTS) provided data for this study. After exclusions, 6,809 adults were included in analyses. Awareness of physical activity in reduced cancer risk was the main outcome. Logistic regression models tested relationships. Non-Hispanic Blacks had a 0.71 (0.54,0.93) lower odds of being aware of physical activity in reduced cancer risk than non-Hispanic Whites. Current attempts to lose weight were associated with greater odds for awareness among non-Hispanic Blacks and Hispanics (p < .01). Among non-Hispanic Blacks, trust in traditional and Internet media was associated with greater odds of awareness (p < .01). This study is the first national study to examine racial/ethnic disparities in awareness of physical activity and cancer risk. Comparisons between racial/ethnic groups found Black-White disparities in awareness. Variables associated with awareness within racial/ethnic groups identify potential subgroups to whom communication efforts to promote awareness may be targeted.

Racial and ethnic disparities in work-related injuries and socio-economic resources among nursing assistants employed in US nursing homes.

PubMed

Tak, SangWoo; Alterman, Toni; Baron, Sherry; Calvert, Geoffrey M

2010-10-01

We aimed to estimate the proportion of nursing assistants (NAs) in the US with work-related injuries and insufficient socio-economic resources by race/ethnicity. Data from the 2004 National Nursing Assistant Survey (NNAS), a nationally representative sample survey of NAs employed in United States nursing homes, were analyzed accounting for the complex survey design. Among 2,880 participants, 44% reported "scratch, open wounds, or cuts" followed by "back injuries" (17%), "black eyes or other types of bruising" (16%), and "human bites" (12%). When compared to non-Hispanic white NAs, the adjusted rate ratio (RR) for wound/cut was 0.74 for non-Hispanic black NAs (95% confidence interval [CI]: 0.65-0.85). RRs for black eyes/bruises were 0.18 for non-Hispanic black NAs (95% CI: 0.12-0.26), and 0.55 for Hispanic NAs (95% CI: 0.37-0.82). Minority racial and ethnic groups were less likely to report having experienced injuries compared with non-Hispanic white NAs. Future research should focus on identifying preventable risk factors, such as differences by race and ethnicity in the nature of NA jobs and the extent of their engagement in assisting patients with activities of daily living. © 2010 Wiley-Liss, Inc.

Cancer Incidence Among Arab Americans in California, Detroit, and New Jersey SEER Registries

PubMed Central

Bergmans, Rachel; Ruterbusch, Julie; Meza, Rafael; Hirko, Kelly; Graff, John; Schwartz, Kendra

2014-01-01

Objectives. We calculated cancer incidence for Arab Americans in California; Detroit, Michigan; and New Jersey, and compared rates with non-Hispanic, non-Arab Whites (NHNAWs); Blacks; and Hispanics. Methods. We conducted a study using population-based data. We linked new cancers diagnosed in 2000 from the Surveillance, Epidemiology, and End Results Program (SEER) to an Arab surname database. We used standard SEER definitions and methodology for calculating rates. Population estimates were extracted from the 2000 US Census. We calculated incidence and rate ratios. Results. Arab American men and women had similar incidence rates across the 3 geographic regions, and the rates were comparable to NHNAWs. However, the thyroid cancer rate was elevated among Arab American women compared with NHNAWs, Hispanics, and Blacks. For all sites combined, for prostate and lung cancer, Arab American men had a lower incidence than Blacks and higher incidence than Hispanics in all 3 geographic regions. Arab American male bladder cancer incidence was higher than that in Hispanics and Blacks in these regions. Conclusions. Our results suggested that further research would benefit from the federal recognition of Arab Americans as a specified ethnicity to estimate and address the cancer burden in this growing segment of the population. PMID:24825237

White, Black, and Hispanic Students' Perceptions of a Community College Environment.

ERIC Educational Resources Information Center

de Armas, Cristina P.; McDavis, Roderick J.

1981-01-01

Administered the College and University Environment Scale (CUES) to White, Black, and Hispanic students (N=150). An analysis of variance was used to test for significant differences on the five scales of the CUES. Results indicated that these students perceive the college environment in significantly different ways. Implications discussed. (RC)

Outdoor Recreation Participation: Blacks, Whites, Hispanics, and Asians in Illinois

Treesearch

John F. Dwyer

1992-01-01

Blacks, Whites, Hispanics, and Asians in Illinois attach a high level of significance to outdoor recreation. However, there are important differences in the outdoor recreation participation patterns of these four groups, including the activities participated in and where they participate, that have important implications for recreation resource planning and research....

Recruiting Minorities: What Explains Recent Trends in the Army and Navy?

ERIC Educational Resources Information Center

Asch, Beth J.; Heaton, Paul; Savych, Bogdan

2009-01-01

Since 2000, black representation among high-quality recruits in the Army has decreased, while Hispanic representation has increased; in the Navy, black representation has remained stable and Hispanic representation has increased. (Recruits are considered to be high-quality if they have graduated high school and score above average on the Armed…

College-Ready Urban Black, Hispanic, and Biracial Students: Why Are They Not Applying to College?

ERIC Educational Resources Information Center

Lindsey, DeLois

2012-01-01

The study explored reasons why Black, Hispanic, and Biracial, first generation high school seniors who wish to attend college, do not apply. The literature indicated that these populations have consistently lower rates of college enrollment and educational attainment than Whites and Asians (Ashburn, 2008). Enrollment challenges included…

An Academic Partnership

ERIC Educational Resources Information Center

Horwedel, Dina M.

2005-01-01

Black and Hispanic studies are separate fields at most universities. However, at Baruch College, part of the City University of New York system, the Black and Hispanic studies minors are housed under the same roof. The somewhat unique partnership seems to be working, as the minors are among the most popular on the business-oriented campus. Dr.…

Racial and ethnic differences in men's knowledge and attitudes about contraception.

PubMed

Borrero, Sonya; Farkas, Amy; Dehlendorf, Christine; Rocca, Corinne H

2013-10-01

Little is known about racial/ethnic differences in men's contraceptive knowledge and attitudes. We used multivariable logistic regression to examine racial/ethnic differences in contraceptive knowledge and attitudes among 903 men aged 18-29 in the 2009 National Survey of Reproductive and Contraceptive Knowledge. Black and Hispanic men were less likely than Whites to have heard of most contraceptive methods, including female and male sterilization, and also had lower knowledge about hormonal and long-acting reversible methods. They were less likely to know that pills are ineffective when 2-3 pills are missed [Blacks: adjusted odds ratio (aOR)=0.42; Hispanics: aOR=0.53] and that fertility was not delayed after stopping the pill (Blacks: aOR=0.52; Hispanics: aOR=0.27). Hispanics were less likely to know that nulliparous women can use the intrauterine device (aOR=0.47). Condom knowledge was similar by race/ethnicity, but Blacks were less likely to view condoms as a hassle than Whites (aOR=0.46). Efforts to educate men, especially men of color, about contraceptive methods are needed. Published by Elsevier Inc.

Teenage pregnancy in an urban hospital setting.

PubMed

Davis, J K; Fink, R; Yesupria, A; Rajegowda, B; Lala, R

1986-01-01

Recent research suggests that adverse consequences of teenage pregnancy are largely a function of social background factors and adequacy of prenatal care. This study examines the situation of young mothers with new babies in a low income, urban environment. The study explores the relationship between age and ethnicity and various life circumstance and life style differences which might effect long term developmental outcome. 475 Hispanic and black mothers were interviewed using a structured questionnaire. The majority are poorly educated, single parents. Educational attainment is higher for blacks than for Hispanics and for older mothers than for younger. Older mothers are more likely to be living with the father, to be married, and to have received adequate prenatal care. Hispanic parents are more likely than Blacks to be planning to live together. Hispanic mothers are more likely than blacks to be planning to be the primary caretaker for their babies. Adequacy of prenatal care is related to both prematurity and low birth weight. The implications of these findings are discussed in relation to pregnancy prevention and parenting education programs.

The Peoples Multicultural Almanac: America from the 1400s to Present. 365 Days of Contributions by African Americans, Asian Americans, Hispanic Americans, Native Americans, European Americans.

ERIC Educational Resources Information Center

Taylor, Earl J., Jr.; And Others

The Peoples Multicultural Almanac provides five entries for each day in the school year, September through May, organized for the following ethnic groups: (1) African Americans; (2) Asian Americans; (3) European Americans; (4) Hispanic Americans; and (5) Native Americans. The entries highlight significant social, political, historical, cultural,…

Racial and ethnic disparities in police-reported intimate partner violence perpetration: a mixed methods approach.

PubMed

Lipsky, Sherry; Cristofalo, Meg; Reed, Sarah; Caetano, Raul; Roy-Byrne, Peter

2012-07-01

The objectives of this study were to examine racial and ethnic disparities in perpetrator and incident characteristics and discrepancies between police charges and reported perpetrator behaviors in police-reported intimate partner violence (IPV). This cross-sectional study used standardized police data and victim narratives of IPV incidents reported to the police in Dallas, Texas in 2004. The sample included non-Hispanic White, non-Hispanic Black, and Hispanic male perpetrators who were residents of Dallas (N = 4470). Offense charges were prioritized in descending order: sexual assault, aggravated assault, simple assault, kidnapping, robbery, and intimidation. Textual data from the victim narratives were coded, based on the revised Conflict Tactics Scales (CTS), and categorized in descending order of priority: sexual (severe, minor), physical (severe, minor), and psychological (severe, minor) assault. Perpetrators were more likely to be Black and Hispanic. Perpetrator and incident characteristics varied significantly by race/ethnicity, particularly age, age difference between partners, marital status, injury, and interracial relationships. Qualitative data revealed that greater proportions of Black and Hispanic men perpetrated severe physical, but not sexual violence, compared with White men. The greatest disparity between CTS categories and police charges occurred among those cases identified by the CTS as severe physical IPV; 84% were charged with simple assault. Significant differences by race/ethnicity were found only for simple assault charges, which were coded as severe physical as opposed to minor physical IPV more often among Black (69% and 31%) compared with White (62% and 38%) men. The disparities revealed in this study highlight the need to enhance primary and secondary prevention efforts within Black and Hispanic communities and to increase linkages between police, community, and public health organizations.

Ethnic differences in growth and nutritional status: a study of poor schoolchildren in southern New Jersey.

PubMed Central

Scholl, T O; Karp, R J; Theophano, J; Decker, E

1987-01-01

The growth and nutritional status of 2,056 schoolchildren from a poor community in southern New Jersey were assessed. Age-adjusted differences in growth among black, white, and Hispanic children were examined. Black youths were 2.5 centimeters (cm) taller (P less than .001) and 0.9 kilograms (kg) heavier than white youths (P less than .05). Black girls were 4.1 cm taller (P less than .001) and 2.8 kg heavier than white girls (P less than .01). Hispanic girls were 1 kg heavier (P less than .05) and 0.9 cm taller (not significant) than white girls. There was little difference in growth between Hispanic and white youths. Children were assessed with the use of the Centers for Disease Control's nutritional surveillance cutpoints; less than 5 percent of each ethnic group fell below the fifth percentile, according to the National Center for Health Statistics' weight-for-height standards. White and Hispanic youths were twice as likely as blacks to fall below the 5th percentile for stature or to be overweight (above the 95th percentile for weight-for-height). Compared with black girls, white and Hispanic girls were three to four times more likely to fall below the fifth percentile for stature. The prevalence of short stature was also higher among white girls (15.9 percent) compared with Hispanics (10.3 percent). There was little difference in the prevalence of overweight by ethnic group for girls. These data show that white children from poor communities have decreased growth and suggest that they may be at increased risk of nutritional problems. PMID:3108943

Hispanics in the Labor Force: A Conference Report.

ERIC Educational Resources Information Center

Borjas, George, Ed.; Tienda, Marta, Ed.

Hispanics in the U.S. labor force are the subject of the studies in this volume. After an introduction by George J. Borjas and Marta Tienda, the first three papers focus on the same issue: the determination of wage rates for Hispanics and comparison of Hispanic and non-Hispanic wage rates. Cordelia Reimers compares the situation for Black, White,…

Long term trends and racial/ethnic disparities in the prevalence of obesity.

PubMed

Wong, Robert J; Chou, Christina; Ahmed, Aijaz

2014-12-01

Obesity is an epidemic associated with higher rates of hypertension, diabetes, and cardiovascular diseases. However, significant racial disparities in the prevalence of obesity have been reported. To evaluate racial disparities and trends in the prevalence of obesity and obesity-related diseases. A population-based retrospective cohort study utilized data from the 1985 to 2011 California Behavioral Risk Factor Survey. Trends in obesity prevalence were stratified by age, sex, race/ethnicity, and socioeconomic factors. Multivariate logistic regression models evaluated independent predictors of obesity. The prevalence of obesity in significantly increased from 1985 to 2011 (8.6 vs. 22.8%, p < 0.001). This increase was seen among men and women, and among all race/ethnic, age, and socioeconomic groups. Hypertension and diabetes also increased during this time period (hypertension 20.7-35.9%; diabetes 4.2-11.2%). Obesity prevalence was highest in blacks and Hispanics, and lowest in Asians (blacks 33.3%; Hispanics 28.8%; Asians 9.0%; p < 0.001). Obesity prevalence was associated with lower education level, lower income, and unemployment status. After adjustments for age, sex, co morbidities, and surrogates of socioeconomic status, the increased risk of obesity in blacks and Hispanics persisted (blacks OR 1.51; Hispanics OR 1.18), whereas Asians were less likely to be obese (OR 0.37). While the overall prevalence of obesity increased from 1985 to 2011, significant racial/ethnic disparities in obesity have developed, with the highest prevalence seen in blacks and Hispanics, and the lowest seen in Asians.

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.

The publics' understanding of daily caloric recommendations and their perceptions of calorie posting in chain restaurants.

PubMed

Bleich, Sara N; Pollack, Keshia M

2010-03-09

Calorie posting in chain restaurants has received increasing attention as a policy lever to reduce energy intake. Little research has assessed consumer understanding of overall daily energy requirements or perceived effectiveness of calorie posting. A phone survey was conducted from May 1 through 17, 2009 with 663 randomly selected, nationally-representative adults aged 18 and older, including an oversample of Blacks and Hispanics in the United States. To examine differences in responses by race and ethnicity (White, Black, and Hispanic) and gender, we compared responses by conducting chi-squared tests for differences in proportions. We found that most Americans were knowledgeable about energy requirements for moderately active men (78%) and women (69%), but underestimated energy requirements for inactive adults (60%). Whites had significantly higher caloric literacy and confidence about their caloric knowledge than Blacks and Hispanics (p < 0.05). As compared to their counterparts, Blacks, Hispanics and women reported a significantly higher likelihood of eating at a chain restaurant and of selecting lower calorie foods where caloric information was posted. Most Americans favored the government requiring chain restaurants to post calorie information on menus at the point of purchase (68%). Support for government mandated calorie posting in chain restaurants was significantly higher among Blacks, Hispanics and women as compared to their counterparts. The public was divided about the mode of caloric information that would best help them make a lower calorie decision; a third favored number of calories (35%) which is the current standard mode of presenting caloric information in chain restaurants, a third favored a physical activity equivalent (26%), and a third favored percentage of total energy intake (39%). Mandating calorie posting in chain restaurants may be a useful policy tool for promoting energy balance, particularly among Blacks, Hispanics and women who have higher obesity risk.

The publics' understanding of daily caloric recommendations and their perceptions of calorie posting in chain restaurants

PubMed Central

2010-01-01

Background Calorie posting in chain restaurants has received increasing attention as a policy lever to reduce energy intake. Little research has assessed consumer understanding of overall daily energy requirements or perceived effectiveness of calorie posting. Methods A phone survey was conducted from May 1 through 17, 2009 with 663 randomly selected, nationally-representative adults aged 18 and older, including an oversample of Blacks and Hispanics in the United States. To examine differences in responses by race and ethnicity (White, Black, and Hispanic) and gender, we compared responses by conducting chi-squared tests for differences in proportions. Results We found that most Americans were knowledgeable about energy requirements for moderately active men (78%) and women (69%), but underestimated energy requirements for inactive adults (60%). Whites had significantly higher caloric literacy and confidence about their caloric knowledge than Blacks and Hispanics (p < 0.05). As compared to their counterparts, Blacks, Hispanics and women reported a significantly higher likelihood of eating at a chain restaurant and of selecting lower calorie foods where caloric information was posted. Most Americans favored the government requiring chain restaurants to post calorie information on menus at the point of purchase (68%). Support for government mandated calorie posting in chain restaurants was significantly higher among Blacks, Hispanics and women as compared to their counterparts. The public was divided about the mode of caloric information that would best help them make a lower calorie decision; a third favored number of calories (35%) which is the current standard mode of presenting caloric information in chain restaurants, a third favored a physical activity equivalent (26%), and a third favored percentage of total energy intake (39%). Conclusion Mandating calorie posting in chain restaurants may be a useful policy tool for promoting energy balance, particularly among Blacks, Hispanics and women who have higher obesity risk. PMID:20214811

Race, Ethnicity and Participation in the Arts: Patterns of Participation by Black, Hispanic and White Americans in Selected Activities from the 1982 and 1985 Surveys of Public Participation in the Arts.

ERIC Educational Resources Information Center

DiMaggio, Paul; Ostrower, Francie

This report utilizes data from the 1982 and 1985 Surveys of Public Participation in the Arts to describe differences in patterns of participation in selected arts related activities by Black, Hispanic, and White respondents. Arts participation by Whites is greatest for all selected activities, except for Black attendance at jazz music activities.…

Histopathologic differences account for racial disparity in uterine cancer survival☆,☆☆

PubMed Central

Smotkin, David; Nevadunsky, Nicole S.; Harris, Kimala; Einstein, Mark H.; Yu, Yiting; Goldberg, Gary L.

2013-01-01

Objective The incidence for uterine cancers has been reported to be higher among white women, whereas mortality is higher among black women. Reasons for the higher mortality among black women are not completely understood. The aim of our study is to examine the relationship between race/ethnicity, histopathologic subtype, and survival in uterine cancer. Methods We abstracted socio-demographic, treatment, and survival data for all women who were diagnosed with uterine cancer at Montefiore Medical Center from January 1999 through December 2009. Pathology records were reviewed. Results 984 patients were identified. Racial/ethnic distribution was 382 (39%) white, 308 (31%) black, 232 (24%) Hispanic, and 62 (6.3%) other races, mixed, or unknown. 592 (60%) patients had endometrioid histology. Blacks were much more likely than whites to have non-endometrioid histologies (p<0.001), including papillary serous, carcinosarcoma, and leiomyosarcoma. Blacks and Hispanics were at least as likely as whites to receive either chemotherapy or radiation therapy. The hazard ratio for death for black versus white patients was 1.94 (p<0.001) when all histological subtypes were included. The hazard ratio for Hispanics for death was 1.2 (p=0.32) compared to whites. However, when patients were divided into endometrioid and non-endometrioid histological subtypes, there was no significant difference in survival by race/ethnicity. Conclusion Black patients with uterine cancer are much more likely to die and are much more likely to have non-endometrioid histologies than white patients. There are no differences in survival among white, black, or Hispanic women with uterine cancer, after control for histological subtype. PMID:22940487

Racial/ethnic differences in initiation of and engagement with addictions treatment among patients with alcohol use disorders in the veterans health administration.

PubMed

Bensley, Kara M; Harris, Alex H S; Gupta, Shalini; Rubinsky, Anna D; Jones-Webb, Rhonda; Glass, Joseph E; Williams, Emily C

2017-02-01

Specialty addictions treatment can improve outcomes for patients with alcohol use disorders (AUD). Thus, initiation of and engagement with specialty addictions treatment are considered quality care for patients with AUD. Previous studies have demonstrated racial/ethnic differences in alcohol-related care but whether differences exist in initiation of and engagement with specialty addictions treatment among patients with clinically recognized alcohol use disorders is unknown. We investigated racial/ethnic variation in initiation of and engagement with specialty addictions treatment in a national sample of Black, Hispanic, and White patients with clinically recognized alcohol use disorders (AUD) from the US Veterans Health Administration (VA). National VA data were extracted for all Black, Hispanic, and White patients with a diagnosed AUD during fiscal year 2012. Mixed effects regression models estimated the odds of two measures of initiation (an initial visit within 180days of diagnosis; and initiation defined consistent with Healthcare Effectiveness Data and Information Set (HEDIS) as a documented visit ≤14days after index visit or inpatient admission), and three established measures of treatment engagement (≥3 visits within first month after initiation; ≥2 visits in each of the first 3months after initiation; and ≥2 visits within 30days of HEDIS initiation) for Black and Hispanic relative to White patients after adjustment for facility- and patient-level characteristics. Among 302,406 patients with AUD, 30% (90,879) initiated treatment within 180days of diagnosis (38% Black, 32% Hispanic, and 27% White). Black patients were more likely to initiate treatment than Whites for both measures of initiation [odds ratio (OR) for initiation: 1.4, 95% confidence interval (CI) 1.4-1.4; OR for HEDIS initiation: 1.1, 95% CI: 1.1-1.1]. Hispanic patients were more likely than White patients to initiate treatment within 180days (OR: 1.2, 95% CI 1.2-1.3) but HEDIS initiation did not differ between Hispanic and White patients. Engagement results varied depending on the measure but was more likely for Black patients relative to White for all measures (OR for engagement in first month: 1.1, 95% CI: 1.0-1.1; OR for engagement in first three months: 1.2, 95% CI: 1.1-1.2; OR for HEDIS measure: 1.1, 95% CI: 1.0-1.1), and did not differ between Hispanic and White patients. After accounting for facility- and patient-level characteristics, Black and Hispanic patients with AUD were more likely than Whites to initiate specialty addictions treatment, and Black patients were more likely than Whites to engage. Research is needed to understand underlying mechanisms and whether differences in initiation of and engagement with care influence health outcomes. Published by Elsevier Inc.

