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Foell A, Amano T, Newransky C, Nebbitt V, Lombe M, Yu M, Horton D, Enelamah N, Riffer A, Villodas ML, Tirmazi MT. Stress Biomarkers in Black Youth: Exploring Psychological, Behavioral, and Socio-Ecological Correlates. J Urban Health 2023; 100:892-903. [PMID: 37584823 PMCID: PMC10618144 DOI: 10.1007/s11524-023-00776-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Exposure to chronic stress is a major public health concern. Black youth are vulnerable to chronic stress exposure given their overrepresentation in urban neighborhoods characterized by socio-ecological stressors. We contribute to this emerging body of knowledge by (1) investigating stress-induced variability in cortisol response patterns among Black youth, and (2) examining risk and protective factors associated with physiological stress responses. Salivary cortisol was collected from a community sample of 123 low-income Black youth ages 13 to 21. Latent class analysis (LCA) and logistic regression were utilized to identify discrete groups based on cortisol reactivity, and psychological, behavioral, and socio-ecological correlates of class membership. LCA supported a 2-class model of cortisol reactivity. Youth in class one were indicative of a normative stress response with mean cortisol awakening response of 0.38 μg/dL (SD = 0.19), 0.48 μg/dL (SD = 0.20) at time 2, and 0.44 μg/dL (SD = 0.20) at time 3. Youth in class two exhibited a blunted stress response with mean cortisol awakening response of 0.20 μg/dL (SD = 0.11), 0.21 μg/dL (SD = 0.09) at time 2, and 0.18 μg/dL (SD = 0.08) at time 3. Delinquent peer exposure and post-traumatic stress symptoms were negatively associated with blunted stress responses, while greater depressive symptoms were positively associated with blunted stress responses. Black youth displayed distinct physiological stress reactivity patterns. Interventions are needed to assist youth in coping with stress while transforming the upstream factors that give rise to adverse community conditions.
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Affiliation(s)
- Andrew Foell
- Jane Addams College of Social Work, University of Illinois Chicago, 1040 West Harrison Street, Chicago, IL, 60607, USA.
| | - Takashi Amano
- School of Social Work, Rutgers University-Newark, 360 Dr. Martin Luther King Jr. Blvd, Hill Hall 325, Newark, NJ, 07102, USA
| | - Chrisann Newransky
- School of Social Work, Adelphi University, Social Work Building Room 309, One South Avenue, Garden City, NY, 11530, USA
| | - Von Nebbitt
- Grace Abbott School of Social Work, University of Nebraska Omaha, 6001 Dodge Street, Omaha, NE, 68182, USA
| | - Margaret Lombe
- School of Social Work, Boston University, 264 Bay State Road, Boston, MA, 02215, USA
| | - Mansoo Yu
- School of Social Work, Department of Public Health, University of Missouri, 720 Clark Hall, Columbia, MO, 65211, USA
| | - Dominique Horton
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA
| | - Ngozi Enelamah
- Department of Social Work, University of New Hampshire, 55 College Road, Durham, NH, 03824, USA
| | - Andie Riffer
- Jane Addams College of Social Work, University of Illinois Chicago, 1040 West Harrison Street, Chicago, IL, 60607, USA
| | - Melissa L Villodas
- Department of Social Work, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA
| | - M Taki Tirmazi
- School of Social Work, Morgan State University, 1700 E. Cold Spring Lane, Baltimore, MD, 21251, USA
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Larrabee Sonderlund A, Charifson M, Ortiz R, Khan M, Schoenthaler A, Williams NJ. A comprehensive framework for operationalizing structural racism in health research: The association between mass incarceration of Black people in the U.S. and adverse birth outcomes. SSM Popul Health 2022; 19:101225. [PMID: 36177482 PMCID: PMC9513165 DOI: 10.1016/j.ssmph.2022.101225] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/06/2022] [Accepted: 09/02/2022] [Indexed: 11/27/2022] Open
Abstract
Structural racism represents a key determinant of the racial health disparities that has characterized the U.S. population throughout its existence. While this reality has recently begun to gain increasing acknowledgment and acceptance within the health sciences, there are still considerable challenges related to defining the concept of structural racism and operationalizing it in empirical study. In this paper, building on the existing evidence base, we propose a comprehensive framework that centers structural racism in terms of its historical roots and continued manifestation in most domains of society, and offer solutions for the study of this phenomenon and the pathways that connect it to population-level health disparities. We showcase our framework by applying it to the known link between spatial and racialized clustering of incarceration - a previously cited representation of structural racism - and disparities in adverse birth outcomes. Through this process we hypothesize pathways that focus on social cohesion and community-level chronic stress, community crime and police victimization, as well as infrastructural community disinvestment. First, we contextualize these mechanisms within the relevant extant literature. Then, we make recommendations for future empirical pathway analyses. Finally, we identify key areas for policy, community, and individual-level interventions that target the impact of concentrated incarceration on birth outcomes among Black people in the U.S.
