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Stefanos R, Lewis RM, Querec TD, Gargano JW, Unger ER, Markowitz LE. High impact of quadrivalent human papillomavirus vaccine across racial/ethnic groups: National Health and Nutrition Examination Survey, 2003-2006 and 2015-2018. Hum Vaccin Immunother 2024; 20:2308378. [PMID: 38372273 PMCID: PMC10877980 DOI: 10.1080/21645515.2024.2308378] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Human papillomavirus (HPV) causes cervical as well as other cancers. Racial and ethnic disparities in cervical cancer incidence and mortality in the United States are well documented. HPV vaccination has been recommended in the United States since 2006 and is expected to prevent HPV-attributable cancers in all racial/ethnic groups. Quadrivalent HPV vaccine-type (HPV6/11/16/18) and nonvaccine-type cervicovaginal HPV prevalences were estimated from National Health and Nutrition Examination Surveys in 2015-2018 (vaccine era) and 2003-2006 (prevaccine era) data. Prevalence ratios comparing 2015-2018 to 2003-2006 were calculated among sexually experienced Non-Hispanic White (NHW), Non-Hispanic Black (NHB), and Mexican American (MA) females aged 14-24 years. Quadrivalent HPV vaccine-type prevalence declined 82% (CI: 60%-92%) among NHW, 86% (CI: 64%-95%) among NHB, and 100% among MA females, forecasting future reductions in cervical cancer across racial/ethnic groups.
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Affiliation(s)
- Ruth Stefanos
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rayleen M. Lewis
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Troy D. Querec
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julia W. Gargano
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth R. Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lauri E. Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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O’Bryan SE, Muñoz F, Smith D, Bearse A, Melendrez B, Kamdar B, James-Price C, Ramirez D, Servin AE. Community based participatory research as a promising practice for addressing vaccine hesitancy, rebuilding trust and addressing health disparities among racial and ethnic minority communities. Hum Vaccin Immunother 2024; 20:2326781. [PMID: 38497273 PMCID: PMC10950264 DOI: 10.1080/21645515.2024.2326781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/01/2024] [Indexed: 03/19/2024] Open
Abstract
The COVID-19 pandemic disproportionately affected racial and ethnic minority communities across the United States (U.S.). Despite the disproportionate burden of COVID-19 faced by communities of color, Black and Hispanic communities are less likely to be fully vaccinated than White non-Hispanic Persons. Health inequity and vaccine hesitancy are complex phenomena that require multilevel responses tailored to the unique needs of each community, a process that inherently necessitates a high level of community engagement in order to develop the most effective health interventions. Building on the principles of community based participatory research (CBPR) and with the support of the National Institutes of Health (NIH), Project 2VIDA! was born. A multidisciplinary collaborative of academic researchers, community members, and clinicians whose aim is to foster sustainable partnerships to reduce the burden of COVID-19 in Hispanic and Black communities across Southern California. Our model was designed to meet our community members where they were - whether on their lunch break or picking their children from school. This CBPR model has been well received by community members. Future health interventions focused on reducing health disparities should prioritize the role of the community, leverage the voices of key community partners, and be grounded in equitable power sharing.
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Affiliation(s)
- Sophie E. O’Bryan
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Fatima Muñoz
- Health Support Services, San Ysidro Health, San Ysidro, CA, USA
| | - David Smith
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Adriana Bearse
- UC San Diego, Center for Community Health, University of California, San Diego, La Jolla, CA, USA
| | - Blanca Melendrez
- UC San Diego, Center for Community Health, University of California, San Diego, La Jolla, CA, USA
| | - Biren Kamdar
- Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego School of Medicine, La Jolla, CA, USA
| | | | - Daniel Ramirez
- Health Support Services, San Ysidro Health, San Ysidro, CA, USA
| | - Argentina E. Servin
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, USA
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Diamond-Smith N, Baer RJ, Jelliffe-Pawlowski L. Impact of being underweight before pregnancy on preterm birth by race/ ethnicity and insurance status in California: an analysis of birth records. J Matern Fetal Neonatal Med 2024; 37:2321486. [PMID: 38433400 DOI: 10.1080/14767058.2024.2321486] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND The US still has a high burden of preterm birth (PTB), with important disparities by race/ethnicity and poverty status. There is a large body of literature looking at the impact of pre-pregnancy obesity on PTB, but fewer studies have explored the association between underweight status on PTB, especially with a lens toward health disparities. Furthermore, little is known about how weight, specifically pre-pregnancy underweight status, and socio-economic-demographic factors such as race/ethnicity and insurance status, interact with each other to contribute to risks of PTB. OBJECTIVES The objective of this study was to measure the association between pre-pregnancy underweight and PTB and small for gestational age (SGA) among a large sample of births in the US. Our secondary objective was to see if underweight status and two markers of health disparities - race/ethnicity and insurance status (public vs. other) - on PTB. STUDY DESIGN We used data from all births in California from 2011 to 2017, which resulted in 3,070,241 singleton births with linked hospital discharge records. We ran regression models to estimate the relative risk of PTB by underweight status, by race/ethnicity, and by poverty (Medi-cal status). We then looked at the interaction between underweight status and race/ethnicity and underweight and poverty on PTB. RESULTS Black and Asian women were more likely to be underweight (aRR = 1.0, 95% CI: 1.01, 1.1 and aRR = 1.4, 95% CI: 1.4, 1.5, respectively), and Latina women were less likely to be underweight (aRR = 0.7, 95% CI: 0.7, 0.7). Being underweight was associated with increased odds of PTB (aRR = 1.3, 95% CI 1.3-1.3) and, after controlling for underweight, all nonwhite race/ethnic groups had increased odds of PTB compared to white women. In interaction models, the combined effect of being both underweight and Black, Indigenous and People of Color (BIPOC) statistically significantly reduced the relative risk of PTB (aRR = 0.9, 95% CI: 0.8, 0.9) and SGA (aRR = 1.0, 95% CI: 0.9, 1.0). The combined effect of being both underweight and on public insurance increased the relative risk of PTB (aRR = 1.1, 95% CI: 1.1, 1.2) but there was no additional effect of being both underweight and on public insurance on SGA (aRR = 1.0, 95% CI: 1.0, 1.0). CONCLUSIONS We confirm and build upon previous findings that being underweight preconception is associated with increased risk of PTB and SGA - a fact often overlooked in the focus on overweight and adverse birth outcomes. Additionally, our findings suggest that the effect of being underweight on PTB and SGA differs by race/ethnicity and by insurance status, emphasizing that other factors related to inequities in access to health care and poverty are contributing to disparities in PTB.
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Affiliation(s)
- Nadia Diamond-Smith
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
| | - Rebecca J Baer
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
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Micheline P, Vanrie J, Petermans A, Smetcoren AS. Exploring older migrants' meaning-making of 'happiness': " The main thing is health. Young people might say otherwise.". Int J Qual Stud Health Well-being 2024; 19:2300873. [PMID: 38184797 PMCID: PMC10773646 DOI: 10.1080/17482631.2023.2300873] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024] Open
Abstract
PURPOSE As our ageing population is growing and diversifying, it is important to gain insight into the well-being of older migrants. However, the meanings of happiness can vary cross-culturally. Therefore, prior to exploring older migrants' happiness, their meaning-making of "happiness" should be explored. This way, cultural or individual variations can be considered when analysing older migrants' happiness. Not only migration background but also age could influence the meaning of well-being. For example, the meaning of well-being can change as people grow older. Therefore, both migration background and age are considered in exploring older migrants' meaning-making of happiness. METHODS To do so, in-depth interviews with older migrants (n = 22) from various ethnicities were conducted in which their meaning-making of happiness was questioned via a semi-structured interview guide. RESULTS After analysing the results via thematic analysis, three overarching themes are discussed: (1) happiness associations, (2) happiness-pursuing strategies, and (3) happiness obstructions. The analysis then further focuses on the role of migration background and ageing on the meaning-making of happiness. CONCLUSIONS Participants' meaning-making of happiness seems strongly imbued with age-related references. On the contrary, the impact of migration background is rather limited. To explain this difference, the value of incorporating participants' life course experiences emerged.
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Affiliation(s)
- Phlix Micheline
- Architecture and Arts, UHasselt – Hasselt University, Diepenbeek, Belgium
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Brussels, Belgium
| | - Jan Vanrie
- Architecture and Arts, UHasselt – Hasselt University, Diepenbeek, Belgium
| | - Ann Petermans
- Architecture and Arts, UHasselt – Hasselt University, Diepenbeek, Belgium
| | - An-Sofie Smetcoren
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Brussels, Belgium
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Qiao WP, Haskins SC, Liu J. Racial and ethnic disparities in regional anesthesia in the United States: A narrative review. J Clin Anesth 2024; 94:111412. [PMID: 38364694 DOI: 10.1016/j.jclinane.2024.111412] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/01/2024] [Accepted: 02/08/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Racial and ethnic disparities exist in the delivery of regional anesthesia in the United States. Anesthesiologists have ethical and economic obligations to address existing disparities in regional anesthesia care. OBJECTIVES Current evidence of racial and ethnic disparities in regional anesthesia utilization in adult patients in the United States is presented. Potential contributors and solutions to racial disparities are also discussed. EVIDENCE REVIEW Literature search was performed for studies examining racial and ethnic disparities in utilization of regional anesthesia, including neuraxial anesthesia and/or peripheral nerve blocks. FINDINGS While minoritized patients are generally less likely to receive regional anesthesia than white patients, the pattern of disparities for different racial/ethnic groups and for types of regional anesthetics can be complex and varied. Contributors to racial/ethnic disparities in regional anesthesia span hospital, provider, and patient-level factors. Potential solutions include standardization of regional anesthetic practices via Enhanced Recovery After Surgery (ERAS) pathways, increasing patient education, health literacy, language translation services, and improving diversity and cultural competency in the anesthesiology workforce. CONCLUSION Racial and ethnic disparities in regional anesthesia exist. Contributors and solutions to these disparities are multifaceted. Much work remains within the subspecialty of regional anesthesia to identify and address such disparities.
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Affiliation(s)
- William P Qiao
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, United States of America; Department of Anesthesiology, Weill Cornell Medical College, New York, NY, United States of America.
| | - Stephen C Haskins
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, United States of America; Department of Anesthesiology, Weill Cornell Medical College, New York, NY, United States of America.
| | - Jiabin Liu
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, United States of America; Department of Anesthesiology, Weill Cornell Medical College, New York, NY, United States of America.
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Vandecasteele R, Schelfhout S, D'hondt F, De Maesschalck S, Derous E, Willems S. Intercultural effectiveness in GPs' communication and clinical assessment: An experimental study. Patient Educ Couns 2024; 122:108138. [PMID: 38237531 DOI: 10.1016/j.pec.2024.108138] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/27/2023] [Accepted: 01/04/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE This study aimed to investigate potential disparities in general practitioners' overall communication and clinical assessments based on patient ethnicity, while examining the influence of intercultural effectiveness. METHODS Employing a 2 × 2 experimental study design, online video recorded consultations with simulated patients were conducted and analyzed using OSCEs. Each GP (N = 100) completed a consultation with both an ethnic majority and an ethnic minority patient. Additionally, a follow-up survey was administered to gather supplementary data. Paired sample t-tests explored ethnic disparities, correlation and regression analyses determined associations with intercultural attitudes, traits and capabilities. RESULTS No statistically significant differences in GPs' communication or clinical assessment were found based on patients' ethnic background. Positive associations were observed between all aspects of intercultural effectiveness and GPs' consultation behavior. Intercultural traits emerged as a strong and robust predictor of clinical assessment of ethnic minority patients. CONCLUSION Intercultural traits, such as ethnocultural empathy, may play a critical role in GPs' clinical assessment skills during intercultural consultations. PRACTICE IMPLICATIONS Findings provide valuable insights into the determinants of intercultural effectiveness in healthcare, fostering promising targets for interventions and training programs aiming to ensure higher-quality and more equitable care delivery.
