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1
Campos López, Ronald. "Dos ecopoemas homoeróticos y otras voces // Two homoerotic ecopoems and other voices." Ecozon@: European Journal of Literature, Culture and Environment 8, no. 2 (2017): 209–16. http://dx.doi.org/10.37536/ecozona.2017.8.2.1494.
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Resumen Por un lado, “Cósmica habitación” y “Velar tu desnudez” pertenecen al poemario inédito Depravación de la luz, el cual buscan abrir de nuevo el espacio de enunciación de la voz homoerótica en la poesía costarricense. Para ello, se apoya no solo en la herencia cultural de las místicas hispano-musulmana, hispano-judía, indoamericana e hispano-cristiana y otras perspectivas filosóficas y estéticas, sino también en una consciencia ecológica, con el fin de configurar un mundo íntimo e interconectado donde las metáforas conducen lo erótico desde una corporalidad dinámica y reflexiva plena hasta las vivencias cotidianas y cósmicas de lo sagrado. De ahí que la cósmica habitación, esa suprarrealidad habitada por estos dos varones amantes, se convierta poema a poema en un espacio vivido de luminosa resistencia, en un espacio transparente, desde donde se lucha simbólica y performativamente contra la injuria ejercida sobre los sujetos gays en el ámbito nacional y mundial. Por otra parte, los poemas I, II y III son muestras de un proyecto poético también inédito en el que se pretende, siguiendo a Roberto Fonrs-Broggi, dar voz a “grietas”: a esas materias vivas no humanas, consideradas tradicionalmente inertes; grietas que, en todo caso, se encuentran interconectadas, por ejemplo: el escarabajo, la calima sahariana o el cedro.Abstract On one hand, “Cosmic room” and “Veil your nudity” belong to Depravity of the Light. This unpublished poetry-book seeks to open again the space of enunciation of homoerotic voice in Costa Rican poetry. For that purpose, it is based not only on cultural heritage of Hispanic-Muslim, Hispanic-Jewish, Indo-American and Hispanic-Christian mystiques and another philosophical and aesthetic perspective, but also on an ecological awareness. According to these, an intimate and interconnected world, where metaphors lead the eroticism from a dynamical and reflexive full corporeality to the daily and cosmic experiences of the sacred. Thus, the cosmic room, this supra-reality dwelled by these two lover men, is poem by poem turned into a space of life, of luminous resistance, where they symbolical and performatively fight against homophobic injury nationally and worldwide. On the other hand, the I, II and III poems are samples of an unpublished poetic project, which pretends, according to Roberto Forns-Broggi, gives a voice to “cracks”: those living no human material, traditionally considered as inert; “cracks” that, in any case, are interconnected, for example: the beetle, the Saharan haze or the cedar.
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Assari, Shervin, Sharon Cobb, Mohammed Saqib, and Mohsen Bazargan. "Diminished Returns of Educational Attainment on Heart Disease among Black Americans." Open Cardiovascular Medicine Journal 14, no. 1 (2020): 5–12. http://dx.doi.org/10.2174/1874192402014010005.
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Background: Socioeconomic Status (SES) indicators, such as educational attainment, are social determinants of heart disease. Marginalization related Diminished Returns (MDRs) refer to smaller health benefits of high SES for racial and ethnic minorities compared to the majority group. It is still unknown, however, if MDRs also apply to the effects of education on heart disease. Purpose: Using a nationally representative sample, we explored racial/ethnic variation in the link between educational attainment and heart disease among American adults. Methods: We analyzed data (n=25,659) from a nationally representative survey of American adults in 2013. The first wave of the Population Assessment of Tobacco and Health - Adult (PATH-Adult) study was used. The independent variable was education (college graduate, high school graduate, less than a high school diploma). The dependent variable was any heart disease. Age and gender were the covariates. Race, as well as ethnicity, were the moderators. Logistic regressions were used to analyze the data. Results: Individuals with higher educational attainment had lower odds of heart disease. Race and ethnicity showed statistically significant interactions with education, suggesting that the protective effect of higher education on reducing odds of heart disease was smaller for Hispanic and Black people than for non-Hispanic and White individuals. Conclusion: Education reduces the risk of heart disease better among non-Hispanic Whites than for Hispanics and Blacks. Therefore, we may expect a disproportionately higher than expected risk of heart disease in Hispanics and Blacks with high educational attainment. Future research should test if the presence of high levels of environmental and behavioral risk factors contribute to the high risk of heart disease in highly educated Black and Hispanic Americans. Policymakers should not reduce health inequalities to just gaps in SES because disparities are present across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.
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Moore, Kevin J., Erin Dunn, Stacey L. Tannenbaum, and Tulay Koru-Sengul. "Racial/ethnic disparities in liver cancer-attributable hepatitis infections in the U.S. population." Journal of Clinical Oncology 33, no. 3_suppl (2015): 259. http://dx.doi.org/10.1200/jco.2015.33.3_suppl.259.
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259 Background: According to the American Cancer Association, hepatitisB and Cinfections may raise liver cancer risk. We identify population-specific cancer-attributable hepatitis prevalence to discern disparities across race/ethnicity for liver cancer risk. Methods: Data from 1999-2012 National Health and Nutrition Examination Survey (NHANES) were used to determine prevalence, unadjusted odds ratios (OR) with 95% confidence intervals (95%CI) for non-Hispanic-Whites (NHW), non-Hispanic-Blacks (NHB), Mexican-Americans, other Hispanics, and other race of hepatitis, taking complex sampling design into account. Results: Among those sampled, the overall highest prevalence of hepatitis infection was 66.4% in NHW for hepatitis-C and the lowest prevalence was 1.4% in Mexican-Americans for hepatitis-B surface-antigen. NHB were more likely than NHW to have hepatitis-B infections of surface-antibody (OR=1.9; 95%CI=1.8-2.0), core-antibody (3.3; 3.1-3.6), surface-antigen (5.3; 3.6-7.7), and hepatitis-C infections (1.7; 1.5-2.0). Compared to NHW, other Hispanics had a higher burden of hepatitis-B infection of surface-antibody (1.5; 1.4-1.7) and core-antibody (2.5; 2.1-2.8); other race had the same higher infection pattern as other Hispanics in surface-antibody (2.4; 2.2-2.6) and core-antibody (6.7; 6.0-7.5). Surface-antibody was more prevalent (1.5; 1.4-1.6) while core-antibody was less prevalent (0.9; 0.8-0.9) among Mexican-Americans compared with NHW. Conclusions: The prevalence of hepatitis B and C infections varies across different race/ethnicities with NHB having the greatest burden compared with NHW. Population-based databases should collect more information regarding infection burden in at-risk groups in order to understand more about these disparities. Appreciating such gaps across demographics could assist in future efforts to decrease the burden of hepatitis and to provide a base for targeted liver cancer prevention programs via screening, vaccination, health promotion, and literacy.
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Assari, Shervin, Hamid Chalian, and Mohsen Bazargan. "Race, Ethnicity, Socioeconomic Status, and Chronic Lung Disease in the U.S." Research in Health Science 5, no. 1 (2020): p48. http://dx.doi.org/10.22158/rhs.v5n1p48.
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Background: Higher socioeconomic status (SES) indicators such as educational attainment and income reduce the risk of chronic lung diseases (CLDs) such as Chronic Obstructive Pulmonary Disease (COPD), emphysema, chronic bronchitis, and asthma. Marginalization-related Diminished Returns (MDRs) refer to smaller health benefits of high SES for marginalized populations such as racial and ethnic minorities compared to the socially privileged groups such as non-Hispanic Whites. It is still unknown, however, if MDRs also apply to the effects of education and income on CLDs. Purpose: Using a nationally representative sample, the current study explored racial and ethnic variation in the associations between educational attainment and income and CLDs among American adults.Methods: In this study, we analyzed data (n = 25,659) from a nationally representative survey of American adults in 2013 and 2014. Wave one of the Population Assessment of Tobacco and Health (PATH)-Adult study was used. The independent variables were educational attainment (less than high school = 1, high school graduate = 2, and college graduate = 3) and income (living out of poverty = 1, living in poverty = 0). The dependent variable was any CLDs (i.e., COPD, emphysema, chronic bronchitis, and asthma). Age, gender, employment, and region were the covariates. Race and ethnicity were the moderators. Logistic regressions were fitted to analyze the data. Results: Individuals with higher educational attainment and those with higher income (who lived out of poverty) had lower odds of CLDs. Race and ethnicity showed statistically significant interactions with educational attainment and income, suggesting that the protective effects of high education and income on reducing odds of CLDs were smaller for Blacks and Hispanics than for non-Hispanic Whites. Conclusions: Education and income better reduce the risk of CLDs among Whites than Hispanics and Blacks. That means we should expect disproportionately higher than expected risk of CLDs in Hispanics and Blacks with high SES. Future research should test if high levels of environmental risk factors contribute to the high risk of CLDs in high income and highly educated Black and Hispanic Americans. Policy makers should not reduce health inequalities to SES gaps because disparities sustain across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.
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Tran, Diem, and OiYan Poon. "The State of Asian American Businesses." AAPI Nexus Journal: Policy, Practice, and Community 9, no. 1-2 (2011): 70–77. http://dx.doi.org/10.36650/nexus9.1-2_70-77_tranetal.
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Business success is a dominant theme in the Asian American narrative. However, Asian American entrepreneurship is more complex and multilayered than commonly believed and requires careful scrutiny. This brief examines the state of Asian American business ownership between 2005 and 2007. Findings suggest that although Asian Americans form businesses at higher rates than other racial/ethnic minorities, Asian American business ownership and outcomes continue to trail those of non-Hispanic whites. Potential factors contributing to racial/ethnic gaps and policy recommendations are discussed.
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Ong, Lee Za, Karisse A. Callender, Kacie M. Blalock, and Jerome J. Holzbauer. "Racial, ethnic differences in complementary and integrative health use among adults with mental illness: Results from the 2017 National Health Interview Survey." Australian Journal of Rehabilitation Counselling 27, no. 1 (2021): 50–73. http://dx.doi.org/10.1017/jrc.2021.3.
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AbstractThe purpose of this study was to examine the patterns of complementary and integrative health (CIH) use among adults with a racial/ethnic minority background and a mental illness. A secondary data analysis of 2017 National Health Interview Survey (N = 793) was conducted using chi-square, multivariate logistic regression, and multinomial logistic regression. Overall, Black/African Americans and Hispanic/Latinx groups remained the least proportional of CIH therapies utilization. Being a male, Black/African American or Latinx/Hispanic and had work experience were predictors of the least use of the CIH therapies. Research is needed to bridge the gaps on the CIH use among a racial/ethnic minority with mental illness and to enhance the equitable and collaborative mental health care in the community.
