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Racial Disparity

Robert Weech-Maldonado, Janice L Dreachslin, Josué Patien Epané, Judith Gail, Shivani Gupta, Joyce Anne Wainio
BACKGROUND: Cultural competency or the ongoing capacity of health care systems to provide for high-quality care to diverse patient populations (National Quality Forum, 2008) has been proposed as an organizational strategy to address disparities in quality of care, patient experience, and workforce representation. But far too many health care organizations still do not treat cultural competency as a business imperative and driver of strategy. PURPOSES: The aim of the study was to examine the impact of a systematic, multifaceted, and organizational level cultural competency initiative on hospital performance metrics at the organizational and individual levels...
October 25, 2016: Health Care Management Review
Dinah Chen, Elena Fuell Wysong, Hong Li, Lisa Perriera, Lydia Furman
OBJECTIVE: The primary aim of this study was to examine the association between postpartum predischarge depot-medroxyprogesterone acetate (ppDMPA) and in-hospital breastfeeding initiation, and the secondary exploratory aim was to determine if any racial disparities are associated with ppDMPA receipt or its relationship to breastfeeding initiation. MATERIALS AND METHODS: We conducted a cross-sectional retrospective chart review of maternal and newborn records at a large urban academic medical center...
October 26, 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
Lisa I Iezzoni
Erroneous assumptions among health care professionals about the daily lives, preferences, values, and expectations of persons with disability can contribute to documented health care disparities, faulty communication, and substandard quality of care affecting this heterogeneous population. Efforts to reduce racial and ethnic disparities have focused on expanding diversity in the physician workforce. Would expanding the numbers of physicians with disability benefit patients with disability? Increasing the number of physicians who identify as "disabled" is one strategy for proactively confronting disability-related barriers affecting patients, but such efforts will likely face substantial challenges...
October 1, 2016: AMA Journal of Ethics
John V Gahagan, Mark H Hanna, Matthew D Whealon, Steven Maximus, Michael J Phelan, Michael Lekawa, Cristobal Barrios, Nicole P Bernal
Disparities in access to health care between white and minority patients are well described. We aimed to analyze the trends and outcomes of cholecystectomy based on racial classification. The Nationwide Inpatient Sample database was reviewed for all patients undergoing cholecystectomy from 2009 to 2012. Patients were stratified as white or non-white. A total of 243,536 patients were analyzed: 159,901 white and 83,635 non-white. Non-white patients had significantly higher proportions of Medicaid (25% vs 9.3%), self-pay (14% vs 7...
October 2016: American Surgeon
Neal D Goldstein, Igor Burstyn, Seth L Welles
BACKGROUND: Men who have sex with men (MSM) continue to be overrepresented for new HIV infections compared to non-MSM. This disparity becomes even more alarming when considering racial groups. We describe the race-specific effects in HIV prevalence among MSM relative to non-MSM and explore the causes of disagreement among estimates. METHODS: We used data from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative longitudinal survey conducted in the U...
October 21, 2016: Epidemiology
Chanelle J Howe
No abstract text is available yet for this article.
October 21, 2016: Epidemiology
Lisa Gallicchio, Carla Calhoun, David Riseberg, Kathy Helzlsouer
The purpose of this study was to compare the cardiovascular health of Black and White breast cancer patients undergoing adjuvant treatment. Baseline data from a cohort study of Black (n = 45) and White (n = 101) breast cancer patients initiating aromatase inhibitor treatment were analyzed. Participants had a cardiovascular health assessment, including carotid intimal medial thickness measurement, donated a blood sample, and completed a questionnaire. Atherosclerotic cardiovascular disease (ASCVD) event risk scores were calculated...
October 25, 2016: Breast Journal
Douglas F Dluzen, Nicole Noren Hooten, Yongqing Zhang, Yoonseo Kim, Frank E Glover, Salman M Tajuddin, Kimberly D Jacob, Alan B Zonderman, Michele K Evans
Systemic arterial hypertension is an important cause of cardiovascular disease morbidity and mortality. African Americans are disproportionately affected by hypertension, in fact the incidence, prevalence, and severity of hypertension is highest among African American (AA) women. Previous data suggests that differential gene expression influences individual susceptibility to selected diseases and we hypothesized that this phenomena may affect health disparities in hypertension. Transcriptional profiling of peripheral blood mononuclear cells from AA or white, normotensive or hypertensive females identified thousands of mRNAs differentially-expressed by race and/or hypertension...