Racial and ethnic disparities in use of 17-alpha hydroxyprogesterone caproate for prevention of preterm birth.

PubMed

Yee, Lynn M; Liu, Lilly Y; Sakowicz, Allie; Bolden, Janelle R; Miller, Emily S

2016-03-01

Racial/ethnic disparities in preterm birth remain a major public health challenge in the United States. While 17-alpha hydroxyprogesterone caproate (17OHP-C) is recommended for preterm birth prevention in women with a prior preterm birth, non-Hispanic black women continue to experience higher rates of recurrent preterm birth than white women receiving the same treatment. Further investigation of disparities in 17OHP-C use and adherence is warranted. We sought to evaluate whether racial and ethnic disparities exist in the use of and adherence to 17OHP-C within a population of eligible women. This was a retrospective cohort study of women with a prior spontaneous, singleton preterm birth who were eligible for 17OHP-C for preterm birth prevention and received care at a single institution from 2010 through 2014. Associations between self-identified race/ethnicity (non-Hispanic black vs women in all other racial/ethnic groups) and documented counseling about 17OHP-C, receipt of any 17OHP-C, and adherence to 17OHP-C administration were each estimated by bivariable analysis and multivariable logistic regression. Adherence to 17OHP-C was defined as not >1 missed dose, initiation <20 weeks' gestational age, and continuation until 37 weeks or delivery. Of 472 women who were clinically eligible for 17OHP-C, 72% (N = 296) had documented 17OHP-C counseling and 48.9% (N = 229) received 17OHP-C. There were no differences in likelihood of 17OHP-C counseling or receipt of 17OHP-C based on race/ethnicity. While overall 83% (N = 176) of women were adherent to 17OHP-C, only 70% (N = 58) of non-Hispanic black women were adherent, compared to 91% (N = 118) of all other women (P < .001). Non-Hispanic black women had more missed doses (2.4 vs 0.4 doses, P < .001) and later initiation of care (12.0 vs 10.2 weeks, P < .001) than women in other racial/ethnic groups. After adjustment for potential confounders, non-Hispanic black women were significantly less likely to be adherent to 17OHP-C (adjusted odds ratio, 0.16; 95% confidence interval, 0.04-0.65). A significant interaction between non-Hispanic black race/ethnicity and public insurance was identified (adjusted odds ratio, 0.16; 95% confidence interval, 0.05-0.52). In a diverse cohort of women eligible for preterm birth prevention, non-Hispanic black women are at an increased risk of nonadherence to 17OHP-C. Non-Hispanic black women with public insurance are at a particularly increased risk of nonadherence. Copyright © 2016 Elsevier Inc. All rights reserved.

Prostate and Colorectal Cancer Screening Uptake among US and Foreign-Born Males: Evidence from the 2015 NHIS Survey.

PubMed

Ilunga Tshiswaka, Daudet; Donley, Tiffany; Okafor, Anthony; Memiah, Peter; Mbizo, Justice

2017-06-01

Research suggests that prostate and colorectal cancers disproportionately affect men in the US, but little is known about the determinants of prostate-specific antigen (PSA) and colorectal cancer (CRC) screening uptake among US and foreign-born males. The purpose of this study was to investigate what factors influence prostate and colorectal cancer screening uptake among US-native born and foreign-born men. Using the 2015 National Health Interview Survey, we conducted bivariate and multivariate analyses to highlight factors associated with the uptake of prostate and colorectal cancer screening among US-native born and foreign-born men. The sample size consisted of 5651 men respondents, with the mean age of 59.7 years (SD = 12.1). Of these, more than two-fifths (42%) were aged 50-64 years old. With respect to race/ethnicity, the sample was predominantly non-Hispanic Whites (65.5%), 863 (15.6%) Hispanics, and 710 (12.4%) Blacks. Our analysis found higher rates of both US-born and foreign-born men aged 65 years or older, who had either a PSA or CRC screening tests than those aged <65 years. Results of the general multivariate model suggest that men under 50 years old, US-born and foreign-born alike, are statistically significantly less likely to have prostate or colorectal cancer screenings than men aged 65 years or above. This study highlights the influencing factors that encourage or discourage PSA and CRC screening uptake between US-native born and foreign-born men. The results of this inquiry provide an evidence-based blueprint for policymakers and interventionists seeking to address prostate and colorectal cancer among men.

Dietary Intake Patterns of Low-Income Urban African American Adolescents

PubMed Central

Wang, Youfa; Jahns, Lisa; Tussing-Humphreys, Lisa; Xie, Bin; Rockett, Helaine; Liang, Huifang; Johnson, LuAnn

2010-01-01

Studies have indicated that family meals may be a protective factor for childhood obesity; however, limited evidence is available in children with different racial, socioeconomic, and individual characteristics. The purpose of this study was to examine family meal frequency (FMF) as a protective factor for obesity in a US-based sample of non-Hispanic White, non-Hispanic Black, and Hispanic children aged 6 to 11, and to identify individual, familial, and socioeconomic factors that moderate this association. Data were from the 2003 National Survey of Children’s Health (n=16,770). Multinomial logistic regression analyses were used to test the association between FMF and weight status, and the moderating effects of household structure, education, poverty level, and sex, by racial group. Non-Hispanic White children who consumed family meals everyday were less likely to be obese than those eating family meals 0 or few days a week. A moderating effect for gender was observed in non-Hispanic Black children such that FMF was marginally protective in boys but not girls. Higher FMF was a marginal risk factor for obesity in Hispanic boys from low-education households, but not in girls from similar households. In conclusion, family meals appear to be protective of obesity in non-Hispanic White children, and non-Hispanic Black boys; whereas, they may put Hispanic boys living in low education households at risk. Greater emphasis is needed in future research on understanding why this association differs among different race/ethnic groups, and the influence of the quality in addition to the quantity of family meals on child obesity. PMID:20800126

Hypertensive disease in pregnancy: an examination of ethnic differences and the Hispanic paradox.

PubMed

Carr, A; Kershaw, T; Brown, H; Allen, T; Small, M

2013-01-01

The "Hispanic paradox" refers to the epidemiological finding that Hispanics in the US have better health outcomes than the average population despite what their aggregate socioeconomic determinants would predict. The aim of this study was to evaluate obstetric outcomes for a multiethnic population with hypertensive diseases. We performed a retrospective review of parturients with hypertensive disease delivering at Duke University Medical Center. We analyzed maternal sociodemographic characteristics and ethnic differences in hypertensive disease types using Chi Square tests. A total of 3,124 women delivered during a period of one year; 9% of them had hypertensive diseases in pregnancy. Gestational hypertension was more commonly diagnosed in Whites, whereas chronic hypertension and mild preeclampsia were more frequently encountered in Blacks and Hispanics respectively (Chi-square = 39.11, p < 0.001). The overall incidence of preeclampsia was less in Hispanics. However, severe preeclampsia rates were equal across groups. Hispanics were more likely to be uninsured and younger, enter prenatal care later, and least likely to complete high school. There was no significant difference in smoking or parity. Stratified analyses by ethnicity showed that the relationship between severe preeclampsia and comorbidities (intrauterine growth restriction, low birth weight, and need for admission to intensive care nursery) were least pronounced in Hispanics and strongest in Black women. Despite similar rates of severe preeclampsia and adverse sociodemographic characteristics, Hispanic women with severe preeclampsia had better pregnancy outcomes than Black or White women with the disease.

Racial/ethnic disparities in the prevalence and awareness of Hepatitis B virus infection and immunity in the United States.

PubMed

Kim, H S; Rotundo, L; Yang, J D; Kim, D; Kothari, N; Feurdean, M; Ruhl, C; Unalp-Arida, A

2017-11-01

Hepatitis B virus (HBV) infection in the United States is the most common among Asians followed by non-Hispanic blacks. However, there have been few studies that describe HBV infection and immunity by racial group. Our study aimed to assess racial/ethnic disparities in the prevalence and awareness of HBV infection and immunity using nationally representative data. In the National Health and Nutrition Examination Survey 2011-2014, 14 722 persons had HBV serology testing. We estimated the prevalence of HBV infection, past exposure, and immunity by selected characteristics and calculated adjusted odds ratios using survey-weighted generalized logistic regression. Awareness of infection and vaccination history was also investigated. The overall prevalence of chronic HBV infection, past exposure and vaccine-induced immunity was 0.34% [95%CI 0.24-0.43], 4.30% [95%CI 3.80-4.81], and 24.4% [95%CI 23.4-25.4], respectively. The prevalence of chronic infection was 2.74% [95% CI 1.72-3.76] in Asians, 0.64% [95% CI 0.35-0.92] in non-Hispanic blacks, and 0.15% [95% CI 0.06-0.24] in non-Asian, non-blacks. Only 26.2% of those with chronic infection were aware of their infection. The prevalence of the past exposure was 21.5% [95%CI 19.3-23.7] in Asians, 8.92% [95%CI 7.84-9.99] in non-Hispanic blacks, 2.05% [95%CI 1.49-2.63] in non-Hispanic whites and 4.47% [95%CI 3.25-5.70] in Hispanics. Prevalence of vaccine-induced immunity by each race was 34.1% [95%CI: 32.0-36.2] in Asians, 25.5% [95%CI: 24.0-27.0] in non-Hispanic blacks, 24.0% [95%CI: 22.6-25.4] in non-Hispanic whites and 22.2% [95%CI: 21.3-23.3] in Hispanics. There are considerable racial/ethnic disparities in HBV infection, exposure and immunity. More active and sophisticated healthcare policies on HBV management may be warranted. © 2017 John Wiley & Sons Ltd.

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.

Discrimination and social anxiety disorder among African-Americans, Caribbean blacks, and non-Hispanic whites.

PubMed

Levine, Debra Siegel; Himle, Joseph A; Abelson, Jamie M; Matusko, Niki; Dhawan, Nikhil; Taylor, Robert Joseph

2014-03-01

The present study investigated the relationship between discrimination and social anxiety disorder (SAD) in a sample of African-Americans, Caribbean blacks, and non-Hispanic whites using the National Survey of American Life, the most comprehensive study of psychopathology among American blacks to date (N = 6082). Previous work has highlighted a strong association between discrimination and mental health symptoms (Keith, Lincoln, Taylor, and Jackson [Sex Roles 62:48-59, ]; Kessler, Mickelson, and Williams [J Health Soc Behav 40:208-230, 1999]; Soto, Dawson-Andoh, and BeLue [J Anxiety Disord 25:258-265, ]). However, few studies have examined the effects of particular types of discrimination on specific anxiety disorders or among different black subgroups. In this study, logistic regression analyses indicated that everyday but not major experiences of discrimination are associated with SAD for African-Americans, Caribbean blacks, and non-Hispanic whites. This study adds to the extant literature by demonstrating that specific types of discrimination may be uniquely associated with SAD for different ethnic/racial groups.

The contribution of geography to black/white differences in the use of low neonatal mortality hospitals in New York City.

PubMed

Hebert, Paul L; Chassin, Mark R; Howell, Elizabeth A

2011-02-01

Racial differences in the use of high-quality hospital care contribute to racial disparities in mortality for very low birth weight (VLBW) neonates. We explored the role that geographic distribution of hospitals plays in the racial disparity in the use of top-tier hospitals by mothers of VLBW neonates in New York City. Retrospective analysis of Vital Statistics and administrative databases. VLBW deliveries in New York City from 1996 to 2001 to non-Hispanic Black (n = 4947) and non-Hispanic White (n = 1615) mothers. Black mothers were less likely to deliver in a top-tier hospitals (White = 44%, Black = 28%; P < 0.001) and top-tier hospitals were less likely to be located in Black mothers' neighborhoods (White = 40%, Black = 33%; P < 0.001). Distance, however, did not contribute to the disparity in use of top-tier hospitals. Non-Hispanic Black mothers lived marginally closer to a top-tier hospital than non-Hispanic White mothers (0.65 miles closer; P < 0.001), and mothers of both the races often bypassed their neighborhood hospital (Black = 62% bypassed, White = 71%; P < 0.001). Inattention to recommended prenatal behaviors was associated with using a closer hospital, suggesting that geographic proximity was most important to mothers of vulnerable neonates. Purported measures of hospital quality such as Neonatal Intensive Care Unit level and volume were more strongly associated with use of hospital for White mothers than for Black mothers. The influence of geography on the use of top-tier hospitals for mothers of VLBW neonates is complex. Other personal and hospital characteristics, not just distance or geography, also influenced hospital use in New York City.

The potential impact of the National Osteoporosis Foundation guidance on treatment eligibility in the USA: an update in NHANES 2005-2008.

PubMed

Dawson-Hughes, B; Looker, A C; Tosteson, A N A; Johansson, H; Kanis, J A; Melton, L J

2012-03-01

This analysis of National Health and Nutrition Examination Survey (NHANES) 2005-2008 data describes the prevalence of risk factors for osteoporosis and the proportions of men and postmenopausal women age 50 years and older who are candidates for treatment to lower fracture risk, according to the new Fracture Risk Assessment Tool (FRAX)-based National Osteoporosis Foundation Clinician's Guide. It is important to update estimates of the proportions of the older US population considered eligible for pharmacologic treatment for osteoporosis for purposes of understanding the health care burden of this disease. This is a cross-sectional study of the NHANES 2005-2008 data in 3,608 men and women aged 50 years and older. Variables in the analysis included race/ethnicity, age, lumbar spine and femoral neck bone mineral density, risk factor profiles, and FRAX 10-year fracture probabilities. The prevalence of osteoporosis of the femoral neck ranged from 6.0% in non-Hispanic black to 12.6% in Mexican American women. Spinal osteoporosis was more prevalent among Mexican American women (24.4%) than among either non-Hispanic blacks (5.3%) or non-Hispanic whites (10.9%). Treatment eligibility was similar in Mexican American and non-Hispanic white women (32.0% and 32.8%) and higher than it was in non-Hispanic black women (11.0%). Treatment eligibility among men was 21.1% in non-Hispanic whites, 12.6% in Mexican Americans, and 3.0% in non-Hispanic blacks. Nineteen percent of older men and 30% of older women in the USA are at sufficient risk for fracture to warrant consideration for pharmacotherapy.

Racial and ethnic variations in phthalate metabolite concentration changes across full-term pregnancies.

PubMed

James-Todd, Tamarra M; Meeker, John D; Huang, Tianyi; Hauser, Russ; Seely, Ellen W; Ferguson, Kelly K; Rich-Edwards, Janet W; McElrath, Thomas F

2017-03-01

Higher concentrations of certain phthalate metabolites are associated with adverse reproductive and pregnancy outcomes, as well as poor infant/child health outcomes. In non-pregnant populations, phthalate metabolite concentrations vary by race/ethnicity. Few studies have documented racial/ethnic differences between phthalate metabolite concentrations at multiple time points across the full-course of pregnancy. The objective of the study was to characterize the change in phthalate metabolite concentrations by race/ethnicity across multiple pregnancy time points. Women were participants in a prospectively collected pregnancy cohort who delivered at term (≥37 weeks) and had available urinary phthalate metabolite concentrations for ≥3 time points across full-term pregnancies (n=350 women). We assessed urinary concentrations of eight phthalate metabolites that were log-transformed and specific gravity-adjusted. We evaluated the potential racial/ethnic differences in phthalate metabolite concentrations at baseline (median 10 weeks gestation) using ANOVA and across pregnancy using linear mixed models to calculate the percent change and 95% confidence intervals adjusted for sociodemographic and lifestyle factors. Almost 30% of the population were non-Hispanic black or Hispanic. With the exception of mono-(3-carboxypropyl) (MCPP) and di-ethylhexyl phthalate (DEHP) metabolites, baseline levels of phthalate metabolites were significantly higher in non-whites (P<0.05). When evaluating patterns by race/ethnicity, mono-ethyl phthalate (MEP) and MCPP had significant percent changes across pregnancy. MEP was higher in Hispanics at baseline and decreased in mid-pregnancy but increased in late pregnancy for non-Hispanic blacks. MCPP was substantially higher in non-Hispanic blacks at baseline but decreased later in pregnancy. Across pregnancy, non-Hispanic black and Hispanic women had higher concentrations of certain phthalate metabolites. These differences may have implications for racial/ethnic differences in adverse pregnancy and child health outcomes.

The geography of recreational open space: influence of neighborhood racial composition and neighborhood poverty.

PubMed

Duncan, Dustin T; Kawachi, Ichiro; White, Kellee; Williams, David R

2013-08-01

The geography of recreational open space might be inequitable in terms of minority neighborhood racial/ethnic composition and neighborhood poverty, perhaps due in part to residential segregation. This study evaluated the association between minority neighborhood racial/ethnic composition, neighborhood poverty, and recreational open space in Boston, Massachusetts (US). Across Boston census tracts, we computed percent non-Hispanic Black, percent Hispanic, and percent families in poverty as well as recreational open space density. We evaluated spatial autocorrelation in study variables and in the ordinary least squares (OLS) regression residuals via the Global Moran's I. We then computed Spearman correlations between the census tract socio-demographic characteristics and recreational open space density, including correlations adjusted for spatial autocorrelation. After this, we computed OLS regressions or spatial regressions as appropriate. Significant positive spatial autocorrelation was found for neighborhood socio-demographic characteristics (all p value = 0.001). We found marginally significant positive spatial autocorrelation in recreational open space (Global Moran's I = 0.082; p value = 0.053). However, we found no spatial autocorrelation in the OLS regression residuals, which indicated that spatial models were not appropriate. There was a negative correlation between census tract percent non-Hispanic Black and recreational open space density (r S = -0.22; conventional p value = 0.005; spatially adjusted p value = 0.019) as well as a negative correlation between predominantly non-Hispanic Black census tracts (>60 % non-Hispanic Black in a census tract) and recreational open space density (r S = -0.23; conventional p value = 0.003; spatially adjusted p value = 0.007). In bivariate and multivariate OLS models, percent non-Hispanic Black in a census tract and predominantly Black census tracts were associated with decreased density of recreational open space (p value < 0.001). Consistent with several previous studies in other geographic locales, we found that Black neighborhoods in Boston were less likely to have recreational open spaces, indicating the need for policy interventions promoting equitable access. Such interventions may contribute to reductions and disparities in obesity.

Discrepancies in employer-sponsored health insurance among Hispanics, blacks, and whites: the effects of sociodemographic and employment factors.

PubMed

Seccombe, K; Clarke, L L; Coward, R T

1994-01-01

Using a nationally representative sample of employed adults from the 1987 National Medical Expenditure Survey (NMES), this research explores differences in the incidence and predictors of employer-sponsored health insurance among Hispanics, blacks, and whites. The data suggest that: 1) whites are most likely, and Hispanics are least likely, to have employer-sponsored medical insurance in their own name, or in the name of another individual; 2) Hispanics are most likely, and whites are least likely, to be completely uninsured; and 3) the factors which increase the odds of receiving employer-sponsored coverage in one's own name are relatively similar across racial groups, though they differ substantially in magnitude.

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

Women's Short-Term Employment Trajectories Following Birth: Patterns, Determinants, and Variations by Race/Ethnicity and Nativity.

PubMed

Lu, Yao; Wang, Julia Shu-Huah; Han, Wen-Jui

2017-02-01

Despite a large literature documenting the impact of childbearing on women's wages, less understanding exists of the actual employment trajectories that mothers take and the circumstances surrounding different paths. We use sequence analysis to chart the entire employment trajectory for a diverse sample of U.S. women by race/ethnicity and nativity in the first year following childbirth. Using data from the 1996-2008 panels of the Survey of Income and Program Participation and sample selection models, we find that women employed before childbirth show a high degree of labor market continuity. However, a notable share of them (24 %) took less stable paths by dropping out or scaling back work. In addition, mothers' attachment to the labor force is simultaneously supported by personal endowments and family resources yet constrained by economic hardship and job characteristics. Moreover, mothers' employment patterns differ by race/ethnicity and nativity. Nonwhite women (blacks, Hispanics, and Asians) who were employed before childbirth exhibited greater labor market continuation than white women. For immigrant women, those with a shorter length of residence were more likely to curtail employment than native-born women, but those with longer duration of residence show greater labor force attachment. We discuss the implications of these findings for income inequality and public policy.

