Nonevent Stress Contributes to Mental Health Disparities Based on Sexual Orientation: Evidence From a Personal Projects Analysis

PubMed Central

Frost, David M.; LeBlanc, Allen J.

2015-01-01

This study examined the role of nonevent stress—in the form of frustrated personal project pursuits in the arenas of relationships and work—as a contributing factor to mental health disparities between heterosexual and lesbian, gay, and bisexual (LGB) populations. A purposive sample of 431 LGB (55%) and heterosexually identified (45%) individuals living in the United States and Canada completed the Personal Project Inventory by describing and rating core personal projects they were pursuing. The intensity of perceived barriers to the achievement of relationship- and work-related personal projects served as indicators nonevent stress. Hierarchical linear regression models tested the hypothesis that nonevent stress contributes to the association between sexual orientation and two indicators of mental health: depressive symptoms and psychological well-being. LGB individuals had significantly more depressive symptoms and lower levels of psychological well-being than heterosexuals. Indicators of nonevent stress were significantly associated with mental health outcomes and their inclusion in models attenuated sexual orientation differences in mental health. The critical indirect pathway leading from sexual minority status to mental health occurred via barriers to relationship projects from interpersonal sources. This research suggests that nonevent stress because of structural and interpersonal stigma may contribute to mental health disparities between LGB and heterosexual individuals. The findings have important implications for policy reform around same-sex relationship recognition and workplace discrimination. Future research and clinical work will benefit by expanding existing foci on stress to include nonevent stressors to better understand and address mental health problems, particularly in LGB populations. PMID:25265219

Integrating disparate lidar datasets for a regional storm tide inundation analysis of Hurricane Katrina

USGS Publications Warehouse

Stoker, Jason M.; Tyler, Dean J.; Turnipseed, D. Phil; Van Wilson, K.; Oimoen, Michael J.

2009-01-01

Hurricane Katrina was one of the largest natural disasters in U.S. history. Due to the sheer size of the affected areas, an unprecedented regional analysis at very high resolution and accuracy was needed to properly quantify and understand the effects of the hurricane and the storm tide. Many disparate sources of lidar data were acquired and processed for varying environmental reasons by pre- and post-Katrina projects. The datasets were in several formats and projections and were processed to varying phases of completion, and as a result the task of producing a seamless digital elevation dataset required a high level of coordination, research, and revision. To create a seamless digital elevation dataset, many technical issues had to be resolved before producing the desired 1/9-arc-second (3meter) grid needed as the map base for projecting the Katrina peak storm tide throughout the affected coastal region. This report presents the methodology that was developed to construct seamless digital elevation datasets from multipurpose, multi-use, and disparate lidar datasets, and describes an easily accessible Web application for viewing the maximum storm tide caused by Hurricane Katrina in southeastern Louisiana, Mississippi, and Alabama.

US Higher Education in a Budgetary Vortex--1992-2007: Tracing the Positioning of Academe in the Context of Growing Inequality

ERIC Educational Resources Information Center

de Oliver, Miguel; Briscoe, Felecia M.

2011-01-01

Through comparative statistical data of public investment trends in higher education, the institution of higher education in the US is contemporarily contextualized within the growing milieu of disparity. Specifically, this study focuses on the period from 1992 to 2007 to see if a mitigation of the growing economic disparity projected per the…

Promoting Health and Behavioral Health Equity in California.

PubMed

Mishra, Meenoo; Lupi, Monica Valdes; Miller, Wm Jahmal; Nolfo, Tamu

2016-01-01

Behavioral health disparities are not usually considered part of the same system of health disparities. However, the California Department of Public Health focused its health equity strategies on reducing behavioral health disparities through its California Statewide Plan to Promote Health and Mental Health Equity. This statewide plan was developed through a community-wide stakeholder engagement and outreach process. In addition, the California Reducing Disparities Project is a prevention and early intervention effort to reduce mental health disparities in underserved populations. This strategic plan represents the voice of several racial/ethnic communities, such as African American, Asian and Pacific Islander, Latino, Native American, as well as lesbian, gay, bisexual, transgender, and queer and questioning communities in California, through 5 strategic planning workgroups. The workgroups were composed of a broad range of stakeholders, including community leaders, mental health care providers, consumer and family members, individuals with lived experience, and academia. This case example highlights the various efforts of California's Office of Health Equity in eliminating behavioral health disparities and promoting mental health equity, as well as discusses the unique statutory and regulatory role of the Office of Health Equity's deputy director.

Multilevel Interventions To Address Health Disparities Show Promise In Improving Population Health.

PubMed

Paskett, Electra; Thompson, Beti; Ammerman, Alice S; Ortega, Alexander N; Marsteller, Jill; Richardson, DeJuran

2016-08-01

Multilevel interventions are those that affect at least two levels of influence-for example, the patient and the health care provider. They can be experimental designs or natural experiments caused by changes in policy, such as the implementation of the Affordable Care Act or local policies. Measuring the effects of multilevel interventions is challenging, because they allow for interaction among levels, and the impact of each intervention must be assessed and translated into practice. We discuss how two projects from the National Institutes of Health's Centers for Population Health and Health Disparities used multilevel interventions to reduce health disparities. The interventions, which focused on the uptake of the human papillomavirus vaccine and community-level dietary change, had mixed results. The design and implementation of multilevel interventions are facilitated by input from the community, and more advanced methods and measures are needed to evaluate the impact of the various levels and components of such interventions. Project HOPE—The People-to-People Health Foundation, Inc.

An ET-CURE Pilot Project Supporting Undergraduate Training in Cancer Research, Emerging Technology, and Health Disparities

PubMed Central

Wilson, Danyell S.; Fang, Bin; Dalton, William S.; Meade, Cathy; Koomen, John M.

2012-01-01

The National Cancer Institute’s Center to Reduce Cancer Health Disparities has created pilot training opportunities under the “Continuing Umbrella of Research Experiences” (CURE) program that focus on emerging technologies (ET). In this pilot project, an eighteen month cancer biology research internship was reinforced with: instruction in an emerging technology (proteomics), a transition from the undergraduate laboratory to a research setting, education in cancer health disparities, and community outreach activities. A major goal was to provide underrepresented undergraduates with hands-on research experiences that are rarely encountered at the undergraduate level, including mentoring, research presentations, and participation in local and national meetings. These opportunities provided education and career development for the undergraduates, and they have given each student the opportunity to transition from learning to sharing their knowledge and from being mentored to mentoring others. Here, we present the concepts, curriculum, infrastructure, and challenges for this training program along with evaluations by both the students and their mentors. PMID:22528637

An ET-CURE pilot project supporting undergraduate training in cancer research, emerging technology, and health disparities.

PubMed

Wilson, Danyell S; Fang, Bin; Dalton, William S; Meade, Cathy D; Koomen, John M

2012-06-01

The National Cancer Institute's Center to Reduce Cancer Health Disparities has created pilot training opportunities under the "Continuing Umbrella of Research Experiences" program that focus on emerging technologies. In this pilot project, an 18-month cancer biology research internship was reinforced with: instruction in an emerging technology (proteomics), a transition from the undergraduate laboratory to a research setting, education in cancer health disparities, and community outreach activities. A major goal was to provide underrepresented undergraduates with hands-on research experiences that are rarely encountered at the undergraduate level, including mentoring, research presentations, and participation in local and national meetings. These opportunities provided education and career development for the undergraduates, and they have given each student the opportunity to transition from learning to sharing their knowledge and from being mentored to mentoring others. Here, we present the concepts, curriculum, infrastructure, and challenges for this training program along with evaluations by both the students and their mentors.

Addressing Health Disparities through Multi-institutional, Multidisciplinary Collaboratories

PubMed Central

Fleming, Erik S.; Perkins, James; Easa, David; Conde, José G.; Baker, Richard S.; Southerland, William M.; Dottin, Robert; Benabe, Julio E.; Ofili, Elizabeth O.; Bond, Vincent C.; McClure, Shelia A.; Sayre, Michael H.; Beanan, Maureen J.; Norris, Keith C.

2009-01-01

The national research leadership has recently become aware of the tremendous potential of translational research as an approach to address health disparities. The Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) is a research network that supports multi-institutional, multidisciplinary collaboration with a focus on key diseases and conditions for which disproportionately adverse racial and ethnic health disparities exist. The RTRN is designed to facilitate the movement of scientific advances across the translational research spectrum by providing researchers at different institutions with the infrastructure and tools necessary to collaborate on interdisciplinary and transdisciplinary research projects relating to specific health outcomes for which major racial/ethnic disparities exist. In the past, the difficulty of overcoming the restrictions imposed by time and space have made it difficult to carry out this type of large-scale, multilevel collaboration efficiently. To address this formidable challenge, the RTRN will deploy a translational research cluster system that uses “cyber workspaces” to bring researchers with similar interests together by using online collaboratory technology. These virtual meeting environments will provide a number of tools, including videoconferences (seminars, works in progress, meetings); project management tools (WebCT, Microsoft Share Point); and posting areas for projects, concepts, and other research and educational activities. This technology will help enhance access to resources across institutions with a common mission, minimize many of the logistical hurdles that impede intellectual exchange, streamline the planning and implementation of innovative interdisciplinary research, and assess the use of protocols and practices to assist researchers in interacting across and within cyber workspaces. PMID:18646341

Addressing health disparities through multi-institutional, multidisciplinary collaboratories.

PubMed

Fleming, Erik S; Perkins, James; Easa, David; Conde, José G; Baker, Richard S; Southerland, William M; Dottin, Robert; Benabe, Julio E; Ofili, Elizabeth O; Bond, Vincent C; McClure, Shelia A; Sayre, Michael H; Beanan, Maureen J; Norris, Keith C

2008-01-01

The national research leadership has recently become aware of the tremendous potential of translational research as an approach to address health disparities. The Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) is a research network that supports multi-institutional, multidisciplinary collaboration with a focus on key diseases and conditions for which disproportionately adverse racial and ethnic health disparities exist. The RTRN is designed to facilitate the movement of scientific advances across the translational research spectrum by providing researchers at different institutions with the infrastructure and tools necessary to collaborate on interdisciplinary and transdisciplinary research projects relating to specific health outcomes for which major racial/ethnic disparities exist. In the past, the difficulty of overcoming the restrictions imposed by time and space have made it difficult to carry out this type of large-scale, multilevel collaboration efficiently. To address this formidable challenge, the RTRN will deploy a translational research cluster system that uses "cyber workspaces" to bring researchers with similar interests together by using online collaboratory technology. These virtual meeting environments will provide a number of tools, including videoconferences (seminars, works in progress, meetings); project management tools (WebCT, Microsoft Share Point); and posting areas for projects, concepts, and other research and educational activities. This technology will help enhance access to resources across institutions with a common mission, minimize many of the logistical hurdles that impede intellectual exchange, streamline the planning and implementation of innovative interdisciplinary research, and assess the use of protocols and practices to assist researchers in interacting across and within cyber workspaces.

IT Labs Proof-of-Concept Project: Technical Data Interoperability (TDI) Pathfinder Via Emerging Standards

NASA Technical Reports Server (NTRS)

Conroy, Mike; Gill, Paul; Ingalls, John; Bengtsson, Kjell

2014-01-01

No known system is in place to allow NASA technical data interoperability throughout the whole life cycle. Life Cycle Cost (LCC) will be higher on many developing programs if action isn't taken soon to join disparate systems efficiently. Disparate technical data also increases safety risks from poorly integrated elements. NASA requires interoperability and industry standards, but breaking legacy ways is a challenge.

"Who Do You Think You Are?": A Multidimensional Analysis of the Impact of Disparities in Higher Educational Attainment within Families of First-Generation College Graduates

ERIC Educational Resources Information Center

Burns, April

2013-01-01

This project explores the impact of disparate educational attainment between first-generation college graduates and their family members. This is a conscious shifting of the unit of analysis, from the changing social position and power of an individual student/graduate, to the relational capacity, tensions, and strategies of the family unit that…

What limits the morphological disparity of clades?

PubMed Central

Oyston, Jack W.; Hughes, Martin; Wagner, Peter J.; Gerber, Sylvain; Wills, Matthew A.

2015-01-01

The morphological disparity of species within major clades shows a variety of trajectory patterns through evolutionary time. However, there is a significant tendency for groups to reach their maximum disparity relatively early in their histories, even while their species richness or diversity is comparatively low. This pattern of early high-disparity suggests that there are internal constraints (e.g. developmental pleiotropy) or external restrictions (e.g. ecological competition) upon the variety of morphologies that can subsequently evolve. It has also been demonstrated that the rate of evolution of new character states decreases in most clades through time (character saturation), as does the rate of origination of novel bodyplans and higher taxa. Here, we tested whether there was a simple relationship between the level or rate of character state exhaustion and the shape of a clade's disparity profile: specifically, its centre of gravity (CG). In a sample of 93 extinct major clades, most showed some degree of exhaustion, but all continued to evolve new states up until their extinction. Projection of states/steps curves suggested that clades realized an average of 60% of their inferred maximum numbers of states. Despite a weak but significant correlation between overall levels of homoplasy and the CG of clade disparity profiles, there were no significant relationships between any of our indices of exhaustion curve shape and the clade disparity CG. Clades showing early high-disparity were no more likely to have early character saturation than those with maximum disparity late in their evolution. PMID:26640649

Project INSPIRE-HBCU Undergraduate Collaborative Summer Training Program to Inspire Students in Prostate Cancer Research

DTIC Science & Technology

2007-02-01

rate – Factors impacting these disparities – Cancer Education/Awareness /Interventions Health Literacy Community Health Fairs Faith-based...approaches that have been developed to address cancer health disparities. One approach considers increasing health literacy as a measure to lessen the...lead to a decreased mortality rate because the cancers would be caught earlier when they are less aggressive and more treatable. The health literacy approach

Diversity in the dermatology workforce.

PubMed

Hinojosa, Jorge A; Pandya, Amit G

2016-12-01

The United States is becoming increasingly diverse, and minorities are projected to represent the majority of our population in the near future. Unfortunately, health disparities still exist for these groups, and inequalities have also become evident in the field of dermatology. There is currently a lack of diversity within the dermatology workforce. Potential solutions to these health care disparities include increasing cultural competence for all physicians and improving diversity in the dermatology workforce. ©2016 Frontline Medical Communications.

Binocular depth processing in the ventral visual pathway

PubMed Central

Vogels, Rufin

2016-01-01

One of the most powerful forms of depth perception capitalizes on the small relative displacements, or binocular disparities, in the images projected onto each eye. The brain employs these disparities to facilitate various computations, including sensori-motor transformations (reaching, grasping), scene segmentation and object recognition. In accordance with these different functions, disparity activates a large number of regions in the brain of both humans and monkeys. Here, we review how disparity processing evolves along different regions of the ventral visual pathway of macaques, emphasizing research based on both correlational and causal techniques. We will discuss the progression in the ventral pathway from a basic absolute disparity representation to a more complex three-dimensional shape code. We will show that, in the course of this evolution, the underlying neuronal activity becomes progressively more bound to the global perceptual experience. We argue that these observations most probably extend beyond disparity processing per se, and pertain to object processing in the ventral pathway in general. We conclude by posing some important unresolved questions whose answers may significantly advance the field, and broaden its scope. This article is part of the themed issue ‘Vision in our three-dimensional world’. PMID:27269602

Binocular depth processing in the ventral visual pathway.

PubMed

Verhoef, Bram-Ernst; Vogels, Rufin; Janssen, Peter

2016-06-19

One of the most powerful forms of depth perception capitalizes on the small relative displacements, or binocular disparities, in the images projected onto each eye. The brain employs these disparities to facilitate various computations, including sensori-motor transformations (reaching, grasping), scene segmentation and object recognition. In accordance with these different functions, disparity activates a large number of regions in the brain of both humans and monkeys. Here, we review how disparity processing evolves along different regions of the ventral visual pathway of macaques, emphasizing research based on both correlational and causal techniques. We will discuss the progression in the ventral pathway from a basic absolute disparity representation to a more complex three-dimensional shape code. We will show that, in the course of this evolution, the underlying neuronal activity becomes progressively more bound to the global perceptual experience. We argue that these observations most probably extend beyond disparity processing per se, and pertain to object processing in the ventral pathway in general. We conclude by posing some important unresolved questions whose answers may significantly advance the field, and broaden its scope.This article is part of the themed issue 'Vision in our three-dimensional world'. © 2016 The Author(s).

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.

Population health-based approaches to utilizing digital technology: a strategy for equity.

PubMed

Graham, Garth N; Ostrowski, MaryLynn; Sabina, Alyse B

2016-11-01

Health care disparities and high chronic disease rates burden many communities and disproportionally impact racial/ethnic populations in the United States. These disparities vary geographically, increase health care expenses, and result in shortened lifespans. Digital technologies may be one tool for addressing health disparities and improving population health by increasing individuals' access to health information-especially as most low-income U.S. residents gain access to smartphones. The Aetna Foundation partners with organizations to use digital technologies, including mobile applications, data collection, and related platforms, for learning and sharing. Projects range from the broad-childhood education, lifestyle modification, health IT training, and nutrition education, to the specific-local healthy foods, stroke rehabilitation, and collection of city-level data. We describe our approaches to grantmaking and discuss lessons learned and their implications. When combined with sound policy strategies, emerging, scalable, digital technologies will likely become powerful allies for improving health and reducing health disparities.

Creating Community–Academic Partnerships for Cancer Disparities Research and Health Promotion

PubMed Central

Meade, Cathy D.; Menard, Janelle M.; Luque, John S.; Martinez-Tyson, Dinorah; Gwede, Clement K.

2010-01-01

To effectively attenuate cancer disparities in multiethnic, medically underserved populations, interventions must be developed collaboratively through solid community–academic partnerships and driven by community-based participatory research (CBPR). The Tampa Bay Community Cancer Network (TBCCN) has been created to identify and implement interventions to address local cancer disparities in partnership with community-based nonprofit organizations, faith-based groups, community health centers, local media, and adult literacy and education organizations. TBCCN activities and research efforts are geared toward addressing critical information and access issues related to cancer control and prevention in diverse communities in the Tampa Bay area. Such efforts include cross-cultural health promotion, screening, and awareness activities in addition to applied research projects that are rooted in communities and guided by CBPR methods. This article describes these activities as examples of partnership building to positively affect cancer disparities, promote community health, and set the stage for community-based research partnerships. PMID:19822724

Building on Leadership and Social Capital to Create Change in 2 Urban Communities

PubMed Central

Farquhar, Stephanie A.; Michael, Yvonne L.; Wiggins, Noelle

2005-01-01

There has been an appeal to reduce health inequities by increasing community involvement and social capital. Poder es Salud/Power for Health is a community-based participatory prevention research project that seeks to address health disparities in the African American and Latino communities by enhancing community-level social capital. We provide specific examples of how this intervention uses community health workers and popular education to reduce language and cultural barriers and enhance community social capital. Although the communities share fundamental challenges related to health disparities, the ways in which the Latino and African American communities identify health concerns, create solutions, and think about social capital vary. Members of the project are working together to identify opportunities for cross-cultural collaboration. PMID:15798115

Sharing a disparate landscape

NASA Astrophysics Data System (ADS)

Ali-Khan, Carolyne

2010-06-01

Working across boundaries of power, identity, and political geography is fraught with difficulties and contradictions. In Tali Tal and Iris Alkaher's, " Collaborative environmental projects in a multicultural society: Working from within separate or mutual landscapes?" the authors describe their efforts to do this in the highly charged atmosphere of Israel. This forum article offers a response to their efforts. Writing from a framework of critical pedagogy, I use the concepts of space and time to anchor my analysis, as I examine the issue of power in this Jew/Arab collaborative environmental project. This response problematizes "sharing" in a landscape fraught with disparities. It also looks to further Tal and Alkaher's work by geographically and politically grounding it in the broader current conflict and by juxtaposing sustainability with equity.

Project (inverted exclamation mark)EXITO!: success through diversity and universality for outcomes improvement among Hispanic home care patients.

PubMed

Woerner, Louise; Espinosa, Javier; Bourne, Susan; O'Toole, Marie; Ingersoll, Gail L

2009-01-01

The National Health Disparities Report notes that Hispanics have poorer quality of care in 23 of 38 core measures. The result of this disparity is great personal and health system costs, which could be reduced. Prior studies have focused on access and language. We studied outcomes improvement. The purpose of this project was to develop a replicable theory-based outcomes improvement model for delivery of nursing care to Hispanic patients. The Leininger Sunrise Enabler approach was used to design a program specific to the cultural needs of a home care population. Outcome and Assessment Information Set (OASIS) data from 125 unduplicated home care patients were tracked. Nursing care delivery was analyzed using ethnographic research techniques. Delivery of nursing care using a culturally congruent approach reduced acute hospitalization and emergent care visits. Medication management and customer and nursing satisfaction also improved. National standards for culturally and linguistically appropriate services in health care help reduce healthcare disparities, but improving Hispanic outcomes requires moving beyond symptoms and symptom management to transcultural care. The estimated savings to the health care system are significant.

Findings from the Community Health Intervention Program in South Carolina: Implications for Reducing Cancer-Related Health Disparities

PubMed Central

McCracken, James Lyndon; Friedman, Daniela B.; Brandt, Heather M.; Adams, Swann Arp; Xirasagar, Sudha; Ureda, John R.; Mayo, Rachel M.; Comer, Kimberly; Evans, Miriam; Fedrick, Delores; Talley, Jacqueline; Broderick, Madeline; Hebert, James R.

2013-01-01

BACKGROUND The South Carolina Cancer Prevention and Control Research Network (SC-CPCRN) implemented the Community Health Intervention Program (CHIP) mini-grants initiative to address cancer-related health disparities and reduce the cancer burden among high-risk populations across the state. The mini-grants project implemented evidence-based health interventions tailored to the specific needs of each community. OBJECTIVE To support the SC-CPCRN’s goals of moving toward greater dissemination and implementation of evidence-based programs in the community to improve public health, prevent disease, and reduce the cancer burden. METHODS Three community-based organizations were awarded $10,000 each to implement one of the National Cancer Institute’s evidence-based interventions. Each group had 12 months to complete their project. SC-CPCRN investigators and staff provided guidance, oversight, and technical assistance for each project. Grantees provided regular updates and reports to their SC-CPCRN liaisons to capture vital evaluation information. RESULTS The intended CHIP mini-grant target population reach was projected to be up to 880 participants combined. Actual combined reach of the three projects reported upon completion totaled 1,072 individuals. The majority of CHIP participants were African-American females. Participants ranged in age from 19 to 81 years. Evaluation results showed an increase in physical activity, dietary improvements, and screening participation. CONCLUSIONS The success of the initiative was the result of a strong community-university partnership built on trust. Active two-way communication and an honest open dialogue created an atmosphere for collaboration. Communities were highly motivated. All team members shared a common goal of reducing cancer-related health disparities and building greater public health capacity across the state. PMID:23645547

The Role of Early-Life Educational Quality and Literacy in Explaining Racial Disparities in Cognition in Late Life

PubMed Central

Gross, Alden L.; Shih, Regina A.; Sachs, Bonnie C.; Glymour, M. Maria; Bangen, Katherine J.; Benitez, Andreana; Skinner, Jeannine; Schneider, Brooke C.; Manly, Jennifer J.

2015-01-01

Objectives. Racial disparities in late-life cognition persist even after accounting for educational attainment. We examined whether early-life educational quality and literacy in later life help explain these disparities. Method. We used longitudinal data from the Washington Heights-Inwood Columbia Aging Project (WHICAP). Educational quality (percent white students; urban/rural school; combined grades in classroom) was operationalized using canonical correlation analysis. Late-life literacy (reading comprehension and ability, writing) was operationalized using confirmatory factor analysis. We examined whether these factors attenuated race-related differences in late-life cognition. Results. The sample consisted of 1,679U.S.-born, non-Hispanic, community-living adults aged 65–102 (71% black, 29% white; 70% women). Accounting for educational quality and literacy reduced disparities by 29% for general cognitive functioning, 26% for memory, and 32% for executive functioning but did not predict differences in rate of cognitive change. Discussion. Early-life educational quality and literacy in late life explain a substantial portion of race-related disparities in late-life cognitive function. PMID:24584038

Reducing Cancer Health Disparities through Community Engagement: Working with Faith-Based Organizations (Project CHURCH)

Cancer.gov

Lorna H. McNeill, PhD, MPH, is Chair and Associate Professor in the Department of Health Disparities at the University of Texas MD Anderson Cancer Center. Dr. McNeill's research is on the elimination of cancer-related health disparities in minority populations. Her research has particular emphasis on understanding the influence of social contextual determinants of cancer in minorities, with a special focus of the role of physical activity as a key preventive behavior and obesity as a major cancer determinant. Her research takes place in minority and underserved communities such as public housing developments, black churches, community-based clinics and low-income neighborhoods-communities with excess cancer death rates. She has been continuously funded, receiving grants from various funding agencies (i.e., National Institutes of Health, Robert Wood Johnson Foundation, etc.), to better understand and design innovative solutions to address obesity in racial/ethnic minority communities. Dr. McNeill is PI of several community-based studies, primarily working with African American churches. One is a called Project CHURCH, an academic-faith-based partnership established to: 1) identify underlying reasons for health disparities in cancer and cancer risk factors (e.g., screening, diet) among AAs using a cohort study (N=2400), 2) engage AAs as partners in the research process, and 3) to ultimately eliminate disparities among AAs. In 2014 Dr. McNeill furthered her partnership through the Faith, Health, and Family (FHF) Collaborative. The goals of FHF are to enhance the Project CHURCH partnership to address family obesity in African Americans, strengthen the partnership by developing a larger coalition of organizations and stakeholders to address the problem, assess church and community interest in family obesity and develop an agenda to address obesity in faith settings. To date we have 50 churches as members. Dr. McNeill is also director of the Center for Community-Engaged Translational Research (CCETR) at MD Anderson. CCETR works with MD Anderson faculty to develop collaborations with underserved communities with a focus on conducting high-quality, relevant cancer prevention research.

Achieving Health Equity: Closing The Gaps In Health Care Disparities, Interventions, And Research.

PubMed

Purnell, Tanjala S; Calhoun, Elizabeth A; Golden, Sherita H; Halladay, Jacqueline R; Krok-Schoen, Jessica L; Appelhans, Bradley M; Cooper, Lisa A

2016-08-01

In the United States, racial/ethnic minority, rural, and low-income populations continue to experience suboptimal access to and quality of health care despite decades of recognition of health disparities and policy mandates to eliminate them. Many health care interventions that were designed to achieve health equity fall short because of gaps in knowledge and translation. We discuss these gaps and highlight innovative interventions that help address them, focusing on cardiovascular disease and cancer. We also provide recommendations for advancing the field of health equity and informing the implementation and evaluation of policies that target health disparities through improved access to care and quality of care. Project HOPE—The People-to-People Health Foundation, Inc.

76 FR 11755 - Sunshine Act Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-03

... Planning: Update and discussion of projects. Consideration of new statutory report topic for FY 2011... Admissions. English Only in the Workplace Report. Healthcare Disparities Report. V. State Advisory Committee...

Reducing disparities for African Americans with diabetes: progress made by the REACH 2010 Charleston and Georgetown Diabetes Coalition.

PubMed Central

Jenkins, Carolyn; McNary, Sara; Carlson, Barbara A.; King, Marilyn Givens; Hossler, Charles L.; Magwood, Gayenell; Zheng, Deyi; Hendrix, Katharine; Beck, Lorna Shelton; Linnen, Florene; Thomas, Virginia; Powell, Sheila; Ma'at, Imani

2004-01-01

Racial and Ethnic Approaches to Community Health (REACH 2010) is a U.S.Centers for Disease Control and Prevention demonstration program that responds to the U.S. Department of Health and Human Services' goal to eliminate racial and ethnic disparities in health status by the year 2010. As part of REACH 2010, community projects were funded to develop, implement, and evaluate community action plans to improve health care and outcomes for racial and ethnic populations. This article describes the program and details the progress of the REACH 2010: Charleston and Georgetown Diabetes Coalition in reducing disparities in care. Approaches employed by the Coalition included community development, empowerment, and education related to diabetes; health systems change associated with access, care, and education; and coalition advocacy. Racial disparities were identified for 12,000 African Americans with diabetes in this urban/rural South Carolina community. After 24 months, significant differences that initially ranged from 11% to 28% in African Americans (when compared with whites/others) were not observed on 270 chart audits for A1C, lipid and kidney testing, eye examinations, and blood pressure control. Future efforts will focus on maintaining progress, eliminating other disparities, and identifying the contributions of each intervention in eliminating racial disparities. PMID:15158111

The Centrality of Relationships for Pedagogy: The "Whanaungatanga" Thesis

ERIC Educational Resources Information Center

Bishop, Russell; Ladwig, James; Berryman, Mere

2014-01-01

"Te Kotahitanga" is a research and professional development project that seeks to reduce educational disparities between indigenous Maori students and their non-Maori peers in New Zealand secondary schools. While evidence of the impact of the project on teachers' practice and the associated gains made by Maori students has been published…

NIH Health Disparities Strategic Plan, Fiscal Years 2004-2008

ERIC Educational Resources Information Center

National Human Genome Research Institute, 2008

2008-01-01

The National Human Genome Research Institute (NHGRI) led the National Institutes of Health's (NIH) contribution to the International Human Genome Project, whose primary goal was the sequencing of the human genome. This project was successfully completed in April 2003. Now, the NHGRI's mission is focused on a broad range of studies aimed at…

Network Access to Visual Information: A Study of Costs and Uses.

ERIC Educational Resources Information Center

Besser, Howard

This paper summarizes a subset of the findings of a study of digital image distribution that focused on the Museum Educational Site Licensing (MESL) project--the first large-scale multi-institutional project to explore digital delivery of art images and accompanying text/metadata from disparate sources. This Mellon Foundation-sponsored study…

Characterizing Community Health Workers on Research Teams: Results From the Centers for Population Health and Health Disparities

PubMed Central

Thompson, Beti; Krok-Schoen, Jessica L.; Weier, Rory C.; Martin, Molly; Bone, Lee; McCarthy, William J.; Noel, Sabrina E.; Garcia, Beverly; Calderón, Nancy E.; Paskett, Electra D.

2016-01-01

Objectives. To quantify the characteristics of community health workers (CHWs) involved in community intervention research and, in particular, to characterize their job titles, roles, and responsibilities; recruitment and compensation; and training and supervision. Methods. We developed and administered a structured questionnaire consisting of 25 closed- and open-ended questions to staff on National Institutes of Health–funded Centers for Population Health and Health Disparities projects between March and April 2014. We report frequency distributions for CHW roles, sought-after skills, education requirements, benefits and incentives offered, and supervision and training activities. Results. A total of 54 individuals worked as CHWs across the 18 research projects and held a diverse range of job titles. The CHWs commonly collaborated on research project implementation, provided education and support to study participants, and collected data. Training was offered across projects to bolster CHW capacity to assist in intervention and research activities. Conclusions. Our experience suggests national benefit in supporting greater efforts to recruit, retain, and support the work of CHWs in community-engagement research. PMID:26794157

Comparing projected impacts of cigarette floor price and excise tax policies on socioeconomic disparities in smoking

PubMed Central

Golden, Shelley D; Farrelly, Matthew C; Luke, Douglas A; Ribisl, Kurt M

2016-01-01

Background About half of all US states have cigarette minimum price laws (MPLs) that require a per cent mark-up on prices, but research suggests they may not be very effective in raising prices. An alternative type of MPL sets a floor price below which packs cannot be sold, and may be more promising. This new type of MPL policy has only been implemented in 1 city, therefore its benefits relative to excise taxes is difficult to assess. Methods We constructed a set of possible state floor price MPL options, and matched them to possible state excise tax hikes designed to produce similar average price increases. Using self-reported price and cigarette consumption data from 23 521 participants in the 2010–2011 Tobacco Use Supplement of the Current Population Survey, we projected changes in pack prices and cigarette consumption following implementation of each paired MPL and tax option, for lower and higher income groups. Results We project that state MPLs set at the average reported pack price would raise prices by $0.33 and reduce cigarette consumption by about 4%; a tax with a similar average price effect would reduce consumption by 2.3%. MPLs and taxes that raise average prices by more than $2.00 would reduce consumption by 15.9% and 13.5%, respectively. In all models, we project that MPLs will reduce income-based smoking disparities more than their comparable excise taxes. Conclusions Floor price cigarette MPLs set at or above what consumers currently report paying could reduce both tobacco use and socioeconomic disparities in smoking. PMID:27697949

Creating diversity in a baccalaureate nursing program: a case study.

PubMed

Barton, Amanda J; Swider, Susan M

2009-01-01

Minority groups in the United States experience disparity in the health care services they receive and in their health related outcomes. Minority healthcare providers are more likely to serve minority under-served populations, thus addressing this healthcare disparity in an effective culturally competent manner (Robert Wood Johnson 2005; Sullivan, 2004). The purpose of the project was to increase the number of racial and ethnic minority students who are successfully recruited and admitted to the nursing program at Hope College in Holland, Michigan. The project involved the identification of perceived barriers to increased minority participation in nursing at the college, review of the literature to identify evidence-based interventions, and implementation of selected interventions to overcome the identified barriers. Implementation and evaluation are still on-going but showing early success.

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.

Oregon's Coordinated Care Organizations Increased Timely Prenatal Care Initiation And Decreased Disparities.

PubMed

Muoto, Ifeoma; Luck, Jeff; Yoon, Jangho; Bernell, Stephanie; Snowden, Jonathan M

2016-09-01

Policies at the state and federal levels affect access to health services, including prenatal care. In 2012 the State of Oregon implemented a major reform of its Medicaid program. The new model, called a coordinated care organization (CCO), is designed to improve the coordination of care for Medicaid beneficiaries. This reform effort provides an ideal opportunity to evaluate the impact of broad financing and delivery reforms on prenatal care use. Using birth certificate data from Oregon and Washington State, we evaluated the effect of CCO implementation on the probability of early prenatal care initiation, prenatal care adequacy, and disparities in prenatal care use by type of insurance. Following CCO implementation, we found significant increases in early prenatal care initiation and a reduction in disparities across insurance types but no difference in overall prenatal care adequacy. Oregon's reforms could serve as a model for other Medicaid and commercial health plans seeking to improve prenatal care quality and reduce disparities. Project HOPE—The People-to-People Health Foundation, Inc.

Eliminating health disparities in the African American population: the interface of culture, gender, and power.

PubMed

Airhihenbuwa, Collins O; Liburd, Leandris

2006-08-01

Since the release of former Secretary Margaret Heckler's Secretary's Task Force Report on Black and Minority Health more than two decades ago, excess death from chronic diseases and other conditions between African Americans and Whites have increased. The conclusion of that report emphasized excess death and thus clinical care, paying little attention to the sociocultural environment and its effects on risk of disease. The authors of this article contend that eliminating health disparities between the African American and White populations in the United States requires a focus on improving the social environment of African Americans. They examine the interface of culture, gender, and power and how those are central to analysis of the root causes of health disparities. The REACH 2010 project of the Centers for Disease Control offers examples on how a coalition of community and research organizations can infuse community interventions with informed considerations of culture, gender, and power to eliminate health disparities.

The Impact of African Dance on Psychosocial and Educational Outcomes

ERIC Educational Resources Information Center

Talpade, Medha

2018-01-01

This project intended to create conditions that are conducive to helping minority students achieve success in learning, in school, and in life. The project is a response to the rising rate of health and career disparities among minority U.S. adolescents. Based on the theoretical framework of the cultural historical activity theory, this attempt…

The role of early-life educational quality and literacy in explaining racial disparities in cognition in late life.

PubMed

Sisco, Shannon; Gross, Alden L; Shih, Regina A; Sachs, Bonnie C; Glymour, M Maria; Bangen, Katherine J; Benitez, Andreana; Skinner, Jeannine; Schneider, Brooke C; Manly, Jennifer J

2015-07-01

Racial disparities in late-life cognition persist even after accounting for educational attainment. We examined whether early-life educational quality and literacy in later life help explain these disparities. We used longitudinal data from the Washington Heights-Inwood Columbia Aging Project (WHICAP). Educational quality (percent white students; urban/rural school; combined grades in classroom) was operationalized using canonical correlation analysis. Late-life literacy (reading comprehension and ability, writing) was operationalized using confirmatory factor analysis. We examined whether these factors attenuated race-related differences in late-life cognition. The sample consisted of 1,679 U.S.-born, non-Hispanic, community-living adults aged 65-102 (71% black, 29% white; 70% women). Accounting for educational quality and literacy reduced disparities by 29% for general cognitive functioning, 26% for memory, and 32% for executive functioning but did not predict differences in rate of cognitive change. Early-life educational quality and literacy in late life explain a substantial portion of race-related disparities in late-life cognitive function. © 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.

Healthy People 2010 and Asian Americans/Pacific Islanders: defining a baseline of information.

PubMed

Ghosh, Chandak

2003-12-01

Healthy People 2010: Understanding and Improving Health lists 6 areas of disparity in minority health services: infant mortality, cancer, cardiovascular disease, HIV/AIDS, diabetes, and immunizations. This study compiles existing Asian American and Pacific Islander (AAPI) health data to establish a baseline. For federally-sponsored research (1986-2000), the Computer Retrieval of Information on Specific Projects (CRISP) database was analyzed. AAPI initiatives were divided by subpopulation and disparity area. MEDLINE articles (1966-2000) were similarly scrutinized. Few federal health-related grants (0.2%) and MEDLINE articles (0.01%) mention AAPIs. For the 6 disparity areas, significant AAPI data gaps remain. To reach the Healthy People 2010 goals and have useful data, researchers and grant makers must focus on obtaining baseline data for disaggregated AAPI subgroups.

Addressing Health Care Disparities and Increasing Workforce Diversity: The Next Step for the Dental, Medical, and Public Health Professions

PubMed Central

Mitchell, Dennis A.; Lassiter, Shana L.

2006-01-01

The racial/ethnic composition of our nation is projected to change drastically in the coming decades. It is therefore important that the health professions improve their efforts to provide culturally competent care to all patients. We reviewed literature concerning health care disparities and workforce diversity issues—particularly within the oral health field—and provide a synthesis of recommendations to address these issues. This review is highly relevant to both the medical and public health professions, because they are facing similar disparity and workforce issues. In addition, the recent establishment of relationships between oral health and certain systemic health conditions will elevate oral health promotion and disease prevention as important points of intervention in the quest to improve our nation’s public health. PMID:17077406

Comparing projected impacts of cigarette floor price and excise tax policies on socioeconomic disparities in smoking.

PubMed

Golden, Shelley D; Farrelly, Matthew C; Luke, Douglas A; Ribisl, Kurt M

2016-10-01

About half of all US states have cigarette minimum price laws (MPLs) that require a per cent mark-up on prices, but research suggests they may not be very effective in raising prices. An alternative type of MPL sets a floor price below which packs cannot be sold, and may be more promising. This new type of MPL policy has only been implemented in 1 city, therefore its benefits relative to excise taxes is difficult to assess. We constructed a set of possible state floor price MPL options, and matched them to possible state excise tax hikes designed to produce similar average price increases. Using self-reported price and cigarette consumption data from 23 521 participants in the 2010-2011 Tobacco Use Supplement of the Current Population Survey, we projected changes in pack prices and cigarette consumption following implementation of each paired MPL and tax option, for lower and higher income groups. We project that state MPLs set at the average reported pack price would raise prices by $0.33 and reduce cigarette consumption by about 4%; a tax with a similar average price effect would reduce consumption by 2.3%. MPLs and taxes that raise average prices by more than $2.00 would reduce consumption by 15.9% and 13.5%, respectively. In all models, we project that MPLs will reduce income-based smoking disparities more than their comparable excise taxes. Floor price cigarette MPLs set at or above what consumers currently report paying could reduce both tobacco use and socioeconomic disparities in smoking. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Sexual HIV Risk Among Male Parolees and Their Female Partners: The Relate Project

PubMed Central

Comfort, Megan; Reznick, Olga Grinstead; Dilworth, Samantha E.; Binson, Diane; Darbes, Lynae A.; Neilands, Torsten B.

2014-01-01

Background The massively disproportionate impact of America’s prison boom on communities of color has raised questions about how incarceration may affect health disparities, including disparities in HIV. Primary partners are an important source of influence on sexual health. In this paper, we investigate sexual HIV risk among male-female couples following a man’s release from prison. Methods We draw upon data from the Relate Project, a novel cross-sectional survey of recently released men and their female partners in Oakland and San Francisco, California (N=344). Inferential analyses use the actor-partner model to explore actor and partner effects on sexual HIV risk outcomes. Results Dyadic analyses of sexual HIV risk among male parolees and their female partners paint a complex portrait of couples affected by incarceration and of partners’ influences on each other. Findings indicate that demographic factors such as education level and employment status, individual psycho-social factors such as perception of risk, and relationship factors such as commitment and power affect sexual HIV risk outcomes. Conclusion The Relate Project provides a novel dataset for the dyadic analysis of sexual risk among male parolees and their female partners, and results highlight the importance of focusing on the couple as a unit when assessing HIV risk and protective behaviors. Results also indicate potentially fruitful avenues for population-specific interventions that may help to reduce sexual health disparities among couples affected by incarceration. PMID:25642396

Project ECHO: A Telementoring Program for Cervical Cancer Prevention and Treatment in Low-Resource Settings.

PubMed

Lopez, Melissa S; Baker, Ellen S; Milbourne, Andrea M; Gowen, Rose M; Rodriguez, Ana M; Lorenzoni, Cesaltina; Mwaba, Catherine; Msadabwe, Susan Citonje; Tavares, José Humberto; Fontes-Cintra, Georgia; Zucca-Matthes, Gustavo; Callegaro-Filho, Donato; Ramos-Martin, Danielle; Thiago de Carvalho, Icaro; Coelho, Robson; Marques, Renato Moretti; Chulam, Thiago; Pontremoli-Salcedo, Mila; Nozar, Fernanda; Fiol, Veronica; Maza, Mauricio; Arora, Sanjeev; Hawk, Ernest T; Schmeler, Kathleen M

2017-10-01

Cervical cancer incidence and mortality rates are significantly higher in low- and middle-income countries compared with the United States and other developed countries. This disparity is caused by decreased access to screening, often coupled with low numbers of trained providers offering cancer prevention and treatment services. However, similar disparities are also found in underserved areas of the United States, such as the Texas-Mexico border, where cervical cancer mortality rates are 30% higher than in the rest of Texas. To address these issues, we have adopted the Project ECHO (Extension for Community Healthcare Outcomes) program, a low-cost telementoring model previously proven to be successful in increasing local capacity, improving patient management skills, and ultimately improving patient outcomes in rural and underserved areas. We use the Project ECHO model to educate local providers in the management of cervical dysplasia in a low-resource region of Texas and have adapted it to inform strategies for the management of advanced cervical and breast cancer in Latin America and sub-Saharan Africa. This innovative approach, using ECHO, is part of a larger strategy to enhance clinical skills and develop collaborative projects between academic centers and partners in low-resource regions.

Reducing Disparities by way of a Cancer Disparities Research Training Program.

PubMed

Caplan, Lee S; Akintobi, Tabia H; Gordon, Tandeca King; Zellner, Tiffany; Smith, Selina A; Blumenthal, Daniel S

2016-01-01

For minority populations, there is a continuing disparity in the burden of death and illness from cancer. Research to address this disparity should be conducted by investigators who can best understand and address the needs of culturally diverse communities. However, minorities are under-represented in health-related research. The goal of this project was to develop and evaluate an approach to motivating and preparing master's degree students for careers dedicated to cancer disparities research. A Cancer Disparities Research Training Program (CDRTP) was initiated in 2010. The program consists of coursework, practicum experiences, and research opportunities. Assessment of the curriculum is based on monitoring achievement of evaluation indicators and included a mixed-method approach with included both quantitative and qualitative approach. In its first three years, the program graduated 20 trainees, all of whom were minorities (18 African Americans and two Asians). When asked about career goals, two-thirds of the trainees indicated interest in pursuing careers in research in cancer prevention and control. The trainees expressed high satisfaction with the courses, instructor, materials, and curriculum. Although trainees had suggestions about course details, evaluations overall were positive. Across focus groups, three recurrent themes emerged regarding activities to enhance the trainee experience: having a wider variety of topics, more guest speakers, and field trips. The CDRTP was intended to recruit students - primarily African Americans - into research on prevention and control of cancer disparities. Although final evaluation of the program's overall outcome will not be available for several years, this preliminary evaluation indicates early program success.

Program Spotlight: Partnership for the Advancement of Cancer Research Project

Cancer.gov

The NMSU and FHCRC PACHE partnership is making progress in recruiting and training Native Americans and Hispanics for careers in cancer research and drawing attention to the importance of cancer health disparities research.

Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health.

PubMed

Thornton, Rachel L J; Glover, Crystal M; Cené, Crystal W; Glik, Deborah C; Henderson, Jeffrey A; Williams, David R

2016-08-01

The opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. We review scientific evidence from promising interventions focused on the social determinants of health and discuss how such interventions can improve population health and reduce health disparities. We found sufficient evidence of successful outcomes to support disparity-reducing policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. Cost-effectiveness evaluations show that these interventions lead to long-term societal savings, but the interventions require more routine attention to cost considerations. We discuss challenges to implementation, including the need for long-term financing to scale up effective interventions for implementation at the local, state, and national levels. Project HOPE—The People-to-People Health Foundation, Inc.

The Urban Context: A Place to Eliminate Health Disparities and Build Organizational Capacity

PubMed Central

GILBERT, KEON L.; QUINN, SANDRA CROUSE; FORD, ANGELA F.; THOMAS, STEPHEN B.

2011-01-01

This study seeks to examine the process of building the capacity to address health disparities in several urban African American neighborhoods. An inter-organizational network consisting of a research university, community members, community organizations, media partners, and foundations was formed to develop a community-based intervention designed to provide health promotion and disease prevention strategies for type 2 diabetes and hypertension. In-depth qualitative interviews (n = 18) with foundation executives and project directors, civic organization leadership, community leaders, county epidemiologist, and university partners were conducted. Our study contextualizes a process to build a public health partnership using cultural, community, organizational, and societal factors necessary to address health disparities. Results showed 5 important factors to build organizational capacity: leadership, institutional commitment, trust, credibility, and inter-organizational networks. These factors reflected other important organizational and community capacity indicators such as: community context, organizational policies, practices and structures, and the establishment of new commitments and partnerships important to comprehensively address urban health disparities. Understanding these factors to address African American health disparities will provide lessons learned for health educators, researchers, practitioners, foundations, and communities interested in building and sustaining capacity efforts through the design, implementation, and maintenance of a community-based health promotion intervention. PMID:21271434

Parent-directed approaches to enrich the early language environments of children living in poverty.

PubMed

Leffel, Kristin; Suskind, Dana

2013-11-01

Children's early language environments are critical for their cognitive development, school readiness, and ultimate educational attainment. Significant disparities exist in these environments, with profound and lasting impacts upon children's ultimate outcomes. Children from backgrounds of low socioeconomic status experience diminished language inputs and enter school at a disadvantage, with disparities persisting throughout their educational careers. Parents are positioned as powerful agents of change in their children's lives, however, and evidence indicates that parent-directed intervention is effective in improving child outcomes. This article explores the efficacy of parent-directed interventions and their potential applicability to the wider educational achievement gap seen in typically developing populations of low socioeconomic status and then describes efforts to develop such interventions with the Thirty Million Words Project and Project ASPIRE (Achieving Superior Parental Involvement for Rehabilitative Excellence) curricula. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Road-traffic injuries: confronting disparities to address a global-health problem.

PubMed

Ameratunga, Shanthi; Hijar, Martha; Norton, Robyn

2006-05-06

Evidence suggests that the present and projected global burden of road-traffic injuries is disproportionately borne by countries that can least afford to meet the health service, economic, and societal challenges posed. Although the evidence base on which these estimates are made remains somewhat precarious in view of the limited data systems in most low-income and middle-income countries (as per the classification on the World Bank website), these projections highlight the essential need to address road-traffic injuries as a public-health priority. Most well-evaluated effective interventions do not directly focus on efforts to protect vulnerable road users, such as motorcyclists and pedestrians. Yet, these groups comprise the majority of road-traffic victims in low-income and middle-income countries, and consequently, the majority of the road-traffic victims globally. Appropriately responding to these disparities in available evidence and prevention efforts is necessary if we are to comprehensively address this global-health dilemma.

Using a Faculty-in-Residence Model to Enhance Curriculae in Computer Science and Social Work with Writing and Critical Thinking

ERIC Educational Resources Information Center

Sarnoff, Susan; Welch, Lonnie; Gradin, Sherrie; Sandell, Karin

2004-01-01

This paper will discuss the results of a project that enabled three faculty members from disparate disciplines: Social Work, Interpersonal Communication and Software Engineering, to enhance writing and critical thinking in their courses. The paper will address the Faculty-in-Residence project model, the activities taken on as a result of it, the…

Stereo using monocular cues within the tensor voting framework.

PubMed

Mordohai, Philippos; Medioni, Gérard

2006-06-01

We address the fundamental problem of matching in two static images. The remaining challenges are related to occlusion and lack of texture. Our approach addresses these difficulties within a perceptual organization framework, considering both binocular and monocular cues. Initially, matching candidates for all pixels are generated by a combination of matching techniques. The matching candidates are then embedded in disparity space, where perceptual organization takes place in 3D neighborhoods and, thus, does not suffer from problems associated with scanline or image neighborhoods. The assumption is that correct matches produce salient, coherent surfaces, while wrong ones do not. Matching candidates that are consistent with the surfaces are kept and grouped into smooth layers. Thus, we achieve surface segmentation based on geometric and not photometric properties. Surface overextensions, which are due to occlusion, can be corrected by removing matches whose projections are not consistent in color with their neighbors of the same surface in both images. Finally, the projections of the refined surfaces on both images are used to obtain disparity hypotheses for unmatched pixels. The final disparities are selected after a second tensor voting stage, during which information is propagated from more reliable pixels to less reliable ones. We present results on widely used benchmark stereo pairs.

Disparities in sexually transmitted disease rates across the "eight Americas".

PubMed

Chesson, Harrell W; Kent, Charlotte K; Owusu-Edusei, Kwame; Leichliter, Jami S; Aral, Sevgi O

2012-06-01

The purpose of this study was to examine rates of 3 bacterial sexually transmitted diseases (STDs; syphilis, gonorrhea, and chlamydia) in 8 subpopulations (known as the "eight Americas") defined by race and a small number of county-level sociodemographic and geographical characteristics. The eight Americas are (1) Asians and Pacific Islanders in specific counties; (2) Northland low-income rural white; (3) Middle America; (4) Low-income whites in Appalachia and Mississippi Valley; (5) Western Native American; (6) Black middle America; (7) Southern low-income rural black; and (8) High-risk urban black. A list of the counties comprising each of the eight Americas was obtained from the corresponding author of the original eight Americas project, which examined disparities in mortality rates across the eight Americas. Using county-level STD surveillance data, we calculated syphilis, gonorrhea, and chlamydia rates (new cases per 100,000) for each of the eight Americas. Reported STD rates varied substantially across the eight Americas. STD rates were generally lowest in Americas 1 and 2 and highest in Americas 6, 7, and 8. Although disparities in STDs across the eight Americas are generally similar to the well-established disparities in STDs across race/ethnicity, the grouping of counties into the eight Americas does offer additional insight into disparities in STDs in the United States. The high STD rates we found for black Middle America are consistent with the assertion that sexual networks and social factors are important drivers of racial disparities in STDs.

Racial Differences in Estimated GFR Decline, ESRD, and Mortality in an Integrated Health System

PubMed Central

Derose, Stephen F.; Rutkowski, Mark P.; Crooks, Peter W.; Shi, Jiaxiao M.; Wang, Jean; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P.; Levin, Nathan W.; Jacobsen, Steven J.

2013-01-01

Background Current evidence does not clearly identify the contribution of kidney function decline and mortality to racial disparities in ESRD incidence. We used observed eGFR to project the time of onset of kidney failure and examined mortality to better understand these racial disparities. Study Design Retrospective cohort. Setting & Participants Adult members of Kaiser Permanente Southern California from 2003–2009 with >2 serum creatinine tests and >180 days between tests: 526,498 whites, 350,919 Hispanics, 136,923 blacks, and 105,476 Asians. Predictor Race/ethnicity. Outcomes ESRD (dialysis, transplantation); mortality. Measurements eGFR decline was modeled using linear regression. Kidney failure was projected based on predicted eGFR <15 mL/min/1.73m2 at specified times. Racial differences in projected kidney failure and mortality among those with projected kidney failure were estimated with adjustment for age, sex, and entry eGFR. Results Blacks had more extreme rates of eGFR decline (1st percentile, −23.6 mL/min/1.73m2 per year), followed by Hispanics (−20.9 mL/min/1.73m2 per year), whites (−20.1 mL/min/1.73m2 per year), and Asians (−17.6 mL/min/1.73m2 per year; P<0.001). There were 25,065 white, 11,368 Hispanic, 6,785 black, and 3,176 Asians with projected kidney failure during the study period. The ORs for projected kidney failure vs. whites during CKD stages 3 and 4 were 1.54 (95% CI, 1.46–1.62) in blacks, 1.49 (95% CI, 1.42–1.56) in Hispanics, and 1.41 (95% CI, 1.32–1.51) in Asians. Among those with projected kidney failure, the HRs of death vs. whites during CKD stages 3 and 4 were 0.82 (95% CI, 0.77–0.88) in blacks, 0.67 (95% CI, 0.63–0.72) in Hispanics, and 0.58 (95% CI, 0.52–0.65) in Asians. Limitations Results may not generalize to the uninsured or subgroups within a race. Projected kidney failure was based on linear trends from clinically obtained eGFR. Conclusions We found more extreme rates of eGFR decline in blacks. Projected kidney failure during CKD stages 3 and 4 was high in blacks, Hispanics, and Asians relative to whites. Mortality among those with projected kidney failure was highest in whites. Differences in eGFR decline and mortality contributed to racial disparities in ESRD incidence. PMID:23499049

The Role of Socioeconomic Status and Health Care Access in Breast Cancer Screening Compliance Among Hispanics.

PubMed

Jadav, Smruti; Rajan, Suja S; Abughosh, Susan; Sansgiry, Sujit S

2015-01-01

Considerable disparities in breast cancer screening exist between Hispanic and non-Hispanic white (NHW) women. Identifying and quantifying the factors contributing to these racial-ethnic disparities can help shape interventions and policies aimed at reducing these disparities. This study, for the first time, identified and quantified individual-level sociodemographic and health-related factors that contribute to racial-ethnic disparities in breast cancer screening using the nonlinear Blinder-Oaxaca decomposition method. Analysis of the retrospective pooled cross-sectional Medical Expenditure Panel Survey data from 2000 to 2010 was conducted. Women aged 40 years and older were included in the study. Logistic regressions were used to estimate racial-ethnic disparities in breast cancer screening. Nonlinear Blinder-Oaxaca decomposition method was used to identify and quantify the contribution of each individual-level factor toward racial-ethnic disparities. Based on the unadjusted analyses, Hispanic women had lower odds of receiving mammogram screening (MS) (odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.69-0.80) and breast cancer screening (OR: 0.75; 95% CI: 0.70-0.81) as compared with NHW women. However, the relationship reversed in adjusted analyses, such that Hispanic women had higher odds of receiving MS (OR: 1.27; 95% CI: 1.16-1.40) and breast cancer screening (OR: 1.28; 95% CI: 1.17-1.40) as compared with NHW women. The Blinder-Oaxaca decomposition estimated that improving insurance status, access to care, education, and income will considerably increase screening rates among Hispanic women. The study projects that improving health care access and health education will considerably increase breast cancer screening compliance among Hispanic women. Policies like the Affordable Care Act, and patient navigation and health education interventions, might considerably reduce screening disparities in the Hispanic population.

ASSESSING THE EFFECTIVENESS OF RESTORATION TECHNOLOGIES

EPA Science Inventory

Numerous stream and riparian restoration projects are being undertaken across the nation at a variety of scales and for disparate reasons. Unfortunately, there are very few studies associated with these restoration efforts which provide a consistent and practical methodology to e...

Institutional Alliances to Reduce Cancer Disparities in Chicago

PubMed Central

Simon, Melissa A.; Malin, Emily L.; Hitsman, Brian L.; Ciecierski, Christina C.; Victorson, David E.; Banas, Jennifer R.; Stuart, Moira; Luedke, Tracy; Cella, David

2017-01-01

A partnership formed between Northeastern Illinois University (NEIU) and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University sought to address well-documented cancer health disparities in Chicago by developing a collaborative research, training, and educational infrastructure between a minority-serving institution and a National Cancer Institute designated comprehensive cancer center. With a critical examination of partnership documentation and outputs, we describe the partnership’s community-engaged approaches, challenges, and lessons learned. Northeastern Illinois University and the Lurie Cancer Center engaged in a yearlong partnership-building phase, identified interdisciplinary research teams, formed a governance structure, and identified collective aims. Partnership outcomes included funded inter-institutional research projects, new curriculum, and an annual research trainee program. Significant challenges faced included uncertain fiscal climate, widespread turnover, and dissimilar institutional demands. Lessons learned from this minority serving institution and comprehensive cancer center partnership may be useful for bridging distinct academic communities in the pursuit of ameliorating health disparities. PMID:27763461

Understanding Cross-Sectional Racial, Ethnic, and Gender Disparities in Antiretroviral Use and Viral Suppression Among HIV Patients in the United States

PubMed Central

Beer, Linda; Mattson, Christine L.; Bradley, Heather; Skarbinski, Jacek

2016-01-01

Abstract To examine racial/ethnic and gender disparities in antiretroviral (ART) use and viral suppression among HIV-infected persons in care and identify factors that might account for observed disparities. The Medical Monitoring Project (MMP) is a complex sample survey of HIV-infected adults receiving medical care in the United States. We used weighted interview and medical record data collected 06/2009 to 05/2012 to estimate the prevalence of ART use and viral suppression among gender-stratified racial/ethnic groups. We used χ2 tests to identify significant differences in outcomes between white men versus other groups, and logistic regression models to identify the most parsimonious set of factors that could account for each observed difference. We found no significant disparity in ART use between white and Hispanic men, and no disparities between white men and white and Hispanic women after adjustment for disease stage, age, and poverty. Disparities in ART use between white men and black persons persisted after adjusting for other factors, but the observed differences were relatively small. Differences in ART use and adherence, demographic characteristics, and social determinants of health such as poverty, education, and insurance accounted for the observed disparities in viral suppression between white men and all groups except black men. In our model, accounting for these factors reduced the prevalence difference in viral suppression between white and black men by almost half. We found that factors associated with disparities differed among men and women of the same race/ethnicity, lending support to the assertion that gender affects access to care and health status among HIV-infected patients. In addition to supporting efforts to increase ART use and adherence among persons living with HIV, our analysis provides evidence for the importance of social determinants of health in understanding racial/ethnic and gender differences in ART use and viral suppression. PMID:27043679

Working to Eliminate Cancer Health Disparities from Tobacco: A Review of the National Cancer Institute’s Community Networks Program

PubMed Central

Fagan, Pebbles; Cooper, Leslie; Canto, Maria; Carroll, William; Foster-Bey, John; Hébert, James R.; Lopez-Class, Maria; Ma, Grace X.; Nez Henderson, Patricia; Pérez-Stable, Eliseo J.; Santos, LorrieAnn; Smith, Justin H.; Tan, Yin; Tsoh, Janice; Chu, Kenneth

2015-01-01

Introduction: In 2005, the National Cancer Institute funded the Community Networks Program (CNP), which aimed to reduce cancer health disparities in minority racial/ethnic and underserved groups through community-based participatory research, education, and training. The purpose of this study was to describe the CNP model and their tobacco-related work in community-based research, education, and training using a tobacco disparities research framework. Methods: We conducted a comprehensive review of the CNP tobacco-related activities including publications, published abstracts, research activities, trainee pilot studies, policy-related activities, educational outreach, and reports produced from 2005–2009. Two authors categorized the tobacco-related activities and publications within the framework. Results: Although there was no mandate to address tobacco, the CNPs produced 103 tobacco-related peer-reviewed publications, which reflects the largest proportion (12%) of all CNP cancer-related publications. Selected publications and research activities were most numerous under the framework areas “Psychosocial Research,” “Surveillance,” “Epidemiology,” and “Treatment of Nicotine Addiction.” Thirteen CNPs participated in tobacco control policymaking in mainstream efforts that affected their local community and populations, and 24 CNPs conducted 1147 tobacco-related educational outreach activities. CNP activities that aimed to build research and infrastructure capacity included nine tobacco-related pilot projects representing 16% of all CNP cancer-related pilot projects, and 17 publications acknowledging leveraged partnerships with other organizations, a strategy encouraged by the CNP. Conclusions: The CNP is a promising academic-community model for working to eliminate tobacco-related health disparities. Future efforts may address scientific gaps, consider collaboration across groups, assess the extent of operationalizing community-based participatory research, and improve common tracking measures. PMID:26180215

New York City Transit Authority automated transit infrastructure maintenance demonstration.