October 25, 2016: Scientific Reports
Ank E Nijhawan
The United States leads the world in incarceration, which disproportionately affects disadvantaged individuals, including those who are mentally ill, poor, homeless and racial minorities. Incarceration is disruptive to families and communities and contributes to health disparities in sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). The objective of this grand rounds is to review (1) the epidemiology of incarceration in the United States, (2) the social factors which contribute to high rates of STIs in incarcerated individuals and (3) the HIV care cascade in incarcerated and recently released individuals...
October 2016: American Journal of the Medical Sciences
Christopher R Friese, Yun Li, Irina Bondarenko, Timothy P Hofer, Kevin C Ward, Ann S Hamilton, Dennis Deapen, Allison W Kurian, Steven J Katz
BACKGROUND: The 21-gene recurrence score (RS) assay stratifies early-stage, estrogen receptor-positive breast cancer by recurrence risk. Few studies have examined the ways in which physicians use the RS to recommend adjuvant systemic chemotherapy or patients' experiences with testing and decision making. METHODS: This study surveyed 3880 women treated for breast cancer in 2013-2014; they were identified from the Los Angeles County and Georgia Surveillance, Epidemiology, and End Results registries (response rate, 71%)...
October 24, 2016: Cancer
Kerry Ard, Cynthia Colen, Marisol Becerra, Thelma Velez
This study provides an empirical test of two mechanisms (social capital and exposure to air pollution) that are theorized to mediate the effect of neighborhood on health and contribute to racial disparities in health outcomes. To this end, we utilize the Social Capital Benchmark Study, a national survey of individuals nested within communities in the United States, to estimate how multiple dimensions of social capital and exposure to air pollution, explain racial disparities in self-rated health. Our main findings show that when controlling for individual-confounders, and nesting within communities, our indicator of cognitive bridging, generalized trust, decreases the gap in self-rated health between African Americans and Whites by 84%, and the gap between Hispanics and Whites by 54%...
October 19, 2016: International Journal of Environmental Research and Public Health
Sarah Y Nowlin, Charles M Cleland, Maya Vadiveloo, Gail D'Eramo Melkus, Niyati Parekh, Holly Hagan
OBJECTIVE: The purpose of this article is to examine sociodemographic and health behavior factors associated with dietary intake as measured by the healthy eating index (HEI-2010) for persons with and without diabetes (T2D). DESIGN: A secondary data analysis of three NHANES data cycles spanning 2007-2012. Multiple linear regression assessed racial/ethnic differences in HEI-2010 scores in those without T2D, with T2D, and with undiagnosed T2D. PARTICIPANTS: The sample included non-pregnant adults aged ≥20 years who had two days of reliable dietary recall data...
October 20, 2016: Ethnicity & Disease
Irena Stepanikova, Gabriela R Oates
OBJECTIVE: Perceived discrimination is an important risk factor for minority health. Drawing from the scholarship on multidimensionality of race, this study examines the relationships between perceived discrimination in health care and two dimensions of racial identity: self-identified race/ethnicity and perceived attributed race/ethnicity (respondents' perceptions of how they are racially classified by others). METHODS: We used Behavioral Risk Factor Surveillance System data collected in 2004-2013 and we specifically examined the data on perceived racial discrimination in health care during the past 12 months, perceived attributed race/ethnicity, and self-identified race/ethnicity...
October 20, 2016: Ethnicity & Disease
Chinwe C Madubata, Ying Liu, Melody S Goodman, Shumei Yun, Jennifer Yu, Min Lian, Graham A Colditz
PURPOSE: To investigate whether treatment (surgery, radiation therapy, and endocrine therapy) contributes to racial disparities in outcomes of ductal carcinoma in situ (DCIS). PATIENTS AND METHODS: The analysis included 8184 non-Hispanic White and 954 non-Hispanic Black women diagnosed with DCIS between 1996 and 2011 and identified in the Missouri Cancer Registry. Logistic regression models were used to estimate odds ratios (ORs) of treatment for race. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) of ipsilateral breast tumor (IBT) and contralateral breast tumor (CBT) for race...
