Perspectives of Orthopedic Surgeons on Racial/Ethnic Disparities in Care.

PubMed

Adelani, Muyibat A; O'Connor, Mary I

2017-08-01

Racial/ethnic disparities in healthcare, including orthopedics, have been extensively documented. However, the level of knowledge among orthopedic surgeons regarding racial/ethnic disparities is unknown. The purpose of this study is to determine the views of orthopedic surgeons on (1) the extent of racial/ethnic disparities in orthopedic care, (2) patient and system factors that may contribute, and (3) the potential role of orthopedic surgeons in the reduction of disparities. Three hundred five members of the American Orthopaedic Association completed a survey to assess their knowledge of racial/ethnic disparities and their perceptions about the underlying causes. Twelve percent of respondents believe that patients often receive different care based on race/ethnicity in healthcare in general, while 9 % believe that differences exist in orthopedic care in general, 3 % believe that differences exist within their hospitals/clinics, and 1 % reported differences in their own practices. Despite this, 68 % acknowledge that there is evidence of disparities in orthopedic care. Fifty-one percent believe that a lack of insurance significantly contributes to disparities. Thirty-five percent believe that diversification of the orthopedic workforce would be a "very effective" strategy in addressing disparities, while 25 % percent believe that research would be "very effective" and 24 % believe that surgeon education would be "very effective." Awareness regarding racial/ethnic disparities in musculoskeletal care is low among orthopedic surgeons. Additionally, respondents were more likely to acknowledge disparities within the practices of others than their own. Increased diversity, research, and education may help improve knowledge of this problem.

Ethnic/racial differences in the prevalence of injurious spanking and other child physical abuse in a National Survey of Adolescents.

PubMed

Hawkins, Alesia Oscea; Danielson, Carla Kmett; de Arellano, Michael A; Hanson, Rochelle F; Ruggiero, Kenneth J; Smith, Daniel W; Saunders, Benjamin E; Kilpatrick, Dean G

2010-08-01

Limited research has examined whether similar patterns in injurious spanking and other forms of child physical abuse (CPA) exist across specific ethnic/racial groups. The authors examined and compared differences in the lifetime prevalence of injurious spanking and CPA in two national samples of adolescents across ethnic/racial groups and over time. Participants were 4,023 youth (12-17 years) and 3,614 youth (12-17 years) who participated in the 1995 National Survey of Adolescents (NSA) and 2005 National Survey of Adolescents-Replication (NSA-R), respectively. Adolescents, who were identified through random digit dial procedures, completed a telephone interview assessment. Results indicated significant ethnic/racial variation across groups in reports of injurious spanking in the NSA and the NSA-R samples; however, significant differences were not observed within groups between the two samples over time. Ethnic/racial differences also were found between groups in reports of CPA in the NSA-R sample. Limitations and future directions of this research are discussed.

Racial and Ethnic Barriers in Counseling.

ERIC Educational Resources Information Center

Vontress, Clemmont E.

There are numerous problems involved in counseling minority group members. Rapport is difficult to establish because of the racial and/or cultural attitudes client and counselor have toward one another; consequently the client often finds his own goals in opposition to those of counseling. The existing cultural gap also leads to different patterns…

Different pain responses to chronic and acute pain in various ethnic/racial groups.

PubMed

Rahavard, Behnoosh B; Candido, Kenneth D; Knezevic, Nebojsa Nick

2017-09-01

Our goal in this study was to review the similarities and differences among ethnic groups and their respective responses to acute and chronic clinically related and experimentally induced pain. In this review, the PUBMED and Google-Scholar databases were searched to analyze articles that have assessed the variations in both acute and chronic pain responses among different ethnic/racial groups. According to the results from 42 reviewed articles, significant differences exist among ethnic-racial groups for pain prevalence as well as responses to acute and chronic pain. Compared with Caucasians, other ethnic groups are more susceptible to acute pain responses to nociceptive stimulation and to the development of long-term chronic pain. These differences need to be addressed and assessed more extensively in the future in order to minimize the pain management disparities among various ethnic-racial groups and also to improve the relationship between pain management providers and their patients.

Now is the Time for a Postracial Medicine: Biomedical Research, the National Institutes of Health, and the Perpetuation of Scientific Racism.

PubMed

Perez-Rodriguez, Javier; de la Fuente, Alejandro

2017-09-01

The consideration of racial differences in the biology of disease and treatment options is a hallmark of modern medicine. However, this time-honored medical tradition has no scientific basis, and the premise itself, that is, the existence of biological differences between the commonly known races, is false inasmuch as races are only sociocultural constructions. It is time to rid medical research of the highly damaging exercise of searching for supposed racial differences in the biological manifestations of disease. The practice not only condoned but required by the National Institutes of Health (NIH) of utilizing racial identification as a demographic characteristic with assumed biological implications is at best badly flawed, and at worst unintentionally contributes to perpetuating the fallacy of natural differences between persons of different skin color, which has been used in the past to advance the cause of racial discrimination.

Equally inequitable? A cross-national comparative study of racial health inequalities in the United States and Canada.

PubMed

Ramraj, Chantel; Shahidi, Faraz Vahid; Darity, William; Kawachi, Ichiro; Zuberi, Daniyal; Siddiqi, Arjumand

2016-07-01

Prior research suggests that racial inequalities in health vary in magnitude across societies. This paper uses the largest nationally representative samples available to compare racial inequalities in health in the United States and Canada. Data were obtained from ten waves of the National Health Interview Survey (n = 162,271,885) and the Canadian Community Health Survey (n = 19,906,131) from 2000 to 2010. We estimated crude and adjusted odds ratios, and risk differences across racial groups for a range of health outcomes in each country. Patterns of racial health inequalities differed across the United States and Canada. After adjusting for covariates, black-white and Hispanic-white inequalities were relatively larger in the United States, while aboriginal-white inequalities were larger in Canada. In both countries, socioeconomic factors did not explain inequalities across racial groups to the same extent. In conclusion, while racial inequalities in health exist in both the United States and Canada, the magnitudes of these inequalities as well as the racial groups affected by them, differ considerably across the two countries. This suggests that the relationship between race and health varies as a function of the societal context in which it operates. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Model for Designing Peer-Initiated Activities to Promote Racial Awareness and an Appreciation of Differences.

ERIC Educational Resources Information Center

Mann, Barbara A.; Moser, Rita M.

1991-01-01

Presents a theoretical framework suggesting ways to design peer intervention programs and group existing programs. Suggests criteria for effective racial awareness programs, discussing examples of successful college prejudice activities. Notes diversity education efforts are most successful when based on a theoretical model that recognizes the…

Racial/ethnic differences in perception of need for mental health treatment in a US national sample.

PubMed

Breslau, Joshua; Cefalu, Matthew; Wong, Eunice C; Burnam, M Audrey; Hunter, Gerald P; Florez, Karen R; Collins, Rebecca L

2017-08-01

To resolve contradictory evidence regarding racial/ethnic differences in perceived need for mental health treatment in the USA using a large and diverse epidemiologic sample. Samples from 6 years of a repeated cross-sectional survey of the US civilian non-institutionalized population were combined (N = 232,723). Perceived need was compared across three non-Hispanic groups (whites, blacks and Asian-Americans) and two Hispanic groups (English interviewees and Spanish interviewees). Logistic regression models were used to test for variation across groups in the relationship between severity of mental illness and perceived need for treatment. Adjusting statistically for demographic and socioeconomic characteristics and for severity of mental illness, perceived need was less common in all racial/ethnic minority groups compared to whites. The prevalence difference (relative to whites) was smallest among Hispanics interviewed in English, -5.8% (95% CI -6.5, -5.2%), and largest among Hispanics interviewed in Spanish, -11.2% (95% CI -12.4, -10.0%). Perceived need was significantly less common among all minority racial/ethnic groups at each level of severity. In particular, among those with serious mental illness, the largest prevalence differences (relative to whites) were among Asian-Americans, -23.3% (95% CI -34.9, -11.7%) and Hispanics interviewed in Spanish, 32.6% (95% CI -48.0, -17.2%). This study resolves the contradiction in empirical evidence regarding the existence of racial/ethnic differences in perception of need for mental health treatment; differences exist across the range of severity of mental illness and among those with no mental illness. These differences should be taken into account in an effort to reduce mental health-care disparities.

Racial/ethnic differences in perception of need for mental health treatment in a US national sample

PubMed Central

Breslau, Joshua; Cefalu, Matthew; Wong, Eunice C.; Burnam, M. Audrey; Hunter, Gerald P.; Florez, Karen R.; Collins, Rebecca L.

2017-01-01

Purpose To resolve contradictory evidence regarding racial/ethnic differences in perceived need for mental health treatment in the USA using a large and diverse epidemiologic sample. Methods Samples from 6 years of a repeated cross-sectional survey of the US civilian non-institutionalized population were combined (N = 232,723). Perceived need was compared across three non-Hispanic groups (whites, blacks and Asian-Americans) and two Hispanic groups (English interviewees and Spanish interviewees). Logistic regression models were used to test for variation across groups in the relationship between severity of mental illness and perceived need for treatment. Results Adjusting statistically for demographic and socioeconomic characteristics and for severity of mental illness, perceived need was less common in all racial/ethnic minority groups compared to whites. The prevalence difference (relative to whites) was smallest among Hispanics interviewed in English, −5.8% (95% CI −6.5, −5.2%), and largest among Hispanics interviewed in Spanish, - 11.2% (95% CI −12.4, −10.0%). Perceived need was significantly less common among all minority racial/ethnic groups at each level of severity. In particular, among those with serious mental illness, the largest prevalence differences (relative to whites) were among Asian-Americans, −23.3% (95% CI −34.9, −11.7%) and Hispanics interviewed in Spanish, 32.6% (95% CI −48.0, −17.2%). Conclusions This study resolves the contradiction in empirical evidence regarding the existence of racial/ethnic differences in perception of need for mental health treatment; differences exist across the range of severity of mental illness and among those with no mental illness. These differences should be taken into account in an effort to reduce mental health-care disparities. PMID:28550518

The Interaction of Attitudes toward Racial Membership and Learning Ability in School-Age Children

ERIC Educational Resources Information Center

Nowicki, Elizabeth A.

2008-01-01

Although prejudice exists during childhood, it is unclear how attitudes toward peers of lower or higher academic ability and from one's own or a different racial group interact. This study qualifies previous research by showing that prejudice varies according to whether children are asked to evaluate peers based on academic ability, racial…

A Comparison of Federal Laws toward Disabled and Racial/Ethnic Groups in the USA.

ERIC Educational Resources Information Center

Barnartt, Sharon N.; Seelman, Katherine

1988-01-01

The paper compares federal legislation for disabled people with that for racial and ethnic groups in the United States. The ways existing laws handle employment discrimination, integration in education, access, and equal protection under the law are considered. Clear differences for each group in the types of discrimination permitted are…

Racial and Ethnic Disparities in Personal Capital During Pregnancy: Findings from the 2007 Los Angeles Mommy and Baby (LAMB) Study

PubMed Central

Wakeel, Fathima; Witt, Whitney P.; Wisk, Lauren E.; Lu, Michael C.; Chao, Shin M.

2013-01-01

Objectives To determine if racial and ethnic differences in personal capital during pregnancy exist and to estimate the extent to which any identified racial and ethnic differences in personal capital are related to differences in maternal sociodemographic and acculturation characteristics. Methods Data are from the 2007 Los Angeles Mommy and Baby (LAMB) study (n=3,716). Personal capital comprised internal resources (self-esteem and mastery) and social resources (partner, social network, and neighborhood support) during pregnancy. The relationships between race/ethnicity and personal capital were assessed using multivariable generalized linear models, examining the impact of sociodemographic and acculturation factors on these relationships. Results Significant racial and ethnic disparities in personal capital during pregnancy exist. However, socioeconomic status (i.e., income and education) and marital status completely explained Black-White disparities and Hispanic-White disparities in personal capital, whereas acculturation factors, especially nativity and language spoken at home, partially mediated the disparities in personal capital between Asian/Pacific Islander women and White women. Conclusions Findings suggest that the risks associated with low socioeconomic status, single motherhood, and low acculturation, rather than race or ethnicity, contribute to low personal capital for many pregnant women. As personal capital during pregnancy may influence subsequent maternal and child health outcomes, the development of interventions should consider addressing sociodemographic and acculturation factors in order to reduce racial and ethnic disparities in personal capital and ultimately in poor maternal and child health outcomes. PMID:23504131

How do race and Hispanic ethnicity affect nursing home admission? Evidence from the Health and Retirement Study.

PubMed

Thomeer, Mieke Beth; Mudrazija, Stipica; Angel, Jacqueline L

2015-07-01

This study investigates how health- and disability-based need factors and enabling factors (e.g., socioeconomic and family-based resources) relate to nursing home admission among 3 different racial and ethnic groups. We use Cox proportional hazard models to estimate differences in nursing home admission for non-Hispanic whites, non-Hispanic blacks, and Hispanics from 1998 to 2010 in the Health and Retirement Study (N = 18,952). Racial-ethnic differences in nursing home admission are magnified after controlling for health- and disability-based need factors and enabling factors. Additionally, the degree to which specific factors contribute to risk of nursing home admission varies significantly across racial-ethnic groups. Our findings indicate that substantial racial and ethnic variations in nursing home admission continue to exist and that Hispanic use is particularly low. We argue that these differences may demonstrate a significant underuse of nursing homes for racial and ethnic minorities. Alternatively, they could signify different preferences for nursing home care, perhaps due to unmeasured cultural factors or structural obstacles. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Latino Immigrants and the U.S. Racial Order: How and where Do They Fit In?

ERIC Educational Resources Information Center

Frank, Reanne; Redstone Akresh, Ilana; Bo Lu,

2010-01-01

How do Latino immigrants in the United States understand existing racial categories? And how does the existing U.S. racial order influence this understanding? Using data from the New Immigrant Survey (NIS), our analysis points to changes in how the U.S. racial order might operate in the future. We find that most Latino immigrants recognize the…

Racial and Social Class Differences in How Parents Respond to Inadequate Achievement: Consequences for Children’s Future Achievement

PubMed Central

Robinson, Keith; Harris, Angel L.

2013-01-01

Objective Despite numerous studies on parental involvement in children’s academic schooling, there is a dearth of knowledge on how parents respond specifically to inadequate academic performance. This study examines whether 1) racial differences exist in parenting philosophy for addressing inadequate achievement, 2) social class has implications for parenting philosophy, and 3) parents’ philosophies are consequential for children’s academic achievement. Methods Using data from the Child Development Supplement (N=1041) to the Panel Study of Income Dynamics, we sort parents into two categories—those whose parenting repertoires for addressing poor achievement include punitive responses and those whose repertoires do not. We then determine whether racial differences exist between these categories and how various responses within the aforementioned categories are related to students’ academic achievement. Results The findings show that white and black parents have markedly different philosophies on how to respond to inadequate performance, and these differences appear to impact children’s achievement in dramatically different ways. Conclusion Educators and policy makers should pay particular attention to how parents respond to inadequate achievement as imploring parents of inadequately performing students to be more involved without providing them with some guidance might exacerbate the problem. PMID:24563554

The Importance of History in the Racial Inequality and Racial Inequity in Education: New Orleans as a Case Example

ERIC Educational Resources Information Center

Parsons, Eileen Carlton; Turner, Kea

2014-01-01

Racial equality and racial equity in U.S. education has been elusive although decades of education reform have them as goals. Current discourse advocate colorblind and post-racial solutions to racial inequality and racial inequity in education; these solutions implicate presentism, a view that exclusively circumscribes the existence of present-day…

The Road to Law School and Beyond: Examining Challenges to Racial and Ethnic Diversity in the Legal Profession. LSAC Research Report Series.

ERIC Educational Resources Information Center

Wilder, Gita Z.

To explore possible sources of the underrepresentation of minority groups in law school, this paper brings together existing data that describe the participation of members of different racial/ethnic groups, especially African Americans and Hispanics, at successive points along the way to employment in the law. It focuses on the process by which…

The Changing Urban Landscape: Interconnections Between Racial/Ethnic Segregation and Exposure in the Study of Race-Specific Violence Over Time

PubMed Central

Stansfield, Richard

2015-01-01

Objectives. We investigated how racial/ethnic shifts in the urban landscape influence race-specific violence by considering changes in the size of the Hispanic population, racial/ethnic contact, and racial segregation patterns. Methods. We used a time-series approach incorporating 4 decennial periods (1980, 1990, 2000, and 2010) to determine whether racial/ethnic demographic changes in 144 US cities influenced White and Black homicide rates. Sources included census and Uniform Crime Reports Supplemental Homicide Report data. Results. The growing diversity in the residential population of US cities contributed to the dramatic decline in homicide rates over time, but the effects differed by racial group. Exposure between Hispanics and Blacks and the growing presence of Hispanics led to a reduced Black homicide trend but had no impact on Whites, after adjustment for economic shifts and other important structural features in US cities. Conclusions. Our research highlights the importance of paying closer attention to exposure and integration between immigrants and existing racial groups. Failure to consider racial/ethnic contact and the racial nature of urban violence may produce misleading results in studies of associations between Hispanic immigration and crime. PMID:26180967

The Changing Urban Landscape: Interconnections Between Racial/Ethnic Segregation and Exposure in the Study of Race-Specific Violence Over Time.

PubMed

Parker, Karen F; Stansfield, Richard

2015-09-01

We investigated how racial/ethnic shifts in the urban landscape influence race-specific violence by considering changes in the size of the Hispanic population, racial/ethnic contact, and racial segregation patterns. We used a time-series approach incorporating 4 decennial periods (1980, 1990, 2000, and 2010) to determine whether racial/ethnic demographic changes in 144 US cities influenced White and Black homicide rates. Sources included census and Uniform Crime Reports Supplemental Homicide Report data. The growing diversity in the residential population of US cities contributed to the dramatic decline in homicide rates over time, but the effects differed by racial group. Exposure between Hispanics and Blacks and the growing presence of Hispanics led to a reduced Black homicide trend but had no impact on Whites, after adjustment for economic shifts and other important structural features in US cities. Our research highlights the importance of paying closer attention to exposure and integration between immigrants and existing racial groups. Failure to consider racial/ethnic contact and the racial nature of urban violence may produce misleading results in studies of associations between Hispanic immigration and crime.

Racial Disparities in Early Criminal Justice Involvement

PubMed Central

Crutchfield, Robert D.; Skinner, Martie L.; Haggerty, Kevin P.; McGlynn, Anne; Catalano, Richard F.

2010-01-01

Criminologists have long reported the existence of racial disparity in the criminal justice system, but the important question is why. While some argue that observed differences are a consequence of more criminal behavior among minorities, the weight of the evidence indicates that this is but a partial explanation. In this paper we study data from a sample of juveniles to examine how racial differences in early police contact, and important social environments—family, school, and neighborhoods—affect later contact and arrests, controlling for self-reported delinquency. We find that early (in middle school) contact with police is an important predictor of later (high school) arrests. Also we found that, in addition to being male and living in a low-income family, children who have parents who have a history of arrest, who have experienced school disciplinary actions, who have delinquent peers, and who are in networks with deviant adults are more likely to have problems with law enforcement. These factors help to explain racial differences in police contacts and arrests. PMID:20190860

Racial Differences in Processes of Care at End of Life in VA Medical Centers: Planned Secondary Analysis of Data from the BEACON Trial

PubMed Central

Williams, Beverly R.; Dionne-Odom, J. Nicholas; Redden, David T.; Noh, Hyunjin; Goode, Patricia S.; Kvale, Elizabeth; Bakitas, Marie; Bailey, F. Amos

2016-01-01

Abstract Background: Racial differences exist for a number of health conditions, services, and outcomes, including end-of-life (EOL) care. Objective: The aim of the study was to examine differences in processes of care in the last 7 days of life between African American and white inpatients. Methods: Secondary analysis was conducted of data collected in the Best Practices for End-of-Life Care for Our Nation's Veterans (BEACON) trial (conducted 2005–2011). Subjects were 4891 inpatient decedents in six Veterans Administration Medical Centers. Data were abstracted from decedents' medical records. Multi-variable analyses were conducted to examine the relationship between race and each of 18 EOL processes of care controlling for patient characteristics, study site, year of death, and whether the observation was pre- or post-intervention. Results: The sample consisted of 1690 African American patients (34.6%) and 3201 white patients (65.4%). African Americans were less likely to have: do not resuscitate (DNR) orders (odds ratio [OR]: 0.67; p = 0.004), advance directives (OR: 0.71; p = 0.023), active opioid orders (OR: 0.64, p = 0.0008), opioid medications administered (OR: 0.61, p = 0.004), benzodiazepine orders (OR: 0.68, p < 0.0001), benzodiazepines administered (OR: 0.61, p < 0.0001), antipsychotics administered (OR: 0.73, p = 0.004), and steroids administered (OR: 0.76, p = 0.020). Racial differences were not found for other processes of care, including palliative care consultation, pastoral care, antipsychotic and steroid orders, and location of death. Conclusions: Racial differences exist in some but not all aspects of EOL care. Further study is needed to understand the extent to which racial differences reflect different patient needs and preferences and whether interventions are needed to reduce disparities in patient/family education or access to quality EOL care. PMID:26840851

Racial Differences in Processes of Care at End of Life in VA Medical Centers: Planned Secondary Analysis of Data from the BEACON Trial.

PubMed

Burgio, Kathryn L; Williams, Beverly R; Dionne-Odom, J Nicholas; Redden, David T; Noh, Hyunjin; Goode, Patricia S; Kvale, Elizabeth; Bakitas, Marie; Bailey, F Amos

2016-02-01

Racial differences exist for a number of health conditions, services, and outcomes, including end-of-life (EOL) care. The aim of the study was to examine differences in processes of care in the last 7 days of life between African American and white inpatients. Secondary analysis was conducted of data collected in the Best Practices for End-of-Life Care for Our Nation's Veterans (BEACON) trial (conducted 2005-2011). Subjects were 4891 inpatient decedents in six Veterans Administration Medical Centers. Data were abstracted from decedents' medical records. Multi-variable analyses were conducted to examine the relationship between race and each of 18 EOL processes of care controlling for patient characteristics, study site, year of death, and whether the observation was pre- or post-intervention. The sample consisted of 1690 African American patients (34.6%) and 3201 white patients (65.4%). African Americans were less likely to have: do not resuscitate (DNR) orders (odds ratio [OR]: 0.67; p = 0.004), advance directives (OR: 0.71; p = 0.023), active opioid orders (OR: 0.64, p = 0.0008), opioid medications administered (OR: 0.61, p = 0.004), benzodiazepine orders (OR: 0.68, p < 0.0001), benzodiazepines administered (OR: 0.61, p < 0.0001), antipsychotics administered (OR: 0.73, p = 0.004), and steroids administered (OR: 0.76, p = 0.020). Racial differences were not found for other processes of care, including palliative care consultation, pastoral care, antipsychotic and steroid orders, and location of death. Racial differences exist in some but not all aspects of EOL care. Further study is needed to understand the extent to which racial differences reflect different patient needs and preferences and whether interventions are needed to reduce disparities in patient/family education or access to quality EOL care.

Mediterranean Diet and Cardiometabolic Diseases in Racial/Ethnic Minority Populations in the United States

PubMed Central

Sotos-Prieto, Mercedes; Mattei, Josiemer

2018-01-01

The Mediterranean diet (MedDiet) has been recommended to the general population by many scientific organizations as a healthy dietary pattern, based on strong evidence of association with improved cardiometabolic health, including lower risk of cardiovascular disease, diabetes, and obesity. However, most studies have been conducted in Mediterranean or European countries or among white populations in the United States (US), while few exist for non-Mediterranean countries or racial/ethnic minority populations in the US. Because most existing studies evaluating adherence to the MedDiet use population-specific definitions or scores, the reported associations may not necessarily apply to other racial/ethnic populations that may have different distributions of intake. Moreover, racial/ethnic groups may have diets that do not comprise the typical Mediterranean foods captured by these scores. Thus, there is a need to determine if similar positive effects from following a MedDiet are observed in diverse populations, as well as to identify culturally-relevant foods reflected within Mediterranean-like patterns, that can facilitate implementation and promotion of such among broader racial/ethnic groups. In this narrative review, we summarize and discuss the evidence from observational and intervention studies on the MedDiet and cardiometabolic diseases in racial/ethnic minority populations in the US, and offer recommendations to enhance research on MedDiet for such populations. PMID:29538339

Mediterranean Diet and Cardiometabolic Diseases in Racial/Ethnic Minority Populations in the United States.

PubMed

Sotos-Prieto, Mercedes; Mattei, Josiemer

2018-03-14

The Mediterranean diet (MedDiet) has been recommended to the general population by many scientific organizations as a healthy dietary pattern, based on strong evidence of association with improved cardiometabolic health, including lower risk of cardiovascular disease, diabetes, and obesity. However, most studies have been conducted in Mediterranean or European countries or among white populations in the United States (US), while few exist for non-Mediterranean countries or racial/ethnic minority populations in the US. Because most existing studies evaluating adherence to the MedDiet use population-specific definitions or scores, the reported associations may not necessarily apply to other racial/ethnic populations that may have different distributions of intake. Moreover, racial/ethnic groups may have diets that do not comprise the typical Mediterranean foods captured by these scores. Thus, there is a need to determine if similar positive effects from following a MedDiet are observed in diverse populations, as well as to identify culturally-relevant foods reflected within Mediterranean-like patterns, that can facilitate implementation and promotion of such among broader racial/ethnic groups. In this narrative review, we summarize and discuss the evidence from observational and intervention studies on the MedDiet and cardiometabolic diseases in racial/ethnic minority populations in the US, and offer recommendations to enhance research on MedDiet for such populations.

Examining racial disparities in colorectal cancer care.

PubMed

Berry, Jamillah; Bumpers, Kevin; Ogunlade, Vickie; Glover, Roni; Davis, Sharon; Counts-Spriggs, Margaret; Kauh, John; Flowers, Christopher

2009-01-01

African Americans are disproportionately burdened with colorectal cancer. Although incidence and mortality rates have declined in the past two decades, the disparity in health outcomes has progressively increased. This comprehensive review examines the existing literature regarding racial disparities in colorectal cancer screening, stage at diagnosis, and treatment to determine if differences exist in the quality of care delivered to African Americans. A comprehensive review of relevant literature was performed. Two databases (EBSCOHOST Academic Search Premier and Scopus) were searched from 2000 to 2007. Articles that assessed racial disparities in colorectal cancer screening, stage of disease at diagnosis, and treatment were selected. The majority of studies identified examined colorectal cancer screening outcomes. Although racial disparities in screening have diminished in recent years, African American men and women continue to have higher colorectal cancer incidence and mortality rates and are diagnosed at more advanced stages. Several studies regarding stage of disease at diagnosis identified socioeconomic status (SES) and health insurance status as major determinants of disparity. However, some studies found significant racial disparities even after controlling for these factors. Racial disparities in treatment were also found at various diagnostic stages. Many factors affecting disparities between African Americans and Whites in colorectal cancer incidence and mortality remain unexplained. Although the importance of tumor biology, genetics, and lifestyle risk factors have been established, prime sociodemographic factors need further examination to understand variances in the care of African Americans diagnosed with colorectal cancer.

Impact of availability of hospital-based invasive cardiac services on racial differences in the use of these services.

PubMed

Gregory, P M; Rhoads, G G; Wilson, A C; O'Dowd, K J; Kostis, J B

1999-09-01

Reports indicate that black patients are less likely than white patients to receive invasive cardiac services after hospitalization for acute myocardial infarction (AMI). There is still uncertainty as to why racial differences exist and how they affect patient outcomes. This is the first study to focus on the availability of invasive cardiac services and racial differences in procedure use. Study objectives were to (1) document whether racial differences existed in the use of invasive cardiac procedures, (2) study whether these racial differences were related to availability of hospital-based invasive cardiac services at first admission for AMI, and (3) determine whether there were racial differences in long-term mortality rates. A historical cohort study was conducted with discharge records from all acute care hospitals in New Jersey for 1993 linked to death certificate records for 1993 and 1994. There were 13,690 black and white New Jersey residents hospitalized with primary diagnosis of AMI. Use of cardiac catheterization within 90 days, revascularization within 90 days (percutaneous transluminal coronary angioplasty [PTCA] or coronary artery bypass graft surgery [CABG]), and death within 1 year after admission for AMI were the main outcome measures. Patterns for PTCA and CABG as separate outcomes were also studied. Hospital-based cardiac services available were described as no invasive cardiac services, catheterization only, or PTCA/CABG. To account for payer status and comorbidity differences, patients 65 years and older with Medicare coverage were analyzed separately from those younger than 65 years. Black patients aged 65 and older were generally less likely to receive catheterization and revascularization than white patients, regardless of facilities available at first admission. For patients younger than 65 years, the greatest differences between black and white patients in catheterization and PTCA/CABG use within 90 days after AMI occurred when no hospital-based invasive cardiac services were available. However, use of invasive cardiac procedures within 90 days after AMI was substantially increased if the first hospital offered catheterization only or PTCA/CABG services, among all patients, especially among blacks younger than age 65. No significant racial differences or interactions with available services were found in 1-year mortality rates. Availability of invasive cardiac services at first hospitalization for AMI was associated with increased procedure use for both races. However, use of invasive cardiac procedures was generally lower for black patients than for white patients, regardless of services available. Long-term mortality rates after hospitalization for AMI did not differ between blacks and whites.

BECAUSE IT IS RIGHT EDUCATIONALLY, PARTS 1 AND 2.

ERIC Educational Resources Information Center

ADVISORY COMMITTEE ON RACIAL INBALANCE AND EDUCATION

THE OFFICIAL TASK OF THE ADVISORY COMMITTEE ON RACIAL IMBALANCE WAS TO DETERMINE IF RACIAL IMBALANCE EXISTS, IF IT EXISTS, TO DETERMINE IF RACIAL IMBALANCE IS EDUCATIONALLY HARMFUL, AND IF HARMFUL, TO RECOMMEND WAYS OF ELIMINATING IT. IN ANSWER TO THE FIRST ASPECT OF THIS COMMITTEE CHARGE, A SCHOOL CENSUS IN MARCH, 1964 REVEALED THAT RACIAL…

Racial/ethnic differences in atrial fibrillation symptoms, treatment patterns, and outcomes: Insights from Outcomes Registry for Better Informed Treatment for Atrial Fibrillation Registry.

PubMed

Golwala, Harsh; Jackson, Larry R; Simon, DaJuanicia N; Piccini, Jonathan P; Gersh, Bernard; Go, Alan S; Hylek, Elaine M; Kowey, Peter R; Mahaffey, Kenneth W; Thomas, Laine; Fonarow, Gregg C; Peterson, Eric D; Thomas, Kevin L

2016-04-01

Significant racial/ethnic differences exist in the incidence of atrial fibrillation (AF). However, less is known about racial/ethnic differences in quality of life (QoL), treatment, and outcomes associated with AF. Using data from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, we compared clinical characteristics, QoL, management strategies, and long-term outcomes associated with AF among various racial/ethnic groups. We analyzed 9,542 participants with AF (mean age 74 ± 11 years, 43% women, 91% white, 5% black, 4% Hispanic) from 174 centers. Compared with AF patients identified as white race, patients identified as Hispanic ethnicity and those identified as black race were younger, were more often women, and had more cardiac and noncardiac comorbidities. Black patients were more symptomatic with worse QoL and were less likely to be treated with a rhythm control strategy than other racial/ethnic groups. There were no significant racial/ethnic differences in CHA2DS2-VASc stroke or ATRIA bleeding risk scores and rates of oral anticoagulation use were similar. However, racial and ethnic minority populations treated with warfarin spent a lower median time in therapeutic range of international normalized ratio (59% blacks vs 68% whites vs 62% Hispanics, P < .0001). There was no difference in long-term outcomes associated with AF between the 3 groups at a median follow-up of 2.1 years. Relative to white and Hispanic patients, black patients with AF had more symptoms, were less likely to receive rhythm control interventions, and had lower quality of warfarin management. Despite these differences, clinical events at 2 years were similar by race and ethnicity. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Racial Discrimination during Adolescence Predicts Mental Health Deterioration in Adulthood: Gender Differences among Blacks.

PubMed

Assari, Shervin; Moazen-Zadeh, Ehsan; Caldwell, Cleopatra Howard; Zimmerman, Marc A

2017-01-01

Despite the existing knowledge regarding the negative mental health consequences of perceived racial discrimination, very few researchers have used a longitudinal design with long-term follow-up periods to explore gender differences in this association over time. The current longitudinal study aimed to investigate gender differences in predictive role of an increase in perceived racial discrimination during adolescence for mental health deterioration a decade later when they are transitioning to young adulthood. Current study followed 681 Black youths for 18 years from 1994 (mean age 15) to 2012 (mean age 32). All participants spent their adolescence and transition to young adulthood in an economically disadvantaged urban area in the Midwest of the United States. Independent variable was perceived racial discrimination measured in 1999 and 2002. Outcomes were psychological symptoms (anxiety and depression) measured in 1999 and at end of follow-up (2012). Covariates included sociodemographics (age, family structure, and parental employment) measured in 1994. Gender was used to define groups in a multigroup structural equation model to test moderating effects. Multigroup structural equation modeling showed that among male Black youth, an increase in perceived racial discrimination from age 20 to 23 was predictive for an increase in symptoms of anxiety and depression from age 20 to 32. Among female Black youth, change in perceived racial discrimination did not predict future change in depressive or anxiety symptoms. While racial discrimination is associated with negative mental health consequences for both genders, male and female Black youth differ in regard to long-term effects of an increase in perceived discrimination on deterioration of psychological symptoms. Black males seem to be more susceptible than Black females to the psychological effects of an increase in racial discrimination over time.

An fMRI investigation of racial paralysis.

PubMed

Norton, Michael I; Mason, Malia F; Vandello, Joseph A; Biga, Andrew; Dyer, Rebecca

2013-04-01

We explore the existence and underlying neural mechanism of a new norm endorsed by both black and white Americans for managing interracial interactions: "racial paralysis', the tendency to opt out of decisions involving members of different races. We show that people are more willing to make choices--such as who is more intelligent, or who is more polite-between two white individuals (same-race decisions) than between a white and a black individual (cross-race decisions), a tendency which was evident more when judgments involved traits related to black stereotypes. We use functional magnetic resonance imaging to examine the mechanisms underlying racial paralysis, to examine the mechanisms underlying racial paralysis, revealing greater recruitment of brain regions implicated in socially appropriate behavior (ventromedial prefrontal cortex), conflict detection (anterior cingulate cortex), deliberative processing (dorsolateral prefrontal cortex), and inhibition (ventrolateral prefrontal cortex). We also discuss the impact of racial paralysis on the quality of interracial relations.

An fMRI investigation of racial paralysis

PubMed Central

Mason, Malia F.; Vandello, Joseph A.; Biga, Andrew; Dyer, Rebecca

2013-01-01

We explore the existence and underlying neural mechanism of a new norm endorsed by both black and white Americans for managing interracial interactions: “racial paralysis’, the tendency to opt out of decisions involving members of different races. We show that people are more willing to make choices—such as who is more intelligent, or who is more polite—between two white individuals (same-race decisions) than between a white and a black individual (cross-race decisions), a tendency which was evident more when judgments involved traits related to black stereotypes. We use functional magnetic resonance imaging to examine the mechanisms underlying racial paralysis, to examine the mechanisms underlying racial paralysis, revealing greater recruitment of brain regions implicated in socially appropriate behavior (ventromedial prefrontal cortex), conflict detection (anterior cingulate cortex), deliberative processing (dorsolateral prefrontal cortex), and inhibition (ventrolateral prefrontal cortex). We also discuss the impact of racial paralysis on the quality of interracial relations. PMID:22267521

Racial/Ethnic and Social Inequities in Sleep Medicine: The Tip of the Iceberg?

PubMed

Pandi-Perumal, Seithikurippu R; Abumuamar, Asmaa M; Spence, David Warren; Chattu, Vijay Kumar; Moscovitch, Adam; BaHammam, Ahmed S

2017-01-01

It is known that racial disparities exist in terms of disease prevalence and access to health care. However, the link between race/ethnicity and sleep quality is often under-recognized. Current evidence shows that differences exist between Blacks and Whites in terms of sleep duration, sleep quality, and the likelihood of acquiring a sleep disorder. It has been argued that the adverse effects of ethnicity on sleep quality or duration interact with other social or personal factors (such as employment) and that the effects of these factors are interactive and need to be analyzed simultaneously. There is a growing body of evidence showing that disturbed sleep is a mediator of the effect of environmental stressors on personal health, which is more pronounced in ethnic minorities. These findings support the notion that perceived discrimination or unfair treatment has significant associations with complaints of sleep disturbance and disturbed objective measures of sleep quality and sleep architecture. Hence, greater efforts are needed to demonstrate how racial/ethnic factors influence different sleep processes. Copyright © 2017 National Medical Association. Published by Elsevier Inc. All rights reserved.

Past racial discrimination exacerbates the effects of racial exclusion on negative affect, perceived control, and alcohol-risk cognitions among Black young adults.

PubMed

Stock, Michelle L; Peterson, Laurel M; Molloy, Brianne K; Lambert, Sharon F

2017-06-01

Racial discrimination is associated with alcohol use and risky sex cognitions and behaviors, which are risk factors for negative health outcomes, including human immunodeficiency virus infection. The current study investigated the causal impact of racial discrimination on alcohol and sexual-risk cognitions while exploring potential mediators that might help explain this relation: negative affect, perceived control, and meaningful existence. We also examined if past discrimination impacts the strength of (moderates) these effects. Participants were 287 Black/African American young adults aged 18-25. They were randomly assigned to be excluded or included by White peers via the game Cyberball. Racial exclusion (vs. inclusion) predicted greater: perceived racial discrimination, negative affect, alcohol use willingness, and reduced perceived control and meaningful existence. Furthermore, excluded participants who experienced more past racial discrimination reported the lowest perceived control, and greatest negative affect and alcohol-risk cognitions. The findings suggest that past racial discrimination exacerbates the harmful health effects of immediate experiences of discrimination.

Differences in the Association between Serum Leptin Levels and Body Mass Index in Black and White Women: A Report from the Southern Community Cohort Study

PubMed Central

Cohen, Sarah S.; Fowke, Jay H.; Cai, Qiuyin; Buchowski, Maciej S.; Signorello, Lisa B.; Hargreaves, Margaret K.; Zheng, Wei; Blot, William J.; Matthews, Charles E.

2012-01-01

Background/Aims Leptin may be an important link between obesity and many high-burden diseases, including cancer and cardiovascular disease, but leptin levels and correlates in individuals of diverse racial backgrounds have not been well characterized despite racial differences in incidence and mortality patterns for many obesity-related diseases. Methods In a cross-sectional study of 915 white and 892 black women enrolled in the Southern Community Cohort Study (age 40–79 years, half postmenopausal), serum leptin levels were compared between the race groups and across categories of body mass index (BMI). Potential correlates of leptin were assessed via race-stratified linear regression models. Results Blacks had higher unadjusted leptin levels than whites (geometric mean 22.4 vs. 19.0 ng/ml; p < 0.0001). Leptin increased with increasing BMI, and racial differences in leptin were most pronounced in women with BMI ≥25. Significant correlates of leptin included BMI, age, alcohol consumption, cigarette smoking, diabetes (both races) and fat consumption (black women only). Leptin remained higher in black women (22.7 vs. 18.8 ng/ml) after adjustment for these factors. Conclusions Persistent racial differences in leptin concentrations exist after adjustment for BMI and other factors. Leptin assessment may be informative in future studies that investigate racial differences in the development of obesity-related diseases. PMID:22353927

Racial/Ethnic Disparities in Primary Care Quality Among Type 2 Diabetes Patients, Medical Expenditure Panel Survey, 2012.

PubMed

Hu, Ruwei; Shi, Leiyu; Liang, Hailun; Haile, Geraldine Pierre; Lee, De-Chih

2016-08-04

Racial and ethnic disparities exist in diabetes prevalence, access to diabetes care, diabetes-related complications and mortality rates, and the quality of diabetes care among Americans. We explored racial and ethnic disparities in primary care quality among Americans with type 2 diabetes. We analyzed data on adults with type 2 diabetes derived from the household component of the 2012 Medical Expenditure Panel Survey. Multiple regression and multivariate logistic regressions were used to examine the association between race/ethnicity and primary care attributes related to first contact, longitudinality, comprehensiveness, and coordination, and clusters of confounding factors were added sequentially. Preliminary findings indicated differences in primary care quality between racial/ethnic minorities and whites across measures of first contact, longitudinality, comprehensiveness, and coordination. After controlling for confounding factors, these differences were no longer apparent; all racial/ethnic categories showed similar rates of primary care quality according to the 4 primary care domains of interest in the study. Results indicate equitable primary care quality for type 2 diabetes patients across 4 key domains of primary care after controlling for socioeconomic characteristics. Additional research is necessary to support these findings, particularly when considering smaller racial/ethnic groups and investigating outcomes related to diabetes.

Racial/ethnic disparities in provision of dental procedures to children enrolled in Delta Dental insurance in Milwaukee, Wisconsin.

PubMed

Bhagavatula, Pradeep; Xiang, Qun; Eichmiller, Fredrick; Szabo, Aniko; Okunseri, Christopher

2014-01-01

Most studies on the provision of dental procedures have focused on Medicaid enrollees known to have inadequate access to dental care. Little information on private insurance enrollees exists. This study documents the rates of preventive, restorative, endodontic, and surgical dental procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI) in Milwaukee. We analyzed DDWI claims data for Milwaukee children aged 0-18 years between 2002 and 2008. We linked the ZIP codes of enrollees to the 2000 U.S. Census information to derive racial/ethnic estimates in the different ZIP codes. We estimated the rates of preventive, restorative, endodontic, and surgical procedures provided to children in different racial/ethnic groups based on the population estimates derived from the U.S. Census data. Descriptive and multivariable analysis was done using Poisson regression modeling on dental procedures per year. In 7 years, a total of 266,380 enrollees were covered in 46 ZIP codes in the database. Approximately, 64 percent, 44 percent, and 49 percent of White, African American, and Hispanic children had at least one dental visit during the study period, respectively. The rates of preventive procedures increased up to the age of 9 years and decreased thereafter among children in all three racial groups included in the analysis. African American and Hispanic children received half as many preventive procedures as White children. Our study shows that substantial racial disparities may exist in the types of dental procedures that were received by children. © 2012 American Association of Public Health Dentistry.

Reducing Children's Implicit Racial Bias Through Exposure to Positive Out-Group Exemplars.

PubMed

Gonzalez, Antonya M; Steele, Jennifer R; Baron, Andrew S

2017-01-01

Studies with adults suggest that implicit preferences favoring White versus Black individuals can be reduced through exposure to positive Black exemplars. However, it remains unclear whether developmental differences exist in the capacity for these biases to be changed. This study included 369 children and examined whether their implicit racial bias would be reduced following exposure to positive Black exemplars. Results showed that children's implicit pro-White bias was reduced following exposure to positive Black exemplars, but only for older children (M age  = ~10 years). Younger children's (M age  = ~7 years) implicit bias was not affected by this intervention. These results suggest developmental differences in the malleability of implicit racial biases and point to possible age differences in intervention effectiveness. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

Breast cancer in Latinas: gene expression, differential response to treatments, and differential toxicities in Latinas compared with other population groups.

PubMed

Patel, Tejal A; Colon-Otero, Gerardo; Bueno Hume, Celyne; Copland, John A; Perez, Edith A

2010-01-01

Disparities in clinical outcomes of breast cancer have been described among different racial and ethnic groups in the U.S. Convincing data exist showing that Latina women have a lower incidence of breast cancer but a higher breast cancer-related mortality rate compared with white women. Noticeable differences in breast cancer incidence are present even within different Latina subsets with a higher incidence in second- and third-generation women compared with foreign born. An increasing amount of data exists pointing to significant differences in the genetics and biology of breast cancer in Latinas as a significant contributor to the higher mortality, including a higher incidence of triple-negative breast cancers (which do not overexpress HER-2 protein and are negative for estrogen receptors and progesterone receptors). Other social and environmental factors are likely to play a significant role as well, including a lower rate of screening mammography, variable access to medical care, among others. Recent data are inconclusive regarding differences among racial/ethnic groups in the response to chemotherapy. Data on racial/ethnic variations in the pharmacogenomics of chemotherapy, endocrine treatments, and toxicity are more limited, with some data suggesting differences in frequencies of polymorphisms of genes involved in the metabolism of some of these agents. Further studies are needed on this subject.

Seeing Race: Teaching Residential Segregation with the Racial Dot Map

ERIC Educational Resources Information Center

Seguin, Charles; Nierobisz, Annette; Kozlowski, Karen Phelan

2017-01-01

Students commonly hold erroneous notions of a "post-racial" world and individualistic worldviews that discount the role of structure in social outcomes. Jointly, these two preconceived beliefs can be powerful barriers to effective teaching of racial segregation: Students may be skeptical that racial segregation continues to exist, and…

Racial and ethnic disparities in antidepressant drug use.

PubMed

Chen, Jie; Rizzo, John A

2008-12-01

Little is known about racial and ethnic disparities in health care utilization, expenditures and drug choice in the antidepressant market. This study investigates factors associated with the racial and ethnic disparities in antidepressant drug use. We seek to determine the extent to which disparities reflect differences in observable population characteristics versus heterogeneity across racial and ethnic groups. Among the population characteristics, we are interested in identifying which factors are most important in accounting for racial and ethnic disparities in antidepressant drug use. Using Medical Expenditure Panel Survey (MEPS) data from 1996-2003, we have an available sample of 10,416 Caucasian, 1,089 African American and 1,539 Hispanic antidepressant drug users aged 18 to 64 years. We estimate individual out-of-pocket payments, total prescription drug expenditures, drug utilization, the probability of taking generic versus brand name antidepressants, and the share of drugs that are older types of antidepressants (e.g., TCAs and MAOIs) for these individuals during a calendar year. Blinder-Oaxaca decomposition techniques are employed to determine the extent to which disparities reflect differences in observable population characteristics versus unobserved heterogeneity across racial and ethnic groups. Caucasians have the highest antidepressant drug expenditures and utilization. African-Americans have the lowest drug expenditures and Hispanics have the lowest drug utilization. Relative to Caucasians and Hispanics, African-Americans are more likely to purchase generics and use a higher share of older drugs (e.g., TCAs and MAOIs). Differences in observable characteristics explain most of the racial/ethnic differences in these outcomes, with the exception of drug utilization. Differences in health insurance and education levels are particularly important factors in explaining disparities. In contrast, differences in drug utilization largely reflect unobserved heterogeneity across these population groups. Substantive racial and ethnic disparities exist in all dimensions of antidepressant drug use examined. Observable population characteristics account for most of the differences in the expenditures, with health insurance and education key factors driving differences in spending. Observable characteristics are also important in explaining racial and ethnic disparities in the probability of purchasing generics and new vs old antidepressant drugs used. Differences in total utilization are not well-explained by observable characteristics, and may reflect unobserved heterogeneity such as unobserved physician-patient relationships, mistrust, and cultural factors. Reducing differences in observable characteristics such as health insurance and education will mitigate racial and ethnic disparities in expenditures on antidepressant drug use and in the types of antidepressant used (e.g., generics vs. brands; new vs old). But these factors will have less influence in reducing racial and ethnic disparities in overall antidepressant drug utilization. To limit differences in overall antidepressant drug use, policymakers must take into account cultural factors and other sources of heterogeneity.

Missed Opportunity? Leveraging Mobile Technology to Reduce Racial Health Disparities.

PubMed

Ray, Rashawn; Sewell, Abigail A; Gilbert, Keon L; Roberts, Jennifer D

2017-10-01

Blacks and Latinos are less likely than whites to access health insurance and utilize health care. One way to overcome some of these racial barriers to health equity may be through advances in technology that allow people to access and utilize health care in innovative ways. Yet, little research has focused on whether the racial gap that exists for health care utilization also exists for accessing health information online and through mobile technologies. Using data from the Health Information National Trends Survey (HINTS), we examine racial differences in obtaining health information online via mobile devices. We find that blacks and Latinos are more likely to trust online newspapers to get health information than whites. Minorities who have access to a mobile device are more likely to rely on the Internet for health information in a time of strong need. Federally insured individuals who are connected to mobile devices have the highest probability of reliance on the Internet as a go-to source of health information. We conclude by discussing the importance of mobile technologies for health policy, particularly related to developing health literacy, improving health outcomes, and contributing to reducing health disparities by race and health insurance status. Copyright © 2017 by Duke University Press.

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.

Racial and ethnic variations in one-year clinical and patient-reported outcomes following breast reconstruction.

PubMed

Berlin, Nicholas L; Momoh, Adeyiza O; Qi, Ji; Hamill, Jennifer B; Kim, Hyungjin M; Pusic, Andrea L; Wilkins, Edwin G

2017-08-01

Existing studies evaluating racial and ethnic disparities focus on describing differences in procedure type and the proportion of women who undergo reconstruction following mastectomy. This study seeks to examine racial and ethnic variations in clinical and patient-reported outcomes (PROs) following breast reconstruction. The Mastectomy Reconstruction Outcomes Consortium is an 11 center, prospective cohort study collecting clinical and PROs following autologous and implant-based breast reconstruction. Mixed-effects regression models, weighted to adjust for non-response, were performed to evaluate outcomes at one-year postoperatively. The cohort included 2703 women who underwent breast reconstruction. In multivariable models, Hispanic or Latina patients were less likely to experience any complications and major complications. Black or African-American women reported greater improvements in psychosocial and sexual well-being. Despite differences in pertinent clinical and socioeconomic variables, racial and ethnic minorities experienced equivalent or better outcomes. These findings provide reassurance in the context of numerous racial and ethnic health disparities and build upon our understanding of the delivery of surgical care to women with or at risk for developing breast cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

Past racial discrimination exacerbates the acute effects of racial discrimination on negative affect, perceived control, and alcohol-risk cognitions among Black young adults

PubMed Central

Stock, Michelle L.; Peterson, Laurel M.; Molloy, Brianne; Lambert, Sharon F.

2017-01-01

Racial discrimination is associated with alcohol use and risky sex cognitions and behaviors, which are risk factors for negative health outcomes, including human immunodeficiency virus (HIV) infection. The current study investigated the causal impact of racial discrimination on alcohol and sexual-risk cognitions while exploring potential mediators that might help explain this relation: negative affect, perceived control, and meaningful existence. We also examined if past discrimination impacts the strength of (moderates) these effects. Participants were 287 Black/African American young adults aged 18 to 25. They were randomly assigned to be excluded or included by White peers via the game Cyberball. Racial exclusion (vs. inclusion) predicted greater: perceived racial discrimination, negative affect, alcohol use willingness, and reduced perceived control and meaningful existence. Furthermore, excluded participants who experienced more past racial discrimination reported the lowest perceived control, and greatest negative affect and alcohol-risk cognitions. The findings suggest that past racial discrimination exacerbates the harmful health effects of immediate experiences of discrimination. PMID:27646550

Transracial Communication.

ERIC Educational Resources Information Center

Smith, Arthur L.

This book explores and explains communication among different racial groups within the scope of existing communication theory. Following a brief introduction, chapters cover "Directions in Transracial Communication" (definitions, process, structurization, and purpose); "Culture and Transracial Communication" (a viewpoint on…

Scandinavia: A Racial Utopia?

ERIC Educational Resources Information Center

Weisbord, Robert G.

1972-01-01

Isolated personal observations have shaped the racial image of the Nordic countries--that Scandinavia is a racial paradise; this image is, however, simplistic, superficial, and one-dimensional. There is no gainsaying that prejudice against certain ethnic groups exists in Scandinavia. (Author)

Are There Clinical Implications of Racial Differences in HbA1c? A Difference, to Be a Difference, Must Make a Difference

PubMed Central

Selvin, Elizabeth

2016-01-01

Studies that have compared HbA1c levels by race have consistently demonstrated higher HbA1c levels in African Americans than in whites. These racial differences in HbA1c have not been explained by measured differences in glycemia, sociodemographic factors, clinical factors, access to care, or quality of care. Recently, a number of nonglycemic factors and several genetic polymorphisms that operate through nonglycemic mechanisms have been associated with HbA1c. Their distributions across racial groups and their impact on hemoglobin glycation need to be systematically explored. Thus, on the basis of evidence for racial differences in HbA1c, current clinical guidelines from the American Diabetes Association state: “It is important to take…race/ethnicity…into consideration when using the A1C to diagnose diabetes.” However, it is not clear from the guidelines how this recommendation might be actualized. So, the critical question is not whether racial differences in HbA1c exist between African Americans and whites; the important question is whether the observed differences in HbA1c level are clinically meaningful. Therefore, given the current controversy, we provide a Point-Counterpoint debate on this issue. In the preceding point narrative, Dr. Herman provides his argument that the failure to acknowledge that HbA1c might be a biased measure of average glycemia and an unwillingness to rigorously investigate this hypothesis will slow scientific progress and has the potential to do great harm. In the counterpoint narrative below, Dr. Selvin argues that there is no compelling evidence for racial differences in the validity of HbA1c as a measure of hyperglycemia and that race is a poor surrogate for differences in underlying causes of disease risk. —William T. Cefalu Editor in Chief, Diabetes Care PMID:27457637

Racial and Ethnic Diversity of U.S. Plastic Surgery Trainees.

PubMed

Silvestre, Jason; Serletti, Joseph M; Chang, Benjamin

Increased diversity of U.S. physicians can improve patient communication and mitigate health disparities for racial minorities. This study analyzes trends in racial and ethnic diversity of plastic surgery residents. Demographic data of surgical residents, medical students, and integrated plastic surgery residency applicants were obtained from the Association of American Medical Colleges. Data for college students and the general population were obtained from the U.S. Census for comparison with plastic surgery. Interspecialty differences and temporal trends in racial composition were analyzed with chi-square tests. From 1995 to 2014, Asian and Hispanic plastic surgery residents increased nearly 3-fold (7.4%-21.7%, p < 0.001) and 2-fold (4.6%-7.9%, p < 0.001), respectively. African American plastic surgery residents did not increase significantly (3.0%-3.5%, p = 0.129). Relative to the U.S. population, Hispanics (range: 0.1-0.5-fold) and African Americans (range: 0.1-0.4-fold) were underrepresented, whereas Asians (range: 2.2-5.3-fold) were overrepresented in plastic surgery. A "bottleneck" existed in the pipeline of African American and Hispanic plastic surgery residents. Significant differences in racial composition existed between plastic surgery and other surgical disciplines, which varied over time. The percentage of Hispanic (10.6% vs 7.0%, p = 0.402) and African American (6.4% vs 2.1%, p < 0.001) plastic surgery residency applicants exceeded those in residency. Hispanics and African Americans are underrepresented in plastic surgery residency relative to whites and Asians. This study underscores the need for greater initiatives to increase diversity in plastic surgery residency. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Racial Differences in Cigarette Smoking Among Homeless Youth.

PubMed

Golinelli, Daniela; Tucker, Joan S; Shadel, William G

2016-12-01

Several studies have reported pronounced racial/ethnic differences in smoking behavior among homeless youth. Better understanding the factors underlying racial/ethnic differences in daily smoking among homeless youth may help inform programs to reduce smoking in this population. Data come from a probability sample of homeless youth in Los Angeles County collected between 2008 and 2009. The sample includes 116 African American, 99 Hispanic, and 119 White youth with ages ranging from 13 to 24 years. Chi-square tests were used to test the differences in daily smoking among African American, Hispanic, and White youth. Propensity score and doubly robust methods were used to produce a less biased estimate of the association between daily smoking and race/ethnicity after having removed the effect of potential confounders. The daily smoking rate for White youth was 70.1%, more than 31 percentage points than the rates for either African American or Hispanic youth. Propensity score analysis revealed that the majority of the racial/ethnic differences in smoking rates could be explained by differences in homelessness severity, although background characteristics and comorbidity were relevant as well. As programs are developed to reduce smoking among homeless youth, results suggest that additional outreach may be needed to engage White youth in services. Also, smoking prevention programs may benefit from incorporating a social network-based approach that assists youth in fostering relationships with lower-risk peers, as well as addressing other forms of substance use. Incorporating these elements may help reduce the large racial/ethnic disparities in daily smoking among homeless youth. This report extends the small existing literature on racial/ethnic differences in smoking among homeless youth in two important respects. First, it confirms differences in daily smoking, an important indicator of dependence, across racial/ethnic groups. Second, it seeks to understand the extent to which differences in smoking can be explained by demographic characteristics (other than race/ethnicity), background factors, homelessness severity, and comorbidity characteristics known to be associated with substance use among homeless youth. © The Author 2016. 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.

Rural-urban and racial-ethnic differences in awareness of direct-to-consumer genetic testing.

PubMed

Salloum, Ramzi G; George, Thomas J; Silver, Natalie; Markham, Merry-Jennifer; Hall, Jaclyn M; Guo, Yi; Bian, Jiang; Shenkman, Elizabeth A

2018-02-23

Access to direct-to-consumer genetic testing services has increased in recent years. However, disparities in knowledge and awareness of these services are not well documented. We examined awareness of genetic testing services by rural/urban and racial/ethnic status. Analyses were conducted using pooled cross-sectional data from 4 waves (2011-2014) of the Health Information National Trends Survey (HINTS). Descriptive statistics compared sample characteristics and information sources by rural/urban residence. Logistic regression was used to examine the relationship between geography, racial/ethnic status, and awareness of genetic testing, controlling for sociodemographic characteristics. Of 13,749 respondents, 16.7% resided in rural areas, 13.8% were Hispanic, and 10.1% were non-Hispanic black. Rural residents were less likely than urban residents to report awareness of genetic testing (OR = 0.74, 95% CI = 0.63-0.87). Compared with non-Hispanic whites, racial/ethnic minorities were less likely to be aware of genetic testing: Hispanic (OR = 0.68, 95% CI = 0.56-0.82); and non-Hispanic black (OR = 0.74, 95% CI = 0.61-0.90). Rural-urban and racial-ethnic differences exist in awareness of direct-to-consumer genetic testing. These differences may translate into disparities in the uptake of genetic testing, health behavior change, and disease prevention through precision and personalized medicine.

Effects of integrated trauma treatment on outcomes in a racially/ethnically diverse sample of women in urban community-based substance abuse treatment.

PubMed

Amaro, Hortensia; Dai, Jianyu; Arévalo, Sandra; Acevedo, Andrea; Matsumoto, Atsushi; Nieves, Rita; Prado, Guillermo

2007-07-01

This study presents findings from a quasiexperimental, nonequivalent, group-design study with repeated measures that explored the effects of integrated trauma-informed services on the severity of substance abuse, mental health, posttraumatic stress disorder (PTSD) symptomatology among women with histories of trauma in urban, community-based substance abuse treatment. The study also explored if the model of integrated services was equally beneficial for women of various racial/ethnic groups. Participants in the study were 342 women receiving substance abuse treatment in intervention and comparison sites. Results indicated that at 6 and 12 month follow-ups, those in the trauma-informed intervention group, in contrast to the comparison group, had significantly better outcomes in drug abstinence rates in the past 30 days as well as in mental health and PTSD symptomatology. Results also showed that, overall, integrated services were beneficial for women across the different racial/ethnic groups in substance abuse treatment, although some differences appear to exist across racial/ethnic groups in improving addiction severity and mental health and PTSD symptomatology.

Effects of Integrated Trauma Treatment on Outcomes in a Racially/Ethnically Diverse Sample of Women in Urban Community-based Substance Abuse Treatment

PubMed Central

Dai, Jianyu; Arévalo, Sandra; Acevedo, Andrea; Matsumoto, Atsushi; Nieves, Rita; Prado, Guillermo

2007-01-01

This study presents findings from a quasiexperimental, nonequivalent, group-design study with repeated measures that explored the effects of integrated trauma-informed services on the severity of substance abuse, mental health, posttraumatic stress disorder (PTSD) symptomatology among women with histories of trauma in urban, community-based substance abuse treatment. The study also explored if the model of integrated services was equally beneficial for women of various racial/ethnic groups. Participants in the study were 342 women receiving substance abuse treatment in intervention and comparison sites. Results indicated that at 6 and 12 month follow-ups, those in the trauma-informed intervention group, in contrast to the comparison group, had significantly better outcomes in drug abstinence rates in the past 30 days as well as in mental health and PTSD symptomatology. Results also showed that, overall, integrated services were beneficial for women across the different racial/ethnic groups in substance abuse treatment, although some differences appear to exist across racial/ethnic groups in improving addiction severity and mental health and PTSD symptomatology. PMID:17356904

Multi-Institutional Experience of Ductal Carcinoma In Situ in Black vs White Patients Treated With Breast-Conserving Surgery and Whole Breast Radiation Therapy

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

Nelson, Carl; Bai, Harrison; Neboori, Hanmanth

2012-11-01

Purpose: Given the paucity of data on racial disparities in ductal carcinoma in situ (DCIS), the data from a multi-institutional cohort of DCIS patients treated with breast-conserving surgery and whole breast radiation therapy (RT) were analyzed to determine whether racial disparities or differences exist. Methods and Materials: A total of 533 white and 76 black DCIS patients from 3 university-based cancer centers were uniformly treated with breast-conserving surgery and RT. All patient data were collected and analyzed as a function of race. Results: The median follow-up was 5.2 years. No significant racial differences were seen in tumor size, age atmore » diagnosis, estrogen receptor status, necrosis, or grade (all P>.05). Of the treatment parameters, the RT dose delivered, boost, positive margin rates, frequency of hormone receptor status assessment, and receipt of hormonal therapy for the 2 cohorts did not significantly differ (all P>.05). The local relapse-free survival was similar at 5 years (96.1% and 98.1%, P=.399) and 10 years (92.8% vs 95.8%, P=.360), with no significant overall survival difference at 10 years (94.0% vs 88.9%, P=.290) between the white and black patients, respectively. On multivariate analysis, race was not an independent predictor of local relapse-free survival or overall survival when accounting for age, grade, and margin status. Conclusion: In our large cohort of DCIS patients uniformly treated at 3 institutions with breast conservation without any apparent differences in treatment delivery parameters, we demonstrated that the clinical and pathologic features and local survival outcomes did not differ as a function of race. Our results suggest that when black patients with DCIS are appropriately selected for breast conservation and receive adjuvant RT without racial disparities in the treatment parameters, differences in the outcomes as a function of race do not exist.« less

Racial differences in barriers to blood pressure control in a family practice setting.

PubMed

Scott, Jonathan M; Spees, Colleen K; Taylor, Christopher A; Wexler, Randy

2010-10-01

Hypertension prevalence in the African American community is greater than in all other ethnic groups. Cultural perceptions of health and disease introduce barriers to providing effective care. The purpose of this study was to identify racial differences in the perceived causes of hypertension, current behaviors performed to control blood pressure, and perceived barriers to preventing or treating hypertension. A self-administered survey of patients seen for medical care in a primary care network was conducted. The survey was developed to measure perceptions of hypertension etiology and treatments. Data from African American (n = 69) and Caucasian (n = 218) respondents were used to assess racial differences in perceptions of blood pressure control. About half of respondents knew their current blood pressures. African American patients were significantly less likely to believe that hypertension was caused by a lack of exercise and obesity. Significantly more Caucasians were less likely to report cutting down on table salt and taking prescription medications for blood pressure control. Both African Americans and Caucasians believed that sodium reduction was the most easily changed behavior to control their blood pressure, while both groups identified weight loss as being the most difficult. Racial differences exist in the perceived causes and treatments of high blood pressure, indicating a need for further patient education. When treating and counseling patients, physicians and support staff members must be sensitive to racial diversity and strive to offer culturally relevant solutions, especially for behaviors perceived as most difficult to change.

The role of provider supply and organization in reducing racial/ethnic disparities in mental health care in the U.S

PubMed Central

Cook, Benjamin Lê; Doksum, Teresa; Chen, Chih-nan; Carle, Adam; Alegría, Margarita

2013-01-01

Racial and ethnic disparities in mental health care access in the United States are well documented. Prior studies highlight the importance of individual and community factors such as health insurance coverage, language and cultural barriers, and socioeconomic differences, though these factors fail to explain the extent of measured disparities. A critical factor in mental health care access is a local area’s organization and supply of mental health care providers. However, it is unclear how geographic differences in provider organization and supply impact racial/ethnic disparities. The present study is the first analysis of a nationally representative U.S. sample to identify contextual factors (county-level provider organization and supply, as well as socioeconomic characteristics) associated with use of mental health care services and how these factors differ across racial/ethnic groups. Hierarchical logistic models were used to examine racial/ethnic differences in the association of county-level provider organization (health maintenance organization (HMO) penetration) and supply (density of specialty mental health providers and existence of a community mental health center) with any use of mental health services and specialty mental health services. Models controlled for individual- and county-level socio-demographic and mental health characteristics. Increased county-level supply of mental health care providers was significantly associated with greater use of any mental health services and any specialty care, and these positive associations were greater for Latinos and African-Americans compared to non-Latino Whites. Expanding the mental health care workforce holds promise for reducing racial/ethnic disparities in mental health care access. Policymakers should consider that increasing the management of mental health care may not only decrease expenditures, but also provide a potential lever for reducing mental health care disparities between social groups. PMID:23466259

Reproductive Health of Urban Adolescents: Differences in the Behaviors, Cognitions, and Social Context of African-American and Puerto Rican Females

ERIC Educational Resources Information Center

Milan, Stephanie; Ethier, Kathleen; Lewis, Jessica; Kershaw, Trace; Niccolai, Linda; Ickovics, Jeannette

2006-01-01

Although ethnic and racial disparities exist in adolescent reproductive health, few studies have examined differences between members of different minority groups. This paper describes differences in measures of reproductive health behaviors, cognitions and social context between African-American (n=170) and Puerto Rican (n=150) adolescent females…

Examining Racial Microaggressions in Rehabilitation Counselor Education

ERIC Educational Resources Information Center

Cartwright, Brenda Y.; Washington, Robin D.; McConnell, L. Robert

2009-01-01

This research extends the Constantine et al. (2008) study which identified racial microaggressions against Black faculty working in counseling and counseling psychology programs. Semi-structured interviews and qualitative analyses were used to: (1) ascertain the existence of racial microaggressions among African American faculty employed in…

How Do Race and Hispanic Ethnicity Affect Nursing Home Admission? Evidence From the Health and Retirement Study

PubMed Central

Mudrazija, Stipica; Angel, Jacqueline L.

2015-01-01

Objectives. This study investigates how health- and disability-based need factors and enabling factors (e.g., socioeconomic and family-based resources) relate to nursing home admission among 3 different racial and ethnic groups. Method. We use Cox proportional hazard models to estimate differences in nursing home admission for non-Hispanic whites, non-Hispanic blacks, and Hispanics from 1998 to 2010 in the Health and Retirement Study (N = 18,952). Results. Racial–ethnic differences in nursing home admission are magnified after controlling for health- and disability-based need factors and enabling factors. Additionally, the degree to which specific factors contribute to risk of nursing home admission varies significantly across racial–ethnic groups. Discussion. Our findings indicate that substantial racial and ethnic variations in nursing home admission continue to exist and that Hispanic use is particularly low. We argue that these differences may demonstrate a significant underuse of nursing homes for racial and ethnic minorities. Alternatively, they could signify different preferences for nursing home care, perhaps due to unmeasured cultural factors or structural obstacles. PMID:25204311

Building Collections: Recognizing and Appreciating Differences

ERIC Educational Resources Information Center

Krapp, Joanna Vergona

2004-01-01

A huge world exists outside the family. When youngsters enter school, they meet children from diverse and unfamiliar backgrounds--regional, ethnic, religious, and racial. Often there is confusion, mistrust, and apprehension. In the eyes of a child, being different is not always a good thing. Parents and teachers bear the burden of discussing…

Population density and racial differences in the performance of emergency medical services.

PubMed

David, Guy; Harrington, Scott E

2010-07-01

This paper analyzes the existence and scope of possible racial differences/disparities in the provision of emergency medical services (EMS) response capability (time from dispatch to arrival at the scene and level of training of the responding team) using data on approximately 120,000 cardiac incidents in the state of Mississippi during 1995-2004. The conceptual framework and empirical analysis focus on the likely effects of population density on the efficient production of EMS as a local public good subject to congestion, and on the need to control adequately for population density to avoid bias in testing for racial differences. Models that control for aggregate population density at the county-level indicate "reverse" disparities: faster estimated response times for African-Americans than for whites. When a refined county-level measure of population density is used that incorporates differences in African-American and white population density by Census tract, the reverse disparity in response times disappears. There also is little or no evidence of race-related differences in the certification level of EMS responders. However, there is evidence that, controlling for response time, African-Americans on average were significantly more likely to be deceased than whites upon EMS arrival at the scene. The overall results are germane to the debate over the scope of conditioning variables that should be included when testing for racial disparities in health care.

The Associations of Intergroup Interactions and School Racial Socialization with Academic Motivation

ERIC Educational Resources Information Center

Byrd, Christy M.

