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"North Carolina" disparities

Thomas M Ludden, Yhenneko J Taylor, Laura K Simmons, Heather A Smith, Brisa Urquieta de Hernandez, Hazel Tapp, Owen J Furuseth, Michael F Dulin
Hispanic immigrant communities across the U.S. experience persistent health disparities and barriers to primary care. We examined whether community-based participatory research (CBPR) and geospatial modeling could systematically and reproducibly pinpoint neighborhoods in Charlotte, North Carolina with large proportions of Hispanic immigrants who were at-risk for poor health outcomes and health disparities. Using a CBPR framework, we identified 21 social determinants of health measures and developed a geospatial model from a subset of those measures to identify neighborhoods with large proportions of Hispanic immigrant populations at risk for poor health outcomes...
February 26, 2018: Journal of Primary Prevention
Ann L Coker, Huong T Luu, Heather M Bush
PURPOSE: The purpose was to determine whether Appalachian residence alone or in combination with violence was linked to poorer quality of life (QOL). METHODS: Women recently diagnosed and included in either the Kentucky or North Carolina Cancer Registries were interviewed by phone between 2009 and 2015 (n = 3320; mean age = 56.74). Response rates were similar by state (40.1 in Kentucky and 40.9% in North Carolina). Appalachian (N = 990) versus non-Appalachian residents (N = 2330) were hypothesized to have poorer QOL defined as (a) lower Functional Assessment of Cancer Therapy-General (FACT-G) scores and (b) more symptoms of depression, stress, or comorbid physical conditions...
January 27, 2018: Quality of Life Research
Justin G Trogdon, Paul Shafer, Brianna Lindsay, Tamera Coyne-Beasley
OBJECTIVES: The objective of this study was to describe the transition from bi- and quadrivalent HPV vaccines to 9vHPV in aggregate and identify determinants of the receipt of 9vHPV among youth following the introduction of 9vHPV in North Carolina. METHODS: The study used a retrospective cohort design with data from the North Carolina Immunization Registry (NCIR). Our sample included all doses of HPV vaccine administered between July 2015 and October 2016 to age-eligible youth (ages 9-17)...
January 20, 2018: Vaccine
Elizabeth F Racine, Eric Delmelle, Elizabeth Major, Corliss A Solomon
BACKGROUND: The Supplemental Nutrition Assistance Program (SNAP) is the largest food assistance program in the United States. Participants receive electronic benefits that are redeemable at a variety of food stores. Previous research notes that low-income neighborhoods often lack supermarkets with high-quality, affordable food. OBJECTIVE: The first aim of this study was to explore the number and spatial distribution of SNAP stores by type and to assess how SNAP benefit redemption is linked to store type in North Carolina in 2015...
January 20, 2018: Journal of the Academy of Nutrition and Dietetics
M Fontana, G J Eckert, M A Keels, R Jackson, B Katz, B T Levy, S M Levy
Expanded partnership with the medical community is an important strategy for reducing dental caries disparities. The purpose of this study was to assess the relationship between fluoride (F) "in office" (drops/tablets and/or varnish), as prescribed or applied by a health care professional by age 1 y, and 1) caries development and 2) presence of other caries risk factors or mediators (e.g., socioeconomic status). Child-primary caregiver (PCG) pairs ( N = 1,325) were recruited in Indiana, Iowa, and North Carolina as part of a longitudinal cohort study to validate a caries risk tool for primary health care settings...
February 2018: Advances in Dental Research
Monica Webb Hooper, Kelly Carpenter, Michael Payne, Ken Resnicow
BACKGROUND: African Americans suffer disproportionately from tobacco-related illness and have more difficulty quitting smoking than other racial/ethnic groups. Previous research indicates that African American treatment-seekers are high utilizers of tobacco quitlines, yet cessation rates via quitlines are lower relative to whites. The goal of the present study is to test the effectiveness of adding a culturally specific, video-based, adjunct to standard quitline care. It is hypothesized that the integration of an evidence-based intervention (Pathways to Freedom: Leading the Way to a Smoke-Free Community©; PTF) into quitline services will increase cessation and treatment engagement compared to control conditions, and that effects will be moderated by sociocultural factors (e...