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Gomes, Chantal, Dina Ginzberg, and Robert J. Wong. "Delays and gaps in progressing through the hepatitis C virus cascade of care: An underserved safety-net hospital experience." Journal of Translational Internal Medicine 8, no. 4 (2020): 261–67. http://dx.doi.org/10.2478/jtim-2020-0039.
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Abstract Background and Objective While highly effective hepatitis C virus (HCV) therapies exist, gaps in the cascade of care remain. Disparities in the HCV cascade are prominent among underserved safety-net populations. We aim to evaluate the HCV cascade among an urban safety-net cohort of HCV patients. Methods We retrospectively evaluated adults with chronic HCV to determine rates of linkage to care (LTC), retention to care, and receiving HCV treatment from 2002 to 2018. Comparisons between groups utilized Chi-square testing; comparisons of median time to LTC and HCV treatment were evaluated with Student’s t-test and analysis of variance. Results Among 600 chronic HCV patients (60.7% male, 20.7% non-Hispanic white, 49.2% African American, 92.5% treatment naïve, 26.8% cirrhosis), successful LTC within one year of HCV diagnosis was 57.7%, among which, 91.6% were successfully retained into care. In those with successful LTC, 72.6% received HCV treatment, 91.8% completed treatment, and 89% achieved SVR12. Women with HCV experienced longer delays from LTC to HCV treatment (331 vs. 206 days in men, P < 0.05), as did African Americans (280 vs. 165 days in non-Hispanic whites, P < 0.05). Compared to the non-Hispanic whites, HCV treatment was lower in African Americans (70.4% vs. 74.4%, P < 0.05). Conclusion Women with HCV experienced significant delays along the HCV cascade, with median time of over 2 years from diagnosis to treatment. African Americans also experienced significant delays along the HCV cascade of care. However, sex and race/ethnicity were not found to be significant predictors of overall LTC or treatment.
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Adepoju, Omolola E., Luz Herrera, Minji Chae, and Daikwon Han. "Optimizing Disaster Preparedness Planning for Minority Older Adults: One Size Does Not Fit All." International Journal of Environmental Research and Public Health 20, no. 1 (2022): 401. http://dx.doi.org/10.3390/ijerph20010401.
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By 2050, one in five Americans will be 65 years and older. The growing proportion of older adults in the U.S. population has implications for many aspects of health including disaster preparedness. This study assessed correlates of disaster preparedness among community-dwelling minority older adults and explored unique differences for African American and Hispanic older adults. An electronic survey was disseminated to older minority adults 55+, between November 2020 and January 2021 (n = 522). An empirical framework was used to contextualize 12 disaster-related activities into survival an0000000d planning actions. Multivariate logistic regression models were stratified by race/ethnicity to examine the correlates of survival and planning actions in African American and Hispanic older adults, separately. We found that approximately 6 in 10 older minority adults did not perceive themselves to be disaster prepared. Medicare coverage was positively associated with survival and planning actions. Income level and prior experience with disaster were related to survival actions in the African American population. In conclusion, recognizing the gaps in disaster-preparedness in elderly minority communities can inform culturally sensitive interventions to improve disaster preparedness and recovery.
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Soewito, Stephanie, Rachel Wyatt, Emily Berenson, et al. "Abstract P2-09-06: Increased rates of genetic variants of unknown significance in Latino and African American populations of south Texas." Cancer Research 82, no. 4_Supplement (2022): P2–09–06—P2–09–06. http://dx.doi.org/10.1158/1538-7445.sabcs21-p2-09-06.
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Abstract Hereditary susceptibility studies for breast cancer are key to enhancing early detection and exercising prevention strategies in order to reduce breast cancer mortality. Germline pathogenic variants that have shown susceptibility to breast and ovarian cancer are detected in gene panels including ATM, BRCA1, BRCA2, BRIP1, CDH1, CDKN2A, CHEK2, DICER1, EPCAM, MLH1, MSH2, MSH6, NBN, NF1, PALB2, PMS2, PTEN, POLE, RAD50, RAD51C, RAD51D, RECQL, STK11, and TP53. Historically, minority populations have been overlooked both in reach and access to genetic testing, resulting in a lack of knowledge of the genomic landscape and creating a barrier to the application of genetics in clinical medicine. This is the case with the populations of South Texas including the Texas-Mexico border region. According to the US Census Bureau, the South Texas region population is comprised of 69% Hispanics while the Texas-Mexico border region population is comprised of over 90% Hispanics. Previous studies have shown multiple pathogenic variants and also variants of unknown significance (VUS) specific to ethnic populations and regions, but there is little information regarding the Mexican American population of South Texas.Our GRACIAS Texas Program has provided services to individuals and professionals across 26 counties in the South Texas area by specifically providing cancer genetic counseling and testing to individuals and families at highest risk. Recruitment was accomplished through comprehensive outreach to communities through health fairs, small group education sessions, mammography centers, hospitals, FQHCs, and direct interactions with medical providers. Although our program focused on recognizing both breast and colon cancer, and also reached those with rare cancer predisposition syndromes, the concern for breast cancer risk was most commonly addressed, accounting for the majority of cases. A total of 1595 individuals were identified as appropriate for cancer genetic counseling, and of these, 1377 individuals completed genetic testing. Of all individuals who received cancer genetic counseling, 1269 (79.5%) were Hispanic, 16% non-Hispanic White, 3% African American, and 1% other race/ethnicity. The group of individuals receiving testing consisted of 86% females and 14% males. Of those tested, 259 (18.8%) individuals were found to have pathogenic genetic variant and 187 (13.7%) individuals were found to have a VUS. Notedly, the VUS were nearly twice as common in the Hispanic population (14%) as compared to non-Hispanic White population (7.2%). This underscores the disparities of knowledge in genomic variation in Hispanic and non-Hispanic population. We also note that although the percentage of African American patients seen was small, 12 of 45 (26.6%) were found to have a VUS which further reflects the underrepresentation of African Americans in genomic landscape studies.These variants are important because they present a dilemma when advising patients as to need for cancer screening. However, recognition and further exploration of these VUS provide a future pathway to functional assessment and thus eventual knowledge to guide patient care. We continue to monitor for any changes to the status of these VUS. Although many variants are ultimately classified as benign variations, we have seen cases in which a VUS is reclassified into a likely pathogenic or definitely pathogenic variation having significant implications for screening, prevention, and management for these individuals and their families emphasizing further the need to continue to follow individuals tested. Our observations will help define the gene-specific risks of individuals and families in our underserved communities and will support the goal of closing gaps in genomic disparities.Supported by CPRIT grants PP120089 and PP160011 and NIH P30 CA54174. Citation Format: Stephanie Soewito, Rachel Wyatt, Emily Berenson, Natalie Poullard, Shawn Gessay, Lindsey Mette, Kristin Shelby, Elise Alvarez, Clarissa Aviles, Anna Maria Pulido Saldivar, Pamela Otto, Ismail Jatoi, Virginia Kaklamani, Gail E Tomlinson. Increased rates of genetic variants of unknown significance in Latino and African American populations of south Texas [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-09-06.
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Chatterji, Madhabi. "Achievement gaps and correlates of early mathematics achievement: Evidence from the ECLS K—first grade sample. Vol. 13 No. 46." education policy analysis archives 13 (November 23, 2005): 46. http://dx.doi.org/10.14507/epaa.v13n46.2005.
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In light of the NCLB Act of 2001, this study estimated mathematics achievement gaps in different subgroups of kindergartners and first graders, and identified child- and school-level correlates and moderators of early mathematics achievement. A subset of 2300 students nested in 182 schools from the Early Childhood Longitudinal Study K-First Grade data set was analyzed with hierarchical linear models. Relative to school mean estimates at the end of kindergarten, significant mathematics achievement gaps were found in Hispanics, African Americans and high poverty students. At the end of Grade 1, mathematics gaps were significant in African American, high poverty, and female subgroups, but not in Hispanics. School-level correlates of Grade 1 Mathematics achievement were class size (with a small negative main effect), at-home reading time by parents (with a large positive main effect) and school size (with a small positive main effect). Cross-level interactions in Grade 1 indicated that schools with larger class and school sizes had a negative effect on African American children's math scores; schools giving more instructional time to reading and math had a positive effect on high poverty students' scores, and schools with higher elementary teacher certification rates had a positive effect on boys' mathematics achievement.
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Ryabov, Igor. "The Role of Residential Segregation in Explaining Racial Gaps in Childhood and Adolescent Obesity." Youth & Society 50, no. 4 (2015): 485–505. http://dx.doi.org/10.1177/0044118x15607165.
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The present study used nationally representative data from the U.S. Panel Study of Income Dynamics (PSID) merged with census-track data from the American Community Survey (ACS) to model race-ethnic disparities in overweight, obesity, and obesity-related disease among children and adolescents as a function of neighborhood race-ethnic segregation, socio-economic status, household size and structure, family history of obesity, and other important predictors. Results indicate that African American and Hispanic children and adolescents are more likely to suffer from obesity and obesity-related disease than their non-Hispanic White peers. We also found that race-ethnic segregation proxied by the Index of Dissimilarity has a strong and negative effect on the weight status and health outcomes mentioned above. Moreover, race-ethnic segregation appears to explain up to 20% of the difference between minority children and their non-Hispanic White peers in the prevalence rate of overweight, obesity, and obesity-related disease.
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Assari, Shervin. "Combined Effects of Ethnicity and Education on Burden of Depressive Symptoms over 24 Years in Middle-Aged and Older Adults in the United States." Brain Sciences 10, no. 4 (2020): 209. http://dx.doi.org/10.3390/brainsci10040209.