2015-01-01

School racial climate is an important aspect of the school environment that can have significant implications for youths' development. However, existing research is limited by conceptual and methodological concerns that restrict the ability of researchers and educators to identify "what" about and "how" the racial climate is…

The Existence of Implicit Racial Bias in Nursing Faculty

ERIC Educational Resources Information Center

Fitzsimmons, Kathleen A.

2009-01-01

This study examined the existence of implicit racial bias in nursing faculty using the Implicit Association Test (IAT). It was conducted within a critical race theory framework where race was seen as a permanent, pervasive, and systemic condition, not an individual process. The study was fueled by data showing continued disparate academic and…

Are There Clinical Implications of Racial Differences in HbA1c? A Difference, to Be a Difference, Must Make a Difference.

PubMed

Selvin, Elizabeth

2016-08-01

Studies that have compared HbA1c levels by race have consistently demonstrated higher HbA1c levels in African Americans than in whites. These racial differences in HbA1c have not been explained by measured differences in glycemia, sociodemographic factors, clinical factors, access to care, or quality of care. Recently, a number of nonglycemic factors and several genetic polymorphisms that operate through nonglycemic mechanisms have been associated with HbA1c Their distributions across racial groups and their impact on hemoglobin glycation need to be systematically explored. Thus, on the basis of evidence for racial differences in HbA1c, current clinical guidelines from the American Diabetes Association state: "It is important to take…race/ethnicity…into consideration when using the A1C to diagnose diabetes." However, it is not clear from the guidelines how this recommendation might be actualized. So, the critical question is not whether racial differences in HbA1c exist between African Americans and whites; the important question is whether the observed differences in HbA1c level are clinically meaningful. Therefore, given the current controversy, we provide a Point-Counterpoint debate on this issue. In the preceding point narrative, Dr. Herman provides his argument that the failure to acknowledge that HbA1c might be a biased measure of average glycemia and an unwillingness to rigorously investigate this hypothesis will slow scientific progress and has the potential to do great harm. In the counterpoint narrative below, Dr. Selvin argues that there is no compelling evidence for racial differences in the validity of HbA1c as a measure of hyperglycemia and that race is a poor surrogate for differences in underlying causes of disease risk.-William T. CefaluEditor in Chief, Diabetes Care. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Racial bullying and adolescent substance use: An examination of school-attending young adolescents in the United States.

PubMed

Stone, Andrea L; Carlisle, Shauna K

2017-01-01

This article examines the association between race and racial bullying (bullying due to one's race), in relation to youth substance use in school attending young adolescents in the United States. Weighted unadjusted and adjusted logistic regression models were run to assess if racial bullying involvement was associated with youth substance use. Data for this study come from the Health Behaviors in School-Aged Children survey (n = 7,585). An association between racial bullying status (not involve, bullying victim, bullying perpetrator, or mixed bullying victim/perpetrator) and youth substance was identified in this study. Racial bully perpetrators were most likely to have used cigarettes, alcohol, and marijuana, followed by youth in the mixed victim/perpetrator group. When analyses were stratified by race, non-Hispanic White and Hispanic youth experienced an increased risk of cigarette, alcohol, and marijuana use if in the perpetrator or mixed group (compared to those not involved with racial bullying). Non-Hispanic White and Asian youth were also more likely to report marijuana use if in the victim group. Non-Hispanic Black youth were more likely to use alcohol and marijuana if they were a perpetrator or in the mixed group, but they were not more likely to use cigarettes. Differences appear to exist in relation to racial bullying experience and substance across racial/ethnic group among youth in grades 7-10. Implications for prevention and educational professionals are discussed.

Differential Effects of Personal-Level vs Group-Level Racial Discrimination on Health among Black Americans.

PubMed

Hagiwara, Nao; Alderson, Courtney J; Mezuk, Briana

2016-07-21

Racial/ethnic minorities in the United States not only experience discrimination personally but also witness or hear about fellow in-group members experiencing discrimination (ie, group-level discrimination). The objective of our study was to examine whether the effects of group-level discrimination on mental and physical health are different from those of personal-level discrimination among Black Americans by drawing upon social psychology research of the Personal/Group Discrimination Discrepancy. We conducted a secondary analysis of cross-sectional survey data from a larger study. One hundred and twenty participants, who self-identified as Black/African Americans during the laboratory sessions (57.5% women, mean age = 48.97, standard deviation = 8.58) in the parent study, were included in our analyses. Perceived personal-level discrimination was assessed with five items that were taken from two existing measures, and group-level racial discrimination was assessed with three items. Self-reported physical and mental health were assessed with a modified version of SF-8. Perceived personal-level racial discrimination was associated with worse mental health. In contrast, perceived group-level racial discrimination was associated with better mental as well as physical health. Perceived group-level racial discrimination may serve as one of several health protective factors even when individuals perceive personal-level racial discrimination. The present findings demonstrate the importance of examining both personal- and group-level experiences of racial discrimination as they independently relate to health outcomes for Black Americans.

Men's mobility into management from blue collar and white collar jobs: race differences across the early work-career.

PubMed

Wilson, George; Maume, David

2014-07-01

Within the context of the "particularistic mobility thesis" we examine racial differences in the incidence, and determinants of, as well as timing to, mobility into management across the critical early career years at a refined level, namely, when groups share similar white collar and blue collar jobs. Findings from a Panel Study of Income Dynamics sample of men support theory and indicate that from both job levels a racial hierarchy exists: African Americans have the lowest rate of mobility, reach management through a route that is relatively formal and structured by a traditional range of stratification-based causal factors and take longest to reach management. Whites, in contrast, have the highest mobility rate, reach management through a relatively informal path that is less structured by traditional stratification-based factors, and reach management the quickest, and, across all three issues Latinos occupy an intermediate ground between African Americans and Latinos. Further, as predicted by theory, racial differences, particularly, relative to whites, are greater among those tracked from blue collar jobs than white collar jobs. Discussed are implications of the findings for understanding racial disadvantage in the American labor market across the work-career and on an inter-generational basis. Copyright © 2014 Elsevier Inc. All rights reserved.

Racial Disparities in Seeking Care for Help Getting Pregnant

PubMed Central

Chin, HB; Howards, PP; Kramer, MR; Mertens, AC; Spencer, JB

2015-01-01

Background Fertility counseling and treatment can help women achieve their desired family size, however, disparities exist in the utilization of this care. Methods This study examines the persistence of a racial disparity in visiting a doctor for help getting pregnant by estimating the direct effect of this association using data from the FUCHSIA Women’s Study, a population-based cohort study. This cohort included 1073 reproductive age women (22-45 years) with 28% reporting infertility. We fit log binomial models to quantify the magnitude of the racial difference in reported care seeking after adjustment for hypothesized mediators using inverse probability weighting. Results Compared with white women, black women were less likely to visit a doctor in the total population [adjusted risk ratio (aRR) = 0.57, 95% confidence interval (CI): 0.41, 0.80] and in the subgroup of women with infertility [aRR = 0.75, 95% CI: 0.56, 0.99]. In addition, black women waited twice as long on average before seeking help compared with white women. Conclusions There were notable racial differences in visiting a doctor for help getting pregnant in this study although reports of infertility were similar by race. These differences may be mitigated through improved communication about the range of counseling and treatment options available. PMID:26201443

Racial and ethnic disparity in food allergy in the United States: a systematic review.

PubMed

Greenhawt, Matthew; Weiss, Christopher; Conte, Marisa L; Doucet, Marlie; Engler, Amy; Camargo, Carlos A

2013-01-01

The prevalence of food allergy is rising among US children. Little is known about racial/ethnic disparities in food allergy. We performed a systematic literature review to understand racial/ethnic disparities in food allergy in the United States. We searched PubMed/MEDLINE, Embase, and Scopus for original data about racial/ethnic disparities in the diagnosis, prevalence, treatment, or clinical course of food allergy or sensitization, with a particular focus on black (African American) race. Articles were analyzed by study methodology, racial/ethnic composition, food allergy definition, outcomes, summary statistic used, and covariate adjustment. Twenty of 645 identified articles met inclusion criteria. The studies used multiple differing criteria to define food allergy, including self-report, sensitization assessed by serum food-specific IgE to selected foods without corroborating history, discharge codes, clinic chart review, and event-reporting databases. None used oral food challenge. In 12 studies, black persons (primarily children) had significantly increased adjusted odds of food sensitization or significantly higher proportion or odds of food allergy by self-report, discharge codes, or clinic-based chart review than white children. Major differences in study methodology and reporting precluded calculation of a pooled estimate of effect. Sparse and methodologically limited data exist about racial/ethnic disparity in food allergy in the United States. Available data lack a common definition for food allergy and use indirect measures of allergy, not food challenge. Although data suggest an increased risk of food sensitization, self-reported allergy, or clinic-based diagnosis of food allergy among black children, no definitive racial/ethnic disparity could be found among currently available studies. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Ethnic/racial disparities in adolescents' home food environments and linkages to dietary intake and weight status

PubMed Central

Larson, Nicole; Eisenberg, Marla E.; Berge, Jerica M.; Arcan, Chrisa; Neumark-Sztainer, Dianne

2014-01-01

Research is needed to confirm that public health recommendations for home/family food environments are equally relevant for diverse populations. This study examined ethnic/racial differences in the home/family environments of adolescents and associations with dietary intake and weight status. The sample included 2,382 ethnically/racially diverse adolescents and their parents enrolled in coordinated studies, EAT 2010 (Eating and Activity in Teens) and Project F-EAT (Families and Eating and Activity in Teens), in the Minneapolis/St. Paul metropolitan area. Adolescents and parents completed surveys and adolescents completed anthropometric measurements in 2009-2010. Nearly all home/family environment variables (n=7 of 8 examined) were found to vary significantly across the ethnic/racial groups. Several of the home/family food environment variables were significantly associated with one or more adolescent outcome in expected directions. For example, parental modeling of healthy food choices was inversely associated with BMI z-score (p=0.03) and positively associated with fruit/vegetable consumption (p<0.001). Most observed associations were applicable across ethnic/racial groups; however; eight relationships were found to differ by ethnicity/race. For example, parental encouragement for healthy eating was associated with lower intake of sugar-sweetened beverages only among youth representing the White, African American, Asian, and mixed/other ethnic/racial groups and was unrelated to intake among East African, Hispanic, and Native American youth. Food and nutrition professionals along with other providers of health programs and services for adolescents should encourage ethnically/racially diverse parents to follow existing recommendations to promote healthy eating such as modeling nutrient-dense food choices, but also recognize the need for cultural sensitivity in providing such guidance. PMID:25464066

African American Men, Gender Role Conflict, and Psychological Distress: The Role of Racial Identity

ERIC Educational Resources Information Center

Wester, Stephen R.; Vogel, David L.; Wei, Meifen; McLain, Rodney

2006-01-01

Little research exists exploring the intersection of male gender role conflict (GRC), racial identity, and psychological distress. Accordingly, using a sample of 130 self-identified African American male participants, this study explored which aspects of racial identity mediated the relationship between GRC and psychological distress. Results…

"You Are Not Born Being Racist, Are You?" Discussing Racism with Primary Aged-Children

ERIC Educational Resources Information Center

Priest, Naomi; Walton, Jessica; White, Fiona; Kowal, Emma; Fox, Brandi; Paradies, Yin

2016-01-01

Ethnic-racial socialisation is broadly described as processes by which both minority and majority children and young people learn about and negotiate racial, ethnic and cultural diversity. This article extends the existing ethnic-racial socialisation literature in three significant ways: (1) it explores ways children make sense of their…

Miles to Go before We Sleep: Racial Inequities in Health

ERIC Educational Resources Information Center

Williams, David R.

2012-01-01

Large, pervasive, and persistent racial inequalities exist in the onset, courses, and outcomes of illness. A comprehensive understanding of the patterning of racial disparities indicates that racism in both its institutional and individual forms remains an important determinant. There is an urgent need to build the science base that would identify…

Mental Health Diagnostic Considerations in Racial/Ethnic Minority Youth

PubMed Central

Liang, June; Matheson, Brittany E.; Douglas, Jennifer M.

2015-01-01

Misdiagnoses of racial/ethnic minority youth’s mental health problems can potentially contribute to inappropriate mental health care. Therefore, we conducted a systematic review that focuses on current theory and empirical research in an attempt to answer the following two questions: 1) What evidence exists that supports or contradicts the idea that racial/ethnic minority youth’s mental health problems are misdiagnosed? 2) What are the sources of misdiagnoses? Articles were reviewed from 1967 to 2014 using PsychINFO, PubMed, and GoogleScholar. Search terms included “race”, “ethnicity”, “minority”, “culture”, “children”, “youth”, “adolescents”, “mental health”, “psychopathology”, “diagnosis”, “misdiagnosis”, “miscategorization”, “underdiagnosis”, and “overdiagnosis”. Seventy-two articles and book chapters met criteria and were included in this review. Overall, evidence was found that supports the possibility of misdiagnosis of ethnic minority youth’s emotional and behavioral problems. However, the evidence is limited such that it cannot be determined whether racial/ethnic differences are due to differences in psychopathology, mental health biases, and/or inaccurate diagnoses. Cultural and contextual factors that may influence misdiagnosis as well as recommendations for research and practice are discussed. PMID:27346929

Children Associate Racial Groups with Wealth: Evidence from South Africa

ERIC Educational Resources Information Center

Olson, Kristina R.; Shutts, Kristin; Kinzler, Katherine D.; Weisman, Kara G.

2012-01-01

Group-based social hierarchies exist in nearly every society, yet little is known about whether children understand that they exist. The present studies investigated whether 3- to 10-year-old children (N = 84) in South Africa associate higher status racial groups with higher levels of wealth, one indicator of social status. Children matched higher…

Is facial skin tone sufficient to produce a cross-racial identification effect?

PubMed

Alley, T R; Schultheis, J A

2001-06-01

Research clearly supports the existence of an other race effect for human faces whereby own-race faces are more accurately perceived and recognized. Why this occurs remains unclear. A computerized program (Mac-a-Mug Pro) for face composition was used to create pairs of target and distractor faces that differed only in skin tone. The six target faces were rated on honesty and aggressiveness by 72 university students, with just one 'Black' and one 'White' face viewed by each student. One week later, they attempted to identify these faces in four lineups: two with target-present and two with target-absent. The order of presentation of targets, lineups, and faces within lineups was varied. Own-race identification was slightly better than cross-racial identification. There was no significant difference in the confidence of responses to own- versus other-race faces. These results indicate that neither morphological variation nor differential confidence is necessary for a cross-racial identification effect.

Ulcerative colitis in a multiracial Asian country: racial differences and clinical presentation among Malaysian patients.

PubMed

Tan, Yan-Mei; Goh, Khean-Lee

2005-10-07

Inflammatory bowel disease appears to be uncommon among Asians. This study was conducted to determine the prevalence of ulcerative colitis (UC) in Malaysian patients and to establish the spectrum of the disease seen in Malaysian patients. Three major Asian races: Malay, Chinese, and Indian co-exist in Malaysia and we sought to determine if there were any racial differences in the prevalence and presentation of disease. Racial differences for several other gastrointestinal diseases have previously been observed and found to be extremely interesting. Data were obtained retrospectively from a review of the medical records of in- and out-patients with a diagnosis of UC at the University Hospital, Kuala Lumpur between 1985 and 1998. There were 45 confirmed cases of UC of which 3 were foreigners, who were excluded from analysis. Thirty new cases of UC were diagnosed during the study period. Their mean age at presentation was 33.0+/-10.0 years. The highest prevalence of UC was 17.9/100 000 hospital admissions in the Indians, followed by 11.2/100 000 hospital admissions in the Chinese. The lowest prevalence was 3.7/100 000 hospital admissions in the Malays. The prevalence of UC was significantly higher in the Indians and the Chinese when compared with the Malays with an OR of 4.89 (CI = 2.02-12.24; chi2 = 15.45, P<0.001) and 3.06 (CI = 1.24-7.78; chi2 = 6.30; P = 0.012) respectively. The extent of colonic disease was similar in the Malay and Indian patients. In contrast, distal or left-sided colitis predominated in the Chinese with an OR of 8.17 (95%CI = 1.31-64.87; chi2 = 5.53, P = 0.02). Extraintestinal manifestations were uncommon (11.9%). UC is an uncommon disease in Malaysia, but racial differences exist. The Indians had the highest prevalence of UC with the Chinese demonstrating the least extensive disease.

Does Attending Worship Mitigate Racial/Ethnic Discrimination in Influencing Health Behaviors? Results from an Analysis of the California Health Interview Survey

ERIC Educational Resources Information Center

Caldwell, Julia T.; Takahashi, Lois M.

2014-01-01

Existing research suggests that religious institutions play a significant role in improving the health of communities, particularly those coping with racial and ethnic discrimination. Using the California Health Interview Survey, this article examines the relationship of self-reported experiences of racial/ethnic discrimination, worship…

Racial differences in colorectal cancer survival at a safety net hospital.

PubMed

Tapan, Umit; Lee, Shin Yin; Weinberg, Janice; Kolachalama, Vijaya B; Francis, Jean; Charlot, Marjory; Hartshorn, Kevan; Chitalia, Vipul

2017-08-01

While racial disparity in colorectal cancer survival have previously been studied, whether this disparity exists in patients with metastatic colorectal cancer receiving care at safety net hospitals (and therefore of similar socioeconomic status) is poorly understood. We examined racial differences in survival in a cohort of patients with stage IV colorectal cancer treated at the largest safety net hospital in the New England region, which serves a population with a majority (65%) of non-Caucasian patients. Data was extracted from the hospital's electronic medical record. Survival differences among different racial and ethnic groups were examined graphically using Kaplan-Meier analysis. A univariate cox proportional hazards model and a multivariable adjusted model were generated. Black patients had significantly lower overall survival compared to White patients, with median overall survival of 1.9 years and 2.5 years respectively. In a multivariate analysis, Black race posed a significant hazard (HR 1.70, CI 1.01-2.90, p=0.0467) for death. Though response to therapy emerged as a strong predictor of survival (HR=0.4, CI=0.2-0.7, p=0.0021), it was comparable between Blacks and Whites. Despite presumed equal access to healthcare and socioeconomic status within a safety-net hospital system, our results reinforce findings from previous studies showing lower colorectal cancer survival in Black patients, and also point to the importance of investigating other factors such as genetic and pathologic differences. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Influence of Social Class and Race on Language Test Performance and Spontaneous Speech of Preschool Children.

ERIC Educational Resources Information Center

Johnson, Dale L.

This investigation compares child language obtained with standardized tests and samples of spontaneous speech obtained in natural settings. It was hypothesized that differences would exist between social class and racial groups on the unfamiliar standard tests, but such differences would not be evident on spontaneous speech measures. Also, higher…

The role of provider supply and organization in reducing racial/ethnic disparities in mental health care in the U.S.

PubMed

Cook, Benjamin Lê; Doksum, Teresa; Chen, Chih-Nan; Carle, Adam; Alegría, Margarita

2013-05-01

Racial and ethnic disparities in mental health care access in the United States are well documented. Prior studies highlight the importance of individual and community factors such as health insurance coverage, language and cultural barriers, and socioeconomic differences, though these factors fail to explain the extent of measured disparities. A critical factor in mental health care access is a local area's organization and supply of mental health care providers. However, it is unclear how geographic differences in provider organization and supply impact racial/ethnic disparities. The present study is the first analysis of a nationally representative U.S. sample to identify contextual factors (county-level provider organization and supply, as well as socioeconomic characteristics) associated with use of mental health care services and how these factors differ across racial/ethnic groups. Hierarchical logistic models were used to examine racial/ethnic differences in the association of county-level provider organization (health maintenance organization (HMO) penetration) and supply (density of specialty mental health providers and existence of a community mental health center) with any use of mental health services and specialty mental health services. Models controlled for individual- and county-level socio-demographic and mental health characteristics. Increased county-level supply of mental health care providers was significantly associated with greater use of any mental health services and any specialty care, and these positive associations were greater for Latinos and African-Americans compared to non-Latino Whites. Expanding the mental health care workforce holds promise for reducing racial/ethnic disparities in mental health care access. Policymakers should consider that increasing the management of mental health care may not only decrease expenditures, but also provide a potential lever for reducing mental health care disparities between social groups. Copyright © 2013 Elsevier Ltd. All rights reserved.

Mismatched racial identities, colourism, and health in Toronto and Vancouver.

PubMed

Veenstra, Gerry

2011-10-01

Using original telephone survey data collected from adult residents of Toronto (n = 685) and Vancouver (n = 814) in 2009, I investigate associations between mental and physical health and variously conceived racial identities. An 'expressed racial identity' is a self-identification with a racial grouping that a person will readily express to others when asked to fit into official racial classifications presented by Census forms, survey researchers, insurance forms, and the like. Distinguishing between Asian, Black, South Asian, and White expressed racial identities, I find that survey respondents expressing Black identity are the most likely to report high blood pressure or hypertension, a risk that is slightly attenuated by socioeconomic status, and that respondents expressing Asian identity are the most likely to report poorer self-rated mental health and self-rated overall health, risks that are not explained by socioeconomic status. I also find that darker-skinned Black respondents are more likely than lighter-skinned Black respondents to report poor health outcomes, indicating that colourism, processes of discrimination which privilege lighter-skinned people of colour over their darker-skinned counterparts, exists and has implications for well-being in Canada as it does in the United States. Finally, 'reflected racial identity' refers to the racial identity that a person believes that others tend to perceive him or her to be. I find that expressed and reflected racial identities differ from one another for large proportions of self-expressed Black and South Asian respondents and relatively few self-expressed White and Asian respondents. I also find that mismatched racial identities correspond with relatively high risks of various poor health outcomes, especially for respondents who consider themselves White but believe that others tend to think they are something else. I conclude by presenting a framework for conceptualizing multifaceted suites of racial identities and relating their various components and inconsistencies between them to health outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Public Willingness to Participate in and Public Opinions About Genetic Variation Research: A Review of the Literature

PubMed Central

Sterling, Rene; Henderson, Gail E.; Corbie-Smith, Giselle

2006-01-01

Scientists are turning to genetic variation research in hopes of addressing persistent racial/ethnic disparities in health. Despite ongoing controversy, the advancement of genetic variation research is likely to produce new knowledge and technologies that will substantially change the ways in which we understand and value health. They also may affect the ways in which individuals and groups organize socially, politically, and economically. Addressing concerns that may exist in different communities is vital to the scientific and ethical advancement of genetic variation research. We review empirical studies of public willingness to participate in and opinions about genetic research with particular attention to differences in consent and opinion by racial/ethnic group membership. PMID:17018829

Ethnic and Racial Identity during Adolescence and into Young Adulthood: An Integrated Conceptualization

ERIC Educational Resources Information Center

Umaña-Taylor, Adriana J.; Quintana, Stephen M.; Lee, Richard M.; Cross, William E., Jr.; Rivas-Drake, Deborah; Schwartz, Seth J.; Syed, Moin; Yip, Tiffany; Seaton, Eleanor

2014-01-01

Although ethnic and racial identity (ERI) are central to the normative development of youth of color, there have been few efforts to bring scholars together to discuss the theoretical complexities of these constructs and provide a synthesis of existing work. The Ethnic and Racial Identity in the 21st Century Study Group was assembled for this…

Fair Play: A Study of Scientific Workforce Trainers' Experience Playing an Educational Video Game about Racial Bias

ERIC Educational Resources Information Center

Katz, Anna; Carnes, Molly; Gutierrez, Belinda; Savoy, Julia; Samuel, Clem; Filut, Amarette; Pribbenow, Christine Maidl

2017-01-01

Explicit racial bias has decreased in the United States, but racial stereotypes still exist and conspire in multiple ways to perpetuate the underparticipation of Blacks in science careers. Capitalizing on the potential effectiveness of role-playing video games to promote the type of active learning required to increase awareness of and reduce…

Race and Beliefs about Mental Health Treatment Among Anxious Primary Care Patients

PubMed Central

Hunt, Justin; Sullivan, Greer; Chavira, Denise A.; Stein, Murray B.; Craske, Michelle G.; Golinelli, Daniella; Roy-Byrne, Peter P.; Sherbourne, Cathy D.

2013-01-01

Large racial disparities in the utilization of mental health care persist. Differences in treatment preferences could partially explain the differences in care between minority and non-minority populations. We compared beliefs about mental illness and treatment preferences among adult African Americans, Hispanics, Asian Americans, Native Americans, and whites, with diagnosed anxiety disorders. Measures of beliefs about mental illness and treatment were drawn from the National Comorbidity Survey Replication and from our previous work. There were no significant differences between African-Americans’ and whites’ beliefs. Hispanics’ and Native Americans’ beliefs were most distinctive, but the differences were small in magnitude. Across race/ethnicity, the associations between beliefs and service use were generally weak and statistically insignificant. Differences in illness beliefs and treatment preferences do not fully explain the large, persistent racial disparities in mental health care. Other crucial barriers to quality care exist in our health care system and our society as a whole. PMID:23407203

Anthropometric and Anthroposcopic Analysis of Periorbital Features in Malaysian Population: An Inter-racial Study.

PubMed

Packiriswamy, Vasanthakumar; Kumar, Pramod; Bashour, Mounir

2018-05-03

In oculoplastic operations, knowledge of the dimensions of periorbital features based on age, gender, and race is essential for achieving better aesthetic result. This article seeks to determine the racial and gender differences of periorbital features among Malaysian Malay (MM), Malaysian Indian (MI), and Malaysian Chinese (MI) subjects. Evaluation of periorbital features was done on photographs of 200 MM, 200 MI, and 200 MC subjects, aged 18 to 26 years. The measured values were evaluated by an independent t -test. A significant difference was found between MM and MI in all measurements except interbrow distance in males, eyebrow thickness in females, and apex to lateral limbus distance in both sexes. Between MI and MC the difference was insignificant for interbrow distance in male groups, apex to lateral limbus distance in females, and palpebral fissure inclination and eyebrow apex angle in both sexes. Between MM and MC, significant differences were found for eyebrow thickness and medial canthus tilt in female group. Male groups showed significant difference for apex to lateral limbus and lateral canthus distance and eyebrow apex angle. Eyebrow height, palpebral fissure width, and intercanthal distance were significantly different in both sexes. Sexual dimorphism was found for all measurements in MI, but MM and MC showed insignificant difference for eyebrow apex angle. Four types of epicanthus were observed in MM and MC and three types in MI. Eyebrow apex between lateral limbus and lateral canthus was the most common position in all racial groups. Significant racial and gender differences exist for certain periorbital measurements. The knowledge of these differences is expected to influence the surgical outcome. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Direct-to-Consumer Racial Admixture Tests and Beliefs About Essential Racial Differences

PubMed Central

Phelan, Jo C.; Link, Bruce G.; Zelner, Sarah; Yang, Lawrence H.

2015-01-01

Although at first relatively disinterested in race, modern genomic research has increasingly turned attention to racial variations. We examine a prominent example of this focus—direct-to-consumer racial admixture tests—and ask how information about the methods and results of these tests in news media may affect beliefs in racial differences. The reification hypothesis proposes that by emphasizing a genetic basis for race, thereby reifying race as a biological reality, the tests increase beliefs that whites and blacks are essentially different. The challenge hypothesis suggests that by describing differences between racial groups as continua rather than sharp demarcations, the results produced by admixture tests break down racial categories and reduce beliefs in racial differences. A nationally representative survey experiment (N = 526) provided clear support for the reification hypothesis. The results suggest that an unintended consequence of the genomic revolution may be to reinvigorate age-old beliefs in essential racial differences. PMID:25870464

Racial Differences in Awareness of the Affordable Care Act and Application Assistance Among Low-Income Adults in Three Southern States

PubMed Central

Garcia Mosqueira, Adrian; Hua, Lynn M.; Sommers, Benjamin D.

2015-01-01

The Affordable Care Act (ACA) expanded Medicaid eligibility to adults with incomes under 138% of the federal poverty level, leading to substantial reductions in uninsured rates among low-income adults. Despite large gains in coverage, studies suggest that Latinos may be less likely than other racial/ethnic groups to apply and enroll in health insurance, and they remain the group with the highest uninsured rate in the United States. We explore two potential factors related to racial/ethnic differences in ACA enrollment—awareness of the law and receipt of application assistance such as navigator services. Using a survey of nearly 3000 low-income U.S. citizens (aged 19-64) in 3 states in late 2014, we find that Latinos had significantly lower levels of awareness of the ACA relative to other groups, even after adjusting for demographic covariates. Higher education was the strongest positive predictor of ACA awareness. In contrast, Latinos were much more likely to receive assistance from navigators or social workers when applying, relative to other racial/ethnic groups. Taken together, these results highlight the importance of ACA outreach efforts to increase awareness among low-income and less educated populations, two groups that are overrepresented in the Latino population, to close existing disparities in coverage. PMID:26453675

Racial and gender identity among Black adolescent males: an intersectionality perspective.

PubMed

Rogers, Leoandra Onnie; Scott, Marc A; Way, Niobe

2015-01-01

A considerable amount of social identity research has focused on race and racial identity, while gender identity, particularly among Black adolescents, remains underexamined. The current study used survey data from 183 Black adolescent males (13-16 years old) to investigate the development and relation between racial and gender identity centrality and private regard, and how these identities impact adjustment over time. It was found that dimensions of racial and gender identity were strongly correlated. Levels of racial centrality increased over time while gender centrality, and racial and gender private regard declined. In addition, racial and gender identity uniquely contributed to higher levels of psychological well-being and academic adjustment. These findings are discussed within the context of existing identity theories and intersectionality theory. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.

Analysis of Multi-Cultural Education Concept in Order to Explain Its Components

ERIC Educational Resources Information Center

Mostafazadeh, Esmail; Keshtiaray, Narges; Ghulizadeh, Azar

2015-01-01

Existing racial, ethnic, linguistic, cultural variety, in different countries, educational systems, committed them to respond decently to plurality & diversity of their communities, and they are considered to be decently in educational curriculum. Multicultural education is an approach that is adopted in response to cultural diversity in a…

Cross-Cultural Perspectives in Counseling: Mental Health Conceptions in Malaysia.

ERIC Educational Resources Information Center

Mohamed, Othman

The general societal pattern in Malaysia is reflected by the distinct multi-racial composition of the population, comprised of Malays, Chinese, and Indians. In Malaysia, ethnicity determines the varied differences in the socio-cultural and religious diversity of the population. Organized modern medical services have existed in Malaysia since…

Administrative Leadership and Effective Small-Rural Schools: A Comparative Case Study.

ERIC Educational Resources Information Center

Jacobson, Stephen L.

A study of two neighboring rural school districts in New York State was undertaken to determine if differences in educational quality existed between the two communities--Applegate and Bakerville--and to identify factors affecting educational quality. Comparison of demographic and socioeconomic characteristics included racial and ethnic…

The political economy of health care for elderly blacks.

PubMed

Wallace, S P

1990-01-01

The author analyzes the influences of race and class on the life chances of blacks by focusing on the health care of black elderly. Theories based on cultural, class, and racial forces are explained in the context of how each would be used to analyze the health care of older blacks. The lower health and socioeconomic statuses of older blacks compared with older whites are documented. The author argues that cultural factors are unable to explain those differences adequately, and that class factors such as the profit orientation of the medical care system, and race factors such as residential segregation and racial discrimination in the medical care system, both contribute to the disparities in medical care. Since proposals for a U.S. national health insurance or national health service fail to include race-conscious measures, the proposals will fail to eliminate existing racial disparities in the health and health care of the elderly.

Understanding the relations between different forms of racial prejudice: a cognitive consistency perspective.

PubMed

Gawronski, Bertram; Peters, Kurt R; Brochu, Paula M; Strack, Fritz

2008-05-01

Research on racial prejudice is currently characterized by the existence of diverse concepts (e.g., implicit prejudice, old-fashioned racism, modern racism, aversive racism) that are not well integrated from a general perspective. The present article proposes an integrative framework for these concepts employing a cognitive consistency perspective. Specifically, it is argued that the reliance on immediate affective reactions toward racial minority groups in evaluative judgments about these groups depends on the consistency of this evaluation with other relevant beliefs pertaining to central components of old-fashioned, modern, and aversive forms of prejudice. A central prediction of the proposed framework is that the relation between "implicit" and "explicit" prejudice should be moderated by the interaction of egalitarianism-related, nonprejudicial goals and perceptions of discrimination. This prediction was confirmed in a series of three studies. Implications for research on prejudice are discussed.

Family meals then and now: A qualitative investigation of intergenerational transmission of family meal practices in a racially/ethnically diverse and immigrant population.

PubMed

Trofholz, Amanda C; Thao, Mai See; Donley, Mia; Smith, Mireya; Isaac, Hassan; Berge, Jerica M

2018-02-01

Having frequent family meals has consistently been associated with better health outcomes in children/adolescents. It is important to identify how intergenerational transmission of family meal practices occurs to help families benefit from the protective nature of family meals. Limited studies exist that explore the intergenerational transmission of family meal practices, particularly among racially/ethnically diverse and immigrant populations. This study explores how parents describe differences and similarities between meals "then" and "now", lessons they learned as children about family meals, lessons they passed onto their children, the challenges of carrying out family meals, and how families handle the barriers/challenges to intergenerational transmission of family meal practices. The study was conducted with a sample of African American, Native American, Latino, Hmong, Somali, and White families (25/category). Qualitative themes were explored with the overall sample, by race/ethnicity, immigrant status, and by time in the United States (US) as an immigrant. Parents overwhelmingly reported learning as children that family meals were important and conveying this message to their own children. Differences existed among racial/ethnic groups and time in the US as an immigrant. For example, Somali parents frequently endorsed having no challenges with intergenerational transmission of family meal practices. Immigrant parents in the US for a longer period of time were more likely to endorse learning/teaching about family meal importance, that the food eaten now is different than growing up, that a chaotic environment is a challenge to having family meals, and that they accommodate family member's schedules when planning family meals. Results demonstrate that exploring a parent's early family meal experiences may be important when intervening with parents from diverse racial/ethnic and immigrant populations when trying to improve or increase family meal practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

Racial classification in the evolutionary sciences: a comparative analysis.

PubMed

Billinger, Michael S

2007-01-01

Human racial classification has long been a problem for the discipline of anthropology, but much of the criticism of the race concept has focused on its social and political connotations. The central argument of this paper is that race is not a specifically human problem, but one that exists in evolutionary thought in general. This paper looks at various disciplinary approaches to racial or subspecies classification, extending its focus beyond the anthropological race concept by providing a comparative analysis of the use of racial classification in evolutionary biology, genetics, and anthropology.

The interplay between gender, race and weight status: self perceptions and social consequences.

PubMed

Fletcher, Jason M

2014-07-01

This paper uses data from nearly 15,000 young adult respondents to the Add Health survey to examine racial and gender differences in the perceptions and social rewards to weight. The data include information on several typically unmeasured domains: self-perceptions of ideal weight, attractiveness ratings, and measured weight information, along with ties to a series of adult outcomes. Results show important gender and racial differences in ideal weight as well as differences for both self-perceived attractiveness and interviewer rated attractiveness. Findings also suggest the existence of large differences in socio-cultural rewards and sanctions for weight status. Black respondents, particularly women, appear to receive lower "obesity penalties" in both their self-perceived and interviewer accessed attractiveness ratings than other groups. These findings suggest the need to consider new classes of policies directed at shifting relative social benefits and consequences to weight status. Copyright © 2012 Elsevier B.V. All rights reserved.

"Racial bias in mock juror decision-making: A meta-analytic review of defendant treatment": Correction to Mitchell et al. (2005).

PubMed

2017-06-01

Reports an error in "Racial Bias in Mock Juror Decision-Making: A Meta-Analytic Review of Defendant Treatment" by Tara L. Mitchell, Ryann M. Haw, Jeffrey E. Pfeifer and Christian A. Meissner ( Law and Human Behavior , 2005[Dec], Vol 29[6], 621-637). In the article, all of the numbers in Appendix A were correct, but the signs were reversed for z' in a number of studies, which are listed. Also, in Appendix B, some values were incorrect, some signs were reversed, and some values were missing. The corrected appendix is included. (The following abstract of the original article appeared in record 2006-00971-001.) Common wisdom seems to suggest that racial bias, defined as disparate treatment of minority defendants, exists in jury decision-making, with Black defendants being treated more harshly by jurors than White defendants. The empirical research, however, is inconsistent--some studies show racial bias while others do not. Two previous meta-analyses have found conflicting results regarding the existence of racial bias in juror decision-making (Mazzella & Feingold, 1994, Journal of Applied Social Psychology, 24, 1315-1344; Sweeney & Haney, 1992, Behavioral Sciences and the Law, 10, 179-195). This research takes a meta-analytic approach to further investigate the inconsistencies within the empirical literature on racial bias in juror decision-making by defining racial bias as disparate treatment of racial out-groups (rather than focusing upon the minority group alone). Our results suggest that a small, yet significant, effect of racial bias in decision-making is present across studies, but that the effect becomes more pronounced when certain moderators are considered. The state of the research will be discussed in light of these findings. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Race/ethnicity and racial group composition moderate the effectiveness of mindfulness-based relapse prevention for substance use disorder.

PubMed

Greenfield, Brenna L; Roos, Corey; Hagler, Kylee J; Stein, Elena; Bowen, Sarah; Witkiewitz, Katie A

2018-06-01

Mindfulness-based relapse prevention has shown promise as a treatment for substance use disorder but its efficacy according to racial/ethnic minority status and group composition is unknown. This is a secondary analysis of existing data (Bowen et al., 2014) testing individual race/ethnicity and racial/ethnic group composition as moderators of mindfulness-based relapse prevention (MBRP). Participants (N = 191; 29% female; 47% racial/ethnic minority; mean age = 39) with substance use disorder were randomized to MBRP or relapse prevention (RP). Outcomes were heavy drinking days (HDD) and drug use days (DUD) 12 months after treatment completion. Negative binominal regression models were conducted. Analyses accounted for drug of choice. Individual race/ethnicity was a significant moderator of substance use outcomes. White participants had lower HDD in MBRP than RP (IRR = 0, 95% CI: 0,0), whereas for minority participants, there was no treatment difference in HDD. Conversely, minorities had lower DUD in MBRP than RP (IRR = 0.03, 95% CI: 0.01, 0.10), whereas for whites there was no treatment difference in DUD. Group racial/ethnic composition was a significant moderator. Participants in groups with more than half whites had lower HDD in MBRP than RP (IRR = 0.01, 95% CI: 0, 0.09), whereas for participants in groups with more than half minorities there was no treatment difference in HDD. Exploratory analyses suggested MBRP resulted in better outcomes than RP when individual race/ethnic status was reflected in the group race/ethnicity (i.e., whites in groups with more than half whites or minorities in groups with more than half minorities). Among whites, MBRP appears to be more effective than RP in preventing heavy drinking relapse. However, among racial/ethnic minorities, MBRP appears to more effective than RP in preventing drug use relapse. This suggests that the interaction between individual race/ethnicity and group composition may influence primary outcomes. Copyright © 2018 Elsevier Ltd. All rights reserved.

Comparison of diameters at the cementoenamel junction between South Asians and Japanese.

PubMed

Nose, Hirohisa; Tawada, Yasuyuki; Watanabe, Fumihiko; Kageyama, Ikuo

2011-01-01

Previously, sex differences among the various tooth types in Japanese skulls were examined to facilitate choosing an implant diameter similar to the cervical diameter of each tooth, and it was found that mesiodistal diameters at the cementoenamel junction were narrower in women than in men. Also interesting and relevant to the selection of implant diameter is the possible existence of racial differences in diameters at the cementoenamel junction. The purpose of this research was to test the hypothesis that the diameter at the cementoenamel junction of the tooth differs in humans of different races. We compared 106 skulls of unknown sex collected from South Asia with the skulls of Japanese women. Our conclusions are as follows: (1) Except for the lower canine, no significant racial differences were found in the labiolingual diameter of any teeth. (2) Except for the upper canine, upper central incisor, lower second premolar, and lower first premolar, a significant racial difference was found in the mesiodistal diameter. In all teeth in which this value differed, the mesiodistal diameters of South Asians were narrower than those of Japanese women, except for the lower canine. (3) The labiolingual and mesiodistal diameters of the lower canine were significantly larger in South Asians than in Japanese women. (4) Among South Asians, no significant left/right differences were found in the diameter at the cementoenamel junction of any tooth.

Application of the nonlinear Blinder-Oaxaca decomposition to study racial/ethnic disparities in antiobesity medication use in the United States.

PubMed

Mehta, Hemalkumar B; Rajan, Suja S; Aparasu, Rajender R; Johnson, Michael L

2013-01-01

The nonlinear Blinder-Oaxaca (BO) decomposition method is gaining popularity in health services research because of its ability to explain disparity issues. The present study demonstrates the use of this method for categorical variables by addressing antiobesity medication use disparity. To examine racial/ethnic disparity in antiobesity medication use and to quantify the observed factor contribution behind the disparity using the nonlinear BO decomposition. Medical Expenditure Panel Survey data, 2002-2007, were used in this retrospective cross-sectional study. Adults with body mass index (BMI) >30, or BMI ≥27 and comorbidities such as hypertension, cardiovascular diseases, diabetes, or hyperlipidemia were included in the cohort (N=65,886,625). Multivariable logistic regression was performed to examine racial/ethnic disparity in antiobesity medication use controlling for predisposing, enabling, and need factors. The nonlinear BO decomposition was used to identify the contribution of each predisposing, enabling, and need factors in explaining the racial/ethnic disparity and to estimate the residual unexplained disparity. Non-Hispanic Blacks were 46% (odds ratio [OR]: 0.54; 95% confidence interval [CI]: 0.35-0.83) less likely to use antiobesity drugs compared with non-Hispanic Whites, whereas no difference was observed between Hispanics and non-Hispanic Whites. A 0.22 percentage point of disparity existed between non-Hispanic Whites and Blacks. The nonlinear BO decomposition estimated a decomposition coefficient of -0.0013 indicating that the observed disparity would have been 58% higher (-0.0013/0.0022) if non-Hispanic Blacks had similar observed characteristics as non-Hispanic Whites. Age, gender, marital status, region, and BMI were significant factors in the decomposition model; only marital status explained the racial/ethnic disparity among all observed characteristics. The study revealed that differences in the predisposing, enabling, and need characteristics (except marital status) did not successfully explain the racial/ethnic disparity in antiobesity medication use. Further studies examining racial/ethnic differences in individual beliefs, behavioral patterns, and provider prescription patterns are vital to understand these disparities. Copyright © 2013 Elsevier Inc. All rights reserved.

Parent-child mealtime interactions in racially/ethnically diverse families with preschool-age children.

PubMed

Kong, Angela; Jones, Blake L; Fiese, Barbara H; Schiffer, Linda A; Odoms-Young, Angela; Kim, Yoonsang; Bailey, Lauren; Fitzgibbon, Marian L

2013-12-01

Family meals may improve diet and weight outcomes in children; however, results from nationally representative samples suggest that these relationships vary by race/ethnicity. Observing parent-child mealtime interactions may lend insight to why racial/ethnic differences exist. In this pilot study, a multi-ethnic sample of low-income families (n = 30) with a preschool-age child was videotaped during a dinner in their home. A global coding scheme was used to assess the following: 'Action' (behaviors that divert attention from eating), 'Behavior Control' (behaviors intended to modify another person's behavior), and 'Communication' (i.e., meal-oriented, interpersonal, and critical). All families spent a significant amount of time in 'action' oriented behaviors that diverted their attention from eating. We also observed racial/ethnic differences in communication (i.e. critical) and behavior patterns (i.e. behavior control). This study demonstrated that this approach for observing parent-child mealtime interactions in a naturalistic setting among a diverse study sample was feasible; however, future studies should address how these patterns relate to dietary intake and weight status. © 2013.

Parent-child mealtime interactions in racially/ethnically diverse families with preschool-age children

PubMed Central

Kong, Angela; Jones, Blake L.; Fiese, Barbara H.; Schiffer, Linda A.; Odoms-Young, Angela; Kim, Yoonsang; Bailey, Lauren; Fitzgibbon, Marian L.

2013-01-01

Family meals may improve diet and weight outcomes in children; however, results from nationally representative samples suggest these relationships vary by race/ethnicity. Observing parent-child mealtime interactions may lend insight to why racial/ethnic differences exist. In this pilot study, a multi-ethnic sample of low-income families (n=30) with a preschool-age child were videotaped during a dinner in their home. A global coding scheme was used to assess the following: `Action' (behaviors that divert attention from eating), `Behavior Control' (behaviors intended to modify another person's behavior), and `Communication' (i.e., meal-oriented, interpersonal, and critical). All families spent a significant amount of time in `action' oriented behaviors that diverted their attention from eating. We also observed racial/ethnic differences in communication (i.e. critical) and behavior patterns (i.e. behavior control). This study demonstrated that this approach for observing parent-child mealtime interactions in a naturalistic setting among a diverse study sample was feasible; however, future studies should address how these patterns relate to dietary intake and weight status. PMID:24183134

Racial differences in treatment effect among men in a substance abuse and domestic violence program.

PubMed

Scott, Melanie C; Easton, Caroline J

2010-11-01

It is unclear whether racial differences in treatment effect exist for individuals in substance abuse and domestic violence programs. This study examined racial differences in treatment effect among substance dependent Caucasian and African-American male intimate partner violence (IPV) offenders court mandated to an integrated substance abuse and domestic violence treatment. From baseline to completion of treatment (week 12), 75 participants (39 Caucasian; 36 African-American) were assessed on demographics, substance use, legal characteristics, and use of violence (physical, verbal, and psychological). African-American men served more months incarcerated in their life than Caucasian men. Both groups showed decreases in their use of physical violence and alcohol abuse over treatment. Caucasian men also showed a decrease in their use of verbal abuse. At treatment completion, both groups showed a reduction in physical abuse and alcohol abuse. Caucasian men showed a reduction in their use of verbal abuse, but African-American men did not. Substance dependent African-American male IPV offenders may benefit from interventions that thoroughly target communication skills in addition to issues of substance abuse and IPV to reduce use of verbal abuse and improve treatment outcomes among African American men.

Racial differences in diabetes among Union Forces during the US Civil War.

PubMed

Smith, Jeffrey A; Frueh, B Christopher; Campbell, Jennifer; Egede, Leonard

2015-01-01

Diabetes is the seventh leading cause of death in the United States and disproportionately affects ethnic minorities. While research examining health disparities is well-established, an historical understanding of how the disparities evolved over time may be warranted. This article examined racial differences in prevalence of diabetes and associated mortality in Blacks and Whites during the US Civil War. Data were extracted from the Medical and Surgical History of the War of Rebellion, 1861-1865, representing segregated White and Black Union Forces who served during the war. Data were collapsed by war theater (Atlantic, Central, Pacific). Results by race show that, from 1861 to 1866, the rates of Whites diagnosed with diabetes ranged overall from 0% to .11% and was distributed throughout the war theaters as: Atlantic 0.3% to .05%; Central 0.3% to .08%, and Pacific 0% to .11%. For Blacks, Atlantic ranged from .02% to .07% and Central .03% to .06%. None were reported for Pacific. Mortality was approximately .01% for both Blacks and Whites. These data suggest no racial differences in diabetes prevalence and mortality existed between Blacks and Whites during this time, implying that disparities may have evolved more recently.

Reducing Children's Implicit Racial Bias through Exposure to Positive Out-Group Exemplars

ERIC Educational Resources Information Center

Gonzalez, Antonya M.; Steele, Jennifer R.; Baron, Andrew S.

2017-01-01

Studies with adults suggest that implicit preferences favoring White versus Black individuals can be reduced through exposure to positive Black exemplars. However, it remains unclear whether developmental differences exist in the capacity for these biases to be changed. This study included 369 children and examined whether their implicit racial…

Multiple-Choice Test Bias Due to Answering Strategy Variation.

ERIC Educational Resources Information Center

Frary, Robert B.; Giles, Mary B.

This paper describes the development and investigation of a new approach to determining the existence of bias in multiple-choice test scores. Previous work in this area has concentrated almost exclusively on bias attributable to specific test items or to differences in test score distributions across racial or ethnic groups. In contrast, the…

Gender/racial Differences in Jock Identity, Dating, and Adolescent Sexual Risk.

ERIC Educational Resources Information Center

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

2005-01-01

Despite recent declines in overall sexual activity, sexual risk-taking remains a substantial danger to US youth. Existing research points to athletic participation as a promising venue for reducing these risks. Linear regressions and multiple analyses of covariance were performed on a longitudinal sample of nearly 600 Western New York adolescents…

High School Predictors of a Career in Medicine

ERIC Educational Resources Information Center

Fuchs, Travis T.; Sadler, Philip M.; Sonnert, Gerhard

2015-01-01

While there is no dearth of high school students who are interested in becoming physicians, racial/ethnic disparities still exist in the medical profession. This retrospective cohort study examined the influences on students' desire, at the end of high school, for a medical career, and, in particular, how these influences differed by…

Latino Parents' Choice of Magnet School: How School Choice Differs across Racial and Ethnic Boundaries

ERIC Educational Resources Information Center

Haynes, Katherine Taylor; Phillips, Kristie J. R.; Goldring, Ellen B.

2010-01-01

Historically, magnet schools have served predominantly Black and Anglo populations. Consequently, little research exists on Latino parent's engagement in school choice and their patterns of participation. Magnet schools are increasingly part of the landscape for improving school achievement for all students. Yet Latino enrollment rates in magnet…

Health care disparities in emergency medicine.

PubMed

Cone, David C; Richardson, Lynne D; Todd, Knox H; Betancourt, Joseph R; Lowe, Robert A

2003-11-01

The Institute of Medicine's landmark report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care," documents the pervasiveness of racial and ethnic disparities in the U.S. health care delivery system, and provides several recommendations to address them. It is clear from research data, such as those demonstrating racial and ethnic disparities in emergency department (ED) pain management, that emergency medicine (EM) is not immune to this problem. The IOM authors describe two strategies that can reduce disparities in EM. First, workforce diversity is likely to result in a community of emergency physicians who are better prepared to understand, learn from, and collaborate with persons from other racial, ethnic, and cultural backgrounds, whether these be patients, fellow clinicians, or the larger medical and scientific community. Given the ethical and practical advantages of a more diverse EM workforce, continued and expanded initiatives to increase diversity within EM should be undertaken. Second, the specialty's educational programs should produce emergency physicians with the skills and knowledge needed to serve an increasingly diverse population. This cultural competence should include an awareness of existing racial and ethnic health disparities, recognition of the risks of stereotyping and biased treatment, and knowledge of the incidence and prevalence of health conditions among diverse populations. Culturally competent emergency care providers also possess the skills to identify and manage racial and ethnic differences in health values, beliefs, and behaviors with the ultimate goal of delivering quality health services to all patients cared for in EDs.

Racial differences in the incidence of acute low back pain in United States military service members.

PubMed

Knox, Jeffrey B; Orchowski, Joseph R; Owens, Brett

2012-09-01

An epidemiological study. To determine the effect of race on the incidence of acute low back pain, resulting in a health care encounter in active duty military service members. Although racial differences in the incidence of low back pain have been documented in previous studies, currently no consensus exists on the relative risk between these groups. A query was performed using the Armed Forces Health Surveillance Center database for the International Classification of Diseases, Ninth Revision code for low back pain (724.20). A total of 12,399,276 person-years of data were analyzed and stratified by age, race, and sex. Incidence rates were calculated and compared using the multivariate Poisson regression analysis. A total of 467,950 cases of low back pain resulted in a visit to a health care provider in our population, with an overall incidence rate of 37.74 per 1000 person-years. Asians/Pacific Islanders had the lowest incidence rate of 30.7 and blacks had the highest with 43.7. Female sex and older age were also significant risk factors but with significantly different effect sizes between racial groups. Native Americans/Alaskan Natives demonstrated the greatest effect of age on low back pain incidence rates, with a 126% increase between the youngest and oldest age groups compared with a 36% difference in whites. Race, sex, and age were all found to be significant risk factors for acute low back pain. The highest rates were identified in blacks followed by whites, Hispanics, and American Indian/Alaskan Native, and the lowest rates were identified in Asians/Pacific Islanders. Significant differences in the effect of sex and age were identified between the different racial groups.

Associations between self-rated mental health and psychiatric disorders among older adults: do racial/ethnic differences exist?

PubMed

Kim, Giyeon; DeCoster, Jamie; Chiriboga, David A; Jang, Yuri; Allen, Rebecca S; Parmelee, Patricia

2011-05-01

[corrected] This study examined racial/ethnic differences in the association between self-rated mental health (SRMH) and psychiatric disorders among community-dwelling older adults in the United States. Cross-sectional analyses of nationally representative data from the Collaborative Psychiatric Epidemiology Surveys (2001-2003). In-person household interviews. Older adults aged 60 and older (N = 1,840), including non-Hispanic Whites (N = 351), Blacks (N = 826), Hispanics (N = 406), and Asians (N = 257). SRMH was measured with a single item, "How would you rate your own mental health?" Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnoses for mood and anxiety disorders were measured with the World Health Organization's World Mental Health version of the Composite International Diagnostic Interview. Results from logistic regression analyses showed significant main effects of both SRMH and race/ethnicity on the presence of mood and anxiety disorders: people who have poor SRMH and are non-Hispanic Whites were more likely to have mood and anxiety disorders. There were also significant interaction effects between SRMH and race/ethnicity, such that the relation of SRMH with diagnoses of psychiatric disorders was strongest in non-Hispanic Whites. Racial/ethnic variations were found in the relationship between self-perception of mental health and DSM-IV psychiatric disorders. The findings suggest the need to develop race/ethnicity-specific strategies to screen psychiatric disorders in diverse elderly populations. Future studies are needed to investigate possible reasons for the racial/ethnic group differences.

Ecodevelopmental contexts for preventing type 2 diabetes in Latino and other racial/ethnic minority populations

PubMed Central

Shaibi, Gabriel Q.; Boehm-Smith, Edna

2009-01-01

Diabetes is the sixth leading cause of death in the United States and it is now cited along with obesity as a global epidemic. Significant racial/ethnic disparities exist in the prevalence of diabetes within the US, with racial and ethnic minorities disproportionately affected by type 2 diabetes and its complications. Racial/ethnic and socioeconomic factors influence the development and course of diabetes at multiple levels, including genetic, individual, familial, community and national. From an ecodevelopmental perspective, cultural variables assessed at one level (e.g., family level dietary practices) may interact with other types of variables examined at other levels (e.g., the availability of healthy foods within a low-income neighborhood), thus prompting the need for a clear analysis of these systemic relationships as they may increase risks for disease. Therefore, the need exists for models that aid in “mapping out” these relationships. A more explicit conceptualization of such multi-level relationships would aid in the design of culturally relevant interventions that aim to maximize effectiveness when applied with Latinos and other racial/ethnic minority groups. This paper presents an expanded ecodevelopmental model intended to serve as a tool to aid in the design of multi-level diabetes prevention interventions for application with racial/ethnic minority populations. This discussion focuses primarily on risk factors and prevention intervention in Latino populations, although with implications for other racial/ethnic minority populations that are also at high risk for type 2 diabetes. PMID:19101788

Racialized risk environments in a large sample of people who inject drugs in the United States.

PubMed

Cooper, Hannah L F; Linton, Sabriya; Kelley, Mary E; Ross, Zev; Wolfe, Mary E; Chen, Yen-Tyng; Zlotorzynska, Maria; Hunter-Jones, Josalin; Friedman, Samuel R; Des Jarlais, Don; Semaan, Salaam; Tempalski, Barbara; DiNenno, Elizabeth; Broz, Dita; Wejnert, Cyprian; Paz-Bailey, Gabriela

2016-01-01

Substantial racial/ethnic disparities exist in HIV infection among people who inject drugs (PWID) in many countries. To strengthen efforts to understand the causes of disparities in HIV-related outcomes and eliminate them, we expand the "Risk Environment Model" to encompass the construct "racialized risk environments," and investigate whether PWID risk environments in the United States are racialized. Specifically, we investigate whether black and Latino PWID are more likely than white PWID to live in places that create vulnerability to adverse HIV-related outcomes. As part of the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance, 9170 PWID were sampled from 19 metropolitan statistical areas (MSAs) in 2009. Self-reported data were used to ascertain PWID race/ethnicity. Using Census data and other administrative sources, we characterized features of PWID risk environments at four geographic scales (i.e., ZIP codes, counties, MSAs, and states). Means for each feature of the risk environment were computed for each racial/ethnic group of PWID, and were compared across racial/ethnic groups. Almost universally across measures, black PWID were more likely than white PWID to live in environments associated with vulnerability to adverse HIV-related outcomes. Compared to white PWID, black PWID lived in ZIP codes with higher poverty rates and worse spatial access to substance abuse treatment and in counties with higher violent crime rates. Black PWID were less likely to live in states with laws facilitating sterile syringe access (e.g., laws permitting over-the-counter syringe sales). Latino/white differences in risk environments emerged at the MSA level (e.g., Latino PWID lived in MSAs with higher drug-related arrest rates). PWID risk environments in the US are racialized. Future research should explore the implications of this racialization for racial/ethnic disparities in HIV-related outcomes, using appropriate methods. Copyright © 2015 Elsevier B.V. All rights reserved.

Racialized Risk Environments in a Large Sample of People who Inject Drugs In the United States

PubMed Central

Cooper, Hannah L.F.; Linton, Sabriya; Kelley, Mary E.; Ross, Zev; Wolfe, Mary E; Chen, Yen-Tyng; Zlotorzynska, Maria; Hunter-Jones, Josalin; Friedman, Samuel R.; Jarlais, Don Des; Semaan, Salaam; Tempalski, Barbara; DiNenno, Elizabeth; Broz, Dita; Wejnert, Cyprian; Paz-Bailey, Gabriela

2015-01-01

Background Substantial racial/ethnic disparities exist in HIV infection among people who inject drugs (PWID) in many countries. To strengthen efforts to understand the causes of disparities in HIV-related outcomes and eliminate them, we expand the “Risk Environment Model” to encompass the construct “racialized risk environments,” and investigate whether PWID risk environments in the United States are racialized. Specifically, we investigate whether black and Latino PWID are more likely than white PWID to live in places that create vulnerability to adverse HIV-related outcomes. Methods As part of the Centers for Disease Control and Prevention’s National HIV Behavioral Surveillance, 9,170 PWID were sampled from 19 metropolitan statistical areas (MSAs) in 2009. Self-reported data were used to ascertain PWID race/ethnicity. Using Census data and other administrative sources, we characterized features of PWID risk environments at four geographic scales (i.e., ZIP codes, counties, MSAs, and states). Means for each feature of the risk environment were computed for each racial/ethnic group of PWID, and were compared across racial/ethnic groups. Results Almost universally across measures, black PWID were more likely than white PWID to live in environments associated with vulnerability to adverse HIV-related outcomes. Compared to white PWID, black PWID lived in ZIP codes with higher poverty rates and worse spatial access to substance abuse treatment and in counties with higher violent crime rates. Black PWID were less likely to live in states with laws facilitating sterile syringe access (e.g., laws permitting over-the-counter syringe sales). Latino/white differences in risk environments emerged at the MSA level (e.g., Latino PWID lived in MSAs with higher drug-related arrest rates). Conclusion PWID risk environments in the US are racialized. Future research should explore the implications of this racialization for racial/ethnic disparities in HIV-related outcomes, using appropriate methods. PMID:26342272

New evidence of racial differences in access and their effects on the use of nursing homes among older adults.

PubMed

Akamigbo, Adaeze B; Wolinsky, Fredric D

2007-07-01

Historical disparities in rates of nursing home placement between blacks and whites have been well documented, and are thought to result from more extensive and supportive social networks, cultural aversion, and poorer geographic access among African Americans. A few recent studies, however, suggest that these racial disparities may no longer exist. We used comprehensive data to assess whether racial differences in nursing home placement remain, and if so, to identify the reasons for them. Data on 6242 black and white self-respondents to the Survey of Assets and Health Dynamics Among the Oldest Old cohort who were 70 years old or older at baseline (1993) were used. Placement status was ascertained at each biennial follow-up through 2004, and discrete-time hazards models were estimated. After adjusting for baseline covariates, it was found that blacks were 26% (lambda = 0.74, P < 0.001) less likely to use a nursing home over an 11-year period than whites. Moreover, the supply of skilled nursing beds was more salient for nursing home placement for blacks than whites, as was the increasing supply of assisted living beds. The racial gap in nursing home placement remains, despite the increased supply of nursing home beds and the emergence of assisted living facilities as the preferred alternative. As the supply of skilled nursing beds increases, in part due to whites choosing assisted living facilities, the racial gap in the risks of nursing home placement may be lessening. Blacks, however, remain less likely to be placed in a nursing home than whites.

The weight of racism: Vigilance and racial inequalities in weight-related measures

PubMed Central

Hicken, Margaret T.; Lee, Hedwig; Hing, Anna K.

2017-01-01

In the United States, racial/ethnic inequalities in obesity are well-documented, particularly among women. Using the Chicago Community Adult Health Study, a probability-based sample in 2001–2003 (N=3,105), we examined the roles of discrimination and vigilance in racial inequalities in two weight-related measures, body mass index (BMI) and waist circumference (WC), viewed through a cultural racism lens. Cultural racism creates a social environment in which Black Americans bear the stigma burden of their racial group while White Americans are allowed to view themselves as individuals. We propose that in this context, interpersonal discrimination holds a different meaning for Blacks and Whites, while vigilance captures the coping style for Blacks who carry the stigma burden of the racial group. By placing discrimination and vigilance within the context of cultural racism, we operationalize existing survey measures and utilize statistical models to clarify the ambiguous associations between discrimination and weight-related inequalities in the extant literature. Multivariate models were estimated for BMI and WC separately and were stratified by gender. Black women had higher mean BMI and WC than any other group, as well as highest levels of vigilance. White women did not show an association between vigilance and WC but did show a strong positive association between discrimination and WC. Conversely, Black women displayed an association between vigilance and WC, but not between discrimination and WC. These results demonstrate that vigilance and discrimination may hold different meanings for obesity by ethnoracial group that are concealed when all women are examined together and viewed without considering a cultural racism lens. PMID:28372829

Do Irregularly Shaped School Attendance Zones Contribute to Racial Segregation or Integration?

PubMed Central

Saporito, Salvatore; Van Riper, David

2017-01-01

This research investigates if and how much the shapes of school attendance zones contribute to racial segregation in schools. We find that the typical school attendance zone is relatively compact and resembles a square-like shape. Compact zones typically draw children from local residential areas, and since local areas are often racially homogeneous, this suggests that high levels of racial segregation in the largest school districts are largely structured by existing residential segregation. Still, this study finds that the United States contains some attendance zones with highly irregular shapes—some of which are as irregular as the most irregular Congressional District. Although relatively rare, attendance zones that are highly irregular in shape almost always contain racially diverse student populations. This racial diversity contributes to racial integration within school districts. These findings contradict recent theoretical and empirical scholarship arguing that irregularly shaped zones contribute to racial segregation in schools. Our findings suggest that most racial segregation in school attendance zones is driven by large-scale segregation across residential areas rather than a widespread practice among school districts to exacerbate racial segregation by delineating irregularly shaped attendance zones. PMID:28804732

Stigmatizing attitudes toward mental illness among racial/ethnic older adults in primary care.

PubMed

Jimenez, Daniel E; Bartels, Stephen J; Cardenas, Veronica; Alegría, Margarita

2013-10-01

The current study applies the perceived stigma framework to identify differences in attitudes toward mental health and mental health treatment among various racial/ethnic minority older adults with common mental health problems including depression, anxiety disorders, or at-risk alcohol use. Specifically, this study examines to what extent race/ethnicity is associated with differences in (1) perceived stigma of mental illness and (2) perceived stigma for different mental health treatment options. Analyses were conducted using baseline data collected from participants who completed the SAMHSA Mental Health and Alcohol Abuse Stigma Assessment, developed for the PRISM-E (Primary Care Research in Substance Abuse and Mental Health for the Elderly) study, a multisite randomized trial for older adults (65+ years) with depression, anxiety, or at-risk alcohol consumption. The final sample consisted of 1247 non-Latino Whites, 536 African-Americans, 112 Asian-Americans, and 303 Latinos. African-Americans and Latinos expressed greater comfort in speaking to primary care physicians or mental health professionals concerning mental illness compared with non-Latino Whites. Asian-Americans and Latinos expressed greater shame and embarrassment about having a mental illness than non-Latino Whites. Asian-Americans expressed greater difficulty in seeking or engaging in mental health treatment. Racial/ethnic differences exist among older adults with mental illness with respect to stigmatizing attitudes toward mental illness and mental health treatment. Results of this study could help researchers and clinicians educate racial/ethnic minority older adults about mental illness and engage them in much needed mental health services. Copyright © 2013 John Wiley & Sons, Ltd.

Stigmatizing Attitudes towards Mental Illness among Racial/Ethnic Older Adults in Primary Care

PubMed Central

Jimenez, Daniel E.; Bartels, Stephen J.; Cardenas, Veronica; Alegría, Margarita

2013-01-01

Objective The current study applies the perceived stigma framework to identify differences in attitudes toward mental health and mental health treatment among various racial/ethnic minority older adults with common mental health problems including depression, anxiety disorders, or at-risk alcohol use. Specifically, this study examines to what extent race/ethnicity is associated with differences in: (1) perceived stigma of mental illness; and (2) perceived stigma for different mental health treatment options. Methods Analyses were conducted using baseline data collected from participants who completed the SAMHSA Mental Health and Alcohol Abuse Stigma Assessment, developed for the PRISM-E (Primary Care Research in Substance Abuse and Mental Health for the Elderly) study, a multi-site randomized trial for older adults (65+) with depression, anxiety, or at-risk alcohol consumption. The final sample consisted of 1247 non-Latino Whites, 536 African-Americans, 112 Asian-Americans, and 303 Latinos. Results African-Americans and Latinos expressed greater comfort in speaking to primary care physicians or mental health professionals concerning mental illness compared to non-Latino Whites. Asian-Americans and Latinos expressed greater shame and embarrassment about having a mental illness than non-Latino Whites. Asian-Americans expressed greater difficulty in seeking or engaging in mental health treatment. Conclusions Racial/ethnic differences exist among older adults with mental illness with respect to stigmatizing attitudes towards mental illness and mental health treatment. Results of this study could help researchers and clinicians educate racial/ethnic minority older adults about mental illness and engage them in much needed mental health services. PMID:23361866

Racial/ethnic differences in health insurance adequacy and consistency among children: Evidence from the 2011/12 National Survey of Children's Health.

PubMed

Soylu, Tulay G; Elashkar, Eman; Aloudah, Fatemah; Ahmed, Munir; Kitsantas, Panagiota

2018-02-05

Surveillance of disparities in healthcare insurance, services and quality of care among children are critical for properly serving the medical/healthcare needs of underserved populations. The purpose of this study was to assess racial/ethnic differences in children's (0 to 17 years old) health insurance adequacy and consistency (child has insurance coverage for the last 12 months). We used data from the 2011/2012 National Survey of Children's Health (n=79,474). Descriptive statistics and logistic regression analyses were conducted to examine the distribution and influence of several sociodemographic/family related factors on insurance adequacy and consistency across different racial/ethnic groups. Stratified analyses by race/ethnicity revealed that white and black children living in households at or below 299% of the Federal Poverty Level (FPL) were approximately 29 to 42% less likely to have adequate insurance compared to children living in families of higher income levels. Regardless of race/ethnicity, we found that children with public health insurance were more likely to have adequate insurance than their privately insured counterparts, while adolescents were at greater risk of inadequate coverage. Hispanic and black children were more likely to lack consistent insurance coverage. This study provides evidence that racial/ethnic differences in adequate and consistent health insurance exists with both white and minority children being affected adversely by poverty. Establishing outreach programs for low income families, and cross-cultural education for healthcare providers may help increase health insurance adequacy and consistency within certain underserved populations.

The Need to Consider Longer-term Outcomes of Care: Racial/Ethnic Disparities Among Adult and Older Adult Emergency General Surgery Patients at 30, 90, and 180 Days.

