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Nakatsuka N, Holguin B, Sedig J, Langenwalter PE, Carpenter J, Culleton BJ, García-Moreno C, Harper TK, Martin D, Martínez-Ramírez J, Porcayo-Michelini A, Tiesler V, Villapando-Canchola ME, Valdes Herrera A, Callan K, Curtis E, Kearns A, Iliev L, Lawson AM, Mah M, Mallick S, Micco A, Michel M, Workman JN, Oppenheimer J, Qiu L, Zalzala F, Rohland N, Punzo Diaz JL, Johnson JR, Reich D. Genetic continuity and change among the Indigenous peoples of California. Nature 2023; 624:122-129. [PMID: 37993721 PMCID: PMC10872549 DOI: 10.1038/s41586-023-06771-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/20/2023] [Indexed: 11/24/2023]
Abstract
Before the colonial period, California harboured more language variation than all of Europe, and linguistic and archaeological analyses have led to many hypotheses to explain this diversity1. We report genome-wide data from 79 ancient individuals from California and 40 ancient individuals from Northern Mexico dating to 7,400-200 years before present (BP). Our analyses document long-term genetic continuity between people living on the Northern Channel Islands of California and the adjacent Santa Barbara mainland coast from 7,400 years BP to modern Chumash groups represented by individuals who lived around 200 years BP. The distinctive genetic lineages that characterize present-day and ancient people from Northwest Mexico increased in frequency in Southern and Central California by 5,200 years BP, providing evidence for northward migrations that are candidates for spreading Uto-Aztecan languages before the dispersal of maize agriculture from Mexico2-4. Individuals from Baja California share more alleles with the earliest individual from Central California in the dataset than with later individuals from Central California, potentially reflecting an earlier linguistic substrate, whose impact on local ancestry was diluted by later migrations from inland regions1,5. After 1,600 years BP, ancient individuals from the Channel Islands lived in communities with effective sizes similar to those in pre-agricultural Caribbean and Patagonia, and smaller than those on the California mainland and in sampled regions of Mexico.
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Affiliation(s)
- Nathan Nakatsuka
- Department of Genetics, Harvard Medical School, Boston, MA, USA.
- Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA.
| | - Brian Holguin
- Department of Anthropology, University of California at Santa Barbara, Santa Barbara, CA, USA
| | - Jakob Sedig
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, USA
| | | | - John Carpenter
- Instituto Nacional de Antropología e Historia, Sonora, Hermosillo, México
| | - Brendan J Culleton
- Institute of Energy and the Environment, The Pennsylvania State University, University Park, PA, USA
| | | | - Thomas K Harper
- Institute of Energy and the Environment, The Pennsylvania State University, University Park, PA, USA
| | - Debra Martin
- Department of Anthropology, University of Nevada, Las Vegas, NV, USA
| | | | | | - Vera Tiesler
- Universidad Autónoma de Yucatán, Facultad de Ciencias Antropológicas, Mérida, México
| | | | | | - Kim Callan
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Elizabeth Curtis
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Aisling Kearns
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Lora Iliev
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Ann Marie Lawson
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Matthew Mah
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Swapan Mallick
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Adam Micco
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Megan Michel
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - J Noah Workman
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Jonas Oppenheimer
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Lijun Qiu
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Fatma Zalzala
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Nadin Rohland
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | | | - John R Johnson
- Santa Barbara Museum of Natural History, Santa Barbara, CA, USA.
| | - David Reich
- Department of Genetics, Harvard Medical School, Boston, MA, USA.
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, USA.
- Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA.
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.
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T. Tchakoute C, Rhee SY, Hare CB, Shafer RW, Sainani K. Adherence to contemporary antiretroviral treatment regimens and impact on immunological and virologic outcomes in a US healthcare system. PLoS One 2022; 17:e0263742. [PMID: 35157724 PMCID: PMC8843209 DOI: 10.1371/journal.pone.0263742] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 01/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Only a few recent reports have examined longitudinal adherence patterns in US clinics and its impact on immunological and virological outcomes among large cohorts initiating contemporary antiretroviral therapy (ART) in US clinics. Methods We followed all persons with HIV (PLWH) in a California clinic population initiating ART between 2010 and 2017. We estimated longitudinal adherence for each PLWH by calculating the medication possession ratio within multiple 6-month intervals using pharmacy refill records. Results During the study, 2315 PWLH were followed for a median time of 210.8 weeks and only 179 (7.7%) were lost-to-follow-up. The mean adherence was 84.9%. Age (Hazard Ratio (HR): (95% confidence interval): 1.25 (1.20–1.31) per 10-year increase) and Black race (HR: 0.62 (0.53–0.73) vs. White) were associated with adherence in the cohort. A 10% percent increase in adherence increased the odds of being virally suppressed by 37% (OR and 95% CI: 1.37 [1.33–1.41]) and was associated with an increase in mean CD4 count by 8.54 cells/ul in the next 6-month interval (p-value <0.0001). Conclusions Our study shows that despite large improvements in retention in care, demographic disparities in adherence to ART persist. Adherence was lower among younger patients and black patients. Our study confirmed the strong association between adherence to ART and viral suppression but could only establish a weak association between adherence and CD4 count. These findings reaffirm the importance of adherence and retention in care and further highlight the need for tailored patient-centered HIV Care Models as a strategy to improve PLWH’s outcomes.
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Affiliation(s)
- Christophe T. Tchakoute
- Division of Epidemiology and Population Health, Department of Medicine, Stanford University, Stanford, CA, United States of America
| | - Soo-Yon Rhee
- Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA, United States of America
| | - C. Bradley Hare
- Department of Infectious Diseases, Kaiser Permanente Northern California, San Francisco, CA, United States of America
| | - Robert W. Shafer
- Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA, United States of America
- * E-mail: (RWS); (KS)
| | - Kristin Sainani
- Division of Epidemiology and Population Health, Department of Medicine, Stanford University, Stanford, CA, United States of America
- * E-mail: (RWS); (KS)
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DeRouen MC, Canchola AJ, Thompson CA, Jin A, Nie S, Wong C, Lichtensztajn D, Allen L, Patel MI, Daida YG, Luft HS, Shariff-Marco S, Reynolds P, Wakelee HA, Liang SY, Waitzfelder BE, Cheng I, Gomez SL. Incidence of Lung Cancer Among Never-Smoking Asian American, Native Hawaiian, and Pacific Islander Females. J Natl Cancer Inst 2022; 114:78-86. [PMID: 34345919 PMCID: PMC8755498 DOI: 10.1093/jnci/djab143] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/17/2021] [Accepted: 07/16/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Although lung cancer incidence rates according to smoking status, sex, and detailed race/ethnicity have not been available, it is estimated that more than half of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) females with lung cancer have never smoked. METHODS We calculated age-adjusted incidence rates for lung cancer according to smoking status and detailed race/ethnicity among females, focusing on AANHPI ethnic groups, and assessed relative incidence across racial/ethnic groups. We used a large-scale dataset that integrates data from electronic health records from 2 large health-care systems-Sutter Health in Northern California and Kaiser Permanente Hawai'i-linked to state cancer registries for incident lung cancer diagnoses between 2000 and 2013. The study population included 1 222 694 females (n = 244 147 AANHPI), 3297 of which were diagnosed with lung cancer (n = 535 AANHPI). RESULTS Incidence of lung cancer among never-smoking AANHPI as an aggregate group was 17.1 per 100 000 (95% confidence interval [CI] = 14.9 to 19.4) but varied widely across ethnic groups. Never-smoking Chinese American females had the highest rate (22.8 per 100 000, 95% CI = 17.3 to 29.1). Except for Japanese American females, incidence among every never-smoking AANHPI female ethnic group was higher than that of never-smoking non-Hispanic White females, from 66% greater among Native Hawaiian females (incidence rate ratio = 1.66, 95% CI = 1.03 to 2.56) to more than 100% greater among Chinese American females (incidence rate ratio = 2.26, 95% CI = 1.67 to 3.02). CONCLUSIONS Our study revealed high rates of lung cancer among most never-smoking AANHPI female ethnic groups. Our approach illustrates the use of innovative data integration to dispel the myth that AANHPI females are at overall reduced risk of lung cancer and demonstrates the need to disaggregate this highly diverse population.
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Affiliation(s)
- Mindy C DeRouen
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Alison J Canchola
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Caroline A Thompson
- San Diego State University School of Public Health, San Diego, CA, USA
- University of California San Diego School of Medicine, San Diego, CA, USA
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Anqi Jin
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Sixiang Nie
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Carmen Wong
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Daphne Lichtensztajn
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Laura Allen
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | | | - Yihe G Daida
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Harold S Luft
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Peggy Reynolds
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Heather A Wakelee
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Su-Ying Liang
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Beth E Waitzfelder
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Scarlett L Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
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Peterson RL, George KM, Barnes LL, Gilsanz P, Mayeda ER, Glymour MM, Mungas DM, Whitmer RA. Association of Timing of School Desegregation in the United States With Late-Life Cognition in the Study of Healthy Aging in African Americans (STAR) Cohort. JAMA Netw Open 2021; 4:e2129052. [PMID: 34668943 PMCID: PMC8529411 DOI: 10.1001/jamanetworkopen.2021.29052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Prior research suggests schooling differences for Black individuals in the US are associated with worse cognitive aging. It is unknown whether age when experiencing school desegregation is associated with differences in late-life cognition in this population. OBJECTIVE To examine patterns of association between age of school desegregation in grades 1 to 12 and late-life cognition. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed baseline data from the Study of Healthy Aging in African Americans (STAR) cohort collected from 2018 through 2019 in Northern California, primarily in the cities of Richmond and Oakland. Participants were 699 self-identified Black individuals aged 50 years or older who were community-dwelling, long-term members of Kaiser Permanente Northern California and dementia free at baseline. EXPOSURES Participants reported whether they attended a segregated school in grades 1, 6, 9, and 12 and were placed in 1 of 6 transition categories: (1) always attended integrated schools; (2) integrated between grades 1 through 5; (3) integrated between grades 6 through 8; (4) integrated between grades 9 through 12; (5) ever moved from integrated to segregated school; (6) never attended integrated schools. MAIN OUTCOMES AND MEASURES Executive function, semantic memory, and verbal episodic memory ascertained via the Spanish and English Neuropsychological Assessment Battery and z standardized for analyses. RESULTS The mean (SD) age of the 699 participants was 68.5 (8.7) years, and 484 (69.2%) were female. Most participants transitioned from segregated to integrated schools owing to historical timing and cohort geography. Compared with 111 participants who never attended integrated schools (reference group), executive function was better among 50 participants who transitioned to integrated schools between grades 1 and 5 (β = 0.35; 95% CI, 0.08-0.61; P = .01). Semantic memory was better among 435 participants who only attended integrated schools (β = 0.34; 95% CI, 0.14-0.54; P = .001) or among 50 participants who transitioned to integrated schools between grades 1 and 5 (β = 0.43; 95% CI, 0.15-0.72; P = .003). However, no significant differences were found by group for verbal episodic memory function (eg, for 50 participants who transitioned to integrated schools between grades 1 and 5: β = 0.07; 95% CI, -0.22 to 0.35; P = .66). No significant differences were found when testing for potential interactions by sex, Southern birth, or baseline age. CONCLUSIONS AND RELEVANCE The STAR cohort data indicated that executive function and semantic memory were higher among Black individuals with some integrated school experience. These results suggest that racially segregated schooling experiences, including de facto segregation present today, may be associated with worse late-life cognition.
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Affiliation(s)
| | - Kristen M. George
- Department of Public Health Sciences, University of California, Davis
| | - Lisa L. Barnes
- Department of Neurological Sciences, Rush University, Chicago, Illinois
| | - Paola Gilsanz
- Kaiser Permanente Northern California Division of Research, Oakland
| | | | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Dan M. Mungas
- Department of Neurology, University of California, Davis
| | - Rachel A. Whitmer
- Department of Public Health Sciences, University of California, Davis
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Mack JW, Fisher L, Kushi L, Chao CR, Vega B, Rodrigues G, Josephs I, Brock KE, Buchanan S, Casperson M, Cooper RM, Fasciano KM, Kolevska T, Lakin JR, Lefebvre A, Schwartz CM, Shalman DM, Wall CB, Wiener L, Altschuler A. Patient, Family, and Clinician Perspectives on End-of-Life Care Quality Domains and Candidate Indicators for Adolescents and Young Adults With Cancer. JAMA Netw Open 2021; 4:e2121888. [PMID: 34424305 PMCID: PMC8383130 DOI: 10.1001/jamanetworkopen.2021.21888] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE End-of-life care quality indicators specific to adolescents and young adults (AYAs) aged 12 to 39 years with cancer have not been developed. OBJECTIVE To identify priority domains for end-of-life care from the perspectives of AYAs, family caregivers, and clinicians, and to propose candidate quality indicators reflecting priorities. DESIGN, SETTING, AND PARTICIPANTS This qualitative study was conducted from December 6, 2018, to January 5, 2021, with no additional follow-up. In-depth interviews were conducted with patients, family caregivers, and clinicians and included a content analysis of resulting transcripts. A multidisciplinary advisory group translated priorities into proposed quality indicators. Interviews were conducted at the Dana-Farber Cancer Institute, Kaiser Permanente Northern California, Kaiser Permanente Southern California, and an AYA cancer support community (lacunaloft.org). Participants included 23 AYAs, 28 caregivers, and 29 clinicians. EXPOSURE Stage IV or recurrent cancer. MAIN OUTCOMES AND MEASURES Care priorities. RESULTS Interviews were conducted with 23 patients (mean [SD] age, 29.3 [7.3] years; 12 men [52%]; 18 White participants [78%]), 28 family caregivers (23 women [82%]; 14 White participants [50%]), and 29 clinicians (20 women [69%]; 13 White participants [45%]). Caregivers included 22 parents (79%), 5 spouses or partners (18%), and 1 other family member (4%); the 29 clinicians included 15 physicians (52%), 6 nurses or nurse practitioners (21%), and 8 social workers or psychologists (28%). Interviews identified 7 end-of-life priority domains: attention to physical symptoms, attention to quality of life, psychosocial and spiritual care, communication and decision-making, relationships with clinicians, care and treatment, and independence. Themes were consistent across the AYA age range and participant type. Although some domains were represented in quality indicators developed for adults, unique domains were identified, as well as AYA-specific manifestations of existing domains. For example, quality of life included global quality of life; attainment of life goals, legacy, and meaning; support of personal relationships; and normalcy. Within communication and decision-making, domains included communication early in the disease course, addressing prognosis and what to expect at the end of life, and opportunity for AYAs to hold desired roles in decision-making. Care and treatment domains relevant to cancer therapy, use of life-prolonging measures, and location of death emphasized the need for preference sensitivity rather than a standard path. This finding differs from existing adult indicators that propose that late-life chemotherapy, intensive measures, and hospital death should be rare. CONCLUSIONS AND RELEVANCE The findings of this qualitative study suggest that AYAs with cancer have priorities for care at the end of life that are not fully encompassed in existing indicators for adults. Use of new indicators for this young population may better reflect patient- and family-centered experiences of quality care.