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Affiliation(s)
- Anders Larrabee Sonderlund
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, USA
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Denmark
| | - Mia Charifson
- Department of Population Health, NYU Grossman School of Medicine, USA
- Vilcek Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, USA
| | - Robin Ortiz
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, USA
- Department of Pediatrics, NYU Grossman School of Medicine, USA
| | - Maria Khan
- Department of Population Health, NYU Grossman School of Medicine, USA
| | - Antoinette Schoenthaler
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, USA
| | - Natasha J. Williams
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Grossman School of Medicine, USA
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Xu Y, Farkouh EK, Dunetz CA, Varanasi SL, Mathews S, Gollust SE, Fowler EF, Moore S, Lewis NA, Niederdeppe J. Local TV News Coverage of Racial Disparities in COVID-19 During the First Wave of the Pandemic, March-June 2020. Race Soc Probl 2022; 15:201-213. [PMID: 35855105 PMCID: PMC9283845 DOI: 10.1007/s12552-022-09372-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 06/13/2023]
Abstract
The COVID-19 pandemic has disproportionately impacted health and social outcomes for people of color in the United States. This study examined how local TV news stories attributed causes and solutions for COVID-19-related racial health and social disparities, and whether coverage of such disparities changed after George Floyd's murder, during the first wave of the COVID-19 pandemic. We systematically validated keywords to extract relevant news content and conducted a content analysis of 169 discrete local TV news stories aired between March and June 2020 from 80 broadcast networks within 22 purposefully selected media markets. We found that social determinants of COVID-19 related racial disparities have been part of the discussion in local TV news, but racism as a public health crisis was rarely mentioned. Coverage of racial disparities focused far more attention on physical health outcomes than broader social impacts. Stories cited more structural factors than individual factors, as causes of these disparities. After the murder of George Floyd, stories were more likely to mention Black and Latinx people than other populations impacted by COVID-19. Only 9% of local news stories referenced racism, and stories referenced politicians more frequently than public health experts.
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Affiliation(s)
- Yiwei Xu
- Cornell University, Ithaca, NY 14853 USA
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Tuda D, Stefancic A, Hawes M, Wang X, Guo S, Cabassa LJ. Correlates of Attendance in a Peer-Led Healthy Lifestyle Intervention for People with Serious Mental Illness Living in Supportive Housing. Community Ment Health J 2022; 58:761-769. [PMID: 34417635 PMCID: PMC8858335 DOI: 10.1007/s10597-021-00881-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022]
Abstract
Healthy lifestyle interventions can improve the physical health of people with serious mental illness (SMI; e.g., schizophrenia). Yet, people with SMI report challenges participating in these interventions, thus limiting their potential benefits. This study examined attendance of participants (N = 155), largely comprised of racial and ethnic minorities, in a peer-led healthy lifestyle intervention living in supportive housing. A logistic regression model was used to identify correlates associated with attendance. Results indicated that females, those with at least a high school education, and a diagnosis of schizophrenia were more likely to attend. In contrast, the odds of attending at least one session were significantly lower for those who reported any drug use and for those who rated their health as good or excellent. Our findings indicate certain subgroups of people with SMI could benefit from tailored motivational strategies and supports to improve their participation in healthy lifestyle interventions. clinicaltrials.gov (NCT02175641).