PubMed

Zogg, Cheryl K; Olufajo, Olubode A; Jiang, Wei; Bystricky, Anna; Scott, John W; Shafi, Shahid; Havens, Joaquim M; Salim, Ali; Schoenfeld, Andrew J; Haider, Adil H

2017-07-01

Following calls from the National Institutes of Health and American College of Surgeons for "urgently needed" research, the objectives of the present study were to (1) ascertain whether differences in 30/90/180-day mortality, major morbidity, and unplanned readmissions exist among adult (18-64 yr) and older adult (≥65 yr) emergency general surgery (EGS) patients; (2) vary by diagnostic category; and (3) are explained by variations in insurance, income, teaching status, hospital EGS volume, and a hospital's proportion of minority patients. Racial/ethnic disparities have been described in in-hospital and 30-day settings. How longer-term outcomes compare-a critical consideration for the lived experience of patients-has, however, only been limitedly considered. Survival analysis of 2007 to 2011 California State Inpatient Database using Cox proportional hazards models. A total of 737,092 adults and 552,845 older adults were included. In both cohorts, significant differences in 30/90/180-day mortality, major morbidity, and unplanned readmissions were found, pointing to persistently worse outcomes between non-Hispanic Black and White patients [180-d readmission hazard ratio (95% confidence interval):1.04 (1.03-1.06)] and paradoxically better outcomes among Hispanic adults [0.85 (0.84-0.86)] that were not encountered among Hispanic older adults [1.06 (1.04-1.07)]. Stratified results demonstrated robust morbidity and readmission trends between non-Hispanic Black and White patients for the majority of diagnostic categories, whereas variations in insurance/income/teaching status/EGS volume/proportion of minority patients all significantly altered the effect-combined accounting for up to 80% of risk-adjusted differences between racial/ethnic groups. Racial/ethnic disparities exist in longer-term outcomes of EGS patients and are, in part, determined by differences in factors associated with emergency care. Efforts such as these are needed to understand the interplay of influences-both in-hospital and during the equally critical, postacute phase-that underlie disparities' occurrence among surgical patients.

Racial disparities in prescription drug use for mental illness among population in US.

PubMed

Han, Euna; Liu, Gordon G

2005-09-01

Racial minorities are a rapidly growing portion of the US population. Research suggests that racial minorities are more vulnerable to mental illness due to risk factors, such as higher rates of poverty. Given that the burden of mental illnesses is significant, equal likelihood of mental health services utilization is important to reduce such burden. Racial minorities have been known to use mental health services less than Whites. However, it is unclear whether racial disparity in prescription drug use for mental illnesses exists in a nationally representative sample. For a valid estimation of prescription drug use patterns, the characteristic in the distribution of prescription drug use should be accounted for in the estimation model. This study is intended to document whether there was a disparity in psychiatric drug use in both extensive and intensive margins between Whites and three racial minorities: Blacks, Hispanics, and Asian-Indians. The study looked at several specified mental illnesses, controlling for underlying health status and other confounding factors. Secondary data analysis was conducted using the multiyear Medical Expenditure Panel Survey (MEPS), a nationally representative panel sample from 1996 through 2000. This analysis provides estimates of the actual expenditure on prescription drug use for people with specified mental illnesses for this study, based on comparison of Whites and other racial minorities. We derived the estimates from the two-part model, a framework that adjusts the likelihood of using prescription drugs for the specified mental illnesses while estimating the total actual expenditures on prescription drugs among the users. This study found that Blacks, Hispanics, and Asian-Indians were less likely than Whites to use prescription drugs by 8.3, 6.1 and 23.6 percentage points, respectively, holding other factors constant in the sample, with at least one of the specified mental illnesses. The expenditure on prescription drugs for the specified mental illnesses differs between each of racial minorities (Blacks, Hispanics, and Asian-Indians) and Whites even after adjusting for the different likelihood of using those prescription drugs. Blacks, Hispanics, and Asian-Indians with the specified mental illnesses were estimated to spend 606.53 US dollars, 9.83 US dollars and 179.60 US dollars less per year, respectively, on their actual prescription drugs than Whites. This study concludes that three racial minorities: Blacks, Hispanics, and Asian-Indians, with the specified mental illnesses are less likely to use psychiatric drugs than Whites. Among users, racial minorities use less psychiatric drugs than Whites in terms of actual spending on those drugs. There is a need to focus on a program to reach out to racial minorities with a diagnosis of mental illnesses, and this program should consider the cultural specificity of each minority group regarding mental illnesses. In the development of mental health policy, it is crucial to understand the underlying non-socioeconomic factors which may significantly determine the access to mental health service. Also, education programs or other outreach programs for racial minorities are necessary to understand the different distribution of mental health services for racial minorities. Future research should examine the causes for racial disparity in the use of prescription drugs for mental illness both in the extensive and intensive margins. An in-depth analysis is needed to map out the attributes for the observed disparity between Whites and racial minorities in mental health service use.

Making a business case for small medical practices to maintain quality while addressing racial healthcare disparities.

PubMed

Dunston, Frances J; Eisenberg, Andrew C; Lewis, Evelyn L; Montgomery, John M; Ramos, Diana; Elster, Arthur

2008-11-01

Various reports have documented variations in quality of care that occur among racial and ethnic populations, even after accounting for socioeconomic factors and health insurance status. Although quality improvement initiatives are often touted as the answer to healthcare disparities, researchers have questioned whether a business case exists that supports this notion. We assess various barriers and incentives for using quality improvement to address racial and ethnic healthcare disparities in small-to-medium-sized practices. We believe that although both indirect and direct cost incentives may exist, a favorable business case for small private practices cannot be made unless there are additional financial incentives. The business community can work with health plans to provide these incentives.

Vitamin D intake and serum vitamin D in ethnically diverse urban schoolchildren

PubMed Central

Au, Lauren E; Economos, Christina D; Goodman, Elizabeth; Must, Aviva; Chomitz, Virginia R; Sacheck, Jennifer M

2015-01-01

Objective Low serum vitamin D, which largely affects ethnic minorities, is associated with obesity and other chronic diseases. Little is known about racial/ethnic differences in intake, particularly in children, or if any differences are associated with differences in serum 25-hydroxyvitamin D (25(OH)D). The objective of the present study was to determine whether racial/ethnic differences in dietary vitamin D intake exist and whether they explain differences in 25(OH)D. Design Vitamin D intakes (Block Kids 2004 FFQ) and 25(OH)D were measured. Race/ethnicity was parent-reported (white (37·9%), Hispanic (32·4%), black (8·3%), Asian (10·3%), multi-racial/other (11·0%)). Multivariable analyses were conducted to examine the associations among dietary vitamin D and race/ethnicity, as well as 25(OH)D, independent of BMI Z-score and other covariates. Setting Elementary/middle schools in Somerville, MA, USA, during January–April 2010. Subjects Schoolchildren (n 145) in 4th–8th grade. Results Only 2·1% met the 2011 RDA (15 µg/d (600 IU/d)). Average dietary intake was 3.5 (sd 2.2) µg/d (140 (sd 89·0) IU/d). No racial/ethnic differences in intake were evident. Most (83·4%) were 25(OH)D deficient (<20 ng/ml; 16·0 (sd 6·5) ng/ml). In ANOVA post hoc analyses, 25(OH)D levels were lower in Hispanics than whites (14·6 (sd 6·1) ng/ml v. 17·9 (sd 4·6) ng/ml; P< 0·01). Dietary vitamin D was associated with 25(OH)D overall (P< 0·05), but did not explain the racial/ethnic differences in 25(OH)D. Conclusions Most children in this north-east US sample did not meet dietary recommendations for vitamin D and were vitamin D deficient. Dietary vitamin D did not explain the difference in 25(OH)D between Hispanic and white children. Further research is needed to determine if changes in dietary vitamin D by race/ethnicity can impact 25(OH)D levels. PMID:22857261

Racial Differences in Home Dialysis Utilization and Outcomes in Canada.

PubMed

Trinh, Emilie; Na, Yingbo; Sood, Manish M; Chan, Christopher T; Perl, Jeffrey

2017-11-07

Data on racial disparities in home dialysis utilization and outcomes are lacking in Canada, where health care is universally available. We studied patients starting maintenance dialysis between 1996 and 2012 in the Canadian Organ Replacement Register, stratified by race: white, Asian, black, Aboriginal, Indian subcontinent, and other. The association between race and treatment with home dialysis was examined using generalized linear models. Secondary outcomes assessed racial differences in all-cause mortality and technique failure using a Fine and Gray competing risk model. 66,600 patients initiated chronic dialysis between 1996 and 2012. Compared with whites ( n =46,092), treatment with home dialysis was lower among Aboriginals ( n =3866; adjusted relative risk, RR, 0.71; 95% confidence interval, CI, 0.66 to 0.76) and higher in Asians ( n =4157; adjusted RR, 1.28; 95% CI, 1.22 to 1.35) and others ( n =2170; adjusted RR, 1.12; 95% CI, 1.04 to 1.20) but similar in blacks ( n =2143) and subcontinent Indians ( n =2809). Black (adjusted hazard ratio, HR, 1.31; 95% CI, 1.16 to 1.48) and Aboriginal (adjusted HR, 1.19; 95% CI, 1.06 to 1.33) patients treated with peritoneal dialysis had a significantly higher adjusted risk of technique failure compared with whites, whereas Asians had a lower risk (adjusted HR, 0.89; 95% CI, 0.82 to 0.99). In patients on peritoneal dialysis, the risk of death was significantly lower in Asians (adjusted HR, 0.83; 95% CI, 0.75 to 0.92), blacks (adjusted HR, 0.71; 95% CI, 0.59 to 0.85), and others (adjusted HR, 0.79; 95% CI, 0.68 to 0.92) but higher in Aboriginals (adjusted HR, 1.16; 95% CI, 1.02 to 1.32) compared with whites. Among patients on home hemodialysis, no significant racial differences in patient and technique survival were observed, which may be limited by the low number of events among each subgroups. With the exception of Aboriginals, all racial minority groups in Canada were as likely to be treated with home dialysis compared with whites. However, significant racial differences exist in outcomes. Copyright © 2017 by the American Society of Nephrology.

Sexual Networks of Racially Diverse Young MSM Differ in Racial Homophily But Not Concurrency.

PubMed

Janulis, Patrick; Phillips, Gregory; Birkett, Michelle; Mustanski, Brian

2018-04-15

Substantial racial disparities exist in HIV infection among young men who have sex with men (YMSM). However, evidence suggests black YMSM do not engage in greater levels of risk behavior. Sexual networks may help explain this paradox. This study used egocentric exponential random graph models to examine variation in concurrency (ie, 2 or more simultaneous partners) and homophily (ie, same race/ethnicity partners) across race/ethnicity groups in a diverse sample of YMSM. Data for this study come from a longitudinal cohort study of YMSM. Participants (n = 1012) provided data regarding their sexual contacts during the 6 months before their first study visit. A series of egocentric exponential random graph models examined how providing separate estimates for homophily and concurrency parameters across race/ethnicity improved the fit of these models. Networks were simulated using these parameters to examine how local network characteristics impact risk at the whole network level. Results indicated that homophily, but not concurrency, varied across race/ethnicity. Black participants witnessed significantly higher race/ethnicity homophily compared with white and Latino peers. Extrapolating from these models, black individuals were more likely to be in a connected component with an HIV-positive individual and closer to HIV-positive individuals. However, white individuals were more likely to be in large connected components. These findings suggest that high racial homophily combined with existing disparities in HIV help perpetuate the spread of HIV among black YMSM. Nonetheless, additional work is required to understand these disparities given that homophily alone cannot sustain them indefinitely.

MEASURING EVERYDAY RACIAL/ETHNIC DISCRIMINATION IN HEALTH SURVEYS: How Best to Ask the Questions, in One or Two Stages, Across Multiple Racial/Ethnic Groups?

PubMed

Shariff-Marco, Salma; Breen, Nancy; Landrine, Hope; Reeve, Bryce B; Krieger, Nancy; Gee, Gilbert C; Williams, David R; Mays, Vickie M; Ponce, Ninez A; Alegría, Margarita; Liu, Benmei; Willis, Gordon; Johnson, Timothy P

2011-01-01

While it is clear that self-reported racial/ethnic discrimination is related to illness, there are challenges in measuring self-reported discrimination or unfair treatment. In the present study, we evaluate the psychometric properties of a self-reported instrument across racial/ ethnic groups in a population-based sample, and we test and interpret findings from applying two different widely-used approaches to asking about discrimination and unfair treatment. Even though we found that the subset of items we tested tap into a single underlying concept, we also found that different groups are more likely to report on different aspects of discrimination. Whether race is mentioned in the survey question affects both frequency and mean scores of reports of racial/ethnic discrimination. Our findings suggest caution to researchers when comparing studies that have used different approaches to measure racial/ethnic discrimination and allow us to suggest practical empirical guidelines for measuring and analyzing racial/ethnic discrimination. No less important, we have developed a self-reported measure of recent racial/ethnic discrimination that functions well in a range of different racial/ethnic groups and makes it possible to compare how racial/ethnic discrimination is associated with health disparities among multiple racial/ethnic groups.

Race and beliefs about mental health treatment among anxious primary care patients.

PubMed

Hunt, Justin; Sullivan, Greer; Chavira, Denise A; Stein, Murray B; Craske, Michelle G; Golinelli, Daniela; Roy-Byrne, Peter P; Sherbourne, Cathy D

2013-03-01

Large racial disparities in the use of mental health care persist. Differences in treatment preferences could partially explain the differences in care between minority and nonminority populations. We compared beliefs about mental illness and treatment preferences between adult African-Americans, Hispanics, Asian Americans, Native Americans, and White Americans with diagnosed anxiety disorders. Measures of beliefs about mental illness and treatment were drawn from the National Comorbidity Survey Replication and from our previous work. There were no significant differences in beliefs between the African-Americans and the White Americans. The beliefs of the Hispanics and the Native Americans were most distinctive, but the differences were small in magnitude. Across race/ethnicity, the associations between beliefs and service use were generally weak and statistically insignificant. The differences in illness beliefs and treatment preferences do not fully explain the large, persistent racial disparities in mental health care. Other crucial barriers to quality care exist in our health care system and our society as a whole.

Racial disparities in age at time of cardiovascular events and cardiovascular-related death in patients with systemic lupus erythematosus.

PubMed

Scalzi, Lisabeth V; Hollenbeak, Christopher S; Wang, Li

2010-09-01

To determine whether racial disparities exist with regard to the age at which patients with systemic lupus erythematosus (SLE) experience cardiovascular disease (CVD) and CVD-associated death. Using the 2003-2006 Nationwide Inpatient Sample, we calculated the age difference between patients with SLE and their race- and sex-matched controls at the time of hospitalization for a cardiovascular event and for CVD-associated death. In addition, we calculated the age difference between white patients with SLE and sex-matched controls for each minority group for the same outcomes. The mean age difference between women with and those without SLE at the time of admission for a CVD event was 10.5 years. All age differences between women with SLE (n = 3,627) and women without SLE admitted for CVD were significant (P < 0.0001). Among different racial groups with SLE, black women were the youngest to be admitted with CVD (53.9 years) and to have a CVD-associated in-hospital death (52.8 years; n = 218). Black women with SLE were 19.8 years younger than race- and sex-matched controls at the time of CVD-associated death. Admission trends for CVD were reversed for black women, such that the highest proportions of these patients were admitted before age 55 years, and then the proportions steadily decreased across age categories. Among the 805 men with SLE who were admitted with a CVD event, those who were black or Hispanic were youngest. There are significant racial disparities with regard to age at the time of hospital admission for CVD events and CVD-related hospitalization resulting in death in patients with SLE.

Association between perceived racial discrimination and hypertension: findings from the ELSA-Brasil study.

PubMed

Mendes, Patrícia Miranda; Nobre, Aline Araújo; Griep, Rosane Härter; Guimarães, Joanna Miguez Nery; Juvanhol, Leidjaira Lopes; Barreto, Sandhi Maria; Pereira, Alexandre; Chor, Dóra

2018-03-01

"Pardos" and blacks in Brazil and blacks in the USA are at greater risk of developing arterial hypertension than whites, and the causes of this inequality are still little understood. Psychosocial and contextual factors, including racial discrimination, are indicated as conditions associated with this inequality. The aim of this study was to identify the association between perceived racial discrimination and hypertension. The study evaluated 14,012 workers from the ELSA-Brazil baseline population. Perceived discrimination was measured by the Lifetime Major Events Scale, adapted to Portuguese. Classification by race/color followed the categories proposed by Brazilian Institute of Geography and Statistics (IBGE). Hypertension was defined by standard criteria. The association between the compound variable - race/racial discrimination - and hypertension was estimated by Poisson regression with robust variance and stratified by the categories of body mass index (BMI) and sex. Choosing white women as the reference group, in the BMI < 25kg/m2 stratum, "pardo" women showed adjusted OR for arterial hypertension of 1.98 (95%CI: 1.17-3.36) and 1.3 (95%CI: 1.13-1.65), respectively, whether or not they experienced racial discrimination. For black women, ORs were 1.9 (95%CI: 1.42-2.62) and 1.72 (95%CI: 1.36-2.18), respectively, for the same categories. Among women with BMI > 25kg/m2 and men in any BMI category, no effect of racial discrimination was identified. Despite the differences in point estimates of prevalence of hypertension between "pardo" women who reported and those who did not report discrimination, our results are insufficient to assert that an association exists between racial discrimination and hypertension.

The effect of patient and contextual characteristics on racial/ethnic disparity in breast cancer mortality

PubMed Central

Sposto, Richard; Keegan, Theresa H. M.; Vigen, Cheryl; Kwan, Marilyn L.; Bernstein, Leslie; John, Esther M.; Cheng, Iona; Yang, Juan; Koo, Jocelyn; Kurian, Allison W.; Caan, Bette J.; Lu, Yani; Monroe, Kristine R.; Shariff-Marco, Salma; Gomez, Scarlett Lin; Wu, Anna H.

2016-01-01

Background Racial/ethnic disparity in breast cancer-specific mortality in the U.S. is well documented. We examined whether accounting for racial/ethnic differences in the prevalence of clinical, patient, and lifestyle and contextual factors that are associated with breast cancer-specific mortality can explain this disparity. Methods The California Breast Cancer Survivorship Consortium combined interview data from six California-based breast cancer studies with cancer registry data to create a large racially diverse cohort of women with primary invasive breast cancer. We examined the contribution of variables in a previously reported Cox regression baseline model plus additional contextual, physical activity, body size, and comorbidity variables to the racial/ethnic disparity in breast cancer-specific mortality. Results The cohort comprised 12,098 women. Fifty-four percent were non-Latina Whites, 17% African Americans, 17% Latinas, and 12% Asian Americans. In a model adjusting only for age and study, breast cancer-specific hazard ratios relative to Whites were 1.69 (95% CI 1.46 -1.96), 1.00 (0.84 - 1.19), and 0.52 (0.33 - 0.85) for African Americans, Latinas, and Asian Americans respectively. Adjusting for baseline-model variables decreased disparity primarily by reducing the hazard ratio for African Americans to 1.13 (0.96 - 1.33). The most influential variables were related to disease characteristics, neighborhood socioeconomic status, and smoking status at diagnosis. Other variables had negligible impact on disparity. Conclusions While contextual, physical activity, body size, and comorbidity variables may influence breast cancer-specific mortality, they do not explain racial/ethnic mortality disparity. Impact Other factors besides those investigated here may explain the existing racial/ethnic disparity in mortality. PMID:27197297

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/Ethnic Differences in Cardiovascular Symptoms in Four Major Racial/Ethnic Groups of Midlife Women: A Secondary Analysis

PubMed Central

Im, Eun-Ok; Ham, Ok Kyung; Chee, Eunice; Chee, Wonshik

2015-01-01

Ethnic minority midlife women frequently do not recognize cardiovascular symptoms that they experience during the menopausal transition. Racial/ethnic differences in cardiovascular symptoms are postulated as a plausible reason for their lack of knowledge and recognition of the symptoms. The purpose of this study was to explore racial/ethnic differences in midlife women’s cardiovascular symptoms and to determine the factors related to these symptoms in each racial/ethnic group. This was a secondary analysis of the data from a larger study among 466 participants, collected from 2006 to 2011. The instruments included questions on background characteristics, health and menopausal status and the Cardiovascular Symptom Index for Midlife Women. The data were analyzed using inferential statistics, including Poisson regression and logistic regression analyses. Significant racial/ethnic differences were observed in the total numbers and total severity scores of cardiovascular symptoms (p<0.01). Non-Hispanic Asians had significantly lower total numbers and total severity scores compared to other racial/ethnic groups (p<0.05). The demographic and health factors associated with cardiovascular symptoms were somewhat different in each racial/ethnic group. Further studies are needed about possible reasons for the racial/ethnic differences and the factors associated with cardiovascular symptoms in each racial/ethnic group. PMID:25826460

Effect of Medicaid Managed Care on racial disparities in health care access.

PubMed

Cook, Benjamin Lê

2007-02-01

To evaluate the impact of Medicaid Managed Care (MMC) on racial disparities in access to care consistent with the Institute of Medicine (IOM) definition of racial disparity, which excludes differences stemming from health status but includes socioeconomic status (SES)-mediated differences. Secondary data from the Adult Samples of the 1997-2001 National Health Interview Survey, metropolitan statistical area (MSA)-level Medicaid Health Maintenance Organization (MHMO) market share from the 1997 to 2001 InterStudy MSA Trend Dataset, and MSA characteristics from the 1997 to 2001 Area Resource File. I estimate multivariate regression models to compare racial disparities in doctor visits, emergency room (ER) use, and having a usual source of care between enrollees in MMC and Medicaid Fee-for-Service (FFS) plans. To contend with potential selection bias, I use a difference-in-difference analytical strategy and assess the impact of greater MHMO market share at the MSA level on Medicaid enrollees' access measures. To implement the IOM definition of racial disparity, I adjust for health status but not SES factors using a novel method to transform the distribution of health status for minority populations to approximate the white health status distribution. MMC enrollment is associated with lowered disparities in having any doctor visit in the last year for blacks, and in having any usual source of care for both blacks and Hispanics. Increasing Medicaid HMO market share lowered disparities in having any doctor visits in the last year for both blacks and Hispanics. Although disparities in most other measures were not much affected, black-white ER use disparities exist among MMC enrollees and in areas of high MHMO market share. MMC programs' reduction of some disparities suggests that recent shifts in Medicaid policy toward managed care plans have benefited minority enrollees. Future research should investigate whether black-white disparities in ER use within MMC groups represent the flexibility of MMC plans to locate primary care in ERs or an inefficient delivery of care.

Disparities in breast cancer treatment and outcomes: biological, social, and health system determinants and opportunities for research.

PubMed

Wheeler, Stephanie B; Reeder-Hayes, Katherine E; Carey, Lisa A

2013-01-01

Racial disparities in breast cancer mortality have been widely documented for several decades and persist despite advances in receipt of mammography across racial groups. This persistence leads to questions about the roles of biological, social, and health system determinants of poor outcomes. Cancer outcomes are a function not only of innate biological factors but also of modifiable characteristics of individual behavior and decision making as well as characteristics of patient-health system interaction and the health system itself. Attempts to explain persistent racial disparities have mostly been limited to discussion of differences in insurance coverage, socioeconomic status, tumor stage at diagnosis, comorbidity, and molecular subtype of the tumor. This article summarizes existing literature exploring reasons for racial disparities in breast cancer mortality, with an emphasis on treatment disparities and opportunities for future research. Because breast cancer care requires a high degree of multidisciplinary team collaboration, ensuring that guideline recommended treatment (such as endocrine therapy for hormone receptor positive patients) is received by all racial/ethnic groups is critical and requires coordination across multiple providers and health care settings. Recognition that variation in cancer care quality may be correlated with race (and socioeconomic and health system factors) may assist policy makers in identifying strategies to more equally distribute clinical expertise and health infrastructure across multiple user populations.

Stimulant Use and Sexual Risk Behaviors for HIV in Rural North Carolina

ERIC Educational Resources Information Center

Zule, William A.; Costenbader, Elizabeth; Coomes, Curtis M.; Meyer, William J., Jr.; Riehman, Kara; Poehlman, Jon; Wechsberg, Wendee M.

2007-01-01

Context: While literature exists on sexual risks for HIV among rural populations, the specific role of stimulants in increasing these risks has primarily been studied in the context of a single drug and/or racial group. Purpose: This study explores the use of multiple stimulants and sexual risk behaviors among individuals of different races and…

Social, Spatial, and Skill Mismatch among Immigrants and Native-Born Workers in Los Angeles. Working Paper.

ERIC Educational Resources Information Center

Pastor, Manuel, Jr.; Marcelli, Enrico A.

Racially different economic outcomes stem from multiple causes, including various "mismatches" between minority employees and available jobs. A skill mismatch occurs when individuals' education and job skills do not qualify them for existing jobs. A spatial mismatch means that people live far from the work for which they qualify. A…

Patterns of racial and educational assortative mating in Brazil.

PubMed

Gullickson, Aaron; Torche, Florencia

2014-06-01

Exchange of racial for educational status has been documented for black/white marriages in the United States. Exchange may be an idiosyncratic feature of U.S. society, resulting from unusually strong racial boundaries historically developed there. We examine status exchange across racial lines in Brazil. In contrast to the United States, Brazil features greater fluidity of racial boundaries and a middle tier of "brown" individuals. If exchange is contingent on strong racial boundaries, it should be weak or non-existent in Brazilian society. Contrary to this expectation, we find strong evidence of status exchange. However, this pattern results from a generalized penalty for darkness, which induces a negative association between higher education and marrying darker spouses ("market exchange") rather than from a direct trading of resources by partners ("dyadic exchange"). The substantive and methodological distinction between market and dyadic exchange helps clarify and integrate prior findings in the status exchange literature.

An Experimental Study of Implicit Racial Bias in Recognition of Child Abuse.

PubMed

Rojas, Mary; Walker-Descartes, Ingrid; Laraque-Arena, Danielle

2017-05-01

We evaluated whether implicit racial bias influences pediatricians' suspicion of child abuse. Child abuse experts developed 9 injury vignettes. Pediatricians (N = 342) were randomly assigned one of 2 versions to rate for suspicion of abuse, with the child's race in each vignette varying between white and black. Data were collected online and anonymously. There were no statistically significant differences in suspicion for an abuse-related injury based on the race of the child. We adjusted for pediatrician race/ethnicity, years since graduation, location, and gender and did not find race effects. We demonstrated an experimental approach to study the influence of implicit racial bias on recognition of child abuse. Though we failed to find an effect, it is too early to conclude that none exists. The relationship among human cognition, behavior, and healthcare disparities is complex. Studies are needed that incorporate diverse approaches, clinical contexts and scenarios, patient and physician characteristics, and validated measures if we are to understand how it might be used to reduce healthcare disparities.

Miles to go before we sleep: racial inequities in health.

PubMed

Williams, David R

2012-09-01

Large, pervasive, and persistent racial inequalities exist in the onset, courses, and outcomes of illness. A comprehensive understanding of the patterning of racial disparities indicates that racism in both its institutional and individual forms remains an important determinant. There is an urgent need to build the science base that would identify how to trigger the conditions that would facilitate needed societal change and to identify the optimal interventions that would confront and dismantle the societal conditions that create and sustain health inequalities.

White fear, dehumanization, and low empathy: Lethal combinations for shooting biases.

PubMed

Mekawi, Yara; Bresin, Konrad; Hunter, Carla D

2016-07-01

A growing number of studies have documented the existence racial shooting biases against Black versus White targets (Correll et al., 2002). Little is known about individual differences that may moderate these biases. The goals of this study were to examine (a) whether White participants' fear of racial/ethnic minorities is associated with racial shooting biases, and (b) whether dehumanization and empathy moderate this effect. Participants (N = 290) completed a dehumanization implicit association test and simulated shooting task, then reported their fear of racial minorities (i.e., White fear) and empathic ability. We found that (a) individuals high in White fear showed a shooting bias, such that they had a lower threshold for shooting Black relative to White and East Asian targets, (b) Dehumanization moderated the White fear and shooting bias relation, such that individuals high in White fear and high in dehumanization had a significantly more liberal shooting threshold for Black versus White targets, and (c) Empathy moderated the White fear and shooting bias relation, such that people who were high in White fear and low in empathic ability had a more liberal shooting threshold for Black versus White targets. In sum, fearing racial/ethnic minorities can have devastating shooting bias outcomes for Black individuals, but this effect is stronger when people also dehumanize Black individuals, and weaker when people have high empathy. These findings contribute to the literature by identifying theory driven moderators that identify both risk and protective factors in predicting racial shooting biases. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Racial Differences in Treatment Effect among Men in a Substance Abuse and Domestic Violence Program

PubMed Central

Scott, Melanie C.; Easton, Caroline J.

2013-01-01

Background It isunclear whether racial differences in treatment effect exist for individuals in substance abuse and domestic violence programs. Objectives This study examined racial differences in treatment effect among substance dependent Caucasian and African-American male intimate partner violence (IPV) offenders court mandated to an integrated substance abuse and domestic violence treatment. Methods From baseline to completion of treatment (week 12), 75 participants (39 Caucasian; 36 African-American) were assessed on demographics, substance use, legal characteristics, and use of violence (physical, verbal, and psychological). Results African-American men served more months incarcerated in their life than Caucasian men. Both groups showed decreases in their use of physical violence and alcohol abuse over treatment. Caucasian men also showed a decrease in their use of verbal abuse. Conclusions and Scientific Significance At treatment completion, both groups showed a reduction in physical abuse and alcohol abuse. Caucasian men showed a reduction in their use of verbal abuse, but African-American men did not. Substance dependent African-American male IPV offenders may benefit from interventions that thoroughly target communication skills in addition to issues of substance abuse and IPV to reduce use of verbal abuse and improve treatment outcomes among African American men. PMID:20936990

Conditional Risk for PTSD among Latinos: A Systematic Review of Racial/Ethnic Differences and Sociocultural Explanations

PubMed Central

Alcántara, Carmela; Casement, Melynda D.; Lewis-Fernández, Roberto

2012-01-01

Conditional risk for Posttraumatic Stress Disorder (PTSD)—defined as prevalence, onset, persistence, or severity of PTSD after traumatic exposure—appears to be higher among Latinos relative to non-Latinos after accounting for sociodemographic factors. This systematic review focuses on differences in conditional risk for PTSD between Latinos and non-Latinos (White, Black, or combined) and across Latino subgroups in studies that adjust for trauma exposure. We discuss methodological characteristics of existing articles and sociocultural explanatory factors. Electronic bibliographic searches were conducted for English-language articles published in peer-reviewed journals between 1991 and 2012. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Twenty-eight articles met inclusion criteria. Consistent support was found for elevated rates of PTSD onset and PTSD severity among Latinos relative to non-Latino Whites. The evidence on racial/ethnic differences in conditional risk for PTSD prevalence and PTSD persistence is mixed. Twenty-four articles evaluated sociocultural explanations, with the strongest support found for racial/ethnic variation in peritraumatic responses and structure of PTSD. There were also consistent main effects for social disadvantage in studies that simultaneously adjusted for effects of race/ethnicity. Future research should use theoretically-driven models to formally test for interactions between sociocultural factors, race/ethnicity, and PTSD probability. PMID:23159328

See no evil: color blindness and perceptions of subtle racial discrimination in the workplace.

PubMed

Offermann, Lynn R; Basford, Tessa E; Graebner, Raluca; Jaffer, Salman; De Graaf, Sumona Basu; Kaminsky, Samuel E

2014-10-01

Workplace discrimination has grown more ambiguous, with interracial interactions often perceived differently by different people. The present study adds to the literature by examining a key individual difference variable in the perception of discrimination at work, namely individual color-blind attitudes. We examined relationships between 3 dimensions of color-blind attitudes (Racial Privilege, Institutional Discrimination, and Blatant Racial Issues) and perceptions of racial microaggressions in the workplace as enacted by a White supervisor toward a Black employee (i.e., discriminatory actions ranging from subtle to overt). Findings showed that observer views on institutional discrimination fully mediated, and blatant racial issues partially mediated, the relationships between racial group membership and the perception of workplace microaggressions. Non-Hispanic Whites endorsed color blindness as institutional discrimination and blatant racial issues significantly more than members of racioethnic minority groups, and higher levels of color-blind worldviews were associated with lower likelihoods of perceiving microaggressions. Views on racial privilege did not differ significantly between members of different racial groups or affect microaggression perceptions. Implications for organizations concerned about promoting more inclusive workplaces are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

The Cumulative Probability of Arrest by Age 28 Years in the United States by Disability Status, Race/Ethnicity, and Gender.

PubMed

McCauley, Erin J

2017-12-01

To estimate the cumulative probability (c) of arrest by age 28 years in the United States by disability status, race/ethnicity, and gender. I estimated cumulative probabilities through birth cohort life tables with data from the National Longitudinal Survey of Youth, 1997. Estimates demonstrated that those with disabilities have a higher cumulative probability of arrest (c = 42.65) than those without (c = 29.68). The risk was disproportionately spread across races/ethnicities, with Blacks with disabilities experiencing the highest cumulative probability of arrest (c = 55.17) and Whites without disabilities experiencing the lowest (c = 27.55). Racial/ethnic differences existed by gender as well. There was a similar distribution of disability types across race/ethnicity, suggesting that the racial/ethnic differences in arrest may stem from racial/ethnic inequalities as opposed to differential distribution of disability types. The experience of arrest for those with disabilities was higher than expected. Police officers should understand how disabilities may affect compliance and other behaviors, and likewise how implicit bias and structural racism may affect reactions and actions of officers and the systems they work within in ways that create inequities.

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.

The weight of racism: Vigilance and racial inequalities in weight-related measures.

PubMed

Hicken, Margaret T; Lee, Hedwig; Hing, Anna K

2018-02-01

In the United States, racial/ethnic inequalities in obesity are well-documented, particularly among women. Using the Chicago Community Adult Health Study, a probability-based sample in 2001-2003 (N = 3105), we examined the roles of discrimination and vigilance in racial inequalities in two weight-related measures, body mass index (BMI) and waist circumference (WC), viewed through a cultural racism lens. Cultural racism creates a social environment in which Black Americans bear the stigma burden of their racial group while White Americans are allowed to view themselves as individuals. We propose that in this context, interpersonal discrimination holds a different meaning for Blacks and Whites, while vigilance captures the coping style for Blacks who carry the stigma burden of the racial group. By placing discrimination and vigilance within the context of cultural racism, we operationalize existing survey measures and utilize statistical models to clarify the ambiguous associations between discrimination and weight-related inequalities in the extant literature. Multivariate models were estimated for BMI and WC separately and were stratified by gender. Black women had higher mean BMI and WC than any other group, as well as highest levels of vigilance. White women did not show an association between vigilance and WC but did show a strong positive association between discrimination and WC. Conversely, Black women displayed an association between vigilance and WC, but not between discrimination and WC. These results demonstrate that vigilance and discrimination may hold different meanings for obesity by ethnoracial group that are concealed when all women are examined together and viewed without considering a cultural racism lens. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sex and race differences in young people's responsiveness to price and tobacco control policies

PubMed Central

Chaloupka, F.; Pacula, R. L.

1999-01-01

OBJECTIVE—To determine if there are differences in young people's responsiveness to price and tobacco control policies for population subgroups and to examine whether or not these differences, if they exist, can explain sex and racial differences in trends in the prevalence of smoking in young people in the United States.
DESIGN—Use cross-sectional and intertemporal variation in local and state tobacco control policies and prices to calculate demand responses to these policies using regression analysis techniques.
SUBJECTS—A nationally representative sample of American eighth grade (ages 13-14 years), 10th grade (15-16 years) and 12th grade (17-18 years) students obtained from the 1992-1994 Monitoring the Future surveys.
MAIN OUTCOME MEASURE—Thirty-day smoking prevalence.
RESULTS—Young men are much more responsive to changes in the price of cigarettes than young women. The prevalence elasticity for young men is almost twice as large as that for young women. Smoking rates of young black men are significantly more responsive to changes in price than young white men. Significant differences in responsiveness to particular tobacco control policies also exist. These differences, however, explain relatively little of the differences in smoking prevalence among young population subgroups.
CONCLUSIONS—Policymakers need to keep in mind that there is not a "one-size fits all" strategy for discouraging smoking among young people.


Keywords: adolescents; tobacco control policies; price; sex differences; racial differences PMID:10629242

Racial/Ethnic Differences in Sleep Disorders and Reporting of Trouble Sleeping Among Women of Childbearing Age in the United States.

PubMed

Amyx, Melissa; Xiong, Xu; Xie, Yiqiong; Buekens, Pierre

2017-02-01

Objectives Whether racial/ethnic differences in prevalence/reporting of sleep disorders exist in pregnant women/women of child-bearing age is unknown. Study objectives were to estimate prevalence of sleep disorders and to examine racial/ethnic differences in sleep disorders, reporting of sleep issues, and amount of sleep among women of child-bearing age (15-44 years) in the US. Methods Through a secondary analysis of the National Health and Nutrition Examination Survey 2005-2010 (3175 non-pregnant, 432 pregnant women in main analysis), prevalence of sleep disorders, reporting of sleep disorders to a physician/health professional, and amount of sleep were estimated overall, by pregnancy status, and by race/ethnicity stratified by pregnancy status. Racial/ethnic differences in reporting of trouble sleeping by pregnancy status were examined using univariate and multivariate logistic regression. Results Prevalence of diagnosed sleep disorders among women of childbearing age was 4.9 % [3.9 % pregnant; 5.1 % non-pregnant (p < 0.01)]. Significantly fewer pregnant and non-pregnant minority women reported adequate sleep (7-8 h) than non-Hispanic white (white) women (p < 0.05). Among non-pregnant women, odds of report of trouble sleeping were significantly higher for white compared to black (aOR 0.47 [95 % CI 0.36, 0.61]) or Mexican-American women (aOR 0.29 [95 % CI 0.21, 0.41]); non-pregnant minority women were also significantly less likely to report trouble sleeping than white women when controlling for amount of sleep. Among pregnant women, these same trends were found. Discussion Compared to white women, minority women, despite reporting less adequate sleep, are less likely to report trouble sleeping, providing evidence of an important health disparity.

Racial/ethnic differences in report of drug testing practices at the workplace level in the U.S.

PubMed

Becker, William C; Meghani, Salimah; Tetrault, Jeanette M; Fiellin, David A

2014-01-01

It is unknown whether racial/ethnic differences in report of workplace drug testing persist when analyzed within and across various occupations. We sought to examine the association between worker demographics, workplace characteristics, and report of employment in a workplace that performs drug testing. We performed a cross-sectional study of the 2008-2010 National Survey on Drug Use and Health examining the relationship between race/ethnicity and report of workplace drug testing among employed, white, black, or Hispanic respondents ≥18 years old. In logistic regression analysis, we adjusted for demographic, occupational, and other relevant variables and performed stratified analyses among three specific occupations. Among 69,163 respondents, 48.2% reported employment in a workplace that performs drug testing. On multivariable analysis, younger age, male sex, black race, income greater than $20,000, completion of high school and non-urban residence were associated with report of drug testing at one's workplace among the full sample as were non-white collar occupation, work in medium or large workplace, and absence of other substance abuse/dependence. In stratified analyses, black race was associated with report of workplace level drug testing among executive/administrative/managerial/financial workers and technicians/related support occupations; Hispanic ethnicity was associated with the outcome among technicians/related support occupations. Racial/ethnic differences in report of workplace drug testing exist within and across various occupations. These differences have important public health implications deserving further study. Increased report of drug testing where racial/ethnic minorities work highlights the potential bias that can be introduced when drug testing policies are not implemented in a universal fashion. © American Academy of Addiction Psychiatry.

Racial/Ethnic Differences in Sleep Disorders and Reporting of Trouble Sleeping among Women of Childbearing Age in the United States

PubMed Central

Amyx, Melissa; Xiong, Xu; Xie, Yiqiong; Buekens, Pierre

2016-01-01

Objectives Whether racial/ethnic differences in prevalence/reporting of sleep disorders exist in pregnant women/women of child-bearing age is unknown. Study objectives were to estimate prevalence of sleep disorders and to examine racial/ethnic differences in sleep disorders, reporting of sleep issues, and amount of sleep among women of child-bearing age (15–44 years) in the US. Methods Through a secondary analysis of the National Health and Nutrition Examination Survey 2005–2010 (3175 non-pregnant, 432 pregnant women in main analysis), prevalence of sleep disorders, reporting of sleep disorders to a physician/health professional, and amount of sleep were estimated overall, by pregnancy status, and by race/ethnicity stratified by pregnancy status. Racial/ethnic differences in reporting of trouble sleeping by pregnancy status were examined using univariate and multivariate logistic regression. Results Prevalence of diagnosed sleep disorders among women of childbearing age was 4.9% (3.9% pregnant; 5.1% non-pregnant [p<0.01]). Significantly fewer pregnant and non-pregnant minority women reported adequate sleep (7–8 hours) than non-Hispanic white (white) women (p<0.05). Among non-pregnant women, odds of report of trouble sleeping were significantly higher for white compared to black (aOR 0.47 [95% CI 0.36, 0.61]) or Mexican-American women (aOR 0.29 [95% CI 0.21, 0.41]); non-pregnant minority women were also significantly less likely to report trouble sleeping than white women when controlling for amount of sleep. Among pregnant women, these same trends were found. Discussion Compared to white women, minority women, despite reporting less adequate sleep, are less likely to report trouble sleeping, providing evidence of an important health disparity. PMID:27439422

Ethnic or racial differences revisited: impact of dosage regimen and dosage form on pharmacokinetics and pharmacodynamics.

PubMed

Chen, Mei-Ling

2006-01-01

Ethnic or racial differences in pharmacokinetics and pharmacodynamics have been attributed to the distinctions in the genetic, physiological and pathological factors between ethnic/racial groups. These pharmacokinetic/pharmacodynamic differences are also known to be influenced by several extrinsic factors such as socioeconomic background, culture, diet and environment. However, it is noted that other factors related to dosage regimen and dosage form have largely been ignored or overlooked when conducting or analysing pharmacokinetic/pharmacodynamic studies in relation to ethnicity/race. Potential interactions can arise between the characteristics of ethnicity/race and a unique feature of dosage regimen or dosage form used in the study, which may partly account for the observed pharmacokinetic/pharmacodynamic differences between ethnic/racial groups. Ethnic/racial differences in pharmacokinetics/pharmacodynamics can occur from drug administration through a specific route that imparts distinct pattern of absorption, distribution, transport, metabolism or excretion. For example, racial differences in the first-pass metabolism of a drug following oral administration may not be relevant when the drug is applied to the skin. On the other hand, ethnic/racial difference in pharmacokinetics/pharmacodynamics can also happen via two different routes of drug delivery, with varying levels of dissimilarity between routes. For example, greater ethnic/racial differences were observed in oral clearance than in systemic clearance of some drugs, which might be explained by the pre-systemic factors involved in the oral administration as opposed to the intravenous administration. Similarly, changes in the dose frequency and/or duration may have profound impact on the ethnic/racial differences in pharmacokinetic/pharmacodynamic outcome. Saturation of enzymes, transporters or receptors at high drug concentrations is a possible reason for many observed ethnic/racial discrepancies between single- and multiple-dose regimens, or between low- and high-dose administrations. The presence of genetic polymorphism of enzymes and/or transporters can further complicate the analysis of pharmacokinetic/pharmacodynamic data in ethnic/racial populations. Even within the same dosage regimen, the use of different dosage forms may trigger significantly different pharmacokinetic/pharmacodynamic responses in various ethnic/racial groups, given that different dosage forms may exhibit different rates of drug release, may release the drug at different sites, and/or have different retention times at specific sites of the body. It is thus cautioned that the pharmacokinetic/pharmacodynamic data obtained from different ethnic/racial groups cannot be indiscriminately compared or combined for analysis if there is a lack of homogeneity in the apparent 'extrinsic' factors, including dosage regimen and dosage form.

10 Years Later: Changes in Food Access Disparities in New Orleans since Hurricane Katrina.

PubMed

Mundorf, Adrienne R; Willits-Smith, Amelia; Rose, Donald

2015-08-01

Inadequate access to healthy food is a problem in many urban neighborhoods, particularly for racial-ethnic minorities and low-income groups who are more likely to reside in food deserts. Although substantial research throughout the country has documented the existence of these disparities, few studies have focused on how this access changes over time or is affected by environmental shocks. This study examined citywide supermarket access in New Orleans as well as racial-ethnic disparities in this access, prior to Hurricane Katrina and at three times afterwards. On-the-ground verification of supermarket locations was conducted in 2004-2005, 2007, 2009, and 2014 and was mapped with secondary demographic data. Census tracts were defined as predominantly African-American neighborhoods if 80 % or more of the population identified as such. HLM Poisson regression analyses were conducted in 2014 to identify the difference in likelihood of finding supermarkets in a neighborhood by race-ethnicity and across all years of interest. Racial-ethnic disparities existed before the storm and worsened after it (IRR = 0.35; 95 % CI = 0.21, 0.60). Improvements in disparities to pre-storm levels were not seen until 2009, 4 years after the storm. By 2014, supermarket access, on average, was not significantly different in African-American neighborhoods than in others (IRR = 0.90; 95 % CI = 0.65, 1.26). The slow recovery of New Orleans' retail food infrastructure after Hurricane Katrina highlights the need for an increased focus on long-term planning to address disparities, especially those that may be exaggerated by shocks.

The Genomic Revolution and Beliefs about Essential Racial Differences: A Backdoor to Eugenics?

PubMed Central

Phelan, Jo C.; Link, Bruce G.; Feldman, Naumi M.

2014-01-01

Could the explosion of genetic research in recent decades affect our conceptions of race? In Backdoor to Eugenics, Duster argues that reports of specific racial differences in genetic bases of disease, in part because they are presented as objective facts whose social implications are not readily apparent, may heighten public belief in more pervasive racial differences. We tested this hypothesis with a multi-method study. A content analysis showed that news articles discussing racial differences in genetic bases of disease increased significantly between 1985 and 2008 and were significantly less likely than non–health-related articles about race and genetics to discuss social implications. A survey experiment conducted with a nationally representative sample of 559 adults found that a news-story vignette reporting a specific racial difference in genetic risk for heart attacks (the Backdoor Vignette) produced significantly greater belief in essential racial differences than did a vignette portraying race as a social construction or a no-vignette condition. The Backdoor Vignette produced beliefs in essential racial differences that were virtually identical to those produced by a vignette portraying race as a genetic reality. These results suggest that an unintended consequence of the genomic revolution may be the reinvigoration of age-old beliefs in essential racial differences. PMID:24855321

Racial and Ethnic Disparities and Perceptions of Health Care: Does Health Plan Type Matter?

PubMed Central

Hunt, Kelly A; Gaba, Ayorkor; Lavizzo-Mourey, Risa

2005-01-01

Objective To examine whether racial and ethnic differences in the distribution of individuals across types of health plans explain differences in satisfaction and trust with their physicians. Data Sources Data were derived from the 1998–1999 Community Tracking Household and Followback Studies and consisted of a nationwide sample of adults (18 years and older). Data Collection The data were collected by telephone survey. Surveys were administered in English and Spanish. The response rate for the Household Survey was 63 percent, and the match rate for the Followback Survey was 59 percent. Study Design Multivariate analyses used regression methods to detect independent effects of respondent race and ethnicity on satisfaction and trust with physician, while controlling for enrollment in different types of health plans. Principal Findings Racial and ethnic minorities are more likely than whites to have lower levels of trust and satisfaction with their physician. The most prominent differences occurred within the Latino and Native American/Asian American/Pacific Islander/Other (“Other”) populations. Plan type does not mitigate the relationship between race/ethnicity and trust and satisfaction for the overall adult population. Conclusions Disparate levels of trust and satisfaction exist within ethnic and minority populations, even when controlling for the distribution of individuals across types of health plans. The results demonstrate a need to better understand the health care-related factors that drive disparate trust and satisfaction. PMID:15762907

Racial differences in the relationship between tobacco, alcohol, and the risk of head and neck cancer: pooled analysis of US studies in the INHANCE Consortium.

PubMed

Voltzke, Kristin J; Lee, Yuan-Chin Amy; Zhang, Zuo-Feng; Zevallos, Jose P; Yu, Guo-Pei; Winn, Deborah M; Vaughan, Thomas L; Sturgis, Erich M; Smith, Elaine; Schwartz, Stephen M; Schantz, Stimson; Muscat, Joshua; Morgenstern, Hal; McClean, Michael; Li, Guojun; Lazarus, Philip; Kelsey, Karl; Gillison, Maura; Chen, Chu; Boffetta, Paolo; Hashibe, Mia; Olshan, Andrew F

2018-05-14

There have been few published studies on differences between Blacks and Whites in the estimated effects of alcohol and tobacco use on the incidence of head and neck cancer (HNC) in the United States. Previous studies have been limited by small numbers of Blacks. Using pooled data from 13 US case-control studies of oral, pharyngeal, and laryngeal cancers in the International Head and Neck Cancer Epidemiology Consortium, this study comprised a large number of Black HNC cases (n = 975). Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for several tobacco and alcohol consumption characteristics. Blacks were found to have consistently stronger associations than Whites for the majority of tobacco consumption variables. For example, compared to never smokers, Blacks who smoked cigarettes for > 30 years had an OR 4.53 (95% CI 3.22-6.39), which was larger than that observed in Whites (OR 3.01, 95% CI 2.73-3.33; p interaction  < 0.0001). The ORs for alcohol use were also larger among Blacks compared to Whites. Exclusion of oropharyngeal cases attenuated the racial differences in tobacco use associations but not alcohol use associations. These findings suggest modest racial differences exist in the association of HNC risk with tobacco and alcohol consumption.

Birth Order, Educational Attainment, and Earnings: An Investigation Using the PSID

ERIC Educational Resources Information Center

Kantarevic, Jasmin; Mechoulan, Stephane

2006-01-01

We examine the implications of being early in the birth order, and whether a pattern exists within large families of falling then rising attainment with respect to birth order. Unlike other studies using U.S. data, we go beyond grade for age and look at racial differences. Drawing from OLS and fixed effects estimations, we find that being…

Collective pedagogical teacher culture, teacher-student ethno-racial mismatch, and teacher job satisfaction.

PubMed

Stearns, Elizabeth; Banerjee, Neena; Mickelson, Roslyn; Moller, Stephanie

2014-05-01

Teacher job satisfaction is critical to schools' successful functioning. Using a representative sample of kindergarten teachers from the Early Childhood Longitudinal Study, we investigate the association among professional learning community and teacher collaboration, teacher ethno-racial group, teacher-student ethno-racial mismatch, and teacher job satisfaction. We find that White teachers are significantly less satisfied than African-American and Latino teachers, especially when they teach in majority non-White classrooms. However, the existence of a professional community moderates the negative influence of teacher-student ethno-racial mismatch on White teachers' job satisfaction. In effect, strong professional communities serve as a cushion to bolster teacher job satisfaction. Copyright © 2014 Elsevier Inc. All rights reserved.

Identifying health disparities across the tobacco continuum.

PubMed

Fagan, Pebbles; Moolchan, Eric T; Lawrence, Deirdre; Fernander, Anita; Ponder, Paris K

2007-10-01

Few frameworks have addressed work-force diversity, inequities and inequalities as part of a comprehensive approach to eliminating tobacco-related health disparities. This paper summarizes the literature and describes the known disparities that exist along the tobacco disease continuum for minority racial and ethnic groups, those living in poverty, those with low education and blue-collar and service workers. The paper also discusses how work-force diversity, inequities in research practice and knowledge allocation and inequalities in access to and quality of health care are fundamental to addressing disparities in health. We examined the available scientific literature and existing public health reports to identify disparities across the tobacco disease continuum by minority racial/ethnic group, poverty status, education level and occupation. Results indicate that differences in risk indicators along the tobacco disease continuum do not explain fully tobacco-related cancer consequences among some minority racial/ethnic groups, particularly among the aggregate groups, blacks/African Americans and American Indians/Alaska Natives. The lack of within-race/ethnic group data and its interactions with socio-economic factors across the life-span contribute to the inconsistency we observe in the disease causal paradigm. More comprehensive models are needed to understand the relationships among disparities, social context, diversity, inequalities and inequities. A systematic approach will also help researchers, practitioners, advocates and policy makers determine critical points for interventions, the types of studies and programs needed and integrative approaches needed to eliminate tobacco-related disparities.

White Undergraduate Social Justice Advocates: Experiences That Influence Continued Participation in Racially and Ethnically Diverse Campus Settings

ERIC Educational Resources Information Center

Watson, Jesse S.

2013-01-01

This study explored how the experiences of four white, undergraduate, self-identified social justice advocates influenced their on campus participation in racially and ethnically diverse settings. Acknowledging the existence and persistence of white privilege, ontological expansiveness, and epistemological ignorance, the research was grounded in…

Tracing Family, Teaching Race: Critical Race Pedagogy in the Millennial Sociology Classroom

ERIC Educational Resources Information Center

Mueller, Jennifer C.

2013-01-01

The "millennial" historical moment presents fresh dilemmas for race-critical instructors. In addition to being well-versed in colorblind racial discourse, millennial students are socialized in a pop-cultural milieu that implies a more integrated, racially egalitarian world than exists in reality and includes claims that U.S. society is now…

Academic Freedom and Racial Injustice: South Africa's Former "Open Universities"

ERIC Educational Resources Information Center

Taylor, Y.; Taylor, R.

2010-01-01

The article critically re-interrogates three high profile cases of white racism at South Africa's former "open universities" to highlight the way in which existing debates around academic freedom fail to come to terms with questions of racial injustice after apartheid. The cases covered are the Makgoba affair at Wits, the Mamdani affair…

Developing Principals as Racial Equity Leaders: A Mixed Method Study

ERIC Educational Resources Information Center

Raskin, Candace F.; Krull, Melissa; Thatcher, Roberta

2015-01-01

This article will present information and research on how a college of education is intentionally developing principals to lead with confidence and racial competence. The nation's student achievement research is sobering: our current school systems widen already existing gaps between white students and students of color, (Darling-Hammond, L. 2004,…

Multiple Pathways to Whiteness: White Teachers' Unsteady Racial Identities

ERIC Educational Resources Information Center

Miller, Erin T.

2017-01-01

Teacher education programs in the US, recognizing the mismatch that exists in preschool provision between mostly white teachers and a very diverse intake of young children, have begun to explore ways of raising racial awareness among pre-service teachers, with the aim of improving non-white children's classroom experiences and outcomes. This paper…

Racial/Ethnic Disparities in Alcohol-related Problems: Differences by Gender and Level of Heavy Drinking

PubMed Central

Witbrodt, Jane; Mulia, Nina; Zemore, Sarah E.; Kerr, William C.

2014-01-01

Objective While prior studies have reported racial/ethnic disparities in alcohol-related problems at a given level of heavy drinking, particularly lower levels, it is unclear whether these occur in both genders and are an artifact of racial/ethnic differences in drink alcohol content. Such information is important to understanding disparities and developing specific, targeted interventions. This study addresses these questions and examines disparities in specific types of alcohol problems across racial-gender groups. Method Using 2005 and 2010 National Alcohol Survey data (N=7,249 current drinkers), gender-stratified regression analyses were conducted to assess black-white and Hispanic-white disparities in alcohol dependence and negative drinking consequences at equivalent levels of heavy drinking. Heavy drinking was measured using a gender-specific, composite drinking-patterns variable derived through factor analysis. Analyses were replicated using adjusted-alcohol consumption variables that account for group differences in drink alcohol content based on race/ethnicity, gender, age and alcoholic beverage. Results Compared to white men, black and Hispanic men had higher rates of injuries/accidents/health and social consequences, and marginally greater work/legal consequences (p< .10). Hispanic women had marginally higher rates of social consequences. In main effects models controlling for demographics, light drinking and heavy drinking, only black women and men had greater odds of alcohol-related problems relative to whites. Interaction models indicated that compared to whites, black women had greater odds of dependence at all levels of heavy drinking, while both black and Hispanic men had elevated risk of alcohol problems only at lower levels of heavy drinking. Drink alcohol content adjustments did not significantly alter findings for either gender. Conclusions This study highlights the gender-specific nature of racial/ethnic disparities. Interventions focused on reducing heavy drinking might not address disparities in alcohol-related problems that exist at low levels of heavy drinking. Future research should consider the potential role of environmental and genetic factors in these disparities. PMID:24730475

Americans misperceive racial economic equality

PubMed Central

Kraus, Michael W.; Rucker, Julian M.; Richeson, Jennifer A.

2017-01-01

The present research documents the widespread misperception of race-based economic equality in the United States. Across four studies (n = 1,377) sampling White and Black Americans from the top and bottom of the national income distribution, participants overestimated progress toward Black–White economic equality, largely driven by estimates of greater current equality than actually exists according to national statistics. Overestimates of current levels of racial economic equality, on average, outstripped reality by roughly 25% and were predicted by greater belief in a just world and social network racial diversity (among Black participants). Whereas high-income White respondents tended to overestimate racial economic equality in the past, Black respondents, on average, underestimated the degree of past racial economic equality. Two follow-up experiments further revealed that making societal racial discrimination salient increased the accuracy of Whites’ estimates of Black–White economic equality, whereas encouraging Whites to anchor their estimates on their own circumstances increased their tendency to overestimate current racial economic equality. Overall, these findings suggest a profound misperception of and unfounded optimism regarding societal race-based economic equality—a misperception that is likely to have any number of important policy implications. PMID:28923915

Americans misperceive racial economic equality.

PubMed

Kraus, Michael W; Rucker, Julian M; Richeson, Jennifer A

2017-09-26

The present research documents the widespread misperception of race-based economic equality in the United States. Across four studies ( n = 1,377) sampling White and Black Americans from the top and bottom of the national income distribution, participants overestimated progress toward Black-White economic equality, largely driven by estimates of greater current equality than actually exists according to national statistics. Overestimates of current levels of racial economic equality, on average, outstripped reality by roughly 25% and were predicted by greater belief in a just world and social network racial diversity (among Black participants). Whereas high-income White respondents tended to overestimate racial economic equality in the past, Black respondents, on average, underestimated the degree of past racial economic equality. Two follow-up experiments further revealed that making societal racial discrimination salient increased the accuracy of Whites' estimates of Black-White economic equality, whereas encouraging Whites to anchor their estimates on their own circumstances increased their tendency to overestimate current racial economic equality. Overall, these findings suggest a profound misperception of and unfounded optimism regarding societal race-based economic equality-a misperception that is likely to have any number of important policy implications.

The role of geographic and network factors in racial disparities in HIV among young men who have sex with men: An egocentric network study

PubMed Central

Mustanski, Brian; Birkett, Michelle; Kuhns, Lisa M.; Latkin, Carl A.; Muth, Stephen Q.

2014-01-01

The objective of this study was to characterize and compare individual and sexual network characteristics of Black, White, and Latino YMSM as potential drivers of racial disparities in HIV. Egocentric network interviews were conducted with 175 diverse YMSM who described 837 sex partners within 167 sexual-active egos. Sexual partner alter attributes were summarized by ego. Descriptives of ego demographics, sexual partner demographics, and network characteristics were calculated by race of the ego and compared. No racial differences were found in individual engagement in HIV risk behaviors or concurrent sexual partnership. Racial differences were found in partner characteristics, including female gender, non-gay sexual orientations, older age, and residence in a high HIV prevalence neighborhood. Racial differences in relationship characteristics included type of relationships (i.e., main partner) and strength of relationships. Network characteristics also showed differences, including sexual network density and assortativity by race. Most racial differences were in the direction of effects that would tend to increase HIV incidence among Black YMSM. These data suggest that racial disparities in HIV may be driven and/or maintained by a combination of racial differences in partner characteristics, assortativity by race, and increased sexual network density, rather than differences in individual’s HIV risk behaviors. PMID:25430501

Racial discrimination's influence on smoking rates among American Indian Alaska Native two-spirit individuals: does pain play a role?

PubMed

Johnson-Jennings, Michelle D; Belcourt, Annie; Town, Matthew; Walls, Melissa L; Walters, Karina L

2014-11-01

High rates of racial discrimination and non-ceremonial tobacco smoking exist among American Indian/Alaska Native (AIAN) Two-Spirit/LGBT (Lesbian, Gay, Bisexual, Transgender) populations. The authors examined whether or not pain mediates between racial discrimination and smoking among Two-Spirits. Two-Spirit adults (n=447) from seven urban U.S. locations were surveyed during the HONOR project. The Indigenist stress coping model was used as framework in which to conduct descriptive, bivariate and regression analyses. A majority of the participants reported smoking (45.2%) and pain (57%). Pain was found to mediate the association between racial discrimination and smoking. Racial discrimination appears to be a significant factor influencing tobacco smoking and health behaviors within Two-Spirit populations. Effective tobacco cessation and/or prevention planning for Two-Spirits and others who experience frequent racial discrimination, stress, and trauma should also consider the influence of pain. Pain may serve as the embodiment of discrimination, and this possibility requires future research

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

Perineal Body Length Among Different Racial Groups in the First Stage of Labor

PubMed Central

Tsai, Pai-Jong Stacy; Oyama, Ian A.; Hiraoka, Mark; Minaglia, Steven; Thomas, Jennifer; Kaneshiro, Bliss

2018-01-01

Objective Anatomic differences among racial groups may contribute to observed differences in the occurrence of severe perineal lacerations at the time of vaginal delivery. The purpose of this study was to identify differences in perineal body length between racial groups. Methods Perineal body length was measured in primigravid women aged 18 to 45 years who were admitted in labor. Women were classified into 1 of 6 racial groups: White, Filipino, Japanese, Chinese, Native Hawaiian, or Micronesian. The primary outcome, perineal body length, was compared using analysis of variance. Results A total of 200 women were recruited. There were no significant differences in perineal body length (P = 0.42) and severe perineal lacerations (P = 0.82) between the different racial groups. The mean (SD) perineal body length of women who had a severe laceration was 3.9 (0.5) versus 3.9 (0.6) cm in women who did not have a severe laceration (P = 0.98). Conclusion Perineal body length does not seem to differ among the different racial groups studied and therefore an unlikely cause of racial variation in rates of severe perineal lacerations. PMID:22543769

Racialized Space: Framing Latino and Latina Experience in Public Schools

ERIC Educational Resources Information Center

Barajas, Heidi Lasley; Ronnkvist, Amy

2007-01-01

Background: Educational research shows differences in experience, access, and outcomes across racial groups with some groups advantaged and others disadvantaged. One of the concepts used to explain racial differences, racialization, is a taken-for-granted term that is yet to be fully defined in the context of the school. We differentiate the term…

Importance of race-ethnicity: An exploration of Asian, Black, Latino, and Multiracial adolescent identity

PubMed Central

Charmaraman, Linda; Grossman, Jennifer M.

2010-01-01

This mixed-method study used a grounded theory approach to explore the meanings underlying the importance adolescents attach to their racial-ethnic identities. The sample consisted of 923 9th–12th grade students from Black, Latino, Asian, and Multiracial backgrounds. Thematic findings identified a broad range of explanations for adolescents’ racial-ethnic centrality, ranging from pride and cultural connection to ambivalence and colorblind attitudes. While racial-ethnic groups differed in reported levels of racial-ethnic centrality, few group differences were identified in participants’ thematic explanations, with the exception of racial-ethnic and gender differences for Positive Regard and Disengagement. These findings highlight the diversity of meanings adolescents attribute to their racial-ethnic centrality as well as the many commonalities among adolescents across gender and racial-ethnic groups. PMID:20438152

Socioeconomic, health, and psychosocial mediators of racial disparities in cognition in early, middle, and late adulthood

PubMed Central

Zahodne, Laura B.; Manly, Jennifer J.; Smith, Jacqui; Seeman, Teresa; Lachman, Margie

2017-01-01

Racial disparities in cognitive performance exist across the life course, but it is not known whether mediators of disparities differ by age. Understanding sources of cognitive disparities at different ages can inform policies and interventions. Data were obtained for non-Hispanic Black and White respondents to The National Survey of Midlife Development in the United States (MIDUS-II) from three age groups: 28–44 (N=1210; 20% Black); 45–64 (N=2693; 15% Black), 65–85 (N=1298; 11% Black). Moderated mediation models characterized direct and indirect effects of race on episodic memory and executive function composite scores through economic, health, and psychosocial variables as a function of age group. Education, income, chronic health conditions, and external locus of control mediated cognitive disparities across the life course, though income was a stronger mediator at younger ages. Perceived discrimination was a weaker mediator among young adults due to an absence of racial differences in perceived discrimination in that group. Despite multiple indirect effects, there were still significant unexplained effects of race on cognition that were not moderated by age group. Interventional work is needed to determine whether increasing educational attainment and income, and reducing chronic health conditions and perceived constraints among Blacks, reduce cognitive disparities. Targeting income inequality and discrimination (or buffering the impact of those variables) may be differently effective at reducing cognitive disparities at different stages of the adult life course. PMID:28287782

Socioeconomic Disparities in Breast Cancer Treatment Among Older Women

PubMed Central

Richardson, Lisa C.; Krontiras, Helen; Pisu, Maria

2014-01-01

Abstract Background: Racial disparities in breast cancer treatment among Medicare beneficiaries have been documented. This study aimed to determine whether racial disparities exist among white and black female Medicare beneficiaries in Alabama, an economically disadvantaged U.S. state. Methods: From a linked dataset of breast cancer cases from the Alabama Statewide Cancer Registry and fee-for-service claims from Medicare, we identified 2,097 white and black females, aged 66 years and older, who were diagnosed with stages 1–3 breast cancer from January 1, 2000, to December 31, 2002. Generalized estimating equation (GEE) models were used to determine whether there were racial differences in initiating and completing National Comprehensive Cancer Network Clinical Practice guideline-specific treatment. Results: Sixty-two percent of whites and 64.7% of blacks had mastectomy (p=0.27); 34.6% of whites and 30.2% of blacks had breast conserving surgery (BCS) (p=0.12). Among those who had BCS, 76.8% of whites and 83.3% of blacks started adjuvant radiation therapy (p=0.33) and they equally completed adjuvant radiation therapy (p=0.29). For women with tumors over 1 centimeter, whites and blacks were equally likely to start (16.1% of whites and 18.3% of black; p=0.34) and complete (50.6% of whites and 46.3% of black; p=0.87) adjuvant chemotherapy. There were still no differences after adjusting for confounders using GEE. However, differences were observed by area-level socioeconomic status (SES), with lower SES residents more likely to receive a mastectomy (odds ratio [OR]=1.26; 95% confidence interval [CI]: 1.01–1.57) and initiate radiation after BCS (OR=2.24; 95% CI: 1.28–3.93). Conclusions: No racial differences were found in guideline-specific breast cancer treatment or treatment completion, but there were differences by SES. Future studies should explore reasons for SES differences and whether similar results hold in other economically disadvantaged U.S. states. PMID:24350590

Perceived discrimination, race and health in South Africa.

PubMed

Williams, David R; Gonzalez, Hector M; Williams, Stacey; Mohammed, Selina A; Moomal, Hashim; Stein, Dan J

2008-08-01

To assess the levels of perceived acute and chronic racial and non-racial discrimination in South Africa, their association with health, and the extent to which they contribute to racial differences in physical and mental health, data were used from a national probability sample of adults, the South African Stress and Health Study (SASH). All Black groups in South Africa (African, Coloured and Indian) were two to four times more likely than Whites to report acute and chronic experiences of racial discrimination. Africans and Coloureds report higher levels of ill health than Whites, but acute and chronic racial discrimination were unrelated to ill health and unimportant in accounting for racial differences in self-rated health. In contrast, all Black groups had higher levels of psychological distress than Whites, and perceived chronic discrimination was positively associated with distress. Moreover, these experiences accounted for some of the residual racial differences in distress after adjustment for socioeconomic status. Our main findings indicate that, in a historically racialized society, perceived chronic racial and especially non-racial discrimination acts independently of demographic factors, other stressors, psychological factors (social desirability, self-esteem and personal mastery), and multiple SES indicators to adversely affect mental health.

Perceived Discrimination, Race and Health in South Africa

PubMed Central

Williams, David R.; Gonzalez, Hector M; Williams, Stacey; Mohammed, Selina A; Moomal, Hashim; Stein, Dan J

2009-01-01

To assess the levels of perceived acute and chronic racial and non-racial discrimination in South Africa, their association with health, and the extent to which they contribute to racial differences in physical and mental health, data were used from a national probability sample of adults, the South African Stress and Health Study (SASH). All Black groups in South Africa (African, Coloured and Indian) were two to four times more likely than Whites to report acute and chronic experiences of racial discrimination. Africans and Coloureds report higher levels of ill health than Whites, but acute and chronic racial discrimination were unrelated to ill health and unimportant in accounting for racial differences in self rated health. In contrast, all Black groups had higher levels of psychological distress than Whites, and perceived chronic discrimination, was positively associated with distress. Moreover, these experiences accounted for some of the residual racial differences in distress after adjustment for socioeconomic status. Our main findings indicate that, in a historically racialized society, perceived chronic racial and especially non-racial discrimination acts independently of demographic factors, other stressors, psychological factors (social desirability, self-esteem and personal mastery), and multiple SES indicators to adversely affect mental health. PMID:18486292

Implicit Bias in Pediatric Academic Medicine.