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Ethnicity and educational attainment are among the major social determinants of depression in the general population. While high education credentials protect individuals against depressive symptoms, this protection may be weaker for ethnic minority groups such as Hispanic Whites compared to the majority group (non-Hispanic Whites). Built on marginalization-related diminished returns (MDRs), the current study used 24-year follow-up data from a nationally representative sample of middle-aged and older adults to explore ethnic variation in the protective effect of education levels against the burden of depressive symptoms over time. Data for this analysis were borrowed from the Health and Retirement Study (HRS 1992–ongoing), a nationally representative longitudinal study. HRS followed 8314 middle-aged and older adults (50+ years old) for up to 24 years. From this number, 763 (9.2%) were Hispanic White, and 7551 (90.8%) were non-Hispanic White Americans. Education level was the independent variable. We had two outcomes. Firstly, using cluster analysis, individuals were categorized to low- and high-risk groups (regarding the burden of depressive symptoms over 24 years); secondly, average depressive symptoms were observed over the 24 years of follow up. Age and gender were the covariates. Ethnicity was the moderator. Linear and logistic regression were used for analysis. Logistic regression showed that, overall, high educational credentials reduced the odds of chronic depressive symptoms over the 24 years of follow-up. Linear regression also showed that higher years of education were associated with lower average depressive symptoms over time. Both models showed statistically significant interactions between ethnicity and graduation, indicating a smaller protective effect of high education against depressive symptoms over the 24 years of follow-up time among Hispanic with respect to non-Hispanic White people. In line with the MDRs, highly educated Hispanic White Americans remain at high risk for depressive symptoms, a risk that is unexpected given their education. The burden of depressive symptoms, however, is lowest for highly educated non-Hispanic White Americans. Policies that exclusively focus on equalizing educational gaps across ethnic groups may fail to eliminate the ethnic gap in the burden of chronic depressive symptoms, given the diminished marginal health return of education for ethnic minorities. Public policies must equalize not only education but also educational quality across ethnic groups. This aim would require addressing structural and environmental barriers that are disproportionately more common in the lives of ethnic minorities across education levels. Future research should test how contextual factors, residential segregation, school segregation, labor market practices, childhood poverty, and education quality in urban schools reduce the health return of educational attainment for highly educated ethnic minorities such as Hispanics.
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Ghidei, Winta, and Tracie C. Collins. "African Americans and Peripheral Arterial Disease: A Review Article." ISRN Vascular Medicine 2012 (August 7, 2012): 1–9. http://dx.doi.org/10.5402/2012/165653.
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Peripheral arterial disease (PAD)—atherosclerosis of the abdominal aorta and arteries of the lower extremities—affects 12 million Americans. African Americans (AAs) are more than twice as likely as non-Hispanic whites to suffer from PAD. When compared to non-Hispanic whites with PAD, AAs with PAD have more severe disease and a greater reduction in walking distance, speed, and/or stair climbing. AAs with PAD are at increased risk for disease progression and worsening lower limb function. Reasons for the higher risk for disease progression have not been defined. One potential modifiable risk is a lower level of physical activity. Lower levels of physical activity are more common among African American seniors. Walking is a common type of physical activity. The benefits of walking therapy are only realized if the patient adheres to such therapy. Efforts are needed to increase walking in AAs with PAD. Additionally, risk factor management is key to reducing adverse events in AAs with PAD-yet few studies have targeted this high-risk group. In this paper, we discuss the management of PAD in AAs. Identifying current gaps will help to inform clinicians, researchers, and policy makers on next steps in identifying innovative approaches to increase home-based walking and reduce walking impairment in AAs with PAD.
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Fu, Steven S., Scott E. Sherman, Elizabeth M. Yano, Michelle van Ryn, Andy B. Lanto, and Anne M. Joseph. "Ethnic Disparities in the Use of Nicotine Replacement Therapy for Smoking Cessation in an Equal Access Health Care System." American Journal of Health Promotion 20, no. 2 (2005): 108–16. http://dx.doi.org/10.4278/0890-1171-20.2.108.
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Purpose. To examine ethnic variations in the use of nicotine replacement therapy (NRT) in an equal access health care system. Design. Cross-sectional survey. Setting. Eighteen Veterans Affairs medical and ambulatory care centers. Subjects. A cohort of male current smokers (n = 1606). Measures. Use of NRT (nicotine patch or nicotine gum), ethnicity, sociodemographics, health status, smoking-related history, and facility prescribing policy. Results. Overall, only 34% of African-American and 26% of Hispanic smokers have ever used NRT as a cessation aid compared with 50% of white smokers. In the past year, African-American smokers were most likely to have attempted quitting. During a serious past-year quit attempt, however, African-American and Hispanic smokers reported lower rates of NRT use than white smokers (20% vs. 22% vs. 34%, respectively, p = .001). In multivariate analyses, ethnicity was independently associated with NRT use during a past-year quit attempt. Compared with white smokers, African-American (adjusted odds ratio, .53; 95% confidence interval, .34–.83) and Hispanic (adjusted odds ratio, .55; 95% confidence interval, .28–1.08) smokers were less likely to use NRT. Conclusions. Assessment of variations in use of NRT demonstrates that African-American and Hispanic smokers are less likely to use NRT during quit attempts. Future research is needed on the relative contributions of patient, physician, and system features to gaps in guideline implementation to provide treatment for ethnic minority smokers.
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Abraham, Ivy, Anand Ashwin Patel, Yanyu Zhang, Li C. Liu, Olga Frankfurt, and Irum Khan. "Impact of Race on Outcomes in Intermediate Risk Acute Myeloid Leukemia." Blood 132, Supplement 1 (2018): 3603. http://dx.doi.org/10.1182/blood-2018-99-115156.
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Abstract Introduction: A 2012 retrospective review of acute myeloid leukemia (AML) patient outcomes in the SEER national database showed higher mortality rates for African Americans and Hispanics despite lower rates of incidence and more favorable genetics at presentation compared to non-Hispanic whites (Patel. Cancer Causes & Control, 2011). While age is a known negative prognostic factor, it has been difficult to analyze the contribution of additional demographic factors predicting outcomes in AML. The purpose of this study was to investigate the impact of race on disease outcome in a diverse patient cohort of intermediate risk AML treated at two urban academic centers in Chicago. Methods: We retrospectively analyzed patients with intermediate risk AML cytogenetics treated with intensive chemotherapy with or without allogeneic stem cell transplant from 2003-2018 at Northwestern Memorial and the University of Illinois Hospital. Baseline clinical and molecular characteristics and treatment response were compared across racial groups. Categorical variables were compared using Pearson's chi square or the Fisher's exact test while overall survival (OS) was estimated by the Kaplan-Meier analysis and compared by the log-rank test. Risk factors for OS were assessed by the Cox regression model. Results: A total of 111 intermediate risk AML patients were included with the 3 major groups being Caucasian (non-Hispanic white), African American (AA) and Hispanic patients (Figure 1). Nearly half of each group was> 60 years of age at presentation. At the time of diagnosis, AA had a significantly higher body mass index (BMI) with a mean of 33.7 kg/m2 compared to 28.1 kg/m2 in the Caucasian group and 27.7 kg/m2 of Hispanic/others (p = 0.0047). There was no statistically significant difference in presenting labs including LDH, WBC count, blast percentage or molecular characteristics including FLT3-ITD or NPM1 mutation status (Figure 2). In log-rank analysis, Caucasians had significantly improved median OS compared to AA and Hispanics/others (31.6 vs. 16.7 vs.18.1 mos; p=0.026) (Figure 3). Multivariate analysis indicated that non-Caucasian patients had a 1.8 times higher risk of death compared to Caucasians (p = 0.059) even when adjusted for age and NPM1 and FLT3-ITD mutational status. We sought to examine whether this outcome disparity could be explained by chemotherapy resistance. The predominantly Hispanic group had a decreased response to induction chemotherapy compared to other groups (52% complete response (CR) vs. 70.6% of Caucasians and 68.8% of AA ; p=NS). In multivariate analysis, age (p = 0.046) and NPM1 status (p = 0.0006) predicted response to therapy while race did not. The favorable risk NPM1 mutation was enriched in Caucasians while the unfavorable FLT3 mutation was more commonly found in the primarily Hispanic group of patients (p = NS). Transplant emerged as a significant predictor of overall survival (p = 0.03). There was a difference approaching statistical significance in transplant utilization between the groups with only 36.8% of AA transplanted compared to 58.1% of non-African Americans (p = 0.09). Underrepresentation of minorities in the transplant registry was reflected in the significantly higher utilization of alternate donor sources in the AA and Hispanic patients. The proportion of patients receiving haploidentical and cord blood transplants was 5.7% of Caucasians vs. 57.1% of AA and 40% of Hispanic/others (p = 0.0006). Conclusion: In a cytogenetically homogenous cohort of AML patients we show that Caucasian patients had significantly superior overall survival compared to other racial groups. We found a statistically significant difference in BMI between racial groups, which may be reflective of comorbidities and chronic illnesses that affect clinical outcome. Our data also showed there was increased utilization of transplant in Caucasian patients likely related to donor availability and insurance coverage. We will next use Geographic Information Systems and payer source data to dissect the contribution of socioeconomic status and health care access to these disparities in disease outcome. Identifying health service gaps in these populations will enable healthcare providers to provide personalized and equitable care to an increasingly diverse patient population. Disclosures Frankfurt: Celgene, Jazz, Agios: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; AbbVie: Membership on an entity's Board of Directors or advisory committees. Khan:Teva: Speakers Bureau.
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Khan, Ambreen, Charles R. Rogers, Carson D. Kennedy, AnaMaria Lopez, and Joanne Jeter. "Genetic Evaluation for Hereditary Cancer Syndromes Among African Americans: A Critical Review." Oncologist 27, no. 4 (2022): 285–91. http://dx.doi.org/10.1093/oncolo/oyab082.
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Abstract While hereditary cancer syndromes have been described and studied for centuries, the completion of the human genome project fueled accelerated progress in precision medicine due to the introduction of genetic testing in the 1990s, creating avenues for tailored treatments and medical management options. However, genetic testing has not benefited everyone equitably, with nearly all of the published work based on individuals of non-Hispanic White/European ancestry. There remains a gap in knowledge regarding the prevalence, penetrance, and manifestations of common hereditary cancer syndromes in the African-American population due to significant disparities in access and uptake of genetic testing. This review summarizes the available literature on genetic testing for breast, colon, and prostate cancers in the African-American population and explores the disparities in access to genetic testing between non-Hispanic White and African-American patients. This article also addresses the barriers to genetic testing and discrepancies in the uptake of recommendations for hereditary cancer syndromes in the African-American population when compared with non-Hispanic Whites. The review offers practice implications for many healthcare providers and demonstrates gaps in the existing knowledge to be addressed in future studies to help eliminate the persisting health disparities faced by the African-American population.
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Wong, Michelle S., Taona P. Haderlein, Anita H. Yuan, Ernest Moy, Kenneth T. Jones, and Donna L. Washington. "Time Trends in Racial/Ethnic Differences in COVID-19 Infection and Mortality." International Journal of Environmental Research and Public Health 18, no. 9 (2021): 4848. http://dx.doi.org/10.3390/ijerph18094848.