Family, Work, and Women: The Labor Supply of Hispanic Immigrant Wives.

ERIC Educational Resources Information Center

Stier, Haya; Tienda, Marta

1992-01-01

Results from analyses of census data for 997 immigrant Mexican wives, 347 Puerto Ricans, and 405 other Hispanics in comparison with 1,210 native-born counterparts and 8,766 white wives indicate that the labor force behavior of Hispanic wives is highly responsive to their earning potential. (SLD)

Examining the Efficacy of a Family Peer Advocate Model for Black and Hispanic Caregivers of Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Jamison, J. M.; Fourie, E.; Siper, P. M.; Trelles, M. P.; George-Jones, Julia; Buxbaum Grice, A.; Krata, J.; Holl, E.; Shaoul, J.; Hernandez, B.; Mitchell, L.; McKay, M. M.; Buxbaum, J. D.; Kolevzon, Alexander

2017-01-01

Autism spectrum disorder (ASD) affects individuals across all racial and ethnic groups, yet rates of diagnosis are disproportionately higher for Black and Hispanic children. Caregivers of children with ASD experience significant stressors, which have been associated with parental strain, inadequate utilization of mental health services and lower…

Counselor Trainee Perceptions of Hispanic, Black, and White Teenage Expectant Mothers and Fathers.

ERIC Educational Resources Information Center

Softas-Nall, Basilia; Baldo, Tracy D.; Williams, Scott C.

1997-01-01

Investigates perceptions of counselors-in-training (N=133) of Black, Hispanic, and White male and female adolescents facing a teen pregnancy. After viewing video vignettes, participants indicated that boys would be more encouraged to leave school and work than would girls. Girls were seen as having more control over pregnancy decisions compared to…

Gender Identity and Adjustment in Black, Hispanic, and White Preadolescents

ERIC Educational Resources Information Center

Corby, Brooke C.; Hodges, Ernest V. E.; Perry, David G.

2007-01-01

The generality of S. K. Egan and D. G. Perry's (2001) model of gender identity and adjustment was evaluated by examining associations between gender identity (felt gender typicality, felt gender contentedness, and felt pressure for gender conformity) and social adjustment in 863 White, Black, and Hispanic 5th graders (mean age = 11.1 years).…

DataTrack 6: Blacks and Hispanics in the United States.

ERIC Educational Resources Information Center

American Council of Life Insurance, Washington, DC.

Sixth in a series of reports which compile and interpret statistical information of direct concern to life insurance executives, this report deals with Blacks and Hispanics in the United States. It can be used in the design of new products and services to meet changing consumer needs, the selection of new markets and marketing strategies, the…

Multicultural Issues: Recruiting and Retaining Black and Hispanic Students in Gifted Education: Equality Versus Equity Schools

ERIC Educational Resources Information Center

Ford, Donna Y.

2015-01-01

This article addresses an ongoing problem in gifted education: How severe is under-representation among Black and Hispanic students in gifted education nationally and in school districts and buildings? The degree of severity that is accepted, tolerated, or rejected depends on whether one adopts an equality or equity philosophy and associated…

Access and Equity Denied: Key Theories for School Psychologists to Consider When Assessing Black and Hispanic Students for Gifted Education

ERIC Educational Resources Information Center

Ford, Donna Y.; Wright, Brian L.; Washington, Ahmad; Henfield, Malik S.

2016-01-01

Black and Hispanic students are consistently underrepresented in gifted education. Several factors contribute to their low identification and lack of access to such programs and services. While teacher underreferral is a significant contributing factor, problematic also is testing and assessment, which is often administered by school…

The Effect of Enrolling in a Minority-Serving Institution for Black and Hispanic Students in Texas

ERIC Educational Resources Information Center

Flores, Stella M.; Park, Toby J.

2015-01-01

Using state administrative data for three cohorts of college enrollees from 1997 to 2008 and incorporating propensity score matching techniques, we examine the effects of attending a Minority-Serving Institution (MSI)--that is, a Historically Black College or University (HBCU) or a Hispanic-Serving Institution (HSI)--on college-completion outcomes…

Racial, Ethnic, and Gender Differences in School Discipline among U.S. High School Students: 1991-2005

ERIC Educational Resources Information Center

Wallace, John M., Jr.; Goodkind, Sara; Wallace, Cynthia M.; Bachman, Jerald G.

2008-01-01

Large nationally representative samples of White, Black, Hispanic, Asian American, and American Indian students were used in this study to examine current patterns and recent trends in racial, ethnic, and gender differences in school discipline from 1991 to 2005. Findings revealed that Black, Hispanic, and American Indian youth are slightly more…

A Systems Approach for Ameliorating Possible Prima Facie Denial of Hispanic/Black Students' Rights Through Disproportionate Enrollment in Special Education.

ERIC Educational Resources Information Center

McDonnell, James R.

The paper discusses the issue of educational equity, principles of systems analysis, systems approaches in the educational milieu, the evaluation aspect of the systems approach, and application of the systems approach to preventing disproportionate enrollment of Hispanics and Blacks in special education classes in Holyoke, Massachusetts. The…

Factors Related to White, Black, and Hispanic Women's Mathematics Attainments: A Descriptive Study.

ERIC Educational Resources Information Center

Rothschild, Susan J. S.; Lichtman, Marilyn

Virtually no research conducted on women and mathematics is longitudinal in scope, generalizable in extent, and ethnic-race specific in nature. This descriptive study begins to fill the gap by examining the effects of background, school, and social-psychological factors on Hispanic, black, and white women's mathematics attainments. Data for the…

Using the theory of planned behavior to understand caregivers' intention to serve sugar-sweetened beverages to non-Hispanic black preschoolers.

PubMed

Tipton, Julia A

2014-01-01

The purpose of this correlational study was to determine the ability the Theory of Planned Behavior (TPB) to explain caregivers' intention to serve sugar-sweetened beverages to non-Hispanic black preschoolers. A sample of 165 caregivers of non-Hispanic black children preschoolers completed a written questionnaire. Multiple regression with path analysis confirmed the relationships of attitude and subjective norm, but not perceived behavioral control (PBC),with intention. After removing PBC, the model accounted for 45.1% of variance in intention. Nurses and other health care professionals can use these findings to tailor behaviorally-based obesity prevention programs at the individual, family, and community-based levels. Copyright © 2014 Elsevier Inc. All rights reserved.

Racial-ethnic disparities in health and the labor market: Losing and leaving jobs.

PubMed

Strully, Kate

2009-09-01

This study examines whether employment disruptions have varying health consequences for White and Black or Hispanic workers in the U.S. Since employment disruptions mark major shocks to socioeconomic status (SES), this analysis also speaks to a broader set of questions about how race/ethnicity and SES shape population-level health disparities. Data from 1999, 2001 and 2003 waves of the U.S. Panel Study of Income Dynamics provide no evidence of racial/ethnic variation in the health consequences of involuntary job loss. However, associations between leaving jobs voluntarily and poor self-assessed health are larger for Black and Hispanic workers than for White workers. This pattern may be linked to downward occupational mobility within the Black and Hispanic sample.

Edentulism trends among middle-aged and older adults in the United States: comparison of five racial/ethnic groups.

PubMed

Wu, Bei; Liang, Jersey; Plassman, Brenda L; Remle, Corey; Luo, Xiao

2012-04-01

This study examined edentulism trends among adults aged 50 and above in five ethnic groups in the United States: Asians, African Americans, Hispanics, Native Americans, and non-Hispanic Caucasians. Data came from the National Health Interview Surveys between 1999 and 2008. Respondents included 616 Native Americans, 2,666 Asians, 15,295 African Americans, 13,068 Hispanics, and 86,755 Caucasians. In 2008, Native Americans had the highest predicated rate of edentulism (23.98%), followed by African Americans (19.39%), Caucasians (16.90%), Asians (14.22%), and Hispanics (14.18%). Overall, there was a significant downward trend in edentulism rates between 1999 and 2008 (OR = 0.97, 95% CI: 0.96, 0.98). However, compared with Caucasians, Native Americans showed a significantly less decline of edentulism during this period (OR = 1.10, 95% CI: 1.02, 1.19). While there was a downward trend in edentulism between 1999 and 2008, significant variations existed across racial/ethnic groups. Innovative public health programs and services are essential to prevent oral health diseases and conditions for minority populations who lack access to adequate dental care. Additionally, given the increasing numbers of adults retaining their natural teeth, interventions designed to assist individuals in maintaining healthy teeth becomes more critical. © 2011 John Wiley & Sons A/S.

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

Nativity differences in allostatic load by age, sex, and Hispanic background from the Hispanic Community Health Study/Study of Latinos.

PubMed

Salazar, Christian R; Strizich, Garrett; Seeman, Teresa E; Isasi, Carmen R; Gallo, Linda C; Avilés-Santa, M Larissa; Cai, Jianwen; Penedo, Frank J; Arguelles, Willian; Sanders, Anne E; Lipton, Richard B; Kaplan, Robert C

2016-12-01

Allostatic load (AL), an index of biological "wear and tear" on the body from cumulative exposure to stress, has been little studied in US Hispanics/Latinos. We investigated AL accumulation patterns by age, sex, and nativity in the Hispanic Community Health Study/Study of Latinos. We studied 15,830 Hispanic/Latinos of Mexican, Cuban, Dominican, Puerto Rican, Central and South American descent aged 18-74 years, 77% of whom were foreign-born. Consistent with the conceptualization of AL, we developed an index based upon 16 physiological markers that spanned the cardiometabolic, parasympathetic, and inflammatory systems. We computed mean adjusted AL scores using log-linear models across age-groups (18-44, 45-54, 55-74 years), by sex and nativity status. Among foreign-born individuals, differences in AL by duration of residence in the US (<10, ≥10 years) and age at migration (<24, ≥24 years) were also examined. In persons younger than 55 years old, after controlling for socioeconomic and behavioral factors, AL was highest among US-born individuals, intermediate in foreign-born Hispanics/Latinos with longer duration in the US (≥10 years), and lowest among those with shorter duration in the US (<10 years) ( P <0.0001 for increasing trend). Similarly, AL increased among the foreign-born with earlier age at immigration. These trends were less pronounced among individuals ≥55 years of age. Similar patterns were observed across all Hispanic/Latino heritage groups ( P for interaction=0.5). Our findings support both a "healthy immigrant" pattern and a loss of health advantage over time among US Hispanics/Latinos of diverse heritages.

Perceptions of Female Hispanic ESL Students toward First-Year College Writing Courses: A Phenomenological Examination of Cultural Influences

ERIC Educational Resources Information Center

Booker, Barbara B.

2012-01-01

The role of culture as a phenomenon guided this qualitative study, which examined the influence of diverse Hispanic cultures on the attitudes and perceptions towards college writing courses of female Hispanic students who are non-native speakers of English. With the increasing number of Hispanic immigrants coming to the U.S., the minority student…

For blacks in America, the gap in neighborhood poverty has declined faster than segregation.

PubMed

Firebaugh, Glenn; Acciai, Francesco

2016-11-22

Black residential segregation has been declining in the United States. That accomplishment rings hollow, however, if blacks continue to live in much poorer neighborhoods than other Americans. This study uses census data for all US metropolitan areas in 1980 and 2010 to compare decline in the neighborhood poverty gap between blacks and other Americans with decline in the residential segregation of blacks. We find that both declines resulted primarily from narrowing differences between blacks and whites as opposed to narrowing differences between blacks and Hispanics or blacks and Asians. Because black-white differences in neighborhood poverty declined much faster than black-white segregation, the neighborhood poverty disadvantage of blacks declined faster than black segregation-a noteworthy finding because the narrowing of the racial gap in neighborhood poverty for blacks has gone largely unnoticed. Further analysis reveals that the narrowing of the gap was produced by change in both the medians and shapes of the distribution of poverty across the neighborhoods where blacks, whites, Hispanics, and Asians reside.

Gene-carbohydrate and gene-fiber interactions and type 2 diabetes in diverse populations from the National Health and Nutrition Examination Surveys (NHANES) as part of the Epidemiologic Architecture for Genes Linked to Environment (EAGLE) study.

PubMed

Villegas, Raquel; Goodloe, Robert J; McClellan, Bob E; Boston, Jonathan; Crawford, Dana C

2014-06-14

Both environmental and genetic factors impact type 2 diabetes (T2D). To identify such modifiers, we genotyped 15 T2D-associated variants from genome-wide association studies (GWAS) in 6,414 non-Hispanic whites, 3,073 non-Hispanic blacks, and 3,633 Mexican American participants from the National Health and Nutrition Examination Surveys (NHANES) and evaluated interactions between these variants and carbohydrate intake and fiber intake. We calculated a genetic risk score (GRS) with the 15 SNPs. The odds ratio for T2D with each GRS point was 1.10 (95% CI: 1.05-1.14) for non-Hispanic whites, 1.07 (95% CI: 1.02-1.13) for non-Hispanic blacks, and 1.11 (95% CI: 1.06-1.17) for Mexican Americans. We identified two gene-carbohydrate interactions (P < 0.05) in non-Hispanic whites (with CDKAL1 rs471253 and FTO rs8050136), two in non-Hispanic blacks (with IGFBP2 rs4402960 and THADA rs7578597), and two in Mexican Americans (with NOTCH2 rs1092398 and TSPAN8-LGRS rs7961581). We found three gene-fiber interactions in non-Hispanic whites (with ADAMT59 rs4607103, CDKN2A/2B rs1801282, and FTO rs8050136), two in non-Hispanic blacks (with ADAMT59 rs4607103 and THADA rs7578597), and two in Mexican Americans (with THADA rs7578597 and TSPAN8-LGRS rs796158) at the P < 0.05 level. Interactions between the GRS and nutrients failed to reach significance in all the racial/ethnic groups. Our results suggest that dietary carbohydrates and fiber may modify T2D-associated variants, highlighting the importance of dietary nutrients in predicting T2D risk.

Adolescent Bullying Involvement and Perceived Family, Peer and School Relations: Commonalities and Differences Across Race/Ethnicity

PubMed Central

Spriggs, Aubrey L.; Iannotti, Ronald J.; Nansel, Tonja R.; Haynie, Denise L.

2007-01-01

Purpose Although bullying is recognized as a serious problem in the U.S., little is known about racial/ethnic differences in bullying risk. This study examined associations between bullying and family, peer, and school relations for White, Black and Hispanic adolescents. Methods A nationally-representative sample (n=11,033) of adolescents in grades six to ten participated in the 2001 Health Behaviors in School-Aged Children survey, self-reporting bullying involvement and information on family, peer and school relations. Descriptive statistics and multinomial logistic regression analyses controlling for gender, age and affluence were stratified by race/ethnicity. Results Nine percent of respondents were victims of bullying, 9% were bullies, and 3% were bully-victims. Black adolescents reported a significantly lower prevalence of victimization than White and Hispanic students. Multivariate results indicated modest racial/ethnic variation in associations between bullying and family, peer and school factors. Parental communication, social isolation, and classmate relationships were similarly related to bullying across racial/ethnic groups. Living with two biological parents was protective against bullying involvement for White students only. Further, although school satisfaction and performance were negatively associated with bullying involvement for White and Hispanic students, school factors were largely unrelated to bullying among Black students. Conclusions Although school attachment and performance were inconsistently related to bullying behavior across race/ethnicity, bullying behaviors are consistently related to peer relationships across Black, White and Hispanic adolescents. Negative associations between family communication and bullying behaviors for White, Black and Hispanic adolescents suggest the importance of addressing family interactions in future bullying prevention efforts. PMID:17707299

Adolescent bullying involvement and perceived family, peer and school relations: commonalities and differences across race/ethnicity.

PubMed

Spriggs, Aubrey L; Iannotti, Ronald J; Nansel, Tonja R; Haynie, Denise L

2007-09-01

Although bullying is recognized as a serious problem in the United States, little is known about racial/ethnic differences in bullying risk. This study examined associations between bullying and family, peer, and school relations for white, black and Hispanic adolescents. A nationally representative sample (n = 11,033) of adolescents in grades six to ten participated in the 2001 Health Behaviors in School-Aged Children survey, self-reporting bullying involvement and information on family, peer and school relations. Descriptive statistics and multinomial logistic regression analyses controlling for gender, age and affluence were stratified by race/ethnicity. Nine percent of respondents were victims of bullying, 9% were bullies, and 3% were bully-victims. Black adolescents reported a significantly lower prevalence of victimization than white and Hispanic students. Multivariate results indicated modest racial/ethnic variation in associations between bullying and family, peer, and school factors. Parental communication, social isolation, and classmate relationships were similarly related to bullying across racial/ethnic groups. Living with two biological parents was protective against bullying involvement for white students only. Furthermore, although school satisfaction and performance were negatively associated with bullying involvement for white and Hispanic students, school factors were largely unrelated to bullying among black students. Although school attachment and performance were inconsistently related to bullying behavior across race/ethnicity, bullying behaviors are consistently related to peer relationships across black, white, and Hispanic adolescents. Negative associations between family communication and bullying behaviors for white, black, and Hispanic adolescents suggest the importance of addressing family interactions in future bullying prevention efforts.

Pregnancy risk among black, white, and Hispanic teen girls in New York City public schools.

PubMed

Waddell, Elizabeth Needham; Orr, Mark G; Sackoff, Judith; Santelli, John S

2010-05-01

Disparities in teen pregnancy rates are explained by different rates of sexual activity and contraceptive use. Identifying other components of risk such as race/ethnicity and neighborhood can inform strategies for teen pregnancy prevention. Data from the 2005 and 2007 New York City Youth Risk Behavior Surveys were used to model demographic differences in odds of recent sexual activity and birth control use among black, white, and Hispanic public high school girls. Overall pregnancy risk was calculated using pregnancy risk index (PRI) methodology, which estimates probability of pregnancy based on current sexual activity and birth control method at last intercourse. Factors of race/ethnicity, grade level, age, borough, and school neighborhood were assessed. Whites reported lower rates of current sexual activity (23.4%) than blacks (35.4%) or Hispanics (32.7%), and had lower predicted pregnancy risk (PRI = 5.4% vs. 9.0% and 10.5%, respectively). Among sexually active females, hormonal contraception use rates were low in all groups (11.6% among whites, 7.8% among blacks, and 7.5% among Hispanics). Compared to white teens, much of the difference in PRI was attributable to poorer contraceptive use (19% among blacks and 50% among Hispanics). Significant differences in contraceptive use were also observed by school neighborhood after adjusting for age group and race/ethnicity. Interventions to reduce teen pregnancy among diverse populations should include messages promoting delayed sexual activity, condom use and use of highly effective birth control methods. Access to long-acting contraceptive methods must be expanded for all sexually active high school students.

The intersection of race, gender, and primary care: results from the Women Physicians' Health Study.

PubMed Central

Corbie-Smith, G.; Frank, E.; Nickens, H.

2000-01-01

The Women Physicians' Health Study is a nationally distributed mailed questionnaire survey of a random sample of 4501 female physicians. We examined differences in the professional characteristics and personal health habits of minority women physicians compared to other women physicians, with regard to the choice of primary care specialties, type or location of practice site, and career satisfaction. Most women physicians were self-described as non-Hispanic white (77.4%), with 13% Asians, and few blacks (4.3%) or Hispanics (5.2%). Blacks and Hispanics were more likely to choose primary care specialties (61.6% and 57.9%, respectively, vs. 49.3% of whites, p < 0.05). Black and Hispanic physicians were most likely to practice in urban areas (71.8% and 72.2%, respectively, p < 0.001). Minority physicians were most likely to report spending some time each week on clinical work for which they did not expect compensation. Black physicians were least likely to report high levels of work control and were least likely to be satisfied with their careers. While most physicians were compliant with the examined recommendations of the U.S. Preventive Services Task Force, we did find significant differences by ethnicity in compliance with clinical breast exams, mammograms, and pap smears. In conclusion, there continues to be fewer blacks and Hispanics in the U.S. physician workforce than in the general population. Minority women physicians are more likely to provide primary care services in communities that have been traditionally underserved and may also report higher rates of career dissatisfaction. PMID:11105727

Racial and ethnic differences in the prevalence of adverse childhood experiences: Findings from a low-income sample of U.S. women.

PubMed

Mersky, Joshua P; Janczewski, Colleen E

2018-02-01

Despite great interest in adverse childhood experiences (ACEs), there has been limited research on racial and ethnic differences in their prevalence. Prior research in the United States suggests that the prevalence of ACEs varies along socioeconomic lines, but it is uncertain whether there are racial/ethnic differences in ACE rates among low-income populations. This study examined the distribution of ACEs in a sample of 1523 low-income women in Wisconsin that received home visiting services. Participants ranging in age from 16 to 50 years were coded into five racial/ethnic groups, including Hispanics and four non-Hispanic groups: blacks, whites, American Indians, and other race. Following measurement conventions, ten dichotomous indicators of child maltreatment and household dysfunction were used to create a composite ACE score. Five other potential childhood adversities were also assessed: food insecurity, homelessness, prolonged parental absence, peer victimization, and violent crime victimization. Results from bivariate and multivariate analyses revealed that, while rates of adversity were high overall, there were significant racial/ethnic differences. Total ACE scores of American Indians were comparable to the ACE scores of non-Hispanic whites, which were significantly higher than the ACE scores of non-Hispanic blacks and Hispanics. Whites were more likely than blacks to report any abuse or neglect, and they were more likely than blacks and Hispanics to report any household dysfunction. The results underscore the need to account for socioeconomic differences when making racial/ethnic comparisons. Potential explanations for the observed differences are examined. Copyright © 2017 Elsevier Ltd. All rights reserved.