PubMed

Johnson, Tiffani J; Ellison, Angela M; Dalembert, George; Fowler, Jessica; Dhingra, Menaka; Shaw, Kathy; Ibrahim, Said

2017-01-01

Despite known benefits of diversity, certain racial/ethnic groups remain underrepresented in academic pediatrics. Little research exists regarding unconscious racial attitudes among pediatric faculty responsible for decisions on workforce recruitment and retention in academia. This study sought to describe levels of unconscious racial bias and perceived barriers to minority recruitment and retention among academic pediatric faculty leaders. Authors measured unconscious racial bias in a sample of pediatric faculty attending diversity workshops conducted at local and national meetings in 2015. A paper version of the validated Implicit Association Test (IAT) measured unconscious racial bias. Subjects also reported perceptions about minority recruitment and retention. Of 68 eligible subjects approached, 58 (85%) consented and completed the survey with IAT. Of participants, 83% had leadership roles and 93% were involved in recruitment. Participants had slight pro-white/anti-black bias on the IAT (M = 0.28, SD = 0.49). There were similar IAT scores among participants in leadership roles (M = 0.33, SD = 0.47) and involved in recruitment (M = 0.28, SD = 0.43). Results did not differ when comparing participants in local workshops to the national workshop (n = 36, M = 0.29, SD = 0.40 and n = 22, M = 0.27, SD = 0.49 respectively; p = 0.88). Perceived barriers to minority recruitment and retention included lack of minority mentors, poor recruitment efforts, and lack of qualified candidates. Unconscious pro-white/anti-black racial bias was identified in this sample of academic pediatric faculty and leaders. Further research is needed to examine how unconscious bias impacts decisions in academic pediatric workforce recruitment. Addressing unconscious bias and perceived barriers to minority recruitment and retention represent opportunities to improve diversity efforts. Copyright © 2017 National Medical Association. All rights reserved.

Discussions about Racial and Ethnic Differences in Internationally Adoptive Families: Links with Family Engagement, Warmth, & Control.

PubMed

Anderson, Kayla N; Rueter, Martha A; Lee, Richard M

Discussions about racial and ethnic differences may allow international, transracial adoptive families to construct multiracial and/or multiethnic family identities. However, little is known about the ways family communication influences how discussions about racial and ethnic differences occur. This study examined associations between observed family communication constructs, including engagement, warmth, and control, and how adoptive families discuss racial and ethnic differences using a sample of families with adolescent-aged children adopted internationally from South Korea ( N = 111 families, 222 adolescents). Using data collected during mid-adolescence and again during late adolescence, higher levels of maternal control and positive adolescent engagement were independently associated with a greater likelihood that family members acknowledged the importance of racial and ethnic differences and constructed a multiracial and/or multiethnic family identity. Adolescent engagement was also related to a greater likelihood that family members disagreed about the importance of racial and ethnic differences, and did not build a cohesive identity about differences.

Discussions about Racial and Ethnic Differences in Internationally Adoptive Families: Links with Family Engagement, Warmth, & Control

PubMed Central

Anderson, Kayla N.; Rueter, Martha A.; Lee, Richard M.

2015-01-01

Discussions about racial and ethnic differences may allow international, transracial adoptive families to construct multiracial and/or multiethnic family identities. However, little is known about the ways family communication influences how discussions about racial and ethnic differences occur. This study examined associations between observed family communication constructs, including engagement, warmth, and control, and how adoptive families discuss racial and ethnic differences using a sample of families with adolescent-aged children adopted internationally from South Korea (N = 111 families, 222 adolescents). Using data collected during mid-adolescence and again during late adolescence, higher levels of maternal control and positive adolescent engagement were independently associated with a greater likelihood that family members acknowledged the importance of racial and ethnic differences and constructed a multiracial and/or multiethnic family identity. Adolescent engagement was also related to a greater likelihood that family members disagreed about the importance of racial and ethnic differences, and did not build a cohesive identity about differences. PMID:26648791

Racial, Ethnic, and Gender Differences in School Discipline among U.S. High School Students: 1991-2005.

PubMed

Wallace, John M; Goodkind, Sara; Wallace, Cynthia M; Bachman, Jerald G

2008-01-01

The present study uses large nationally representative samples of White, Black, Hispanic, Asian American, and American Indian students to examine current patterns and recent trends (1991 to 2005) in racial, ethnic, and gender differences in school discipline. We found that Black, Hispanic, and American Indian youth are slightly more likely than White and Asian American youth to be sent to the office and substantially (two to five times) more likely to be suspended or expelled. Although school discipline rates decreased over time for most ethnic groups, among Black students school discipline rates increased between 1991 and 2005. Logistic regression analyses that controlled for racial and ethnic differences in socio-demographic factors suggest racial and ethnic differences in school discipline do not result from racial and ethnic differences in socioeconomic status. Future research and practice efforts should seek to better understand and to eliminate racial, ethnic and gender disproportionality in school discipline.

Racial-ethnic disparities in stroke care: the American experience: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

PubMed

Cruz-Flores, Salvador; Rabinstein, Alejandro; Biller, Jose; Elkind, Mitchell S V; Griffith, Patrick; Gorelick, Philip B; Howard, George; Leira, Enrique C; Morgenstern, Lewis B; Ovbiagele, Bruce; Peterson, Eric; Rosamond, Wayne; Trimble, Brian; Valderrama, Amy L

2011-07-01

Our goal is to describe the effect of race and ethnicity on stroke epidemiology, personal beliefs, access to care, response to treatment, and participation in clinical research. In addition, we seek to determine the state of knowledge on the main factors that may explain disparities in stroke care, with the goal of identifying gaps in knowledge to guide future research. The intended audience includes physicians, nurses, other healthcare professionals, and policy makers. Members of the writing group were appointed by the American Heart Association Stroke Council Scientific Statement Oversight Committee and represent different areas of expertise in relation to racial-ethnic disparities in stroke care. The writing group reviewed the relevant literature, with an emphasis on reports published since 1972. The statement was approved by the writing group; the statement underwent peer review, then was approved by the American Heart Association Science Advisory and Coordinating Committee. There are limitations in the definitions of racial and ethnic categories currently in use. For the purpose of this statement, we used the racial categories defined by the US federal government: white, black or African American, Asian, American Indian/Alaskan Native, and Native Hawaiian/other Pacific Islander. There are 2 ethnic categories: people of Hispanic/Latino origin or not of Hispanic/Latino origin. There are differences in the distribution of the burden of risk factors, stroke incidence and prevalence, and stroke mortality among different racial and ethnic groups. In addition, there are disparities in stroke care between minority groups compared with whites. These disparities include lack of awareness of stroke symptoms and signs and lack of knowledge about the need for urgent treatment and the causal role of risk factors. There are also differences in attitudes, beliefs, and compliance among minorities compared with whites. Differences in socioeconomic status and insurance coverage, mistrust of the healthcare system, the relatively limited number of providers who are members of minority groups, and system limitations may contribute to disparities in access to or quality of care, which in turn might result in different rates of stroke morbidity and mortality. Cultural and language barriers probably also contribute to some of these disparities. Minorities use emergency medical services systems less, are often delayed in arriving at the emergency department, have longer waiting times in the emergency department, and are less likely to receive thrombolysis for acute ischemic stroke. Although unmeasured factors may play a role in these delays, the presence of bias in the delivery of care cannot be excluded. Minorities have equal access to rehabilitation services, although they experience longer stays and have poorer functional status than whites. Minorities are inadequately treated with both primary and secondary stroke prevention strategies compared with whites. Sparse data exist on racial-ethnic disparities in access to surgical care after intracerebral hemorrhage and subarachnoid hemorrhage. Participation of minorities in clinical research is limited. Barriers to participation in clinical research include beliefs, lack of trust, and limited awareness. Race is a contentious topic in biomedical research because race is not proven to be a surrogate for genetic constitution. There are limitations in the current definitions of race and ethnicity. Nevertheless, racial and ethnic disparities in stroke exist and include differences in the biological determinants of disease and disparities throughout the continuum of care, including access to and quality of care. Access to and participation in research is also limited among minority groups. Acknowledging the presence of disparities and understanding the factors that contribute to them are necessary first steps. More research is required to understand these differences and find solutions.

Strange Fruit Indeed: Interrogating Contemporary Textbook Representations of Racial Violence toward African Americans

ERIC Educational Resources Information Center

Brown, Anthony L.; Brown, Keffrelyn D.

2010-01-01

Background/Context: Recent racial incidents on college and high school campuses throughout the United States have catalyzed a growing conversation around issues of race and racism. These conversations exist alongside ongoing concerns about the lack of attention given to race and racism in the official school curriculum. Given that the field of…

Conflicts Based on Race/Ethnicity among Latina/o Students in Schools

ERIC Educational Resources Information Center

Martinez, Michael J.

2017-01-01

Conflicts based on race/ethnicity continue to occur today in a wide range of settings. Of particular interest are racial/ethnic conflicts that occur in schools due to the impact they can have on students' emotional well-being, academic achievement and the overall and racial school climate. Evidence exists that indicates the occurrence of…

School Discipline Data Indicators: A Guide for Districts and Schools. REL 2017-240

ERIC Educational Resources Information Center

Nishioka, Vicki

2017-01-01

This guide is designed to supply educators with a means to identify whether racial/ethnic disproportionality in discipline practice exists in their schools or districts. It also aims to help educators use data to reduce racial/ethnic disproportionality in suspensions and expulsions. The guide is organized into two sections. The first section…

Learning to Lead for Racial Equity

ERIC Educational Resources Information Center

Ngounou, Gislaine; Gutierrez, Nancy

2017-01-01

If education leaders aspire to confront and undo the severe racial inequities that exist in so many of our schools and school systems, then they will have to create opportunities for teachers and staff to engage in productive discussions about questions that many of them will be reluctant to consider Given how complex and how deeply felt are…

The Equity Myth: Racialization and Indigeneity at Canadian Universities

ERIC Educational Resources Information Center

Henry, Frances; Dua, Enakshi; James, Carl E.; Kobayashi, Audrey; Li, Peter; Ramos, Howard; Smith, Malinda S.

2017-01-01

The university is often regarded as a bastion of liberal democracy where equity and diversity are promoted and racism does not exist. In reality, the university still excludes many people and is a site of racialization that is subtle, complex, and sophisticated. While some studies do point to the persistence of systemic barriers to equity and…

Worship Discourse and White Race-based Policy Attitudes

PubMed Central

Brown, R. Khari; Kaiser, Angela; Jackson, James S.

2014-01-01

The current study relies upon the 2004 National Politics Study to examine the association between exposure to race-based messages within places of worship and White race-based policy attitudes. The present study challenges the notion that, for White Americans, religiosity inevitably leads to racial prejudice. Rather, we argue, as others have, that religion exists on a continuum that spans from reinforcing to challenging the status quo of social inequality. Our findings suggests that the extent to which Whites discuss race along with the potential need for public policy solutions to address racial inequality within worship spaces, worship attendance contributes to support for public policies aimed at reducing racial inequality. On the other hand, apolitical and non-structural racial discussions within worship settings do seemingly little to move many Whites to challenge dominant idealistic perceptions of race that eschews public policy interventions as solutions to racial inequality. PMID:25324579

The Role of Geographic and Network Factors in Racial Disparities in HIV Among Young Men Who have Sex with Men: An Egocentric Network Study.

PubMed

Mustanski, Brian; Birkett, Michelle; Kuhns, Lisa M; Latkin, Carl A; Muth, Stephen Q

2015-06-01

The objective of this study was to characterize and compare individual and sexual network characteristics of Black, White, and Latino young men who have sex with men (YMSM) as potential drivers of racial disparities in HIV. Egocentric network interviews were conducted with 175 diverse YMSM who described 837 sex partners within 167 sexual-active egos. Sexual partner alter attributes were summarized by ego. Descriptives of ego demographics, sexual partner demographics, and network characteristics were calculated by race of the ego and compared. No racial differences were found in individual engagement in HIV risk behaviors or concurrent sexual partnership. Racial differences were found in partner characteristics, including female gender, non-gay sexual orientations, older age, and residence in a high HIV prevalence neighborhood. Racial differences in relationship characteristics included type of relationships (i.e., main partner) and strength of relationships. Network characteristics also showed differences, including sexual network density and assortativity by race. Most racial differences were in the direction of effects that would tend to increase HIV incidence among Black YMSM. These data suggest that racial disparities in HIV may be driven and/or maintained by a combination of racial differences in partner characteristics, assortativity by race, and increased sexual network density, rather than differences in individual's HIV risk behaviors.

Racial Differences in Pregnancy Intention, Reproductive Coercion, and Partner Violence among Family Planning Clients: A Qualitative Exploration.

PubMed

Holliday, Charvonne N; Miller, Elizabeth; Decker, Michele R; Burke, Jessica G; Documet, Patricia I; Borrero, Sonya B; Silverman, Jay G; Tancredi, Daniel J; Ricci, Edmund; McCauley, Heather L

Unintended pregnancy (UIP) is a persistent public health concern in the United States disproportionately experienced by racial/ethnic minorities and women of low socioeconomic status. UIP often occurs with experiences of reproductive coercion (RC) and intimate partner violence (IPV). The purpose of the study was to qualitatively describe and compare contexts for UIP risk between low-income Black and White women with histories of IPV/RC. Semistructured interviews were conducted with low-income Black and White women with histories of IPV or RC, ages 18 to 29 years, recruited from family planning clinics in Pittsburgh, Pennsylvania. Interviews with 10 non-Hispanic Black women and 34 non-Hispanic White women (N = 44) were included in the analysis. Differences between White and Black women emerged regarding IPV/RC experiences, gender roles in intimate relationships, and trauma histories, including childhood adversity. Fatal threats and IPV related to childbearing were most influential among White women. Among Black women, pregnancy was greatly influenced by RC related to impending incarceration, subfertility, and condom nonuse, and decisions about contraception were often dependent on the male. Sexual abuse, including childhood sexual assault, in the context of sexual/reproductive health was more prominent among White women. Childhood experiences of neglect impacted pregnancy intention and love-seeking behaviors among Black women. Racial differences exist in experiences of IPV/RC with regard to UIP even among women with similar economic resources and health care access. These findings provide much-needed context to the persistent racial/ethnic disparities in UIP and illustrate influences beyond differential access to care and socioeconomic status. Copyright © 2018 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

The Impact of African American Parents’ Racial Discrimination Experiences and Perceived Neighborhood Cohesion on their Racial Socialization Practices

PubMed Central

English, Devin; Busby, Danielle R.; Lambert, Sharon F.; Harrison, Aubrey; Stock, Michelle L.; Gibbons, Frederick X.

2016-01-01

Parental racial socialization is a parenting tool used to prepare African American adolescents for managing racial stressors. While it is known that parents’ racial discrimination experiences affect the racial socialization messages they provide, little is known about the influence of factors that promote supportive and communal parenting, such as perceived neighborhood cohesion. In cohesive neighborhoods, neighbors may help parents address racial discrimination by monitoring youth and conveying racial socialization messages; additionally, the effect of neighborhood cohesion on parents’ racial socialization may differ for boys and girls because parents socialize adolescents about race differently based on expected encounters with racial discrimination. Therefore, the current study examines how parents’ perception of neighborhood cohesion and adolescents’ gender moderate associations between parents’ racial discrimination experiences and the racial socialization messages they deliver to their adolescents. Participants were a community sample of 608 African American adolescents (54 % girls; mean age = 15.5) and their primary caregivers (86 % biological mothers; mean age = 42.0). Structural equation modeling indicated that parental racial discrimination was associated with more promotion of mistrust messages for boys and girls in communities with low neighborhood cohesion. In addition, parental racial discrimination was associated with more cultural socialization messages about racial pride and history for boys in neighborhoods with low neighborhood cohesion. The findings suggest that parents’ racial socialization messages are influenced by their own racial discrimination experiences and the cohesiveness of the neighborhood; furthermore, the content of parental messages delivered varies based on adolescents’ gender. PMID:27189721

Exposure to Pre- and Perinatal Risk Factors Partially Explains Mean Differences in Self-Regulation between Races.

PubMed

Barnes, J C; Boutwell, Brian B; Miller, J Mitchell; DeShay, Rashaan A; Beaver, Kevin M; White, Norman

2016-01-01

To examine whether differential exposure to pre- and perinatal risk factors explained differences in levels of self-regulation between children of different races (White, Black, Hispanic, Asian, and Other). Multiple regression models based on data from the Early Childhood Longitudinal Study, Birth Cohort (n ≈ 9,850) were used to analyze the impact of pre- and perinatal risk factors on the development of self-regulation at age 2 years. Racial differences in levels of self-regulation were observed. Racial differences were also observed for 9 of the 12 pre-/perinatal risk factors. Multiple regression analyses revealed that a portion of the racial differences in self-regulation was explained by differential exposure to several of the pre-/perinatal risk factors. Specifically, maternal age at childbirth, gestational timing, and the family's socioeconomic status were significantly related to the child's level of self-regulation. These factors accounted for a statistically significant portion of the racial differences observed in self-regulation. The findings indicate racial differences in self-regulation may be, at least partially, explained by racial differences in exposure to pre- and perinatal risk factors.

Associations between Discussions of Racial and Ethnic Differences in Internationally Adoptive Families and Delinquent Behavior among Korean Adopted Adolescents.

PubMed

Anderson, Kayla N; Lee, Richard M; Rueter, Martha A; Kim, Oh Myo

2015-04-01

Internationally adopted adolescents may have more delinquent behavior than non-adopted adolescents. One explanation is these adolescents experience discrimination and loss of culture, and adoptive parents are not adequately addressing these experiences. However, studies have not examined the effects of family discussions of racial and ethnic differences within adoptive families on adopted adolescents' delinquent behavior. To test this relationship, this study utilized data from 111 U.S. internationally adoptive families with 185 South Korean adopted adolescents (55% female, M age = 17.75). During an observational assessment, families discussed the importance of their racial and ethnic differences, and adolescents completed a delinquent behavior questionnaire. Analysis of covariance showed differences in adolescent delinquent behavior across three ways adoptive families discussed racial and ethnic differences; adolescents whose families acknowledged differences had the fewest mean delinquent behaviors. There were no significant differences in delinquent behavior between adolescents whose families acknowledged or rejected the importance of racial and ethnic differences. However, adopted adolescents whose families held discrepant views of differences had significantly more problem behavior than adolescents whose families either acknowledged or rejected the importance of racial and ethnic differences. Clinicians, adoption professionals, and other parenting specialists should focus on building cohesive family identities about racial and ethnic differences, as discrepant views of differences are associated with the most adoptee delinquent behavior.

Associations between Discussions of Racial and Ethnic Differences in Internationally Adoptive Families and Delinquent Behavior among Korean Adopted Adolescents

PubMed Central

Anderson, Kayla N.; Lee, Richard M.; Rueter, Martha A.; Kim, Oh Myo

2015-01-01

Internationally adopted adolescents may have more delinquent behavior than non-adopted adolescents. One explanation is these adolescents experience discrimination and loss of culture, and adoptive parents are not adequately addressing these experiences. However, studies have not examined the effects of family discussions of racial and ethnic differences within adoptive families on adopted adolescents’ delinquent behavior. To test this relationship, this study utilized data from 111 U.S. internationally adoptive families with 185 South Korean adopted adolescents (55% female, M age = 17.75). During an observational assessment, families discussed the importance of their racial and ethnic differences, and adolescents completed a delinquent behavior questionnaire. Analysis of covariance showed differences in adolescent delinquent behavior across three ways adoptive families discussed racial and ethnic differences; adolescents whose families acknowledged differences had the fewest mean delinquent behaviors. There were no significant differences in delinquent behavior between adolescents whose families acknowledged or rejected the importance of racial and ethnic differences. However, adopted adolescents whose families held discrepant views of differences had significantly more problem behavior than adolescents whose families either acknowledged or rejected the importance of racial and ethnic differences. Clinicians, adoption professionals, and other parenting specialists should focus on building cohesive family identities about racial and ethnic differences, as discrepant views of differences are associated with the most adoptee delinquent behavior. PMID:25729119

Racial differences in sexual prejudice and its correlates among heterosexual men.

PubMed

Daboin, Irene; Peterson, John L; Parrott, Dominic J

2015-04-01

Previous research has consistently found sexual prejudice to be a predictor of antigay aggression and has also revealed specific correlates and antecedents of sexual prejudice. However, extant literature reveals mixed findings about potential racial group differences in sexual prejudice, and few studies have examined racial differences in the correlates of sexual prejudice. The aims of this descriptive study were to determine whether there are (a) racial group differences in reports of sexual prejudice and (b) racial group differences in previously identified correlates of sexual prejudice. Participants were 195 heterosexual males, ages 18 to 30 (98 Blacks and 97 Whites), recruited from a large metropolitan city in the southeastern United States. Based on cultural differences in the influence of religion and in attitudes about male sexuality, it was hypothesized that Black participants would report higher sexual prejudice than White participants. Additionally, based on cultural differences in racial views on masculinity and in sociocultural experiences of male gender roles, it was hypothesized that Blacks would report greater endorsement of religious fundamentalism and the traditional male role norm of status than Whites. Results confirmed all of the hypothesized racial differences and revealed additional differences, including a differential effect of the traditional male role norm of status on sexual prejudice, which explains, at least in part, the racial differences found in sexual prejudice. These findings may reflect underlying cultural differences between Black and White males and may aid in the development of future efforts to reduce sexual prejudice and consequently antigay aggression toward sexual minorities. (c) 2015 APA, all rights reserved).

Psychiatrists' attitudes toward and awareness about racial disparities in mental health care.

PubMed

Mallinger, Julie B; Lamberti, J Steven

2010-02-01

Psychiatrists may perpetuate racial-ethnic disparities in health care through racially biased, albeit unconscious, behaviors. Changing these behaviors requires that physicians accept that racial-ethnic disparities exist and accept their own contributions to disparities. The purposes of this study were to assess psychiatrists' awareness of racial disparities in mental health care, to evaluate the extent to which psychiatrists believe they contribute to disparities, and to determine psychiatrists' interest in participating in disparities-reduction programs. A random sample of psychiatrists, identified through the American Psychiatric Association's member directory, was invited to complete the online survey. The survey was also distributed to psychiatrists at a national professional conference. Of the 374 respondents, most said they were not familiar or only a little familiar with the literature on racial disparities. Respondents tended to believe that race has a moderate influence on quality of psychiatric care but that race is more influential in others' practices than in their own practices. One-fourth had participated in any type of disparities-reduction program within the past year, and approximately one-half were interested in participating in such a program. Psychiatrists may not recognize the pervasiveness of racial inequality in psychiatric care, and they may attribute racially biased thinking to others but not to themselves. Interventions to eliminate racial-ethnic disparities should focus on revealing and modifying unconscious biases. Lack of physician interest may be one barrier to such interventions.

Racial and Ethnic Differences in the Desire to Marry.

ERIC Educational Resources Information Center

South, Scott J.

1993-01-01

Used data from over 2,000 respondents to explore racial, ethnic, and gender differences in desire to marry. African Americans were significantly less desiring of marriage than whites; racial difference among men was significantly larger than difference among women. Compared to nonhispanic whites of same gender, Hispanic men were more likely,…

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

Racial and non-racial discrimination and smoking status among South African adults 10 years after apartheid.

PubMed

Dutra, Lauren M; Williams, David R; Kawachi, Ichiro; Okechukwu, Cassandra A

2014-11-01

Despite a long history of discrimination and persisting racial disparities in smoking prevalence, little research exists on the relationship between discrimination and smoking in South Africa. This analysis examined chronic (day-to-day) and acute (lifetime) experiences of racial and non-racial (eg, age, gender or physical appearance) discrimination and smoking status among respondents to the South Africa Stress and Health study. Logistic regression models were constructed using SAS-Callable SUDAAN. Both chronic racial discrimination (RR=1.45, 95% CI 1.14 to 1.85) and chronic non-racial discrimination (RR=1.69, 95% CI 1.37 to 2.08) predicted a higher risk of smoking, but neither type of acute discrimination did. Total (sum of racial and non-racial) chronic discrimination (RR=1.46, 95% CI 1.20 to 1.78) and total acute discrimination (RR=1.28, 95% CI 1.01 to 1.60) predicted a higher risk of current smoking. Racial and non-racial discrimination may be related to South African adults' smoking behaviour, but this relationship likely varies by the timing and frequency of these experiences. Future research should use longitudinal data to identify the temporal ordering of the relationships studied, include areas outside of South Africa to increase generalisability and consider the implications of these findings for smoking cessation approaches in South Africa. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Racial and Ethnic Differences in Antibiotic Use for Viral Illness in Emergency Departments.

PubMed

Goyal, Monika K; Johnson, Tiffani J; Chamberlain, James M; Casper, T Charles; Simmons, Timothy; Alessandrini, Evaline A; Bajaj, Lalit; Grundmeier, Robert W; Gerber, Jeffrey S; Lorch, Scott A; Alpern, Elizabeth R

2017-10-01

In the primary care setting, there are racial and ethnic differences in antibiotic prescribing for acute respiratory tract infections (ARTIs). Viral ARTIs are commonly diagnosed in the pediatric emergency department (PED), in which racial and ethnic differences in antibiotic prescribing have not been previously reported. We sought to investigate whether patient race and ethnicity was associated with differences in antibiotic prescribing for viral ARTIs in the PED. This is a retrospective cohort study of encounters at 7 PEDs in 2013, in which we used electronic health data from the Pediatric Emergency Care Applied Research Network Registry. Multivariable logistic regression was used to examine the association between patient race and ethnicity and antibiotics administered or prescribed among children discharged from the hospital with viral ARTI. Children with bacterial codiagnoses, chronic disease, or who were immunocompromised were excluded. Covariates included age, sex, insurance, triage level, provider type, emergency department type, and emergency department site. Of 39 445 PED encounters for viral ARTIs that met inclusion criteria, 2.6% (95% confidence interval [CI] 2.4%-2.8%) received antibiotics, including 4.3% of non-Hispanic (NH) white, 1.9% of NH black, 2.6% of Hispanic, and 2.9% of other NH children. In multivariable analyses, NH black (adjusted odds ratio [aOR] 0.44; CI 0.36-0.53), Hispanic (aOR 0.65; CI 0.53-0.81), and other NH (aOR 0.68; CI 0.52-0.87) children remained less likely to receive antibiotics for viral ARTIs. Compared with NH white children, NH black and Hispanic children were less likely to receive antibiotics for viral ARTIs in the PED. Future research should seek to understand why racial and ethnic differences in overprescribing exist, including parental expectations, provider perceptions of parental expectations, and implicit provider bias. Copyright © 2017 by the American Academy of Pediatrics.

The Impact of African American Parents' Racial Discrimination Experiences and Perceived Neighborhood Cohesion on their Racial Socialization Practices.

PubMed

Saleem, Farzana T; English, Devin; Busby, Danielle R; Lambert, Sharon F; Harrison, Aubrey; Stock, Michelle L; Gibbons, Frederick X

2016-07-01

Parental racial socialization is a parenting tool used to prepare African American adolescents for managing racial stressors. While it is known that parents' racial discrimination experiences affect the racial socialization messages they provide, little is known about the influence of factors that promote supportive and communal parenting, such as perceived neighborhood cohesion. In cohesive neighborhoods, neighbors may help parents address racial discrimination by monitoring youth and conveying racial socialization messages; additionally, the effect of neighborhood cohesion on parents' racial socialization may differ for boys and girls because parents socialize adolescents about race differently based on expected encounters with racial discrimination. Therefore, the current study examines how parents' perception of neighborhood cohesion and adolescents' gender moderate associations between parents' racial discrimination experiences and the racial socialization messages they deliver to their adolescents. Participants were a community sample of 608 African American adolescents (54 % girls; mean age = 15.5) and their primary caregivers (86 % biological mothers; mean age = 42.0). Structural equation modeling indicated that parental racial discrimination was associated with more promotion of mistrust messages for boys and girls in communities with low neighborhood cohesion. In addition, parental racial discrimination was associated with more cultural socialization messages about racial pride and history for boys in neighborhoods with low neighborhood cohesion. The findings suggest that parents' racial socialization messages are influenced by their own racial discrimination experiences and the cohesiveness of the neighborhood; furthermore, the content of parental messages delivered varies based on adolescents' gender.

Achieving Diversity. Issues in the Recruitment and Retention of Underrepresented Racial/Ethnic Students in Higher Education: A Review of the Literature.

ERIC Educational Resources Information Center

Lee, Courtland

Much has been done in recent years to enhance the quality of the educational experience for students from underrepresented racial/ethnic groups on college campuses. However, many major problems still exist, presenting professionals concerned with the educational development of students with many significant challenges. This literature review…

Racial/Ethnic Socialization and Identity Development in Black Families: The Role of Parent and Youth Reports

ERIC Educational Resources Information Center

Peck, Stephen C.; Brodish, Amanda B.; Malanchuk, Oksana; Banerjee, Meeta; Eccles, Jacquelynne S.

2014-01-01

Racial/ethnic (R/E) socialization is widely practiced in R/E minority families. However, only recently have models been developed to understand how parents' R/E socialization messages influence adolescent development. The primary goal of the present study was to clarify and extend existing work on R/E socialization in African American (Black)…

The Socioeconomic, Health, Safety, and Educational Disparities Faced by Boys and Men of Color in California. Research Highlights

ERIC Educational Resources Information Center

Steinberg, Paul

2009-01-01

In the United States, racial/ethnic disparities exist across an array of domains. A broad literature addresses how racial/ethnic disparities have developed and persisted over time in the context of historical and structural racism that has shaped policies, practices, and programs in ways that create disadvantage for certain groups. In recognition…

Race/ethnicity and socio-economic differences in colorectal cancer surgery outcomes: analysis of the nationwide inpatient sample.

PubMed

Akinyemiju, Tomi; Meng, Qingrui; Vin-Raviv, Neomi

2016-09-05

The purpose of this study was to examine racial and socio-economic differences in the receipt of laparoscopic or open surgery among patients with colorectal cancer, and to determine if racial and socio-economic differences exist in post-surgical complications, in-hospital mortality and hospital length of stay among patients who received surgery. We conducted a cross-sectional analysis of hospitalized patients with a primary diagnosis of colorectal cancer between 2007 and 2011 using data from Nationwide Inpatient Sample. ICD-9 codes were used to capture primary diagnosis, surgical procedures, and health outcomes during hospitalization. We used logistic regression analysis to determine racial and socio-economic predictors of surgery type, post-surgical complications and mortality, and linear regression analysis to assess hospital length of stay. A total of 122,631 patients were admitted with a primary diagnosis of malignant colorectal cancer between 2007 and 2011. Of these, 17,327 (14.13 %) had laparoscopic surgery, 70,328 (57.35 %) received open surgery, while 34976 (28.52 %) did not receive any surgery. Black (36 %) and Hispanic (34 %) patients were more likely to receive no surgery compared with Whites (27 %) patients. However, among patients that received any surgery, there were no racial differences in which surgery was received (laparoscopic versus open, p = 0.2122), although socio-economic differences remained, with patients from lower residential income areas significantly less likely to receive laparoscopic surgery compared with patients from higher residential income areas (OR: 0.74, 95 % CI: 0.70-0.78). Among patients who received any surgery, Black patients (OR = 1.07, 95 % CI: 1.01-1.13), and patients with Medicare (OR = 1.16, 95 % CI: 1.11-1.22) and Medicaid (OR = 1.15, 95 % CI: 1.07-1.25) insurance experienced significantly higher post-surgical complications, in-hospital mortality (Black OR = 1.18, 95 % CI: 1.00-1.39), and longer hospital stay (Black β = 1.33, 95 % CI: 1.16-1.50) compared with White patients or patients with private insurance. Racial and socio-economic differences were observed in the receipt of surgery and surgical outcomes among hospitalized patients with malignant colorectal cancer in the US.

A Religious Framework as a Lens for Understanding the Intersection of Genetics, Health, and Disease

PubMed Central

Harris, Tina M.; Keeley, Bethany; Barrientos, Samantha; Gronnvoll, Marita; Landau, Jamie; Groscurth, Chris; Shen, Lijiang; Cheng, You-You; Cisneros, David

2009-01-01

The primary goal of this study was to determine the extent to which religious frameworks inform lay public understandings of genes and disease. Contrary to existing research, there were minimal differences between racial groups. We did, however, observe two patterns in that data that are worthy of discussion. First, because participants were from the South, the finding that participants from both racial groups ascribe to a religious belief system to make sense of their lived experiences is not surprising. Rather, it appears to be reflective of the religious culture that is an integral part of the South and our identity as a nation. A second noteworthy finding is that while a significant number of participants believe a relationship exists between health status, genes, and religious behaviors, they also recognize that positive health behaviors must also be adopted as a means for staving off disease. In some cases, however, there was a belief that health issues could dissolve or disappear as a result of certain religious behaviors such as prayer. PMID:19170099

Disparity vs inequity: toward reconceptualization of pain treatment disparities.

PubMed

Meghani, Salimah H; Gallagher, Rollin M

2008-01-01

"Disparity" and "inequity" are two interdependent, yet distinct concepts that inform our discourse on ethics and morals in pain medicine practice and in health policy. Disparity implies a difference of some kind, whereas inequity implies unfairness and injustice. An overwhelming body of literature documents racial/ethnic disparities in health. The debate on health disparities is generally formulated using the principle of "horizontal equity," which requires that individuals having the same needs be treated equally. While some types of health treatments are amenable to the principle of horizontal equity, others may not be appropriately studied in this way. The existing research surrounding racial/ethnic disparities in pain treatment presents a conceptual predicament when placed within the framework of horizontal equity. Using pain treatment as a prototype, we advance the conceptual debate about racial/ethnic disparities in health. More specifically, we ask three questions: (1) When may disparities be considered inequities? (2) When may disparities not be considered inequities? (3) What are the uncertainties in the disparity-inequity discourse? Significant policy implications may result from the manner in which health disparities are conceptualized. Increasingly, researchers and policy makers use the term disparity interchangeably with inequity. This usage confuses the meaning and application of these distinct concepts. In a given health care setting, different types of disparities may operate simultaneously, each requiring serious scrutiny to avoid categorical interpretation leading to misguided practice and policy. While the science of pain treatment disparities is still emerging, the authors present one perspective toward the conceptualization of racial/ethnic disparities in pain treatment.

Racial disparities in knowledge of stroke and heart attack risk factors and warning signs among Michigan adults.

PubMed

Fussman, Chris; Rafferty, Ann P; Reeves, Mathew J; Zackery, Shannon; Lyon-Callo, Sarah; Anderson, Beth

2009-01-01

To describe the level of knowledge regarding risk factors and warning signs for stroke and heart attack among White and African American adults in Michigan and to quantify racial disparities. Knowledge of stroke and heart attack risk factors and warning signs was assessed by using data from the 2004 Michigan Behavioral Risk Factor Survey. Prevalence estimates of knowledge were generated, and statistical differences in knowledge between Whites and African Americans were assessed. Adequate knowledge was defined as knowing 3 correct warning signs or risk factors. Logistic regression models were used to quantify the racial disparity in knowledge while controlling for potential confounding. Whites had substantially higher levels of adequate knowledge of risk factors (stroke: 31.6% vs 13.8%; heart attack: 52.6% vs 24.3%) and warning signs (stroke: 30.0% vs 17.2%; heart attack: 29.3% vs 13.8%) compared with African Americans (all observed differences were significant at P < .05). The odds of adequate knowledge of risk factors (stroke: adjusted odds ratio [AOR] 2.9; heart attack: AOR 3.4) and warning signs (stroke: AOR 2.0; heart attack: AOR 2.4) were significantly higher for Whites than for African Americans. A strong racial disparity in the knowledge of stroke and heart attack risk factors and warning signs exists among Michigan adults. Communitywide public education programs in conjunction with targeted interventions for at-risk populations are necessary to produce meaningful improvements in the awareness of stroke and heart attack risk factors and warning signs among Michigan adults.

Racial and Marital Status Differences in Faculty Pay.

ERIC Educational Resources Information Center

Toutkoushian, Robert K.

1998-01-01

Study estimated how pay disparity varied by race, marital status, gender, and field. Results show considerable differences overall, with unexplained wage gaps for racial/ethnic group, dramatic variations between men and women, and further by field. Earnings differences among racial/ethnic categories are not uniform. The return on marriage for men…

Is there progress toward eliminating racial/ethnic disparities in the leading causes of death?

PubMed

Keppel, Kenneth G; Pearcy, Jeffrey N; Heron, Melonie P

2010-01-01

We examined changes in relative disparities between racial/ethnic populations for the five leading causes of death in the United States from 1990 to 2006. The study was based on age-adjusted death rates for four racial/ethnic populations from 1990-1998 and 1999-2006. We compared the percent change in death rates over time between racial/ethnic populations to assess changes in relative differences. We also computed an index of disparity to assess changes in disparities relative to the most favorable group rate. Except for stroke deaths from 1990 to 1998, relative disparities among racial/ethnic populations did not decline between 1990 and 2006. Disparities among racial/ethnic populations increased for heart disease deaths from 1999 to 2006, for chronic obstructive pulmonary disease deaths from 1990 to 1998, and for chronic lower respiratory disease deaths from 1999 to 2006. Deaths rates for the leading causes of death are generally declining; however, relative differences between racial/ethnic groups are not declining. The lack of reduction in relative differences indicates that little progress is being made toward the elimination of racial/ethnic disparities.

Racialized legal status as a social determinant of health.

PubMed

Asad, Asad L; Clair, Matthew

2018-02-01

This article advances the concept of racialized legal status (RLS) as an overlooked dimension of social stratification with implications for racial/ethnic health disparities. We define RLS as a social position based on an ostensibly race-neutral legal classification that disproportionately impacts racial/ethnic minorities. To illustrate the implications of RLS for health and health disparities in the United States, we spotlight existing research on two cases: criminal status and immigration status. We offer a conceptual framework that outlines how RLS shapes disparities through (1) primary effects on those who hold a legal status and (2) spillover effects on racial/ethnic in-group members, regardless of these individuals' own legal status. Primary effects of RLS operate by marking an individual for material and symbolic exclusion. Spillover effects result from the vicarious experiences of those with social proximity to marked individuals, as well as the discredited meanings that RLS constructs around racial/ethnic group members. We conclude by suggesting multiple avenues for future research that considers RLS as a mechanism of social inequality with fundamental effects on health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Deaf college students' attitudes toward racial/ethnic diversity, campus climate, and role models.

PubMed

Parasnis, Ila; Samar, Vincent J; Fischer, Susan D

2005-01-01

Deaf college students' attitudes toward a variety of issues related to racial/ethnic diversity were surveyed by contacting all racial/ethnic minority deaf students and a random sample of Caucasian deaf students attending the National Technical Institute for the Deaf (NTID), Rochester Institute of Technology; 38% completed the survey. Although racial/ethnic groups similarly perceived NTID's commitment and efforts related to diversity, they differed significantly on some items related to campus climate and role models. Furthermore, the racial/ethnic minority groups differed from each other in their perceptions of campus comfort level, racial conflict, friendship patterns, and availability of role models. Educational satisfaction was positively correlated with campus comfort level; both correlated negatively with perception of discrimination and racial conflict. Qualitative data analyses supported quantitative data analyses and provided rich detail that facilitated interpretation of deaf students' experiences related to racial/ethnic diversity.

Racial Differences in Communication Apprehension and Interprofessional Socialization in Fourth-Year Doctor of Pharmacy Students

PubMed Central

Karpinski, Aryn C.

2016-01-01

Objective. To examine racial differences in communication apprehension and interprofessional socialization in fourth-year PharmD students and to investigate the relationship between the two constructs. Methods. Two measures with reliability and validity psychometric evidence were administered to fourth-year pharmacy students at a single historically black university with a large racial minority population. The Personal Report of Communication Apprehension (PRCA-24) measures level of fear or anxiety associated with communication. The Interprofessional Socialization and Valuing Scale (ISVS) measures beliefs, attitudes, and behaviors towards interprofessional collaborative practice. Results. One hundred fourteen students completed the survey. This produced a 77.4% response rate and 45.6% of the participants were African American. There were significant differences between races (ie, White, African-American, and Asian) on both measures. The PCRA-24 and ISVS were significantly correlated in each racial group. Conclusion. As pharmacy education moves to more interprofessional collaborations, the racial differences need to be considered and further explored. Pharmacy curricula can be structured to promote students’ comfort when communicating interprofessionally across racial groups. Understanding of culture and early education in cultural competence may need to be emphasized to navigate racial or cultural differences. PMID:26941434

Primary Care Providers Perceptions of Racial/Ethnic and Socioeconomic Disparities in Hypertension Control

PubMed Central

Nuccio, Eugene; Leiferman, Jenn A.; Sauaia, Angela

2015-01-01

OBJECTIVE To evaluate the attitudes and perceptions of primary care providers (PCPs) regarding the presence and underlying sources of racial/ethnic and socioeconomic disparities in hypertension control. METHODS We conducted a survey of 115 PCPs from 2 large academic centers in Colorado. We included physicians, nurse practitioners, and physician assistants. The survey assessed provider recognition and perceived contributors of disparities in hypertension control. RESULTS Respondents were primarily female (66%), non-Hispanic White (84%), and physicians (80%). Among respondents, 67% and 73% supported the collection of data on the patients’ race/ethnicity and socioeconomic status (SES), respectively. Eighty-six percent and 89% agreed that disparities in race/ethnicity and SES existed in hypertension care within the US health system. However, only 33% and 44% thought racial/ethnic and socioeconomic disparities existed in the care of their own patients. Providers were more likely to perceive patient factors rather than provider or health system factors as mediators of disparities. However, most supported interventions such as improving provider communication skills (87%) and cultural competency training (89%) to reduce disparities in hypertension control. CONCLUSIONS Most providers acknowledged that racial/ethnic and socioeconomic disparities in hypertension control exist in the US health system, but only a minority reported disparities in care among patients they personally treat. Our study highlights the need for testing an intervention aimed at increasing provider awareness of disparities within the local health setting to improve hypertension control for minority patients. PMID:25631381

Racial and ethnic disparities in the receipt of cancer treatment.

PubMed

Shavers, Vickie L; Brown, Martin L

2002-03-06

A disproportionate number of cancer deaths occur among racial/ethnic minorities, particularly African Americans, who have a 33% higher risk of dying of cancer than whites. Although differences in incidence and stage of disease at diagnosis may contribute to racial disparities in mortality, evidence of racial disparities in the receipt of treatment of other chronic diseases raises questions about the possible role of inequities in the receipt of cancer treatment. To evaluate racial/ethnic disparities in the receipt of cancer treatment, we examined the published literature that addressed access/use of specific cancer treatment procedures, trends in patterns of use, or survival studies. We found evidence of racial disparities in receipt of definitive primary therapy, conservative therapy, and adjuvant therapy. These treatment differences could not be completely explained by racial/ethnic variation in clinically relevant factors. In many studies, these treatment differences were associated with an adverse impact on the health outcomes of racial/ethnic minorities, including more frequent recurrence, shorter disease-free survival, and higher mortality. Reducing the influence of nonclinical factors on the receipt of cancer treatment may, therefore, provide an important means of reducing racial/ethnic disparities in health. New data resources and improved study methodology are needed to better identify and quantify the full spectrum of nonclinical factors that contribute to the higher cancer mortality among racial/ethnic minorities and to develop strategies to facilitate receipt of appropriate cancer care for all patients.

Racial Differences in Social Support and Coping Among Family Caregivers of Patients with Prostate Cancer

PubMed Central

Vines, Anissa I.; Demissie, Zewditu

2018-01-01

More than 60 million Americans are informal caregivers to adults, which can negatively affect their health. Data from 126 White and 62 African American female caregivers in North Carolina were analyzed to describe social support and coping among family caregivers of patients with prostate cancer and to assess for racial differences. Social support amount and some coping methods differed by race. There was no racial difference in social support satisfaction. Borderline significant difference in social support by health status was found and this differed by race. These racial differences should be explored further to better understand the availability of caregiving resources and their health effects. PMID:23656257

Racial discrimination & cardiovascular disease risk: my body my story study of 1005 US-born black and white community health center participants (US).

PubMed

Krieger, Nancy; Waterman, Pamela D; Kosheleva, Anna; Chen, Jarvis T; Smith, Kevin W; Carney, Dana R; Bennett, Gary G; Williams, David R; Thornhill, Gisele; Freeman, Elmer R

2013-01-01

To date, limited and inconsistent evidence exists regarding racial discrimination and risk of cardiovascular disease (CVD). Cross-sectional observational study of 1005 US-born non-Hispanic black (n = 504) and white (n = 501) participants age 35-64 randomly selected from community health centers in Boston, MA (2008-2010; 82.4% response rate), using 3 racial discrimination measures: explicit self-report; implicit association test (IAT, a time reaction test for self and group as target vs. perpetrator of discrimination); and structural (Jim Crow status of state of birth, i.e. legal racial discrimination prior 1964). Black and white participants both had adverse cardiovascular and socioeconomic profiles, with black participants most highly exposed to racial discrimination. Positive crude associations among black participants occurred for Jim Crow birthplace and hypertension (odds ratio (OR) 1.92, 95% confidence interval (CI) 1.28, 2.89) and for explicit self-report and the Framingham 10 year CVD risk score (beta = 0.04; 95% CI 0.01, 0.07); among white participants, only negative crude associations existed (for IAT for self, for lower systolic blood pressure (SBP; beta = -4.86; 95% CI -9.08, -0.64) and lower Framingham CVD score (beta = -0.36, 95% CI -0.63, -0.08)). All of these associations were attenuated and all but the white IAT-Framingham risk score association were rendered null in analyses that controlled for lifetime socioeconomic position and additional covariates. Controlling for racial discrimination, socioeconomic position, and other covariates did not attenuate the crude black excess risk for SBP and hypertension and left unaffected the null excess risk for the Framingham CVD score. Despite worse exposures among the black participants, racial discrimination and socioeconomic position were not associated, in multivariable analyses, with risk of CVD. We interpret results in relation to constrained variability of exposures and outcomes and discuss implications for valid research on social determinants of health.

Racial/Ethnic Disparities in Meeting 5-2-1-0 Recommendations among Children and Adolescents in the United States.

PubMed

Haughton, Christina F; Wang, Monica L; Lemon, Stephenie C

2016-08-01

To evaluate racial/ethnic disparities among children and adolescents in meeting the 4 daily 5-2-1-0 nutrition and activity targets in a nationally representative sample. The 5-2-1-0 message summarizes 4 target daily behaviors for obesity prevention: consuming ≥5 servings of fruit and vegetables, engaging in ≤2 hours of screen time, engaging in ≥1 hour of physical activity, and consuming 0 sugar-sweetened beverages daily. The National Health and Nutrition Examination Survey (2011-2012) data were used. The study sample included Hispanic (n = 608), non-Hispanic black (n = 609), Asian (n = 253), and non-Hispanic white (n = 484) youth 6-19 years old. The 5-2-1-0 targets were assessed using 24-hour dietary recalls, the Global Physical Activity Questionnaire, and sedentary behavior items. Outcomes included meeting all targets, no targets, and individual targets. Multivariable logistic regression models accounting for the complex sampling design were used to evaluate the association of race/ethnicity with each outcome among children and adolescents separately. None of the adolescents and <1% of children met all 4 of the 5-2-1-0 targets, and 19% and 33%, of children and adolescents, respectively, met zero targets. No racial/ethnic differences in meeting zero targets were observed among children. Hispanic (aOR, 1.76 [95% CI, 1.04-2.98]), non-Hispanic black (aOR, 1.82 [95% CI, 1.04-3.17]), and Asian (aOR, 1.48 [95% CI, 1.08-2.04]) adolescents had greater odds of meeting zero targets compared with non-Hispanic whites. Racial/ethnic differences in meeting individual targets were observed among children and adolescents. Despite national initiatives, youth in the US are far from meeting 5-2-1-0 targets. Racial/ethnic disparities exist, particularly among adolescents. Copyright © 2016 Elsevier Inc. All rights reserved.

The Economic Benefits of Closing Educational Achievement Gaps: Promoting Growth and Strengthening the Nation by Improving the Educational Outcomes of Children of Color

ERIC Educational Resources Information Center

Lynch, Robert G.; Oakford, Patrick

2014-01-01

Our nation is currently experiencing growing levels of income and wealth inequality, which are contributing to longstanding racial and ethnic gaps in education outcomes and other areas. This report quantifies the economic benefits of closing one of the most harmful racial and ethnic gaps: the educational achievement gap that exists between black…

Tricks of the Trade: State Legislative Actions in School Finance Policy that Perpetuate Racial Disparities in the Post-Brown Era

ERIC Educational Resources Information Center

Baker, Bruce D.; Green, Preston C., III

2005-01-01

This article discusses the tricks of the trade that legislatures in formerly de jure segregated states might use to maintain racial funding disparities in existence before Brown and whether such ploys might be vulnerable to legal challenges. The first section provides an overview of modern school finance formulas and explains how legislatures in…

Outdoor recreation and nontraditional users: results of focus group interviews with racial and ethnic minorities

Treesearch

Robert C. Burns; Elizabeth Covelli; Alan Graefe

2008-01-01

Resource managers in Oregon State Parks and the Pacific Northwest Region of the U.S. Department of Agriculture, Forest Service (U.S. Forest Service) identified a need to better understand the needs of existing and potential stakeholders who may visit public recreation lands in Oregon. Specifically, this research was designed to understand the perceptions of racial and...

Racial residential segregation: a fundamental cause of racial disparities in health.

PubMed

Williams, D R; Collins, C

2001-01-01

Racial residential segregation is a fundamental cause of racial disparities in health. The physical separation of the races by enforced residence in certain areas is an institutional mechanism of racism that was designed to protect whites from social interaction with blacks. Despite the absence of supportive legal statutes, the degree of residential segregation remains extremely high for most African Americans in the United States. The authors review evidence that suggests that segregation is a primary cause of racial differences in socioeconomic status (SES) by determining access to education and employment opportunities. SES in turn remains a fundamental cause of racial differences in health. Segregation also creates conditions inimical to health in the social and physical environment. The authors conclude that effective efforts to eliminate racial disparities in health must seriously confront segregation and its pervasive consequences.

White on black: can white parents teach black adoptive children how to understand and cope with racism?

PubMed

Smith, Darron T; Juarez, Brenda G; Jacobson, Cardell K

2011-01-01

In this article, the authors examine White parents’ endeavors toward the racial enculturation and inculcation of their transracially adopted Black children. Drawing on in-depth interviews, the authors identify and analyze themes across the specific race socialization strategies and practices White adoptive parents used to help their adopted Black children to develop a positive racial identity and learn how to effectively cope with issues of race and racism. The central aim of this article is to examine how these lessons about race help to connect family members to U.S. society’s existing racial hierarchy and how these associations position individuals to help perpetuate or challenge the deeply embedded and historical structures of White supremacy. The authors use the notion of White racial framing to move outside of the traditional arguments for or against transracial adoption to instead explore how a close analysis of the adoptive parents’ racial instructions may serve as a learning tool to foster more democratic and inclusive forms of family and community.

Fair Play: A Study of Scientific Workforce Trainers’ Experience Playing an Educational Video Game about Racial Bias

PubMed Central

Kaatz, Anna; Carnes, Molly; Gutierrez, Belinda; Savoy, Julia; Samuel, Clem; Filut, Amarette; Pribbenow, Christine Maidl

2017-01-01

Explicit racial bias has decreased in the United States, but racial stereotypes still exist and conspire in multiple ways to perpetuate the underparticipation of Blacks in science careers. Capitalizing on the potential effectiveness of role-playing video games to promote the type of active learning required to increase awareness of and reduce subtle racial bias, we developed the video game Fair Play, in which players take on the role of Jamal, a Black male graduate student in science, who experiences discrimination in his PhD program. We describe a mixed-methods evaluation of the experience of scientific workforce trainers who played Fair Play at the National Institutes of Health Division of Training Workforce Development and Diversity program directors’ meeting in 2013 (n = 47; 76% female, n = 34; 53% nonwhite, n = 26). The evaluation findings suggest that Fair Play can promote perspective taking and increase bias literacy, which are steps toward reducing racial bias and affording Blacks equal opportunities to excel in science. PMID:28450447

Racial/ethnic Differences in Body Mass Index: The Roles of Beliefs about Thinness and Dietary Restriction

PubMed Central

Vaughan, Christine A.; Sacco, William P.; Beckstead, Jason W.

2014-01-01

The greater BMI of African American relative to Caucasian women is implicated in racial/ethnic disparities in health outcomes. The principal aim of the current study was to evaluate a theoretical account of racial/ethnic differences in BMI. Thin-ideal internalization, the perceived romantic appeal of thinness, dietary restriction, weight, and height were assessed via self-report measures on a sample of female undergraduates of African American (n = 140) and Caucasian (n = 676) race/ethnicity. Using structural equation modeling, support was obtained for the primary hypothesis that racial/ethnic differences in BMI are explained by Caucasian women’s greater thin-ideal internalization and perceived romantic appeal of thinness, thereby resulting in greater levels of dietary restriction. Current findings illustrate the potential for racial/ethnic differences in sociocultural standards of appearance to influence racial/ethnic disparities in physical health, of which BMI is a marker, via effects on weight control behavior. PMID:18585109

Constructing Authority across Racial Difference: A White Teacher Signifyin(g) with African American Students in a High School English Classroom

ERIC Educational Resources Information Center

Ford, Amy Carpenter

2010-01-01

This in-depth case study of classroom interaction illuminated how a white female teacher and African American students used talk to build positive authority relationships across their racial difference. Racial difference in classrooms can engender cultural misunderstandings between teachers and students around behavior, communication, and learning…

"As Nature Has Formed Them": The History and Current Status of Racial Difference Research

ERIC Educational Resources Information Center

Skiba, Russell

2012-01-01

Background/Context: Research in the latter half of the 20th century purporting to show significant racial differences in intelligence and social behavior appears to pit civil rights concerns against the freedom of scientific inquiry. The core hypotheses and presumptions of recent research on racial difference are not new, however, but spring from…

Racial and Ethnic Disparities in Dietary Intake among California Children

PubMed Central

Guerrero, Alma D.; Chung, Paul

2015-01-01

Background The prevalence of childhood obesity among racial and ethnic minority groups is high. Multiple factors affect the development of childhood obesity including dietary practices. Objective To examine the racial and ethnic differences in reported dietary practices among the largest minority groups of California children. Methods Data from the 2007 and 2009 California Health Interview Survey were analyzed using multivariate regression with survey weights to examine how race, ethnicity, socio-demographics, and child factors were associated with specific dietary practices. Results The sample included 15,902 children ages 2-11. In multivariate regressions, substantial differences in fruit juice, fruit, vegetable, sugar-sweetened beverages, sweets, and fast food consumption were found among the major racial and ethnic groups of children. Asians regardless of interview language were more likely than Whites to have low vegetable intake (Asians English interview OR, 1.20; 95% CI, 1.01-1.43; Asians non-English-interview OR, 2.09; 95% CI, 1.23-3.57) and low fruit (Asians English interview OR, 1.69; 95% CI, 1.41-2.03; Asians non-English interview OR, 3.04; 95% CI, 2.00-4.62) consumption. Latinos regardless of interview language were also more likely than Whites to have high fruit juice (Latinos English interview OR, 1.54; 95% CI and 1.28-1.84; Latinos non-English interview OR, 1.29; 95% 1.02-1.62) and fast food (Latinos English interview OR 1.74; 95% CI, 1.46-2.08 2.16; Latinos non-English interview OR 1.48; 95% CI, 1.16-1.91) consumption; but Latinos were less likely than Whites to consume sweets (Latinos English interview OR, 0.81; 95% CI, 0.66-0.99; Latinos non-English interview OR, 0.56; 95% CI 1.16-1.91). Conclusions Significant racial and ethnic differences exist in the dietary practices of California children. Increased fruit and vegetable consumption appears to be associated with parental education but not income. Our findings suggest that anticipatory guidance and dietary counseling might benefit from tailoring to specific ethnic groups to potentially address disparities in overweight and obesity. PMID:26433453

Racial disparity in colorectal cancer: the role of equal treatment.

PubMed

Laryea, Jonathan A; Siegel, Eric; Klimberg, Suzanne

2014-03-01

Racial disparity exists in colorectal cancer outcomes. The reasons for this are multifactorial. The aim of this study was to evaluate the role of equal treatment of blacks and whites in the elimination of racial disparity in colorectal cancer outcomes. A retrospective cohort study of 878 patients with colorectal cancer diagnosed between 1998 and 2008 was done at a University tertiary referral center. Demographic variables including age, sex, and race were abstracted. Tumor-specific variables including American Joint Committee on Cancer stage, anatomic tumor location, vital status, and survival were obtained. Treatment-specific variables including surgery, chemotherapy, radiotherapy, and follow-up were also obtained. Racial differences in these variables were studied and their effect on overall survival was determined by using univariate and multivariate analyses. The findings were then compared with previous data from our institution. University tertiary referral center. The primary outcomes measured were overall survival and cancer-specific mortality. A total of 878 patients met the inclusion criteria, 186 (21.2%) of whom were black. Blacks were significantly younger at diagnosis in comparison with whites, with a median (quartiles) age of 55 years (28-87) compared with 59 years (23-94) (p = 0.0012). Equal proportions of blacks (78.5%) and whites (79.2%) underwent surgery (p = 0.84), similar proportions of blacks (55.4%) and whites (60.8%) received chemotherapy (p = 0.18), and similar proportions of blacks (17.2%) and whites (20.5%) received radiation therapy (p = 0.31). There was no difference in overall survival or cancer-specific mortality between the 2 racial groups. Univariate analysis showed American Joint Committee on Cancer stage and surgery as the only statistically significant factors for overall survival. On multivariate analysis, stage, surgery, and chemotherapy were the only statistically significant factors. Race was not an independent determinant of survival. There were no differences in overall survival and cancer-related mortality between blacks and whites, and this may have resulted from identical treatment. The previously noted disparities in treatment and overall survival at our institution have disappeared.

Racial differences in dietary changes and quality of life after a colorectal cancer diagnosis: a follow-up of the Study of Outcomes in Colorectal Cancer Survivors cohort.

PubMed

Lewis, Cari M; Wolf, W Asher; Xun, Pengcheng; Sandler, Robert S; He, Ka

2016-06-01

Substantial racial disparities exist in colorectal cancer (CRC) survival. This was an exploratory study to assess the racial differences in dietary changes in relation to quality of life (QoL), recurrence, and survival after a CRC diagnosis. Four hundred fifty-three stage II CRC patients were enrolled in the cohort study through the North Carolina Central Cancer Registry. Self-reported diet, physical activity, treatment, comorbidities, demographic characteristics, and QoL were collected at diagnosis and 12 and 24 mo after diagnosis. QoL was assessed with the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) and the Medical Outcomes 12-Item Short Form Health Survey (SF-12) inventories. An overall dietary index score was calculated. Generalized estimating equations and logistic regression models were used to explore potential associations. Statistical power for this study was ∼50%. African Americans (n = 81) were more likely to increase intakes of reduced-fat milk, vegetables, and fruit and decrease intakes of regular cheese, red meat, fried food, fast food, and fat (P < 0.05) than were Caucasians (n = 184) 24 mo after diagnosis. The least-squares means ± SEs for changes in dietary index were 6.05 ± 0.40 and 4.07 ± 0.27 for African Americans and Caucasians, respectively (P < 0.001). African Americans exhibited higher scores on portions of the FACT-C (colorectal cancer subscale: β = 1.04; 95% CI: 0.26, 1.82) and the SF-12 (Physical Component Summary: β = 2.49; 95% CI: 0.51, 4.48). Those who improved their dietary quality over 24 mo had lower risk of recurrence and mortality combined (OR: 0.42; 95% CI: 0.25, 0.72). African Americans made more healthful changes in diet and had a higher QoL than did Caucasians in this underpowered study that used self-reported dietary data. No racial differences in recurrence or survival were evident, although improvements in dietary quality did reveal survival benefits overall. More prospective research on racial disparities in health behavior changes after diagnosis is desperately needed. © 2016 American Society for Nutrition.

Exploring Student Affairs Professionals' Experiences with the Campus Racial Climate at a Hispanic Serving Institution (HSI)

ERIC Educational Resources Information Center

Garcia, Gina A.

2016-01-01

Although we know that people experience the campus racial climate differently based on their racial/ethnic identity, less is known about how they perceive the climate based on the racial/ethnic diversity of their institution and specifically within their department. Instead, the campus racial climate has largely been studied at Predominantly White…

Impulsivity moderates the association between racial discrimination and alcohol problems.

PubMed

Latzman, Robert D; Chan, Wing Yi; Shishido, Yuri

2013-12-01

Alcohol use among university students is a serious public health concern, particularly among minority students who may use alcohol to cope with experiences of racial discrimination. Although the impact of racial discrimination on alcohol use has been well-established, individual differences in factors that may act to either attenuate or exacerbate the negative effects of racial discrimination are largely unknown. One potentially fruitful individual differences trait that has repeatedly been found to predict alcohol problems is the multidimensional personality trait of impulsivity. Nonetheless, the ways in which various aspects of impulsivity interact with racial discrimination is yet unknown. The current study, therefore, examined the joint and interactive contribution of racial discrimination and impulsivity in the prediction of alcohol consumption among racial minority university students. Participants included 336 Black/African-American and Asian/Asian-American university students. Results revealed both racial discrimination and impulsivity to be significantly associated with alcohol problems. Further, individuals' responses to racial discrimination were not uniform. Specifically, the association between racial discrimination and alcohol problems was moderated by lack of Premeditation; racial discrimination was most strongly predictive of alcohol problems for those who reported low level of premeditation. Findings from the present study highlight the importance of investigating risk factors for alcohol problems across multiple levels of the ecology as individual personality traits appear to relate to how one might respond to the experience of racial discrimination. © 2013.

Social status correlates of reporting gender discrimination and racial discrimination among racially diverse women.

PubMed

Ro, Annie E; Choi, Kyung-Hee

2009-01-01

The growing body of research on discrimination and health indicates a deleterious effect of discrimination on various health outcomes. However, less is known about the sociodemographic correlates of reporting racial discrimination and gender discrimination among racially diverse women. We examined the associations of social status characteristics with lifetime experiences of racial discrimination and gender discrimination using a racially-diverse sample of 754 women attending family planning clinics in North California (11.4% African American, 16.8% Latina, 10.1% Asian and 61.7% Caucasian). A multivariate analysis revealed that race, financial difficulty and marital status were significantly correlated with higher reports of racial discrimination, while race, education, financial difficulty and nativity were significantly correlated with gender discrimination scores. Our findings suggest that the social patterning of perceiving racial discrimination is somewhat different from that of gender discrimination. This has implications in the realm of discrimination research and applied interventions, as different forms of discrimination may have unique covariates that should be accounted for in research analysis or program design.

An initial evaluation of the role of emotion and impulsivity in explaining racial/ethnic differences in the use of corporal punishment.

PubMed

Lorber, Michael F; O'Leary, Susan G; Slep, Amy M Smith

2011-11-01

The authors sought to provide an initial evaluation of the hypothesis that corporal punishment is less strongly associated with parental emotion and impulsivity among African American ("Black") in contrast to European American ("White") parents. White-Latino and Black-Latino differences in corporal punishment, emotion, and impulsivity were explored, given the lack of existing theory predicting group differences. Couples with 3- to 7-year-old children were recruited via random digit dialing, and the parents completed questionnaires and an analog parent-child conflict task in the laboratory. Group differences were tested pooling mothers and fathers via dyadic data analyses. Black parents (N = 57) had more positive attitudes toward and used more corporal punishment than White parents (N = 730). Latino American parents' (N = 78) views and use of corporal punishment were similar to those of White parents. By and large, associations of corporal punishment with parents' impulsivity and emotion did not significantly vary by race/ethnicity. The present findings, although preliminary, do not support the emotion-impulsivity hypothesis of racial differences in the use of corporal punishment suggested by K. Deater-Deckard, K. A. Dodge, J. E. Bates, and G. S. Pettit (1996).

Racial differences in attitudes toward personalized medicine.

PubMed

Diaz, V A; Mainous, A G; Gavin, J K; Wilson, D

2014-01-01

Patient concerns regarding personalized medicine may limit its use. This study assesses racial differences in attitudes toward personalized medicine, evaluating variables that may influence these attitudes. A convenience sample of 190 adults (≥18 years) from an academic primary care practice was surveyed regarding awareness and acceptance of personalized medicine, plus concerns and benefits regarding its use. Logistic regressions predicting awareness, acceptance and concerns were performed, controlling for race, gender, marital status, education, children, internet use, and self-reported discrimination. The sample was 35% non-Hispanic white (NHW) and 34.7% male. More NHW participants expressed acceptance of personalized medicine than non-Hispanic black (NHB) participants (94.4 vs. 81.9%, p = 0.0190). More NHBs were concerned about the use of genes without consent (57.3 vs. 20.6%, p < 0.0001), sharing genetic information without consent (65.0 vs. 35.6%, p < 0.0001), discrimination based on genes (62.4 vs. 34.3%, p = 0.0002), and lack of access due to cost (75.0 vs. 48.0%, p = 0.0002). In logistic regressions, NHBs (OR = 7.46, 95% CI = 3.04-18.32) and those self-reporting discrimination (OR = 2.87, 95% CI = 1.22-6.78) had more concerns about the misuse of genes and costs associated with personalized medicine. Racial differences exist in attitudes toward personalized medicine and may be influenced by self-reported discrimination. Further study to understand factors influencing the acceptance of personalized medicine could help encourage its use.

Mommy markets: Racial differences in lesbians' dating preferences for women with children.

PubMed

Rafalow, Matthew H; Kizer, Jessica M

2017-11-22

Recent work shows that race is a critical factor in shaping sexual identities, partner preference, and family formation, suggesting there may be racial differences in whether lesbians already have children at the time that they look for companions. In this study, we draw on a sample of 1,923 lesbians on Match.com to quantitatively test whether there are racial differences in dating preferences for women with children, underscoring implications for family inequality through racial differences in who has children when looking for a partner. We find that Blacks, Latinas, and Asians are more likely than Whites to not only have children but also be open to dating other women with children. This suggests that race differentially structures lesbians' openness to partners with children, and such preferences may be a possible mechanism for racial stratification.

More eyes on the prize: variability in White Americans' perceptions of progress toward racial equality.

PubMed

Brodish, Amanda B; Brazy, Paige C; Devine, Patricia G

2008-04-01

Much recent research suggests that Whites and non-Whites think differently about issues of race in contemporary America. For example, Eibach and Ehrlinger (2006) recently demonstrated that Whites perceive that more progress toward racial equality has been made as compared to non-Whites. The authors of this article sought to extend Eibach and Ehrlinger's analysis. To this end, they found that differences in Whites' and non-Whites' perceptions of racial progress can be explained by the reference points they use for understanding progress toward racial equality (Study 1). Furthermore, they demonstrated that there is variability in White people's perceptions of racial progress that can be explained by self-reported racial prejudice (Studies 1 and 2). Finally, they demonstrated that White people's perceptions of racial progress predict reactions to affirmative action (Study 2). Implications for better understanding intergroup relations and reactions to social policies are discussed.

Racial/Ethnic Differences in Internalizing and Externalizing Symptoms in Adolescents

ERIC Educational Resources Information Center

McLaughlin, Katie A.; Hilt, Lori M.; Nolen-Hoeksema, Susan

2007-01-01

The prevalence of most adult psychiatric disorders varies across racial/ethnic groups and has important implications for prevention and intervention efforts. Research on racial/ethnic differences in the prevalence of internalizing and externalizing symptoms and disorders in adolescents has been less consistent or generally lacking. The current…

Differences in the Gender Gap: Comparisons across Racial/Ethnic Groups in Education and Work. Policy Information Report.

ERIC Educational Resources Information Center

Coley, Richard J.

This report considers the interaction of gender and racial/ethnic differences by addressing the issue of whether gender differences vary within racial/ethnic groups. The data encompass the education and work pipeline from elementary school, through high school, college, and graduate school, and into the workforce. Data come from a variety of…

Similarities and Differences in the Outdoor Recreation Participation of Racial/Ethnic Groups: An Example from Illinois

Treesearch

John F. Dwyer

2000-01-01

Much of the initial research on the outdoor recreation participation of racial/ethnic groups focused on between-group differences in percent participating in an activity. This tended to focus research, policy, and management on between-group differences at the expense of a more comprehensive look at the participation patterns of racial/ethnic groups. This paper...

Increasing Latency Age Children's Sensitivity to Racial and Ethnic Differences through Enhancing their Awareness and Knowledge.

ERIC Educational Resources Information Center

Lewis, Alvin D.

This practicum addressed the needs of latency age children who were insensitive to racial and ethnic differences. These needs were met by designing and developing a Cultural Awareness Program, so as to increase latency age children's sensitivity to racial and ethnic differences. The program's focus was on helping the children gain an appreciation…

Racial/Ethnic Differences in the Correlates of Mental Health Services Use among Pregnant Women with Depressive Symptoms.