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Affiliation(s)
- Jennifer W Mack
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Lauren Fisher
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Larry Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Chun R Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Brenda Vega
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Gilda Rodrigues
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Katharine E Brock
- Divisions of Pediatric Oncology and Palliative Care, Emory University and Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Susan Buchanan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Now with Agios Pharmaceuticals, Cambridge, Massachusetts
| | | | - Robert M Cooper
- Department of Pediatric Oncology, Kaiser Permanente Southern California, Pasadena
| | - Karen M Fasciano
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Tatjana Kolevska
- Division of Medical Oncology, Kaiser Permanente Northern California, Oakland
| | - Joshua R Lakin
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Anna Lefebvre
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Corey M Schwartz
- Division of Medical Oncology, Kaiser Permanente Northern California, Oakland
| | - Dov M Shalman
- Department of Palliative Care, Kaiser Permanente Southern California, Pasadena
| | - Catherine B Wall
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Lori Wiener
- Psychosocial Support and Research Program, National Cancer Institute, Bethesda, Maryland
| | - Andrea Altschuler
- Division of Research, Kaiser Permanente Northern California, Oakland
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Baumhofer NK, Panapasa SV, Cook EF, Williams DR. Association of cultural affinity and island food consumption in the Pacific Islander health study. Ethn Health 2021; 26:769-785. [PMID: 30458623 DOI: 10.1080/13557858.2018.1547815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 11/09/2018] [Indexed: 06/09/2023]
Abstract
Objectives: The dietary patterns of Pacific Islander Americans are partially influenced by a rich cultural heritage. There is little known about how cultural affinity affects the dietary choices of this small, but quickly growing population. This analysis attempts to understand how the association of cultural affinity on island foods consumption (IFC) varies by key demographic characteristics.Design: A sample of 240 Samoan and Tongan adults in California from the Pacific Islander Health Study (PIHS) was used. Psychometric properties of a novel 11-item cultural affinity scale were assessed. Univariate and bivariate analyses of the cultural affinity scale were completed to understand the distribution of cultural affinity score. Separate multivariable Poisson regression was used to assess the effect of interactions between cultural affinity and five key demographic factors on IFC.Results: Psychometric analysis of the PIHS cultural affinity scale revealed two unique factors. Significant interactions were found between cultural affinity and ethnicity and birthplace: the association between cultural affinity and IFC was larger among Samoans compared to Tongans and Samoan or Tongan birthplace was found to have a weaker association between cultural affinity and IFC. Interactions between cultural affinity and age, financial insecurity, and educational attainment were not significant.Conclusion: Understanding how cultural affinity varies in its effect on IFC is a part of understanding overall dietary patterns in this population.
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Affiliation(s)
- N Kau'i Baumhofer
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
- Department of Native Hawaiian Health, University of Hawai'i John A. Burns School of Medicine, Honolulu, USA
| | - Sela V Panapasa
- Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - E Francis Cook
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - David R Williams
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
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Chen YH, Glymour M, Riley A, Balmes J, Duchowny K, Harrison R, Matthay E, Bibbins-Domingo K. Excess mortality associated with the COVID-19 pandemic among Californians 18-65 years of age, by occupational sector and occupation: March through November 2020. PLoS One 2021; 16:e0252454. [PMID: 34086762 PMCID: PMC8177528 DOI: 10.1371/journal.pone.0252454] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/14/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Though SARS-CoV-2 outbreaks have been documented in occupational settings and in-person essential work has been suspected as a risk factor for COVID-19, occupational differences in excess mortality have, to date, not been examined. Such information could point to opportunities for intervention, such as vaccine prioritization or regulations to enforce safer work environments. METHODS AND FINDINGS Using autoregressive integrated moving average models and California Department of Public Health data representing 356,188 decedents 18-65 years of age who died between January 1, 2016 and November 30, 2020, we estimated pandemic-related excess mortality by occupational sector and occupation, with additional stratification of the sector analysis by race/ethnicity. During these first 9 months of the COVID-19 pandemic, working-age adults experienced 11,628 more deaths than expected, corresponding to 22% relative excess and 46 excess deaths per 100,000 living individuals. Sectors with the highest relative and per-capita excess mortality were food/agriculture (39% relative excess; 75 excess deaths per 100,000), transportation/logistics (31%; 91 per 100,000), manufacturing (24%; 61 per 100,000), and facilities (23%; 83 per 100,000). Across racial and ethnic groups, Latino working-age Californians experienced the highest relative excess mortality (37%) with the highest excess mortality among Latino workers in food and agriculture (59%; 97 per 100,000). Black working-age Californians had the highest per-capita excess mortality (110 per 100,000), with relative excess mortality highest among transportation/logistics workers (36%). Asian working-age Californians had lower excess mortality overall, but notable relative excess mortality among health/emergency workers (37%), while White Californians had high per-capita excess deaths among facilities workers (70 per 100,000). CONCLUSIONS Certain occupational sectors are associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through vaccination and strict enforcement of health orders in workplace settings.
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Affiliation(s)
- Yea-Hung Chen
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
| | - Alicia Riley
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
| | - John Balmes
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Kate Duchowny
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
| | - Robert Harrison
- Department of Medicine, University of California, San Francisco, California, United States of America
| | - Ellicott Matthay
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
- Department of Medicine, University of California, San Francisco, California, United States of America
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Carthon JMB, Travers JL, Hounshell D, Udoeyo I, Chittams J. Disparities in Nurse Job Dissatisfaction and Intent to Leave: Implications for Retaining a Diverse Workforce. J Nurs Adm 2021; 51:310-317. [PMID: 33989239 PMCID: PMC8137650 DOI: 10.1097/nna.0000000000001019] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine if Black nurses are more likely to report job dissatisfaction and whether factors related to dissatisfaction influence differences in intent to leave. BACKGROUND Minority nurses report higher job dissatisfaction and intent to leave, yet little is known about factors associated with these differences in community settings. METHOD Cross-sectional analysis of 11 778 nurses working in community-based settings was conducted. Logistic regression was used to estimate the association among race, job satisfaction, and intent to leave. RESULTS Black nurses were more likely to report job dissatisfaction and intent to leave. Black nurses' intent to leave decreased in adjusted models that accounted for dissatisfaction with aspects of their jobs including salary, advancement opportunities, autonomy, and tuition benefits. CONCLUSION Nurse administrators may find opportunities to decrease intent to leave among Black nurses through focused efforts to target areas of dissatisfaction.
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Affiliation(s)
- J Margo Brooks Carthon
- Author Affiliations: Associate Professor (Dr Carthon), University of Pennsylvania School of Nursing, Philadelphia; Assistant Professor (Dr Travers), New York University Rory Meyers College of Nursing, New York; and Research Assistant (Ms Hounshell), Statistician (Ms Udoeyo), and Senior Biostatistician (Mr Chittams), University of Pennsylvania, Philadelphia
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9
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Brooks Carthon M, Brom H, McHugh M, Sloane DM, Berg R, Merchant R, Girotra S, Aiken LH. Better Nurse Staffing Is Associated With Survival for Black Patients and Diminishes Racial Disparities in Survival After In-Hospital Cardiac Arrests. Med Care 2021; 59:169-176. [PMID: 33201082 PMCID: PMC7855314 DOI: 10.1097/mlr.0000000000001464] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Racial disparities in survival among patients who had an in-hospital cardiac arrest (IHCA) have been linked to hospital-level factors. OBJECTIVES To determine whether nurse staffing is associated with survival disparities after IHCA. RESEARCH DESIGN Cross-sectional data from (1) the American Heart Association's Get With the Guidelines-Resuscitation database; (2) the University of Pennsylvania Multi-State Nursing Care and Patient Safety Survey; and (3) The American Hospital Association annual survey. Risk-adjusted logistic regression models, which took account of the hospital and patient characteristics, were used to determine the association of nurse staffing and survival to discharge for black and white patients. SUBJECTS A total of 14,132 adult patients aged 18 and older between 2004 and 2010 in 75 hospitals in 4 states. RESULTS In models that accounted for hospital and patient characteristics, the odds of survival to discharge was lower for black patients than white patients [odds ratio (OR)=0.70; 95% confidence interval (CI), 0.61-0.82]. A significant interaction was found between race and medical-surgical nurse staffing for survival to discharge, such that each additional patient per nurse lowered the odds of survival for black patients (OR=0.92; 95% CI, 0.87-0.97) more than white patients (OR=0.97; 95% CI, 0.93-1.00). CONCLUSIONS Our findings suggest that disparities in IHCA survival between black and white patients may be linked to the level of medical-surgical nurse staffing in the hospitals in which they receive care and that the benefit of being admitted to hospitals with better staffing may be especially pronounced for black patients.
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Affiliation(s)
- Margo Brooks Carthon
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Heather Brom
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Matthew McHugh
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Douglas M. Sloane
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
| | - Robert Berg
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care, Children’s Hospital of Philadelphia
| | - Raina Merchant
- Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Saket Girotra
- Department of Internal Medicine, Division of Cardiovascular Diseases, University of Iowa Carver College of Medicine Comprehensive Access Delivery Research & Evaluation (CADRE), Iowa City Veterans Affairs Medical Center, Iowa City, IA
| | - Linda H. Aiken
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
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10
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Abstract
County-level ASD prevalence was estimated using an age-resolved snapshot from the California Department of Developmental Services (DDS) for birth years 1993–2013. ASD prevalence increased among all children across birth years 1993–2000 but plateaued or declined thereafter among whites from wealthy counties. In contrast, ASD rates increased continuously across 1993–2013 among whites from lower income counties and Hispanics from all counties. Both white ASD prevalence and rate of change in prevalence were inversely correlated to county income from birth year 2000–2013 but not 1993–2000. These disparate trends within the dataset suggest that wealthy white parents, starting around 2000, may have begun opting out of DDS in favor of private care and/or making changes that effectively lowered their children’s risk of ASD.
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Affiliation(s)
- Cynthia Nevison
- Institute for Alpine and Arctic Research, University of Colorado, Campus Box 450, Boulder, 80309-0450, USA.
| | - William Parker
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
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11
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Xiong D, Zhang L, Watson GL, Sundin P, Bufford T, Zoller JA, Shamshoian J, Suchard MA, Ramirez CM. Pseudo-likelihood based logistic regression for estimating COVID-19 infection and case fatality rates by gender, race, and age in California. Epidemics 2020; 33:100418. [PMID: 33221671 PMCID: PMC7837024 DOI: 10.1016/j.epidem.2020.100418] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/23/2020] [Accepted: 11/02/2020] [Indexed: 12/16/2022] Open
Abstract
In emerging epidemics, early estimates of key epidemiological characteristics of the disease are critical for guiding public policy. In particular, identifying high-risk population subgroups aids policymakers and health officials in combating the epidemic. This has been challenging during the coronavirus disease 2019 (COVID-19) pandemic because governmental agencies typically release aggregate COVID-19 data as summary statistics of patient demographics. These data may identify disparities in COVID-19 outcomes between broad population subgroups, but do not provide comparisons between more granular population subgroups defined by combinations of multiple demographics. We introduce a method that helps to overcome the limitations of aggregated summary statistics and yields estimates of COVID-19 infection and case fatality rates - key quantities for guiding public policy related to the control and prevention of COVID-19 - for population subgroups across combinations of demographic characteristics. Our approach uses pseudo-likelihood based logistic regression to combine aggregate COVID-19 case and fatality data with population-level demographic survey data to estimate infection and case fatality rates for population subgroups across combinations of demographic characteristics. We illustrate our method on California COVID-19 data to estimate test-based infection and case fatality rates for population subgroups defined by gender, age, and race/ethnicity. Our analysis indicates that in California, males have higher test-based infection rates and test-based case fatality rates across age and race/ethnicity groups, with the gender gap widening with increasing age. Although elderly infected with COVID-19 are at an elevated risk of mortality, the test-based infection rates do not increase monotonically with age. The workforce population, especially, has a higher test-based infection rate than children, adolescents, and other elderly people in their 60-80. LatinX and African Americans have higher test-based infection rates than other race/ethnicity groups. The subgroups with the highest 5 test-based case fatality rates are all-male groups with race as African American, Asian, Multi-race, LatinX, and White, followed by African American females, indicating that African Americans are an especially vulnerable California subpopulation.