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Affiliation(s)
- Robin Vandecasteele
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, University Hospital Campus entrance 42, C. Heymanslaan 10, 9000 Ghent, Belgium.
| | - Stijn Schelfhout
- Ghent University, Faculty of Psychology and Educational Sciences, Department of Work, Organization and Society, Vocational and Personnel Psychology Lab, H. Dunantlaan 2, 9000 Ghent, Belgium; Ghent University, Faculty of Psychology and Educational Sciences, Department of Experimental Psychology, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Fanny D'hondt
- Department of Sociology, Faculty of Political and Social Sciences, Ghent University, Sint-Pietersnieuwstraat 41, 9000 Ghent, Belgium
| | - Stéphanie De Maesschalck
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, University Hospital Campus entrance 42, C. Heymanslaan 10, 9000 Ghent, Belgium; Ghent University, Centre for the Social Study of Migration and Refugees, H. Dunantlaan 2, 9000 Ghent, Belgium
| | - Eva Derous
- Ghent University, Faculty of Psychology and Educational Sciences, Department of Work, Organization and Society, Vocational and Personnel Psychology Lab, H. Dunantlaan 2, 9000 Ghent, Belgium; Erasmus University Rotterdam, Erasmus School of Social and Behavioural Sciences, Burgemeester Oudlaan 50, 3062 Rotterdam, the Netherlands
| | - Sara Willems
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Research Group Equity in Health Care, University Hospital Campus entrance 42, C. Heymanslaan 10, 9000 Ghent, Belgium; Ghent University, Centre for the Social Study of Migration and Refugees, H. Dunantlaan 2, 9000 Ghent, Belgium; Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Quality & Safety Ghent, University Hospital Campus entrance 42, C. Heymanslaan 10, 9000 Ghent, Belgium
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Amboree TL, Damgacioglu H, Sonawane K, Adsul P, Montealegre JR, Deshmukh AA. Recent trends in cervical cancer incidence, stage at diagnosis, and mortality according to county-level income in the United States, 2000-2019. Int J Cancer 2024; 154:1549-1555. [PMID: 38270521 DOI: 10.1002/ijc.34860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024]
Abstract
Early evidence suggests that declining cervical cancer incidence reversed in low-income regions in the United States in recent years; however, it is unclear whether there are distinct patterns by race/ethnicity and stage at diagnosis and if the increase has translated into rising mortality. Using Surveillance, Epidemiology, and End Results data, we evaluated trends in hysterectomy-corrected cervical cancer incidence rates (2000-2019) and mortality rates (2005-2019) by county-level income and race/ethnicity, with further stratification of incidence by stage at diagnosis. Following a period of decline, hysterectomy-corrected cervical cancer incidence increased 1.0%/year (95% CI = 0.1% to 4.5%) among Non-Hispanic White women in low-income counties. Particularly, a statistically significant 4.4%/year (95% CI = 1.7% to 7.5%) increase in distant-stage cancer occurred in this group. Additionally, recent increases in cervical cancer mortality (1.1%/year [95% CI = -1.4% to 3.7%]) were observed among this group and Non-Hispanic Black women in low-income counties (2.9%/year [95% CI = -2.3% to 18.2%]), but trends were not statistically significant. Among Hispanic women in low-income counties, distant-stage cervical cancer incidence increased 1.5%/year (95% CI = -0.6% to 4.1%), albeit not statistically significant. The increasing incidence of distant-stage cervical cancer and mortality in specific racial/ethnic groups suggests that the recent introduction of higher sensitivity screening tests may not explain increasing trends in low-income counties. Our findings suggest that the observed rise in cervical cancer incidence may reflect disruptions along the screening and treatment continuum. Future research to further comprehend these trends and continued enhancements in prevention are crucial to combat rising cervical cancer incidence and mortality in low-income counties in the United States.
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Affiliation(s)
- Trisha L Amboree
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Haluk Damgacioglu
- Department of Public Health Science, Medical University of South Carolina, Charleston, South Carolina, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kalyani Sonawane
- Department of Public Health Science, Medical University of South Carolina, Charleston, South Carolina, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Prajakta Adsul
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
- Cancer Control and Population Sciences Research Program, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA
| | - Jane R Montealegre
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Ashish A Deshmukh
- Department of Public Health Science, Medical University of South Carolina, Charleston, South Carolina, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA
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Zvolensky MJ, Clausen BK, Shepherd JM, Redmond BY, Robison JH, Santiago-Torres M, Bricker JB. Emotional dysregulation among English-speaking Hispanic persons who smoke living in the United states. Addict Behav 2024; 152:107959. [PMID: 38309241 DOI: 10.1016/j.addbeh.2024.107959] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 02/05/2024]
Abstract
Hispanic/Latinx (hereafter Hispanic) individuals in the United States (US) experience serious tobacco-related disparities and factors contributing to such disparities need to be adequately identified and clinically addressed. Emotion dysregulation is a key transdiagnostic relevant to smoking. The present cross-sectional investigation sought to test if emotion dysregulation was related to more severe problems during smoking quit attempts (e.g., irritability, weight gain), perceptions of difficulty about quitting, as well as negative and positive beliefs about smoking abstinence in a sample of English-speaking Hispanic adults residing in the US who smoke. Participants included 332 Hispanic adults who engaged in daily cigarette smoking (35.46 years old, 37 % identified as female). Emotion dysregulation was significantly related to more severe problems when quitting and perceived barriers for quitting, as well as negative beliefs about smoking abstinence. Additionally, emotion dysregulation was significantly and negatively related to positive outcomes about smoking abstinence. The amount of change in the various smoking criterion variables accounted for by emotion dysregulation was small (sr2 range: 0.028-0.085), but evident in adjusted models that accounted for a wide range of factors (e.g., depression, drug use severity). Overall, this investigation found consistent empirical evidence that individual differences in emotion dysregulation in Hispanic individuals were associated with several clinically significant smoking processes, suggesting this construct may represent an important factor involved in the maintenance and relapse of smoking among this ethnic population.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center; HEALTH Institute, University of Houston.
| | | | | | | | | | | | - Jonathan B Bricker
- Fred Hutchinson Cancer Center, Division of Public Health Sciences; Department of Psychology, University of Washington
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Rathod S, Skórniewska Z, Engelthaler T, Fell B, Sajid S, Phiri P. Treatment resistant depression: A comparative study of access, pathways, and outcomes between Caucasian and ethnic minority individuals. J Affect Disord 2024; 352:357-365. [PMID: 38342322 DOI: 10.1016/j.jad.2024.02.027] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Treatment resistant depression (TRD) is considered when an individual fails to respond to two or more different antidepressants in adequate doses, duration and with adequate adherence within the same major depressive episode. AIM To examine the clinical profiles of TRD patients through data from electronic healthcare records and compare characteristics and treatment pathways of ethnic minority and non-minority patients in UK. METHODS A retrospective, longitudinal, observational cohort study of patients with TRD was carried out in 10 Mental Health NHS Foundation Trusts in the Akrivia Health/UK Clinical Record Interactive Search (CRIS) system network. The CRIS system was used as a means of analysing de-identified data across 3.2 million anonymised patients' records. RESULTS 10,048 patient records were deemed eligible for this study, of which 20.2 % of patients identified as BAME, and 79.8 % patients identified as White. Overall, around half of the patients were likely to be prescribed an antidepressant within 2 months of the MDD diagnosis. White patients were prescribed more antidepressants than the BAME group (p < 0.001), with a significant effect size for comorbidities. LIMITATIONS The nature of the data source limited the ability to filter for short treatment durations as clinicians did not often record concrete medication end-dates in clinical note fields. CONCLUSION There are significant differences in care pathways between ethnic groups in relation to TRD patients. It is vital to understand factors causing these potential clinical biases and increase awareness and education to deliver the most effective treatments for TRD in ethnic minority patients.
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Affiliation(s)
- Shanaya Rathod
- Research and Innovation Department, Southern Health NHS Foundation Trust, Southampton SO30 3JB, UK.
| | | | - Tomas Engelthaler
- Akrivia Health, Clarendon House, Cornmarket Street, Oxford, OX1 3HJ, UK
| | - Benjamin Fell
- Akrivia Health, Clarendon House, Cornmarket Street, Oxford, OX1 3HJ, UK
| | - Sana Sajid
- Research and Innovation Department, Southern Health NHS Foundation Trust, Southampton SO30 3JB, UK
| | - Peter Phiri
- Research and Innovation Department, Southern Health NHS Foundation Trust, Southampton SO30 3JB, UK; School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK
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Weisenburger RL, Mullarkey MC, Labrada J, Labrousse D, Yang MY, MacPherson AH, Hsu KJ, Ugail H, Shumake J, Beevers CG. Conversational assessment using artificial intelligence is as clinically useful as depression scales and preferred by users. J Affect Disord 2024; 351:489-498. [PMID: 38290584 DOI: 10.1016/j.jad.2024.01.212] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/15/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Depression is prevalent, chronic, and burdensome. Due to limited screening access, depression often remains undiagnosed. Artificial intelligence (AI) models based on spoken responses to interview questions may offer an effective, efficient alternative to other screening methods. OBJECTIVE The primary aim was to use a demographically diverse sample to validate an AI model, previously trained on human-administered interviews, on novel bot-administered interviews, and to check for algorithmic biases related to age, sex, race, and ethnicity. METHODS Using the Aiberry app, adults recruited via social media (N = 393) completed a brief bot-administered interview and a depression self-report form. An AI model was used to predict form scores based on interview responses alone. For all meaningful discrepancies between model inference and form score, clinicians performed a masked review to determine which one they preferred. RESULTS There was strong concurrent validity between the model predictions and raw self-report scores (r = 0.73, MAE = 3.3). 90 % of AI predictions either agreed with self-report or with clinical expert opinion when AI contradicted self-report. There was no differential model performance across age, sex, race, or ethnicity. LIMITATIONS Limitations include access restrictions (English-speaking ability and access to smartphone or computer with broadband internet) and potential self-selection of participants more favorably predisposed toward AI technology. CONCLUSION The Aiberry model made accurate predictions of depression severity based on remotely collected spoken responses to a bot-administered interview. This study shows promising results for the use of AI as a mental health screening tool on par with self-report measures.
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Affiliation(s)
- Rachel L Weisenburger
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, United States of America.
| | | | | | - Daniel Labrousse
- Department of Psychiatry, Georgetown University Medical Center, United States of America
| | - Michelle Y Yang
- Department of Psychiatry, Georgetown University Medical Center, United States of America
| | - Allison Huff MacPherson
- Department of Family and Community Medicine, College of Medicine, University of Arizona, United States of America
| | - Kean J Hsu
- Department of Psychiatry, Georgetown University Medical Center, United States of America; Department of Psychology, National University of Singapore, Singapore
| | - Hassan Ugail
- Centre for Visual Computing, University of Bradford, United Kingdom of Great Britain and Northern Ireland
| | | | - Christopher G Beevers
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, United States of America
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Bautista A, Venta A. Attachment security and somatization: The mediating role of emotion dysregulation in a sample of Latinx young adults. J Affect Disord 2024; 351:165-171. [PMID: 38296054 DOI: 10.1016/j.jad.2024.01.235] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/11/2024] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Somatization has been linked to the underdiagnosis of mental health disorders among individuals from racial and ethnic minority groups, notably among Latinxs. While prior research has emphasized sociocultural factors, the exploration of potential inter- and intrapersonal mechanisms behind somatization remains limited. METHODS The current study examined the relation between attachment insecurity, emotion dysregulation, and somatization among Latinx young adults. Data were collected across seven separate Texas universities (N = 822). Most identified as female (76 %), were born in the United States (50.9 %) and were in their first or second year of university (60.6 %). RESULTS Hypothesis testing relied on two mediation models: maternal attachment security and paternal attachment security. The maternal attachment security model significantly predicted somatization, explaining 25 % of the variance. Notably, emotion dysregulation and maternal attachment security had main effects on somatization after accounting for country of origin, age, and gender. Results were similar for the paternal attachment security model. LIMITATIONS Limitations include skewed gender distribution, a non-clinical college student sample, cross-sectional design preventing causal inferences, and potential bias in self-report measures. CONCLUSIONS Attachment security and emotion dysregulation play an essential role in the experience of somatic symptoms among Latinx young adults. Our results suggest that health care providers take into account insecure attachment and emotion regulation history of Latinxs presenting with somatic symptoms.
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Affiliation(s)
| | - Amanda Venta
- University of Houston, United States of America.
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12
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Coles DC, Sawyer J, Perkins NH. Understanding the Behavioral Health Risk Factors that African American and Latinx Women Experience within a National Context. Soc Work Public Health 2024; 39:284-296. [PMID: 38459933 DOI: 10.1080/19371918.2024.2323142] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
In an effort to address social determinants of health and to reduce barriers to care, there have been increased attempts to understand and mitigate public health concerns in ethnic minority communities. As knowledge increases regarding the impact of health disparities on ethnic minority communities, social workers practice knowledge must expand to include intersectional approaches and methods that are inclusive of mechanisms that address inconsistencies in access to health care. Using the 2018 National Survey on Drug Use and Health (NSDUH), this study examined behavioral health and psychosocial risk factors that African American and Latinx women (n = 7008) experienced and identified how these factors are associated with self-reported overall health. Results indicated that overall health and wellbeing is linked to psychosocial risk factors, such as depression, substance use, and even age for African American and Latinx women.
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Affiliation(s)
- D Crystal Coles
- School of Social Work, Morgan State University, Arlington, VA
| | - Jason Sawyer
- Department of Counseling and Human Services, Old Dominion University, Arlington, VA
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13
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Gonzalez T, Nicholas A, Olagbenro M, Feldman SR, Fleischer AB. Race and ethnicity are inadequate predictors of ambulatory visit length and utilization of preventive services. J Natl Med Assoc 2024; 116:131-138. [PMID: 38402107 DOI: 10.1016/j.jnma.2023.12.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 11/22/2023] [Accepted: 12/03/2023] [Indexed: 02/26/2024]
Abstract
Health disparities can be experienced by any disadvantaged group who has limited access to healthcare or decreased quality of care. Quality of care can be measured by physician-patient communication measures such as length of visit, health outcomes, patient satisfaction, or by the services one receives such as screening or health education. This study aims to determine the relationship between length of physician-patient encounter, number of preventive services, ethnicity, and race. This study utilizes data from the National Ambulatory Medical Care Survey (NAMCS) from 2007 to 2016. Visits with a single diagnosis were selected. Visits with the five most frequent diagnoses were selected by International Classification of Diseases, Ninth or Tenth Revision (ICD-9/ICD-10) classification. The primary outcome is time spent with a physician in minutes and the number of preventive services provided represented by the Preventive Service Index (PSI). Of 255,916 visits, non-white individuals made up 16.2% (95% Confidence Interval 15.9-16.4) while Latinos represented 13.4% (95%CI 13.2-13.6) of individuals. Multivariate analysis revealed minimal differences in visit length in race and ethnic groups regardless of diagnosis. Greater PSI was associated with individuals less than 43 years old (Odds Ratio (OR) 2.0, 95% CI 1.8-2.3, p =< 0.0001), those who reside in metropolitan statistical areas (MSAs) (OR 1.2, 95% CI 1.1-1.4, p = 0.006), non-white individuals (OR 1.2, 95% CI 1.1-1.3, p = 0.004), and those with private insurance (OR 1.3, 95% CI 1.1-1.4, p =< 0.0001). Race and ethnicity do not predict length of time with a physician regardless of diagnosis. Age, race, location within a metropolitan area, and insurance are significant but minimal predictors of receiving preventive services in the rank-order leading five most frequent diagnoses. This large, population-based study highlights improvements in the distribution of healthcare services from previous studies.