DOT National Transportation Integrated Search

2009-04-01

The objective of this pilot project was to demonstrate that the safety and reliability of the New York City : Transit transportation system can be improved by automating the correlation and analysis of disparate : track related data. Through the use ...

THE ROLE OF AFFECT IN THE WTP/WTA DISPARITY. (R827931)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

34 CFR 222.161 - How is State aid treated under section 8009 of the Act?

Code of Federal Regulations, 2010 CFR

2010-07-01

... of projected data, that the State's program will meet the disparity standard described in § 222.162... the fiscal year for which the determination is made, the State will pay to each affected LEA the...

Sharing a Disparate Landscape

ERIC Educational Resources Information Center

Ali-Khan, Carolyne

2010-01-01

Working across boundaries of power, identity, and political geography is fraught with difficulties and contradictions. In Tali Tal and Iris Alkaher's, "Collaborative environmental projects in a multicultural society: Working from within separate or mutual landscapes?" the authors describe their efforts to do this in the highly charged…

Using evidence-based policy, systems, and environmental strategies to increase access to healthy food and opportunities for physical activity among Asian Americans, Native Hawaiians, and Pacific Islanders.

PubMed

Patel, Shilpa; Kwon, Simona; Arista, Pedro; Tepporn, Ed; Chung, Marianne; Ko Chin, Kathy; Rideout, Catlin; Islam, Nadia; Trinh-Shevrin, Chau

2015-07-01

Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities.

Social justice in pandemic preparedness.

PubMed

DeBruin, Debra; Liaschenko, Joan; Marshall, Mary Faith

2012-04-01

Pandemic influenza planning in the United States violates the demands of social justice in 2 fundamental respects: it embraces the neutrality of procedural justice at the expense of more substantive concern with health disparities, thus perpetuating a predictable and preventable social injustice, and it fails to move beyond lament to practical planning for alleviating barriers to accessing care. A pragmatic social justice approach, addressing both health disparities and access barriers, should inform pandemic preparedness. Achieving social justice goals in pandemic response is challenging, but strategies are available to overcome the obstacles. The public engagement process of one state's pandemic ethics project influenced the development of these strategies.

Social Justice in Pandemic Preparedness

PubMed Central

Liaschenko, Joan; Marshall, Mary Faith

2012-01-01

Pandemic influenza planning in the United States violates the demands of social justice in 2 fundamental respects: it embraces the neutrality of procedural justice at the expense of more substantive concern with health disparities, thus perpetuating a predictable and preventable social injustice, and it fails to move beyond lament to practical planning for alleviating barriers to accessing care. A pragmatic social justice approach, addressing both health disparities and access barriers, should inform pandemic preparedness. Achieving social justice goals in pandemic response is challenging, but strategies are available to overcome the obstacles. The public engagement process of one state's pandemic ethics project influenced the development of these strategies. PMID:22397337

Using Evidence-Based Policy, Systems, and Environmental Strategies to Increase Access to Healthy Food and Opportunities for Physical Activity Among Asian Americans, Native Hawaiians, and Pacific Islanders

PubMed Central

Kwon, Simona; Arista, Pedro; Tepporn, Ed; Chung, Marianne; Ko Chin, Kathy; Rideout, Catlin; Islam, Nadia; Trinh-Shevrin, Chau

2015-01-01

Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities. PMID:25905839

Empowerment to reduce health disparities.

PubMed

Wallerstein, Nina

2002-01-01

This article articulates the theoretical construct of empowerment and its importance for health-enhancing strategies to reduce health disparities. Powerlessness is explored as a risk factor in the context of social determinants, such as poverty, discrimination, workplace hazards, and income inequities. Empowerment is presented and compared with social capital and community capacity as strategies to strengthen social protective factors. A case study of a youth empowerment and policy project in New Mexico illustrates the usefulness of empowerment strategies in both targeting social determinants, such as public policies which are detrimental to youth, and improving community capacities of youth to be advocates for social change. Challenges for future practice and research are articulated.

Using Community-Based Participatory Research and Human-Centered Design to Address Violence-Related Health Disparities Among Latino/a Youth.

PubMed

Kia-Keating, Maryam; Santacrose, Diana E; Liu, Sabrina R; Adams, Jessica

High rates of exposure to violence and other adversities among Latino/a youth contribute to health disparities. The current article addresses the ways in which community-based participatory research (CBPR) and human-centered design (HCD) can help engage communities in dialogue and action. We present a project exemplifying how community forums, with researchers, practitioners, and key stakeholders, including youths and parents, integrated HCD strategies with a CBPR approach. Given the potential for power inequities among these groups, CBPR + HCD acted as a catalyst for reciprocal dialogue and generated potential opportunity areas for health promotion and change. Future directions are described.

An ASIC-chip for stereoscopic depth analysis in video-real-time based on visual cortical cell behavior.

PubMed

Wörgötter, F

1999-10-01

In a stereoscopic system both eyes or cameras have a slightly different view. As a consequence small variations between the projected images exist ("disparities") which are spatially evaluated in order to retrieve depth information. We will show that two related algorithmic versions can be designed which recover disparity. Both approaches are based on the comparison of filter outputs from filtering the left and the right image. The difference of the phase components between left and right filter responses encodes the disparity. One approach uses regular Gabor filters and computes the spatial phase differences in a conventional way as described already in 1988 by Sanger. Novel to this approach, however, is that we formulate it in a way which is fully compatible with neural operations in the visual cortex. The second approach uses the apparently paradoxical similarity between the analysis of visual disparities and the determination of the azimuth of a sound source. Animals determine the direction of the sound from the temporal delay between the left and right ear signals. Similarly, in our second approach we transpose the spatially defined problem of disparity analysis into the temporal domain and utilize two resonators implemented in the form of causal (electronic) filters to determine the disparity as local temporal phase differences between the left and right filter responses. This approach permits video real-time analysis of stereo image sequences (see movies at http://www.neurop.ruhr-uni-bochum.de/Real- Time-Stereo) and a FPGA-based PC-board has been developed which performs stereo-analysis at full PAL resolution in video real-time. An ASIC chip will be available in March 2000.

Racial disparities in health-related quality of life in a cohort of very-low-birth-weight 2- and 3-year-olds with and without asthma.

PubMed

McManus, Beth Marie; Robert, Stephanie; Albanese, Aggie; Sadek-Badawi, Mona; Palta, Mari

2012-07-01

Children born very low birth weight (VLBW) are at risk for low health-related quality of life (HRQoL), compared with normal-birth-weight peers, and racial disparities may compound the difference. Asthma is the most pervasive health problem among VLBW children and is also more common among black than white children, partly due to unfavourable environmental exposures. This study explores racial disparities in HRQoL among VLBW children and examines whether potential disparities can be explained by asthma and neighbourhood disadvantage. The study population was the Newborn Lung Project, a cohort of infants (n=660) born VLBW in 2003-2004 in Wisconsin, USA, who were followed up at age 2-3. Multilevel linear regression models were used to examine the contributions of asthma, neighbourhood disadvantage, and other child and family socio-demographic covariates, to racial disparities in HRQoL at age 2-3. A child's HRQoL was measured using the Paediatric Quality of Life Inventory 4.0. VLBW, black, non-Hispanic children, on average, score nearly 4 points lower (p<0.01) on HRQoL than do white, non-Hispanic children. Including asthma reduces the difference between black and white children from -3.6 (p<0.01) to 0.08 (p>0.05). The authors found no evidence that the relationship between asthma and HRQoL differs by race. The interaction between neighbourhood disadvantage and asthma is statistically significant, with further examination suggesting that racial disparities are particularly pronounced in the most advantaged neighbourhoods. The authors found that the black disadvantage in HRQoL among 2-3-year-old VLBW children likely stems from a high prevalence of asthma. Neighbourhood attributes did not further explain the disparity, as the racial difference was particularly pronounced in advantaged neighbourhoods.

Confronting Climate Change

ERIC Educational Resources Information Center

Roach, Ronald

2009-01-01

The Joint Center for Political and Economic Studies, an African-American think tank based in Washington, D.C., convenes a commission to focus on the disparate impact of climate change on minority communities and help involve historically Black institutions in clean energy projects. Launched formally in July 2008, the Commission to Engage…

THE CONTRIBUTION OF MATERNAL AGE TO RACIAL DISPARITIES IN BIRTHWEIGHT: A MULTI-LEVEL PERSPECTIVE. (R827027)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Gender Disparity in Third World Technological, Social, and Economic Development.

ERIC Educational Resources Information Center

Akubue, Anthony I.

2001-01-01

Socialization of women in developing countries inhibits their education and employment in scientific and technical fields. This mindset perpetuates poverty and limits economic and social development. Solutions include elimination of gender bias, information dissemination, replication of successful development projects, use of role models, and…

RESEARCH PROJECT A: MAPPING DISPARITIES IN BIRTH OUTCOMES

EPA Science Inventory

A BRIEF OVERVIEW OF RESEARCH TO ASSESS THE EFFECTIVENESS OF STREAM RESTORATION AT USEPA

EPA Science Inventory

Numerous stream and riparian restoration projects are being undertaken across the nation at a variety of scales and for disparate reasons. Unfortunately, there are very few studies associated with these restoration efforts which provide a consistent and practical methodology to e...

Racial and Ethnic Diversity in Grounded Theory Research

PubMed Central

Draucker, Claire Burke; Al-Khattab, Halima; Hines, Dana D.; Mazurczyk, Jill; Russell, Anne C.; Stephenson, Pam Shockey; Draucker, Shannon

2014-01-01

National initiatives in the United States call for health research that addresses racial/ethnic disparities. Although grounded theory (GT) research has the potential to contribute much to the understanding of the health experiences of people of color, the extent to which it has contributed to health disparities research is unclear. In this article we describe a project in which we reviewed 44 GT studies published in Qualitative Health Research within the last five years. Using a framework proposed by Green, Creswell, Shope, and Clark (2007), we categorized the studies at one of four levels based on the status and significance afforded racial/ethnic diversity. Our results indicate that racial/ethnic diversity played a primary role in five studies, a complementary role in one study, a peripheral role in five studies, and an absent role in 33 studies. We suggest that GT research could contribute more to health disparities research if techniques were developed to better analyze the influence of race/ethnicity on health-related phenomena. PMID:26401523

The HCUP SID Imputation Project: Improving Statistical Inferences for Health Disparities Research by Imputing Missing Race Data.

PubMed

Ma, Yan; Zhang, Wei; Lyman, Stephen; Huang, Yihe

2018-06-01

To identify the most appropriate imputation method for missing data in the HCUP State Inpatient Databases (SID) and assess the impact of different missing data methods on racial disparities research. HCUP SID. A novel simulation study compared four imputation methods (random draw, hot deck, joint multiple imputation [MI], conditional MI) for missing values for multiple variables, including race, gender, admission source, median household income, and total charges. The simulation was built on real data from the SID to retain their hierarchical data structures and missing data patterns. Additional predictive information from the U.S. Census and American Hospital Association (AHA) database was incorporated into the imputation. Conditional MI prediction was equivalent or superior to the best performing alternatives for all missing data structures and substantially outperformed each of the alternatives in various scenarios. Conditional MI substantially improved statistical inferences for racial health disparities research with the SID. © Health Research and Educational Trust.

Racial and Ethnic Diversity in Grounded Theory Research.

PubMed

Draucker, Claire Burke; Al-Khattab, Halima; Hines, Dana D; Mazurczyk, Jill; Russell, Anne C; Stephenson, Pam Shockey; Draucker, Shannon

2014-04-28

National initiatives in the United States call for health research that addresses racial/ethnic disparities. Although grounded theory (GT) research has the potential to contribute much to the understanding of the health experiences of people of color, the extent to which it has contributed to health disparities research is unclear. In this article we describe a project in which we reviewed 44 GT studies published in Qualitative Health Research within the last five years. Using a framework proposed by Green, Creswell, Shope, and Clark (2007), we categorized the studies at one of four levels based on the status and significance afforded racial/ethnic diversity. Our results indicate that racial/ethnic diversity played a primary role in five studies, a complementary role in one study, a peripheral role in five studies, and an absent role in 33 studies. We suggest that GT research could contribute more to health disparities research if techniques were developed to better analyze the influence of race/ethnicity on health-related phenomena.

Reducing Low Birth Weight among African Americans in the Midwest: A Look at How Faith-Based Organizations Are Poised to Inform and Influence Health Communication on the Developmental Origins of Health and Disease (DOHaD).

PubMed

Lumpkins, Crystal Y; Saint Onge, Jarron M

2017-02-04

Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups ( n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health.

Reducing Low Birth Weight among African Americans in the Midwest: A Look at How Faith-Based Organizations Are Poised to Inform and Influence Health Communication on the Developmental Origins of Health and Disease (DOHaD)

PubMed Central

Lumpkins, Crystal Y.; Saint Onge, Jarron M.

2017-01-01

Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups (n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health. PMID:28165368

Developing effective interuniversity partnerships and community-based research to address health disparities.

PubMed

Carey, Timothy S; Howard, Daniel L; Goldmon, Moses; Roberson, James T; Godley, Paul A; Ammerman, Alice

2005-11-01

Health disparities are an enormous challenge to American society. Addressing these disparities is a priority for U.S. society and especially for institutions of higher learning, with their threefold mission of education, service, and research. Collaboration across multiple intellectual disciplines will be critical as universities address health disparities. In addition, universities must collaborate with communities, with state partners, and with each other. Development of these collaborations must be sensitive to the history and unique characteristics of each academic institution and population. The authors describe the challenges of all three types of collaboration, but primarily focus on collaboration between research-intensive universities and historically black colleges and universities. The authors describe a four-year collaboration between Shaw University and the University of North Carolina at Chapel Hill (UNC-CH). These universities strategically developed multiple research initiatives to address health disparities, building on modest early success and personal relationships. These activities included participation by Shaw faculty in faculty development activities, multiple collaborative pilot studies, and joint participation in securing grants from the Agency for Health care Research and Quality of the federal Department of Health and Human Services and the National Institutes of Health, including a P-60 Project EXPORT center grant. These multiple activities were sometimes led by UNC-CH, sometimes by Shaw University. Open discussion of problems as they arose, realistic expectations, and mutual recognition of the strengths of each institution and its faculty have been critical in achieving successful collaboration to date.

Developing Effective Interuniversity Partnerships and Community-Based Research to Address Health Disparities

PubMed Central

Carey, Timothy S.; Howard, Daniel L.; Goldmon, Moses; Roberson, James T.; Godley, Paul A.; Ammerman, Alice

2009-01-01

Health disparities are an enormous challenge to American society. Addressing these disparities is a priority for U.S. society and especially for institutions of higher learning, with their threefold mission of education, service, and research. Collaboration across multiple intellectual disciplines will be critical as universities address health disparities. In addition, universities must collaborate with communities, with state partners, and with each other. Development of these collaborations must be sensitive to the history and unique characteristics of each academic institution and population. The authors describe the challenges of all three types of collaboration, but primarily focus on collaboration between research-intensive universities and historically black colleges and universities. The authors describe a four-year collaboration between Shaw University and the University of North Carolina at Chapel Hill (UNC-CH). These universities strategically developed multiple research initiatives to address health disparities, building on modest early success and personal relationships. These activities included participation by Shaw faculty in faculty development activities, multiple collaborative pilot studies, and joint participation in securing grants from the Agency for Health care Research and Quality of the federal Department of Health and Human Services and the National Institutes of Health, including a P-60 Project EXPORT center grant. These multiple activities were sometimes led by UNC-CH, sometimes by Shaw University. Open discussion of problems as they arose, realistic expectations, and mutual recognition of the strengths of each institution and its faculty have been critical in achieving successful collaboration to date. PMID:16249303

Transatlantic Roots of Prostate Cancer Disparities in Black Men: The CaPTC Program

Cancer.gov

Dr. Odedina is Professor in the Colleges of Pharmacy and Medicine at the University of Florida. She is also the PI and Program Director for the NCI-funded (P20 award) Florida Minority Cancer Research & Training (MiCaRT) Center as well as the PI and Founder of the NCI-EGRP supported Prostate Cancer Transatlantic Consortium (CaPTC). She leads the Research Core of the Florida Health Equity Research Institute, a Florida Board of Governors-approved institute. Dr. Odedina’s research program, primarily funded by NIH and Department of Defense, focuses on the predictors of health disparities and cost-effective, community-based behavioral interventions to improve the health of minority populations, especially Black men. She has directed over 30 research projects, including genetic-environmental determinants of prostate cancer disparity studies. Her NCI EGRP-supported consortium, CaPTC, facilitates and supports recruitment and retention of minorities in biomedical research and biobanking for Black men’s research globally. Her contribution to Health Equity in Florida dates back to 1997 and has resulted in multiple accomplishments and recognitions. As far back as 2009, her leadership in health disparities was recognized by the American Society of Health-Systems Pharmacy and the Association of Black Health-System Pharmacists with the Inaugural (1st) Leadership Award for Health Disparities. Due to her extensive experiences in prostate cancer disparity research, she was selected by the US Congressionally Directed Medical Research Programs to give the inaugural Dr. Barbara Terry-Koroma Health Disparity Legacy Lecture in 2013. Her efforts in training underrepresented minorities for over two decades was recognized through the INSIGHT Into Diversity 2016 Inspiring Women in STEM Award. Her most recent awards include the Living Legend Award for innovations with health/economic impact from the Africa Clinical Trial Summit in 2017 and the 2017 Williams Award for Innovation in Cancer care in Africa from the African Organization for Research & Training in Cancer (AORTIC). Her outstanding contributions have also been recognized at University of Florida with her selection as UF Term Professor twice (2015-2017; 2018-2020). Dr. Odedina is personally and professionally committed to eliminating cancer disparities, especially in ethnically diverse Black populations.

Using Community Based Participatory Research and Human Centered Design to Address Violence-Related Health Disparities among Latino/a Youth

PubMed Central

Kia-Keating, Maryam; Capous, Diana; Liu, Sabrina; Adams, Jessica

2016-01-01

High rates of exposure to violence and other adversities among Latino/a youth contributes to health disparities. The current paper addresses the ways in which community-based participatory research (CBPR) and human centered design (HCD) can help to engage communities in dialogue and action. We present a project exemplifying how community forums, with researchers, practitioners, and key stakeholders, including youth and parents, integrated HCD strategies with a CBPR approach. Given the potential for power inequities between these groups, CBPR+HCD acted as a catalyst for reciprocal dialogue and generated potential opportunity areas for health promotion and change. Future directions are described. PMID:28207679

Suspended Education in California

ERIC Educational Resources Information Center

Losen, Daniel J.; Martinez, Tia; Gillespie, Jon

2012-01-01

The Civil Rights Project has been examining out-of-school suspensions since 1999 due to concerns about the frequency of suspensions, observed racial disparities in their systemic use and the possible negative impact, especially for children of color. Most important, a robust study of school discipline by the Council of State Governments tracked…

ENVIRONMENTAL MONITORING, MODELING AND ASSESSMENT (EMMA): AN INTEGRATED DESIGN FOR EVALUATING RISK AND DISPARITIES IN RESIDENTIAL COMMUNITIES

EPA Science Inventory

This will be a student-led research project that incorporates chemical monitoring, integrated modeling, social surveys of residents and qualitative data collection from two sites in the Ventura River, California watershed. The design will define and identify potential pollutan...

Asia's New High-Tech Competitors: An SRS Special Report.

ERIC Educational Resources Information Center

Rausch, Lawrence M.

This report profiles nine economies linked by Asian identity, yet marked by great economic and technological disparity, in order to project which economies will be full-fledged participants and competitors in tomorrow's high-tech product markets. Based on the various indicators of technological activity and competitiveness presented in this…

Lessons from the Indian Satellite Experiment.

ERIC Educational Resources Information Center

Mody, Bella

1978-01-01

Pilot project SITE was undertaken to help shape a national TV system for India. Programing was to provide nonformal education in agriculture and health; formal education for primary school children and teachers; and by promoting Indian culture, to create a sense of political unity among the nation's disparate linguistic groups. (JEG)

Psychosocial and Cultural Barriers to Prostate Cancer Screening: Racial Comparisons

DTIC Science & Technology

2009-03-01

37 REPORTABLE OUTCOMES ............................................................................................... 38 KEY RESEARCH...difference in outcome for prostate cancer, then a fatalistic attitude can develop and discourage screening behavior. Belief in one’s ability to...cancer screening among African American men and reduce racial disparities in prostate cancer outcomes . Specifically, the proposed project examines

Promoting Equalization and Local Control in Financing Colorado's Schools.

ERIC Educational Resources Information Center

Mathers, Judith K.; King, Richard A.

1997-01-01

Per-pupil property valuation extremes among Colorado school districts are as varied as the landscape. A foundation plan levels funding disparities for school operations, but financing of major capital outlay projects still depends on local property taxation. Funds are needed to finance classroom technologies and Internet connections. (MLH)

The neighborhood context of racial and ethnic disparities in arrest.

PubMed

Kirk, David S

2008-02-01

This study assesses the role of social context in explaining racial and ethnic disparities in arrest, with afocus on how distinct neighborhood contexts in which different racial and ethnic groups reside explain variations in criminal outcomes. To do so, I utilize a multilevel, longitudinal research design, combining individual-level data with contextual data from the Project on Human Development in Chicago Neighborhoods (PHDCN). Findings reveal that black youths face multiple layers of disadvantage relative to other racial and ethnic groups, and these layers work to create differences in arrest. At the family level, results show that disadvantages in the form of unstable family structures explain much of the disparities in arrest across race and ethnicity. At the neighborhood level, black youths tend to reside in areas with both significantly higher levels of concentrated poverty than other youths as well as lower levels of collective efficacy than white youths. Variations in neighborhood tolerance of deviance across groups explain little of the arrest disparities, yet tolerance of deviance does influence the frequency with which a crime ultimately ends in an arrest. Even after accounting for relevant demographic, family, and neighborhood-level predictors, substantial residual arrest differences remain between black youths and youths of other racial and ethnic groups.

The Osseus platform: a prototype for advanced web-based distributed simulation

NASA Astrophysics Data System (ADS)

Franceschini, Derrick; Riecken, Mark

2016-05-01

Recent technological advances in web-based distributed computing and database technology have made possible a deeper and more transparent integration of some modeling and simulation applications. Despite these advances towards true integration of capabilities, disparate systems, architectures, and protocols will remain in the inventory for some time to come. These disparities present interoperability challenges for distributed modeling and simulation whether the application is training, experimentation, or analysis. Traditional approaches call for building gateways to bridge between disparate protocols and retaining interoperability specialists. Challenges in reconciling data models also persist. These challenges and their traditional mitigation approaches directly contribute to higher costs, schedule delays, and frustration for the end users. Osseus is a prototype software platform originally funded as a research project by the Defense Modeling & Simulation Coordination Office (DMSCO) to examine interoperability alternatives using modern, web-based technology and taking inspiration from the commercial sector. Osseus provides tools and services for nonexpert users to connect simulations, targeting the time and skillset needed to successfully connect disparate systems. The Osseus platform presents a web services interface to allow simulation applications to exchange data using modern techniques efficiently over Local or Wide Area Networks. Further, it provides Service Oriented Architecture capabilities such that finer granularity components such as individual models can contribute to simulation with minimal effort.

The Neighborhood Context of Racial and Ethnic Disparities in Arrest

PubMed Central

KIRK, DAVID S.

2008-01-01

This study assesses the role of social context in explaining racial and ethnic disparities in arrest, with a focus on how distinct neighborhood contexts in which different racial and ethnic groups reside explain variations in criminal outcomes. To do so, I utilize a multilevel, longitudinal research design, combining individual-level data with contextual data from the Project on Human Development in Chicago Neighborhoods (PHDCN). Findings reveal that black youths face multiple layers of disadvantage relative to other racial and ethnic groups, and these layers work to create differences in arrest. At the family level, results show that disadvantages in the form of unstable family structures explain much of the disparities in arrest across race and ethnicity. At the neighborhood level, black youths tend to reside in areas with both significantly higher levels of concentrated poverty than other youths as well as lower levels of collective efficacy than white youths. Variations in neighborhood tolerance of deviance across groups explain little of the arrest disparities, yet tolerance of deviance does influence the frequency with which a crime ultimately ends in an arrest. Even after accounting for relevant demographic, family, and neighborhood-level predictors, substantial residual arrest differences remain between black youths and youths of other racial and ethnic groups. PMID:18390291

The Social Determinants of Health Core: Taking a Place-Based Approach.

PubMed

Scribner, Richard A; Simonsen, Neal R; Leonardi, Claudia

2017-01-01

There is growing recognition that health disparities research needs to incorporate social determinants in the local environment into explanatory models. In the transdisciplinary setting of the Mid-South Transdisciplinary Collaborative Center (TCC), the Social Determinants of Health (SDH) Core developed an approach to incorporating SDH across a variety of studies. This place-based approach, which is geographically based, transdisciplinary, and inherently multilevel, is discussed. From 2014 through 2016, the SDH Core consulted on a variety of Mid-South TCC research studies with the goal of incorporating social determinants into their research designs. The approach used geospatial methods (e.g., geocoding) to link individual data files with measures of the physical and social environment in the SDH Core database. Once linked, the method permitted various types of analysis (e.g., multilevel analysis) to determine if racial disparities could be explained in terms of social determinants in the local environment. The SDH Core consulted on five Mid-South TCC research projects. In resulting analyses for all the studies, a significant portion of the variance in one or more outcomes was partially explained by a social determinant from the SDH Core database. The SDH Core approach to addressing health disparities by linking neighborhood social and physical environment measures to an individual-level data file proved to be a successful approach across Mid-South TCC research projects. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Integrating information from disparate sources: the Walter Reed National Surgical Quality Improvement Program Data Transfer Project.

PubMed

Nelson, Victoria; Nelson, Victoria Ruth; Li, Fiona; Green, Susan; Tamura, Tomoyoshi; Liu, Jun-Min; Class, Margaret

2008-11-06

The Walter Reed National Surgical Quality Improvement Program Data Transfer web module integrates with medical and surgical information systems, and leverages outside standards, such as the National Library of Medicine's RxNorm, to process surgical and risk assessment data. Key components of the project included a needs assessment with nurse reviewers and a data analysis for federated (standards were locally controlled) data sources. The resulting interface streamlines nurse reviewer workflow by integrating related tasks and data.

A Case Study of Framing and Project Design Impacts on Participant Identity, Views, and Trust of Science in a Phenology Public Participatory Program

NASA Astrophysics Data System (ADS)

Sorensen, A. E.; Jordan, R.

2016-12-01

Recent literature has suggested public participatory research models (e.g., citizen science and similar) as a key opportunity for scientists to meaningfully engage and communicate with the public to increase support for science and encourage pro-science behavior. In this, there has been an inherent assumption that all models of engagement yield similar participant results with few examples of assessment of these programs. While many of these programs do share superficial similarities in their modes of participant engagement and participant motivation, there is a large disparity in participant engagement between them. This disparity suggests that framing of these projects (e.g., citizen science versus crowd sourcing) also plays an important role in decisions about participation. Additionally, participant outcomes, in terms of beliefs about scientific practices and scientific trust, between these two project types has not yet been investigated. To investigate the impact of framing, participants were recruited to a web-based tree phenology public participatory research program where half the participants were engaged in a citizen science framed program and the other were engaged in a crowdsourced framed project. The participants in each frame were engaged in the same task (reporting leaf budding/leaf drop), but the way the projects were framed differed. Post-participation we see that there are indeed statistically significant differences in participant outcomes between individuals who participated as a citizen scientist versus as a crowdsourcer. Particularly we see differences in terms of their views of science, identity, and trust of science. This work is the first to the authors' knowledge that aims to evaluate if projects can be treated synonymously when discussing potential for public engagement and broader trust and literacy outcomes.

Working to Eliminate Cancer Health Disparities from Tobacco: A Review of the National Cancer Institute's Community Networks Program.

PubMed

Tong, Elisa K; Fagan, Pebbles; Cooper, Leslie; Canto, Maria; Carroll, William; Foster-Bey, John; Hébert, James R; Lopez-Class, Maria; Ma, Grace X; Nez Henderson, Patricia; Pérez-Stable, Eliseo J; Santos, LorrieAnn; Smith, Justin H; Tan, Yin; Tsoh, Janice; Chu, Kenneth

2015-08-01

In 2005, the National Cancer Institute funded the Community Networks Program (CNP), which aimed to reduce cancer health disparities in minority racial/ethnic and underserved groups through community-based participatory research, education, and training. The purpose of this study was to describe the CNP model and their tobacco-related work in community-based research, education, and training using a tobacco disparities research framework. We conducted a comprehensive review of the CNP tobacco-related activities including publications, published abstracts, research activities, trainee pilot studies, policy-related activities, educational outreach, and reports produced from 2005-2009. Two authors categorized the tobacco-related activities and publications within the framework. Although there was no mandate to address tobacco, the CNPs produced 103 tobacco-related peer-reviewed publications, which reflects the largest proportion (12%) of all CNP cancer-related publications. Selected publications and research activities were most numerous under the framework areas "Psychosocial Research," "Surveillance," "Epidemiology," and "Treatment of Nicotine Addiction." Thirteen CNPs participated in tobacco control policymaking in mainstream efforts that affected their local community and populations, and 24 CNPs conducted 1147 tobacco-related educational outreach activities. CNP activities that aimed to build research and infrastructure capacity included nine tobacco-related pilot projects representing 16% of all CNP cancer-related pilot projects, and 17 publications acknowledging leveraged partnerships with other organizations, a strategy encouraged by the CNP. The CNP is a promising academic-community model for working to eliminate tobacco-related health disparities. Future efforts may address scientific gaps, consider collaboration across groups, assess the extent of operationalizing community-based participatory research, and improve common tracking measures. © The Author 2015. 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.

Compensation in academic medicine: progress toward gender equity.

PubMed

Wright, Anne L; Ryan, Kenneth; St Germain, Patricia; Schwindt, Leslie; Sager, Rebecca; Reed, Kathryn L

2007-10-01

Studies have documented substantial salary disparities between women and men in academic medicine. While various strategies have been proposed to increase equity, to our knowledge, no interventions have been evaluated. This paper aims to assess the effect of an identity-conscious intervention on salary equity. This study shows comparison of adjusted annual salaries for women and men before and after an intervention. We studied full time faculty employed in FY00 (n = 393) and FY04 (n = 462) in one College of Medicine. Compensation data were obtained from personnel databases for women and men, and adjusted for predictors. After verification of data accuracy by departments, comparable individuals within the same department who had different salaries were identified. The Dean discussed apparent disparities with department heads, and salaries were adjusted. Total adjusted annualized salaries were compared for men and women for the year the project began and the year after the intervention using multivariate models. Female faculty members' salaries were also considered as a percent of male faculty members' salaries. Twenty-one potential salary disparities were identified. Eight women received equity adjustments to their salaries, with the average increase being $17,323. Adjusted salaries for women as a percent of salary for men increased from 89.4% before the intervention to 93.5% after the intervention. Disparities in compensation were no longer significant in FY2004 in basic science departments, where women were paid 97.6% of what men were paid. This study shows that gender disparities in compensation can be reduced through careful documentation, identification of comparable individuals paid different salaries, and commitment from leadership to hold the appropriate person accountable.

Barred from better medicine? Reexamining regulatory barriers to the inclusion of prisoners in research.

PubMed

Huang, Elaine; Cauley, Jacqueline; Wagner, Jennifer K

2017-04-01

In 2015, President Obama announced plans for the Precision Medicine Initiative ® (PMI), an ambitious longitudinal project aimed at revolutionizing medicine. Integral to this Initiative is the recruitment of over one million Americans into a volunteer research cohort, the All of Us SM Research Program. The announcement has generated much excitement but absent is a discussion of how the All of Us Research Program-to be implemented within the context of social realities of mass incarcerations and racial disparities in criminal justice and healthcare-might excaberate health disparities. We examine how attainment of Initiative's stated goals of reflecting the diversity of the American population and including all who are interested in participating might be impeded by regulatory and administrative barriers to the involvement of participants who become incarcerated during longitudinal studies. Changes have been proposed to the federal policy for human subjects research protections, but current regulations and administrative policies-developed under a protectionist paradigm in response to scandalous research practices with confined populations-dramatically limit research involving prisoners. Our review provides rationale for the development of Initiative policies that anticipate recruitment and retention obstacles that might frustrate inclusivity and exacerbate health disparities. Furthermore, we question the effective ban on biomedical and behavioral research involving prisoners and advocate for regulatory reforms that restore participatory research rights of prisoners. Disparities in health and justice are intertwined, and without regulatory reforms to facilitate participatory research rights of prisoners and careful planning of viable and responsible recruitment, engagement, and retention strategies, Initiative could miss discovery opportunities, exacerbate health disparities, and increase levels of distrust in science.

Towards Networked Knowledge: The Learning Registry, an Infrastructure for Sharing Online Learning Resources

ERIC Educational Resources Information Center

Lee, Ashley; Hobson, Joe; Bienkowski, Marie; Midgley, Steve; Currier, Sarah; Campbell, Lorna M.; Novoselova, Tatiana

2012-01-01

In this article, the authors describe an open-source, open-data digital infrastructure for sharing information about open educational resources (OERs) across disparate systems and platforms. The Learning Registry, which began as a project funded by the U.S. Departments of Education and Defense, currently has an active international community…

75 FR 22595 - Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-29

..., funded through the Health Resources and Services Administration's (HRSA) Maternal and Child Health Bureau (MCHB), was developed in 1991 with the goal of reducing infant mortality disparities in high-risk... project within 15 communities that had infant mortality rates 1.5 to 2.5 times above the national average...

Integrative comparison of mRNA expression patterns in breast cancers from Caucasian and Asian Americans with implications for precision medicine

PubMed Central

Wang, Jianan; He, Max M; Li, Liren; Zhang, Jinfeng

2016-01-01

Asian Americans (AS) have significantly lower incidence and mortality rates of breast cancer (BRCA) than Caucasian Americans (CA). While this racial disparity has been documented the underlying pathogenetic factors explaining it are obscure. We addressed this issue by an integrative genomics approach to compare mRNA expression between AS and CA cases of BRCA. RNA-seq data from the Cancer Genome Atlas showed that mRNA expression revealed significant differences at gene and pathway levels. Increased susceptibility and severity in CA patients were likely the result of synergistic environmental and genetic risk factors, with arachidonic acid metabolism and PPAR signaling pathways implicated in linking environmental and genetic factors. An analysis that also added eQTL data from the Genotype-Tissue Expression Project and single nucleotide polymorphism (SNP) data from the 1000 Genomes Project identified several SNPs associated with differentially expressed genes. Overall, the associations we identified may enable a more focused study of genotypic differences that may help explain the disparity in BRCA incidence and mortality rates in CA and AS populations and inform precision medicine. PMID:28069798

Sex and Gender in the US Health Surveillance System: A Call to Action

PubMed Central

Landers, Stewart J.; Reisner, Sari L.; Sell, Randall L.

2014-01-01

Youth Risk Behavior Survey (YRBS) data have exposed significant sexual orientation disparities in health. Interest in examining the health of transgender youths, whose gender identities or expressions are not fully congruent with their assigned sex at birth, highlights limitations of the YRBS and the broader US health surveillance system. In 2009, we conducted the mixed-methods Massachusetts Gender Measures Project to develop and cognitively test measures for adolescent health surveillance surveys. A promising measure of transgender status emerged through this work. Further research is needed to produce accurate measures of assigned sex at birth and several dimensions of gender to further our understanding of determinants of gender disparities in health and enable strategic responses to address them. PMID:24825193

Sex and gender in the US health surveillance system: a call to action.

PubMed

Conron, Kerith J; Landers, Stewart J; Reisner, Sari L; Sell, Randall L

2014-06-01

Youth Risk Behavior Survey (YRBS) data have exposed significant sexual orientation disparities in health. Interest in examining the health of transgender youths, whose gender identities or expressions are not fully congruent with their assigned sex at birth, highlights limitations of the YRBS and the broader US health surveillance system. In 2009, we conducted the mixed-methods Massachusetts Gender Measures Project to develop and cognitively test measures for adolescent health surveillance surveys. A promising measure of transgender status emerged through this work. Further research is needed to produce accurate measures of assigned sex at birth and several dimensions of gender to further our understanding of determinants of gender disparities in health and enable strategic responses to address them.

Service Learning: A Vehicle for Building Health Equity and Eliminating Health Disparities

PubMed Central

Sabo, Samantha; de Zapien, Jill; Teufel-Shone, Nicolette; Rosales, Cecilia; Bergsma, Lynda

2015-01-01

Service learning (SL) is a form of community-centered experiential education that places emerging health professionals in community-generated service projects and provides structured opportunities for reflection on the broader social, economic, and political contexts of health. We describe the elements and impact of five distinct week-long intensive SL courses focused on the context of urban, rural, border, and indigenous health contexts. Students involved in these SL courses demonstrated a commitment to community-engaged scholarship and practice in both their student and professional lives. SL is directly in line with the core public health value of social justice and serves as a venue to strengthen community–campus partnerships in addressing health disparities through sustained collaboration and action in vulnerable communities. PMID:25706014

Employing the church as a marketer of cancer prevention: a look at a health promotion project aimed to reduce colorectal cancer among African Americans in the Midwest.

PubMed

Lumpkins, Crystal Y; Coffey, Candice R; Daley, Christine M; Greiner, K Allen

2013-01-01

Health promotion programs designed to address colorectal cancer disparities among African Americans are increasing. Unfortunately, this group still shoulders a disproportionate mortality burden in the United States; these numbers are also reflective of colorectal cancer (CRC) disparities in the Midwest. The purpose of this study was to extrapolate results from in-depth interviews and brief surveys on the effectiveness of the church as a social marketer of CRC-prevention messages. Results show that pastors believe the congregation has limited knowledge about CRC risk and prevention; they also believe the church can improve cancer-prevention communication among members and those affiliated with the church.

A qualitative assessment of personal and social responsibility for kidney disease: the Increasing Kidney Disease Awareness Network Transplant Project.

PubMed

Spigner, Clarence; Lyles, Courtney Rees; Galvin, Georgia; Sabin, Janice; Davis, Connie; Dick, Andre; Young, Bessie A

2011-01-01

Limited qualitative research has explored opinions of kidney disease health care providers regarding racial and ethnic disparities in access to and receipt of kidney transplantation. Key informant interviews were conducted among transplant nephrologists, nephrologists, transplant social workers, and transplant coordinators to determine barriers to transplantation among African Americans compared to whites with end-stage renal disease (ESRD). Thirty-eight interviews were audio recorded and transcribed to hardcopy for content analysis. Grounded theory was used to determine dominant themes within the interviews. Reliability and validity were ensured by several coinvestigators independently sorting verbatim responses used for generating themes and subsequent explanations. Several major categories arose from analysis of the transcripts. Under the category of personal and social responsibility for kidney transplantation, interviews revealed 4 major themes: negative personal behaviors, acquisition of and lack of self-treatment of comorbid conditions, lack of individual responsibility, and the need for more social responsibility. Many providers perceived patients as being largely responsible for the development of ESRD, while some providers expressed the idea that more social responsibility was needed to improve poor health status and disparities in kidney transplantation rates. Kidney disease health providers seemed torn between notions of patients' accountability and social responsibility for racial disparities in chronic kidney disease and ESRD. Further research is needed to clarify which aspects contribute most to disparities in access to transplantation.

NYC Epi Scholars program: promoting applied health disparities research in an urban public health department-a program model.

PubMed

Blake, Janice; Choden, Tsering; Hemans-Henry, Calaine; Koppaka, Ram; Greene, Carolyn

2011-01-01

Although health disparities research has already contributed to decreased mortality and morbidity in underserved communities, more work is needed. The NYC Epi Scholars program of the New York City Department of Health and Mental Hygiene (NYC DOHMH) aims to address gaps in critical public health needs and to train future public health leaders in epidemiology. The program is designed to increase racial/ethnic and socioeconomic diversity in the public health workforce, to provide fieldwork and practica opportunities, and to cultivate future leaders in epidemiology and public health. Since its inception in 2007, the NYC Epi Scholars program of the NYC DOHMH has sought talented epidemiology students interested in gaining practical experience in applied health disparities research. NYC Epi Scholars is open to graduate epidemiology students who have demonstrated achievement and leadership potential and gives them an opportunity to provide high-quality research assistance to projects that identify and address health disparities of public health significance. Many of the program's 32 alumni have made notable contributions to public health: publishing articles in peer-reviewed journals; making presentations at national and international conferences; and after graduating, pursuing careers at the DOHMH, Centers for Disease Control and Prevention, the Environmental Protection Agency, and the National Institutes of Health. Because of its noted success, the NYC Epi Scholars program may serve as a "best-practice" model for expansion in other urban health departments.

A trans-disciplinary approach to the evaluation of social determinants of health in a Hispanic population.

PubMed

Dulin, Michael F; Tapp, Hazel; Smith, Heather A; de Hernandez, Brisa Urquieta; Coffman, Maren J; Ludden, Tom; Sorensen, Janni; Furuseth, Owen J

2012-09-11

Individual and community health are adversely impacted by disparities in health outcomes among disadvantaged and vulnerable populations. Understanding the underlying causes for variations in health outcomes is an essential step towards developing effective interventions to ameliorate inequalities and subsequently improve overall community health. Working at the neighborhood scale, this study examines multiple social determinates that can cause health disparities including low neighborhood wealth, weak social networks, inadequate public infrastructure, the presence of hazardous materials in or near a neighborhood, and the lack of access to primary care services. The goal of this research is to develop innovative and replicable strategies to improve community health in disadvantaged communities such as newly arrived Hispanic immigrants. This project is taking place within a primary care practice-based research network (PBRN) using key principles of community-based participatory research (CBPR). Associations between social determinants and rates of hospitalizations, emergency department (ED) use, and ED use for primary care treatable or preventable conditions are being examined. Geospatial models are in development using both hospital and community level data to identify local areas where interventions to improve disparities would have the greatest impact. The developed associations between social determinants and health outcomes as well as the geospatial models will be validated using community surveys and qualitative methods. A rapidly growing and underserved Hispanic immigrant population will be the target of an intervention informed by the research process to impact utilization of primary care services and designed, deployed, and evaluated using the geospatial tools and qualitative research findings. The purpose of this intervention will be to reduce health disparities by improving access to, and utilization of, primary care and preventative services. The results of this study will demonstrate the importance of several novel approaches to ameliorating health disparities, including the use of CBPR, the effectiveness of community-based interventions to influence health outcomes by leveraging social networks, and the importance of primary care access in ameliorating health disparities.

College students as facilitators in reducing adolescent obesity disparity in Southern Appalachia: Team Up for Healthy Living

PubMed Central

Dalton, William T.; Dula, Taylor McKeehan; Southerland, Jodi; Wang, Liang; Littleton, Mary Ann; Mozen, Diana; Relyea, George; Schetzina, Karen; Lowe, Elizabeth F.; Stoots, James M.; Wu, Tiejian

2015-01-01

The proportion of obese adolescents in Southern Appalachia is among the highest in the nation. Through funding from the National Institute on Minority Health and Health Disparities – National Institutes of Health, the Team Up for Healthy Living project was a cluster-randomized trial targeting obesity prevention in adolescents through a cross-peer intervention. The specific aims of the project were to: 1) develop a peer-based health education program focusing on establishing positive peer norms towards healthy eating and physical activity (PA) among high school students, 2) test program efficacy, and 3) explore mechanisms underlying the program. The study was guided by the Theory of Planned Behavior, which presupposes that human behavior is primarily driven by attitude, subjective norms, perceived behavioral control, and social support. To deliver the intervention, undergraduate students from the disciplines of public health, nutrition, and kinesiology were hired as peer facilitators. Ten area high schools were invited to participate, were matched on demographics and then randomized to intervention or control. The primary outcomes of the study included body mass status, dietary behaviors, PA, and sedentary behaviors which were assessed at baseline and at three and twelve months post baseline. Intervention schools received Team Up for Healthy Living curriculum, which consists of eight 40-minute sessions. The curriculum focused on improving nutrition awareness, PA, leadership and communication. Control schools received their regularly scheduled Lifetime Wellness curriculum. The long-term goal of the study was to establish an effective academia–community partnership program to address adolescent obesity disparity in Southern Appalachia. PMID:25937506

Toughen up.

PubMed

Donaldson, D; Mayes, M

1999-10-01

Within six months, AHS needed to integrate three recently merged hospitals running on disparate hardware and software systems into one unified system. AHS partnered with DataStudy Inc., Parsippany, N.J., and formed a team to address the specific enterprise resource planning needs of this healthcare organization. The implementation team completed the project within the six-month time frame and incorporated functionality that went beyond the initial specifications for the project. "To maximize the return on the always substantial ERP investment, healthcare executives must be aware of the many pitfalls waiting to derail every well-intentioned implementation."

Making Politics Personal: Leadership Programs as a Tool for Developing Political Interest and Efficacy in Young Women

ERIC Educational Resources Information Center

Stock, Dayna M.

2012-01-01

Encouraging young women to pursue careers in electoral politics is seen as one strategy for ameliorating the gender disparity that has characterized American political institutions for decades. This multi-method project focuses on outcomes obtained by participants in four "NEW Leadership(TM)" Training Institutes that claim to…

Research for Change: Transforming Policy, Scholarship, and the Classroom through Engaged Research with Communities of Color

ERIC Educational Resources Information Center

Curry-Stevens, Ann

2011-01-01

The past year of a five-year campus-community research project marked the release of a substantive report that details broad and deep racial disparities stretching across institutional practices and outcomes, service access, and economic and social conditions. The report has catalyzed an abundance of advocacy opportunities, as the release has…

"Slow the spread" a national program to contain the gypsy moth

Treesearch

Alexei A. Sharov; Donna Leonard; Andrew M. Liebhold; E. Anderson Roberts; Willard Dickerson; Willard Dickerson

2002-01-01

Invasions by alien species can cause substantial damage to our forest resources. The gypsy moth (Lymantria dispar) represents one example of this problem, and we present here a new strategy for its management that concentrates on containment rather than suppression of outbreaks. The "Slow the Spread" project is a combined federal and state...

New Metaphors for Organizing Data Could Change the Nature of Computers.

ERIC Educational Resources Information Center

Young, Jeffrey R.

1997-01-01

Based on the idea that the current framework for organizing electronic data does not take advantage of the mind's ability to make connections among disparate pieces of information, several projects at universities around the country are taking new approaches to classification and storage of vast amounts of computerized data. The new systems take…

University-Community Partnerships: Bridging People and Cultures in an HIV/AIDS Health Intervention in an African American Community

ERIC Educational Resources Information Center

Thompson, Maxine Seaborn; Head, Rachel; Rikard, R. V.; McNeil, Carlotta; White, Caressa

2012-01-01

As universities become more involved in real-world problems that affect racial and ethnic communities, university members are identifying strategies to effectively work with culturally diverse community partners. The Communities and Health Disparities Project described in this article is an example of collaborative scholarship that engages the…

Simulation Methods for Optics and Electromagnetics in Complex Geometries and Extreme Nonlinear Regimes with Disparate Scales

DTIC Science & Technology

2014-09-30

software devel- oped with this project support. S1 Cork School 2013: I. UPPEcore Simulator design and usage, Simulation examples II. Nonlinear pulse...pulse propagation 08/28/13 — 08/02/13, University College Cork , Ireland S2 ACMS MURI School 2012: Computational Methods for Nonlinear PDEs describing

BENEFITS AND LIMITATIONS OF COMMON STUDY DESIGNS. REDUCING DISPARITIES IN ASTHMA CARE: PRIORITIES FOR RESEARCH. NATIONAL HEART, LUNG AND BLOOD INSTITUTE WORKSHOP, BETHESDA, MARYLAND, JANUARY 2001. (R827027)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Minority health perceptions in the Lower Mississippi Delta: a grounded theory study using PhotoVoice methodology

USDA-ARS?s Scientific Manuscript database

The Lower Mississippi Delta (LMD) region has a large minority population with concentrations of poverty and health disparities much higher than other parts of the country. The purpose of this project was to assess the health perceptions of minority women living in the LMD using a combination of Phot...

Compensation in Academic Medicine: Progress Toward Gender Equity

PubMed Central

Ryan, Kenneth; St. Germain, Patricia; Schwindt, Leslie; Sager, Rebecca; Reed, Kathryn L.

2007-01-01

Background Studies have documented substantial salary disparities between women and men in academic medicine. While various strategies have been proposed to increase equity, to our knowledge, no interventions have been evaluated. Objective This paper aims to assess the effect of an identity-conscious intervention on salary equity. Design This study shows comparison of adjusted annual salaries for women and men before and after an intervention. Participants/Setting We studied full time faculty employed in FY00 (n = 393) and FY04 (n = 462) in one College of Medicine. Intervention Compensation data were obtained from personnel databases for women and men, and adjusted for predictors. After verification of data accuracy by departments, comparable individuals within the same department who had different salaries were identified. The Dean discussed apparent disparities with department heads, and salaries were adjusted. Measurements Total adjusted annualized salaries were compared for men and women for the year the project began and the year after the intervention using multivariate models. Female faculty members’ salaries were also considered as a percent of male faculty members’ salaries. Results Twenty-one potential salary disparities were identified. Eight women received equity adjustments to their salaries, with the average increase being $17,323. Adjusted salaries for women as a percent of salary for men increased from 89.4% before the intervention to 93.5% after the intervention. Disparities in compensation were no longer significant in FY2004 in basic science departments, where women were paid 97.6% of what men were paid. Conclusions This study shows that gender disparities in compensation can be reduced through careful documentation, identification of comparable individuals paid different salaries, and commitment from leadership to hold the appropriate person accountable. PMID:17694417

Barred from better medicine? Reexamining regulatory barriers to the inclusion of prisoners in research

PubMed Central

Huang, Elaine; Cauley, Jacqueline

2017-01-01

Abstract In 2015, President Obama announced plans for the Precision Medicine Initiative® (PMI), an ambitious longitudinal project aimed at revolutionizing medicine. Integral to this Initiative is the recruitment of over one million Americans into a volunteer research cohort, the All of UsSM Research Program. The announcement has generated much excitement but absent is a discussion of how the All of Us Research Program—to be implemented within the context of social realities of mass incarcerations and racial disparities in criminal justice and healthcare—might excaberate health disparities. We examine how attainment of Initiative's stated goals of reflecting the diversity of the American population and including all who are interested in participating might be impeded by regulatory and administrative barriers to the involvement of participants who become incarcerated during longitudinal studies. Changes have been proposed to the federal policy for human subjects research protections, but current regulations and administrative policies—developed under a protectionist paradigm in response to scandalous research practices with confined populations—dramatically limit research involving prisoners. Our review provides rationale for the development of Initiative policies that anticipate recruitment and retention obstacles that might frustrate inclusivity and exacerbate health disparities. Furthermore, we question the effective ban on biomedical and behavioral research involving prisoners and advocate for regulatory reforms that restore participatory research rights of prisoners. Disparities in health and justice are intertwined, and without regulatory reforms to facilitate participatory research rights of prisoners and careful planning of viable and responsible recruitment, engagement, and retention strategies, Initiative could miss discovery opportunities, exacerbate health disparities, and increase levels of distrust in science. PMID:28852561

Introducing Students of Color to Health Sciences Research: An Evaluation of the Health Disparities Summer Internship Program.

PubMed

McLean, Nicole A; Fraser, Marilyn; Primus, Nicole A; Joseph, Michael A

2018-04-05

The goal of this analysis is to assess the effectiveness of a summer program designed to introduce high school students of color to health disparities research. A total of 73 students (69.9% Black, 68.5% female and 80.6% either junior/senior) participated in the 4-week Health Disparities Summer Internship Program (HDSIP) during the years 2012-2015. Students attended lectures covering topics such as health disparities, community-based participatory research (CBPR), immigrant health, and policy and advocacy. While working with community-based organizations, students gained hands-on experience related to issues discussed in class. Students completed research projects and provided suggestions for health policy change. Pre/post surveys were completed to evaluate the program. After participating in the HDSIP, students demonstrated heightened awareness of the social determinants of health, especially in regards to racial discrimination (p = .023); borderline statistically significant increases were shown for income (p = .082), community safety (p = .058), and healthcare access (p = .076). Most students (82.1%) planned to advocate for changes in their community; an increase from the initial 65.2% (p = .052). About nine out of ten students (89.6%) reported being satisfied with the summer program; the majority reported improvement in analytical skills, CBPR methods, and oral/communication skills. Increasing diversity in the health workforce has widely been proposed as a means of addressing health disparities. Introducing minority students to health professions can serve as a catalyst for lasting changes in health outcomes. The HDSIP has increased students' awareness of social determinants of health and has fostered their interest in improving the health of minority populations.

Engaging faith-based resources to initiate and support diabetes self-management among African Americans: a collaboration of informal and formal systems of care.

PubMed

Johnson, Patria; Thorman Hartig, Margaret; Frazier, Renee; Clayton, Mae; Oliver, Georgia; Nelson, Belinda W; Williams-Cleaves, Beverly J

2014-11-01

Diabetes for Life (DFL), a project of Memphis Healthy Churches (MHC) and Common Table Health Alliance (CTHA; formerly Healthy Memphis Common Table [HMCT]), is a self-management program aimed at reducing health disparities among African Americans with type 2 Diabetes Mellitus in Memphis and Shelby County, Tennessee. This program is one of five national projects that constitute The Alliance to Reduce Disparities in Diabetes, a 5-year grant-funded initiative of The Merck Foundation. Our purpose is to describe the faith-based strategies supporting DFL made possible by linking with an established informal health system, MHC, created by Baptist Memorial Health Care. The MHC network engaged volunteer Church Health Representatives as educators and recruiters for DFL. The components of the DFL project and the effect on chronic disease management for the participants will be described. The stages of DFL recruitment and implementation from an open-access to a closed model involving six primary care practices created a formal health system. The involvement of CTHA, a regional health collaborative, created the opportunity for DFL to expand the pool of health care providers and then recognize the core of providers most engaged with DFL patients. This collaboration between MHC and HMCT led to the organization of the formal health network. © 2014 Society for Public Health Education.

Communities of Color Creating Healthy Environments to Combat Childhood Obesity

PubMed Central

Subica, Andrew M.; Douglas, Jason A.; Villanueva, Sandra

2016-01-01

Ethnic and racial health disparities present an enduring challenge to community-based health promotion, which rarely targets their underlying population-level determinants (e.g., poverty, food insecurity, health care inequity). We present a novel 3-lens prescription for using community organizing to treat these determinants in communities of color based on the Robert Wood Johnson Foundation’s Communities Creating Healthy Environments initiative, the first national project to combat childhood obesity in communities of color using community organizing strategies. The lenses—Social Justice, Culture–Place, and Organizational Capacity–Organizing Approach—assist health professional–community partnerships in planning and evaluating community organizing–based health promotion programs. These programs activate community stakeholders to alter their community’s disease-causing, population-level determinants through grassroots policy advocacy, potentially reducing health disparities affecting communities of color. PMID:26562108

Characteristics of composite images in multiview imaging and integral photography.

PubMed

Lee, Beom-Ryeol; Hwang, Jae-Jeong; Son, Jung-Young

2012-07-20

The compositions of images projected to a viewer's eyes from the various viewing regions of the viewing zone formed in one-dimensional integral photography (IP) and multiview imaging (MV) are identified. These compositions indicate that they are made up of pieces from different view images. Comparisons of the composite images with images composited at various regions of imaging space formed by camera arrays for multiview image acquisition reveal that the composite images do not involve any scene folding in the central viewing zone for either MV or IP. However, in the IP case, compositions from neighboring viewing regions aligned in the horizontal direction have reversed disparities, but in the viewing regions between the central and side viewing zones, no reversed disparities are expected. However, MV does exhibit them.

Biomedical data integration - capturing similarities while preserving disparities.

PubMed

Bianchi, Stefano; Burla, Anna; Conti, Costanza; Farkash, Ariel; Kent, Carmel; Maman, Yonatan; Shabo, Amnon

2009-01-01

One of the challenges of healthcare data processing, analysis and warehousing is the integration of data gathered from disparate and diverse data sources. Promoting the adoption of worldwide accepted information standards along with common terminologies and the use of technologies derived from semantic web representation, is a suitable path to achieve that. To that end, the HL7 V3 Reference Information Model (RIM) [1] has been used as the underlying information model coupled with the Web Ontology Language (OWL) [2] as the semantic data integration technology. In this paper we depict a biomedical data integration process and demonstrate how it was used for integrating various data sources, containing clinical, environmental and genomic data, within Hypergenes, a European Commission funded project exploring the Essential Hypertension [3] disease model.

[Provision of integrity and reliability in hygienic examination of investment projects for human capital development].

PubMed

Tarkhov, P V; Matsenko, A M; Krugliak, A P; Derkach, Zh V

2012-01-01

To reach normal competitiveness in world division of labour, investment projects should stimulate development of human capital towards advance of modern technologies and organizational development of all types of labour. At present time there are only separate calculations of certain types of people's health damage and completely disparate matters of damage compensation exceptionally for chemical contamination effects. The purpose of the paper is development of algorithms to provide hygienic welfare of human capital in investment projects. For this purpose in investments assessment and hygienic examination it is necessary to apply complete and comprehensive (systematic) evaluation of all factors that influence human capital welfare and practical hygienic and research institutions should be focused on systematic elimination of possible dangers and risks of investment projects.

Project to expand diversity in the nursing workforce.

PubMed

Georges, Catherine

2012-05-01

The Bronx, one of the five boroughs of New York City, has a diverse population, but the largest ethnic group is Hispanic, or Latino. More than half (53 per cent) of the students at Lehman College of the City University of New York are from this group, reflecting the population demographic of the borough, but in 2006 Hispanic students comprised just 8 per cent of those enrolled in the department of nursing. To address this disparity, the department undertook a project to increase recruitment, retention and graduation of Hispanic nursing students. The project involved several activities in collaboration with a Bronx high school, Lehman College's baccalaureate nursing programme, and a partner hospital that serves thousands of people of Hispanic origin. This article describes the project and the lessons learnt.