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Affiliation(s)
- Di Xiong
- Department of Biostatistics, Jonathan and Karen Fielding School of Public Health, University of California, Los Angeles, CA, United States of America
| | - Lu Zhang
- Department of Biostatistics, Jonathan and Karen Fielding School of Public Health, University of California, Los Angeles, CA, United States of America
| | - Gregory L Watson
- Department of Biostatistics, Jonathan and Karen Fielding School of Public Health, University of California, Los Angeles, CA, United States of America
| | - Phillip Sundin
- Department of Biostatistics, Jonathan and Karen Fielding School of Public Health, University of California, Los Angeles, CA, United States of America
| | - Teresa Bufford
- Department of Biostatistics, Jonathan and Karen Fielding School of Public Health, University of California, Los Angeles, CA, United States of America
| | - Joseph A Zoller
- Department of Biostatistics, Jonathan and Karen Fielding School of Public Health, University of California, Los Angeles, CA, United States of America
| | - John Shamshoian
- Department of Biostatistics, Jonathan and Karen Fielding School of Public Health, University of California, Los Angeles, CA, United States of America
| | - Marc A Suchard
- Department of Biostatistics, Jonathan and Karen Fielding School of Public Health, University of California, Los Angeles, CA, United States of America; Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America; Department of Computational Medicine, University of California, Los Angeles, CA, United States of America
| | - Christina M Ramirez
- Department of Biostatistics, Jonathan and Karen Fielding School of Public Health, University of California, Los Angeles, CA, United States of America.
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12
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Neece C, McIntyre LL, Fenning R. Examining the impact of COVID-19 in ethnically diverse families with young children with intellectual and developmental disabilities. J Intellect Disabil Res 2020; 64:739-749. [PMID: 32808424 PMCID: PMC7461180 DOI: 10.1111/jir.12769] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [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: 07/11/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 05/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic introduced challenges to families with young children with developmental delays. Beyond the widespread concerns surrounding illness, loss of employment and social isolation, caregivers are responsible for overseeing their children's educational and therapeutic programmes at home often without the much needed support of professionals. METHOD The present study sought to examine the impact of COVID-19 in 77 ethnically, linguistically and socioeconomically diverse families with young children with intellectual and developmental disabilities (IDDs) in California and Oregon, who were participating in larger intervention studies. Parents responded to five interview questions about the impact of the pandemic, services for their child, silver linings or positive aspects, coping and their concerns about the long-term impact of the pandemic. RESULTS Parents reported that their biggest challenge was being at home caring for their children with the loss of many essential services. Parents reported some positive aspects of the pandemic, especially being together as a family. Although there were positive aspects of the situation, many parents expressed concern about long-term impacts of the pandemic on their children's development, given the loss of services, education and social engagement opportunities. CONCLUSION Results suggest that parents of young children with IDD report significant challenges at home during the pandemic. Professional support, especially during the reopening phases, will be critical to support family well-being and child developmental outcomes.
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Affiliation(s)
- C. Neece
- Department of PsychologyLoma Linda UniversityLoma LindaCAUSA
| | - L. L. McIntyre
- Special Education & Clinical SciencesUniversity of OregonEugeneORUSA
| | - R. Fenning
- Department of Child and Adolescent StudiesCalifornia State University FullertonFullertonCAUSA
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13
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Abstract
BACKGROUND The impact of human milk use on racial/ethnic disparities in necrotizing enterocolitis (NEC) incidence is unknown. METHODS Trends in NEC incidence and human milk use at discharge were evaluated by race/ethnicity among 47,112 very low birth weight infants born in California from 2008 to 2017. We interrogated the association between race/ethnicity and NEC using multilevel regression analysis, and evaluated the effect of human milk use at discharge on the relationship between race/ethnicity and NEC using mediation analysis. RESULTS Annual NEC incidence declined across all racial/ethnic groups from an aggregate average of 4.8% in 2008 to 2.6% in 2017. Human milk use at discharge increased over the time period across all racial groups, and non-Hispanic (NH) black infants received the least human milk each year. In multivariable analyses, Hispanic ethnicity (odds ratio (OR) 1.27, 95% confidence interval (CI) 1.02-1.57) and Asian or Pacific Islander race (OR 1.35, 95% CI 1.01-1.80) were each associated with higher odds of NEC, while the association of NH black race with NEC was attenuated after adding human milk use at discharge to the model. Mediation analysis revealed that human milk use at discharge accounted for 22% of the total risk of NEC in non-white vs. white infants, and 44% in black vs. white infants. CONCLUSIONS Although NEC incidence has declined substantially over the past decade, a sizable racial/ethnic disparity persists. Quality improvement initiatives augmenting human milk use may further reduce the incidence of NEC in vulnerable populations.
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MESH Headings
- Black or African American
- California/epidemiology
- California/ethnology
- Enterocolitis, Necrotizing/epidemiology
- Enterocolitis, Necrotizing/ethnology
- Enterocolitis, Necrotizing/therapy
- Ethnicity
- Female
- Health Status Disparities
- Hispanic or Latino
- Humans
- Incidence
- Infant
- Infant, Low Birth Weight
- Infant, Newborn
- Infant, Newborn, Diseases
- Infant, Premature
- Infant, Very Low Birth Weight
- Male
- Milk, Human
- Odds Ratio
- Regression Analysis
- Risk
- Treatment Outcome
- Vulnerable Populations
- White People
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Affiliation(s)
- Gregory P Goldstein
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Vidya V Pai
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Jessica Liu
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
- California Perinatal Quality Care Collaborative, Stanford, USA
| | - Krista Sigurdson
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Lelis B Vernon
- California Perinatal Quality Care Collaborative, Stanford, USA
- Family expert consultant to the Profit Lab at California Perinatal Quality Care Collaborative, Stanford, CA, USA
| | - Henry C Lee
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
- California Perinatal Quality Care Collaborative, Stanford, USA
| | - Karl G Sylvester
- Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Gary M Shaw
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Jochen Profit
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
- California Perinatal Quality Care Collaborative, Stanford, USA.
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14
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Shariff-Marco S, Gomez SL, Canchola AJ, Fullington H, Hughes AE, Hong Zhu, Pruitt SL. Nativity, ethnic enclave residence, and breast cancer survival among Latinas: Variations between California and Texas. Cancer 2020; 126:2849-2858. [PMID: 32181892 PMCID: PMC7245543 DOI: 10.1002/cncr.32845] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/03/2020] [Accepted: 02/25/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Among Latinas with breast cancer, residence in an ethnic enclave may be associated with survival. However, findings from prior studies are inconsistent. METHODS The authors conducted parallel analyses of California and Texas cancer registry data for adult (aged ≥18 years) Latinas who were diagnosed with invasive breast cancer from 1996 to 2005, with follow-up through 2014. Existing indices applied to tract-level 2000 US Census data were used to measure Latinx enclaves and neighborhood socioeconomic status (nSES). Multivariable Cox proportional hazard models were fit for all-cause and breast cancer-specific survival adjusted for year of diagnosis, patient age, nativity (with multiple imputation), tumor stage, histology, grade, size, and clustering by census tract. RESULTS Among 38,858 Latinas, the majority (61.3% in California and 70.5% in Texas) lived in enclaves. In fully adjusted models for both states, foreign-born women were found to be more likely to die of breast cancer and all causes when compared with US-born women. Living in enclaves and in neighborhoods with higher SES were found to be independently associated with improved survival from both causes. When combined into a 4-level variable, those in low nSES nonenclaves had worse survival for both causes compared with those living in low nSES enclaves and, in the all-cause but not breast cancer-specific models, those in high nSES neighborhoods, regardless of enclave status, had improved survival from all causes. CONCLUSIONS Applying the same methods across 2 states eliminated previously published inconsistent associations between enclave residence and breast cancer survival. Future studies should identify specific protective effects of enclave residence to inform interventions.
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Affiliation(s)
- Salma Shariff-Marco
- Greater Bay Area Cancer Registry, San Francisco, CA
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA
- Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, CA
| | - Scarlett Lin Gomez
- Greater Bay Area Cancer Registry, San Francisco, CA
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA
- Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, CA
| | - Alison J. Canchola
- Greater Bay Area Cancer Registry, San Francisco, CA
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA
| | - Hannah Fullington
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Amy E. Hughes
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Hong Zhu
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Harold C. Simmons Cancer Center, Dallas, Texas, USA
| | - Sandi L. Pruitt
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Harold C. Simmons Cancer Center, Dallas, Texas, USA
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15
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Rogers CJ, Forster M, Vetrone S, Unger JB. The role of perceived discrimination in substance use trajectories in Hispanic young adults: A longitudinal cohort study from high school through emerging adulthood. Addict Behav 2020; 103:106253. [PMID: 31869743 DOI: 10.1016/j.addbeh.2019.106253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/31/2019] [Accepted: 12/05/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Associations between discrimination and substance use have been identified cross-sectionally in multiple populations including Hispanics. However, there is limited research exploring this phenomenon longitudinally in Hispanic youth over the transition from adolescence through emerging adulthood (EA). METHODS Hispanic youth in Southern California (n = 1457) completed surveys over 11 years, from 2006 to 2017, including three high school collection waves and five EA collection waves. Multinomial logistic regression models were used to explore the associations between perceived discrimination during high school and cigarette and marijuana use in both high school and EA, controlling for gender, socioeconomic status, acculturation, and EA discrimination. RESULTS Compared with those who never used cigarettes or marijuana in high school and EA, perceived discrimination in high school was a significant predictor of two patterns of use: high school initiators who discontinued use of smoking (RRR = 1.677, 95%CI = 1.292-2.176) and/or marijuana (RRR = 1.464, 95%CI = 1.162-1.844), and high school initiators who continued smoking (RRR = 1.492, 95%CI = 1.196-1.861) and/or marijuana use (RRR = 1.249, 95%CI = 1.052-1.482) into EA. For late initiators who did not use in high school but started in EA, perceived high school discrimination was a significant predictor for cigarette smoking (RRR = 1.193, 95%CI = 1.036-1.373) but not for marijuana use. CONCLUSIONS Perceived discrimination during adolescence is associated with substance use trajectories across both adolescence and EA. Culturally tailored prevention programs that provide training in skills to cope with psychosocial stressors could improve Hispanic adolescent health.
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Affiliation(s)
- Christopher J Rogers
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90033, United States.
| | - Myriam Forster
- Department of Health Sciences, California State University, Northridge. 18111 Nordhoff St., Northridge, CA 91330, United States
| | - Steven Vetrone
- Department of Health Sciences, California State University, Northridge. 18111 Nordhoff St., Northridge, CA 91330, United States
| | - Jennifer B Unger
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90033, United States
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16
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Durazo EM, Haan MN, Dang K, Aiello AE, Torres JM. Nativity, Neighborhoods, and Body Composition in the Sacramento Area Latino Study on Aging. Gerontologist 2020; 60:239-249. [PMID: 31774118 PMCID: PMC7039378 DOI: 10.1093/geront/gnz139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Globally, obesity influences the risk of many major chronic diseases. Our study examines the association between individual nativity and neighborhood level concentration of immigrants with 10-year changes in weight, body mass index (BMI), and waist circumference (WC) among older Latinos. RESEARCH DESIGN AND METHODS The Sacramento Area Latino Study on Aging (SALSA) is a population-based prospective study of community-dwelling older adults of Mexican origin (baseline ages 58-101 years). The primary outcome was repeated measures of weight over a 10-year period for 1,628 respondents. Nativity was defined by participants' reported place of birth (US-born or Latin American foreign born). Neighborhood immigrant concentration was measured as the percentage of foreign born at census tract level (2000 US Census). We used linear mixed models with repeated measures of weight, height, BMI, and WC as dependent variables (level 1), clustered within individuals (level 2) and neighborhood migrant concentration (level 3). RESULTS Foreign born (FB) respondents had lower baseline weight than the US-born (mean, 160 vs. 171 lbs, p < .0001). Over time, weight differences between the FB and the US-born decreased by 1.7 lbs/5 years as US-born weight decreased more rapidly. We observed a significant interaction between individual nativity and neighborhood immigrant concentration (p = .012). We found similar patterns for BMI, but did not find statistically significant differences in WC trajectories. DISCUSSION AND IMPLICATIONS Our study observed significant differences by foreign born vs. US nativity in baseline weight/BMI and in their trajectories over time. Additionally, we found weight/BMI differences in neighborhood immigrant concentration for the FB, but not for the US-born.