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Affiliation(s)
- Tammy Gonzalez
- University of Cincinnati School of Medicine Department of Dermatology, 3230 Eden Ave, Cincinnati, OH 45267, USA.
| | - Andrew Nicholas
- University of Cincinnati School of Medicine Department of Dermatology, 3230 Eden Ave, Cincinnati, OH 45267, USA
| | - Matthew Olagbenro
- University of Cincinnati School of Medicine Department of Dermatology, 3230 Eden Ave, Cincinnati, OH 45267, USA
| | - Steven R Feldman
- Wake Forest School of Medicine, 4618 Country Club Road, Winston Salem, NC 27104, USA
| | - Alan B Fleischer
- University of Cincinnati School of Medicine Department of Dermatology, 3230 Eden Ave, Cincinnati, OH 45267, USA
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14
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Masala B, Love A, Carmichael P, Masic U. Demographics of referrals to a specialist gender identity service in the UK between 2017 and 2020. Clin Child Psychol Psychiatry 2024; 29:624-636. [PMID: 37698232 DOI: 10.1177/13591045231202372] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Trends in clinical referrals to specialist gender services historically comprised more assigned male at birth young people. In the last decade, this has shifted in adolescent samples to more assigned female young people. An updated review of the current patterns of referrals is important to better understand the potential changing needs of clinically referred gender-diverse children and adolescents. We assessed the demographics of referrals to the Gender Identity Development Service (GIDS) and their attendance patterns from 2017 to 2020. During this period, 9555 referrals were received in total, most were in adolescence (n = 7901, 82.7%), and more assigned female (age range = 1-18 years; M = 14.05; SD = 2.5) were referred than assigned male young people overall (n = 6823, 71.4%). A larger proportion of assigned female adolescents (assigned female: n = 5835, 62.3%, assigned male: n = 1897, 20.3%) and assigned female children (n = 988, 10.6%, assigned male: n = 640, 6.8%) were referred. For 2%, sex assigned at birth was unrecorded, 83.4% were White British and 36.6% had an unidentified ethnicity. Only 4% did not attend a first appointment, indicating the need for care from this specialist service. With more young people presenting to gender services, understanding the demographics of young people seeking gender care is vital for service provision. Future research should explore how to increase access to gender care for ethnic minorities, and how to support those accessing services.
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Affiliation(s)
- Bibi Masala
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Amy Love
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Polly Carmichael
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Una Masic
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, UK
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15
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Thomas M, Verma V, Gheshlaghi N, Esdaile J, Avina-Zubieta A, Barnabe C, Harrison M, De Vera MA. Reporting of determinants of health inequities and participant characteristics in randomized controlled trials of systemic lupus erythematosus in Canada: A scoping review. Lupus 2024; 33:462-469. [PMID: 38339797 PMCID: PMC10955787 DOI: 10.1177/09612033241233032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To report participant characteristics relevant to identifying health inequities in systemic lupus erythematosus (SLE) randomized controlled trials conducted in Canada. METHODS We conducted a scoping review by searching MEDLINE (Ovid) and Embase (1990 to June 2023), and CENTRAL (inception to June 2023). Eligible studies: used an RCT design; evaluated interventions (pharmacologic and non-pharmacologic) among SLE patients aged ≥18 years; and were conducted in Canada. Data extraction was guided by the Campbell and Cochrane Equity Methods Group's PROGRESS-Plus framework on 11 factors leading to health inequities (Place of residence; Race, culture, ethnicity, and language; Occupation; Gender and sex; Religion; Education; Socioeconomic status; Social capital; Plus: Personal characteristics associated with discrimination; Features of relationships; and Time-dependent relationships). RESULTS Of 1901 unique records, 6 met the inclusion criteria. Sex and age were the only PROGRESS factors that were reported in all studies. The majority of participants were female (84.4% to 100%), and mean ages of participants ranged from 42 to 52.3 years. Place of residence, race, education, and social capital were reported in three studies. Socioeconomic status was reported in two studies, and occupation was reported in one study. Religion, features of relationships, and time-dependent relationships were not reported in any included studies. CONCLUSION Limited reporting of determinants of health inequities in RCTs for SLE in Canada suggests the need for reporting standards to support equity, diversity, and inclusion practices in research.
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Affiliation(s)
- Megan Thomas
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
| | - Vanay Verma
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Niloofar Gheshlaghi
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - John Esdaile
- Arthritis Research Canada, Vancouver, BC, Canada
| | | | - Cheryl Barnabe
- Arthritis Research Canada, Vancouver, BC, Canada
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mark Harrison
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Centre for Advancing Health Outcomes, Vancouver, BC, Canada
| | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
- Centre for Advancing Health Outcomes, Vancouver, BC, Canada
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16
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Kranjac AW, Kranjac D, Kain ZN, Ehwerhemuepha L, Jenkins BN. Obesity Heterogeneity by Neighborhood Context in a Largely Latinx Sample. J Racial Ethn Health Disparities 2024; 11:980-991. [PMID: 36997832 PMCID: PMC10933170 DOI: 10.1007/s40615-023-01578-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/07/2022] [Revised: 02/27/2023] [Accepted: 03/19/2023] [Indexed: 04/01/2023]
Abstract
Neighborhood socioeconomic context where Latinx children live may influence body weight status. Los Angeles County and Orange County of Southern California both are on the list of the top ten counties with the largest Latinx population in the USA. This heterogeneity allowed us to estimate differential impacts of neighborhood environment on children's body mass index z-scores by race/ethnicity using novel methods and a rich data source. We geocoded pediatric electronic medical record data from a predominantly Latinx sample and characterized neighborhoods into unique residential contexts using latent profile modeling techniques. We estimated multilevel linear regression models that adjust for comorbid conditions and found that a child's place of residence independently associates with higher body mass index z-scores. Interactions further reveal that Latinx children living in Middle-Class neighborhoods have higher BMI z-scores than Asian and Other Race children residing in the most disadvantaged communities. Our findings underscore the complex relationship between community racial/ethnic composition and neighborhood socioeconomic context on body weight status during childhood.
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Affiliation(s)
- Ashley W Kranjac
- Department of Sociology, Chapman University, Orange, CA, USA
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA
| | - Dinko Kranjac
- Department of Psychology, Institute for Mental Health and Psychological Well-Being, University of La Verne, La Verne, CA, USA
| | - Zeev N Kain
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | | | - Brooke N Jenkins
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA.
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA.
- Department of Psychology, Chapman University, One University Drive, Orange, CA, 92866, USA.
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17
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Jia YJ, Hu FH, Tang W, Zhang WQ, Ge MW, Shen LT, Hu SQ, Shen WQ, Chen HL. Effect of Socioeconomic Disparities on Suicide Risk in Patients With Prostate Cancer During 2005 to 2020: A Population Study. Clin Genitourin Cancer 2024; 22:84-91.e7. [PMID: 37758561 DOI: 10.1016/j.clgc.2023.09.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/03/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE To determine whether socioeconomic disparities have an impact on the likelihood of suicide among prostate cancer patients. METHODS Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with malignant prostate cancer between 2005 and 2020. The socioeconomic disparities of the patients were evaluated by median household income (MHI) and ethnicity. Ethnicity included Spanish-Hispanic-Latino and non-Spanish-Hispanic-Latino. A Cox proportional risk model was utilized. Using the Kaplan-Meier approach, the cumulative incidence of suicide mortality was measured. RESULTS A total of 857,418 US population with prostate cancer were included. In the multivariate analysis, individuals with MHI over $75,000 had a lower risk of suicide mortality than those with MHI between $54,999 and $74,999 in all patients (aHRs: 0.693, 95 CI%: 0.603-0.797). Spanish-Hispanic-Latino displayed lower overall suicide mortality in all patients (aHRs: 0.426, 95% CI: 0.323-0.561). In the subgroup analysis of different ages, individuals with MHI over $75,000 had a lower risk of suicide than those with MHI between $54,999 and $74,999 in patients 60 to 79 years (aHRs: 0.668, 95% CI: 0.562-0.794) and individuals with MHI below $54,999 had higher suicide risk than those with MHI between $54,999 and $74,999 in patients 80+ years (aHRs: 1.786, 95% CI: 1.100-2.902). Hispanic-Latino individuals had lower overall suicide mortality in 00 to 59 years (aHRs: 0.420, 95% CI: 0.240-0.734), 60 to 79 years (aHRs: 0.445, 95% CI: 0.319-0.621), 80+ years (aHRs: 0.363, 95% CI: 0.133-0.988). CONCLUSION Socioeconomic disparities, including MHI and ethnicity, are important factors strongly related to suicide risk in prostate cancer patients. The lower MHI individuals and non-Spanish-Hispanic-Latino individuals were associated with higher suicide risk.
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Affiliation(s)
- Yi-Jie Jia
- Medical School of Nantong University, Nantong, Jiangsu, China
| | - Fei-Hong Hu
- Medical School of Nantong University, Nantong, Jiangsu, China
| | - Wen Tang
- Medical School of Nantong University, Nantong, Jiangsu, China
| | - Wan-Qing Zhang
- Medical School of Nantong University, Nantong, Jiangsu, China
| | - Meng-Wei Ge
- Medical School of Nantong University, Nantong, Jiangsu, China
| | - Lu-Ting Shen
- Medical School of Nantong University, Nantong, Jiangsu, China
| | - Shi-Qi Hu
- Medical School of Nantong University, Nantong, Jiangsu, China
| | - Wang-Qin Shen
- Medical School of Nantong University, Nantong, Jiangsu, China
| | - Hong-Lin Chen
- School of Public Health, Nantong University, Nantong, Jiangsu, China.
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18
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Diaz-Valdes A, Matz-Costa C, Rutledge MS, Calvo E. Determinants of Hispanic and non-Hispanic Workers' Intent to Work Past Age 65: An Analysis From the Life Course Perspective. Int J Aging Hum Dev 2024; 98:300-328. [PMID: 37649283 DOI: 10.1177/00914150231196095] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Background: The average retirement age in the United States (U.S.) has increased over the past few decades. However, the rate of increase for Hispanics is lower than that for non-Hispanics. For Hispanics, the decision to retire later may be more influenced by their migration history and context rather than health or finances. Objective: This study aims to explore the differences in the determinants of intentions to delay retirement (i.e., work beyond the age of 65) between Hispanics and non-Hispanic Whites in the U.S. Methods: A pooled sample was generated from all waves of the Health and Retirement Study (1992-2014), including a unique record for each non-institutionalized individual aged 55-61 who was employed. All eligible Hispanics (n = 3,663) were included, while a random sample of non-Hispanic Whites (n = 3,663) was selected. Logistic mixed models were conducted for each group, and a Two-fold Oaxaca-Blinder decomposition analysis was used to explore differences between the groups. Results: The results indicate that non-Hispanic Whites are more likely to plan to postpone retirement. Furthermore, significant differences were found between Hispanics and non-Hispanic Whites regarding their intentions to delay retirement, specifically related to socioeconomic indicators such as individual earnings, amount of debt, level of education, and parents' level of education. The differences between the groups were primarily influenced by the amount of debt, having a defined benefit plan, and parents' level of education, reflecting the cumulative disadvantage experienced by Hispanics over their life course. Conclusion: Most existing research on the topic has focused on middle-class Whites, while few studies have examined race or ethnicity as the primary focus or explored the extent to which commonly identified predictors of delayed retirement apply to different ethno-racial groups. This is significant because Hispanics and other disadvantaged groups tend to experience financial insecurity during retirement, which directly impacts their health and well-being.