The Social Geography of Childcare: Making up a Middle-Class Child

ERIC Educational Resources Information Center

Vincent, Carol; Ball, Stephen J.; Kemp, Sophie

2004-01-01

Childcare is a condensate of disparate social forces and social processes. It is gendered and classed. It is subject to an excess of policy and political discourse. It is increasingly a focus for commercial exploitation. This is a paper reporting on work in progress in an ESRC funded research project (R000239232) on the choice and provision of…

Playing Fair?: Minority Research Institutions Call for NIH to Address Funding Disparities

ERIC Educational Resources Information Center

Stuart, Reginald

2012-01-01

When Ph.D. science and health researchers are seeking financial support for their health science studies, more often than not they apply to the federal government's National Institutes of Health (NIH) for an RO1 research grant, which boosts a project's standing in the research community as well as the career of the applicant. Even before the NIH…

Alaska Native and Rural Youths' Views of Sexual Health: A Focus Group Project on Sexually Transmitted Diseases, HIV/AIDS, and Unplanned Pregnancy

ERIC Educational Resources Information Center

Leston, Jessica D.; Jessen, Cornelia M.; Simons, Brenna C.

2012-01-01

Background: The disparity in rates of sexually transmitted diseases (STDs), HIV/AIDS, and unplanned pregnancy between Alaska Native (AN) and non-AN populations, particularly among young adults and females, is significant and concerning. Focus groups were conducted to better understand the knowledge, attitudes, and beliefs of rural Alaska youth…

A History of the Huntsville Division U.S. Army Corps of Engineers 1988-1992 Update

DTIC Science & Technology

1996-01-01

37 Figure 20. An artist’s rendition of MAGLEV ...most advanced technology. Included in this group of disparate activities are MAGLEV , support to the U.S. Army Corps of Engineers Engineer Topographic...Emergency Management Agency Key Worker Blast Shelter Program. One of the highest profile projects Huntsville Divi- sion supported was the MAGLEV

Fruit and Vegetable Dietary Behavior in Response to a Low-Intensity Dietary Intervention: The Rural Physician Cancer Prevention Project

ERIC Educational Resources Information Center

Carcaise-Edinboro, Patricia; McClish, Donna; Kracen, Amanda C.; Bowen, Deborah; Fries, Elizabeth

2008-01-01

Context: Increased fruit and vegetable intake can reduce cancer risk. Information from this study contributes to research exploring health disparities in high-risk dietary behavior. Purpose: Changes in fruit and vegetable behavior were evaluated to assess the effects of a low-intensity, physician-endorsed dietary intervention in a rural…

Fachkräftesicherung im ländlichen Raum. Wirtschaft erleben - Menschen binden

NASA Astrophysics Data System (ADS)

Kräußlich, Bernhard; Schwanz, Susanne

2017-09-01

The demand for skilled labor is subject to regional disparities. In Baden-Wuerttemberg staffing shortages are intensified in rural areas. The economic development agency in the county of Sigmaringen has tried to solve the problems of out-migration by developing projects that make technology and business come alive for young people and many other target groups.

Scaling up Education Reform: Addressing the Politics of Disparity

ERIC Educational Resources Information Center

Bishop, Russell; O'Sullivan, Dominic; Berryman, Mere

2010-01-01

What is school reform? What makes it sustainable? Who needs to be involved? How is scaling up achieved? This book is about the need for educational reforms that have built into them, from the outset, those elements that will see them sustained in the original sites and spread to others. Using the Te Kotahitanga Project as a model the authors…

Making climate change projections relevant to water management: opportunities and challenges in the Colorado River basin (Invited)

NASA Astrophysics Data System (ADS)

Vano, J. A.

2013-12-01

By 2007, motivated by the ongoing drought and release of new climate model projections associated with the IPCC AR4 report, multiple independent studies had made estimates of future Colorado River streamflow. Each study had a unique approach, and unique estimate for the magnitude for mid-21st century streamflow change ranging from declines of only 6% to declines of as much as 45%. The differences among studies provided for interesting scientific debates, but to many practitioners this appeared to be just a tangle of conflicting predictions, leading to the question 'why is there such a wide range of projections of impacts of future climate change on Colorado River streamflow, and how should this uncertainty be interpreted?' In response, a group of scientists from academic and federal agencies, brought together through a NOAA cross-RISA project, set forth to identify the major sources of disparities and provide actionable science and guidance for water managers and decision makers. Through this project, four major sources of disparities among modeling studies were identified that arise from both methodological and model differences. These differences, in order of importance, are: (1) the Global Climate Models (GCMs) and emission scenarios used; (2) the ability of land surface hydrology and atmospheric models to simulate properly the high elevation runoff source areas; (3) the sensitivities of land surface hydrology models to precipitation and temperature changes; and (4) the methods used to statistically downscale GCM scenarios. Additionally, reconstructions of pre-instrumental streamflows provided further insights about the greatest risk to Colorado River streamflow of a multi-decadal drought, like those observed in paleo reconstructions, exacerbated by a steady reduction in flows due to climate change. Within this talk I will provide an overview of these findings and insights into the opportunities and challenges encountered in the process of striving to make climate change projections more useful to water managers and decision makers.

A Persistent Disparity: Smoking in Rural Sexual and Gender Minorities.

PubMed

Bennett, Keisa; McElroy, Jane A; Johnson, Andrew O; Munk, Niki; Everett, Kevin D

2015-03-01

Sexual and gender minorities (SGM) smoke cigarettes at higher rates than the general population. Historically, research in SGM health issues was conducted in urban populations and recent population-based studies seldom have sufficient SGM participants to distinguish urban from rural. Given that rural populations also tend to have a smoking disparity, and that many SGM live in rural areas, it is vitally important to understand the intersection of rural residence, SGM identity, and smoking. This study analyzes the patterns of smoking in urban and rural SGM in a large sample. We conducted an analysis of 4280 adult participants in the Out, Proud, and Healthy project with complete data on SGM status, smoking status, and zip code. Surveys were conducted at 6 Missouri Pride Festivals and online in 2012. Analysis involved descriptive and bivariate methods, and multivariable logistic regression. We used GIS mapping to demonstrate the dispersion of rural SGM participants. SGM had higher smoking proportion than the non-SGM recruited from these settings. In the multivariable model, SGM identity conferred 1.35 times the odds of being a current smoker when controlled for covariates. Rural residence was not independently significant, demonstrating the persistence of the smoking disparity in rural SGM. Mapping revealed widespread distribution of SGM in rural areas. The SGM smoking disparity persists among rural SGM. These communities would benefit from continued research into interventions targeting both SGM and rural tobacco control measures. Recruitment at Pride Festivals may provide a venue for reaching rural SGM for intervention.

Remaining missed opportunities of child survival in Peru: modelling mortality impact of universal and equitable coverage of proven interventions.

PubMed

Tam, Yvonne; Huicho, Luis; Huayanay-Espinoza, Carlos A; Restrepo-Méndez, María Clara

2016-10-04

Peru has made great improvements in reducing stunting and child mortality in the past decade, and has reached the Millennium Development Goals 1 and 4. The remaining challenges or missed opportunities for child survival needs to be identified and quantified, in order to guide the next steps to further improve child survival in Peru. We used the Lives Saved Tool (LiST) to project the mortality impact of proven interventions reaching every women and child in need, and the mortality impact of eliminating inequalities in coverage distribution between wealth quintiles and urban-rural residence. Our analyses quantified the remaining missed opportunities in Peru, where prioritizing scale-up of facility-based case management for all small and sick babies will be most effective in mortality reduction, compared to other evidenced-based interventions that prevent maternal and child deaths. Eliminating coverage disparities between the poorest quintiles and the richest will reduce under-five and neonatal mortality by 22.0 and 40.6 %, while eliminating coverage disparities between those living in rural and urban areas will reduce under-five and neonatal mortality by 29.3 and 45.2 %. This projected neonatal mortality reduction achieved by eliminating coverage disparities is almost comparable to that already achieved by Peru over the past decade. Although Peru has made great strides in improving child survival, further improvement in child health, especially in newborn health can be achieved if there is universal and equitable coverage of proven, quality health facility-based interventions. The magnitude of reduction in mortality will be similar to what has been achieved in the past decade. Strengthening health system to identify, understand, and direct resources to the poor and rural areas will ensure that Peru achieve the Sustainable Development Goals by 2030.

A case study of collaborative facilities use in engineering design

NASA Astrophysics Data System (ADS)

Monroe, Laura; Pugmire, David

2010-01-01

In this paper we describe the use of visualization tools and facilities in the collaborative design of a replacement weapons system, the Reliable Replacement Warhead (RRW). We used not only standard collaboration methods but also a range of visualization software and facilities to bring together domain specialists from laboratories across the country to collaborate on the design and integrate this disparate input early in the design. This was the first time in U.S. weapons history that a weapon had been designed in this collaborative manner. Benefits included projected cost savings, design improvements and increased understanding across the project.

Designing a community-based lay health advisor training curriculum to address cancer health disparities.

PubMed

Gwede, Clement K; Ashley, Atalie A; McGinnis, Kara; Montiel-Ishino, F Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B; Wathington, Deanna; Dash-Pitts, Lolita; Green, B Lee

2013-05-01

Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. APPROACH AND STRATEGIES: Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic-community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research.

Creating the Business Case for Achieving Health Equity.

PubMed

Chin, Marshall H

2016-07-01

Health care organizations have increasingly acknowledged the presence of health care disparities across race/ethnicity and socioeconomic status, but significantly fewer have made health equity for diverse patients a true priority. Lack of financial incentives is a major barrier to achieving health equity. To create a business case for equity, governmental and private payors can: 1) Require health care organizations to report clinical performance data stratified by race, ethnicity, and socioeconomic status. 2) Incentivize preventive care and primary care. Implement more aggressive shared savings plans, update physician relative value unit fee schedules, and encourage partnerships across clinical and non-clinical sectors. 3) Incentivize the reduction of health disparities with equity accountability measures in payment programs. 4) Align equity accountability measures across public and private payors. 5) Assist safety-net organizations. Provide adequate Medicaid reimbursement, risk-adjust clinical performance scores for sociodemographic characteristics of patients, provide support for quality improvement efforts, and calibrate cuts to Disproportionate Share Hospital (DSH) payments to the pace of health insurance expansion. 6) Conduct demonstration projects to test payment and delivery system reform interventions to reduce disparities. Commitment to social justice is essential to achieve health equity, but insufficient without a strong business case that makes interventions financially feasible.

Cooperative Learning in Reservoir Simulation Classes: Overcoming Disparate Entry Skills

NASA Astrophysics Data System (ADS)

Awang, Mariyamni

2006-10-01

Reservoir simulation is one of the core courses in the petroleum engineering curriculum and it requires knowledge and skills in three major disciplines, namely programming, numerical methods and reservoir engineering. However, there were often gaps in the students' readiness to undertake the course, even after completing the necessary requirements. The disparate levels of competency of the good and poor students made it difficult to target a certain level. Cooperative learning in the form of projects and peer teaching was designed to address the major concern of disparate entry skills, and at the same time the method used should also succeed in keeping students interest in class, developing communication skills and improving self-learning. Slower and weaker students were expected to benefit from being taught by good students, who were better prepared, and good students would gain deeper comprehension of the subject matter. From evaluations, the approach was considered successful since the overall passing rate was greater than 95% compared to previous years of around 70-80%. It had also succeeded in improving the learning environment in class. Future simulation classes will continue to use the cooperative approach with minor adjustments.

Accelerators: Sparking Innovation and Transdisciplinary Team Science in Disparities Research

PubMed Central

Horowitz, Carol R.; Shameer, Khader; Gabrilove, Janice; Atreja, Ashish; Shepard, Peggy; Goytia, Crispin N.; Smith, Geoffrey W.; Dudley, Joel; Manning, Rachel; Bickell, Nina A.; Galvez, Maida P.

2017-01-01

Development and implementation of effective, sustainable, and scalable interventions that advance equity could be propelled by innovative and inclusive partnerships. Readied catalytic frameworks that foster communication, collaboration, a shared vision, and transformative translational research across scientific and non-scientific divides are needed to foster rapid generation of novel solutions to address and ultimately eliminate disparities. To achieve this, we transformed and expanded a community-academic board into a translational science board with members from public, academic and private sectors. Rooted in team science, diverse board experts formed topic-specific “accelerators”, tasked with collaborating to rapidly generate new ideas, questions, approaches, and projects comprising patients, advocates, clinicians, researchers, funders, public health and industry leaders. We began with four accelerators—digital health, big data, genomics and environmental health—and were rapidly able to respond to funding opportunities, transform new ideas into clinical and community programs, generate new, accessible, actionable data, and more efficiently and effectively conduct research. This innovative model has the power to maximize research quality and efficiency, improve patient care and engagement, optimize data democratization and dissemination among target populations, contribute to policy, and lead to systems changes needed to address the root causes of disparities. PMID:28241508

Despite Increased Insurance Coverage, Nonwhite Sexual Minorities Still Experience Disparities In Access To Care.

PubMed

Hsieh, Ning; Ruther, Matt

2017-10-01

Previous studies suggest that members of sexual minority groups have poorer access to health services than heterosexuals. However, few studies have examined how sexual orientation interacts with gender and race to affect health care experience. Moreover, little is known about the role in health care disparities played by economic strains such as unemployment and poverty, which may result from prejudice and discrimination based on sexual orientation. Using data for 2013-15 from the National Health Interview Survey, we found that most members of sexual minority groups no longer have higher uninsurance rates than heterosexuals, but many continue to experience poorer access to high-quality care. Gay nonwhite men, bisexual white women, and bisexual and lesbian nonwhite women are disadvantaged in multiple aspects of access, compared to straight white men. Only some of these disparities are attributable to economic factors, which implies that noneconomic barriers to care are substantial. Our results suggest that the intersection of multiple social identities can reveal important gaps in health care experience. Making culturally sensitive services available may be key to closing the gaps. Project HOPE—The People-to-People Health Foundation, Inc.

Accelerators: Sparking Innovation and Transdisciplinary Team Science in Disparities Research.

PubMed

Horowitz, Carol R; Shameer, Khader; Gabrilove, Janice; Atreja, Ashish; Shepard, Peggy; Goytia, Crispin N; Smith, Geoffrey W; Dudley, Joel; Manning, Rachel; Bickell, Nina A; Galvez, Maida P

2017-02-23

Development and implementation of effective, sustainable, and scalable interventions that advance equity could be propelled by innovative and inclusive partnerships. Readied catalytic frameworks that foster communication, collaboration, a shared vision, and transformative translational research across scientific and non-scientific divides are needed to foster rapid generation of novel solutions to address and ultimately eliminate disparities. To achieve this, we transformed and expanded a community-academic board into a translational science board with members from public, academic and private sectors. Rooted in team science, diverse board experts formed topic-specific "accelerators", tasked with collaborating to rapidly generate new ideas, questions, approaches, and projects comprising patients, advocates, clinicians, researchers, funders, public health and industry leaders. We began with four accelerators-digital health, big data, genomics and environmental health-and were rapidly able to respond to funding opportunities, transform new ideas into clinical and community programs, generate new, accessible, actionable data, and more efficiently and effectively conduct research. This innovative model has the power to maximize research quality and efficiency, improve patient care and engagement, optimize data democratization and dissemination among target populations, contribute to policy, and lead to systems changes needed to address the root causes of disparities.

Individual, family background, and contextual explanations of racial and ethnic disparities in youths' exposure to violence.

PubMed

Zimmerman, Gregory M; Messner, Steven F

2013-03-01

We used data from the Project on Human Development in Chicago Neighborhoods to examine the extent to which individual, family, and contextual factors account for the differential exposure to violence associated with race/ethnicity among youths. Logistic hierarchical item response models on 2344 individuals nested within 80 neighborhoods revealed that the odds of being exposed to violence were 74% and 112% higher for Hispanics and Blacks, respectively, than for Whites. Appreciable portions of the Hispanic-White gap (33%) and the Black-White gap (53%) were accounted for by family background factors, individual differences, and neighborhood factors. The findings imply that programs aimed at addressing the risk factors for exposure to violence and alleviating the effects of exposure to violence may decrease racial/ethnic disparities in exposure to violence and its consequences.

Individual, Family Background, and Contextual Explanations of Racial and Ethnic Disparities in Youths’ Exposure to Violence

PubMed Central

Messner, Steven F.

2013-01-01

We used data from the Project on Human Development in Chicago Neighborhoods to examine the extent to which individual, family, and contextual factors account for the differential exposure to violence associated with race/ethnicity among youths. Logistic hierarchical item response models on 2344 individuals nested within 80 neighborhoods revealed that the odds of being exposed to violence were 74% and 112% higher for Hispanics and Blacks, respectively, than for Whites. Appreciable portions of the Hispanic–White gap (33%) and the Black–White gap (53%) were accounted for by family background factors, individual differences, and neighborhood factors. The findings imply that programs aimed at addressing the risk factors for exposure to violence and alleviating the effects of exposure to violence may decrease racial/ethnic disparities in exposure to violence and its consequences. PMID:23327266

The Journey Project: a case study in providing health information to mitigate health disparities

PubMed Central

Leisey, Monica

2009-01-01

The Journey Project, part of the Virginia Commonwealth University Libraries' Social Work Information Specialist in Context Fellowship, was designed to merge social work and consumer health librarianship skills in order to improve the provision of health information to patients. A resource notebook was created encompassing the many dimensions of cancer health information. A social work informationist distributed the notebooks and provided individualized consultations with respect to patients' health information needs. Areas of congruence as well as key differences between social work and consumer health librarianship emerged during the course of the project. Merging the two professions into the role of a social work informationist increased the ability to attend holistically to clients' health information needs. PMID:19159008

The Sustainment Management Support Project

DTIC Science & Technology

2010-09-01

on the market that incorporates all of the features of Decision Maker, in particular, the use of the objective weighted...These databases do not necessarily co-exist on the same computer server or even in the same physical location. They are disparate and owned by ...installation on HMAS Ballarat The SIU will be used to provide condition-monitoring (sensor and alarm) data from the FFH control and

From Contradictions to Complementarities: A Social Realist Analysis of the Evolution of Academic Development within a Department

ERIC Educational Resources Information Center

Case, Jennifer M.; Heydenrych, Hilton; Kotta, Linda; Marshall, Delia; McKenna, Sioux; Williams, Kevin

2017-01-01

Academic development is a recent project in the university, intended to enable the university to respond to the needs of a more diverse student body. In South Africa, such work arose during late apartheid, and has now moved to a more central institutional position advocating responsiveness in the light of the educational disparities that are the…

Gender Discrimination in Death Reportage: Reconnoitering Disparities through a Comparative Analysis of Male and Female Paid Obituaries of Pakistani English Newspapers

ERIC Educational Resources Information Center

Chaudhry, Sajid M.; Christopher, Anne A.; Krishnasamy, Hariharan A/L N.

2014-01-01

The study examines the issue of gender discrimination in the post death scenario of obituarial discourse. It aims to identify the way Pakistani newspaper obituaries recognize and project males and females after their deaths. A total of 601 paid obituaries published in a year's time span in Pakistani English newspapers were evaluated for the…

Development and Evaluation of a Staff Training Program on Palliative Care for Persons with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Hahn, Joan E.; Cadogan, Mary P.

2011-01-01

Persons with intellectual and developmental disabilities (I/DD) face barriers and disparities at end of life. Among these barriers are limited educational opportunities and a paucity of targeted training materials on palliative care for staff who provide their day-to-day care. This paper reports on a three-phase project undertaken to develop,…

Elimination of Health Disparities in Racial/Ethnic Minority Communities: Developing Data Indicators To Assess the Progress of Community-Based Efforts.

ERIC Educational Resources Information Center

Edberg, Mark C.; Wong, Frank Y.; Woo, Violet; Doong, Tuei

2003-01-01

Describes the development of a pilot uniform data set (UDS) intended to serve as the primary data collection mechanism for all grants and standard cooperative agreements funded by the U.S. Office of Minority Health. The UDS is the product of a formative research project with implications for other program evaluations. (SLD)

Models of Success, Teacher Quality and Student Disciplinary Infraction: A Critical Analysis of Chicago's Urban Preparatory Academies and Harlem Children's Zone

ERIC Educational Resources Information Center

Williams, John A., III; Wiggan, Greg

2016-01-01

School discipline disparities in U.S. education is accompanied by a litany of literature that focuses on African Americans in low-performing urban schools (Civil Right Project, 2000; Losen, 2011; Mendez & Knoff, 2003; Skiba, Michael, Nardo & Peterson, 2002; Wilson, 2014). Public K-12 institutions in the U.S. report that African Americans…

The Genomes OnLine Database (GOLD) v.5: a metadata management system based on a four level (meta)genome project classification

PubMed Central

Reddy, T.B.K.; Thomas, Alex D.; Stamatis, Dimitri; Bertsch, Jon; Isbandi, Michelle; Jansson, Jakob; Mallajosyula, Jyothi; Pagani, Ioanna; Lobos, Elizabeth A.; Kyrpides, Nikos C.

2015-01-01

The Genomes OnLine Database (GOLD; http://www.genomesonline.org) is a comprehensive online resource to catalog and monitor genetic studies worldwide. GOLD provides up-to-date status on complete and ongoing sequencing projects along with a broad array of curated metadata. Here we report version 5 (v.5) of the database. The newly designed database schema and web user interface supports several new features including the implementation of a four level (meta)genome project classification system and a simplified intuitive web interface to access reports and launch search tools. The database currently hosts information for about 19 200 studies, 56 000 Biosamples, 56 000 sequencing projects and 39 400 analysis projects. More than just a catalog of worldwide genome projects, GOLD is a manually curated, quality-controlled metadata warehouse. The problems encountered in integrating disparate and varying quality data into GOLD are briefly highlighted. GOLD fully supports and follows the Genomic Standards Consortium (GSC) Minimum Information standards. PMID:25348402

Perceived discrimination and health-related quality-of-life: gender differences among older African Americans.

PubMed

Coley, Sheryl L; Mendes de Leon, Carlos F; Ward, Earlise C; Barnes, Lisa L; Skarupski, Kimberly A; Jacobs, Elizabeth A

2017-12-01

Emerging data suggest that African-American women may fare worse than African-American men in health-related quality-of-life (HRQOL). Perceived discrimination is an important contributor to poor health overall among African Americans, but few studies examined the intersecting effects of perceived discrimination and gender in explaining HRQOL disparities. We investigated gender differences in HRQOL and tested whether perceived discrimination accounted for these differences. We examined data from the Chicago Health and Aging Project in which 5652 African-American adults aged 65 and older completed structured questionnaires about demographic and socioeconomic characteristics, HRQOL, perceived discrimination, and health-related variables. Logistic regression models were used to identify associations between perceived discrimination and gender differences in poor HRQOL outcomes (defined as 14+ unhealthy days in overall, physical, or mental health over the past 30 days) when controlling for the other variables. More women reported poor overall HRQOL than men (24 vs. 16% respectively). Higher perceived discrimination was significantly associated with worse overall HRQOL (OR 1.11; 95% CI 1.08, 1.15), with stronger effects for women in overall and mental HRQOL. These gender disparities remained significant until controlling for potentially confounding variables. Perceived discrimination did not account for gender differences in poor physical HRQOL. Perceived discrimination is associated with poor HRQOL in older African Americans, with this association appearing stronger in women than men for mental HRQOL. These findings warrant further investigation of effects of perceived discrimination in gender disparities in overall health, and such research can inform and guide efforts for reducing these disparities.

Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience.

PubMed

Callahan, Edward J; Sitkin, Nicole; Ton, Hendry; Eidson-Ton, W Suzanne; Weckstein, Julie; Latimore, Darin

2015-02-01

Many U.S. populations experience significant health disparities. Increasing health care providers' awareness of and education about sexual orientation (SO) and gender identity (GI) diversity could help reduce health disparities among lesbian, gay, bisexual, and transgender (LGBT) patients. The authors share the University of California, Davis, Health System's (UCDHS's) experience as it became the first U.S. academic health center to formally introduce patient SO/GI demographic data into its electronic health record (EHR) as a step toward reducing LGBT health disparities. Adding these data to the EHR initially met with resistance. The authors, members of the UCDHS Task Force for Inclusion of SO/GI in the EHR, viewed this resistance as an invitation to educate leaders, providers, and staff about LGBT health disparities and to expose providers to techniques for discussing SO/GI with patients. They describe the strategies they employed to effect institutional culture change, including involvement of senior leadership, key informant interviews, educational outreach via grand rounds and resident workshops, and creation of a patient safety net through inviting providers to self-identify as welcoming LGBT patients. The ongoing cultural change process has inspired spin-off projects contributing to an improved climate for LGBT individuals at UCDHS, including an employee organization supporting SO/GI diversity, support for and among LGBT medical learners through events and listservs, development and implementation of an LGBT health curriculum, and creation of peer navigator programs for LGBT patients with cancer. The authors reflect on lessons learned and on institutional pride in and commitment to providing quality care for LGBT patients.

Reducing quality-of-care disparities in childhood asthma: La Red de Asma Infantil intervention in San Juan, Puerto Rico.

PubMed

Lara, Marielena; Ramos-Valencia, Gilberto; González-Gavillán, Jesús A; López-Malpica, Fernando; Morales-Reyes, Beatriz; Marín, Heriberto; Rodríguez-Sánchez, Mario H; Mitchell, Herman

2013-03-01

Although children living in Puerto Rico have the highest asthma prevalence of all US children, little is known regarding the quality-of-care disparities they experience nor the adaptability of existing asthma evidence-based interventions to reduce these disparities. The objective of this study was to describe our experience in reducing quality-of-care disparities among Puerto Rican children with asthma by adapting 2 existing evidence-based asthma interventions. We describe our experience in adapting and implementing 2 previously tested asthma evidence-based interventions: the Yes We Can program and the Inner-City Asthma Study intervention. We assessed the feasibility of combining key components of the 2 interventions to reduce asthma symptoms and estimated the potential cost savings associated with reductions in asthma-related hospitalizations and emergency department visits. A total of 117 children with moderate and severe asthma participated in the 12-month intervention in 2 housing projects in San Juan, Puerto Rico. A community-academic team with the necessary technical and cultural competences adapted and implemented the intervention. Our case study revealed the feasibility of implementing the combined intervention, henceforth referred to as La Red intervention, in the selected Puerto Rican communities experiencing a disproportionately high level of asthma burden. After 1-year follow-up, La Red intervention significantly reduced asthma symptoms and exceeded reductions of the original interventions. Asthma-related hospitalizations and emergency department use, and their associated high costs, were also significantly reduced. Asthma evidence-based interventions can be adapted to improve quality of care for children with asthma in a different cultural community setting.

Mortality among blacks or African Americans with HIV infection--United States, 2008-2012.

PubMed

Siddiqi, Azfar-e-Alam; Hu, Xiaohong; Hall, H Irene

2015-02-06

A primary goal of the National HIV/AIDS Strategy is to reduce HIV-related health disparities, including HIV-related mortality in communities at high risk for human immunodeficiency virus (HIV) infection. As a group, persons who self-identify as blacks or African Americans (referred to as blacks in this report), have been affected by HIV more than any other racial/ethnic population. Forty-seven percent of persons who received an HIV diagnosis in the United States in 2012 and 43% of all persons living with diagnosed HIV infection in 2011 were black. Blacks also experienced a low 3-year survival rate among persons with HIV infection diagnosed during 2003-2008. CDC and its partners have been pursuing a high-impact prevention approach and supporting projects focusing on minorities to improve diagnosis, linkage to care, and retention in care, and to reduce disparities in HIV-related health outcomes. To measure trends in disparities in mortality among blacks, CDC analyzed data from the National HIV Surveillance System. The results of that analysis indicated that among blacks aged ≥13 years the death rate per 1,000 persons living with diagnosed HIV decreased from 28.4 in 2008 to 20.5 in 2012. Despite this improvement, in 2012 the death rate per 1,000 persons living with HIV among blacks was 13% higher than the rate for whites and 47% higher than the rate for Hispanics or Latinos. These data demonstrate the need for implementation of interventions and public health strategies to further reduce disparities in deaths.

Reducing racial/ethnic disparities in diabetes: the Coached Care (R2D2C2) project.

PubMed

Kaplan, Sherrie H; Billimek, John; Sorkin, Dara H; Ngo-Metzger, Quyen; Greenfield, Sheldon

2013-10-01

Despite numerous efforts to change healthcare delivery, the profile of disparities in diabetes care and outcomes has not changed substantially over the past decade. To understand potential contributors to disparities in diabetes care and glycemic control. Cross sectional analysis. Seven outpatient clinics affiliated with an academic medical center. Adult patients with type 2 diabetes who were Mexican American, Vietnamese American or non-Hispanic white (n = 1,484). Glycemic control was measured as hemoglobin A1c (HbA1c) level. Patient, provider and system characteristics included demographic characteristics; access to care; quality of process of care including clinical inertia; quality of interpersonal care; illness burden; mastery (diabetes management confidence, passivity); and adherence to treatment. Unadjusted HbA1c values were significantly higher for Mexican American patients (n = 782) (mean = 8.3 % [SD:2.1]) compared with non-Hispanic whites (n = 389) (mean = 7.1 % [SD:1.4]). There were no significant differences in HbA1c values between Vietnamese American and non-Hispanic white patients. There were no statistically significant group differences in glycemic control after adjustment for multiple measures of access, and quality of process and interpersonal care. Disease management mastery and adherence to treatment were related to glycemic control for all patients, independent of race/ethnicity. Generalizability to other minorities or to patients with poorer access to care may be limited. The complex interplay among patient, physician and system characteristics contributed to disparities in HbA1c between Mexican American and non-Hispanic white patients. In contrast, Vietnamese American patients achieved HbA1c levels comparable to non-Hispanic whites and adjustment for numerous characteristics failed to identify confounders that could have masked disparities in this subgroup. Disease management mastery appeared to be an important contributor to glycemic control for all patient subgroups.

Cross-sector analysis of socioeconomic, racial/ethnic, and urban/rural disparities in food policy enactment in the United States.

PubMed

Taber, Daniel R; Chriqui, Jamie F; Quinn, Christopher M; Rimkus, Leah M; Chaloupka, Frank J

2016-11-01

We examined racial/ethnic, socioeconomic, and urban/rural disparities in food policy enactment across different sectors, as well as retail food access, throughout the United States. Policy and retail food store data were obtained from 443 communities as part of the Bridging the Gap Community Obesity Measures Project. Our results indicated that median household income was inversely associated with healthier retail food zoning policies in Hispanic communities, where competitive food policies for schools were also healthier and mean fruit/vegetable access in stores was higher. In contrast, income was positively associated with healthier retail food zoning in rural communities, where competitive food policies were weaker. Black communities had low scores across all policy domains. Overall, Hispanic communities had the strongest food policies across sectors. Barriers to policy adoption in both rural and Black communities must be explored further. Copyright © 2016. Published by Elsevier Ltd.

Using multilevel, multisource needs assessment data for planning community interventions.

PubMed

Levy, Susan R; Anderson, Emily E; Issel, L Michele; Willis, Marilyn A; Dancy, Barbara L; Jacobson, Kristin M; Fleming, Shirley G; Copper, Elizabeth S; Berrios, Nerida M; Sciammarella, Esther; Ochoa, Mónica; Hebert-Beirne, Jennifer

2004-01-01

African Americans and Latinos share higher rates of cardiovascular disease (CVD) and diabetes compared with Whites. These diseases have common risk factors that are amenable to primary and secondary prevention. The goal of the Chicago REACH 2010-Lawndale Health Promotion Project is to eliminate disparities related to CVD and diabetes experienced by African Americans and Latinos in two contiguous Chicago neighborhoods using a community-based prevention approach. This article shares findings from the Phase 1 participatory planning process and discusses the implications these findings and lessons learned may have for programs aiming to reduce health disparities in multiethnic communities. The triangulation of data sources from the planning phase enriched interpretation and led to more creative and feasible suggestions for programmatic interventions across the four levels of the ecological framework. Multisource data yielded useful information for program planning and a better understanding of the cultural differences and similarities between African Americans and Latinos.

Analysis of ethnic disparities in workers' compensation claims using data linkage.

PubMed

Friedman, Lee S; Ruestow, Peter; Forst, Linda

2012-10-01

The overall goal of this research project was to assess ethnic disparities in monetary compensation among construction workers injured on the job through the linkage of medical records and workers' compensation data. Probabilistic linkage of medical records with workers' compensation claim data. In the final multivariable robust regression model, compensation was $5824 higher (P = 0.030; 95% confidence interval: 551 to 11,097) for white non-Hispanic workers than for other ethnic groups when controlling for injury severity, affected body region, type of injury, average weekly wage, weeks of temporary total disability, percent permanent partial disability, death, or attorney use. The analysis indicates that white non-Hispanic construction workers are awarded higher monetary settlements despite the observation that for specific injuries the mean temporary total disability and permanent partial disability were equivalent to or lower than those in Hispanic and black construction workers.

Transferable Training Modules: Building Environmental Education Opportunities With and for Mexican Community Health Workers (Promotores de Salud).

PubMed

Ramírez, Denise Moreno; Vea, Lourdes; Field, James A; Baker, Paul B; Gandolfi, A Jay; Maier, Raina M

Community health workers (promotores de salud) have the ability to empower communities to mitigate negative health outcomes. Current training efforts in environmental topics are lacking. This project addressed this gap by developing 4 transferable training modules on environmental health. By applying a series of surveys, interviews, and trainings, we evaluated their relevance. Partners provided favorable feedback for 3 of the 4 modules. It was also learned that the development method could be improved by engaging technically trained promotores de salud in the role of co-creators. This project has implications for environmental justice communities as it can lessen information disparities.

Tools and Techniques for Measuring and Improving Grid Performance

NASA Technical Reports Server (NTRS)

Biswas, Rupak; Frumkin, M.; Smith, W.; VanderWijngaart, R.; Wong, P.; Biegel, Bryan (Technical Monitor)

2001-01-01

This viewgraph presentation provides information on NASA's geographically dispersed computing resources, and the various methods by which the disparate technologies are integrated within a nationwide computational grid. Many large-scale science and engineering projects are accomplished through the interaction of people, heterogeneous computing resources, information systems and instruments at different locations. The overall goal is to facilitate the routine interactions of these resources to reduce the time spent in design cycles, particularly for NASA's mission critical projects. The IPG (Information Power Grid) seeks to implement NASA's diverse computing resources in a fashion similar to the way in which electric power is made available.

Hispanic Student Participation and Success in Developmental Education. White Paper Prepared for the Hispanic Association of Colleges and Universities

ERIC Educational Resources Information Center

Nora, Amaury; Crisp, Gloria

2012-01-01

As has been known for some time now, the Hispanic population is projected to grow to 25% of the total United States population by 2050. In spite of this growth, substantial disparities exist between Hispanics and other ethnic groups in terms of bachelor's degree attainment (Llagas & Snyder, 2003). In response, there is a rapidly growing body of…

Geotechnical Factors in the Dredgeability of Sediments. Report 1. Geotechnical Descriptors for Sediments to be Dredged

DTIC Science & Technology

1993-11-01

objectives of the work unit. executing dredging projects. The disparities increase risk factors and thus the cost of such SUMMARY: The study identified the...geologists, environmental engineers, biologists, estimators, dredging equipment manufacturers, and dredging contractor personnel have methods for...changed dramatically. A major increase has occurred in the level of contract dredging. Environmental concerns, the consequences of the oil embargo of

Hearing the Community: Evolution of a Nutrition and Physical Activity Program for African American Women to Improve Weight.

PubMed

Nelson, David; Harris, Angelique; Horner-Ibler, Barbara; Harris, Kimberly Salas; Burns, Edith

2016-01-01

Listening to the needs of the community is an important step toward reducing health disparities. Researchers may need to adjust their methods to maximize participation and benefit to the community. This report describes how the project team adjusted its approach to a weight loss intervention to support a community of African American women seeking to improve their health.

Development of Medical Technology for Contingency Response to Marrow Toxic Agents

DTIC Science & Technology

2014-10-30

mismatches may differ in their impact on transplant outcome, therefore, it is important to identify and quantify the influence of specific HLA ...evaluate HLA disparity and impact on HSC transplantation by adding selected pairs to the Donor/Recipient Pair project utilizing sample selection...to assay the impact of DNA-based HLA matching on unrelated donor transplant outcome, develop strategies for optimal HLA matching, evaluate the

Health Disparities and Toxicant Exposure of Akwesasne Mohawk Young Adults: A Partnership Approach to Research

PubMed Central

Schell, Lawrence M.; Ravenscroft, Julia; Cole, Maxine; Jacobs, Agnes; Newman, Joan

2005-01-01

In this article we describe a research partnership between the Akwesasne Mohawk Nation and scientists at the University at Albany, State University of New York, initiated to address community and scientific concerns regarding environmental contamination and its health consequences (thyroid hormone function, social adjustment, and school functioning). The investigation focuses on cultural inputs into health disparities. It employs a risk-focusing model of biocultural interaction: behaviors expressing cultural identity and values allocate or focus risk, in this instance the risk of toxicant exposure, which alters health status through the effects of toxicants. As culturally based behaviors and activities fulfill a key role in the model, accurate assessment of subtle cultural and behavioral variables is required and best accomplished through integration of local expert knowledge from the community. As a partnership project, the investigation recognizes the cultural and socioeconomic impacts of research in small communities beyond the production of scientific knowledge. The components of sustainable partnerships are discussed, including strategies that helped promote equity between the partners such as hiring community members as key personnel, integrating local expertise into research design, and developing a local Community Outreach and Education Program. Although challenges arose during the design and implementation of the research project, a collaborative approach has benefited the community and facilitated research. PMID:16330372

Using Community Partnerships to Better Understand the Barriers to Using an Evidence-Based, Parent-Mediated Intervention for Autism Spectrum Disorder in a Medicaid System.

PubMed

Pickard, Katherine E; Kilgore, Amanda N; Ingersoll, Brooke R

2016-06-01

Service use disparities have been noted to impede under-resourced families' ability to access high-quality services for their child with autism spectrum disorder (ASD). These disparities are particularly relevant for parent-mediated interventions and may suggest a lack of fit between these interventions and the needs of under-resourced community settings. This study used Roger's Diffusion of Innovations theory to guide community partnerships aimed at understanding the perceived compatibility, complexity, and relative advantage of using an evidence-based, parent-mediated intervention (Project ImPACT) within a Medicaid system. Three focus groups were conducted with 16 Medicaid-eligible parents, and three focus groups were conducted with 16 ASD providers operating within a Medicaid system. Across all groups, parents and providers reported general interest in using Project ImPACT. However, primary themes emerged regarding the need to (a) reduce the complexity of written materials; (b) allow for a more flexible program delivery; (c) ensure a strong parent-therapist alliance; (d) involve the extended family; and (e) help families practice the intervention within their preexisting routines. Results are discussed as they relate to the design and fit of evidence-based, parent-mediated interventions for under-resourced community settings. © Society for Community Research and Action 2016.

Bringing Community and Academic Scholars Together to Facilitate and Conduct Authentic Community Based Participatory Research: Project UNITED

PubMed Central

Lewis, Dwight; Yerby, Lea; Tucker, Melanie; Foster, Pamela Payne; Hamilton, Kara C.; Fifolt, Matthew M.; Hites, Lisle; Shreves, Mary Katherine; Page, Susan B.; Bissell, Kimberly L.; Lucky, Felecia L.; Higginbotham, John C.

2015-01-01

Cultural competency, trust, and research literacy can affect the planning and implementation of sustainable community-based participatory research (CBPR). The purpose of this manuscript is to highlight: (1) the development of a CBPR pilot grant request for application; and (2) a comprehensive program supporting CBPR obesity-related grant proposals facilitated by activities designed to promote scholarly collaborations between academic researchers and the community. After a competitive application process, academic researchers and non-academic community leaders were selected to participate in activities where the final culminating project was the submission of a collaborative obesity-related CBPR grant application. Teams were comprised of a mix of academic researchers and non-academic community leaders, and each team submitted an application addressing obesity-disparities among rural predominantly African American communities in the US Deep South. Among four collaborative teams, three (75%) successfully submitted a grant application to fund an intervention addressing rural and minority obesity disparities. Among the three submitted grant applications, one was successfully funded by an internal CBPR grant, and another was funded by an institutional seed funding grant. Preliminary findings suggest that the collaborative activities were successful in developing productive scholarly relationships between researchers and community leaders. Future research will seek to understand the full-context of our findings. PMID:26703675

Using Reported Rates of Sexually Transmitted Diseases to Illustrate Potential Methodological Issues in the Measurement of Racial and Ethnic Disparities.

PubMed

Chesson, Harrell W; Patel, Chirag G; Gift, Thomas L; Bernstein, Kyle T; Aral, Sevgi O

2017-09-01

Racial disparities in the burden of sexually transmitted diseases (STDs) have been documented and described for decades. Similarly, methodological issues and limitations in the use of disparity measures to quantify disparities in health have also been well documented. The purpose of this study was to use historic STD surveillance data to illustrate four of the most well-known methodological issues associated with the use of disparity measures. We manually searched STD surveillance reports to find examples of racial/ethnic distributions of reported STDs that illustrate key methodological issues in the use of disparity measures. The disparity measures we calculated included the black-white rate ratio, the Index of Disparity (weighted and unweighted by subgroup population), and the Gini coefficient. The 4 examples we developed included illustrations of potential differences in relative and absolute disparity measures, potential differences in weighted and nonweighted disparity measures, the importance of the reference point when calculating disparities, and differences in disparity measures in the assessment of trends in disparities over time. For example, the gonorrhea rate increased for all minority groups (relative to whites) from 1992 to 1993, yet the Index of Disparity suggested that racial/ethnic disparities had decreased. Although imperfect, disparity measures can be useful to quantify racial/ethnic disparities in STDs, to assess trends in these disparities, and to inform interventions to reduce these disparities. Our study uses reported STD rates to illustrate potential methodological issues with these disparity measures and highlights key considerations when selecting disparity measures for quantifying disparities in STDs.

Integration and Beyond

PubMed Central

Stead, William W.; Miller, Randolph A.; Musen, Mark A.; Hersh, William R.

2000-01-01

The vision of integrating information—from a variety of sources, into the way people work, to improve decisions and process—is one of the cornerstones of biomedical informatics. Thoughts on how this vision might be realized have evolved as improvements in information and communication technologies, together with discoveries in biomedical informatics, and have changed the art of the possible. This review identified three distinct generations of “integration” projects. First-generation projects create a database and use it for multiple purposes. Second-generation projects integrate by bringing information from various sources together through enterprise information architecture. Third-generation projects inter-relate disparate but accessible information sources to provide the appearance of integration. The review suggests that the ideas developed in the earlier generations have not been supplanted by ideas from subsequent generations. Instead, the ideas represent a continuum of progress along the three dimensions of workflow, structure, and extraction. PMID:10730596

Disseminating relevant health information to underserved audiences: implications of the Digital Divide Pilot Projects*

PubMed Central

Kreps, Gary L.

2005-01-01

Objective: This paper examines the influence of the digital divide on disparities in health outcomes for vulnerable populations, identifying implications for medical and public libraries. Method: The paper describes the results of the Digital Divide Pilot Projects demonstration research programs funded by the National Cancer Institute to test new strategies for disseminating relevant health information to underserved and at-risk audiences. Results: The Digital Divide Pilot Projects field-tested innovative systemic strategies for helping underserved populations access and utilize relevant health information to make informed health-related decisions about seeking appropriate health care and support, resisting avoidable and significant health risks, and promoting their own health. Implications: The paper builds on the Digital Divide Pilot Projects by identifying implications for developing health communication strategies that libraries can adopt to provide digital health information to vulnerable populations. PMID:16239960

Designing a Community-Based Lay Health Advisor Training Curriculum to Address Cancer Health Disparities

PubMed Central

Gwede, Clement K.; Ashley, Atalie A.; McGinnis, Kara; Montiel-Ishino, F. Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B.; Wathington, Deanna; Dash-Pitts, Lolita; Green, B. Lee

2012-01-01

Introduction Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. Approach and Strategies Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic–community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Discussion and Conclusions Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research. PMID:22982709

The United States Leads Other Nations In Differences By Income In Perceptions Of Health And Health Care.

PubMed

Hero, Joachim O; Zaslavsky, Alan M; Blendon, Robert J

2017-06-01

We examined income gaps in the period 2011-13 in self-assessments of personal health and health care across thirty-two middle- and high-income countries. While high-income respondents were generally more positive about their health and health care in most countries, the gap between them and low-income respondents was much bigger in some than in others. The United States has among the largest income-related differences in each of the measures we studied, which assessed both respondents' past experiences and their confidence about accessing needed health care in the future. Relatively low levels of moral discomfort over income-based health care disparities despite broad awareness of unmet need indicate more public tolerance for health care inequalities in the United States than elsewhere. Nonetheless, over half of Americans felt that income-based health care inequalities are unfair, and these respondents were significantly more likely than their compatriots to support major health system reform-differences that reflect the country's political divisions. Given the many provisions in the Affordable Care Act that seek to reduce disparities, any replacement would also require attention to disparities or risk taking a step backward in an area where the United States is in sore need of improvement. Project HOPE—The People-to-People Health Foundation, Inc.

State-Level Progress in Reducing the Black–White Infant Mortality Gap, United States, 1999–2013

PubMed Central

Goldfarb, Samantha Sittig; Wells, Brittny A.; Beitsch, Leslie; Levine, Robert S.; Rust, George

2017-01-01

Objectives. To assess state-level progress on eliminating racial disparities in infant mortality. Methods. Using linked infant birth–death files from 1999 to 2013, we calculated state-level 3-year rolling average infant mortality rates (IMRs) and Black–White IMR ratios. We also calculated percentage improvement and a projected year for achieving equality if current trend lines are sustained. Results. We found substantial state-level variation in Black IMRs (range = 6.6–13.8) and Black–White rate ratios (1.5–2.7), and also in percentage relative improvement in IMR (range = 2.7% to 36.5% improvement) and in Black–White rate ratios (from 11.7% relative worsening to 24.0% improvement). Thirteen states achieved statistically significant reductions in Black–White IMR disparities. Eliminating the Black–White IMR gap would have saved 64 876 babies during these 15 years. Eighteen states would achieve IMR racial equality by the year 2050 if current trends are sustained. Conclusions. States are achieving varying levels of progress in reducing Black infant mortality and Black–White IMR disparities. Public Health Implications. Racial equality in infant survival is achievable, but will require shifting our focus to determinants of progress and strategies for success. PMID:28323476

Grant writing: Moving from generating ideas to applying to grants that matter.

PubMed

Nelson, David; Ruffalo, Leslie

2017-05-01

There is an extraordinary burden placed upon the healthcare system and people as a result of health disparities that exist within the United States. If there is going to be a concerted effort to develop innovative strategies to reduce health disparities, input from the community and behavioral scientists can and should be included in this approach and narrative. Grant writing provides one vehicle to express the narrative and to provide a means to fund research and programs within clinic-based and community settings. This paper describes a four-step inquiry process to guide healthcare professionals with varying degrees of clinical and scholarship interests through the grant writing process. They include: (1) Why write grants (motivations), (2) what is the area of focus? (Interests), (3) whom should be on the project? (partnerships), and (4) what needs to happen next to move the idea forward? (actions) The complexity of psychosocial issues means that behavioral science is well suited to develop both hypotheses-driven and phenomenological research to understand bio-psycho-social health issues. Grant writing does not need to be mysterious or daunting. It can provide a means to an end, not only to fund research but also as a means to an end of health disparities.

Value propositions of mHealth projects.

PubMed

Gorski, Irena; Bram, Joshua T; Sutermaster, Staci; Eckman, Molly; Mehta, Khanjan

While mHealth holds great potential for addressing global health disparities, a majority of the initiatives never proceed beyond the pilot stage. One fundamental concern is that mHealth projects are seldom designed from the customer's perspective to address their specific problems and/or create appreciable value. A customer-centric view, where direct tangible benefits of interventions are identified and communicated effectively, can drive customer engagement and advance projects toward self-sustaining business models. This article reviews the business models of 234 mHealth projects to identify nine distinct value propositions that solve specific problems for customers. Each of these value propositions is discussed with real-world examples, analyses of their design approaches and business strategies, and common enablers as well as hurdles to surviving past the pilot stage. Furthermore, a deeper analysis of 42 mHealth ventures that have achieved self-sustainability through project revenue provides a host of practical and poignant insights into the design of systems that can fulfil mHealth's promise to address healthcare challenges in the long term.

Patterns of crop cover under future climates.

PubMed

Porfirio, Luciana L; Newth, David; Harman, Ian N; Finnigan, John J; Cai, Yiyong

2017-04-01

We study changes in crop cover under future climate and socio-economic projections. This study is not only organised around the global and regional adaptation or vulnerability to climate change but also includes the influence of projected changes in socio-economic, technological and biophysical drivers, especially regional gross domestic product. The climatic data are obtained from simulations of RCP4.5 and 8.5 by four global circulation models/earth system models from 2000 to 2100. We use Random Forest, an empirical statistical model, to project the future crop cover. Our results show that, at the global scale, increases and decreases in crop cover cancel each other out. Crop cover in the Northern Hemisphere is projected to be impacted more by future climate than the in Southern Hemisphere because of the disparity in the warming rate and precipitation patterns between the two Hemispheres. We found that crop cover in temperate regions is projected to decrease more than in tropical regions. We identified regions of concern and opportunities for climate change adaptation and investment.

Reducing inequities among children with asthma in the island of Puerto Rico: experiences of a community-based, trans-sectoral effort.

PubMed

Lara, Marielena; Valencia, Gilberto Ramos; Gavillán, Jesús A González Gavillán; Reyes, Beatriz Morales; Arabía, Carmen; Malpica, Fernando López; Freytes, Dharma M; Rodríguez-Sánchez, Mario H; Chinman, Matthew

2009-01-01

Children living in the Commonwealth of Puerto Rico have the highest poverty and asthma prevalence rates of all U.S. children. Since 2000, a group of community, health care, education, housing, and academic representatives have been collaborating in a project to improve quality of life and reduce disparities among children with asthma in very poor communities in Puerto Rico. To date the project has implemented a successful intervention in the Luis Lloréns Torres Housing Project, aimed at adapting evidence-based interventions to improve the social and physical environment of children with asthma. The program has recently been extended to another San Juan housing area, the Manuel A. Pérez Housing Project. Using implementation theory, the authors report and reflect on the project's experience to date, provide recommendations, and discuss implications of lessons learned to address inequities in asthma care throughout other underserved areas in the U.S., Latin America, and the Caribbean.

Building Bridges to Address Health Disparities in Puerto Rico: the "Salud para Piñones" Project.

PubMed

García-Rivera, Enid J; Pacheco, Princess; Colón, Marielis; Mays, Mary Helen; Rivera, Maricruz; Munet-Díaz, Verónica; González, María Del R; Rodríguez, María; Rodríguez, Rebecca; Morales, Astrid

2017-06-01

Over the past several decades, Puerto Ricans have faced increased health threats from chronic diseases, particularly diabetes and hypertension. The patient-provider relationship is the main platform for individual disease management, whereas the community, as an agent of change for the community's health status, has been limited in its support of individual health. Likewise, traditional research approaches within communities have placed academic researchers at the center of the process, considering their knowledge was of greater value than that of the community. In this paradigm, the academic researcher frequently owns and controls the research process. The primary aim is contributing to the scientific knowledge, but not necessarily to improve the community's health status or empower communities for social change. In contrast, the community-based participatory research (CBPR) model brings community members and leaders together with researchers in a process that supports mutual learning and empowers the community to take a leadership role in its own health and well-being. This article describes the development of the community-campus partnership between the University of Puerto Rico School of Medicine and Piñones, a semi-rural community, and the resulting CBPR project: "Salud para Piñones". This project represents a collaborative effort to understand and address the community's health needs and health disparities based on the community's participation as keystone of the process. This participatory approach represents a valuable ally in the development of long-term community-academy partnerships, thus providing opportunities to establish relevant and effective ways to translate evidence-based interventions into concrete actions that impact the individual and community's wellbeing.

Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

PubMed

Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina

2014-04-01

The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

Developing a Community-Academic Partnership to Improve Recognition and Treatment of Depression in Underserved African American and White Elders

PubMed Central

Dobransky-Fasiska, Deborah; Brown, Charlotte; Pincus, Harold A.; Nowalk, Mary P.; Wieland, Melissa; Parker, Lisa S.; Cruz, Mario; McMurray, Michelle L.; Mulsant, Benoit; Reynolds, Charles F.

2011-01-01

Objective Reducing mental health disparities among underserved populations, particularly African American elders, is an important public health priority. The authors describe the process and challenges of developing a community/academic research partnership to address these disparities. Methods The authors are using a Community-Based Participatory Research approach to gain access to underserved populations in need of depression treatment. The authors identify six stages: 1) Collaborating to Secure Funding; 2) Building a Communications Platform and Research Infrastructure; 3) Fostering Enduring Relationships; 4) Assessing Needs/Educating about Research Process; 5) Initiating Specific Collaborative Projects (meeting mutual needs/interests); and 6) Maintaining a Sustainable and Productive Partnership. Data from a needs assessment developed collaboratively by researchers and community agencies facilitated agreement on mutual research goals, while strengthening the partnership. Results A community/academic-based partnership with a solid research infrastructure has been established and maintained for 3 years. Using the results of a needs assessment, the working partnership prioritized and launched several projects. Through interviews and questionnaires, community partners identified best practices for researchers working in the community. Future research and interventional projects have been developed, including plans for sustainability that will eventually shift more responsibility from the academic institution to the community agencies. Conclusions To reach underserved populations by developing and implementing models of more effective mental health treatment, it is vital to engage community agencies offering services to this population. A successful partnership requires “cultural humility,” collaborative efforts, and the development of flexible protocols to accommodate diverse communities. PMID:20104053

Towards a Unified Taxonomy of Health Indicators: Academic Health Centers and Communities Working Together to Improve Population Health

PubMed Central

Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J.; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton “Mickey”; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B.; Strelnick, A. Hal; Wallerstein, Nina

2014-01-01

The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public’s health and reducing health disparities, the CTSA Consortium’s Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators. The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy’s application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health. PMID:24556775

The absolute disparity anomaly and the mechanism of relative disparities.

PubMed

Chopin, Adrien; Levi, Dennis; Knill, David; Bavelier, Daphne

2016-06-01

There has been a long-standing debate about the mechanisms underlying the perception of stereoscopic depth and the computation of the relative disparities that it relies on. Relative disparities between visual objects could be computed in two ways: (a) using the difference in the object's absolute disparities (Hypothesis 1) or (b) using relative disparities based on the differences in the monocular separations between objects (Hypothesis 2). To differentiate between these hypotheses, we measured stereoscopic discrimination thresholds for lines with different absolute and relative disparities. Participants were asked to judge the depth of two lines presented at the same distance from the fixation plane (absolute disparity) or the depth between two lines presented at different distances (relative disparity). We used a single stimulus method involving a unique memory component for both conditions, and no extraneous references were available. We also measured vergence noise using Nonius lines. Stereo thresholds were substantially worse for absolute disparities than for relative disparities, and the difference could not be explained by vergence noise. We attribute this difference to an absence of conscious readout of absolute disparities, termed the absolute disparity anomaly. We further show that the pattern of correlations between vergence noise and absolute and relative disparity acuities can be explained jointly by the existence of the absolute disparity anomaly and by the assumption that relative disparity information is computed from absolute disparities (Hypothesis 1).

The absolute disparity anomaly and the mechanism of relative disparities

PubMed Central

Chopin, Adrien; Levi, Dennis; Knill, David; Bavelier, Daphne

2016-01-01

There has been a long-standing debate about the mechanisms underlying the perception of stereoscopic depth and the computation of the relative disparities that it relies on. Relative disparities between visual objects could be computed in two ways: (a) using the difference in the object's absolute disparities (Hypothesis 1) or (b) using relative disparities based on the differences in the monocular separations between objects (Hypothesis 2). To differentiate between these hypotheses, we measured stereoscopic discrimination thresholds for lines with different absolute and relative disparities. Participants were asked to judge the depth of two lines presented at the same distance from the fixation plane (absolute disparity) or the depth between two lines presented at different distances (relative disparity). We used a single stimulus method involving a unique memory component for both conditions, and no extraneous references were available. We also measured vergence noise using Nonius lines. Stereo thresholds were substantially worse for absolute disparities than for relative disparities, and the difference could not be explained by vergence noise. We attribute this difference to an absence of conscious readout of absolute disparities, termed the absolute disparity anomaly. We further show that the pattern of correlations between vergence noise and absolute and relative disparity acuities can be explained jointly by the existence of the absolute disparity anomaly and by the assumption that relative disparity information is computed from absolute disparities (Hypothesis 1). PMID:27248566

Disparities in Minority Promotion Rates: A Total Quality Approach

DTIC Science & Technology

1992-01-01

UCL - p + 3 x.’ { p ( I - p) / n data, The statistical theory of logistic regression is beyond the scope of this report. Several computer statistical ... Statistics . Richard D. Irwin, Inc., Homewood IL: 1986. Feagin, J. R., Discrimination 4merican style: Institutional racism and sexism . Englewood Cliffs...current year data and the previous three years. Data for fiscal year One purpose of this project is to provide a statistical 1987, 1988, 1989, 1990, and

Reducing US cardiovascular disease burden and disparities through national and targeted dietary policies: A modelling study

PubMed Central

Rehm, Colin D.; Gaziano, Tom; Wilde, Parke; Micha, Renata; Lloyd-Williams, Ffion; Capewell, Simon

2017-01-01

Background Large socio-economic disparities exist in US dietary habits and cardiovascular disease (CVD) mortality. While economic incentives have demonstrated success in improving dietary choices, the quantitative impact of different dietary policies on CVD disparities is not well established. We aimed to quantify and compare the potential effects on total CVD mortality and disparities of specific dietary policies to increase fruit and vegetable (F&V) consumption and reduce sugar-sweetened beverage (SSB) consumption in the US. Methods and findings Using the US IMPACT Food Policy Model and probabilistic sensitivity analyses, we estimated and compared the reductions in CVD mortality and socio-economic disparities in the US population potentially achievable from 2015 to 2030 with specific dietary policy scenarios: (a) a national mass media campaign (MMC) aimed to increase consumption of F&Vs and reduce consumption of SSBs, (b) a national fiscal policy to tax SSBs to increase prices by 10%, (c) a national fiscal policy to subsidise F&Vs to reduce prices by 10%, and (d) a targeted policy to subsidise F&Vs to reduce prices by 30% among Supplemental Nutrition Assistance Program (SNAP) participants only. We also evaluated a combined policy approach, combining all of the above policies. Data sources included the Surveillance, Epidemiology, and End Results Program, National Vital Statistics System, National Health and Nutrition Examination Survey, and published meta-analyses. Among the individual policy scenarios, a national 10% F&V subsidy was projected to be most beneficial, potentially resulting in approximately 150,500 (95% uncertainty interval [UI] 141,400–158,500) CVD deaths prevented or postponed (DPPs) by 2030 in the US. This far exceeds the approximately 35,100 (95% UI 31,700–37,500) DPPs potentially attributable to a 30% F&V subsidy targeting SNAP participants, the approximately 25,800 (95% UI 24,300–28,500) DPPs for a 1-y MMC, or the approximately 31,000 (95% UI 26,800–35,300) DPPs for a 10% SSB tax. Neither the MMC nor the individual national economic policies would significantly reduce CVD socio-economic disparities. However, the SNAP-targeted intervention might potentially reduce CVD disparities between SNAP participants and SNAP-ineligible individuals, by approximately 8% (10 DPPs per 100,000 population). The combined policy approach might save more lives than any single policy studied (approximately 230,000 DPPs by 2030) while also significantly reducing disparities, by approximately 6% (7 DPPs per 100,000 population). Limitations include our effect estimates in the model; these estimates use interventional and prospective observational studies (not exclusively randomised controlled trials). They are thus imperfect and should be interpreted as the best available evidence. Another key limitation is that we considered only CVD outcomes; the policies we explored would undoubtedly have additional beneficial effects upon other diseases. Further, we did not model or compare the cost-effectiveness of each proposed policy. Conclusions Fiscal strategies targeting diet might substantially reduce CVD burdens. A national 10% F&V subsidy would save by far the most lives, while a 30% F&V subsidy targeting SNAP participants would most reduce socio-economic disparities. A combined policy would have the greatest overall impact on both mortality and socio-economic disparities. PMID:28586351

Gender disparities in the utilization of laparoscopic groin hernia repair.