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Affiliation(s)
- Daniela Tuda
- George Warren Brown School of Social Work at Washington, University in St. Louis, Goldfarb Hall, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Ana Stefancic
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Mark Hawes
- George Warren Brown School of Social Work at Washington, University in St. Louis, Goldfarb Hall, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Xiaoyan Wang
- George Warren Brown School of Social Work at Washington, University in St. Louis, Goldfarb Hall, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Shenyang Guo
- George Warren Brown School of Social Work at Washington, University in St. Louis, Goldfarb Hall, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Leopoldo J Cabassa
- George Warren Brown School of Social Work at Washington, University in St. Louis, Goldfarb Hall, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
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Barrett BW, Abraham AG, Dean LT, Plankey MW, Friedman MR, Jacobson LP, Teplin LA, Gorbach PM, Surkan PJ. Social inequalities contribute to racial/ethnic disparities in depressive symptomology among men who have sex with men. Soc Psychiatry Psychiatr Epidemiol 2021; 56:259-272. [PMID: 32780176 PMCID: PMC7870462 DOI: 10.1007/s00127-020-01940-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 08/07/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE Racial/ethnic minorities experience disproportionate rates of depressive symptoms in the United States. The magnitude that underlying factors-such as social inequalities-contribute to these symptoms is unknown. We sought to identify exposures that explain racial/ethnic differences in clinically significant depressive symptomology among men who have sex with men (MSM). METHODS Data from the Multicenter AIDS Cohort Study (MACS), a prospective cohort study, were used to examine clinically significant symptoms of depression (Center for Epidemiologic Studies Depression Scale score ≥ 20) among non-Latinx White, non-Latinx Black, and Latinx MSM. We included 44,823 person-visits by 1729 MSM seen in the study sites of Baltimore/Washington, DC; Chicago; Pittsburgh/Columbus; and Los Angeles from 2000 to 2017. Regression models estimated the percentage of depressive symptom risk explained by social, treatment, and health-related variables related to race/ethnicity. Machine-learning methods were used to predict the impact of mitigating differences in determinants of depressive symptoms by race/ethnicity. RESULTS At the most recent non-missing MACS visit, 16% of non-Latinx White MSM reported clinically significant depressive symptoms, compared to 22% of non-Latinx Black and 25% of Latinx men. We found that income and social-environmental stress were the largest contributors to racial/ethnic disparities in risk for depressive symptoms. Similarly, setting the prevalence of these two exposures to be equal across racial/ethnic groups was estimated to be most effective at reducing levels of clinically significant depressive symptoms. CONCLUSION Results suggested that reducing socioeconomic inequalities and stressful experiences may be effective public health targets to decrease racial/ethnic disparities in depressive symptoms among MSM.