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Affiliation(s)
- Antonia Diaz-Valdes
- Society and Health Research Center, Social Science and Arts Faculty, Universidad Mayor, Santiago, Chile
- Millennium Nucleo of Socio Medicine (SocioMed), Universidad Mayor, Santiago, Chile
| | | | | | - Esteban Calvo
- Society and Health Research Center, Social Science and Arts Faculty, Universidad Mayor, Santiago, Chile
- Millennium Nucleo of Socio Medicine (SocioMed), Universidad Mayor, Santiago, Chile
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Babatunde OA, Ramkumar SP, Nguyen SA, Okereke OI, Clark FA, Nagar A, Osazuwa-Peters N, Adjei Boakye E. Association between number of Adverse Childhood Experiences and depression among older adults is moderated by race. Prev Med 2024; 181:107921. [PMID: 38423302 DOI: 10.1016/j.ypmed.2024.107921] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE This study aimed to assess the association between number of Adverse Childhood Experiences (ACE) and history of depression among older adults and to explore the interaction by race. METHODS This study was a cross-sectional analysis of the 2020 Behavioral Risk Factor Surveillance System (BRFSS) data among 60,122 older respondents (≥ 60 years old). The ACE score (zero, one, two-three, ≥four) included questions assessing exposure to eight types of ACEs before age 18. The outcome was the respondent's self-report depression diagnosed (yes/no). Multivariable logistic regression models examined the association between ACEs and depression stratified by race. Each model adjusted for age, smoking status, income, education, marital status, and body mass index. RESULTS In this sample of older adults, 47%, 23%, 19% and 10% reported having experienced zero, one, two-three, and four or more types of ACEs, respectively. Depression was reported by 16% of survey respondents. There was a significant interaction between ACE score and race and depression (p = 0.038). Respondents who experienced ≥4 ACEs had higher likelihood of reporting depression for all race/ethnicity groups: non-Hispanic Whites (aOR = 3.83; 95% CI: 3.07, 4.79), non-Hispanic Blacks (aOR = 3.39, 95% CI: 1.71, 6.71), or Hispanics (aOR = 12.61; 95% CI: 4.75, 33.43). This translated to a large effect size for non-Hispanic Whites and Hispanics although the magnitude was bigger for Hispanics. CONCLUSION The association between number of ACEs and depression was strongest for older adults who identify as Hispanic, but weaker and less consistent for adults who identify as White and Black.
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Affiliation(s)
| | | | - Sarah A Nguyen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, LA, USA
| | - Olivia I Okereke
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Frank A Clark
- Prisma Health, Greer, SC, USA; University of South Carolina School of Medicine-Greenville, Greenville, SC, USA
| | - Anusuiya Nagar
- Prisma Health, Greer, SC, USA; University of South Carolina School of Medicine-Greenville, Greenville, SC, USA
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA; Duke University School of Medicine, Department of Population Health Sciences, Durham, NC, USA; Duke Cancer Institute, Durham, NC, USA
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA; Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, MI, USA
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20
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Reliford A, Liu A, Dhir S, Schlechter A. Race, Ethnicity, and the Medical "One-Liner": How Child and Adolescent Psychiatry Can Chart Its Own Antiracist Path Forward. Acad Psychiatry 2024; 48:178-182. [PMID: 37993762 DOI: 10.1007/s40596-023-01904-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/03/2023] [Indexed: 11/24/2023]
Affiliation(s)
- Aaron Reliford
- NYU Grossman School of Medicine, New York, NY, USA.
- Family Health Centers at NYU Langone Brooklyn, Brooklyn, NY, USA.
| | - Anni Liu
- NYU Grossman School of Medicine, New York, NY, USA
| | - Sakshi Dhir
- NYU Grossman School of Medicine, New York, NY, USA
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21
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Dodge J, Sullivan K, Miech E, Clomax A, Riviere L, Castro C. Exploring the Social Determinants of Mental Health by Race and Ethnicity in Army Wives. J Racial Ethn Health Disparities 2024; 11:669-684. [PMID: 36952121 PMCID: PMC10933139 DOI: 10.1007/s40615-023-01551-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/26/2023] [Accepted: 02/22/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE To explore the social determinants of mental health (SDoMH) by race/ethnicity in a sample with equal access to healthcare. Using an adaptation of the World Health Organization's SDoMH Framework, this secondary analysis examines the socio-economic factors that make up the SDoMH by race/ethnicity. METHOD This paper employed configurational comparative methods (CCMs) to analyze various racial/ethnic subsets from quantitative survey data from (N = 327) active-duty Army wives. Data was collected in 2012 by Walter Reed Army Institute of Research. RESULTS Initial exploratory analysis revealed the highest-scoring factors for each racial/ethnic subgroup: non-Hispanic Black: employment and a history of adverse childhood events (ACEs); Hispanic: living off post and a recent childbirth; junior enlisted non-Hispanic White: high work-family conflict and ACEs; non-Hispanic other race: high work-family conflict and not having a military history. Final analysis showed four models consistently explained clinically significant depression symptoms and four models consistently explained the absence of clinical depression symptoms, providing a solution for each racial/ethnic minority group (non-Hispanic Black, Hispanic, junior enlisted non-Hispanic White, and non-Hispanic other). DISCUSSION These findings highlight that Army wives are not a monolithic group, despite their collective exposure to military-specific stressors. These findings also highlight the potential for applying configurational approaches to gain new insights into mental health outcomes for social science and clinical researchers.
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Affiliation(s)
- Jessica Dodge
- Center for Clinical Management Research, Health Services Research and Development, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
| | - Kathrine Sullivan
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY, 10003, USA
| | - Edward Miech
- Regenstrief Institute, Center for Health Services Research, 1101 W 10th Street, Indianapolis, IN, 46202, USA
| | - Adriane Clomax
- Center for Innovation and Research on Veterans and Military Families, Suzanne Dworak-Peck School of Social Work, 669 West 34th Street, Suite 201D, Los Angeles, CA, 90089, USA
| | - Lyndon Riviere
- Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD, 20910, USA
| | - Carl Castro
- Center for Innovation and Research on Veterans and Military Families, Suzanne Dworak-Peck School of Social Work, 669 West 34th Street, Suite 201D, Los Angeles, CA, 90089, USA
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22
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Amjad S, Tromburg C, Adesunkanmi M, Mawa J, Mahbub N, Campbell S, Chari R, Rowe BH, Ospina MB. Social Determinants of Health and Pediatric Emergency Department Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Ann Emerg Med 2024; 83:291-313. [PMID: 38069966 DOI: 10.1016/j.annemergmed.2023.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 10/03/2023] [Accepted: 10/20/2023] [Indexed: 03/24/2024]
Abstract
STUDY OBJECTIVE Social determinants of health contribute to disparities in pediatric health and health care. Our objective was to synthesize and evaluate the evidence on the association between social determinants of health and emergency department (ED) outcomes in pediatric populations. METHODS This review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity Extension guidelines. Observational epidemiological studies were included if they examined at least 1 social determinant of health from the PROGRESS-Plus framework in relation to ED outcomes among children <18 years old. Effect direction plots were used for narrative results and pooled odds ratios (pOR) with 95% confidence intervals (CI) for meta-analyses. RESULTS Fifty-eight studies were included, involving 17,275,090 children and 103,296,839 ED visits. Race/ethnicity and socioeconomic status were the most reported social determinants of health (71% each). Black children had 3 times the odds of utilizing the ED (pOR 3.16, 95% CI 2.46 to 4.08), whereas visits by Indigenous children increased the odds of departure prior to completion of care (pOR 1.58, 95% CI 1.39 to 1.80) compared to White children. Public insurance, low income, neighborhood deprivation, and proximity to an ED were also predictors of ED utilization. Children whose caregivers had a preferred language other than English had longer length of stay and increased hospital admission. CONCLUSION Social determinants of health, particularly race, socioeconomic deprivation, proximity to an ED, and language, play important roles in ED care-seeking patterns of children and families. Increased utilization of ED services by children from racial minority and lower socioeconomic status groups may reflect barriers to health insurance and access to health care, including primary and subspecialty care, and/or poorer overall health, necessitating ED care. An intersectional approach is needed to better understand the trajectories of disparities in pediatric ED outcomes and to develop, implement, and evaluate future policies.
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Affiliation(s)
- Sana Amjad
- Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Courtney Tromburg
- Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Adesunkanmi
- Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Jannatul Mawa
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Nazif Mahbub
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sandra Campbell
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
| | - Radha Chari
- Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Brian H Rowe
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Maria B Ospina
- Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada; Department of Public Health Sciences, Queen's University; Kingston, Ontario, Canada.
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Daungsupawong H, Wiwanitkit V. Uptake of Adolescent Vaccines Among Racial/Ethnic Minority Adolescents Before and During the COVID-19 Pandemic: Comment. J Adolesc Health 2024; 74:855. [PMID: 38519253 DOI: 10.1016/j.jadohealth.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/14/2023] [Indexed: 03/24/2024]
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Khera N, Edwards ML, Song Y, Sun R, Manghani R, Shin H, Simantov R, Signorovitch J, Sivaraman S, Gergis U. Projected Impact of Omidubicel-onlv on Racial/Ethnic Disparities in Allogeneic Hematopoietic Cell Transplantation (Allo-HCT) Outcomes in Hematologic Malignancies. Adv Ther 2024; 41:1637-1651. [PMID: 38427220 PMCID: PMC10960759 DOI: 10.1007/s12325-023-02771-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/14/2023] [Indexed: 03/02/2024]
Abstract
INTRODUCTION In a phase III clinical trial (NCT02730299), omidubicel-onlv, a nicotinamide-modified allogeneic hematopoietic progenitor cell therapy, showed rapid hematopoietic and immune recovery compared with standard umbilical cord blood (UCB) transplant across all racial/ethnic groups. METHODS A decision-tree model was used to project the effect of omidubicel-onlv availability on addressing health disparities in allogeneic hematopoietic cell transplantation (allo-HCT) access and outcomes for patients with hematologic malignancies. The model used a hypothetical population of 10,000 allo-HCT-eligible US adults, for whom matched related donors were not available. Patients received matched or mismatched unrelated donor, haploidentical, UCB transplant, or no transplant. Scenarios with omidubicel-onlv use of 0% (status quo), 10%, 15%, 20%, and 30% were modeled on the basis of proportional reductions in other allo-HCT sources or no transplant by racial/ethnic group. RESULTS Increased omidubicel-onlv use was associated with a higher proportion of patients undergoing allo-HCT, decreased time to allo-HCT, decreased 1-year non-relapse mortality, and increased 1-year overall survival, particularly among racial minorities. In the scenario modeling 20% omidubicel-onlv use, the proportion of Black patients receiving allo-HCT increased by 129%; increases were also observed in Asian (64%), Hispanic (45%), and other (42%) patient groups. Modeled time to allo-HCT improved among transplanted patients (23%) from 11.4 weeks to 8.8 weeks. One-year OS in the overall population increased by 3%, with improvements ranging from 3% for White patients to 5% for Black patients. CONCLUSION This study demonstrates that broad access to omidubicel-onlv could increase access to allo-HCT and improve outcomes for patients, with the greatest benefits seen among racial/ethnic minority groups.
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Affiliation(s)
- Nandita Khera
- Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA
| | | | - Yan Song
- Analysis Group Inc., Boston, MA, USA
| | | | | | | | | | | | | | - Usama Gergis
- Department of Medical Oncology, Thomas Jefferson University, 834 Chestnut St, Ste 308, Philadelphia, PA, 19107, USA.
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Kindratt TB, Dallo FJ, Brown KK. Maternal and Perinatal Health Disparities Among Middle Eastern and North African Women and Children in the United States. Matern Child Health J 2024; 28:719-728. [PMID: 38194128 DOI: 10.1007/s10995-023-03863-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/10/2024]
Abstract
INTRODUCTION Few studies have evaluated the health of Middle Eastern and North African (MENA) women and children in the United States. Objectives were to determine the odds of well-visits, preventive behaviors during pregnancy, and low birthweight among foreign-born non-Hispanic MENA women and children compared to their US- and foreign-born non-Hispanic White counterparts after adjusting for covariates (hereafter, reported as MENA and White). METHODS We analyzed 2000-2018 National Health Interview Survey data (411,709 women, 311,961 children). Outcomes included well-woman visits (past 12 months); dentist visits (past 6 months) and current smoking among pregnant women; and low, moderately low, and very low birthweight among children. Covariates included age, family income, and health insurance for children. Education and marital status were also evaluated among women. RESULTS Over half (53.4%) of foreign-born MENA women were of childbearing age (ages 18-45) compared to 47.7% US-born and 43.2% foreign-born White women. The odds of completing a well-women visit were 0.73 times lower (95% CI = 0.38-0.89) among foreign-born MENA women compared to US-born White women after adjusting for age, education, and marital status. There was no statistically significant difference in dental visits between groups. No foreign-born MENA pregnant women reported current smoking. Foreign-born MENA children had higher odds of low (OR = 1.65; 95% CI = 1.16-2.35) and moderately low birthweight (OR = 1.78; 95% CI = 1.19-2.66) compared to US-born White children in adjusted models. DISCUSSION MENA women and children are classified as White by the federal government. Our results highlight that the health of foreign-born MENA women and children differ from their White counterparts.
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Affiliation(s)
- Tiffany B Kindratt
- Public Health Program, Department of Kinesiology, University of Texas at Arlington, 500 West Nedderman Drive, Arlington, TX, 76019-0259, USA.
| | - Florence J Dallo
- School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
| | - Kyrah K Brown
- Public Health Program, Department of Kinesiology, University of Texas at Arlington, 500 West Nedderman Drive, Arlington, TX, 76019-0259, USA
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Jacobs SR, Ramsey N, Bagnato M, Pitt T, Davis CM. Health disparities in allergic diseases. Curr Opin Allergy Clin Immunol 2024; 24:94-101. [PMID: 38295102 PMCID: PMC10923006 DOI: 10.1097/aci.0000000000000972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
PURPOSE OF REVIEW Healthcare disparities impact prevalence, diagnosis, and management of allergic disease. The purpose of this review is to highlight the most recent evidence of healthcare disparities in allergic conditions to provide healthcare providers with better understanding of the factors contributing to disparities and to provide potential management approaches to address them. This review comes at a time in medicine where it is well documented that disparities exist, but we seek to answer the Why , How and What to do next? RECENT FINDINGS The literature highlights the socioeconomic factors at play including race/ ethnicity, neighborhood, insurance status and income. Management strategies have been implemented with the hopes of mitigating the disparate health outcomes including utilization of school-based health, distribution of educational tools and more inclusive research recruitment. SUMMARY The studies included describe the associations between upstream structural and social factors with downstream outcomes and provide ideas that can be recreated at other institutions of how to address them. Focus on research and strategies to mitigate healthcare disparities and improve diverse research participant pools are necessary to improve patient outcomes in the future.