PubMed

Thiels, Cornelius A; Holst, Kimberly A; Ubl, Daniel S; McKenzie, Travis J; Zielinski, Martin D; Farley, David R; Habermann, Elizabeth B; Bingener, Juliane

2017-04-01

Clinical treatment guidelines have suggested that laparoscopic hernia repair should be the preferred approach in both men and women with bilateral or recurrent elective groin hernias. Anecdotal evidence suggests, however, that women are less likely to undergo a laparoscopic repair than men, and therefore, we aimed to delineate if these disparities persisted after controlling for patient factors and comorbidities. The American College of Surgeons National Surgical Quality Improvement Project data were abstracted for all elective groin hernia repairs between 2005 and 2014. Univariate analysis was used to compare rates of laparoscopic surgery between men and women. Multivariable analysis was performed, controlling for patient demographics, preoperative comorbidities, and year of surgery. Over the 10-y period, 141,490 patients underwent elective groin hernia repair, of which 13,325 were women (9.4%). The rate of general anesthesia utilization was high in both men (81.3%) and women (77.2%) with 75.1% of open repairs being performed under general anesthesia. Overall, 20.2% of women underwent laparoscopic repair compared with 28.0% of men (P < 0.01). Women tended to be older, had a lesser body mass index, and slightly greater American Anesthesia Association (all P < 0.05). On multivariable regression, women had decreased odds of undergoing a laparoscopic approach compared with men (odds ratio: 0.70; 95% confidence interval, 0.67-0.73, P < 0.01). In the elective setting, women were less likely to undergo laparoscopic repair of groin hernias than men. Although we are unable to ascertain underlying causes for these gender disparities, these data suggest that there remains a disparity in the management of groin hernias in women. Copyright © 2016 Elsevier Inc. All rights reserved.

Racial/ethnic disparities in maternal morbidities: a statewide study of labor and delivery hospitalizations in Wisconsin.

PubMed

Cabacungan, Erwin T; Ngui, Emmanuel M; McGinley, Emily L

2012-10-01

We examined racial/ethnic disparities in maternal morbidities (MM) and the number of MM during labor and delivery among hospital discharges in Wisconsin. We conducted a retrospective cohort study of hospital discharge data for 206,428 pregnant women aged 13-53 years using 2005-2007 Healthcare Cost and Utilization Project State Inpatient Dataset (HCUP-SID) for Wisconsin. After adjustments for covariates, MM (preterm labor, antepartum and postpartum hemorrhage, hypertension in pregnancy, gestational diabetes, membrane-related disorders, infections and 3rd and 4th perineal lacerations) were examined using logistic regression models, and number of MM (0, 1, 2, >2 MM) were examined using multivariable ordered logistic regressions with partial proportional odds models. African-Americans had significantly higher likelihood of infections (OR = 1.74; 95% CI 1.60-1.89), preterm labor (OR = 1.42; 1.33-1.50), antepartum hemorrhage (OR = 1.63; 1.44-1.83), and hypertension complicating pregnancy (OR = 1.39; 1.31-1.48) compared to Whites. Hispanics, Asian/Pacific Islanders, and Native Americans had significantly higher likelihood of infections, postpartum hemorrhage, and gestational diabetes than Whites. Major perineal lacerations were significantly higher among Asian/Pacific Islanders (OR = 1.53; 1.34-1.75). All minority racial/ethnic groups, except Asians, had significantly higher likelihood of having 0 versus 1, 2 or >2 MM, 0 or 1 versus 2 or >2 MM, and 0, 1 or 2 versus >2 MM than white women. Findings show significant racial/ethnic disparities in MM, and suggest the need for better screening, management, and timely referral of these conditions, particularly among racial/ethnic women. Disparities in MM may be contributing to the high infant mortality and adverse birth outcomes among different racial/ethnic groups in Wisconsin.

Interactions of form and orientation

NASA Technical Reports Server (NTRS)

Mittelstaedt, Horst

1989-01-01

It is well known that the orientation of an optical pattern relative to egocentric or extraneous references affects its figural quality, that is, alters its perceived form and concomitantly delays or quickens its identification (Rock 1973). A square presented in the frontal plane to an upright person (S), for instance, changes from a box to a diamond when it is rotated with respect to the S's median plane by 45 deg. This angle, that is, the angle between the orientations of the pattern in which the two apparent figures (Gestalten) attain a summit of purity and distinctness, will be called the figural disparity of the pattern. If, as in this case, the S is upright, the retinal meridian and the subjective vertical (SV) are both in the viewer's median plane. The question arises with respect to which of these orientation references the two figures are identified. The answer may be found when the pattern and the S are oriented in such a way that the projections of the retinal meridian and the SV into the plane of the pattern diverge by the pattern's figural disparity or its periodic multiples: that is, in this case of a square by 45 or 135 deg, respectively. Similarly, which reference determines whether an equilateral triangle is seen as a pyramid or a traffic warning sign may be revealed at a divergence of SV and retinal meridian of 60 or 180 deg, respectively. It is generally found that for head roll tilts (Rho) and figural disparities of up to 90 deg, the figure whose axis coincides with the SV is seen. At head tilts of Rho=180 deg, however, the retinal reference dominates, as a rule independently of the figural disparity.

The Genomes OnLine Database (GOLD) v.5: a metadata management system based on a four level (meta)genome project classification

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

Reddy, Tatiparthi B. K.; Thomas, Alex D.; Stamatis, Dimitri

The Genomes OnLine Database (GOLD; http://www.genomesonline.org) is a comprehensive online resource to catalog and monitor genetic studies worldwide. GOLD provides up-to-date status on complete and ongoing sequencing projects along with a broad array of curated metadata. Within this paper, we report version 5 (v.5) of the database. The newly designed database schema and web user interface supports several new features including the implementation of a four level (meta)genome project classification system and a simplified intuitive web interface to access reports and launch search tools. The database currently hosts information for about 19 200 studies, 56 000 Biosamples, 56 000 sequencingmore » projects and 39 400 analysis projects. More than just a catalog of worldwide genome projects, GOLD is a manually curated, quality-controlled metadata warehouse. The problems encountered in integrating disparate and varying quality data into GOLD are briefly highlighted. Lastly, GOLD fully supports and follows the Genomic Standards Consortium (GSC) Minimum Information standards.« less

Collaboration across eight research centers: unanticipated benefits and outcomes for project managers.

PubMed

Perez, Norma A; Weathers, Benita; Willis, Marilyn; Mendez, Jacqueline

2013-02-01

Managers of transdisciplinary collaborative research lack suitable didactic material to support the implementation of research methodologies and to build ongoing partnerships with community representatives and peers, both between and within multiple academic centers. This article will provide insight on the collaborative efforts of project managers involved in multidisciplinary research and their subsequent development of a tool kit for research project managers and/or directors. Project managers from the 8 Centers for Population Health and Health Disparities across the nation participated in monthly teleconferences to share experiences and offer advice on how to achieve high participation rates and maintain community involvement in collaboration with researchers and community leaders to achieve the common goal of decreasing health inequities. In the process, managers recognized and seized the opportunity to produce a tool kit that was designed for future project managers and directors. Project managers in geographically distinct locations maintained a commitment to work together over 4 years and subsequently built upon an existing communications network to design a tool kit that could be disseminated easily to a diverse audience.

Cancer Data and Aboriginal Disparities (CanDAD)-developing an Advanced Cancer Data System for Aboriginal people in South Australia: a mixed methods research protocol.

PubMed

Yerrell, Paul Henry; Roder, David; Cargo, Margaret; Reilly, Rachel; Banham, David; Micklem, Jasmine May; Morey, Kim; Stewart, Harold Bundamurra; Stajic, Janet; Norris, Michael; Brown, Alex

2016-12-23

In Australia, Aboriginal and Torres Strait Islander People carry a greater burden of cancer-related mortality than non-Aboriginal Australians. The Cancer Data and Aboriginal Disparities Project aims to develop and test an integrated, comprehensive cancer monitoring and surveillance system capable of incorporating epidemiological and narrative data to address disparities and advocate for clinical system change. The Advanced Cancer Data System will integrate routinely collected unit record data from the South Australian Population Cancer Registry and a range of other data sources for a retrospective cohort of indigenous people with cancers diagnosed from 1990 to 2010. A randomly drawn non-Aboriginal cohort will be matched by primary cancer site, sex, age and year at diagnosis. Cross-tabulations and regression analyses will examine the extent to which demographic attributes, cancer stage and survival vary between the cohorts. Narratives from Aboriginal people with cancer, their families, carers and service providers will be collected and analysed using patient pathway mapping and thematic analysis. Statements from the narratives will structure both a concept mapping process of rating, sorting and prioritising issues, focusing on issues of importance and feasibility, and the development of a real-time Aboriginal Cancer Measure of Experience for ongoing linkage with epidemiological data in the Advanced Cancer Data System. Aboriginal Community engagement underpins this Project. The research has been approved by relevant local and national ethics committees. Findings will be disseminated in local and international peer-reviewed journals and conference presentations. In addition, the research will provide data for knowledge translation activities across the partner organisations and feed directly into the Statewide Cancer Control Plan. It will provide a mechanism for monitoring and evaluating the implementation of the recommendations in these documents. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cancer Data and Aboriginal Disparities (CanDAD)—developing an Advanced Cancer Data System for Aboriginal people in South Australia: a mixed methods research protocol

PubMed Central

Yerrell, Paul Henry; Roder, David; Cargo, Margaret; Reilly, Rachel; Banham, David; Micklem, Jasmine May; Morey, Kim; Stewart, Harold Bundamurra; Stajic, Janet; Norris, Michael; Brown, Alex

2016-01-01

Introduction In Australia, Aboriginal and Torres Strait Islander People carry a greater burden of cancer-related mortality than non-Aboriginal Australians. The Cancer Data and Aboriginal Disparities Project aims to develop and test an integrated, comprehensive cancer monitoring and surveillance system capable of incorporating epidemiological and narrative data to address disparities and advocate for clinical system change. Methods and analysis The Advanced Cancer Data System will integrate routinely collected unit record data from the South Australian Population Cancer Registry and a range of other data sources for a retrospective cohort of indigenous people with cancers diagnosed from 1990 to 2010. A randomly drawn non-Aboriginal cohort will be matched by primary cancer site, sex, age and year at diagnosis. Cross-tabulations and regression analyses will examine the extent to which demographic attributes, cancer stage and survival vary between the cohorts. Narratives from Aboriginal people with cancer, their families, carers and service providers will be collected and analysed using patient pathway mapping and thematic analysis. Statements from the narratives will structure both a concept mapping process of rating, sorting and prioritising issues, focusing on issues of importance and feasibility, and the development of a real-time Aboriginal Cancer Measure of Experience for ongoing linkage with epidemiological data in the Advanced Cancer Data System. Aboriginal Community engagement underpins this Project. Ethics and dissemination The research has been approved by relevant local and national ethics committees. Findings will be disseminated in local and international peer-reviewed journals and conference presentations. In addition, the research will provide data for knowledge translation activities across the partner organisations and feed directly into the Statewide Cancer Control Plan. It will provide a mechanism for monitoring and evaluating the implementation of the recommendations in these documents. PMID:28011808

Project Integration Architecture: A Practical Demonstration of Information Propagation

NASA Technical Reports Server (NTRS)

Jones, William Henry

2005-01-01

One of the goals of the Project Integration Architecture (PIA) effort is to provide the ability to propagate information between disparate applications. With this ability, applications may then be formed into an application graph constituting a super-application. Such a super-application would then provide all of the analysis appropriate to a given technical system. This paper reports on a small demonstration of this concept in which a Computer Aided Design (CAD) application was connected to an inlet analysis code and geometry information automatically propagated from one to the other. The majority of the work reported involved not the technology of information propagation, but rather the conversion of propagated information into a form usable by the receiving application.

Development of Relative Disparity Sensitivity in Human Visual Cortex.

PubMed

Norcia, Anthony M; Gerhard, Holly E; Meredith, Wesley J

2017-06-07

Stereopsis is the primary cue underlying our ability to make fine depth judgments. In adults, depth discriminations are supported largely by relative rather than absolute binocular disparity, and depth is perceived primarily for horizontal rather than vertical disparities. Although human infants begin to exhibit disparity-specific responses between 3 and 5 months of age, it is not known how relative disparity mechanisms develop. Here we show that the specialization for relative disparity is highly immature in 4- to 6-month-old infants but is adult-like in 4- to 7-year-old children. Disparity-tuning functions for horizontal and vertical disparities were measured using the visual evoked potential. Infant relative disparity thresholds, unlike those of adults, were equal for vertical and horizontal disparities. Their horizontal disparity thresholds were a factor of ∼10 higher than adults, but their vertical disparity thresholds differed by a factor of only ∼4. Horizontal relative disparity thresholds for 4- to 7-year-old children were comparable with those of adults at ∼0.5 arcmin. To test whether infant immaturity was due to spatial limitations or insensitivity to interocular correlation, highly suprathreshold horizontal and vertical disparities were presented in alternate regions of the display, and the interocular correlation of the interdigitated regions was varied from 0% to 100%. This manipulation regulated the availability of coarse-scale relative disparity cues. Adult and infant responses both increased with increasing interocular correlation by similar magnitudes, but adult responses increased much more for horizontal disparities, further evidence for qualitatively immature stereopsis based on relative disparity at 4-6 months of age. SIGNIFICANCE STATEMENT Stereopsis, our ability to sense depth from horizontal image disparity, is among the finest spatial discriminations made by the primate visual system. Fine stereoscopic depth discriminations depend critically on comparisons of disparity relationships in the image that are supported by relative disparity cues rather than the estimation of single, absolute disparities. Very young human and macaque infants are sensitive to absolute disparity, but no previous study has specifically studied the development of relative disparity sensitivity, a hallmark feature of adult stereopsis. Here, using high-density EEG recordings, we show that 4- to 6-month-old infants display both quantitative and qualitative response immaturities for relative disparity information. Relative disparity responses are adult-like no later than 4-7 years of age. Copyright © 2017 the authors 0270-6474/17/375608-12$15.00/0.

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

PubMed Central

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

2008-01-01

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

Summarizing Social Disparities in Health

PubMed Central

Asada, Yukiko; Yoshida, Yoko; Whipp, Alyce M

2013-01-01

Context Reporting on health disparities is fundamental for meeting the goal of reducing health disparities. One often overlooked challenge is determining the best way to report those disparities associated with multiple attributes such as income, education, sex, and race/ethnicity. This article proposes an analytical approach to summarizing social disparities in health, and we demonstrate its empirical application by comparing the degrees and patterns of health disparities in all fifty states and the District of Columbia (DC). Methods We used the 2009 American Community Survey, and our measure of health was functional limitation. For each state and DC, we calculated the overall disparity and attribute-specific disparities for income, education, sex, and race/ethnicity in functional limitation. Along with the state rankings of these health disparities, we developed health disparity profiles according to the attribute making the largest contribution to overall disparity in each state. Findings Our results show a general lack of consistency in the rankings of overall and attribute-specific disparities in functional limitation across the states. Wyoming has the smallest overall disparity and West Virginia the largest. In each of the four attribute-specific health disparity rankings, however, most of the best- and worst-performing states in regard to overall health disparity are not consistently good or bad. Our analysis suggests the following three disparity profiles across states: (1) the largest contribution from race/ethnicity (thirty-four states), (2) roughly equal contributions of race/ethnicity and socioeconomic factor(s) (ten states), and (3) the largest contribution from socioeconomic factor(s) (seven states). Conclusions Our proposed approach offers policy-relevant health disparity information in a comparable and interpretable manner, and currently publicly available data support its application. We hope this approach will spark discussion regarding how best to systematically track health disparities across communities or within a community over time in relation to the health disparity goal of Healthy People 2020. PMID:23488710

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA.

PubMed

Doyle, John T; Kindness, Larry; Realbird, James; Eggers, Margaret J; Camper, Anne K

2018-03-21

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps-especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges.

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA

PubMed Central

Doyle, John T.; Kindness, Larry; Realbird, James; Camper, Anne K.

2018-01-01

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps—especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges. PMID:29561815

Reducing Disparities in Cancer Screening and Prevention through Community-Based Participatory Research Partnerships with Local Libraries: A Comprehensive Dynamic Trial.

PubMed

Rapkin, Bruce D; Weiss, Elisa; Lounsbury, David; Michel, Tamara; Gordon, Alexis; Erb-Downward, Jennifer; Sabino-Laughlin, Eilleen; Carpenter, Alison; Schwartz, Carolyn E; Bulone, Linda; Kemeny, Margaret

2017-09-01

Reduction of cancer-related disparities requires strategies that link medically underserved communities to preventive care. In this community-based participatory research project, a public library system brought together stakeholders to plan and undertake programs to address cancer screening and risk behavior. This study was implemented over 48 months in 20 large urban neighborhoods, selected to reach diverse communities disconnected from care. In each neighborhood, Cancer Action Councils were organized to conduct a comprehensive dynamic trial, an iterative process of program planning, implementation and evaluation. This process was phased into neighborhoods in random, stepped-wedge sequence. Population-level outcomes included self-reported screening adherence and smoking cessation, based on street intercept interviews. Event-history regressions (n = 9374) demonstrated that adherence outcomes were associated with program implementation, as were mediators such as awareness of screening programs and cancer information seeking. Findings varied by ethnicity, and were strongest among respondents born outside the U.S. or least engaged in care. This intervention impacted health behavior in diverse, underserved and vulnerable neighborhoods. It has been sustained as a routine library system program for several years after conclusion of grant support. In sum, participatory research with the public library system offers a flexible, scalable approach to reduce cancer health disparities. © Society for Community Research and Action 2017.

Near Real Time Integration of Satellite and Radar Data for Probabilistic Nearcasting of Severe Weather

NASA Astrophysics Data System (ADS)

Pilone, D.; Quinn, P.; Mitchell, A. E.; Baynes, K.; Shum, D.

2014-12-01

This talk introduces the audience to some of the very real challenges associated with visualizing data from disparate data sources as encountered during the development of real world applications. In addition to the fundamental challenges of dealing with the data and imagery, this talk discusses usability problems encountered while trying to provide interactive and user-friendly visualization tools. At the end of this talk the audience will be aware of some of the pitfalls of data visualization along with tools and techniques to help mitigate them. There are many sources of variable resolution visualizations of science data available to application developers including NASA's Global Imagery Browse Services (GIBS), however integrating and leveraging visualizations in modern applications faces a number of challenges, including: - Varying visualized Earth "tile sizes" resulting in challenges merging disparate sources - Multiple visualization frameworks and toolkits with varying strengths and weaknesses - Global composite imagery vs. imagery matching EOSDIS granule distribution - Challenges visualizing geographically overlapping data with different temporal bounds - User interaction with overlapping or collocated data - Complex data boundaries and shapes combined with multi-orbit data and polar projections - Discovering the availability of visualizations and the specific parameters, color palettes, and configurations used to produce them In addition to discussing the challenges and approaches involved in visualizing disparate data, we will discuss solutions and components we'll be making available as open source to encourage reuse and accelerate application development.

Data Visualization Challenges and Opportunities in User-Oriented Application Development

NASA Astrophysics Data System (ADS)

Pilone, D.; Quinn, P.; Mitchell, A. E.; Baynes, K.; Shum, D.

2015-12-01

This talk introduces the audience to some of the very real challenges associated with visualizing data from disparate data sources as encountered during the development of real world applications. In addition to the fundamental challenges of dealing with the data and imagery, this talk discusses usability problems encountered while trying to provide interactive and user-friendly visualization tools. At the end of this talk the audience will be aware of some of the pitfalls of data visualization along with tools and techniques to help mitigate them. There are many sources of variable resolution visualizations of science data available to application developers including NASA's Global Imagery Browse Services (GIBS), however integrating and leveraging visualizations in modern applications faces a number of challenges, including: - Varying visualized Earth "tile sizes" resulting in challenges merging disparate sources - Multiple visualization frameworks and toolkits with varying strengths and weaknesses - Global composite imagery vs. imagery matching EOSDIS granule distribution - Challenges visualizing geographically overlapping data with different temporal bounds - User interaction with overlapping or collocated data - Complex data boundaries and shapes combined with multi-orbit data and polar projections - Discovering the availability of visualizations and the specific parameters, color palettes, and configurations used to produce them In addition to discussing the challenges and approaches involved in visualizing disparate data, we will discuss solutions and components we'll be making available as open source to encourage reuse and accelerate application development.

Multifactorial discrimination as a fundamental cause of mental health inequities.

PubMed

Khan, Mariam; Ilcisin, Misja; Saxton, Katherine

2017-03-04

The theory of fundamental causes explains why health disparities persist over time, even as risk factors, mechanisms, and diseases change. Using an intersectional framework, we evaluated multifactorial discrimination as a fundamental cause of mental health disparities. Using baseline data from the Project STRIDE: Stress, Identity, and Mental Health study, we examined the health effects of discrimination among individuals who self-identified as lesbian, gay, or bisexual. We used logistic and linear regression to assess whether multifactorial discrimination met the four criteria designating a fundamental cause, namely that the cause: 1) influences multiple health outcomes, 2) affects multiple risk factors, 3) involves access to resources that can be leveraged to reduce consequences of disease, and 4) reproduces itself in varied contexts through changing mechanisms. Multifactorial discrimination predicted high depression scores, psychological well-being, and substance use disorder diagnosis. Discrimination was positively associated with risk factors for high depression scores: chronic strain and total number of stressful life events. Discrimination was associated with significantly lower levels of mastery and self-esteem, protective factors for depressive symptomatology. Even after controlling for risk factors, discrimination remained a significant predictor for high depression scores. Among subjects with low depression scores, multifactorial discrimination also predicted anxiety and aggregate mental health scores. Multifactorial discrimination should be considered a fundamental cause of mental health inequities and may be an important cause of broad health disparities among populations with intersecting social identities.

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.

Harnessing Implementation Science to Increase the Impact of Health Disparity Research

PubMed Central

Chinman, Matthew; Woodward, Eva N.; Curran, Geoffrey M.; Hausmann, Leslie R. M.

2017-01-01

Background Health disparities are differences in health or health care between groups based on social, economic, and/or environmental disadvantage. Disparity research often follows three steps: detecting (Phase 1), understanding (Phase 2), and reducing (Phase 3), disparities. While disparities have narrowed over time, many remain. Objectives We argue that implementation science could enhance disparities research by broadening the scope of Phase 2 studies and offering rigorous methods to test disparity-reducing implementation strategies in Phase 3 studies. Methods We briefly review the focus of Phase 2 and Phase 3 disparities research. We then provide a decision tree and case examples to illustrate how implementation science frameworks and research designs could further enhance disparity research. Results Most health disparities research emphasizes patient and provider factors as predominant mechanisms underlying disparities. Applying implementation science frameworks like the Consolidated Framework for Implementation Research could help disparities research widen its scope in Phase 2 studies and, in turn, develop broader disparities-reducing implementation strategies in Phase 3 studies. Many Phase 3 studies of disparity reducing implementation strategies are similar to case studies, whose designs are not able to fully test causality. Implementation science research designs offer rigorous methods that could accelerate the pace at which equity is achieved in real world practice. Conclusions Disparities can be considered a “special case” of implementation challenges—when evidence-based clinical interventions are delivered to, and received by, vulnerable populations at lower rates. Bringing together health disparities research and implementation science could advance equity more than either could achieve on their own. PMID:28806362

The National Library of Medicine's 2004 "Symposium on community-based health information outreach". Introduction.

PubMed

Peay, Wayne J; Rockoff, Maxine L

2005-10-01

This paper introduces the special supplement to the Journal of the Medical Library Association (JMLA) that documents the proceedings of the "Symposium on Community-based Health Information Outreach" held on December 2 and 3, 2004, at the National Library of Medicine (NLM). The goal of the symposium was to explore new models of health information outreach that are emerging as technology dramatically changes the abilities of medical and health services libraries to provide resources and services beyond their traditional institutional boundaries, with particular concern for consumer health information outreach through community-based organizations. The symposium's primary objectives were to learn about successful and promising work that had already been done as well as to develop a vision for the future that could inform the NLM's next National Network of Libraries of Medicine (NN/LM) contract. Another objective was to review and assess the NLM's Strategic Plan to Reduce Health Disparities with special emphasis on Native Americans. The paper describes the background events and rationale that led to the NLM's decision to convene the symposium and summarizes the supplement's ten other papers, some of which were presented at the symposium and some of which were written afterward to capture the symposium's working sessions. The symposium convened approximately 150 invited participants with a wide variety of perspectives and experience. Sessions were held to present exemplary outreach projects, to review the NLM's Strategic Plan to Reduce Health Disparities, to summarize the research underpinnings for evaluating outreach projects, and to provide a futurist's perspective. A panel of community representatives gave voice to the participants in outreach projects, and sixteen posters describing outreach projects were available, many of them with community representatives on hand to explain the work. This JMLA supplement provides a comprehensive summary of the state of the art in community-based outreach and a jumping-off point for future outreach efforts.

Introduction*

PubMed Central

Peay, Wayne J.; Rockoff, Maxine L.

2005-01-01

Objectives: This paper introduces the special supplement to the Journal of the Medical Library Association (JMLA) that documents the proceedings of the “Symposium on Community-based Health Information Outreach” held on December 2 and 3, 2004, at the National Library of Medicine (NLM). The goal of the symposium was to explore new models of health information outreach that are emerging as technology dramatically changes the abilities of medical and health services libraries to provide resources and services beyond their traditional institutional boundaries, with particular concern for consumer health information outreach through community-based organizations. The symposium's primary objectives were to learn about successful and promising work that had already been done as well as to develop a vision for the future that could inform the NLM's next National Network of Libraries of Medicine (NN/LM) contract. Another objective was to review and assess the NLM's Strategic Plan to Reduce Health Disparities with special emphasis on Native Americans. Method: The paper describes the background events and rationale that led to the NLM's decision to convene the symposium and summarizes the supplement's ten other papers, some of which were presented at the symposium and some of which were written afterward to capture the symposium's working sessions. Results: The symposium convened approximately 150 invited participants with a wide variety of perspectives and experience. Sessions were held to present exemplary outreach projects, to review the NLM's Strategic Plan to Reduce Health Disparities, to summarize the research underpinnings for evaluating outreach projects, and to provide a futurist's perspective. A panel of community representatives gave voice to the participants in outreach projects, and sixteen posters describing outreach projects were available, many of them with community representatives on hand to explain the work. Implications: This JMLA supplement provides a comprehensive summary of the state of the art in community-based outreach and a jumping-off point for future outreach efforts. PMID:16437797

Harnessing Implementation Science to Increase the Impact of Health Equity Research.

PubMed

Chinman, Matthew; Woodward, Eva N; Curran, Geoffrey M; Hausmann, Leslie R M

2017-09-01

Health disparities are differences in health or health care between groups based on social, economic, and/or environmental disadvantage. Disparity research often follows 3 steps: detecting (phase 1), understanding (phase 2), and reducing (phase 3), disparities. Although disparities have narrowed over time, many remain. We argue that implementation science could enhance disparities research by broadening the scope of phase 2 studies and offering rigorous methods to test disparity-reducing implementation strategies in phase 3 studies. We briefly review the focus of phase 2 and phase 3 disparities research. We then provide a decision tree and case examples to illustrate how implementation science frameworks and research designs could further enhance disparity research. Most health disparities research emphasizes patient and provider factors as predominant mechanisms underlying disparities. Applying implementation science frameworks like the Consolidated Framework for Implementation Research could help disparities research widen its scope in phase 2 studies and, in turn, develop broader disparities-reducing implementation strategies in phase 3 studies. Many phase 3 studies of disparity-reducing implementation strategies are similar to case studies, whose designs are not able to fully test causality. Implementation science research designs offer rigorous methods that could accelerate the pace at which equity is achieved in real-world practice. Disparities can be considered a "special case" of implementation challenges-when evidence-based clinical interventions are delivered to, and received by, vulnerable populations at lower rates. Bringing together health disparities research and implementation science could advance equity more than either could achieve on their own.

Census Tract Poverty and Racial Disparities in HIV Rates in Milwaukee County, Wisconsin, 2009-2014.

PubMed

Gibson, Crystal; Grande, Katarina; Schumann, Casey; Gasiorowicz, Mari

2018-02-22

Previous work has documented associations between poverty and HIV. Understanding of these relationships at local levels could help target prevention efforts; however, HIV surveillance systems do not capture individual-level poverty measures. We utilized the Public Health Disparities Geocoding Project methods to examine HIV rates by census tract poverty. HIV rates and rate ratios were computed by census tract poverty (< 5.0, 5.0-9.9, 10.0-19.9, > 20.0% of individual below the federal poverty level) for all races and stratified by Black and White race using Poisson regression. We observed higher HIV rates in the highest poverty gradient compared to the lowest poverty gradient for all races combined and among White cases. After adjustment, HIV rates were similar across poverty gradients for all comparisons. Our findings suggest that the association between poverty and HIV may differ by subpopulation, while demonstrating the potential for HIV prevention targeting residents of high poverty areas.

Leading by Success: Impact of a Clinical & Translational Research Infrastructure Program to Address Health Inequities

PubMed Central

Shiramizu, Bruce; Shambaugh, Vicki; Petrovich, Helen; Seto, Todd B.; Ho, Tammy; Mokuau, Noreen; Hedges, Jerris R.

2016-01-01

Building research infrastructure capacity to address clinical and translational gaps has been a focus of funding agencies and foundations. Clinical and Translational Sciences Awards, Research Centers in Minority Institutions Infrastructure for Clinical and Translational Research (RCTR) and the Institutional Development Award Infrastructure for Clinical and Translational Research funded by United States (US) government to fund clinical translational research programs have existed for over a decade to address racial and ethnic health disparities across the US. While the impact on the nation’s health can’t be made in a short period, assessment of a program’s impact could be a litmus test to gauge its effectiveness at the institution and communities. We report the success of a Pilot Project Program in the University of Hawaii RCTR Award in advancing careers of emerging investigators and community collaborators. Our findings demonstrated that the investment has a far-reaching impact on engagement with community-based research collaborators, career advancement of health disparities investigators, and favorable impacts on health policy. PMID:27797013

Building Bridges to Address Health Disparities in Puerto Rico: the “Salud para Piñones” Project

PubMed Central

García-Rivera, Enid J.; Pacheco, Princess; Colón, Marielis; Mays, Mary Helen; Rivera, Maricruz; Munet-Díaz, Verónica; González, María del R.; Rodríguez, María; Rodríguez, Rebecca; Morales, Astrid

2017-01-01

Over the past several decades, Puerto Ricans have faced increased health threats from chronic diseases, particularly diabetes and hypertension. The patient-provider relationship is the main platform for individual disease management, whereas the community, as an agent of change for the community’s health status, has been limited in its support of individual health. Likewise, traditional research approaches within communities have placed academic researchers at the center of the process, considering their knowledge was of greater value than that of the community. In this paradigm, the academic researcher frequently owns and controls the research process. The primary aim is contributing to the scientific knowledge, but not necessarily to improve the community’s health status or empower communities for social change. In contrast, the community-based participatory research (CBPR) model brings community members and leaders together with researchers in a process that supports mutual learning and empowers the community to take a leadership role in its own health and well-being. This article describes the development of the community-campus partnership between the University of Puerto Rico School of Medicine and Piñones, a semi-rural community, and the resulting CBPR project: “Salud para Piñones”. This project represents a collaborative effort to understand and address the community’s health needs and health disparities based on the community’s participation as keystone of the process. This participatory approach represents a valuable ally in the development of long-term community-academy partnerships, thus providing opportunities to establish relevant and effective ways to translate evidence-based interventions into concrete actions that impact the individual and community’s wellbeing. PMID:28622406

Processing vertical size disparities in distinct depth planes.

PubMed

Duke, Philip A; Howard, Ian P

2012-08-17

A textured surface appears slanted about a vertical axis when the image in one eye is horizontally enlarged relative to the image in the other eye. The surface appears slanted in the opposite direction when the same image is vertically enlarged. Two superimposed textured surfaces with different horizontal size disparities appear as two surfaces that differ in slant. Superimposed textured surfaces with equal and opposite vertical size disparities appear as a single frontal surface. The vertical disparities are averaged. We investigated whether vertical size disparities are averaged across two superimposed textured surfaces in different depth planes or whether they induce distinct slants in the two depth planes. In Experiment 1, two superimposed textured surfaces with different vertical size disparities were presented in two depth planes defined by horizontal disparity. The surfaces induced distinct slants when the horizontal disparity was more than ±5 arcmin. Thus, vertical size disparities are not averaged over surfaces with different horizontal disparities. In Experiment 2 we confirmed that vertical size disparities are processed in surfaces away from the horopter, so the results of Experiment 1 cannot be explained by the processing of vertical size disparities in a fixated surface only. Together, these results show that vertical size disparities are processed separately in distinct depth planes. The results also suggest that vertical size disparities are not used to register slant globally by their effect on the registration of binocular direction of gaze.

Trends in Disparities in School District Level Expenditures per Pupil.

ERIC Educational Resources Information Center

Hussar, William; Sonnenberg, William

2000-01-01

Examines trends in disparities between districts in education expenditures from 1979-1980 to 1993-1994. Uses seven measures of educational disparity to present a cross-section of the different methods available. A majority of disparity measures indicate a decline in disparity in most states, but an increase in disparity for the United States as a…

Facilitating cancer research using natural language processing of pathology reports.

PubMed

Xu, Hua; Anderson, Kristin; Grann, Victor R; Friedman, Carol

2004-01-01

Many ongoing clinical research projects, such as projects involving studies associated with cancer, involve manual capture of information in surgical pathology reports so that the information can be used to determine the eligibility of recruited patients for the study and to provide other information, such as cancer prognosis. Natural language processing (NLP) systems offer an alternative to automated coding, but pathology reports have certain features that are difficult for NLP systems. This paper describes how a preprocessor was integrated with an existing NLP system (MedLEE) in order to reduce modification to the NLP system and to improve performance. The work was done in conjunction with an ongoing clinical research project that assesses disparities and risks of developing breast cancer for minority women. An evaluation of the system was performed using manually coded data from the research project's database as a gold standard. The evaluation outcome showed that the extended NLP system had a sensitivity of 90.6% and a precision of 91.6%. Results indicated that this system performed satisfactorily for capturing information for the cancer research project.

The syphilis elimination project: targeting the Hispanic community of Baltimore city.

PubMed

Endyke-Doran, Cara; Gonzalez, Rosa Maria; Trujillo, Marangellie; Solera, Angelo; Vigilance, Pierre N; Edwards, Lori A; Groves, Sara L

2007-01-01

The objective of the Syphilis Elimination Project was to decrease the incidence of syphilis in the Hispanic community of Baltimore City through a culturally appropriate health initiative. Both qualitative and quantitative methods were used in the study design. Surveillance data were used to collect testing information. Comparisons at the start and end of the project measured change in individual knowledge about syphilis. Cross-sectional data from interviews with business owners and qualitative comments from outreach workers evaluated perception of program effectiveness. The local health department collected surveillance data. A convenience sample of 63 Hispanic community members, 12 business owners/managers, and 8 outreach workers was utilized throughout the evaluation process. The project was a culturally appropriate approach to health promotion with street and business outreach. Post intervention there was a statistically significant increase in knowledge about syphilis within the Hispanic community and an increase in testing behaviors. The Syphilis Elimination Project was created in response to a marked increase in syphilis in Baltimore among the Hispanic population and a health disparity that existed within the city. It increased community members' knowledge of syphilis and positively influenced testing behaviors.

Conceptual framework of the Controlling Asthma in American Cities Project.

PubMed

Herman, Elizabeth Jane

2011-02-01

The Controlling Asthma in American Cities Project (CAACP) was designed to improve the control of asthma in inner-city populations of children with a disparate burden of symptoms and adverse outcomes. As with many chronic diseases, asthma is the manifestation of multiple biologic, environmental, and social determinants. In addition to appropriate medical management, individuals with asthma must have logistical, financial, and cultural access to environments that allow avoidance of asthma triggers and encourage good asthma management practices. In recognition of this complexity, the CAACP required the seven project sites to coordinate and synchronize multiple interventions (education, healthcare access, medical management, trigger reduction) at multiple levels (individual, home, school, community, and policy) through the collaboration of relevant groups, institutions, and individuals. This paper describes the "program theory" of the CAACP project-the assumptions about how the project worked, how the components were linked, and what outcomes were anticipated. It relates the subsequent papers in the supplement to the program theory and describes how the papers can inform and guide other community-based interventions, and advance the translation of scientific knowledge to effective interventions in communities of need.

Recurrent connectivity can account for the dynamics of disparity processing in V1

PubMed Central

Samonds, Jason M.; Potetz, Brian R.; Tyler, Christopher W.; Lee, Tai Sing

2013-01-01

Disparity tuning measured in the primary visual cortex (V1) is described well by the disparity energy model, but not all aspects of disparity tuning are fully explained by the model. Such deviations from the disparity energy model provide us with insight into how network interactions may play a role in disparity processing and help to solve the stereo correspondence problem. Here, we propose a neuronal circuit model with recurrent connections that provides a simple account of the observed deviations. The model is based on recurrent connections inferred from neurophysiological observations on spike timing correlations, and is in good accord with existing data on disparity tuning dynamics. We further performed two additional experiments to test predictions of the model. First, we increased the size of stimuli to drive more neurons and provide a stronger recurrent input. Our model predicted sharper disparity tuning for larger stimuli. Second, we displayed anti-correlated stereograms, where dots of opposite luminance polarity are matched between the left- and right-eye images and result in inverted disparity tuning in the disparity energy model. In this case, our model predicted reduced sharpening and strength of inverted disparity tuning. For both experiments, the dynamics of disparity tuning observed from the neurophysiological recordings in macaque V1 matched model simulation predictions. Overall, the results of this study support the notion that, while the disparity energy model provides a primary account of disparity tuning in V1 neurons, neural disparity processing in V1 neurons is refined by recurrent interactions among elements in the neural circuit. PMID:23407952

Urban Green Space and the Pursuit of Health Equity in Parts of the United States.

PubMed

Jennings, Viniece; Baptiste, April Karen; Osborne Jelks, Na'Taki; Skeete, Renée

2017-11-22

Research has demonstrated that inequitable access to green space can relate to health disparities or inequalities. This commentary aims to shift the dialogue to initiatives that have integrated green spaces in projects that may promote health equity in the United States. Specifically, we connect this topic to factors such as community revitalization, affordable housing, neighborhood walkability, food security, job creation, and youth engagement. We provide a synopsis of locations and initiatives in different phases of development along with characteristics to support effectiveness and strategies to overcome challenges. The projects cover locations such as Atlanta (GA), Los Angeles (CA), the District of Columbia (Washington D.C.), South Bronx (NY), and Utica (NY). Such insight can develop our understanding of green space projects that support health equity and inform the dialogue on this topic in ways that advance research and advocacy.

Urban Green Space and the Pursuit of Health Equity in Parts of the United States

PubMed Central

Jennings, Viniece; Baptiste, April Karen; Osborne Jelks, Na’Taki; Skeete, Renée

2017-01-01

Research has demonstrated that inequitable access to green space can relate to health disparities or inequalities. This commentary aims to shift the dialogue to initiatives that have integrated green spaces in projects that may promote health equity in the United States. Specifically, we connect this topic to factors such as community revitalization, affordable housing, neighborhood walkability, food security, job creation, and youth engagement. We provide a synopsis of locations and initiatives in different phases of development along with characteristics to support effectiveness and strategies to overcome challenges. The projects cover locations such as Atlanta (GA), Los Angeles (CA), the District of Columbia (Washington D.C.), South Bronx (NY), and Utica (NY). Such insight can develop our understanding of green space projects that support health equity and inform the dialogue on this topic in ways that advance research and advocacy. PMID:29165367

What Are Disparities? | NIH MedlinePlus the Magazine

MedlinePlus

... this page please turn JavaScript on. Feature: Health Disparities What Are Disparities? Past Issues / Spring 2016 Table of Contents The ... white males and black females. Why Do Health Disparities Exist? Disparities exist in nearly every aspect of ...

Comparative analysis of mitochondrial genomes of geographic variants of the gypsy moth, Lymantria dispar, reveals a previously undescribed genotypic entity

USDA-ARS?s Scientific Manuscript database

The gypsy moth, Lymantria dispar L., is one of the most destructive forest pests in the world. While the subspecies established in North America is the European gypsy moth (L. dispar dispar), whose females are flightless, the two Asian subspecies, L. dispar asiatica and L. dispar japonica, have flig...

Health-related disparities: influence of environmental factors.

PubMed

Olden, Kenneth; White, Sandra L

2005-07-01

Racial disparities in health cannot be explained solely on the basis of poverty, access to health care, behavior, or environmental factors. Their complex etiology is dependent on interactions between all these factors plus genetics. Scientists have been slow to consider genetics as a risk factor because genetic polymorphisms tend to be more variable within a race than between races. Now that studies are demonstrating the existence of racial differences in allelic frequencies for multiple genes affecting a single biologic mechanism, the present argument for a significant genetic role in contributing to health disparities is gaining support. Individuals vary, often significantly, in their response to environmental agents. This variability provides a high "background noise" when scientists examine human populations to identify environmental links to disease. This variability often masks important environmental contributors to disease risk and is a major impediment to efforts to investigate the causes of diseases.Fortunately, investments in the various genome projects have led to the development of tools and databases that can be used to help identify the genetic variations in environmental response genes that can lead to such wide differences in disease susceptibility. NIEHS developed the environ-mental genome project to catalog these genetic variants (polymorphisms)and to identify the ones that play a major role in human susceptibility to environmental agents. This information is being used in epidemiologic studies to pinpoint environmental contributors to disease better. The research summarized in this article is critically important for tying genetics and the environment to health disparities, and for the development of a rational approach to gauge environmental threats. Common variants in genes play pivotal roles in determining if or when illness or death result from exposure to drugs or environmental xenobiotics. Most common variants exist in all human populations, but their frequency can vary substantially,rendering individuals or groups more or less susceptible to particular environmental exposures. Such findings are consistent with the highly publicized analogy, "genetics loads the gun, but the environment pulls the trigger." That is, one can inherit the genetic predisposition to develop a disease but will do so only if or when exposed to the environmental trigger. Poor people have approximately the same genetic makeup as everyone else,but they have the unfortunate experience of living and working in environments containing multiple and high levels of carcinogens or other toxicants capable of interacting with susceptibility genes to cause disease.Furthermore, certain disadvantaged ethnic groups may have a higher incidence of certain susceptible genes that render them more vulnerable to adverse effects of the environments they inhabit. For both of these reasons,much of the nation's disease burden could likely be reduced through better environmental protection practices, especially in low-income and minority communities. Of the many implications of polymorphisms and frequency variations for public health and the practice of medicine, however, none is more urgent than the choice of drugs in therapy. Using such knowledge,randomized trials have identified race-specific drug response differences between blacks and whites [42].To date, most knowledge of the health effects of environmental factors is derived from studies of single agents. The reality, though, is that environmental contributions to health disparities are mostly from multiple agents. These simultaneous exposures to multiple risk factors, which may accumulate or interact synergistically, remain to be fully explained and defined.Finally, health disparity is a significant public health problem that cannot be solved using "business as usual" approaches for funding and priority setting. The current emphasis on basic and clinical research at the exclusion of public health and the social sciences does not provide the interdisciplinary research teams necessary to address such a complex problem as health disparities. Although the poor will always be with us, their health could be greatly improved if social, environmental, and genetic scientists could find ways to collaborate and develop more insightful and relevant ways to address the health of disadvantaged communities.

The Ensembl Web Site: Mechanics of a Genome Browser

PubMed Central

Stalker, James; Gibbins, Brian; Meidl, Patrick; Smith, James; Spooner, William; Hotz, Hans-Rudolf; Cox, Antony V.

2004-01-01

The Ensembl Web site (http://www.ensembl.org/) is the principal user interface to the data of the Ensembl project, and currently serves >500,000 pages (∼2.5 million hits) per week, providing access to >80 GB (gigabyte) of data to users in more than 80 countries. Built atop an open-source platform comprising Apache/mod_perl and the MySQL relational database management system, it is modular, extensible, and freely available. It is being actively reused and extended in several different projects, and has been downloaded and installed in companies and academic institutions worldwide. Here, we describe some of the technical features of the site, with particular reference to its dynamic configuration that enables it to handle disparate data from multiple species. PMID:15123591

The Ensembl Web site: mechanics of a genome browser.

PubMed

Stalker, James; Gibbins, Brian; Meidl, Patrick; Smith, James; Spooner, William; Hotz, Hans-Rudolf; Cox, Antony V

2004-05-01

The Ensembl Web site (http://www.ensembl.org/) is the principal user interface to the data of the Ensembl project, and currently serves >500,000 pages (approximately 2.5 million hits) per week, providing access to >80 GB (gigabyte) of data to users in more than 80 countries. Built atop an open-source platform comprising Apache/mod_perl and the MySQL relational database management system, it is modular, extensible, and freely available. It is being actively reused and extended in several different projects, and has been downloaded and installed in companies and academic institutions worldwide. Here, we describe some of the technical features of the site, with particular reference to its dynamic configuration that enables it to handle disparate data from multiple species.

Integrating Art and Science Through "Design Challenges"

NASA Astrophysics Data System (ADS)

Conner, L.; Pompea, S. M.; Tzou, C.; Guthrie, M.; Tsurusaki, B.; Danielson, J.

2015-12-01

Combining art with science can be a powerful way to engage audiences, yet there is little published evidence about effective STEAM approaches. Through our NSF-funded effort "Project STEAM: Integrating Art with Science to Build Science Identities among Girls," our team has developed a "design challenge" approach that combines optics, biology, and art. During these challenges, participants explore scientific concepts and use their understandings to design artistic products. The project aims to ultimately increase female representation in careers that currently have a high gender disparity, such as the geosciences, by changing attitudes and dispositions towards science among pre-middle school girls. We present evaluation and research results that suggest that our approach is effective in engaging and building science identities in participants.

The Data Acquisition System for the AAO 2-Degree Field Project

NASA Astrophysics Data System (ADS)

Shortridge, K.; Farrell, T. J.; Bailey, J. A.

1993-01-01

The software system being produced by AAO to control the new 2-degree field fibre positioner and spectrographs is described. The system has to mesh cleanly with the ADAM systems used at AAO for CCD data acquisition, and has to run on a network of disparate machines including VMS Vaxes, UNIX workstations, and VME systems running VxWorks. The basis of the new system is a task control layer that operates by sending self-defining hierarchically-structured and machine-independent messages.

Stereoscopic processing of crossed and uncrossed disparities in the human visual cortex.

PubMed

Li, Yuan; Zhang, Chuncheng; Hou, Chunping; Yao, Li; Zhang, Jiacai; Long, Zhiying

2017-12-21

Binocular disparity provides a powerful cue for depth perception in a stereoscopic environment. Despite increasing knowledge of the cortical areas that process disparity from neuroimaging studies, the neural mechanism underlying disparity sign processing [crossed disparity (CD)/uncrossed disparity (UD)] is still poorly understood. In the present study, functional magnetic resonance imaging (fMRI) was used to explore different neural features that are relevant to disparity-sign processing. We performed an fMRI experiment on 27 right-handed healthy human volunteers by using both general linear model (GLM) and multi-voxel pattern analysis (MVPA) methods. First, GLM was used to determine the cortical areas that displayed different responses to different disparity signs. Second, MVPA was used to determine how the cortical areas discriminate different disparity signs. The GLM analysis results indicated that shapes with UD induced significantly stronger activity in the sub-region (LO) of the lateral occipital cortex (LOC) than those with CD. The results of MVPA based on region of interest indicated that areas V3d and V3A displayed higher accuracy in the discrimination of crossed and uncrossed disparities than LOC. The results of searchlight-based MVPA indicated that the dorsal visual cortex showed significantly higher prediction accuracy than the ventral visual cortex and the sub-region LO of LOC showed high accuracy in the discrimination of crossed and uncrossed disparities. The results may suggest the dorsal visual areas are more discriminative to the disparity signs than the ventral visual areas although they are not sensitive to the disparity sign processing. Moreover, the LO in the ventral visual cortex is relevant to the recognition of shapes with different disparity signs and discriminative to the disparity sign.

Cancer Disparities - Cancer Currents Blog

Cancer.gov

Blog posts on cancer health disparities research—including factors that influence disparities, disparities-related research efforts, and diversity in the cancer research workforce—from NCI Cancer Currents.

75 FR 9421 - National Center on Minority Health and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

... Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel; Loan Repayment Program for Health Disparities Research..., National Center on Minority Health and Health Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda...

75 FR 29357 - National Center on Minority and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-25

... and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special NCMHD Health Disparities Research on Minority and Underserved... Health and Health Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892. (301) 594-8696...

The Growing Rural-Urban Disparity in India: Some Issues

NASA Astrophysics Data System (ADS)

Das, Dinesh; Pathak, Minakshee

2012-10-01

The paper critically examines the understanding, approach and indicators that have been used to measure the degree of disparity. It is fact that disparity exists everywhere. However, this paper highlights on disparities existing between rural and urban areas. In this context, it talks about 'whyí and 'howí disparities exist between rural and urban areas. The study suggests that 'incomeí is not a sufficient indicator to capture the magnitude of disparities at any level. It is, therefore, necessary to develop some indicators representing human resource development and infrastructure facility to understand the growing rural-urban disparity in India.

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

PubMed

Rowley, Diane L; Hogan, Vijaya

2012-04-01

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

Area-socioeconomic disparities in mental health service use among children involved in the child welfare system.

PubMed

Kim, Minseop; Garcia, Antonio R; Yang, Shuyan; Jung, Nahri

2018-06-01

Relying on data from a nationally representative sample of youth involved in the child welfare system (CWS) in 1999-2000 (the National Survey of Child and Adolescent Well-Being, Cohort 1) and 2008-2009 (Cohort 2), this study implemented a diverse set of disparity indicators to estimate area-socioeconomic disparities in mental health (MH) services use and changes in area-socioeconomic disparities between the two cohorts. Our study found that there are area-socioeconomic disparities in MH service use, indicating that the rates of MH service use among youth referred to the CWS differ by area-socioeconomic positions defined by county-level poverty rates. We also found that area-socioeconomic disparities increased over time. However, the magnitude of the increase varied widely across disparity measures, suggesting that there are different conclusions about the trend and magnitude of area-socioeconomic disparities, depending upon which disparity measures are implemented. A greater understanding of the methodological differences among disparity measures is warranted, which will in turn impact how interventions are designed to reduce socioeconomic disparities among children in the CWS. Copyright © 2018 Elsevier Ltd. All rights reserved.

Neural activity in cortical area V4 underlies fine disparity discrimination.

PubMed

Shiozaki, Hiroshi M; Tanabe, Seiji; Doi, Takahiro; Fujita, Ichiro

2012-03-14

Primates are capable of discriminating depth with remarkable precision using binocular disparity. Neurons in area V4 are selective for relative disparity, which is the crucial visual cue for discrimination of fine disparity. Here, we investigated the contribution of V4 neurons to fine disparity discrimination. Monkeys discriminated whether the center disk of a dynamic random-dot stereogram was in front of or behind its surrounding annulus. We first behaviorally tested the reference frame of the disparity representation used for performing this task. After learning the task with a set of surround disparities, the monkey generalized its responses to untrained surround disparities, indicating that the perceptual decisions were generated from a disparity representation in a relative frame of reference. We then recorded single-unit responses from V4 while the monkeys performed the task. On average, neuronal thresholds were higher than the behavioral thresholds. The most sensitive neurons reached thresholds as low as the psychophysical thresholds. For subthreshold disparities, the monkeys made frequent errors. The variable decisions were predictable from the fluctuation in the neuronal responses. The predictions were based on a decision model in which each V4 neuron transmits the evidence for the disparity it prefers. We finally altered the disparity representation artificially by means of microstimulation to V4. The decisions were systematically biased when microstimulation boosted the V4 responses. The bias was toward the direction predicted from the decision model. We suggest that disparity signals carried by V4 neurons underlie precise discrimination of fine stereoscopic depth.

Counties eliminating racial disparities in colorectal cancer mortality.

PubMed

Rust, George; Zhang, Shun; Yu, Zhongyuan; Caplan, Lee; Jain, Sanjay; Ayer, Turgay; McRoy, Luceta; Levine, Robert S

2016-06-01

Although colorectal cancer (CRC) mortality rates are declining, racial-ethnic disparities in CRC mortality nationally are widening. Herein, the authors attempted to identify county-level variations in this pattern, and to characterize counties with improving disparity trends. The authors examined 20-year trends in US county-level black-white disparities in CRC age-adjusted mortality rates during the study period between 1989 and 2010. Using a mixed linear model, counties were grouped into mutually exclusive patterns of black-white racial disparity trends in age-adjusted CRC mortality across 20 three-year rolling average data points. County-level characteristics from census data and from the Area Health Resources File were normalized and entered into a principal component analysis. Multinomial logistic regression models were used to test the relation between these factors (clusters of related contextual variables) and the disparity trend pattern group for each county. Counties were grouped into 4 disparity trend pattern groups: 1) persistent disparity (parallel black and white trend lines); 2) diverging (widening disparity); 3) sustained equality; and 4) converging (moving from disparate outcomes toward equality). The initial principal component analysis clustered the 82 independent variables into a smaller number of components, 6 of which explained 47% of the county-level variation in disparity trend patterns. County-level variation in social determinants, health care workforce, and health systems all were found to contribute to variations in cancer mortality disparity trend patterns from 1990 through 2010. Counties sustaining equality over time or moving from disparities to equality in cancer mortality suggest that disparities are not inevitable, and provide hope that more communities can achieve optimal and equitable cancer outcomes for all. Cancer 2016;122:1735-48. © 2016 American Cancer Society. © 2016 American Cancer Society.

Stereo transparency and the disparity gradient limit

NASA Technical Reports Server (NTRS)

McKee, Suzanne P.; Verghese, Preeti

2002-01-01

Several studies (Vision Research 15 (1975) 583; Perception 9 (1980) 671) have shown that binocular fusion is limited by the disparity gradient (disparity/distance) separating image points, rather than by their absolute disparity values. Points separated by a gradient >1 appear diplopic. These results are sometimes interpreted as a constraint on human stereo matching, rather than a constraint on fusion. Here we have used psychophysical measurements on stereo transparency to show that human stereo matching is not constrained by a gradient of 1. We created transparent surfaces composed of many pairs of dots, in which each member of a pair was assigned a disparity equal and opposite to the disparity of the other member. For example, each pair could be composed of one dot with a crossed disparity of 6' and the other with uncrossed disparity of 6', vertically separated by a parametrically varied distance. When the vertical separation between the paired dots was small, the disparity gradient for each pair was very steep. Nevertheless, these opponent-disparity dot pairs produced a striking appearance of two transparent surfaces for disparity gradients ranging between 0.5 and 3. The apparent depth separating the two transparent planes was correctly matched to an equivalent disparity defined by two opaque surfaces. A test target presented between the two transparent planes was easily detected, indicating robust segregation of the disparities associated with the paired dots into two transparent surfaces with few mismatches in the target plane. Our simulations using the Tsai-Victor model show that the response profiles produced by scaled disparity-energy mechanisms can account for many of our results on the transparency generated by steep gradients.

26 CFR 1.401(l)-5 - Overall permitted disparity limits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... fractions under Plan P as well as the employee's annual defined benefit excess plan disparity fractions... disparity rules apply to limit the disparity provided for a plan year if an employee benefits under more... the disparity provided for an employee's total years of service, either in a single plan or in more...

The (Missed) Potential of the Patient-centered Medical Home for Disparities.

PubMed

Reibling, Nadine; Rosenthal, Meredith B

2016-01-01

Disparities in health care and health outcomes are a significant problem in the United States. Delivery system reforms such as the patient-centered medical home (PCMH) could have important implications for disparities. To investigate what role disparities play in current PCMH initiatives and how their set-up might impact on disparities. We selected 4 state-based PCMH initiatives (Colorado, Massachusetts, Pennsylvania, and Rhode Island), 1 regional initiative in New Orleans, and 1 multistate initiative. We interviewed 30 key actors in these initiatives and 3 health policy experts on disparities in the context of PCMH. Interview data were coded using the constant comparative method. We find that disparities are not an explicit priority in PCMH initiatives. Nevertheless, many policymakers, providers, and initiative leaders believe that the model has the potential to reduce disparities. However, because of the funding structure of initiatives and the lack of adjustment of quality metrics, health policy experts do not share this optimism and safety-net providers report concerns and frustration. Even though disparities are currently not a priority in the PCMH community, the design of initiatives has important implications for disparities.

Health disparities between lesbian, gay, and bisexual adults and the general population in South Korea: Rainbow Connection Project I.

PubMed

Yi, Horim; Lee, Hyemin; Park, Jooyoung; Choi, Bokyoung; Kim, Seung-Sup

2017-01-01

This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in Korea, where there is low public acceptance of sexual minorities and a lack of research on the health of sexual minorities. The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPRs) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPRs of the LGB adults and the general population which participated in three different nationally representative surveys in Korea. SPRs were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women). Korean LGB adults exhibited a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempts, and musculoskeletal pain than the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general women population, whereas gay and bisexual men showed no differences with the general men population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed in bisexual men. The findings suggest that LGB adults have poorer health conditions compared to the general population in Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.

Stereo-based Collision Avoidance System for Urban Traffic

NASA Astrophysics Data System (ADS)

Moriya, Takashi; Ishikawa, Naoto; Sasaki, Kazuyuki; Nakajima, Masato

2002-11-01

Numerous car accidents occur on urban road. However, researches done so far on driving assistance are subjecting highways whose environment is relatively simple and easy to handle, and new approach for urban settings is required. Our purpose is to extend its support to the following conditions in city traffic: the presence of obstacles such as pedestrians and telephone poles; the lane mark is not always drawn on a road; drivers may lack the sense of awareness of the lane mark. We propose a collision avoidance system, which can be applied to both highways and urban traffic environment. In our system, stereo cameras are set in front of a vehicle and the captured images are processed through a computer. We create a Projected Disparity Map (PDM) from stereo image pair, which is a disparity histogram taken along ordinate direction of obtained disparity image. When there is an obstacle in front, we can detect it by finding a peak appeared in the PDM. With a speed meter and a steering sensor, the stop distance and the radius of curvature of the self-vehicle are calculated, in order to set the observation-required area, which does not depend on lane marks, within a PDM. A danger level will be computed from the distance and the relative speed to the closest approaching object detected within the observation-required area. The method has been tested in urban traffic scenes and has shown to be effective for judging dangerous situation, and gives proper alarm to a driver.