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Affiliation(s)
- Eva M Durazo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
- Center for the Study of Adversity and Cardiovascular Disease (NURTURE Center), Division of Cardiology, Department of Medicine, University of California, San Francisco, California
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Kristina Dang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Allison E Aiello
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Jacqueline M Torres
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
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de Smith AJ, Walsh KM, Morimoto LM, Francis SS, Hansen HM, Jeon S, Gonseth S, Chen M, Sun H, Luna-Fineman S, Antillón F, Girón V, Kang AY, Smirnov I, Shao X, Whitehead TP, Barcellos LF, Jolly KW, Healy J, Laverdière C, Sinnett D, Taub JW, Birch JM, Thompson PD, Pombo-de-Oliveira MS, Spector LG, DeWan AT, Mueller BA, Chiang C, Metayer C, Ma X, Wiemels JL. Heritable variation at the chromosome 21 gene ERG is associated with acute lymphoblastic leukemia risk in children with and without Down syndrome. Leukemia 2019; 33:2746-2751. [PMID: 31296947 PMCID: PMC6858994 DOI: 10.1038/s41375-019-0514-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/03/2019] [Accepted: 05/01/2019] [Indexed: 01/07/2023]
Affiliation(s)
- Adam J de Smith
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Kyle M Walsh
- Department of Neurosurgery, Duke University, Durham, NC, USA
- Duke Cancer Institute, Duke University, Durham, NC, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Libby M Morimoto
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Stephen S Francis
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Division of Epidemiology, School of Community Health Sciences, University of Nevada, Reno, NV, USA
| | - Helen M Hansen
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Soyoung Jeon
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Semira Gonseth
- Division of Chronic Disease, Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - Minhui Chen
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hanxiao Sun
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Federico Antillón
- Unidad Nacional de Oncología Pediatrica; and Universidad Francisco Marroquín, Guatemala City, Guatemala
| | - Verónica Girón
- Unidad Nacional de Oncología Pediatrica; and Universidad Francisco Marroquín, Guatemala City, Guatemala
| | - Alice Y Kang
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Ivan Smirnov
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Xiaorong Shao
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Todd P Whitehead
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Lisa F Barcellos
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Kent W Jolly
- Department of Pediatrics, Kaiser Permanente, Roseville, CA, USA
| | - Jasmine Healy
- Sainte-Justine University Health Center, Montreal, QC, Canada
| | | | - Daniel Sinnett
- Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Jeffrey W Taub
- Division of Hematology/Oncology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | | | | | | | - Logan G Spector
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Andrew T DeWan
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Beth A Mueller
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Charleston Chiang
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Catherine Metayer
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Joseph L Wiemels
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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18
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Tanjasiri SP, Mouttapa M, Sablan-Santos L, Weiss JW, Chavarria A, Lacsamana JD, May VT, Quitugua L, Tupua M, Schmidt-Vaivao D. Design and Outcomes of a Community Trial to Increase Pap Testing in Pacific Islander Women. Cancer Epidemiol Biomarkers Prev 2019; 28:1435-1442. [PMID: 31186260 DOI: 10.1158/1055-9965.epi-18-1306] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/08/2019] [Accepted: 06/05/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Pap tests remain an essential cervical cancer detection method in the United States, yet they are underutilized among Pacific Islanders (PI) who experience elevated cervical cancer incidence and mortality. This study describes the design, methods, participants, and outcomes of a multiyear (2010-2016), community-based randomized intervention trial in southern California. Based upon strong collectivistic norms, the trial tested the efficacy of a unique social support intervention targeting Chamorro, Samoan, and Tongan women and their male husbands/partners. METHODS A single-session educational intervention was designed and tailored for ethnic- and gender-specific groups to increase men's social support for their female wives/partners to receive a Pap test, and for women to receive a Pap test. The comparison group received preexisting brochures on Pap testing (for women) or general men's health (for men). Pretest and 6-month follow-up data were analyzed. RESULTS Intervention and comparison groups were mostly equivalent on pretest demographics and outcome variables. Intervention women who were not compliant with Pap screening recommendations at pretest were significantly more likely to have scheduled and received a Pap test at 6-month follow-up. However, 6-month follow-up results indicated no intervention effect on changes in women's Pap testing knowledge, fatalistic attitudes, or perceived social support from their male partner. CONCLUSIONS Ethnic- and gender-tailored community interventions can successfully increase Pap test behaviors for PI women, although more research is needed on the specific pathways leading to behavior change. IMPACT Collaborative community-based interventions lead to increases in women's cancer prevention and early detection for Pacific Islander and other collectivistic communities.
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Affiliation(s)
| | - Michele Mouttapa
- Department of Public Health, California State University, Fullerton
| | | | - Jie W Weiss
- Department of Public Health, California State University, Fullerton
| | | | | | - Vanessa Tuiòne May
- Tongan Community Service Center/Special Service for Groups, Inc., Los Angeles, California
| | | | - Marina Tupua
- Samoan National Nurses Association, Long Beach, California
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Abstract
In this Invited Commentary, the author probes current events overlapping with his early medical education for unwritten lessons. Today's generation of trainees studies the careful application of science to suffering in the roiling context of resurgent white supremacy, anti-immigrant hatred, climate disasters, contentious public health epidemics, and attacks on the structures undergirding access to health care for millions. The author reflects on the connections between sociopolitical events and his own experiences, as well as those of his classmates, friends, and family members. These experiences, he argues, have galvanized his and his fellow medical students' commitment to decency, truth, diversity, and equity. He concludes that, in the current climate, the practice of healing is inextricably tied to the social and political context, such that advocacy and activism have become essential to a career in medicine.
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Affiliation(s)
- Dereck W Paul
- D.W. Paul Jr is an MD candidate, Class of 2021, University of California, San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0001-6099-5933
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20
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Gong S, Wang K, Li Y, Alamian A. The influence of immigrant generation on obesity among Asian Americans in California from 2013 to 2014. PLoS One 2019; 14:e0212740. [PMID: 30794650 PMCID: PMC6386338 DOI: 10.1371/journal.pone.0212740] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 02/10/2019] [Indexed: 12/12/2022] Open
Abstract
Objectives We aimed to examine the association between immigrant generation and obesity among Californian adults and Asian Americans. Methods We pooled weighted data (n = 2,967) on Asian Americans from the 2013–2014 California Health Interview Survey. Overweight and obesity were defined using body mass indices (BMI) of 25 kg/m2 and 30 kg/m2, respectively, in non-Asians, compared with BMI of 23 kg/m2 (for being overweight) and 27.5 kg/m2 (for being obese) in Asians. First-generation or immigrant Asian Americans were defined as those born outside of the U.S. Second-generation Asian Americans were defined as those born in the U.S. with at least one foreign-born parent. All other Asian participants were classified as third-generation or higher. Multiple logistic regression analyses were used with adjustment for age, sex, family income, smoking status, marital status, education, physical activity, and fast food consumption. Results Overall, 23.3% of the Asian population was obese, and 40.0% was overweight. The percentage of 1st, 2nd, and 3rd generation were 72.7%, 22.6%, and 4.6%, respectively. Overall, 1st generation of Asians had lower odds of being obese compared to Whites (OR = 0.34, 95%CI = 0.26–0.45). Multiple logistic regression analyses showed that overall, 2nd generation (OR = 1.69, 95%CI = 1.10–2.60) and 3rd generation (OR = 2.33, 95%CI = 1.29–4.22) Asians had higher odds of being obese compared to 1st generation Asians. Among Chinese, compared to the 1st generation, the 3rd generation had increased likelihood of being obese (OR = 6.29, 95%CI = 2.38–16.6). Conclusion Compared to Whites, Hispanics, and Blacks, Asian immigrants are less likely to be obese. Among Asians, 2nd and 3rd generations were more likely to be obese compared to 1st generation. The obesity rate seems to increase the longer Asian immigrants remain in the U.S.
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Affiliation(s)
- Shaoqing Gong
- Institute of Health Administration and Policy, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi Province, China
- * E-mail:
| | - Kesheng Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, United States of America
| | - Ying Li
- Department of Environment Health, College of Public Health, East Tennessee State University, Johnson City, Tennessee, United States of America
| | - Arsham Alamian
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, United States of America
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21
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Harley KG, Parra KL, Camacho J, Bradman A, Nolan JES, Lessard C, Anderson KA, Poutasse CM, Scott RP, Lazaro G, Cardoso E, Gallardo D, Gunier RB. Determinants of pesticide concentrations in silicone wristbands worn by Latina adolescent girls in a California farmworker community: The COSECHA youth participatory action study. Sci Total Environ 2019; 652:1022-1029. [PMID: 30380470 PMCID: PMC6309742 DOI: 10.1016/j.scitotenv.2018.10.276] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [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: 05/25/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 05/18/2023]
Abstract
Personal exposure to pesticides has not been well characterized, especially among adolescents. We used silicone wristbands to assess pesticide exposure in 14 to 16 year old Latina girls (N = 97) living in the agricultural Salinas Valley, California, USA and enrolled in the COSECHA (CHAMACOS of Salinas Examining Chemicals in Homes and Agriculture) Study, a youth participatory action study in an agricultural region of California. We determined pesticide concentrations (ng/g/day) in silicone wristbands worn for one week using gas chromatography electron capture detection and employed gas chromatography mass spectrometry to determine the presence or absence of over 1500 chemicals. Predictors of pesticide detections and concentrations were identified using logistic regression, Wilcoxon rank sum tests, and Tobit regression models. The most frequently detected pesticides in wristbands were fipronil sulfide (87%), cypermethrin (56%), dichlorodiphenyldichloroethylene (DDE) (56%), dacthal (53%), and trans-permethrin (52%). Living within 100 m of active agricultural fields, having carpeting in the home, and having an exterminator treat the home in the past six months were associated with higher odds of detecting certain pesticides. Permethrin concentrations were lower for participants who cleaned their homes daily (GM: 1.9 vs. 6.8 ng/g/day, p = 0.01). In multivariable regression models, participants with doormats in the entryway of their home had lower concentrations (p < 0.05) of cypermethrin (87%), permethrin (99%), fipronil sulfide (69%) and DDE (75%). The results suggest that both nearby agricultural pesticide use and individual behaviors are associated with pesticide exposures.
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Affiliation(s)
- Kim G Harley
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Ave Suite 265, Berkeley, CA 94704, USA.
| | - Kimberly L Parra
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Ave Suite 265, Berkeley, CA 94704, USA
| | - Jose Camacho
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Ave Suite 265, Berkeley, CA 94704, USA
| | - Asa Bradman
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Ave Suite 265, Berkeley, CA 94704, USA
| | - James E S Nolan
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Ave Suite 265, Berkeley, CA 94704, USA
| | - Chloe Lessard
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Ave Suite 265, Berkeley, CA 94704, USA
| | - Kim A Anderson
- Department of Environmental and Molecular Toxicology, Oregon State University, 2750 SW Campus Way, Corvallis, OR 97331, USA
| | - Carolyn M Poutasse
- Department of Environmental and Molecular Toxicology, Oregon State University, 2750 SW Campus Way, Corvallis, OR 97331, USA
| | - Richard P Scott
- Department of Environmental and Molecular Toxicology, Oregon State University, 2750 SW Campus Way, Corvallis, OR 97331, USA
| | - Giselle Lazaro
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Ave Suite 265, Berkeley, CA 94704, USA
| | - Edgar Cardoso
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Ave Suite 265, Berkeley, CA 94704, USA
| | - Daisy Gallardo
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Ave Suite 265, Berkeley, CA 94704, USA
| | - Robert B Gunier
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Ave Suite 265, Berkeley, CA 94704, USA
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Luna JA, Moore RS, Calac DJ, Grube JW, McGaffigan RP. Practices Surrounding Pain Management Among American Indians and Alaska Natives in Rural Southern California: An Exploratory Study. J Rural Health 2019; 35:133-138. [PMID: 30288803 PMCID: PMC6298821 DOI: 10.1111/jrh.12327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Received: 03/18/2018] [Revised: 09/12/2018] [Accepted: 09/16/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This exploratory study examined pain management practices among American Indians and Alaska Natives in the service area of a rural tribal clinic in Southern California. METHODS Researchers invited 325 individuals to complete an anonymous survey in clinic waiting rooms and tribal gatherings. Analyses of the 295 eligible responses included calculating frequencies and conducting multiple logistic regressions and a Mantel-Haenszel analysis. RESULTS Among respondents in this study, being male, younger, and having less education were strong predictors for riskier methods for managing pain. CONCLUSIONS Understanding the methods individuals use to manage pain in a rural setting constitute a stepping-stone to develop strategies for reducing and preventing misuse and abuse of prescription medications and other drugs in rural American Indian and Alaska Native communities.
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Affiliation(s)
- Juan A.A. Luna
- Southern California Tribal Health Clinic, Southern California, California
| | - Roland S. Moore
- Pacific Institute for Research and Evaluation, Berkeley, California
| | - Daniel J. Calac
- Southern California Tribal Health Clinic, Southern California, California
| | - Joel W. Grube
- Pacific Institute for Research and Evaluation, Berkeley, California
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23
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de Smith AJ, Walsh KM, Francis SS, Zhang C, Hansen HM, Smirnov I, Morimoto L, Whitehead TP, Kang A, Shao X, Barcellos LF, McKean-Cowdin R, Zhang L, Fu C, Wang R, Yu H, Hoh J, Dewan AT, Metayer C, Ma X, Wiemels JL. BMI1 enhancer polymorphism underlies chromosome 10p12.31 association with childhood acute lymphoblastic leukemia. Int J Cancer 2018; 143:2647-2658. [PMID: 29923177 PMCID: PMC6235695 DOI: 10.1002/ijc.31622] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/10/2018] [Accepted: 05/14/2018] [Indexed: 01/07/2023]
Abstract
Genome-wide association studies of childhood acute lymphoblastic leukemia (ALL) have identified regions of association at PIP4K2A and upstream of BMI1 at chromosome 10p12.31-12.2. The contribution of both loci to ALL risk and underlying functional variants remain to be elucidated. We carried out single nucleotide polymorphism (SNP) imputation across chromosome 10p12.31-12.2 in Latino and non-Latino white ALL cases and controls from two independent California childhood leukemia studies, and additional Genetic Epidemiology Research on Aging study controls. Ethnicity-stratified association analyses were performed using logistic regression, with meta-analysis including 3,133 cases (1,949 Latino, 1,184 non-Latino white) and 12,135 controls (8,584 Latino, 3,551 non-Latino white). SNP associations were identified at both BMI1 and PIP4K2A. After adjusting for the lead PIP4K2A SNP, genome-wide significant associations remained at BMI1, and vice-versa (pmeta < 10-10 ), supporting independent effects. Lead SNPs differed by ethnicity at both peaks. We sought functional variants in tight linkage disequilibrium with both the lead Latino SNP among Admixed Americans and lead non-Latino white SNP among Europeans. This pinpointed rs11591377 (pmeta = 2.1 x 10-10 ) upstream of BMI1, residing within a hematopoietic stem cell enhancer of BMI1, and which showed significant preferential binding of the risk allele to MYBL2 (p = 1.73 x 10-5 ) and p300 (p = 1.55 x 10-3 ) transcription factors using binomial tests on ChIP-Seq data from a SNP heterozygote. At PIP4K2A, we identified rs4748812 (pmeta = 1.3 x 10-15 ), which alters a RUNX1 binding motif and demonstrated chromosomal looping to the PIP4K2A promoter. Fine-mapping chromosome 10p12 in a multi-ethnic ALL GWAS confirmed independent associations and identified putative functional variants upstream of BMI1 and at PIP4K2A.