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Affiliation(s)
- Samantha R. Jacobs
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nicole Ramsey
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Mariangela Bagnato
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Tracy Pitt
- Department of Pediatrics, Humber Hospital, Toronto, Ontario, Canada
| | - Carla M. Davis
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
- Division of Immunology, Allergy and Retrovirology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, United States
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, United States
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Ashraf H, Nadeem ZA, Ashfaq H, Ahmed S, Ashraf A, Nashwan AJ. Mortality patterns in older adults with infective endocarditis in the US: A retrospective analysis. Curr Probl Cardiol 2024; 49:102455. [PMID: 38342352 DOI: 10.1016/j.cpcardiol.2024.102455] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Infective Endocarditis (IE) has become a significant cause of morbidity and mortality over the last two decades. Despite management advancements, mortality trends in the USA's geriatric population are unexplored. The aim of this study was to assess the trends and regional differences in IE related mortality among geriatric patients in the USA. METHODS We analyzed death certificates sourced from the CDC WONDER database spanning 1999 to 2020. The research targeted individuals aged 65 and older. Age-adjusted mortality rates (AAMRs) per 100,000 and annual percent change (APC), along with 95% CI, were calculated through joinpoint regression analysis. RESULTS From 1999 to 2020, infective endocarditis caused 222,573 deaths, showing a declining trend (APC: -0.8361). Males had higher AAMR (26.8) than females (22.2). NH White had the highest AAMR (25.8), followed by NH American Indians or Alaska Natives (19.6). Geographically, the Midwest had the highest AAMR (27.4), followed by the Northeast (25.8). Rural areas consistently had higher AAMRs (26.6) than urban areas (23.6), while 80.16% of deaths occurring in urban settings. North Dakota, Nebraska, and Montana had the highest state AAMRs, approximately double than the states with the lowest mortality rates: Mississippi, Hawaii, California, and Massachusetts. Those aged 85 and above accounted for 42.9% of deaths. CONCLUSION IE mortality exhibited a clear pattern: rising till 2004, declining from 2004 to 2018, and increasing again till 2020. Key risk factors were male gender, Midwest residence, NH White ethnicity, and age ≥85.Targeted interventions are essential to reduce IE mortality, especially among vulnerable older populations.
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Affiliation(s)
- Hamza Ashraf
- Department of Cardiology, Allama Iqbal Medical College, Pakistan
| | - Zain Ali Nadeem
- Department of Medicine, Allama Iqbal Medical College, Pakistan
| | - Haider Ashfaq
- Department of Medicine, Allama Iqbal Medical College, Pakistan
| | - Sophia Ahmed
- Department of Medicine, Allama Iqbal Medical College, Pakistan
| | - Ali Ashraf
- Department of Medicine, Punjab Medical College, Pakistan
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Lovvorn HN, Renfro LA, Benedetti DJ, Kotagal M, Phelps HM, Ehrlich PF, Lo AC, Sandberg JK, Treece AL, Gow KW, Glick RD, Davidoff AM, Cost NG, Dix DB, Fernandez CV, Dome JS, Geller JI, Mullen EA. Race and Ethnic Group Enrollment and Outcomes for Wilms Tumor: Analysis of the Current Era Children's Oncology Group Study, AREN03B2. J Am Coll Surg 2024; 238:733-749. [PMID: 38251681 DOI: 10.1097/xcs.0000000000000999] [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] [Indexed: 01/23/2024]
Abstract
BACKGROUND To review race and ethnic group enrollment and outcomes for Wilms tumor (WT) across all 4 risk-assigned therapeutic trials from the current era Children's Oncology Group Renal Tumor Biology and Risk Stratification Protocol, AREN03B2. STUDY DESIGN For patients with WT enrolled in AREN03B2 (2006 to 2019), disease and biologic features, therapeutic study-specific enrollment, and event-free (EFS) and overall (OS) 4-year survival were compared between institutionally reported race and ethnic groups. RESULTS Among 5,146 patients with WT, no statistically significant differences were detected between race and ethnic groups regarding subsequent risk-assigned therapeutic study enrollment, disease stage, histology, biologic factors, or overall EFS or OS, except the following variables: Black children were older and had larger tumors at enrollment, whereas Hispanic children had lower rates of diffuse anaplasia WT and loss of heterozygosity at 1p. The only significant difference in EFS or OS between race and ethnic groups was observed among the few children treated for diffuse anaplasia WT with regimen UH-1 and -2 on high-risk protocol, AREN0321. On this therapeutic arm only, Black children showed worse EFS (hazard ratio = 3.18) and OS (hazard ratio = 3.42). However, this finding was not replicated for patients treated with regimen UH-1 and -2 under AREN03B2 but not on AREN0321. CONCLUSIONS Race and ethnic group enrollment appeared constant across AREN03B2 risk-assigned therapeutic trials. EFS and OS on these therapeutic trials when analyzed together were comparable regarding race and ethnicity. Black children may have experienced worse stage-specific survival when treated with regimen UH-1 and -2 on AREN0321, but this survival gap was not confirmed when analyzing additional high-risk AREN03B2 patients.
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Affiliation(s)
| | - Lindsay A Renfro
- Division of Biostatistics, University of Southern California, and Children's Oncology Group, Los Angeles, CA (Renfro)
| | - Daniel J Benedetti
- Division of Pediatric Hematology/Oncology, Department of Pediatrics (Benedetti), Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN
| | - Meera Kotagal
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH (Kotagal)
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH (Kotagal)
| | - Hannah M Phelps
- Department of Surgery, Washington University in St Louis School of Medicine, St Louis, MO (Phelps)
| | - Peter F Ehrlich
- Section of Pediatric Surgery, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI (Ehrlich)
| | - Andrea C Lo
- Department of Radiation on Oncology, BC Cancer, Vancouver, British Columbia, Canada (Lo)
| | - Jesse K Sandberg
- Division of Pediatric Radiology, Lucille Packard Children's Hospital, Stanford University, Palo Alto, CA (Sandberg)
| | - Amanda L Treece
- Department of Pathology and Laboratory Medicine, Children's Hospital of Alabama, Birmingham, AL (Treece)
| | - Kenneth W Gow
- Division of General and Thoracic Surgery, Seattle Children's Hospital, Seattle, WA (Gow)
| | - Richard D Glick
- Division of Pediatric Surgery, Cohen Children's Medical Center, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY (Glick)
| | - Andrew M Davidoff
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN (Davidoff)
| | - Nicholas G Cost
- Division of Urology, Department of Surgery, University of Colorado School of Medicine, Surgical Oncology Program, Children's Hospital Colorado, Aurora, CO (Cost)
| | - David B Dix
- Division of Hematology and Oncology, Department of Pediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia, Canada (Dix)
| | - Conrad V Fernandez
- Division of Paediatric Haematology Oncology, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia (Fernandez)
| | - Jeffrey S Dome
- Center for Cancer and Blood Disorders, Children's National Hospital, Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC (Dome)
| | - James I Geller
- Division of Oncology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH (Geller)
| | - Elizabeth A Mullen
- Division of Pediatric Hematology and Oncology, Dana-Farber Cancer Institute, Boston, MA (Mullen)
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Tung EL, Bruch JD, Chin MH, Menconi M, Peek ME, Huang ES. Associations of U.S. hospital closure (2007-2018) with area socioeconomic disadvantage and racial/ethnic composition. Ann Epidemiol 2024; 92:40-46. [PMID: 38432535 DOI: 10.1016/j.annepidem.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/15/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE To examine whether hospital closure is associated with high levels of area socioeconomic disadvantage and racial/ethnic minority composition. METHODS Pooled cross-sectional analysis (2007-2018) of 6467 U.S. hospitals from the American Hospital Association's Annual Survey, comparing hospital population characteristics of closed hospitals to all remaining open hospitals. We used multilevel mixed-effects logistic regression models to assess closure as a function of population characteristics, including area deprivation index ([ADI], a composite measure of socioeconomic disadvantage), racial/ethnic composition, and rural classification, nesting hospitals within hospital service areas (HSAs) and hospital referral regions. Secondary analyses examined public or private hospital type. RESULTS Overall, 326 (5.0%) of 6467 U.S. hospitals closed during the study period. In multivariable models, hospitals in HSAs with a higher burden of socioeconomic disadvantage (per 10% above median ADI ZIP codes, AOR 1.05; 95% CI, 1.01-1.09) and Black Non-Hispanic composition (highest quartile, AOR 4.03; 95% CI, 2.62-6.21) had higher odds of closure. We did not observe disparities in closure by Hispanic/Latino composition or rurality. Disparities persisted for Black Non-Hispanic communities, even among HSAs with the lowest burden of disadvantage. CONCLUSIONS Disproportionate hospital closure in communities with higher socioeconomic disadvantage and Black racial composition raises concerns about unequal loss of healthcare resources in the U.S.
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Affiliation(s)
- Elizabeth L Tung
- Section of General Internal Medicine, University of Chicago, United States; Center for Health and the Social Sciences, University of Chicago, United States.
| | - Joseph D Bruch
- Section of General Internal Medicine, University of Chicago, United States; Department of Public Health Sciences, University of Chicago, United States
| | - Marshall H Chin
- Section of General Internal Medicine, University of Chicago, United States; Center for Chronic Disease Research and Policy, University of Chicago, United States
| | - Maxwell Menconi
- Section of General Internal Medicine, University of Chicago, United States
| | - Monica E Peek
- Section of General Internal Medicine, University of Chicago, United States; Center for Chronic Disease Research and Policy, University of Chicago, United States
| | - Elbert S Huang
- Section of General Internal Medicine, University of Chicago, United States; Center for Chronic Disease Research and Policy, University of Chicago, United States
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Isautier JMJ, Wang S, Houssami N, McCaffery K, Brennan ME, Li T, Nickel B. The impact of breast density notification on psychosocial outcomes in racial and ethnic minorities: A systematic review. Breast 2024; 74:103693. [PMID: 38430905 PMCID: PMC10918326 DOI: 10.1016/j.breast.2024.103693] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND High breast density is an independent risk factor for breast cancer and decreases the sensitivity of mammography. This systematic review synthesizes the evidence on the impact of breast density (BD) information and/or notification on women's psychosocial outcomes among women from racial and ethnic minority groups. METHODS A systematic search was performed in March 2023, and the articles were identified using CINHAL, Embase, Medline, and PsychInfo databases. The search strategy combined the terms "breast", "density", "notification" and synonyms. The authors specifically kept the search terms broad and did not include terms related to race and ethnicity. Full-text articles were reviewed for analysis by race, ethnicity and primary language of participants. Two authors evaluated the eligibility of studies with verification from the study team, extracted and crosschecked data, and assessed the risk of bias. RESULTS Of 1784 articles, 32 articles published from 2003 to 2023 were included. Thirty-one studies were conducted in the United States and one in Australia, with 28 quantitative and four qualitative methodologies. The overall results in terms of breast density awareness, knowledge, communication with healthcare professionals, screening intentions and supplemental screening practice were heterogenous across studies. Barriers to understanding BD notifications and intentions/access to supplemental screening among racial and ethnic minorities included socioeconomic factors, language, health literacy and medical mistrust. CONCLUSIONS A one-size approach to inform women about their BD may further disadvantage racial and ethnic minority women. BD notification and accompanying information should be tailored and translated to ensure readability and understandability by all women.
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Affiliation(s)
- J M J Isautier
- The University of Sydney, Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, New South Wales Australia; Wiser Healthcare, School of Public Health, The University of Sydney, New South Wales, Australia
| | - S Wang
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - N Houssami
- Wiser Healthcare, School of Public Health, The University of Sydney, New South Wales, Australia; The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - K McCaffery
- The University of Sydney, Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, New South Wales Australia; Wiser Healthcare, School of Public Health, The University of Sydney, New South Wales, Australia
| | - M E Brennan
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Sydney, Australia; National School of Medicine, University of Notre Dame Australia, Sydney, Australia
| | - T Li
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - B Nickel
- The University of Sydney, Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, New South Wales Australia; Wiser Healthcare, School of Public Health, The University of Sydney, New South Wales, Australia.