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Grants
- U54 AG062334 NIA NIH HHS
- U01 HL146205 NHLBI NIH HHS
- U01 HL146208 NHLBI NIH HHS
- U01-HL146242-01 National Heart, Lung, and Blood Institute (US)
- P30-CA006973 Sidney Kimmel Comprehensive Cancer Center
- U01-HL146333-01 National Heart, Lung, and Blood Institute (US)
- U01 HL146240 NHLBI NIH HHS
- U01-HL146192-01 National Heart, Lung, and Blood Institute (US)
- R25-MH083620 NIMH NIH HHS
- U01 HL146241 NHLBI NIH HHS
- U01 HL146333 NHLBI NIH HHS
- R38 AI140299 NIAID NIH HHS
- U01-HL146208-01 National Heart, Lung, and Blood Institute (US)
- U01 HL146245 NHLBI NIH HHS
- U01-HL146241-01 National Heart, Lung, and Blood Institute (US)
- U01-HL146240-01 National Heart, Lung, and Blood Institute (US)
- P30 CA006973 NCI NIH HHS
- P30 AI094189 NIAID NIH HHS
- R25 MH083620 NIMH NIH HHS
- U01-HL146204-01 National Heart, Lung, and Blood Institute (US)
- U01-HL146245-01 National Heart, Lung, and Blood Institute (US)
- K01 CA184288 NCI NIH HHS
- U01-HL146202-01 National Heart, Lung, and Blood Institute (US)
- U01 HL146192 NHLBI NIH HHS
- U01 AI035041 NIAID NIH HHS
- K01-CA184288 NCI NIH HHS
- U01-HL146193-01 National Heart, Lung, and Blood Institute (US)
- U01 HL146242 NHLBI NIH HHS
- P30-AI094189 Johns Hopkins University Center for AIDS Research
- R03-MH103961 NIMH NIH HHS
- U01-HL146203-01 National Heart, Lung, and Blood Institute (US)
- R01 DA022936 NIDA NIH HHS
- R21 AG059505 NIA NIH HHS
- R01-DA022936 NIDA NIH HHS
- U01 HL146201 NHLBI NIH HHS
- U01-HL146194-01 National Heart, Lung, and Blood Institute (US)
- U01 HL146193 NHLBI NIH HHS
- U01 HL146204 NHLBI NIH HHS
- U01 HL146202 NHLBI NIH HHS
- U01 HL146194 NHLBI NIH HHS
- U01-HL146205-01 National Heart, Lung, and Blood Institute (US)
- R03 MH103961 NIMH NIH HHS
- U01-HL146201-01 National Heart, Lung, and Blood Institute (US)
- U01 HL146203 NHLBI NIH HHS
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Affiliation(s)
- Benjamin W Barrett
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Alison G Abraham
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Lorraine T Dean
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Michael W Plankey
- Department of Medicine, Medical Center, Georgetown University, Washington, DC, USA
| | - M Reuel Friedman
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lisa P Jacobson
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Linda A Teplin
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Pamela J Surkan
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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6
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Bacon E. Racial/ethnic differences in treatment recommendations: lifestyle changes and medication prescriptions for high cholesterol. Ethn Health 2020; 25:273-288. [PMID: 29092619 PMCID: PMC5932286 DOI: 10.1080/13557858.2017.1398315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 10/13/2017] [Indexed: 06/07/2023]
Abstract
Objective: High cholesterol is a common condition in the United States, affecting nearly one third of adults, and is a leading precursor to coronary heart disease. This study investigates race/ethnic differences in treatment recommendations for patients with high cholesterol, including prescription medication and lifestyle changes such as eating less fat, losing weight, or exercising more.Design: Data were obtained from the 2005 to 2010 National Health and Nutrition Examination Survey (N = 4846), a representative sample of adults in the United States, and the 2005-2010 National Ambulatory Medical Care Survey (N = 12,113), a representative sample of patient visits in the United States. Logistic regression analyses were used to assess whether health professionals recommended lifestyle changes or medication prescriptions differently by patient race/ethnicity and age. Models adjusted for demographic characteristics, socioeconomic status, health behaviors, health care access/utilization, and comorbidities.Results: Non-Hispanic Black and Hispanic patients with high cholesterol were significantly and substantially more likely to receive recommendations for lifestyle changes compared to non-Hispanic White patients. These differences were exacerbated at younger ages and largely diminished for adults over the age of 65. These patterns were reflected in both datasets. However, non-Hispanic Black patients from the NHANES analysis were less likely than non-Hispanic White patients to receive medication prescriptions for high cholesterol, particularly at younger ages. There were no race/ethnic differences in odds of medication prescriptions for Hispanic patients compared to White patients.Conclusions: Results suggest widespread and pervasive race/ethnic differences in recommending lifestyle changes for patients with high cholesterol. Although lifestyle changes may lower cholesterol they are often less effective than prescription medication. Because differences in lifestyle recommendations were not reflected in prescription practices, results may indicate a form of discrimination within physician-patient interactions that could be addressed by increased provider education about most effective treatment practices.