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Affiliation(s)
- Adam J. de Smith
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94158
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, CA 90033
| | - Kyle M. Walsh
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94158
- Department of Neurosurgery, Duke University, Durham, NC 27710
| | - Stephen S. Francis
- Department of Epidemiology, School of Community Health Sciences, University of Nevada Reno, Reno, NV 89557
| | - Chenan Zhang
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94158
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94158
| | - Helen M. Hansen
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94158
| | - Ivan Smirnov
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94158
| | - Libby Morimoto
- School of Public Health, University of California Berkeley, Berkeley, CA 94720
| | - Todd P. Whitehead
- School of Public Health, University of California Berkeley, Berkeley, CA 94720
| | - Alice Kang
- School of Public Health, University of California Berkeley, Berkeley, CA 94720
| | - Xiaorong Shao
- School of Public Health, University of California Berkeley, Berkeley, CA 94720
| | - Lisa F. Barcellos
- School of Public Health, University of California Berkeley, Berkeley, CA 94720
| | - Roberta McKean-Cowdin
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, CA 90033
| | - Luoping Zhang
- School of Public Health, University of California Berkeley, Berkeley, CA 94720
| | - Cecilia Fu
- Children’s Hospital of Los Angeles, Los Angeles, CA 90027
| | - Rong Wang
- Department of Chronic Diseases Epidemiology, School of Public Health, Yale University, New Haven, CT 06520
| | - Herbert Yu
- University of Hawaii Cancer Center, Honolulu, HI 96813
| | - Josephine Hoh
- Department of Chronic Diseases Epidemiology, School of Public Health, Yale University, New Haven, CT 06520
| | - Andrew T. Dewan
- Department of Chronic Diseases Epidemiology, School of Public Health, Yale University, New Haven, CT 06520
| | - Catherine Metayer
- School of Public Health, University of California Berkeley, Berkeley, CA 94720
| | - Xiaomei Ma
- Department of Chronic Diseases Epidemiology, School of Public Health, Yale University, New Haven, CT 06520
| | - Joseph L. Wiemels
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94158
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, CA 90033
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94158
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24
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Montanari S, Mayr R, Subrahmanyam K. Bilingual Speech Sound Development During the Preschool Years: The Role of Language Proficiency and Cross-Linguistic Relatedness. J Speech Lang Hear Res 2018; 61:2467-2486. [PMID: 30458530 PMCID: PMC10568612 DOI: 10.1044/2018_jslhr-s-17-0393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 03/05/2018] [Accepted: 05/16/2018] [Indexed: 06/09/2023]
Abstract
Purpose The purpose of this study was to investigate typical Spanish-English speech sound development longitudinally in a group of bilingual preschoolers enrolled in a Head Start Program and to examine the extent to which such development is linked to language proficiency. The study also aimed to identify whether speech development is related cross-linguistically and to improve our understanding of error patterns in this population. Method Thirty-five bilingual preschool children produced single-word speech samples in Spanish and English both at the beginning of their first and their second year in a Head Start Program. Conversational samples in both languages were also collected at these data points to calculate mean length of utterance in words (MLUw) and thus assess the children's linguistic proficiency. The phonetically transcribed speech samples were compared over time in terms of segmental accuracy measures and error pattern frequencies. Correlation analyses were run to examine the relation between segmental accuracy measures across languages and between speech sound production and MLUw. Results One-way within-subject analysis of variance revealed significant improvements in accuracy over time in both languages, but not always for cross-linguistically unshared segments, nor for all consonant manner classes. Overall error rates decreased over time in both languages; although, certain error types showed no change. Cross-linguistic interactions were low in both languages. The results also revealed significant cross-linguistic correlations in segmental accuracy between Spanish and English, as well as between MLUw and speech sound production in both languages on a range of measures, with language-specific differences in Year 2 of the Head Start Program, but not in Year 1. Conclusions This study is the first to document developmental changes in the speech patterns of Spanish-English bilingual preschool children over 1 year. Accuracy rates improved significantly in both languages, suggesting that enhanced exposure to the majority language at school may not impede phonological development in the home language. Bootstrapping effects were particularly pronounced on cross-linguistically shared sounds, which suggests that the same underlying skills are utilized in both languages, whereas language-specific singleton consonants and consonant clusters did not appear to benefit from exposure to the other language. The results also suggest an intricate link between phonological skills and morphosyntactic performance at the early stages of development, but a more complex pattern thereafter with differences that may be based on language-specific phonological properties.
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Affiliation(s)
| | - Robert Mayr
- Cardiff Metropolitan University, United Kingdom
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25
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Tanjasiri SP, Wiersma LD, Moy KL, McEligot A. Physical Activity, Nutrition, and Obesity among Pacific Islander Youth and Young Adults in Southern California: An Exploratory Study. Hawaii J Med Public Health 2018; 77:251-258. [PMID: 30324003 PMCID: PMC6176268] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This exploratory study aimed to assess obesity, physical activity, and nutrition among Pacific Islander youth and young adults in Southern California. A total of 129 Tongan, Samoan, and Marshallese participated in the study, including relatively similar proportions of males and females and age groups. We calculated Body Mass Index (BMI), dietary intake by a food frequency questionnaire (FFQ), and 7-day physical activity levels with accelerometers. Overall, 84% of Tongan, 76% of Samoan, and 24% of Marshallese participants were overweight or obese, with mean BMI of 31.2 and 34.3 kg/m2 (for Tongan males and females), 32.3 and 33.4 kg/m2 (Samoan males and females), and 25.3 and 22.1 kg/m2 (Marshallese males and females). We found moderate- and vigorous-intensity physical activity (MVPA) fell below current guidelines at 38 min/day, with over 87% engaging in light-intensity PA and large sedentary times. Daily percent of energy from saturated fat, fiber/1,000 kcal and dairy intake were higher in Tongans compared to Samoans and Marshallese. Despite promising outcomes from this study, high prevalence of overweight, low physical activity levels, and high caloric intake put Pacific Islander youth and young adults at risk for a variety of health concerns and future efforts should focus on further research as well as community-wide prevention and amelioration efforts.
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Affiliation(s)
- Sora P Tanjasiri
- Department of Epidemiology, California State University, Fullerton, Fullerton, CA (SPT)
- Department of Health Science, California State University, Fullerton, Fullerton, CA (AM)
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA (LDW)
- Walk San Diego, San Diego, CA (KLM)
| | - Lenny D Wiersma
- Department of Epidemiology, California State University, Fullerton, Fullerton, CA (SPT)
- Department of Health Science, California State University, Fullerton, Fullerton, CA (AM)
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA (LDW)
- Walk San Diego, San Diego, CA (KLM)
| | - Karen L Moy
- Department of Epidemiology, California State University, Fullerton, Fullerton, CA (SPT)
- Department of Health Science, California State University, Fullerton, Fullerton, CA (AM)
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA (LDW)
- Walk San Diego, San Diego, CA (KLM)
| | - Archana McEligot
- Department of Epidemiology, California State University, Fullerton, Fullerton, CA (SPT)
- Department of Health Science, California State University, Fullerton, Fullerton, CA (AM)
- Department of Kinesiology, California State University, Fullerton, Fullerton, CA (LDW)
- Walk San Diego, San Diego, CA (KLM)
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Mooney AC, McConville S, Rappaport AJ, Hsia RY. Association of Legal Intervention Injuries With Race and Ethnicity Among Patients Treated in Emergency Departments in California. JAMA Netw Open 2018; 1:e182150. [PMID: 30646155 PMCID: PMC6324617 DOI: 10.1001/jamanetworkopen.2018.2150] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE Increased public concern regarding police use of force has coincided with a dearth of available data to uncover the magnitude and trends in injuries, particularly across race or ethnicity. OBJECTIVE To examine trends in injury rates, severity, and disparities across black individuals, white individuals, Hispanic individuals, and Asian/Pacific Islander individuals. DESIGN, SETTING, AND PARTICIPANTS In this retrospective, cross-sectional study, data collected on every hospital visit in California from January 1, 2005, to September 30, 2015, were used to model trends in rates of legal intervention injuries (n = 92 386) per capita and per arrest for men aged 14 to 64 years, by race or ethnicity. The study also examined descriptive statistics on injury dispositions to assess changes in severity. Analyses were conducted between December 2017 and June 2018. MAIN OUTCOMES AND MEASURES All visits with an external cause of injury code of E970 to E977 were classified as legal intervention injuries. This range of codes includes injuries inflicted by the police or other law-enforcing agents in the course of arresting or attempting to arrest lawbreakers, suppressing disturbances, maintaining order, and other legal action. RESULTS The study identified a total of 92 386 hospital visits that were the result of legal intervention among males aged 14 to 64 years. Black individuals were at the highest risk of legal intervention injury per capita in 2005 (for black vs white individuals, rate ratio, 2.90; 95% CI, 2.74-3.06), and remained so across the study period. Although rates among Asian/Pacific Islander individuals remained stable, rates in all other groups increased from 2005 to 2009 and then declined from 2009 to 2015, nearly returning to 2005 levels. During the period of increasing rates, the black to white disparity widened by 3% annually (rate ratio, 1.03; 95% CI, 1.01-1.05), then narrowed as rates declined. In contrast, rates of injury per arrest have increased over the past decade, although rates were broadly similar across race or ethnicity. The proportion of injuries involving firearms (ie, shootings by police) declined from 7.0% in 2005 and 2006 to 3.7% in 2014 and 2015. CONCLUSIONS AND RELEVANCE States with central repositories for hospital visits offer data sources to illuminate the public health problem of legal intervention injuries, and warrant greater attention to ensure consistent coding for complete capture.
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Affiliation(s)
- Alyssa C. Mooney
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | | | | | - Renee Y. Hsia
- Department of Emergency Medicine, University of California, San Francisco
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
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Felicitas-Perkins JQ, Sakuma KLK, Blanco L, Fagan P, Pérez-Stable EJ, Bostean G, Xie B, Trinidad DR. Smoking Among Hispanic/Latino Nationality Groups and Whites, Comparisons Between California and the United States. Nicotine Tob Res 2018; 20:1085-1094. [PMID: 29059350 PMCID: PMC6093426 DOI: 10.1093/ntr/ntx191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 08/25/2017] [Indexed: 11/14/2022]
Abstract
Introduction Although California is home to the largest Hispanic/Latino population, few studies have compared smoking behavior trends of Hispanic/Latino nationality groups in California to the remaining United States, which may identify the impact of the states antitobacco efforts on these groups. This study compared smoking status, frequency, and intensity among Mexican Americans, Central/South Americans, and non-Hispanic Whites in California to the remaining United States in the 1990s and 2000s. Methods Data were analyzed using the 1992-2011 Current Population Survey Tobacco Use Supplement to report the estimated prevalence of smoking status, frequency, and intensity by decade, race/ethnicity, and state residence. Weighted logistic regression explored sociodemographic factors associated with never and heavy smoking (≥20 cigarettes per day). Results There were absolute overall increases from 6.8% to 9.6% in never smoking across all groups. Compared to the remaining United States, there was a greater decrease in heavy smoking among Mexican American current smokers in California (5.1%) and a greater increase in light and intermittent smokers among Central/South American current smokers in California (9.3%) between decades. Compared to those living in the remaining United States, smokers living in California had lower odds of heavy smoking (1990s: odds ratio [OR] = 0.64, 95% confidence interval [CI] = 0.62, 0.66; 2000s: 0.54, 95% CI = 0.52, 0.55). Conclusions California state residence significantly impacted smoking behaviors as indicated by significant differences in smoking intensity between California and the remaining United States among Hispanic/Latino nationality groups. Understanding smoking behaviors across Hispanic/Latino nationality groups in California and the United States can inform tobacco control and smoking prevention strategies for these groups. Implications The present study explored the differences in smoking behaviors between Whites, Mexican Americans, and Central South/Americans living in California versus the rest of the United States in the 1990s and the 2000s. The results contribute to our current knowledge as there have been minimal efforts to provide disaggregated cigarette consumption information among Hispanic/Latino nationality groups. Additionally, by comparing cigarette consumption between those in California and the remaining United States, our data may provide insight into the impact of California's antitobacco efforts in reaching Hispanic/Latino subpopulations relative to the remaining US states, many of which have had less tobacco control policy implementation.
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Affiliation(s)
| | - Kari-Lyn K Sakuma
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Lyzette Blanco
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
- Lyzette Blanco is now at Touro University Worldwide, Los Alamitos, CA, USA
| | - Pebbles Fagan
- Cancer Center, University of Hawaii, Honolulu, HI
- Pebbles Fagan is now at College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Eliseo J Pérez-Stable
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Georgiana Bostean
- Department of Sociology and Environmental Science & Policy, Chapman University, Orange, CA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Dennis R Trinidad
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA
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Cabeza de Baca T, Wojcicki JM, Epel ES, Adler NE. Lack of partner impacts newborn health through maternal depression: A pilot study of low-income immigrant Latina women. Midwifery 2018; 64:63-68. [PMID: 29990627 DOI: 10.1016/j.midw.2018.05.014] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/23/2018] [Accepted: 05/30/2018] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Latina women have a high burden of depression and other mental health issues, particularly in the perinatal period. Suboptimal maternal mental health can have adverse developmental and physiological impacts on child growth. The present study examines the impact of unplanned pregnancy and pregnancy relationship status on prenatal maternal depression in a sample of low-income Latina women. We hypothesized that the association between these prenatal stressors and newborn health would be mediated through prenatal depression. METHOD The present study included a sample 201 Latina mothers and their children recruited from prenatal clinics during their second or third trimesters. Depression symptomology, relationship status were collected prenatally. At birth, several indices of newborn health were examined, including head circumference percentile and birthweight. Finally, planned pregnancy status was retrospectively collected when the child was between 1 and 2 years old. RESULTS Structural equation modelling revealed that single women, compared to partnered women, had higher levels of depression. Higher levels of depression, in turn, predicted poorer newborn health. Unplanned pregnancy was not significantly associated with newborn health. DISCUSSION These results suggest that relationship status may be an important screening question for medical examiners to ask to pregnant Latina women during prenatal visits. These results are consistent with past research investigating the effects of maternal mental health on adverse birth outcomes that propose that stressful early environments shape developmental trajectories.