The network of Shanghai Stroke Service System (4S): A public health-care web-based database using automatic extraction of electronic medical records.

PubMed

Dong, Yi; Fang, Kun; Wang, Xin; Chen, Shengdi; Liu, Xueyuan; Zhao, Yuwu; Guan, Yangtai; Cai, Dingfang; Li, Gang; Liu, Jianmin; Liu, Jianren; Zhuang, Jianhua; Wang, Panshi; Chen, Xin; Shen, Haipeng; Wang, David Z; Xian, Ying; Feng, Wuwei; Campbell, Bruce Cv; Parsons, Mark; Dong, Qiang

2018-07-01

Background Several stroke outcome and quality control projects have demonstrated the success in stroke care quality improvement through structured process. However, Chinese health-care systems are challenged with its overwhelming numbers of patients, limited resources, and large regional disparities. Aim To improve quality of stroke care to address regional disparities through process improvement. Method and design The Shanghai Stroke Service System (4S) is established as a regional network for stroke care quality improvement in the Shanghai metropolitan area. The 4S registry uses a web-based database that automatically extracts data from structured electronic medical records. Site-specific education and training program will be designed and administrated according to their baseline characteristics. Both acute reperfusion therapies including thrombectomy and thrombolysis in the acute phase and subsequent care were measured and monitored with feedback. Primary outcome is to evaluate the differences in quality metrics between baseline characteristics (including rate of thrombolysis in acute stroke and key performance indicators in secondary prevention) and post-intervention. Conclusions The 4S system is a regional stroke network that monitors the ongoing stroke care quality in Shanghai. This project will provide the opportunity to evaluate the spectrum of acute stroke care and design quality improvement processes for better stroke care. A regional stroke network model for quality improvement will be explored and might be expanded to other large cities in China. Clinical Trial Registration-URL http://www.clinicaltrials.gov . Unique identifier: NCT02735226.

Increasing access to care for young adults with cancer: Results of a quality-improvement project using a novel telemedicine approach to supportive group psychotherapy.

PubMed

Melton, Laura; Brewer, Benjamin; Kolva, Elissa; Joshi, Tanisha; Bunch, Michelle

2017-04-01

Young adults with cancer experience high levels of psychological distress. Group interventions for cancer patients have been effective in reducing levels of psychological distress but suffer from high levels of attrition and serve a limited geographic area. In a quality-improvement project, we converted an existing in-person support group to a telemedicine format in the hopes of improving attendance and reducing geographic disparities in access to care. Eight young adults (18-40 years) with cancer were recruited from across Colorado. Participants received a tablet equipped with Wi-Fi and downloaded an HIPAA-compliant video-conferencing application. Participants attended six weekly supportive psychotherapy sessions. Participants found the group to be beneficial: the technology worked, they enjoyed the group format, and they would recommend it to others. The novel treatment interface allowed for low attrition rates due to the flexibility of a patient's location during the intervention. It allowed for provision of services to a geographically diverse population of medically ill young adults, as participants lived an average of 148 miles from the cancer center (range = 25-406 miles). Internet-based mental health care is an area of growing interest for providers, but few studies have evaluated its efficacy in patients with cancer, and even fewer in young adults with cancer. Incorporating technological advances into clinical practice will increase access to care, reduce geographic health disparities, and provide more consistent services.

Response functions for sine- and square-wave modulations of disparity.

NASA Technical Reports Server (NTRS)

Richards, W.

1972-01-01

Depth sensations cannot be elicited by modulations of disparity that are more rapid than about 6 Hz, regardless of the modulation amplitude. Vergence tracking also fails at similar modulation rates, suggesting that this portion of the oculomotor system is limited by the behavior of disparity detectors. For sinusoidal modulations of disparity between 1/2 to 2 deg of disparity, most depth-response functions exhibit a low-frequency decrease that is not observed with square-wave modulations of disparity.

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…

Current Trends in Racial, Ethnic, and Healthcare Disparities Associated with Pediatric Cardiac Surgery Outcomes

PubMed Central

Peterson, Jennifer K.; Chen, Yanjun; Nguyen, Danh V.; Setty, Shaun P.

2017-01-01

Objective Despite overall improvements in congenital heart disease outcomes, racial and ethnic disparities have continued. The purpose of this study is to examine the effect of race and ethnicity, as well as other risk factors on congenital heart surgery length of stay and in-hospital mortality. Design From the 2012 Healthcare Cost and Utilization Project Kids Inpatient Database (KID), we identified 13,130 records with Risk Adjustment in Congenital Heart Surgery complexity score-eligible procedures. Multivariate logistic and linear regression modeling with survey weights, stratification and clustering was used to examine the relationships between predictor variables and length of stay as well as in-hospital mortality. Results No significant mortality differences were found among all race and ethnicity groups across each age group. Black neonates and black infants had a longer length of stay (neonatal Estimate = 8.73 days, p = .0034; infant Estimate 1.10 days, p = 0.0253), relative to whites. Government-sponsored insurance was associated with increased odds of neonatal mortality (odds ratio = 1.51, p = .0055), increased length of stay in neonates (Estimate = 4.26 days, p = .0009) and infants (Estimate = 1.52 days, p = .0181), relative to private insurance. Government-sponsored insurance was associated with increased number of chronic conditions, which were also associated with increased LOS (estimate 8.39 days, p < 0.001 in neonates; estimate 3.60 days, p < 0.001 in infants; estimate 1.87 days, p < 0.001 children). Conclusions Racial/ethnic disparities in congenital heart surgical outcomes may be changing compared to previous studies using the KID database. Increased length of stay in children with government-sponsored insurance may reflect expansion of individual states government-sponsored insurance eligibility criteria for children with complex chronic medical conditions. These findings warrant cautious optimism regarding racial and ethnic disparities in congenital heart surgery outcomes. PMID:28544396

Cross-matching: a modified cross-correlation underlying threshold energy model and match-based depth perception

PubMed Central

Doi, Takahiro; Fujita, Ichiro

2014-01-01

Three-dimensional visual perception requires correct matching of images projected to the left and right eyes. The matching process is faced with an ambiguity: part of one eye's image can be matched to multiple parts of the other eye's image. This stereo correspondence problem is complicated for random-dot stereograms (RDSs), because dots with an identical appearance produce numerous potential matches. Despite such complexity, human subjects can perceive a coherent depth structure. A coherent solution to the correspondence problem does not exist for anticorrelated RDSs (aRDSs), in which luminance contrast is reversed in one eye. Neurons in the visual cortex reduce disparity selectivity for aRDSs progressively along the visual processing hierarchy. A disparity-energy model followed by threshold nonlinearity (threshold energy model) can account for this reduction, providing a possible mechanism for the neural matching process. However, the essential computation underlying the threshold energy model is not clear. Here, we propose that a nonlinear modification of cross-correlation, which we term “cross-matching,” represents the essence of the threshold energy model. We placed half-wave rectification within the cross-correlation of the left-eye and right-eye images. The disparity tuning derived from cross-matching was attenuated for aRDSs. We simulated a psychometric curve as a function of graded anticorrelation (graded mixture of aRDS and normal RDS); this simulated curve reproduced the match-based psychometric function observed in human near/far discrimination. The dot density was 25% for both simulation and observation. We predicted that as the dot density increased, the performance for aRDSs should decrease below chance (i.e., reversed depth), and the level of anticorrelation that nullifies depth perception should also decrease. We suggest that cross-matching serves as a simple computation underlying the match-based disparity signals in stereoscopic depth perception. PMID:25360107

Disparities in long-term care: building equity into market-based reforms.

PubMed

Konetzka, R Tamara; Werner, Rachel M

2009-10-01

A growing body of evidence documents pervasive racial, ethnic, and class disparities in long-term care in the United States. At the same time, major quality improvement initiatives are being implemented that rely on market-based incentives, many of which may have the unintended consequence of exacerbating disparities. We review existing evidence on disparities in the use and quality of long-term care services, analyze current market-based policy initiatives in terms of their potential to ameliorate or exacerbate these disparities, and suggest policies and policy modifications that may help decrease disparities. We find that racial disparities in the use of formal long-term care have decreased over time. Disparities in quality of care are more consistently documented and appear to be related to racial and socioeconomic segregation of long-term care facilities as opposed to within-provider discrimination. Market-based incentives policies should explicitly incorporate the goal of mitigating the potential unintended consequence of increased disparities.

The Moral Problem of Health Disparities

PubMed Central

2010-01-01

Health disparities exist along lines of race/ethnicity and socioeconomic class in US society. I argue that we should work to eliminate these health disparities because their existence is a moral wrong that needs to be addressed. Health disparities are morally wrong because they exemplify historical injustices. Contractarian ethics, Kantian ethics, and utilitarian ethics all provide theoretical justification for viewing health disparities as a moral wrong, as do several ethical principles of primary importance in bioethics. The moral consequences of health disparities are also troubling and further support the claim that these disparities are a moral wrong. The Universal Declaration of Human Rights provides additional support that health disparities are a moral wrong, as does an analogy with the generally accepted duty to provide equal access to education. In this article, I also consider and respond to 3 objections to my thesis. PMID:20147677

Reducing and eliminating health disparities: a targeted approach.

PubMed Central

Green, B. Lee; Lewis, Rhonda K.; Bediako, Shawn M.

2005-01-01

Health disparities have dominated recent discourse among public health and medical researchers. Ever since the United States began to compile health statistics, differences in health status have been noted between majority and non-majority populations. Myriad approaches have been undertaken in an attempt to reduce or eliminate racial and ethnic disparities in health. However, the disparities continue to persist. We are at a point in our history where innovative strategies must be explored that will be more effective in addressing racial and ethnic disparities in health. In large part, health disparities exist as a result of inequitable distribution of goods, resources, services and power in America. We have learned that improvements in health cannot come about solely through primary and secondary interventions but rather through an examination of the availability of resources that would allow individuals to improve their health. The goal of this paper is to provide an overview of the contextual factors that affect health disparities, to integrate theory to address disparities and to provide recommendations to encourage systematic changes to eliminate health disparities. It is hoped that this paper will bring about a national discussion relating to addressing the real issues we face in reducing and ultimately eliminating health disparities. PMID:15719868

Decomposing Racial/Ethnic Disparities in Influenza Vaccination among the Elderly

PubMed Central

Yoo, Byung-Kwang; Hasebe, Takuya; Szilagyi, Peter G.

2015-01-01

While persistent racial/ethnic disparities in influenza vaccination have been reported among the elderly, characteristics contributing to disparities are poorly understood. This study aimed to assess characteristics associated with racial/ethnic disparities in influenza vaccination using a nonlinear Oaxaca-Blinder decomposition method. We performed cross-sectional multivariable logistic regression analyses for which the dependent variable was self-reported receipt of influenza vaccine during the 2010–2011 season among community dwelling non-Hispanic African-American (AA), non-Hispanic White (W), English-speaking Hispanic (EH) and Spanish-speaking Hispanic (SH) elderly, enrolled in the 2011 Medicare Current Beneficiary Survey (MCBS) (un-weighted/weighted N= 6,095/19.2million). Using the nonlinear Oaxaca-Blinder decomposition method, we assessed the relative contribution of seventeen covariates—including socio-demographic characteristics, health status, insurance, access, preference regarding healthcare, and geographic regions —to disparities in influenza vaccination. Unadjusted racial/ethnic disparities in influenza vaccination were 14.1 percentage points (pp) (W-AA disparity, p<.001), 25.7 pp (W-SH disparity, p<.001) and 0.6 pp (W-EH disparity, p>.8). The Oaxaca-Blinder decomposition method estimated that the unadjusted W-AA and W-SH disparities in vaccination could be reduced by only 45% even if AA and SH groups become equivalent to Whites in all covariates in multivariable regression models. The remaining 55% of disparities were attributed to (a) racial/ethnic differences in the estimated coefficients (e.g., odds ratios) in the regression models and (b) characteristics not included in the regression models. Our analysis found that only about 45% of racial/ethnic disparities in influenza vaccination among the elderly could be reduced by equalizing recognized characteristics among racial/ethnic groups. Future studies are needed to identify additional modifiable characteristics causing disparities in influenza vaccination. PMID:25900133

GIMI: the past, the present and the future.

PubMed

Simpson, Andrew; Power, David; Russell, Douglas; Slaymaker, Mark; Bailey, Vernon; Tromans, Chris; Brady, Michael; Tarassenko, Lionel

2010-08-28

In keeping with the theme of this year's e-Science All Hands Meeting--past, present and future--we consider the motivation for, the current status of, and the future directions for, the technologies developed within the GIMI (Generic Infrastructure for Medical Informatics) project. This analysis provides insights into how some key problems in data federation may be addressed. GIMI was funded by the UK's Technology Strategy Board with the intention of developing a service-oriented framework to facilitate the secure sharing and aggregation of heterogeneous data from disparate sources to support a range of healthcare applications. The project, which was led by the University of Oxford, involved collaboration from the National Cancer Research Institute Informatics Initiative, Loughborough University, University College London, t+ Medical, Siemens Molecular Imaging and IBM UK.

The intersection of disability and healthcare disparities: a conceptual framework.

PubMed

Meade, Michelle A; Mahmoudi, Elham; Lee, Shoou-Yih

2015-01-01

This article provides a conceptual framework for understanding healthcare disparities experienced by individuals with disabilities. While health disparities are the result of factors deeply rooted in culture, life style, socioeconomic status, and accessibility of resources, healthcare disparities are a subset of health disparities that reflect differences in access to and quality of healthcare and can be viewed as the inability of the healthcare system to adequately address the needs of specific population groups. This article uses a narrative method to identify and critique the main conceptual frameworks that have been used in analyzing disparities in healthcare access and quality, and evaluating those frameworks in the context of healthcare for individuals with disabilities. Specific models that are examined include the Aday and Anderson Model, the Grossman Utility Model, the Institute of Medicine (IOM)'s models of Access to Healthcare Services and Healthcare Disparities, and the Cultural Competency model. While existing frameworks advance understandings of disparities in healthcare access and quality, they fall short when applied to individuals with disabilities. Specific deficits include a lack of attention to cultural and contextual factors (Aday and Andersen framework), unrealistic assumptions regarding equal access to resources (Grossman's utility model), lack of recognition or inclusion of concepts of structural accessibility (IOM model of Healthcare Disparities) and exclusive emphasis on supply side of the healthcare equation to improve healthcare disparities (Cultural Competency model). In response to identified gaps in the literature and short-comings of current conceptualizations, an integrated model of disability and healthcare disparities is put forth. We analyzed models of access to care and disparities in healthcare to be able to have an integrated and cohesive conceptual framework that could potentially address issues related to access to healthcare among individuals with disabilities. The Model of Healthcare Disparities and Disability (MHDD) provides a framework for conceptualizing how healthcare disparities impact disability and specifically, how a mismatch between personal and environmental factors may result in reduced healthcare access and quality, which in turn may lead to reduced functioning, activity and participation among individuals with impairments and chronic health conditions. Researchers, health providers, policy makers and community advocate groups who are engaged in devising interventions aimed at reducing healthcare disparities would benefit from the discussions. Implications for Rehabilitation Evaluates the main models of healthcare disparity and disability to create an integrated framework. Provides a comprehensive conceptual model of healthcare disparity that specifically targets issues related to individuals with disabilities. Conceptualizes how personal and environmental factors interact to produce disparities in access to healthcare and healthcare quality. Recognizes and targets modifiable factors to reduce disparities between and within individuals with disabilities.

Promoting Health Equity And Eliminating Disparities Through Performance Measurement And Payment.

PubMed

Anderson, Andrew C; O'Rourke, Erin; Chin, Marshall H; Ponce, Ninez A; Bernheim, Susannah M; Burstin, Helen

2018-03-01

Current approaches to health care quality have failed to reduce health care disparities. Despite dramatic increases in the use of quality measurement and associated payment policies, there has been no notable implementation of measurement strategies to reduce health disparities. The National Quality Forum developed a road map to demonstrate how measurement and associated policies can contribute to eliminating disparities and promote health equity. Specifically, the road map presents a four-part strategy whose components are identifying and prioritizing areas to reduce health disparities, implementing evidence-based interventions to reduce disparities, investing in the development and use of health equity performance measures, and incentivizing the reduction of health disparities and achievement of health equity. To demonstrate how the road map can be applied, we present an example of how measurement and value-based payment can be used to reduce racial disparities in hypertension among African Americans.

Socioeconomic disparities in indoor air, breath, and blood perchloroethylene level among adult and child residents of buildings with or without a dry cleaner.

PubMed

Storm, Jan E; Mazor, Kimberly A; Shost, Stephen J; Serle, Janet; Aldous, Kenneth M; Blount, Benjamin C

2013-04-01

In many cities, dry cleaners using perchloroethylene are frequently located in multifamily residential buildings and often cause elevated indoor air levels of perchloroethylene throughout the building. To assess individual perchloroethylene exposures associated with co-located dry cleaners, we measured perchloroethylene in residential indoor air, and in blood and breath of adults and children residing in buildings with a dry cleaner as part of the New York City (NYC) Perc Project. We also measured perchloroethylene in indoor air, and in blood and breath of residents of buildings without a dry cleaner for comparison. Here, we evaluate whether an environmental disparity in perchloroethylene exposures is present. Study participants are stratified by residential building type (dry cleaner or reference) and socioeconomic characteristics (race/ethnicity and income); measures of perchloroethylene exposure are examined; and, the influence of stratified variables and other factors on perchloroethylene exposure is assessed using multivariate regression. All measures of perchloroethylene exposure for residents of buildings with a dry cleaner indicated a socioeconomic disparity. Mean indoor air perchloroethylene levels were about five times higher in minority (82.5 ug/m(3)) than in non-minority (16.5 ug/m(3)) households, and about six times higher in low-income (105.5 ug/m(3)) than in high income (17.8 ug/m(3)) households. Mean blood perchloroethylene levels in minority children (0.27 ng/mL) and adults (0.46 ng/mL) were about two and three times higher than in non-minority children (0.12 ng/mL) and adults (0.15 ng/mL), respectively. Mean blood perchloroethylene levels in low income children (0.34 ng/mL) and adults (0.62 ng/mL) were about three and four times higher than in high income children (0.11 ng/mL) and adults (0.14 ng/mL), respectively. A less marked socioeconomic disparity was observed in perchloroethylene breath levels with minority and low income residents having slightly higher levels than non-minority and high income residents. Multivariate regression affirmed that indoor air perchloroethylene level in dry cleaner buildings was the single most important factor determining perchloroethylene in blood and breath. Neither age, gender, nor socioeconomic status significantly influenced perchloroethylene levels in breath or blood. We previously reported that increased indoor air, breath, and blood perchloroethylene levels among NYC Perc Project child participants were associated with an increased risk for slightly altered vision. Thus, the disproportionately elevated perchloroethylene exposures of minority and low-income child residents of buildings with a dry cleaner shown here constitutes an environmental exposure disparity with potential public health consequences. Among residents of buildings without a dry cleaner, we observed some small increases in perchloroethylene breath and blood levels among non-minority or high income residents compared to minority or low income residents. These differences were not attributable to differences in indoor air levels of perchloroethylene which did not differ across socioeconomic categories, but appear to be associated with more frequent exposures dry cleaned garments. Copyright © 2013 Elsevier Inc. All rights reserved.

An exploration of gender participation patterns in science competitions

NASA Astrophysics Data System (ADS)

Arámbula Greenfield, Teresa

This study investigated participation in a state-level science competition over most of its 35-year history. Issues examined included whether different gender patterns occurred with respect to entry rate, project topic (life science, physical science, earth science, and math), and project type (research or display). The study also examined to what extent the identified patterns reflected or contradicted nationwide patterns of girls' academic performance in science over roughly the same time period. It was found that although girls initially participated in the fair less frequently than boys, for the past 20 years their participation rate has been greater than that of boys. Examination of topic preferences over the years indicates that both girls and boys have traditionally favored life science; however, boys have been and continue to be more likely to prepare physical, earth, and math/computer science projects than girls. Another gender difference is that girls are generally less likely than boys to prepare projects based on experimental research as opposed to library research. The study provides some suggestions for teachers and teacher educators for addressing these disparities.Received: 4 February 1994; Revised: 12 January 1995;

A Community-Engaged Cardiovascular Health Disparities Research Training Curriculum: Implementation and Preliminary Outcomes

PubMed Central

Golden, Sherita Hill; Purnell, Tanjala; Halbert, Jennifer P.; Matens, Richard; Miller, Edgar R. “Pete”; Levine, David M.; Nguyen, Tam H.; Gudzune, Kimberly A.; Crews, Deidra C.; Mahlangu-Ngcobo, Mankekolo; Cooper, Lisa A.

2014-01-01

To overcome cardiovascular disease (CVD) disparities impacting high-risk populations, it is critical to train researchers and leaders in conducting community-engaged CVD disparities research. The authors summarize the key elements, implementation, and preliminary outcomes of the CVD Disparities Fellowship and Summer Internship Programs at the Johns Hopkins University Schools of Medicine, Nursing, and Bloomberg School of Public Health. In 2010, program faculty and coordinators established a trans-disciplinary CVD disparities training and career development fellowship program for scientific investigators who desire to conduct community-engaged clinical and translational disparities research. The program was developed to enhance mentorship support and research training for faculty, post-doctoral fellows, and pre-doctoral students interested in conducting CVD disparities research. A CVD Disparities Summer Internship Program for undergraduate and pre-professional students was also created to provide a broad experience in public health and health disparities in Baltimore, Maryland, with a focus on CVD. Since 2010, 39 pre-doctoral, post-doctoral, and faculty fellows have completed the program. Participating fellows have published disparities-related research and given presentations both nationally and internationally. Five research grant awards have been received by faculty fellows. Eight undergraduates, 1 post-baccalaureate, and 2 medical professional students representing seven universities have participated in the summer undergraduate internship. Over half of the undergraduate students are applying to or have been accepted into medical or graduate school. The tailored CVD health disparities training curriculum has been successful at equipping varying levels of trainees (from undergraduate students to faculty) with clinical research and public health expertise to conducting community-engaged CVD disparities research. PMID:25054421

Semi-autonomous wheelchair system using stereoscopic cameras.

PubMed

Nguyen, Jordan S; Nguyen, Thanh H; Nguyen, Hung T

2009-01-01

This paper is concerned with the design and development of a semi-autonomous wheelchair system using stereoscopic cameras to assist hands-free control technologies for severely disabled people. The stereoscopic cameras capture an image from both the left and right cameras, which are then processed with a Sum of Absolute Differences (SAD) correlation algorithm to establish correspondence between image features in the different views of the scene. This is used to produce a stereo disparity image containing information about the depth of objects away from the camera in the image. A geometric projection algorithm is then used to generate a 3-Dimensional (3D) point map, placing pixels of the disparity image in 3D space. This is then converted to a 2-Dimensional (2D) depth map allowing objects in the scene to be viewed and a safe travel path for the wheelchair to be planned and followed based on the user's commands. This assistive technology utilising stereoscopic cameras has the purpose of automated obstacle detection, path planning and following, and collision avoidance during navigation. Experimental results obtained in an indoor environment displayed the effectiveness of this assistive technology.

Communication strategies to reduce cancer disparities: Insights from African-American mother-daughter dyads.

PubMed

Mosavel, Maghboeba; Wilson Genderson, Maureen; Ports, Katie A; Carlyle, Kellie E

2015-12-01

Mothers and daughters share a powerful and unique bond, which has potential for the dissemination of information on a variety of women's health issues, including the primary and secondary prevention of breast and cervical cancer. This study presents formative research from a long-term project examining the potential of mother-daughter communication in promoting cancer screening among African American women. Thirty-two mother-daughter pairs (N = 64) completed orally administered surveys regarding their cancer knowledge, beliefs and attitudes, and barriers to care. This study compares the attitudes and beliefs of low-income, urban, African American mothers and their adolescent daughters regarding cervical and breast cancer screening. Both mothers and daughters had fairly high levels of knowledge about breast and cervical cancer. In addition, there was a high concordance rate between mothers' and daughters' responses, suggesting a potential sharing of health knowledge between mother and daughter. These results have implications for selecting communication strategies to reduce health disparities, and support that the mother-daughter dyad could be a viable unit to disseminate targeted screening information. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

An Integrated and Collaborative Approach for NASA Earth Science Data

NASA Technical Reports Server (NTRS)

Murphy, K.; Lowe, D.; Behnke, J.; Ramapriyan, H.; Behnke, J.; Sofinowski, E.

2012-01-01

Earth science research requires coordination and collaboration across multiple disparate science domains. Data systems that support this research are often as disparate as the disciplines that they support. These distinctions can create barriers limiting access to measurements, which could otherwise enable cross-discipline Earth science. NASA's Earth Observing System Data and Information System (EOSDIS) is continuing to bridge the gap between discipline-centric data systems with a coherent and transparent system of systems that offers up to date and engaging science related content, creates an active and immersive science user experience, and encourages the use of EOSDIS earth data and services. The new Earthdata Coherent Web (ECW) project encourages cohesiveness by combining existing websites, data and services into a unified website with a common look and feel, common tools and common processes. It includes cross-linking and cross-referencing across the Earthdata site and NASA's Distributed Active Archive Centers (DAAC), and by leveraging existing EOSDIS Cyber-infrastructure and Web Service technologies to foster re-use and to reduce barriers to discovering Earth science data (http://earthdata.nasa.gov).

A Multistate Asian-Language Tobacco Quitline: Addressing a Disparity in Access to Care.

PubMed

Cummins, Sharon E; Wong, Shiushing; Bonnevie, Erika; Lee, Hye-Ryeon; Goto, Cynthia J; McCree Carrington, Judy; Kirby, Carrie; Zhu, Shu-Hong

2015-10-01

We conducted a dissemination and implementation study to translate an intervention protocol for Asian-language smokers from an efficacy trial into an effective and sustainable multistate service. Three state tobacco programs (in California, Colorado, and Hawaii) promoted a multistate cessation quitline to 3 Asian-language-speaking communities: Chinese, Korean, and Vietnamese. The California quitline provided counseling centrally to facilitate implementation. Three more states joined the program during the study period (January 2010-July 2012). We assessed the provision of counseling, quitting outcomes, and dissemination of the program. A total of 2004 smokers called for the service, with 88.3% opting for counseling. Among those opting for counseling, the 6-month abstinence rate (18.8%) was similar to results of the earlier efficacy trial (16.4%). The intervention protocol, based on an efficacy trial, was successfully translated into a multistate service and further disseminated. This project paved the way for the establishment of a national quitline for Asian-language speakers, which serves as an important strategy to address disparities in access to care.

Effects of Human Development Index and Its Components on Colorectal Cancer Incidence and Mortality: a Global Ecological Study.

PubMed

Khazaei, Salman; Rezaeian, Shahab; Khazaei, Somayeh; Mansori, Kamyar; Sanjari Moghaddam, Ali; Ayubi, Erfan

2016-01-01

Geographic disparity for colorectal cancer (CRC) incidence and mortality according to the human development index (HDI) might be expected. This study aimed at quantifying the effect measure of association HDI and its components on the CRC incidence and mortality. In this ecological study, CRC incidence and mortality was obtained from GLOBOCAN, the global cancer project for 172 countries. Data were extracted about HDI 2013 for 169 countries from the World Bank report. Linear regression was constructed to measure effects of HDI and its components on CRC incidence and mortality. A positive trend between increasing HDI of countries and age-standardized rates per 100,000 of CRC incidence and mortality was observed. Among HDI components education was the strongest effect measure of association on CRC incidence and mortality, regression coefficients (95% confidence intervals) being 2.8 (2.4, 3.2) and 0.9 (0.8, 1), respectively. HDI and its components were positively related with CRC incidence and mortality and can be considered as targets for prevention and treatment intervention or tracking geographic disparities.

Luminance, Colour, Viewpoint and Border Enhanced Disparity Energy Model

PubMed Central

Martins, Jaime A.; Rodrigues, João M. F.; du Buf, Hans

2015-01-01

The visual cortex is able to extract disparity information through the use of binocular cells. This process is reflected by the Disparity Energy Model, which describes the role and functioning of simple and complex binocular neuron populations, and how they are able to extract disparity. This model uses explicit cell parameters to mathematically determine preferred cell disparities, like spatial frequencies, orientations, binocular phases and receptive field positions. However, the brain cannot access such explicit cell parameters; it must rely on cell responses. In this article, we implemented a trained binocular neuronal population, which encodes disparity information implicitly. This allows the population to learn how to decode disparities, in a similar way to how our visual system could have developed this ability during evolution. At the same time, responses of monocular simple and complex cells can also encode line and edge information, which is useful for refining disparities at object borders. The brain should then be able, starting from a low-level disparity draft, to integrate all information, including colour and viewpoint perspective, in order to propagate better estimates to higher cortical areas. PMID:26107954

Disparities in birth weight and gestational age by ethnic ancestry in South American countries.

PubMed

Wehby, George L; Gili, Juan A; Pawluk, Mariela; Castilla, Eduardo E; López-Camelo, Jorge S

2015-03-01

We examine disparities in birth weight and gestational age by ethnic ancestry in 2000-2011 in eight South American countries. The sample included 60,480 singleton live births. Regression models were estimated to evaluate differences in birth outcomes by ethnic ancestry controlling for time trends. Significant disparities were found in seven countries. In four countries-Brazil, Ecuador, Uruguay, and Venezuela-we found significant disparities in both low birth weight and preterm birth. Disparities in preterm birth alone were observed in Argentina, Bolivia, and Colombia. Several differences in continuous birth weight, gestational age, and fetal growth rate were also observed. There were no systematic patterns of disparities between the evaluated ethnic ancestry groups across the study countries, in that no racial/ethnic group consistently had the best or worst outcomes in all countries. Racial/ethnic disparities in infant health are common in several South American countries. Differences across countries suggest that racial/ethnic disparities are driven by social and economic mechanisms. Researchers and policymakers should acknowledge these disparities and develop research and policy programs to effectively target them.

The Limits of Human Stereopsis in Space and Time

PubMed Central

Kane, David; Guan, Phillip

2014-01-01

To encode binocular disparity, the visual system determines the image patches in one eye that yield the highest correlation with patches in the other eye. The computation of interocular correlation occurs after spatiotemporal filtering of monocular signals, which leads to restrictions on disparity variations that can support depth perception. We quantified those restrictions by measuring humans' ability to see disparity variation at a wide range of spatial and temporal frequencies. Lower-disparity thresholds cut off at very low spatiotemporal frequencies, which is consistent with the behavior of V1 neurons. Those thresholds are space–time separable, suggesting that the underlying neural mechanisms are separable. We also found that upper-disparity limits were characterized by a spatiotemporal, disparity-gradient limit; to be visible, disparity variation cannot exceed a fixed amount for a given interval in space–time. Our results illustrate that the disparity variations that humans can see are very restricted compared with the corresponding luminance variations. The results also provide insight into the neural mechanisms underlying depth from disparity, such as why stimuli with long interocular delays can still yield clear depth percepts. PMID:24453329

Center for Research on Minority Health -- Prostate Cancer and Health Disparities Research

DTIC Science & Technology

2008-05-01

making in various ethnic  groups . The “POP” model may facilitate further research with  underserved  communities and result in enhanced knowledge and...and about 65 students from Rice, Texas Southern University, UT Health Science Center, University of Houston-Main Campus and the University of...journal articles. 5. Hand in assigned work in a timely fashion. Group Research Projects for Powerpoint Presentations and Papers Students in

Using Community-based Participatory Research (CBPR) To Target Health Disparities in Families

PubMed Central

Berge, Jerica M.; Mendenhall, Tai J.; Doherty, William J.

2010-01-01

Community-based participatory research (CBPR) is an action research approach that emphasizes collaborative partnerships between community members, community organizations, health care providers, and researchers to generate knowledge and solve local problems. Although relatively new to the field of family social science, family and health researchers have been using CBPR for over a decade. This paper will introduce CBPR methods, illustrate the usefulness of CBPR methods in families and health research, describe two CBPR projects related to diabetes, and conclude with lessons learned and strengths and weaknesses of CBPR. PMID:20625444

Tales from the Paleoclimate Underground: Lessons Learned from Reconstructing Extreme Events

NASA Astrophysics Data System (ADS)

Frappier, A. E.

2017-12-01

Tracing patterns of paleoclimate extremes over the past two millennia is becoming ever more important in the effort to understand and predict costly weather hazards and their varied societal impacts. I present three paleoclimate vignettes from the past ten years of different paleotempestology projects I have worked on closely, illustrating our collective challenges and productive pathways in reconstructing rainfall extremes: temporal, spatial, and combining information from disparate proxies. Finally, I aim to share new results from modeling multiple extremes and hazards in Yucatan, a climate change hotspot.

Food Systems and Public Health Disparities

PubMed Central

Neff, Roni A.; Palmer, Anne M.; Mckenzie, Shawn E.; Lawrence, Robert S.

2009-01-01

The United States has set a national goal to eliminate health disparities. This article emphasizes the importance of food systems in generating and exacerbating health disparities in the United States and suggests avenues for reducing them. It presents a conceptual model showing how broad food system conditions interplay with community food environments—and how these relationships are filtered and refracted through prisms of social disparities to generate and exacerbate health disparities. Interactions with demand factors in the social environment are described. The article also highlights the separate food systems pathway to health disparities via environmental and occupational health effects of agriculture. PMID:23173027

Stereopsis, vertical disparity and relief transformations.

PubMed

Gårding, J; Porrill, J; Mayhew, J E; Frisby, J P

1995-03-01

The pattern of retinal binocular disparities acquired by a fixating visual system depends on both the depth structure of the scene and the viewing geometry. This paper treats the problem of interpreting the disparity pattern in terms of scene structure without relying on estimates of fixation position from eye movement control and proprioception mechanisms. We propose a sequential decomposition of this interpretation process into disparity correction, which is used to compute three-dimensional structure up to a relief transformation, and disparity normalization, which is used to resolve the relief ambiguity to obtain metric structure. We point out that the disparity normalization stage can often be omitted, since relief transformations preserve important properties such as depth ordering and coplanarity. Based on this framework we analyse three previously proposed computational models of disparity processing; the Mayhew and Longuet-Higgins model, the deformation model and the polar angle disparity model. We show how these models are related, and argue that none of them can account satisfactorily for available psychophysical data. We therefore propose an alternative model, regional disparity correction. Using this model we derive predictions for a number of experiments based on vertical disparity manipulations, and compare them to available experimental data. The paper is concluded with a summary and a discussion of the possible architectures and mechanisms underling stereopsis in the human visual system.

Gender Disparity in Late-life Cognitive Functioning in India: Findings From the Longitudinal Aging Study in India

PubMed Central

Shih, Regina; Feeney, Kevin; Langa, Kenneth M.

2014-01-01

Objectives. To examine gender disparities in cognitive functioning in India and the extent to which education explains this disparity in later life. Methods. This study uses baseline interviews of a prospective cohort study of 1,451 community-residing adults 45 years of age or older in four geographically diverse states of India (Karnataka, Kerala, Punjab, Rajasthan). Data collected during home visits includes cognitive performance tests, and rich sociodemographic, health, and psychosocial variables. The cognitive performance tests include episodic memory, numeracy, and a modified version of the Mini-Mental State Examination. Results. We find gender disparity in cognitive function in India, and this disparity is greater in the north than the south. We also find that gender disparities in educational attainment, health, and social and economic activity explain the female cognitive disadvantage in later life. Discussion. We report significant gender disparities in cognitive functioning among older Indian adults, which differ from gender disparities in cognition encountered in developed countries. Our models controlling for education, health status, and social and economic activity explain the disparity in southern India but not the region-specific disparity in the northern India. North Indian women may face additional sources of stress associated with discrimination against women that contribute to persistent disadvantages in cognitive functioning at older ages. PMID:24622150

Measuring Racial/Ethnic Disparities in Health Care: Methods and Practical Issues

PubMed Central

Cook, Benjamin Lê; McGuire, Thomas G; Zaslavsky,, Alan M

2012-01-01

Objective To review methods of measuring racial/ethnic health care disparities. Study Design Identification and tracking of racial/ethnic disparities in health care will be advanced by application of a consistent definition and reliable empirical methods. We have proposed a definition of racial/ethnic health care disparities based in the Institute of Medicine's (IOM) Unequal Treatment report, which defines disparities as all differences except those due to clinical need and preferences. After briefly summarizing the strengths and critiques of this definition, we review methods that have been used to implement it. We discuss practical issues that arise during implementation and expand these methods to identify sources of disparities. We also situate the focus on methods to measure racial/ethnic health care disparities (an endeavor predominant in the United States) within a larger international literature in health outcomes and health care inequality. Empirical Application We compare different methods of implementing the IOM definition on measurement of disparities in any use of mental health care and mental health care expenditures using the 2004–2008 Medical Expenditure Panel Survey. Conclusion Disparities analysts should be aware of multiple methods available to measure disparities and their differing assumptions. We prefer a method concordant with the IOM definition. PMID:22353147

Conjunctions between motion and disparity are encoded with the same spatial resolution as disparity alone.

PubMed

Allenmark, Fredrik; Read, Jenny C A

2012-10-10

Neurons in cortical area MT respond well to transparent streaming motion in distinct depth planes, such as caused by observer self-motion, but do not contain subregions excited by opposite directions of motion. We therefore predicted that spatial resolution for transparent motion/disparity conjunctions would be limited by the size of MT receptive fields, just as spatial resolution for disparity is limited by the much smaller receptive fields found in primary visual cortex, V1. We measured this using a novel "joint motion/disparity grating," on which human observers detected motion/disparity conjunctions in transparent random-dot patterns containing dots streaming in opposite directions on two depth planes. Surprisingly, observers showed the same spatial resolution for these as for pure disparity gratings. We estimate the limiting receptive field diameter at 11 arcmin, similar to V1 and much smaller than MT. Higher internal noise for detecting joint motion/disparity produces a slightly lower high-frequency cutoff of 2.5 cycles per degree (cpd) versus 3.3 cpd for disparity. This suggests that information on motion/disparity conjunctions is available in the population activity of V1 and that this information can be decoded for perception even when it is invisible to neurons in MT.

The Impact of the Patient-Centered Medical Home on Health Care Disparities: Exploring Stakeholder Perspectives on Current Standards and Future Directions.

PubMed

De Marchis, Emilia H; Doekhie, Kirti; Willard-Grace, Rachel; Olayiwola, J Nwando

2018-06-19

Over the past decade, the Patient-Centered Medical Home (PCMH) has become a preeminent model for primary care delivery. Simultaneously, health care disparities have gained increasing attention. There has been limited research on whether and how the PCMH can or should affect health care disparities. The authors conducted qualitative interviews with key stakeholders and experts on the PCMH model and health care disparities, including grant and policy makers, accreditors, researchers, patient advocates, primary care practices, practice transformation organizations, and payers, to assess perspectives on the role of the PCMH in addressing health care disparities. The application of grounded theory and thematic analysis elucidated best practice recommendations for the PCMH model's role in addressing health care disparities. Although the majority of stakeholders support greater integration of efforts to reduce health care disparities into the PCMH model, most stakeholders view the current PCMH model as having minimal or indirect influence on health care disparities. The majority supported greater integration of efforts to reduce health care disparities into the PCMH model. As the PCMH model continues to be refined, and as the health care system strives toward improving population health, there must be reflection on the policies and delivery systems that impact health care disparities.

Measuring disparities across the distribution of mental health care expenditures.

PubMed

Le Cook, Benjamin; Manning, Willard; Alegria, Margarita

2013-03-01

Previous mental health care disparities studies predominantly compare mean mental health care use across racial/ethnic groups, leaving policymakers with little information on disparities among those with a higher level of expenditures. To identify racial/ethnic disparities among individuals at varying quantiles of mental health care expenditures. To assess whether disparities in the upper quantiles of expenditure differ by insurance status, income and education. Data were analyzed from a nationally representative sample of white, black and Latino adults 18 years and older (n=83,878). Our dependent variable was total mental health care expenditure. We measured disparities in any mental health care expenditures, disparities in mental health care expenditure at the 95th, 97.5 th, and 99 th expenditure quantiles of the full population using quantile regression, and at the 50 th, 75 th, and 95 th quantiles for positive users. In the full population, we tested interaction coefficients between race/ethnicity and income, insurance, and education levels to determine whether racial/ethnic disparities in the upper quantiles differed by income, insurance and education. Significant Black-white and Latino-white disparities were identified in any mental health care expenditures. In the full population, moving up the quantiles of mental health care expenditures, Black-White and Latino-White disparities were reduced but remained statistically significant. No statistically significant disparities were found in analyses of positive users only. The magnitude of black-white disparities was smaller among those enrolled in public insurance programs compared to the privately insured and uninsured in the 97.5 th and 99 th quantiles. Disparities persist in the upper quantiles among those in higher income categories and after excluding psychiatric inpatient and emergency department (ED) visits. Disparities exist in any mental health care and among those that use the most mental health care resources, but much of disparities seem to be driven by lack of access. The data do not allow us to disentangle whether disparities were related to white respondent's overuse or underuse as compared to minority groups. The cross-sectional data allow us to make only associational claims about the role of insurance, income, and education in disparities. With these limitations in mind, we identified a persistence of disparities in overall expenditures even among those in the highest income categories, after controlling for mental health status and observable sociodemographic characteristics. Interventions are needed to equalize resource allocation to racial/ethnic minority patients regardless of their income, with emphasis on outreach interventions to address the disparities in access that are responsible for the no/low expenditures for even Latinos at higher levels of illness severity. Increased policy efforts are needed to reduce the gap in health insurance for Latinos and improve outreach programs to enroll those in need into mental health care services. Future studies that conclusively disentangle overuse and appropriate use in these populations are warranted.

Life expectancy and disparity: an international comparison of life table data

PubMed Central

Zhang, Zhen; van Raalte, Alyson A

2011-01-01

Objectives To determine the contribution of progress in averting premature deaths to the increase in life expectancy and the decline in lifespan variation. Design International comparison of national life table data from the Human Mortality Database. Setting 40 developed countries and regions, 1840–2009. Population Men and women of all ages. Main outcome measure We use two summary measures of mortality: life expectancy and life disparity. Life disparity is a measure of how much lifespans differ among individuals. We define a death as premature if postponing it to a later age would decrease life disparity. Results In 89 of the 170 years from 1840 to 2009, the country with the highest male life expectancy also had the lowest male life disparity. This was true in 86 years for female life expectancy and disparity. In all years, the top several life expectancy leaders were also the top life disparity leaders. Although only 38% of deaths were premature, fully 84% of the increase in life expectancy resulted from averting premature deaths. The reduction in life disparity resulted from reductions in early-life disparity, that is, disparity caused by premature deaths; late-life disparity levels remained roughly constant. Conclusions The countries that have been the most successful in averting premature deaths have consistently been the life expectancy leaders. Greater longevity and greater equality of individuals' lifespans are not incompatible goals. Countries can achieve both by reducing premature deaths. PMID:22021770

Health Disparities in Veterans: A Map of the Evidence.

PubMed

Kondo, Karli; Low, Allison; Everson, Teresa; Gordon, Christine D; Veazie, Stephanie; Lozier, Crystal C; Freeman, Michele; Motu'apuaka, Makalapua; Mendelson, Aaron; Friesen, Mark; Paynter, Robin; Friesen, Caroline; Anderson, Johanna; Boundy, Erin; Saha, Somnath; Quiñones, Ana; Kansagara, Devan

2017-09-01

Goals for improving the quality of care for all Veterans and eliminating health disparities are outlined in the Veterans Health Administration Blueprint for Excellence, but the degree to which disparities in utilization, health outcomes, and quality of care affect Veterans is not well understood. To characterize the research on health care disparities in the Veterans Health Administration by means of a map of the evidence. We conducted a systematic search for research studies published from 2006 to February 2016 in MEDLINE and other data sources. We included studies of Veteran populations that examined disparities in 3 outcome categories: utilization, quality of health care, and patient health. We abstracted data on study design, setting, population, clinical area, outcomes, mediators, and presence of disparity for each outcome category. We grouped the data by population characteristics including race, disability status, mental illness, demographics (age, era of service, rural location, and distance from care), sex identity, socioeconomic status, and homelessness, and created maps illustrating the evidence. We reviewed 4249 citations and abstracted data from 351 studies which met inclusion criteria. Studies examining disparities by race/ethnicity comprised by far the vast majority of the literature, followed by studies examining disparities by sex, and mental health condition. Very few studies examined disparities related to lesbian, gay, bisexual, or transgender identity or homelessness. Disparities findings vary widely by population and outcome. Our evidence maps provide a "lay of the land" and identify important gaps in knowledge about health disparities experienced by different Veteran populations.

The design and conduct of a community-based registry and biorepository: a focus on cardiometabolic health in Latinos.

PubMed

Shaibi, Gabriel Q; Coletta, Dawn K; Vital, Veronica; Mandarino, Lawrence J

2013-12-01

Latinos are disproportionately impacted by obesity and type 2 diabetes but remain underrepresented in biomedical research. Therefore, the purpose of this project was to develop a research registry and biorepository to examine cardiometabolic disease risk in the Latino community of Phoenix, Arizona. The overarching goal was to establish the research infrastructure that would encourage transdisciplinary research regarding the biocultural mechanisms of obesity-related health disparities and facilitate access to this research for the Latino community. Prior to recruitment, key stakeholders from the local Latino community were engaged to develop a broad rapport within the community and seek advice regarding recruitment, enrollment, and follow-up. Self-identified community-dwelling Latinos underwent a comprehensive cardiometabolic health assessment that included anthropometrics, a fasting laboratory panel, and a 2-hour oral glucose tolerance test with measures of insulin and glucose to estimate insulin action and secretion. Separate consent was requested for future contact and banking of serum, DNA, and RNA. Research collaborations were sought out based on the cultural and metabolic profile of participants, faculty research agendas, and the potential for generating hypotheses. A total of 667 participants (20.4% children, and 79.6% adults) were enrolled with 97% consenting to the registry and 94% to banking of samples. The prevalence of overweight/obesity was 50% in children and 81% in adults. Nearly 20% of children and more than 45% of the adults exhibited some degree of hyperglycemia. To date, more than 15 research projects have been supported through this infrastructure and have included projects on the molecular biology of insulin resistance to the sociocultural determinants of health behaviors and outcomes. The high prevalence of obesity and cardiometabolic disease risk factors coupled with the overwhelming majority of participants consenting to be re-contacted, highlights the importance of supporting research infrastructure to generate hypotheses about obesity-related health in Latinos. Future studies that stem from the initial project will likely advance the limited understanding regarding the biocultural determinants of health disparities in the Latino community. © 2013 Wiley Periodicals, Inc.

The Design and Conduct of a Community‐Based Registry and Biorepository: A Focus on Cardiometabolic Health in Latinos

PubMed Central

Coletta, Dawn K.; Vital, Veronica; Mandarino, Lawrence J.

2013-01-01

Abstract Background Latinos are disproportionately impacted by obesity and type 2 diabetes but remain underrepresented in biomedical research. Therefore, the purpose of this project was to develop a research registry and biorepository to examine cardiometabolic disease risk in the Latino community of Phoenix, Arizona. The overarching goal was to establish the research infrastructure that would encourage transdisciplinary research regarding the biocultural mechanisms of obesity‐related health disparities and facilitate access to this research for the Latino community. Methods Prior to recruitment, key stakeholders from the local Latino community were engaged to develop a broad rapport within the community and seek advice regarding recruitment, enrollment, and follow‐up. Self‐identified community‐dwelling Latinos underwent a comprehensive cardiometabolic health assessment that included anthropometrics, a fasting laboratory panel, and a 2‐hour oral glucose tolerance test with measures of insulin and glucose to estimate insulin action and secretion. Separate consent was requested for future contact and banking of serum, DNA, and RNA. Research collaborations were sought out based on the cultural and metabolic profile of participants, faculty research agendas, and the potential for generating hypotheses. Results A total of 667 participants (20.4% children, and 79.6% adults) were enrolled with 97% consenting to the registry and 94% to banking of samples. The prevalence of overweight/obesity was 50% in children and 81% in adults. Nearly 20% of children and more than 45% of the adults exhibited some degree of hyperglycemia. To date, more than 15 research projects have been supported through this infrastructure and have included projects on the molecular biology of insulin resistance to the sociocultural determinants of health behaviors and outcomes. Conclusions The high prevalence of obesity and cardiometabolic disease risk factors coupled with the overwhelming majority of participants consenting to be re‐contacted, highlights the importance of supporting research infrastructure to generate hypotheses about obesity‐related health in Latinos. Future studies that stem from the initial project will likely advance the limited understanding regarding the biocultural determinants of health disparities in the Latino community. PMID:24119012

Disparity modifications and the emotional effects of stereoscopic images

NASA Astrophysics Data System (ADS)

Kawai, Takashi; Atsuta, Daiki; Tomiyama, Yuya; Kim, Sanghyun; Morikawa, Hiroyuki; Mitsuya, Reiko; Häkkinen, Jukka

2014-03-01

This paper describes a study that focuses on disparity changes in emotional scenes of stereoscopic (3D) images, in which an examination of the effects on pleasant and arousal was carried out by adding binocular disparity to 2D images that evoke specific emotions, and applying disparity modification based on the disparity analysis of famous 3D movies. From the results of the experiment, for pleasant, a significant difference was found only for the main effect of the emotions. On the other hand, for arousal, there was a trend of increasing the evaluation values in the order 2D condition, 3D condition and 3D condition applied the disparity modification for happiness, surprise, and fear. This suggests the possibility that binocular disparity and the modification affect arousal.

Big concerns with small projects: Evaluating the socio-ecological impacts of small hydropower projects in India.

PubMed

Jumani, Suman; Rao, Shishir; Machado, Siddarth; Prakash, Anup

2017-05-01

Although Small Hydropower Projects (SHPs) are encouraged as sources of clean and green energy, there is a paucity of research examining their socio-ecological impacts. We assessed the perceived socio-ecological impacts of 4 SHPs within the Western Ghats in India by conducting semi-structured interviews with local respondents. Primary interview data were sequentially validated with secondary data, and respondent perceptions were subsequently compared against the expected baseline of assured impacts. We evaluated the level of awareness about SHPs, their perceived socio-economic impacts, influence on resource access and impacts on human-elephant interactions. The general level of awareness about SHPs was low, and assurances of local electricity and employment generation remained largely unfulfilled. Additionally most respondents faced numerous unanticipated adverse impacts. We found a strong relationship between SHP construction and increasing levels of human-elephant conflict. Based on the disparity between assured and actual social impacts, we suggest that policies regarding SHPs be suitably revised.

Development of FuGO: An Ontology for Functional Genomics Investigations

PubMed Central

Whetzel, Patricia L.; Brinkman, Ryan R.; Causton, Helen C.; Fan, Liju; Field, Dawn; Fostel, Jennifer; Fragoso, Gilberto; Gray, Tanya; Heiskanen, Mervi; Hernandez-Boussard, Tina; Morrison, Norman; Parkinson, Helen; Rocca-Serra, Philippe; Sansone, Susanna-Assunta; Schober, Daniel; Smith, Barry; Stevens, Robert; Stoeckert, Christian J.; Taylor, Chris; White, Joe; Wood, Andrew

2009-01-01

The development of the Functional Genomics Investigation Ontology (FuGO) is a collaborative, international effort that will provide a resource for annotating functional genomics investigations, including the study design, protocols and instrumentation used, the data generated and the types of analysis performed on the data. FuGO will contain both terms that are universal to all functional genomics investigations and those that are domain specific. In this way, the ontology will serve as the “semantic glue” to provide a common understanding of data from across these disparate data sources. In addition, FuGO will reference out to existing mature ontologies to avoid the need to duplicate these resources, and will do so in such a way as to enable their ease of use in annotation. This project is in the early stages of development; the paper will describe efforts to initiate the project, the scope and organization of the project, the work accomplished to date, and the challenges encountered, as well as future plans. PMID:16901226

A Method for Achieving Reciprocity of Funding in Community-Based Participatory Research

PubMed Central

Gehlert, Sarah; Fayanju, Oluwadamilola M.; Jackson, Sherrill; Kenkel, Sandi; McCullough, Isaac C.; Oliver, Cheryl; Sanford, Mark

2015-01-01

Background The St. Louis Komen Project was conceived to address disparities in breast cancer treatment and outcomes between African-American and White women in St. Louis, Missouri. Our goal was to apportion tasks and funding through a process to which all researcher partners had input and to which all could agree, thus eliminating institutionalized inequalities. Methods This paper describes the collaborative process and resulting division of responsibilities, determination of costs, and ultimate allocation of funds and resources, as well as the documentation employed to achieve funding reciprocity and equal accountability. Results Both communication and documentation are critical. Although the Memoranda of Understanding employed are not a panacea, they codify roles and expectations and promote trust. The process of developing financial transparency set the tone for subsequent steps in the research process. Conclusions The exhaustive planning process and project-specific procedures developed by its partners have helped the project foster reciprocity, facilitate participation, and equitably distribute resources. PMID:25727989

The Role of Stage at Diagnosis in Colorectal Cancer Black-White Survival Disparities: A Counterfactual Causal Inference Approach.

PubMed

Valeri, Linda; Chen, Jarvis T; Garcia-Albeniz, Xabier; Krieger, Nancy; VanderWeele, Tyler J; Coull, Brent A

2016-01-01

To date, a counterfactual framework has not been used to study determinants of social inequalities in cancer. Considering the case of colorectal cancer, for which racial/ethnic differences in stage at diagnosis and survival are well documented, we quantify the extent to which black versus white survival disparities would be reduced had disparities in stage at diagnosis been eliminated in a large patient population. We obtained data on colorectal cancer patients (diagnosed between 1992 and 2005 and followed until 2010) from US-SEER (Surveillance, Epidemiology, and End Results) cancer registries. We employed a counterfactual approach to estimate the mean survival time up to the 60th month since diagnosis for black colorectal cancer patients had black-white disparities in stage at diagnosis been eliminated. Black patients survive approximately 4.0 [confidence interval (CI), 4.6-3.2] months less than white patients within five years since diagnosis. Had disparities in stage at diagnosis been eliminated, survival disparities decrease to 2.6 (CI, 3.4-1.7) months, an approximately 35% reduction. For patients diagnosed after the age of 65 years, disparities would be halved, while reduction of approximately 30% is estimated for younger patients. Survival disparities would be reduced by approximately 44% for women and approximately 26% for men. Employing a counterfactual approach and allowing for heterogeneities in black-white disparities across patients' characteristics, we give robust evidence that elimination of disparities in stage at diagnosis contributes to a substantial reduction in survival disparities in colorectal cancer. We provide the first evidence in the SEER population that elimination of inequities in stage at diagnosis might lead to larger reductions in survival disparities among elderly and women. ©2015 American Association for Cancer Research.

29 CFR 1607.11 - Disparate treatment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Disparate treatment. 1607.11 Section 1607.11 Labor... EMPLOYEE SELECTION PROCEDURES (1978) General Principles § 1607.11 Disparate treatment. The principles of disparate or unequal treatment must be distinguished from the concepts of validation. A selection procedure...

Health Disparities of Adults with Intellectual Disabilities: What Do We Know? What Do We Do?

PubMed Central

Krahn, Gloria L.; Fox, Michael H.

2015-01-01

Background Recent attention to health of people with intellectual disabilities has used a health disparities framework. Building on historical context, the paper summarizes what is known about health disparities from reports and research and provide direction on what to do to reduce these disparities among adults with intellectual disabilities. Methods The present authors examined literature from 2002 to 2011 on health disparities and people with disabilities looking for broad themes on documenting disparities and on research approaches and methods. Results Multiple countries published reports on health of people with intellectual disabilities. Researchers summarized existing research within a health disparities framework. A number of promising methodologies are identified such as health services research, health indicators, enhanced surveillance and mixed-methods. Conclusions Strategies to reduce health disparities include use of data to educate decision makers, attention to social determinants and a life-course model and emphasis on leveraging inclusion in mainstream services where possible. PMID:23913632

Trends in Racial and Ethnic Disparities in Infant Mortality Rates in the United States, 1989–2006

PubMed Central

Rossen, Lauren M.; Schoendorf, Kenneth C.

2014-01-01

Objectives. We sought to measure overall disparities in pregnancy outcome, incorporating data from the many race and ethnic groups that compose the US population, to improve understanding of how disparities may have changed over time. Methods. We used Birth Cohort Linked Birth–Infant Death Data Files from US Vital Statistics from 1989–1990 and 2005–2006 to examine multigroup indices of racial and ethnic disparities in the overall infant mortality rate (IMR), preterm birth rate, and gestational age–specific IMRs. We calculated selected absolute and relative multigroup disparity metrics weighting subgroups equally and by population size. Results. Overall IMR decreased on the absolute scale, but increased on the population-weighted relative scale. Disparities in the preterm birth rate decreased on both the absolute and relative scales, and across equally weighted and population-weighted indices. Disparities in preterm IMR increased on both the absolute and relative scales. Conclusions. Infant mortality is a common bellwether of general and maternal and child health. Despite significant decreases in disparities in the preterm birth rate, relative disparities in overall and preterm IMRs increased significantly over the past 20 years. PMID:24028239

Geographic variation in racial disparities in child maltreatment: The influence of county poverty and population density.

PubMed

Maguire-Jack, Kathryn; Lanier, Paul; Johnson-Motoyama, Michelle; Welch, Hannah; Dineen, Michael

2015-09-01

There are documented disparities in the rates at which black children come into contact with the child welfare system in the United States compared to white children. A great deal of research has proliferated aimed at understanding whether systematic biases or differential rates of risk among different groups drive these disparities (Drake et al., 2011). In the current study, county rates of maltreatment disparity are compared across the United States and examined in relation to rates of poverty disparity as well as population density. Specifically, using hierarchical linear modeling with a spatially lagged dependent variable, the current study examined data from the National Child Abuse and Neglect Data System (NCANDS) and found that poverty disparities were associated with rates of maltreatment disparities, and densely populated metropolitan counties tended to have the greatest levels of maltreatment disparity for both black and Hispanic children. A significant curvilinear relationship was also observed between these variables, such that in addition to the most densely populated counties, the most sparsely populated counties also tended to have higher rates of maltreatment disparity for black and Hispanic children. Copyright © 2015 Elsevier Ltd. All rights reserved.

Challenges for Multilevel Health Disparities Research in a Transdisciplinary Environment

PubMed Central

Holmes, John H.; Lehman, Amy; Hade, Erinn; Ferketich, Amy K.; Sarah, Gehlert; Rauscher, Garth H.; Abrams, Judith; Bird, Chloe E.

2008-01-01

Numerous factors play a part in health disparities. Although health disparities are manifested at the level of the individual, other contexts should be considered when investigating the associations of disparities with clinical outcomes. These contexts include families, neighborhoods, social organizations, and healthcare facilities. This paper reports on health disparities research as a multilevel research domain from the perspective of a large national initiative. The Centers for Population Health and Health Disparities (CPHHD) program was established by the NIH to examine the highly dimensional, complex nature of disparities and their effects on health. Because of its inherently transdisciplinary nature, the CPHHD program provides a unique environment in which to perform multilevel health disparities research. During the course of the program, the CPHHD centers have experienced challenges specific to this type of research. The challenges were categorized along three axes: sources of subjects and data, data characteristics, and multilevel analysis and interpretation. The CPHHDs collectively offer a unique example of how these challenges are met; just as importantly, they reveal a broad range of issues that health disparities researchers should consider as they pursue transdisciplinary investigations in this domain, particularly in the context of a large team science initiative. PMID:18619398

Adaptive Neuromorphic Circuit for Stereoscopic Disparity Using Ocular Dominance Map

PubMed Central

Sharma, Sheena; Gupta, Priti; Markan, C. M.