PubMed

Chang, Jen Jen; Tabet, Maya; Elder, Keith; Kiel, Deborah W; Flick, Louise H

2016-09-01

Objectives To examine correlates of lifetime mental health services (MHS) use among pregnant women reporting prenatal depressive symptoms by race/ethnicity. Methods This cross-sectional population-based study included 81,910 pregnant women with prenatal depressive symptoms using data from the Florida Healthy Start prenatal screening program (2008-2012). Multivariable logistic regression was conducted to ascertain adjusted odds ratios and corresponding 95 % confidence intervals for racial/ethnic differences in the correlates of lifetime MHS use. Results Findings of this study revealed racial/ethnic differences in MHS use among women with prenatal depressive symptoms, the highest rates being among non-Hispanic Whites and the lowest rates among Mexicans and other Hispanics. Most need for care factors, including illness, tobacco use, and physical or emotional abuse, consistently predicted MHS use across racial/ethnic groups after adjusting for covariates. Adjusted associations between predisposing and enabling/restricting factors and MHS use were different for different racial/ethnic groups. Conclusions Racial/ethnic differences in MHS use were found, with pregnant Hispanic women reporting prenatal depressive symptoms being the least likely to use MHS. Our study findings have significant public health implications for targeted intervention for pregnant women with prenatal depressive symptoms.

Cultural humility and racial microaggressions in counseling.

PubMed

Hook, Joshua N; Farrell, Jennifer E; Davis, Don E; DeBlaere, Cirleen; Van Tongeren, Daryl R; Utsey, Shawn O

2016-04-01

Racial microaggressions may contribute to poor counseling outcomes in racial/ethnic minority clients. The present study examined the occurrence of racial microaggressions in counseling using a large and diverse sample and explored the association between perceived cultural humility of the counselor and racial microaggressions. Racial/ethnic minority participants (N = 2,212) answered questions about the frequency and impact of racial microaggressions in counseling and the characteristics of their counselor. The majority of clients (81%) reported experiencing at least 1 racial microaggression in counseling. Participants most commonly reported racial microaggressions involving denial or lack of awareness of stereotypes and bias and avoidance of discussing cultural issues. There were few differences in racial microaggression frequency or impact based on client race/ethnicity and counselor race/ethnicity. Racially matched clients viewed racial microaggressions as more impactful than did clients who were not racially matched. Client-perceived cultural humility of the counselor was associated with fewer microaggressions experienced in counseling. We conclude by discussing limitations, areas for future research, and implications for counseling. (c) 2016 APA, all rights reserved).

Queering Black Racial Identity Development

ERIC Educational Resources Information Center

Johnson, Alandis A.; Quaye, Stephen John

2017-01-01

We used queer theory to encourage readers to think differently about previous theories about Black racial identity development. Queer theory facilitates new and deeper understandings of how Black people develop their racial identities, prompting more fluidity and nuance. Specifically, we present a queered model of Black racial identity development…

Lack of racial and sex stereotypes in the prediction of completed suicide.

PubMed

Redd, Charlitta S; Lester, David

2013-12-01

A sample of 252 college students was presented with vignettes and asked to predict the likelihood that the protagonist in each vignette would complete suicide. The crisis confronting the protagonist significantly affected judgments of the likelihood of completed suicide, but neither the race nor the sex of the protagonist affected this judgment, suggesting that sex and racial stereotypes about who completes suicide may no longer exist.

Exploring racial/ethnic differences in substance use: a preliminary theory-based investigation with juvenile justice-involved youth.

PubMed

Feldstein Ewing, Sarah W; Venner, Kamilla L; Mead, Hilary K; Bryan, Angela D

2011-08-16

Racial/ethnic differences in representation, substance use, and its correlates may be linked to differential long-term health outcomes for justice-involved youth. Determining the nature of these differences is critical to informing more efficacious health prevention and intervention efforts. In this study, we employed a theory-based approach to evaluate the nature of these potential differences. Specifically, we hypothesized that (1) racial/ethnic minority youth would be comparatively overrepresented in the juvenile justice system, (2) the rates of substance use would be different across racial/ethnic groups, and (3) individual-level risk factors would be better predictors of substance use for Caucasian youth than for youth of other racial/ethnic groups. To evaluate these hypotheses, we recruited a large, diverse sample of justice-involved youth in the southwest (N = 651; M age = 15.7, SD = 1.05, range = 14-18 years); 66% male; 41% Hispanic, 24% African American, 15% Caucasian, 11% American Indian/Alaska Native). All youth were queried about their substance use behavior (alcohol, marijuana, tobacco, illicit hard drug use) and individual-level risk factors (school involvement, employment, self-esteem, level of externalizing behaviors). As predicted, racial/ethnic minority youth were significantly overrepresented in the juvenile justice system. Additionally, Caucasian youth reported the greatest rates of substance use and substance-related individual-level risk factors. In contrast, African American youth showed the lowest rates for substance use and individual risk factors. Contrary to predictions, a racial/ethnic group by risk factor finding emerged for only one risk factor and one substance use category. This research highlights the importance of more closely examining racial/ethnic differences in justice populations, as there are likely to be differing health needs, and subsequent treatment approaches, by racial/ethnic group for justice-involved youth. Additionally, this study highlights the need for timely, empirically supported (developmentally and cross-culturally) substance abuse interventions for all justice-involved youth.

Exploring racial/ethnic differences in substance use: a preliminary theory-based investigation with juvenile justice-involved youth

PubMed Central

2011-01-01

Background Racial/ethnic differences in representation, substance use, and its correlates may be linked to differential long-term health outcomes for justice-involved youth. Determining the nature of these differences is critical to informing more efficacious health prevention and intervention efforts. In this study, we employed a theory-based approach to evaluate the nature of these potential differences. Specifically, we hypothesized that (1) racial/ethnic minority youth would be comparatively overrepresented in the juvenile justice system, (2) the rates of substance use would be different across racial/ethnic groups, and (3) individual-level risk factors would be better predictors of substance use for Caucasian youth than for youth of other racial/ethnic groups. Methods To evaluate these hypotheses, we recruited a large, diverse sample of justice-involved youth in the southwest (N = 651; M age = 15.7, SD = 1.05, range = 14-18 years); 66% male; 41% Hispanic, 24% African American, 15% Caucasian, 11% American Indian/Alaska Native). All youth were queried about their substance use behavior (alcohol, marijuana, tobacco, illicit hard drug use) and individual-level risk factors (school involvement, employment, self-esteem, level of externalizing behaviors). Results As predicted, racial/ethnic minority youth were significantly overrepresented in the juvenile justice system. Additionally, Caucasian youth reported the greatest rates of substance use and substance-related individual-level risk factors. In contrast, African American youth showed the lowest rates for substance use and individual risk factors. Contrary to predictions, a racial/ethnic group by risk factor finding emerged for only one risk factor and one substance use category. Conclusions This research highlights the importance of more closely examining racial/ethnic differences in justice populations, as there are likely to be differing health needs, and subsequent treatment approaches, by racial/ethnic group for justice-involved youth. Additionally, this study highlights the need for timely, empirically supported (developmentally and cross-culturally) substance abuse interventions for all justice-involved youth. PMID:21846356

Chronic rhinosinusitis, race, and ethnicity.

PubMed

Soler, Zachary M; Mace, Jess C; Litvack, Jamie R; Smith, Timothy L

2012-01-01

Little is known regarding the epidemiology of chronic rhinosinusitis (CRS) in racial and ethnic minorities in the United States. This study was designed to comprehensively evaluate the current prevalence of CRS across various treatment settings to identify possible disparities in health care access and use between racial and ethnic populations. The National Health Interview Survey (NHIS), National Ambulatory Medical Care Survey (NAMCS), and National Hospital Ambulatory Medical Care Survey (NHAMCS) database registries were extracted to identify the national prevalence of CRS in race/ethnic populations and resource use in ambulatory care settings. Systematic literature review identified studies reporting treatment outcomes in minority patients electing endoscopic sinus surgery (ESS). Data were supplemented using a multi-institutional cohort of patients undergoing surgical treatment. National survey data suggest CRS is a significant health condition for all major race/ethnic groups in the United States, accounting for a sizable portion of office, emergency, and outpatient visits. Differences in insurance status, work absenteeism, and resource use were found between race/ethnic groups. Despite its prevalence, few published studies include information regarding minority patients with CRS. Most (90%) cohort studies did not provide details of race/ethnicity for ESS outcomes. Prospective cohort analysis indicated that minority surgical patients accounted for only 18%, when compared with national census estimates (35%). CRS is an important health condition for all major race/ethnic groups in the United States. Significant differences may exist across racial and ethnic categories with regard to CRS health status and health care use. Given current demographic shifts in the United States, specific attention should be given to understanding CRS within the context of racial and ethnic populations. Public clinical trial registration (www.clinicaltrials.gov) I.D. No. NCT00799097.

Racial and ethnic differences in contraceptive use among women who desire no future children, 2006-2010 National Survey of Family Growth.

PubMed

Grady, Cynthia D; Dehlendorf, Christine; Cohen, Elan D; Schwarz, E Bimla; Borrero, Sonya

2015-07-01

To evaluate racial/ethnic differences in contraceptive use among women who do not desire future pregnancy. We used the 2006-2010 National Survey of Family Growth to examine the associations between race/ethnicity and 1) use of any contraceptive method at last heterosexual intercourse and 2) effectiveness of contraceptive method used among women who stated that they did not desire any (more) children. We conducted multivariable logistic regression to assess the independent effect of race/ethnicity on these outcomes, adjusting for socio-demographic factors, reproductive characteristics, and indicators of healthcare access and utilization. The study sample consisted of 2900 women, aged 15-44 years. The vast majority of women (91.2%) used contraception at last sex, although this varied significantly by race/ethnicity (p<.01). In the fully adjusted model controlling for demographic and reproductive characteristics as well as healthcare access, compared to whites, black women were significantly less likely to use any contraception at last sex (OR: 0.43; 95% CI: 0.27-0.73), while there was no significant difference for Hispanic women (OR: 0.95; 95% CI: 0.52-1.72). Among women who used a method at last sex, the type of contraceptive method varied significantly by race/ethnicity in bivariate analysis (p<.01), although most women (59%) used a highly effective method. In the fully adjusted model, racial/ethnic differences were no longer significant. In this nationally representative cohort of women who report that they do not desire (more) children, black women were significantly less likely than white women to use any contraception at last intercourse; this difference did not appear to be due to differential access to health care. Significant racial/ethnic differences exist in contraceptive use among women who have completed childbearing, which do not appear to be explained by differential socioeconomic status, reproductive characteristics or utilization of healthcare. Other factors, including social mobility and locus of reproductive control, that may contribute to these variations should be further explored. Published by Elsevier Inc.

Poverty and racial disparities in kidney disease: the REGARDS study.

PubMed

McClellan, William M; Newsome, Britt B; McClure, Leslie A; Howard, George; Volkova, Nataliya; Audhya, Paul; Warnock, David G

2010-01-01

There are pronounced disparities among black compared to white Americans for risk of end-stage renal disease. This study examines whether similar relationships exist between poverty and racial disparities in chronic kidney disease (CKD) prevalence. We studied 22,538 participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study. We defined individual poverty as family income below USD 15,000 and a neighborhood as poor if 25% or more of the households were below the federal poverty level. As the estimated glomerular filtration rate (GFR) declined from 50-59 to 10-19 ml/min/ 1.73 m2, the black:white odds ratio (OR) for impaired kidney function increased from 0.74 (95% CI 0.66, 0.84) to 2.96 (95% CI 1.96, 5.57). Controlling for individual income below poverty, community poverty, demographic and comorbid characteristics attenuated the black:white prevalence to an OR of 0.65 (95% CI 0.57, 0.74) among individuals with a GFR of 59-50 ml/min/1.73 m2 and an OR of 2.21 (95% CI 1.25, 3.93) among individuals with a GFR between 10 and 19 ml/min/ 1.73 m2. Household, but not community poverty, was independently associated with CKD and attenuated but did not fully account for differences in CKD prevalence between whites and blacks. Copyright 2010 S. Karger AG, Basel.

Contradictions of Identity: Education and the Problem of Racial Absolutism.

ERIC Educational Resources Information Center

McCarthy, Cameron

1995-01-01

Critiques tendencies toward dogmatism and essentialism in current educational theories of racial inequality. Argues that different gender, class, and ethnic interests intersect with racial coordination and affiliation, and that to reduce racial antagonism or ameliorate educational inequities educators must consider the powerful role of nuance,…

Inter-Ethnic/Racial Facial Variations: A Systematic Review and Bayesian Meta-Analysis of Photogrammetric Studies

PubMed Central

Wen, Yi Feng; Wong, Hai Ming; Lin, Ruitao; Yin, Guosheng; McGrath, Colman

2015-01-01

Background Numerous facial photogrammetric studies have been published around the world. We aimed to critically review these studies so as to establish population norms for various angular and linear facial measurements; and to determine inter-ethnic/racial facial variations. Methods and Findings A comprehensive and systematic search of PubMed, ISI Web of Science, Embase, and Scopus was conducted to identify facial photogrammetric studies published before December, 2014. Subjects of eligible studies were either Africans, Asians or Caucasians. A Bayesian hierarchical random effects model was developed to estimate posterior means and 95% credible intervals (CrI) for each measurement by ethnicity/race. Linear contrasts were constructed to explore inter-ethnic/racial facial variations. We identified 38 eligible studies reporting 11 angular and 18 linear facial measurements. Risk of bias of the studies ranged from 0.06 to 0.66. At the significance level of 0.05, African males were found to have smaller nasofrontal angle (posterior mean difference: 8.1°, 95% CrI: 2.2°–13.5°) compared to Caucasian males and larger nasofacial angle (7.4°, 0.1°–13.2°) compared to Asian males. Nasolabial angle was more obtuse in Caucasian females than in African (17.4°, 0.2°–35.3°) and Asian (9.1°, 0.4°–17.3°) females. Additional inter-ethnic/racial variations were revealed when the level of statistical significance was set at 0.10. Conclusions A comprehensive database for angular and linear facial measurements was established from existing studies using the statistical model and inter-ethnic/racial variations of facial features were observed. The results have implications for clinical practice and highlight the need and value for high quality photogrammetric studies. PMID:26247212

Inter-Ethnic/Racial Facial Variations: A Systematic Review and Bayesian Meta-Analysis of Photogrammetric Studies.

PubMed

Wen, Yi Feng; Wong, Hai Ming; Lin, Ruitao; Yin, Guosheng; McGrath, Colman

2015-01-01

Numerous facial photogrammetric studies have been published around the world. We aimed to critically review these studies so as to establish population norms for various angular and linear facial measurements; and to determine inter-ethnic/racial facial variations. A comprehensive and systematic search of PubMed, ISI Web of Science, Embase, and Scopus was conducted to identify facial photogrammetric studies published before December, 2014. Subjects of eligible studies were either Africans, Asians or Caucasians. A Bayesian hierarchical random effects model was developed to estimate posterior means and 95% credible intervals (CrI) for each measurement by ethnicity/race. Linear contrasts were constructed to explore inter-ethnic/racial facial variations. We identified 38 eligible studies reporting 11 angular and 18 linear facial measurements. Risk of bias of the studies ranged from 0.06 to 0.66. At the significance level of 0.05, African males were found to have smaller nasofrontal angle (posterior mean difference: 8.1°, 95% CrI: 2.2°-13.5°) compared to Caucasian males and larger nasofacial angle (7.4°, 0.1°-13.2°) compared to Asian males. Nasolabial angle was more obtuse in Caucasian females than in African (17.4°, 0.2°-35.3°) and Asian (9.1°, 0.4°-17.3°) females. Additional inter-ethnic/racial variations were revealed when the level of statistical significance was set at 0.10. A comprehensive database for angular and linear facial measurements was established from existing studies using the statistical model and inter-ethnic/racial variations of facial features were observed. The results have implications for clinical practice and highlight the need and value for high quality photogrammetric studies.

Racial and ethnic differences in psychotropic medication use among community-dwelling persons with dementia in the United States.

PubMed

Grace, Elsie L; Allen, Rebecca S; Ivey, Keisha; Knapp, Shannon M; Burgio, Louis D

2018-04-01

Little is known about the patterns of psychotropic medication use in community-dwelling minority persons with dementia (PWD). The purpose of this study was to investigate racial/ethnic differences in psychotropic medication use across a diverse population of community-dwelling PWD and to examine the extent to which caregiver characteristics influence this use. Data were drawn from the baseline assessment of the Resources for Enhancing Alzheimer's Caregiver Health II trial. Generalized linear models were used to identify racial/ethnic differences in psychotropic medication use. Akaike Information Criterion (AIC) model selection was used to evaluate possible explanations for observed differences across racial/ethnic group. Differences in anxiolytic and antipsychotic medication use were observed across racial/ethnic groups; however, race/ethnicity alone was not sufficient to explain those differences. Perceptions of caregiving and caregiver socioeconomic status were important predictors of anxiolytic use while PWD characteristics, including cognitive impairment, functional impairment, problem behavior frequency, pain, relationship to the caregiver, sex, and age were important for antipsychotic use. Racial/ethnic differences in psychotropic medication use among community-dwelling PWD cannot be explained by race/ethnicity alone. The importance of caregiver characteristics in predicting anxiolytic medication use suggest that interventions aimed at caregivers may hold promise as an effective alternative to pharmacotherapy.

Racial/Ethnic Differences in Social Vulnerability among Women with Co-Occurring Mental Health and Substance Abuse Disorders: Implications for Treatment Services

ERIC Educational Resources Information Center

Amaro, Hortensia; Larson, Mary Jo; Gampel, Joanne; Richardson, Erin; Savage, Andrea; Wagler, Debra

2005-01-01

Little attention has been given to racial/ethnic differences in studies of co-occurring disorders among women. In this article, we present findings from analyses conducted on the influence of racial/ethnic differences on the demographic and clinical profiles of 2,534 women in the Substance Abuse and Mental Health Services Administration-sponsored…

Driving Outcomes among Older Adults: A Systematic Review on Racial and Ethnic Differences over 20 Years.

PubMed

Babulal, Ganesh M; Williams, Monique M; Stout, Sarah H; Roe, Catherine M

2018-03-01

The population of older adults (aged 65 years and older) in the United States will become more racially and ethnically diverse in the next three decades. Additionally, the growth of the aging population will come with an expansion in the number of older drivers and an increased prevalence of chronic neurological conditions. A major gap in the aging literature is an almost exclusive focus on homogenous, non-Hispanic white samples of older adults. It is unclear if this extends to the driving literature. A systematic review of SCOPUS, PubMed, CINAHL Plus, and Web of Science examined articles on driving and racial/ethnic differences among older adults. Eighteen studies met inclusion criteria and their results indicate that racial and ethnic minorities face a greater risk for driving reduction, mobility restriction, and driving cessation. The majority of studies compared African Americans to non-Hispanic whites but only examined race as a covariate. Only four studies explicitly examined racial/ethnic differences. Future research in aging and driving research needs to be more inclusive and actively involve different racial/ethnic groups in study design and analysis.

Racial/ethnic differences in midlife women's attitudes toward physical activity.

PubMed

Im, Eun-Ok; Ko, Young; Hwang, Hyenam; Chee, Wonshik; Stuifbergen, Alexa; Walker, Lorraine; Brown, Adama

2013-01-01

Women's racial/ethnic-specific attitudes toward physical activity have been pointed out as a plausible reason for their low participation rates in physical activity. However, very little is actually known about racial/ethnic commonalities and differences in midlife women's attitudes toward physical activity. The purpose of this study was to explore commonalities and differences in midlife women's attitudes toward physical activity among 4 major racial/ethnic groups in the United States (whites, Hispanics, African Americans, and Asians). This was a secondary analysis of the qualitative data from a larger study that explored midlife women's attitudes toward physical activity. Qualitative data from 4 racial/ethnic-specific online forums among 90 midlife women were used for this study. The data were analyzed using thematic analysis, and themes reflecting commonalties and differences in the women's attitudes toward physical activity across the racial/ethnic groups were extracted. The themes reflecting the commonalities were: 1) physical activity is good for health, 2) not as active as I could be, 3) physical activity was not encouraged, 4) inherited diseases motivated participation in physical activity, and 5) lack of accessibility to physical activity. The themes reflecting the differences were: 1) physical activity as necessity or luxury, 2) organized versus natural physical activity, 3) individual versus family-oriented physical activity, and 4) beauty ideal or culturally accepted physical appearance. Developing an intervention that could change the social influences and environmental factors and address the women's racial/ethnic-specific attitudes would be a priority in increasing physical activity of racial/ethnic minority midlife women. © 2013 by the American College of Nurse-Midwives.

A spatial-temporal approach to surveillance of prostate cancer disparities in population subgroups.

PubMed Central

Hsu, Chiehwen Ed; Mas, Francisco Soto; Miller, Jerry A.; Nkhoma, Ella T.

2007-01-01

BACKGROUND: Prostate cancer mortality disparities exist among racial/ethnic groups in the United States, yet few studies have explored the spatiotemporal trend of the disease burden. To better understand mortality disparities by geographic regions over time, the present study analyzed the geographic variations of prostate cancer mortality by three Texas racial/ethnic groups over a 22-year period. METHODS: The Spatial Scan Statistic developed by Kulldorff et al was used. Excess mortality was detected using scan windows of 50% and 90% of the study period and a spatial cluster size of 50% of the population at risk. Time trend was analyzed to examine the potential temporal effects of clustering. Spatial queries were used to identify regions with multiple racial/ethnic groups having excess mortality. RESULTS: The most likely area of excess mortality for blacks occurred in Dallas-Metroplex and upper east Texas areas between 1990 and 1999; for Hispanics, in central Texas between 1992 and 1996: and for non-Hispanic whites, in the upper south and west to central Texas areas between 1990 and 1996. Excess mortality persisted among all racial/ethnic groups in the identified counties. The second scan revealed that three counties in west Texas presented an excess mortality for Hispanics from 1980-2001. Many counties bore an excess mortality burden for multiple groups. There is no time trend decline in prostate cancer mortality for blacks and non-Hispanic whites in Texas. CONCLUSION: Disparities in prostate cancer mortality among racial/ethnic groups existed in Texas. Central Texas counties with excess mortality in multiple subgroups warrant further investigation. PMID:17304971

Racial and sex differences in timing of the cervical vertebrae maturation stages.

PubMed

Montasser, Mona A; Viana, Grace; Evans, Carla A

2017-04-01

Our objective was to investigate skeletal maturation of female and male subjects from different racial groups by comparing the cervical vertebrae maturation (CVM) stages. The study included 3 racial groups: white, African American, and Hispanic subjects. Each group was subdivided into female and male. The age range of the subjects was between 7 and 18 years. The sample included 60 lateral cephalographs for each subgroup. Skeletal maturation of the cervical vertebrae was assessed according to a method that described 6 CVM stages. Racial differences were evident in the mean ages of CVM stages 2, 3, 4, and 5 (P = 0.002; P = 0.003; P = 0.001; and P = 0.001, respectively) among females; among males, only stage 3 was different (P = 0.001). Sex differences in the mean ages of stages 1, 2, and 3 in Hispanic subjects (P <0.001), and in stages 2 and 3 in African American subjects (P = 0.019 and P <0.001) and white subjects (P = 0.004 and P <0.001) were detected. In both sexes, racial differences were not apparent between whites and African Americans, but differences were evident between Hispanics vs both whites and African Americans. Sex differences were apparent between the sexes in each of the 3 ethnic groups in CVM stages 2 and 3. No sex differences were detected in stages 4, 5, or 6 in any of the 3 racial groups. It is recommended to consider racial and sex differences when using the CVM stage as a skeletal maturation indicator. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

The challenge of racial difference: skills for clinical practice.

PubMed

Proctor, E K; Davis, L E

1994-05-01

Just as racial injustice negatively affects the plight of minorities in society, racial tensions impede professional helping. Often, the racially dissimilar social worker and client approach each other with little understanding of each other's social realities and with unfounded assumptions. Unfortunately, professionals find it difficult to acknowledge such differences or their effect on their relationships. Yet the fruitfulness of the helping encounter often depends on the ability to develop and invest in a trusting relationship. This article identifies the societal roots of the stresses associated with cross-racial relationships. Three concerns commonly experienced by clients whose workers are racially different are identified: (1) Is the helper a person of goodwill? (2) Is the helper trained and skilled? (3) Is the help offered valid and meaningful for me and my social reality? Case vignettes are used to illustrate how each concern is typically mishandled. The importance of successfully managing each concern is stressed, and skills for successful management are illustrated.

Marriage, Work, and Racial Inequalities in Poverty: Evidence from the U.S.

PubMed

Thiede, Brian; Kim, Hyojung; Slack, Tim

2017-10-01

This paper explores recent racial and ethnic inequalities in poverty, estimating the share of racial poverty differentials that can be explained by variation in family structure and workforce participation. The authors use logistic regression to estimate the association between poverty and race, family structure, and workforce participation. They then decompose between-race differences in poverty risk to quantify how racial disparities in marriage and work explain observed inequalities in the log odds of poverty. They estimate that 47.7-48.9% of black-white differences in poverty risk can be explained by between-group variance in these two factors, while only 4.3-4.5% of the Hispanic-white differential in poverty risk can be explained by these variables. These findings underscore the continued association between racial disparities in poverty and those in labor and marriage markets. However, clear racial differences in the origin of poverty suggest that family- and worked-related policy interventions will not have uniformly effective or evenly distributed impacts on poverty reduction.

The Impact of Race on Organ Donation Authorization Discussed in the Context of Liver Transplantation

PubMed Central

Bodenheimer, Henry C.; Okun, Jeffrey M.; Tajik, Waheed; Obadia, Julienne; Icitovic, Nikolina; Friedmann, Patricia; Marquez, Emmanuel; Goldstein, Michael J.

2012-01-01

Inadequate organ donation limits transplantation for many in need of a life-saving organ. Race of donor families and requesting coordinators may impact the authorization rate for organ donation. We evaluated authorization rates for organ donation within the New York Organ Donor Network by race during 2009 and 2010. The donation authorization rate varied considerably according to the race of the donor. The authorization rate was 57% for Hispanic, 53% for Caucasian, 48% for African-American, and 23% for Asian donor families. Fifty-five percent of donor families agreed to donation when there was racial concordance between coordinator and donor. Donation authorization was 49% when a racial mis-match existed. When adjusted for coordinator training and experience, racial discordance had a lesser impact on authorization rates. Our findings suggest the need for education and communication strategies to overcome racial-associated perception during the organ donation process. PMID:23303969

Analysis of differences between Western and East-Asian faces based on facial region segmentation and PCA for facial expression recognition

NASA Astrophysics Data System (ADS)

Benitez-Garcia, Gibran; Nakamura, Tomoaki; Kaneko, Masahide

2017-01-01

Darwin was the first one to assert that facial expressions are innate and universal, which are recognized across all cultures. However, recent some cross-cultural studies have questioned this assumed universality. Therefore, this paper presents an analysis of the differences between Western and East-Asian faces of the six basic expressions (anger, disgust, fear, happiness, sadness and surprise) focused on three individual facial regions of eyes-eyebrows, nose and mouth. The analysis is conducted by applying PCA for two feature extraction methods: appearance-based by using the pixel intensities of facial parts, and geometric-based by handling 125 feature points from the face. Both methods are evaluated using 4 standard databases for both racial groups and the results are compared with a cross-cultural human study applied to 20 participants. Our analysis reveals that differences between Westerns and East-Asians exist mainly on the regions of eyes-eyebrows and mouth for expressions of fear and disgust respectively. This work presents important findings for a better design of automatic facial expression recognition systems based on the difference between two racial groups.

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

Analyzing Anti-Asian Prejudice from a Racial Identity and Color-Blind Perspective

ERIC Educational Resources Information Center

Kohatsu, Eric L.; Victoria, Rodolfo; Lau, Andrew; Flores, Michelle; Salazar, Andrea

2011-01-01

The purpose of this study was to examine to what extent both racial identity and color-blind racial attitudes help explain anti-Asian prejudice across different socioracial groups. Participants of color from a culturally diverse West Coast university were surveyed (N = 260). Hierarchical regression analyses showed that resistance racial identity…

Social Status Correlates of Reporting Racial Discrimination and Gender Discrimination among Racially Diverse Women

PubMed Central

Ro, Annie E.; Choi, Kyung-Hee

2009-01-01

The growing body of research on discrimination and health indicates a deleterious effect of discrimination on various health outcomes. However, less is known about the sociodemographic correlates of reporting racial discrimination and gender discrimination among racially diverse women. We examined the associations of social status characteristics with lifetime experiences of racial discrimination and gender discrimination using a racially-diverse sample of 754 women attending family planning clinics in Northern California (11.4% African American, 16.8% Latina, 10.1% Asian and 61.7% Caucasian). A multivariate analysis revealed that race, financial difficulty and marital status were significantly correlated with higher reports of racial discrimination, while race, education, financial difficulty and nativity were significantly correlated with gender discrimination scores. Our findings suggest that the social patterning of perceiving racial discrimination is somewhat different from that of gender discrimination. This has implications in the realm of discrimination research and applied interventions, as different forms of discrimination may have unique covariates that should be accounted for in research analysis or program design. PMID:19485231

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

Racial and Gender Disparities in the Physician Assistant Profession.

PubMed

Smith, Darron T; Jacobson, Cardell K

2016-06-01

To examine whether racial, gender, and ethnic salary disparities exist in the physician assistant (PA) profession and what factors, if any, are associated with the differentials. We use a nationally representative survey of 15,105 PAs from the American Academy of Physician Assistants (AAPA). We use bivariate and multivariate statistics to analyze pay differentials from the 2009 AAPA survey. Women represent nearly two-thirds of the profession but receive approximately $18,000 less in primary compensation. The differential reduces to just over $9,500 when the analysis includes a variety of other variables. According to AAPA survey, minority PAs tend to make slightly higher salaries than White PAs nationally, although the differences are not statistically significant once the control variables are included in the analysis. Despite the rough parity in primary salary, PAs of color are vastly underrepresented in the profession. The salaries of women lag in comparison to their male counterparts. © Health Research and Educational Trust.

Confirmatory factor analysis of the Center for Epidemiologic Studies – Depression Scale in Black and White dementia caregivers

PubMed Central

Flynn Longmire, Crystal V.; Knight, Bob G.

2012-01-01

Objectives In order to better understand if measurement problems underlie the inconsistent findings that exist regarding differences in depression levels between Black and White caregivers, this study examined the factor structure and invariance of the Center for Epidemiologic Studies-Depression scale (CES-D). Method A confirmatory factor analysis of the 20-item CES-D was performed on a sample of 167 Black and 214 White family caregivers of older adults with dementia from Los Angeles County. Results The relationships between the 20 items and the four factors, as well as the relationships among each of the factors, were equivalent across both caregiver groups, indicating that the four-factor model fit the data for both racial groups. Conclusion These findings offer further evidence that the standard four-factor model is the best fitting model for the CES-D and is invariant across racial groups. PMID:21069602

Confirmatory factor analysis of the Center for Epidemiologic Studies-Depression Scale in black and white dementia caregivers.

PubMed

Flynn Longmire, Crystal V; Knight, Bob G

2010-11-01

In order to better understand if measurement problems underlie the inconsistent findings that exist regarding differences in depression levels between Black and White caregivers, this study examined the factor structure and invariance of the Center for Epidemiologic Studies-Depression (CES-D) Scale. A confirmatory factor analysis of the 20-item CES-D was performed on a sample of 167 Black and 214 White family caregivers of older adults with dementia from Los Angeles County. The relationships between the 20 items and the four factors, as well as the relationships among each of the factors, were equivalent across both caregiver groups, indicating that the four-factor model fit the data for both the racial groups. These findings offer further evidence that the standard four-factor model is the best fitting model for the CES-D and is invariant across racial groups.

Racial/ethnic disparities and culturally competent health care among youth and young men.

PubMed

Vo, Dzung X; Park, M Jane

2008-06-01

Racial/ethnic disparities in health and health care are receiving increasing national attention from the fields of public health and medicine. Efforts to reduce disparities should adopt a life-span approach and recognize the role of gender. During adolescence, young people make increasingly independent decisions about health-related behavior and health care, while developing gender identity. Little is known about how cultural context shapes gender identity and gender identity's influence on health-related behavior and health care utilization. The authors review disparities in health status and health care among adolescents, especially young men, by reviewing health care access, clinical services, and issues related to culture, identity, and acculturation. Significant differences in health status by gender exist in adolescence, with young men faring worse on many health markers. This article discusses gaps in research and offers recommendations for improving health care quality and strengthening the research base on gender and disparities during adolescence.

Paved With Good Intentions: Do Public Health and Human Service Providers Contribute to Racial/Ethnic Disparities in Health?

PubMed Central

van Ryn, Michelle; Fu, Steven S.

2003-01-01

There is extensive evidence of racial/ethnic disparities in receipt of health care. The potential contribution of provider behavior to such disparities has remained largely unexplored. Do health and human service providers behave in ways that contribute to systematic inequities in care and outcomes? If so, why does this occur? The authors build on existing evidence to provide an integrated, coherent, and sound approach to research on providers’ contributions to racial/ethnic disparities. They review the evidence regarding provider contributions to disparities in outcomes and describe a causal model representing an integrated set of hypothesized mechanisms through which health care providers’ behaviors may contribute to these disparities. PMID:12554578

Paved with good intentions: do public health and human service providers contribute to racial/ethnic disparities in health?

PubMed

van Ryn, Michelle; Fu, Steven S

2003-02-01

There is extensive evidence of racial/ethnic disparities in receipt of health care. The potential contribution of provider behavior to such disparities has remained largely unexplored. Do health and human service providers behave in ways that contribute to systematic inequities in care and outcomes? If so, why does this occur? The authors build on existing evidence to provide an integrated, coherent, and sound approach to research on providers' contributions to racial/ethnic disparities. They review the evidence regarding provider contributions to disparities in outcomes and describe a causal model representing an integrated set of hypothesized mechanisms through which health care providers' behaviors may contribute to these disparities.

Miles to Go Before We Sleep: Racial Inequities in Health

PubMed Central

Williams, David R.

2013-01-01

Large, pervasive and persistent racial inequalities exist in the onset, course and outcomes of illness. A comprehensive understanding of the patterning of racial disparities indicates that racism in both its institutional and individual forms remains an important determinant. Despite our extensive knowledge of the magnitude, trends and determinants of these social inequalities in health, there is still much that we need to learn about the forces that drive them. There is also an even greater opportunity to build the science base that would identify how to trigger the conditions that would facilitate needed societal change, and identify the optimal interventions that would confront and dismantle the societal conditions that create and sustain health inequalities. PMID:22940811

Ethnic and racial differences in clinically relevant symptoms in active duty military personnel with posttraumatic stress disorder.

PubMed

Kaczkurkin, Antonia N; Asnaani, Anu; Hall-Clark, Brittany; Peterson, Alan L; Yarvis, Jeffrey S; Foa, Edna B

2016-10-01

Previous research has shown racial/ethnic differences in Vietnam veterans on symptoms related to posttraumatic stress disorder (PTSD). The current study explored racial/ethnic differences in PTSD symptoms and clinically relevant symptoms. Resilience and social support were tested as potential moderators of racial/ethnic differences in symptoms. The sample included 303 active duty male service members seeking treatment for PTSD. After controlling for age, education, military grade, and combat exposure, Hispanic/Latino and African American service members reported greater PTSD symptoms compared to non-Hispanic White service members. Higher alcohol consumption was endorsed by Hispanic/Latino service members compared to non-Hispanic White or African American service members, even after controlling for PTSD symptom severity. No racial/ethnic differences were found with regard to other variables. These results suggest that care should be made to thoroughly assess PTSD patients, especially those belonging to minority groups, for concurrent substance use problems that may impede treatment utilization or adherence. Copyright © 2016 Elsevier Ltd. All rights reserved.

Periodic Limb Movements During Sleep: Population Prevalence, Clinical Correlates, and Racial Differences

PubMed Central

Scofield, Holly; Roth, Thomas; Drake, Christopher

2008-01-01

Study Objective: There is growing interest in the study of periodic limb movements during sleep and their potential clinical correlates. The aim of the present analysis is to address the lack of population-based studies using polysomnographic (PSG) measures to determine the prevalence of period limb movements during sleep in specific racial groups as well as the general population. Settings and participants: A community-based sample of 592 participants drawn from the general population of tricounty Detroit (mean age = 41.9 ± 12.6 years; 52.9% F; 31.5% African American). All individuals were assessed using objective and subjective measures in the sleep laboratory. Measurements: Participants were evaluated during a 24-h laboratory assessment, including a polysomnogram and multiple sleep latency test. Periodic leg movements were scored using standard criteria. Reports of sleep disturbance and daytime sleepiness were also assessed using standardized measures including the Global Sleep Assessment Questionnaire (GSAQ) and the Epworth Sleepiness Scale (ESS). Results: The overall prevalence of periodic limb movements during sleep (PLMSI >15) was 7.6%. African Americans had a lower prevalence of PLMSI >15 than Caucasians (4.3% vs. 9.3%; Χ2 = 4.5, P < 0.05). Regardless of race, symptoms of insomnia were significantly higher in individuals with PLMSI >15 than in those with PLMSI ≤15 (45% vs. 25%; Χ2 = 6.84, P < 0.01). Conclusion: This is the first study to determine the prevalence of PLMS in a population-based sample using standardized objective criteria. A key finding of the present study is that racial differences in this PSG parameter do exist, with African Americans being less likely to have elevated PLMS. Citation: Scofield H; Roth T; Drake C. Periodic limb movements during sleep: population prevalence, clinical correlates, and racial differences. SLEEP 2008;31(9):1221-1227. PMID:18788647

Disparities at Presentation, Diagnosis, Treatment and Survival in African American Men, Affected by Prostate Cancer

PubMed Central

Chornokur, Ganna; Dalton, Kyle; Borysova, Meghan; Kumar, Nagi

2011-01-01

Background Prostate cancer (PCa) remains the most common malignancy and the second leading cause of cancer death among men in the United States. PCa exhibits the most striking racial disparity, as African American men are at 1.4 times higher risk of being diagnosed, and two to three times higher risk of dying of PCa, compared to Caucasian men. The etiology of the disparity has not been clearly elucidated. The objective of this paper is to critically review the literature and summarize the most prominent PCa racial disparities accompanied by proposed explanations. Methods The present literature on disparities at presentation, diagnosis, treatment and survival of African American men affected by PCa was systematically reviewed. Original research as well as relevant review articles were included. Results African American men recurrently present with more advanced disease than Caucasian men, are administered different treatment regimens than Caucasian men, and have shorter progression-free survival following treatment. In addition, African American men report more treatment related side-effects that translates to the diminished quality of life. Conclusions PCa racial disparity exists at stages of presentation, diagnosis, treatment regimens and subsequent survival, and the quality of life. The disparities are complex in involving biological, socio-economic and socio-cultural determinants. These mounting results highlight an urgent need for future clinical, scientific and socio-cultural research involving transdisciplinary teams to elucidate the causes for PCa racial disparities. PMID:21541975

Racial/Ethnic disparities in patient experience with communication in hospitals: real differences or measurement errors?

PubMed

Zhu, Junya; Weingart, Saul N; Ritter, Grant A; Tompkins, Christopher P; Garnick, Deborah W

2015-05-01

An important aspect of medical care is clear and effective communication, which can be particularly challenging for individuals based on race/ethnicity. Quality of communication is measured systematically in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, and analyzed frequently such as in the National Healthcare Disparities Report. Caution is needed to discern differences in communication quality from racial/ethnic differences in perceptions about concepts or expectations about their fulfillment. To examine assumptions about the degree of commonality across racial/ethnic groups in their perceptions and expectations, and to investigate the validity of conclusions regarding racial/ethnic differences in communication quality. We used 2007 HCAHPS data from the National CAHPS Benchmarking Database to construct racial/ethnic samples that controlled for other patient characteristics (828 per group). Using multiple-groups confirmatory factor analyses, we tested whether the factor structure and model parameters (ie, factor loadings, intercepts) differed across groups. We identified support for basic tests of equivalence across 7 racial/ethnic groups in terms of equivalent factor structure and loadings. Even stronger support was found for Communication with Doctors and Nurses. However, potentially important nonequivalence was found for Communication about Medicines, including instances of statistically significant differences between non-Hispanic whites and non-Hispanic blacks, Asians, and Native Hawaiian/other Pacific Islanders. Our results provide strongest support for racial/ethnic comparisons on Communication with Nurses and Doctors, and reason to caution against comparisons on Communication about Medicines due to significant differences in model parameters across groups; that is, a lack of invariance in the intercept.

A Study of Race and Class Heterogeneity Among Preschool Children.

ERIC Educational Resources Information Center

Vietze, Peter M.; Sigel, Irving E.

An experimental preschool was set up to study the effect of mixing children differing in SES and race on racial awareness and interaction. It was hypothesized that racial self-selection could be explained in terms of SES level and that interracial contact when different SES children were included would serve to counteract racial stereotypes and…

Racial Differences in the Prevalence of Intimate Partner Violence against Women and Associated Factors

ERIC Educational Resources Information Center

Cho, Hyunkag

2012-01-01

Intimate partner violence against women (IPV) affects all populations, but significant variations among these groups have been suggested. However, research results on racial differences in IPV are not only inconclusive, they are also limited--particularly with regard to racial minorities. As a result, it has been challenging for practitioners and…

Racial/Ethnic Differences in the Use of Primary Care Providers and Preventive Health Services at a Midwestern University.

PubMed

Focella, Elizabeth S; Shaffer, Victoria A; Dannecker, Erin A; Clark, Mary J; Schopp, Laura H

2016-06-01

Many universities seek to improve the health and wellbeing of their faculty and staff through employer wellness programs but racial/ethnic disparities in health care use may still persist. The purpose of this research was to identify racial/ethnic disparities in the use of preventive health services at a Midwestern university. A record review was conducted of self-reported health data from University employees, examining the use of primary care and common screening procedures collected in a Personal Health Assessment conducted by the University's wellness program. Results show that there were significant racial/ethnic differences in the use of primary care and participation in screening. Notably, Asian employees in this sample were less likely to have a primary care provider and participate in routine cancer screenings. The observed racial/ethnic differences in screening behavior were mediated by the use of primary care. Together, these data show that despite equal access to care, racial and ethnic disparities in screening persist and that having a primary care provider is an important predictor of screening behavior. Results suggest that health communications designed to increase screening among specific racial/ethnic minority groups should target primary care use.

Racial and Ethnic Disparities in Mode of Anesthesia for Cesarean Delivery

PubMed Central

Butwick, Alexander J; Blumenfeld, Yair J; Brookfield, Kathleen F.; Nelson, Lorene M; Weiniger, Carolyn F

2015-01-01

Background Racial and ethnic disparities have been identified in the provision of neuraxial labor analgesia. These disparities may exist in other key aspects of obstetric anesthesia care. We sought to determine if racial/ethnic disparities exist in mode of anesthesia for cesarean delivery (CD). Methods Women who underwent CD between 1999 and 2002 at 19 different obstetric centers in the United States were identified from the Maternal-Fetal Medicine Units Network Cesarean Registry. Race/ethnicity was categorized as: Caucasian, African-American, Hispanic, Non-Hispanic Others (NHOs). Mode of anesthesia was classified as neuraxial anesthesia (spinal, epidural or combined spinal-epidural anesthesia) or general anesthesia. To account for obstetric and nonobstetric covariates that may have influenced mode of anesthesia, multiple logistic regression analyses were performed using sequential sets of covariates. Results The study cohort comprised 50,974 women who underwent CD. Rates of general anesthesia among racial/ethnic groups were: 5.2% for Caucasians, 11.3% for African Americans, 5.8% for Hispanics and 6.6% for NHOs. After adjustment for obstetric and nonobstetric covariates, African Americans had the highest odds of receiving general anesthesia compared to Caucasians (adjusted odds ratio (aOR) = 1.7; 95% CI: 1.5 – 1.8; P<0.001). The odds of receiving general anesthesia were also higher among Hispanics (aOR = 1.1; 95% CI: 1.0 – 1.3; P=0.02) and NHOs (aOR = 1.2; 95% CI: 1.0 – 1.4; P=0.03) compared to Caucasians, respectively. In our sensitivity analysis, we reconstructed the models after excluding women who underwent neuraxial anesthesia prior to general anesthesia. The adjusted odds of receiving general anesthesia were similar to those in the main analysis: African-Americans (aOR=1.7; 95% CI=1.5 – 1.9; P<0.001; Hispanics (aOR=1.2; 95% CI=1.1 – 1.4; P=0.006); and NHOs (aOR=1.2; 95% CI=1.0 – 1.5; P=0.05). Conclusion Based on data from the Cesarean Registry, African-American women had the highest odds of undergoing general anesthesia for CD compared to Caucasian women. It is uncertain whether this disparity exists in current obstetric practice. PMID:26797554

United by Faith? Race/Ethnicity, Congregational Diversity, and Explanations of Racial Inequality

PubMed Central

Cobb, Ryon J.; Perry, Samuel L.; Dougherty, Kevin D.

2016-01-01

This study examines the extent to which the racial composition of a congregation moderates explanations for Black/White inequality among White, Black, and Hispanic congregants. Using nationally representative data from General Social Surveys and National Congregations Studies, we find that religiously affiliated Blacks and Hispanics tend to hold different racial attitudes than religiously affiliated Whites, but these differences largely disappear inside multiracial congregations. Importantly, we find that attending a multiracial congregation is unassociated with Whites’ explanations for racial inequality, and Blacks who attend multiracial congregations are actually less likely to affirm structural explanations for Black/White inequality than Blacks in nonmultiracial congregations or Whites in multiracial congregations. We find little evidence that multiracial congregations promote progressive racial views among attendees of any race or ethnicity. Rather, our findings suggest that multiracial congregations (1) leave dominant White racial frames unchallenged, potentially influencing minority attendees to embrace such frames and/or (2) attract racial minorities who are more likely to embrace those frames in the first place. PMID:27429542

Sexual harassment across the color line: experiences and outcomes of cross- versus intraracial sexual harassment among Black women.

PubMed

Woods, Krystle C; Buchanan, Nicole T; Settles, Isis H

2009-01-01

The current study examined differences in appraisal, harassment, and severity of posttraumatic stress symptoms among 105 Black women who were sexually harassed by either a White (cross-racial sexual harassment) or a Black man (intraracial sexual harassment). Analyses revealed that women appraised cross-racial more negatively than intraracial harassment, despite there being no significant differences in the likelihood of experiencing gender harassment, unwanted sexual attention, or sexual coercion. Further, cross-racial harassment was more likely to include racialized sexual harassment (harassing behaviors combining race and gender simultaneously) and higher status perpetrators. Finally, cross-racial sexual harassment had an indirect (but not direct) mediated effect on posttraumatic stress via participants' appraisals of their harassment. Specifically, the more negative appraisal associated with cross-racial sexual harassment was associated with increased posttraumatic stress symptoms. In light of these findings, consideration of perpetrator race and racially sexualized behaviors could prove significant additions to current models of sexual harassment.

Racial and Ethnic Socialization as Moderators of Racial Discrimination and School Adjustment of Adopted and Non-adopted Korean American Adolescents

PubMed Central

Seol, Kyoung Ok; Yoo, Hyung Chol; Lee, Richard M.; Park, Ji Eun; Kyeong, Yena

2015-01-01

This study investigated roles of racial and ethnic socialization in the link between racial discrimination and school adjustment among a sample of 233 adopted Korean American adolescents from White adoptive families and 155 non-adopted Korean American adolescents from immigrant Korean families. Adopted Korean American adolescents reported lower levels of racial discrimination, racial socialization, and ethnic socialization than non-adopted Korean American adolescents. However, racial discrimination was negatively related to school belonging and school engagement, and ethnic socialization was positively related to school engagement for both groups. Racial socialization also had a curvilinear relationship with school engagement for both groups. Moderate level of racial socialization predicted positive school engagement, whereas low and high levels of racial socialization predicted negative school engagement. Finally, ethnic socialization moderated the link between racial discrimination and school belonging, which differed between groups. In particular, ethnic socialization exacerbated the relations between racial discrimination and school belonging for adopted Korean American adolescents, whereas, ethnic socialization buffered this link for non-adopted Korean American adolescents. Findings illustrate the complex relationship between racial and ethnic socialization, racial discrimination, and school adjustment. PMID:26479418

Racial and ethnic socialization as moderators of racial discrimination and school adjustment of adopted and nonadopted Korean American adolescents.

PubMed

Seol, Kyoung Ok; Yoo, Hyung Chol; Lee, Richard M; Park, Ji Eun; Kyeong, Yena

2016-04-01

This study investigated the roles of racial and ethnic socialization in the link between racial discrimination and school adjustment among a sample of 233 adopted Korean American adolescents from White adoptive families and 155 nonadopted Korean American adolescents from immigrant Korean families. Adopted Korean American adolescents reported lower levels of racial discrimination, racial socialization, and ethnic socialization than nonadopted Korean American adolescents. However, racial discrimination was negatively related to school belonging and school engagement, and ethnic socialization was positively related to school engagement for both groups. Racial socialization also had a curvilinear relationship with school engagement for both groups. A moderate level of racial socialization predicted positive school engagement, whereas low and high levels of racial socialization predicted negative school engagement. Finally, ethnic socialization moderated the link between racial discrimination and school belonging, which differed between groups. In particular, ethnic socialization exacerbated the relations between racial discrimination and school belonging for adopted Korean American adolescents, whereas ethnic socialization buffered this link for nonadopted Korean American adolescents. The findings illustrate the complex relationship between racial and ethnic socialization, racial discrimination, and school adjustment. (c) 2016 APA, all rights reserved).

Racial Discrimination & Cardiovascular Disease Risk: My Body My Story Study of 1005 US-Born Black and White Community Health Center Participants (US)

PubMed Central

Krieger, Nancy; Waterman, Pamela D.; Kosheleva, Anna; Chen, Jarvis T.; Smith, Kevin W.; Carney, Dana R.; Bennett, Gary G.; Williams, David R.; Thornhill, Gisele; Freeman, Elmer R.

2013-01-01

Objectives To date, limited and inconsistent evidence exists regarding racial discrimination and risk of cardiovascular disease (CVD). Methods Cross-sectional observational study of 1005 US-born non-Hispanic black (n = 504) and white (n = 501) participants age 35–64 randomly selected from community health centers in Boston, MA (2008–2010; 82.4% response rate), using 3 racial discrimination measures: explicit self-report; implicit association test (IAT, a time reaction test for self and group as target vs. perpetrator of discrimination); and structural (Jim Crow status of state of birth, i.e. legal racial discrimination prior 1964). Results Black and white participants both had adverse cardiovascular and socioeconomic profiles, with black participants most highly exposed to racial discrimination. Positive crude associations among black participants occurred for Jim Crow birthplace and hypertension (odds ratio (OR) 1.92, 95% confidence interval (CI) 1.28, 2.89) and for explicit self-report and the Framingham 10 year CVD risk score (beta  = 0.04; 95% CI 0.01, 0.07); among white participants, only negative crude associations existed (for IAT for self, for lower systolic blood pressure (SBP; beta  = −4.86; 95% CI −9.08, −0.64) and lower Framingham CVD score (beta  = −0.36, 95% CI −0.63, −0.08)). All of these associations were attenuated and all but the white IAT-Framingham risk score association were rendered null in analyses that controlled for lifetime socioeconomic position and additional covariates. Controlling for racial discrimination, socioeconomic position, and other covariates did not attenuate the crude black excess risk for SBP and hypertension and left unaffected the null excess risk for the Framingham CVD score. Conclusion Despite worse exposures among the black participants, racial discrimination and socioeconomic position were not associated, in multivariable analyses, with risk of CVD. We interpret results in relation to constrained variability of exposures and outcomes and discuss implications for valid research on social determinants of health. PMID:24204765

Parent-Child Interaction and the Development of Racial Group Identity and Self Concepts of Preschool Children.

ERIC Educational Resources Information Center

McAdoo, Harriette; McAdoo, John L.

This study focuses on three areas: (1) mother-child and father-child verbal and nonverbal interactions; (2) racial differences in parent-child interactions, children's self esteem and children's racial attitudes; and (3) relationships between parenting style and children's feelings of self-worth and racial preferences. Subjects were 40 black and…

Bidirectional Influence between African American Mothers' and Children's Racial Centrality from Elementary through High School

ERIC Educational Resources Information Center

Hoffman, Adam J.; Kurtz-Costes, Beth; Rowley, Stephanie J.; Adams, Elizabeth A.

2017-01-01

For many African Americans, racial identity is an important aspect of their individual identity. We explored developmental change and stability of individual differences in the racial centrality of African American youths and their mothers as well as the relation between maternal and child racial centrality across time. African American youths (N…

Prior experiences of racial discrimination and racial differences in health care system distrust.

PubMed

Armstrong, Katrina; Putt, Mary; Halbert, Chanita H; Grande, David; Schwartz, Jerome Sanford; Liao, Kaijun; Marcus, Noora; Demeter, Mirar B; Shea, Judy A

2013-02-01

Factors contributing to racial differences in health care system distrust (HCSD) are currently unknown. Proposed potential contributing factors are prior experiences of racial discrimination and racial residential segregation. Random digit dialing survey of 762 African American and 1267 white adults living in 40 US metropolitan statistical areas. Measures included the Revised Health Care System Distrust scale, the Experiences of Discrimination scale, metrics of access to care, sociodemographic characteristics, and the level of racial residential segregation in the city (using the isolation index). In unadjusted analyses, African Americans had higher levels of HCSD, particularly values distrust, and greater experiences of discrimination. Experience of discrimination was also strongly associated with HCSD. Adjusting for sociodemographic characteristics, health care access, and residential segregation had little effect on the association between African American race and overall HCSD or values distrust. In contrast, adjusting for experiences of racial discrimination reversed the association so that distrust was lower among African Americans than whites (odds ratio 0.53; 95% confidence interval, 0.33-0.85 for the overall measure). The Sobel test for mediation was strongly significant (P<0.001). Higher HCSD among African Americans is explained by a greater burden of experiences of racial discrimination than whites. Reasons for higher distrust among whites after adjusting for experiences of racial discrimination are not known. Efforts to eliminate racial discrimination and restore trust given prior discrimination are needed.

Racial Differences in the Impact of Elevated Systolic Blood Pressure on Stroke Risk

PubMed Central

Howard, George; Lackland, Daniel T.; Kleindorfer, Dawn O.; Kissela, Brett M.; Moy, Claudia S.; Judd, Suzanne E.; Safford, Monika M.; Cushman, Mary; Glasser, Stephen P.; Howard, Virginia J.

2013-01-01

Background Between the ages 45 and 65 years, incident stroke is 2 to 3 times more common in blacks than in whites, a difference not explained by traditional stroke risk factors. Methods Stroke risk was assessed in 27 748 black and white participants recruited between 2003 and 2007, who were followed up through 2011, in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Racial differences in the impact of systolic blood pressure (SBP) was assessed using proportional hazards models. Racial differences in stroke risk were assessed in strata defined by age (<65 years, 65–74 years, and ≥75 years) and SBP (<120 mm Hg, 120–139 mm Hg, and 140–159 mm Hg). Results Over 4.5 years of follow-up, 715 incident strokes occurred. A 10–mm Hg difference in SBP was associated with an 8% (95% CI, 0%-16%) increase in stroke risk for whites, but a 24% (95% CI, 14%-35%) increase for blacks (P value for interaction, .02). For participants aged 45 to 64 years (where disparities are greatest), the black to white hazard ratio was 0.87 (95% CI, 0.48–1.57) for normotensive participants, 1.38 (95% CI, 0.94–2.02) for those with prehypertension, and 2.38 (95% CI, 1.19–4.72) for those with stage 1 hypertension. Conclusions These findings suggest racial differences in the impact of elevated blood pressure on stroke risk. When these racial differences are coupled with the previously documented higher prevalence of hypertension and poorer control of hypertension in blacks, they may account for much of the racial disparity in stroke risk. PMID:23229778

Neighborhood Racial Composition, Racial Discrimination, and Depressive Symptoms in African Americans

PubMed Central

Lambert, Sharon F.; Evans, Michele K.; Zonderman, Alan B.

2015-01-01

While evidence indicates that experienced racial discrimination is associated with increased depressive symptoms for African Americans, there is little research investigating predictors of experienced racial discrimination. This paper examines neighborhood racial composition and sociodemographic factors as antecedents to experienced racial discrimination and resultant levels of depressive symptoms among African American adults. The sample included 505 socioeconomically-diverse African American adults from Baltimore, MD. Study data were obtained via self-report and geocoding of participant addresses based on 2010 census data. Study hypotheses were tested using multiple pathways within a longitudinal Structural Equation Model. Experienced racial discrimination was positively associated with age and sex such that older individuals and males experienced increased levels of racial discrimination. In addition, the percentage of White individuals residing in a neighborhood was positively associated with levels of experienced racial discrimination for African American neighborhood residents. Experienced racial discrimination was positively associated with later depressive symptoms. Neighborhood-level contextual factors such as neighborhood racial composition and individual differences in sociodemographic characteristics appear to play an important role in the experience of racial discrimination and the etiology of depression in African American adults. PMID:24969707

Neighborhood racial composition, racial discrimination, and depressive symptoms in African Americans.

PubMed

English, Devin; Lambert, Sharon F; Evans, Michele K; Zonderman, Alan B

2014-12-01

While evidence indicates that experienced racial discrimination is associated with increased depressive symptoms for African Americans, there is little research investigating predictors of experienced racial discrimination. This paper examines neighborhood racial composition and sociodemographic factors as antecedents to experienced racial discrimination and resultant levels of depressive symptoms among African American adults. The sample included 505 socioeconomically-diverse African American adults from Baltimore, MD. Study data were obtained via self-report and geocoding of participant addresses based on 2010 census data. Study hypotheses were tested using multiple pathways within a longitudinal Structural Equation Model. Experienced racial discrimination was positively associated with age and sex such that older individuals and males experienced increased levels of racial discrimination. In addition, the percentage of White individuals residing in a neighborhood was positively associated with levels of experienced racial discrimination for African American neighborhood residents. Experienced racial discrimination was positively associated with later depressive symptoms. Neighborhood-level contextual factors such as neighborhood racial composition and individual differences in sociodemographic characteristics appear to play an important role in the experience of racial discrimination and the etiology of depression in African American adults.

Trends in the Family Income Distribution by Race/Ethnicity and Income Source, 1988–2009

PubMed Central

Monnat, Shannon M.; Raffalovich, Lawrence E.; Tsao, Hui-shien

2015-01-01

The recent dramatic rise in U.S. income inequality has prompted a great deal of research on trends in overall family income and changes in sources of family income, especially among the highest income earners. However, less is known about changes in sources of income among the bottom 99% or about racial/ethnic differences in those trends. The present research contributes to the literatures on income trends and racial economic inequality by using family-level data from the 1988–2009 Current Population Survey to examine changes in overall family income and the proportion of income coming from employment, property/assets, and transfers across five different levels of family income for white-, black, and Hispanic-headed families. We find that at all income levels above the 25th percentile, employment income is by far the largest contributor to family income for all racial/ethnic groups. Employment income trended upward over the period in both real dollars and as a percentage of total family income. In this respect, white, black and Hispanic families are remarkably similar. The racial gap in total family income has remained fairly stable over the period, but this trend conceals a narrowing of racial differences in property income, mostly as a function of the decline in property income among whites, a widening of racial differences in transfer income among the bottom 25%, and a widening of racial differences in employment income, particularly at the top of the family income distribution. Income accrued from wealth is a very small component of overall family income for all three racial groups, even for the highest-income families (top 1%). PMID:26180265

Racial/Ethnic Differences in Midlife Women’s Attitudes toward Physical Activity

PubMed Central

Im, Eun-Ok; Ko, Young; Hwang, Hyenam; Chee, Wonshik; Stuifbergen, Alexa; Walker, Lorraine; Brown, Adama

2012-01-01

Introduction Women’s racial/ethnic-specific attitudes toward physical activity have been pointed out as a plausible reason for their low participation rates in physical activity. However, very little is actually known about racial/ethnic commonalties and differences in midlife women’s attitudes toward physical activity. The purpose of this study was to explore commonalities and differences in midlife women’s attitudes toward physical activity among four major racial/ethnic groups in the United States (whites, Hispanics, African Americans, and Asians). Methods This was a secondary analysis of the qualitative data from a larger study that explored midlife women’s attitudes toward physical activity. Qualitative data from four racial/ethnic-specific online forums among 90 midlife women were used for this study. The data were analyzed using thematic analysis, and themes reflecting commonalties and differences in the women’s attitudes toward physical activity across the racial/ethnic groups were extracted. Results The themes reflecting the commonalities were: (a) “physical activity is good for health”; (b) “not as active as I could be”; (c) “physical activity was not encouraged”; (d) “inherited diseases motivated participation in physical activity”; and (e) “lack of accessibility to physical activity.” The themes reflecting the differences were: (a) “physical activity as necessity or luxury”; (b) “organized versus natural physical activity”; (c) “individual versus family-oriented physical activity”; and (d) “beauty ideal or culturally accepted physical appearance.” Discussion Developing an intervention that could change the social influences and environmental factors and that could incorporate the women’s racial/ethnic-specific attitudes would be a priority in increasing physical activity of racial/ethnic minority midlife women. PMID:23931661

Race as Biology Is Fiction, Racism as a Social Problem Is Real: Anthropological and Historical Perspectives on the Social Construction of Race

ERIC Educational Resources Information Center

Smedley, Audrey; Smedley, Brian D.

2005-01-01

Racialized science seeks to explain human population differences in health, intelligence, education, and wealth as the consequence of immutable, biologically based differences between "racial" groups. Recent advances in the sequencing of the human genome and in an understanding of biological correlates of behavior have fueled racialized science,…

Racial and Ethnic Disparities: A Population-Based Examination of Risk Factors for Involvement with Child Protective Services

ERIC Educational Resources Information Center

Putnam-Hornstein, Emily; Needell, Barbara; King, Bryn; Johnson-Motoyama, Michelle

2013-01-01

Objective: Data from the United States indicate pronounced and persistent racial/ethnic differences in the rates at which children are referred and substantiated as victims of child abuse and neglect. In this study, we examined the extent to which aggregate racial differences are attributable to variations in the distribution of individual and…

Toward an Interdisciplinary Understanding of Educational Equity and Difference: The Case of the Racialization of Ability

ERIC Educational Resources Information Center

Artiles, Alfredo J.

2011-01-01

The author argues for an interdisciplinary perspective to study the complexities of educational equity and transcend the limits of previous research. He focuses on the racialization of disability as a case in point; specifically, he reviews the visions of justice that inform the scholarship on racial and ability differences and situates their…

Does the Colorline Still Exist in the 21st Century: Examining Racial Climate on the Campus of a University with a Diverse Student Body (UDSB) as Perceived by a Group of African American College Students

ERIC Educational Resources Information Center

Charles-Johnson, Princess Jasmine

2013-01-01

This qualitative study employs three theoretical frameworks as the source of its foundation, covering literature from Acting White, Stereotype Threat and Campus Climate. The purpose of this study was to evaluate the perceptions of Racial Climate as perceived by African American college students attending a University with a Diverse Student Body…

Racial/Ethnic Disparities in Nursing Home Quality of Life Deficiencies, 2001 to 2011

PubMed Central

Campbell, Lauren J.; Cai, Xueya; Gao, Shan; Li, Yue

2016-01-01

Objectives: Racial/ethnic disparities in nursing homes (NHs) are associated with lower quality of care, and state Medicaid payment policies may influence NH quality. However, no studies analyzing disparities in NH quality of life (QoL) exist. Therefore, this study aims to estimate associations at the NH level between average number of QoL deficiencies and concentrations of racial/ethnic minority residents, and to identify effects of state Medicaid payment policies on racial/ethnic disparities. Method: Multivariable Poisson regression with NH random effects was used to determine the association between NH minority concentration in 2000 to 2010 and average number of QoL deficiencies in 2001 to 2011 at the NH level, and the effect of state NH payment policies on QoL deficiencies and racial/ethnic disparities in QoL deficiencies across NH minority concentrations. Results: Racial/ethnic disparities in QoL between high and low minority concentration NHs decrease over time, but are not eliminated. Case mix payment was associated with an increased disparity between high and low minority concentration NHs in QoL deficiencies. Discussion: NH managers and policy makers should consider initiatives targeting minority residents or low-performing NHs with higher minority concentrations for improvement to reduce disparities and address QoL deficiencies. PMID:27819015

Measuring racial microaggression in medical practice.

PubMed

Almond, Amanda Lee

2017-08-01

The purpose of this study was to validate the already existing Racial Microaggression in Counseling Scale (RMCS) when the term 'therapist' was replaced with 'physician', thus constituting the modification as the Racial Microaggression in Medical Practice Scale (RMMPS). Racial microaggressions work at reinforcing inferior social status on a cognitive level. Unlike overt racism, messages behind microaggression are subtler and more every day. A lack of acceptance, respect, and regard emerges from interactions in medical contexts as there are layers of in-group and out-group statuses at play (e.g. physician-patient, Black-White, expert-lay, and Westernized-alternative). The layer focused on in this study was that of race or skin color. A sample of racial minorities in the Northeast (n = 91) was investigated both quantitatively and qualitatively to validate the modification and future use of a RMMPS. The scale was related to the racial incongruence between patient and provider. Qualitative findings support the original concepts and themes used when developing the 10-item measure in a counseling setting. Psychometric findings for the scale also supported its factorial structure using generalizability theory estimates. Future implications of this research relate to health behavior, trustworthiness, and health outcomes of minority patients. Its potential for use among various practitioners, educators, and researchers is also discussed.

Racial identity and academic achievement in the neighborhood context: a multilevel analysis.

PubMed

Byrd, Christy M; Chavous, Tabbye M

2009-04-01

Increasingly, researchers have found relationships between a strong, positive sense of racial identity and academic achievement among African American youth. Less attention, however, has been given to the roles and functions of racial identity among youth experiencing different social and economic contexts. Using hierarchical linear modeling, the authors examined the relationship of racial identity to academic outcomes, taking into account neighborhood-level factors. The sample consisted of 564 African American eighth-graders (56% male). The authors found that neighborhood characteristics and racial identity related positively to academic outcomes, but that some relationships were different across neighborhood types. For instance, in neighborhoods low in economic opportunity, high pride was associated with a higher GPA, but in more advantaged neighborhoods, high pride was associated with a lower GPA. The authors discuss the need to take youth's contexts into account in order to understand how racial identity is active in the lives of African American youth.

Accounting for racial/ethnic variation in bone mineral content and density: the competing influences of socioeconomic factors, body composition, health and lifestyle, and circulating androgens and estrogens.

PubMed

Travison, T G; Chiu, G R; McKinlay, J B; Araujo, A B

2011-10-01

The relative importance of various contributors to racial/ethnic variation in BMC/BMD is not established. Using population-based data, we determined that body composition differences (specifically skeletal muscle and fat mass) are among the strongest contributors to these variations. Racial/ethnic variation in fracture risk is well documented, but the mechanisms by which such heterogeneity arises are poorly understood. We analyzed data from black, Hispanic, and white men enrolled in the Boston Area Community Health/Bone (BACH/Bone) Survey to determine the contributions of risk factors to racial/ethnic differences in bone mineral content (BMC) and density (BMD). In a population-based study, BMC, BMD, and body composition were ascertained by DXA. Socioeconomic status, health history, and dietary intake were obtained via interview. Hormones and markers of bone turnover were obtained from non-fasting blood samples. Multivariate analyses measured percentage reductions in estimated racial/ethnic differences in BMC/BMD, accompanying the successive removal of covariates from linear regression models. Black men demonstrated greater BMC than their Hispanic and white counterparts. At the femoral neck, adjustment for covariables was sufficient to reduce these differences by 46% and 35%, respectively. While absolute differences in BMC were smaller at the distal radius than femoral neck, the proportionate reductions in racial/ethnic differences after covariable adjustment were comparable or greater. Multivariate models provided evidence that lean and fat mass, serum 25(OH)D, osteocalcin, estradiol, and aspects of socioeconomic status influence the magnitude of racial/ethnic differences in BMC, with lean and fat mass providing the strongest effects. Results for BMD were similar, but typically of lesser magnitude and statistical significance. These cross-sectional analyses demonstrate that much of the racial/ethnic heterogeneity in measures of bone mass and density can be accounted for through variation in body composition, diet, and socio-demographic factors.

Asians demonstrate reduced sensitivity to unpredictable threat: a preliminary startle investigation using genetic ancestry in a multiethnic sample.