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Affiliation(s)
- Tomás Cabeza de Baca
- Division of Cardiology, Department of Medicine, University of California, San Francisco, 400 Parnassus Ave, Room AC-16, Box 0369, San Francisco, CA 94143, USA.
| | - Janet M Wojcicki
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California, San Francisco, 550 16th Street, San Francisco CA 94158, USA.
| | - Elissa S Epel
- Department of Psychiatry, University of California, San Francisco, USA
| | - Nancy E Adler
- Center for Health and Community, Department of Psychiatry, University of California, San Francisco, USA
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Abstract
This study investigated mental health indicators, substance use, and their relationships, by race/ethnicity. A probability sample of 1,053 students at two California universities self-reported their frequency of substance use and rated their experience with indicators of mental health. One-way analysis of variance (ANOVA), chi-square tests, and multivariate censored regression models were estimated to examine which indicators of mental health were associated with each substance use form by race/ethnicity. Results from the one-way ANOVA and chi-square tests showed differences in substance use prevalence and mental health by race/ethnicity. For example, students who identified as White demonstrate a higher prevalence for every form of substance use in comparison to the Asian, Latino, and "All other" categories. Results from the regression showed, among Whites, inattention was associated with prescription stimulant misuse, and psychological distress was associated with marijuana use. Among Latinos, inattention was associated with cocaine and prescription stimulant use. Among Asians, psychological distress was associated with tobacco use and the misuse of prescription painkillers. Findings highlight the need to ensure subpopulations receive needed services.
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Affiliation(s)
| | - Sheena Cruz
- a California State University , Long Beach , California
| | | | - Summer Takeda
- a California State University , Long Beach , California
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Mungas D, Early DR, Glymour MM, Al Hazzouri AZ, Haan MN. Education, bilingualism, and cognitive trajectories: Sacramento Area Latino Aging Study (SALSA). Neuropsychology 2018; 32:77-88. [PMID: 28967765 PMCID: PMC5814330 DOI: 10.1037/neu0000356] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 11/08/2022] Open
Abstract
OBJECTIVE This study examined the influence of education, country where education occurred, and monolingual-bilingual (English/Spanish) language usage on late life cognitive trajectories in the Sacramento Area Latino Study on Aging (SALSA), an epidemiological study of health and cognition in Hispanics, mostly of Mexican origin, age 60 and over (N = 1,499). METHOD SALSA followed a large cohort of older Latinos for up to 7 assessment waves from 1998 to 2007. Global cognition was assessed by using the Modified Mini Mental State Examination, and the Spanish English Verbal Learning Test was used to measure episodic memory. Education, country of origin, and language usage patterns were collected at the baseline assessment and used as predictors of longitudinal trajectories of cognition. Parallel process mixed effects models were used to examine effects of education and language variables on baseline cognition and rate of cognitive decline. RESULTS Mixed effects longitudinal models showed that education had strong effects on baseline global cognition and verbal memory but was not related to decline over up to 9 years of longitudinal follow-up. Differences in education effects between subgroups educated in Mexico and in the United States were minor. Monolingual-bilingual language usage was not related to cognitive decline, and bilinguals did not significantly differ from monolingual English speakers on baseline cognitive scores. CONCLUSIONS Hypotheses that higher education and bilingualism protect against late life cognitive decline were not supported and education effects on late-life cognitive trajectories did not substantially differ across U.S.- and Mexico-educated groups. (PsycINFO Database Record
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Affiliation(s)
- Dan Mungas
- Department of Neurology, University of California, Davis, Davis, CA
| | - Dawnté R. Early
- Department of Neurology, University of California, Davis, Davis, CA
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | | | - Mary N. Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
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31
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Martínez ME, Gomez SL, Tao L, Cress R, Rodriguez D, Unkart J, Schwab R, Nodora JN, Cook L, Komenaka I, Li C. Contribution of clinical and socioeconomic factors to differences in breast cancer subtype and mortality between Hispanic and non-Hispanic white women. Breast Cancer Res Treat 2017; 166:185-193. [PMID: 28698973 PMCID: PMC5647237 DOI: 10.1007/s10549-017-4389-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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] [Received: 03/27/2017] [Accepted: 07/07/2017] [Indexed: 01/07/2023]
Abstract
PURPOSE To assess tumor subtype distribution and the relative contribution of clinical and sociodemographic factors on breast cancer survival between Hispanic and non-Hispanic whites (NHWs). METHODS We analyzed data from the California Cancer Registry, which included 29,626 Hispanic and 99,862 NHW female invasive breast cancer cases diagnosed from 2004 to 2014. Logistic regression was used to assess ethnic differences in tumor subtype, and Cox proportional hazard modeling to assess differences in breast cancer survival. RESULTS Hispanics compared to NHWs had higher odds of having triple-negative (OR = 1.29; 95% CI 1.23-1.35) and HER2-overexpressing tumors (OR = 1.19; 95% CI 1.14-1.25 [HR-] and OR = 1.39; 95% CI 1.31-1.48 [HR+]). In adjusted models, Hispanic women had a higher risk of breast cancer mortality than NHW women (mortality rate ratio [MRR] = 1.24; 95% CI 1.19-1.28). Clinical factors accounted for most of the mortality difference (MRR = 1.05; 95% CI 1.01-1.09); however, neighborhood socioeconomic status (SES) and health insurance together accounted for all of the mortality difference (MRR = 1.01; 95% CI 0.97-1.05). CONCLUSIONS Addressing SES disparities, including increasing access to health care, may be critical to overcoming poorer breast cancer outcomes in Hispanics.
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Affiliation(s)
- María Elena Martínez
- Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Dr., #0901, La Jolla, CA, 92093-0829, USA.
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA.
| | - Scarlett L Gomez
- Cancer Prevention Institute of California, Fremont, CA, USA
- Stanford Cancer Institute, Palo Alto, CA, USA
| | - Li Tao
- Cancer Prevention Institute of California, Fremont, CA, USA
| | - Rosemary Cress
- California Cancer Registry, Public Health Institute, Sacramento, CA, USA
| | - Danielle Rodriguez
- California Cancer Registry, Public Health Institute, Sacramento, CA, USA
| | - Jonathan Unkart
- Department of Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Richard Schwab
- Department of Internal Medicine, University of New Mexico and the University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Jesse N Nodora
- Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Dr., #0901, La Jolla, CA, 92093-0829, USA
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Linda Cook
- Department of Internal Medicine, University of New Mexico and the University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Ian Komenaka
- Maricopa Medical Center, Department of Surgery, Phoenix, AZ, USA
| | - Christopher Li
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Saw A, Tang H, Tsoh JY, Chen MS, Tong EK. Non-smoker assertive behaviour against smoke exposure: Chinese and Korean American non-smokers. Drug Alcohol Rev 2017; 36:779-787. [PMID: 28439993 PMCID: PMC5656557 DOI: 10.1111/dar.12557] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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] [Received: 06/29/2016] [Revised: 03/03/2017] [Accepted: 03/16/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Non-smokers' assertive behaviour towards smokers by asking them not to smoke is important in promoting smoke-free environments. Korean and Chinese Americans come from countries where most women are non-smokers and assertive behaviour may not be prevalent but may increase after migration because of social-ecological factors. This study assessed the extent to which Korean and Chinese American non-smokers ask someone not to smoke and associated factors. DESIGN AND METHODS The 2003 California Chinese American and Korean American Tobacco Use Surveys were analysed. Multivariate logistic regression analyses examined factors related to non-smoker self-reports that they asked someone not to smoke within the past year. RESULTS About 40% reported past-year assertive behaviour against smoking, with higher rates among Koreans than Chinese (60.4% vs. 34.5%), those living with smokers (63.5%), ever exposed with a smoke-free home rule (62.3%), recently exposed at work without a smoke-free work policy (67.6%) and regularly exposed at other locations (52.3%). In combined multivariate analyses of both ethnic groups, assertive behaviour was associated with individual factors (single vs. married; tobacco exposure knowledge), family factors (living with smokers, exposed at home despite a smoke-free rule), community factors (exposed at work with no smoke-free policy, exposed at other locations) and cultural factors (Korean vs. Chinese ethnicity; lower acculturation). DISCUSSION AND CONCLUSIONS Chinese and Korean American non-smokers report assertive behaviour against smoking, which is associated with social-ecological factors. Results help identify target groups and strategies for future intervention, including the need to implement or enforce smoke-free environments and promote empowerment. [Saw A, Tang H, Tsoh JY, Chen MS Jr, Tong EK. Non-smoker assertive behaviour against smoke exposure: Chinese and Korean American non-smokers.
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Affiliation(s)
- Anne Saw
- Department of Psychology, DePaul University, Chicago, USA
| | - Hao Tang
- Genetic Disease Screening Program, California Department of Public Health, Richmond, USA
| | - Janice Y. Tsoh
- Department of Psychiatry, University of California, San Francisco, USA
| | - Moon S. Chen
- Department of Internal Medicine, University of California Davis, Sacramento, USA
| | - Elisa K. Tong
- Department of Internal Medicine, University of California Davis, Sacramento, USA
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Montag AC, Dusek ML, Ortega ML, Camp-Mazzetti A, Calac DJ, Chambers CD. Tailoring an Alcohol Intervention for American Indian Alaska Native Women of Childbearing Age: Listening to the Community. Alcohol Clin Exp Res 2017; 41:1938-1945. [PMID: 28833270 DOI: 10.1111/acer.13485] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 08/17/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reduction of risky drinking in women of childbearing age is 1 strategy that may be employed to prevent fetal alcohol spectrum disorder, a sequela of prenatal alcohol exposure. Communities differ in risk and protective factors, necessitating culturally informed interventions for maximal efficacy. This article describes the modification of an existing web-based screening, brief intervention, and referral to treatment intervention to reduce risky drinking among American Indian Alaska Native (AIAN) women of childbearing age in Southern California into a peer-to-peer-based intervention using motivational interviewing (MI). METHODS The modification process was iterative and included various community focus groups, interviews, and a final review. RESULTS Intervention modification was required for cultural congruence. Components of the peer-to-peer intervention designed by this project included a flip chart used to guide the motivational interviewing, charts of the financial and physical costs of alcohol consumption, revised baseline and follow-up questionnaires, and guidance regarding the application of MI techniques. CONCLUSIONS This study may inform the modification of future interventions among AIAN communities.
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Affiliation(s)
- Annika C Montag
- Department of Pediatrics , University of California San Diego, San Diego, California
| | - Marlené L Dusek
- Southern California Tribal Health Clinic , San Diego, California
| | - Marina L Ortega
- Southern California Tribal Health Clinic , San Diego, California
| | | | - Dan J Calac
- Southern California Tribal Health Clinic , San Diego, California
| | - Christina D Chambers
- Department of Pediatrics , University of California San Diego, San Diego, California
- Department Family Medicine and Public Health , University of California San Diego, San Diego, California
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Benmarhnia T, Huang J, Basu R, Wu J, Bruckner TA. Decomposition Analysis of Black-White Disparities in Birth Outcomes: The Relative Contribution of Air Pollution and Social Factors in California. Environ Health Perspect 2017; 125:107003. [PMID: 28977781 PMCID: PMC5933346 DOI: 10.1289/ehp490] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 12/16/2016] [Accepted: 01/03/2017] [Indexed: 05/24/2023]
Abstract
BACKGROUND Racial/ethnic disparities in preterm birth (PTB) are well documented in the epidemiological literature, but little is known about the relative contribution of different social and environmental determinants of such disparities in birth outcome. Furthermore, increased focus has recently turned toward modifiable aspects of the environment, including physical characteristics, such as neighborhood air pollution, to reduce disparities in birth outcomes. OBJECTIVES To apply decomposition methods to understand disparities in preterm birth (PTB) prevalence between births of non-Hispanic black individuals and births of non-Hispanic white individuals in California, according to individual demographics, neighborhood socioeconomic environment, and neighborhood air pollution. METHODS We used all live singleton births in California spanning 2005 to 2010 and estimated PTBs and other adverse birth outcomes for infants borne by non-Hispanic black mothers and white mothers. To compare individual-level, neighborhood-level, and air pollution [Particulate Matter, 2.5 micrometers or less (PM2.5) and nitrogen dioxide (NO2)] predictors, we conducted a nonlinear extension of the Blinder-Oaxaca method to decompose racial/ethnic disparities in PTB. RESULTS The predicted differences in probability of PTB between black and white infants was 0.056 (95% CI: 0.054, 0.058). All included predictors explained 37.8% of the black-white disparity. Overall, individual (17.5% for PTB) and neighborhood-level variables (16.1% for PTB) explained a greater proportion of the black-white difference in birth outcomes than air pollution (5.7% for PTB). CONCLUSIONS Our results suggest that, although the role of individual and neighborhood factors remains prevailing in explaining black-white differences in birth outcomes, the individual contribution of PM2.5 is comparable in magnitude to any single individual- or neighborhood-level factor. https://doi.org/10.1289/EHP490.