January 10, 2018: BMC Public Health
R Gary Rozier
A downward trend in dental caries in permanent teeth of children that began in the 1970s has leveled out at historic lows. Severe periodontal disease affects a small percentage of people, and tooth loss has plummeted so that complete tooth loss, once a common occurrence, now is almost non-existent in upper socioeconomic groups. But not all people have benefited equally from these positive trends. Dental problems continue to affect the disadvantaged in society at unacceptable rates, and their disease burden is likely to increase because of trends in social determinants of oral diseases...
November 2017: North Carolina Medical Journal
Christopher J Mansfield, Katherine Jones, Satomi Imai
BACKGROUND Death rates for white, middle-aged Americans are increasing after decades of steady decline. In this paper, mortality and health behavior trends are examined for midlife North Carolinians. METHODS Mortality rates were calculated for midlife whites from 2000 to 2013 for the state as a whole and in counties grouped by level of economic distress. Trend lines were used to estimate future death rates, and comparisons were made to rates for nonwhites. Current and past health risk behaviors were also analyzed...
November 2017: North Carolina Medical Journal
Anissa I Vines, William R Carpenter, Ronald C Chen, Michele W Cherry, Debra G Long, Keith D Amos, Paul A Godley
BACKGROUND A 2007 national report identified North Carolina's Edgecombe County as having among the highest breast cancer incidence and mortality rates nationally, motivating the initiation of a task force and other local efforts to address the problem. The goal of this study is to examine county breast cancer characteristics before and after the report, including whether geographic variation may mask racial disparities in this majority African American community. METHOD With guidance from community partners, breast cancer cases from 2000 to 2012 in Edgecombe, Nash, and Orange Counties (N = 2,641) were obtained from the North Carolina Central Cancer Registry...
November 2017: North Carolina Medical Journal
Mollie Ashe Scott, Stephanie Kiser, Irene Park, Rebecca Grandy, Pamela U Joyner
PURPOSE: An innovative certificate program aimed at expanding the rural pharmacy workforce, increasing the number of pharmacists with expertise in rural practice, and improving healthcare outcomes in rural North Carolina is described. SUMMARY: Predicted shortages of primary care physicians and closures of critical access hospitals are expected to worsen existing health disparities. Experiential education in schools and colleges of pharmacy primarily takes place in academic medical centers and, unlike experiential education in medical schools, rarely emphasizes the provision of patient care in rural U...
December 1, 2017: American Journal of Health-system Pharmacy: AJHP
Dianne R Browne, Sherolde Hackett, Allison Burger
Objectives Women living in communities with low-socioeconomic status, substandard healthcare, and ongoing exposure to social disparities encounter barriers to healthcare, often making it difficult to access health services. Barriers may stem from provider interactions with clients, conditions of the healthcare facility, or even language barriers. This prompts a call for providers to be keenly aware of the obstacles women encounter when attempting to access services. Methods In an effort to facilitate better access to services, Camden Healthy Start conducted six focus groups...
November 11, 2017: Maternal and Child Health Journal
Gaurav Dave, Tiarney Ritchwood, Tiffany L Young, Malika Roman Isler, Adina Black, Aletha Y Akers, Ziya Gizlice, Connie Blumenthal, Leslie Atley, Mysha Wynn, Doris Stith, Crystal Cene, Danny Ellis, Giselle Corbie-Smith
PURPOSE: Parents and caregivers play an important role in sexual socialization of youth, often serving as the primary source of information about sex. For African American rural youth who experience disparate rates of HIV/sexually transmitted infection, improving caregiver-youth communication about sexual topics may help to reduce risky behaviors. This study assessed the impact of an intervention to improve sexual topic communication. DESIGN: A Preintervention-postintervention, quasi-experimental, controlled, and community-based trial...
November 2017: American Journal of Health Promotion: AJHP
Alison Gustafson, Stephanie Jilcott Pitts, Jordan McDonald, Hannah Ford, Paige Connelly, Rachel Gillespie, Emily Liu, Heather Bush, Candace Brancato, Toyin Babatande, Janet Mullins
Background: Obesity rates are higher among rural versus urban adolescents. To examine possible mechanisms for the rural-urban adolescent obesity disparity, we examined the direct and indirect effects of food purchasing patterns, and the home, school, and consumer food environments on dietary intake among rural adolescents. Methods: A baseline survey was conducted among adolescents in eight rural high schools (four in Eastern Kentucky, and four in Eastern North Carolina). Participants answered questions about food purchasing patterns, dietary intake, home food availability, and demographics...