October 22, 2016: Breast Cancer Research and Treatment
M A Beydoun, H A Beydoun, N Mode, G A Dore, J A Canas, S M Eid, A B Zonderman
BACKGROUND: Studies uncovering factors beyond socio-economic status (SES) that would explain racial and ethnic disparities in mortality are scarce. METHODS: Using prospective cohort data from the Third National Health and Nutrition Examination Survey (NHANES III), we examined all-cause and cause-specific mortality disparities by race, mediation through key factors and moderation by age (20-49 vs. 50+), sex and poverty status. Cox proportional hazards, discrete-time hazards and competing risk regression models were conducted (N = 16,573 participants, n = 4207 deaths, Median time = 170 months (1-217 months))...
October 22, 2016: BMC Public Health
Stephanie H Cook, Robert-Paul Juster, Benjamin J Calebs, Justin Heinze, Alison L Miller
Much of the extant scientific research examining hypothalamic-pituitary-adrenal (HPA)-axis functioning is conducted among White heterosexuals. Very little research examines HPA-axis functioning between different minority groups. Individuals who identify as both sexual and racial minorities may experience increased stigma and discrimination that can affect HPA-axis functioning. In the current study, we examined diurnal cortisol rhythm in young White gay men (WGM) compared to young Black gay men (BGM). The sample consisted of 70 healthy gay men (mean [SD] age=22...
October 13, 2016: Psychoneuroendocrinology
Rui Wang, Yan Dong, Jia Weng, Emily Z Kontos, Ronald D Chervin, Carol L Rosen, Carole L Marcus, Susan Redline
RATIONALE: Prior research found that individual-level environmental and social indicators did not explain the racial disparity in obstructive sleep apnea syndrome. Neighborhood socioeconomic variables, risk factors for a range of adverse behavioral and health outcomes, may better explain this racial disparity and help identify modifiable intervention targets. OBJECTIVES: To evaluate the associations of neighborhood socioeconomic variables with obstructive sleep apnea severity and to assess whether the neighborhood variables explain the association between race and obstructive sleep apnea severity...
October 21, 2016: Annals of the American Thoracic Society
Philip M Massey, Brent A Langellier, Tetine Sentell, Jennifer Manganello
OBJECTIVE: To examine differences in health information seeking between U.S.-born and foreign-born populations in the U.S. DESIGN: Data from 2008 to 2014 from the Health Information National Trends Survey were used in this study (n = 15,249). Bivariate analyses, logistic regression, and predicted probabilities were used to examine health information seeking and sources of health information. RESULTS: Findings demonstrate that 59.3% of the Hispanic foreign-born population reported looking for health information, fewer than other racial/ethnic groups in the sample...
October 21, 2016: Ethnicity & Health
David Y Lee, Annabelle Teng, Rose C Pedersen, Farees R Tavangari, Vikram Attaluri, Elisabeth C McLemore, Stacey L Stern, Anton J Bilchik, Melanie R Goldfarb
INTRODUCTION: Stage II-III rectal cancer requires multidisciplinary cancer care, and adolescents and young adults (AYA, ages 15-39 years) often do not receive optimal cancer therapy. METHODS: Overall, 3295 AYAs with clinical stage II-III rectal cancer were identified in the National Cancer Database. Factors associated with the receipt of adjuvant and surgical therapies, as well as overall survival (OS), were examined. RESULTS: The majority of patients were non-Hispanic White (72...
October 20, 2016: Annals of Surgical Oncology
Pradip B Devhare, Robert Steele, Adrian M Di Bisceglie, David E Kaplan, Ratna B Ray
African Americans (AA) have higher hepatocellular carcinoma (HCC) and mortality rates than Caucasians Americans (CA). Chronic hepatitis C virus (HCV) infection leads to cirrhosis and HCC. HCV infection is highly prevalent in AA population compared to other racial groups. African Americans are also less likely to naturally clear HCV, potentially contributing to higher prevalence of HCV. However, the explanation for this disparity is currently unknown. Circulating microRNAs (miRNAs) in the blood are emerging as biomarkers for pathological conditions...
October 19, 2016: Gene Expression
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