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Affiliation(s)
- Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography , University of California
| | - Jonathan Huang
- Institute for Health and Social Policy, McGill University Montreal , Quebec, Canada
| | - Rupa Basu
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency , Oakland, California, USA
| | - Jun Wu
- Program in Public Health, University of California, Irvine , Irvine, California, USA
| | - Tim A Bruckner
- Program in Public Health, University of California, Irvine , Irvine, California, USA
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Sanossian N, Rosenberg L, Liebeskind DS, Starkman S, Eckstein M, Stratton S, Pratt FD, Hamilton S, Kim-Tenser M, Sharma LK, Restrepo L, Valdes-Suieras M, Conwit R, Saver JL. A Dedicated Spanish Language Line Increases Enrollment of Hispanics Into Prehospital Clinical Research. Stroke 2017; 48:1389-1391. [PMID: 28389617 DOI: 10.1161/strokeaha.117.014745] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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] [Received: 01/09/2017] [Revised: 01/09/2017] [Accepted: 02/07/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Novel methods are needed to reduce the disparity of Hispanic enrollment in stroke clinical trials. Prehospital enrollment using a dedicated Spanish language line may help overcome this bias. METHODS Subjects or legally authorized representatives provided information on race and ethnicity for all cases enrolled in the FAST-MAG clinical trial (Field Administration of Stroke Therapy-Magnesium), a prehospital phase 3 randomized study of intravenous magnesium for neuroprotection. One of 2 in-ambulance cell phones (in English or Spanish) was used to obtain informed content in the field. We describe the yield and characteristics of subjects enrolled via Spanish line. RESULTS There were 1700 subjects enrolled from 2005 to 2012, of which 402 (24%) identified as Hispanic ethnicity. Study racial makeup was 1325 (78%) white, 219 (13%) black, and 139 (8%) Asian. The dedicated Spanish line was used for 195 (12%) enrollments. Spanish-line enrollments were younger (65 versus 70 years old; P<0.001), more likely to identify as Hispanic (98% versus 14%; P<0.001), and more likely to present with intracerebral hemorrhage (36% versus 21%; P<0.001). CONCLUSIONS The use of a dedicated Spanish language enrollment line allowed for greater enrollment of Hispanics, a population with significantly different baseline characteristics. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00059332.
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Affiliation(s)
- Nerses Sanossian
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.).
| | - Lauren Rosenberg
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - David S Liebeskind
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - Sidney Starkman
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - Marc Eckstein
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - Samuel Stratton
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - Franklin D Pratt
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - Scott Hamilton
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - May Kim-Tenser
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - Latisha K Sharma
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - Lucas Restrepo
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - Miguel Valdes-Suieras
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - Robin Conwit
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
| | - Jeffrey L Saver
- From the Departments of Neurology (N.S., L.R., M.K.-T.) and Emergency Medicine (M.E.), University of Southern California, Los Angeles; UCLA Stroke Center, Los Angeles, CA (D.S.L., S.S., L.K.S., L.R., M.V.-S., J.L.S.); School of Public Health, University of California Los Angeles (S.S.); Los Angeles County Fire Department, CA (F.D.P.); Stanford University, CA (S.H.); and National Institutes of Health, Bethesda, MD (R.C.)
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Asiodu IV, Waters CM, Dailey DE, Lyndon A. Infant Feeding Decision-Making and the Influences of Social Support Persons Among First-Time African American Mothers. Matern Child Health J 2017; 21:863-872. [PMID: 27565664 PMCID: PMC5329142 DOI: 10.1007/s10995-016-2167-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background While breast milk is considered the gold standard of infant feeding, a majority of African American mothers are not exclusively breastfeeding their newborn infants. Objective The overall goal of this critical ethnographic research study was to describe infant feeding perceptions and experiences of African American mothers and their support persons. Methods Twenty-two participants (14 pregnant women and eight support persons) were recruited from public health programs and community based organizations in northern California. Data were collected through field observations, demographic questionnaires, and multiple in-person interviews. Thematic analysis was used to identify key themes. Results Half of the mothers noted an intention to exclusively breastfeed during the antepartum period. However, few mothers exclusively breastfed during the postpartum period. Many participants expressed guilt and shame for not being able to accomplish their antepartum goals. Life experiences and stressors, lack of breastfeeding role models, limited experiences with breastfeeding and lactation, and changes to the family dynamic played a major role in the infant feeding decision making process and breastfeeding duration. Conclusions for Practice Our observations suggest that while exclusivity goals were not being met, a considerable proportion of African American women were breastfeeding. Future interventions geared towards this population should include social media interventions, messaging around combination feeding, and increased education for identified social support persons. Public health measures aimed at reducing the current infant feeding inequities would benefit by also incorporating more culturally inclusive messaging around breastfeeding and lactation.
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Affiliation(s)
- Ifeyinwa V Asiodu
- Department of Women, Children, and Family Health Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, NURS 839, Chicago, IL, 60612, USA.
| | - Catherine M Waters
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Dawn E Dailey
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Audrey Lyndon
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, USA
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Bacong AM, Holub C, Porotesano L. Comparing Obesity-Related Health Disparities among Native Hawaiians/Pacific Islanders, Asians, and Whites in California: Reinforcing the Need for Data Disaggregation and Operationalization. Hawaii J Med Public Health 2016; 75:337-344. [PMID: 27920944 PMCID: PMC5125359] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Since the 2000 Census, Asians and Pacific Islanders have been categorized as separate races. Government initiatives have called for greater study of Asian, Native Hawaiian, and other Pacific Islander (NHPI) health outcomes. NHPI often have worse health outcomes than Asians and Whites. Despite this, the lack of operationalization of racial definitions may affect the magnitude of health disparities. This analysis examined how utilizing different sociological race definitions could influence NHPI health outcomes when compared to Asians and Whites. Utilizing data from the 2009 California Health Interview Survey, NHPI had significantly higher age adjusted obesity prevalence than Whites under the UCLA Center for Health Policy Research (CHPR) (OR = 1.72, P = .03) and Self-Report (OR = 1.57, P = .01) definitions, but not the Census definition (OR = 1.42, P = .11). NHPI had significantly higher age adjusted obesity prevalence than Asians under all definitions (Census OR = 4.05, P < .01; CHPR OR = 4.81, P < .01; Self-Report OR = 4.46, P < .01). NHPI had significantly higher age adjusted diabetes/pre-diabetes prevalence than Whites across all definitions (Census OR = 3.27, P < .01, CHPR OR = 3.03, P < .01, Self-Report OR = 1.99, P = .01) but only the Census (OR = 2.12, P = .01) and CHPR (OR = 1.86, P = .04) when NHPI were compared to Asians. Overall, race definition changed the identification of health disparities. Future studies should operationalize racial definitions, as health disparities are masked post-hoc when utilizing different race definitions.
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Affiliation(s)
- Adrian Matias Bacong
- San Diego State University Institute for Behavioral and Community Health, San Diego, CA (all)
| | - Christina Holub
- San Diego State University Institute for Behavioral and Community Health, San Diego, CA (all)
| | - Liki Porotesano
- San Diego State University Institute for Behavioral and Community Health, San Diego, CA (all)
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Babey SH, Wolstein J, Diamant AL, Goldstein H. Prediabetes in California: Nearly Half of California Adults on Path to Diabetes. Policy Brief UCLA Cent Health Policy Res 2016:1-8. [PMID: 27197309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In California, more than 13 million adults (46 percent of all adults in the state) are estimated to have prediabetes or undiagnosed diabetes. An additional 2.5 million adults have diagnosed diabetes. Altogether, 15.5 million adults (55 percent of all California adults) have prediabetes or diabetes. Although rates of prediabetes increase with age, rates are also high among young adults, with one-third of those ages 18-39 having prediabetes. In addition, rates of prediabetes are disproportionately high among young adults of color, with more than one-third of Latino, Pacific Islander, American Indian, African-American, and multiracial Californians ages 18-39 estimated to have prediabetes. Policy efforts should focus on reducing the burden of prediabetes and diabetes through support for prevention and treatment.
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Affiliation(s)
- Susan H Babey
- UCLA Center for Health Policy Research. Los Angeles, California
| | - Joelle Wolstein
- UCLA Center for Health Policy Research. Los Angeles, California
| | - Allison L Diamant
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, UCLA, Los Angeles, California
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Abstract
Psychological distress occurs frequently in older minority immigrants because many have limited social resources and undergo a difficult process related to immigration and acculturation. Despite a rapid increase in the number of Asian immigrants, relatively little research has focused on subgroup mental health comparisons. This study examines the prevalence of psychological distress, and relationship with socio-demographic factors, and health care utilization among older Asian immigrants. Weighted data from Asian immigrants 65 and older from 5 countries (n = 1,028) who participated in the California Health Interview Survey (CHIS) were analyzed descriptively and in multiple linear regressions. The prevalence of psychological distress varied significantly across the 5 ethnic groups, from Filipinos (4.83%) to Chinese (1.64%). General health status, cognitive and physical impairment, and health care utilization are all associated (p < .05) with psychological distress in multiple linear regressions. These findings are similar to those from previous studies. The findings reinforce the need to develop more culturally effective mental health services and outreach programs.
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Affiliation(s)
- Miya Chang
- a Department of Social Welfare , Los Angeles , California , USA
| | - Ailee Moon
- a Department of Social Welfare , Los Angeles , California , USA
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40
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Sakuma KLK, Felicitas J, Fagan P, Gruder CL, Blanco L, Cappelli C, Trinidad DR. Smoking Trends and Disparities Among Black and Non-Hispanic Whites in California. Nicotine Tob Res 2015; 17:1491-8. [PMID: 25666813 PMCID: PMC5967264 DOI: 10.1093/ntr/ntv032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 01/26/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The current study examined disparities in smoking trends across Blacks and non-Hispanic Whites in California. METHODS Data from the 1996 to 2008 California Tobacco Survey were analyzed to examine trends in smoking behaviors and cessation across Blacks and non-Hispanic Whites. RESULTS A decrease in overall ever and current smoking was observed for both Black and non-Hispanic Whites across the 12-year time period. A striking decrease in proportions of heavy daily smokers for both Black and non-Hispanic Whites were observed. Proportions of light and intermittent smokers and moderate daily smokers displayed modest increases for Blacks, but large increases for non-Hispanic Whites. Increases in successful cessation were also observed for Blacks and, to a lesser extent, for non-Hispanic Whites. DISCUSSION Smoking behavior and cessation trends across Blacks and non-Hispanic Whites were revealing. The decline in heavy daily and former smokers may demonstrate the success and effectiveness of tobacco control efforts in California. However, the increase in proportions of light and intermittent smokers and moderate daily smokers for both Blacks and non-Hispanic Whites demonstrates a need for tobacco cessation efforts focused on lighter smokers.
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Affiliation(s)
- Kari-Lyn Kobayakawa Sakuma
- College of Public Health and Human Sciences, School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR;
| | - Jamie Felicitas
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | | | | | - Lyzette Blanco
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Christopher Cappelli
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Dennis R Trinidad
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
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Castro Y, Heck K, Forster JL, Widome R, Cubbin C. Social and Environmental Factors Related to Smoking Cessation among Mothers: Findings from the Geographic Research on Wellbeing (GROW) Study. Am J Health Behav 2015; 39:809-22. [PMID: 26450549 DOI: 10.5993/ajhb.39.6.9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The current study examined associations between race/ethnicity and psychosocial/environmental factors with current smoking status, and whether psychosocial/environmental factors accounted for racial differences in smoking status in a population-based sample of mothers in California. METHODS Cross-sectional data from 542 women with a history of smoking were used. Analyses adjusted for age, partner status, and educational attainment. RESULTS In models adjusted for sociodemographics, black women had significantly lower odds, and Latina immigrants had significantly higher odds of being a former smoker compared to white women. Persons smoking in the home, having a majority of friends who smoke, having perceptions of their neighborhood as being somewhat or very unsafe, and experiencing food insecurity were associated with decreased odds of being a former smoker. When these variables were entered into a single model, only being a Latina immigrant and having a majority of friends who smoke were significantly associated with smoking status. CONCLUSIONS Black women demonstrated a notable disparity compared with white women in smoking status, accounted for by psychosocial/environmental factors. Immigrant Latinas demonstrated notable success in ever quitting smoking. Social networks may be important barriers to smoking cessation among women.
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Affiliation(s)
- Yessenia Castro
- University of Texas at Austin, School of Social Work, Austin, TX, USA
| | - Katherine Heck
- University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA, USA
| | - Jean L Forster
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Rachel Widome
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Catherine Cubbin
- University of Texas at Austin, School of Social Work, Austin, TX, USA.
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Gomez SL, Shariff-Marco S, Von Behren J, Kwan ML, Kroenke CH, Keegan THM, Reynolds P, Kushi LH. Representativeness of breast cancer cases in an integrated health care delivery system. BMC Cancer 2015; 15:688. [PMID: 26467773 PMCID: PMC4604822 DOI: 10.1186/s12885-015-1696-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 10/07/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Integrated health care delivery systems, with their comprehensive and integrated electronic medical records (EMR), are well-poised to conduct research that leverages the detailed clinical data within the EMRs. However, information regarding the representativeness of these clinical populations is limited, and thus the generalizability of research findings is uncertain. METHODS Using data from the population-based California Cancer Registry, we compared age-adjusted distributions of patient and neighborhood characteristics for three groups of breast cancer patients: 1) those diagnosed within Kaiser Permanente Northern California (KPNC), 2) non-KPNC patients from NCI-designated cancer centers, and 3) those from all other hospitals. RESULTS KPNC patients represented 32 % (N = 36,109); cancer center patients represented 7 % (N = 7805); and all other hospitals represented 61 % (N = 68,330) of the total breast cancer patients from this geographic area during 1996-2009. Compared with cases from all other hospitals, KPNC had slightly fewer non-Hispanic Whites (70.6 % versus 74.4 %) but more Blacks (8.1 % versus 5.0 %), slightly more patients in the 50-69 age range and fewer in the younger and older age groups, a slightly lower proportion of in situ but higher proportion of stage I disease (41.6 % versus 38.9 %), were slightly less likely to reside in the lowest (4.2 % versus 6.5 %) and highest (36.2 % versus 39.0 %) socioeconomic status neighborhoods, and more likely to live in suburban metropolitan areas and neighborhoods with more racial/ethnic minorities. Cancer center patients differed substantially from patients from KPNC and all other hospitals on all characteristics assessed. All differences were statistically significant (p < .001). CONCLUSIONS Although much of clinical research discoveries are based in academic medical centers, patients from large, integrated medical centers are likely more representative of the underlying population, providing support for the generalizability of cancer research based on electronic data from these centers.