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Garfein J, Chen Y, Swabe G, Guhl E, Forman DE, Magnani JW. Race or ethnicity and education in cardiac rehabilitation enrollment. J Cardiol 2024; 83:280-283. [PMID: 37562543 PMCID: PMC10850430 DOI: 10.1016/j.jjcc.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Although cardiac rehabilitation (CR) has established benefits for cardiovascular health, it remains significantly underutilized, with substantial differences in participation related to factors such as educational attainment (EA), race, and ethnicity. We studied a geographically and racially diverse cohort of insured individuals in a health claims database to (1) evaluate differences in CR participation by EA and race or ethnicity and (2) assess how EA modifies associations between race or ethnicity and CR participation. METHODS We conducted a retrospective cohort study of individuals identified in Optum's de-identified Clinformatics® database between 1/1/2016 and 12/31/2019. Eligible individuals included those aged ≥18 years with a hospitalization for an incident CR-qualifying diagnosis. We calculated incidence rates of CR enrollment by EA and race or ethnicity, as well as associations of EA and race or ethnicity with CR enrollment, and evaluated interaction between EA and race or ethnicity with respect to CR participation. RESULTS We identified 171,297 individuals eligible for CR with a mean ± SD age of 70.4 ± 11.6 years; 37.4 % were female, and 68.3 % had >high school education. We observed a dose-response association between EA and rate of participation in CR. After adjustment, compared to White individuals, the odds of attending CR was 24 % lower for Asian individuals [95 % confidence interval (CI): 17 %, 30 %], 13 % lower for Black individuals (95 % CI: 9 %, 17 %), and 32 % lower for Hispanic individuals (95 % CI: 28 %, 35 %), all p < 0.0001. However, Black individuals with ≥bachelor's degree had a similar odds of CR enrollment as White individuals with ≥bachelor's degree (odds ratio 1.01, 95 % CI: 0.85, 1.20, p = 0.95). CONCLUSIONS EA was positively associated with CR enrollment across racial and ethnic groups. Higher EA might partially attenuate racial and ethnic differences in CR participation, but significant disparities persist. Our findings support increased attention to individuals with limited education to improve CR enrollment.
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Affiliation(s)
- Joshua Garfein
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yimin Chen
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gretchen Swabe
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Emily Guhl
- Division of Cardiology, UPMC Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel E Forman
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Division of Cardiology, UPMC Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jared W Magnani
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Division of Cardiology, UPMC Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; Center for Research on Health Care, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
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Pino B, Velu PS, Levi JR. Racial and Ethnic Disparities in Otolaryngology Applicants and Residents: Recruiting a Diverse Workforce. J Surg Educ 2024; 81:543-550. [PMID: 38383238 DOI: 10.1016/j.jsurg.2023.12.016] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/25/2023] [Accepted: 12/30/2023] [Indexed: 02/23/2024]
Abstract
OBJECTIVE The purpose of this study is to examine the racial and ethnic representation of otolaryngology applicants and residents and determine if there have been any improvements in recruiting a diverse workforce over the past several years. METHODS A retrospective study was conducted on self-reported race and ethnicity data of otolaryngology applicants to United States residency programs from 2016 to 2022 from the Association of American Medical Colleges (AAMC) and residents from 2011 to 2022 from the Accreditation Council for Graduate Medical Education (ACGME). The changes in proportions of applicants and residents by race and ethnicity separately was compared as well as the proportion of applicants to residents. Descriptive analyses and chi-square tests were used to compare proportions of groups by race and ethnicity. RESULTS There was no statistically significant difference in the proportion of applicants by race or ethnicity from 2016-2017 to 2021-2022. There was a decrease in the proportion of White residents from 58.1% to 54.5% from 2011-2012 to 2018-2019. There were higher proportions of White residents than applicants and lower proportions of Black residents than applicants in the two cycles analyzed. In the most recent cycle analyzed, the proportion of Hispanic or Latino residents was higher than the proportion of Hispanic or Latino applicants. CONCLUSION While there may be improvements to increase representation of otolaryngology applicants and residents, there continues to be inequalities and a lack of diversity. Further initiatives are needed to ensure diversity in the field improves moving forward.
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Affiliation(s)
- Bruna Pino
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.
| | - Preetha S Velu
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Jessica R Levi
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts
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Shi YK, Yuan KH, Fu ZM, Hu RR, Wang H. The Relationship Between Systemic Lupus Erythematosus and Osteoporosis Based on Different Ethnic Groups: a Two-Sample Mendelian Randomization Analysis. Calcif Tissue Int 2024; 114:386-396. [PMID: 38355832 DOI: 10.1007/s00223-024-01190-8] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
The previous observational studies could not overcome the effects of confounding variables and reverse causality. We aimed to determine whether there is a causal relationship between systemic lupus erythematosus and osteoporosis in East Asian and European populations, respectively, by two-sample Mendelian Randomization analysis. We obtained and downloaded data from publicly available genome-wide association study databases and analyses for East Asian and European populations, including systemic lupus erythematosus (SLE), osteoporosis (OP), multisite bone mineral density (BMD), and OP with fracture. After screening for instrumental single-nucleotide polymorphisms (SNPs) significantly correlated to SLE, the inverse-variance weighted (IVW) method was used for calculating the ratio and 95% confidence interval, besides utilizing MR-Egger, weighted median, and weighted mode to assess the robustness of the primary outcome. Moreover, multiple analyses, including MR-PRESSO, MR-Egger intercept, Cochran's Q test, as well as "leave-one-out" sensitivity, were used for evaluating horizontal pleiotropy, heterogeneity, and stability. Finally, we exchanged exposure and outcome and performed a reverse MR analysis. IVW (OR = 1.05, 95% CI = 1.01-1.09, P = 0.009) indicated a significant positive correlation between genetically predicted SLE and OP in East Asians. Furthermore, neither heterogeneity nor horizontal pleiotropy was observed. In Europe, there was no significant genetically predicted causal relation between SLE and OP. Bi-directional MR analysis showed no reverse causality between SLE and OP. In the East Asian population, genetically predicted SLE may have had a positive causal relationship with OP. In Europe, there is insufficient evidence for a potential causal relation between SLE and OP or BMD and fracture, and the correlations currently observed may be attributed to a variety of confounder variables.
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Affiliation(s)
- Y K Shi
- Department of Nuclear Medicine, Hainan Hospital Of PLA General Hospital, 80 Jianglin Road, Sanya, China
| | - K H Yuan
- Department of Nuclear Medicine, Hainan Hospital Of PLA General Hospital, 80 Jianglin Road, Sanya, China
| | - Z M Fu
- Department of Nuclear Medicine, Hainan Hospital Of PLA General Hospital, 80 Jianglin Road, Sanya, China
| | - R R Hu
- Department of Nuclear Medicine, Hainan Hospital Of PLA General Hospital, 80 Jianglin Road, Sanya, China
| | - H Wang
- Department of Nuclear Medicine, Hainan Hospital Of PLA General Hospital, 80 Jianglin Road, Sanya, China.
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Elfaki LA, Nwakoby A, Keshishi M, Vervoort D, Yanagawa B, Fremes SE. Race and Ethnicity in Cardiac Surgery: A Missed Opportunity? Ann Thorac Surg 2024; 117:714-722. [PMID: 37914147 DOI: 10.1016/j.athoracsur.2023.10.025] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/02/2023] [Accepted: 10/20/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Patients' race and/or ethnicity are increasingly being associated with differential surgical access and outcomes in cardiac surgery. However, deriving evidence-based conclusions that can inform surgical care has been difficult because of poor diversity in study populations and conflicting research methodology and findings. Using a fictional patient example, this review identifies areas of concern in research engagement, methodology, and analyses, as well as potential steps to improve race and ethnicity considerations in cardiac surgical research. METHODS A narrative literature review was performed using the PubMed/MEDLINE and Google Scholar databases, with a combination of cardiac surgery, race, ethnicity, and disparities keywords. RESULTS Less than half of the published cardiac surgery randomized control trials report the race and/or ethnicity of research participants. Racial and/or ethnic minorities make up <20% of most study populations and are significantly underrepresented relative to their proportions of the general population. Further, race and/or ethnicity of research participants is variably categorized based on ancestry, geographic regions, cultural similarities, or minority status. There is growing consideration of analyzing interrelated and confounding variables, such as socioeconomic status, geographic location, or hospital quality, to better elucidate racial and/or ethnic disparities; however, intersectionality considerations remain limited in cardiac surgery research. CONCLUSIONS Racial and/or ethnic disparities are increasingly being reported in research engagement, cardiac pathologies, and surgical outcomes. To promote equitable surgical care, tangible efforts are needed to recruit racially and/or ethnically minoritized patients to research studies, be transparent and consistent in their groupings, and elucidate the impact of their intersectional social identities.
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Affiliation(s)
- Lina A Elfaki
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Akachukwu Nwakoby
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Melanie Keshishi
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dominique Vervoort
- Division of Cardiac Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Cardiac Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Bobby Yanagawa
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Cardiac Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Stephen E Fremes
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Cardiac Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
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Benevides TW, Datta B, Jaremski J, McKee M. Prevalence of intellectual disability among adults born in the 1980s and 1990s in the United States. J Intellect Disabil Res 2024; 68:377-384. [PMID: 38234197 DOI: 10.1111/jir.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Prevalence of intellectual disability (ID) is currently estimated through parent report on surveys of children. It is difficult to estimate the number of adults living with ID in the United States because no comprehensive survey or surveillance allows for identification. The purpose of this study was to estimate the prevalence and number of adults with ID born between 1980 and 1999 using multiple years of the National Health Interview Survey (NHIS) and Census data. METHODS We concatenated the NHIS from 1997-2016 that evaluated parental response about whether a child aged 3-17 years had an ID. Using weighted survey analyses, we estimated the prevalence of ID among individuals across four birth cohorts-(1) 1980-1984, (2) 1985-1989, (3) 1990-1994, and (4) 1995-1999. The number of adults with ID was then extrapolated by applying these prevalence rates to Census population estimates (as of 1 July 2021) of respective birth cohorts. RESULTS Weighted prevalence of ID varied by birth cohort, sex, race and ethnicity, and US Census Bureau regions. The overall prevalence rate was 1.066 [95% confidence interval (CI): 0.831-1.302] for adults born between 1980 and 1984, 0.772 (CI: 0.654-0.891) for adults born between 1985 and 1989, 0.774 (0.675-0.874) for adults born between 1990 and 1994, and 1.069 (CI: 0.898-1.240) for adults born between 1995 and 1999. Overall, we estimate that 818 564 adults with ID who were approximately 21-41 years were living in the United States as of 2021. CONCLUSIONS This study provides researchers examining adult health outcomes with an estimated denominator of young and middle-aged adults living with ID in the United States. Policymakers can use this information to support justification for resource and service needs, and clinicians may benefit from understanding that ID is a lifelong developmental condition often with additional physical, emotional and developmental needs requiring tailored care.
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Affiliation(s)
- T W Benevides
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - B Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - J Jaremski
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - M McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
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Riley ED, Vittinghoff E, Ravi A, Coffin PO, Lynch KL, Wu AHB, Martinez C, Hsue PY. Brief Report: The Role of Substance Use in Structural Heart Disease Among Women Living With HIV. J Acquir Immune Defic Syndr 2024; 95:342-346. [PMID: 38133589 PMCID: PMC10922783 DOI: 10.1097/qai.0000000000003366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND People living with HIV have increased risk of cardiovascular disease, but few studies focus on women with HIV (WWH) and few account for the use of multiple substances. SETTING We recruited WWH from San Francisco shelters, free meal programs, street encampments, and a safety net HIV clinic. METHODS Between 2016 and 2019, participants completed 6 monthly interviews, specimen collection, and a transthoracic echocardiogram. We assessed associations between 3 echocardiographic indices of cardiac hypertrophy (concentric hypertrophy, concentric remodeling, and eccentric hypertrophy) and study factors, including cardiovascular risk factors, substance use, and HIV-specific factors (CD4 + count, viral load, HIV medication). RESULTS Among 62 participants, the average age was 53 years and 70% were ethnic minority women. Just over 70% had elevated blood pressure. Toxicology-confirmed substance use included tobacco (63%), cannabis (52%), cocaine (51%), methamphetamine (29%), and alcohol (26%). Concentric hypertrophy was detected in 26% of participants. It was positively associated with cocaine use [adjusted relative risk (aRR) = 32.5, P < 0.01] and negatively associated with cannabis use (aRR = 0.07, P < 0.01). Concentric remodeling was detected in 40% of participants. It was positively associated with cocaine use (aRR = 11.2, P < 0.01) and negatively associated with cannabis use (aRR = 0.17, P = 0.02). Eccentric hypertrophy was not significantly associated with factors studied here. CONCLUSIONS Routine evaluation of stimulant use as a contributing factor to cardiovascular risk may improve risk assessment in WWH. Whether cannabis use mitigates the impact of cocaine use on structural heart disease among WWH merits further investigation.