2016-01-01

Stereopsis or depth perception is a critical aspect of information processing in the brain and is computed from the positional shift or disparity between the images seen by the two eyes. Various algorithms and their hardware implementation that compute disparity in real time have been proposed; however, most of them compute disparity through complex mathematical calculations that are difficult to realize in hardware and are biologically unrealistic. The brain presumably uses simpler methods to extract depth information from the environment and hence newer methodologies that could perform stereopsis with brain like elegance need to be explored. This paper proposes an innovative aVLSI design that leverages the columnar organization of ocular dominance in the brain and uses time-staggered Winner Take All (ts-WTA) to adaptively create disparity tuned cells. Physiological findings support the presence of disparity cells in the visual cortex and show that these cells surface as a result of binocular stimulation received after birth. Therefore, creating in hardware cells that can learn different disparities with experience not only is novel but also is biologically more realistic. These disparity cells, when allowed to interact diffusively on a larger scale, can be used to adaptively create stable topological disparity maps in silicon. PMID:27243029

From Politics to Parity: Using a Health Disparities Index to Guide Legislative Efforts for Health Equity

PubMed Central

Simpson, Sean L.; Hairston, Kristen G.

2011-01-01

Objectives. We created an index quantifying the longitudinal burden of racial health disparities by state and compared this index to variables to guide the construction of, and validate support for, legislative efforts aimed at eliminating health disparities. Methods. We evaluated 5 focus areas of greatest racial disparities in health from 1999 to 2005 and compiled state health disparities index (HDI) scores. We compared these scores with variables representing the purported social determinants of health. Results. Massachusetts (0.35), Oklahoma (0.35), and Washington (0.39) averaged the fewest disparities. Michigan (1.22), Wisconsin (1.32), and Illinois (1.50) averaged the greatest disparities. The statistical reference point for nationwide average racial disparities was 1.00. The longitudinal mixed model procedure yielded statistically significant correlations between HDI scores and Black state population percentage as well as with the racial gap in uninsured percentages. We noted a trend for HDI correlations with median household income ratios. Conclusions. On the basis of the HDI-established trends in the extent and distribution of racial health disparities, and their correlated social determinants of health, policymakers should consider incorporating this tool to advise future efforts in minority health legislation. PMID:21233445

Heterophoria and fixation disparity: a review.

PubMed

Kommerell, G; Gerling, J; Ball, M; de Paz, H; Bach, M

2000-06-01

Heterophoria does not provide a reliable clue for ordering prisms in an asthenopic patient. The same reservation applies to associated phoria, as determined by prism correction of fixation disparity. Subjective tests for fixation disparity, even those with a fusionable fixation target, do not correctly indicate the vergence position of the eyes under natural viewing conditions. Attempts to measure fixation disparity on the basis of stereo disparity, using the "Measuring and Correction Methods of H.-J. Haase", have failed.

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.

Health disparity knowledge and support for intervention in Saskatoon.

PubMed

Lemstra, Mark; Neudorf, Cory; Beaudin, Gary

2007-01-01

A number of reports suggest that we need to determine public understanding about the broad determinants of health and also determine public support for actions to reduce health disparities in Canada. A cross-sectional random survey of 5,000 Saskatoon residents was used to determine knowledge about health determinants and health disparity and then determine public support for various interventions to address health disparity. Saskatoon residents understand most of the determinants of health except they understate the importance of social class and gender. Saskatoon residents do not have a good understanding of the magnitude of health disparity between income groups. A majority believe risk behaviours are mostly individual choices and are not associated with income status. Most residents believe even small differences in health status between income groups is unacceptable and a majority believe that something can be done to address health disparity by income status. Interventions proposed by residents to alleviate health disparity were evidence-based, including work-earning supplements and strengthening early intervention programs. Logistic regression revealed that greatest support for transferring money from health care treatment to health creation services (like affordable housing and education) came from young Aboriginal males with low income. Saskatoon residents have knowledge of health determinants and have a strong desire to support health disparity intervention. More knowledge transfer is required on the magnitude of health disparity based on income status. Broad-based health disparity intervention in Saskatoon appears possible.

A Plan for Action: Key Perspectives from the Racial/Ethnic Disparities Strategy Forum

PubMed Central

King, Roderick K; Green, Alexander R; Tan-Mcgrory, Aswita; Donahue, Elizabeth J; Kimbrough-Sugick, Jessie; Betancourt, Joseph R

2008-01-01

Context Racial and ethnic disparities in health care in the United States have been well documented, with research largely focusing on describing the problem rather than identifying the best practices or proven strategies to address it. Methods In 2006, the Disparities Solutions Center convened a one-and-a-half-day Strategy Forum composed of twenty experts from the fields of racial/ethnic disparities in health care, quality improvement, implementation research, and organizational excellence, with the goal of deciding on innovative action items and adoption strategies to address disparities. The forum used the Results Based Facilitation model, and several key recommendations emerged. Findings The forum's participants concluded that to identify and effectively address racial/ethnic disparities in health care, health care organizations should: (1) collect race and ethnicity data on patients or enrollees in a routine and standardized fashion; (2) implement tools to measure and monitor for disparities in care; (3) develop quality improvement strategies to address disparities; (4) secure the support of leadership; (5) use incentives to address disparities; and (6) create a messaging and communication strategy for these efforts. This article also discusses these recommendations in the context of both current efforts to address racial and ethnic disparities in health care and barriers to progress. Conclusions The Strategy Forum's participants concluded that health care organizations needed a multifaceted plan of action to address racial and ethnic disparities in health care. Although the ideas offered are not necessarily new, the discussion of their practical development and implementation should make them more useful. PMID:18522613

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.

Breast Cancer Disparities at home and abroad: A Review of the Challenges and Opportunities for System-Level Change

PubMed Central

Reeder-Hayes, Katherine E.; Anderson, Benjamin O.

2017-01-01

Sizeable disparities exist in breast cancer outcomes, both between Black and White patients in the United States, and between patients in the US and other high-income countries compared to low- and middle-income countries (LMICs). In both settings, health system factors are key drivers of disparities. In the US, Black women are more likely to die of breast cancer than Whites, and have poorer outcomes even among patients with similar stage and tumor subtype. Over-representation of higher-risk “triple negative” breast cancers contributes to breast cancer mortality in Black women; however, the greatest survival disparities occur within the good-prognosis hormone-receptor positive (HR+) subtypes. Disparities in access to treatment within the complex US health system may be responsible for a substantial portion of these differences in survival. In LMICs, breast cancer mortality rates are substantially higher than in the US, while incidence continues to rise. This mortality burden is largely attributable to health system factors, including late-stage presentation at diagnosis and lack of availability of systemic therapy. This article will review the existing evidence for how health-system factors in the United States contribute to breast cancer disparities, discuss methods for studying the relationship of health system factors to racial disparities, and provide examples of health system interventions that show promise for mitigating breast cancer disparities. We will then review evidence of global breast cancer disparities in low and middle income countries, the treatment factors that contribute to these disparities, and actions being taken to combat breast cancer disparities around the world. PMID:28572260

A study of national physician organizations' efforts to reduce racial and ethnic health disparities in the United States.

PubMed

Peek, Monica E; Wilson, Shannon C; Bussey-Jones, Jada; Lypson, Monica; Cordasco, Kristina; Jacobs, Elizabeth A; Bright, Cedric; Brown, Arleen F

2012-06-01

To characterize national physician organizations' efforts to reduce health disparities and identify organizational characteristics associated with such efforts. This cross-sectional study was conducted between September 2009 and June 2010. The authors used two-sample t tests and chi-square tests to compare the proportion of organizations with disparity-reducing activities between different organizational types (e.g., primary care versus subspecialty organizations, small [<1,000 members] versus large [>5,000 members]). Inclusion criteria required physician organizations to be (1) focused on physicians, (2) national in scope, and (3) membership based. The number of activities per organization ranged from 0 to 22. Approximately half (53%) of organizations had 0 or 1 disparity-reducing activities. Organizational characteristics associated with having at least 1 disparity-reducing effort included membership size (88% of large groups versus 58% of small groups had at least 1 activity; P = .004) and the presence of a health disparities committee (95% versus 59%; P < .001). Primary care (versus subspecialty) organizations and racial/ethnic minority physician organizations were more likely to have disparity-reducing efforts, although findings were not statistically significant. Common themes addressed by activities were health care access, health care disparities, workforce diversity, and language barriers. Common strategies included education of physicians/trainees and patients/general public, position statements, and advocacy. Despite the national priority to eliminate health disparities, more than half of national physician organizations are doing little to address this problem. Primary care and minority physician organizations, and those with disparities committees, may provide leadership to extend the scope of disparity-reduction efforts.

Dialysis facility staff perceptions of racial, gender, and age disparities in access to renal transplantation.

PubMed

Lipford, Kristie J; McPherson, Laura; Hamoda, Reem; Browne, Teri; Gander, Jennifer C; Pastan, Stephen O; Patzer, Rachel E

2018-01-10

Racial/ethnic, gender, and age disparities in access to renal transplantation among end-stage renal disease (ESRD) patients have been well documented, but few studies have explored health care staff attitudes towards these inequalities. Staff perceptions can influence patient care and outcomes, and identifying staff perceptions on disparities could aid in the development of potential interventions to address these health inequities. The objective of this study was to investigate dialysis staff (n = 509), primarily social workers and nurse managers, perceptions of renal transplant disparities in the Southeastern United States. This is a mixed methods study that uses both deductive and inductive qualitative analysis of a dialysis staff survey conducted in 2012 using three open-ended questions that asked staff to discuss their perceptions of factors that may contribute to transplant disparities among African American, female, and elderly patients. Study results suggested that the majority of staff (n = 255, 28%) perceived patients' low socioeconomic status as the primary theme related to why renal transplant disparities exist between African Americans and non-Hispanic whites. Staff cited patient perception of old age as a primary contributor (n = 188, 23%) to the disparity between young and elderly patients. The dialysis staff responses on gender transplant disparities suggested that staff were unaware of differences due to limited experience and observation (n = 76, 14.7%) of gender disparities. These findings suggest that dialysis facilities should educate staff on existing renal transplantation disparities, particularly gender disparities, and collaboratively work with transplant facilities to develop strategies to actively address modifiable patient barriers for transplant.

A survey of the population genetic variation in the human kinome.

PubMed

Zhang, Wei; Catenacci, Daniel V T; Duan, Shiwei; Ratain, Mark J

2009-08-01

Protein kinases are key regulators of various biological processes, such as control of cell growth, metabolism, differentiation and apoptosis. Therefore, protein kinases have been an important class of targets for anticancer drugs. Health-related disparities such as differential drug response have been observed between human populations. A survey of the human kinases and their ligand genes for those containing population-specific genetic variants could provide new insights into the mechanisms of these health disparities and suggest novel targets for ethnicity-specific personalized medicine. Using the International HapMap Project genotypic data on single-nucleotide polymorphisms (SNPs), the protein kinase complement of the human genome (kinome) and some experimentally verified ligand genes were scanned for the existence of population-specific SNPs (eSNPs). In general, protein kinases were found to contain a much higher proportion of eSNPs than the whole genome background, indicating a stronger pressure for adaptation in individual populations. In contrast, the proportion of ligand genes containing eSNPs was not different from that of the whole genome background. Although with some important limitations, our results suggest that human kinases are more likely to be under recent positive selection than ligands. Our findings suggest that the health-related disparities associated with kinase signaling pathways are more likely to be driven by the genetic variation in the kinase genes than their cognate ligands. Illustrating the role of molecular evolution in the genetic variation of the human kinome could provide a promising route to understand the ethnic differences in cancer and facilitate the realization of ethnicity-based individualized medicine.

Cost of ownership for military cargo aircraft using a common versus disparate display configuration

NASA Astrophysics Data System (ADS)

Desjardins, Daniel D.; Most, Marvin C.

2010-04-01

A 2009 paper considered possibilities for applying a common display suite to various front-line bubble canopy fighters, whereas further research suggests the cost savings, post Milestone C production/deployment, might not be advantageous. The situation for military cargo and tanker aircraft, may offer a different paradigm. The primary objective of Defense acquisition is to acquire quality products that satisfy user needs with measurable improvements to mission capability and operational support, in a timely manner, and at a fair and reasonable price. DODD 5000.01 specifies that all participants in the acquisition system shall recognize the reality of fiscal constraints, viewing cost as an independent variable. DoD Components must therefore plan programs based on realistic projections of the dollars and manpower likely to be available in future years and also identify the total costs of ownership, as well as the major drivers of total ownership costs. In theory, therefore, this has already been done for existing cargo/tanker aircraft programs accommodating independent, disparate display suites. This paper goes beyond that stage by exploring total costs of ownership for a hypothetical common approach to cargo/tanker display avionics, bounded by looking at a limited number of such aircraft, e.g., C-5, C-17, C-130H (variants), and C-130J. It is the purpose of this paper to reveal whether there are total cost of ownership advantages for a common approach over and above the existing disparate approach. Aside from cost issues, other considerations, i.e., availability and supportability, may also be analyzed.

African American community leaders' policy recommendations for reducing racial disparities in HIV infection, treatment, and care: results from a community-based participatory research project in Philadelphia, Pennsylvania.

PubMed

Nunn, Amy; Sanders, Julia; Carson, Lee; Thomas, Gladys; Cornwall, Alexandra; Towey, Caitlin; Lee, Hwajin; Tasco, Marian; Shabazz-El, Waheedah; Yolken, Annajane; Smith, Tyrone; Bell, Gary; Feller, Sophie; Smith, Erin; James, George; Shelton Dunston, Brenda; Green, Derek

2015-01-01

African Americans account for 45% of new HIV infections in the United States. Little empirical research investigates African American community leaders' normative recommendations for addressing these disparities. Philadelphia's HIV infection rate is 5 times the national average, nearly 70% of new infections are among African Americans, and 2% of African Americans in Philadelphia are living with HIV/AIDS. Using a community-based participatory research approach, we convened focus groups among 52 African American community leaders from diverse backgrounds to solicit normative recommendations for reducing Philadelphia's racial disparities in HIV infection. Leaders recommended that (a) Philadelphia's city government should raise awareness about HIV/AIDS with media campaigns featuring local leaders, (b) local HIV-prevention interventions should address social and structural factors influencing HIV risks rather than focus exclusively on mode of HIV transmission, (c) resources should be distributed to the most heavily affected neighborhoods of Philadelphia, and (d) faith institutions should play a critical role in HIV testing, treatment, and prevention efforts. We developed a policy memo highlighting these normative recommendations for how to enhance local HIV prevention policy. This policy memo led to Philadelphia City Council hearings about HIV/AIDS in October 2010 and subsequently informed local HIV/AIDS prevention policy and development of local HIV prevention interventions. This community-based participatory research case study offers important lessons for effectively engaging community leaders in research to promote HIV/AIDS policy change. © 2014 Society for Public Health Education.

Characteristics of the original patient navigation programs to reduce disparities in the diagnosis and treatment of breast cancer.

PubMed

Vargas, Roberto B; Ryan, Gery W; Jackson, Catherine A; Rodriguez, Rian; Freeman, Harold P

2008-07-15

Patient navigation is an intervention developed to reduce disparities in cancer care that is being widely replicated and receiving considerable support for demonstration projects and research to test its effectiveness. In the current study, the authors present an in-depth descriptive analysis of the original patient navigation programs to inform current and future program development. A qualitative multistakeholder case study using interviews and site visits of the first patient navigation site and 2 sites subsequently developed by the leadership of the original site were evaluated. At these sites, patient navigation is a system, as opposed to a person, comprised primarily of navigators and directors that work together to remove barriers and facilitate access in a well-defined course of care; navigators were from the community or were culturally similar to the patient population served but were also paid employees of the clinical care site with detailed knowledge of the clinical course patients must traverse to complete care plans. Directors had administrative authority over the clinical facility and social capital across institutions, and communicated regularly and openly with navigators to implement system level changes to remove barriers to care. Contextual factors such as policies supporting breast cancer care also influenced the implementation of these programs. The first patient navigation programs combined community and culturally sensitive care-coordination with aspects of disease management programs to reduce racial, ethnic, and poverty-driven disparities in care. Future efforts to replicate and evaluate patient navigation should take into account these unique aspects of the original patient navigation programs. (c) 2008 American Cancer Society.

Measuring Disparities across the Distribution of Mental Health Care Expenditures

PubMed Central

Cook, Benjamin Lê; Manning, Willard; Alegría, Margarita

2013-01-01

Background Previous mental health care disparities studies predominantly compare mean mental health care use across racial/ethnic groups, leaving policymakers with little information on disparities among those with a higher level of expenditures. Aims of the Study To identify racial/ethnic disparities among individuals at varying quantiles of mental health care expenditures. To assess whether disparities in the upper quantiles of expenditure differ by insurance status, income and education. Methods Data were analyzed from a nationally representative sample of white, black and Latino adults 18 years and older (n=83,878). Our dependent variable was total mental health care expenditure. We measured disparities in any mental health care expenditures, disparities in mental health care expenditure at the 95th, 97.5th, and 99th expenditure quantiles of the full population using quantile regression, and at the 50th, 75th, and 95th quantiles for positive users. In the full population, we tested interaction coefficients between race/ethnicity and income, insurance, and education levels to determine whether racial/ethnic disparities in the upper quantiles differed by income, insurance and education. Results Significant Black-white and Latino-white disparities were identified in any mental health care expenditures. In the full population, moving up the quantiles of mental health care expenditures, Black-White and Latino-White disparities were reduced but remained statistically significant. No statistically significant disparities were found in analyses of positive users only. The magnitude of black-white disparities was smaller among those enrolled in public insurance programs compared to the privately insured and uninsured in the 97.5th and 99th quantiles. Disparities persist in the upper quantiles among those in higher income categories and after excluding psychiatric inpatient and emergency department (ED) visits. Discussion Disparities exist in any mental health care and among those that use the most mental health care resources, but much of disparities seem to be driven by lack of access. The data do not allow us to disentangle whether disparities were related to white respondent’s overuse or underuse as compared to minority groups. The cross-sectional data allow us to make only associational claims about the role of insurance, income, and education in disparities. With these limitations in mind, we identified a persistence of disparities in overall expenditures even among those in the highest income categories, after controlling for mental health status and observable sociodemographic characteristics. Implications for Health Care Provision and Use Interventions are needed to equalize resource allocation to racial/ethnic minority patients regardless of their income, with emphasis on outreach interventions to address the disparities in access that are responsible for the no/low expenditures for even Latinos at higher levels of illness severity. Implications for Health Policies Increased policy efforts are needed to reduce the gap in health insurance for Latinos and improve outreach programs to enroll those in need into mental health care services. Implications for Further Research Future studies that conclusively disentangle overuse and appropriate use in these populations are warranted. PMID:23676411

Engaging youth in food activism in New York City: lessons learned from a youth organization, health department, and university partnership.

PubMed

Tsui, Emma; Bylander, Kim; Cho, Milyoung; Maybank, Aletha; Freudenberg, Nicholas

2012-10-01

Research indicates that insufficient emphasis on community collaboration and partnership can thwart innovative community-driven work on the social determinants of health by local health departments. Appreciating the importance of enhancing community participation, the New York City Department of Health and Mental Hygiene (DOHMH) helped lead the development of the Health Equity Project (HEP), an intervention aimed at increasing the capacity of urban youth to identify and take action to reduce food-related health disparities. DOHMH partnered with the City University of New York School of Public Health and several local youth organizations to design and implement the intervention. HEP was conducted with 373 young people in 17 cohorts at 14 unique sites: six in Brooklyn, six in the Bronx, and two in Harlem. Partnered youth organizations hosted three stages of work: interactive workshops on neighborhood health disparities, food environments, and health outcomes; food-focused research projects conducted by youth; and small-scale action projects designed to change local food environments. Through these activities, HEP appears to have been successful in introducing youth to the social, economic, and political factors that shape food environments and to the influence of food on health outcomes. The intervention was also somewhat successful in providing youth with community-based participatory research skills and engaging them in documenting and then acting to change their neighborhood food environments. In the short term, we are unable to assess how successful HEP has been in building young leaders who will continue to engage in this kind of activism, but we suspect that more extended interactions would be needed to achieve this more ambitious goal. Experiences at these sites suggest that youth organizations with a demonstrated capacity to engage youth in community service or activism and a commitment to improving food or other health-promoting community resources make the most suitable and successful partners for this kind of effort.

Merging Disparate Data Sources Into a Paleoanthropological Geodatabase for Research, Education, and Conservation in the Greater Hadar Region (Afar, Ethiopia)

NASA Astrophysics Data System (ADS)

Campisano, C. J.; Dimaggio, E. N.; Arrowsmith, J. R.; Kimbel, W. H.; Reed, K. E.; Robinson, S. E.; Schoville, B. J.

2008-12-01

Understanding the geographic, temporal, and environmental contexts of human evolution requires the ability to compare wide-ranging datasets collected from multiple research disciplines. Paleoanthropological field- research projects are notoriously independent administratively even in regions of high transdisciplinary importance. As a result, valuable opportunities for the integration of new and archival datasets spanning diverse archaeological assemblages, paleontological localities, and stratigraphic sequences are often neglected, which limits the range of research questions that can be addressed. Using geoinformatic tools we integrate spatial, temporal, and semantically disparate paleoanthropological and geological datasets from the Hadar sedimentary basin of the Afar Rift, Ethiopia. Applying newly integrated data to investigations of fossil- rich sediments will provide the geospatial framework critical for addressing fundamental questions concerning hominins and their paleoenvironmental context. We present a preliminary cyberinfrastructure for data management that will allow scientists, students, and interested citizens to interact with, integrate, and visualize data from the Afar region. Examples of our initial integration efforts include generating a regional high-resolution satellite imagery base layer for georeferencing, standardizing and compiling multiple project datasets and digitizing paper maps. We also demonstrate how the robust datasets generated from our work are being incorporated into a new, digital module for Arizona State University's Hadar Paleoanthropology Field School - modernizing field data collection methods, on-the-fly data visualization and query, and subsequent analysis and interpretation. Armed with a fully fused database tethered to high-resolution satellite imagery, we can more accurately reconstruct spatial and temporal paleoenvironmental conditions and efficiently address key scientific questions, such as those regarding the relative importance of internal and external ecological, climatological, and tectonic forcings on evolutionary change in the fossil record. In close association with colleagues working in neighboring project areas, this work advances multidisciplinary and collaborative research, training, and long-range antiquities conservation in the Hadar region.

Health impact assessment of traffic-related air pollution at the urban project scale: influence of variability and uncertainty.

PubMed

Chart-Asa, Chidsanuphong; Gibson, Jacqueline MacDonald

2015-02-15

This paper develops and then demonstrates a new approach for quantifying health impacts of traffic-related particulate matter air pollution at the urban project scale that includes variability and uncertainty in the analysis. We focus on primary particulate matter having a diameter less than 2.5 μm (PM2.5). The new approach accounts for variability in vehicle emissions due to temperature, road grade, and traffic behavior variability; seasonal variability in concentration-response coefficients; demographic variability at a fine spatial scale; uncertainty in air quality model accuracy; and uncertainty in concentration-response coefficients. We demonstrate the approach for a case study roadway corridor with a population of 16,000, where a new extension of the University of North Carolina (UNC) at Chapel Hill campus is slated for construction. The results indicate that at this case study site, health impact estimates increased by factors of 4-9, depending on the health impact considered, compared to using a conventional health impact assessment approach that overlooks these variability and uncertainty sources. In addition, we demonstrate how the method can be used to assess health disparities. For example, in the case study corridor, our method demonstrates the existence of statistically significant racial disparities in exposure to traffic-related PM2.5 under present-day traffic conditions: the correlation between percent black and annual attributable deaths in each census block is 0.37 (t(114)=4.2, p<0.0001). Overall, our results show that the proposed new campus will cause only a small incremental increase in health risks (annual risk 6×10(-10); lifetime risk 4×10(-8)), compared to if the campus is not built. Nonetheless, the approach we illustrate could be useful for improving the quality of information to support decision-making for other urban development projects. Copyright © 2014 Elsevier B.V. All rights reserved.

Wealth Inequality: Ethnic Disparities in Israeli Society

ERIC Educational Resources Information Center

Semyonov, Moshe; Lewin-Epstein, Noah

2011-01-01

This research examines wealth distribution across ethnic groups in Israel and evaluates the role of labor market rewards and intergenerational transfers in producing ethnic disparities. Israel SHARE data from 2005-2006 are used in the analyses. The findings reveal considerable ethnic disparities in wealth. Wealth disparities are most pronounced…

Racial and Ethnic Health Disparities among People with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Magaña, Sandra; Parish, Susan; Morales, Miguel A.; Li, Henan; Fujiura, Glenn

2016-01-01

Racial and ethnic health disparities are a pervasive public health problem. Emerging research finds similar health disparities among people with intellectual and developmental disabilities (IDD) compared to nondisabled adults. However, few studies have examined racial and ethnic health disparities among adults with IDD. Using national data, we…

77 FR 36564 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-19

... Minority Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal... and Health Disparities Special Emphasis Panel; NIMHD Support for Conference and Scientific meetings... Institutes of Health, National Institute on Minority Health and Health Disparities, 6707 Democracy Blvd...

Health Disparities and Intellectual Disabilities: Lessons from Individuals with down Syndrome

ERIC Educational Resources Information Center

Booth, Karin Vander Ploeg

2011-01-01

Individuals with intellectual disabilities experience health disparities and disparities in accessing health care services compared to individuals within the general population. In order to eliminate these disparities the contributors to them must be understood. In this article, we aim to describe a recent reconceptualization of health and…

41 CFR 60-3.11 - Disparate treatment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Disparate treatment. 60-3... treatment. The principles of disparate or unequal treatment must be distinguished from the concepts of..., or members have not been subjected to that standard. Disparate treatment occurs where members of a...

Lessons learned about coordinating academic partnerships from an international network for health education.

PubMed

Luo, Airong; Omollo, Kathleen Ludewig

2013-11-01

There is a growing trend of academic partnerships between U.S., Canadian, and European health science institutions and academic health centers in low- and middle-income countries. These partnerships often encounter challenges such as resource disparities and power differentials, which affect the motivations, expectations, balance of benefits, and results of the joint projects. Little has been discussed in previous literature regarding the communication and project management processes that affect the success of such partnerships. To fill the gap in the literature, the authors present lessons learned from the African Health Open Educational Resources Network, a multicountry, multiorganizational partnership established in May 2008. The authors introduce the history of the network, then discuss actively engaging stakeholders throughout the project's life cycle (design, planning, execution, and closure) through professional development, relationship building, and assessment activities. They focus on communication and management practices used to identify mutually beneficial project goals, ensure timely completion of deliverables, and develop sustainable sociotechnical infrastructure for future collaborative projects. These activities yielded an interactive process of action, assessment, and reflection to ensure that project goals and values were aligned with implementation. The authors conclude with a discussion of lessons learned and how the partnership project may serve as a model for other universities and academic health centers in high-income countries and low- and middle-income countries that are interested in or currently pursuing international academic partnerships.

Factors associated with differential uptake of seasonal influenza immunizations among underserved communities during the 2009-2010 influenza season.

PubMed

Vlahov, David; Bond, Keosha T; Jones, Kandice C; Ompad, Danielle C

2012-04-01

Influenza vaccination coverage remains low and disparities persist. In New York City, a community-based participatory research project (Project VIVA) worked to address this issue in Harlem and the South Bronx by supplementing existing vaccination programs with non-traditional venues (i.e., community-based organizations). We conducted a 10 min survey to assess access to influenza vaccine as well as attitudes and beliefs towards influenza vaccination that could inform intervention development for subsequent seasons. Among 991 participants recruited using street intercept techniques, 63% received seasonal vaccine only, 11% seasonal and H1N1, and 26% neither; 89% reported seeing a health care provider (HCP) during the influenza season. Correlates of immunization among those with provider visits during the influenza season included being US-born, interest in getting the vaccine, concern about self or family getting influenza, an HCP's recommendation and comfort with government. Among those without an HCP visit, factors associated with immunization included being US born, married, interest in getting the vaccine, understanding influenza information, and concern about getting influenza. Factors associated with lack of interest in influenza vaccine included being born outside the US, Black and uncomfortable with government. In medically underserved areas, having access to routine medical care and understanding the medical implications of influenza play an important role in enhancing uptake of seasonal influenza vaccination. Strategies to improve vaccination rates among Blacks and foreign-born residents need to be addressed. The use of non-traditional venues to provide influenza vaccinations in underserved communities has the potential to reduce health disparities.

Addressing regional disparities in pediatric oncology: Results of a collaborative initiative across the Mexican-North American border.

PubMed

Aristizabal, Paula; Fuller, Spencer; Rivera-Gomez, Rebeca; Ornelas, Mario; Nuno, Laura; Rodriguez-Galindo, Carlos; Ribeiro, Raul; Roberts, William

2017-06-01

Cancer is emerging as a major cause of childhood mortality in low- and middle-income countries. In Mexico, cancer is the number one cause of death in children aged 5-14. Until recently, many children with cancer from Baja California, Mexico, went untreated. We reasoned that an initiative inspired by the St. Jude Children's Research Hospital (SJCRH) "twinning" model could successfully be applied to the San Diego-Tijuana border region. In 2008, a twinning project was initiated by Rady Children's Hospital, SJCRH, and the General Hospital Tijuana (GHT). Our aim was to establish a pediatric oncology unit in a culturally sensitive manner, adapted to the local healthcare system. An initial assessment revealed that despite existence of basic hospital infrastructure at the GHT, the essential elements of a pediatric cancer unit were lacking, including dedicated space, trained staff, and uniform treatment. A 5-year action plan was designed to offer training, support the staff financially, and improve the infrastructure. After 7 years, accomplishments include the opening of a new inpatient unit with updated technology, fully trained staff, and a dedicated, interdisciplinary team. Over 700 children have benefited from accurate diagnosis and treatment. Initiatives that implement long-term partnerships between institutions along the Mexican-North American border can be highly effective in establishing successful pediatric cancer control programs. The geographic proximity facilitated accelerated training and close monitoring of project development. Similar initiatives across other disciplines may benefit additional patients and synergize with pediatric oncology programs to reduce health disparities in underserved areas. © 2016 Wiley Periodicals, Inc.

Building Social Networks for Health Promotion: Shout-out Health, New Jersey, 2011

PubMed Central

Jones, Veronica M.; Storm, Deborah S.; Parrott, J. Scott; O’Brien, Kathy Ahearn

2013-01-01

Background Building social networks for health promotion in high-poverty areas may reduce health disparities. Community involvement provides a mechanism to reach at-risk people with culturally tailored health information. Shout-out Health was a feasibility project to provide opportunity and support for women at risk for or living with human immunodeficiency virus infection to carry out health promotion within their informal social networks. Community Context The Shout-out Health project was designed by an academic–community agency team. During 3 months, health promotion topics were chosen, developed, and delivered to community members within informal social networks by participants living in Paterson and Jersey City, New Jersey. Methods We recruited women from our community agency partner’s clients; 57 women participated in in-person or online meetings facilitated by our team. The participants identified and developed the health topics, and we discussed each topic and checked it for message accuracy before the participants provided health promotion within their informal social networks. The primary outcome for evaluating feasibility included the women’s feedback about their experiences and the number of times they provided health promotion in the community. Other data collection included participant questionnaires and community-recipient evaluations. Outcome More than half of the participants reported substantial life challenges, such as unemployment and housing problems, yet with technical support and a modest stipend, women in both groups successfully provided health promotion to 5,861 people within their informal social networks. Interpretation Shout-out Health was feasible and has implications for building social networks to disseminate health information and reduce health disparities in communities. PMID:23987253

ADDRESSING REGIONAL DISPARITIES IN PEDIATRIC ONCOLOGY: RESULTS OF A COLLABORATIVE INITIATIVE ACROSS THE MEXICAN-NORTH AMERICAN BORDER

PubMed Central

Aristizabal, Paula; Fuller, Spencer; Rivera-Gomez, Rebeca; Ornelas, Mario; Nuno, Laura; Rodriguez-Galindo, Carlos; Ribeiro, Raul; Roberts, William

2017-01-01

Background Cancer is emerging as a major cause of childhood mortality in low-income and middle-income countries. In Mexico, cancer is the number one cause of death in children aged 5–14. Until recently, many children with cancer from Baja California, Mexico went untreated. We reasoned that an initiative inspired by the St. Jude Children’s Research Hospital (SJCRH) “twinning” model could successfully be applied to the San Diego–Tijuana border region. In 2008, a twinning project was initiated by Rady Children’s Hospital, SJCRH and the General Hospital Tijuana (GHT). Our aim was to establish a pediatric oncology unit in a culturally sensitive manner, adapted to the local health care system. Procedure An initial assessment revealed that despite existence of basic hospital infrastructure at the GHT, the essential elements of a pediatric cancer unit were lacking, including dedicated space, trained staff, and uniform treatment. A 5-year action plan was designed to offer training, support the staff financially, and improve the infrastructure. Results After seven years, accomplishments include the opening of a new inpatient unit with updated technology, fully-trained staff and a dedicated, interdisciplinary team. Over 700 children have benefited from accurate diagnosis and treatment. Conclusions Initiatives that implement long-term partnerships between institutions along the Mexican-North American border can be highly effective in establishing successful pediatric cancer control programs. The geographic proximity facilitated accelerated training and close monitoring of project development. Similar initiatives across other disciplines may benefit additional patients and synergize with pediatric oncology programs to reduce health disparities in underserved areas. PMID:28000395

A Perinatal Intervention Program for Urban American Indians Part 1: Design, Implementation, and Outcomes

PubMed Central

Davis, Carol L.; Prater, Sandra L.

2001-01-01

High infant mortality rates among American Indians are disproportionate to state statistics for other races and higher than the national average. These findings prompted a community health center in a large Midwestern city to create and provide an American Indian infant mortality reduction project in the early 1990s. Strategies for program implementation included networking with local organizations, communicating with reservation health clinics throughout the state, educating American Indian mothers and their community about factors contributing to American Indian infant mortality, and providing individual case management to American Indian women and infants. We offer this article for three reasons: This grant project was successful, disparity in rates of infant mortality among peoples of color continues, and a paucity of information exists about the health behaviors of American Indian women. PMID:17273261

Mobile text messaging solutions for obesity prevention

NASA Astrophysics Data System (ADS)

Akopian, David; Jayaram, Varun; Aaleswara, Lakshmipathi; Esfahanian, Moosa; Mojica, Cynthia; Parra-Medina, Deborah; Kaghyan, Sahak

2011-02-01

Cellular telephony has become a bright example of co-evolution of human society and information technology. This trend has also been reflected in health care and health promotion projects which included cell phones in data collection and communication chain. While many successful projects have been realized, the review of phone-based data collection techniques reveals that the existing technologies do not completely address health promotion research needs. The paper presents approaches which close this gap by extending existing versatile platforms. The messaging systems are designed for a health-promotion research to prevent obesity and obesity-related health disparities among low-income Latino adolescent girls. Messaging and polling mechanisms are used to communicate and automatically process response data for the target constituency. Preliminary survey data provide an insight on phone availability and technology perception for the study group.

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.

Philanthropy and disparities: progress, challenges, and unfinished business.

PubMed

Mitchell, Faith; Sessions, Kathryn

2011-10-01

Philanthropy has invested millions of dollars to reduce disparities in health care and improve minority health. Grants to strengthen providers' cultural competence, diversify health professions, and collect data have improved understanding of and spurred action on disparities. The persistence of disparities in spite of these advances has shifted philanthropic attention toward strategies to change social, economic, and environmental conditions. We argue that these evolving perspectives, along with earlier groundwork, present new opportunities for funders, especially in combination with progress toward universal health coverage. This article looks at how philanthropy has addressed health disparities over the past decade, with a focus on accomplishments, the work remaining to be done, and how funders can help advance the disparities agenda.

Probabilistic choice between symmetric disparities in motion stereo matching for a lateral navigation system

NASA Astrophysics Data System (ADS)

Ershov, Egor; Karnaukhov, Victor; Mozerov, Mikhail

2016-02-01

Two consecutive frames of a lateral navigation camera video sequence can be considered as an appropriate approximation to epipolar stereo. To overcome edge-aware inaccuracy caused by occlusion, we propose a model that matches the current frame to the next and to the previous ones. The positive disparity of matching to the previous frame has its symmetric negative disparity to the next frame. The proposed algorithm performs probabilistic choice for each matched pixel between the positive disparity and its symmetric disparity cost. A disparity map obtained by optimization over the cost volume composed of the proposed probabilistic choice is more accurate than the traditional left-to-right and right-to-left disparity maps cross-check. Also, our algorithm needs two times less computational operations per pixel than the cross-check technique. The effectiveness of our approach is demonstrated on synthetic data and real video sequences, with ground-truth value.

Interventions to reduce racial and ethnic disparities in health care.

PubMed

Chin, Marshall H; Walters, Amy E; Cook, Scott C; Huang, Elbert S

2007-10-01

In 2005, the Robert Wood Johnson Foundation created Finding Answers: Disparities Research for Change, a program to identify, evaluate, and disseminate interventions to reduce racial and ethnic disparities in the care and outcomes of patients with cardiovascular disease, depression, and diabetes. In this introductory paper, we present a conceptual model for interventions that aim to reduce disparities. With this model as a framework, we summarize the key findings from the six other papers in this supplement on cardiovascular disease, diabetes, depression, breast cancer, interventions using cultural leverage, and pay-for-performance and public reporting of performance measures. Based on these findings, we present global conclusions regarding the current state of health disparities interventions and make recommendations for future interventions to reduce disparities. Multifactorial, culturally tailored interventions that target different causes of disparities hold the most promise, but much more research is needed to investigate potential solutions and their implementation.

Racial/Ethnic Disparities in Mental Health Care Utilization among U.S. College Students: Applying the Institution of Medicine Definition of Health Care Disparities.

PubMed

Hunt, Justin B; Eisenberg, Daniel; Lu, Liya; Gathright, Molly

2015-10-01

The authors apply the Institute of Medicine's definition of health care disparities to college students. The analysis pools data from the first two waves of the Healthy Minds Study, a multicampus survey of students' mental health (N = 13,028). A probit model was used for any past-year service utilization, and group differences in health status were adjusted by transforming the entire distribution for each minority population to approximate the white distribution. Disparities existed between whites and all minority groups. Compared to other approaches, the predicted service disparities were greater because this method included the effects of mediating SES variables. Health care disparities persist in the college setting despite improved access and nearly universal insurance coverage. Our findings emphasize the importance of investigating potential sources of disparities beyond geography and coverage.

The Persistence of American Indian Health Disparities

PubMed Central

Jones, David S.

2006-01-01

Disparities in health status between American Indians and other groups in the United States have persisted throughout the 500 years since Europeans arrived in the Americas. Colonists, traders, missionaries, soldiers, physicians, and government officials have struggled to explain these disparities, invoking a wide range of possible causes. American Indians joined these debates, often suggesting different explanations. Europeans and Americans also struggled to respond to the disparities, sometimes working to relieve them, sometimes taking advantage of the ill health of American Indians. Economic and political interests have always affected both explanations of health disparities and responses to them, influencing which explanations were emphasized and which interventions were pursued. Tensions also appear in ongoing debates about the contributions of genetic and socioeconomic forces to the pervasive health disparities. Understanding how these economic and political forces have operated historically can explain both the persistence of the health disparities and the controversies that surround them. PMID:17077399

76 FR 28795 - National Center on Minority and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-18

... and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel; R25 Grant Review. Date: May 23-24, 2011. Time: 8 a.m..., National Institute on Minority Health and Health Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda...

78 FR 10621 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-14

... Minority Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal... and Health Disparities Special Emphasis Panel; NIMHD Conference Grant Review (R13). Date: March 15... Health Disparities, 6707 Democracy Blvd., Suite 800, Bethesda, MD 20892, (301) 594-7784, [email protected

76 FR 55078 - National Center on Minority and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel, ZMD1 RN (02) NIMHD Comprehensive Center of Excellence... Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892, (301) 496-3996, [email protected

76 FR 40384 - National Center on Minority and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-08

... and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special, Emphasis Panel, U24 Grant Review. Date: July 11-12, 2011. Time: 8 a.m..., National Institute on Minority Health and Health Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda...

75 FR 25273 - National Center on Minority and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel, Faith Based R21. Date: June 29-July 1, 2010. Time: 5 p..., Chief, Office of Scientific Review, National Center on Minority Health and Health Disparities, 6707...

76 FR 57068 - National Center on Minority and Health Disparities Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-15

... and Health Disparities Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel; ZMD1 RN 01 NIMHD Exploratory Centers of Excellence (P20... Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892, (301) 496-3996, [email protected

75 FR 42100 - National Center on Minority and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-20

... and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel, NCMHD Social Determinants of Health (R01) Panel. Date... Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892, (301) 594-8696, [email protected

76 FR 52959 - National Center on Minority and Health Disparities; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... and Health Disparities; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel; NIMHD Revision Applications to Support Environmental Health Disparities Research P20. Date: August 29, 2011. Time: 8 a.m. to 12 p.m. Agenda: To review and...

26 CFR 1.401(a)(4)-7 - Imputation of permitted disparity.

Code of Federal Regulations, 2010 CFR

2010-04-01

... + permitted disparity rate (3) Employees whose plan year compensation exceeds taxable wage base. If an... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Imputation of permitted disparity. 1.401(a)(4)-7... Imputation of permitted disparity. (a) Introduction. In determining whether a plan satisfies section 401(a)(4...

Path Not Found: Disparities in Access to Computer Science Courses in California High Schools

ERIC Educational Resources Information Center

Martin, Alexis; McAlear, Frieda; Scott, Allison

2015-01-01

"Path Not Found: Disparities in Access to Computer Science Courses in California High Schools" exposes one of the foundational causes of underrepresentation in computing: disparities in access to computer science courses in California's public high schools. This report provides new, detailed data on these disparities by student body…

Effects of temperature on development of Lymantria dispar asiatica and Lymantria dispar japonica (Lepidoptera: Erebidae)

Treesearch

Samita Limbu; Melody Keena; Fang Chen; Gericke Cook; Hannah Nadel; Kelli Hoover

2017-01-01

Periodic introductions of the Asian subspecies of gypsy moth, Lymantria dispar asiatica Vnukovskij and Lymantria dispar japonica Motschulsky, in North America are threatening forests and interrupting foreign trade. Although Asian gypsy moth has similar morphology to that of European and North American gypsy moth, it has several...

Racial and Ethnic Disparities in ADHD Diagnosis from Kindergarten to Eighth Grade

ERIC Educational Resources Information Center

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

2013-01-01

Objective: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur across early and middle childhood is currently unknown. We examined the over-time dynamics of race/ethnic disparities in diagnosis from kindergarten to eighth grade and disparities in treatment in fifth and eighth…

Classification, genetic variation and pathogenicity of Lymantria dispar nucleopolyhedrovirus isolates from Asia, Europe, and North America

USDA-ARS?s Scientific Manuscript database

Lymantria dispar multiple nucleopolyhedrovirus (LdMNPV) has been formulated and applied to control outbreaks of the gypsy moth, L. dispar. To classify and determine the degree of genetic variation among isolates of L. dispar NPVs from different parts of the range of the gypsy moth, partial sequence...

Stigma and Racial/Ethnic HIV Disparities: Moving toward Resilience

ERIC Educational Resources Information Center

Earnshaw, Valerie A.; Bogart, Laura M.; Dovidio, John F.; Williams, David R.

2013-01-01

Prior research suggests that stigma plays a role in racial/ethnic health disparities. However, there is limited understanding about the mechanisms by which stigma contributes to HIV-related disparities in risk, incidence and screening, treatment, and survival and what can be done to reduce the impact of stigma on these disparities. We introduce…

Explaining Ethnic Disparities in Preterm Birth in Argentina and Ecuador

PubMed Central

Wehby, George L.; Pawluk, Mariela; Nyarko, Kwame A.; López-Camelo, Jorge S.

2017-01-01

Background Little is understood about racial/ethnic disparities in infant health in South America. We quantified the extent to which the disparity in preterm birth rate (PTB; < 37 gestational weeks) between infants of Native only ancestry and those of European only ancestry in Argentina and Ecuador are explained by household socioeconomic, demographic, healthcare use, and geographic location indicators. Methods The samples included 5199 infants born between 2000 and 2011 from Argentina and 1579 infants born between 2001 and 2011 from Ecuador. An Oaxaca-Blinder type decomposition model adapted to binary outcomes was estimated to explain the disparity in PTB risk across groups of variables and specific variables. Results Maternal use of prenatal care services significantly explained the PTB disparity, by nearly 57% and 30% in Argentina and Ecuador, respectively. Household socioeconomic status explained an additional 26% of the PTB disparity in Argentina. Conclusions Differences in maternal use of prenatal care may partly explain ethnic disparities in PTB in Argentina and Ecuador. Improving access to prenatal care may reduce ethnic disparities in PTB risk in these countries. PMID:27875924

The Lung Corps’ Approach to Reducing Health Disparities in Respiratory Disease

PubMed Central

McGarry, Meghan E.; S. Oh, Sam; M. Galanter, Joshua; Finn, Patricia W.; Burchard, Esteban G.

2014-01-01

Health disparities are prevalent across diseases of the respiratory system, and are major sources of morbidity and mortality among disadvantaged populations in the United States. The American Thoracic Society (ATS) aims to reduce disparities that are both avoidable and unjust. In meeting this goal, the ATS is committed to creating the Lung Corps, a diverse group of senior, mid-level, and junior clinicians, trainees, researchers, and public health practitioners to help achieve health equality. This will be achieved through the following mechanisms: (1) increase awareness of health disparities; (2) empower health professionals with the knowledge and tools to address disparities; (3) shape research agendas to focus on the root causes, to identify modifiable targets, and to promote innovative approaches to reduce disparities; and (4) develop and advocate for health-related policies and regulations that improve the respiratory health of the population. To ensure success, the Lung Corps will interact with other societies, agencies, and organizations to effect elimination of disparities in respiratory health. The ATS is committed to identifying and addressing health disparities to improve the overall health of individuals affected by respiratory diseases. PMID:24697756

Explaining Racial Disparities in Infant Health in Brazil

PubMed Central

Nyarko, Kwame A.; Lopez-Camelo, Jorge; Castilla, Eduardo E.

2015-01-01

Objectives. We sought to quantify how socioeconomic, health care, demographic, and geographic effects explain racial disparities in low birth weight (LBW) and preterm birth (PTB) rates in Brazil. Methods. We employed a sample of 8949 infants born between 1995 and 2009 in 15 cities and 7 provinces in Brazil. We focused on disparities in LBW (< 2500 g) and PTB (< 37 gestational weeks) prevalence between infants of African ancestry alone or African mixed with other ancestries, and European ancestry alone. We used a decomposition model to quantify the contributions of conceptually relevant factors to these disparities. Results. The model explained 45% to 94% of LBW and 64% to 94% of PTB disparities between the African ancestry groups and European ancestry. Differences in prenatal care use and geographic location were the most important contributors, followed by socioeconomic differences. The model explained the majority of the disparities for mixed African ancestry and part of the disparity for African ancestry alone. Conclusions. Public policies to improve children’s health should target prenatal care and geographic location differences to reduce health disparities between infants of African and European ancestries in Brazil. PMID:26313046

Explaining Racial Disparities in Infant Health in Brazil

PubMed Central

Nyarko, Kwame A.; Lopez-Camelo, Jorge; Castilla, Eduardo E.

2013-01-01

Objectives. We sought to quantify how socioeconomic, health care, demographic, and geographic effects explain racial disparities in low birth weight (LBW) and preterm birth (PTB) rates in Brazil. Methods. We employed a sample of 8949 infants born between 1995 and 2009 in 15 cities and 7 provinces in Brazil. We focused on disparities in LBW (< 2500 g) and PTB (< 37 gestational weeks) prevalence between infants of African ancestry alone or African mixed with other ancestries, and European ancestry alone. We used a decomposition model to quantify the contributions of conceptually relevant factors to these disparities. Results. The model explained 45% to 94% of LBW and 64% to 94% of PTB disparities between the African ancestry groups and European ancestry. Differences in prenatal care use and geographic location were the most important contributors, followed by socioeconomic differences. The model explained the majority of the disparities for mixed African ancestry and part of the disparity for African ancestry alone. Conclusions. Public policies to improve children’s health should target prenatal care and geographic location differences to reduce health disparities between infants of African and European ancestries in Brazil. PMID:23409894

Influence of hormonal contraceptive use and health beliefs on sexual orientation disparities in Papanicolaou test use.

PubMed

Charlton, Brittany M; Corliss, Heather L; Missmer, Stacey A; Frazier, A Lindsay; Rosario, Margaret; Kahn, Jessica A; Austin, S Bryn

2014-02-01

Reproductive health screenings are a necessary part of quality health care. However, sexual minorities underutilize Papanicolaou (Pap) tests more than heterosexuals do, and the reasons are not known. Our objective was to examine if less hormonal contraceptive use or less positive health beliefs about Pap tests explain sexual orientation disparities in Pap test intention and utilization. We used multivariable regression with prospective data gathered from 3821 females aged 18 to 25 years in the Growing Up Today Study (GUTS). Among lesbians, less hormonal contraceptive use explained 8.6% of the disparities in Pap test intention and 36.1% of the disparities in Pap test utilization. Less positive health beliefs associated with Pap testing explained 19.1% of the disparities in Pap test intention. Together, less hormonal contraceptive use and less positive health beliefs explained 29.3% of the disparities in Pap test intention and 42.2% of the disparities in Pap test utilization. Hormonal contraceptive use and health beliefs, to a lesser extent, help to explain sexual orientation disparities in intention and receipt of a Pap test, especially among lesbians.

The role of socioeconomic factors in Black-White disparities in preterm birth.

PubMed

Braveman, Paula A; Heck, Katherine; Egerter, Susan; Marchi, Kristen S; Dominguez, Tyan Parker; Cubbin, Catherine; Fingar, Kathryn; Pearson, Jay A; Curtis, Michael

2015-04-01

We investigated the role of socioeconomic factors in Black-White disparities in preterm birth (PTB). We used the population-based California Maternal and Infant Health Assessment survey and birth certificate data on 10 400 US-born Black and White California residents who gave birth during 2003 to 2010 to examine rates and relative likelihoods of PTB among Black versus White women, with adjustment for multiple socioeconomic factors and covariables. Greater socioeconomic advantage was generally associated with lower PTB rates among White but not Black women. There were no significant Black-White disparities within the most socioeconomically disadvantaged subgroups; Black-White disparities were seen only within more advantaged subgroups. Socioeconomic factors play an important but complex role in PTB disparities. The absence of Black-White disparities in PTB within certain socioeconomic subgroups, alongside substantial disparities within others, suggests that social factors moderate the disparity. Further research should explore social factors suggested by the literature-including life course socioeconomic experiences and racism-related stress, and the biological pathways through which they operate-as potential contributors to PTB among Black and White women with different levels of social advantage.

Disparities in Underserved White Populations: The Case of Cancer-Related Disparities in Appalachia

PubMed Central

Paskett, Electra D.; Lengerich, Eugene J.; Schoenberg, Nancy E.; Kennedy, Stephenie K.; Conn, Mary Ellen; Roberto, Karen A.; Dwyer, Sharon K.; Fickle, Darla; Dignan, Mark

2011-01-01

There are meaningful cancer-related disparities in the Appalachian region of the U.S. To address these disparities, the Appalachia Community Cancer Network (ACCN), a collaboration of investigators and community partners in five states (Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia), is involved in increasing cancer education and awareness, conducting community-based participatory research (CBPR), and creating mentorship and training opportunities. The primary objective of this paper is to describe cancer-related disparities in the Appalachian region of the U.S. as an example of the disparities experienced by underserved, predominantly white, rural populations, and to describe ACCN activities designed to intervene regarding these disparities. An ACCN overview/history and the diverse activities of ACCN-participating states are presented in an effort to suggest potential useful strategies for working to reduce health-related disparities in underserved white populations. Strengths that have emerged from the ACCN approach (e.g., innovative collaborations, long-standing established networks) and remaining challenges (e.g., difficulties with continually changing communities, scarce resources) are described. Important recommendations that have emerged from the ACCN are also presented, including the value of allowing communities to lead CBPR efforts. Characteristics of the community-based work of the ACCN provide a framework for reducing health-related disparities in Appalachia and in other underserved white and rural populations. PMID:21873582

Local Health Departments’ Activities to Address Health Disparities and Inequities: Are We Moving in the Right Direction?

PubMed Central

Shah, Gulzar H.; Sheahan, John P.

2015-01-01

Context: Health disparities are among the critical public health challenges. Objectives: To analyze the extent to which local health departments (LHDs) perform activities for addressing health disparities, changes in proportion of LHDs’ performing those activities since 2005, and factors associated with variation in such engagement. Methods: We used the 2013 National Profile of LHDs Survey to perform Logistic Regression of activities LHDs performed to address health disparities. Results: About 20 percent of LHDs did not perform any activity to address health disparities. Significant decreases occurred since 2005 in the proportion of LHDs that performed health disparity reduction/elimination activities for four activities. LHD characteristics significantly associated (p≤0.05) with the increased likelihood of performing activities to address health disparities were: recent completion of community health assessment, community health improvement plan and agency wide strategic plan. Other significant positive impacts on such activities included per capita expenditures, local governance, having one or more local boards of health, larger population size and metropolitan status of the LHD jurisdiction. Conclusions: Reduced infrastructural capacity of LHDs has resulted in fewer LHDs addressing health disparities in their jurisdictions. LHD characteristics associated with higher performance of activities for health disparity reduction identified by this research have important policy implications. PMID:26703693

The Role of Binocular Disparity in Stereoscopic Images of Objects in the Macaque Anterior Intraparietal Area

PubMed Central

Romero, Maria C.; Van Dromme, Ilse C. L.; Janssen, Peter

2013-01-01

Neurons in the macaque Anterior Intraparietal area (AIP) encode depth structure in random-dot stimuli defined by gradients of binocular disparity, but the importance of binocular disparity in real-world objects for AIP neurons is unknown. We investigated the effect of binocular disparity on the responses of AIP neurons to images of real-world objects during passive fixation. We presented stereoscopic images of natural and man-made objects in which the disparity information was congruent or incongruent with disparity gradients present in the real-world objects, and images of the same objects where such gradients were absent. Although more than half of the AIP neurons were significantly affected by binocular disparity, the great majority of AIP neurons remained image selective even in the absence of binocular disparity. AIP neurons tended to prefer stimuli in which the depth information derived from binocular disparity was congruent with the depth information signaled by monocular depth cues, indicating that these monocular depth cues have an influence upon AIP neurons. Finally, in contrast to neurons in the inferior temporal cortex, AIP neurons do not represent images of objects in terms of categories such as animate-inanimate, but utilize representations based upon simple shape features including aspect ratio. PMID:23408970

Getting to equal: strategies to understand and eliminate general and orthopaedic healthcare disparities.

PubMed

Dykes, Daryll C; White, Augustus A

2009-10-01

The 2001 Institute of Medicine report entitled Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care pointed out extensive healthcare disparities in the United States even when controlling for disease severity, socioeconomic status, education, and access. The literature identifies several groups of Americans who receive disparate healthcare: ethnic minorities, women, children, the elderly, the handicapped, the poor, prisoners, lesbians, gays, and the transgender population. Disparate healthcare represents an enormous current challenge with substantial moral, ethical, political, public health, public policy, and economic implications, all of which are likely to worsen over the next several decades without immediate and comprehensive action. A review of recent literature reveals over 100 general and specific suggestions and solutions to eliminate healthcare disparities. While healthcare disparities have roots in multiple sources, racial stereotypes and biases remain a major contributing factor and are prototypical of biases based on age, physical handicap, socioeconomic status, religion, sexual orientation or other differences. Given that such disparities have a strong basis in racial biases, and that the principles of racism are similar to those of other "isms", we summarize the current state of healthcare disparities, the goals of their eradication, and the various potential solutions from a conceptual model of racism affecting patients (internalized racism), caregivers (personally mediated racism), and society (institutionalized racism).

The Enduring Association between Education and Mortality: The Role of Widening and Narrowing Disparities

PubMed Central

Miech, Richard; Pampel, Fred; Kim, Jinyoung; Rogers, Richard G.

2015-01-01

This paper examines how educational disparities in mortality emerge, grow, decline, and disappear across causes of death in the United States and how these change contribute to the enduring association of education and mortality over time. Focusing on adults age 40–64, we first examine the extent to which disparities in all-cause mortality by education persisted from 1989–2007. We then test the “fundamental cause” prediction that mortality disparities persist, in part, by shifting to new health outcomes over time, most importantly for those causes of death that have increasing mortality rates. To test this hypothesis, we focus in depth on the period from 1999–2007, when all causes of death were coded to the same classification system. The results indicate (a) both substantial widening and narrowing of mortality disparities across causes of death, (b) almost all causes of death that had increasing mortality rates also had widening disparities by education, and (c) the total disparity by education in all-cause mortality would be about 25% smaller today were it not for newly widened or emergent disparities since 1999. These results point to the theoretical and policy importance of identifying the social forces that cause health disparities to widen over time. PMID:26937041

Gender disparity in late-life cognitive functioning in India: findings from the longitudinal aging study in India.

PubMed

Lee, Jinkook; Shih, Regina; Feeney, Kevin; Langa, Kenneth M

2014-07-01

To examine gender disparities in cognitive functioning in India and the extent to which education explains this disparity in later life. This study uses baseline interviews of a prospective cohort study of 1,451 community-residing adults 45 years of age or older in four geographically diverse states of India (Karnataka, Kerala, Punjab, Rajasthan). Data collected during home visits includes cognitive performance tests, and rich sociodemographic, health, and psychosocial variables. The cognitive performance tests include episodic memory, numeracy, and a modified version of the Mini-Mental State Examination. We find gender disparity in cognitive function in India, and this disparity is greater in the north than the south. We also find that gender disparities in educational attainment, health, and social and economic activity explain the female cognitive disadvantage in later life. We report significant gender disparities in cognitive functioning among older Indian adults, which differ from gender disparities in cognition encountered in developed countries. Our models controlling for education, health status, and social and economic activity explain the disparity in southern India but not the region-specific disparity in the northern India. North Indian women may face additional sources of stress associated with discrimination against women that contribute to persistent disadvantages in cognitive functioning at older ages. © 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.

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

Trends in Racial-Ethnic Disparities in Access to Mental Health Care, 2004-2012.

PubMed

Cook, Benjamin Lê; Trinh, Nhi-Ha; Li, Zhihui; Hou, Sherry Shu-Yeu; Progovac, Ana M

2017-01-01

This study compared trends in racial-ethnic disparities in mental health care access among whites, blacks, Hispanics, and Asians by using the Institute of Medicine definition of disparities as all differences except those due to clinical appropriateness, clinical need, and patient preferences. Racial-ethnic disparities in mental health care access were examined by using data from a nationally representative sample of 214,597 adults from the 2004-2012 Medical Expenditure Panel Surveys. The main outcome measures included three mental health care access measures (use of any mental health care, any outpatient care, and any psychotropic medication in the past year). Significant disparities were found in 2004-2005 and in 2011-2012 for all three racial-ethnic minority groups compared with whites in all three measures of access. Between 2004 and 2012, black-white disparities in any mental health care and any psychotropic medication use increased, respectively, from 8.2% to 10.8% and from 7.6% to 10.0%. Similarly, Hispanic-white disparities in any mental health care and any psychotropic medication use increased, respectively, from 8.4% to 10.9% and 7.3% to 10.3%. No reductions in racial-ethnic disparities in access to mental health care were identified between 2004 and 2012. For blacks and Hispanics, disparities were exacerbated over this period. Clinical interventions that improve identification of symptoms of mental illness, expansion of health insurance, and other policy interventions that remove financial barriers to access may help to reduce these disparities.