PubMed

Nelson, Brady D; Bishop, Jeffrey R; Sarapas, Casey; Kittles, Rick A; Shankman, Stewart A

2014-06-01

Research has indicated that individuals of Asian descent, relative to other racial groups, demonstrate reduced emotional responding and lower prevalence rates of several anxiety disorders. It is unclear though whether these group differences extend to biomarkers of anxiety disorders and whether genetic differences play a role. This study compared self-identified Caucasian, Latino, and Asian persons (total N = 174) on startle response during a baseline period and while anticipating unpredictable threat-a putative biomarker for certain anxiety disorders--as well as predictable threat. In addition, the association between genetic ancestry and startle response was examined within each racial group to determine potential genetic influences on responding. For the baseline period, Asian participants exhibited a smaller startle response relative to Caucasian and Latino participants, who did not differ. Within each racial group, genetic ancestry was associated with baseline startle. Furthermore, genetic ancestry mediated racial group differences in baseline startle. For the threat conditions, a Race × Condition interaction indicated that Asian participants exhibited reduced startle potentiation to unpredictable, but not predicable, threat relative to Caucasian and Latino participants, who did not differ. However, genetic ancestry was not associated with threat-potentiated startle in any racial group. This study adds to the growing literature on racial differences in emotional responding and provides preliminary evidence suggesting that genetic ancestry may play an important role. Moreover, reduced sensitivity to unpredictable threat may reflect a mechanism for why individuals of Asian descent are at less risk for particular anxiety disorders relative to other racial groups.

Asians Demonstrate Reduced Sensitivity to Unpredictable Threat: A Preliminary Startle Investigation using Genetic Ancestry in a Multi-Ethnic Sample

PubMed Central

Nelson, Brady D.; Bishop, Jeffrey R.; Sarapas, Casey; Kittles, Rick A.; Shankman, Stewart A.

2014-01-01

Research has indicated that individuals of Asian descent, relative to other racial groups, demonstrate reduced emotional responding and lower prevalence rates of several anxiety disorders. It is unclear though whether these group differences extend to biomarkers of anxiety disorders and whether genetic differences play a role. The present study compared self-identified Caucasians, Latinos, and Asians (total N = 174) on startle response during a baseline period and while anticipating unpredictable threat–a putative biomarker for certain anxiety disorders–as well as predictable threat. In addition, the association between genetic ancestry and startle response was examined within each racial group to determine potential genetic influences on responding. For the baseline period, Asian participants exhibited a smaller startle response relative to Caucasian and Latino participants, who did not differ. Within each racial group, genetic ancestry was associated with baseline startle. Furthermore, genetic ancestry mediated racial group differences in baseline startle. For the threat conditions, a Race × Condition interaction indicated that Asian participants exhibited reduced startle potentiation to unpredictable, but not predicable, threat relative to Caucasian and Latino participants, who did not differ. However, genetic ancestry was not associated with threat-potentiated startle in any racial group. The present study adds to the growing literature on racial differences in emotional responding and provides preliminary evidence suggesting that genetic ancestry may play an important role. Moreover, reduced sensitivity to unpredictable threat may reflect a mechanism for why individuals of Asian descent are at less risk for particular anxiety disorders relative to other racial groups. PMID:24708496

Racial discrimination as race-based trauma, coping strategies, and dissociative symptoms among emerging adults.

PubMed

Polanco-Roman, Lillian; Danies, Ashley; Anglin, Deidre M

2016-09-01

The race-based traumatic stress theory (Carter, 2007) suggests that some racial- and ethnic-minority individuals experience racial discrimination as psychological trauma, as it may elicit a response comparable to posttraumatic stress. In the present study, we examined this further by determining the relation between racial discrimination and dissociation, a common response to trauma exposure. Further, we examined whether active coping strategies specifically employed to cope with racial discrimination related to less dissociative symptomatology. The predominant racial- and ethnic-minority sample (N = 743) of emerging adults, ages 18-29, recruited from a public university in northeastern United States completed a battery of self-report measures on racial discrimination, responses to racial discrimination, traumatic life events, and dissociative symptoms. Frequency of racial discrimination was positively associated with dissociative symptoms in regression analyses adjusted for demographics and other traumatic life events. In addition, more active coping strategies in response to racial discrimination were negatively associated with dissociative symptoms. Racial- and ethnic-minority emerging adults who experience racial discrimination, possibly as traumatic, may be more vulnerable to dissociative symptoms. However, different strategies of coping with racial discrimination may differentially impact risk for dissociation. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Racial discrimination as race-based trauma, coping strategies and dissociative symptoms among emerging adults

PubMed Central

Polanco-Roman, Lillian; Danies, Ashley; Anglin, Deidre M.

2016-01-01

Objective The race-based traumatic stress theory (Carter, 2007) suggests that some racial and ethnic minority individuals may experience racial discrimination as a psychological trauma, as it may elicit a response comparable to posttraumatic stress. The present study examined this further by determining the relation between racial discrimination and dissociation, a common response to trauma exposure. Further, we examined whether active coping strategies specifically employed to cope with racial discrimination related to less dissociative symptomatology. Methods The predominant racial and ethnic minority sample (N=743) of emerging adults (i.e., ages 18-29) recruited from a public university in Northeastern U.S. completed a battery of self-report measures on racial discrimination, responses to racial discrimination, traumatic life events and dissociative symptoms. Results Frequency of racial discrimination was positively associated with dissociative symptoms in regression analyses adjusted for demographics and other traumatic life events. Additionally, more active coping strategies in response to racial discrimination were negatively associated with dissociative symptoms. Conclusion Racial and ethnic minority emerging adults who experience racial discrimination, possibly as traumatic, may be more vulnerable to dissociative symptoms. However, different strategies of coping with racial discrimination may differentially impact risk for dissociation. PMID:26963957

Disparities in hospitalization outcomes among African-American and White prostate cancer patients.

PubMed

Naik, Gurudatta; Akinyemiju, Tomi

2017-02-01

This paper aims to determine whether racial disparities exist in hospitalization outcomes among African-American and White hospitalized prostate cancer patients in the United States. We evaluated racial differences among matched groups of patients in post-operative complications, hospital length of stay and in-hospital mortality. We identified a total of 183,856 men aged 40 years and older with a primary diagnosis of prostate cancer, of which 58,701 underwent prostatectomy, through the Nationwide Inpatient Sample, and matched all African-American patients with White patients on: 1) Demographics, 2) Demographics+Clinical presentation and 3) Demographics+Clinical presentation+Treatment. Multivariable regression analyses were conducted in SAS and estimates were reported with 95% confidence intervals. African-American patients were more likely to be admitted with metastatic disease (24.8%) compared with White patients matched on demographics (17.9%), and demographics+presentation (23.6%). However, 23.9% of African-American patients received surgery compared with 38.2% and 34.2% of Whites matched on demographics and demographics+presentation, respectively. White patients had lower in-hospital mortality compared with African-American patients matched on demographics (OR: 0.72, 95% CI: 0.66-0.79), demographics+presentation (OR: 0.88, 95% CI: 0.81-0.96), but was no longer significantly lower when matched on demographics, presentation and treatment (OR: 0.92, 95% CI: 0.85-1.00). There were significant racial differences in outcomes among prostate cancer patients within the inpatient setting, even after accounting for demographic and presentation differences. Copyright © 2016 Elsevier Ltd. All rights reserved.

Racial/ethnic differences in health insurance adequacy and consistency among children: Evidence from the 2011/12 National Survey of Children’s Health

PubMed Central

Soylu, Tulay G.; Elashkar, Eman; Aloudah, Fatemah; Ahmed, Munir; Kitsantas, Panagiota

2018-01-01

Background Surveillance of disparities in healthcare insurance, services and quality of care among children are critical for properly serving the medical/healthcare needs of underserved populations. The purpose of this study was to assess racial/ethnic differences in children’s (0 to 17 years old) health insurance adequacy and consistency (child has insurance coverage for the last 12 months). Design and methods We used data from the 2011/2012 National Survey of Children’s Health (n=79,474). Descriptive statistics and logistic regression analyses were conducted to examine the distribution and influence of several sociodemographic/family related factors on insurance adequacy and consistency across different racial/ethnic groups. Results Stratified analyses by race/ethnicity revealed that white and black children living in households at or below 299% of the Federal Poverty Level (FPL) were approximately 29 to 42% less likely to have adequate insurance compared to children living in families of higher income levels. Regardless of race/ethnicity, we found that children with public health insurance were more likely to have adequate insurance than their privately insured counterparts, while adolescents were at greater risk of inadequate coverage. Hispanic and black children were more likely to lack consistent insurance coverage. Conclusions This study provides evidence that racial/ethnic differences in adequate and consistent health insurance exists with both white and minority children being affected adversely by poverty. Establishing outreach programs for low income families, and cross-cultural education for healthcare providers may help increase health insurance adequacy and consistency within certain underserved populations. Significance for public healthAs the number of minority US children increases, monitoring racial/ethnic differences in health insurance coverage becomes critical in creating insurance programs that can provide adequate and consistent coverage. Using a nationally representative sample, the findings of this study suggest that low income and poor maternal health can adversely affect insurance consistency and adequacy for both minority and white children. This indicates that research studies on inequalities of healthcare coverage should also focus on underserved white populations of children as their insurance coverage is affected by similar factors as those for minority children. Elimination of inequalities may require targeted interventions that include the well-being of the entire family, cross-cultural education of healthcare providers, policy changes to grant low-income children with appropriate and reliable health insurance, and an ongoing monitoring of disparities by health plans. PMID:29780766

Racial and Ethnic Differences in Diurnal Cortisol Rhythms in Preadolescents: The Role of Parental Psychosocial Risk and Monitoring

PubMed Central

Martin, Christina Gamache; Bruce, Jacqueline; Fisher, Philip A.

2012-01-01

Racial/ethnic minorities experience persistent health disparities due in part to their exposure to chronic SES and psychosocial risk. The hypothalamic-pituitary-adrenal axis and its hormonal end product, cortisol, are believed to mediate the associations between chronic stress and poor health. In this study, racial/ethnic differences in diurnal salivary cortisol rhythms in 179 preadolescent youths and the contributing roles of SES risk, psychosocial risk, perceived discrimination, harsh parenting, and parental monitoring were examined. The analyses revealed racial/ethnic differences in diurnal cortisol rhythms, with African Americans having significantly flatter morning-to-evening cortisol slopes than Caucasians and with Latinos having significantly lower evening cortisol levels than Caucasians. Greater psychosocial risk and less parental monitoring were associated with flatter cortisol slopes. Racial/ethnic differences on the cortisol measures persisted when controlling for SES, psychosocial risk, and parenting quality. The need to assess chronic risk across the lifespan and disentangle possible genetic from environmental contributors is discussed. PMID:22414445

Modeling Racial Differences in the Effects of Racial Representation on 2-Year College Student Success

ERIC Educational Resources Information Center

Museus, Samuel D.; Jayakumar, Uma M.; Robinson, Thomas

2012-01-01

The failure of many 2-year college students to persist and complete a post-secondary credential or degree remains a problem of paramount importance to higher education policymakers and practitioners. While racial representation--or the extent to which a student's racial group is represented on their respective campus--might be one factor that…

"One of the Most Uniform Races of the Entire World": Creole Eugenics and the Myth of Chilean Racial Homogeneity.

PubMed

Walsh, Sarah

2015-11-01

This article illuminates why Nicolás Palacios's 1904 monograph, Raza chilena: Libro escrito por un Chileno i para los Chilenos [Chilean Race: A Book Written by a Chilean for Chileans], is central to the creation of a myth of Chilean racial homogeneity at the turn of the twentieth century. Placing Palacios in the context of Latin American eugenic discourse, it demonstrates how he selected a specific racial origin story in order to accommodate his belief in racial hierarchy while also depicting race mixing in a positive light. Specifically, the article highlights how the myth of Chilean racial homogeneity elided the difference between the term "mestizo," which was applied to people of mixed racial heritage, and "white." I contend that Palacios sought to differentiate Chileans from other Latin Americans by emphasizing their racial distinctiveness. The article therefore highlights that Latin American eugenics was concerned with the creation of national narratives that historicized particular racial mixtures in order to reify and affirm national differences. As such, it connects to literature regarding the history of eugenics, race, nation, and the creation of whiteness.

Intergroup Consensus/Disagreement in Support of Group Based Hierarchy: An Examination of Socio-Structural and Psycho-Cultural Factors

PubMed Central

Lee, I-Ching; Pratto, Felicia; Johnson, Blair T.

2011-01-01

A meta-analysis examined the extent to which socio-structural and psycho-cultural characteristics of societies correspond with how much gender and ethnic/racial groups differ on their support of group-based hierarchy. Robustly, women opposed group-based hierarchy more than men did and members of lower-power ethnic/racial groups opposed group-based hierarchy more than members of higher-power ethnic/racial groups. As predicted by social dominance theory, gender differences were larger, more stable, and less variable from sample to sample than differences between ethnic/racial groups. Subordinate gender and ethnic/racial group members disagreed more with dominants in their views of group-based hierarchy in societies that can be considered more liberal and modern (e.g., emphasizing individualism and change from traditions), as well as in societies that enjoyed greater gender equality. The relations between gender and ethnic/racial groups are discussed and implications are developed for social dominance theory, social role theory and biosocial theory, social identity theory, system justification theory, realistic group conflict theory and relative deprivation theory. PMID:22023142

Why genes don't count (for racial differences in health).

PubMed Central

Goodman, A H

2000-01-01

There is a paradoxical relationship between "race" and genetics. Whereas genetic data were first used to prove the validity of race, since the early 1970s they have been used to illustrate the invalidity of biological races. Indeed, race does not account for human genetic variation, which is continuous, complexly structured, constantly changing, and predominantly within "races." Despite the disproof of race-as-biology, genetic variation continues to be used to explain racial differences. Such explanations require the acceptance of 2 disproved assumptions: that genetic variation explains variation in disease and that genetic variation explains racial variation in disease. While the former is a form of geneticization, the notion that genes are the primary determinants of biology and behavior, the latter represents a form of racialization, an exaggeration of the salience of race. Using race as a proxy for genetic differences limits understandings of the complex interactions among political-economic processes, lived experiences, and human biologies. By moving beyond studies of racialized genetics, we can clarify the processes by which varied and interwoven forms of racialization and racism affect individuals "under the skin." PMID:11076233

Why genes don't count (for racial differences in health).

PubMed

Goodman, A H

2000-11-01

There is a paradoxical relationship between "race" and genetics. Whereas genetic data were first used to prove the validity of race, since the early 1970s they have been used to illustrate the invalidity of biological races. Indeed, race does not account for human genetic variation, which is continuous, complexly structured, constantly changing, and predominantly within "races." Despite the disproof of race-as-biology, genetic variation continues to be used to explain racial differences. Such explanations require the acceptance of 2 disproved assumptions: that genetic variation explains variation in disease and that genetic variation explains racial variation in disease. While the former is a form of geneticization, the notion that genes are the primary determinants of biology and behavior, the latter represents a form of racialization, an exaggeration of the salience of race. Using race as a proxy for genetic differences limits understandings of the complex interactions among political-economic processes, lived experiences, and human biologies. By moving beyond studies of racialized genetics, we can clarify the processes by which varied and interwoven forms of racialization and racism affect individuals "under the skin."

Gender and Racial/Ethnic Differences in Binge Eating Symptoms in a Nationally Representative Sample of Adolescents in the United States

PubMed Central

Lee-Winn, Angela E.; Reinblatt, Shauna P.; Mojtabai, Ramin; Mendelson, Tamar

2016-01-01

Objective Binge eating disorder (BED) is the most prevalent eating disorder in the U.S. adolescent population. Both BED and subthreshold binge eating disorder (SBED) are associated with physical and mental health problems. Gender and racial/ethnic differences in prevalence of binge eating in a nationally representative sample of adolescents have been reported but have not yet been assessed in relation to individual symptoms of binge eating. We examined gender and racial/ethnic differences in endorsement of eight binge eating symptoms in a nationally representative sample of U.S. adolescents. Methods We used data from the National Comorbidity Survey-Adolescent Supplement (NCS-A; 2001–2004), a nationally representative cross-sectional study of adolescents aged 13 to 18 years (n=9,336). We compared binge eating symptoms across genders and racial/ethnic groups using multivariable regression models. Results Females endorsed more binge eating symptoms than males associated with loss of control (‘eat when not hungry’ (adjusted prevalence ratio [aPR]=1.18, 95% confidence interval [CI]=1.02, 1.37, p=0.024) and distress (e.g., ‘afraid of weight gain while binge eating’ [aPR=3.29, CI=2.43, 4.47, p<0.001). Racial/ethnic minorities displayed different patterns of binge eating symptoms than non-Hispanic Whites. Hispanics reported being more ‘afraid of weight gain while binge eating’ (aPR=2.05, CI=1.25, 3.37, p=0.006) than non-Hispanic Blacks. Discussion Our findings suggest significant gender and racial/ethnic differences in binge eating symptom presentation. Future work should explore reasons for these gender and racial/ethnic differences and consider these differences when determining how best to prevent and treat binge eating in adolescents. PMID:27085166

Differences in subclinical cardiovascular disease between African American and Caucasian women with systemic lupus erythematosus.

PubMed

Rhew, Elisa Y; Manzi, Susan M; Dyer, Alan R; Kao, Amy H; Danchenko, Natalya; Barinas-Mitchell, Emma; Sutton-Tyrrell, Kim; McPherson, David D; Pearce, William; Edmundowicz, Daniel; Kondos, George T; Ramsey-Goldman, Rosalind

2009-02-01

Racial differences exist in disease rates and mortality in both cardiovascular disease (CVD) and systemic lupus erythematosus (SLE). The objective of this cross-sectional study was to compare the frequency and risk factors for subclinical CVD in African American (AA) and Caucasian women with SLE and no prior CVD events. Traditional CVD risk factors and SLE-related factors were assessed in 309 SLE women. Subclinical CVD was assessed by carotid ultrasound to measure intimamedial thickness (IMT) and plaque, and electron beam computed tomography (EBCT) was used to measure coronary artery calcium (CAC). AA women had less education and higher levels of body mass index, blood pressure, lipoprotein(a), C-reactive protein (CRP), fibrinogen, and erythrocyte sedimentation rate (ESR). However, AA women had lower albumin, more and longer duration of corticosteroid use, higher SLE disease activity and damage, and more dsDNA antibodies compared with Caucasian women after adjustment for age and study site. More AA women had carotid plaque (adjusted odds ratio [OR], 1.94; 95% confidence interval [CI], 1.03-3.65) and higher carotid IMT (0.620 vs 0.605 mm, P = 0.07) but similar CAC compared with Caucasians. A multivariate analysis revealed that the following risk factor variables were significantly different between the racial groups and associated with plaque: blood pressure, current corticosteroid use, SLE disease activity, and SLE damage. All factors contributed to the result, but no individual risk factor fully accounted for the association between race and plaque. In conclusion, the presence of carotid plaque was higher in AA compared with Caucasian women with SLE, in contrast to studies of non-SLE subjects, in which AA have similar or less plaque than Caucasians. A combination of SLE-related and traditional CVD risk factors explained the racial difference in plaque burden.

Differences in Subclinical Cardiovascular Disease between African American and Caucasian Women with Systemic Lupus Erythematosus

PubMed Central

Rhew, Elisa Y.; Manzi, Susan M.; Dyer, Alan R.; Kao, Amy H.; Danchenko, Natalya; Barinas-Mitchell, Emma; Sutton-Tyrrell, Kim; McPherson, David D.; Pearce, William; Edmundowicz, Daniel; Kondos, George T.; Ramsey-Goldman, Rosalind

2009-01-01

Racial differences exist in disease rates and mortality in both cardiovascular disease (CVD) and Systemic Lupus Erythematosus (SLE). The objective of this cross-sectional study was to compare the frequency of and risk factors for subclinical CVD in African-American (AA) and Caucasian women with SLE and no prior CVD events. Traditional CVD risk factors and SLE-related factors were assessed in 309 SLE women. Subclinical CVD was assessed by carotid ultrasound to measure intima-medial thickness (IMT) and plaque, and electron beam computed tomography (EBCT) to measure coronary artery calcium (CAC). AA had less education, higher body mass index, blood pressure, lipoprotein(a), CRP, fibrinogen, and ESR, but lower albumin; more and longer duration of corticosteroid use; higher SLE disease activity and damage; and more had dsDNA antibodies compared to Caucasian women, after adjustment for age and study-site. More AA had carotid plaque (adjusted OR 1.94, 95%CI 1.03, 3.65) and higher carotid IMT (0.620 vs. 0.605mm, p=0.07) compared with Caucasians, but similar CAC. Multivariate analysis included risk factor variables significantly different between the racial groups and associated with plaque: blood pressure, current corticosteroid use, SLE disease activity and damage. All factors contributed, but no individual risk factor fully accounted for the association between race and plaque. In conclusion, the presence of carotid plaque was higher in AA compared with Caucasian women with SLE, in contrast to studies of non-SLE subjects, where AA have similar or less plaque than Caucasians. A combination of SLE-related and traditional CVD risk factors explained the racial difference in plaque burden. PMID:19138649

Racial Differences in Ideal Cardiovascular Health Metrics Among Mississippi Adults, 2009 Mississippi Behavioral Risk Factor Surveillance System

PubMed Central

Gamble, Abigail; Mendy, Vincent

2013-01-01

Introduction Cardiovascular disease is a leading cause of death and health disparities in Mississippi. Identifying populations with poor cardiovascular health may help direct interventions toward those populations disproportionately affected, which may ultimately increase cardiovascular health and decrease prominent disparities. Our objective was to assess racial differences in the prevalence of cardiovascular health metrics among Mississippi adults. Methods We used data from the 2009 Mississippi Behavioral Risk Factor Surveillance System to determine age-standardized prevalence estimates and 95% confidence intervals of cardiovascular health metrics among 2,003 black and 5,125 white adults. Logistic regression models were used to evaluate the relationship between race and cardiovascular health metrics. The mean cardiovascular metrics score and percentage of the population with ideal and poor cardiovascular health were calculated by subgroup. Results Approximately 1.3% of blacks and 2.6% of whites exhibited ideal levels of all 7 cardiovascular health metrics. The prevalence of 4 of the 7 cardiovascular health metrics was significantly lower among the total population of blacks than among whites, including a normal body mass index (20.8% vs 32.3%, P < .001), no history of diabetes (85.1% vs 91.3%, P < .001), no history of hypertension (53.9% vs 67.9%, P < .001), and physical activity (52.8% vs 62.2%, P < .001). The logistic regression models revealed significant race-by-sex interactions; differences between blacks and whites for normal body mass index, no history of diabetes mellitus, and no current smoking were found among women but not among men. Conclusion Cardiovascular health is poor among Mississippi adults overall, and racial differences exist. PMID:24262026

Racial and Gender Disparities in Patients with Gout

PubMed Central

Singh, Jasvinder A.

2012-01-01

Gout affects 8.3 million Americans according to NHANES 2007–2008, roughly 3.9% of the U.S. population. Gout has significant impact on physical function, productivity, health-related quality of life (HRQOL) and health care costs. Uncontrolled gout is also associated with significant utilization of emergent care services. Women are less likely to have gout than men, but in the postmenopausal years the gender difference in disease incidence decreases. Compared to Whites, racial/ethnic minorities, especially blacks, have higher prevalence of gout. On the other hand, blacks are less likely to receive quality gout care, leading to a disproportionate morbidity. Women are less likely than men to receive allopurinol, less likely to get joint aspirations for crystal analyses for establishing diagnosis, but those on urate-lowering therapy are as/more likely as men to get serum urate check within 6-months of initiation. While a few studies provide the knowledge related to gender and race/ethnicity disparities in gout, several knowledge gaps exist in gout epidemiology and outcomes differences by gender and race/ethnicity. These should be explored in future studies. PMID:23315156

Race, Socioeconomic Status, and Health during Childhood: A Longitudinal Examination of Racial/Ethnic Differences in Parental Socioeconomic Timing and Child Obesity Risk.

PubMed

Jones, Antwan

2018-04-11

Prior research suggests that socioeconomic standing during the early years of life, particularly in utero, is associated with child health. However, it is unclear whether socioeconomic benefits are only maximized at very young ages. Moreover, given the link between socioeconomic status (SES) and race, research is inconclusive whether any SES benefits during those younger ages would uniformly benefit all racial and ethnic groups. Using 1986-2014 data from the National Longitudinal Study of Youth (NLSY79), this study examines the impact of socioeconomic timing on child weight outcomes by race. Specifically, this research investigates whether specific points exist where socioeconomic investment would have higher returns on child health. Findings suggest that both the timing and the type of socioeconomic exposure is important to understanding child weight status. SES, particularly mother's employment and father's education, is important in determining child health, and each measure is linked to weight gain differently for White, Black, and Hispanic children at specific ages. Policies such as granting more educational access for men and work-family balance for women are discussed.

Why the racial gap in life expectancy is declining in the United States

PubMed Central

Firebaugh, Glenn; Acciai, Francesco; Noah, Aggie J.; Prather, Christopher; Nau, Claudia

2014-01-01

BACKGROUND Blacks have lower life expectancy than whites in the United States. That disparity could be due to racial differences in the causes of death, with blacks being more likely to die of causes that affect the young, or it could be due to differences in the average ages of blacks and whites who die of the same cause. Prior studies fail to distinguish these two possibilities. OBJECTIVE In this study we determine how much of the 2000–10 reduction in the racial gap in life expectancy resulted from narrowing differences in the cause-specific mean age at death for blacks and whites, as opposed to changing cause-specific probabilities for blacks and whites. METHOD We introduce a method for separating the difference-in-probabilities and difference-inage components of group disparities in life expectancy. RESULTS Based on the new method, we find that 60% of the decline in the racial gap in life expectancy from 2000 to 2010 was attributable to reduction in the age component, largely because of declining differences in the age at which blacks and whites die of chronic diseases. CONCLUSION Our findings shed light on the sources of the declining racial gap in life expectancy in the United States, and help to identify where advances need to be made to achieve the goal of eliminating racial disparities in life expectancy. PMID:25580083

Discrimination, Racial/Ethnic Identity, and Substance Use Among Latina/os: Are They Gendered?

PubMed

Molina, Kristine M; Jackson, Benita; Rivera-Olmedo, Noemi

2016-02-01

Prior research suggests that stronger racial/ethnic identification offsets negative effects of discrimination on substance use. Yet research in this area and on whether gender modifies this association is limited for Latina/os. The purpose of the present study is to examine whether different sources of discrimination (everyday and racial/ethnic) are associated with substance use (alcohol use disorder, smoking), if racial/ethnic identity buffers this association, and the potential moderating role of gender among these variables. We present cross-sectional, US population-based data from the Latina/o adult sample (1427 females and 1127 males) of the National Latino and Asian American Study. Respondents completed self-reported measures of everyday and racial/ethnic discrimination, racial/ethnic identity, smoking status, and Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) lifetime alcohol use disorder. Weighted logistic regression analyses showed that before inclusion of three-way interactions and adjusting for covariates, everyday discrimination predicted increased risk for any DSM-IV lifetime alcohol use disorders. Moderation analyses revealed that the effect of everyday discrimination on the risk of being a current smoker was strongest for Latino men with high levels of racial/ethnic identity compared to those with low racial/ethnic identity. No differences were noted among Latino women. There were no main or interaction effects of racial/ethnic discrimination for any substance use outcome. Findings suggest differential associations for type of discrimination and outcome and that the role of racial/ethnic identity is gender-specific for smoking, appearing particularly detrimental for Latino men reporting high levels of racial/ethnic identity.

Dimensions of Perceived Racism and Self-Reported Health: Examination of Racial/Ethnic Differences and Potential Mediators

PubMed Central

Hausmann, Leslie R. M.; Jhalani, Juhee; Pencille, Melissa; Atencio-Bacayon, Jennifer; Kumar, Asha; Kwok, Jasmin; Ullah, Jahanara; Roth, Alan; Chen, Daniel; Crupi, Robert; Schwartz, Joseph

2016-01-01

Background Many details of the negative relationship between perceived racial/ethnic discrimination and health are poorly understood. Purpose The purpose of this study was to examine racial/ ethnic differences in the relationship between perceived discrimination and self-reported health, identify dimensions of discrimination that drive this relationship, and explore psychological mediators. Methods Asian, Black, and Latino(a) adults (N=734) completed measures of perceived racial/ethnic discrimination, self-reported health, depression, anxiety, and cynical hostility. Results The association between perceived discrimination and poor self-reported health was significant and did not differ across racial/ethnic subgroups. Race-related social exclusion and threat/harassment uniquely contributed to poor health for all groups. Depression, anxiety, and cynical hostility fully mediated the effect of social exclusion on health, but did not fully explain the effect of threat. Conclusions Our results suggest that noxious effects of race-related exclusion and threat transcend between-group differences in discriminatory experiences. The effects of race-related exclusion and threat on health, however, may operate through different mechanisms. PMID:21374099

Cumulative Inequality and Racial Disparities in Health: Private Insurance Coverage and Black/White Differences in Functional Limitations

PubMed Central

Taylor, Miles G.

2014-01-01

Objectives. To test different forms of private insurance coverage as mediators for racial disparities in onset, persistent level, and acceleration of functional limitations among Medicare age-eligible Americans. Method. Data come from 7 waves of the Health and Retirement Study (1996–2008). Onset and progression latent growth models were used to estimate racial differences in onset, level, and growth of functional limitations among a sample of 5,755 people aged 65 and older in 1996. Employer-provided insurance, spousal insurance, and market insurance were next added to the model to test how differences in private insurance mediated the racial gap in physical limitations. Results. In baseline models, African Americans had larger persistent level of limitations over time. Although employer-provided, spousal provided, and market insurances were directly associated with lower persistent levels of limitation, only differences in market insurance accounted for the racial disparities in persistent level of limitations. Discussion. Results suggest private insurance is important for reducing functional limitations, but market insurance is an important mediator of the persistently larger level of limitations observed among African Americans. PMID:24569001

Attitudes and beliefs about organ donation among different racial groups.

PubMed Central

Yuen, C. C.; Burton, W.; Chiraseveenuprapund, P.; Elmore, E.; Wong, S.; Ozuah, P.; Mulvihill, M.

1998-01-01

Many people on the waiting list for organ donation die each year without receiving organs. The shortage of organs is even more pronounced in minority communities. Despite the fact that minorities are at higher risk, they may be less likely to support or consent to organ donation. This investigation was undertaken to study racial factors in organ donation, by focusing on differences in awareness, attitudes, and behavior. Three family practice centers in the Bronx with racially diverse but socioeconomically homogenous communities were studied. The study population consisted of a convenience sample of 163 patients who were approached for participation while they waited to see a doctor. Respondents filled out a 25-item survey that measured demographic information; their exposure to, awareness of, and attitudes toward organ donation; and whether they had signed an organ donor card. The results demonstrated overwhelming support for organ donation across all racial groups. Racial differences were found on awareness of and attitudes toward organ donation, and in the signing of organ donation cards. In contrast to other studies, racial minorities were not less likely than whites to support organ donation. These results suggest that making it easier for racial minorities to obtain organ donor cards could increase their rates of consenting to donate organs. PMID:9473924

Racial Differences in the Usage of Information Technology: Evidence from a National Physician Survey

PubMed Central

Lee, Doohee; Rutsohn, Phil

2012-01-01

Information technology (IT) is a key mechanism for improving the quality of healthcare and containing costs, but racial differences in the utilization of IT among practicing physicians are unknown. The current study, using a national physician survey (n = 6,628), investigated racial differences in the utilization of IT. White physicians and minority physicians were directly compared. We first conducted both descriptive and inferential analyses to detect the difference in IT utilization by race and then performed multiple logistic regressions to test whether race remains significant in relation to IT utilization. Results reveal racial differences in the usage of IT. Compared to their minority counterparts, white physicians underutilized a preventive service reminder system. On the other hand, white physicians favored utilizing electronic communications with patients and exchanging clinical data and images with other providers. PMID:22783155

FINANCIAL CAPACITY OF OLDER AFRICAN AMERICANS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT

PubMed Central

Triebel, Kristen L.; Okonkwo, Ozioma C.; Martin, Roy; Griffith, H. Randall; Crowther, Martha; Marson, Daniel C.

2010-01-01

This study investigated financial abilities of 154 patients with mild cognitive impairment (MCI) (116 Caucasian, 38 African American) using the Financial Capacity Instrument (FCI). In a series of linear regression models, we examined the effect of race on FCI performance and identified preliminary predictor variables that mediated observed racial differences on the FCI. Prior/premorbid abilities were identified. Predictor variables examined in the models included race and other demographic factors (age, education, gender), performance on global cognitive measures (MMSE, DRS-2 Total Score), history of cardiovascular disease (hypertension, diabetes, hypercholesterolemia), and a measure of educational achievement (WRAT-3 Arithmetic). African American patients with MCI performed below Caucasian patients with MCI on six of the seven FCI domains examined and on the FCI total score. WRAT-3 Arithmetic emerged as a partial mediator of group differences on the FCI, accounting for 54% of variance. In contrast, performance on global cognitive measures and history of cardiovascular disease only accounted for 14% and 2%, respectively, of the variance. Racial disparities in financial capacity appear to exist among patients with amnestic MCI. Basic academic math skills related to educational opportunity and quality of education account for a substantial proportion of the group difference in financial performance. PMID:20625268

Financial capacity of older African Americans with amnestic mild cognitive impairment.

PubMed

Triebel, Kristen L; Okonkwo, Ozioma C; Martin, Roy; Griffith, Henry Randall; Crowther, Martha; Marson, Daniel C

2010-01-01

This study investigated financial abilities of 154 patients with mild cognitive impairment (MCI) (116 white, 38 African American) using the Financial Capacity Instrument (FCI). In a series of linear regression models, we examined the effect of race on FCI performance and identified preliminary predictor variables that mediated observed racial differences on the FCI. Prior/premorbid abilities were identified. Predictor variables examined in the models included race and other demographic factors (age, education, sex), performance on global cognitive measures (MMSE, DRS-2 Total Score), history of cardiovascular disease (hypertension, diabetes, hypercholesterolemia), and a measure of educational achievement (WRAT-3 Arithmetic). African American patients with MCI performed below white patients with MCI on 6 of the 7 FCI domains examined and on the FCI total score. WRAT-3 Arithmetic emerged as a partial mediator of group differences on the FCI, accounting for 54% of variance. In contrast, performance on global cognitive measures and history of cardiovascular disease only accounted for 14% and 2%, respectively, of the variance. Racial disparities in financial capacity seem to exist among patients with amnestic MCI. Basic academic math skills related to educational opportunity and quality of education account for a substantial proportion of the group difference in financial performance.

Racial/ethnic standards for fetal growth: the NICHD Fetal Growth Studies.

PubMed

Buck Louis, Germaine M; Grewal, Jagteshwar; Albert, Paul S; Sciscione, Anthony; Wing, Deborah A; Grobman, William A; Newman, Roger B; Wapner, Ronald; D'Alton, Mary E; Skupski, Daniel; Nageotte, Michael P; Ranzini, Angela C; Owen, John; Chien, Edward K; Craigo, Sabrina; Hediger, Mary L; Kim, Sungduk; Zhang, Cuilin; Grantz, Katherine L

2015-10-01

Fetal growth is associated with long-term health yet no appropriate standards exist for the early identification of undergrown or overgrown fetuses. We sought to develop contemporary fetal growth standards for 4 self-identified US racial/ethnic groups. We recruited for prospective follow-up 2334 healthy women with low-risk, singleton pregnancies from 12 community and perinatal centers from July 2009 through January 2013. The cohort comprised: 614 (26%) non-Hispanic whites, 611 (26%) non-Hispanic blacks, 649 (28%) Hispanics, and 460 (20%) Asians. Women were screened at 8w0d to 13w6d for maternal health status associated with presumably normal fetal growth (aged 18-40 years; body mass index 19.0-29.9 kg/m(2); healthy lifestyles and living conditions; low-risk medical and obstetrical history); 92% of recruited women completed the protocol. Women were randomized among 4 ultrasonography schedules for longitudinal fetal measurement using the Voluson E8 (GE Healthcare, Milwaukee, WI). In-person interviews and anthropometric assessments were conducted at each visit; medical records were abstracted. The fetuses of 1737 (74%) women continued to be low risk (uncomplicated pregnancy, absent anomalies) at birth, and their measurements were included in the standards. Racial/ethnic-specific fetal growth curves were estimated using linear mixed models with cubic splines. Estimated fetal weight (EFW) and biometric parameter percentiles (5th, 50th, 95th) were determined for each gestational week and comparisons made by race/ethnicity, with and without adjustment for maternal and sociodemographic factors. EFW differed significantly by race/ethnicity >20 weeks. Specifically at 39 weeks, the 5th, 50th, and 95th percentiles were 2790, 3505, and 4402 g for white; 2633, 3336, and 4226 g for Hispanic; 2621, 3270, and 4078 g for Asian; and 2622, 3260, and 4053 g for black women (adjusted global P < .001). For individual parameters, racial/ethnic differences by order of detection were: humerus and femur lengths (10 weeks), abdominal circumference (16 weeks), head circumference (21 weeks), and biparietal diameter (27 weeks). The study-derived standard based solely on the white group erroneously classifies as much as 15% of non-white fetuses as growth restricted (EFW <5th percentile). Significant differences in fetal growth were found among the 4 groups. Racial/ethnic-specific standards improve the precision in evaluating fetal growth. Published by Elsevier Inc.

Alexander Disease

MedlinePlus

... there are no ethnic, racial, geographic, or cultural/economic differences in its distribution. Alexander disease is a ... there are no ethnic, racial, geographic, or cultural/economic differences in its distribution. Alexander disease is a ...

Health care barriers, racism, and intersectionality in Australia.

PubMed

Bastos, João L; Harnois, Catherine E; Paradies, Yin C

2018-02-01

While racism has been shown to negatively affect health care quality, little is known about the extent to which racial discrimination works with and through gender, class, and sexuality to predict barriers to health care (e.g., perceived difficulty accessing health services). Additionally, most existing studies focus on racial disparities in the U.S. context, with few examining marginalized groups in other countries. To address these knowledge gaps, we analyze data from the 2014 Australian General Social Survey, a nationally representative survey of individuals aged 15 and older living in 12,932 private dwellings. Following an intersectional perspective, we estimate a series of multivariable logit regression models to assess three hypotheses: racial discrimination will be positively associated with perceived barriers to health care (H1); the effect of perceived racial discrimination will be particularly severe for women, sexual minorities, and low socio-economic status individuals (H2); and, in addition to racial discrimination, other forms of perceived discrimination will negatively impact perceived barriers to health care (H3). Findings show that perceptions of racial discrimination are significantly associated with perceived barriers to health care, though this relationship is not significantly stronger for low status groups. In addition, our analyses reveal that perceived racism and other forms of discrimination combine to predict perceived barriers to health care. Taken together, these results speak to the benefits of an intersectional approach for examining racial inequalities in perceived access to health care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perceived racial discrimination and hypertension: a comprehensive systematic review.

PubMed

Dolezsar, Cynthia M; McGrath, Jennifer J; Herzig, Alyssa J M; Miller, Sydney B

2014-01-01

Discrimination is posited to underlie racial disparities in hypertension. Extant literature suggests a possible association between racial discrimination and blood pressure, although inconsistent findings have been reported. The aim of this comprehensive systematic review was to quantitatively evaluate the association between perceived racial discrimination with hypertensive status and systolic, diastolic, and ambulatory blood pressure. Electronic database search of PubMed and PsycINFO (keywords: blood pressure/hypertension/diastolic/systolic, racism/discrimination/prejudice/unfair treatment) was combined with descendancy and ascendancy approaches. Forty-four articles (N = 32,651) met inclusion criteria. Articles were coded for demographics, hypertensive diagnosis, blood pressure measurement, discrimination measure and constructs, study quality, and effect sizes. Random effects meta-analytic models were tested based on Fisher's Z, the derived common effect size metric. Overall, perceived racial discrimination was associated with hypertensive status, Zhypertension = 0.048, 95% CI [.013, .087], but not with resting blood pressure, Zsystolic = 0.011, 95% CI [-.006, .031], Zdiastolic = .016, 95% CI [-.006, .034]. Moderators that strengthened the relation included sex (male), race (Black), age (older), education (lower), and hypertensive status. Perceived discrimination was most strongly associated with nighttime ambulatory blood pressure, especially among Blacks. Despite methodological limitations in the existing literature, there was a small, significant association between perceived discrimination and hypertension. Future studies should consider ambulatory nighttime blood pressure, which may more accurately capture daily variation attributable to experienced racial discrimination. Perceived discrimination may partly explain racial health disparities. 2014 APA, all rights reserved

Perceived Racial Discrimination and Hypertension: A Comprehensive Systematic Review

PubMed Central

Dolezsar, Cynthia M.; McGrath, Jennifer J.; Herzig, Alyssa J. M.; Miller, Sydney B.

2017-01-01

Objective Discrimination is posited to underlie racial disparities in hypertension. Extant literature suggests a possible association between racial discrimination and blood pressure, although inconsistent findings have been reported. The aim of this comprehensive systematic review was to quantitatively evaluate the association between perceived racial discrimination with hypertensive status and systolic, diastolic, and ambulatory blood pressure. Method Electronic database search of PubMed and PsycINFO (keywords: blood pressure/hypertension/diastolic/systolic, racism/discrimination/prejudice/unfair treatment) was combined with descendancy and ascendancy approaches. Forty-four articles (N = 32,651) met inclusion criteria. Articles were coded for demographics, hypertensive diagnosis, blood pressure measurement, discrimination measure and constructs, study quality, and effect sizes. Results Random effects meta-analytic models were tested based on Fisher’s Z, the derived common effect size metric. Overall, perceived racial discrimination was associated with hypertensive status, Zhypertension = 0.048, 95% CI [.013, .087], but not with resting blood pressure, Zsystolic = 0.011, 95% CI [−.006, .031], Zdiastolic = .016, 95% CI [−.006, .034]. Moderators that strengthened the relation included sex (male), race (Black), age (older), education (lower), and hypertensive status. Perceived discrimination was most strongly associated with nighttime ambulatory blood pressure, especially among Blacks. Conclusions Despite methodological limitations in the existing literature, there was a small, significant association between perceived discrimination and hypertension. Future studies should consider ambulatory nighttime blood pressure, which may more accurately capture daily variation attributable to experienced racial discrimination. Perceived discrimination may partly explain racial health disparities. PMID:24417692

Color-blind racial ideology: theory, training, and measurement implications in psychology.

PubMed

Neville, Helen A; Awad, Germine H; Brooks, James E; Flores, Michelle P; Bluemel, Jamie

2013-09-01

Synthesizing the interdisciplinary literature, we characterize color-blind racial ideology (CBRI) as consisting of two interrelated domains: color-evasion (i.e., denial of racial differences by emphasizing sameness) and power-evasion (i.e., denial of racism by emphasizing equal opportunities). Mounting empirical data suggest that the color-evasion dimension is ineffective and in fact promotes interracial tension and potential inequality. CBRI may be conceived as an ultramodern or contemporary form of racism and a legitimizing ideology used to justify the racial status quo. Four types of CBRI are described: denial of (a) race, (b) blatant racial issues, (c) institutional racism, and (d) White privilege. We discuss empirical findings suggesting a relationship between CBRI and increased racial prejudice, racial anger, and racial fear. Implications for education, training, and research are provided. © 2013 APA, all rights reserved.

Pharmacogenomics and the challenge of health disparities.

PubMed

Lee, S S

2009-01-01

This paper examines emerging technologies and recent research on population differences in pharmacogenomics and the perspectives of scientists, community advocates, policymakers, and social critics on the use of race as a proxy for genetic variation. The discussion focuses on how recent developments in genomic science impact social understandings of racial difference and the public health goal to eliminate ongoing health disparities among racially identified groups. This paper examines how factors such as governmental policies--requiring the use of racial and ethnic categories in genetic research and increasing interest in identifying untapped racial market niches by the pharmaceutical and biotechnology industries--and weak governmental oversight of race-based therapeutics converge to create an 'infrastructure of racialization' that may alter the vision of personalized medicine that has been so highly anticipated. This paper argues that significant public investment in pharmacogenomics requires careful consideration of the emerging discourse that tethers racial justice to notions of racial biology and discusses the social and ethical implications for the pendulum shift towards a geneticization of race in drug development. Copyright 2009 S. Karger AG, Basel.

Can Racial Disparity in Health between Black and White Americans Be Attributed to Racial Disparities in Body Weight and Socioeconomic Status?

ERIC Educational Resources Information Center

Kahng, Sang Kyoung

2010-01-01

Few studies have examined to what extent racial disparities in chronic health conditions (CHCs) are attributable to racial differences in body weight (measured as body mass index [BMI]) and socioeconomic status (SES) among older adults. To address this gap, using longitudinal data from the Health and Retirement Study, the current study examined…

Framing the Genetics Curriculum for Social Justice: An Experimental Exploration of How the Biology Curriculum Influences Beliefs about Racial Difference

ERIC Educational Resources Information Center

Donovan, Brian M.

2016-01-01

This field experiment manipulated the racial framing of a reading on human genetic disease to explore whether racial terminology in the biology curriculum affects how adolescents explain and respond to the racial achievement gap in American education. Carried out in a public high school in the San Francisco Bay Area, students recruited for the…

Gender Matters, Too: The Influences of School Racial Discrimination and Racial Identity on Academic Engagement Outcomes among African American Adolescents

ERIC Educational Resources Information Center

Chavous, Tabbye M.; Rivas-Drake, Deborah; Smalls, Ciara; Griffin, Tiffany; Cogburn, Courtney

2008-01-01

The authors examined relationships among racial identity, school-based racial discrimination experiences, and academic engagement outcomes for adolescent boys and girls in Grades 8 and 11 (n = 204 boys and n = 206 girls). The authors found gender differences in peer and classroom discrimination and in the impact of earlier and later discrimination…

A pilot study to explore how low-income mothers of different ethnic/racial backgrounds perceive and implement recommended childhood obesity prevention messages.

PubMed

Vollmer, Rachel L; Mobley, Amy R

2013-06-01

Mothers often serve as the "gatekeepers" of food and the eating experience for young children in the home. Children of different ethnic/racial groups have different obesity prevalence rates, but little is known about how mothers of these groups interpret or implement common childhood obesity prevention messages. The purpose of this mixed methods pilot study was to explore comprehension and implementation of common childhood obesity prevention messages and to identify feeding styles among low-income mothers of young children. White, black, and Hispanic low-income mothers (n=30) of children ages 3-10 were recruited from Indiana. Mothers were interviewed individually regarding the perception and implementation of eight commonly used nutrition and/or physical activity messages. Other outcomes included the results of the Caregiver Feeding Styles Questionnaire and self-reported weight of mothers and child(ren). Interviews were analyzed using thematic analysis to find common themes among the different ethnic/racial groups. Childhood obesity prevention messages were often interpreted or implemented differently among the different ethnic/racial groups. For example, white mothers cited control as a means to manage a child's weight more often compared to the other racial/ethnic groups, whereas black and Hispanic mothers reported catering to a child's preference more frequently compared to white mothers. The pilot study provides evidence that it may be prudent to tailor nutrition messages to mothers of different ethnic/racial backgrounds during nutrition education.

A Pilot Study To Explore How Low-Income Mothers of Different Ethnic/Racial Backgrounds Perceive and Implement Recommended Childhood Obesity Prevention Messages

PubMed Central

Vollmer, Rachel L.

2013-01-01

Abstract Background Mothers often serve as the “gatekeepers” of food and the eating experience for young children in the home. Children of different ethnic/racial groups have different obesity prevalence rates, but little is known about how mothers of these groups interpret or implement common childhood obesity prevention messages. The purpose of this mixed methods pilot study was to explore comprehension and implementation of common childhood obesity prevention messages and to identify feeding styles among low-income mothers of young children. Methods White, black, and Hispanic low-income mothers (n=30) of children ages 3–10 were recruited from Indiana. Mothers were interviewed individually regarding the perception and implementation of eight commonly used nutrition and/or physical activity messages. Other outcomes included the results of the Caregiver Feeding Styles Questionnaire and self-reported weight of mothers and child(ren). Interviews were analyzed using thematic analysis to find common themes among the different ethnic/racial groups. Results Childhood obesity prevention messages were often interpreted or implemented differently among the different ethnic/racial groups. For example, white mothers cited control as a means to manage a child's weight more often compared to the other racial/ethnic groups, whereas black and Hispanic mothers reported catering to a child's preference more frequently compared to white mothers. Conclusion The pilot study provides evidence that it may be prudent to tailor nutrition messages to mothers of different ethnic/racial backgrounds during nutrition education. PMID:23679199

A selected, annotated list of materials that support the development of policies designed to reduce racial and ethnic health disparities

PubMed Central

Donatiello, Joann E.; Droese, Peter W.; Kim, Soo H.

2004-01-01

Research documents the existence of racial and ethnic health disparities. As a result, policy makers are seeking to address these disparities. This list is a starting point for building or updating a collection that supports this policy development process. It is written for health policy librarians and researchers and includes annotated recommendations for books, periodicals, government publications, and Websites. Entries for print publications are primarily from 1998 to 2003. PMID:15098056

A selected, annotated list of materials that support the development of policies designed to reduce racial and ethnic health disparities.

PubMed

Donatiello, Joann E; Droese, Peter W; Kim, Soo H

2004-04-01

Research documents the existence of racial and ethnic health disparities. As a result, policy makers are seeking to address these disparities. This list is a starting point for building or updating a collection that supports this policy development process. It is written for health policy librarians and researchers and includes annotated recommendations for books, periodicals, government publications, and Websites. Entries for print publications are primarily from 1998 to 2003.

Racial/ethnic differences in obesity and comorbidities between safety-net- and non safety-net integrated health systems

PubMed Central

Balasubramanian, Bijal A.; Garcia, Michael P.; Corley, Douglas A.; Doubeni, Chyke A.; Haas, Jennifer S.; Kamineni, Aruna; Quinn, Virginia P.; Wernli, Karen; Zheng, Yingye; Skinner, Celette Sugg

2017-01-01

Abstract Previous research shows that patients in integrated health systems experience fewer racial disparities compared with more traditional healthcare systems. Little is known about patterns of racial/ethnic disparities between safety-net and non safety-net integrated health systems. We evaluated racial/ethnic differences in body mass index (BMI) and the Charlson comorbidity index from 3 non safety-net- and 1 safety-net integrated health systems in a cross-sectional study. Multinomial logistic regression modeled comorbidity and BMI on race/ethnicity and health care system type adjusting for age, sex, insurance, and zip-code-level income The study included 1.38 million patients. Higher proportions of safety-net versus non safety-net patients had comorbidity score of 3+ (11.1% vs. 5.0%) and BMI ≥35 (27.7% vs. 15.8%). In both types of systems, blacks and Hispanics were more likely than whites to have higher BMIs. Whites were more likely than blacks or Hispanics to have higher comorbidity scores in a safety net system, but less likely to have higher scores in the non safety-nets. The odds of comorbidity score 3+ and BMI 35+ in blacks relative to whites were significantly lower in safety-net than in non safety-net settings. Racial/ethnic differences were present within both safety-net and non safety-net integrated health systems, but patterns differed. Understanding patterns of racial/ethnic differences in health outcomes in safety-net and non safety-net integrated health systems is important to tailor interventions to eliminate racial/ethnic disparities in health and health care. PMID:28296752

Women Exiting Street-Based Sex Work: Correlations between Ethno-Racial Identity, Number of Children, and Violent Experiences.

PubMed

Hankel, Jennifer; Dewey, Susan; Martinez, Nina

2016-01-01

Through this article the authors examine data collected from 126 women seeking services at a transitional housing facility, primarily for women leaving street-based prostitution. Descriptive statistics on the women's ethno-racial identity, numbers of children, and experiences with violence are presented and analyzed to determine correlations and implications for social service providers working with this unique population of women. Nearly half of respondents are women of color, a majority have given birth to at least one child, and more than half are in a non-commercial intimate partnership, with a significant number reporting extensive experiences with violent trauma and abuse. Results indicate statistically significant differences in women's ethno-racial self-identification and their experiences of sex work and violence, as well as their marital status. Most notably, African-American and Hispanic women face the greatest and most diverse forms of intimate partner violence and negative sex industry experiences, with African-Americans more likely to engage in sex work as minors, be sexually abused as children, work for a pimp, and face physical assault and instances of sex trafficking. Results also support existing research showing correlations between traumatic childhood events and adult substance abuse, sexual assault, and other negative outcomes.

Racial/ethnic and socioeconomic variations in duration of smoking: results from 2003, 2006 and 2007 Tobacco Use Supplement of the Current Population Survey.

PubMed

Siahpush, M; Singh, G K; Jones, P R; Timsina, L R

2010-06-01

Little is known about racial/ethnic and socioeconomic variations in the duration of smoking. The goal of this research was to examine these variations. Data came from the 2003, 2006 and 2007 Tobacco Use Supplement of the Current Population Survey. The analysis was limited to ever-smokers (n = 117,168). The outcome was number of years of daily smoking. Survival analysis was employed to predict smoking duration. American Indians with 32 years had the highest median duration of smoking, followed by Blacks and 'other' races with 30 years, Whites with 28 years and Hispanics with 24 years. The difference in the duration of smoking between Blacks and Whites disappeared after adjusting for poverty. Individuals in poverty had a median duration of smoking of 40 years, while those with a family income of at least three times that of the poverty threshold had a median duration of 22 years. Median duration of smoking was 40 years among individuals without a high-school diploma and 18 years among those with a bachelors or higher degree. This research revealed large variations in smoking duration between racial/ethnic and socioeconomic groups. Longer exposure to tobacco among groups that are already disadvantaged is likely to exacerbate existing health disparities.

Increasing Inequality in Physical Activity Among Minnesota Secondary Schools, 2001-2010.

PubMed

Nelson, Toben F; MacLehose, Richard F; Davey, Cynthia; Rode, Peter; Nanney, Marilyn S

2018-05-01

Two Healthy People 2020 goals are to increase physical activity (PA) and to reduce disparities in PA. We explored whether PA at the school level changed over time in Minnesota schools and whether differences existed by demographic and socioeconomic factors. We examine self-reported PA (n = 276,089 students; N = 276 schools) for 2001-2010 from the Minnesota Student Survey linked to school demographic data from the National Center for Education Statistics and the Rural-Urban Commuting Area Codes. We conducted analyses at the school level using multivariable linear regression with cluster-robust recommendation errors. Overall, students who met PA recommendations increased from 59.8% in 2001 to 66.3% in 2010 (P < .001). Large gains in PA occurred at schools with fewer racial/ethnic minority students (0%-60.1% in 2001 to 67.5% in 2010, P < .001), whereas gains in PA were comparatively small at schools with a high proportion of racial/ethnic minority students in 2001 (30%-59.2% in 2001 to 62.7% in 2010). We found increasing inequalities in school-level PA by racial/ethnic characteristics of their schools and communities among secondary school students. Future research should monitor patterns of PA over time and explore mechanisms for patterns of inequality.

Racial/Ethnic Differences in Expectations Regarding Aging Among Older Adults.

PubMed

Menkin, Josephine A; Guan, Shu-Sha Angie; Araiza, Daniel; Reyes, Carmen E; Trejo, Laura; Choi, Sarah E; Willis, Phyllis; Kotick, John; Jimenez, Elizabeth; Ma, Sina; McCreath, Heather E; Chang, Emiley; Witarama, Tuff; Sarkisian, Catherine A

2017-08-01

The study identifies differences in age-expectations between older adults from Korean, Chinese, Latino, and African American backgrounds living in the United States. This study uses baseline demographic, age-expectation, social, and health data from 229 racial/ethnic minority seniors in a stroke-prevention intervention trial. Unadjusted regression models and pair-wise comparisons tested for racial/ethnic differences in age-expectations, overall, and across domain subscales (e.g., physical-health expectations). Adjusted regression models tested whether age-expectations differed across racial/ethnic groups after controlling for demographic, social, and health variables. Regression and negative binomial models tested whether age-expectations were consistently associated with health and well-being across racial/ethnic groups. Age-expectations differed by race/ethnicity, overall and for each subscale. African American participants expected the least age-related functional decline and Chinese American participants expected the most decline. Although African American participants expected less decline than Latino participants in unadjusted models, they had comparable expectations adjusting for education. Latino and African American participants consistently expected less decline than Korean and Chinese Americans. Acculturation was not consistently related to age-expectations among immigrant participants over and above ethnicity. Although some previously observed links between expectations and health replicated across racial/ethnic groups, in adjusted models age-expectations were only related to depression for Latino participants. With a growing racial/ethnic minority older population in the United States, it is important to note older adults' age-expectations differ by race/ethnicity. Moreover, expectation-health associations may not always generalize across diverse samples. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Challenges to Reducing Discrimination and Health Inequity Through Existing Civil Rights Laws

PubMed Central

Chandra, Amitabh; Frakes, Michael; Malani, Anup

2017-01-01

Fifty years after the passage of Civil Rights Act, minority healthcare remains separate and unequal. We combine insights from Civil Rights Law and research on racial-disparities to understand whether stronger enforcement of existing Civil Rights laws would improve minority healthcare today, or whether complementary approaches are also necessary. Despite earlier success, modern challenges to improving minority healthcare are different than those confronted during de jure segregation. We review these challenges and the potential effectiveness of existing Civil Rights legislation in overcoming them. We conclude that enforcement could be strengthened by executive orders that strengthen existing laws, but Congressional action would be required to allow private individuals to bring suits against discriminatory providers. We contrast the relative benefits of this approach to wider non-litigation-based solutions. We conclude that a combination of the two approaches would better address the challenge of improving minority healthcare in the 21st century. PMID:28583962

Race and food store availability in an inner-city neighbourhood.

PubMed

Galvez, Maida P; Morland, Kimberly; Raines, Cherita; Kobil, Jessica; Siskind, Jodi; Godbold, James; Brenner, Barbara

2008-06-01

A growing body of research has shown that disparities in resources, including food stores, exist at the neighbourhood level and the greatest disparities are seen in minority neighbourhoods, the same neighbourhoods at increased risk of obesity and diabetes. Less is known about whether differences in availability of resources by African American or Latino race/ethnicity exist within a single minority community. The present study examined whether census blocks either 75% African American (AA) or 75% Latino (L) are associated with food store availability, as compared with racially mixed (RM) census blocks, in East Harlem, New York. A cross-sectional study utilising a walking survey of East Harlem was performed. Food stores were classified into: supermarkets, grocery stores, convenience stores, specialty stores, full-service restaurants and fast-food stores. One hundred and sixty-five East Harlem census blocks were examined; 17 were AA, 34 were L and 114 were RM. Of AA census blocks, 100% had neither supermarkets nor grocery stores. AA census blocks were less likely to have convenience stores (prevalence ratio (PR) = 0.25, 95% confidence interval (CI) 0.07-0.86) compared with RM census blocks. In contrast, predominantly L census blocks were more likely to have convenience stores (PR = 1.8, 95% CI 1.20-2.70), specialty food stores (PR = 3.74, 95% CI 2.06-7.15), full-service restaurants (PR = 1.87, 95% CI 1.04-3.38) and fast-food restaurants (PR = 2.14, 95% CI 1.33-3.44) compared with RM census blocks. We found that inequities in food store availability exist by race/ethnicity in East Harlem, New York. This has implications for racial/ethnic differences in dietary quality, obesity and obesity-related disorders.

Removing Obstacles To Eliminating Racial And Ethnic Disparities In Behavioral Health Care.

PubMed

Alegría, Margarita; Alvarez, Kiara; Ishikawa, Rachel Zack; DiMarzio, Karissa; McPeck, Samantha

2016-06-01

Despite decades of research, racial and ethnic disparities in behavioral health care persist. The Affordable Care Act expanded access to behavioral health care, but many reform initiatives fail to consider research about racial/ethnic minorities. Mistaken assumptions that underlie the expansion of behavioral health care run the risk of replicating existing service disparities. Based on a review of relevant literature and numerous observational and field studies with minority populations, we identified the following three mistaken assumptions: Improvement in health care access alone will reduce disparities, current service planning addresses minority patients' preferences, and evidence-based interventions are readily available for diverse populations. We propose tailoring the provision of care to remove obstacles that minority patients face in accessing treatment, promoting innovative services that respond to patients' needs and preferences, and allowing flexibility in evidence-based practice and the expansion of the behavioral health workforce. These proposals should help meet the health care needs of a growing racial/ethnic minority population. Project HOPE—The People-to-People Health Foundation, Inc.

Removing Obstacles To Eliminate Racial And Ethnic Disparities In Behavioral Health Care

PubMed Central

Alegría, Margarita; Alvarez, Kiara; Ishikawa, Rachel Zack; DiMarzio, Karissa; McPeck, Samantha

2016-01-01

Despite decades of research, racial and ethnic disparities in behavioral health care persist. The Affordable Care Act expanded access to behavioral health care, but many reform initiatives fail to consider research about racial/ethnic minorities. Mistaken assumptions that underlie the expansion of behavioral health care risk replicating existing service disparities. Based on a review of relevant literature and numerous observational and field studies with minority populations, we identified the following three mistaken assumptions: improvement in health care access alone will reduce disparities, current service planning addresses minority patients’ preferences, and evidence-based interventions are readily available for diverse populations. We propose tailoring the provision of care to remove obstacles that minority patients face in accessing treatment, promoting innovative services that respond to patient needs and preferences, and allowing flexibility in evidence-based practice and the expansion of the behavioral health workforce. These proposals should help meet the health care needs of a growing racial/ethnic minority population. PMID:27269014

The economics of race and eugenic sterilization in North Carolina: 1958-1968.

PubMed

Price, Gregory N; Darity, William A

2010-07-01

Theoretical justifications for state-sanctioned sterilization of individuals provided by Irving Fisher rationalized its racialization on grounds that certain non-white racial groups, particularly blacks due to their dysgenic biological and behavioral traits, retarded economic growth and should be bred out of existence. Fisher's rationale suggests that national or state level eugenic policies that sterilized the so-called biological and genetically unfit could have been racist in both design and effect by disproportionately targeting black Americans. We empirically explore this with data on eugenic sterilizations in the State of North Carolina between 1958 and 1968. Count data parameter estimates from a cross-county population allocation model of sterilization reveal that the probability of non-institutional and total sterilizations increased with a county's black population share-an effect not found for any other racial group in the population. Our results suggest that in North Carolina, eugenic sterilization policies were racially biased and genocidal. 2010 Elsevier B.V. All rights reserved.

Racial liberalism, the Moynihan Report & the Daedalus Project on "The Negro American".

PubMed

Geary, Daniel

2011-01-01

In 1965, Daniel Patrick Moynihan, then an official in the Johnson administration, published "The Negro Family: The Case for National Action," better known as the Moynihan Report. He was influenced by his participation in two conferences organized by the American Academy of Arts and Sciences in the mid-1960s, as well as two issues of its journal Daedalus, on the topic of "The Negro American." Arguing that the "damaged" family structure of African Americans would impede efforts to achieve full racial equality in the United States, the Moynihan Report launched an explosive debate that helped fracture a fragile liberal consensus on civil rights. Geary examines the report alongside the Daedalus project, establishing its roots in the racial liberalism of the mid-1960s and connecting it to efforts by liberals to address the socioeconomic dimensions of racial inequality. He considers the close relationship between scholarship and public policy that existed at the time and reflects on the ways liberal ideas about race have changed in the decades since.

Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties.

PubMed

Slopen, Natalie; Williams, David R

2014-01-01

To advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes. Cross-sectional probability sample. Chicago, IL. There were 2,983 black, Hispanic, and white adults. Outcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (β = -0.14)) and nonracial (β = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (β = -0.17), and workplace harassment and incivilities (β = -0.14) were associated with shorter sleep (P < 0.05). The association between major experiences of discrimination attributed to race/ethnicity and sleep duration (β = -0.09, P < 0.05) was independent of concurrent stressors (i.e., acute events, childhood adversity, and financial, community, employment, and relationship stressors). Racial (β = 0.04) and non-racial (β = 0.05) everyday discrimination and racial (β = 0.04) and nonracial (β = 0.04) major experiences of discrimination, and workplace harassment and incivilities (β = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P < 0.05). Racial/ethnic differences in sleep duration and difficulties were not significant after adjustment for discrimination (P > 0.05). Discrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep.

Racial and ethnic disparities in human papillomavirus-associated cancer burden with first-generation and second-generation human papillomavirus vaccines.

PubMed

Burger, Emily A; Lee, Kyueun; Saraiya, Mona; Thompson, Trevor D; Chesson, Harrell W; Markowitz, Lauri E; Kim, Jane J

2016-07-01

In the United States, the burden of human papillomavirus (HPV)-associated cancers varies by racial/ethnic group. HPV vaccination may provide opportunities for primary prevention of these cancers. Herein, the authors projected changes in HPV-associated cancer burden among racial/ethnic groups under various coverage assumptions with the available first-generation and second-generation HPV vaccines to evaluate changes in racial/ethnic disparities. Cancer-specific mathematical models simulated the burden of 6 HPV-associated cancers. Model parameters, informed using national registries and epidemiological studies, reflected sex-specific, age-specific, and racial/ethnic-specific heterogeneities in HPV type distribution, cancer incidence, stage of disease at detection, and mortality. Model outcomes included the cumulative lifetime risks of developing and dying of 6 HPV-associated cancers. The level of racial/ethnic disparities was evaluated under each alternative HPV vaccine scenario using several metrics of social group disparity. HPV vaccination is expected to reduce the risks of developing and dying of HPV-associated cancers in all racial/ethnic groups as well as reduce the absolute degree of disparities. However, alternative metrics suggested that relative disparities would persist and in some scenarios worsen. For example, when assuming high uptake with the second-generation HPV vaccine, the lifetime risk of dying of an HPV-associated cancer for males decreased by approximately 60%, yet the relative disparity increased from 3.0 to 3.9. HPV vaccines are expected to reduce the overall burden of HPV-associated cancers for all racial/ethnic groups and to reduce the absolute disparity gap. However, even with the second-generation vaccine, relative disparities will likely still exist and may widen if the underlying causes of these disparities remain unaddressed. Cancer 2016;122:2057-66. © 2016 American Cancer Society. © 2016 American Cancer Society.

Racial and sexual identity-related maltreatment among minority YMSM: prevalence, perceptions, and the association with emotional distress.

PubMed

Hightow-Weidman, Lisa B; Phillips, Gregory; Jones, Karen C; Outlaw, Angulique Y; Fields, Sheldon D; Smith, Justin C

2011-08-01

Bullying is a form of violence characterized as an aggressive behavior that is unprovoked and intended to cause harm. Prior studies have found that lesbian, gay, bisexual, and transgender (LGBT) youth experience high levels of bullying related to their sexuality and this harassment can lead to engagement in risk behaviors, depression, and suicide. Ethnic/racial minority young men who have sex with men (YMSM) may experience dual levels of stigma and maltreatment due to both their sexuality and their race. The aim of the current study was to assess the prevalence and perceptions of racial and sexual identity-based abuse among a sample of minority YMSM, and whether this maltreatment plays a role in the emotional distress of these youth. We found that overall 36% and 85% of participants experienced racial and sexuality-related bullying, respectively. There was a significant association between experiencing a high level of sexuality-related bullying and depressive symptomatology (p=0.03), having attempted suicide (p=0.03), and reporting parental abuse (p=0.05). We found no association between racial bullying and suicide attempts. In a multivariable logistic regression model, experiencing any racial bullying and high sexuality-related bullying were significant predictors of having a CES-D score ≥16; adjusted odds ratio (OR) 1.83 and 2.29, respectively. These findings contribute to the existing literature regarding the negative experiences and daily stressors facing LGBT youth with regard to both their minority status and LGBT identities. Future interventions for racial/ethnic minority YMSM should provide assistance to achieve a positive view of self that encompasses both their racial and sexual identities.

Discrimination, Racial/Ethnic Identity, and Substance Use Among Latina/os: Are They Gendered?

PubMed Central

Jackson, Benita; Rivera-Olmedo, Noemi

2016-01-01

Background Prior research suggests that stronger racial/ethnic identification offsets negative effects of discrimination on substance use. Yet research in this area and on whether gender modifies this association is limited for Latina/os. Purpose The purpose of the present study is to examine whether different sources of discrimination (everyday and racial/ethnic) are associated with substance use (alcohol use disorder, smoking), if racial/ethnic identity buffers this association, and the potential moderating role of gender among these variables. Methods We present cross-sectional, US population-based data from the Latina/o adult sample (1427 females and 1127 males) of the National Latino and Asian American Study. Respondents completed self-reported measures of everyday and racial/ethnic discrimination, racial/ethnic identity, smoking status, and Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) lifetime alcohol use disorder. Results Weighted logistic regression analyses showed that before inclusion of three-way interactions and adjusting for covariates, everyday discrimination predicted increased risk for any DSM-IV lifetime alcohol use disorders. Moderation analyses revealed that the effect of everyday discrimination on the risk of being a current smoker was strongest for Latino men with high levels of racial/ethnic identity compared to those with low racial/ethnic identity. No differences were noted among Latino women. There were no main or interaction effects of racial/ethnic discrimination for any substance use outcome. Conclusions Findings suggest differential associations for type of discrimination and outcome and that the role of racial/ethnic identity is gender-specific for smoking, appearing particularly detrimental for Latino men reporting high levels of racial/ethnic identity. PMID:26489844

Race and health in Guyana: an empirical assessment from survey data.