Racial/Ethnic Differences in Electronic Cigarette Use and Reasons for Use among Current and Former Smokers: Findings from a Community-Based Sample

PubMed Central

Webb Hooper, Monica; Kolar, Stephanie K.

2016-01-01

The prevalence of e-cigarette use is increasing, yet few studies have focused on its use in racial/ethnic minority populations. We examined associations between race/ethnicity and e-cigarette use, plans to continue using e-cigarettes, and reasons for use among current/former smokers. Participants (285 in total; 29% non-Hispanic White, 42% African American/Black, and 29% Hispanic) were recruited between June and November 2014. Telephone-administered surveys assessed demographics, cigarette smoking, e-cigarette use, plans to continue using, and reasons for use. Analyses of covariance (ANCOVAs) and multivariable logistic regressions were conducted. African Americans/Blacks were significantly less likely to report ever-use compared to Whites and Hispanics (50% vs. 71% and 71%, respectively; p < 0.001). However, African American/Black ever users were more likely to report plans to continue using e-cigarettes compared to Whites and Hispanics (72% vs. 53% and 47%, respectively, p = 0.01). African American/Black participants were more likely to use e-cigarettes as a cessation aid compared to both Whites (p = 0.03) and Hispanics (p = 0.48). White participants were more likely to use e-cigarettes to save money compared to Hispanics (p = 0.02). In conclusion, racial/ethnic differences in e-cigarette use, intentions, and reasons for use emerged in our study. African American ever users may be particularly vulnerable to maintaining their use, particularly to try to quit smoking. These findings have implications for cigarette smoking and e-cigarette dual use, continued e-cigarette use, and potentially for smoking-related disparities. PMID:27754449

Racial/Ethnic Differences in Electronic Cigarette Use and Reasons for Use among Current and Former Smokers: Findings from a Community-Based Sample.

PubMed

Webb Hooper, Monica; Kolar, Stephanie K

2016-10-14

The prevalence of e-cigarette use is increasing, yet few studies have focused on its use in racial/ethnic minority populations. We examined associations between race/ethnicity and e-cigarette use, plans to continue using e-cigarettes, and reasons for use among current/former smokers. Participants (285 in total; 29% non-Hispanic White, 42% African American/Black, and 29% Hispanic) were recruited between June and November 2014. Telephone-administered surveys assessed demographics, cigarette smoking, e-cigarette use, plans to continue using, and reasons for use. Analyses of covariance (ANCOVAs) and multivariable logistic regressions were conducted. African Americans/Blacks were significantly less likely to report ever-use compared to Whites and Hispanics (50% vs. 71% and 71%, respectively; p < 0.001). However, African American/Black ever users were more likely to report plans to continue using e-cigarettes compared to Whites and Hispanics (72% vs. 53% and 47%, respectively, p = 0.01). African American/Black participants were more likely to use e-cigarettes as a cessation aid compared to both Whites ( p = 0.03) and Hispanics ( p = 0.48). White participants were more likely to use e-cigarettes to save money compared to Hispanics ( p = 0.02). In conclusion, racial/ethnic differences in e-cigarette use, intentions, and reasons for use emerged in our study. African American ever users may be particularly vulnerable to maintaining their use, particularly to try to quit smoking. These findings have implications for cigarette smoking and e-cigarette dual use, continued e-cigarette use, and potentially for smoking-related disparities.

Cognitive Behavioral Therapy: A Meta-Analysis of Race and Substance Use Outcomes

PubMed Central

Windsor, Liliane Cambraia; Jemal, Alexis; Alessi, Edward

2015-01-01

Cognitive behavioral therapy (CBT) is an effective intervention for reducing substance use. However, because CBT trials have included predominantly White samples caution must be used when generalizing these effects to Blacks and Hispanics. This meta-analysis compared the impact of CBT in reducing substance use between studies with a predominantly non-Hispanic White sample (hereafter NHW studies) and studies with a predominantly Black and/or Hispanic sample (hereafter BH studies). From 322 manuscripts identified in the literature, 17 met criteria for inclusion. Effect sizes between CBT and comparison group at posttest had similar effects on substance abuse across NHW and BH studies. However, when comparing pre-posttest effect sizes from groups receiving CBT between NHW and BH studies, CBT’s impact was significantly stronger in NHW studies. T-test comparisons indicated reduced retention/engagement in BH studies, albeit failing to reach statistical significance. Results highlight the need for further research testing CBT’s impact on substance use among Blacks and Hispanics. PMID:25285527

Longitudinal Links between Spanking and Children's Externalizing Behaviors in a National Sample of White, Black, Hispanic, and Asian American Families

ERIC Educational Resources Information Center

Gershoff, Elizabeth T.; Lansford, Jennifer E.; Sexton, Holly R.; Davis-Kean, Pamela; Sameroff, Arnold J.

2012-01-01

This study examined whether the longitudinal links between mothers' use of spanking and children's externalizing behaviors are moderated by family race/ethnicity, as would be predicted by cultural normativeness theory, once mean differences in frequency of use are controlled. A nationally representative sample of White, Black, Hispanic, and Asian…

Importance of Religion and Spirituality in the Lives of African Americans, Caribbean Blacks and Non-Hispanic Whites

ERIC Educational Resources Information Center

Taylor, Robert Joseph; Chatters, Linda M.

2010-01-01

This study examined the importance of spirituality and religion in daily life (i.e., only religion, only spirituality, both religion and spirituality, and neither religion nor spirituality) among a nationally representative sample of African Americans, Caribbean Blacks and non-Hispanic Whites. A majority in each group felt they were both important…

Unemployment and Underemployment among Blacks, Hispanics, and Women. United States Commission on Civil Rights Clearinghouse Publication 74.

ERIC Educational Resources Information Center

Gordon, Henry A.; And Others

Blacks, Hispanics, and women are more likely to be unemployed or underemployed than white males, regardless of economic conditions. This conclusion was drawn from an analysis of data gathered from the March Current Population Survey for the years 1971 through 1980, the Dictionary of Occupational Titles, and state and local unemployment rates…

Status Variations in Alcohol Use among Young Adults: Results from the 1984 National Longitudinal Surveys of Youth.

ERIC Educational Resources Information Center

Crowley, Joan E.

This document gives descriptive results on alcohol use patterns among young adults from the 1984 National Longitudinal Survey of Labor Market of Youth, a survey of a large, nationally representative sample supplemented by samples of blacks, Hispanics, and economically disadvantaged non-black, non-Hispanic youth and covering the entire range of…

Down and Out in Rural America: The Status of Blacks and Hispanics in the 1980s.

ERIC Educational Resources Information Center

Lyson, Thomas A.

Blacks and Hispanics in rural America face opportunities and life circumstances distinctively different from their urban counterparts. Not only are rural conditions generally worse than urban areas in job opportunity, social services, and human capital, but the problem of inequity is also more severe within rural areas than within urban areas.…

Unitas: Evaluating a Preventative Program for Hispanic and Black Youth. Monograph No. 13.

ERIC Educational Resources Information Center

Procidano, Mary E.; Glenwick, David S.

This monograph is the third of a trilogy of studies on the Unitas Therapeutic Community, a program that attempts to strengthen the competencies of the Hispanic and Black youngsters living in the Longwood/Hunts Point section of the South Bronx, New York City. The program uses indigenous nonprofessionals as surrogate parents, uncles, and aunts for…

School-Based HIV/STD Testing Behaviors and Motivations among Black and Hispanic Teen MSM: Results from a Formative Evaluation

ERIC Educational Resources Information Center

Morris, Elana; Topete, Pablo; Rasberry, Catherine N.; Lesesne, Catherine A.; Kroupa, Elizabeth; Carver, Lisa

2016-01-01

Background: This evaluation explores experiences with, and motivations for, human immunodeficiency virus (HIV) and sexually transmitted disease (STD) testing among black and Hispanic school-aged young men who have sex with men (YMSM). Methods: Participants were recruited at community-based organizations that serve YMSM in New York City,…

Post-Baccalaureate Attainment of Black, Hispanic, and White Students at Texas Public Institutions: a Multi-Year Study

ERIC Educational Resources Information Center

Franklin, Somer L.

2013-01-01

Purpose: The purpose of this study was to determine the extent to which differences were present by ethnic membership in graduate degrees attained at Texas public, 4-year institutions of higher education. Specifically, the numbers of master's, doctoral, and professional degrees awarded to White, Hispanic, and Black students in the State of Texas…

Racial and ethnic disparities over time in the treatment and mortality of women with gynecological malignancies.

PubMed

Rauh-Hain, J Alejandro; Melamed, Alexander; Schaps, Diego; Bregar, Amy J; Spencer, Ryan; Schorge, John O; Rice, Laurel W; Del Carmen, Marcela G

2018-04-01

To examine temporal trends in treatment and survival among black, Asian, Hispanic, and white women diagnosed with endometrial, ovarian, cervical, and vulvar cancer. Using the National Cancer Database (2004-2014), we identified women diagnosed with endometrial, ovarian, cervical, and vulvar cancer. For each disease site, we analyzed race/ethnicity-specific trends in receipt of evidence-based practices. Professional societies' recommendations were used to define these practices. Using data from the Surveillance, Epidemiology, and End Results Program (2000-2009) we analyzed trends in 5-year survival. Throughout the study period black (64.8%) and Hispanic (68.3%) women were less likely to undergo lymphadenectomy for stage I ovarian cancer compared to Asian (79.5%) and white patients (74.6%). Black women were the least likely group to undergo lymphadenectomy in all periods. Among patients with stage II-IV ovarian cancer, 76.6% of white and Asian women received both surgery and chemotherapy, compared to 70.8% of black and 73.9% Hispanic women. Hispanic women with deeply invasive or high-grade stage I endometrial cancer underwent lymphadenectomy less frequently (74.5%) than all other groups (80.7%). Black women were less likely to have chemo-radiotherapy for stage IIB-IVA cervical cancer (75.6% versus 80.4% of all others). Black women were also less likely to have a surgical lymph node evaluation for vulvar cancer (58.8% versus 63.5% of all others). Among women diagnosed with ovarian, endometrial, and cervical cancer, black women had lower five-year survival than other groups. Significant racial disparities persist in the delivery of evidence-based care. Black women with ovarian, endometrial, and cervical cancer continue to experience higher cancer-specific mortality than other groups. Copyright © 2017 Elsevier Inc. All rights reserved.

The beneficial effect of family meals on obesity differs by race, sex, and household education: the national survey of children's health, 2003-2004.

PubMed

Rollins, Brandi Y; Belue, Rhonda Z; Francis, Lori A

2010-09-01

Studies have indicated that family meals may be a protective factor for childhood obesity; however, limited evidence is available in children with different racial, socioeconomic, and individual characteristics. The purpose of this study was to examine family meal frequency as a protective factor for obesity in a US-based sample of non-Hispanic white, non-Hispanic black, and Hispanic children age 6 to 11 years, and to identify individual, familial, and socioeconomic factors that moderate this association. Data were from the 2003 National Survey of Children's Health (n=16,770). Multinomial logistic regression analyses were used to test the association between family meal frequency and weight status, and the moderating effects of household structure, education, poverty level, and sex, by racial group. Non-Hispanic white children who consumed family meals every day were less likely to be obese than those eating family meals zero or a few days per week. A moderating effect for sex was observed in non-Hispanic black children such that family meal frequency was marginally protective in boys but not in girls. Higher family meal frequency was a marginal risk factor for obesity in Hispanic boys from low-education households, but not in girls from similar households. In conclusion, family meals seem to be protective of obesity in non-Hispanic white children and non-Hispanic black boys, whereas they may put Hispanic boys living in low-education households at risk. Greater emphasis is needed in future research on assessing why this association differs among different race/ethnic groups, and evaluating the influence of the quality and quantity of family meals on child obesity. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Anxiety disorders among Mexican Americans and non-Hispanic whites in Los Angeles.

PubMed

Karno, M; Golding, J M; Burnam, M A; Hough, R L; Escobar, J I; Wells, K M; Boyer, R

1989-04-01

This report from the Los Angeles site of the NIMH Epidemiologic Catchment Area study reveals significant ethnic and national origin differences in lifetime prevalence rates for three out of six specific, DSM-III-defined anxiety disorders. In the case of simple phobia, United States-born Mexican Americans report higher rates than native non-Hispanic whites or immigrant Mexican Americans, the latter two groups having similar rates. Mexican Americans born in the United States had higher rates of agoraphobia than immigrant Mexican Americans, and non-Hispanic whites reported higher lifetime rates of generalized anxiety disorder compared with both immigrant and native Mexican Americans. Neither ethnic nor national origin differences in lifetime prevalence rates were found for panic disorder, social phobia, and obsessive-compulsive disorder. Selective migration is postulated as a potential factor influencing prevalence differences between native and immigrant Mexican Americans.

Trends in US minority red blood cell unit donations.

PubMed

Yazer, Mark H; Delaney, Meghan; Germain, Marc; Karafin, Matthew S; Sayers, Merlyn; Vassallo, Ralph; Ziman, Alyssa; Shaz, Beth

2017-05-01

To provide the appropriately diverse blood supply necessary to support alloimmunized and chronically transfused patients, minority donation recruitment programs have been implemented. This study investigated temporal changes in minority red blood cell (RBC) donation patterns in the United States. Data on donor race and ethnicity from 2006 through 2015, including the number of unique donors, collections, RBCs successfully donated, and average annual number of RBC donations per donor (donor fraction), were collected from eight US blood collectors. Minority donors were stratified into the following groups: Asian, black or African American, Hispanic or Latino, Native Indian or Alaska Native, Native Hawaiian or other Pacific Islander, white, multiracial/other, and no answer/not sure. Over the 10-year period, white donors annually constituted the majority of unique donors (range, 70.7%-73.9%), had the greatest proportion of collections (range, 76.1%-79.8%), and donated the greatest proportion of RBC units (range, 76.3%-80.2%). These donors also had the highest annual donor fraction (range, 1.82-1.91 units per donor). Black or African American donors annually constituted between 4.9 and 5.2% of all donors during the study period and donated between 4.0 and 4.3% of all RBC units. Linear regression analysis revealed decreasing numbers of donors, collections, and donated RBC units from white donors over time. Although the US population has diversified, and minority recruitment programs have been implemented, white donors constitute the majority of RBC donors and donations. Focused and effective efforts are needed to increase the proportion of minority donors. © 2017 AABB.

Family and neighborhood disadvantage, home environment, and children's school readiness.

PubMed

Jeon, Lieny; Buettner, Cynthia K; Hur, Eunhye

2014-10-01

The purpose of this study was to examine associations between family socioeconomic risk, neighborhood disadvantage, and children's school readiness. A sample of 420 children from 48 early childcare programs yielded multi-informant data. The average age was 55.3 months (SD = 6.4), with 38% of children being Black, non-Hispanic, Hispanic, or other minority race (American Indian or Alaska Native, Asian, and Native Hawaiian or Pacific Islander). One third (32.4%) of the parents had annual incomes less than $30,000. We used multilevel structural equation modeling to test direct and indirect associations among family socioeconomic risk and neighborhood disadvantage and children's cognitive and social-emotional development through home learning environment and parental depression. Children with a greater number of family socioeconomic risks and a higher level of neighborhood disadvantage demonstrated lower scores on cognitive skills. The degree of family socioeconomic risk was indirectly associated with children's cognitive ability through parents' cognitive stimulation at home. Parents who had more family socioeconomic risks and neighborhood disadvantage reported more depressive symptoms, which, in turn, suggested children's greater probability of having social-emotional problems. In other words, home learning environments explained associations between family socioeconomic disadvantage and children's cognitive skills, while parental depression explained associations between family/neighborhood disadvantages and children's social-emotional problems. Results suggest the importance of intervention or prevention strategies for parents to improve cognitive stimulation at home and to reduce depressive symptoms. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Suicidality, ethnicity and immigration in the USA.

PubMed

Borges, G; Orozco, R; Rafful, C; Miller, E; Breslau, J

2012-06-01

Suicide is the 11th leading cause of death in the USA. Suicide rates vary across ethnic groups. Whether suicide behavior differs by ethnic groups in the USA in the same way as observed for suicide death is a matter of current discussion. The aim of this report was to compare the lifetime prevalence of suicide ideation and attempt among four main ethnic groups (Asians, Blacks, Hispanics, and Whites) in the USA. Suicide ideation and attempts were assessed using the World Mental Health version of the Composite International Diagnostic Interview (WMH-CIDI). Discrete time survival analysis was used to examine risk for lifetime suicidality by ethnicity and immigration among 15 180 participants in the Collaborative Psychiatric Epidemiological Surveys (CPES), a group of cross-sectional surveys. Suicide ideation was most common among Non-Hispanic Whites (16.10%), least common among Asians (9.02%) and intermediate among Hispanics (11.35%) and Non-Hispanic Blacks (11.82%). Suicide attempts were equally common among Non-Hispanic Whites (4.69%), Hispanics (5.11%) and Non-Hispanic Blacks (4.15%) and less common among Asians (2.55%). These differences in the crude prevalence rates of suicide ideation decreased but persisted after control for psychiatric disorders, but disappeared for suicide attempt. Within ethnic groups, risk for suicidality was low among immigrants prior to migration compared to the US born, but equalized over time after migration. Ethnic differences in suicidal behaviors are explained partly by differences in psychiatric disorders and low risk prior to arrival in the USA. These differences are likely to decrease as the US-born proportion of Hispanics and Asians increases.

Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States

PubMed Central

BRESLAU, JOSHUA; KENDLER, KENNETH S.; SU, MAXWELL; GAXIOLA-AGUILAR, SERGIO; KESSLER, RONALD C.

2009-01-01

Background Recent research in the United States has demonstrated striking health disparities across ethnic groups. Despite a longstanding interest in ethnic disadvantage in psychiatric epidemiology, patterns of psychiatric morbidity across ethnic groups have never been examined in a nationally representative sample. Method Ethnic differences in psychiatric morbidity are analyzed using data from the National Comorbidity Survey (NCS). The three largest ethnic groups in the United States – Hispanics, Non-Hispanic Blacks and Non-Hispanic Whites – were compared with respect to lifetime risk and persistence of three categories of psychiatric disorder: mood disorder, anxiety disorder, and substance use disorder. Results Where differences across ethnic groups were found in lifetime risk, socially disadvantaged groups had lower risk. Relative to Non-Hispanic Whites, Hispanics had lower lifetime risk of substance use disorder and Non-Hispanic Blacks had lower lifetime risk of mood, anxiety and substance use disorders. Where differences were found in persistence of disorders, disadvantaged groups had higher risk. Hispanics with mood disorders were more likely to be persistently ill as were Non-Hispanic Blacks with respect to both mood disorders and anxiety disorders. Closer examination found these differences to be generally consistent across population subgroups. Conclusions Members of disadvantaged ethnic groups in the United States do not have an increased risk for psychiatric disorders. Members of these groups, however, do tend to have more persistent disorders. Future research should focus on explanations for these findings, including the possibility that these comparisons are biased, and on potential means of reducing the disparity in persistence of disorders across ethnic groups. PMID:15841868

Suicidality, ethnicity and immigration in the United States

PubMed Central

Borges, Guilherme; Orozco, Ricardo; Rafful, Claudia; Miller, Elizabeth; Breslau, Joshua

2013-01-01

Background Suicide is the eleventh cause of death in the US. This rate varies across ethnic groups. Whether suicide behavior differs by ethnic groups in the US in the same way as observed for suicide death is a matter of current discussion. The goal of this report is to compare the lifetime prevalence of suicide ideation and attempt among four main ethnic groups (Asians, Blacks, Hispanics, and Whites) in the US. Methods Suicide ideation and attempts were assessed using the World Mental Health version of the Composite International Diagnostic Interview. Discrete time survival analysis was used to examine risk for life-time suicidality by ethnicity and immigration among 15,180 participants in the Collaborative Psychiatric Epidemiological Surveys, a group of cross-sectional surveys. Results Suicide ideation was most common among Non-Hispanic Whites (16.10%), least common among Asians (9.02%), and intermediate among Hispanics (11.35%) and Non-Hispanic Blacks (11.82%). Suicide attempts were equally common among Non-Hispanic Whites (4.69%), Hispanics (5.11%) and Non-Hispanic Blacks (4.15%) and slightly less common among Asians (2.55%). These differences in the crude prevalence rates of suicide ideation decreased but persisted after control for psychiatric disorders, but disappeared for suicide attempt. Within ethnic groups, risk for suicidality was low among immigrants prior to migration compared to the US-born, but equalized over time after migration. Conclusions Ethnic differences in suicidal behaviors are partly explained by differences in psychiatric disorders and low risk prior to arrival in the US. These differences are likely to decrease as the US-born proportion of Hispanics and Asians increases. PMID:22030006

Organ Donation in the United States: The Tale of the African-American Journey of Moving From the Bottom to the Top.