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Affiliation(s)
- Emily Bacon
- Department of Sociology and Population Program, Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
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Chang E, Choi S, Kwon I, Araiza D, Moore M, Trejo L, Sarkisian C. Characterizing Beliefs about Stroke and Walking for Exercise among Seniors from Four Racial/Ethnic Minority Communities. J Cross Cult Gerontol 2018; 33:387-410. [PMID: 30141095 PMCID: PMC7672710 DOI: 10.1007/s10823-018-9356-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We described and compared seniors' stroke-related health beliefs among four racial/ethnic communities to inform a culturally-tailored stroke prevention walking intervention. Specific attention was paid to how seniors combined pathophysiology-based biomedical beliefs with non-biomedical beliefs. We conducted twelve language-concordant, structured focus groups with African American, Chinese American, Korean American, and Latino seniors aged 60 years and older with a history of hypertension (n = 132) to assess stroke-related health beliefs. Participants were asked their beliefs about stroke mechanism and prevention strategies in addition to questions corresponding to four constructs from the Health Belief Model: perceived susceptibility, perceived severity, and benefits and barriers to walking for exercise. Using thematic analysis, we iteratively reviewed and coded focus group transcripts to identify recurrent themes within and between racial/ethnic groups. Participants across all four racial/ethnic groups believed that blockages in brain arteries caused strokes. Factors believed to increase susceptibility to stroke were often similar to biomedical risk factors across racial/ethnic groups, but participants also endorsed non-biomedical factors such as strong emotions. The majority of participants perceived stroke as a serious condition requiring urgent medical attention, fearing paralysis or death, but few mentioned severe disability as a stroke consequence. Participants largely believed stroke to be preventable through physical activity, dietary changes, and medication adherence. Perceived benefits of walking for exercise included improved physical health, decreased bodily pain, and ease of participation. Perceived barriers to walking included limited mobility due to chronic medical conditions, increased bodily pain, and low motivation. While seniors' stroke-related health beliefs were often similar to biomedical beliefs across racial/ethnic groups, we also identified several non-biomedical beliefs that were shared across groups. These non-biomedical beliefs regarding perceived stroke susceptibility and severity may warrant further discussion in stroke education interventions. Patterns in non-biomedical beliefs that vary between groups may reflect cultural differences. Stroke education could potentially increase cultural relevancy and impact by addressing such differences in health beliefs as well as perceived benefits and barriers to walking for exercise that vary between different racial/ethnic groups.
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Affiliation(s)
- Emiley Chang
- Department of Medicine, General Internal Medicine, Harbor-UCLA Medical Center, 1000 W. Carson Street, Torrance, CA, 90502, USA.
- David Geffen School of Medicine, University of California, Los Angeles, 885 Tiverton Drive, Los Angeles, CA, 90095, USA.