Health disparities monitoring in the U.S.: lessons for monitoring efforts in Israel and other countries.

PubMed

Abu-Saad, Kathleen; Avni, Shlomit; Kalter-Leibovici, Ofra

2018-02-28

Health disparities are a persistent problem in many high-income countries. Health policymakers recognize the need to develop systematic methods for documenting and tracking these disparities in order to reduce them. The experience of the U.S., which has a well-established health disparities monitoring infrastructure, provides useful insights for other countries. This article provides an in-depth review of health disparities monitoring in the U.S. Lessons of potential relevance for other countries include: 1) the integration of health disparities monitoring in population health surveillance, 2) the role of political commitment, 3) use of monitoring as a feedback loop to inform future directions, 4) use of monitoring to identify data gaps, 5) development of extensive cross-departmental cooperation, and 6) exploitation of digital tools for monitoring and reporting. Using Israel as a case in point, we provide a brief overview of the healthcare and health disparities landscape in Israel, and examine how the lessons from the U.S. experience might be applied in the Israeli context. The U.S. model of health disparities monitoring provides useful lessons for other countries with respect to documentation of health disparities and tracking of progress made towards their elimination. Given the persistence of health disparities both in the U.S. and Israel, there is a need for monitoring systems to expand beyond individual- and healthcare system-level factors, to incorporate social and environmental determinants of health as health indicators/outcomes.

Implementing the Institute of Medicine definition of disparities: an application to mental health care.

PubMed

McGuire, Thomas G; Alegria, Margarita; Cook, Benjamin L; Wells, Kenneth B; Zaslavsky, Alan M

2006-10-01

In a recent report, the Institute of Medicine (IOM) defines a health service disparity between population groups to be the difference in treatment or access not justified by the differences in health status or preferences of the groups. This paper proposes an implementation of this definition, and applies it to disparities in outpatient mental health care. Health Care for Communities (HCC) reinterviewed 9,585 respondents from the Community Tracking Study in 1997-1998, oversampling individuals with psychological distress, alcohol abuse, drug abuse, or mental health treatment. The HCC is designed to make national estimates of service use. Expenditures are modeled using generalized linear models with a log link for quantity and a probit model for any utilization. We adjust for group differences in health status by transforming the entire distribution of health status for minority populations to approximate the white distribution. We compare disparities according to the IOM definition to other methods commonly used to assess health services disparities. Our method finds significant service disparities between whites and both blacks and Latinos. Estimated disparities from this method exceed those for competing approaches, because of the inclusion of effects of mediating factors (such as income) in the IOM approach. A rigorous definition of disparities is needed to monitor progress against disparities and to compare their magnitude across studies. With such a definition, disparities can be estimated by adjusting for group differences in models for expenditures and access to mental health services.

A Study of National Physician Organizations’ Efforts to Reduce Racial and Ethnic Health Disparities in the United States

PubMed Central

Peek, Monica E.; Wilson, Shannon C.; Bussey-Jones, Jada; Lypson, Monica; Cordasco, Kristina; Jacobs, Elizabeth A.; Bright, Cedric; Brown, Arleen F.

2012-01-01

Purpose To characterize national physician organizations’ efforts to reduce health disparities and identify organizational characteristics associated with such efforts. Method This cross-sectional study was conducted between September 2009 and June 2010. The authors used two-sample t tests and chi-square tests to compare the proportion of organizations with disparity-reducing activities between different organizational types (e.g., primary care versus subspecialty organizations, small [<1,000 members] versus large [>5,000 members]). Inclusion criteria required physician organizations to be (1) focused on physicians, (2) national in scope, and (3) membership based. Results The number of activities per organization ranged from 0 to 22. Approximately half (53%) of organizations had 0 or 1 disparity-reducing activities. Organiza-tional characteristics associated with having at least 1 disparity-reducing effort included membership size (88% of large groups versus 58% of small groups had at least 1 activity; P = .004) and the presence of a health disparities committee (95% versus 59%; P < .001). Primary care (versus subspecialty) organizations and racial/ethnic minority physician organizations were more likely to have disparity-reducing efforts, although findings were not statistically significant. Common themes addressed by activities were health care access, health care disparities, workforce diversity, and language barriers. Common strategies included education of physicians/trainees and patients/general public, position statements, and advocacy. Conclusions Despite the national priority to eliminate health disparities, more than half of national physician organizations are doing little to address this problem. Primary care and minority physician organizations, and those with disparities committees, may provide leadership to extend the scope of disparity-reduction efforts. PMID:22534593

Prevalence and framing of health disparities in local print news: Implications for multilevel interventions to address cancer inequalities

PubMed Central

Nagler, Rebekah H.; Bigman, Cabral A.; Ramanadhan, Shoba; Ramamurthi, Divya; Viswanath, K.

2016-01-01

Background Americans remain under-informed about cancer and other health disparities and the social determinants of health (SDH). The news media may be contributing to this knowledge deficit, whether by discussing these issues narrowly or ignoring them altogether. Because local media are particularly important in influencing public opinion and support for public policies, this study examines the prevalence and framing of disparities/SDH in local mainstream and ethnic print news. Methods We conducted a multi-method content analysis of local mainstream (English-language) and ethnic (Spanish-language) print news in two lower-income cities in New England with substantial racial/ethnic minority populations. After establishing inter-coder reliability (kappa=0.63–0.88), coders reviewed the primary English- and Spanish-language newspaper in each city, identifying both disparities and non-disparities health stories published between February 2010 and January 2011. Results Local print news coverage of cancer and other health disparities was rare. Of 650 health stories published across four newspapers during the one-year study period, only 21 (3.2%) discussed disparities/SDH. Although some stories identified causes of and solutions for disparities, these were often framed in individual (e.g., poor dietary habits) rather than social contextual terms (e.g., lack of food availability/affordability). Cancer and other health stories routinely missed opportunities to discuss disparities/SDH. Conclusion Local mainstream and ethnic media may be ideal targets for multilevel interventions designed to address cancer and other health inequalities. Impact By increasing media attention to and framing of health disparities, we may observe important downstream effects on public opinion and support for structural solutions to disparities, particularly at the local level. PMID:27196094

Racial and Ethnic Disparities in Health and Health Care: an Assessment and Analysis of the Awareness and Perceptions of Public Health Workers Implementing a Statewide Community Transformation Grant in Texas.

PubMed

Akinboro, Oladimeji; Ottenbacher, Allison; Martin, Marcus; Harrison, Roderick; James, Thomas; Martin, Eddilisa; Murdoch, James; Linnear, Kim; Cardarelli, Kathryn

2016-03-01

Little is known about the awareness of public health professionals regarding racial and ethnic disparities in health in the United States of America (USA). Our study objective was to assess the awareness and perceptions of a group of public health workers in Texas regarding racial health disparities and their chief contributing causes. We surveyed public health professionals working on a statewide grant in Texas, who were participants at health disparities' training workshops. Multivariable logistic regression was employed in examining the association between the participants' characteristics and their perceptions of the social determinants of health as principal causes of health disparities. There were 106 respondents, of whom 38 and 35 % worked in health departments and non-profit organizations, respectively. The racial/ethnic groups with the highest incidence of HIV/AIDS and hypertension were correctly identified by 63 and 50 % of respondents, respectively, but only 17, and 32 % were knowledgeable regarding diabetes and cancer, respectively. Seventy-one percent of respondents perceived that health disparities are driven by the major axes of the social determinants of health. Exposure to information about racial/ethnic health disparities within the prior year was associated with a higher odds of perceiving that social determinants of health were causes of health disparities (OR 9.62; 95 % CI 2.77, 33.41). Among public health workers, recent exposure to information regarding health disparities may be associated with their perceptions of health disparities. Further research is needed to investigate the impact of such exposure on their long-term perception of disparities, as well as the equity of services and programs they administer.

Individual Objective and Subjective Fixation Disparity in Near Vision

PubMed Central

Jaschinski, Wolfgang

2017-01-01

Binocular vision refers to the integration of images in the two eyes for improved visual performance and depth perception. One aspect of binocular vision is the fixation disparity, which is a suboptimal condition in individuals with respect to binocular eye movement control and subsequent neural processing. The objective fixation disparity refers to the vergence angle between the visual axes, which is measured with eye trackers. Subjective fixation disparity is tested with two monocular nonius lines which indicate the physical nonius separation required for perceived alignment. Subjective and objective fixation disparity represent the different physiological mechanisms of motor and sensory fusion, but the precise relation between these two is still unclear. This study measures both types of fixation disparity at viewing distances of 40, 30, and 24 cm while observers fixated a central stationary fusion target. 20 young adult subjects with normal binocular vision were tested repeatedly to investigate individual differences. For heterophoria and subjective fixation disparity, this study replicated that the binocular system does not properly adjust to near targets: outward (exo) deviations typically increase as the viewing distance is shortened. This exo proximity effect—however—was not found for objective fixation disparity, which–on the average–was zero. But individuals can have reliable outward (exo) or inward (eso) vergence errors. Cases with eso objective fixation disparity tend to have less exo states of subjective fixation disparity and heterophoria. In summary, the two types of fixation disparity seem to respond in a different way when the viewing distance is shortened. Motor and sensory fusion–as reflected by objective and subjective fixation disparity–exhibit complex interactions that may differ between individuals (eso versus exo) and vary with viewing distance (far versus near vision). PMID:28135308

Prevalence and Framing of Health Disparities in Local Print News: Implications for Multilevel Interventions to Address Cancer Inequalities.

PubMed

Nagler, Rebekah H; Bigman, Cabral A; Ramanadhan, Shoba; Ramamurthi, Divya; Viswanath, K

2016-04-01

Americans remain under-informed about cancer and other health disparities and the social determinants of health (SDH). The news media may be contributing to this knowledge deficit, whether by discussing these issues narrowly or ignoring them altogether. Because local media are particularly important in influencing public opinion and support for public policies, this study examines the prevalence and framing of disparities/SDH in local mainstream and ethnic print news. We conducted a multi-method content analysis of local mainstream (English language) and ethnic (Spanish language) print news in two lower income cities in New England with substantial racial/ethnic minority populations. After establishing intercoder reliability (κ = 0.63-0.88), coders reviewed the primary English and Spanish language newspaper in each city, identifying both disparities and non-disparities health stories published between February 2010 and January 2011. Local print news coverage of cancer and other health disparities was rare. Of 650 health stories published across four newspapers during the one-year study period, only 21 (3.2%) discussed disparities/SDH. Although some stories identified causes of and solutions for disparities, these were often framed in individual (e.g., poor dietary habits) rather than social contextual terms (e.g., lack of food availability/affordability). Cancer and other health stories routinely missed opportunities to discuss disparities/SDH. Local mainstream and ethnic media may be ideal targets for multilevel interventions designed to address cancer and other health inequalities. By increasing media attention to and framing of health disparities, we may observe important downstream effects on public opinion and support for structural solutions to disparities, particularly at the local level. Cancer Epidemiol Biomarkers Prev; 25(4); 603-12. ©2016 AACR SEE ALL ARTICLES IN THIS CEBP FOCUS SECTION, "MULTILEVEL APPROACHES TO ADDRESSING CANCER HEALTH DISPARITIES". ©2016 American Association for Cancer Research.

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.

[Do prisms according to Hans-Joachim Haase improve stereoacuity?].

PubMed

Kromeier, Miriam; Schmitt, Christina; Bach, Michael; Kommerell, Guntram

2002-06-01

The "Measuring and Correcting Methodology" after H.-J. Haase (MKH) aims at converting "fixation disparity" into bicentral fixation, using prismatic spectacles. In the context of the MKH, fixation disparity is diagnosed by a series of subjective tests. According to H.-J. Haase, a long-standing fixation disparity can lead to "disparate correspondence" between the central areas of both retinae, which consolidates the fixation disparity and gradually converts a "young" into an "old fixation disparity". In "old fixation disparity" it is thought that bicentral fixation does not occur anymore, so that stereoacuity is impaired. However, prismatic spectacles can, according to H.-J. Haase, restitute bicentral fixation and consequently improve stereoacuity, even in some cases of "old fixation disparity". Ten non-strabismic subjects with a visual acuity of >/= 1.0 in both eyes were examined. It turned out that all ten had, according to MKH, a "disparate correspondence", 5 subjects with a "young" and 5 with an "old fixation disparity". According to the MKH, a correcting prism was determined. All 10 subjects underwent the automatic Freiburg Stereoacuity Test, without and with the MKH-prism. Without the MKH-prism, the stereoscopic threshold ranged between 1.5 and 14.5 arcsec. With the MKH-prism, the values were not significantly different. Stereoacuity ranged between good and excellent in the 5 subjects with "young" as well as in the 5 subjects with "old fixation disparity". The MKH-prism did not improve the stereoacuity in any of the subjects. These results cast doubt on Haase's assertion that an "old fixation disparity" implies a reduced stereoacuity. Hence, the premise for a benefit of the MKH-prism with respect of stereoacuity is not substantiated. In the 5 subjects with a "young fixation disparity", the good stereoacuity is consistent with Haase's theory, so that a benefit of the MKH-prism for stereoacuity was not expected. In previous studies, stereoacuity was found to be better with the MKH-prism than without it. These studies are questionable since learning with repeated testing was not taken into account. We conclude that there is no sound evidence for the assumption that the MKH-prism can improve stereoacuity.

Minority Health and Health Disparities

MedlinePlus

... Populations & Co-occurring Disorders » Minority Health and Health Disparities In this Section Underage Drinking College Drinking Women Older Adults Minority Health & Health Disparities Other Psychiatric ...

Elucidating empowerment in El Proyecto Bienestar (the Well-Being Project).

PubMed

Postma, Julie

2008-05-01

This paper describes differences in how socioculturally diverse participants in one community-based participatory research project negotiated 'empowerment', and the implications of those differences for nurses involved in farmworker health and safety efforts. Internationally, empowerment and community participation are increasingly being used as strategies to reduce health disparities. Theories of empowerment vary in the academic literature and their connotations vary across cultures. Study participants were part of El Proyecto Bienestar, a community-based participatory research (CBPR) project whose aim was to identify and respond to occupational and environmental health threats in one Mexican-American farmworker community in the United States of America. Participant observation was used to audiorecord 18 participants in the third year (2006) of this 4-year project discussing future project activities. Discourse analysis was used to analyse the transcripts. While participants agreed that 'empowerment' was central to the project, they had different perspectives on what the term meant and the role that the project should play in empowering the farmworker community. Empowerment discourses positioned the project in three ways: (1) as an instrument used to strengthen farmworkers' collective political voice, (2) as an instrument used to represent multiple community interests and (3) as an instrument used to advocate on behalf of farmworkers. Individuals used multiple discourses signifying the complexity in participants' roles and obligations. Balancing power and developing knowledge collaboratively requires understanding multiple approaches to empowerment. Community empowerment as an outcome should not come at the expense of individual empowerment as part of the CBPR process.

Disparity : scalable anomaly detection for clusters.

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

Desai, N.; Bradshaw, R.; Lusk, E.

2008-01-01

In this paper, we describe disparity, a tool that does parallel, scalable anomaly detection for clusters. Disparity uses basic statistical methods and scalable reduction operations to perform data reduction on client nodes and uses these results to locate node anomalies. We discuss the implementation of disparity and present results of its use on a SiCortex SC5832 system.

76 FR 31618 - National Center on Minority Health and Health Disparities; Notice of Meeting

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Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-02

... Health and Health Disparities; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory... Council on Minority Health and Health Disparities. The meeting will be open to the public as indicated... on Minority Health and Health Disparities. Date: September 14, 2010. Closed: 8 a.m. to 9:30 a.m...

Gender Disparity at Elementary Education Level in Jammu and Kashmir: An Exploratory Study

ERIC Educational Resources Information Center

Gul, Showkeen Bilal Ahmad; Khan, Zebun Nisa

2014-01-01

This paper is based on a study to explore gender disparity at elementary education level in Jammu and Kashmir. Gender disparity in education refers to differences in outcomes observed between two sexes. Education disparities can be seen in different enrolment rates, dropout rates, and survival rates among the sexes. The central government and…

Urban-Rural Disparities in Injury Mortality in China, 2006

ERIC Educational Resources Information Center

Hu, Guoqing; Baker, Susan P.; Baker, Timothy D.

2010-01-01

Context: Urban-rural disparity is an important issue for injury control in China. Details of the urban-rural disparities in fatal injuries have not been analyzed. Purpose: To target key injury causes that most contribute to the urban-rural disparity, we decomposed total urban-rural differences in 2006 injury mortality by gender, age, and cause.…

Classification, genetic variation and pathogenicity of Lymantria dispar nucleopolyhedrovirus isolates from Asia, Europe, and North America

Treesearch

Robert L. Harrison; Melody A. Keena; Daniel L. Rowley

2014-01-01

Lymantria dispar multiple nucleopolyhedrovirus (LdMNPV) has been formulated and applied to control outbreaks of the gypsy moth, L. dispar. To classify and determine the degree of genetic variation among isolates of L. dispar NPVs from different parts of the range of the gypsy moth, partial sequences of the

Health Disparities of Adults with Intellectual Disabilities: What Do We Know? What Do We Do?

ERIC Educational Resources Information Center

Krahn, Gloria L.; Fox, Michael H.

2014-01-01

Background: Recent attention to health of people with intellectual disabilities has used a health disparities framework. Building on historical context, the paper summarizes what is known about health disparities from reports and research and provides direction on what to do to reduce these disparities among adults with intellectual disabilities.…

The Role of High Schools in Addressing Racial/Ethnic Health Disparities: A Mixed-Methods Assessment

ERIC Educational Resources Information Center

Payton, Erica; Price, James H.

2014-01-01

Racial/ethnic health disparities start early in life and become exacerbated throughout the life cycle. Schools have the opportunity to reduce the severity of disparities. The purpose of this study was to examine whether journals in school health cover racial/ethnic health disparities and to identify what leading authorities in school health…

The Effects of Hurricane Katrina on Food Access Disparities in New Orleans

PubMed Central

Bodor, J. Nicholas; Rice, Janet C.; Swalm, Chris M.; Hutchinson, Paul L.

2011-01-01

Disparities in neighborhood food access are well documented, but little research exists on how shocks influence such disparities. We examined neighborhood food access in New Orleans at 3 time points: before Hurricane Katrina (2004–2005), in 2007, and in 2009. We combined existing directories with on-the-ground verification and geographic information system mapping to assess supermarket counts in the entire city. Existing disparities for African American neighborhoods worsened after the storm. Although improvements have been made, by 2009 disparities were no better than prestorm levels. PMID:21233432

An overview of disparities in childhood cancer: Report on the Inaugural Symposium on Childhood Cancer Health Disparities, Houston, Texas, 2016.

PubMed

Scheurer, Michael E; Lupo, Philip J; Schüz, Joachim; Spector, Logan G; Wiemels, Joseph L; Aplenc, Richard; Gramatges, M Monica; Schiffman, Joshua D; Pombo-de-Oliveira, Maria S; Yang, Jun J; Heck, Julia E; Metayer, Catherine; Orjuela-Grimm, Manuela A; Bona, Kira; Aristizabal, Paula; Austin, Mary T; Rabin, Karen R; Russell, Heidi V; Poplack, David G

2018-05-08

The Inaugural Symposium on Childhood Cancer Health Disparities was held in Houston, Texas, on November 2, 2016. The symposium was attended by 109 scientists and clinicians from diverse disciplinary backgrounds with interests in pediatric cancer disparities and focused on reviewing our current knowledge of disparities in cancer risk and outcomes for select childhood cancers. Following a full day of topical sessions, everyone participated in a brainstorming session to develop a working strategy for the continued expansion of research in this area. This meeting was designed to serve as a springboard for examination of childhood cancer disparities from a more unified and systematic approach and to enhance awareness of this area of need.

A Participatory Action Research Pilot Study of Urban Health Disparities Using Rapid Assessment Response and Evaluation

PubMed Central

Brown, David Richard; Hernández, Agueda; Saint-Jean, Gilbert; Evans, Siân; Tafari, Ida; Brewster, Luther G.; Celestin, Michel J.; Gómez-Estefan, Carlos; Regalado, Fernando; Akal, Siri; Nierenberg, Barry; Kauschinger, Elaine D.; Schwartz, Robert; Page, J. Bryan

2008-01-01

Healthy People 2010 made it a priority to eliminate health disparities. We used a rapid assessment response and evaluation (RARE) to launch a program of participatory action research focused on health disparities in an urban, disadvantaged Black community serviced by a major south Florida health center. We formed partnerships with community members, identified local health disparities, and guided interventions targeting health disparities. We describe the RARE structure used to triangulate data sources and guide intervention plans as well as findings and conclusions drawn from scientific literature and epidemiological, historic, planning, clinical, and ethnographic data. Disenfranchisement and socioeconomic deprivation emerged as the principal determinants of local health disparities and the most appropriate targets for intervention. PMID:18048802

What Are Cancer Disparities?

Cancer.gov

This infographic shows the factors associated with cancer disparities, examples of how the cancer burden differs across certain population groups, and NCI actions to understand and reduce cancer disparities.

Cancer Disparities

Cancer.gov

Basic information about cancer disparities in the U.S., factors that contribute to the disproportionate burden of cancer in some groups, and examples of disparities in incidence and mortality among certain populations.

Two takes on the ecosystem impacts of climate change and fishing: Comparing a size-based and a species-based ecosystem model in the central North Pacific

NASA Astrophysics Data System (ADS)

Woodworth-Jefcoats, Phoebe A.; Polovina, Jeffrey J.; Howell, Evan A.; Blanchard, Julia L.

2015-11-01

We compare two ecosystem model projections of 21st century climate change and fishing impacts in the central North Pacific. Both a species-based and a size-based ecosystem modeling approach are examined. While both models project a decline in biomass across all sizes in response to climate change and a decline in large fish biomass in response to increased fishing mortality, the models vary significantly in their handling of climate and fishing scenarios. For example, based on the same climate forcing the species-based model projects a 15% decline in catch by the end of the century while the size-based model projects a 30% decline. Disparities in the models' output highlight the limitations of each approach by showing the influence model structure can have on model output. The aspects of bottom-up change to which each model is most sensitive appear linked to model structure, as does the propagation of interannual variability through the food web and the relative impact of combined top-down and bottom-up change. Incorporating integrated size- and species-based ecosystem modeling approaches into future ensemble studies may help separate the influence of model structure from robust projections of ecosystem change.

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.

Trends in racial and ethnic-specific rates for the health status indicators: United States, 1990-98.

PubMed

Keppel, Kenneth G; Pearcy, Jeffrey N; Wagener, Diane K

2002-01-01

The Health Status Indicators (HSIs) were developed as part of the Healthy People 2000 process to facilitate the comparison of health status measures at national, State,and local levels. In this report national trends in racial and ethnic-specific rates for 17 HSIs are examined for the period from 1990-8. One of three overarching goals of Healthy People 2000 was to reduce health disparities. Examination of trends in the HSIs indicates that rates for most racial/ethnic groups improved. Rates for American Indian or Alaska Natives did not improve for six of the HSIs. An index of disparity, a summary measure of disparity among race/ethnic-specific rates, was used to measure changes in disparity between 1990 and 1998. The index of disparity decreased for 12 of the HSIs. Based on this index, racial/ethnic disparity in the percent of low birthweight infants declined by 19 percent, disparity in the percent of children under 18 years of age in poverty and in the syphilis case rate declined by 13 percent, and disparity in the stroke death rate declined by 11 percent. The index declined by less than 10 percent for eight other indicators. The index of disparity increased between 1990 and 1998 for the other five HSIs examined here. The index of disparity increased by more than 10 percent for work-related injury death rates, motor vehicle crash death rates, and suicide death rates. While rates for the HSIs have improved, not all groups have benefited equally and substantial differences among racial/ethnic groups persist.

Impact of fetal death reporting requirements on early neonatal and fetal mortality rates and racial disparities.

PubMed

Tyler, Crystal P; Grady, Sue C; Grigorescu, Violanda; Luke, Barbara; Todem, David; Paneth, Nigel

2012-01-01

Racial disparities in infant and neonatal mortality vary substantially across the U.S. with some states experiencing wider disparities than others. Many factors are thought to contribute to these disparities, but state differences in fetal death reporting have received little attention. We examined whether such reporting requirements may explain national variation in neonatal and fetal mortality rates and racial disparities. We used data on non-Hispanic white and non-Hispanic black infants from the U.S. 2000-2002 linked birth/infant death and fetal death records to determine the degree to which state fetal death reporting requirements explain national variation in neonatal and fetal mortality rates and racial disparities. States were grouped depending upon whether they based the lower limit for fetal death reporting on birthweight alone, gestational age alone, both birthweight and gestational age, or required reporting of all fetal deaths. Traditional methods and the fetuses-at-risk approach were used to calculate mortality rates, 95% confidence intervals, and relative and absolute racial disparity measures in these four groups. States with birthweight-alone fetal death thresholds substantially underreported fetal deaths at lower gestations and slightly overreported neonatal deaths at older gestations. This finding was reflected by these states having the highest neonatal mortality rates and disparities, but the lowest fetal mortality rates and disparities. Using birthweight alone as a reporting threshold may promote some shift of fetal deaths to newborn deaths, contributing to racial disparities in neonatal mortality. The adoption of a uniform national threshold for reporting fetal deaths could reduce systematic differences in live birth and fetal death reporting.

African American race and HIV virological suppression: beyond disparities in clinic attendance.

PubMed

Howe, Chanelle J; Napravnik, Sonia; Cole, Stephen R; Kaufman, Jay S; Adimora, Adaora A; Elston, Beth; Eron, Joseph J; Mugavero, Michael J

2014-06-15

Racial disparities in clinic attendance may contribute to racial disparities in plasma human immunodeficiency virus type 1 : HIV-1) RNA levels among HIV-positive patients in care. Data from 946 African American and 535 Caucasian patients receiving HIV care at the University of North Carolina Center for AIDS Research HIV clinic between January 1, 1999, and August 1, 2012, were used to estimate the association between African American race and HIV virological suppression (i.e., undetectable HIV-1 RNA) when racial disparities in clinic attendance were lessened. Clinic attendance was measured as the proportion of scheduled clinic appointments attended (i.e., visit adherence) or the proportion of six 4-month intervals with at least 1 attended scheduled clinic appointment (i.e., visit constancy). In analyses accounting for patient characteristics, the risk ratio for achieving suppression when comparing African Americans with Caucasians was 0.91 (95% confidence interval: 0.85, 0.98). Lessening disparities in adherence or constancy lowered disparities in virological suppression by up to 44.4% and 11.1%, respectively. Interventions that lessen disparities in adherence may be more effective in eliminating disparities in suppression than interventions that lessen disparities in constancy. Given that gaps in care were limited to be no more than 2 years for both attendance measures, the impact of lessening disparities in adherence may be overstated. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Binocular disparity tuning and visual-vestibular congruency of multisensory neurons in macaque parietal cortex

PubMed Central

Yang, Yun; Liu, Sheng; Chowdhury, Syed A.; DeAngelis, Gregory C.; Angelaki, Dora E.

2012-01-01

Many neurons in the dorsal medial superior temporal (MSTd) and ventral intraparietal (VIP) areas of the macaque brain are multisensory, responding to both optic flow and vestibular cues to self-motion. The heading tuning of visual and vestibular responses can be either congruent or opposite, but only congruent cells have been implicated in cue integration for heading perception. Because of the geometric properties of motion parallax, however, both congruent and opposite cells could be involved in coding self-motion when observers fixate a world-fixed target during translation, if congruent cells prefer near disparities and opposite cells prefer far disparities. We characterized the binocular disparity selectivity and heading tuning of MSTd and VIP cells using random-dot stimuli. Most (70%) MSTd neurons were disparity-selective with monotonic tuning, and there was no consistent relationship between depth preference and congruency of visual and vestibular heading tuning. One-third of disparity-selective MSTd cells reversed their depth preference for opposite directions of motion (direction-dependent disparity tuning, DDD), but most of these cells were unisensory with no tuning for vestibular stimuli. Inconsistent with previous reports, the direction preferences of most DDD neurons do not reverse with disparity. By comparison to MSTd, VIP contains fewer disparity-selective neurons (41%) and very few DDD cells. On average, VIP neurons also preferred higher speeds and nearer disparities than MSTd cells. Our findings are inconsistent with the hypothesis that visual/vestibular congruency is linked to depth preference, and also suggest that DDD cells are not involved in multisensory integration for heading perception. PMID:22159105

Implementing the Institute of Medicine Definition of Disparities: An Application to Mental Health Care

PubMed Central

McGuire, Thomas G; Alegria, Margarita; Cook, Benjamin L; Wells, Kenneth B; Zaslavsky, Alan M

2006-01-01

Objective In a recent report, the Institute of Medicine (IOM) defines a health service disparity between population groups to be the difference in treatment or access not justified by the differences in health status or preferences of the groups. This paper proposes an implementation of this definition, and applies it to disparities in outpatient mental health care. Data Sources Health Care for Communities (HCC) reinterviewed 9,585 respondents from the Community Tracking Study in 1997–1998, oversampling individuals with psychological distress, alcohol abuse, drug abuse, or mental health treatment. The HCC is designed to make national estimates of service use. Study Design Expenditures are modeled using generalized linear models with a log link for quantity and a probit model for any utilization. We adjust for group differences in health status by transforming the entire distribution of health status for minority populations to approximate the white distribution. We compare disparities according to the IOM definition to other methods commonly used to assess health services disparities. Principal Findings Our method finds significant service disparities between whites and both blacks and Latinos. Estimated disparities from this method exceed those for competing approaches, because of the inclusion of effects of mediating factors (such as income) in the IOM approach. Conclusions A rigorous definition of disparities is needed to monitor progress against disparities and to compare their magnitude across studies. With such a definition, disparities can be estimated by adjusting for group differences in models for expenditures and access to mental health services. PMID:16987312

What makes African American health disparities newsworthy? An experiment among journalists about story framing.

PubMed

Hinnant, Amanda; Oh, Hyun Jee; Caburnay, Charlene A; Kreuter, Matthew W

2011-12-01

News stories reporting race-specific health information commonly emphasize disparities between racial groups. But recent research suggests this focus on disparities has unintended effects on African American audiences, generating negative emotions and less interest in preventive behaviors (Nicholson RA, Kreuter MW, Lapka C et al. Unintended effects of emphasizing disparities in cancer communication to African-Americans. Cancer Epidemiol Biomarkers Prev 2008; 17: 2946-52). They found that black adults are more interested in cancer screening after reading about the progress African Americans have made in fighting cancer than after reading stories emphasizing disparities between blacks and whites. This study builds on past findings by (i) examining how health journalists judge the newsworthiness of stories that report race-specific health information by emphasizing disparities versus progress and (ii) determining whether these judgments can be changed by informing journalists of audience reactions to disparity versus progress framing. In a double-blind-randomized experiment, 175 health journalists read either a disparity- or progress-framed story on colon cancer, preceded by either an inoculation about audience effects of such framing or an unrelated (i.e. control) information stimuli. Journalists rated the disparity-frame story more favorably than the progress-frame story in every category of news values. However, the inoculation significantly increased positive reactions to the progress-frame story. Informing journalists of audience reactions to race-specific health information could influence how health news stories are framed.

Gender and regional disparities of tuberculosis in Hunan, China.

PubMed

Chen, Mengshi; Kwaku, Abuaku Benjamin; Chen, Youfang; Huang, Xin; Tan, Hongzhuan; Wen, Shi Wu

2014-04-27

Major efforts have been made to improve the health care system in Hunan province, China. The aims of this study were to assess whether and to what extent these efforts have impacted on gender and regional disparities of Tuberculosis (TB) incidence in recent years, especially for less developed areas. We obtained data from the 2005-2009 China Information System for Disease Control and Prevention (CISDCP)to conduct this study in Hunan province. Counties within the province were divided into four regions according to quartiles based on the 2007 per capita GDP. Index of Disparity (ID) and Relative Index of Inequality (RII) were used to measure the disparities of TB incidence in relation to gender and region. Bootstrap technique was used to increase the precision. The average annual incidence of TB was 111.75 per 100,000 in males and 43.44 per 100 000 in females in Hunan. The gender disparity was stable, with ID from 42.34 in 2005 to 43.92 in 2009. For regional disparity, ID, RII (mean) and RII (ratio) decreased significantly from 2005 to 2009 in males (P < 0.05) but remained stable among the female population. As interventions such as introduction of the New Rural Cooperative Scheme put in place to reduce health disparities in China, regional disparity in relation to incidence of TB decreased significantly, but the gender disparity remains in the Hunan province.

Oral health disparities and the workforce: a framework to guide innovation.

PubMed

Hilton, Irene V; Lester, Arlene M

2010-06-01

Oral health disparities currently exist in the United States, and workforce innovations have been proposed as one strategy to address these disparities. A framework is needed to logically assess the possible role of workforce as a contributor to and to analyze workforce strategies addressing the issue of oral health disparities. Using an existing framework, A Strategic Framework for Improving Racial/Ethnic Minority Health and Eliminating Racial/Ethnic Health Disparities, workforce was sequentially applied across individual, environmental/community, and system levels to identify long-term problems, contributing factors, strategies/innovation, measurable outcomes/impacts, and long-term goals. Examples of current workforce innovations were applied to the framework. Contributing factors to oral health disparities included lack of racial/ethnic diversity of the workforce, lack of appropriate training, provider distribution, and a nonuser-centered system. The framework was applied to selected workforce innovation models delineating the potential impact on contributing factors across the individual, environmental/community, and system levels. The framework helps to define expected outcomes from workforce models that would contribute to the goal of reducing oral health disparities and examine impacts across multiple levels. However, the contributing factors to oral health disparities cannot be addressed by workforce innovation alone. The Strategic Framework is a logical approach to guide workforce innovation, solutions, and identification of other aspects of the oral healthcare delivery system that need innovation in order to reduce oral health disparities.

Stigma and Racial/Ethnic HIV Disparities: Moving Toward Resilience

PubMed Central

Earnshaw, Valerie A.; Bogart, Laura M.; Dovidio, John F.; Williams, Davird R.

2013-01-01

Prior research suggests that stigma plays a role in racial/ethnic health disparities. However, there is limited understanding about the mechanisms by which stigma contributes to HIV-related disparities in risk, incidence and screening, treatment, and survival and what can be done to reduce the impact of stigma on these disparities. We introduce the Stigma and HIV Disparities Model to describe how societal stigma related to race and ethnicity is associated with racial/ethnic HIV disparities via its manifestations at the structural level (e.g., residential segregation) as well as the individual level among perceivers (e.g., discrimination) and targets (e.g., internalized stigma). We then review evidence of these associations. Because racial/ethnic minorities at risk of and living with HIV often possess multiple stigmas (e.g., HIV-positive, substance use), we adopt an intersectionality framework and conceptualize interdependence among co-occurring stigmas. We further propose a resilience agenda and suggest that intervening on modifiable strength-based moderators of the association between societal stigma and disparities can reduce disparities. Strengthening economic and community empowerment and trust at the structural level, creating common ingroup identities and promoting contact with people living with HIV among perceivers at the individual level, and enhancing social support and adaptive coping among targets at the individual level can improve resilience to societal stigma and ultimately reduce racial/ethnic HIV disparities. PMID:23688090

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.

Where to Focus Efforts to Reduce the Black-White Disparity In Stroke Mortality: Incidence vs. Case-Fatality?

PubMed Central

Howard, George; Moy, Claudia S.; Howard, Virginia J.; McClure, Leslie A.; Kleindorfer, Dawn O.; Kissela, Brett M.; Judd, Suzanne E.; Unverzagt, Fredrick W.; Soliman, Elsayed Z.; Safford, Monika M.; Cushman, Mary; Flaherty, Matthew L.; Wadley, Virginia G.

2016-01-01

Background and Purpose At age 45, Blacks have a stroke mortality approximately 3-times greater than their White counterparts, with a declining disparity at older ages. We assess whether this Black-White disparity in stroke mortality is attributable to a Black-White disparity in stroke incidence versus a disparity in case-fatality. Methods We first assess if Black-White differences in stroke mortality within 29,681 participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort reflect national Black-White differences in stroke mortality, and then assess the degree to which Black-White differences in stroke incidence or 30-day case-fatality after stroke contribute to the disparities in stroke mortality. Results The pattern of stroke mortality within the study mirrors the national pattern, with the Black-to-White hazard ratio of approximately 4.0 at age 45 decreasing to approximately 1.0 at age 85. The pattern of Black-to-White disparities in stroke incidence shows a similar pattern, but no evidence of a corresponding disparity in stroke case-fatality. Discussion These findings show that the Black-White differences in stroke mortality are largely driven by differences in stroke incidence, with case fatality playing at most a minor role. Therefore to reduce the Black-White disparity in stroke mortality, interventions need to focus on prevention of stroke in Blacks. PMID:27256672

Modelling parasite aggregation: disentangling statistical and ecological approaches.

PubMed

Yakob, Laith; Soares Magalhães, Ricardo J; Gray, Darren J; Milinovich, Gabriel; Wardrop, Nicola; Dunning, Rebecca; Barendregt, Jan; Bieri, Franziska; Williams, Gail M; Clements, Archie C A

2014-05-01

The overdispersion in macroparasite infection intensity among host populations is commonly simulated using a constant negative binomial aggregation parameter. We describe an alternative to utilising the negative binomial approach and demonstrate important disparities in intervention efficacy projections that can come about from opting for pattern-fitting models that are not process-explicit. We present model output in the context of the epidemiology and control of soil-transmitted helminths due to the significant public health burden imposed by these parasites, but our methods are applicable to other infections with demonstrable aggregation in parasite numbers among hosts. Copyright © 2014. Published by Elsevier Ltd.

Health Disparities Calculator (HD*Calc) - SEER Software

Cancer.gov

Statistical software that generates summary measures to evaluate and monitor health disparities. Users can import SEER data or other population-based health data to calculate 11 disparity measurements.

Overcoming the Triad of Rural Health Disparities: How Local Culture, Lack of Economic Opportunity, and Geographic Location Instigate Health Disparities

ERIC Educational Resources Information Center

Thomas, Tami L.; DiClemente, Ralph; Snell, Samuel

2014-01-01

Objective: To discuss how the effects of culture, economy, and geographical location intersect to form a gestalt triad determining health-related disparities in rural areas. Methods: We critically profile each component of the deterministic triad in shaping current health-related disparities in rural areas; evaluate the uniquely composed…

77 FR 50139 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

... Minority Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal... Advisory Council on Minority Health and Health Disparities. The meeting will be closed to the public in... Health and Health Disparities. Date: September 17, 2012. Time: 12 p.m. to 3 p.m. Agenda: To review and...

78 FR 9402 - National Institute on Minority Health and Health; Disparities Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-08

... Minority Health and Health; Disparities Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Advisory Council on Minority Health and Health Disparities. The meeting will be open to the public as... on Minority Health and Health Disparities. Date: February 26, 2013. Closed: 8:00 a.m. to 9:30 a.m...

77 FR 27784 - National Institute on Minority Health and Health Disparities; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... Minority Health and Health Disparities; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Council on Minority Health and Health Disparities. The meeting will be open to the public as indicated... on Minority Health and Health Disparities. Date: June 12, 2012. Closed: 8:00 a.m. to 9:30 a.m. Agenda...

26 CFR 1.401(a)(4)-10 - Testing of former employees.

Code of Federal Regulations, 2010 CFR

2010-04-01

....410(b)-3(b)) is deemed to satisfy this paragraph (b). (2) Permitted disparity. Section 401(l) and § 1... permitted disparity limit, the sum of the former employee's total annual disparity fractions (within the... disparity rate applicable to a former employee is determined under § 1.401(l)-3(e) as of the age the former...

78 FR 28233 - National Institute on Minority Health and Health Disparities; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... Minority Health and Health Disparities; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Council on Minority Health and Health Disparities. The meeting will be open to the public as indicated... on Minority Health and Health Disparities. Date: June 11, 2013. Closed: 8:00 a.m. to 9:30 a.m. Agenda...

78 FR 50428 - National Institute on Minority Health and Health Disparities; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... Minority Health and Health Disparities; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Council on Minority Health and Health Disparities. The meeting will be open to the public as indicated... on Minority Health and Health Disparities. Date: September 10, 2013. Closed: 8:00 a.m. to 9:30 a.m...

34 CFR 222.162 - What disparity standard must a State meet in order to be certified and how are disparities in...

Code of Federal Regulations, 2014 CFR

2014-07-01

... current expenditures or revenues per pupil for free public education among LEAs in the State is no more... State. The method for calculating the percentage of disparity in a State is in the appendix to this... in paragraph (a) of this section. The method for calculating the weighted average disparity...

34 CFR 222.162 - What disparity standard must a State meet in order to be certified and how are disparities in...

Code of Federal Regulations, 2013 CFR

2013-07-01

... current expenditures or revenues per pupil for free public education among LEAs in the State is no more... State. The method for calculating the percentage of disparity in a State is in the appendix to this... in paragraph (a) of this section. The method for calculating the weighted average disparity...

34 CFR 222.162 - What disparity standard must a State meet in order to be certified and how are disparities in...

Code of Federal Regulations, 2012 CFR

2012-07-01

... current expenditures or revenues per pupil for free public education among LEAs in the State is no more... State. The method for calculating the percentage of disparity in a State is in the appendix to this... in paragraph (a) of this section. The method for calculating the weighted average disparity...

Approaching environmental health disparities and green spaces: An ecosystem services perspective

Treesearch

Viniece Jennings; Cassandra Johnson Gaither

2015-01-01

Health disparities occur when adverse health conditions are unequal across populations due in part to gaps in wealth. These disparities continue to plague global health. Decades of research suggests that the natural environment can play a key role in sustaining the health of the public. However, the influence of the natural environment on health disparities is not well...

Pure Social Disparities in Distribution of Dentists: A Cross-Sectional Province-Based Study in Iran

PubMed Central

Kiadaliri, Aliasghar A.; Hosseinpour, Reza; Haghparast-Bidgoli, Hassan; Gerdtham, Ulf-G

2013-01-01

During past decades, the number of dentists has continuously increased in Iran. Beside the quantity, the distribution of dentists affects the oral health status of population. The current study aimed to assess the pure and social disparities in distribution of dentists across the provinces in Iran in 2009. Data on provinces’ characteristics, including population and social situation, were obtained from multiple sources. The disparity measures (including Gini coefficient, index of dissimilarity, Gaswirth index of disparity and relative index of inequality (RII)) and pairwise correlations were used to evaluate the pure and social disparities in the number of dentists in Iran. On average, there were 28 dentists per 100,000 population in the country. There were substantial pure disparities in the distribution of dentists across the provinces in Iran. The unadjusted and adjusted RII values were 3.82 and 2.13, respectively; indicating area social disparity in favor of people in better-off provinces. There were strong positive correlations between density of dentists and better social rank. It is suggested that the results of this study should be considered in conducting plans for redistribution of dentists in the country. In addition, further analyses are needed to explain these disparities. PMID:23648443

Outcomes and disparities in liver transplantation will be improved by redistricting-cons.

PubMed

Goldberg, David Seth; Karp, Seth

2017-04-01

Over the last 2 years, the liver transplant community has been debating a proposal to redraw the maps of organ distribution. The basis for these proposed changes is reported disparities in severity of illness at transplantation across the USA - however, this is based on the allocation model for end-stage liver disease score. In this review, we provide a critical overview of the redistribution proposal, its flaws and how it may worsen outcomes and exacerbate disparities in liver transplantation. The main findings we highlight are data questioning the disparity metric used to justify the redistribution. We also review data published in recent articles and presented at public forums questioning whether there truly are disparities in access to transplant care among the broader population with liver disease, and whether disparities even getting to the waitlist are important and not to be ignored. This review article highlights major methodological and policy flaws with the current redistribution proposal. We demonstrate how the waitlist disparities that the proposal is intended to fix are not as they seem. Furthermore, if this proposal is passed, outcomes of liver transplantation nationally may worsen, and disparities for those with limited access to healthcare will worsen.

Healthcare Disparities in Critical Illness

PubMed Central

Soto, Graciela J.; Martin, Greg S.; Gong, Michelle Ng

2013-01-01

Objective To summarize the current literature on racial and gender disparities in critical care and the mechanisms underlying these disparities in the course of acute critical illness. Data Sources MEDLINE search on the published literature addressing racial, ethnic, or gender disparities in acute critical illness such as sepsis, acute lung injury, pneumonia, venous thromboembolism, and cardiac arrest. Study Selection Clinical studies that evaluated general critically ill patient populations in the United States as well as specific critical care conditions were reviewed with a focus on studies evaluating factors and contributors to health disparities. Data Extraction Study findings are presented according to their association with the incidence, clinical presentation, management, and outcomes in acute critical illness. Data Synthesis This review presents potential contributors for racial and gender disparities related to genetic susceptibility, comorbidities, preventive health services, socioeconomic factors, cultural differences, and access to care. The data is organized along the course of acute critical illness. Conclusions The literature to date shows that disparities in critical care are most likely multifactorial involving individual, community, and hospital-level factors at several points in the continuum of acute critical illness. The data presented identify potential targets as interventions to reduce disparities in critical care and future avenues for research. PMID:24121467

Healthcare disparities in critical illness.

PubMed

Soto, Graciela J; Martin, Greg S; Gong, Michelle Ng

2013-12-01

To summarize the current literature on racial and gender disparities in critical care and the mechanisms underlying these disparities in the course of acute critical illness. MEDLINE search on the published literature addressing racial, ethnic, or gender disparities in acute critical illness, such as sepsis, acute lung injury, pneumonia, venous thromboembolism, and cardiac arrest. Clinical studies that evaluated general critically ill patient populations in the United States as well as specific critical care conditions were reviewed with a focus on studies evaluating factors and contributors to health disparities. Study findings are presented according to their association with the prevalence, clinical presentation, management, and outcomes in acute critical illness. This review presents potential contributors for racial and gender disparities related to genetic susceptibility, comorbidities, preventive health services, socioeconomic factors, cultural differences, and access to care. The data are organized along the course of acute critical illness. The literature to date shows that disparities in critical care are most likely multifactorial involving individual, community, and hospital-level factors at several points in the continuum of acute critical illness. The data presented identify potential targets as interventions to reduce disparities in critical care and future avenues for research.

The role of health-related behaviors in the socioeconomic disparities in oral health.

PubMed

Sabbah, Wael; Tsakos, Georgios; Sheiham, Aubrey; Watt, Richard G

2009-01-01

This study aimed to examine the socioeconomic disparities in health-related behaviors and to assess if behaviors eliminate socioeconomic disparities in oral health in a nationally representative sample of adult Americans. Data are from the US Third National Health and Nutrition Examination Survey (1988-1994). Behaviors were indicated by smoking, dental visits, frequency of eating fresh fruits and vegetables and extent of calculus, used as a marker for oral hygiene. Oral health outcomes were gingival bleeding, loss of periodontal attachment, tooth loss and perceived oral health. Education and income indicated socioeconomic position. Sex, age, ethnicity, dental insurance and diabetes were adjusted for in the regression analysis. Regression analysis was used to assess socioeconomic disparities in behaviors. Regression models adjusting and not adjusting for behaviors were compared to assess the change in socioeconomic disparities in oral health. The results showed clear socioeconomic disparities in all behaviors. After adjusting for behaviors, the association between oral health and socioeconomic indicators attenuated but did not disappear. These findings imply that improvement in health-related behaviors may lessen, but not eliminate socioeconomic disparities in oral health, and suggest the presence of more complex determinants of these disparities which should be addressed by oral health preventive policies.

The Role of Socioeconomic Factors in Black–White Disparities in Preterm Birth

PubMed Central

Heck, Katherine; Egerter, Susan; Marchi, Kristen S.; Dominguez, Tyan Parker; Cubbin, Catherine; Fingar, Kathryn; Pearson, Jay A.; Curtis, Michael

2015-01-01

Objectives. We investigated the role of socioeconomic factors in Black–White disparities in preterm birth (PTB). Methods. We used the population-based California Maternal and Infant Health Assessment survey and birth certificate data on 10 400 US-born Black and White California residents who gave birth during 2003 to 2010 to examine rates and relative likelihoods of PTB among Black versus White women, with adjustment for multiple socioeconomic factors and covariables. Results. Greater socioeconomic advantage was generally associated with lower PTB rates among White but not Black women. There were no significant Black–White disparities within the most socioeconomically disadvantaged subgroups; Black–White disparities were seen only within more advantaged subgroups. Conclusions. Socioeconomic factors play an important but complex role in PTB disparities. The absence of Black–White disparities in PTB within certain socioeconomic subgroups, alongside substantial disparities within others, suggests that social factors moderate the disparity. Further research should explore social factors suggested by the literature—including life course socioeconomic experiences and racism-related stress, and the biological pathways through which they operate—as potential contributors to PTB among Black and White women with different levels of social advantage. PMID:25211759

Commentary: what role should physician organizations play in addressing social justice issues?

PubMed

Bright, Cedric M

2012-06-01

A study by Peek and colleagues in this issue reveals that although racial and ethnic health disparities are recognized as a major national challenge, few physician organizations with both the influence and ability to change practice standards and address disparities appear to be effectively directing their resources to mitigate health disparities. In this commentary, the author examines the history of U.S. health disparities through the lens of social justice. He argues that today, physician organizations have the opportunity to change the paradigm of medicine from being a reactive industry to becoming a proactive industry through collaborations such as the Commission to End Health Disparities, which brings together more than 60 organizations, and the National Medical Association's "We Stand With You" program to improve health and combat disparities. Physician organizations can also address health disparities through advocacy for fair reimbursement policies, funding for pipeline programs to increase the diversity of the workforce, diversity in clinical trials, and other issues. Health disparities present to us in organized medicine a challenge that is cleverly disguised as an immovable object but that is truly a great opportunity for innovation, improvement, and growth. Physician organizations have a unique opportunity to provide avenues of innovation and accomplishment.

Influence of Hormonal Contraceptive Use and Health Beliefs on Sexual Orientation Disparities in Papanicolaou Test Use

PubMed Central

Corliss, Heather L.; Missmer, Stacey A.; Frazier, A. Lindsay; Rosario, Margaret; Kahn, Jessica A.; Austin, S. Bryn

2014-01-01

Objectives. Reproductive health screenings are a necessary part of quality health care. However, sexual minorities underutilize Papanicolaou (Pap) tests more than heterosexuals do, and the reasons are not known. Our objective was to examine if less hormonal contraceptive use or less positive health beliefs about Pap tests explain sexual orientation disparities in Pap test intention and utilization. Methods. We used multivariable regression with prospective data gathered from 3821 females aged 18 to 25 years in the Growing Up Today Study (GUTS). Results. Among lesbians, less hormonal contraceptive use explained 8.6% of the disparities in Pap test intention and 36.1% of the disparities in Pap test utilization. Less positive health beliefs associated with Pap testing explained 19.1% of the disparities in Pap test intention. Together, less hormonal contraceptive use and less positive health beliefs explained 29.3% of the disparities in Pap test intention and 42.2% of the disparities in Pap test utilization. Conclusions. Hormonal contraceptive use and health beliefs, to a lesser extent, help to explain sexual orientation disparities in intention and receipt of a Pap test, especially among lesbians. PMID:23763393

A Model-Based Approach to Engineering Behavior of Complex Aerospace Systems

NASA Technical Reports Server (NTRS)

Ingham, Michel; Day, John; Donahue, Kenneth; Kadesch, Alex; Kennedy, Andrew; Khan, Mohammed Omair; Post, Ethan; Standley, Shaun

2012-01-01

One of the most challenging yet poorly defined aspects of engineering a complex aerospace system is behavior engineering, including definition, specification, design, implementation, and verification and validation of the system's behaviors. This is especially true for behaviors of highly autonomous and intelligent systems. Behavior engineering is more of an art than a science. As a process it is generally ad-hoc, poorly specified, and inconsistently applied from one project to the next. It uses largely informal representations, and results in system behavior being documented in a wide variety of disparate documents. To address this problem, JPL has undertaken a pilot project to apply its institutional capabilities in Model-Based Systems Engineering to the challenge of specifying complex spacecraft system behavior. This paper describes the results of the work in progress on this project. In particular, we discuss our approach to modeling spacecraft behavior including 1) requirements and design flowdown from system-level to subsystem-level, 2) patterns for behavior decomposition, 3) allocation of behaviors to physical elements in the system, and 4) patterns for capturing V&V activities associated with behavioral requirements. We provide examples of interesting behavior specification patterns, and discuss findings from the pilot project.

Framing a Transdisciplinary Research Agenda in Health Education to address Health Disparities and Social Inequities: a road map for SOPHE action.

PubMed

Gambescia, Stephen F; Woodhouse, Lynn D; Auld, M Elaine; Green, B Lee; Quinn, Sandra Crouse; Airhihenbuwa, Collins O

2006-08-01

SOPHE leaders continue to challenge us to be true to the call for an "open society." SOPHE has supported the Healthy People 2010 goal of eliminating health disparities through its Strategic Plan. SOPHE held an Inaugural Health Education Research Disparities Summit, Health Disparities and Social Inequities: Framing a Transdisciplinary Research Agenda in Health Education, August 8 and 9, 2005. This article explains the process used at the Summit where more than 80 researchers, academicians, practitioners, and students from across the country convened to ask fundamental questions about health disparity associated with race and ethnicity and how a health education research agenda could help in eliminating these disparities. From this Summit, about a dozen questions and/or recommendations have been developed to frame our future discussions about health disparities. Through its Research Agenda Committee, SOPHE has developed a process of translation and dissemination, including community participation, review, dialogue, and action.

Does adopting a prenatal substance use protocol reduce racial disparities in CPS reporting related to maternal drug use? A California case study.

PubMed

Roberts, S C M; Zahnd, E; Sufrin, C; Armstrong, M A

2015-02-01

This study examined whether adopting a standardized prenatal substance use protocol (protocol) in a hospital labor and delivery unit reduced racial disparities in reporting to child protective services (CPS) related to maternal drug use during pregnancy. This study used an interrupted time series design with a non-equivalent control. One hospital adopted a protocol and another hospital group serving a similar geographic population did not change protocols. Data on CPS reporting disparities from these hospitals over 3.5 years were analyzed using segmented regression. In the hospital that adopted the protocol, almost five times more black than white newborns were reported during the study period. Adopting the protocol was not associated with reduced disparities. Adopting a protocol cannot be assumed to reduce CPS reporting disparities. Efforts to encourage hospitals to adopt protocols as a strategy to reduce disparities may be misguided. Other strategies to reduce disparities are needed.

A Review of Mental Health and Mental Health Care Disparities Research: 2011-2014.

PubMed

Cook, Benjamin Lê; Hou, Sherry Shu-Yeu; Lee-Tauler, Su Yeon; Progovac, Ana Maria; Samson, Frank; Sanchez, Maria Jose

2018-06-01

Racial/ethnic minorities in the United States are more likely than Whites to have severe and persistent mental disorders and less likely to access mental health care. This comprehensive review evaluates studies of mental health and mental health care disparities funded by the National Institute of Mental Health (NIMH) to provide a benchmark for the 2015 NIMH revised strategic plan. A total of 615 articles were categorized into five pathways underlying mental health care and three pathways underlying mental health disparities. Identified studies demonstrate that socioeconomic mechanisms and demographic moderators of disparities in mental health status and treatment are well described, as are treatment options that support diverse patient needs. In contrast, there is a need for studies that focus on community- and policy-level predictors of mental health care disparities, link discrimination- and trauma-induced neurobiological pathways to disparities in mental illness, assess the cost effectiveness of disparities reduction programs, and scale up culturally adapted interventions.

Right back like we left something: examining the commodification of Blackness in social services to address racial disparities - the case of Hartford.

PubMed

Searcy, Yan

2018-05-14

Market-based approaches to addressing racial disparities have essentially re-commodified Blackness. Utilizing Hartford, which contains the largest percentage of Blacks per capita in Connecticut, this article examines market-based approaches to address racial disparities while discussing Blackness as an enduring commodity that is tied to private sector profit. The study argues that market based approaches incentivize punitive approaches to social problems associated with Blackness. The study concludes by suggesting that addressing disparities utilizing markets requires reimagining policy incentives to focus on prevention and treatment of social problems associated with Blackness. Failure to reimagine policy incentives serves to commodify Blackness whereby industries benefit from the continuity of disparities rather than the elimination of disparities.

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 and Discrimination: Three Perspectives

PubMed Central

Ndiaye, Khadidiatou; Krieger, Janice R.; Warren, Jennifer R.; Hecht, Michael L.; Okuyemi, Kola

2010-01-01

This article presents three perspectives on health discrimination and disparities, organized around different conceptualizations of the way “space” perpetuates health disparities. The first two perspectives are grounded in conceptualizing space in a physical sense by exploring the manifestation of discrimination as a problem both among and within nations. The third perspective juxtaposes geographical space with cyberspace. The internet, with its ability to blur sense of place, social demarcations, and behavior is often considered a panacea that can eliminate the health disparities. The internet, however, may not be fulfilling its promise as an equal source of health information for all and disparities related to international and rural geography remain problematic. Solutions are proposed for reducing health disparities based on The Principle of Cultural Grounding (Hecht & Krieger, 2006; Hecht & Miller-Day, in press). PMID:20694161

Moving Toward Paradigm-Shifting Research in Health Disparities Through Translational, Transformational, and Transdisciplinary Approaches

PubMed Central

Rhee, Kyu B.; Stoff, David M.; Pohlhaus, Jennifer Reineke; Sy, Francisco S.; Stinson, Nathaniel; Ruffin, John

2010-01-01

Translational, transdisciplinary, and transformational research stands to become a paradigm-shifting mantra for research in health disparities. A windfall of research discoveries using these 3 approaches has increased our understanding of the health disparities in racial, ethnic, and low socioeconomic status groups. These distinct but related research spheres possess unique environments, which, when integrated, can lead to innovation in health disparities science. In this article, we review these approaches and propose integrating them to advance health disparities research through a change in philosophical position and an increased emphasis on community engagement. We argue that a balanced combination of these research approaches is needed to inform evidence-based practice, social action, and effective policy change to improve health in disparity communities. PMID:20147662

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.

Federal Investments to Eliminate Racial/Ethnic Health-Care Disparities

PubMed Central

Freeman, William

2014-01-01

Health care is an important lever for moderating the effects of social determinants on health. We present a model that describes the relationships among social disadvantage, health-care disparities, and health disparities. Improving access to health care and enhancing patient-provider interaction are critical pathways for reducing disparities. Increasing the diversity of the public health and health-care workforces is an efficient strategy for reducing disparities because it impacts both access to care and patient-provider communication. Federal policy makers should continue interest in workforce diversity to optimize the health of all Americans. PMID:24385667

Disparity modification in stereoscopic images for emotional enhancement

NASA Astrophysics Data System (ADS)

Kawai, Takashi; Atsuta, Daiki; Kim, Sanghyun; Häkkinen, Jukka

2015-03-01

This paper describes an experiment that focuses on disparity changes in emotional scenes of stereoscopic (3D) images, in which an examination of the effects on pleasant and arousal was carried out by adding binocular disparity to 2D images that evoke specific emotions, and applying disparity modification based on the disparity analysis of prominent 3D movies. From the results of the experiment, it was found that pleasant and arousal was increased by expanding 3D space to a certain level. In addition, pleasant gradually decreased and arousal gradually increased by expansion of 3D space above a certain level.