PubMed

Wilson, Leon C; Wilson, Colwick M; Johnson, Bridgette M

2010-01-01

This paper examines racial differences in physical health and mental well-being in Guyana, South America: a country with cultural ties to the Caribbean. It explores the complex relationship among race, socioeconomic status and health outcomes which in developed societies continues to be of significant research interest. Utilizing a random probability sample of over 900 adults, the analyses provide information on the general physical and mental health status of this population and examine the differences by racial groups when other factors are controlled. The results indicate significant age-specific racial differences in physical and mental health in Guyana. Higher rates of diabetes, arthritis or rheumatism, back and breathing problems among Indo-Guyanese when compared to other groups were noted. Racial differences in physical health were attenuated when gender and educational levels were controlled.

Hospital consolidation and racial/income disparities in health insurance coverage.

PubMed

Town, Robert J; Wholey, Douglas R; Feldman, Roger D; Burns, Lawton R

2007-01-01

Non-Hispanic whites are significantly more likely to have health insurance coverage than most racial/ethnic minorities, and this differential grew during the 1990s. Similarly, wealthier Americans are more likely to have health insurance than the poor, and this difference also grew over the 1990s. This paper examines the role of provider competition in increasing these disparities in insurance coverage. Over the 1990s, the hospital industry consolidated; we analyze the impact of this consolidation on health insurance take-up for different racial/ethnic minorities and income groups. We found that the hospital consolidation wave increased health insurance disparities along racial and income dimensions.

Intergroup consensus/disagreement in support of group-based hierarchy: an examination of socio-structural and psycho-cultural factors.

PubMed

Lee, I-Ching; Pratto, Felicia; Johnson, Blair T

2011-11-01

A meta-analysis examined the extent to which socio-structural and psycho-cultural characteristics of societies correspond with how much gender and ethnic/racial groups differ on their support of group-based hierarchy. Robustly, women opposed group-based hierarchy more than men did, and members of lower power ethnic/racial groups opposed group-based hierarchy more than members of higher power ethnic/racial groups did. As predicted by social dominance theory, gender differences were larger, more stable, and less variable from sample to sample than differences between ethnic/racial groups. Subordinate gender and ethnic/racial group members disagreed more with dominants in their views of group-based hierarchy in societies that can be considered more liberal and modern (e.g., emphasizing individualism and change from traditions), as well as in societies that enjoyed greater gender equality. The relations between gender and ethnic/racial groups are discussed, and implications are developed for social dominance theory, social role theory, biosocial theory, social identity theory, system justification theory, realistic group conflict theory, and relative deprivation theory. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Racial and nonracial discrimination and smoking status among South African adults ten years after apartheid

PubMed Central

Dutra, Lauren M; Williams, David R; Kawachi, Ichiro; Okechukwu, Cassandra A

2014-01-01

Background Despite a long history of discrimination and persisting racial disparities in smoking prevalence, little research exists on the relationship between discrimination and smoking in South Africa. Methods This analysis examined chronic (day to day) and acute (lifetime) experiences of racial and nonracial (e.g., age, gender, or physical appearance) discrimination and smoking status among respondents to the South Africa Stress and Health Study (SASH). Logistic regression models were constructed using SAS-Callable SUDAAN. Results Both chronic racial discrimination (RR=1.45, 95%CI: 1.14–1.85) and chronic nonracial discrimination (RR=1.69, 95%CI: 1.37–2.08) predicted a higher risk of smoking, but neither type of acute discrimination did. Total (sum of racial and nonracial) chronic discrimination (RR=1.46, 95%CI: 1.20–1.78) and total acute discrimination (RR=1.28, 95%CI: 1.01–1.60) predicted a higher risk of current smoking. Conclusions Racial and nonracial discrimination may be related to South African adults’ smoking behavior, but this relationship likely varies by the timing and frequency of these experiences. Future research should use longitudinal data to identify the temporal ordering of the relationships studied, include areas outside of South Africa to increase generalizability, and consider the implications of these findings for smoking cessation approaches in South Africa. PMID:24789604

Racial Discrimination, Psychological Distress, and Self-Rated Health Among US-Born and Foreign-Born Black Americans

PubMed Central

Kosheleva, Anna; Waterman, Pamela D.; Chen, Jarvis T.; Koenen, Karestan

2011-01-01

Objectives. We investigated associations among racial discrimination, psychological distress, and self-rated health among US-born and immigrant Black Americans. Methods. We conducted a cross-sectional analysis of a cohort of employed working-class Black Americans (193 US-born, 275 foreign-born). Results. Both US-born and foreign-born Black participants had high levels of exposure to poverty (51% and 57%, respectively) and racial discrimination (76% and 60%) and reported high levels of severe psychological distress (14% and 16% had a Kessler 6 [K6] score of 13 or greater); 17% and 7% reported fair or poor health. After controlling for relevant covariates, their risk parameters for racial discrimination (high vs no exposure) were 4.0 (95% confidence interval [CI] = 2.3, 5.6) and 3.3 (95% CI = 2.1, 4.5), respectively, for continuous K6 score; corresponding odds ratios for severe psychological distress were 6.9 (95% CI = 1.4, 35.7) and 6.8 (95% CI = 2.5, 18.3). No associations existed between racial discrimination and self-reported health, suggesting that an underlying propensity to report adversity does not account for our psychological distress findings. Conclusions. Our results attest to the salience of racial discrimination, nativity, and socioeconomic position in understanding the experiences and psychological health of Black Americans. PMID:21778504

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)

Aftercare engagement: A review of the literature through the lens of disparities.

PubMed

Keefe, Kristen; Cardemil, Esteban V; Thompson, Matthew

2017-02-01

While prior research has well documented racial and ethnic disparities in mental health care broadly, significantly less attention has been given to possible disparities existing in the transition to aftercare. Grounded in Klinkenberg and Calsyn's (1996) framework, we review current research on aftercare, identify commonalities between the prior and current reviews, and highlight gaps for future research. We focus on variables pertinent to our understanding of racial/ethnic disparities. Articles were retrieved via PsycINFO, PubMed, PsycARTICLES, and Google Scholar. We targeted those written in English and conducted in the United States after 1996 that examined aftercare and disparities-related variables. Accumulating evidence across the 18 studies that we reviewed suggests that disparities exist in aftercare engagement. We found clear support for significant racial/ethnic effects on aftercare engagement, such that racial/ethnic minorities are typically more vulnerable to disengagement than Whites. In addition, we found modest support for the association between aftercare engagement and other individual- and community-level variables, including sex, insurance status, prior outpatient treatment, and residence in an urban versus rural setting. Moreover, extant qualitative research has identified barriers to aftercare engagement including stigma, low mental health literacy, and negative attitudes toward treatment. Finally, systems-level variables including assertive outreach efforts and reduced length of time on waitlists were identified as consistent predictors of engagement. Suggestions for future research and clinical implications are explored. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Engagement of health plans and employers in addressing racial and ethnic disparities in health care.

PubMed

Rosenthal, Meredith B; Landon, Bruce E; Normand, Sharon-Lise T; Ahmad, Thaniyyah S; Epstein, Arnold M

2009-04-01

Disparities in access to and quality of health care along racial and ethnic lines are an important national problem. Health care purchasers and payers have a potentially important role to play in alleviating this problem. Using national surveys of 609 employers and 252 health plans with HMO products in 41 U.S. markets, we examined awareness of racial and ethnic disparities in health care access and quality, perceptions of employer and health plan role in addressing disparities, and reported efforts to measure and reduce disparities. Our findings suggest that most health plans and many employers are aware of the existence of substantial disparities and that health plans, but not employers, have taken steps to examine and influence patterns of care by race and ethnicity among their members.

Health disparities: a primer for public health social workers.

PubMed

Keefe, Robert H

2010-05-01

In 2001, the U.S. Department of Health and Human Services published Healthy People 2010, which identified objectives to guide health promotion and to eliminate health disparities. Since 2001, much research has been published documenting racial and ethnic disparities in healthcare. Although progress has been made in eliminating the disparities, ongoing work by public health social workers, researchers, and policy analysts is needed. This paper focuses on racial and ethnic health disparities, why they exist, where they can be found, and some of the key health/medical conditions identified by the U.S. Department of Health and Human Services to receive attention. Finally, there is a discussion of what policy, professional and community education, and research can to do to eliminate racial and ethnic disparities in healthcare.

Perceived cancer risk: why is it lower among nonwhites than whites?

PubMed

Orom, Heather; Kiviniemi, Marc T; Underwood, Willie; Ross, Levi; Shavers, Vickie L

2010-03-01

We explored racial/ethnic differences in perceived cancer risk and determinants of these differences in a nationally representative sample of whites, blacks, Hispanics, and Asians. Multiple regression techniques, including mediational analyses, were used to identify determinants and quantify racial/ethnic differences in the perception of the risk of developing cancer among 5,581 adult respondents to the 2007 Health Information Trends Survey (HINTS). Blacks, Hispanics, and Asians reported lower perceived cancer risk than whites [Bs = -0.40, -0.34, and -0.69, respectively; (Ps < 0.001)]. Contributing factors included relatively lower likelihood of reporting a family history of cancer, lower likelihood of having smoked, and a less strong belief that everything causes cancer among nonwhites than among whites. Racial/ethnic differences in perceived risk were attenuated in older respondents because perceived cancer risk was negatively associated with age for whites but not for nonwhites. Nonwhites had lower perceptions of cancer risk than whites. Some of the racial/ethnic variability in perceived risk may be due to racial and ethnic differences in awareness of one's family history of cancer and its relevance for cancer risk, experiences with behavioral risk factors, and salience of cancer risk information.

Racial and socioeconomic differences in psychiatric symptoms in nursing home residents: a minimum data set-based pilot study.

PubMed

Zisselman, Marc H; Smith, Robert V; Smith, Stephanie A; Daskalakis, Constantine; Sanchez, Francisco

2006-01-01

Little research has explored racial and socioeconomic differences in the presence, detection, and treatment of neuropsychiatric symptoms in nursing home residents. To evaluate racial and socioeconomic differences on mood and behavior Minimum Data Set (MDS) recorded symptoms, MDS recorded psychiatric diagnoses, and MDS identified psychotropic medication use. Data were obtained through a cross-sectional review of MDS data of 290 African-American and white residents of 2 nursing homes. The association between age, gender, race, and pay status with mood and behavior patterns, psychiatric diagnoses, and use of psychotropic medication was evaluated. White residents were more likely than African American residents to have MDS recorded psychiatric diagnoses (odds ratio, OR = 3.24), but there were no significant racial differences in recorded mood or behavior symptomatology or in the pharmacologic treatment of mental illness. Medicaid recipients were more likely than nonrecipients to have behavior symptoms (OR = 2.09), have a psychiatric diagnosis (OR = 2.91), and receive psychotropic medications in the absence of a psychiatric diagnosis (OR = 3.62). Pay status was associated with recorded symptoms, diagnoses, and medications, but racial differences were found only for recorded diagnoses.

How Do Racial/Ethnic Groups Differ in Their Use of Neighborhood Parks? Findings from the National Study of Neighborhood Parks.

PubMed

Vaughan, Christine A; Cohen, Deborah A; Han, Bing

2018-06-18

The current study examined racial/ethnic differences in use of parks and park facilities and features and self-reported park use and perceptions. We conducted observations in a nationally representative sample of 193 neighborhood parks in 27 US cities over a 1-week period between April and August of 2016 using the System of Observing Play and Recreation in Communities (SOPARC). To determine the propensity of different racial/ethnic groups to use parks relative to expectation based on their representation in the surrounding neighborhood, we calculated the percentages of park users of each race/ethnicity and compared these to the percentages of racial/ethnic groups residing in the neighborhood within a 1-mile radius of the park based on 2010 U.S. Census data. In the same parks, we administered an intercept survey to assess park users' self-reported use and perceptions of the park (N = 1872). We examined racial/ethnic differences in self-reported use and perceptions of parks using GEE models that adjusted for several individual- and park-level covariates. Hispanics comprised a disproportionate percentage of observed park users. Racial/ethnic groups generally did not differ in their self-reported park use and perceptions, except for the social context of park visits. In adjusted models, Hispanics had significantly higher odds of visiting with a child family member (OR = 1.44) and lower odds of visiting alone than non-Hispanic whites (OR = .55). Findings highlight Hispanics' greater propensity to use parks and indicate that parks may serve a communal purpose for Hispanics that they do not serve for other racial/ethnic groups.

Racial Differences in Chronic Conditions and Sociodemographic Characteristics Among High-Utilizing Veterans.

PubMed

Breland, Jessica Y; Chee, Christine Pal; Zulman, Donna M

2015-06-01

African-Americans are disproportionally represented among high-risk, high-utilizing patients. To inform program development for this vulnerable population, the current study describes racial variation in chronic conditions and sociodemographic characteristics among high-utilizing patients in the Veterans Affairs Healthcare System (VA). We identified the 5 % most costly Veterans who used inpatient or outpatient care at the VA during fiscal year 2010 (N = 237,691) based on costs of inpatient and outpatient care, pharmacy services, and VA-sponsored contract care. Patient costs and characteristics were abstracted from VA outpatient and inpatient data files. Racial differences in sociodemographic characteristics (age, sex, marital support, homelessness, and health insurance status) were assessed with chi-square tests. Racial differences in 32 chronic condition diagnoses were calculated as relative risk ratios. African-Americans represented 21 % of high-utilizing Veterans. African-Americans had higher rates of homelessness (26 vs. 10 %, p < 0.001) and lower rates of supplemental health insurance (44 vs. 58 %, p < 0.001). The mean number of chronic conditions was similar across race. However, there were racial differences in the prevalence of specific chronic conditions, including a higher prevalence of HIV/AIDS (95 % confidence interval (CI) 4.86, 5.50) and schizophrenia (95 % CI 1.94, 2.07) and a lower prevalence of ischemic heart disease (95 % CI 0.57, 0.59) and bipolar disorder (95 % CI 0.78, 0.85) among African-American high-utilizing Veterans. Racial disparities among high-utilizing Veterans may differ from those found in the general population. Interventions should devote attention to social, environmental, and mental health issues in order to reduce racial disparities in this vulnerable population.

Ethnic density and area deprivation: neighbourhood effects on Māori health and racial discrimination in Aotearoa/New Zealand.

PubMed

Bécares, Laia; Cormack, Donna; Harris, Ricci

2013-07-01

Some studies suggest that ethnic minority people are healthier when they live in areas with a higher concentration of people from their own ethnic group, a so-called ethnic density effect. To date, no studies have examined the ethnic density effect among indigenous peoples, for whom connections to land, patterns of settlement, and drivers of residential location may differ from ethnic minority populations. The present study analysed the Māori sample from the 2006/07 New Zealand Health Survey to examine the association between increased Māori ethnic density, area deprivation, health, and experiences of racial discrimination. Results of multilevel regressions showed that an increase in Māori ethnic density was associated with decreased odds of reporting poor self-rated health, doctor-diagnosed common mental disorders, and experienced racial discrimination. These associations were strengthened after adjusting for area deprivation, which was consistently associated with increased odds of reporting poor health and reports of racial discrimination. Our findings show that whereas ethnic density is protective of the health and exposure to racial discrimination of Māori, this effect is concealed by the detrimental effect of area deprivation, signalling that the benefits of ethnic density must be interpreted within the current socio-political context. This includes the institutional structures and racist practices that have created existing health and socioeconomic inequities in the first place, and maintain the unequal distribution of concentrated poverty in areas of high Māori density. Addressing poverty and the inequitable distribution of socioeconomic resources by ethnicity and place in New Zealand is vital to improving health and reducing inequalities. Given the racialised nature of access to goods, services, and opportunities within New Zealand society, this also requires a strong commitment to eliminating racism. Such commitment and action will allow the benefits potentially flowing from strong communities to be fully realised. Copyright © 2013 Elsevier Ltd. All rights reserved.

Do r/K reproductive strategies apply to human differences?

PubMed

Rushton, J P

1988-01-01

This article discusses the r/K theory of Social Biology and how it relates to humans. The symbols r and K originate in the mathematics of population biology and refer to 2 ends of a continuum in which a compensatory exchange occurs between gamete production (the r-strategy) and longevity (the K-strategy). Both across and within species, r and K strategists differ in a suite of correlated characteristics. Humans are the most K of all. K's supposedly have a longer gestation period, a higher birthweight, a more delayed sexual maturation, a lower sex drive, and a longer life. Studies providing evidence for the expected covariation among K attributes are presented. Additional evidence for r/K theory comes from the comparison of human population known to differ in gamete production. The pattern of racial differences observed to occur in sexual behavior has also been found to exist on numerous other indices of K. For instance, there are racial differences in brain size, intelligence, and maturation rate, among others. The findings suggest that, on the average, Mongoloids are more K than Caucasoids, who in turn, are more K than Negroids. Recently conducted studies have extended the data in favor of r/K theory, and further research is currently underway, including whether r/K attributes underlie individual and social class differences in health and longevity.

Bridging Differences -- how Social Relationships and Racial Diversity Matter in a Girls' Technology Program

NASA Astrophysics Data System (ADS)

Kekelis, Linda S.; Ancheta, Rebecca Wepsic; Heber, Etta; Countryman, Jeri

In this article, we explore an understudied dimension of girls' single-sex education - how social relationships and racial diversity impact the educational environment for girls, and how teachers may best address these concerns. Findings are presented from a 3-year qualitative study of girls' experiences in a single-sex technology program. Girls valued the all-girls aspect of the programs, and friendships formed the foundation of their social experiences. Girls' friendship groups influenced their experiences and eventually their success in the after school technology programs. When friendship groups were observed to be racially homogeneous, they created challenges for including and supporting a racially diverse student membership. Our responses to the challenges that cultural differences and tensions present are outlined, along with recommendations for helping girls bridge these differences.

Race/ethnicity and workplace discrimination: results of a national survey of physicians.

PubMed

Nunez-Smith, Marcella; Pilgrim, Nanlesta; Wynia, Matthew; Desai, Mayur M; Jones, Beth A; Bright, Cedric; Krumholz, Harlan M; Bradley, Elizabeth H

2009-11-01

Promoting racial/ethnic diversity within the physician workforce is a national priority. However, the extent of racial/ethnic discrimination reported by physicians from diverse backgrounds in today's health-care workplace is unknown. To determine the prevalence of physician experiences of perceived racial/ethnic discrimination at work and to explore physician views about race and discussions regarding race/ethnicity in the workplace. Cross-sectional, national survey conducted in 2006-2007. Practicing physicians (total n = 529) from diverse racial/ethnic backgrounds in the United States. We examined physicians' experience of racial/ethnic discrimination over their career course, their experience of discrimination in their current work setting, and their views about race/ethnicity and discrimination at work. The proportion of physicians who reported that they had experienced racial/ethnic discrimination "sometimes, often, or very often" during their medical career was substantial among non-majority physicians (71% of black physicians, 45% of Asian physicians, 63% of "other" race physicians, and 27% of Hispanic/Latino(a) physicians, compared with 7% of white physicians, all p < 0.05). Similarly, the proportion of non-majority physicians who reported that they experienced discrimination in their current work setting was substantial (59% of black, 39% of Asian, 35% of "other" race, 24% of Hispanic/Latino(a) physicians, and 21% of white physicians). Physician views about the role of race/ethnicity at work varied significantly by respondent race/ethnicity. Many non-majority physicians report experiencing racial/ethnic discrimination in the workplace. Opportunities exist for health-care organizations and diverse physicians to work together to improve the climate of perceived discrimination where they work.

Asian Americans and Campus Climate: Investigating Group Differences around a Racial Incident

ERIC Educational Resources Information Center

Johnston, Marc P.; Yeung, Fanny P. F

2014-01-01

Racially biased incidents pervade college campuses warranting further attention to their influence on campus climate. This study examines one such incident that targeted Asian American students, who are the largest racial group at the compositionally diverse institution. Using the Diverse Learning Environments survey and the "naturally…

Racial Identity and Academic Achievement in the Neighborhood Context: A Multilevel Analysis

ERIC Educational Resources Information Center

Byrd, Christy M.; Chavous, Tabbye M.

2009-01-01

Increasingly, researchers have found relationships between a strong, positive sense of racial identity and academic achievement among African American youth. Less attention, however, has been given to the roles and functions of racial identity among youth experiencing different social and economic contexts. Using hierarchical linear modeling, the…

Multiracial Women Students and Racial Stereotypes on the College Campus

ERIC Educational Resources Information Center

Harris, Jessica C.

2017-01-01

Researchers have explored how multiracial women students encounter different racialized experiences when compared to their monoracial peers and multiracial men on campus, suggesting that their experiences with racial stereotypes may also diverge from both of these populations. Guided by critical race theory, in this study I explored 10 multiracial…

Addressing Racialized Multicultural Discourses in an EAP Textbook: Working toward a Critical Pedagogies Approach

ERIC Educational Resources Information Center

Chun, Christian W.

2016-01-01

Racialized multicultural discourses emerge in the TESOL classroom via textbook representations of immigrant success stories and perceived racial and cultural differences among students. Although liberal multicultural discourses may be well intentioned, these discourses warrant closer examination for the ways in which they can essentialize cultural…

Racial and Ethnic Identities in American Society.

ERIC Educational Resources Information Center

Yin, Robert K.

The investigation of race relations, of social problems related to race and ethnicity, and of different racial and social groups, all presume prior information about the definition of racial or ethnic group identity, about the formation, maintenance, and dissolution of such identities, and about the importance of such identities in American…

Modification of Children's Racial Attitudes. Final Progress Report.

ERIC Educational Resources Information Center

Katz, Phyllis

This study investigated some of the attitudinal and behavioral components of racial prejudice in elementary school children. It also assessed the effectiveness of various modification procedures upon children's racial attitudes and inter-group behavior at different age levels. A four-stage research design was used. The pre-test stage involved…

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

Entry risk into the juvenile justice system: African American, American Indian, Asian American, European American, and Hispanic children and adolescents.

PubMed

Vazsonyi, Alexander T; Chen, Pan

2010-06-01

Findings on disproportionate minority contact remain mixed. Few empirical studies have examined to what extent entry risk into juvenile justice varies across ethnic/racial groups, and to what extent childhood aggressive behaviors foretell later deviance and entry risk. In the current study, we sought to address these shortcomings by implementing a survival analysis on a representative sample of youth followed from age 8 to 18. The sample included N = 2,754 lower to lower-middle SES youth from five different ethnic/racial groups (African American, American Indian, Asian American, European American, and Hispanic youth), part of a large-scale violence prevention effort. Aggressive behaviors were rated by teachers during elementary school, entry risk into juvenile justice was measured by official data, while SES was based on census data. Developmental entry risk into the juvenile justice system peaked at age 14 and subsequently declined. No differences were found across the four racial groups; however, Hispanic youth were at elevated risk (by 73%). Only childhood physical aggressive behavior increased entry risk (by 87%); this was above and beyond a 'simple' maturational liability we found and net any effects by sex, race/ethnicity, and SES. Some evidence suggested disproportionate minority contact, but only for Hispanic youth. Entry risk was invariant by race, but differed for males versus females and for youth from relatively higher socioeconomic status (SES) strata compared to youth from lower ones. Intervention efforts should target physically aggressive children during the elementary school years; however, some of the evidence also suggests that there exists a 'maturational liability' developmentally over time, between the ages of 8 and 18, independent of any of the focal predictors tested.

Does the response to alcohol taxes differ across racial/ethnic groups? Some evidence from 1984-2009 Behavioral Risk Factor Surveillance System

PubMed Central

An, Ruopeng; Sturm, Roland

2011-01-01

Background Excessive alcohol use remains an important lifestyle-related contributor to morbidity and mortality in the U.S. and worldwide. It is well documented that drinking patterns differ across racial/ethnic groups, but not how those different consumption patterns would respond to tax changes. Therefore, policy makers are not informed on whether the effects of tax increases on alcohol abuse are shared equally by the whole population, or policies in addition to taxation should be pursued to reach certain sociodemographic groups. Aims of the Study To estimate differential demand responses to alcohol excise taxes across racial/ethnic groups in the U.S. Methods Individual data from the Behavioral Risk Factor Surveillance System 1984-2009 waves (N= 3,921,943, 39.3% male; 81.3% White, 7.8% African American, 5.8% Hispanic, 1.9% Asian or Pacific Islander, 1.4% Native American, and 1.8% other race/multi-race) are merged with tax data by residential state and interview month. Dependent variables include consumption of any alcohol and number of drinks consumed per month. Demand responses to alcohol taxes are estimated for each race/ethnicity in separate regressions conditional on individual characteristics, state and time fixed effects, and state-specific secular trends. Results The null hypothesis on the identical tax effects among all races/ethnicities is strongly rejected (P < 0.0001), although pairwise comparisons using t-test are often not statistically significant due to a lack of precision. Our point estimates suggest that the tax effect on any alcohol consumption is largest among White and smallest among Hispanic. Among existing drinkers, Native American and other race/multi-race are most responsive to tax effects while Hispanic least. For all races/ethnicities, the estimated tax effects on consumption are large and significant among light drinkers (1-40 drinks per month), but shrink substantially for moderate (41-99) and heavy drinkers (≥ 100). Discussion Extensive research has been conducted on overall demand responses to alcohol excise taxes, but not on heterogeneity across various racial/ethnic groups. Only one similar prior study exists, but used a much smaller dataset. The authors did not identify differential effects. With this much larger dataset, we found some evidence for different responses across races/ethnicities to alcohol taxes, although we lack precision for individual group estimates. Limitations of our study include the absence of intrastate tax variations, no information on what type of alcohol is consumed, lack of controls for subgroup baseline alcohol consumption rates, and measurement error in self-reported alcohol use data. Implications for Health Policies Tax policies aimed to reduce alcohol-related health and social problems should consider whether they target the most harmful drinking behaviors, affect subgroups in unintended ways, or influence some groups disproportionately. This requires information on heterogeneity across subpopulations. Our results are a first step in this direction and suggest that there exists a differential impact across races/ethnicities, which may further increase health disparities. Tax increases also appear to be less effective among the heaviest consumers who are associated with highest risk. Implications for Further Research More research, including replications in different settings, is required to obtain better estimates on differential responses to alcohol tax across races/ethnicities. Population heterogeneity is also more complex than our first cut by race/ethnicity and needs more fine-grained analyses and model structures. PMID:21552394

Does the response to alcohol taxes differ across racial/ethnic groups? Some evidence from 1984-2009 Behavioral Risk Factor Surveillance System.

PubMed

An, Ruopeng; Sturm, Roland

2011-03-01

Excessive alcohol use remains an important lifestyle-related contributor to morbidity and mortality in the U.S. and worldwide. It is well documented that drinking patterns differ across racial/ethnic groups, but not how those different consumption patterns would respond to tax changes. Therefore, policy makers are not informed on whether the effects of tax increases on alcohol abuse are shared equally by the whole population, or policies in addition to taxation should be pursued to reach certain sociodemographic groups. To estimate differential demand responses to alcohol excise taxes across racial/ethnic groups in the U.S. Individual data from the Behavioral Risk Factor Surveillance System 1984-2009 waves (N= 3,921,943, 39.3% male; 81.3% White, 7.8% African American, 5.8% Hispanic, 1.9% Asian or Pacific Islander, 1.4% Native American, and 1.8% other race/multi-race) are merged with tax data by residential state and interview month. Dependent variables include consumption of any alcohol and number of drinks consumed per month. Demand responses to alcohol taxes are estimated for each race/ethnicity in separate regressions conditional on individual characteristics, state and time fixed effects, and state-specific secular trends. The null hypothesis on the identical tax effects among all races/ethnicities is strongly rejected (P < 0.0001), although pairwise comparisons using t-test are often not statistically significant due to a lack of precision. Our point estimates suggest that the tax effect on any alcohol consumption is largest among White and smallest among Hispanic. Among existing drinkers, Native American and other race/multi-race are most responsive to tax effects while Hispanic least. For all races/ethnicities, the estimated tax effects on consumption are large and significant among light drinkers (1-40 drinks per month), but shrink substantially for moderate (41-99) and heavy drinkers (≥ 100). Extensive research has been conducted on overall demand responses to alcohol excise taxes, but not on heterogeneity across various racial/ethnic groups. Only one similar prior study exists, but used a much smaller dataset. The authors did not identify differential effects. With this much larger dataset, we found some evidence for different responses across races/ethnicities to alcohol taxes, although we lack precision for individual group estimates. Limitations of our study include the absence of intrastate tax variations, no information on what type of alcohol is consumed, lack of controls for subgroup baseline alcohol consumption rates, and measurement error in self-reported alcohol use data. Tax policies aimed to reduce alcohol-related health and social problems should consider whether they target the most harmful drinking behaviors, affect subgroups in unintended ways, or influence some groups disproportionately. This requires information on heterogeneity across subpopulations. Our results are a first step in this direction and suggest that there exists a differential impact across races/ethnicities, which may further increase health disparities. Tax increases also appear to be less effective among the heaviest consumers who are associated with highest risk. More research, including replications in different settings, is required to obtain better estimates on differential responses to alcohol tax across races/ethnicities. Population heterogeneity is also more complex than our first cut by race/ethnicity and needs more fine-grained analyses and model structures.

Racial Differences in Stage at Diagnosis and Survival from Epithelial Ovarian Cancer: A Fundamental Cause of Disease Approach

PubMed Central

Dolecek, Therese A; Davis, Faith G

2011-01-01

Associations between race, socioeconomic status (SES) and health outcomes have been well established. One of the ways in which race and SES affect health is by influencing one’s access to resources, which confers ability to avoid or mitigate adverse outcomes. The fundamental cause of disease approach argues that when a new screening tool is introduced, individuals with greater resources tend to have better access to the innovation, thus benefiting from early detection and leading to better survival. Conversely, when there is no established screening tool, racial and SES differences in early detection may be less pronounced. Most ovarian cancer is diagnosed at advanced stages, because of the lack of an effective screening tool and few early symptoms. However, once detected, racial differences may still be observed in mortality and survival outcomes. We examined the racial differences in diagnosis and survival among ovarian cancer cases diagnosed during 1994–1998, in Cook County, Illinois (N=351). There were no racial differences in the stage at diagnosis: 51.7% of white and 52.9% of black women were diagnosed at later stages (III and IV). Only age was associated with the stage at diagnosis. Tumor characteristics also did not differ between white and black women. Compared to white women, black women were less likely to be married, less educated, more frequently used genital powder, had tubal ligation, and resided in higher poverty census tracts. As of December 31, 2005, 44.3% of white and 54.5% of black women had died of ovarian cancer. Controlling for known confounding variables, the hazard ratio for ovarian cancer death between black and white women was 2.2. The findings show that fundamental cause perspective provides a potential framework to explore subtleties in racial disparities, with which broader social causes may be accounted for in explaining post diagnosis racial differences. PMID:20483517

Racial and Ethnic Health Disparities and the Affordable Care Act: a Status Update

PubMed Central

Sealy-Jefferson, Shawnita; Vickers, Jasmine; Elam, Angela; Wilson, M. Roy

2015-01-01

Persistent racial and ethnic health disparities exist in the USA, despite decades of research and public health initiatives. Several factors contribute to health disparities, including (but not limited to) implicit provider bias, access to health care, social determinants, and biological factors. Disparities in health by race/ethnicity are unacceptable and correctable. The Patient Protection and Affordable Care Act is a comprehensive legislation that is focused on improving health care access, quality, and cost control. This health care reform includes specific provisions which focus on preventive care, the standardized collection of data on race, ethnicity, primary language and disability status, and health information technology. Although some provisions of the Patient Protection and Affordable Care Act have not been implemented, such as funding for the U.S. Public Health Sciences track, which would have addressed the shortage of medical professionals in the USA who are trained to use patient-centered, interdisciplinary, and care coordination approaches, this legislation is still poised to make great strides toward eliminating health disparities. The purpose of this manuscript is to highlight the unprecedented opportunities that exist for the Patient Protection and Affordable Care Act to reduce racial and ethnic disparities in health in the USA. PMID:26668787

Deconstructing racial differences: the effects of quality of education and cerebrovascular risk factors.

PubMed

Carvalho, Janessa O; Tommet, Doug; Crane, Paul K; Thomas, Michael L; Claxton, Amy; Habeck, Christian; Manly, Jennifer J; Romero, Heather R

2015-07-01

To evaluate the effects of vascular conditions and education quality on cognition over time in White and African American (AA) older adults. We investigated cross-sectional and longitudinal racial differences in executive functioning (EF) and memory composites among Whites (n = 461) and AAs (n = 118) enrolled in a cohort study. We examined whether cerebrovascular risk factors and Shipley Vocabulary scores (a proxy for education quality) accounted for racial differences. On average, AAs had lower quality of education and more cerebrovascular risk factors including hypertension, diabetes, and obesity. AAs had lower mean EF and memory at baseline, but there were no group differences in rates of decline. Cross-sectional racial differences in EF and memory persisted after controlling for vascular disease, but disappeared when controlling for Shipley Vocabulary. Quality of education appears to be more important than cerebrovascular risk factors in explaining cross-sectional differences in memory and EF performance between White and AA older adults. Further investigation is needed regarding the relative contribution of education quality and cerebrovascular risk factors to cognitive decline among ethnically/racially diverse older adults. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Geographic and racial-ethnic differences in satisfaction with and perceived benefits of mental health services.

PubMed

Kim, Giyeon; Parton, Jason M; Ford, Katy-Lauren; Bryant, Ami N; Shim, Ruth S; Parmelee, Patricia

2014-12-01

This study examined whether racial-ethnic differences in satisfaction with and perceived benefits from mental health services vary by geographic region among U.S. adults. Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES), selected samples consisted of 2,160 adults age 18 and older from diverse racial-ethnic groups (Asian, black, Hispanic/Latino, and white) who had used mental health services in the past 12 months. Generalized linear model analysis was conducted for the United States as a whole and separately by geographic region (Northeast, South, Midwest, and West) after adjustment for covariates. In the national sample, no significant main effects of race-ethnicity and geographic region were found in either satisfaction with or perceived benefits from mental health services. In the stratified analyses for geographic regions, however, significant racial-ethnic differences were observed in the West; blacks in the West were significantly more likely to report higher satisfaction and perceived benefits, whereas Hispanics/Latinos in the West were significantly less likely to do so. The findings suggest that there are regional variations of racial-ethnic differences in satisfaction with and perceived benefits from mental health services among U.S. adults and that addressing needs of Hispanics/Latinos in the West may help reduce racial-ethnic disparities in mental health care. Clinical and policy implications are discussed.

Associations of racial discrimination and parental discrimination coping messages with African American adolescent racial identity.

PubMed

Richardson, Bridget L; Macon, Tamarie A; Mustafaa, Faheemah N; Bogan, Erin D; Cole-Lewis, Yasmin; Chavous, Tabbye M

2015-06-01

Research links racial identity to important developmental outcomes among African American adolescents, but less is known about the contextual experiences that shape youths' racial identity. In a sample of 491 African American adolescents (48% female), associations of youth-reported experiences of racial discrimination and parental messages about preparation for racial bias with adolescents' later racial identity were examined. Cluster analysis resulted in four profiles of adolescents varying in reported frequency of racial discrimination from teachers and peers at school and frequency of parental racial discrimination coping messages during adolescents' 8th grade year. Boys were disproportionately over-represented in the cluster of youth experiencing more frequent discrimination but receiving fewer parental discrimination coping messages, relative to the overall sample. Also examined were clusters of adolescents' 11th grade racial identity attitudes about the importance of race (centrality), personal group affect (private regard), and perceptions of societal beliefs about African Americans (public regard). Girls and boys did not differ in their representation in racial identity clusters, but 8th grade discrimination/parent messages clusters were associated with 11th grade racial identity cluster membership, and these associations varied across gender groups. Boys experiencing more frequent discrimination but fewer parental coping messages were over-represented in the racial identity cluster characterized by low centrality, low private regard, and average public regard. The findings suggest that adolescents who experience racial discrimination but receive fewer parental supports for negotiating and coping with discrimination may be at heightened risk for internalizing stigmatizing experiences. Also, the findings suggest the need to consider the context of gender in adolescents' racial discrimination and parental racial socialization.

Racial gaps in child health insurance coverage in four South American countries: the role of wealth, human capital, and other household characteristics.

PubMed

Wehby, George L; Murray, Jeffrey C; McCarthy, Ann Marie; Castilla, Eduardo E

2011-12-01

OBJECTIVE. To evaluate the extent of racial gaps in child health insurance coverage in South America and study the contribution of wealth, human capital, and other household characteristics to accounting for racial disparities in insurance coverage. DATA SOURCES/STUDY SETTING. Primary data collected between 2005 and 2006 in 30 pediatric practices in Argentina, Brazil, Ecuador, and Chile. DESIGN. Country-specific regression models are used to assess differences in insurance coverage by race. A decomposition model is used to quantify the extent to which wealth, human capital, and other household characteristics account for racial disparities in insurance coverage. DATA COLLECTION/EXTRACTION METHODS. In-person interviews were conducted with the mothers of 2,365 children. PRINCIPAL FINDINGS. The majority of children have no insurance coverage except in Chile. Large racial disparities in insurance coverage are observed. Household wealth is the single most important household-level factor accounting for racial disparities in coverage and is significantly and positively associated with coverage, followed by maternal education and employment/occupational status. Geographic differences account for the largest part of racial disparities in insurance coverage in Argentina and Ecuador. CONCLUSIONS. Increasing the coverage of children in less affluent families is important for reducing racial gaps in health insurance coverage in the study countries. © Health Research and Educational Trust.

The role of chronic psychosocial stress in explaining racial differences in stress reactivity and pain sensitivity

PubMed Central

Gordon, Jennifer L.; Johnson, Jacqueline; Nau, Samantha; Mechlin, Beth; Girdler, Susan S.

2016-01-01

Objective To examine the role of psychosocial factors in mediating the relationship between African American (AA) race and both increased pain sensitivity and blunted stress reactivity. Methods Participants included 133 AA and non-Hispanic White (nHW) individuals (mean (SD) age = 37 (9)) matched for age, sex and socioeconomic status. Participants underwent mental stress testing (Trier Social Stress Test) while cardiovascular, hemodynamic, and neuroendocrine reactivity were measured. Participants completed questionnaires assessing potential sources of psychosocial stress and were tested for pain responses to cold pain and the temporal summation of heat pulses. Mediation analyses were used to determine the extent to which exposure to psychosocial stress accounted for the observed racial differences in stress reactivity and pain. Results Chronic stress exposure and reactivity to mental stress was largely similar among AAs and nHWs; however, AAs exhibited heightened pain to both cold (p = .012) and heat (p = .004). Racial differences in the relationship between stress reactivity and pain were also observed: while greater stress reactivity was associated with decreased pain among nHWs, reactivity was either unrelated to or even positively associated with pain among AAs (e.g. r = −.21 among nHWs and r = .41 among AAs for stroke volume reactivity and cold pressor intensity). Adjusting for minor racial differences in chronic psychosocial stress did not change these findings. Conclusion Accounting for psychosocial factors eliminated racial differences in stress reactivity but not racial differences in sensitivity to experimental pain tasks. Increased exposure to chronic stress may not explain AAs’ increased pain sensitivity in laboratory settings. PMID:27669431

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.

Neighborhood Racial and Socioeconomic Disparities in the Food and Alcohol Environment: Are There Differences by Commercial Data Sources?

PubMed

Mendez, Dara D; Kim, Kevin H; Hardaway, Cecily R; Fabio, Anthony

2016-03-01

This study examined neighborhood racial and socioeconomic disparities and the density of food and alcohol establishments. We also examined whether these disparities differed by data source. This study included commercial data for 2003 and 2009 from InfoUSA and Dun and Bradstreet (D&B) in 416 census tracts in Allegheny County, PA. Food and alcohol establishment densities were calculated by using area and population data from the 2000 US census. Differences between InfoUSA and D&B of food and alcohol densities across neighborhood racial and socioeconomic characteristics were tested using correlations and two-way mixed analysis of variance (ANOVA). There were differences by data source in the association between neighborhood racial and socioeconomic characteristics and food/alcohol establishment density. There was a positive correlation between grocery store/supermarket density and percentage black, poverty, and percentage without a car among D&B data but not in InfoUSA. Alcohol outlet density (AOD) increased as neighborhood poverty increased for both data sources, but the mean difference in AOD between InfoUSA and D&B was highest among neighborhoods with 25-50 % poverty (Cohen's d -0.49, p < 0.001) compared to neighborhoods with lower or higher poverty (2003 data). Mean grocery store density increased as percentage poverty increased, but only among D&B (2009 data). Differences in commercial data in the location and numeration of food and alcohol establishments are associated with neighborhood racial and socioeconomic characteristics and may introduce biases concerning neighborhood food and alcohol environments, racial and socioeconomic disparities, and health.

The Role of Chronic Psychosocial Stress in Explaining Racial Differences in Stress Reactivity and Pain Sensitivity.

PubMed

Gordon, Jennifer L; Johnson, Jacqueline; Nau, Samantha; Mechlin, Beth; Girdler, Susan S

To examine the role of psychosocial factors in mediating the relationship between African American (AA) race and both increased pain sensitivity and blunted stress reactivity. Participants included 133 AA and non-Hispanic white (nHW) individuals (mean [SD] age, 37 [9]) matched for age, sex, and socioeconomic status. Participants underwent mental stress testing (Trier Social Stress Test) while cardiovascular, hemodynamic, and neuroendocrine reactivity were measured. Participants completed questionnaires assessing potential sources of psychosocial stress and were tested for pain responses to cold pain and the temporal summation of heat pulses. Mediation analyses were used to determine the extent to which exposure to psychosocial stress accounted for the observed racial differences in stress reactivity and pain. Chronic stress exposure and reactivity to mental stress was largely similar among AAs and nHWs; however, AAs exhibited heightened pain to both cold (p = .012) and heat (p = .004). Racial differences in the relationship between stress reactivity and pain were also observed: while greater stress reactivity was associated with decreased pain among nHWs, reactivity was either unrelated to or even positively associated with pain among AAs (e.g., r = -.21 among nHWs and r = .41 among AAs for stroke volume reactivity and cold pressor intensity). Adjusting for minor racial differences in chronic psychosocial stress did not change these findings. Accounting for psychosocial factors eliminated racial differences in stress reactivity but not racial differences in sensitivity to experimental pain tasks. Increased exposure to chronic stress may not explain AAs' increased pain sensitivity in laboratory settings.

Are Smart People Less Racist? Verbal Ability, Anti-Black Prejudice, and the Principle-Policy Paradox

PubMed Central

Wodtke, Geoffrey T.

2016-01-01

It is commonly hypothesized that higher cognitive abilities promote racial tolerance and a greater commitment to racial equality, but an alternative theoretical framework contends that higher cognitive abilities merely enable members of a dominant racial group to articulate a more refined legitimizing ideology for racial inequality. According to this perspective, ideological refinement occurs in response to shifting patterns of racial conflict and is characterized by rejection of overt prejudice, superficial support for racial equality in principle, and opposition to policies that challenge the dominant group's status. This study estimates the impact of verbal ability on a comprehensive set of racial attitudes, including anti-black prejudice, views about black-white equality in principle, and racial policy support. It also investigates cohort differences in the effects of verbal ability on these attitudes. Results suggest that high-ability whites are less likely than low-ability whites to report prejudicial attitudes and more likely to support racial equality in principle. Despite these liberalizing effects, high-ability whites are no more likely to support a variety of remedial policies for racial inequality. Results also suggest that the ostensibly liberalizing effects of verbal ability on anti-black prejudice and views about racial equality in principle emerged slowly over time, consistent with ideological refinement theory. PMID:27134315

Are Smart People Less Racist? Verbal Ability, Anti-Black Prejudice, and the Principle-Policy Paradox.

PubMed

Wodtke, Geoffrey T

2016-01-08

It is commonly hypothesized that higher cognitive abilities promote racial tolerance and a greater commitment to racial equality, but an alternative theoretical framework contends that higher cognitive abilities merely enable members of a dominant racial group to articulate a more refined legitimizing ideology for racial inequality. According to this perspective, ideological refinement occurs in response to shifting patterns of racial conflict and is characterized by rejection of overt prejudice, superficial support for racial equality in principle, and opposition to policies that challenge the dominant group's status. This study estimates the impact of verbal ability on a comprehensive set of racial attitudes, including anti-black prejudice, views about black-white equality in principle, and racial policy support. It also investigates cohort differences in the effects of verbal ability on these attitudes. Results suggest that high-ability whites are less likely than low-ability whites to report prejudicial attitudes and more likely to support racial equality in principle. Despite these liberalizing effects, high-ability whites are no more likely to support a variety of remedial policies for racial inequality. Results also suggest that the ostensibly liberalizing effects of verbal ability on anti-black prejudice and views about racial equality in principle emerged slowly over time, consistent with ideological refinement theory.

Differences in placental telomere length suggest a link between racial disparities in birth outcomes and cellular aging

PubMed Central

JONES, Christopher W.; GAMBALA, Cecilia; ESTEVES, Kyle C.; WALLACE, Maeve; SCHLESINGER, Reid; O’QUINN, Marguerite; KIDD, Laura; THEALL, Katherine P.; DRURY, Stacy S.

2017-01-01

BACKGROUND Health disparities begin early in life and persist across the life course. Despite current efforts Black women exhibit greater risk for pregnancy complications and negative perinatal outcomes compared to White women. The placenta, a complex multi-tissue organ, serves as the primary transducer of bidirectional information between the mother and fetus. Altered placental function is linked to multiple racially disparate pregnancy complications, however little is known about racial differences in molecular factors within the placenta. Several pregnancy complications, including preeclampsia and fetal growth restriction, exhibit racial disparities and are associated with shorter placental telomere length, an indicator of cellular stress and aging. Cellular senescence and telomere dynamics are linked to the molecular mechanisms associated with the onset of labor and parturition. Further, racial differences in telomere length are found in a range of different peripheral tissues. Together these factors suggest that exploration of racial differences in telomere length of the placenta may provide novel mechanistic insight into racial disparities in birth outcomes. OBJECTIVE This study examined whether telomere length measured in four distinct fetally-derived tissues were significantly different between Blacks and Whites. The study had two hypotheses: (1) that telomere length measured in different placental tissue types would be correlated and (2) that across all sampled tissues telomere length would differ by race. STUDY DESIGN In a prospective study, placental tissue samples were collected from the amnion, chorion, villus, and umbilical cord from Black and White singleton pregnancies (N=46). Telomere length was determined using monochrome multiplex quantitative real-time polymerase chain reaction in each placental tissue. Demographic and pregnancy-related data were also collected. Descriptive statistics characterized the sample overall and among Black and White women separately. The overall impact of race was assessed by multilevel mixed-effects linear regression models that included empirically relevant covariates. RESULTS Telomere length was significantly correlated across all placental tissues. Pairwise analyses of placental tissue telomere length revealed significantly longer telomere length in the amnion compared to the chorion (t=−2.06, p=0.043). Overall telomere length measured in placenta samples from Black mothers were significantly shorter than those from White mothers (β=−0.09, p=0.04). Controlling for relevant maternal and infant characteristics strengthened the significance of the observed racial differences (β=−0.12, p=0.02). Within tissue analyses revealed that the greatest difference by race was found in chorionic telomere length (t=−2.81, p=0.007). CONCLUSION These findings provide the first evidence of racial differences in placental telomere length. Telomere length was significantly shorter in placental samples derived from Black mothers compared to White. Given previous studies reporting that telomere length, cellular senescence, and telomere dynamics are molecular factors contributing to the rupture of the amniotic sac, onset of labor, and parturition, our findings of shorter telomere length in placentas from Black mothers suggests that accelerated cellular aging across placental tissues may be relevant to the increased risk of preterm delivery in Blacks. Our results suggest that racial differences in cellular aging in the placenta contribute to the earliest roots of health disparities. PMID:27865975

The role of mothers' and adolescents' perceptions of ethnic-racial socialization in shaping ethnic-racial identity among early adolescent boys and girls.

PubMed

Hughes, Diane; Hagelskamp, Carolin; Way, Niobe; Foust, Monica D

2009-05-01

The current study examined relationships between adolescents' and mothers' reports of ethnic-racial socialization and adolescents' ethnic-racial identity. The sample included 170 sixth graders (49% boys, 51% girls) and their mothers, all of whom identified as Black, Puerto Rican, Dominican, or Chinese. Two dimensions of ethnic-racial socialization (cultural socialization and preparation for bias) were evaluated alongside three dimensions of ethnic-racial identity (exploration, affirmation and belonging, and behavioral engagement). Mothers' reports of their cultural socialization predicted adolescents' reports, but only adolescents' reports predicted adolescents' ethnic-racial identity processes. Mothers' reports of preparation for bias predicted boys' but not girls' reports of preparation for bias. Again, only adolescents' reports of preparation for bias predicted their ethnic-racial identity. Thus, several gender differences in relationships emerged, with mothers' and adolescents' perceptions of cultural socialization, in particular, playing a more important role in girls' than in boys' identity processes. We discuss the implications of these findings for future research.

The ethics of characterizing difference: guiding principles on using racial categories in human genetics

PubMed Central

Lee, Sandra Soo-Jin; Mountain, Joanna; Koenig, Barbara; Altman, Russ; Brown, Melissa; Camarillo, Albert; Cavalli-Sforza, Luca; Cho, Mildred; Eberhardt, Jennifer; Feldman, Marcus; Ford, Richard; Greely, Henry; King, Roy; Markus, Hazel; Satz, Debra; Snipp, Matthew; Steele, Claude; Underhill, Peter

2008-01-01

We are a multidisciplinary group of Stanford faculty who propose ten principles to guide the use of racial and ethnic categories when characterizing group differences in research into human genetic variation. PMID:18638359

"American" or "Multiethnic"? Family Ethnic Identity among Transracial Adoptive Families, Ethnic-Racial Socialization, and Children's Self-Perception

ERIC Educational Resources Information Center

Pinderhughes, Ellen E.; Zhang, Xian; Agerbak, Susanne

2015-01-01

Drawing on a model of ethnic-racial socialization (E-RS; Pinderhughes, 2013), this study examined hypothesized relations among parents' role variables (family ethnic identity and acknowledgment of cultural and racial differences), cultural socialization (CS) behaviors, and children's self-perceptions (ethnic self-label and feelings about…

"Stick with Yourselves; It's What's Normal": The Intergroup Racial Attitudes of Senior, White, Fraternity Men

ERIC Educational Resources Information Center

Morgan, Demetri L.; Zimmerman, Hilary B.; Terrell, Tanner N.; Marcotte, Beth A.

2015-01-01

Substantive cross-racial interaction on college campuses has been known to have positive effects on student learning and development (Chang, Astin, & Kim, 2004). However, literature shows that students from different minoritized racial groups often remain separated from majority White groups, such as fraternities, thus prohibiting each group…

Racial/Ethnic Differences in Adults in Randomized Clinical Trials of Binge Eating Disorder

ERIC Educational Resources Information Center

Franko, Debra L.; Thompson-Brenner, Heather; Thompson, Douglas R.; Boisseau, Christina L.; Davis, Angela; Forbush, Kelsie T.; Roehrig, James P.; Bryson, Susan W.; Bulik, Cynthia M.; Crow, Scott J.; Devlin, Michael J.; Gorin, Amy A.; Grilo, Carlos M.; Kristeller, Jean L.; Masheb, Robin M.; Mitchell, James E.; Peterson, Carol B.; Safer, Debra L.; Striegel, Ruth H.; Wilfley, Denise E.; Wilson, G. Terence

2012-01-01

Objective: Recent studies suggest that binge eating disorder (BED) is as prevalent among African American and Hispanic Americans as among Caucasian Americans; however, data regarding the characteristics of treatment-seeking individuals from racial and ethnic minority groups are scarce. The purpose of this study was to investigate racial/ethnic…

Racialized Subjects in a Colour Blind School

ERIC Educational Resources Information Center

Lagermann, Laila Colding

2013-01-01

In this paper I examine processes of racialization in a school in Copenhagen, Denmark. On the basis of the data produced in 2009, which is part of a larger study, I investigate themes of race as a difference-making and constituting category for subjective (human) becoming and racialization as contingent and negotiated processes (Butler, 1997). As…

Predictors of Career Indecision in Three Racial/Ethnic Groups of College Women

ERIC Educational Resources Information Center

Lopez, Frederick G.; Ann-Yi, Sujin

2006-01-01

This study examines the contributions of career-related barrier and social support perceptions, barrier-related coping beliefs, and career decision-making self-efficacy beliefs to the prediction of career indecision in three racial/ethnic groups of college women. Results indicate that although there are no racial/ethnic differences across scores…

Do wealth disparities contribute to health disparities within racial/ethnic groups?

PubMed

Pollack, Craig Evan; Cubbin, Catherine; Sania, Ayesha; Hayward, Mark; Vallone, Donna; Flaherty, Brian; Braveman, Paula A

2013-05-01

Though wide disparities in wealth have been documented across racial/ethnic groups, it is largely unknown whether differences in wealth are associated with health disparities within racial/ethnic groups. Data from the Survey of Consumer Finances (2004, ages 25-64) and the Health and Retirement Survey (2004, ages 50+), containing a wide range of assets and debts variables, were used to calculate net worth (a standard measure of wealth). Among non-Hispanic black, Hispanic and non-Hispanic white populations, we tested whether wealth was associated with self-reported poor/fair health status after accounting for income and education. Except among the younger Hispanic population, net worth was significantly associated with poor/fair health status within each racial/ethnic group in both data sets. Adding net worth attenuated the association between education and poor/fair health (in all racial/ethnic groups) and between income and poor/fair health (except among older Hispanics). The results add to the literature indicating the importance of including measures of wealth in health research for what they may reveal about disparities not only between but also within different racial/ethnic groups.

Gender matters, too: the influences of school racial discrimination and racial identity on academic engagement outcomes among African American adolescents.

PubMed

Chavous, Tabbye M; Rivas-Drake, Deborah; Smalls, Ciara; Griffin, Tiffany; Cogburn, Courtney

2008-05-01

The authors examined relationships among racial identity, school-based racial discrimination experiences, and academic engagement outcomes for adolescent boys and girls in Grades 8 and 11 (n = 204 boys and n = 206 girls). The authors found gender differences in peer and classroom discrimination and in the impact of earlier and later discrimination experiences on academic outcomes. Racial centrality related positively to school performance and school importance attitudes for boys. Also, centrality moderated the relationship between discrimination and academic outcomes in ways that differed across gender. For boys, higher racial centrality related to diminished risk for lower school importance attitudes and grades from experiencing classroom discrimination relative to boys lower in centrality, and girls with higher centrality were protected against the negative impact of peer discrimination on school importance and academic self-concept. However, among lower race-central girls, peer discrimination related positively to academic self-concept. Finally, socioeconomic background moderated the relationship of discrimination with academic outcomes differently for girls and boys. The authors discuss the need to consider interactions of individual- and contextual-level factors in better understanding African American youths' academic and social development. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

Does Medicare Managed Care reduce racial/ethnic disparities in diabetes preventive care and healthcare expenditures?

PubMed

Mahmoudi, Elham; Tarraf, Wassim; Maroukis, Brianna L; Levy, Helen G

2016-10-01

Large and persistent racial/ethnic disparities exist in diabetes care. Considering the rapid rate of growth of Medicare Managed Care (MMC) plans among minority populations, our aim was to investigate whether disparities in diabetes management and healthcare expenditures are smaller in MMC versus Medicare fee-for-service (MFFS) plans. We hypothesized that racial/ethnic disparities in diabetes care and in health expenditures would be less pronounced in MMC compared with MFFS plans. Nationally representative data from the 2006 to 2011 Medical Expenditure Panel Survey on white, African American, and Hispanic seniors with diabetes were analyzed. We examined 4 measures of diabetes care-regular foot check, eye exam, cholesterol check, and flu vaccine-and total and out-of-pocket (OOP) healthcare expenditures. We implemented the Institute of Medicine's definition of disparity, applied propensity score weighting to adjust for potential differential selection, and used a difference-in-differences generalized linear framework to estimate outcome measures. For African Americans, MMC was associated with a $1183 (P <.036) reduction and a $547 (P <.001) increase in disparities in total and OOP healthcare expenditures, respectively. For Hispanics, disparities in foot exam, flu shot, and cholesterol check decreased by 5, 10, and 7 percentage points (P <.001); additionally, disparities in total and OOP healthcare expenditures were reduced by $3588 and $276 (P <.001), respectively. MMC plans spend less on everyone, including whites. Hispanic/white disparities in diabetes management and healthcare expenditures were smaller in MMC than in MFFS plans. African American/white disparities were not consistently larger in 1 setting than the other.

Comparative outcomes of transcatheter aortic valve replacement in African American and Caucasian patients with severe aortic stenosis.

PubMed

Alqahtani, Fahad; Aljohani, Sami; Almustafa, Ahmad; Alhijji, Mohammed; Ali, Oluseun; Holmes, David R; Alkhouli, Mohamad

2018-04-01

Racial disparities in cardiovascular care have been extensively investigated. The introduction of transcatheter aortic valve replacement (TAVR) revolutionized the treatment of aortic stenosis (AS) in the last decade. Whether a racial disparity in the utilization and outcome of TAVR exists is unknown. We utilized the nationwide inpatient sample (NIS) to compare utilization rates, and in-hospital outcomes of Caucasians and African American (AA) patients who underwent TAVR between August 2011 and December 2014. A total of 7,176 patients (6870 Caucasians, 95.7%) and (306 AAs, 4.3%) were included in this analysis. Among patients who underwent aortic valve replacement between 2011 and 2014, the rates of TAVR utilization increased from 0.32% to 7.6% in AAs and from 0.4% to 8.8% in Caucasians. In propensity-matched cohorts of patients (n = 300 Caucasians and n = 300 AAs), in-hospital mortality was similar (3.7% and 3.3%, respectively, P = 0.99). Also, rates of key complications including stroke, permanent pacemaker implantation (PPMI), vascular complications, acute kidney injury, new dialysis, blood transfusion, and tamponade were similar in both races. There was also no significant difference between Caucasians and AAs with regards to length of stay, cost of hospitalization, and intermediate care facility utilization. There was no significant difference in the utilization rates, in-hospital outcomes, and cost of TAVR between Caucasians and AA patients in contemporary US practice. Further comparative studies of surgical and TAVR in AAs and other racial minorities are warranted. © 2017 Wiley Periodicals, Inc.

Modern racism attitudes among white students: the role of dominance and authoritarianism and the mediating effects of racial color-blindness.

PubMed

Poteat, V Paul; Spanierman, Lisa B

2012-01-01

Among 342 white college students, we examined the effects of social dominance orientation (SDO), right-wing authoritarianism (RWA), and racial color-blindness on modern racism attitudes. Structural equation modeling was used to test the indirect effects of SDO and RWA on modern racism attitudes through color-blind racial attitudes. We found strong indirect effects of SDO and RWA on modern racism through racial color-blindness. We did not find support for an alternative model, in which we tested racial color-blindness as a moderator of the effects of SDO and RWA on modern racism. Findings suggest that highly dominant and authoritarian white students endorse color-blind racial attitudes, although likely for different reasons. In turn, this predicts their modern racism attitudes. These findings indicate racial color-blindness is important to address as part of anti-racism education.

Racial bias shapes social reinforcement learning.

PubMed

Lindström, Björn; Selbing, Ida; Molapour, Tanaz; Olsson, Andreas

2014-03-01

Both emotional facial expressions and markers of racial-group belonging are ubiquitous signals in social interaction, but little is known about how these signals together affect future behavior through learning. To address this issue, we investigated how emotional (threatening or friendly) in-group and out-group faces reinforced behavior in a reinforcement-learning task. We asked whether reinforcement learning would be modulated by intergroup attitudes (i.e., racial bias). The results showed that individual differences in racial bias critically modulated reinforcement learning. As predicted, racial bias was associated with more efficiently learned avoidance of threatening out-group individuals. We used computational modeling analysis to quantitatively delimit the underlying processes affected by social reinforcement. These analyses showed that racial bias modulates the rate at which exposure to threatening out-group individuals is transformed into future avoidance behavior. In concert, these results shed new light on the learning processes underlying social interaction with racial-in-group and out-group individuals.

Ethnic and racial differences in mental health service utilization for suicidal ideation and behavior in a nationally representative sample of adolescents

PubMed Central

Nestor, Bridget A.; Cheek, Shayna M.; Liu, Richard T.

2016-01-01

Background This study examined racial/ethnic differences in mental health treatment utilization for suicidal ideation and behavior in a nationally representative sample of adolescents. Method Data were drawn from the National Survey on Drug Use and Health. Participants included 4,176 depressed adolescents with suicidal ideation and behavior in the previous year. Weighted logistic regressions were estimated to examine whether adolescent racial/ethnic minorities had lower rates of past-year treatment for suicidal ideation and behavior in inpatient or outpatient settings, while adjusting for age, depressive symptom severity, family income, and health insurance status. Results Among adolescents with any suicidal ideation and behavior, and suicide attempts specifically, non-Hispanic blacks and Native Americans were less likely than whites to receive outpatient treatment, and multiracial adolescents were less likely to be admitted to inpatient facilities. Apart from Hispanics, racial/ethnic minorities were generally less likely to receive mental health care for suicidal ideation, particularly within psychiatric outpatient settings. A pattern emerged with racial/ethnic differences in treatment receipt being greatest for adolescents with the least severe suicidal ideation and behavior. Limitations The cross-sectional data limits our ability to form causal inferences. Conclusion Strikingly low rates of treatment utilization for suicidal ideation and behavior were observed across all racial/ethnic groups. Certain racial/ethnic minorities may be less likely to seek treatment for suicidal ideation and behavior when symptoms are less severe, with this gap in treatment use narrowing as symptom severity increases. Native Americans were among the racial/ethnic groups with lowest treatment utilization, but also among the highest for rates of suicide attempts, highlighting the pressing need for strategies to increase mental health service use in this particularly vulnerable population. PMID:27262642

Disparities in alcohol-related problems among white, black, and Hispanic Americans.

PubMed

Mulia, Nina; Ye, Yu; Greenfield, Thomas K; Zemore, Sarah E

2009-04-01

This study assesses racial/ethnic disparities in negative social consequences of drinking and alcohol dependence symptoms among white, black, and Hispanic Americans. We examine whether and how disparities relate to heavy alcohol consumption and pattern, and the extent to which social disadvantage (poverty, unfair treatment, and racial/ethnic stigma) accounts for observed disparities. We analyzed data from the 2005 U.S. National Alcohol Survey, a nationally representative telephone-based survey of adults ages 18 and older (N = 6,919). Given large racial/ethnic differences in abstinence rates, core analyses were restricted to current drinkers (N = 4,080). Logistic regression was used to assess disparities in alcohol-related problems at 3 levels of heavy drinking, measured using a composite variable incorporating frequency of heavy episodic drinking, frequency of drunkenness, and maximum amount consumed in a single day. A mediational approach was used to assess the role of social disadvantage. African American and Hispanic drinkers were significantly more likely than white drinkers to report social consequences of drinking and alcohol dependence symptoms. Even after adjusting for differences in heavy drinking and demographic characteristics, disparities in problems remained. The racial/ethnic gap in alcohol problems was greatest among those reporting little or no heavy drinking, and gradually diminished to nonsignificance at the highest level of heavy drinking. Social disadvantage, particularly in the form of racial/ethnic stigma, appeared to contribute to racial/ethnic differences in problems. These findings suggest that to eliminate racial/ethnic disparities in alcohol-related problems, public health efforts must do more than reduce heavy drinking. Future research should address the possibility of drink size underestimation, identify the particular types of problems that disproportionately affect racial/ethnic minorities, and investigate social and cultural determinants of such problems.

Ethnic and racial differences in mental health service utilization for suicidal ideation and behavior in a nationally representative sample of adolescents.

PubMed

Nestor, Bridget A; Cheek, Shayna M; Liu, Richard T

2016-09-15

This study examined racial/ethnic differences in mental health treatment utilization for suicidal ideation and behavior in a nationally representative sample of adolescents. Data were drawn from the National Survey on Drug Use and Health. Participants included 4176 depressed adolescents with suicidal ideation and behavior in the previous year. Weighted logistic regressions were estimated to examine whether adolescent racial/ethnic minorities had lower rates of past-year treatment for suicidal ideation and behavior in inpatient or outpatient settings, while adjusting for age, depressive symptom severity, family income, and health insurance status. Among adolescents with any suicidal ideation and behavior, and suicide attempts specifically, non-Hispanic blacks and Native Americans were less likely than whites to receive outpatient treatment, and multiracial adolescents were less likely to be admitted to inpatient facilities. Apart from Hispanics, racial/ethnic minorities were generally less likely to receive mental health care for suicidal ideation, particularly within psychiatric outpatient settings. A pattern emerged with racial/ethnic differences in treatment receipt being greatest for adolescents with the least severe suicidal ideation and behavior. The cross-sectional data limits our ability to form causal inferences. Strikingly low rates of treatment utilization for suicidal ideation and behavior were observed across all racial/ethnic groups. Certain racial/ethnic minorities may be less likely to seek treatment for suicidal ideation and behavior when symptoms are less severe, with this gap in treatment use narrowing as symptom severity increases. Native Americans were among the racial/ethnic groups with lowest treatment utilization, but also among the highest for rates of suicide attempts, highlighting the pressing need for strategies to increase mental health service use in this particularly vulnerable population. Copyright © 2016 Elsevier B.V. All rights reserved.

Racial difference in lung function in African-American and White children: effect of anthropometric, socioeconomic, nutritional, and environmental factors.

PubMed

Harik-Khan, Raida I; Muller, Denis C; Wise, Robert A

2004-11-01

African-American children have lower lung volumes than White children. However, the contributions of anthropometric, socioeconomic, nutritional, and environmental factors to this difference are unknown. From participants in the Third National Health and Nutrition Examination Survey (1988-1994), the authors selected 1,462 healthy nonsmoking children (623 White and 839 African-American) aged 8-17 years. The African-American children were taller and heavier but had lower lung function. African Americans were poorer and had lower levels of the antioxidant vitamins A and C and alpha-carotene. The authors performed regression analyses using data on anthropometric, socioeconomic, and nutritional factors and smoke exposure. Adjustment for sitting height explained 42-53% of the racial difference. Socioeconomic factors and antioxidant vitamin levels accounted for an additional 7-10%. Overall, the authors could account for only 50-63% of the racial difference. Exposure to tobacco in the home was weakly associated with forced expiratory volume in 1 second in girls, accounting for 1% of the difference. In children aged 8-12 years (n = 752), birth weight explained 3-5% of the racial difference, whereas in-utero exposure to maternal smoking had no significant effect. The authors conclude that in healthy children, the major explanatory variable for the racial difference in lung function is body habitus; socioeconomic, nutritional, and environmental confounders play a smaller role.

Gambling Disorder and Minority Populations: Prevalence and Risk Factors.

PubMed

Okuda, Mayumi; Liu, Weiwei; Cisewski, Jodi A; Segura, Luis; Storr, Carla L; Martins, Silvia S

2016-09-01

Previous studies demonstrate disparities in health and health services including gambling disorders (GD) among ethnic and racial minority groups. In this review, we summarize studies examining the prevalence of GD across different ethnic and racial minorities. We describe the sociodemographic subgroup variations at heightened risk for GD and factors associated with GD in racial and ethnic minority groups including gambling availability, comorbid substance use, psychiatric conditions, stress, acculturation, and differences in cultural values and cognitions. We found that research of GD among minority groups is scant, and the prevalence of GD among these groups is at a magnitude of concern. Racial and ethnic minority status in it of itself is not a risk factor for GD but may be a proxy for underlying potential risk factors. The need for prevention and treatment programs for different cultural group remains unmet.

RACE/ETHNICITY AND U.S. ADULT MORTALITY

PubMed Central

Hummer, Robert A.; Chinn, Juanita J.

2011-01-01

Although there have been significant decreases in U.S. mortality rates, racial/ethnic disparities persist. The goals of this study are to: (1) elucidate a conceptual framework for the study of racial/ethnic differences in U.S. adult mortality, (2) estimate current racial/ethnic differences in adult mortality, (3) examine empirically the extent to which measures of socioeconomic status and other risk factors impact the mortality differences across groups, and (4) utilize findings to inform the policy community with regard to eliminating racial/ethnic disparities in mortality. Relative Black-White differences are modestly narrower when compared to a decade or so ago, but remain very wide. The majority of the Black-White adult mortality gap can be accounted for by measures of socioeconomic resources that reflect the historical and continuing significance of racial socioeconomic stratification. Further, when controlling for socioeconomic resources, MexicanAmericans and Mexican immigrants exhibit significantly lower mortality risk than non-Hispanic Whites. Without aggressive efforts to create equality in socioeconomic and social resources, Black-White disparities in mortality will remain wide, and mortality among the Mexican-origin population will remain higher than what would be the case if that population achieved socioeconomic equality with Whites. PMID:21687782

Prejudiced interactions: implicit racial bias reduces predictive simulation during joint action with an out-group avatar.