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Studies documenting coronavirus disease 2019 (COVID-19) racial/ethnic disparities in the United States were limited to data from the initial few months of the pandemic, did not account for changes over time, and focused primarily on Black and Hispanic minority groups. To fill these gaps, we examined time trends in racial/ethnic disparities in COVID-19 infection and mortality. We used the Veteran Health Administration’s (VHA) national database of veteran COVID-19 infections over three time periods: 3/1/2020–5/31/2020 (spring); 6/1/2020–8/31/2020 (summer); and 9/1/2020–11/25/2020 (fall). We calculated COVID-19 infection and mortality predicted probabilities from logistic regression models that included time period-by-race/ethnicity interaction terms, and controlled for age, gender, and prior diagnosis of CDC risk factors. Racial/ethnic groups at higher risk for COVID-19 infection and mortality changed over time. American Indian/Alaskan Natives (AI/AN), Blacks, Hispanics, and Native Hawaiians/Other Pacific Islanders experienced higher COVID-19 infections compared to Whites during the summertime. There were mortality disparities for Blacks in springtime, and AI/ANs, Asians, and Hispanics in summertime. Policy makers should consider the dynamic nature of racial/ethnic disparities as the pandemic evolves, and potential effects of risk mitigation and other (e.g., economic) policies on these disparities. Researchers should consider how trends in disparities change over time in other samples.
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Yu, Eun-mi, Hongkun Wang, and Jeanny B. Aragon-Ching. "Racial differences and predictors of outcomes in testicular cancer based on the National Cancer Database (NCDB)." Journal of Clinical Oncology 42, no. 4_suppl (2024): 503. http://dx.doi.org/10.1200/jco.2024.42.4_suppl.503.
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503 Background: The incidence of testicular cancer in the U.S. is highest in white (W) men and lower in black (B), Hispanic (H) and Asian-American men, with reports of increasing trends in Hispanic men with worse outcomes (Li et al., BMC Cancer 2020). We aim to verify the emerging ethnicity variations in a large database. Methods: Using the NCDB database with patient-level data extraction from 2004 to 2020, we sought to identify the incidence, demographics, regional differences, treatment, and outcomes in men who are Hispanic versus non-Hispanic White (NHW) and other races with testicular cancer diagnoses (non-seminoma, NS; seminoma, S) with differences in treatment patterns from different institution types, insurance across regions. Results: There were 81571 pts in all with 46979 S pts W and 34592 NS pts W vs 1754 S pts B and 1106 NS pts B with 5396 S pts H and 5609 NS pts H with other races/unknown for the rest. More S patients were treated at comprehensive community cancer programs (17%) compared to NS pts (6.1%). The majority of patients had Charlson-Deyo Score of 0 (92.7% of S pts and 93.7% of NS pts), had private insurance (74.1% S pts, 69.1% NS pts), though incidence appeared to be similar except for a slight drop in 2020 at 5.9% compared to 6.6% during years 2018 to 2019. Most were diagnosed with Stage I (29.6%) and Stage II and III (16.3%) though it was unknown/missing for 54%. Overall survival (OS) was better for S compared to NS in all pts (p<0.0001), and in stages II & III (p<0.001). OS was better for W vs B (p<0.0001), NHW vs H (p<0.0001), and with differences in Charlson-Deyo score (p <0.0001), facility type (p=0.008) and insurance status (p <0.0001). OS p-values are from Log-rank tests. Conclusions: Our analysis reveals some differences in survival trends with better survival in seminoma compared to non-seminoma, though Blacks and Hispanics have worse outcomes compared to Whites and Non-Hispanic Whites. This highlights the need for targeted efforts to bridge gaps in care.
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Gasca Jiménez, Laura, Maira E. Álvarez, and Sylvia Fernández. "Language and translation practices of Spanish-language newspapers published in the U.S. borderlands between 1808 and 1930." Translation and/in Periodical Publications 14, no. 2 (2019): 218–42. http://dx.doi.org/10.1075/tis.00039.gas.
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Abstract This article examines the impact of the anglicizing language policies implemented after the annexation of the U.S. borderlands to the United States on language use by describing the language and translation practices of Spanish-language newspapers published in the U.S. borderlands across different sociohistorical periods from 1808 to 1930. Sixty Hispanic-American newspapers (374 issues) from 1808 to 1980 were selected for analysis. Despite aggressive anglicizing legislation that caused a societal shift of language use from Spanish into English in most borderland states after the annexation, the current study suggests that the newspapers resisted assimilation by adhering to the Spanish language in the creation of original content and in translation.
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Chetty, Raj, Nathaniel Hendren, Maggie R. Jones, and Sonya R. Porter. "Race and Economic Opportunity in the United States: an Intergenerational Perspective*." Quarterly Journal of Economics 135, no. 2 (2019): 711–83. http://dx.doi.org/10.1093/qje/qjz042.
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Abstract We study the sources of racial disparities in income using anonymized longitudinal data covering nearly the entire U.S. population from 1989 to 2015. We document three results. First, black Americans and American Indians have much lower rates of upward mobility and higher rates of downward mobility than whites, leading to persistent disparities across generations. Conditional on parent income, the black-white income gap is driven by differences in wages and employment rates between black and white men; there are no such differences between black and white women. Hispanic Americans have rates of intergenerational mobility more similar to whites than blacks, leading the Hispanic-white income gap to shrink across generations. Second, differences in parental marital status, education, and wealth explain little of the black-white income gap conditional on parent income. Third, the black-white gap persists even among boys who grow up in the same neighborhood. Controlling for parental income, black boys have lower incomes in adulthood than white boys in 99% of Census tracts. The few areas with small black-white gaps tend to be low-poverty neighborhoods with low levels of racial bias among whites and high rates of father presence among blacks. Black males who move to such neighborhoods earlier in childhood have significantly better outcomes. However, less than 5% of black children grow up in such areas. Our findings suggest that reducing the black-white income gap will require efforts whose impacts cross neighborhood and class lines and increase upward mobility specifically for black men.
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Assari, Shervin. "Blacks’ Diminished Health Returns of Educational Attainment: Health and Retirement Study." Journal of Medical Research and Innovation 4, no. 2 (2020): e000212. http://dx.doi.org/10.32892/jmri.212.
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Background: Education level reduces the risk of health problems such as poor self-rated health (SRH), high body mass index (BMI), and depressive symptoms (DS). Marginalization – related Diminished Returns (MDRs), however, refer to smaller health benefits of socioeconomic status (SES) indicators particularly educational attainment for the members of racial minority groups such as non-Hispanic Blacks compared to the majority group (non-Hispanic Whites). It is not known, however, if MDRs also hold for middle-age and older adults over a long period of time. 
 Aims: The current study used a nationally representative data set to explore racial variation in the predictive utility of baseline education level on protecting people against poor SRH, BMI, and DS. 
 Methods: Data for this analysis were borrowed from the Health and Retirement Study (HRS 1992-ongoing), a nationally representative longitudinal study that followed 10,023 middle-aged and older adults (50+ years old) for up to 26 years. From this number, 1877 (18.7%) were non-Hispanic Black Americans, and 8,146 (81.3%) were non-Hispanic White Americans. Education level was the independent variable. We used cluster analysis to categorize individuals to low and high-risk groups (outcome) based on SRH, BMI, and DS over 26 years. Age and gender were the covariates. Race was the moderator. 
 Results: Overall, high education level reduced the odds of poor SRH, BMI, and DS over the 26 years of follow up. Interactions were observed between race and education on all three health outcomes indicating smaller protective effects of baseline educational attainment on poor health over time, regardless of the outcome. 
 Conclusions: In line with the MDRs, highly educated non-Hispanic Black Americans remain at high risk for poor health across domains, a risk which is unexpected given their education. The risk of all health outcomes, however, is lowest for non-Hispanic White Americans with highest education. Policies that exclusively focus on equalizing racial gaps in SES (e.g., education) may fail to eliminate the racial and ethnic health inequalities because of the racial inequalities in the marginal health return of education. Public policies must equalize education quality and address structural and environmental barriers that are disproportionately more common in the lives of non-Hispanic Black Americans, even at high education levels. Future research should test how contextual factors, segregation, labor market practices, childhood poverty, and education quality reduces the health return of education for highly educated non-Hispanic Black Americans.
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Lin, Zhuoer, Justin Ye, Heather Allore, Thomas Gill, and Xi Chen. "EARLY-LIFE CIRCUMSTANCES AND RACIAL DISPARITIES IN COGNITION AMONG US OLDER ADULTS." Innovation in Aging 7, Supplement_1 (2023): 304. http://dx.doi.org/10.1093/geroni/igad104.1011.
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Abstract There are marked racial disparities in cognitive outcomes between non-Hispanic Black (Black) and non-Hispanic White (White) older adults in the US. Existing studies concentrate on exploring mid-life to late-life risk factors, yet the early-life circumstances through which the racial gaps may arise remain under-explored. Using a wide spectrum of early-life factors assembled from the Health and Retirement Study, including demographics, SES, health, trauma, family relationships, and genetics, we investigated how racial gaps in cognitive score and cognitive impairment among older Americans were tied to racial differences in early-life circumstances. 9,015 (7,381 White, 1,634 Black) Americans aged 50 and older were included in the analysis. Using Blinder-Oaxaca-Decomposition, we showed that Black participants generally had less favorable early-life circumstances than White participants, especially in early-life residence, education level, quality and experience. We demonstrated that overall, differences in early-life circumstances explained up to 61.9% of the racial gaps in cognitive score, and 80.9% of the racial gaps in cognitive impairment between White and Black participants. Disentangling racial gaps by individual factors, we found that differences in the level and quality of education contributed the most. Years of education and school racial segregation respectively accounted for 22.7-24.8% and 26.0%-42.8% of the gaps in cognitive outcomes. Early-life educational experience and place of birth/residence additionally contributed to the disparities. However, childhood trauma, health, and genetic factors were not significant contributors. These findings suggest that exposure to less favorable early-life circumstances is associated with clinically meaningful and statistically significant racial gaps in cognition, which warrants targeted interventions.
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Salhotra, Neeraj. "The Vocabulary Initiative: A Model for Vocabulary Instruction." Undergraduate Journal of Service Learning & Community-Based Research 2 (November 22, 2013): 1–14. http://dx.doi.org/10.56421/ujslcbr.v2i0.127.
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The U.S. currently has wide income and racial achievement gaps in reading. The disparity between African Americans or Hispanics and Caucasians is multiple grade levels; in other words, 13-year-old Caucasians' reading scores are equivalent to those of 17-year-old Hispanics or African Americans (Family Facts 2009). While this reading gap has multiple causes, the vocabulary disparity is one of the primary drivers. These vocabulary differences are present when students begin school and only widen in each successive school year. Additionally, vocabulary understanding is critical for reading comprehension and thus success on standardized tests and ultimately success in high school and college. It is clear, therefore, that if the nationhopes to reduce the reading achievement gap and help boost college completion rates for lowincome and minority Americans, the vocabulary gap must be addressed.
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Lee, Shawn, Federico Antillón, Deqing Pei, et al. "The Impact of Genetic Ancestry on the Biology and Prognosis of Childhood Acute Lymphoblastic Leukemia." Blood 138, Supplement 1 (2021): 3476. http://dx.doi.org/10.1182/blood-2021-145655.