October 21, 2017: International Journal of Environmental Research and Public Health
Jessica L King, Beth A Reboussin, John Spangler, Jennifer Cornacchione Ross, Erin L Sutfin
BACKGROUND: Individuals with mental health conditions represent a priority population for tobacco control. This population smokes cigarettes at disproportionately higher rates than the general population, but less is known about the relationship between non-cigarette tobacco use and mental health status. METHOD: In 2013, 2370 young adults recruited from 11 colleges in North Carolina and Virginia completed an online survey on tobacco use. We compared past 6-month self-reported mental health diagnosis, past 30-day depression score, and past 7-day stress score to past 30-day cigarette, e-cigarette, waterpipe, cigar, and smokeless tobacco use...
February 2018: Addictive Behaviors
Lisa C Campbell
Racial and ethnic disparities in musculoskeletal disorders have been consistently documented in research conducted both nationally and in North Carolina. These disparities represent a higher clinical need that must be met with increased access to safe and effective interventions across medical, pharmacological, and psychosocial/behavioral modalities.
September 2017: North Carolina Medical Journal
Kristine Grayson, Derek M Johnson
Quantifying the complex spatial dynamics taking place at range edges is critical for understanding future distributions of species, yet very few systems have sufficient data or the spatial resolution to empirically test these dynamics. This paper reviews how data from a large-scale pest management program have provided important contributions to the fields of population dynamics and invasion biology. The invasion of gypsy moth (Lymantria dispar) is well-documented from its introduction near Boston, Massachusetts USA in 1869 to its current extent of over 900,000 km(2) in Eastern North America...
September 11, 2017: Journal of Animal Ecology
Daniel H Wiznia, Emmanuel Nwachuku, Alexander Roth, Chang-Yeon Kim, Ameya Save, Nidharshan S Anandasivam, Michael Medvecky, Richard Pelker
BACKGROUND: The goal of the Patient Protection and Affordable Care Act (PPACA) was to expand patient access to health care. Since the rollout of the PPACA, Medicaid patients have demonstrated difficulty obtaining appointments in some specialty care settings. PURPOSE: To assess the effect of insurance type (Medicaid and private) on patient access to orthopaedic surgery sports medicine specialists for a semiurgent evaluation of a likely operative bucket-handle meniscus tear...
July 2017: Orthopaedic Journal of Sports Medicine
Melicia C Whitt-Glover, Moses V Goldmon, Ziya Gizlice, Daniel P Heil, Njeri Karanja
OBJECTIVE: Physical activity (PA) is beneficial for health, yet most African American women do not achieve recommended levels. Successful, sustainable strategies could help to address disparities in health outcomes associated with low levels of PA. The Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a Better Life study compared a faith-based and a secular intervention for increasing PA with a self-guided control group. DESIGN SETTING AND PARTICIPANTS: This cluster randomized, controlled trial was conducted from 2010 - 2011 in African American churches (n=31) in suburban North Carolina...
2017: Ethnicity & Disease
Jacqueline MacDonald Gibson, Kelsey J Pieper
BACKGROUND: Evidence suggests that the 44.5 million U.S. residents drawing their drinking water from private wells face higher risks of waterborne contaminant exposure than those served by regulated community water supplies. Among U.S. states, North Carolina (N.C.) has the second-largest population relying on private wells, making it a useful microcosm to study challenges to maintaining private-well water quality. OBJECTIVES: This paper summarizes recommendations from a two-day summit to identify options to improve drinking-water quality for N...
July 7, 2017: Environmental Health Perspectives
Noell L Rowan, Kelsey Beyer
This study explored issues of culturally sensitive healthcare practice and needs among lesbian, gay, bisexual and transgender aging adults in coastal North Carolina. Survey data results indicated the largest problem was a history of verbally harassment and need for culturally sensitive healthcare. In conclusion, culturally sensitive interventions are needed to address the health disparities and unique needs of LGBT aging adults. Cultural sensitivity training for service providers is suggested as a vital step in addressing health disparities of aging LGBT adults...
August 2017: Journal of Gerontological Social Work
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