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Affiliation(s)
- Elise D Riley
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, School of Medicine, San Francisco, CA
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, School of Medicine, San Francisco, CA
| | - Akshay Ravi
- University of California, School of Medicine, Clinical Informatics, San Francisco, CA
| | - Phillip O Coffin
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, School of Medicine, San Francisco, CA
- San Francisco Department of Public Health, San Francisco, CA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California, School of Medicine, San Francisco, CA
| | - Alan H B Wu
- Department of Laboratory Medicine, University of California, School of Medicine, San Francisco, CA
| | - Claudia Martinez
- Division of Cardiovascular Medicine, Department of Medicine, University of Miami, School of Medicine, Miami, FL; and
| | - Priscilla Y Hsue
- Division of Cardiology, Department of Medicine, University of California, School of Medicine, San Francisco, CA
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Daw J, Roberts MK, Salim Z, Porter ND, Verdery AM, Ortiz SE. Relationships, race/ ethnicity, gender, age, and living kidney donation evaluation willingness. Transpl Immunol 2024; 83:101980. [PMID: 38184217 PMCID: PMC10939764 DOI: 10.1016/j.trim.2023.101980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/18/2023] [Accepted: 12/31/2023] [Indexed: 01/08/2024]
Abstract
Racial/ethnic and gender disparities in living donor kidney transplantation are large and persistent but incompletely explained. One previously unexplored potential contributor to these disparities is differential willingness to donate to recipients in specific relationships such as children, parents, and friends. We collected and analyzed data from an online sample featuring an experimental vignette in which respondents were asked to rate their willingness to donate to a randomly chosen member of their family or social network. Results show very large differences in respondents' willingness to donate to recipients with different relationships to them, favoring children, spouses/partners, siblings, and parents, and disfavoring friends, aunts/uncles, and coworkers. Evidence suggesting an interactive effect between relationship, respondent race/ethnicity, respondent or recipient gender, was limited to a few cases. At the p < 0.05 level, the parent-recipient gender interaction was statistically significant, favoring mothers over fathers, as was other/multiracial respondents' greater willingness to donate to friends compared to Whites. Additionally, other interactions were significant at the p < 0.10 level, such as Hispanics' and women's higher willingness to donate to parents compared to Whites and men respectively, women's lower willingness to donate to friends compared to men, and Blacks' greater willingness to donate to coworkers than Whites. We also examined differences by age and found that older respondents were less willing to donate to recipients other than their parents. Together these results suggest that differential willingness to donate by relationship group may be a moderately important factor in understanding racial/ethnic and gender disparities in living donor kidney transplantation.
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Affiliation(s)
- Jonathan Daw
- Department of Sociology & Criminology, The Pennsylvania State University.
| | - Mary K Roberts
- Department of Sociology & Criminology, The Pennsylvania State University
| | - Zarmeen Salim
- Department of Sociology & Criminology, The Pennsylvania State University
| | - Nathaniel D Porter
- University Libraries and Department of Sociology, Virginia Polytechnic Institute and State University
| | - Ashton M Verdery
- Department of Sociology & Criminology, The Pennsylvania State University
| | - Selena E Ortiz
- Department of Health Policy and Administration, The Pennsylvania State University
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Wallis KE, Guthrie W. Screening for Autism: A Review of the Current State, Ongoing Challenges, and Novel Approaches on the Horizon. Pediatr Clin North Am 2024; 71:127-155. [PMID: 38423713 DOI: 10.1016/j.pcl.2023.12.003] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Screening for autism is recommended in pediatric primary care. However, the median age of autism spectrum disorder (ASD) diagnosis is substantially higher than the age at which autism can reliably be identified, suggesting room for improvements in autism recognition at young ages, especially for children from minoritized racial and ethnic groups, low-income families, and families who prefer a language other than English. Novel approaches are being developed to utilize new technologies in aiding in autism recognition. However, attention to equity is needed to minimize bias. Additional research on the benefits and potential harms of universal autism screening is needed. The authors provide suggestions for pediatricians who are considering implementing autism-screening programs.
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Affiliation(s)
- Kate E Wallis
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Whitney Guthrie
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Fashaw‐Walters SA, Rahman M, Jarrín OF, Gee G, Mor V, Nkimbeng M, Thomas KS. Getting to the root: Examining within and between home health agency inequities in functional improvement. Health Serv Res 2024; 59:e14194. [PMID: 37356822 PMCID: PMC10915486 DOI: 10.1111/1475-6773.14194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
OBJECTIVE To quantify racial, ethnic, and income-based disparities in home health (HH) patients' functional improvement within and between HH agencies (HHAs). DATA SOURCES 2016-2017 Outcome and Assessment Information Set, Medicare Beneficiary Summary File, and Census data. DATA COLLECTION/EXTRACTION METHODS Not Applicable. STUDY DESIGN We use multinomial-logit analyses with and without HHA fixed effects. The outcome is a mutually exclusive five-category outcome: (1) any functional improvement, (2) no functional improvement, (3) death while a patient, (4) transfer to an inpatient setting, and (5) continuing HH as of December 31, 2017. The adjusted outcome rates are calculated by race, ethnicity, and income level using predictive margins. PRINCIPAL FINDINGS Of the 3+ million Medicare beneficiaries with a HH start-of-care assessment in 2016, 77% experienced functional improvement at discharge, 8% were discharged without functional improvement, 0.6% died, 2% were transferred to an inpatient setting, and 12% continued using HH. Adjusting for individual-level characteristics, Black, Hispanic, American Indian/Alaska Native (AIAN), and low-income HH patients were all more likely to be discharged without functional improvement (1.3 pp [95% CI: 1.1, 1.5], 1.5 pp [95% CI: 0.8, 2.1], 1.2 pp [95% CI: 0.6, 1.8], 0.7 pp [95% CI:0.5, 0.8], respectively) compared to White and higher income patients. After including HHA fixed effects, the differences for Black, Hispanic, and AIAN HH patients were mitigated. However, income-based disparities persisted within HHAs. Black-White, Hispanic-White, and AIAN-White disparities were largely driven by between-HHA differences, whereas income-based disparities were mostly due to within-HHA differences, and Asian American/Pacific Islander patients did not experience any observable disparities. CONCLUSIONS Both within- and between-HHA differences contribute to the overall disparities in functional improvement. Mitigating functional improvement inequities will require a diverse set of culturally appropriate and socially conscious interventions. Improving the quality of HHAs that serve more marginalized patients and incentivizing improved equity within HHAs are approaches that are imperative for ameliorating outcomes.
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Affiliation(s)
- Shekinah A. Fashaw‐Walters
- Division of Health Policy and Management, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Momotazur Rahman
- Center for Gerontology and Healthcare Research, School of Public HealthBrown UniversityProvidenceRhode IslandUSA
- Department of Health Services, Policy, and Practice, School of Public HealthBrown UniversityProvidenceRhode IslandUSA
| | - Olga F. Jarrín
- Division of Nursing Science, School of Nursing, RutgersThe State University of New JerseyNew BrunswickNew HampshireUSA
| | - Gilbert Gee
- Department of Community Health Sciences, Fielding School of Public HealthUniversity of California at Los AngelesLos AngelesCaliforniaUSA
| | - Vincent Mor
- Center for Gerontology and Healthcare Research, School of Public HealthBrown UniversityProvidenceRhode IslandUSA
- Department of Health Services, Policy, and Practice, School of Public HealthBrown UniversityProvidenceRhode IslandUSA
- Center of Innovation in Long‐Term Services and SupportsU.S. Department of Veterans Affairs Medical CenterProvidenceRhode IslandUSA
| | - Manka Nkimbeng
- Division of Health Policy and Management, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Kali S. Thomas
- Center for Gerontology and Healthcare Research, School of Public HealthBrown UniversityProvidenceRhode IslandUSA
- Department of Health Services, Policy, and Practice, School of Public HealthBrown UniversityProvidenceRhode IslandUSA
- Center of Innovation in Long‐Term Services and SupportsU.S. Department of Veterans Affairs Medical CenterProvidenceRhode IslandUSA
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Walker CR, Gunasinghe C, Harwood H, Ehsan A, Ahmed F, Dorrington S, Onwumere J, Meriez P, Stanley N, Stoll N, Woodhead C, Hatch SL, Rhead RD. Ethnic inequalities during clinical placement: A qualitative study of student nurses' experiences within the London National Health Service. J Adv Nurs 2024; 80:1497-1510. [PMID: 37788114 DOI: 10.1111/jan.15891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/25/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023]
Abstract
AIM To understand how student nurse experiences on clinical placement, within National Health Service (NHS) hospitals, differ for ethnic minority and White British groups. DESIGN A qualitative thematic analysis with an inductive approach. METHODS Data from semi-structured interviews with 21 London (United Kingdom) hospital-based student nurses were examined using thematic analysis. Participants were interviewed as part of the Tackling Inequalities and Discrimination Experiences in Health Services (TIDES) study and asked about their experiences during clinical placement. RESULTS Five main themes were identified: (1) Role of mentors, (2) Discrimination and unfair treatment, (3) Speaking up/out, (4) Career progression, and (5) Consequences of adverse experiences. All themes were linked, with the social dynamics and workplace environment (referred to as "ward culture") providing a context that normalizes mistreatment experienced by nursing students. Students from ethnic minority backgrounds reported racism as well as cultural and/or religious microaggressions. While being valued for their race and ethnicity, White British students also experienced discrimination and inequity due to their age, sex, gender, and sexual orientation. Students from both White British and ethnic minority groups acknowledged that being treated badly was a barrier to career progression. Ethnic minority students also noted the lack of diverse representation within senior nursing positions discouraged career progression within the UK NHS. CONCLUSION These initial experiences of inequality and discrimination are liable to shape a student's perspective of their profession and ability to progress within nursing. The NHS is responsible for ensuring that student nurses' developmental opportunities are equal, irrespective of ethnicity. IMPACT Ward culture is perpetuated by others who normalize mistreatment and concurrently disadvantage ethnic minority students, making them feel unvalued. This in turn impacts both staff retention and career progression within the NHS. Training assessors should be aware of the existing culture of discrimination within clinical placements and work to eradicate it.
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Affiliation(s)
- Chenel R Walker
- Department of Psychological Medicine, King's College London, London, UK
| | - Cerisse Gunasinghe
- Department of Psychological Medicine, King's College London, London, UK
- Department of Psychology, City University of London, London, UK
| | - Hannah Harwood
- Department of Psychological Medicine, King's College London, London, UK
| | - Annahita Ehsan
- Department of Psychological Medicine, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Farah Ahmed
- Department of Psychological Medicine, King's College London, London, UK
| | - Sarah Dorrington
- Department of Psychological Medicine, King's College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
| | - Juliana Onwumere
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Paula Meriez
- Department of Psychological Medicine, King's College London, London, UK
| | - Nathan Stanley
- Department of Psychological Medicine, King's College London, London, UK
| | - Nkasi Stoll
- Department of Psychological Medicine, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Charlotte Woodhead
- Department of Psychological Medicine, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Stephani L Hatch
- Department of Psychological Medicine, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Rebecca D Rhead
- Department of Psychological Medicine, King's College London, London, UK
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Chidiac C, Phan P, Rhee DS, Garcia AV. Access to Laparoscopic Pediatric Surgery: Do Ethnic and Racial Disparities Exist? J Surg Res 2024; 296:265-272. [PMID: 38295714 DOI: 10.1016/j.jss.2023.12.041] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/12/2023] [Accepted: 12/30/2023] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Disparate access to laparoscopic surgery may contribute to poorer health outcomes among racial and ethnic minorities, especially among children. We investigated whether racial and ethnic disparities in laparoscopic procedures existed among four common surgical operations in the pediatric population in the United States. METHODS Using the American College of Surgeons National Surgical Quality Improvement Program-Pediatrics, we conducted a retrospective review of pediatric patients, aged less than 18 y old, undergoing appendectomy, fundoplication, cholecystectomy, and colectomy from 2012 to 2021. To compare the surgical approach (laparoscopy or open), a propensity score matching algorithm was used to compare laparoscopic and open procedures between non-Hispanic Black with non-Hispanic White children and Hispanic with non-Hispanic White children. RESULTS 143,205, 9,907, 4,581, and 26,064 children underwent appendectomy, fundoplication, colectomy, and cholecystectomy, respectively. After propensity score matching, non-Hispanic Black children undergoing appendectomy were found to be treated laparoscopically less than non-Hispanic White children (93.5% versus 94.4%, P = 0.007). With fundoplication, Hispanic children were more likely to be treated laparoscopically than White ones (86.7% versus 80.9%, P < 0.0001). There were no statistically significant differences between Black or Hispanic children and White children in rates of laparoscopy for other procedures. CONCLUSIONS Though some racial and ethnic disparities exist with appendectomies and fundoplications, there is limited evidence to indicate that widespread inequities among common laparoscopic procedures exist in the pediatric population.