PubMed

Callender, C O; Koizumi, N; Miles, P V; Melancon, J K

2016-09-01

The purpose was to review the increase of minority organ donation. The methodology was based on the efforts of the DC Organ Donor Program and the Dow Take Initiative Program that focused on increasing donors among African Americans (AAs). From 1982 to 1988, AA donor card signings increased from 20/month to 750/month, and Black donations doubled. A review of the data, including face-to-face grassroots presentations combined with national media, was conducted. Gallup polls in 1985 and 1990 indicated a tripling of black awareness of transplantation and the number of blacks signing donor cards. Based on the applied successful methodologies, in 1991, the National Minority Organ Tissues Transplant Education Program was established targeting AA, Hispanic, Asian, and other ethnic groups. A review of the United Network for Organ Sharing (UNOS) database from 1990 to 2010 was accomplished. Nationally, ethnic minority organ donors per million (ODM) increased from 8-10 ODM (1982) to 35 ODM (AA and Latino/Hispanics) in 2002. In 1995, ODMs were white 34.2, black 33.1, Hispanic 31.5, and Asian 17.9. In 2010, Black organ donors per million totaled 35.36 versus white 27.07, Hispanic 25.59, and Asian 14.70. Based on the data retrieved from UNOS in 2010, blacks were ranked above whites and other ethnic minority populations as the number one ethnic group of organ donors per million in the US. Copyright © 2016 Elsevier Inc. All rights reserved.

For blacks in America, the gap in neighborhood poverty has declined faster than segregation

PubMed Central

Acciai, Francesco

2016-01-01

Black residential segregation has been declining in the United States. That accomplishment rings hollow, however, if blacks continue to live in much poorer neighborhoods than other Americans. This study uses census data for all US metropolitan areas in 1980 and 2010 to compare decline in the neighborhood poverty gap between blacks and other Americans with decline in the residential segregation of blacks. We find that both declines resulted primarily from narrowing differences between blacks and whites as opposed to narrowing differences between blacks and Hispanics or blacks and Asians. Because black–white differences in neighborhood poverty declined much faster than black–white segregation, the neighborhood poverty disadvantage of blacks declined faster than black segregation—a noteworthy finding because the narrowing of the racial gap in neighborhood poverty for blacks has gone largely unnoticed. Further analysis reveals that the narrowing of the gap was produced by change in both the medians and shapes of the distribution of poverty across the neighborhoods where blacks, whites, Hispanics, and Asians reside. PMID:27821759

Neighborhood Disadvantage, Racial Concentration and the Birthweight of Infants born to Adolescent Mothers

PubMed Central

Madkour, Aubrey Spriggs; Harville, Emily Wheeler; Xie, Yiqiong

2013-01-01

Objective To study the relationship between neighborhood demographic characteristics (disadvantage, racial concentration) and the birthweight of infants born to adolescent mothers, potentially as mediated by smoking, prenatal care use, or perceptions of neighborhood safety. Methods Data from Waves I and IV of the National Longitudinal Survey of Adolescent Health were analyzed. Birthweight (continuous) and low birthweight (<2.5 kg) of singleton infants born to non-Hispanic Black and non-Hispanic White adolescent mothers (<20 years) after Wave I were examined as outcomes. Neighborhood demographic characteristics included Census Block Group socioeconomic disadvantage and Black racial concentration. Possible mediators (smoking during pregnancy, early initiation of prenatal care, and perceptions of safety) were also examined. Controls for adolescent baseline age, age at pregnancy, body mass index (BMI) and parental education were included. Analyses were run stratified on race. Results Baseline continuous birthweight, BMI and neighborhood demographics varied significantly between non-Hispanic Black and White adolescent mothers, with Black adolescent mothers evidencing lower birthweight and higher BMI, neighborhood disadvantage and Black racial concentration. In multivariable analyses among Black adolescent mothers, Black racial concentration was positively associated with birthweight, and negatively associated with low birthweight; no mediators were supported. Neighborhood disadvantage and Black racial concentration were unassociated with birthweight outcomes among White adolescent mothers. Conclusions Infants born to Black adolescent mothers evidenced higher birthweight with increasing Black neighborhood concentration. Further exploration of mechanisms by which Black racial concentration may positively impact birthweight is warranted. PMID:23771237

Do Adolescents Who Live or Go to School Near Fast Food Restaurants Eat More Frequently From Fast Food Restaurants?

PubMed Central

Forsyth, Ann; Wall, Melanie; Larson, Nicole; Story, Mary; Neumark-Sztainer, Dianne

2012-01-01

This population-based study examined whether residential or school neighborhood access to fast food restaurants is related to adolescents’ eating frequency of fast food. A classroom-based survey of racially/ethnically diverse adolescents (n=2,724) in 20 secondary schools in Minneapolis/St. Paul, Minnesota was used to assess eating frequency at five types of fast food restaurants. Black, Hispanic, and Native American adolescents lived near more fast food restaurants than white and Asian adolescents and also ate at fast food restaurants more often. After controlling for individual-level socio-demographics, adolescent males living near high numbers fast food restaurants ate more frequently from these venues compared to their peers. PMID:23064515

Underrepresentation by race-ethnicity across stages of U.S. science and engineering education.

PubMed

Garrison, Howard

2013-01-01

Blacks, Hispanics, and American Indians/Alaskan Natives are underrepresented in science and engineering fields. A comparison of race-ethnic differences at key transition points was undertaken to better inform education policy. National data on high school graduation, college enrollment, choice of major, college graduation, graduate school enrollment, and doctoral degrees were used to quantify the degree of underrepresentation at each level of education and the rate of transition to the next stage. Disparities are found at every level, and their impact is cumulative. For the most part, differences in graduation rates, rather than differential matriculation rates, make the largest contribution to the underrepresentation. The size, scope, and persistence of the disparities suggest that small-scale, narrowly targeted remediation will be insufficient.

Using Geographic Information Science to Explore Associations between Air Pollution, Environmental Amenities, and Preterm Births

PubMed Central

Ogneva-Himmelberger, Yelena; Dahlberg, Tyler; Kelly, Kristen; Simas, Tiffany A. Moore

2015-01-01

The study uses geographic information science (GIS) and statistics to find out if there are statistical differences between full term and preterm births to non-Hispanic white, non-Hispanic Black, and Hispanic mothers in their exposure to air pollution and access to environmental amenities (green space and vendors of healthy food) in the second largest city in New England, Worcester, Massachusetts. Proximity to a Toxic Release Inventory site has a statistically significant effect on preterm birth regardless of race. The air-pollution hazard score from the Risk Screening Environmental Indicators Model is also a statistically significant factor when preterm births are categorized into three groups based on the degree of prematurity. Proximity to green space and to a healthy food vendor did not have an effect on preterm births. The study also used cluster analysis and found statistically significant spatial clusters of high preterm birth volume for non-Hispanic white, non-Hispanic Black, and Hispanic mothers. PMID:29546120

Using Geographic Information Science to Explore Associations between Air Pollution, Environmental Amenities, and Preterm Births.

PubMed

Ogneva-Himmelberger, Yelena; Dahlberg, Tyler; Kelly, Kristen; Simas, Tiffany A Moore

2015-01-01

The study uses geographic information science (GIS) and statistics to find out if there are statistical differences between full term and preterm births to non-Hispanic white, non-Hispanic Black, and Hispanic mothers in their exposure to air pollution and access to environmental amenities (green space and vendors of healthy food) in the second largest city in New England, Worcester, Massachusetts. Proximity to a Toxic Release Inventory site has a statistically significant effect on preterm birth regardless of race. The air-pollution hazard score from the Risk Screening Environmental Indicators Model is also a statistically significant factor when preterm births are categorized into three groups based on the degree of prematurity. Proximity to green space and to a healthy food vendor did not have an effect on preterm births. The study also used cluster analysis and found statistically significant spatial clusters of high preterm birth volume for non-Hispanic white, non-Hispanic Black, and Hispanic mothers.

Racial and Ethnic Residential Segregation, the Neighborhood Socioeconomic Environment, and Obesity Among Blacks and Mexican Americans

PubMed Central

Kershaw, Kiarri N.; Albrecht, Sandra S.; Carnethon, Mercedes R.

2013-01-01

We used cross-sectional data on 2,660 black and 2,611 Mexican-American adult participants in the National Health and Nutrition Examination Survey (1999–2006) to investigate the association between metropolitan-level racial/ethnic residential segregation and obesity and to determine whether it was mediated by the neighborhood socioeconomic environment. Residential segregation was measured using the black and Hispanic isolation indices. Neighborhood poverty and negative income incongruity were assessed as mediators. Multilevel Poisson regression with robust variance estimates was used to estimate prevalence ratios. There was no relationship between segregation and obesity among men. Among black women, in age-, nativity-, and metropolitan demographic-adjusted models, high segregation was associated with a 1.29 (95% confidence interval (CI): 1.00, 1.65) times higher obesity prevalence than was low segregation; medium segregation was associated with a 1.35 (95% CI: 1.07, 1.70) times higher obesity prevalence. Mexican-American women living in high versus low segregation areas had a significantly lower obesity prevalence (prevalence ratio, 0.54; 95% CI: 0.33, 0.90), but there was no difference between those living in medium versus low segregation areas. These associations were not mediated by neighborhood poverty or negative income incongruity. These findings suggest variability in the interrelationships between residential segregation and obesity for black and Mexican-American women. PMID:23337312

The Hispanic Paradox and Older Adults’ Disabilities: Is There a Healthy Migrant Effect?

PubMed Central

Thomson, Esme Fuller; Nuru-Jeter, Amani; Richardson, Dawn; Raza, Ferrah; Minkler, Meredith

2013-01-01

The “Hispanic Paradox” suggests that despite rates of poverty similar to African Americans, Hispanics have far better health and mortality outcomes, more comparable to non-Hispanic White Americans. Three prominent possible explanations for the Hispanic Paradox have emerged. The “Healthy Migrant Effect” suggests a health selection effect due to the demands of migration. The Hispanic lifestyle hypothesis focuses on Hispanics’ strong social ties and better health behaviors. The reverse migration argument suggests that the morbidity profile in the USA is affected when many Hispanic immigrants return to their native countries after developing a serious illness. We analyzed data from respondents aged 55 and over from the nationally representative 2006 American Community Survey including Mexican Americans (13,167 U.S. born; 11,378 immigrants), Cuban Americans (314 U.S. born; 3,730 immigrants), and non-Hispanic White Americans (629,341 U.S. born; 31,164 immigrants). The healthy migrant effect was supported with SES-adjusted disability comparable between Mexican, Cuban and non-Hispanic Whites born in the USA and all immigrants having lower adjusted odds of functional limitations than U.S. born non-Hispanic Whites. The reverse migration hypothesis was partially supported, with citizenship and longer duration in the USA associated with higher rates of SES-adjusted disability for Mexican Americans. The Hispanic healthy life-style explanation had little support in this study. Our findings underline the importance of considering nativity when planning for health interventions to address the needs of the growing Hispanic American older adult population. PMID:23644828

Vital signs: Repeat births among teens - United States, 2007-2010.

PubMed

2013-04-05

Teen childbearing has potential negative health, economic, and social consequences for mother and child. Repeat teen childbearing further constrains the mother's education and employment possibilities. Rates of preterm and low birth weight are higher in teens with a repeat birth, compared with first births. To assess patterns of repeat childbearing and postpartum contraceptive use among teens, CDC analyzed natality data from the National Vital Statistics System (NVSS) and the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2007-2010. Based on 2010 NVSS data from all 50 states and the District of Columbia, of more than 367,000 births to teens aged 15-19 years, 18.3% were repeat births. The percentage of teen births that represented repeat births decreased by 6.2% between 2007 and 2010. Disparities in repeat teen births exist by race/ethnicity, with the highest percentages found among American Indian/Alaska Natives (21.6%), Hispanics (20.9%), and non-Hispanic blacks (20.4%) and lowest among non-Hispanic whites (14.8%). Wide geographic disparities in the percentage of teen births that were repeat births also exist, ranging from 22% in Texas to 10% in New Hampshire. PRAMS data from 16 reporting areas (15 states and New York City) indicate that 91.2% of teen mothers used a contraceptive method 2-6 months after giving birth, but only 22.4% of teen mothers used the most effective methods. Teens with a previous live birth were significantly more likely to use the most effective methods postpartum compared with those with no prior live birth (29.6% versus 20.9%, respectively). Non-Hispanic white and Hispanic teens were significantly more likely to use the most effective methods than non-Hispanic black teens (24.6% and 27.9% versus 14.3%, respectively). The percentage of teens reporting postpartum use of the most effective methods varied greatly geographically across the PRAMS reporting areas, ranging from 50.3% in Colorado to 7.2% in New York State. Although the prevalence of repeat teen birth has declined in recent years, nearly one in five teen births is a repeat birth. Large disparities exist in repeat teen births and use of the most effective contraceptive methods postpartum, which was reported by fewer than one out of four teen mothers. Evidence-based approaches are needed to reduce repeat teen childbearing. These include linking pregnant and parenting teens to home visiting and similar programs that address a broad range of needs, and offering postpartum contraception to teens, including long-acting methods of reversible contraception.

Racial And Ethnic Differences In The Frequency Of Workplace Injuries And Prevalence Of Work-Related Disability.

PubMed

Seabury, Seth A; Terp, Sophie; Boden, Leslie I

2017-02-01

Occupational injuries and illnesses lead to significant health care costs and productivity losses for millions of workers each year. This study used national survey data to test for differences between members of minority groups and non-Hispanic white workers in the risk of workplace injuries and the prevalence of work-related disabilities. Non-Hispanic black workers and foreign-born Hispanic workers worked in jobs with the highest injury risk, on average, even after adjustment for education and sex. These elevated levels of workplace injury risk led to a significant increase in the prevalence of work-related disabilities for non-Hispanic black and foreign-born Hispanic workers. These findings suggest that disparities in economic opportunities expose members of minority groups to increased risk of workplace injury and disability. Project HOPE—The People-to-People Health Foundation, Inc.

Spirituality and Subjective Religiosity among African Americans, Caribbean Blacks and Non-Hispanic Whites

PubMed Central

Chatters, Linda M.; Taylor, Robert Joseph; Bullard, Kai McKeever; Jackson, James S.

2010-01-01

Patterns and correlates of self-perceptions of spirituality and subjective religiosity are examined using data from the National Survey of American Life, a nationally representative study of African Americans, Caribbean Blacks and non-Hispanic Whites. Demographic and denominational correlates of patterns of subjective religiosity and spirituality (i.e., religious only, spiritual only, both religious/spiritual and neither religious/spiritual) are examined. In addition, the study of African Americans and Caribbean Blacks permits the investigation of possible ethnic variation in the meaning and conceptual significance of these constructs within the U.S. Black population. African Americans and Caribbean Blacks are more likely than Non-Hispanic Whites to indicate that they are “both religious and spiritual” and less likely to indicate that they are “spiritual only” or “neither spiritual nor religious.” Demographic and denominational differences in the patterns of spirituality and subjective religiosity are also indicated. Study findings are discussed in relation to prior research in this field and noted conceptual and methodological issues deserving further study. PMID:21052481

The Contribution of Biogeographic Ancestry and Socioeconomic Status to Racial/Ethnic Disparities in Type 2 Diabetes: Results from the Boston Area Community Health (BACH) Survey

PubMed Central

Piccolo, Rebecca S.; Pearce, Neil; Araujo, Andre B.; McKinlay, John B.

2014-01-01

Purpose Racial/ethnic disparities in the incidence of type 2 diabetes (T2DM) are well documented and many researchers have proposed that biogeographical ancestry (BGA) may play a role in these disparities. However, studies examining the role of BGA on T2DM have produced mixed results to date. Therefore, the objective of this research is to quantify the contribution of BGA to racial/ethnic disparities in T2DM incidence controlling for the mediating influences of socioeconomic factors. Methods We analyzed data from the Boston Area Community Health (BACH) Survey, a prospective cohort with approximately equal numbers of Black, Hispanic, and White participants. We used Ancestry Informative Markers to calculate the percentages of West African and Native American ancestry of participants. We used logistic regression with g-computation to analyze the contribution of BGA and socioeconomic factors to racial/ethnic disparities in T2DM incidence. Results We found that socioeconomic factors accounted for 44.7% of the total effect of T2DM attributed to Black race and 54.9% of the effect attributed to Hispanic ethnicity. We found that BGA had almost no direct association with T2DM and was almost entirely mediated by self-identified race/ethnicity and socioeconomic factors. Conclusions It is likely that non-genetic factors, specifically socioeconomic factors, account for much of the reported racial/ethnic disparities in T2DM incidence. PMID:25088753

The Spectrum of CFTR Variants in Nonwhite Cystic Fibrosis Patients: Implications for Molecular Diagnostic Testing.

PubMed

Schrijver, Iris; Pique, Lynn; Graham, Steve; Pearl, Michelle; Cherry, Athena; Kharrazi, Martin

2016-01-01

Despite the implementation of cystic fibrosis (CF) newborn screening programs across the United States, the identification of CFTR gene variants in nonwhite populations compared with whites remains suboptimal. Our objective was to establish the spectrum of CFTR variants and their frequencies in CF patients in the United States with African, Native American, Asian, East Indian, or Middle Eastern backgrounds. By using direct DNA sequencing, we identified two CFTR variants in 89 of 140 affected nonwhite individuals with uncharacterized genotypes. Seven variants were novel. Multiplex ligation-dependent probe amplification detected 14 rearrangements in the remaining 51 patients, 6 of which were novel. Deletions and duplications accounted for 17% of unidentified alleles. A cross-sectional analysis of genotyping data from the CF Foundation Patient Registry was performed, comparing 3496 nonwhite patients with 22,206 white CF patients. Patients of Hispanic, black, or Asian ancestry were less likely to have two identified CFTR variants (P < 0.0001 for Hispanics and blacks, P = 0.003 for Asians), and more likely to carry no mutations on the commonly used 23 mutation carrier screening panel (P < 0.0001). We analyzed the mutations recorded for each ancestry and summarized the most frequent ones. This research could facilitate equity in mutation detection between white and nonwhite or mixed-ethnicity CF patients, enabling an earlier diagnosis improving their quality of life. Copyright © 2016 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

Quality and equity of care in U.S. hospitals.

PubMed

Trivedi, Amal N; Nsa, Wato; Hausmann, Leslie R M; Lee, Jonathan S; Ma, Allen; Bratzler, Dale W; Mor, Maria K; Baus, Kristie; Larbi, Fiona; Fine, Michael J

2014-12-11

Nearly every U.S. hospital publicly reports its performance on quality measures for patients who are hospitalized for acute myocardial infarction, heart failure, or pneumonia. Because performance rates are not reported according to race or ethnic group, it is unclear whether improvements in equity of care have accompanied aggregate improvements in health care quality over time. We assessed performance rates for quality measures covering three conditions (six measures for acute myocardial infarction, four for heart failure, and seven for pneumonia). These rates, adjusted for patient- and hospital-level covariates, were compared among non-Hispanic white, non-Hispanic black, and Hispanic patients who received care between 2005 and 2010 in acute care hospitals throughout the United States. Adjusted performance rates for the 17 quality measures improved by 3.4 to 57.6 percentage points between 2005 and 2010 for white, black, and Hispanic adults (P<0.001 for all comparisons). In 2005, as compared with adjusted performance rates for white patients, adjusted performance rates were more than 5 percentage points lower for black patients on 3 measures (range of differences, 12.3 to 14.2) and for Hispanic patients on 6 measures (5.6 to 14.5). Gaps decreased significantly on all 9 of these measures between 2005 and 2010, with adjusted changes for differences between white patients and black patients ranging from -8.5 to -11.8 percentage points and from -6.2 to -15.1 percentage points for differences between white patients and Hispanic patients. Decreasing differences according to race or ethnic group were attributable to more equitable care for white patients and minority patients treated in the same hospital, as well as to greater performance improvements among hospitals that disproportionately serve minority patients. Improved performance on quality measures for white, black, and Hispanic adults hospitalized for acute myocardial infarction, heart failure, or pneumonia was accompanied by increased racial and ethnic equity in performance rates both within and among U.S. hospitals. (Funded by the Centers for Medicare and Medicaid Services and the Veterans Affairs Health Services Research and Development Career Development Program.).

Hispanic ethnicity is associated with increased costs after carotid endarterectomy and carotid stenting in the United States.