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Abstract INTRODUCTION Acute lymphoblastic leukemia (ALL) is the most common cancer in children. Despite improvements in treatment over the past few decades, stark racial disparities persist in disease risk and cure rates. There is a paucity of data describing the genetic basis of these disparities, especially in relation to modern ALL molecular taxonomy and in the context of contemporary treatment regimens. To this end, we sought to determine the associations of genetic ancestry with ALL biology, and the relevance of genetic ancestry to survival outcomes of modern ALL therapy. METHODS This was a multi-national genomic study of 2,428 children with ALL on front-line trials from United States (St Jude Children's Research Hospital and Children's Oncology Group), South-East Asia (Ma-Spore trials) and Latin America (Guatemala), representing diverse populations of European (EUR), African (AFR), Native American (NA), East Asian (EAS), and South Asian (SAS) descent. We performed RNA-sequencing to characterize ALL molecular subtype, and also estimated their genetic ancestral composition by comparing allele frequencies of patient and reference genomes (1000 Genomes Project reference populations). For categorization of patients into racial groups, individuals were classified based on composition of genetic ancestry as: "white" (EUR &gt;90%), "black" (AFR &gt;70%), "Hispanic" (NA &gt;10% and NA greater than AFR), "East Asian" (EAS &gt;90%), "South Asian" (SAS &gt;70%), with the rest defined as "Other". We then evaluated the associations of ancestry with ALL molecular subtypes and survival. RESULTS Genetic ancestral composition of the entire cohort is shown in Figure 1A. Of 21 ALL subtypes, 11 showed significant associations with ancestry. Hyperdiploid ALL was most common in white children (30.6%) and the least frequent in blacks (14.4%) (P&lt;0.001). The frequency of ETV6-RUNX1 was highest in blacks (25.6%) and lowest in Hispanics (10.6%) (P&lt;0.001). The DUX4 subtype was markedly more common in Asian children (14.4% of East Asians and 14.8% of South Asians) compared to black children (1.9%) (P&lt;0.001). There was a similar trend for ZNF384 fusion, representing 6.9% of East Asians, compared to 1.7% for whites (P=0.001). TCF3-PBX1 was most prevalent in blacks at 11.9%, with the lowest at 1.7% in whites (P&lt;0.001). PAX5 alteration frequency was highest in South Asians (11.5%) and lowest in whites (4.5%) (P=0.046). CRLF2 rearrangement occurred significantly more frequently in Hispanics (9.0%) and was least common in blacks (1.3%) (P&lt;0.001). BCR-ABL1-like (excluding CRLF2) was also overrepresented in Hispanic children (11.4%), and occurred less frequently in East Asians (4.2%) (P&lt;0.001). MEF2D fusion was most common in blacks (4.4%), and rare in whites (1.4%) and South Asians (0%) (P=0.013). T-ALL differed dramatically in frequency amongst races, especially between blacks and Hispanics with a 7-fold difference (26.5% vs 3.6%, P&lt;0.001). The pattern of ALL subtype in the "Other" racial category generally mirrored that of the dominant ancestral composition, indicating a strong correlation with ancestry even within admixed populations (Figure 1B). We then examined outcomes across racial/ethnic categories. Event-free survival (EFS), overall survival (OS) and cumulative incidence of any relapse (CIR) all differed significantly across population groups (P=0.017 for EFS, P=0.05 for OS, P=0.015 for relapse). White, East Asian and South Asian children overall had more favorable outcomes compared to their black and Hispanic counterparts. Specifically, Hispanics had the poorest 5-year EFS (72.1 ± 4.2 %) and OS (82.3 ± 3.6 %), whereas South Asians had the highest EFS (94.6 ± 3.6 %) and OS (98.2 ± 2.1 %). Relapse risk trended in parallel with that of EFS and OS, with South Asians having one of the lowest CIR of 3.7 ± 2.6 %, and Hispanics having the highest at 22.8 ± 2.9 %. We repeated the analysis with genetic ancestry as a continuous variable and obtained largely similar results. Importantly, even after adjusting for biological subtypes and clinical features, Native American and African ancestries remained independently associated with poor prognosis. CONCLUSIONS ALL biology and prognosis are highly associated with genetic ancestry, pointing to a genetic basis for racial disparities in ALL. Biology-driven treatment individualization is needed to eliminate racial gaps in the cure of this cancer. Figure 1 Figure 1. Disclosures Evans: Princess Máxima Center for Pediatric Oncology, Scientific Advisory Board, Chair: Membership on an entity's Board of Directors or advisory committees; BioSkryb, Inc.: Membership on an entity's Board of Directors or advisory committees; St. Jude Children's Research Hospital, Emeritus Member (began Jan 2021): Ended employment in the past 24 months. Mullighan: Illumina: Membership on an entity's Board of Directors or advisory committees; AbbVie: Research Funding; Pfizer: Research Funding; Amgen: Current equity holder in publicly-traded company. Loh: MediSix therapeutics: Membership on an entity's Board of Directors or advisory committees. Yeoh: Amgen: Honoraria, Other: Chair, Steering Committee for ALL Academy in South East Asia. Pui: Novartis: Other: Data Monitoring Committee; Adaptive Biotechnologies: Membership on an entity's Board of Directors or advisory committees.
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Mata, Holly, Elias Provencio-Vasquez, Jacob Martinez, and Joseph De Santis. "HIV Risk Knowledge among Hispanic Adults in a U.S. – Mexico Border Community." Californian Journal of Health Promotion 12, no. 1 (2014): 88–94. http://dx.doi.org/10.32398/cjhp.v12i1.1559.
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Background and Purpose: Hispanics experience a disproportionate burden of chronic disease, including HIV/AIDS. Community-level data regarding HIV risk and transmission are vital to effectively respond to health disparities in unique, high-risk populations. This study described HIV risk behavior knowledge among Hispanics in El Paso, Texas, in order to contribute to culturally and linguistically appropriate services for clinical and community settings in this U.S.-Mexico border community. Specifically, this project highlights misconceptions and gaps in HIV risk knowledge in two Mexican-American adult samples: (1) 103 men recruited primarily through agencies providing HIV-related medical and social services, and (2) 98 women recruited primarily through events hosted at a local community center. Methods: Data were gathered through structured interviews with participants as part of a larger study of HIV risk factors. Results: Less than 20% of men and 5% of women answered all 12 knowledge items correctly. Conclusion: This study builds on previous research identifying gaps in HIV knowledge by prioritizing two different at-risk populations in a U.S.- Mexico border community, where sociodemographic factors such as poverty, stigma, and limited access to healthcare services may contribute to increased HIV risk.
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Ng, Ashley H., Deborah A. Greenwood, Eli Iacob, et al. "Examining a Continuous Glucose Monitoring Plus Online Peer Support Community Intervention to Support Hispanic Adults With Type 2 Diabetes: Protocol for a Mixed Methods Feasibility Study." JMIR Research Protocols 11, no. 2 (2022): e31595. http://dx.doi.org/10.2196/31595.
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Background Type 2 diabetes is twice as likely to affect Hispanic people than their White counterparts. Technology and social support may be an important part of behavior change. In this study, we address gaps in diabetes care for Hispanic Spanish-speaking people with diabetes through an online peer support community (OPSC) pilot intervention using Hispanic Spanish-speaking peer facilitators with diabetes to enhance the use of continuous glucose monitoring (CGM) for diabetes management. Objective This study aims to address gaps in diabetes care for Hispanic Spanish-speaking people with diabetes through an OPSC pilot intervention using Hispanic Spanish-speaking peer facilitators with diabetes to enhance the use of CGM for diabetes management. Methods A mixed-methods, pre-post test design will be used in this feasibility study. A total of 50 Hispanic participants with type 2 diabetes willing to wear a continuous glucose monitor for 13 weeks will be recruited. Hispanic Spanish-speaking peer facilitators with diabetes and experience wearing a continuous glucose monitor will be employed and undergo training. Peer facilitators will help participants learn how CGM data can inform behavior changes via an OPSC. Participants will interact with the private OPSC at least three times a week. Weekly questions and prompts derived from the Association of Diabetes Care and Education Specialists, previously American Association of Diabetes Educators, and seven self-care behaviors will be delivered by peer facilitators to engage participants. Measures of feasibility and acceptability will be determined by the percentage of participants who enroll, complete the study, and use CGM (number of scans) and objective metrics from the OPSC. Efficacy potential outcomes include change in time in range of 70 to 180 mg/dL from baseline to 12 weeks, A1c, diabetes online community engagement, self-efficacy, and quality of life. Additionally, semistructured exit interviews will be conducted. Results Funding for this project was secured in November 2018 and approved by the institutional review board in April 2019. Peer facilitator recruitment and training were undertaken in the second half of 2019, with participant recruitment and data collection conducted in January and April 2020. The study has now concluded. Conclusions This study will generate new evidence about the use of an OPSC for Hispanic Spanish-speaking patients with diabetes to make behavior changes incorporating feedback from CGM. Trial Registration ClinicalTrials.gov NCT03799796; https://clinicaltrials.gov/ct2/show/NCT03799796 International Registered Report Identifier (IRRID) RR1-10.2196/31595
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Tao, Yu. "Earnings of Academic Scientists and Engineers: Intersectionality of Gender and Race/Ethnicity Effects." American Behavioral Scientist 62, no. 5 (2018): 625–44. http://dx.doi.org/10.1177/0002764218768870.
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While research increasingly examines the intersection of gender and race/ethnicity in science and engineering, not much is known regarding how they work together to affect career outcomes. This article examines gender earnings gaps among academic scientists and engineers by race/ethnicity. Using data from National Science Foundation’s Survey of Doctorate Recipients (2003, 2006, 2008, 2010, and 2013), I find that White women earned less than their male counterparts in 2003 and 2006, but the earnings gap closed over time. African American women did not earn less than their male counterparts in any year. Asian American women earned less only in 2013 (due to the high income of Asian American men), and Hispanic women earned less only in 2010 (due to their low income relative to other groups). The findings of relative improvement in gender earnings equality are analyzed in the context of disadvantages women face in other aspects of their careers.
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Brito, Natalie H. "Influence of the Home Linguistic Environment on Early Language Development." Policy Insights from the Behavioral and Brain Sciences 4, no. 2 (2017): 155–62. http://dx.doi.org/10.1177/2372732217720699.
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Approximately 15.5 million children in the United States (21%) live in impoverished households, with child poverty rates highest among Black, Hispanic, and American Indian children. Growing up in a socioeconomically disadvantaged environment is associated with substantially worse health and impaired psychological, cognitive, and emotional development throughout the life span. Socioeconomic status (SES) has a robust association with language development—across different language outcomes, across different ethnic and language-exposure groups, as well as within these groups. This review examines pathways for SES disparities in language skills emerging early in development and contributing to later gaps in school readiness and academic achievement.