Physicians' Participation In ACOs Is Lower In Places With Vulnerable Populations Than In More Affluent Communities.

PubMed

Yasaitis, Laura C; Pajerowski, William; Polsky, Daniel; Werner, Rachel M

2016-08-01

Early evidence suggested that accountable care organizations (ACOs) could improve health care quality while constraining costs, and ACOs are expanding throughout the United States. However, if disadvantaged patients have unequal access to physicians who participate in ACOs, that expansion may exacerbate health care disparities. We examined the relationship between physicians' participation in both Medicare and commercial ACOs across the country and the sociodemographic characteristics of their likely patient populations. Physicians' participation in ACOs varied widely across hospital referral regions, from nearly 0 percent to over 85 percent. After we adjusted for individual physician and practice characteristics, we found that physicians who practiced in ZIP Code Tabulation Areas where a higher percentage of the population was black, living in poverty, uninsured, or disabled or had less than a high school education-compared to other areas-had significantly lower rates of ACO participation than other physicians. Our findings suggest that vulnerable populations' access to physicians participating in ACOs may not be as great as access for other groups, which could exacerbate existing disparities in health care quality. Project HOPE—The People-to-People Health Foundation, Inc.

The Tuskegee Legacy Project: history, preliminary scientific findings, and unanticipated societal benefits

PubMed Central

Katz, Ralph V.; Kegeles, S. Stephen; Green, B. Lee; Kressin, Nancy R.; James, Sherman A.; Claudio, Cristina

2006-01-01

Summary This article is intended to provide a relatively complete picture of how a pilot study—conceived and initiated within an NIDCR-funded RRCMOH—matured into a solid line of investigation within that center and “with legs”into a fully funded study within the next generation of NIDCR centers on this topic of health disparities, the Centers for Research to Reduce Oral Health Disparities. It highlights the natural opportunity that these centers provide for multicenter, cross-disciplinary research and for research career pipelining for college and dental school students; with a focus, in this case, on minority students. Furthermore, this series of events demonstrates the rich potential that these types of research centers have to contribute in ways that far exceed the scientific outcomes that form their core. In this instance, the NMOHRC played a central—and critical, if unanticipated—role in contributing to two events of national significance, namely the presidential apology to the African American community for the research abuses of the USPHS–Tuskegee syphilis study and the establishment of the National Center for Bioethics in Research and Health Care at Tuskegee University. PMID:12519002

Reducing Mental Health Disparities Through Transformative Learning: A Social Change Model With Refugees and Students

PubMed Central

Hess, Julia M.; Isakson, Brian; Githinji, Ann; Roche, Natalie; Vadnais, Kathryn; Parker, Danielle P.; Goodkind, Jessica R.

2014-01-01

Distribution of power and resources greatly impacts the mental health of individuals and communities. Thus, in order to reduce mental health disparities, it is imperative to address these social determinants of mental health through social change. Engaging in social change efforts requires people to critically engage with present conditions on personal, local, national and global levels and to develop knowledge, capacity, and experience with envisioning and creating more equitable conditions. This critical engagement can be fostered through a process of transformative learning. In this article, we examine the Refugee Well-being Project (RWP), a program that aims to improve the mental health of refugees in the United States. From 2007 to 2009, participants in the RWP in New Mexico were refugees from the Great Lakes region of Africa. The RWP paired undergraduate students with refugees to engage in mutual learning and advocacy. Data from in-depth qualitative interviews with 72 refugees and 53 undergraduate students suggest that participation in the RWP constituted a transformative learning experience through which refugees and students came to new understandings of the relationship between social inequities and well-being. For many, this provided an impetus to work towards change at multiple levels. PMID:24417257

People Awakening: Collaborative Research to Develop Cultural Strategies for Prevention in Community Intervention

PubMed Central

Allen, James; Mohatt, Gerald V.; Beehler, Sarah; Rowe, Hillary L.

2014-01-01

The consequences of alcohol use disorder (AUD) and suicide create immense health disparities among Alaska Native people. The People Awakening project is a long-term collaboration between Alaska Native (AN) communities and university researchers seeking to foster health equity through development of positive solutions to these disparities. These efforts initiated a research relationship that identified individual, family, and community protective factors from AUD and suicide. AN co-researchers next expressed interest in translating these findings into intervention. This led to development of a strengths-based community intervention that is the focus of the special issue. The intervention builds these protective factors to prevent AUD and suicide risk within AN youth, and their families and communities. This review provides a critical examination of existing literature and a brief history of work leading to the intervention research. These work efforts portray a shared commitment of university researchers and community members to function as co-researchers, and to conduct research in accord with local Yup’ik cultural values. This imperative allowed the team to navigate several tensions we locate in a convergence of historical and contemporary ecological contextual factors inherent in AN tribal communities with countervailing constraints imposed by Western science. PMID:24903819

Early diffusion of gene expression profiling in breast cancer patients associated with areas of high income inequality.

PubMed

Ponce, Ninez A; Ko, Michelle; Liang, Su-Ying; Armstrong, Joanne; Toscano, Michele; Chanfreau-Coffinier, Catherine; Haas, Jennifer S

2015-04-01

With the Affordable Care Act reducing coverage disparities, social factors could prominently determine where and for whom innovations first diffuse in health care markets. Gene expression profiling is a potentially cost-effective innovation that guides chemotherapy decisions in early-stage breast cancer, but adoption has been uneven across the United States. Using a sample of commercially insured women, we evaluated whether income inequality in metropolitan areas was associated with receipt of gene expression profiling during its initial diffusion in 2006-07. In areas with high income inequality, gene expression profiling receipt was higher than elsewhere, but it was associated with a 10.6-percentage-point gap between high- and low-income women. In areas with low rates of income inequality, gene expression profiling receipt was lower, with no significant differences by income. Even among insured women, income inequality may indirectly shape diffusion of gene expression profiling, with benefits accruing to the highest-income patients in the most unequal places. Policies reducing gene expression profiling disparities should address low-inequality areas and, in unequal places, practice settings serving low-income patients. Project HOPE—The People-to-People Health Foundation, Inc.

Asthma and Health Disparities

MedlinePlus

... Javascript on. Feature: Breathing Easier Asthma and Health Disparities Past Issues / Fall 2013 Table of Contents Among ... Action Plan to Reduce Racial and Ethnic Asthma Disparities. The Action Plan presents a framework to maximize ...

Changes in Disparity in County-Level Diagnosed Diabetes Prevalence and Incidence in the United States, between 2004 and 2012

PubMed Central

Gregg, Edward W.; Beckles, Gloria L.; Luman, Elizabeth T.; Barker, Lawrence E.; Geiss, Linda S.

2016-01-01

Background In recent decades, the United States experienced increasing prevalence and incidence of diabetes, accompanied by large disparities in county-level diabetes prevalence and incidence. However, whether these disparities are widening, narrowing, or staying the same has not been studied. We examined changes in disparity among U.S. counties in diagnosed diabetes prevalence and incidence between 2004 and 2012. Methods We used 2004 and 2012 county-level diabetes (type 1 and type 2) prevalence and incidence data, along with demographic, socio-economic, and risk factor data from various sources. To determine whether disparities widened or narrowed over the time period, we used a regression-based β-convergence approach, accounting for spatial autocorrelation. We calculated diabetes prevalence/incidence percentage point (ppt) changes between 2004 and 2012 and modeled these changes as a function of baseline diabetes prevalence/incidence in 2004. Covariates included county-level demographic and, socio-economic data, and known type 2 diabetes risk factors (obesity and leisure-time physical inactivity). Results For each county-level ppt increase in diabetes prevalence in 2004 there was an annual average increase of 0.02 ppt (p<0.001) in diabetes prevalence between 2004 and 2012, indicating a widening of disparities. However, after accounting for covariates, diabetes prevalence decreased by an annual average of 0.04 ppt (p<0.001). In contrast, changes in diabetes incidence decreased by an average of 0.04 ppt (unadjusted) and 0.09 ppt (adjusted) for each ppt increase in diabetes incidence in 2004, indicating a narrowing of county-level disparities. Conclusions County-level disparities in diagnosed diabetes prevalence in the United States widened between 2004 and 2012, while disparities in incidence narrowed. Accounting for demographic and, socio-economic characteristics and risk factors for type 2 diabetes narrowed the disparities, suggesting that these factors are strongly associated with changes in disparities. Public health interventions that target modifiable risk factors, such as obesity and physical inactivity, in high burden counties might further reduce disparities in incidence and, over time, in prevalence. PMID:27487006

Socio-demographic and behavioural correlates of oral hygiene status and oral health related quality of life, the Limpopo - Arusha school health project (LASH): A cross-sectional study

PubMed Central

2010-01-01

Background Promoting oral health of adolescents is important for improvement of oral health globally. This study used baseline-data from LASH-project targeting secondary students to; 1) assess frequency of poor oral hygiene status and oral impacts on daily performances, OIDP, by socio-demographic and behavioural characteristics, 2) examine whether socio-economic and behavioural correlates of oral hygiene status and OIDP differed by gender and 3) examine whether socio-demographic disparity in oral health was explained by oral health-related behaviours. Methods Cross-sectional study was conducted in 2009 using one-stage cluster sampling design. Total of 2412 students (mean age 15.2 yr) completed self-administered questionnaires, whereas 1077 (mean age 14.9 yr) underwent dental-examination. Bivariate analyses were conducted using cross-tabulations and chi-square statistics. Multiple variable analyses were conducted using stepwise standardized logistic regression (SLR) with odds ratios and 95% Confidence intervals (CI). Results 44.8% presented with fair to poor OHIS and 48.2% reported any OIDP. Older students, those from low socio-economic status families, had parents who couldn't afford dental care and had low educational-level reported oral impacts, poor oral hygiene, irregular toothbrushing, less dental attendance and fewer intakes of sugar-sweetened drinks more frequently than their counterparts. Stepwise logistic regression revealed that reporting any OIDP was independently associated with; older age-groups, parents do not afford dental care, smoking experience, no dental visits and fewer intakes of sugar-sweetened soft drinks. Behavioural factors accounted partly for association between low family SES and OIDP. Low family SES, no dental attendance and smoking experience were most important in males. Low family SES and fewer intakes of sugar-sweetened soft drinks were the most important correlates in females. Socio-behavioural factors associated with higher odds ratios for poor OHIS were; older age, belonging to the poorest household category and having parents who did not afford dental care across both genders. Conclusion Disparities in oral hygiene status and OIDP existed in relation to age, affording dental care, smoking and intake of sugar sweetened soft drinks. Gender differences should be considered in intervention studies, and modifiable behaviours have some relevance in reducing social disparity in oral health. PMID:21118499

When mixed methods produce mixed results: integrating disparate findings about miscarriage and women's wellbeing.

PubMed

Lee, Christina; Rowlands, Ingrid J

2015-02-01

To discuss an example of mixed methods in health psychology, involving separate quantitative and qualitative studies of women's mental health in relation to miscarriage, in which the two methods produced different but complementary results, and to consider ways in which the findings can be integrated. We describe two quantitative projects involving statistical analysis of data from 998 young women who had had miscarriages, and 8,083 who had not, across three waves of the Australian Longitudinal Study on Women's Health. We also describe a qualitative project involving thematic analysis of interviews with nine Australian women who had had miscarriages. The quantitative analyses indicate that the main differences between young women who do and do not experience miscarriage relate to social disadvantage (and thus likelihood of relatively early pregnancy) and to a lifestyle that makes pregnancy likely: Once these factors are accounted for, there are no differences in mental health. Further, longitudinal modelling demonstrates that women who have had miscarriages show a gradual increase in mental health over time, with the exception of women with prior diagnoses of anxiety, depression, or both. By contrast, qualitative analysis of the interviews indicates that women who have had miscarriages experience deep emotional responses and a long and difficult process of coming to terms with their loss. A contextual model of resilience provides a possible framework for understanding these apparently disparate results. Considering positive mental health as including the ability to deal constructively with negative life events, and consequent emotional distress, offers a model that distinguishes between poor mental health and the processes of coping with major life events. In the context of miscarriage, women's efforts to struggle with difficult emotions, and search for meaning, can be viewed as pathways to resilience rather than to psychological distress. Statement of contribution What is already known on this subject? Quantitative research shows that women who miscarry usually experience moderate depression and anxiety, which persists for around 6 months. Qualitative research shows that women who miscarry frequently experience deep grief, which can last for years. What does this study add? We consider ways in which these disparate findings might triangulate. The results suggest a need to distinguish between poor mental health and the experience of loss and grief. Adjusting to miscarriage is often emotionally challenging but not always associated with poor mental health. © 2014 The British Psychological Society.

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.

Prevalence and Risk Factors Associated with Entamoeba histolytica/dispar/moshkovskii Infection among Three Orang Asli Ethnic Groups in Malaysia

PubMed Central

Shahrul Anuar, Tengku; M. Al-Mekhlafi, Hesham; Abdul Ghani, Mohamed Kamel; Osman, Emelia; Mohd Yasin, Azlin; Nordin, Anisah; Nor Azreen, Siti; Md Salleh, Fatmah; Ghazali, Nuraffini; Bernadus, Mekadina; Moktar, Norhayati

2012-01-01

Background Entamoeba histolytica/Entamoeba dispar/Entamoeba moshkovskii infection is still prevalent in rural Malaysia especially among Orang Asli communities. Currently, information on prevalence of this infection among different ethnic groups of Orang Asli is unavailable in Malaysia. To contribute to a better comprehension of the epidemiology of this infection, a cross-sectional study aimed at providing the first documented data on the prevalence and risk factors associated with E. histolytica/E. dispar/E. moshkovskii infection was carried out among three Orang Asli ethnic groups (Proto-Malay, Negrito, and Senoi) in selected villages in Negeri Sembilan, Perak, and Pahang states, Malaysia. Methods/Findings Faecal samples were examined by formalin-ether sedimentation and trichrome staining techniques. Of 500 individuals, 8.7% (13/150) of Proto-Malay, 29.5% (41/139) of Negrito, and 18.5% (39/211) of Senoi were positive for E. histolytica/E. dispar/E. moshkovskii, respectively. The prevalence of this infection showed an age-dependency relationship, with higher rates observed among those aged less than 15 years in all ethnic groups studied. Multivariate analysis confirmed that not washing hands after playing with soils or gardening and presence of other family members infected with E. histolytica/E. dispar/E. moshkovskii were significant risk factors of infection among all ethnic groups. However, eating with hands, the consumption of raw vegetables, and close contact with domestic animals were identified as significant risk factors in Senoi. Conclusions Essentially, the findings highlighted that E. histolytica/E. dispar/E. moshkovskii parasites are still prevalent in Malaysia. Further studies using molecular approaches to distinguish the morphologically identical species of pathogenic, E. histolytica from the non-pathogenic, E. dispar and E. moshkovskii are needed. The establishment of such data will be beneficial for the public health authorities in the planning and implementation of specific prevention and control strategies of this infection in different Orang Asli ethnic groups in Malaysia. PMID:23133561

Prevalence and risk factors associated with Entamoeba histolytica/dispar/moshkovskii infection among three Orang Asli ethnic groups in Malaysia.

PubMed

Shahrul Anuar, Tengku; M Al-Mekhlafi, Hesham; Abdul Ghani, Mohamed Kamel; Osman, Emelia; Mohd Yasin, Azlin; Nordin, Anisah; Nor Azreen, Siti; Md Salleh, Fatmah; Ghazali, Nuraffini; Bernadus, Mekadina; Moktar, Norhayati

2012-01-01

Entamoeba histolytica/Entamoeba dispar/Entamoeba moshkovskii infection is still prevalent in rural Malaysia especially among Orang Asli communities. Currently, information on prevalence of this infection among different ethnic groups of Orang Asli is unavailable in Malaysia. To contribute to a better comprehension of the epidemiology of this infection, a cross-sectional study aimed at providing the first documented data on the prevalence and risk factors associated with E. histolytica/E. dispar/E. moshkovskii infection was carried out among three Orang Asli ethnic groups (Proto-Malay, Negrito, and Senoi) in selected villages in Negeri Sembilan, Perak, and Pahang states, Malaysia. Faecal samples were examined by formalin-ether sedimentation and trichrome staining techniques. Of 500 individuals, 8.7% (13/150) of Proto-Malay, 29.5% (41/139) of Negrito, and 18.5% (39/211) of Senoi were positive for E. histolytica/E. dispar/E. moshkovskii, respectively. The prevalence of this infection showed an age-dependency relationship, with higher rates observed among those aged less than 15 years in all ethnic groups studied. Multivariate analysis confirmed that not washing hands after playing with soils or gardening and presence of other family members infected with E. histolytica/E. dispar/E. moshkovskii were significant risk factors of infection among all ethnic groups. However, eating with hands, the consumption of raw vegetables, and close contact with domestic animals were identified as significant risk factors in Senoi. Essentially, the findings highlighted that E. histolytica/E. dispar/E. moshkovskii parasites are still prevalent in Malaysia. Further studies using molecular approaches to distinguish the morphologically identical species of pathogenic, E. histolytica from the non-pathogenic, E. dispar and E. moshkovskii are needed. The establishment of such data will be beneficial for the public health authorities in the planning and implementation of specific prevention and control strategies of this infection in different Orang Asli ethnic groups in Malaysia.

Why should we investigate the morphological disparity of plant clades?

PubMed Central

Oyston, Jack W.; Hughes, Martin; Gerber, Sylvain; Wills, Matthew A.

2016-01-01

Background Disparity refers to the morphological variation in a sample of taxa, and is distinct from diversity or taxonomic richness. Diversity and disparity are fundamentally decoupled; many groups attain high levels of disparity early in their evolution, while diversity is still comparatively low. Diversity may subsequently increase even in the face of static or declining disparity by increasingly fine sub-division of morphological ‘design’ space (morphospace). Many animal clades reached high levels of disparity early in their evolution, but there have been few comparable studies of plant clades, despite their profound ecological and evolutionary importance. This study offers a prospective and some preliminary macroevolutionary analyses. Methods Classical morphometric methods are most suitable when there is reasonable conservation of form, but lose traction where morphological differences become greater (e.g. in comparisons across higher taxa). Discrete character matrices offer one means to compare a greater diversity of forms. This study explores morphospaces derived from eight discrete data sets for major plant clades, and discusses their macroevolutionary implications. Key Results Most of the plant clades in this study show initial, high levels of disparity that approach or attain the maximum levels reached subsequently. These plant clades are characterized by an initial phase of evolution during which most regions of their empirical morphospaces are colonized. Angiosperms, palms, pines and ferns show remarkably little variation in disparity through time. Conifers furnish the most marked exception, appearing at relatively low disparity in the latest Carboniferous, before expanding incrementally with the radiation of successive, tightly clustered constituent sub-clades. Conclusions Many cladistic data sets can be repurposed for investigating the morphological disparity of plant clades through time, and offer insights that are complementary to more focused morphometric studies. The unique structural and ecological features of plants make them ideally suited to investigating intrinsic and extrinsic constraints on disparity. PMID:26658292

Why should we investigate the morphological disparity of plant clades?

PubMed

Oyston, Jack W; Hughes, Martin; Gerber, Sylvain; Wills, Matthew A

2016-04-01

Disparity refers to the morphological variation in a sample of taxa, and is distinct from diversity or taxonomic richness. Diversity and disparity are fundamentally decoupled; many groups attain high levels of disparity early in their evolution, while diversity is still comparatively low. Diversity may subsequently increase even in the face of static or declining disparity by increasingly fine sub-division of morphological 'design' space (morphospace). Many animal clades reached high levels of disparity early in their evolution, but there have been few comparable studies of plant clades, despite their profound ecological and evolutionary importance. This study offers a prospective and some preliminary macroevolutionary analyses. Classical morphometric methods are most suitable when there is reasonable conservation of form, but lose traction where morphological differences become greater (e.g. in comparisons across higher taxa). Discrete character matrices offer one means to compare a greater diversity of forms. This study explores morphospaces derived from eight discrete data sets for major plant clades, and discusses their macroevolutionary implications. Most of the plant clades in this study show initial, high levels of disparity that approach or attain the maximum levels reached subsequently. These plant clades are characterized by an initial phase of evolution during which most regions of their empirical morphospaces are colonized. Angiosperms, palms, pines and ferns show remarkably little variation in disparity through time. Conifers furnish the most marked exception, appearing at relatively low disparity in the latest Carboniferous, before expanding incrementally with the radiation of successive, tightly clustered constituent sub-clades. Many cladistic data sets can be repurposed for investigating the morphological disparity of plant clades through time, and offer insights that are complementary to more focused morphometric studies. The unique structural and ecological features of plants make them ideally suited to investigating intrinsic and extrinsic constraints on disparity. © The Author 2015. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Research for Improved Health: Variability and Impact of Structural Characteristics in Federally Funded Community Engaged Research

PubMed Central

Pearson, Cythina R.; Duran, Bonnie; Oetzel, John; Margarati, Maya; Villegas, Malia; Lucero, Julie; Wallerstein, Nina

2016-01-01

Background Although there is strong scientific, policy, and community support for community-engaged research (CEnR)—including community-based participatory research (CBPR)—the science of CEnR is still developing. Objective To describe structural differences in federally funded CEnR projects by type of research (i.e., descriptive, intervention, or dissemination/policy change) and race/ethnicity of the population served. Methods We identified 333 federally funded projects in 2009 that potentially involved CEnR, 294 principal investigators/project directors (PI/PD) were eligible to participate in a key informant (KI) survey from late 2011 to early 2012 that asked about partnership structure (68% response rate). Results The National Institute on Minority Health & Health Disparities (19.1%), National Cancer Institute (NCI; 13.3%), and the Centers for Disease Control and Prevention (CDC; 12.6%) funded the most CEnR projects. Most were intervention projects (66.0%). Projects serving American Indian or Alaskan Native (AIAN) populations (compared with other community of color or multiple-race/unspecified) were likely to be descriptive projects (p < .01), receive less funding (p < .05), and have higher rates of written partnership agreements (p < .05), research integrity training (p < .05), approval of publications (p < .01), and data ownership (p < .01). AIAN-serving projects also reported similar rates of research productivity and greater levels of resource sharing compared with those serving multiple-race/unspecified groups. Conclusions There is clear variability in the structure of CEnR projects with future research needed to determine the impact of this variability on partnering processes and outcomes. In addition, projects in AIAN communities receive lower levels of funding yet still have comparable research productivity to those projects in other racial/ethnic communities. PMID:25981421

Scholarship for Nuclear Communications and Methods for Evaluation of Nuclear Project Acceptability

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

Golay, Michael

This project aims to go beyond effective communication in understanding how to design nuclear enterprise projects that will gain stakeholder acceptability. Much of what we are studying is generally applicable to controversial projects, and we expect our results to be of broad value beyond the nuclear arena. Acceptability is more than effective communication; it also requires varying degrees of engagement with a disparate number of stakeholder groups. In the nuclear enterprise, previous attempts have been well designed physically (i.e., technologically sound), but have floundered by being insensitive concerning acceptance. Though effective communication is a necessary, but insufficient, condition for suchmore » success, there is a lack of scholarship regarding how to gain stakeholder acceptance for new controversial projects, including nuclear ones. Our work is building a model for use in assessing the performance of a project in the area of acceptability. In the nuclear-social nexus, gaining acceptance requires a clear understanding of factors regarded as being important by the many stakeholders that are common to new nuclear project (many of whom hold an effective veto power). Projects tend to become socially controversial when public beliefs, expert opinion and decision-maker understanding are misaligned. As such, stakeholder acceptance is hypothesized as both an ongoing process and an initial project design parameter comprised of complex, social, cognitive and technical components. Controversial projects may be defined as aspects of modern technologies that some people question, or are cautious about. They could range from genetic modifications, biological hazards, effects of chemical agents, nuclear radiation or hydraulic fracturing operations. We intend that our work will result in a model likely to be valuable for refining project design and implementation to increase the knowledge needed for successful management of stakeholder relationships.« less

Examining the Gap: Compensation Disparities between Male and Female Physician Assistants.

PubMed

Smith, Noël; Cawley, James F; McCall, Timothy C

Compensation disparities between men and women have been problematic for decades, and there is considerable evidence that the gap cannot be entirely explained by nongender factors. The current study examined the compensation gap in the physician assistant (PA) profession. Compensation data from 2014 was collected by the American Academy of PAs in 2015. Practice variables, including experience, specialty, and hours worked, were controlled for in an ordinary least-squares sequential regression model to examine whether there remained a disparity in total compensation. In addition, the absolute disparity in compensation was compared with historical data collected by American Academy of PAs over the previous 1.5 decades. Without controlling for practice variables, a total compensation disparity of $16,052 existed between men and women in the PA profession. Even after PA practice variables were controlled for, a total compensation disparity of $9,695 remained between men and women (95% confidence interval, $8,438-$10,952). A 17-year trend indicates the absolute disparity between men and women has not lessened, although the disparity as a percent of male compensation has decreased in recent years. There remain challenges to ensuring pay equality in the PA profession. Even when compensation-relevant factors such as experience, hours worked, specialty, postgraduate training, region, and call are controlled for, there is still a substantial gender disparity in PA compensation. Remedies that may address this pay inequality include raising awareness of compensation disparities, teaching effective negotiation skills, assisting employers as they develop equitable compensation plans, having less reliance on past salary in position negotiation, and professional associations advocating for policies that support equal wages and opportunities, regardless of personal characteristics. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Trends in Longevity in the Americas: Disparities in Life Expectancy in Women and Men, 1965-2010

PubMed Central

Hambleton, Ian R.; Howitt, Christina; Jeyaseelan, Selvi; Murphy, Madhuvanti M.; Hennis, Anselm J; Wilks, Rainford; Harris, E. Nigel; MacLeish, Marlene; Sullivan, Louis

2015-01-01

Objective We describe trends in life expectancy at birth (LE) and between-country LE disparities since 1965, in Latin America and the Caribbean. Methods & Findings LE trends since 1965 are described for three geographical sub-regions: the Caribbean, Central America, and South America. LE disparities are explored using a suite of absolute and relative disparity metrics, with measurement consensus providing confidence to observed differences. LE has increased throughout Latin America and the Caribbean. Compared to the Caribbean, LE has increased by an additional 6.6 years in Central America and 4.1 years in South America. Since 1965, average reductions in between-country LE disparities were 14% (absolute disparity) and 23% (relative disparity) in the Caribbean, 55% and 51% in Central America, 55% and 52% in South America. Conclusions LE in Latin America and the Caribbean is exceeding ‘minimum standard’ international targets, and is improving relative to the world region with the highest human longevity. The Caribbean, which had the highest LE and the lowest between-country LE disparities in Latin America and the Caribbean in 1965-70, had the lowest LE and the highest LE disparities by 2005-10. Caribbean Governments have championed a collaborative solution to the growing burden of non-communicable disease, with 15 territories signing on to the Declaration of Port of Spain, signalling regional commitment to a coordinated public-health response. The persistent LE inequity between Caribbean countries suggests that public health interventions should be tailored to individual countries to be most effective. Between- and within-country disparity monitoring for a range of health metrics should be a priority, first to guide country-level policy initiatives, then to contribute to the assessment of policy success. PMID:26091090

Functional Architecture for Disparity in Macaque Inferior Temporal Cortex and Its Relationship to the Architecture for Faces, Color, Scenes, and Visual Field

PubMed Central

Verhoef, Bram-Ernst; Bohon, Kaitlin S.

2015-01-01

Binocular disparity is a powerful depth cue for object perception. The computations for object vision culminate in inferior temporal cortex (IT), but the functional organization for disparity in IT is unknown. Here we addressed this question by measuring fMRI responses in alert monkeys to stimuli that appeared in front of (near), behind (far), or at the fixation plane. We discovered three regions that showed preferential responses for near and far stimuli, relative to zero-disparity stimuli at the fixation plane. These “near/far” disparity-biased regions were located within dorsal IT, as predicted by microelectrode studies, and on the posterior inferotemporal gyrus. In a second analysis, we instead compared responses to near stimuli with responses to far stimuli and discovered a separate network of “near” disparity-biased regions that extended along the crest of the superior temporal sulcus. We also measured in the same animals fMRI responses to faces, scenes, color, and checkerboard annuli at different visual field eccentricities. Disparity-biased regions defined in either analysis did not show a color bias, suggesting that disparity and color contribute to different computations within IT. Scene-biased regions responded preferentially to near and far stimuli (compared with stimuli without disparity) and had a peripheral visual field bias, whereas face patches had a marked near bias and a central visual field bias. These results support the idea that IT is organized by a coarse eccentricity map, and show that disparity likely contributes to computations associated with both central (face processing) and peripheral (scene processing) visual field biases, but likely does not contribute much to computations within IT that are implicated in processing color. PMID:25926470

Fast repurposing of high-resolution stereo video content for mobile use

NASA Astrophysics Data System (ADS)

Karaoglu, Ali; Lee, Bong Ho; Boev, Atanas; Cheong, Won-Sik; Gotchev, Atanas

2012-06-01

3D video content is captured and created mainly in high resolution targeting big cinema or home TV screens. For 3D mobile devices, equipped with small-size auto-stereoscopic displays, such content has to be properly repurposed, preferably in real-time. The repurposing requires not only spatial resizing but also properly maintaining the output stereo disparity, as it should deliver realistic, pleasant and harmless 3D perception. In this paper, we propose an approach to adapt the disparity range of the source video to the comfort disparity zone of the target display. To achieve this, we adapt the scale and the aspect ratio of the source video. We aim at maximizing the disparity range of the retargeted content within the comfort zone, and minimizing the letterboxing of the cropped content. The proposed algorithm consists of five stages. First, we analyse the display profile, which characterises what 3D content can be comfortably observed in the target display. Then, we perform fast disparity analysis of the input stereoscopic content. Instead of returning the dense disparity map, it returns an estimate of the disparity statistics (min, max, meanand variance) per frame. Additionally, we detect scene cuts, where sharp transitions in disparities occur. Based on the estimated input, and desired output disparity ranges, we derive the optimal cropping parameters and scale of the cropping window, which would yield the targeted disparity range and minimize the area of cropped and letterboxed content. Once the rescaling and cropping parameters are known, we perform resampling procedure using spline-based and perceptually optimized resampling (anti-aliasing) kernels, which have also a very efficient computational structure. Perceptual optimization is achieved through adjusting the cut-off frequency of the anti-aliasing filter with the throughput of the target display.

Trends in Longevity in the Americas: Disparities in Life Expectancy in Women and Men, 1965-2010.

PubMed

Hambleton, Ian R; Howitt, Christina; Jeyaseelan, Selvi; Murphy, Madhuvanti M; Hennis, Anselm J; Wilks, Rainford; Harris, E Nigel; MacLeish, Marlene; Sullivan, Louis

2015-01-01

We describe trends in life expectancy at birth (LE) and between-country LE disparities since 1965, in Latin America and the Caribbean. LE trends since 1965 are described for three geographical sub-regions: the Caribbean, Central America, and South America. LE disparities are explored using a suite of absolute and relative disparity metrics, with measurement consensus providing confidence to observed differences. LE has increased throughout Latin America and the Caribbean. Compared to the Caribbean, LE has increased by an additional 6.6 years in Central America and 4.1 years in South America. Since 1965, average reductions in between-country LE disparities were 14% (absolute disparity) and 23% (relative disparity) in the Caribbean, 55% and 51% in Central America, 55% and 52% in South America. LE in Latin America and the Caribbean is exceeding 'minimum standard' international targets, and is improving relative to the world region with the highest human longevity. The Caribbean, which had the highest LE and the lowest between-country LE disparities in Latin America and the Caribbean in 1965-70, had the lowest LE and the highest LE disparities by 2005-10. Caribbean Governments have championed a collaborative solution to the growing burden of non-communicable disease, with 15 territories signing on to the Declaration of Port of Spain, signalling regional commitment to a coordinated public-health response. The persistent LE inequity between Caribbean countries suggests that public health interventions should be tailored to individual countries to be most effective. Between- and within-country disparity monitoring for a range of health metrics should be a priority, first to guide country-level policy initiatives, then to contribute to the assessment of policy success.

[New considerations on the health of the persons with intellectual developmental disorders].

PubMed

Folch-Mas, Anabel; Cortés-Ruiz, María José; Salvador-Carulla, Luis; Kazah-Soneyra, Natalia; Irazábal-Giménez, Marcia; Muñoz-Lorente, Silvia; Tamarit-Cuadrado, Javier; Martínez-Leal, Rafael

2017-01-01

Recent literature indicates that people with Disorders of Intellectual Development (DID) experience health disparities in the pathologies that they present, and a worst access to health care. However, current evidence-based knowledge is still sparse outside the Anglo-Saxon countries. The POMONA-I and POMONA-II European projects aimed to collect information on the health status of people with DID in Europe. The POMONA-ESP project in Spain is meant to collect health information in a wide and representative sample of persons with DID. Also, there are studies that claim for the need of specialized services for people with DID at the public health system. There are also studies about the current state of the education and training about DID for students within the health sector. In this paper we review the latest evidences about the health of the persons with DID and we present the main research activities and care initiatives about this issue.

BioMart: a data federation framework for large collaborative projects.

PubMed

Zhang, Junjun; Haider, Syed; Baran, Joachim; Cros, Anthony; Guberman, Jonathan M; Hsu, Jack; Liang, Yong; Yao, Long; Kasprzyk, Arek

2011-01-01

BioMart is a freely available, open source, federated database system that provides a unified access to disparate, geographically distributed data sources. It is designed to be data agnostic and platform independent, such that existing databases can easily be incorporated into the BioMart framework. BioMart allows databases hosted on different servers to be presented seamlessly to users, facilitating collaborative projects between different research groups. BioMart contains several levels of query optimization to efficiently manage large data sets and offers a diverse selection of graphical user interfaces and application programming interfaces to ensure that queries can be performed in whatever manner is most convenient for the user. The software has now been adopted by a large number of different biological databases spanning a wide range of data types and providing a rich source of annotation available to bioinformaticians and biologists alike.

Rural school-based telehealth: how to make it happen.

PubMed

Burke, Bryan; Bynum, Ann; Hall-Barrow, Julie; Ott, Rachel; Albright, Margaret

2008-11-01

When organizing new health care interventions among a rural population, a careful planning process respecting community-specific considerations should be used. The project objective centered on the successful implementation of a school-based telehealth clinic serving a rural, health-disparate population. Using an American Academy of Pediatrics Community Access to Child Health planning grant, a needs assessment of the Delta community was conducted. In synthesizing the results of this planning project, consensually addressed issues led to establishing a pilot school-based telehealth clinic within the rural county schools. Seven essential steps emerged as a set of guidelines that entities might consider in introducing a telemedicine school-based service in a rural community. The steps included assessing local and regional needs, securing community support and establishing goals, evaluating resources, configuring logistics, training staff, informing parents, and launching the clinic. Proper planning is crucial to the establishment of a rural school-based telehealth clinic.

Mental Status Documentation: Information Quality and Data Processes

PubMed Central

Weir, Charlene; Gibson, Bryan; Taft, Teresa; Slager, Stacey; Lewis, Lacey; Staggers, Nancy

2016-01-01

Delirium is a fluctuating disturbance of cognition and/or consciousness associated with poor outcomes. Caring for patients with delirium requires integration of disparate information across clinicians, settings and time. The goal of this project was to characterize the information processes involved in nurses’ assessment, documentation, decisionmaking and communication regarding patients’ mental status in the inpatient setting. VA nurse managers of medical wards (n=18) were systematically selected across the US. A semi-structured telephone interview focused on current assessment, documentation, and communication processes, as well as clinical and administrative decision-making was conducted, audio-recorded and transcribed. A thematic analytic approach was used. Five themes emerged: 1) Fuzzy Concepts, 2) Grey Data, 3) Process Variability 4) Context is Critical and 5) Goal Conflict. This project describes the vague and variable information processes related to delirium and mental status that undermine effective risk, prevention, identification, communication and mitigation of harm. PMID:28269919

Addressing women's health needs and improving birth outcomes: results from a peer-to-peer state Medicaid learning project.

PubMed

Johnson, Kay

2012-08-01

High rates of maternal mortality, infant mortality, and preterm births, as well as continuing disparities in pregnancy outcomes, have prompted a number of state Medicaid agencies to focus on improving the quality and continuity of care delivered to women of childbearing age. As part of a peer-to-peer learning project, seven Medicaid agencies worked to develop the programs, policies, and infrastructures needed to identify and reduce women's health risks either prior to or between pregnancies. The states also identified public health strategies. These strategies led to a policy checklist to help leaders in other states identify improvement opportunities that fit within their programs' eligibility requirements, quality improvement objectives, and health system resources. Many of the identified programs and policies may help states use the upcoming expansion of the Medicaid program to improve women's health and thereby reduce adverse birth outcomes.

Mental Status Documentation: Information Quality and Data Processes.

PubMed

Weir, Charlene; Gibson, Bryan; Taft, Teresa; Slager, Stacey; Lewis, Lacey; Staggers, Nancy

2016-01-01

Delirium is a fluctuating disturbance of cognition and/or consciousness associated with poor outcomes. Caring for patients with delirium requires integration of disparate information across clinicians, settings and time. The goal of this project was to characterize the information processes involved in nurses' assessment, documentation, decisionmaking and communication regarding patients' mental status in the inpatient setting. VA nurse managers of medical wards (n=18) were systematically selected across the US. A semi-structured telephone interview focused on current assessment, documentation, and communication processes, as well as clinical and administrative decision-making was conducted, audio-recorded and transcribed. A thematic analytic approach was used. Five themes emerged: 1) Fuzzy Concepts, 2) Grey Data, 3) Process Variability 4) Context is Critical and 5) Goal Conflict. This project describes the vague and variable information processes related to delirium and mental status that undermine effective risk, prevention, identification, communication and mitigation of harm.

Culturally Tailored Depression/Suicide Prevention in Latino Youth: Community Perspectives.

PubMed

Ford-Paz, Rebecca E; Reinhard, Christine; Kuebbeler, Andrea; Contreras, Richard; Sánchez, Bernadette

2015-10-01

Latino adolescents are at elevated risk for depression and suicide compared to other ethnic groups. Project goals were to gain insight from community leaders about depression risk factors particular to Latino adolescents and generate innovative suggestions to improve cultural relevance of prevention interventions. This project utilized a CBPR approach to enhance cultural relevance, acceptability, and utility of the findings and subsequent program development. Two focus groups of youth and youth-involved Latino community leaders (n = 18) yielded three overarching themes crucial to a culturally tailored depression prevention intervention: (1) utilize a multipronged and sustainable intervention approach, (2) raise awareness about depression in culturally meaningful ways, and (3) promote Latino youth's social connection and cultural enrichment activities. Findings suggest that both adaptation of existing prevention programs and development of hybrid approaches may be necessary to reduce depression/suicide disparities for Latino youth. One such hybrid program informed by community stakeholders is described.

NASA's EOSDIS Near Term Challenges

NASA Technical Reports Server (NTRS)

Behnke, Jeanne

2018-01-01

Given the long-term requirements, and the rapid pace of information technology and changing expectations of the user community, the ESDIS Project has had to evolve EOSDIS continually over the past three decades. However, many challenges remain. One near-term challenge is the enormous quantity of new data that will need to be managed by the EOSDIS. With the upcoming launch of the latest NASA missions coupled with existing operational missions and field campaigns, EOSDIS can expect to handle as much as 50 petabytes of data per year. In perspective, this is twice the size of the current existing archive, which took over 21 years to collect. Another continuing challenge is the disparate requirements of a diverse science community. Maintaining rigorous long-term data preservation, supporting ease of discovery and access, incorporating user feedback, enabling reanalysis/ reprocessing, and agile integration of new data sources, continue to be the Project's objectives.

3-D Imaging In Virtual Environment: A Scientific Clinical and Teaching Tool

NASA Technical Reports Server (NTRS)

Ross, Muriel D.; DeVincenzi, Donald L. (Technical Monitor)

1996-01-01

The advent of powerful graphics workstations and computers has led to the advancement of scientific knowledge through three-dimensional (3-D) reconstruction and imaging of biological cells and tissues. The Biocomputation Center at NASA Ames Research Center pioneered the effort to produce an entirely computerized method for reconstruction of objects from serial sections studied in a transmission electron microscope (TEM). The software developed, ROSS (Reconstruction of Serial Sections), is now being distributed to users across the United States through Space Act Agreements. The software is in widely disparate fields such as geology, botany, biology and medicine. In the Biocomputation Center, ROSS serves as the basis for development of virtual environment technologies for scientific and medical use. This report will describe the Virtual Surgery Workstation Project that is ongoing with clinicians at Stanford University Medical Center, and the role of the Visible Human data in the project.

Physics of magnetospheric boundary layers

NASA Technical Reports Server (NTRS)

Cairns, Iver H.

1995-01-01

This final report was concerned with the ideas that: (1) magnetospheric boundary layers link disparate regions of the magnetosphere-solar wind system together; and (2) global behavior of the magnetosphere can be understood only by understanding its internal linking mechanisms and those with the solar wind. The research project involved simultaneous research on the global-, meso-, and micro-scale physics of the magnetosphere and its boundary layers, which included the bow shock, the magnetosheath, the plasma sheet boundary layer, and the ionosphere. Analytic, numerical, and simulation projects were performed on these subjects, as well as comparisons of theoretical results with observational data. Other related activity included in the research included: (1) prediction of geomagnetic activity; (2) global MHD (magnetohydrodynamic) simulations; (3) Alfven resonance heating; and (4) Critical Ionization Velocity (CIV) effect. In the appendixes are list of personnel involved, list of papers published; and reprints or photocopies of papers produced for this report.

Basic Information about Health Disparities in Cancer

MedlinePlus

... Stay Informed Cancer Home Basic Information About Health Disparities in Cancer Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Health disparities are differences in the incidence, prevalence, and mortality ...

77 FR 43850 - National Institute on Minority Health and Health Disparities; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-26

... and Health Disparities Special Emphasis Panel; NIMHD Community-Based Participatory Research (CBPR... Review Officer, National Institute on Minority Healthand Health Disparities, 6707 Democracy Blvd., Suite...

Awareness and action for eliminating health care disparities in pain care: Web-based resources.

PubMed

Fan, Ling; Thomas, Melissa; Deitrick, Ginna E; Polomano, Rosemary C

2008-01-01

Evidence shows that disparities in pain care exist, and this problem spans across all health care settings. Health care disparities are complex, and stem from the health system climate, limitations imposed by laws and regulations, and discriminatory practices that are deep seated in biases, stereotypes, and uncertainties surrounding communication and decision-making processes. A search of the Internet identified thousands of Web sites, documents, reports, and educational materials pertaining to health and pain disparities. Web sites for federal agencies, private foundations, and professional and consumer-oriented organizations provide useful information on disparities related to age, race, ethnicity, geography, socioeconomic status, and specific populations. The contents of 10 Web sites are examined for resources to assist health professionals and consumers in better understanding health and pain disparities and ways to overcome them in practice.

Vector disparity sensor with vergence control for active vision systems.

PubMed

Barranco, Francisco; Diaz, Javier; Gibaldi, Agostino; Sabatini, Silvio P; Ros, Eduardo

2012-01-01

This paper presents an architecture for computing vector disparity for active vision systems as used on robotics applications. The control of the vergence angle of a binocular system allows us to efficiently explore dynamic environments, but requires a generalization of the disparity computation with respect to a static camera setup, where the disparity is strictly 1-D after the image rectification. The interaction between vision and motor control allows us to develop an active sensor that achieves high accuracy of the disparity computation around the fixation point, and fast reaction time for the vergence control. In this contribution, we address the development of a real-time architecture for vector disparity computation using an FPGA device. We implement the disparity unit and the control module for vergence, version, and tilt to determine the fixation point. In addition, two on-chip different alternatives for the vector disparity engines are discussed based on the luminance (gradient-based) and phase information of the binocular images. The multiscale versions of these engines are able to estimate the vector disparity up to 32 fps on VGA resolution images with very good accuracy as shown using benchmark sequences with known ground-truth. The performances in terms of frame-rate, resource utilization, and accuracy of the presented approaches are discussed. On the basis of these results, our study indicates that the gradient-based approach leads to the best trade-off choice for the integration with the active vision system.

Racial disparities in self-rated health: Trends, explanatory factors, and the changing role of socio-demographics

PubMed Central

Beck, Audrey N.; Finch, Brian K.; Lin, Shih-Fan; Hummer, Robert A.; Masters, Ryan K.

2014-01-01

This paper uses data from the U.S. National Health Interview Surveys (N = 1,513,097) to describe and explain temporal patterns in black-white health disparities with models that simultaneously consider the unique effects of age, period, and cohort. First, we employ cross-classified random effects age–period–cohort (APC) models to document black-white disparities in self-rated health across temporal dimensions. Second, we use decomposition techniques to shed light on the extent to which socio-economic shifts in cohort composition explain the age and period adjusted racial health disparities across successive birth cohorts. Third, we examine the extent to which exogenous conditions at the time of birth help explain the racial disparities across successive cohorts. Results show that black-white disparities are wider among the pre-1935 cohorts for women, falling thereafter; disparities for men exhibit a similar pattern but exhibit narrowing among cohorts born earlier in the century. Differences in socioeconomic composition consistently contribute to racial health disparities across cohorts; notably, marital status differences by race emerge as an increasingly important explanatory factor in more recent cohorts for women whereas employment differences by race emerge as increasingly salient in more recent cohorts for men. Finally, our cohort characteristics models suggest that cohort economic conditions at the time of birth (percent large family, farm or Southern birth) help explain racial disparities in health for both men and women. PMID:24581075

What makes African American health disparities newsworthy? An experiment among journalists about story framing

PubMed Central

Hinnant, Amanda; Oh, Hyun Jee; Caburnay, Charlene A.; Kreuter, Matthew W.

2011-01-01

News stories reporting race-specific health information commonly emphasize disparities between racial groups. But recent research suggests this focus on disparities has unintended effects on African American audiences, generating negative emotions and less interest in preventive behaviors (Nicholson RA, Kreuter MW, Lapka C et al. Unintended effects of emphasizing disparities in cancer communication to African-Americans. Cancer Epidemiol Biomarkers Prev 2008; 17: 2946–52). They found that black adults are more interested in cancer screening after reading about the progress African Americans have made in fighting cancer than after reading stories emphasizing disparities between blacks and whites. This study builds on past findings by (i) examining how health journalists judge the newsworthiness of stories that report race-specific health information by emphasizing disparities versus progress and (ii) determining whether these judgments can be changed by informing journalists of audience reactions to disparity versus progress framing. In a double-blind-randomized experiment, 175 health journalists read either a disparity- or progress-framed story on colon cancer, preceded by either an inoculation about audience effects of such framing or an unrelated (i.e. control) information stimuli. Journalists rated the disparity-frame story more favorably than the progress-frame story in every category of news values. However, the inoculation significantly increased positive reactions to the progress-frame story. Informing journalists of audience reactions to race-specific health information could influence how health news stories are framed. PMID:21911844

Racial and ethnic disparities in the clinical practice of emergency medicine.

PubMed

Richardson, Lynne D; Babcock Irvin, Charlene; Tamayo-Sarver, Joshua H

2003-11-01

There is convincing evidence that racial and ethnic disparities exist in the provision of health care, including the provision of emergency care; and that stereotyping, biases, and uncertainty on the part of health care providers all contribute to unequal treatment. Situations, such as the emergency department (ED), that are characterized by time pressure, incomplete information, and high demands on attention and cognitive resources increase the likelihood that stereotypes and bias will affect diagnostic and treatment decisions. It is likely that there are many as-yet-undocumented disparities in clinical emergency practice. Racial and ethnic disparities may arise in decisions made by out-of-hospital personnel regarding ambulance destination, triage assessments made by nursing personnel, diagnostic testing ordered by physicians or physician-extenders, and in disposition decisions. The potential for disparate treatment includes the timing and intensity of ED therapy as well as patterns of referral, prescription choices, and priority for hospital admission and bed assignment. At a national roundtable discussion, strategies suggested to address these disparities included: increased use of evidence-based clinical guidelines; use of continuous quality improvement methods to document individual and institutional disparities in performance; zero tolerance for stereotypical remarks in the workplace; cultural competence training for emergency providers; increased workforce diversity; and increased epidemiologic, clinical, and services research. Careful scrutiny of the clinical practice of emergency medicine and diligent implementation of strategies to prevent disparities will be required to eliminate the individual behaviors and systemic processes that result in the delivery of disparate care in EDs.

Vector Disparity Sensor with Vergence Control for Active Vision Systems

PubMed Central

Barranco, Francisco; Diaz, Javier; Gibaldi, Agostino; Sabatini, Silvio P.; Ros, Eduardo

2012-01-01

This paper presents an architecture for computing vector disparity for active vision systems as used on robotics applications. The control of the vergence angle of a binocular system allows us to efficiently explore dynamic environments, but requires a generalization of the disparity computation with respect to a static camera setup, where the disparity is strictly 1-D after the image rectification. The interaction between vision and motor control allows us to develop an active sensor that achieves high accuracy of the disparity computation around the fixation point, and fast reaction time for the vergence control. In this contribution, we address the development of a real-time architecture for vector disparity computation using an FPGA device. We implement the disparity unit and the control module for vergence, version, and tilt to determine the fixation point. In addition, two on-chip different alternatives for the vector disparity engines are discussed based on the luminance (gradient-based) and phase information of the binocular images. The multiscale versions of these engines are able to estimate the vector disparity up to 32 fps on VGA resolution images with very good accuracy as shown using benchmark sequences with known ground-truth. The performances in terms of frame-rate, resource utilization, and accuracy of the presented approaches are discussed. On the basis of these results, our study indicates that the gradient-based approach leads to the best trade-off choice for the integration with the active vision system. PMID:22438737

An Integrated Approach to Diabetes Prevention: Anthropology, Public Health, and Community Engagement.

PubMed

Page-Reeves, Janet; Mishra, Shiraz I; Niforatos, Joshua; Regino, Lidia; Bulten, Robert

2013-01-01

Diabetes is an enormous public health problem with particular concern within Hispanic communities and among individuals with low wealth. However, attempts to expand the public health paradigm to include social determinants of health rarely include analysis of social and contextual factors considered outside the purview of health research. As a result, conceptualization of the dynamics of diabetes health disparities remains shallow. We argue that using a holistic anthropological lens has the potential to offer insights regarding the nature of the interface between broader social determinants, health outcomes and health disparity. In a primarily Hispanic, immigrant community in Albuquerque, New Mexico, we conducted a mixed methods study that integrates an anthropological lens with a community engaged research design. Our data from focus groups, interviews, a survey and blood sampling demonstrate the need to conceptualize social determinants more broadly, more affectively and more dynamically than often considered. These results highlight a need to include, in addition to individual-level factors that are traditionally the focus of public health and more innovative structural factors that are currently in vogue, an in-depth, qualitative exploration of local context, social environment, and culture, and their interactions and intersectionality, as key factors when considering how to achieve change. The discussion presented here offers a model for culturally situated and contextually relevant scientific research. This model achieves the objectives and goals of both public health and anthropology while providing valuable insights and mechanisms for addressing health disparity such as that which exists in relation to diabetes among Hispanic immigrants in New Mexico. Such an approach has implications for how research projects are designed and conceptualizing social determinants more broadly. The discussion presented provides insights with relevance for both disciplines.

Quantifying the contributions of behavioral and biological risk factors to socioeconomic disparities in coronary heart disease incidence: The MORGEN study

PubMed Central

Kershaw, Kiarri N.; Droomers, Mariël; Robinson, Whitney R.; Carnethon, Mercedes R.; Daviglus, Martha L.; Verschuren, W.M. Monique

2013-01-01

Quantifying the impact of different modifiable behavioral and biological risk factors on socioeconomic disparities in coronary heart disease (CHD) may help inform targeted, population-specific strategies to reduce the unequal distribution of the disease. Previous studies have used analytic approaches that limit our ability to disentangle the relative contributions of these risk factors to CHD disparities. The goal of this study was to assess mediation of the effect of low education on incident CHD by multiple risk factors simultaneously. Analyses are based on 15,067 participants of the Dutch Monitoring Project on Risk Factors for Chronic Diseases aged 20–65 years examined 1994–1997 and followed for events until January 1, 2008. Path analysis was used to quantify and test mediation of the low education-CHD association by behavioral (current cigarette smoking, heavy alcohol use, poor diet, and physical inactivity) and biological (obesity, hypertension, diabetes, and hypercholesterolemia) risk factors. Behavioral and biological risk factors accounted for 56.6% (95% CI: 42.6%–70.8%) of the low education-incident CHD association. Smoking was the strongest mediator, accounting for 27.3% (95% CI: 17.7%–37.4%) of the association, followed by obesity (10.2%; 95% CI: 4.5%–16.1%), physical inactivity (6.3%; 95% CI: 2.7%–10.0%), and hypertension (5.3%; 95% CI: 2.8%–8.0%). In summary, in a Dutch cohort, the majority of the relationship between low education and incident CHD was mediated by traditional behavioral and biological risk factors. Addressing barriers to smoking cessation, blood pressure and weight management, and physical activity may be the most effective approaches to eliminating socioeconomic inequalities in CHD. PMID:24037117

Addressing Disparities in Low Back Pain Care by Developing Culturally Appropriate Information for Aboriginal Australians: "My Back on Track, My Future".

PubMed

Lin, Ivan B; Ryder, Kim; Coffin, Juli; Green, Charmaine; Dalgety, Eric; Scott, Brian; Straker, Leon M; Smith, Anne J; O'Sullivan, Peter B

2017-11-01

Addressing disparities in low back pain care (LBP) is an important yet largely unaddressed issue. One avenue to addressing disparities, recommended by clinical guidelines, is to ensure that LBP information is culturally appropriate. Our objectives were, first, to develop LBP information that was culturally appropriate for Aboriginal Australians living in a rural area and, second, to compare this to traditional information. The overall information development process was guided by a "cultural security" framework and included partnerships between Aboriginal/non-Aboriginal investigators, a synthesis of research evidence, and participation of a project steering group consisting of local Aboriginal people. LBP information (entitled My Back on Track, My Future [MBOT]) was developed as five short audio-visual scenarios, filmed using Aboriginal community actors. A qualitative randomized crossover design compared MBOT with an evidence-based standard (the Back Book [BB]). Twenty Aboriginal adults participated. Qualitatively we ascertained which information participants' preferred and why, perceptions about each resource, and LBP management. Thirteen participants preferred MBOT, four the BB, two both, and one neither. Participants valued seeing "Aboriginal faces," language that was understandable, the visual format, and seeing Aboriginal people undertaking positive changes in MBOT. In contrast, many participants found the language and format of the BB a barrier. Participants who preferred the BB were more comfortable with written information and appreciated the detailed content. The MBOT information was more preferred and addressed important barriers to care, providing support for use in practice. Similar processes are needed to develop pain information for other cultural groups, particularly those underserved by existing approaches to care. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Sequential matched analysis of racial disparities in breast cancer hospitalization outcomes among African American and White patients.

PubMed

Ogunsina, Kemi; Naik, Gurudatta; Vin-Raviv, Neomi; Akinyemiju, Tomi F

2017-08-01

The purpose of this study is to determine if racial disparities in inpatient outcomes persist among hospitalized patients comparing African American and White breast cancer patients matched on demographics, presentation and treatment. A total of 136,211 African American and White breast cancer patients from the Healthcare Cost and Utilization Project - Nationwide Inpatient Sample (HCUP-NIS) database, matched on demographics alone, demographics and presentation or demographics, presentation and treatment were studied. Conditional logistic regression was conducted to evaluate post-surgical complications, length of stay and in-hospital mortality outcomes. Analysis was further stratified by age (≤65 years and >65years) to evaluate whether disparities were larger in younger or older patients. All analysis was conducted using SAS 9.3. White women had significantly shorter hospital length of stay when matched on demographics (β=-0.87, p-value=<0.0001), demographics and presentation (β=-0.63, p-value=<0.0001), and demographics, presentation and treatment (β=-0.51, p-value=<0.0001) compared with African Americans. White women also had lower odds of mortality compared with African American women when matched on demographics (OR: 0.72, 95% CI: 0.65-0.79), demographics and presentation (OR: 0.77, 95% CI: 0.71-0.85), or matched on demographics, presentation and treatment (OR: 0.80, 95% CI: 0.73-0.88). The racial difference observed in length of stay and mortality was larger in the age group ≤65 years compared with >65years CONCLUSION: African American women experienced higher odds of inpatient mortality and longer length of stay compared with White women even after accounting for differences in demographics, presentation and treatment characteristics. Copyright © 2017 Elsevier Ltd. All rights reserved.

microRNA in Prostate Cancer Racial Disparities and Aggressiveness

DTIC Science & Technology

2015-10-01

1 AWARD NUMBER: W81XWH-13-1-0477 TITLE: microRNA in Prostate Cancer Racial Disparities and Aggressiveness PRINCIPAL INVESTIGATOR: Cathryn...microRNA in Prostate Cancer Racial Disparities and Aggressiveness 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-13-1-0477 5c. PROGRAM ELEMENT NUMBER...final analyses. 15. SUBJECT TERMS prostate cancer, microRNA, racial disparities, African American, genetic polymorphisms, biochemical recurrence

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

Terminator Disparity Contributes to Stereo Matching for Eye Movements and Perception

PubMed Central

Optican, Lance M.; Cumming, Bruce G.

2013-01-01

In the context of motion detection, the endings (or terminators) of 1-D features can be detected as 2-D features, affecting the perceived direction of motion of the 1-D features (the barber-pole illusion) and the direction of tracking eye movements. In the realm of binocular disparity processing, an equivalent role for the disparity of terminators has not been established. Here we explore the stereo analogy of the barber-pole stimulus, applying disparity to a 1-D noise stimulus seen through an elongated, zero-disparity, aperture. We found that, in human subjects, these stimuli induce robust short-latency reflexive vergence eye movements, initially in the direction orthogonal to the 1-D features, but shortly thereafter in the direction predicted by the disparity of the terminators. In addition, these same stimuli induce vivid depth percepts, which can only be attributed to the disparity of line terminators. When the 1-D noise patterns are given opposite contrast in the two eyes (anticorrelation), both components of the vergence response reverse sign. Finally, terminators drive vergence even when the aperture is defined by a texture (as opposed to a contrast) boundary. These findings prove that terminators contribute to stereo matching, and constrain the type of neuronal mechanisms that might be responsible for the detection of terminator disparity. PMID:24285893

Terminator disparity contributes to stereo matching for eye movements and perception.

PubMed

Quaia, Christian; Optican, Lance M; Cumming, Bruce G

2013-11-27

In the context of motion detection, the endings (or terminators) of 1-D features can be detected as 2-D features, affecting the perceived direction of motion of the 1-D features (the barber-pole illusion) and the direction of tracking eye movements. In the realm of binocular disparity processing, an equivalent role for the disparity of terminators has not been established. Here we explore the stereo analogy of the barber-pole stimulus, applying disparity to a 1-D noise stimulus seen through an elongated, zero-disparity, aperture. We found that, in human subjects, these stimuli induce robust short-latency reflexive vergence eye movements, initially in the direction orthogonal to the 1-D features, but shortly thereafter in the direction predicted by the disparity of the terminators. In addition, these same stimuli induce vivid depth percepts, which can only be attributed to the disparity of line terminators. When the 1-D noise patterns are given opposite contrast in the two eyes (anticorrelation), both components of the vergence response reverse sign. Finally, terminators drive vergence even when the aperture is defined by a texture (as opposed to a contrast) boundary. These findings prove that terminators contribute to stereo matching, and constrain the type of neuronal mechanisms that might be responsible for the detection of terminator disparity.