| | - Sarah Choi
- School of Nursing, University of California, Los Angeles, 700 Tiverton Avenue, Los Angeles, CA, 90095, USA
| | - Ivy Kwon
- Clinical Solutions Associate, Science 37, 12121 Bluff Creek Drive, Suite 100, Los Angeles, CA, 90094, USA
| | - Daniel Araiza
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Mignon Moore
- Department of Sociology, Barnard College, Columbia University, 3009 Broadway, New York, NY, 10027, USA
| | - Laura Trejo
- City of Los Angeles Department of Aging, 221 N. Figueroa Street, Suite 500, Los Angeles, CA, 90012, USA
| | - Catherine Sarkisian
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA, 90095, USA
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Soulakova JN, Pack R, Ha T. Patterns and correlates of purchasing cigarettes on Indian reservations among daily smokers in the United States. Drug Alcohol Depend 2018; 192:88-93. [PMID: 30243144 PMCID: PMC6200596 DOI: 10.1016/j.drugalcdep.2018.07.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/13/2018] [Accepted: 07/24/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION We described the population of daily smokers purchasing cigarettes on Indian reservations (IRs), estimated the rates of cigarette purchasing on IRs for diverse populations of daily smokers in the U.S., and assessed the trends in the period from 2010-11 to 2014-15. METHODS We used the 2010-11 and 2014-15 Tobacco Use Supplement to the Current Population Survey data for adult daily smokers as well as additional information, e.g., state excise tax on tobacco (n = 33,871). RESULTS Daily smokers who purchased cigarettes on IRs were primarily 45+ years old, non-Hispanic (NH) White, resided in a state with an IR, paid less than $4.50 per pack, and purchased cigarettes in the state of their residency. The majority of purchases on IRs were made in New York (28%), Oklahoma (14%), Washington (10%), Arizona (9%), and Florida (6%). The rate of purchasing cigarettes on IRs decreased from 4% in 2010-11 to 3% in 2014-15 (p = 0.012). The rates were higher for females than males (OR = 1.23, CI = 1.09:1.40) and heavy than non-heavy smokers (OR = 1.35, CI = 1.17:1.55). Higher state excise tax on tobacco, on average, was associated with purchasing cigarettes on IRs. CONCLUSIONS The rate of purchasing cigarettes on IRs is relatively low and has decreased in recent years. However, the rates differ across sociodemographic factors of daily smokers, including the state of residency and purchase. Purchasing cigarettes on IRs at lower prices can affect smokers' intentions to quit and can reduce federal and state efforts toward a tobacco-free nation.
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Mai Y, Soulakova JN. Retrospective reports of former smokers: Receiving doctor's advice to quit smoking and using behavioral interventions for smoking cessation in the United States. Prev Med Rep 2018; 11:290-296. [PMID: 30116700 PMCID: PMC6082974 DOI: 10.1016/j.pmedr.2018.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/11/2018] [Accepted: 07/21/2018] [Indexed: 11/25/2022] Open
Abstract
The study investigated the over-time changes and racial/ethnic disparities in the quality of health care services for cigarette smoking cessation in the U.S. from 2007 to 2015. The primary measures included receiving a doctor's advice to quit smoking in the year before smoking cessation and using behavioral interventions for smoking cessation (telephone helplines and web-based interventions) while trying to quit smoking. The study was conducted from January to July 2018. We used merged data from the 2010-11 and 2014-15 Tobacco Use Supplement to the Current Population Survey. The sample sizes were 7011 and 12,025, respectively, for the analyses corresponding to two primary measures. The rate of receiving a doctor's advice to quit increased significantly from 66% (SE = 2%) in 2007 to 73% (SE = 4%) in 2015. The rate of usage of telephone helplines or web-based interventions for smoking cessation increased only from 3% (SE = 1%) in 2007 to 5% (SE = 1%) in 2015. These positive trends remained even after adjusting for several important factors. For both measures, the rates were consistently lower among Hispanic smokers than Non-Hispanic Black/African American and White smokers. Despite the availability of states' behavioral interventions for cessation of tobacco use, utilization of these interventions remains very low, indicating that smokers may not be aware of these free resources, may have misconceptions about these interventions being evidence-based, or there are barriers for using these interventions.