PubMed

Sacheli, Lucia Maria; Christensen, Andrea; Giese, Martin A; Taubert, Nick; Pavone, Enea Francesco; Aglioti, Salvatore Maria; Candidi, Matteo

2015-02-17

During social interactions people automatically apply stereotypes in order to rapidly categorize others. Racial differences are among the most powerful cues that drive these categorizations and modulate our emotional and cognitive reactivity to others. We investigated whether implicit racial bias may also shape hand kinematics during the execution of realistic joint actions with virtual in- and out-group partners. Caucasian participants were required to perform synchronous imitative or complementary reach-to-grasp movements with avatars that had different skin color (white and black) but showed identical action kinematics. Results demonstrate that stronger visuo-motor interference (indexed here as hand kinematics differences between complementary and imitative actions) emerged: i) when participants were required to predict the partner's action goal in order to on-line adapt their own movements accordingly; ii) during interactions with the in-group partner, indicating the partner's racial membership modulates interactive behaviors. Importantly, the in-group/out-group effect positively correlated with the implicit racial bias of each participant. Thus visuo-motor interference during joint action, likely reflecting predictive embodied simulation of the partner's movements, is affected by cultural inter-individual differences.

Racial discrimination, socioeconomic position, and illicit drug use among US Blacks.

PubMed

Carliner, Hannah; Delker, Erin; Fink, David S; Keyes, Katherine M; Hasin, Deborah S

2016-04-01

We assessed the relationship of self-reported racial discrimination with illicit drug use among US Blacks, and whether this differed by socioeconomic position (SEP). Among 6587 Black participants in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005), we used multiple logistic regression models to test the association between racial discrimination (measured on the 6-item Experiences of Discrimination scale) and past-year illicit drug use, and whether this differed by SEP. Racial discrimination was associated with past-year drug use [adjusted odds ratio (aOR) 2.32; 95 % confidence interval (CI) 1.70, 3.16] and with frequent drug use (aOR 1.91; 95 % CI 1.22, 2.99). For frequent illicit drug use, this relationship was stronger among higher SEP participants (aOR 3.55; 95 % CI 2.09, 6.02; p interaction < 0.01). The stronger association between racial discrimination and frequent illicit drug use among higher SEP Blacks suggests a complex interplay between disadvantaged and privileged statuses that merits further investigation. The finding of a significant difference by SEP highlights the importance of considering differences within heterogeneous race/ethnic groups when investigating health disparities.

Racial Disparities in Access to and Outcomes of Kidney Transplantation in Children, Adolescents, and Young Adults: Results From the ESPN/ERA-EDTA (European Society of Pediatric Nephrology/European Renal Association-European Dialysis and Transplant Association) Registry.

PubMed

Tjaden, Lidwien A; Noordzij, Marlies; van Stralen, Karlijn J; Kuehni, Claudia E; Raes, Ann; Cornelissen, Elisabeth A M; O'Brien, Catherine; Papachristou, Fotios; Schaefer, Franz; Groothoff, Jaap W; Jager, Kitty J

2016-02-01

Racial disparities in kidney transplantation in children have been found in the United States, but have not been studied before in Europe. Cohort study. Data were derived from the ESPN/ERA-EDTA Registry, an international pediatric renal registry collecting data from 36 European countries. This analysis included 1,134 young patients (aged ≤19 years) from 8 medium- to high-income countries who initiated renal replacement therapy (RRT) in 2006 to 2012. Racial background. Differences between racial groups in access to kidney transplantation, transplant survival, and overall survival on RRT were examined using Cox regression analysis while adjusting for age at RRT initiation, sex, and country of residence. 868 (76.5%) patients were white; 59 (5.2%), black; 116 (10.2%), Asian; and 91 (8.0%), from other racial groups. After a median follow-up of 2.8 (range, 0.1-3.0) years, we found that black (HR, 0.49; 95% CI, 0.34-0.72) and Asian (HR, 0.54; 95% CI, 0.41-0.71) patients were less likely to receive a kidney transplant than white patients. These disparities persisted after adjustment for primary renal disease. Transplant survival rates were similar across racial groups. Asian patients had higher overall mortality risk on RRT compared with white patients (HR, 2.50; 95% CI, 1.14-5.49). Adjustment for primary kidney disease reduced the effect of Asian background, suggesting that part of the association may be explained by differences in the underlying kidney disease between racial groups. No data for socioeconomic status, blood group, and HLA profile. We believe this is the first study examining racial differences in access to and outcomes of kidney transplantation in a large European population. We found important differences with less favorable outcomes for black and Asian patients. Further research is required to address the barriers to optimal treatment among racial minority groups. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Self-rated health and residential segregation: how does race/ethnicity matter?

PubMed

Gibbons, Joseph; Yang, Tse-Chuan

2014-08-01

Despite recent declines, racial segregation remains a detriment to minority neighborhoods. However, existing research is inconclusive as to the effects racial segregation has on health. Some argue that racial segregation is related to poor health outcomes, whereas others suspect that racial segregation may actually lead to improved health for some minority communities. Even less is known about whether minority access to white neighborhoods improves health. We address these gaps with individual data from the 2010 Public Health Management Corporation's Southeastern Pennsylvania Household Health Survey and census tract data from the 2010 Decennial Census and the 2006-2010 American Community Survey. We implement logistic multilevel models to determine whether and how a resident's self-rated health is affected by the racial/ethnic segregation of their neighborhoods. Our key finding suggests that the effects of segregation on self-rated health depend on an individual's race/ethnicity, with blacks and Latino residents most likely to experience adverse effects. Particularly, minorities living in predominantly white communities have a significantly higher likelihood to report poor/fair health than they would in segregated minority neighborhoods. These findings make clear that access to white neighborhoods is not sufficient to improve minority health; fuller neighborhood integration is necessary to ensure all have health equity.

Beyond the realism debate: The metaphysics of 'racial' distinctions.

PubMed

Lemeire, Olivier

2016-10-01

The current metaphysical race debate is very much focused on the realism question whether races exist. In this paper I argue against the importance of this question. Philosophers, biologists and anthropologists expect that answering this question will tell them something substantive about the metaphysics of racial classifications, and will help them to decide whether it is justified to use racial categories in scientific research and public policy. I argue that there are two reasons why these expectations are not fulfilled. First of all, the realism question about race leads to a very broad philosophical debate about the semantics of general terms and the criteria for real kinds, rather than to a debate about the metaphysics of racial categories specifically. Secondly, there is a type of race realism that is so toothless that it is almost completely uninformative about the metaphysics of race. In response to these worries, I argue that the metaphysical race debate should rather be focused on the question in what way and to what extent 'racial' distinctions can ground the epistemic practices of various scientific disciplines. I spell out what I mean by this, and go on to demonstrate that trying to answer this question leads to a more fruitful metaphysical debate. Copyright © 2016 Elsevier Ltd. All rights reserved.

Racial Variation in the Effect of Incarceration on Neighborhood Attainment

PubMed Central

Massoglia, Michael; Firebaugh, Glenn; Warner, Cody

2013-01-01

Each year, more than 700,000 convicted offenders are released from prison and reenter neighborhoods across the country. Prior studies have found that minority ex-inmates tend to reside in more disadvantaged neighborhoods than do white ex-inmates. However, because these studies do not control for pre-prison neighborhood conditions, we do not know how much (if any) of this racial variation is due to arrest and incarceration, or if these observed findings simply reflect existing racial residential inequality. Using a nationally representative dataset that tracks individuals over time, we find that only whites live in significantly more disadvantaged neighborhoods after prison than prior to prison. Blacks and Hispanics do not, nor do all groups (whites, blacks, and Hispanics) as a whole live in worse neighborhoods after prison. We attribute this racial variation in the effect of incarceration to the high degree of racial neighborhood inequality in the United States: because white offenders generally come from much better neighborhoods, they have much more to lose from a prison spell. In addition to advancing our understanding of the social consequences of the expansion of the prison population, these findings demonstrate the importance of controlling for preprison characteristics when investigating the effects of incarceration on residential outcomes. PMID:24367134

Discrimination, Other Psychosocial Stressors, and Self-Reported Sleep Duration and Difficulties

PubMed Central

Slopen, Natalie; Williams, David R.

2014-01-01

Objectives: To advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes. Design: Cross-sectional probability sample. Setting: Chicago, IL. Participants: There were 2,983 black, Hispanic, and white adults. Measurements and Results: Outcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (β = -0.14)) and nonracial (β = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (β = -0.17), and workplace harassment and incivilities (β = -0.14) were associated with shorter sleep (P < 0.05). The association between major experiences of discrimination attributed to race/ethnicity and sleep duration (β = -0.09, P < 0.05) was independent of concurrent stressors (i.e., acute events, childhood adversity, and financial, community, employment, and relationship stressors). Racial (β = 0.04) and non-racial (β = 0.05) everyday discrimination and racial (β = 0.04) and nonracial (β = 0.04) major experiences of discrimination, and workplace harassment and incivilities (β = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P < 0.05). Racial/ethnic differences in sleep duration and difficulties were not significant after adjustment for discrimination (P > 0.05). Conclusions: Discrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep. Citation: Slopen N; Williams DR. Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties. SLEEP 2014;37(1):147-156. PMID:24381373

Racial differences in neighborhood disadvantage, inflammation and metabolic control in black and white pediatric type 1 diabetes patients.

PubMed

Coulon, Sara J; Velasco-Gonzalez, Cruz; Scribner, Richard; Park, Chi L; Gomez, Ricardo; Vargas, Alfonso; Stender, Sarah; Zabaleta, Jovanny; Clesi, Patrice; Chalew, Stuart A; Hempe, James M

2017-03-01

Racial variation in the relationship between blood glucose and hemoglobin A1c (HbA1c) complicates diabetes diagnosis and management in racially mixed populations. Understanding why HbA1c is persistently higher in blacks than whites could help reduce racial disparity in diabetes outcomes. Test the hypothesis that neighborhood disadvantage is associated with inflammation and poor metabolic control in a racially mixed population of pediatric type 1 diabetes patients. Patients (n = 86, 53 white, 33 black) were recruited from diabetes clinics. Self-monitored mean blood glucose (MBG) was downloaded from patient glucose meters. Blood was collected for analysis of HbA1c and C-reactive protein (CRP). Patient addresses and census data were used to calculate a concentrated disadvantage index (CDI). High CDI reflects characteristics of disadvantaged neighborhoods. HbA1c and MBG were higher (p < 0.0001) in blacks [10.4% (90.3 mmol/mol), 255 mg/dL] than whites [8.9% (73.9 mmol/mol), 198 mg/dL). CDI was higher in blacks (p < 0.0001) and positively correlated with HbA1c (r = 0.40, p = 0.0002) and MBG (r = 0.35, p = 0.0011) unless controlled for race. CDI was positively associated with CRP by linear regression within racial groups. CRP was not different between racial groups, and was not correlated with MBG, but was positively correlated with HbA1c when controlled for race (p = 0.04). Neighborhood disadvantage was associated with inflammation and poor metabolic control in pediatric type 1 diabetes patients. Marked racial differences in potential confounding factors precluded differentiation between genetic and environmental effects. Future studies should recruit patients matched for neighborhood characteristics and treatment regimen to more comprehensively assess racial variation in HbA1c. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Implicit Messages:A Review of "Bias in Mental Testing."

ERIC Educational Resources Information Center

Scarr, Sandra

1981-01-01

Reviews Arthur Jensen's "Bias in Mental Testing" in terms of its implications for racial genetic inferiority, and offers alternate explanations for racial differences in testing based on data from studies on Black socialization and cultural differences in child rearing. (CM)

The decision to exclude agricultural and domestic workers from the 1935 Social Security Act.

PubMed

DeWitt, Larry

2010-01-01

The Social Security Act of 1935 excluded from coverage about half the workers in the American economy. Among the excluded groups were agricultural and domestic workers-a large percentage of whom were African Americans. This has led some scholars to conclude that policymakers in 1935 deliberately excluded African Americans from the Social Security system because of prevailing racial biases during that period. This article examines both the logic of this thesis and the available empirical evidence on the origins of the coverage exclusions. The author concludes that the racial-bias thesis is both conceptually flawed and unsupported by the existing empirical evidence. The exclusion of agricultural and domestic workers from the early program was due to considerations of administrative feasibility involving tax-collection procedures. The author finds no evidence of any other policy motive involving racial bias.

Class advantages and disadvantages are not so Black and White: intersectionality impacts rank and selves.

PubMed

Brannon, Tiffany N; Higginbotham, Gerald D; Henderson, Kyshia

2017-12-01

At the intersection of race and class the consequences of being working-class or middle-class are not so Black and White. Rather, established and emerging research suggests that race/ethnicity and social class intersect to differentially afford benefits and burdens. For instance, racial/ethnic minorities often do not reap the social, psychological or economic benefits of higher social class; yet, in some key life domains (e.g. health and mortality) racial/ethnic minorities in the U.S. seem to be buffered from some burdens of lower social class. We integrate empirical evidence to suggest that such differential advantages and disadvantages along racial lines reflect that social class exists alongside, rather than separate from, race/ethnicity as two distinct yet intersecting sources of rank and in turn selves. Copyright © 2017 Elsevier Ltd. All rights reserved.

Racial Differences in Adolescents' Answering Questions About Suicide.

PubMed

Anderson, Laura M; Lowry, Lynda S; Wuensch, Karl L

2015-01-01

The present purpose was to examine racial differences in response rate and serious behavioral suicide risk based on the national Youth Risk Behavior Surveillance Survey (YRBS). Data from 15,245 adolescents (YRBS, 2011) were included. Survey items pertaining to making suicidal plans and attempting suicide were included. Significant differences in responding and content emerged, especially with regard to suicide attempts. Racial minority adolescents are at elevated risk for serious suicidal behaviors and are more likely to omit items pertaining to suicide attempts. African American adolescents rarely reported having attempted suicide, but they also frequently failed to respond to that question.

Towards an Understanding of Racial Differences in Post-stroke Disability

PubMed Central

Skolarus, Lesli E.; Burke, James F.

2015-01-01

Due to the aging of the baby boomer generation, the number of stroke survivors is expected to increase from 7 million to over 10 million in 2030. Stroke survivorship will be particularly important for African Americans who have a higher incidence of strokes compared to non-Hispanics whites and greater post stroke disability. Current evidence suggests that the most prominent racial differences in post-stroke disability emerge in the post-stroke period. Further work, with a focus on modifiable factors, is needed to understand which factors in the post-stroke period lead to racial differences in post-stroke disability. PMID:26525431

Cumulative inequality and racial disparities in health: private insurance coverage and black/white differences in functional limitations.

PubMed

Kail, Ben Lennox; Taylor, Miles G

2014-09-01

To test different forms of private insurance coverage as mediators for racial disparities in onset, persistent level, and acceleration of functional limitations among Medicare age-eligible Americans. Data come from 7 waves of the Health and Retirement Study (1996-2008). Onset and progression latent growth models were used to estimate racial differences in onset, level, and growth of functional limitations among a sample of 5,755 people aged 65 and older in 1996. Employer-provided insurance, spousal insurance, and market insurance were next added to the model to test how differences in private insurance mediated the racial gap in physical limitations. In baseline models, African Americans had larger persistent level of limitations over time. Although employer-provided, spousal provided, and market insurances were directly associated with lower persistent levels of limitation, only differences in market insurance accounted for the racial disparities in persistent level of limitations. Results suggest private insurance is important for reducing functional limitations, but market insurance is an important mediator of the persistently larger level of limitations observed among African Americans. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cross-Sectional Analysis on Racial and Economic Disparities Affecting Mortality in Preterm Infants with Posthemorrhagic Hydrocephalus.

PubMed

Jin, Diana L; Christian, Eisha A; Attenello, Frank; Melamed, Edward; Cen, Steven; Krieger, Mark D; McComb, J Gordon; Mack, William J

2016-04-01

Despite major advances in medicine, racial and socioeconomic disparities continue to affect health care outcomes. Higher overall infant mortality has been reported for black neonates compared with their Hispanic and white counterparts. The underlying basis for these differences remains unclear. A potential influencing factor is the management of premature neurologic complications in this disadvantaged group. This study examines racial and socioeconomic disparities on mortality in preterm infants with posthemorrhagic hydrocephalus (PHH). Data from the Nationwide Inpatient Sample and Kids Inpatient Database were combined from 2000 to 2010. Discharges with International Classification of Diseases, Ninth Revision, Clinical Modification codes for preterm births with intraventricular hemorrhage and PHH were included. Relative risk (RR) ratios for mortality, complications, length of stay, and hospital costs were obtained with multivariate analysis after controlling for patient-level, hospital-level, and admission-level factors. When controlling for patient and hospital factors, black neonates had increased mortality compared with whites and Hispanics (RR = 1.47; P < 0.01). This association existed despite lower rates of congenital cardiac defects (RR = 0.84; P < 0.01), gastrointestinal complications (RR = 0.84; P < 0.01), and general complications of prematurity (RR = 0.95; P = 0.04) in the black cohort. Preterm infants insured by Medicaid had increased mortality compared with those with private insurance (RR = 1.2; P = 0.04) after adjusting for patient and hospital factors. Among preterm infants with intraventricular hemorrhage and resultant PHH, black infants and those insured by Medicaid have significantly increased mortality but these 2 effects are independent. Further studies are needed to fully understand the factors affecting these racial and socioeconomic disparities. Copyright © 2016 Elsevier Inc. All rights reserved.

Visiting Black Patients: Racial Disparities in Security Standby Requests.

PubMed

Green, Carmen R; McCullough, Wayne R; Hawley, Jamie D

2018-02-01

Structural inequalities exist within healthcare. Racial disparities in hospital security standby requests (SSRs) have not been previously explored. We speculated hospital SSRs varied based upon race with black patients and their visitors negatively impacted. An 8-year retrospective study of hospital security dispatch information was performed. Data were analyzed to determine demographic information, and service location patterns for SSRs involving patients and their visitors. The race of the patient's visitors was imputed using the patient's race. The observed and expected (using hospital census data) number of patients impacted by SSRs was compared. Descriptive statistics were computed. Categorical data were analyzed using chi-square or Fisher exact test statistic. A p < 0.05 was statistically significant. The majority of the 1023 SSRs occurred for visitors of patients who were white (N = 642; 63%), female (56%), or < 21 years old (50.7%). However, SSRs differed significantly based upon the patient's race. Although Black patients represent 12% of the hospital population, they and their visitors were more than twice as likely (p < 0.0001) to have a SSR generated (N = 275; 27%) when compared to the visitors of both White and other (i.e., race unknown) patients (N = 106; 10%) combined (p < 0.0001). This study adds to the medical errors and healthcare disparities literature by being the first to describe racial disparities in SSRs for Black patients and their visitors. It also introduces the concept of "security intervention errors in healthcare environments." New metrics and continuous quality improvement initiatives are needed to understand and eliminate racial/ethnic based disparities in SSRs. Copyright © 2018 National Medical Association. Published by Elsevier Inc. All rights reserved.

Are there common familial influences for major depressive disorder and an overeating-binge eating dimension in both European American and African American female twins?

PubMed

Munn-Chernoff, Melissa A; Grant, Julia D; Agrawal, Arpana; Koren, Rachel; Glowinski, Anne L; Bucholz, Kathleen K; Madden, Pamela A F; Heath, Andrew C; Duncan, Alexis E

2015-05-01

Although prior studies have demonstrated that depression is associated with an overeating-binge eating dimension (OE-BE) phenotypically, little research has investigated whether familial factors contribute to the co-occurrence of these phenotypes, especially in community samples with multiple racial/ethnic groups. We examined the extent to which familial (i.e., genetic and shared environmental) influences overlapped between Major Depressive Disorder (MDD) and OE-BE in a population-based sample and whether these influences were similar across racial/ethnic groups. Participants included 3,226 European American (EA) and 550 African American (AA) young adult women from the Missouri Adolescent Female Twin Study. An adaptation of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) was administered to assess lifetime DSM-IV MDD and OE-BE. Quantitative genetic modeling was used to estimate familial influences between both phenotypes; all models controlled for age. The best-fitting model, which combined racial/ethnic groups, found that additive genetic influences accounted for 44% (95% CI: 34%, 53%) of the MDD variance and 40% (25%, 54%) for OE-BE, with the remaining variances due to non-shared environmental influences. Genetic overlap was substantial (rg  = .61 [.39, .85]); non-shared environmental influences on MDD and OE-BE overlapped weakly (re  = .26 [.09, .42]). Results suggest that common familial influences underlie MDD and OE-BE, and the magnitude of familial influences contributing to the comorbidity between MDD and OE-BE is similar between EA and AA women. If racial/ethnic differences truly exist, then larger sample sizes may be needed to fully elucidate familial risk for comorbid MDD and OE-BE across these groups. © 2014 Wiley Periodicals, Inc.

Are There Common Familial Influences for Major Depressive Disorder and an Overeating-Binge Eating Dimension in both European-American and African-American Female Twins?

PubMed Central

Munn-Chernoff, Melissa A.; Grant, Julia D.; Agrawal, Arpana; Koren, Rachel; Glowinski, Anne L.; Bucholz, Kathleen K.; Madden, Pamela A. F.; Heath, Andrew C.; Duncan, Alexis E.

2014-01-01

Objective Although prior studies have demonstrated that depression is associated with an overeating-binge eating dimension (OE-BE), phenotypically, little research has investigated whether familial factors contribute to the co-occurrence of these phenotypes, especially in community samples with multiple racial/ethnic groups. We examined the extent to which familial (i.e., genetic and shared environmental) influences overlapped between Major Depressive Disorder (MDD) and OE-BE in a population-based sample and whether these influences were similar across racial/ethnic groups Method Participants included 3226 European-American (EA) and 550 African-American (AA) young adult women from the Missouri Adolescent Female Twin Study. An adaptation of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) was administered to assess lifetime DSM-IV MDD and OE-BE. Quantitative genetic modeling was used to estimate familial influences between both phenotypes; all models controlled for age. Results The best-fitting model, which combined racial/ethnic groups, found that additive genetic influences accounted for 44% (95% CI: 34%, 53%) of the MDD variance and 40% (25%, 54%) for OE-BE, with the remaining variances due to non-shared environmental influences. Genetic overlap was substantial (rg = .61 [.39, .85]); non-shared environmental influences on MDD and OE-BE overlapped weakly (re = .26 [.09, .42]) Discussion Results suggest that common familial influences underlie MDD and OE-BE, and the magnitude of familial influences contributing to the comorbidity between MDD and OE-BE is similar between EA and AA women. If racial/ethnic differences truly exist, then larger sample sizes may be needed to fully elucidate familial risk for comorbid MDD and OE-BE across these groups. PMID:24659561

Racial/Ethnic Disparity in NICU Quality of Care Delivery.

PubMed

Profit, Jochen; Gould, Jeffrey B; Bennett, Mihoko; Goldstein, Benjamin A; Draper, David; Phibbs, Ciaran S; Lee, Henry C

2017-09-01

Differences in NICU quality of care provided to very low birth weight (<1500 g) infants may contribute to the persistence of racial and/or ethnic disparity. An examination of such disparities in a population-based sample across multiple dimensions of care and outcomes is lacking. Prospective observational analysis of 18 616 very low birth weight infants in 134 California NICUs between January 1, 2010, and December 31, 2014. We assessed quality of care via the Baby-MONITOR, a composite indicator consisting of 9 process and outcome measures of quality. For each NICU, we calculated a risk-adjusted composite and individual component quality score for each race and/or ethnicity. We standardized each score to the overall population to compare quality of care between and within NICUs. We found clinically and statistically significant racial and/or ethnic variation in quality of care between NICUs as well as within NICUs. Composite quality scores ranged by 5.26 standard units (range: -2.30 to 2.96). Adjustment of Baby-MONITOR scores by race and/or ethnicity had only minimal effect on comparative assessments of NICU performance. Among subcomponents of the Baby-MONITOR, non-Hispanic white infants scored higher on measures of process compared with African Americans and Hispanics. Compared with whites, African Americans scored higher on measures of outcome; Hispanics scored lower on 7 of the 9 Baby-MONITOR subcomponents. Significant racial and/or ethnic variation in quality of care exists between and within NICUs. Providing feedback of disparity scores to NICUs could serve as an important starting point for promoting improvement and reducing disparities. Copyright © 2017 by the American Academy of Pediatrics.

Poor Sleep Quality and Associated Inflammation Predict Preterm Birth: Heightened Risk among African Americans.

PubMed

Blair, Lisa M; Porter, Kyle; Leblebicioglu, Binnaz; Christian, Lisa M

2015-08-01

Poor sleep promotes inflammation. In turn, inflammation is a causal mechanism in term as well as preterm parturition. In the United States, a persistent racial disparity in preterm birth exists, with African Americans showing ∼1.5 times greater risk. This study examined associations among sleep quality, serum proinflammatory cytokines, and length of gestation in a racially diverse sample of 138 pregnant women. Observational. Women completed the Pittsburgh Sleep Quality Index (PSQI) and other psychosocial and behavioral measures during midpregnancy. Serum levels of interleukin (IL)-6, IL-8, IL-1β, and tumor necrosis factor (TNF)-α were determined by high-sensitivity assays. Birth outcomes were determined via medical record review. Among African American women (n = 79), shorter gestation was predicted by poorer overall sleep (rs = -0.35, P = 0.002) as well the following PSQI subscales: subjective sleep quality (rs = -0.34, P = 0.002), sleep latency (rs = -0.27, P = 0.02), and sleep efficiency (rs = -0.27, P = 0.02). African American women with poor sleep quality (PSQI > 5) had 10.2 times the odds of preterm birth compared to those with good sleep quality. In contrast, among European American women (n = 53), gestational length was not significantly predicted by sleep quality (Ps > 0.12). Bootstrapping analyses showed that, among African Americans, IL-8 significantly mediated the association between sleep quality and length of gestation (indirect effect estimate -0.029; 95% confidence interval -0.06, -0.002). The data provide novel evidence that African American women exhibit greater inflammation in response to sleep disturbance than European American women and these effects correspond with length of gestation. Racial differences in susceptibility to sleep induced immune dysregulation may contribute to marked racial disparities in preterm birth. © 2015 Associated Professional Sleep Societies, LLC.

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.

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 differences in marijuana-users' risk of arrest in the United States.

PubMed

Ramchand, Rajeev; Pacula, Rosalie Liccardo; Iguchi, Martin Y

2006-10-01

A recent study of arrest data show that African Americans are 2.5 times more likely to be arrested for marijuana possession offences than Whites, even though general prevalence estimates show that they are no more likely to be using. The current study investigates the purchase patterns of marijuana users from the 2002 National Survey on Drug Use and Health (NSDUH) to evaluate whether differences in purchasing behaviors exist across racial groups. Although in general people who purchase marijuana are more likely to buy in private settings and from someone they know, this analysis shows that African Americans are statistically more likely to engage in risky purchasing behaviors that increase their likelihood of arrest. Using trivariate probit regression with demographic, drug use, and drug market covariates, analyses reveal that African Americans are nearly twice as likely to buy outdoors (0.31 versus 0.14), three times more likely to buy from a stranger (0.30 versus 0.09), and significantly more likely to buy away from their homes (0.61 versus 0.48). These results provide an additional explanation for the differential in arrest rates between African Americans and Whites.

Perceptions of genetics research as harmful to society: differences among samples of African-Americans and European-Americans.

PubMed

Furr, L Allen

2002-01-01

Genetics has the potential not only to find cures for diseases, but to possess the mechanisms to change the bio-social make-up of populations. A specific question that has arisen on this issue is how developments in genetic technology may intersect with existing race and ethnic relations. Evidence of the racialization of some genetic disorders has been demonstrated elsewhere. The purpose of this study is to compare and contrast African-American and European-American attitudes on the benefits of genetics research for society. Findings show that African-Americans were more likely to say genetics research is harmful for society. This relationship remained statistically significant after controls were introduced in a regression model. Demographic characteristics and self-rated knowledge of genetics had no effect on attitudes among African-Americans. A willingness to use genetic services correlated with favorable attitudes. Differences in social position may lead some groups to opposing interpretations and symbolic meanings of genetics. This may be true in the context of this study because the social meanings of genetics may be tainted by racialization, historical attempts at eugenics, and the potential abuse of genetics targeting groups partially defined by superficial genetic characteristics.

'Use what God has given me': difference and disparity in breast reconstruction.

PubMed

Rubin, Lisa R; Chavez, Jessica; Alderman, Amy; Pusic, Andrea L

2013-01-01

African-American women are significantly less likely to undergo postmastectomy breast reconstruction compared to white women in the USA. These observed differences have been interpreted as evidence of a healthcare disparity. The current study examines breast reconstruction decision-making among African-American women, locating reconstruction decisions in a context of culture, racial inequality and biomedicalisation. Semi-structured interviews were conducted with 27 African-American women who underwent mastectomy for breast cancer to add patient-centred perspectives to existing conceptualisations of racial/ethnic differences in reconstruction. Participants were socio-demographically diverse, and resided in the New York metropolitan area. Data analysis was informed by grounded theory. Spiritually and culturally informed body ethics often guided surgery decisions. Participants expressed reservations about breast implants, preferring autologous procedures that use 'what God has given'. For some, breast reconstruction restored a sense of normalcy after cancer; others challenged an imperative to reconstruct. Several participants redirected our focus on access to reconstruction toward access to alternatives, noting the low reimbursement for prostheses, or their unavailability in patients' skin tones. We suggest that a framework of 'stratified biomedicalization' better addresses the complexities of race, class and gender that inform preference, access and recommendations for breast reconstruction, and focuses attention on access to high and low-tech interventions.

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

PubMed

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

2016-01-01

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

Experiencing ownership over a dark-skinned body reduces implicit racial bias.

PubMed

Maister, Lara; Sebanz, Natalie; Knoblich, Günther; Tsakiris, Manos

2013-08-01

Previous studies have investigated how existing social attitudes towards other races affect the way we 'share' their bodily experiences, for example in empathy for pain, and sensorimotor mapping. Here, we ask whether it is possible to alter implicit racial attitudes by experimentally increasing self-other bodily overlap. Employing a bodily illusion known as the 'Rubber Hand Illusion', we delivered multisensory stimulation to light-skinned Caucasian participants to induce the feeling that a dark-skinned hand belonged to them. We then measured whether this could change their implicit racial biases against people with dark skin. Across two experiments, the more intense the participants' illusion of ownership over the dark-skinned rubber hand, the more positive their implicit racial attitudes became. Importantly, it was not the pattern of multisensory stimulation per se, but rather, it was the change in the subjective experience of body ownership that altered implicit attitudes. These findings suggest that inducing an overlap between the bodies of self and other through illusory ownership is an effective way to change and reduce negative implicit attitudes towards outgroups. Copyright © 2013 Elsevier B.V. All rights reserved.

Racial/Ethnic and Gender Disparities in Health Care Use and Access.

PubMed

Manuel, Jennifer I

2018-06-01

To document racial/ethnic and gender differences in health service use and access after the Affordable Care Act went into effect. Secondary data from the 2006-2014 National Health Interview Survey. Linear probability models were used to estimate changes in health service use and access (i.e., unmet medical need) in two separate analyses using data from 2006 to 2014 and 2012 to 2014. Adult respondents aged 18 years and older (N = 257,560). Results from the 2006-2014 and 2012-2014 analyses show differential patterns in health service use and access by race/ethnicity and gender. Non-Hispanic whites had the greatest gains in health service use and access across both analyses. While there was significant progress among Hispanic respondents from 2012 to 2014, no significant changes were found pre-post-health care reform, suggesting access may have worsened before improving for this group. Asian men had the largest increase in office visits between 2006 and 2014, and although not statistically significant, the increase continued 2012-2014. Black women and men fared the worst with respect to changes in health care access. Ongoing research is needed to track patterns of health service use and access, especially among vulnerable racial/ethnic and gender groups, to determine whether existing efforts under health care reform reduce long-standing disparities. © Health Research and Educational Trust.

Racial and Ethnic Disparities in Diabetes Care and Impact of Vendor-Based Disease Management Programs.

PubMed

Meng, Ying-Ying; Diamant, Allison; Jones, Jenna; Lin, Wenjiao; Chen, Xiao; Wu, Shang-Hua; Pourat, Nadereh; Roby, Dylan; Kominski, Gerald F

2016-05-01

We examined the existence of disparities in receipt of appropriate diabetes care among California's fee-for-service Medicaid beneficiaries and the effectiveness of a telephonic-based disease management program delivered by a disease management vendor on the reduction of racial/ethnic disparities in diabetes care. We conducted an intervention-control cohort study to test the effectiveness of a 3-year-long disease management program delivered to Medicaid fee-for-service beneficiaries aged 22 to 75 with a diagnosis of diabetes in Los Angeles and Alameda counties. The outcome measures were the receipt of at least one hemoglobin A1c (HbA1c) test, LDL cholesterol test, and retinal examination each year. We used generalized estimating equations models with logit link to analyze the claims data for a cohort of beneficiaries in two intervention counties (n = 2,933) and eight control counties (n = 2,988) from September 2005 through August 2010. Racial/ethnic disparities existed in the receipt of all three types of testing in the intervention counties before the program. African Americans (0.66; 95% CI 0.62-0.70) and Latinos (0.77; 95% CI 0.74-0.80) had lower rates of receipt for HbA1c testing than whites (0.83; 95% CI 0.81-0.85) in the intervention counties. After the intervention, the disparity among African Americans and Latinos compared with whites persisted in the intervention counties. For Asian Americans and Pacific Islanders, the disparity in testing rates decreased. We did not find similar disparities in the control counties. This disease management program was not effective in reducing racial/ethnic disparities in diabetes care in the most racially/ethnically diverse counties in California. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

The Influence of Intersecting Identities on Self-Harm, Suicidal Behaviors, and Depression among Lesbian, Gay, and Bisexual Individuals

PubMed Central

Lytle, Megan C.; De Luca, Susan M.; Blosnich, John R.

2014-01-01

Individuals with lesbian, gay, and bisexual (LGB) identities have higher prevalence of self-directed violence, but very little is known about racial/ethnic differences among LGB populations. This study aimed to examine racial/ethnic differences in self-harm, suicidal ideation, suicide attempt, and depression among LGB and heterosexual emerging adults. Data are compiled from the Fall 2008 and Spring 2009 National College Health Assessment and limited to respondents within emerging adulthood (ages 18-24) who indicated their sexual orientation and racial/ethnic identities (n=89,199). Within each racial/ethnic group, LGB individuals were significantly more likely to report self-harm, suicidal ideation, suicide attempt, and depression than non-LGB individuals. PMID:25250405

Racial/ethnic disparities in the use of mental health services in poverty areas.

PubMed

Chow, Julian Chun-Chung; Jaffee, Kim; Snowden, Lonnie

2003-05-01

This study examined racial/ethnic disparities in mental health service access and use at different poverty levels. We compared demographic and clinical characteristics and service use patterns of Whites, Blacks, Hispanics, and Asians living in low-poverty and high-poverty areas. Logistic regression models were used to assess service use patterns of minority racial/ethnic groups compared with Whites in different poverty areas. Residence in a poverty neighborhood moderates the relationship between race/ethnicity and mental health service access and use. Disparities in using emergency and inpatient services and having coercive referrals were more evident in low-poverty than in high-poverty areas. Neighborhood poverty is a key to understanding racial/ethnic disparities in the use of mental health services.

Perceived Racial/Ethnic Discrimination and Mental Health: a Review and Future Directions for Social Epidemiology

PubMed Central

Vines, Anissa I.; Ward, Julia B.; Cordoba, Evette; Black, Kristin Z.

2017-01-01

Purpose of review Recent literature on racial or ethnic discrimination and mental health was reviewed to assess the current science and identify key areas of emphasis for social epidemiology. Objectives of this review were to: 1) Determine whether there have been advancements in the measurement and analysis of perceived discrimination; 2) Identify the use of theories and/or frameworks in perceived discrimination and mental health research; and 3) Assess the extent to which stress buffers are being considered and evaluated in the existing literature. Recent findings Metrics and analytic approaches used to assess discrimination remain largely unchanged. Theory and/or frameworks such as the stress and coping framework continue to be underused in majority of the studies. Adolescents and young adults experiencing racial/ethnic discrimination were at greater risk of adverse mental health outcomes, and the accumulation of stressors over the life course may have an aggregate impact on mental health. Some growth seems evident in studies examining the mediation and moderation of stress buffers and other key factors with the findings suggesting a reduction in the effects of discrimination on mental health. Summary Discrimination scales should consider the multiple social identities of a person, the context where the exposure occurs, how the stressor manifests specifically in adolescents, the historical traumas, and cumulative exposure. Life course theory and intersectionality may help guide future work. Despite existing research, gaps remain in in elucidating the effects of racial and ethnic discrimination on mental health, signaling an opportunity and a call to social epidemiologists to engage in interdisciplinary research to speed research progress. PMID:28920011

Perceived Racial/Ethnic Discrimination and Mental Health: a Review and Future Directions for Social Epidemiology.

PubMed

Vines, Anissa I; Ward, Julia B; Cordoba, Evette; Black, Kristin Z

2017-06-01

Recent literature on racial or ethnic discrimination and mental health was reviewed to assess the current science and identify key areas of emphasis for social epidemiology. Objectives of this review were to: 1) Determine whether there have been advancements in the measurement and analysis of perceived discrimination; 2) Identify the use of theories and/or frameworks in perceived discrimination and mental health research; and 3) Assess the extent to which stress buffers are being considered and evaluated in the existing literature. Metrics and analytic approaches used to assess discrimination remain largely unchanged. Theory and/or frameworks such as the stress and coping framework continue to be underused in majority of the studies. Adolescents and young adults experiencing racial/ethnic discrimination were at greater risk of adverse mental health outcomes, and the accumulation of stressors over the life course may have an aggregate impact on mental health. Some growth seems evident in studies examining the mediation and moderation of stress buffers and other key factors with the findings suggesting a reduction in the effects of discrimination on mental health. Discrimination scales should consider the multiple social identities of a person, the context where the exposure occurs, how the stressor manifests specifically in adolescents, the historical traumas, and cumulative exposure. Life course theory and intersectionality may help guide future work. Despite existing research, gaps remain in in elucidating the effects of racial and ethnic discrimination on mental health, signaling an opportunity and a call to social epidemiologists to engage in interdisciplinary research to speed research progress.

Racial variation in tumor stage at diagnosis among Department of Defense beneficiaries.

PubMed

Enewold, Lindsey; Zhou, Jing; McGlynn, Katherine A; Devesa, Susan S; Shriver, Craig D; Potter, John F; Zahm, Shelia H; Zhu, Kangmin

2012-03-01

Tumor stage at diagnosis often varies by racial/ethnic group, possibly because of inequitable health care access. Within the Department of Defense (DoD) Military Health System, beneficiaries have equal health care access. The objective of this study was to determine whether tumor stage differed between whites and blacks with breast, cervical, colorectal, and prostate cancers, which have effective screening regimens, based on data from the DoD Automated Cancer Tumor Registry from 1990 to 2003. Distributions of tumor stage (localized vs nonlocalized) between whites and blacks in the military were compared stratified by sex, active duty status, and age at diagnosis. Logistic regression was used to further adjust for age, marital status, year of diagnosis, geographic region, military service branch, and tumor grade. Distributions of tumor stage were then compared between the military and general populations. Racial differences in the distribution of stage were significant only among nonactive duty beneficiaries. After adjusting for covariates, earlier stages of breast cancer after age 49 years and prostate cancer after age 64 years were significantly more common among white than black nonactive duty beneficiaries (P < .05), although the absolute difference was minimal for prostate cancer. Racial differences in stage for cervical and colorectal cancers were not significant after adjustment. Compared with the general population, racial differences in the military were similar or were slightly attenuated. Racial disparities in stage at diagnosis were apparent in the DoD equal-access health care system among older nonactive duty beneficiaries. Socioeconomic status, supplemental insurance, cultural beliefs, and biologic factors may be related to these results. Copyright © 2011 American Cancer Society.

Differences in blood pressure control in a large population-based sample of older African Americans and non-Hispanic whites.

PubMed

Delgado, Jose; Jacobs, Elizabeth A; Lackland, Daniel T; Evans, Denis A; de Leon, Carlos F Mendes

2012-11-01

Cardiovascular disease is the main cause of death in older adults. Uncontrolled blood pressure is an important risk factor for cardiovascular disease. African Americans have poorer blood pressure control than non-Hispanic whites. Little is known about whether this difference persists in older ages or the factors that contribute to this racial gap. Data were obtained from participants of the Chicago Health and Aging Program. Blood pressure control was defined according to JNC-7 criteria. Univariate chi-square analyses were used to determine racial differences in hypertension and blood pressure control, whereas sequential multivariate logistic regression models were used to determine the effect of race on blood pressure control. African Americans had a higher prevalence of hypertension (74% vs 63%; p < .001), higher awareness of hypertension (81% vs 72%; p < .001), and poorer blood pressure control (45% vs 51%, p < .001) than non-Hispanic whites. Racial differences in blood pressure control persisted after adjustment for socioeconomic status, medical conditions, obesity, and use of antihypertensive medications (odds ratio = 0.84, 95% confidence interval = 0.70-0.94). From 1993 to 2008, blood pressure control improved more among non-Hispanic whites than among African Americans. Racial differences in blood pressure control in older adults were not explained by socioeconomic status. The racial disparity in the prevalence and control of hypertension remained consistent for older hypertensive individuals eligible for Medicare. Although the rates of hypertension control improved for both racial groups, the improvement was greater among whites, thus widening the gap in this older population at high risk for cardiovascular disease.

Ethnic and Racial Disparities in Education: Psychology's Role in Understanding and Reducing Disparities

ERIC Educational Resources Information Center

Quintana, Stephen M.; Mahgoub, Lana

2016-01-01

We review the scope and sources of ethnic and racial disparities in education with a focus on the the implications of psychological theory and research for understanding and redressing these disparities. We identify 3 sources of ethnic and racial disparities including (a) social class differences, (b) differential treatment based on ethnic and…

Racial Attitudes of PreK-12 and Postsecondary Educators: Descriptive Evidence from Nationally Representative Data

ERIC Educational Resources Information Center

Quinn, David M.

2017-01-01

PreK-12 and postsecondary educators' racial attitudes have important consequences for students' learning and development, yet we know little about educators' racial attitudes overall, how their attitudes might differ from those of noneducators, or how attitudes might be changing over time. I investigate these questions using the nationally…

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…

Brain behavior relationships among African Americans, whites, and Hispanics.

PubMed

DeCarli, Charles; Reed, Bruce R; Jagust, William; Martinez, Oliver; Ortega, Mario; Mungas, Dan

2008-01-01

There is an increasing racial and ethnic diversity within the elderly population of the United States. Although increased diversity offers unique opportunities to study novel influences on aging and dementia, some aspects of racial and ethnic research have been hampered by the lack of culturally and linguistically consistent testing protocols. Structural brain imaging is commonly used to study the biology of normal aging and cognitive impairment and may therefore serve to explore potential biologic differences of cognitive impairment among racially and ethnically diverse individuals. To test this hypothesis, we recruited a cohort of approximately 400 African American, white, and Hispanic subjects with various degrees of cognitive ability. Each subject was carefully evaluated using standardized diagnostic protocols that included clinical review of brain magnetic resonance image (MRI) to arrive at a clinical diagnosis of normal cognition, mild cognitive impairment or dementia. Each MRI was then independently quantified for measures of brain, white matter hyperintensities, and hippocampal volumes by a technician blind to subject age, sex, ethnicity, race, and diagnostic category. The appearance of infarction on MRI was also rated by examining neurologists. Regression analyses were used to assess associations with various MRI measures across clinical diagnostic categories in relation to racial and ethnic differences. Hispanic subjects were, on average, significantly younger and had less years of education than African Americans or whites. Whites with dementia were significantly older than both African American and Hispanic dementia patients. Highly significant differences in MRI measures were associated with clinical diagnoses for the group as a whole after adjusting for the effects of age, sex, education, race, and ethnicity. Subsequent independent analyses by racial and ethnic status revealed consistent relationships between diagnostic category and MRI measures. Clinical diagnoses were associated with consistent differences in brain structure among a group of racially and ethnically diverse individuals. We believe these results help to validate current diagnostic assessment of individuals across a broad range of racial, ethnic, linguistic, and educational backgrounds. Moreover, interesting and potentially biologically relevant differences were found that might stimulate further research related to the understanding of dementia etiology within an increasingly racially and ethnically diverse population.

Deciphering Community and Race Effects on Adolescent Premarital Childbearing.

ERIC Educational Resources Information Center

South, Scott J.; Baumer, Eric P.

2000-01-01

Racial differences in adolescent premarital childbearing were largely explained by racial differences in neighborhood quality. These neighborhood effects were attributed to peer attitudes and behaviors, adolescents' more tolerant attitudes toward unmarried parenthood, and greater residential mobility in distressed communities. Neighborhood effects…

Racial discrimination experiences and African American youth adjustment: The role of parenting profiles based on racial socialization and involved-vigilant parenting.

PubMed

Varner, Fatima A; Hou, Yang; Hodzic, Tajma; Hurd, Noelle M; Butler-Barnes, Sheretta T; Rowley, Stephanie J

2018-04-01

The purpose of this study was to test whether parenting profiles based on racial socialization and involved-vigilant parenting would compensate for or moderate associations between racial discrimination experiences and academic outcomes and psychological well-being among African American adolescents. Participants were 1,363 African American adolescents (M age = 14.19; 52.3% female) from 3 Midwestern suburban school districts. Latent profile analysis was used to examine whether there were distinct combinations of parenting. The relationships among racial discrimination experiences, parenting profiles, and adjustment were examined using structural equation modeling (SEM). Three distinct parenting profiles were found: moderate positive (n = 767; moderately high involved-vigilant parenting and racial barrier, racial pride, behavioral, and egalitarian messages, and low negative messages), unengaged (n = 351; low racial socialization messages and moderately low involved-vigilant parenting), and high negative parenting (n = 242; high negative messages, moderate other racial socialization messages, and moderately low involved-vigilant parenting). Racial discrimination experiences were negatively associated with youth adjustment. Moderate positive parenting was related to the best academic outcomes and unengaged parenting was associated with more positive academic outcomes than high negative parenting. Moderate positive parenting was associated with better psychological well-being than unengaged or high negative parenting although the benefits were greater for adolescents with fewer racial discrimination experiences. Distinct patterns of racial socialization messages and involved-vigilant parenting contribute to differences in African American youth adjustment. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Racial identity invalidation with multiracial individuals: An instrument development study.

PubMed

Franco, Marisa G; O'Brien, Karen M

2018-01-01

Racial identity invalidation, others' denial of an individual's racial identity, is a salient racial stressor with harmful effects on the mental health and well-being of Multiracial individuals. The purpose of this study was to create a psychometrically sound measure to assess racial identity invalidation for use with Multiracial individuals (N = 497). The present sample was mostly female (75%) with a mean age of 26.52 years (SD = 9.60). The most common racial backgrounds represented were Asian/White (33.4%) and Black/White (23.7%). Participants completed several online measures via Qualtrics. Exploratory factor analyses revealed 3 racial identity invalidation factors: behavior invalidation, phenotype invalidation, and identity incongruent discrimination. A confirmatory factor analysis provided support for the initial factor structure. Alternative model testing indicated that the bifactor model was superior to the 3-factor model. Thus, a total score and/or 3 subscale scores can be used when administering this instrument. Support was found for the reliability and validity of the total scale and subscales. In line with the minority stress theory, challenges with racial identity mediated relationships between racial identity invalidation and mental health and well-being outcomes. The findings highlight the different dimensions of racial identity invalidation and indicate their negative associations with connectedness and psychological well-being. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Racial Differences in Satisfaction with VA Health Care: A Mixed Methods Pilot Study.

PubMed

Zickmund, Susan L; Burkitt, Kelly H; Gao, Shasha; Stone, Roslyn A; Rodriguez, Keri L; Switzer, Galen E; Shea, Judy A; Bayliss, Nichole K; Meiksin, Rebecca; Walsh, Mary B; Fine, Michael J

2015-09-01

As satisfied patients are more adherent and play a more active role in their own care, a better understanding of factors associated with patient satisfaction is important. In response to a United States Veterans Administration (VA) Hospital Report Card that revealed lower levels of satisfaction with health care for African Americans compared to Whites, we conducted a mixed methods pilot study to obtain preliminary qualitative and quantitative information about possible underlying reasons for these racial differences. We conducted telephone interviews with 30 African American and 31 White veterans with recent inpatient and/or outpatient health care visits at three urban VA Medical Centers. We coded the qualitative interviews in terms of identified themes within defined domains. We summarized racial differences using ordinal logistic regression for Likert scale outcomes and used random effects logistic regression to assess racial differences at the domain level. Compared to Whites, African Americans were younger (p < 0.001) and better educated (p = 0.04). Qualitatively, African Americans reported less satisfaction with trust/confidence in their VA providers and healthcare system and less satisfaction with patient-provider communication. Quantitatively, African Americans reported less satisfaction with outpatient care (odds ratio = 0.28; 95 % confidence interval (CI) 0.10-0.82), but not inpatient care. At the domain level, African Americans were significantly less likely than Whites to express satisfaction themes in the domain of trust/confidence (odds ratio = 0.36; 95 % CI 0.18-0.73). The current pilot study demonstrates racial differences in satisfaction with outpatient care and identifies some specific sources of dissatisfaction. Future research will include a large national cohort, including Hispanic veterans, in order to gain further insight into the sources of racial and ethnic differences in satisfaction with VA care and inform future interventions.

Racial and Regional Differences in Age at Menopause in the United States: Findings from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

PubMed Central

Mcknight, Katherine K.; Wellons, Melissa F.; Sites, Cynthia K.; Roth, David L.; Szychowski, Jeff M.; Halanych, Jewell H.; Cushman, Mary; Safford, Monika M.

2011-01-01

Objectives To examine regional and Black-White differences in mean age at self-reported menopause among community-dwelling women in the US. Study Design Cross-sectional survey conducted in the context of the REasons for Geographic And Racial Differences in Stroke and Myocardial Infarction study. Results We studied 22,484 menopausal women. After controlling for covariates, Southern women reported menopause 10.8 months earlier than Northeastern women, 8.4 months earlier than Midwestern women, and 6.0 months earlier than Western women (p<0.05 for all). No difference was observed in menopausal age between Black and White women after controlling for covariates (p=0.69). Conclusions Women in the South report earlier menopause than those in other regions, but the cause remains unclear. Our study's large sample size and adjustment for multiple confounders lends weight to our finding of no racial difference in age at menopause. More study is needed of the implications of these findings with regard to vascular health. PMID:21663888

Gender and racial differences in risk factors for sexually transmitted diseases among justice-involved youth

PubMed Central

Dembo, Richard; Childs, Kristina; Belenko, Steven; Schmeidler, James; Wareham, Jennifer

2010-01-01

Gender and racial differences in infection rates for chlamydia and gonorrhea have been reported within community-based populations, but little is known of such differences within juvenile offending populations. Moreover, while research has demonstrated that certain individual-level and community-level factors affect risky behaviors associated with sexually transmitted disease (STD), less is known about how multi-level factors affect STD infection, particularly among delinquent populations. The present study investigated gender and racial differences in STD infection among a sample of 924 juvenile offenders. Generalized linear model regression analyses were conducted to examine the influence of individual-level factors such as age, offense history, and substance use and community-level factors such as concentrated disadvantage, ethnic heterogeneity, and family disruption on STD status. Results revealed significant racial and STD status differences across gender, as well as interaction effects for race and STD status for males only. Gender differences in individual-level and community-level predictors were also found. Implications of these findings for future research and public health policy are discussed. PMID:20700475

Racial differences in the elderly's use of medical procedures and diagnostic tests.

PubMed Central

Escarce, J J; Epstein, K R; Colby, D C; Schwartz, J S

1993-01-01

OBJECTIVES. This study sought to examine racial differences in the use of medical procedures and diagnostic tests by elderly Americans. METHODS. We used 1986 physician claims data for a 5% national sample of Medicare enrollees aged 65 years and older to study 32 procedures and tests. For each service, we calculated the age- and sex-adjusted rate of use by race and the corresponding White-Black relative risk. RESULTS. Whites were more likely than Blacks to receive 23 services, and for many of these services, the differences in use were substantial. In contrast, Blacks were more likely than Whites to receive seven services. Whites had a particular advantage in access to higher-technology or newer services. Racial differences in use persisted among elders who had Medicaid in addition to Medicare coverage and increased among rural elders. CONCLUSIONS. There are pervasive racial differences in the use of medical services by elderly Americans that cannot be explained by differences in the prevalence of specific clinical conditions. Financial barriers to care do not fully account for these findings. Race may exacerbate the impact of other barriers to access. PMID:8328615

Racial Differences in Exposure and Reactivity to Daily Family Stressors

PubMed Central

Cichy, Kelly E.; Stawski, Robert S.; Almeida, David M.

2013-01-01

Using data from the National Study of Daily Experiences (NSDE), this study examined racial differences in exposure and reactivity to daily stressors involving family members. Respondents included African American and European American adults aged 34 to 84 (N = 1,931) who participated in 8 days of daily interviews where they reported on daily stressors, affect, and physical health symptoms. Results revealed racial similarities in family stressor exposure. Both races were also emotionally reactive to family arguments and family network events (i.e., events that happen to a family member), whereas African Americans were more physically reactive to family arguments. For African Americans, reactivity to family arguments endured; the increased negative affect and physical symptoms associated with family arguments lasted into the next day. Findings provide evidence for racial similarities and differences, suggesting that family relationships are universally stressful, whereas the negative effects of family stressors are more enduring among African Americans. PMID:23543937

Racial and Ethnic Differences in Factors Related to Work Place Violence Victimization

PubMed Central

Sabri, Bushra; St. Vil, Noelle M.; Campbell, Jacquelyn C.; Fitzgerald, Sheila; Kub, Joan; Agnew, Jacqueline

2014-01-01

Work place violence (WPV) is a significant public health concern affecting all racial or ethnic groups. This study examined whether different racial/ethnic groups differed in vulnerability to WPV exposure and utilization of resources at the workplace. This cross sectional research focused on White, Black and Asian nursing employees (N=2033) employed in four health care institutions in a Mid-Atlantic US metropolitan area. While childhood physical abuse was significantly related to risk for WPV among workers from all racial/ethnic backgrounds, intimate partner abuse was a significant factor for Asians and Whites. Blacks and Asians were found to be less likely than Whites to be knowledgeable about WPV resources or use resources to address WPV. Services to address past trauma, and education and training opportunities for new workers may reduce risk for WPV and promote resource utilization among minority workers. PMID:24658287

Differences in placental telomere length suggest a link between racial disparities in birth outcomes and cellular aging.

PubMed

Jones, Christopher W; Gambala, Cecilia; Esteves, Kyle C; Wallace, Maeve; Schlesinger, Reid; O'Quinn, Marguerite; Kidd, Laura; Theall, Katherine P; Drury, Stacy S

2017-03-01

Health disparities begin early in life and persist across the life course. Despite current efforts, black women exhibit greater risk for pregnancy complications and negative perinatal outcomes compared with white women. The placenta, which is a complex multi-tissue organ, serves as the primary transducer of bidirectional information between the mother and fetus. Altered placental function is linked to multiple racially disparate pregnancy complications; however, little is known about racial differences in molecular factors within the placenta. Several pregnancy complications, which include preeclampsia and fetal growth restriction, exhibit racial disparities and are associated with shorter placental telomere length, which is an indicator of cellular stress and aging. Cellular senescence and telomere dynamics are linked to the molecular mechanisms that are associated with the onset of labor and parturition. Further, racial differences in telomere length are found in a range of different peripheral tissues. Together these factors suggest that exploration of racial differences in telomere length of the placenta may provide novel mechanistic insight into racial disparities in birth outcomes. This study examined whether telomere length measured in 4 distinct fetally derived tissues were significantly different between black and white women. The study had 2 hypotheses: (1) that telomere length that is measured in different placental tissue types would be correlated and (2) that across all sampled tissues telomere length would differ by race. In a prospective study, placental tissue samples were collected from the amnion, chorion, villus, and umbilical cord from black and white singleton pregnancies (N=46). Telomere length was determined with the use of monochrome multiplex quantitative real-time polymerase chain reaction in each placental tissue. Demographic and pregnancy-related data were also collected. Descriptive statistics characterized the sample overall and among black and white women separately. The overall impact of race was assessed by multilevel mixed-effects linear regression models that included empirically relevant covariates. Telomere length was correlated significantly across all placental tissues. Pairwise analyses of placental tissue telomere length revealed significantly longer telomere length in the amnion compared with the chorion (t=-2.06; P=.043). Overall telomere length measured in placenta samples from black mothers were significantly shorter than those from white mothers (β=-0.09; P=.04). Controlling for relevant maternal and infant characteristics strengthened the significance of the observed racial differences (β=-0.12; P=.02). Within tissue analyses revealed that the greatest difference by race was found in chorionic telomere length (t=-2.81; P=.007). These findings provide the first evidence of racial differences in placental telomere length. Telomere length was significantly shorter in placental samples from black mothers compared with white mothers. Given previous studies that have reported that telomere length, cellular senescence, and telomere dynamics are molecular factors that contribute to the rupture of the amniotic sac, onset of labor, and parturition, our findings of shorter telomere length in placentas from black mothers suggest that accelerated cellular aging across placental tissues may be relevant to the increased risk of preterm delivery in black pregnancies. Our results suggest that racial differences in cellular aging in the placenta contribute to the earliest roots of health disparities. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Racial/ethnic differences in perceived reasons for mental health treatment in US adolescents with major depression.

PubMed

Cummings, Janet R; Case, Brady G; Ji, Xu; Chae, David H; Druss, Benjamin G

2014-09-01

Racial/ethnic differences in the course of treatment for a major depressive episode (MDE) among adolescents may arise, in part, from variation in the perceived rationale for treatment. We examined racial/ethnic differences in the perceived reasons for receiving mental health (MH) treatment among adolescents with an MDE. A total of 2,789 adolescent participants who experienced an MDE and received MH treatment in the past year were drawn from the 2005 to 2008 National Survey on Drug Use and Health. Adolescents reported the settings in which they received care and reasons for their most recent visit to each setting. Distributions of specific depressive symptoms were compared across racial/ethnic groups. Racial/ethnic differences in endorsing each of 11 possible reasons for receiving treatment were examined using weighted probit regressions adjusted for sociodemographic characteristics, health and mental health status, treatment setting, and survey year. Despite similar depressive symptom profiles, Hispanic adolescents were more likely than whites to endorse "breaking rules" or getting into physical fights as reasons for MH treatment. Black adolescents were more likely than white adolescents to endorse "problems at school" but less likely to endorse "felt very afraid or tense" or "eating problems" as reasons for treatment. Asian adolescents were more likely to endorse "problems with people other than friends or family" but less likely than whites to endorse "suicidal thoughts/attempt" and "felt depressed" as reasons for treatment. Racial/ethnic minority participants were more likely than white participants to endorse externalizing or interpersonal problems and less likely to endorse internalizing problems as reasons for MH treatment. Understanding racial/ethnic differences in the patient's perceived treatment rationale can offer opportunities to enhance outcomes for depression among diverse populations. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Racial/ethnic differences in video game and Internet use among US adolescents with mental health and educational difficulties.

PubMed

Carson, Nicholas; Lê Cook, Benjamin; Chen, Chih-Nan; Alegria, Margarita

2012-01-01

Video game and Internet use can be associated with poor mental health and educational outcomes among adolescents. Racial/ethnic minority youth use these media more than White youth. Video game and Internet use among adolescents with mental health and educational difficulties may therefore differ by race/ethnicity in clinically meaningful ways. We analyzed a representative sample of 8 th grade students in the United States from the Early Childhood Longitudinal Survey-Kindergarten (N=6,700). Stratifying by gender, we assessed racial/ethnic differences in the associations between video game and Internet use, mental health, and reading and math achievement. Significant minority-White differences were identified in associations between media use and mental health and educational achievement. Video game use was relatively high among black females with prior mental health diagnoses and Asian-American males with high internalizing symptoms. Understanding video game and Internet use among racial/ethnic minority youth with mental health and educational difficulties may improve clinical practice.

Racial/ethnic differences in video game and Internet use among US adolescents with mental health and educational difficulties

PubMed Central

Carson, Nicholas; Lê Cook, Benjamin; Chen, Chih-Nan; Alegria, Margarita

2013-01-01

Video game and Internet use can be associated with poor mental health and educational outcomes among adolescents. Racial/ethnic minority youth use these media more than White youth. Video game and Internet use among adolescents with mental health and educational difficulties may therefore differ by race/ethnicity in clinically meaningful ways. We analyzed a representative sample of 8th grade students in the United States from the Early Childhood Longitudinal Survey-Kindergarten (N=6,700). Stratifying by gender, we assessed racial/ethnic differences in the associations between video game and Internet use, mental health, and reading and math achievement. Significant minority-White differences were identified in associations between media use and mental health and educational achievement. Video game use was relatively high among black females with prior mental health diagnoses and Asian-American males with high internalizing symptoms. Understanding video game and Internet use among racial/ethnic minority youth with mental health and educational difficulties may improve clinical practice. PMID:29167696

Racial bias in child protection? A comparison of competing explanations using national data.

PubMed

Drake, Brett; Jolley, Jennifer M; Lanier, Paul; Fluke, John; Barth, Richard P; Jonson-Reid, Melissa

2011-03-01

Cases of child abuse and neglect that involve black children are reported to and substantiated by public child welfare agencies at a rate approximately twice that of cases that involve white children. A range of studies have been performed to assess the degree to which this racial disproportionality is attributable to racial bias in physicians, nurses, and other professionals mandated to report suspected child victimization. The prevailing current explanation posits that the presence of bias among reporters and within the child welfare system has led to the current large overrepresentation of black children. A competing explanation is that overrepresentation of black children is mainly the consequence of increased exposure to risk factors such as poverty. We tested the competing models by using data drawn from national child welfare and public health sources. We compared racial disproportionality ratios on rates of victimization from official child welfare organizations to rates of key public health outcomes not subject to the same potential biases (eg, general infant mortality). We found that racial differences in victimization rate data from the official child welfare system are consistent with known differences for other child outcomes. We also found evidence supporting the presence of cultural protective factors for Hispanic children, termed the "Hispanic paradox." Although our findings do not preclude the possibility of racial bias, these findings suggest that racial bias in reporting and in the child welfare system are not large-scale drivers of racial disproportionality. Our data suggest that reduction of black/white racial disproportionality in the child welfare system can best be achieved by a public health approach to reducing underlying risk factors that affect black families.

Hyperinsulinemia, insulin resistance, vitamin D, and colorectal cancer among whites and African Americans.

PubMed

Tsai, Chung-Jyi; Giovannucci, Edward L

2012-10-01

African Americans have the highest incidence and mortality rates of colorectal cancer among all US racial and ethnic groups. Dietary factors, lifestyle factors, obesity, variability in screening rates, socioeconomic differences, barriers to screening, and differences in access to health care may be contributory factors to racial and ethnic disparities. African Americans are more likely to demonstrate microsatellite instability in their colorectal tumors leading to malignancy. However, these differences do not completely explain all the variances. Ample evidence implicates insulin resistance and its associated conditions, including elevated insulin and insulin-like growth factor-1 (IGF-1), in colorectal carcinogenesis. African Americans have a high risk for and a high prevalence of insulin resistance and subsequent overt type 2 diabetes. Recent clinical studies revealed that ethnic differences between whites and African Americans in early diabetes-related conditions including hyperinsulinemia already exist during childhood. African Americans have a much higher prevalence of vitamin D deficiency than whites throughout their life spans. Vitamin D deficiency has been associated with higher rates of diabetes and colorectal cancer, particularly in individuals with high serum insulin and IGF-1 levels. Moreover, African Americans have lower insulin sensitivity in tissues, independent of obesity, fat distribution, and inflammation. Further development of measures of biomarkers of tumor biology and host susceptibility may provide further insight on risk stratification in African Americans.

Gender, Racial, and Health Insurance Differences in the Trend of Implantable Cardioverter-Defibrillator (ICD) Utilization: A United States Experience Over the Last Decade.

PubMed

Patel, Nileshkumar J; Edla, Sushruth; Deshmukh, Abhishek; Nalluri, Nikhil; Patel, Nilay; Agnihotri, Kanishk; Patel, Achint; Savani, Chirag; Patel, Nish; Bhimani, Ronak; Thakkar, Badal; Arora, Shilpkumar; Asti, Deepak; Badheka, Apurva O; Parikh, Valay; Mitrani, Raul D; Noseworthy, Peter; Paydak, Hakan; Viles-Gonzalez, Juan; Friedman, Paul A; Kowalski, Marcin

2016-02-01

Prior studies have highlighted disparities in cardiac lifesaving procedure utilization, particularly among women and in minorities. Although there has been a significant increase in implantable cardioverter-defibrillator (ICD) insertion, socioeconomic disparities still exist in the trend of ICD utilization. With the use of the Nationwide Inpatient Sample from 2003 through 2011, we identified subjects with ICD insertion (procedure code 37.94) and cardiac resynchronization defibrillator (procedure code 00.50, 00.51) as codified by the International Classification of Diseases, Ninth Revision, Clinical Modification. Overall, 1 020 076 ICDs were implanted in the United States from 2003 to 2011. We observed an initial increase in ICD utilization by 51%, from 95 062 in 2003 to 143 262 in 2006, followed by a more recent decline. The majority of ICDs were implanted in men age ≥65 years. Implantation of ICDs was 2.5× more common in men than in women (402 per million vs 163 per million). Approximately 95% of the ICDs were implanted in insured patients, and 5% were used in the uninsured population. There has been a significant increase in ICD implantation in blacks, from 162 per million in 2003 to 291 per million in 2011. We found a significant difference in the volume of ICD implants between the insured and the uninsured patient populations. Racial disparities have narrowed significantly in comparison with those noted in earlier studies and are now more reflective of the population demographics at large. On the other hand, significant gender disparities continue to exist. © 2016 Wiley Periodicals, Inc.

Is Homo sapiens polytypic? Human taxonomic diversity and its implications.

PubMed

Woodley, Michael A

2010-01-01

The term race is a traditional synonym for subspecies, however it is frequently asserted that Homo sapiens is monotypic and that what are termed races are nothing more than biological illusions. In this manuscript a case is made for the hypothesis that H. sapiens is polytypic, and in this way is no different from other species exhibiting similar levels of genetic and morphological diversity. First it is demonstrated that the four major definitions of race/subspecies can be shown to be synonymous within the context of the framework of race as a correlation structure of traits. Next the issue of taxonomic classification is considered where it is demonstrated that H. sapiens possesses high levels morphological diversity, genetic heterozygosity and differentiation (F(ST)) compared to many species that are acknowledged to be polytypic with respect to subspecies. Racial variation is then evaluated in light of the phylogenetic species concept, where it is suggested that the least inclusive monophyletic units exist below the level of species within H. sapiens indicating the existence of a number of potential human phylogenetic species; and the biological species concept, where it is determined that racial variation is too small to represent differentiation at the level of biological species. Finally the implications of this are discussed in the context of anthropology where an accurate picture of the sequence and timing of events during the evolution of human taxa are required for a complete picture of human evolution, and medicine, where a greater appreciation of the role played by human taxonomic differences in disease susceptibility and treatment responsiveness will save lives in the future.

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

Attitude Differences and Task Performance for Black and White Naval Recruits in Problem-Solving Groups of Differing Size and Racial Composition.

DTIC Science & Technology

A field study was made in which 288 black and white naval personnel (224 recruits and 64 squad leaders) in groups of varying size and racial composition performed two problem-solving tasks (knot tying and ship-routing). Black and white leaders, subordinates and group types (25% black tetrads, 75% black tetrads, racially balanced dyads and tetrads) were compared in measures of self - esteem , duration of speech, locus of control, job and general satisfaction, Bales IPA behavior, and performance on the tasks.

Understanding Racial Differences in Exposure to Violent Areas: Integrating Survey, Smartphone, and Administrative Data Resources.

PubMed

Browning, Christopher R; Calder, Catherine A; Ford, Jodi L; Boettner, Bethany; Smith, Anna L; Haynie, Dana

2017-01-01

Emerging evidence indicates that exposure to violent areas may influence youth wellbeing. We employ smartphone GPS data on youth activity spaces to examine the extent of, and potential explanations for, racial disparities in these exposures. Multilevel models of data from the Adolescent Health and Development in Context study indicate that exposures to violent areas vary significantly across days of the week and between youth who reside in the same neighborhood. African American youth are exposed to areas with substantially higher levels of violence. Residing in a disadvantaged neighborhood is significantly associated with exposure to violent areas and explains a non-trivial proportion of the racial difference in this outcome. However, neighborhood factors are incomplete explanations of the racial disparity. Characteristics of the activity locations at which youth spend time explain the residual racial disparity in exposure to violent areas. These findings highlight the importance of youth activity spaces, above and beyond their neighborhood environments.