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Лебедева, Lyudmila Lebedeva, Емельянов, and E. Emelyanov. "The Role of Pensioners in the American Electorate." Administration 5, no. 1 (2017): 98–103. http://dx.doi.org/10.12737/24708.
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The article examines fundamental demographic changes in the USA that have been shifting the electorate
 and as a result - American politics; with wide gaps between the generations on key social, economic, political
 issues. The US presidential elections since 1980 were dominated by baby boomers (born 1946-1964) and
 prior generations, who have cast the vast majority of votes in every presidential election. The 2016 electorate
 has been the most diverse in the US history due to strong growth of young generations, and especially
 among Hispanic eligible voters. Millennials (born 1981–1998) and X generation (born 1965-1980) surpassed
 Baby Boomers and more old generations whose choices differ significantly in many fields; but the key
 problem is who really votes. The age structure of the American electorate and its influence on the election
 results; the role of pensioners and those, who’ll retire in the nearest future, as voters at the federal and state
 levels are in focus.
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Recio-Boiles, Alejandro, Sachin Kumar Deshmukh, Juan Chipollini, et al. "Abstract 1895: Molecular characterization of prostate cancer between Hispanic American and Non-Hispanic Whites: Implications for cancer ethnic health disparities." Cancer Research 83, no. 7_Supplement (2023): 1895. http://dx.doi.org/10.1158/1538-7445.am2023-1895.
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Abstract Background: Although there is increased awareness leading to early detection and prevention, Hispanic American (HA) men with prostate cancer (PC) continue to have greater mortality rates compared to their Non-Hispanic White (NHW) counterparts. Moreover, HA men with PC are more likely to have more advanced disease compared to NHW men. Here, we characterized the molecular and immune differences in HA and NHW tumors and their association with PC ethnic disparity. Methods: 88 PC samples (HA=34, NHW=54) obtained from treatment-naive metastatic hormone-sensitive PC (mHSPC) were analyzed by next-generation sequencing (592, NextSeq; WES, NovaSeq), Whole Transcriptome Sequencing (WTS; NovaSeq) (Caris Life Sciences, Phoenix, AZ). AR signature and NEPC score were calculated based on the expression level of previously defined genes (Hieronymus et al. 2006, Beltran et al. 2016). Medical record was reviewed in a deidentified fashion for clinal features. Statistical significance was determined using chi-square and Mann-Whitney U (p&lt;0.05). Results: HA patients with PC had higher level of PSA (111.5 vs 52.6 ng/ml, p=0.12) and stage (T4: 41% vs 14% p=0.01, M1c: 41% vs 16% p=0.04) but no significant difference in frequency of Gleason score &gt; 4 (79% vs 73%, p=0.61) or stage N1 (69% vs 61%, p=0.85) compared to NHW. HA PC had a significantly higher frequency of TMPRSS2-fusion (46.4% vs 20.0%, p=0.04) compared to NHW PC. By Gene Set Enrichment Analysis, HA PC had enrichment of KRAS signaling (NES: 1.44, FDR=0.02), Hedgehog signaling (NES: 1.45, FDR=0.04), NOTCH signaling (NES: 1.41, FDR=0.07), Hypoxia (NES: 1.38, FDR=0.10) and IL2-STAT5 signaling (NES: 1.35, FDR=0.10) pathways compared to NHW tumors. There was no difference in median Androgen Receptor signature (p=0.78) or Neuroendocrine Prostate Cancer (NEPC) score (p=0.79). Also, no significant difference in AR positivity by IHC (100% vs 95.7%) between HA and NHW PC tumors (p=0.51). HA PC had significantly higher expression of stem cell markers ALDH1A1 (2.1-fold), ALDH1A2 (3-fold), and PROM1 (1.6-fold) and immunoinhibitory genes PDCD1LG2 (1.68-fold) and FOXP3 (1.45-fold) compared to NHW tumors (all p&lt;0.05). Additionally, HA tumors had increased infiltration of M1 Macrophages (0.72% vs 0%) and NK cells (4.84% vs 3.55%, all p&lt;0.05), and increased T-cell inflamed score (44.0 vs -49.0, p=0.14) compared to NHW. Conclusion: Our data suggest that HA mHSPC is associated with higher levels of PSA, stage, TMPRSS2-fusions, stemness marker expression, immunoinhibitory gene expression, and increased M1 Macrophage and NK cell infiltration. Together, these findings suggest a crucial role of differential molecular and tumor immune microenvironment in PC ethnic disparity. A better understanding of these differences with additional research may help in designing the approaches for reducing the ethnic disparities gaps in PC patients. Citation Format: Alejandro Recio-Boiles, Sachin Kumar Deshmukh, Juan Chipollini, Ken Batai, Sharon Wu, Joanne Xiu, Alex Farrell, Milan Radovich, Elisabeth Heath, Rana McKay, Chadi Nabhan. Molecular characterization of prostate cancer between Hispanic American and Non-Hispanic Whites: Implications for cancer ethnic health disparities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1895.
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Thaploo, Advait, Frances Dominique Ho, Katarina Wang, et al. "Cervical cancer disparities in stage at presentation for disaggregated Asian Americans, Native Hawaiians, and Pacific Islanders." Journal of Clinical Oncology 42, no. 16_suppl (2024): 5534. http://dx.doi.org/10.1200/jco.2024.42.16_suppl.5534.
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5534 Background: Over 20 million Americans identify as Asian American, Native Hawaiian, or Pacific Islander (AANHPI). Despite the diversity of indigenous and immigration histories, lived experiences, and health needs within the AANHPI community, prior research has considered this group as an aggregate. Given known disparities in access to cancer screening, this study assessed on cervical cancer stage at presentation, focusing on disaggregated AANHPI groups. Methods: Data from the National Cancer Database (NCDB) from 2004 to 2020 identified patients with newly diagnosed cervical cancer. Patients were disaggregated into AANHPI groups by indigenous history or historical country of origin. We performed ordinal logistic regression, adjusting for clinical and sociodemographic factors, with higher adjusted odds ratios (aORs) indicating diagnoses at later stages on a local, regional, and metastatic scale. Results: Out of 82,193 patients with cervical cancer, 3,943 (4.80%) identified as AANHPI. Compared to non-Hispanic White (NHW) patients, pooled AANHPI patients were slightly older (median age, NHW: 55 years, AANHPI: 56 years, χ2 P<0.001) and more likely to be uninsured or on Medicaid (NHW: 25.6%, AANHPI: 34.0%, χ2 P<0.001). In aggregate, AANHPI patients presented at lower stages of cancer (NWH: 58.7% diagnosed local/regional, AANHPI: 85.6% at local/regional, χ2 P<0.001). The largest AANHPI subgroups included Chinese (n=802, 20.3% of AANHPI), Filipinos (n=777, 19.7%), Asian Indian/Pakistani (n=554, 14.0%), Vietnamese (n=480, 12.2%), and Korean (n=452, 11.5%) Americans respectively. AANHPI disaggregation revealed that Pacific Islander patients had higher odds of later stage at diagnosis (aOR 1.59, 95% CI 1.24–2.03, p < 0.001) relative to NHW patients. Conversely, Chinese (aOR 0.64, 95% CI 0.56–0.73, p < 0.001) and Vietnamese (aOR 0.77, 95% CI 0.65–0.91, p = 0.003) American patients were less likely to represent at later stage. Compared to the largest AANHPI group (Chinese American), all other subgroups were more likely to present at a higher stage. The largest differences were observed in Thai (aOR 2.84, 95% CI 1.56–5.14, p = 0.001), Pacific Islander (aOR 2.71, 95% CI 2.03–3.63, p < 0.001), Hmong (aOR 2.03, 95% CI 1.30–3.18, p = 0.002), Laotian (aOR 1.96, 95% CI 1.27–3.02, p = 0.002), and Korean (aOR 1.87, 95% CI 1.49–2.34, p < 0.001) American patients. Conclusions: Aggregated evaluation of the AANHPI monolith masks disparities in outcomes for distinct populations at risk for equity gaps. This disaggregation study shows that marginalized groups within the larger AANHPI population – including Hmong and Pacific Islander patients – may face different exposures and larger structural barriers to cancer screening and early-stage diagnosis. A future focus on community based disaggregated research and tailored interventions is necessary to close these gaps.
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Nathan, Cody L., and Camilo Gutierrez. "FACETS of health disparities in epilepsy surgery and gaps that need to be addressed." Neurology: Clinical Practice 8, no. 4 (2018): 340–45. http://dx.doi.org/10.1212/cpj.0000000000000490.
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Purpose of reviewDisparities in treatment and outcomes of patients with epilepsy have been identified in several distinct patient populations. The purpose of this review is to organize the literature and establish clear pathways as to why certain patient populations are not receiving epilepsy surgery. By establishing the acronym FACETS (fear of treatment, access to care, communication barriers, education, trust between patient and physician, and social support), we set up a pathway to further study this area in an organized fashion, hopefully leading to objective solutions.Recent findingsStudies revealed that African American, Hispanic, and non-English-speaking patients underwent surgical treatment for epilepsy at rates significantly lower compared to white patients.SummaryThis article explains possible reasons outlined by FACETS for the health disparities in epilepsy surgery that exist in patients of a certain race, socioeconomic status, and language proficiency.
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Higa, Darrel H., Nicole Crepaz, Christina M. McDonald, et al. "HIV Prevention Research on Men Who Have Sex With Men: A Scoping Review of Systematic Reviews, 1988–2017." AIDS Education and Prevention 32, no. 1 (2020): 1—S7. http://dx.doi.org/10.1521/aeap.2020.32.1.1.
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In the United States, men who have sex with men (MSM) are disproportionately affected by HIV. To identify research gaps and inform HIV prevention for MSM, we conducted a scoping review of systematic reviews using CDC's Prevention Research Synthesis database. Eligibility criteria comprised English-language systematic reviews focused on HIV prevention for MSM, published during 1988–2017, and included at least one U.S. primary study. We coded data type, subpopulations, topics, and key findings. To assess study quality, we used the Assessment of Multiple Systematic Reviews (AMSTAR). Among 129 relevant systematic reviews, study quality was high or moderate for 63%. Most common topics were sexual behavior and disease vulnerability. The most frequently mentioned MSM subgroups were HIV-positive, Black or African American, and young. Research gaps include Hispanic/Latino MSM, pre-exposure prophylaxis (PrEP), treatment as prevention, social determinants of health, health disparities, syndemics, and protective factors for sexual health.
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Fine, Adam D., Sachiko Donley, Caitlin Cavanagh, and Elizabeth Cauffman. "Youth Perceptions of Law Enforcement and Worry About Crime from 1976 to 2016." Criminal Justice and Behavior 47, no. 5 (2020): 564–81. http://dx.doi.org/10.1177/0093854820903752.