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Affiliation(s)
| | - Julia N. Soulakova
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, United States of America
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10
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Abstract
Objective To examine the benefits of having a medical home among Latino and Black school-aged children, both with and without special health care needs (CSHCN). Methods Data from the 2011-2012 National Survey of Children's Health (NSCH) were analyzed to examine the associations of preventive dental and medical care, unmet dental or medical care, or missed school days with having a medical home among Latino and Black children compared to White children. Multivariate logistic regression with survey weights was used to adjust for child, parent, home, and geographic characteristics and an interaction term to estimate differences in outcomes among Black or Latino children receiving care in a medical home compared to White children with a medical home. Results Approximately 35% of Latino CSHCN and Latino non-CSHCN ages 6-17 years of age had a medical home. In the adjusted model comparing the effectiveness of the medical home by race and ethnicity, Latino non-CSHCN compared to White non-CSHCN were associated with lower odds of having one or more preventive dental visit in the last 12 months (OR 0.66; 95% CI 0.46-0.95) and no other associations between having a medical home and outcomes were found among Latinos compared to Whites regardless of non-CSHCN or CHSCN status. Meanwhile, having a medical home among Black non-CHSCN and CHSCN, compared to their White counterparts, showed potential benefits in regards to unmet medical care needs after adjusting for covariates, (OR 0.15; 95% CI 0.06-0.35; OR 0.16; 95% CI 0.05-0.55). Conclusions Medical homes may not be effective in delivering health services to the majority of Latino children but provide some benefit to Black children with and without CSHCN. Alternatively, the medical home may function differently for Latinos due to the specific medical home components measured by NSCH.
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Affiliation(s)
- Alma D Guerrero
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
- UCLA Center for Healthier Children, Families and Communities, Los Angeles, CA, USA.
- Children's Discovery and Innovation Institute Mattel Children's Hospital UCLA, Los Angeles, CA, USA.
| | - Xinkai Zhou
- Department of Medicine, Statistics Core, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Paul J Chung
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Children's Discovery and Innovation Institute Mattel Children's Hospital UCLA, Los Angeles, CA, USA
- Department of Health Policy & Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- The RAND Corporation, Santa Monica, CA, USA
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Mujahid MS, Moore LV, Petito LC, Kershaw KN, Watson K, Diez Roux AV. Neighborhoods and racial/ethnic differences in ideal cardiovascular health (the Multi-Ethnic Study of Atherosclerosis). Health Place 2017; 44:61-69. [PMID: 28167269 DOI: 10.1016/j.healthplace.2017.01.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/24/2016] [Accepted: 01/16/2017] [Indexed: 01/01/2023]
Abstract
Using data from the Multi-Ethnic Study of Atherosclerosis baseline sample from 2000 to 2002 (N=5263; mean age=62) we examined cross-sectional racial/ethnic differences in ideal CVH, defined by the American Heart Association 2020 Impact Goals as a summary measure of ideal levels of blood pressure, fasting glucose, cholesterol, body mass index, diet, physical activity, and smoking. Using three different analytical approaches, we examined differences before and after adjustment for neighborhood socioeconomic, physical, and social environments. Significant racial/ethnic differences were present for all indicators of ideal CVH (excluding physical activity). Additional adjustments for neighborhood factors produced modest reductions in racial/ethnic differences. Future research is necessary to better understand the impact of neighborhood context on health disparities using longitudinal study designs.
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Affiliation(s)
- Mahasin S Mujahid
- University of California Berkeley, School of Public Health, Division of Epidemiology, 101 Haviland Hall, Berkeley, CA 94720-7358, United States.
| | - Latetia V Moore
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, 4770 Buford Highway NE, Mailstop F77, Atlanta, GA 30341, United States.
| | - Lucia C Petito
- University of California Berkley School of Public Health, Division of Biostatistics, 101 Haviland Hall, Berkeley, CA 94720-7358, United States.
| | - Kiarri N Kershaw
- Northwestern University Feinberg School of Medicine, Division of Preventive Medicine - Epidemiology, 680 N Lake Shore Dr., Suite 1400, Chicago, IL 60611, United States.
| | - Karol Watson
- University of California Los Angeles David Geffen School of Medicine, Department of Cardiology, 200 UCLA Medical Plaza, Suite, C365, Los Angeles, CA 90095, United States.
| | - Ana V Diez Roux
- Drexel University School of Public Health, Dean's Office, 3215 Market St., Philadelphia, PA 19104, United States.
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