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Affiliation(s)
- Charbel Chidiac
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Paul Phan
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel S Rhee
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alejandro V Garcia
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Lee BA, Neville HA. The iBelong Scale: Construction and validation of a measure of racial-ethnic-cultural belonging. J Couns Psychol 2024; 71:139-154. [PMID: 38271052 DOI: 10.1037/cou0000716] [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] [Indexed: 01/27/2024]
Abstract
The purpose of this study was to develop a measure of racial-ethnic-cultural (REC) belonging for Black, Indigenous, and other people of color (BIPOC). The iBelong Scale was designed to assess the multidimensional components of REC belonging across diverse BIPOC groups. The scale was constructed based on a grounded conceptual framework of REC belonging, and the initial pool of items received feedback from community members and content experts. Validation of the iBelong Scale comprised data from 808 BIPOC participants collected across three interrelated studies for the purposes of initial validation, construct validity, and test-retest reliability. In Study 1, an exploratory factor analysis yielded a 25-item scale with five factors: (a) Home, (b) Connection, (c) Authenticity, (d) REC Thriving, and (e) Self-Definition. Results from Study 2's confirmatory factor analysis indicated that the five-factor model was an acceptable fit of the data and the best fit among competing models. Measurement invariance was assessed, and results indicated that the iBelong Scale measures REC belonging similarly across differing BIPOC groups. The iBelong Scale was related to a range of measures in theoretically expected ways, including positive associations with general belonging, racial/ethnic identity, and general well-being, and negative associations with loneliness and REC nonbelonging. Findings from Study 3 indicated the test-retest reliability of the iBelong Scale over a 2-week period. Limitations of the studies and implications for research and practice are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- B Andi Lee
- Department of Psychology, University of Illinois Urbana-Champaign
| | - Helen A Neville
- Department of Educational Psychology, University of Illinois Urbana-Champaign
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Xu J, Davoudi S, Yoon J, Chen X, Siegel NH, Subramanian ML, Ness S. Effect of race and ethnicity on surgical outcomes for rhegmatogenous retinal detachments. Can J Ophthalmol 2024; 59:102-108. [PMID: 36610705 DOI: 10.1016/j.jcjo.2022.12.003] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/11/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To evaluate the effect of socioeconomic and demographic factors on outcomes in rhegmatogenous retinal detachments (RRDs). DESIGN Retrospective cohort study. METHODS A total of 71 white and 124 black and/or Hispanic patients who had surgical repair of RRDs between October 2013 and September 2021 at a single-centre safety net hospital. Main outcomes were single surgery success rates (SSSR) and postoperative visual acuity at 6-month and final follow-up. RESULTS Black and (or) Hispanic patients were significantly younger (black and [or] Hispanic, 50.7 years vs white, 57.6 years; p = 0.003), had lower mean household incomes (black and [or] Hispanic, $80,932 vs white, $92,911; p = 0.007), were more likely to have more than 1 retinal break (black and [or] Hispanic, 65% vs white, 49%; p = 0.04), and had higher rates of proliferative vitreoretinopathy (PVR) at presentation (black and [or] Hispanic, 35% vs white, 18%; p = 0.02). SSSR was similar (black and [or] Hispanic, 73.4% vs white, 73.2%; p = 0.98), but black and (or) Hispanic patients had worse visual acuity postoperatively (black and [or] Hispanic, 20/63 vs white, 20/40 at final follow-up; p = 0.03). While race was linked to visual outcome in univariate testing; multivariate analysis revealed only macula status (p = 0.007 at 6 months; p = 0.01 at final follow-up), presence of PVR (p < 0.001 at both time points), and SSSR (p = 0.003 at final follow-up) as predictors of worse visual outcomes. CONCLUSIONS Preoperative factors such as higher rates of PVR may contribute to worse vision outcomes in black and (or) Hispanic patients undergoing surgical repair for RRD.
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Affiliation(s)
- Jia Xu
- Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Samaneh Davoudi
- Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Jamie Yoon
- Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Xuejing Chen
- Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Nicole H Siegel
- Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Manju L Subramanian
- Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Steven Ness
- Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA.
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McLaughlin DJ, Van Engen KJ. Social priming of speech perception: The role of individual differences in implicit racial and ethnic associations. J Exp Psychol Hum Percept Perform 2024; 50:329-357. [PMID: 38330329 DOI: 10.1037/xhp0001187] [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] [Indexed: 02/10/2024]
Abstract
Prior research has shown that visual information, such as a speaker's perceived race or ethnicity, prompts listeners to expect a specific sociophonetic pattern ("social priming"). Indeed, a picture of an East Asian face may facilitate perception of second language (L2) Mandarin Chinese-accented English but interfere with perception of first language- (L1-) accented English. The present study builds on this line of inquiry, addressing the relationship between social priming effects and implicit racial/ethnic associations for L1- and L2-accented speech. For L1-accented speech, we found no priming effects when comparing White versus East Asian or Latina primes. For L2- (Mandarin Chinese-) accented speech, however, transcription accuracy was slightly better following an East Asian prime than a White prime. Across all experiments, a relationship between performance and individual differences in implicit associations emerged, but in no cases did this relationship interact with the priming manipulation. Ultimately, exploring social priming effects with additional methodological approaches, and in different populations of listeners, will help to determine whether these effects operate differently in the context of L1- and L2-accented speech. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Drew J McLaughlin
- Department of Psychological and Brain Sciences, Washington University in St. Louis
| | - Kristin J Van Engen
- Department of Psychological and Brain Sciences, Washington University in St. Louis
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Pandit AA, Halpern MT, Gressler LE, Kamel M, Payakachat N, Li C. Association of race/ ethnicity and patient care experiences with receipt of definitive treatment among prostate cancer survivors: a SEER-CAHPS study. Cancer Causes Control 2024; 35:647-659. [PMID: 38001335 DOI: 10.1007/s10552-023-01834-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
PURPOSE This study aimed to evaluate the association of race/ethnicity, patient care experiences (PCEs), and receipt of definitive treatment and treatment modality among older adults in the United States (US) with localized prostate cancer (PCa). METHODS Using Surveillance, Epidemiology and End Results dataset linked to Medicare Consumer Assessment of Healthcare Providers and Systems (SEER-CAHPS) for 2007-2015, we identified men aged ≥ 65 years who completed a CAHPS survey within one year before and one year after PCa diagnosis. Associations of race/ethnicity (non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic, non-Hispanic Asian (NHA), and other) and of interactions between race/ethnicity and PCEs (getting needed care, getting care quickly, doctor communication, and care coordination) with the receipt of definitive PCa treatment and treatment modality within 3 and 6 months of diagnosis were examined using logistic regressions. RESULTS Among 1,438 PCa survivors, no racial/ethnic disparities in the receipt of definitive treatment were identified. However, NHB patients were less likely to receive surgery (vs. radiation) within 3 and 6 months of PCa diagnosis than NHW patients (OR 0.397, p = 0.006 and OR 0.419, p = 0.005), respectively. Among NHA patients, a 1-point higher score for getting care quickly was associated with lower odds (OR 0.981, p = 0.043) of receiving definitive treatment within 3 months of PCa diagnosis, whereas among NHB patients, a 1-point higher score for doctor communication was associated with higher odds (OR 1.023, p = 0.039) of receiving definitive treatment within 6 months of PCa diagnosis. DISCUSSION We observed differential associations between PCEs and receipt of definitive treatment based on patient race/ethnicity. Further research is needed to explore these associations.
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Affiliation(s)
- Ambrish A Pandit
- Department of Pharmacy Practice, Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, 72205, USA
| | - Michael T Halpern
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr., Bethesda, MD, 20892-9762, USA
| | - Laura E Gressler
- Department of Pharmacy Practice, Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, 72205, USA
| | - Mohamed Kamel
- Department of Surgery, College of Medicine, University of Cincinnati, Medical Sciences Building, 231 Albert Sabin Way Suite 2501, Cincinnati, OH, 45267, USA
- Department of Urology, Ain Shams University, Cairo, 11566, Egypt
| | - Nalin Payakachat
- Department of Pharmacy Practice, Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, 72205, USA
| | - Chenghui Li
- Department of Pharmacy Practice, Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, 72205, USA.
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O'Connor MI. Continuing the Conversation: Reply to the Letter to the Editor: Equity360: Gender, Race, and Ethnicity: Sex and Fairness in Sports. Clin Orthop Relat Res 2024; 482:741-744. [PMID: 38329384 PMCID: PMC10936965 DOI: 10.1097/corr.0000000000003004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/12/2024] [Indexed: 02/09/2024]
Affiliation(s)
- Mary I O'Connor
- Cofounder and Chief Medical Officer, Vori Health, Jacksonville, FL, USA
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Middleton KK, Turner A. Racial and Ethnic Disparities in Sports Medicine and the Importance of Diversity. Clin Sports Med 2024; 43:233-244. [PMID: 38383106 DOI: 10.1016/j.csm.2023.07.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Within orthopedics surgery as a specialty, sports medicine is one of the least diverse surgical subspecialties. Differences in minority representation between patient and provider populations are thought to contribute to disparities in care, access, and outcomes.
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Affiliation(s)
| | - Alex Turner
- University of Texas Southwestern Medical School, Dallas, TX, USA
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Low S, Yu L, Temple JR. Traditional and Race-based Bullying in Racial-Minority Majority and Racially Diverse Schools. J Youth Adolesc 2024; 53:772-783. [PMID: 38282064 DOI: 10.1007/s10964-024-01944-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/11/2024] [Indexed: 01/30/2024]
Abstract
Few studies in the U.S. have simultaneously examined general and race-based bullying with consideration of school-level racial composition. The current study examined victimization as a function of school racial composition, in minority-majority and diverse schools (N = 1911, Mage = 13.7 years) enrolled in 7th grade in 24 public schools (42.3% Hispanics, 9.0% non-Hispanic White, 28.9% non-Hispanic Black, and 19.7% non-Hispanic Asian). Multilevel regression analyses suggest student-level protective factors related to both forms of victimization, but, school racial composition was only significant in explaining race-based bullying. Specifically, minority-majority schools had lower levels of race-based victimization compared to racially diverse schools. Findings suggest that consideration of school contextual factors offers a more nuanced understanding of the relation between race and victimization.
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Affiliation(s)
- Sabina Low
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, 85701, USA.
| | - Lu Yu
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73019, USA
| | - Jeff R Temple
- Center for Violence Prevention, University of Texas Medical Branch, Galveston, TX, 77555, USA
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Phillips AZ, Wang Y, Allen NB. Patterns of health care interactions of individuals with alcohol use disorder: A latent class analysis. J Subst Use Addict Treat 2024; 159:209251. [PMID: 38072388 DOI: 10.1016/j.josat.2023.209251] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/29/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Given the high rates at which individuals with alcohol use disorder (AUD) utilize health care for co-existing conditions, health systems are promising venues for interventions that will facilitate access to AUD treatment. However, how individuals with AUD interact with such systems and, thus, how systems should intervene is unclear. In this study, we seek to identify patterns in how individuals diagnosed with AUD within an academic health system interacted with the system prior to diagnosis. METHODS We use electronic health records from a single academic health system in a major US metropolitan area to create a deidentified retrospective cohort including all individuals age 18+ diagnosed with AUD 2010-2019 (n = 26,899). Latent class analysis (LCA) identified subgroups defined by aspects of previous system interaction and health status, including having an in-system primary care provider, previous utilization of primary and specialty care, diagnosis setting, payer, and presence of other chronic conditions. We then assessed subgroup differences in demographics and associations with in-system AUD treatment receipt in the year following diagnosis, adjusting for demographics. RESULTS The population was on average 38.6 years old (standard deviation = 15.4) and predominantly male (66.1 %), White (64.5 %), and not of Hispanic/Latino ethnicity (87.8 %). Only 4.7 % received in-system treatment following diagnosis. We deemed the four-class model the optimal LCA model. This model identified subgroups that can be described as 1) average utilization (20.7 % of population), 2) low utilization (54.5 %), 3) high health burden and low utilization (14.2 %), and 4) high health burden and high utilization (10.6 %). Predicted membership in the high health burden and high utilization subgroup and low utilization subgroup were associated with higher and lower odds of treatment receipt, respectively, compared with predicted membership in the average utilization subgroup (odds ratio (OR) for high/high subgroup = 1.21, 95 % confidence interval (CI) = 1.01, 1.27; OR for low subgroup = 0.29 95 % CI = 0.24, 0.34). CONCLUSION Individuals diagnosed with AUD within a health system interact with that system in markedly different ways and are unlikely to benefit uniformly from system-based interventions to facilitate treatment. Group-tailored interventions are more likely to have impact and provide returns on investments for systems.
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Affiliation(s)
- Aryn Z Phillips
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; Department of Health Policy and Management, University of Maryland School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA.
| | - Yaojie Wang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA.
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA.
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50
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Young E, Szucs LE, Suarez NA, Wilkins NJ, Hertz M, Ivey-Stephenson A. Disparities and Trends in Middle School Students' Suicidal Thoughts and Behaviors: Results From the Youth Risk Behavior Survey, 2015-2019. J Adolesc Health 2024; 74:720-728. [PMID: 38127017 PMCID: PMC10960693 DOI: 10.1016/j.jadohealth.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To examine trends and racial and ethnic disparities in early adolescent suicidal thoughts and behaviors in the years immediately prior to the COVID-19 pandemic. METHODS This study used pooled data from Centers for Disease Control and Prevention's middle school Youth Risk Behavior Survey (n = 127,912) between 2015 and 2019. Three dichotomized measures of suicide-related behaviors were assessed: suicidal thoughts, planning, and attempts. Weighted prevalence estimates with 95% confidence intervals were calculated for each survey year. Linear trends examined disparities in the prevalence of suicidal thoughts and behaviors, overall and by student demographic characteristics. Main effects odds ratios compared estimates among racial and ethnic minority adolescents with non-Hispanic White students, controlling for sex and grade. RESULTS Significant linear increases were observed for the percentage of middle school students who reported seriously thinking about suicide (18.2%-22.3%), ever making a suicide plan (11.8%-14.7%), and ever attempting suicide (6.9%-9.3%). Racial and ethnic minority students, other than non-Hispanic Asian, showed higher odds of suicidal thoughts and behaviors compared with non-Hispanic White students. DISCUSSION Findings indicate a need for comprehensive suicide prevention to address health equity and disparities in suicide-related behaviors among middle school-aged adolescents.
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Affiliation(s)
- Emily Young
- Division of Adolescent and School Health, The Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee.
| | - Leigh E Szucs
- Division of Adolescent and School Health, The Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nicolas A Suarez
- Division of Adolescent and School Health, The Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natalie J Wilkins
- Division of Adolescent and School Health, The Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marci Hertz
- Division of Overdose Prevention, The Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Asha Ivey-Stephenson
- Division of Injury Prevention, The Centers for Disease Control and Prevention, Atlanta, Georgia
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