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Recent unjust interactions between law enforcement and youth of color may have provoked a “crisis” in American law enforcement. Utilizing Monitoring the Future’s data on distinct, cross-sectional cohorts of 12th graders from each year spanning 1976–2016, we examined whether youth perceptions of law enforcement have changed. We also traced youth worry about crime considering declining perceptions of law enforcement may correspond with increasing worry about crime. Across decades, White youth consistently perceived law enforcement the most positively and worried least about crime, followed by Hispanic/Latinx then Black/African American youth. During the 1990s, among all youth, perceptions of law enforcement declined while worry about crime increased. However, recently, such trends were limited to White youth; among youth of color, perceptions of law enforcement declined while worry about crime remained largely stable. Problematically, youth perceptions of law enforcement recently reached a decades-long low and racial/ethnic gaps in perceptions appear to be growing.
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Soewito, Stephanie, Rachel Wyatt, Emily Berenson, et al. "Disparities in Cancer Genetic Testing and Variants of Uncertain Significance in the Hispanic Population of South Texas." JCO Oncology Practice 18, no. 5 (2022): e805-e813. http://dx.doi.org/10.1200/op.22.00090.
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PURPOSE: Racial and ethnic disparities have included a lack of access to both genetic testing and research, resulting in poor understanding of the genomic architecture in under-represented populations. The South Texas population is primarily of Hispanic background and has been largely devoid of genetic services. We extended access to this underserved population and uncovered genetic variants previously not observed, emphasizing the need to continually improve both genomic databases and clarification of variant significance to provide meaningful patient counseling. METHODS: This study consisted of a retrospective cohort review of patients seen through a cancer genetics education and service program across 24 counties in South Texas. In total, 1,595 individuals were identified as appropriate for cancer genetic counseling and 1,377 completed genetic testing. RESULTS: Eighty percent of those receiving genetic counseling self-identified as Hispanic, 16% as non-Hispanic White (NHW), 3% as African American, and 1% as other race/ethnicity. Of reported variants, 18.8% were pathogenic and 13.7% were reported as a variant of uncertain significance (VUS). VUS was reported in 17.2% of the Hispanic individuals compared with 9% NHW ( P = .005). CONCLUSION: Individuals of Hispanic ethnicity were significantly more likely to harbor a VUS compared with NHW. The extended reach into our regional communities revealed a gap in the ability to accurately interpret genomic variation with implications for advising patients on screening, prevention, and management strategies. A higher percentage of VUS also emphasizes the challenge of continued follow-up amid existing barriers that led to disparities in access. As understanding of the variants develops, hopefully gaps in knowledge of the genomic landscape will be lessened with increased clarity to provide accurate cancer risk assessment and recommendations for implementing prevention initiatives.
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Liu, Bennett M., Kelley Paskov, Jack Kent, et al. "Racial and Ethnic Disparities in Geographic Access to Autism Resources Across the US." JAMA Network Open 6, no. 1 (2023): e2251182. http://dx.doi.org/10.1001/jamanetworkopen.2022.51182.
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ImportanceWhile research has identified racial and ethnic disparities in access to autism services, the size, extent, and specific locations of these access gaps have not yet been characterized on a national scale. Mapping comprehensive national listings of autism health care services together with the prevalence of autistic children of various races and ethnicities and evaluating geographic regions defined by localized commuting patterns may help to identify areas within the US where families who belong to minoritized racial and ethnic groups have disproportionally lower access to services.ObjectiveTo evaluate differences in access to autism health care services among autistic children of various races and ethnicities within precisely defined geographic regions encompassing all serviceable areas within the US.Design, Setting, and ParticipantsThis population-based cross-sectional study was conducted from October 5, 2021, to June 3, 2022, and involved 530 965 autistic children in kindergarten through grade 12. Core-based statistical areas (CBSAs; defined as areas containing a city and its surrounding commuter region), the Civil Rights Data Collection (CRDC) data set, and 51 071 autism resources (collected from October 1, 2015, to December 18, 2022) geographically distributed into 912 CBSAs were combined and analyzed to understand variation in access to autism health care services among autistic children of different races and ethnicities. Six racial and ethnic categories (American Indian or Alaska Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian or other Pacific Islander, and White) assigned by the US Department of Education were included in the analysis.Main Outcomes and MeasuresA regularized least-squares regression analysis was used to measure differences in nationwide resource allocation between racial and ethnic groups. The number of autism resources allocated per autistic child was estimated based on the child’s racial and ethnic group. To evaluate how the CBSA population size may have altered the results, the least-squares regression analysis was run on CBSAs divided into metropolitan (&amp;gt;50 000 inhabitants) and micropolitan (10 000-50 000 inhabitants) groups. A Mann-Whitney U test was used to compare the model estimated ratio of autism resources to autistic children among specific racial and ethnic groups comprising the proportions of autistic children in each CBSA.ResultsAmong 530 965 autistic children aged 5 to 18 years, 83.9% were male and 16.1% were female; 0.7% of children were American Indian or Alaska Native, 5.9% were Asian, 14.3% were Black or African American, 22.9% were Hispanic or Latino, 0.2% were Native Hawaiian or other Pacific Islander, 51.7% were White, and 4.2% were of 2 or more races and/or ethnicities. At a national scale, American Indian or Alaska Native autistic children (β = 0; 95% CI, 0-0; P = .01) and Hispanic autistic children (β = 0.02; 95% CI, 0-0.06; P = .02) had significant disparities in access to autism resources in comparison with White autistic children. When evaluating the proportion of autistic children in each racial and ethnic group, areas in which Black autistic children (&amp;gt;50% of the population: β = 0.05; &amp;lt;50% of the population: β = 0.07; P = .002) or Hispanic autistic children (&amp;gt;50% of the population: β = 0.04; &amp;lt;50% of the population: β = 0.07; P &amp;lt; .001) comprised greater than 50% of the total population of autistic children had significantly fewer resources than areas in which Black or Hispanic autistic children comprised less than 50% of the total population. Comparing metropolitan vs micropolitan CBSAs revealed that in micropolitan CBSAs, Black autistic children (β = 0; 95% CI, 0-0; P &amp;lt; .001) and Hispanic autistic children (β = 0; 95% CI, 0-0.02; P &amp;lt; .001) had the greatest disparities in access to autism resources compared with White autistic children. In metropolitan CBSAs, American Indian or Alaska Native autistic children (β = 0; 95% CI, 0-0; P = .005) and Hispanic autistic children (β = 0.01; 95% CI, 0-0.06; P = .02) had the greatest disparities compared with White autistic children.Conclusions and RelevanceIn this study, autistic children from several minoritized racial and ethnic groups, including Black and Hispanic autistic children, had access to significantly fewer autism resources than White autistic children in the US. This study pinpointed the specific geographic regions with the greatest disparities, where increases in the number and types of treatment options are warranted. These findings suggest that a prioritized response strategy to address these racial and ethnic disparities is needed.
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Yi, Eun-Hye, Michin Hong, and Cherish Bolton. "EXPERIENCE OF UNFAIR TREATMENT IN HEALTHCARE SETTING AND RELATED STRESS AMONG OLDER AMERICANS: RACIAL/ETHNIC GAPS." Innovation in Aging 6, Supplement_1 (2022): 473–74. http://dx.doi.org/10.1093/geroni/igac059.1834.
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Abstract Guided by the intersectionality framework, this study examined the experience of unfair treatment in healthcare settings over lifetime and related stress. A subsample drawn from the California Health and Interview Survey 2017, including residents age 55 or higher, was used (N=12,261). Significant differences existed in unfair treatment and corresponding stress among racial/ethnic groups, including Whites, African Americans (AA), Hispanics, and Asian Americans (AS). Using weighted chi-square tests, we found that most Whites (75.99%) never experienced unfair treatment, while around 60% of AA answered never. Whites tended to feel extreme stress more when mistreated (23.47%) than Hispanics (14.83%) and AS (15.69%). Weighted logistic regression analyses revealed that younger older adults with lower mental health were more likely to experience unfair treatment across all race/ethnic groups. Intersectional factors contributing to unfair treatment experience were identified for each race/ethnic group. Being a female, living in poverty, poor health, being a naturalized citizen, and living in an urban area were factors for Whites while having higher education was a factor for AA. Mental health was associated with extreme stress for the unfair treatment in all racial/ethnic groups. Different contributors to the stress were found by race/ethnicity. Gender, poverty, citizenship, and length of staying in the U.S. were significant for Whites. For AA, poverty, healthcare insurance, and obesity were significant, and for AS, physical health and obesity were. This study highlights the importance of culturally/ethnically sensitive approaches shaping interventions and policies to enhance awareness about unfair treatment and preventing discrimination toward diverse older adults.
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Churchill, Victoria, Yu-Mei Schoenberger, Vivian L. Carter, et al. "Abstract A005: The development of a bioethically sensitive education video: Addressing the barriers to African Americans’ and Hispanics’ participation in clinical and genomic research through digital animation." Cancer Epidemiology, Biomarkers & Prevention 32, no. 12_Supplement (2023): A005. http://dx.doi.org/10.1158/1538-7755.disp23-a005.
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Abstract Introduction: Research advances on effective methods to prevent, diagnose and treat cancer continue to emerge through clinical and genomic research. To ensure the results from these research studies help those who need it most, a diverse population needs to enroll. Despite guidance from authorities, such as the National Institutes of Health, most clinical trial and genomic research participants identify as White. At the participant level, mistrust of research, unawareness of research opportunities and gaps in bioethical knowledge about clinical trials and genomic research remain proven barriers to participating, especially among African Americans (AA) and Hispanics. With the development and access to technology, digital delivery of salient and tailored health education may provide innovative pathways to increase representation of AA and Hispanics in research. Methods: Members from the NCI-funded Partnerships to Advance Cancer Health Equity (PACHE) including experts from the community, healthcare, biomedical research and public health, such as oncologists, cancer geneticists, behavioral scientists and bioethicists collaborated on all phases. A design lab with experience synthesizing complex health messages into brief animations was contracted. The goal was to utilize existing educational resources from the National Cancer Institute and the National Human Genome Research Institute to create a tailored message to address AA's and Hispanics’ beliefs, values and bioethical concerns related to participation in clinical and genomic research. Models of behavior change and communication theories were leveraged to frame key components of the message, which then informed the animated video. Results: Development of the video consisted of six iterative phases: 1) writing sessions; 2) storyboarding; 3) animating; 4) screening/revisions; 5) acceptability testing; 6) finalization. In the last two steps, the video was presented to family members of cancer patients, cancer survivors and community members who provided quantitative and qualitative feedback which informed further edits. The final animated video is approximately five minutes in length and covers several topics including the goal of clinical research, disparities in clinical trials and genomic research participation, genomic research regulations and the purpose of a biobank. Supporting imagery to emphasize specific concepts, such as racial disparities in research, was dispersed throughout the video. A voiceover emphasized key bioethical concepts, including how research participation is safe and voluntary. When possible, characters were designed to resemble the targeted viewing audience. Discussion: Increasing AA and Hispanic participation in clinical and genomic research is imperative to achieving health equity. Tailored messages via short videos may assist in addressing the barriers and facilitators towards research participation and increase intentions to enroll in trials. Future research will evaluate the efficacy of the video through a multi-level framework in real-world settings. Citation Format: Victoria Churchill, Yu-Mei Schoenberger, Vivian L Carter, Windy Dean-Colomb, Roland Matthews, Desiree Rivers, Stephen O Sodeke, Jamirah Chevrin, Brian Rivers. The development of a bioethically sensitive education video: Addressing the barriers to African Americans’ and Hispanics’ participation in clinical and genomic research through digital animation [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A005.