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Affiliation(s)
- Scarlett Lin Gomez
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94538, USA.
- Department of Health Research and Policy, School of Medicine, Stanford, 94305, CA, USA.
| | - Salma Shariff-Marco
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94538, USA.
- Department of Health Research and Policy, School of Medicine, Stanford, 94305, CA, USA.
| | - Julie Von Behren
- Cancer Prevention Institute of California, 2001 Center Street, Suite 700, Berkeley, CA, 94704, USA.
| | - Marilyn L Kwan
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
| | - Theresa H M Keegan
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94538, USA.
- Department of Health Research and Policy, School of Medicine, Stanford, 94305, CA, USA.
| | - Peggy Reynolds
- Cancer Prevention Institute of California, 2001 Center Street, Suite 700, Berkeley, CA, 94704, USA.
- Department of Health Research and Policy, School of Medicine, Stanford, 94305, CA, USA.
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
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Vaeth PA, Caetano R, Mills BA. Binge Drinking and Perceived Neighborhood Characteristics Among Mexican Americans Residing on the U.S.-Mexico Border. Alcohol Clin Exp Res 2015; 39:1727-33. [PMID: 26247487 PMCID: PMC4572518 DOI: 10.1111/acer.12818] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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] [Received: 10/08/2014] [Accepted: 06/15/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study examines the association between perceived neighborhood violence, perceived neighborhood collective efficacy, and binge drinking among Mexican Americans residing on the U.S.-Mexico border. METHODS Data were collected from a multistage cluster sample of adult Mexican Americans residing in the U.S.-Mexico border areas of California, Arizona, New Mexico, and Texas (N = 1,307). The survey weighted response rate was 67%. Face-to-face interviews lasting approximately 1 hour were conducted in respondents' homes in English or Spanish. Path analysis was used to test whether collective efficacy mediated the impact of perceived neighborhood violence on binge drinking. RESULTS Among 30+-year-old women, perceived neighborhood collective efficacy mediated the effects of perceived neighborhood violence on binge drinking in a theoretically predicted way: Lower perceptions of violence predicted an increased perception of collective efficacy, which in turn, predicted less binge drinking. Direct effects of violence perceptions on binge were nonsignificant. Younger 18- to 29-year-old women showed a similar (but nonsignificant) pattern of effects. Perceived collective efficacy also mediated the effects of perceived violence on binge drinking among men, but in opposite ways for older and younger men. Older men showed the same mediating effect as older women, but the effect reversed among younger men due to a strong, positive relation between collective efficacy and binge drinking. There were also age differences in the direct effect of violence perceptions on binge drinking: Perceptions of violence predicted more binge drinking among young men, but less among older men. CONCLUSIONS These results highlight the complexity of people's responses to neighborhood characteristics in regard to their drinking. Young men in particular seem to react very differently to perceptions of collective efficacy than other groups. However, among both men and women, collective efficacy may come to play an increasingly important protective role in health outcomes with age.
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Affiliation(s)
| | | | - Britain A. Mills
- University of Texas School of Public Health, Dallas Regional Campus
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Guevara RE, Motala T, Terashita D. The Changing Epidemiology of Coccidioidomycosis in Los Angeles (LA) County, California, 1973-2011. PLoS One 2015; 10:e0136753. [PMID: 26313151 PMCID: PMC4551673 DOI: 10.1371/journal.pone.0136753] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 08/07/2015] [Indexed: 11/18/2022] Open
Abstract
Coccidioidomycosis, also known as Valley Fever, is often thought of as an endemic disease of central California exclusive of Los Angeles County. The fungus that causes Valley Fever, Coccidioides spp., grows in previously undisturbed soil of semi-arid and arid environments of certain areas of the Americas. LA County has a few large areas with such environments, particularly the Antelope Valley which has been having substantial land development. Coccidioidomycosis that is both clinically- and laboratory-confirmed is a mandated reportable disease in LA County. Population surveillance data for 1973–2011 reveals an annual rate increase from 0.87 to 3.2 cases per 100,000 population (n = 61 to 306 annual cases). In 2004, case frequency started substantially increasing with notable epidemiologic changes such as a rising 2.1 to 5.7 male-to-female case ratio stabilizing to 1.4–2.2. Additionally, new building construction in Antelope Valley greatly rose in 2003 and displayed a strong correlation (R = 0.92, Pearson p<0.0001) with overall LA County incidence rates for 1996–2007. Of the 24 LA County health districts, 19 had a 100%-1500% increase in cases when comparing 2000–2003 to 2008–2011. Case residents of endemic areas had stronger odds of local exposures, but cases from areas not known to be endemic had greater mortality (14% versus 9%) with notably more deaths during 2008–2011. Compared to the 57 other California counties during 2001–2011, LA County had the third highest average annual number of cases and Antelope Valley had a higher incidence rate than all but six counties. With the large number of reported coccidioidomycosis cases, multi-agency and community partnering is recommended to develop effective education and prevention strategies to protect residents and travelers.
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Affiliation(s)
- Ramon E. Guevara
- Emergency Preparedness and Response Program, Department of Public Health, County of Los Angeles, Los Angeles, California, United States of America
- * E-mail:
| | - Tasneem Motala
- Acute Communicable Disease Control Program, Department of Public Health, County of Los Angeles, Los Angeles, California, United States of America
| | - Dawn Terashita
- Acute Communicable Disease Control Program, Department of Public Health, County of Los Angeles, Los Angeles, California, United States of America
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Abstract
Hodgkin lymphoma (HL) incidence varies with migration and nativity, suggesting an influence of acculturation on risk. In population-based California data including 1483 Hispanic and 348 Asian/Pacific Islander (API) HL cases, we examined HL rates in residential neighborhoods classified by ethnic enclave status (measuring degree of acculturation) and socioeconomic status (SES). Rates were inversely associated with enclave intensity, although associations varied by gender and race. In females, the enclave effect was stronger in low-SES settings, but rates were higher in less-ethnic/high-SES than more-ethnic/low-SES neighborhoods--diminishing enclave intensity affected rates more than higher SES. In Hispanics, associations were modest, and only females experienced SES modification of rates; in APIs, the enclave effect was much stronger. Thus, acculturation measured by residence in ethnic enclaves affects HL rates independently of neighborhood SES but in complex patterns. Living in less-ethnic neighborhoods may increase HL rates by facilitating social isolation and other gender-specific exposures implicated in risk.
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Affiliation(s)
- Sally L. Glaser
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538
- Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA 94306
| | - Ellen T. Chang
- Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA 94306
- Health Sciences Practice, Exponent, Inc., 149 Commonwealth Drive, Menlo Park, CA 94025
| | - Christina A. Clarke
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538
- Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA 94306
| | - Theresa H.M. Keegan
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538
- Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA 94306
| | - Juan Yang
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538
| | - Scarlett Lin Gomez
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538
- Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA 94306
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Abstract
The Asian Grocery Store-Based Cancer Education Program (the Program) is a proven strategy for promoting early breast cancer detection among Asian American women. The authors sought to test whether the same public health model can become an effective strategy for increasing the Asian community's awareness of the California Smokers' Helpline (the Helpline) and thereby, potentially decreasing this community's use of tobacco products. The new module, mainly staffed by four well-trained, volunteer undergraduates, explained the risks of first- and second-hand tobacco exposure and how to access the Helpline's services. A brochure, provided in English, Chinese, Korean, and Vietnamese (the Helpline's available Asian languages), was used to guide the bicultural, bilingual students' tobacco-related discussions with shoppers. The students' repeated presence at the nine partnering Asian grocery stores served as reminders of the Helpline's availability. In its first year of operation, the student trainers reached 1,052 men and 1,419 women with tobacco cessation messages. Equally important, the participating grocery stores' managers did not object to students telling their customers to quit using the tobacco products sold in their stores. The results suggest that the Program's tobacco cessation module is a viable, community-specific, public health strategy. It is also a strategy with the potential for applications to reduce other health threats.
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Affiliation(s)
- John Tat
- Department of Cell and Molecular Biology, Scripps Research Institute, 10550 North Torrey Pines Rd MB-07, La Jolla, CA 92037-1000
- Kellogg School of Science and Technology, Scripps Research Institute, 10550 North Torrey Pines Rd MB-07, La Jolla, CA 92037-1000
- Moores UCSD Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0850
| | - Mike Nguy
- Moores UCSD Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0850
| | - Eric K. Tong
- Moores UCSD Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0850
| | - Aaron J. Cheng
- Moores UCSD Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0850
| | - Lois Y. Chung
- Moores UCSD Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0850
| | - Georgia Robins Sadler
- Moores UCSD Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093-0850
- Department of Surgery, University of California, San Diego, 9500 Gilman Drive, La Jolla, California, 92093-0850
- Address correspondence and reprint requests to: Georgia Robins Sadler, BSN, MBA, PhD, Professor, Department of Surgery, Moores UCSD Cancer Center, 3855 Health Sciences Drive MC 0850, La Jolla, CA 92093-0850, Phone: (858) 822-7611, Fax: (858) 534-7628,
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Tao L, Ladabaum U, Gomez SL, Cheng I. Colorectal cancer mortality among Hispanics in California: differences by neighborhood socioeconomic status and nativity. Cancer 2014; 120:3510-8. [PMID: 25042119 PMCID: PMC5736794 DOI: 10.1002/cncr.28837] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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] [Received: 01/22/2014] [Revised: 04/11/2014] [Accepted: 05/12/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND Socioeconomic status (SES) plays an important role in colorectal cancer (CRC) mortality, although the independent and joint effects with nativity and neighborhood factors have yet to be evaluated. METHODS With nearly one-third of all US Hispanics residing in California, the authors obtained information from the California Cancer Registry to examine the associations between neighborhood SES and mortality in all 33,146 Hispanic individuals diagnosed with CRC from 1988 through 2010, with a particular focus on associations among US-born and foreign-born Hispanics. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CI) for overall and CRC-specific mortality. RESULTS Hispanics residing in lower SES neighborhoods demonstrated a higher rate of overall and CRC-specific mortality than those residing in high SES neighborhoods (SES quintile 1[low] vs quintile 5 [high]: HR, 1.15 [95% CI, 1.05-1.26] and HR, 1.16 [95% CI, 1.03-1.30], respectively). Nativity modified the associations between SES and mortality (P for interaction, .02 for overall and P for interaction, .01 for CRC-specific mortality) such that the SES associations were observed only among US-born (P for trend < .01 for overall and CRC-specific mortality) but not among foreign-born Hispanics. CONCLUSIONS Neighborhood SES demonstrates significant differential effects on overall and CRC-specific mortality between US-born and foreign-born Hispanics. Future efforts should investigate the underlying contextual and individual-level factors that could account for these differential associations by nativity.
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Affiliation(s)
- Li Tao
- Cancer Prevention Institute of California, Fremont, California
| | - Uri Ladabaum
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Scarlett Lin Gomez
- Cancer Prevention Institute of California, Fremont, California
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Iona Cheng
- Cancer Prevention Institute of California, Fremont, California
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Abstract
This study investigated contextual antecedents (i.e., cross-ethnic peers and friends) and correlates (i.e., intergroup attitudes) of social identity complexity in seventh grade. Social identity complexity refers to the perceived overlap among social groups with which youth identify. Identifying mostly with out-of-school sports, religious affiliations, and peer crowds, the ethnically diverse sample (N = 622; Mage in seventh grade = 12.56) showed moderately high complexity. Social identity complexity mediated the link between cross-ethnic friendships and ethnic intergroup attitudes, but only when adolescents had a high proportion of cross-ethnic peers at school. Results are discussed in terms of how school diversity can promote complex social identities and positive intergroup attitudes.
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50
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Abstract
Anal intercourse poses a greater risk for human immunodeficiency virus (HIV) transmission than vaginal intercourse, and in recent years there has been a growing understanding that heterosexual anal intercourse (HAI) is not uncommon. However, the majority of the anal intercourse literature has focused on men who have sex with men. The little research on HAI has mostly looked at women, with limited work among men. This analysis examined the association between HAI and high-risk behaviors (N = 1,622) and sexual sensation seeking (N = 239) in a sample of men recruited from 2001 to 2012 in Long Beach, California. Almost half of the sample was non-Hispanic Black. The median age was 42 years, 42% were homeless, and 20% reported recent HAI. Men who reported HAI were likely to be Hispanic, were likely to be homeless, had a male partner, engaged in sex exchange, and used cocaine or amphetamines during sex. Men who reported HAI scored higher on the Sexual Sensation Seeking scale. This research supports other work showing the relationship between HAI and high-risk behaviors. More important, it contributes new knowledge by demonstrating the association between HAI and sexual sensation seeking. This research highlights the importance of personality traits when trying to understand sexual behavior and when developing HIV prevention interventions.
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Affiliation(s)
- Kristen L. Hess
- Center for Behavioral Research and Services, California State University, Long Beach Long Beach, California
| | - Grace L. Reynolds
- Center for Behavioral Research and Services, California State University, Long Beach Long Beach, California
| | - Dennis G. Fisher
- Center for Behavioral Research and Services, California State University, Long Beach Long Beach, California
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