PubMed

Propper, Brandon; Black, James H; Schneider, Eric B; Lum, Ying Wei; Malas, Mahmoud B; Arnold, Margaret W; Abularrage, Christopher J

2013-09-01

We have previously demonstrated an adverse impact of black race and Hispanic ethnicity on the outcomes of carotid endarterectomy (CEA) and carotid artery stenting (CAS). The current study was undertaken to examine the influence of race and ethnicity on the cost of CEA and CAS. The Nationwide Inpatient Sample (2005-2009) was queried using ICD-9 codes for CEA and CAS in patients with carotid artery stenosis. The primary outcome was total hospital charges. Multivariate analysis was performed using a generalized linear model adjusting for age, sex, race, comorbidities (Charlson index), high-risk status, procedure type, symptomatic status, year, insurance type, and surgeon and hospital operative volumes and characteristics. Hispanic and black patients were more likely to have a symptomatic presentation, and were more likely to undergo either CEA or CAS by low-volume surgeons at low-volume hospitals (P < 0.05, all). They were also less likely to have private insurance or Medicare (P < 0.001). Overall, CEA was less expensive than CAS over the 4-y study period ($29,502 ± $104 versus $46,713 ± $409, P < 0.001). Total hospital charges after CEA were increased in both blacks ($39,562 ± $843) and Hispanics ($45,325 ± $735) compared with whites on univariate analysis ($28,403 ± $101, P < 0.001). After CAS, total hospital charges were similarly increased in both blacks ($51,770 ± $2085) and Hispanics ($63,637 ± $2766) compared with whites on univariate analysis ($45,550 ± $412, P < 0.001). On multivariable analysis, however, only Hispanic ethnicity remained independently associated with increased charges after both CEA (exponentiated coefficient 1.18; 95% CI [1.15-1.20]; P < 0.001) and CAS (exponentiated coefficient 1.17; 95% CI [1.09-1.24]; P < 0.001). Hispanic ethnicity was independently associated with increased hospital charges after both CEA and CAS. The increased charges seen in black patients were explained, in part, by decreased surgeon operative volume and increased postoperative complications. Further efforts are warranted to contain costs in minorities undergoing carotid revascularization. Copyright © 2013 Elsevier Inc. All rights reserved.

Trends in Workforce Diversity in Vascular Surgery Programs in the United States

PubMed Central

Kane, Katherine; Rosero, Eric B; Clagett, G Patrick; Adams-Huet, Beverley; Timaran, Carlos H

2009-01-01

Background US black and Hispanic populations are growing at a steady pace. In contrast, the medical profession lacks the same minority growth and representation. Women are also under-represented in many surgical disciplines. The purpose of this study was to assess trends in the proportion of women, blacks and Hispanics admitted to vascular surgery (VS) and related specialties, and to compare them to each other and to a surgical specialty, orthopedic surgery (OS), with a formal diversity initiative. Methods Data on the fellowship pool of VS, interventional radiology (IR), and interventional cardiology (IC), as well as the resident pools of general surgery (GS) and orthopedic surgery (OS) were obtained from US graduate medical education reports for 1999 through 2005. Cochrane-Armitage trend tests were used to assess trends in the proportion of females, blacks and Hispanics in relation to the total physician workforce for each subspecialty. Results No significant trends in the proportion of females, blacks or Hispanics accepted into VS and IC fellowship programs occurred during the study period. In contrast, IR, GS, and OS programs revealed significant trends for increasing proportions of at least one of the underrepresented study groups. In particular, OS, which has implemented a diversity awareness program, showed a positive trend in female and Hispanic trainees (P < .04 and P <.02, respectively). Blacks showed a significant increasing trend only in IR (P =.05). Conversely, a positive trend toward continued growth in the Hispanic group was seen in GS (P <.001), IR and OS (P =.04 and P =0.02, respectively). Conclusions The racial/ethnic and gender composition of the physician trainee pool in vascular specialties, particularly VS, has not matched the increasing growth of underrepresented groups in the US population of patients with vascular disease. Formal programs to recruit qualified women and minorities appear successful in increasing workforce diversity. PMID:19398186

Trends in workforce diversity in vascular surgery programs in the United States.

PubMed

Kane, Katherine; Rosero, Eric B; Clagett, G Patrick; Adams-Huet, Beverley; Timaran, Carlos H

2009-06-01

U.S. black and Hispanic populations are growing at a steady pace. In contrast, the medical profession lacks the same minority growth and representation. Women are also under-represented in many surgical disciplines. The purpose of this study was to assess trends in the proportion of women, blacks, and Hispanics admitted to vascular surgery (VS) and related specialties, and to compare them with each other and with a surgical specialty, orthopedic surgery (OS), with a formal diversity initiative. Data on the fellowship pool of VS, interventional radiology (IR), and interventional cardiology (IC), as well as the resident pools of general surgery (GS) and orthopedic surgery (OS), were obtained from U.S. graduate medical education reports for 1999 through 2005. Cochrane-Armitage trend tests were used to assess trends in the proportion of females, blacks, and Hispanics in relation to the total physician workforce for each subspecialty. No significant trends in the proportion of females, blacks, or Hispanics accepted into VS and IC fellowship programs occurred during the study period. In contrast, IR, GS, and OS programs revealed significant trends for increasing proportions of at least one of the underrepresented study groups. In particular, OS, which has implemented a diversity awareness program, showed a positive trend in female and Hispanic trainees (P < .04 and P < .02, respectively). Blacks showed a significant increasing trend only in IR (P = .05). Conversely, a positive trend toward continued growth in the Hispanic group was seen in GS (P < .001), IR, and OS (P = .04 and P = .02, respectively). The racial/ethnic and gender composition of the physician trainee pool in vascular specialties, particularly VS, has not matched the increasing growth of underrepresented groups in the US population of patients with vascular disease. Formal programs to recruit qualified women and minorities appear successful in increasing workforce diversity.

Association of Renin and Aldosterone With Ethnicity and Blood Pressure: The Multi-Ethnic Study of Atherosclerosis

PubMed Central

2014-01-01

BACKGROUND Although variations in plasma renin activity (PRA) and aldosterone have been examined in whites and blacks, the association of these hormones with blood pressure in multiethnic populations has not been described. METHODS We measured PRA and aldosterone in 1,021 participants in the Multi-Ethnic Study of Atherosclerosis not taking antihypertensives and examined the association between ethnicity and PRA/aldosterone and the association between PRA/aldosterone with systolic blood pressure (SBP). RESULTS Average age was 62 (SD = 9) years, and 49% of participants were women. Median PRA was 0.51 (interquartile range (IQR) = 0.29–0.87) ng/ml/hour, and median aldosterone was 12.6 (IQR = 9.1–17.1) ng/dl. After age and sex adjustment, compared with whites, blacks had 28% lower PRA and 17.4% lower aldosterone, and Hispanics had 20.1% higher PRA but similar aldosterone levels. After multivariable adjustment, compared with whites, only Hispanic ethnicity independently associated with higher PRA (0.18ng/ml/hour; 95% confidence interval (CI) = 0.06–0.31). Blacks had lower aldosterone (−1.7ng/dl; 95% CI = −3.2 to −0.2) compared with whites. After multivariable adjustment, PRA was associated with lower SBP in whites (−3.2mm Hg; 95% CI = −5.2 to −1.2 per standardized unit PRA), Chinese (−3.5mm Hg; 95% CI = −6.2 to −0.80 per standardized unit), and Hispanics (−2.3mm Hg; 95% CI = −4.1 to −0.6 per standardized unit) but not blacks. Aldosterone was associated with higher SBP only in Hispanics (2.5mm Hg; 95% CI = 0.4–4.5 per SD). CONCLUSIONS Compared with whites, blacks have lower aldosterone and Hispanics have higher PRA. Aldosterone had significant associations with higher SBP in Hispanics compared with other groups, a finding that may suggest a different mechanism of hypertension. PMID:24436325

Project Amistad (Friendship), a Joint Venture between DHS and Family Outreach. Final Report: Innovations in Protective Services.

ERIC Educational Resources Information Center

Dennis-Small, Lucretia

Conducted by the Texas Department of Human Services (DHS), Project Amistad (Friendship) originally set out to recruit and train Black and Hispanic volunteers to conduct lay therapy sessions with Black and Hispanic families in which abuse and neglect of children had occurred. Start-up was significantly delayed due to personnel changes; as a result,…

Descubriendo mi lugar: Understanding Sense of Belonging and Community of Black STEM-H Students Enrolled at a Hispanic Serving Institution

ERIC Educational Resources Information Center

Pichon, Henrietta Williams

2016-01-01

Purpose: The purpose of this quantitative study is to explore the differences and relations among how Black science, technology, engineering and mathematics-life and health sciences (STEM-H) and non-STEM-H students develop a sense of belonging and community at a Hispanic serving institution (HSI). Design/methodology/approach: This paper used…

The Demographics of Alcohol Use among Young Americans: Results from the 1983 National Longitudinal Survey of Labor Market Experience of Youth.

ERIC Educational Resources Information Center

Crowley, Joan E.

This document gives results of research on alcohol use by young Americans from the 1983 National Longitudinal Survey of Labor Market Experience of Youth, a survey of a large, nationally representative sample supplemented by samples of blacks, Hispanics, and economically disadvantaged non-black, non-Hispanic youth and covering the entire range of…

Agreement on Reporting of Physical, Psychological, and Sexual Violence among White, Black, and Hispanic Couples in the United States

ERIC Educational Resources Information Center

Caetano, Raul; Field, Craig; Ramisetty-Mikler, Suhasini; Lipsky, Sherry

2009-01-01

This article examines agreement on reports of male-to-female and female-to-male psychological, physical, and sexual violence among White, Black, and Hispanic couples in the United States. Using a probability sample, separate face-to-face interviews were conducted in respondents' homes with both members of 1,025 intact couples living in the 48…

Testimony to the State of New York Legislative Hearing on Dropouts.

ERIC Educational Resources Information Center

Smith, Donald H.

This paper, which was presented as testimony at the State of New York hearing on dropouts, presents three causes for the high dropout rates of Black and Hispanic students and offers some solutions. It is noted that in large cities dropout rates range from as high as 50% to 70% among Blacks and Hispanics. The reasons cited for these high rates are:…

Tuberculosis in Blacks

MedlinePlus

... 995 non-Hispanic blacks in the United States, accounting for nearly 21% of all people reported with ... to identify the socio-cultural, racial, and health system barriers specifically for blacks with or at risk ...

76 FR 17620 - Census Advisory Committees

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-30

... African American Population, the American Indian and Alaska Native Populations, the Asian Population, the... American Population, the American Indian and Alaska Native Populations, the Asian Population, the Hispanic...

76 FR 56395 - Census Advisory Committees

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-13

... African American Population, the American Indian and Alaska Native Populations, the Asian Population, the... American Population, the American Indian and Alaska Native Populations, the Asian Population, the Hispanic...

42 CFR 52c.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Americans, Hispanic Americans, Asian/Pacific Islanders, and American Indians/Native Alaskans (Native Americans). HHS means the Department of Health and Human Services. Nonprofit as applied to any institution...

Racial/ethnic disparities in hypertension prevalence: reconsidering the role of chronic stress.

PubMed

Hicken, Margaret T; Lee, Hedwig; Morenoff, Jeffrey; House, James S; Williams, David R

2014-01-01

We investigated the association between anticipatory stress, also known as racism-related vigilance, and hypertension prevalence in Black, Hispanic, and White adults. We used data from the Chicago Community Adult Health Study, a population-representative sample of adults (n = 3105) surveyed in 2001 to 2003, to regress hypertension prevalence on the interaction between race/ethnicity and vigilance in logit models. Blacks reported the highest vigilance levels. For Blacks, each unit increase in vigilance (range = 0-12) was associated with a 4% increase in the odds of hypertension (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 1.00, 1.09). Hispanics showed a similar but nonsignificant association (OR = 1.05; 95% CI = 0.99, 1.12), and Whites showed no association (OR = 0.95; 95% CI = 0.87, 1.03). Vigilance may represent an important and unique source of chronic stress that contributes to the well-documented higher prevalence of hypertension among Blacks than Whites; it is a possible contributor to hypertension among Hispanics but not Whites.

Residential segregation and racial disparities in self-rated health: How do dimensions of residential segregation matter?1

PubMed Central

Yang, Tse-Chuan; Zhao, Yunhan; Song, Qian

2016-01-01

Previous research on segregation and health has been criticized for overlooking the fact that segregation is a multi-dimensional concept (i.e., evenness, exposure, concentration, centralization, and clustering) and recent evidence drawn from non-black minorities challenges the conventional belief that residential segregation widens racial health disparities. Combining a survey data (n=18,752) from Philadelphia with the 2010 Census tract (n=925) data, we examine two theoretical frameworks to understand why the association of segregation with health may differ by race/ethnicity. Specifically, we investigate how each dimension of segregation contributed to racial disparities in self-rated health. We found (1) high levels of white/ black concentration could exacerbate the white/black health disparities up to 25 percent, (2) the white/Hispanic health disparities was narrowed by increasing the level of white/Hispanic centralization, and (3) no single dimension of segregation statistically outperforms others. Our findings supported that segregation is bad for blacks but may be beneficial for Hispanics. PMID:27886735

Prevalence of Mental Disorder and Service Use by Immigrant Generation and Race/Ethnicity Among U.S. Adolescents.

PubMed

Georgiades, Katholiki; Paksarian, Diana; Rudolph, Kara E; Merikangas, Kathleen R

2018-04-01

To examine differences in lifetime prevalence of mental disorder and service use among U.S. adolescents by both immigrant generation and race/ethnicity. A total of 6,250 adolescents aged 13 to 18 years in the National Comorbidity Survey Replication Adolescent Supplement were assessed for lifetime prevalence of mood and/or anxiety disorders, behavior disorders, and mental health service use. Twelve groups defined by self-identified race/ethnicity (non-Hispanic white, Hispanic, non-Hispanic black, Asian) and immigrant generation (first, second, third, or more) were compared. Differences in prevalence of lifetime mental disorder were most apparent when immigrant generation and race/ethnicity were considered jointly. Compared to third+generation non-Hispanic white adolescents, the odds of mood/anxiety disorder were increased among second-generation Asian (adjusted odds ratio [AOR] = 2.51; 95% CI = 1.22-5.17) and third+generation Hispanic (AOR = 1.28; 95% CI = 1.00-1.63) but reduced among first-generation Asian (AOR = 0.27; 95% CI = 0.10-0.71) and second-generation non-Hispanic white adolescents (AOR = 0.50; 95% CI = 0.30-0.81). The odds of behavior disorder were lower among first-generation Asian (AOR = 0.26; 95% CI = 0.09-0.71) and all generations of non-Hispanic black adolescents (AOR range 0.43-0.55). Adjusting for lifetime disorder, first-generation Hispanic and non-Hispanic white adolescents and all generations of non-Hispanic black adolescents were less likely to receive mental health services (AOR range 0.24-0.55). Variation in risk of disorder by immigrant generation and race/ethnicity underscores the importance of considering social, economic, and cultural influences in etiologic and treatment studies of adolescent psychopathology. Lower rates of service use, particularly among first-generation immigrant adolescents, highlight the need to identify and address barriers to recognition and treatment of mental disorders among adolescents from immigrant and racial/ethnic minority backgrounds. Published by Elsevier Inc.

Racial/Ethnic Differences in Left Ventricular Structure and Function in Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort.

PubMed

Ahmad, Faraz S; Cai, Xuan; Kunkel, Katherine; Ricardo, Ana C; Lash, James P; Raj, Dominic S; He, Jiang; Anderson, Amanda H; Budoff, Matthew J; Wright Nunes, Julie A; Roy, Jason; Wright, Jackson T; Go, Alan S; St John Sutton, Martin G; Kusek, John W; Isakova, Tamara; Wolf, Myles; Keane, Martin G

2017-08-01

Chronic kidney disease (CKD) is associated with increased risk of cardiovascular disease (CVD) and it is especially common among Blacks. Left ventricular hypertrophy (LVH) is an important subclinical marker of CVD, but there are limited data on racial variation in left ventricular structure and function among persons with CKD. In a cross-sectional analysis of the Chronic Renal Insufficiency Cohort Study, we compared the prevalence of different types of left ventricular remodeling (concentric hypertrophy, eccentric hypertrophy, and concentric remodeling) by race/ethnicity. We used multinomial logistic regression to test whether race/ethnicity associated with different types of left ventricular remodeling independently of potential confounding factors. We identified 1,164 non-Hispanic Black and 1,155 non-Hispanic White participants who completed Year 1 visits with echocardiograms that had sufficient data to categorize left ventricular geometry type. Compared to non-Hispanic Whites, non-Hispanic Blacks had higher mean left ventricular mass index (54.7 ± 14.6 vs. 47.4 ± 12.2 g/m2.7; P < 0.0001) and prevalence of concentric LVH (45.8% vs. 24.9%). In addition to higher systolic blood pressure and treatment with >3 antihypertensive medications, Black race/ethnicity was independently associated with higher odds of concentric LVH compared to White race/ethnicity (odds ratio: 2.73; 95% confidence interval: 2.02, 3.69). In a large, diverse cohort with CKD, we found significant differences in left ventricular mass and hypertrophic morphology between non-Hispanic Blacks and Whites. Future studies will evaluate whether higher prevalence of LVH contribute to racial/ethnic disparities in cardiovascular outcomes among CKD patients. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Performance of a risk index for advanced proximal colorectal neoplasia among a racially/ethnically diverse patient population (risk index for advanced proximal neoplasia).

PubMed

Levitzky, Benjamin E; Brown, Colin C; Heeren, Timothy C; Schroy, Paul C

2011-06-01

Tailoring the use of screening colonoscopy based on the risk of advanced proximal neoplasia (APN) has been advocated as a strategy for reducing demand and optimizing effectiveness. A 7-point index based on age, sex, and distal findings at sigmoidoscopy has been proposed that stratifies individuals into low, intermediate, and high-risk categories. The aim of this cross-sectional analysis was to determine the validity of this index, which was originally derived and validated among mostly whites, for black and Hispanic patients. Data, including age, sex, colonoscopic findings, and pathology, were collected retrospectively from 1,481 white, 1,329 black, and 689 Hispanic asymptomatic, average-risk patients undergoing screening colonoscopy between 2000 and 2005. Cumulative scores ranging from 0 to 7 were derived for each subject and categorized as low, intermediate, or high risk. Rates of APN were assessed for each risk category after stratification by race/ethnicity. Index performance was assessed using the C-statistic and compared across the three racial groups. Rates of APN among patients categorized as low, intermediate, or high risk increased from 1.0 to 2.8 to 3.7% for whites, 1.0 to 2.2 to 4.2% for blacks, and 0.6 to 1.9 to 3.7% for Hispanics. The index performed similarly for all three groups, but showed limited ability to discriminate low from intermediate-risk patients, with C-statistic values of 0.62 for whites, 0.63 for blacks, and 0.68 for Hispanics. A risk index based on age, sex, and distal endoscopic findings has limited ability to discriminate low from intermediate-risk white, black, and Hispanic patients for APN.

Racial and ethnic differences in patient navigation: Results from the Patient Navigation Research Program.

PubMed

Ko, Naomi Y; Snyder, Frederick R; Raich, Peter C; Paskett, Electra D; Dudley, Donald J; Lee, Ji-Hyun; Levine, Paul H; Freund, Karen M

2016-09-01

Patient navigation was developed to address barriers to timely care and reduce cancer disparities. The current study explored navigation and racial and ethnic differences in time to the diagnostic resolution of a cancer screening abnormality. The authors conducted an analysis of the multisite Patient Navigation Research Program. Participants with an abnormal cancer screening test were allocated to either navigation or control. The unadjusted median time to resolution was calculated for each racial and ethnic group by navigation and control. Multivariable Cox proportional hazards models were fit, adjusting for sex, age, cancer abnormality type, and health insurance and stratifying by center of care. Among a sample of 7514 participants, 29% were non-Hispanic white, 43% were Hispanic, and 28% were black. In the control group, black individuals were found to have a longer median time to diagnostic resolution (108 days) compared with non-Hispanic white individuals (65 days) or Hispanic individuals (68 days) (P<.0001). In the navigated groups, black individuals had a reduction in the median time to diagnostic resolution (97 days) (P<.0001). In the multivariable models, among controls, black race was found to be associated with an increased delay to diagnostic resolution (hazard ratio, 0.77; 95% confidence interval, 0.69-0.84) compared with non-Hispanic white individuals, which was reduced in the navigated arm (hazard ratio, 0.85; 95% confidence interval, 0.77-0.94). Patient navigation appears to have the greatest impact among black patients, who had the greatest delays in care. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2715-2722. © 2016 American Cancer Society. © 2016 American Cancer Society.

Racial and ethnic disparities associated with knowledge of symptoms of heart attack and use of 911: National Health Interview Survey, 2001.

PubMed

McGruder, Henraya E; Greenlund, Kurt J; Malarcher, Ann M; Antoine, Theresa L; Croft, Janet B; Zheng, Zhi-Jie

2008-01-01

Heart attacks are more prevalent among Hispanics and Blacks than among Whites. Bystanders must be able to recognize heart attack symptoms and activate the emergency response system in order to receive time-dependent therapies that increase survival. This study estimated racial/ethnic disparities in awareness of heart attack symptoms in a sample of the US population. We evaluated data from 33,059 adult participants in the 2001 National Health Interview Survey. Respondents indicated their awareness of five heart attack symptoms and the need to call 911 in the presence of such symptoms. Hispanics and Blacks were less likely to recognize each heart attack symptom than were Whites (P<.05). Hispanics (25.6%), people aged 18-24 years (33.6%), men (39.1%), and those with less than a high school education (31.3%) were less likely to recognize all five heart attack symptoms and report that they would call 911 than were Whites (45.8%), Blacks (36.1%), respondents aged 45-64 years (47.7%) and >65 years (43.9%), and those with a high school education (41.0%) or more (45.6%). In multivariate logistic regression analyses, Blacks (OR .73, 95% CI .66-.80) and Hispanics (OR .49, 95% CI .45-.54) were less likely than were Whites to recognize all five heart attack symptoms and the need to call 911 if someone had these symptoms. One Healthy People 2010 goal is to eliminate health disparities. Racial/ethnic disparities exist in knowledge of heart attack symptoms and the need to call 911. Special educational efforts should focus on Black and Hispanic populations and highlight the importance of symptoms and time-dependent therapies.

Food insecurity and adult overweight/obesity: Gender and race/ethnic disparities.

PubMed

Hernandez, Daphne C; Reesor, Layton M; Murillo, Rosenda

2017-10-01

The majority of the food insecurity-obesity research has indicated a positive association among women, especially minority women. Less research has been conducted on men, and the findings are inconsistent. The aim was to assess whether gender and race/ethnic disparities exists between the food insecurity and overweight/obesity relationship among adults ages 18-59. We used the cross-sectional 2011 and 2012 National Health Interview Survey data (N = 19,990). Three or more affirmative responses on the 10-item USDA Food Security Scale indicated food insecure experiences. Self-reported height and weight were used to calculate body mass index according to the Centers for Disease Control and Prevention. Multivariate logistic regression models were stratified by gender and race/ethnicity to estimate the association between food insecurity and overweight/obesity controlling for several demographic characteristics. Adults on average were 36 years of age (51% female; 56% white, 27% Hispanic, and 17% black), 27% were food insecure, and 65% were overweight/obese. Food insecurity was most prevalent among blacks and Hispanics, regardless of gender. A greater percentage of food insecure women were overweight/obese compared to food secure women among all race/ethnicity groups; while similar proportions of white, black, and Hispanic men were overweight/obese irrespective of their food security status. In covariate-adjusted models, food insecurity was associated with a 41% and 29% higher odds of being overweight/obese among white and Hispanic women, respectively. Food insecurity was not related to overweight/obesity among black women nor among white, black, and Hispanic men. The complex relationship between food insecurity and obesity suggests a need to investigate potential behavioral and physiological mechanisms, and moderators of this relationship. Copyright © 2017 Elsevier Ltd. All rights reserved.

F8 and F9 mutations in US haemophilia patients: correlation with history of inhibitor and race/ethnicity.

PubMed

Miller, C H; Benson, J; Ellingsen, D; Driggers, J; Payne, A; Kelly, F M; Soucie, J M; Craig Hooper, W

2012-05-01

Both genetic and treatment-related risk factors contribute to the development of inhibitors in haemophilia. An inhibitor surveillance system piloted at 12 US sites has the goal of assessing risk factors through prospective data collection. This report examines the relationship of genotype and race/ethnicity to history of inhibitor in a large cohort of US haemophilia patients. Mutation analysis was performed on 676 haemophilia A (HA) and 153 haemophilia B (HB) patients by sequencing, Multiplex Ligation-dependent Probe Amplification, and PCR for inversions in F8 introns 22 (inv22) and 1 (inv1). Two HB patients with deletions had history of inhibitor. In severe HA, frequency of history of inhibitor was: large deletion 57.1%, splice site 35.7%, inv22 26.8%, nonsense 24.5%, frameshift 12.9%, inv1 11.1% and missense 9.5%. In HA, 19.6% of 321 White non-Hispanics (Whites), 37.1% of 35 Black non-Hispanics (Blacks) and 46.9% of 32 Hispanics had history of inhibitor (P = 0.0003). Mutation types and novel mutation rates were similar across ethnicities. When F8 haplotypes were constructed, Whites and Hispanics showed only H1 and H2. Within H1, history of inhibitor was 12.4% in Whites, 40.0% in Blacks (P = 0.009) and 32.4% in Hispanics (P = 0.002). Inhibitor frequency is confirmed to vary by mutation type and race in a large US population. White patients with history of inhibitor did not exhibit rare F8 haplotypes. F8 gene analysis did not reveal a cause for the higher inhibitor frequencies in Black and Hispanic patients. © 2011 Blackwell Publishing Ltd.

Epstein-Barr virus, cytomegalovirus, and multiple sclerosis susceptibility: A multiethnic study.

PubMed

Langer-Gould, Annette; Wu, Jun; Lucas, Robyn; Smith, Jessica; Gonzales, Edlin; Amezcua, Lilyana; Haraszti, Samantha; Chen, Lie Hong; Quach, Hong; James, Judith A; Barcellos, Lisa F; Xiang, Anny H

2017-09-26

To determine whether Epstein-Barr virus (EBV) or cytomegalovirus (CMV) seropositivity is associated with multiple sclerosis (MS) in blacks and Hispanics and to what extent measures of the hygiene hypothesis or breastfeeding could explain these findings. EBV and CMV have been associated with MS risk in whites, and the timing and frequency of both viruses vary by factors implicated in the hygiene hypothesis. Incident cases of MS or its precursor, clinically isolated syndrome (CIS), and matched controls (blacks, 111 cases/128 controls; Hispanics, 173/187; whites, 235/256) were recruited from the membership of Kaiser Permanente Southern California. Logistic regression models accounted for HLA-DRB1*1501 status, smoking, socioeconomic status, age, sex, genetic ancestry, and country of birth. Epstein-Barr nuclear antigen-1 (EBNA-1) seropositivity was independently associated with an increased odds of MS/CIS in all 3 racial/ethnic groups ( p < 0.001 for blacks and whites, p = 0.02 for Hispanics). In contrast, CMV seropositivity was associated with a lower risk of MS/CIS in Hispanics ( p = 0.004) but not in blacks ( p = 0.95) or whites ( p = 0.96). Being born in a low/middle-income country was associated with a lower risk of MS in Hispanics ( p = 0.02) but not after accounting for EBNA-1 seropositivity. Accounting for breastfeeding did not diminish the association between CMV and MS in Hispanics. The consistency of EBNA-1 seropositivity with MS across racial/ethnic groups and between studies points to a strong biological link between EBV infection and MS risk. The association between past CMV infection and MS risk supports the broader hygiene hypothesis, but the inconsistency of this association across racial/ethnic groups implies noncausal associations. © 2017 American Academy of Neurology.

Racial and ethnic differences in health care utilization for childhood eczema: An analysis of the 2001-2013 Medical Expenditure Panel Surveys.

PubMed

Fischer, Alexander H; Shin, Daniel B; Margolis, David J; Takeshita, Junko

2017-12-01

Eczema is a common chronic inflammatory disease of the skin. Studies suggest differences in disease prevalence and severity by race/ethnicity. Our knowledge of health care utilization for eczema among different racial/ethnic groups remains limited. To evaluate health care utilization for childhood eczema among different racial/ethnic groups in the United States. We performed a cohort study of non-Hispanic white (reference), non-Hispanic black, and Hispanic white individuals under the age of 18 years with caregiver-reported eczema (N = 2043) pooled from the 2-year longitudinal cohorts of the 2001-2013 Medical Expenditure Panel Surveys. Health care utilization outcomes were evaluated over the 2-year follow-up period by race/ethnicity using multivariable regression. Among all children with eczema, non-Hispanic blacks were less likely than whites to report an ambulatory visit for eczema (adjusted odds ratio [OR adj ] 0.69; 95% confidence interval [CI] 0.51-0.92). Among those with ≥1 ambulatory visit for eczema, non-Hispanic blacks reported more visits (adjusted incidence rate ratio [IRR adj ] 1.68; 95% CI 1.10-2.55) and prescriptions (IRR adj 1.22; 95% CI 1.01-1.46) than whites and were more likely than whites to report a dermatology visit (OR adj 1.82; 95% CI 1.06-3.14) for eczema. We used caregiver- or self-reported data. Our findings suggest disparities in health care utilization for eczema among non-Hispanic black children despite utilization patterns suggestive of more severe disease. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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

Acute infection contributes to racial disparities in stroke mortality

PubMed Central

Langa, Kenneth M.; Rogers, Mary A.M.

2014-01-01

Objective: It is unknown whether racial differences in exposure to acute precipitants of stroke, specifically infection, contribute to racial disparities in stroke mortality. Methods: Among participants in the nationally representative Health and Retirement Study with linked Medicare data (1991–2007), we conducted a case-crossover study employing within-person comparisons to study racial/ethnic differences in the risks of death and hospitalization from ischemic stroke following acute infection. Results: There were 964 adults hospitalized for ischemic stroke. Acute infection increased the 30-day risks of ischemic stroke death (5.82-fold) and ischemic stroke hospitalization (1.87-fold). Acute infection was a more potent trigger of acute ischemic stroke death in non-Hispanic blacks (odds ratio [OR] 39.21; 95% confidence interval [CI] 9.26–166.00) than in non-Hispanic whites (OR 4.50; 95% CI 3.14–6.44) or Hispanics (OR 5.18; 95% CI 1.34–19.95) (race-by-stroke interaction, p = 0.005). When adjusted for atrial fibrillation, infection remained more strongly associated with stroke mortality in blacks (OR 34.85) than in whites (OR 3.58) and Hispanics (OR 3.53). Acute infection increased the short-term risk of incident stroke similarly across racial/ethnic groups. Infection occurred often before stroke death in non-Hispanic blacks, with 70% experiencing an infection in the 30 days before stroke death compared to a background frequency of 15%. Conclusions: Acute infection disproportionately increases the risk of stroke death for non-Hispanic blacks, independently of atrial fibrillation. Stroke incidence did not explain this finding. Acute infection appears to be one factor that contributes to the black–white disparity in stroke mortality. PMID:24510494

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.

Racial/Ethnic and gender prevalences in reported common pains in a national sample.

PubMed

Plesh, Octavia; Adams, Sally H; Gansky, Stuart A

2011-01-01

To compare prevalences of self-reported temporomandibular joint and muscle disorders (TMJMD)-type pain, headaches, and neck and back pains in the 2000 to 2005 US National Health Interview Survey (NHIS) by gender and age for non-Hispanic Whites (Whites), Hispanics, and non-Hispanic Blacks (Blacks). Data from the 2000 to 2005 NHIS included information on gender, age, race, ethnicity, and different common types of pain specifically: TMJMD-type pain, severe headaches/migraine, neck, and low back pains. A total of 189,992 people were included: 52% female and 48% male, 73% White, 12% Hispanic, 11% Black, and 4% "Other." The overall prevalence of TMJMD-type pain was 4.6%; severe headaches/migraine was 15.4%; neck, 14.9%; and low back, 28.0%. Survey logistic regression models estimating race-specific, age-adjusted curves revealed race by age pain differences. For TMJMD-type pain, White females presented the highest prevalence at younger ages, decreasing after age 40. Prevalences for Hispanic and Black females, although lower at younger ages, increased up to age 60 and remained higher than Whites. Males showed less racial/ethnic and age variation. Severe headaches/migraines presented an age pattern similar to TMJMD-type pain for White females and little overall variation for males, but without racial differences. Neck pain showed some similarities to TMJMD-type pain: higher in Whites at younger ages, lower at older ages, with Hispanics having the highest rates after their 60's. For low back pain, the rates peaked around the sixth decade for all racial/ethnic groups. The patterns of TMJMD-type pain varied greatly within and across racial/ethnic groups by gender and across the adult lifespan. Similarities and differences for the other pains were noted.

75 FR 13494 - Census Advisory Committees

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... African American Population, the American Indian and Alaska Native Populations, the Asian Population, the... Populations, the Asian Population, the Hispanic Population, and the Native Hawaiian and Other Pacific Islander...

75 FR 54853 - Census Advisory Committees

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... American Population, the American Indian and Alaska Native Populations, the Asian Population, the Hispanic...: The CACs on the African American Population, the American Indian and Alaska Native [[Page 54854

Racial/Ethnic Disparities in the Mental Health Care Utilization of Fifth Grade Children

PubMed Central

Coker, Tumaini R.; Elliott, Marc N.; Kataoka, Sheryl; Schwebel, David C.; Mrug, Sylvie; Grunbaum, Jo Anne; Cuccaro, Paula; Peskin, Melissa F.; Schuster, Mark A.

2015-01-01

Objective The aim of this study was to examine racial/ethnic differences in fifth grade children’s mental health care utilization. Methods We analyzed cross-sectional data from a study of 5147 fifth graders and their parents in 3 US metropolitan areas from 2004–06. Multivariate logistic regression was used to examine racial/ethnic differences in mental health care utilization. Results Nine percent of parents reported that their child had ever used mental health care services; fewer black (6%) and Hispanic (8%) children had used services than white children (14%). Fewer black and Hispanic children with recent symptoms of attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder, and fewer black children with symptoms of depression had ever utilized services compared with white children. In multivariate analyses controlling for demographic factors, parental mental health, social support, and symptoms of the 4 mental health conditions, we found that black children were less likely than white children to have ever used services (Odds ratio [OR] 0.3, 95% confidence interval [95% CI], 0.2–0.4, P <.001). The odds ratio for black children remained virtually unchanged when the analysis was restricted to children with symptoms of ≥1 mental health condition, and when the analysis was stratified by mental health condition. The difference in utilization for Hispanic compared with white children was fully explained by sociodemographics in all multivariate models. Conclusions Disparities exist in mental health care utilization for black and Hispanic children; the disparity for black children is independent of sociodemographics and child mental health need. Efforts to reduce this disparity may benefit from addressing not only access and diagnosis issues, but also parents’ help-seeking preferences for mental health care for their children. PMID:19329099

Serum cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanonol levels among non-Hispanic Asian American smokers and nonsmokers as compared to other race/ethnicities: data from NHANES 2011-2012.

PubMed

Jain, Ram B

2015-02-01

The objective of this study was to evaluate serum cotinine and total urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanonol (NNAL) levels from a nationally representative sample of non-Hispanic Asian Americans as compared with other racial/ethnic groups. Data from the latest National Health and Nutrition Examination Survey for the years 2011-2012 were used for this purpose. The total sample size used was 4580. Regression models were fitted to estimate serum cotinine and urinary NNAL levels for smokers and nonsmokers aged 20 years and older adjusted for other factors that affect these levels. For nonsmokers, exposure to second hand smoke at home was associated with about 30 times higher serum cotinine levels when compared to those without such exposure (0.717 ng mL(-1) vs. 0.024 ng mL(-1), p<0.01). NNAL levels among nonsmokers with second hand smoke exposure at home were about twenty times what they were in those without such exposure (9 pg mL(-1) vs. 109 pg mL(-1), p<0.01). As compared to other racial/ethnic groups, the lowest adjusted serum cotinine levels occurred in non-Hispanic Asian smokers (92.6 ng mL(-1)) and Hispanics (84.5 ng mL(-1)) as compared to non-Hispanic whites (143.8 ng mL(-1)) and non-Hispanic blacks (158.4 ng mL(-1)). Urinary NNAL levels for smokers were in the order: non-Hispanic Asian (0.121 ng mL(-1))

Economic, racial and ethnic disparities in breast cancer in the US: towards a more comprehensive model.

PubMed

Campbell, Richard T; Li, Xue; Dolecek, Therese A; Barrett, Richard E; Weaver, Kathryn E; Warnecke, Richard B

2009-09-01

Using cancer registry data, we focus on racial and ethnic disparities in stage of breast cancer diagnosis in Cook County, IL. The county health system is the "last resort" health-care provider for low-income persons. Socioeconomic status is measured using empirical Bayes estimates of tract-level poverty, specific to non-Hispanic whites, non-Hispanic blacks or Hispanics in one of three age groups. We use ordinal logistic regression with non-proportional odds to model stage. Blacks and Hispanics are at greater risk for regional and distant stage diagnosis, but the disparity declines with age. Women in high-poverty areas are at substantially greater risk for late-stage diagnosis. The effects of poverty do not differ by age or across racial and ethnic groups.

Developing and Validating a Science Notebook Rubric for Fifth-Grade Non-Mainstream Students

NASA Astrophysics Data System (ADS)

Huerta, Margarita; Lara-Alecio, Rafael; Tong, Fuhui; Irby, Beverly J.

2014-07-01

We present the development and validation of a science notebook rubric intended to measure the academic language and conceptual understanding of non-mainstream students, specifically fifth-grade male and female economically disadvantaged Hispanic English language learner (ELL) and African-American or Hispanic native English-speaking students. The science notebook rubric is based on two main constructs: academic language and conceptual understanding. The constructs are grounded in second-language acquisition theory and theories of writing and conceptual understanding. We established content validity and calculated reliability measures using G theory and percent agreement (for comparison) with a sample of approximately 144 unique science notebook entries and 432 data points. Results reveal sufficient reliability estimates, indicating that the instrument is promising for use in future research studies including science notebooks in classrooms with populations of economically disadvantaged Hispanic ELL and African-American or Hispanic native English-speaking students.

Neighborhood context and the Hispanic health paradox: differential effects of immigrant density on children׳s wheezing by poverty, nativity and medical history.

PubMed

Kim, Young-An; Collins, Timothy W; Grineski, Sara E

2014-05-01

Prior research suggests that immigrant enclaves provide respiratory health benefits for US Hispanic residents. We test if immigrant enclaves provide differential respiratory health benefits for Hispanic children in El Paso (Texas) based on individual-level factors. Results reveal that higher neighborhood immigrant density is associated with reduced odds of wheezing, but that the protective immigrant enclave effect is modified by poverty, general health status, body mass index (BMI), and caretaker nativity. Higher immigrant density is significantly more protective for poor children and those with foreign-born caretakers; conversely, it is significantly less protective for children in worse health and those with higher BMI. These findings foster a novel understanding of how immigrant enclaves may be differentially protective for Hispanic children based on individual-level factors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Testing equivalence of mediating models of income, parenting, and school readiness for white, black, and Hispanic children in a national sample.

PubMed

Raver, C Cybele; Gershoff, Elizabeth T; Aber, J Lawrence

2007-01-01

This paper examines complex models of the associations between family income, material hardship, parenting, and school readiness among White, Black, and Hispanic 6-year-olds, using the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K). It is critical to test the universality of such complex models, particularly given their implications for intervention, prevention, and public policy. Therefore this study asks: Do measures and models of low income and early school readiness indicators fit differently or similarly for White, Black, and Hispanic children? Measurement equivalence of material hardship, parent stress, parenting behaviors, child cognitive skills, and child social competence is first tested. Model equivalence is then tested by examining whether category membership in a race/ethnic group moderates associations between predictors and young children's school readiness.

Testing Equivalence of Mediating Models of Income, Parenting, and School Readiness for White, Black, and Hispanic Children in a National Sample

PubMed Central

Raver, C. Cybele; Gershoff, Elizabeth T.; Aber, J. Lawrence

2010-01-01

This paper examines complex models of the associations between family income, material hardship, parenting, and school readiness among White, Black, and Hispanic 6-year-olds, using the Early Childhood Longitudinal Study – Kindergarten Cohort (ECLS – K). It is critical to test the universality of such complex models, particularly given their implications for intervention, prevention, and public policy. Therefore this study asks: Do measures and models of low income and early school readiness indicators fit differently or similarly for White, Black, and Hispanic children? Measurement equivalence of material hardship, parent stress, parenting behaviors, child cognitive skills, and child social competence is first tested. Model equivalence is then tested by examining whether category membership in a race/ethnic group moderates associations between predictors and young children’s school readiness. PMID:17328695

Trends and differentials in higher-birthweight infants at 28-31 weeks of gestation, by race and Hispanic origin, United States, 1990-2002.

PubMed

Kirmeyer, Sharon E W; Martin, Joyce A

2007-09-01

Birth certificate gestational age data based on the date of the mother's last menstrual period (LMP) are considered problematic. Of particular concern are birthweight distributions for infants reported on the birth certificate as having been delivered at 28-31 weeks' gestation; these distributions have been shown to be distinctly bimodal. The 'second curve' of the birthweight distribution at 28-31 weeks includes implausible birthweight/gestational age combinations and, thus, has been hypothesised to represent erroneous gestational ages due to misidentification of the date of LMP. It has been suggested that such 'misclassification' has declined in recent years and that this change can affect trends in preterm birth rates (<37 weeks' gestation), particularly rates among non-Hispanic black infants. This present study used primarily simple and multivariable analyses to review trends and differentials in birthweight distributions at 28-31 weeks by race and Hispanic origin of the mother. It aggregated data for the years 1990-92 and 2000-02 from the US vital statistics Natality files. Over the decade, the percentage of births in the second curve declined for all births and for each racial and Hispanic origin group studied. The largest decline was observed for non-Hispanic blacks; the smallest for Hispanic births. Later initiation of prenatal care, younger maternal age, lower educational attainment, higher birth order and vaginal and singleton delivery were positively associated with a larger second curve, suggesting misclassification of gestational age. Declines in the second curve over the study period were suggested to contribute significantly to the observed decrease in overall preterm birth rates for non-Hispanic black births. Further analysis is needed to estimate the influence of reporting error on preterm birth rates by race and Hispanic origin.

Racial/Ethnic Disproportionality in Psychiatric Diagnoses and Treatment in a Sample of Serious Juvenile Offenders.

PubMed

Baglivio, Michael T; Wolff, Kevin T; Piquero, Alex R; Greenwald, Mark A; Epps, Nathan

2017-07-01

Psychiatric disorder prevalence has been shown demonstrably higher among justice-involved adolescents than youth in the general population. Yet, among arrested juveniles, little is known regarding racial/ethnic differences in disorder prevalence, the role of trauma exposure in the diagnosis of behavioral disorders, or subsequent psychiatric treatment provided to adolescents with such diagnoses. The current study examines racial/ethnic disparity in psychiatric diagnoses and treatment of behavioral disorders associated with delinquency, controlling for traumatic experiences, behavioral indicators, and prior offending among serious juvenile offenders. Logistic regression is employed to explore the racial/ethnic disproportionality in behavioral disorder diagnoses and psychiatric treatment provision among 8763 males (57.7 % Black, 11.8 % Hispanic) and 1,347 females (53.7 % Black, 7.6 % Hispanic) admitted to long-term juvenile justice residential placements in Florida. The results indicate Black males are 40 % more likely, and Black females 54 % more likely to be diagnosed with conduct disorder than Whites, even upon considerations of trauma, behavioral indicators, and criminal offending. Black and Hispanic males are approximately 40 % less likely to be diagnosed with ADHD than White males, with no racial/ethnic differences for females. Importantly, Black males are 32 % less likely to receive psychiatric treatment than White males, with no differences between White and Hispanic males, or any female subgroups. Traumatic exposures increased the odds of oppositional defiant disorder and ADHD, but not conduct disorder for males, though adverse childhood experiences were unrelated to behavioral disorder diagnoses among females.

Medicare D Subsidies and Racial Disparities in Persistence and Adherence With Hormonal Therapy

PubMed Central

Shi, Yushu; Charlson, John; Smith, Elizabeth C.; Smallwood, Alicia J.; Nattinger, Ann B.; Laud, Purushottam W.; Neuner, Joan M.

2016-01-01

Purpose To investigate the role of out-of-pocket cost supports through the Medicare Part D Low-Income Subsidy on disparities in breast cancer hormonal therapy persistence and adherence by race or ethnicity. Methods A nationwide cohort of women age ≥ 65 years with a breast cancer operation between 2006 and 2007 and at least one prescription filled for oral breast cancer hormonal therapy was identified from all Medicare D enrollees. The association of race or ethnicity with nonpersistence (90 consecutive days with no claims for a hormonal therapy prescription) and nonadherence (medication possession rate < 80%) was examined. Survival analyses were used to account for potential differences in age, comorbidity, or intensity of other treatments. Results Among the 25,111 women in the study sample, 77% of the Hispanic and 70% of the black women received a subsidy compared with 21% of the white women. By 2 years, 69% of black and 70% of Hispanic patients were persistent compared with 61% of white patients. In adjusted analyses, patients in all three unsubsidized race or ethnicity groups had greater discontinuation than subsidized groups (white patients: hazard ratio [HR], 1.83; 95% CI, 1.70 to 1.95; black patients: HR, 2.09; 95% CI, 1.73 to 2.51; Hispanic patients: HR, 3.00; 95% CI, 2.37 to 3.89). Racial or ethnic persistence disparities that were present for unsubsidized patients were not present or reversed among subsidized patients. All three subsidized race or ethnicity groups also had higher adherence than all three unsubsidized groups, although with the smallest difference occurring in black women. Conclusion Receipt of a prescription subsidy was associated with substantially improved persistence to breast cancer hormonal therapy among white, black, and Hispanic women and lack of racial or ethnic disparities in persistence. Given high subsidy enrollment among black and Hispanic women, policies targeted at low-income patients have the potential to also substantially reduce racial and ethnic disparities. PMID:27998232

Medicare D Subsidies and Racial Disparities in Persistence and Adherence With Hormonal Therapy.

PubMed

Biggers, Alana; Shi, Yushu; Charlson, John; Smith, Elizabeth C; Smallwood, Alicia J; Nattinger, Ann B; Laud, Purushottam W; Neuner, Joan M

2016-12-20

Purpose To investigate the role of out-of-pocket cost supports through the Medicare Part D Low-Income Subsidy on disparities in breast cancer hormonal therapy persistence and adherence by race or ethnicity. Methods A nationwide cohort of women age ≥ 65 years with a breast cancer operation between 2006 and 2007 and at least one prescription filled for oral breast cancer hormonal therapy was identified from all Medicare D enrollees. The association of race or ethnicity with nonpersistence (90 consecutive days with no claims for a hormonal therapy prescription) and nonadherence (medication possession rate < 80%) was examined. Survival analyses were used to account for potential differences in age, comorbidity, or intensity of other treatments. Results Among the 25,111 women in the study sample, 77% of the Hispanic and 70% of the black women received a subsidy compared with 21% of the white women. By 2 years, 69% of black and 70% of Hispanic patients were persistent compared with 61% of white patients. In adjusted analyses, patients in all three unsubsidized race or ethnicity groups had greater discontinuation than subsidized groups (white patients: hazard ratio [HR], 1.83; 95% CI, 1.70 to 1.95; black patients: HR, 2.09; 95% CI, 1.73 to 2.51; Hispanic patients: HR, 3.00; 95% CI, 2.37 to 3.89). Racial or ethnic persistence disparities that were present for unsubsidized patients were not present or reversed among subsidized patients. All three subsidized race or ethnicity groups also had higher adherence than all three unsubsidized groups, although with the smallest difference occurring in black women. Conclusion Receipt of a prescription subsidy was associated with substantially improved persistence to breast cancer hormonal therapy among white, black, and Hispanic women and lack of racial or ethnic disparities in persistence. Given high subsidy enrollment among black and Hispanic women, policies targeted at low-income patients have the potential to also substantially reduce racial and ethnic disparities.

Differences in Natriuretic Peptide Levels by Race/Ethnicity (From the Multi-Ethnic Study of Atherosclerosis).

PubMed

Gupta, Deepak K; Daniels, Lori B; Cheng, Susan; deFilippi, Christopher R; Criqui, Michael H; Maisel, Alan S; Lima, Joao A; Bahrami, Hossein; Greenland, Philip; Cushman, Mary; Tracy, Russell; Siscovick, David; Bertoni, Alain G; Cannone, Valentina; Burnett, John C; Carr, John Jeffrey; Wang, Thomas J

2017-09-15

Natriuretic peptides (NP) are cardiac-derived hormones with favorable cardiometabolic actions. Low NP levels are associated with increased risks of hypertension and diabetes mellitus, conditions with variable prevalence by race and ethnicity. Heritable factors underlie a significant proportion of the interindividual variation in NP concentrations, but the specific influences of race and ancestry are unknown. In 5597 individuals (40% white, 24% black, 23% Hispanic, and 13% Chinese) without prevalent cardiovascular disease at baseline in the Multi-Ethnic Study of Atherosclerosis, multivariable linear regression and restricted cubic splines were used to estimate differences in serum N-terminal pro B-type natriuretic peptide (NT-proBNP) levels according to, ethnicity, and ancestry. Ancestry was determined using genetic ancestry informative markers. NT-proBNP concentrations differed significantly by race and ethnicity (black, median 43 pg/ml [interquartile range 17 to 94], Chinese 43 [17 to 90], Hispanic 53 [23 to 107], white 68 [34 to 136]; p = 0.0001). In multivariable models, NT-proBNP was 44% lower (95% confidence interval -48 to -40) in black and 46% lower (-50 to -41) in Chinese, compared with white individuals. Hispanic individuals had intermediate concentrations. Self-identified blacks and Hispanics were the most genetically admixed. Among self-identified black individuals, a 20% increase in genetic European ancestry was associated with 12% higher (1% to 23%) NT-proBNP. Among Hispanic individuals, genetic European and African ancestry were positively and negatively associated with NT-proBNP levels, respectively. In conclusion, NT-proBNP levels differ according to race and ethnicity, with the lowest concentrations in black and Chinese individuals. Racial and ethnic differences in NT-proBNP may have a genetic basis, with European and African ancestry associated with higher and lower NT-proBNP concentrations, respectively. Copyright © 2017 Elsevier Inc. All rights reserved.

Diversity in the Emerging Critical Care Workforce: Analysis of Demographic Trends in Critical Care Fellows From 2004 to 2014.

PubMed

Lane-Fall, Meghan B; Miano, Todd A; Aysola, Jaya; Augoustides, John G T

2017-05-01

Diversity in the physician workforce is essential to providing culturally effective care. In critical care, despite the high stakes and frequency with which cultural concerns arise, it is unknown whether physician diversity reflects that of critically ill patients. We sought to characterize demographic trends in critical care fellows, who represent the emerging intensivist workforce. We used published data to create logistic regression models comparing annual trends in the representation of women and racial/ethnic groups across critical care fellowship types. United States Accreditation Council on Graduate Medical Education-approved residency and fellowship training programs. Residents and fellows employed by Accreditation Council on Graduate Medical Education-accredited training programs from 2004 to 2014. None. From 2004 to 2014, the number of critical care fellows increased annually, up 54.1% from 1,606 in 2004-2005 to 2,475 in 2013-2014. The proportion of female critical care fellows increased from 29.5% (2004-2005) to 38.3% (2013-2014) (p < 0.001). The absolute number of black fellows increased each year but the percentage change was not statistically significantly different (5.1% in 2004-2005 vs 3.9% in 2013-2014; p = 0.92). Hispanic fellows increased in number from 124 (7.7%) in 2004-2005 to 216 (8.4%) in 2013-2014 (p = 0.015). The number of American Indian/Alaskan Native/Native Hawaiian/Pacific Islander fellows decreased from 15 (1.0%) to seven (0.3%) (p < 0.001). When compared with population estimates, female critical care fellows and those from racial/ethnic minorities were underrepresented in all years. The demographics of the emerging critical care physician workforce reflect underrepresentation of women and racial/ethnic minorities. Trends highlight increases in women and Hispanics and stable or decreasing representation of non-Hispanic underrepresented minority critical care fellows. Further research is needed to elucidate the reasons underlying persistent underrepresentation of racial and ethnic minorities in critical care fellowship programs.

Obesity Prevalence Maps

MedlinePlus

... Download Maps Prevalence of Self-Reported Obesity Among Non-Hispanic White Adults by State and Territory, BRFSS, ... 29.2) Prevalence of Self-Reported Obesity Among Non-Hispanic Black Adults by State and Territory, BRFSS, ...

Alternative Environments for Army Recruiting, 1987-2001. Volume 3

DTIC Science & Technology

1988-01-01

study investigating the cultural script, known as ’simpatia’, among Hispanic and mainstream recruits found’that Hispanics expect more positive...A16 joblessness of black men. Another reason for more black children in single-parent families is the high degree of teen-age pregnancies among ... investigate systematically the "cross correlations" among future events (and only future events) to determine, among other things, if improved

Ethnicity and Changing Functional Health in Middle and Late Life: A Person-Centered Approach

PubMed Central

Xu, Xiao; Bennett, Joan M.; Ye, Wen; Quiñones, Ana R.

2010-01-01

Objectives. Following a person-centered approach, this research aims to depict distinct courses of disability and to ascertain how the probabilities of experiencing these trajectories vary across Black, Hispanic, and White middle-aged and older Americans. Methods. Data came from the 1995–2006 Health and Retirement Study, which involved a national sample of 18,486 Americans older than 50 years of age. Group-based semiparametric mixture models (Proc Traj) were used for data analysis. Results. Five trajectories were identified: (a) excellent functional health (61%), (b) good functional health with small increasing disability (25%), (c) accelerated increase in disability (7%), (d) high but stable disability (4%), and (e) persistent severe impairment (3%). However, when time-varying covariates (e.g., martial status and health conditions) were controlled, only 3 trajectories emerged: (a) healthy functioning (53%), moderate functional decrement (40%), and (c) large functional decrement (8%). Black and Hispanic Americans had significantly higher probabilities than White Americans in experiencing poor functional health trajectories, with Blacks at greater risks than Hispanics. Conclusions. Parallel to the concepts of successful aging, usual aging, and pathological aging, there exist distinct courses of changing functional health over time. The mechanisms underlying changes in disability may vary between Black and Hispanic Americans. PMID:20008483

Connecting race and place: a county-level analysis of White, Black, and Hispanic HIV prevalence, poverty, and level of urbanization.

PubMed

Vaughan, Adam S; Rosenberg, Eli; Shouse, R Luke; Sullivan, Patrick S

2014-07-01

We evaluated the role of poverty in racial/ethnic disparities in HIV prevalence across levels of urbanization. Using national HIV surveillance data from the year 2009, we constructed negative binomial models, stratified by urbanization, with an outcome of race-specific, county-level HIV prevalence rates and covariates of race/ethnicity, poverty, and other publicly available data. We estimated model-based Black-White and Hispanic-White prevalence rate ratios (PRRs) across levels of urbanization and poverty. We observed racial/ethnic disparities for all strata of urbanization across 1111 included counties. Poverty was associated with HIV prevalence only in major metropolitan counties. At the same level of urbanization, Black-White and Hispanic-White PRRs were not statistically different from 1.0 at high poverty rates (Black-White PRR = 1.0, 95% confidence interval [CI] = 0.4, 2.9; Hispanic-White PRR = 0.4, 95% CI = 0.1, 1.6). In nonurban counties, racial/ethnic disparities remained after we controlled for poverty. The association between HIV prevalence and poverty varies by level of urbanization. HIV prevention interventions should be tailored to this understanding. Reducing racial/ethnic disparities will require multifactorial interventions linking social factors with sexual networks and individual risks.

Cost of Racial Disparity in Preterm Birth: Evidence from Michigan

PubMed Central

Xu, Xiao; Grigorescu, Violanda; Siefert, Kristine A.; Lori, Jody R.; Ransom, Scott B.

2009-01-01

This study examined the economic costs associated with racial disparity in preterm birth and preterm fetal death in Michigan. Linked 2003 Michigan vital statistics and hospital discharge data were used for data analysis. Thirteen percent of the singleton births among non-Hispanic Blacks were before 37 completed weeks of gestation, compared to only 7.7% among non-Hispanic Whites (risk ratio = 1.66, 95% confidence interval: 1.59-1.72; p<0.0001). One thousand one hundred and eighty four non-Hispanic Black, singleton preterm births and preterm fetal deaths would have been avoided in 2003 had their preterm birth rate been the same as Michigan non-Hispanic Whites. Economic costs associated with these excess Black preterm births and preterm fetal deaths amounted to $329 million (range: $148 million - $598 million) across their lifespan over and above the costs if they were born at term, including costs associated with the initial hospitalization, productivity loss due to perinatal death, and major developmental disabilities. Hence, racial disparity in preterm birth and preterm fetal death has substantial cost implications for society. Improving pregnancy outcomes for African American women and reducing the disparity between Blacks and Whites should continue to be a focus of future research and interventions. PMID:19648701

Racial and Ethnic Disparities in Structural Disadvantage and Crime: White, Black, and Hispanic Comparisons*

PubMed Central

Ulmer, Jeffery T.; Harris, Casey T.; Steffensmeier, Darrell

2014-01-01

Objectives The objective of this study is to advance knowledge on racial/ethnic disparities in violence and the structural sources of those disparities. We do so by extending scarce and limited research exploring the relationship between race/ethnic gaps in disadvantage and differences in violent crime across groups. Methods Using census place-level data from California and New York, we construct White, Black, and Hispanic “gap” measures that take as a given the existence of disparities across race/ethnic groups in structural disadvantage and crime and subsequently utilize seemingly unrelated regression models to assess the extent to which gaps in disadvantage are predictive of gaps in homicide and index violence. Results Our results suggest that (1) there is considerable heterogeneity in the size of White-Black, White-Hispanic, and Black-Hispanic gaps in structural disadvantage and crime and (2) that race/ethnic disparities in structural disadvantage, particularly poverty and female headship, are positively associated with race/ethnic gaps in homicide and index violence. Conclusion In light of recent scholarship on the racial invariance hypothesis and on the relationship between structural inequality and crime, the current study demonstrates that disparities in disadvantage, particularly family structure and poverty, are important in driving racial and ethnic disparities in crime. PMID:25035523

Differential mortality in New York City (1988-1992). Part One: excess mortality among non-Hispanic blacks.

PubMed

Fang, J; Madhavan, S; Cohen, H; Alderman, M H

1995-01-01

To determine the distribution of mortality for non-Hispanic blacks and non-Hispanic whites in New York City, death certificates issued in New York City during 1988 through 1992, and the relevant 1990 US census data for New York City, have been examined. Age-adjusted death rates for blacks and whites by gender and cause of death were computed based on the US population in 1940. Also, standard mortality ratios and excess mortality were calculated using the New York City mortality rate as reference. The results showed that New York City blacks had higher age-adjusted death rates than whites regardless of cause, including stroke, AIDS, homicide, and diabetes. The rate for New York City blacks was also higher than the US total for both genders. Using New York City mortality rates as a reference, more than 80% of excess deaths in blacks occurred before age 65. Injury/poisoning was the leading cause of excess death (20.1%) in black males, while in black females, cardiovascular disease was the largest single cause of excess deaths (24.8%). The higher death rates, especially premature death, of blacks in New York City are related to conditions such as violence, substance abuse, and AIDS, for which prevention rather than medical care is the more likely solution, as well as to cardiovascular diseases, where both prevention through behavioral change, and health and medical care, can influence outcome.

Dental morphology and ancestry in Albuquerque, New Mexico Hispanics.

PubMed

Willermet, C M; Edgar, H J H

2009-01-01

The term "Hispanic" groups people from Central and South America and the Caribbean, combining disparate cultures, languages, and ancestry, and masking biological differences. Historical and current admixture patterns within these populations and with indigenous and European-, African-, and/or Asian- derived populations complicate the biological picture. Although "Hispanic" has little biological meaning, it is used widely in epidemiology, disease management, and forensics as a biologically significant group. An interdisciplinary approach combining historical, cultural, and biological data can characterize regional and temporal differences between Hispanic populations. We examined biological distances with a population of central New Mexico Hispanics, as a case study of the local specificity of population history. We collected dental morphological trait frequencies from samples of recent Albuquerque-area Hispanic Americans and several ancestral and contemporary groups. To explore regional admixture patterns we calculated biological distances using the modified Mahalanobis D(2) statistic. Our results indicate that Albuquerque Hispanics are more similar to their European and African ancestral groups than to Native Americans in New Mexico. Additionally, their affinity to Native Americans is greater with prehistoric rather than contemporary samples. We argue that these results reflect a local rather than pan-Hispanic admixture pattern; they underscore that populations are better understood at the local and regional levels. It is undesirable to make sweeping biological generalizations for groups known to be geographically and genetically disparate. This research is part of a growing trend in biological research concerning Hispanics and other groups-an emphasis on local samples, informed by historical, cultural, and biological factors.

Neighborhoods and Race/Ethnic Disparities in Adolescent Sexual Risk Behavior

PubMed Central

Carlson, Daniel L.; McNulty, Thomas L.; Bellair, Paul E.; Watts, Stephen

2013-01-01

Understanding the determinants of racial/ethnic disparities in adolescent sexual risk behavior is important given its links to the differential risk of teen pregnancy, childbearing, and sexually transmitted infections. This article tests a contextual model that emphasizes the concentration of neighborhood disadvantage in shaping racial/ethnic disparities in sexual risk behavior. We focus on two risk behaviors that are prevalent among Black and Hispanic youth: the initiation of sexual activity in adolescence and the number of sex partners. Using data from the 1997 National Longitudinal Study of Youth (N = 6,985; 48% female; 57% non-Hispanic White) evidence indicates that neighborhood disadvantage – measured by concentrated poverty, unemployment rates, and the proportion of female-headed households – partially explains Black and Hispanic disparities from Whites in the odds of adolescent sexual debut, although the prevalence of female-headed households in neighborhoods appears to be the main driver in this domain. Likewise, accounting for neighborhood disadvantage reduces the Black-White and Hispanic-White disparity in the number of sexual partners, although less so relative to sexual debut. We discuss theoretical and practical implications of these findings. PMID:24214727