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Mukand, Nita, Salma Shariff-Marco, James D. Brooks, et al. "Patient-level factors associated with the use of active surveillance: The talking about prostate cancer cohort." Journal of Clinical Oncology 41, no. 16_suppl (2023): 10565. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.10565.
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10565 Background: Talking About Prostate Cancer is a population-based cohort study on multilevel determinants of active surveillance (AS) and patient reported outcomes in a racially and ethnically diverse population of men with low-risk prostate cancer. The study includes qualitative one-on-one interviews with patients and physicians, and quantitative cross-sectional provider and longitudinal (baseline and 12-month follow-up) patient surveys to address gaps in the literature regarding patient-level factors associated with AS, particularly among understudied populations including Asian American and Hispanic patients, we assessed socio-demographic characteristics associated with receipt of AS. Methods: Men aged 40-79 diagnosed with low-risk prostate cancer from May 2018 through March 2022 were identified within 12 months of diagnosis from the population-based Greater Bay Area Cancer Registry. To expand recruitment, men were also identified from the cancer registries covering the rest of California. To ensure sufficient representation of diverse racial and ethnic groups, 20% of non-Hispanic White men were sampled, while all Asian American and Pacific Islander, Black, and Hispanic men were invited to participate. Univariable and multivariable logistic regression were used to estimate the odds ratios (OR), adjusted odds ratios (aOR), and 95% confidence intervals (CI), of receiving AS. Potential predictors included year of diagnosis, age, health insurance, usual source of care, race and ethnicity, educational attainment, employment, nativity, and language preference. Results: Among 500 men with low-risk prostate cancer, 27% went on AS, 30% underwent surgery, radiation, hormonal treatment, cryotherapy, and/or high-intensity focused ultrasound, and 43% had not yet made a treatment decision at baseline. Among those who had made a treatment decision at baseline (N = 287), 27% of Hispanic men received AS, which was the lowest proportion among the racial and ethnic groups (Black 28%; Asian 47%; White 59%). A higher proportion of coupled men (29%) received AS compared to single men (15%). Less than half of men with less than a high school education received AS. Compared to men with a high school education or less, men with a bachelor’s degree had an aOR of 2.91 (95% CI 1.10 – 8.42) and men with a graduate degree had an aOR of 4.37 (95% CI 1.50-12.76) of receiving AS. A significantly lower odds of AS was identified among Black (aOR 0.26; 95% CI 0.11-0.64) and Hispanic men (aOR 0.35; 95% CI 0.15 – 0.81) compared to non-Hispanic White men. Conclusions: We identified several significant socio-demographic differences between patients who received definitive treatment versus AS in this cohort, including race and ethnicity and educational attainment. Further study of these domains in larger, diverse samples will elucidate the strength of these associations within racial and ethnic groups.
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DALLAS, CONSTANCE, and LINDA BURTON. "Health Disparities Among Men from Racial and Ethnic Minority Populations." Annual Review of Nursing Research 22, no. 1 (2004): 77–100. http://dx.doi.org/10.1891/0739-6686.22.1.77.
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The purpose of this chapter is to review empirical nursing literature on the health care of racial and ethnic minority men, specifically African American/Black, Hispanic/Latino, American Indian/Alaskan Native, and Asian/Pacific Islander men. CINAHL and MEDLINE computer databases were searched from their earliest online date until 2003 using a combination of manual and computer-based methods to identify the nursing literature with samples that included minority men. Articles were selected according to their relevance to the four areas of adult health disparities targeted by the Department of Health and Human Services (DHHS): heart disease, malignant neoplasms (cancer), diabetes, and HIV/AIDS.A total of 52 empirical articles were selected. Findings were categorized as addressing disease prevention, disease screening, or disease management of the targeted conditions. This review demonstrates that some important work has already been accomplished in nursing research to address the four adult health disparities targeted by DHHS. Future research should be based on gaps identified in existing literature and should be guided by culturally appropriate theories and constructs.
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Song, Julia, Elizabeth A. Mittendorf, Tari A. King, and Christina Ahn Minami. "Treatment delays in older women with nonmetastatic breast cancer treated at minority-serving hospitals." Journal of Clinical Oncology 39, no. 28_suppl (2021): 122. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.122.
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122 Background: Almost 60% of breast cancer in the U.S. occur in women aged >65, but these women are less likely to receive guideline-concordant care. Given existing treatment disparities by race/ethnicity, older minority women may be especially prone to potential gaps in breast cancer care. Hospitals serving higher proportions of minority patients are at risk to deliver suboptimal care, but how site of care impacts aging patients with breast cancer is not well defined. We sought to evaluate the association between race/ethnicity and breast cancer treatment delays in older women treated at minority-serving hospitals (MSH) vs non-MSHs. Methods: Women >65 years old with non-metastatic breast cancer diagnosed from 2010-2017 were identified in the National Cancer Database using data from Commission on Cancer (CoC)-accredited hospitals. Treatment delay was defined as >90 days from diagnosis to first treatment (surgery, chemotherapy, endocrine therapy). MSHs were defined as the top decile of hospitals serving predominantly Black or Hispanic patients. Multivariable logistic regression models adjusted for patient, disease, and hospital characteristics were used to determine the odds of treatment delay for women at MSHs vs non-MSHs across racial/ethnic groups. Results: 529,128 women (84.5% non-Hispanic White, 3.3% Hispanic White, 9.6% non-Hispanic Black, 0.1% Hispanic Black, 0.2% Native American, 2.5% Asian/Pacific Islander) were identified among 41 MSHs and 1,146 non-MSHs. Overall, time to treatment was <90 days in >95% of women (mean 33.4 days; standard deviation 26.4 days). Older women regardless of race at MSHs were more likely to suffer treatment delays than those at non-MSHs (odds ratio 1.31; 95% confidence interval 1.22-1.41). Compared to non-Hispanic White women, all minority groups had a higher likelihood of treatment delay regardless of MSH status (Table). Conclusions: Although most older women with non-metastatic breast cancer treated at CoC hospitals received care in a timely fashion, minorities and those treated at MSHs were more likely to experience treatment delays. Effective interventions addressing barriers to timely care at MSHs and among racial/ethnic minorities are needed. [Table: see text]
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Torres, Jaime Rafael, Tomás Agustín Orduna, Maricela Piña-Pozas, Daniela Vázquez-Vega, and Elsa Sarti. "Epidemiological Characteristics of Dengue Disease in Latin America and in the Caribbean: A Systematic Review of the Literature." Journal of Tropical Medicine 2017 (2017): 1–18. http://dx.doi.org/10.1155/2017/8045435.
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Dengue, an important mosquito-borne virus transmitted mainly byAedes aegypti, is a major public health issue in Latin America and the Caribbean. National epidemiological surveillance systems, usually based on passive detection of symptomatic cases, while underestimating the true burden of dengue disease, can provide valuable insight into disease trends and excess reporting and potential outbreaks. We carried out a systematic review of the literature to characterize the recent epidemiology of dengue disease in Latin America and the English-speaking and Hispanic Caribbean Islands. We identified 530 articles, 60 of which met criteria for inclusion. In general, dengue seropositivity across the region was high and increased with age. All four virus serotypes were reported to circulate in the region. These observations varied considerably between and within countries and over time, potentially due to climatic factors (temperature, rainfall, and relative humidity) and their effect on mosquito densities and differences in socioeconomic factors. This review provides important insight into the major epidemiological characteristics of dengue in distinct regions of Latin America and the Caribbean, allowing gaps in current knowledge and future research needs to be identified.
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Goodman, Julia M., Dawn M. Richardson, and William H. Dow. "Racial and Ethnic Inequities in Paid Family and Medical Leave: United States, 2011 and 2017–2018." American Journal of Public Health 112, no. 7 (2022): 1050–58. http://dx.doi.org/10.2105/ajph.2022.306825.
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Objectives. To examine racial and ethnic inequities in paid family and medical leave (PFML) access and the extent to which these inequities are mediated by employment characteristics. Methods. We used data from the 2011 and 2017–2018 American Time Use Survey in the United States to describe paid leave access by race/ethnicity. We present unadjusted models, models stratified by policy-targetable employment characteristics, and adjusted regression models. Results. We found that 54.4% of non-Hispanic White workers reported access to PFML in 2017–2018 but that access was significantly lower among Asian, Black, and Hispanic workers. Inequities were strongest among private-sector and nonunionized workers. Leave access improved slightly between 2011 and 2017–2018, but the inequity patterns were unchanged. Conclusions. We observed large and significant racial and ethnic inequities in access to PFML that were only weakly mediated by job characteristics. PFML has a range of health benefits for workers and their families, but access remains limited and inequitable. Public Health Implications. Our findings suggest that broad PFML mandates (such as those in other high-income countries) may be needed to substantially narrow racial and ethnic gaps in paid leave access. (Am J Public Health. 2022;112(7):1050–1058. https://doi.org/10.2105/AJPH.2022.306825 )
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Wilkerson, Jasmine G., Frances Wang, Yadurshini Raveendran, and Tomi Akinyemiju. "Abstract 3474: Racial disparities in receipt of surveillance mammography after breast cancer diagnosis." Cancer Research 84, no. 6_Supplement (2024): 3474. http://dx.doi.org/10.1158/1538-7445.am2024-3474.
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Abstract Background: The 5-year survival rate for breast cancer (BC) stands at an estimated 91%, with approximately 3.8 million BC survivors in the U.S. This large population of breast cancer survivors remains at risk of loco-regional recurrence, with variations noted across racial groups. White survivors face a locoregional breast cancer recurrence rate of 1.8%, whereas Black, Asian, and Hispanic survivors experience higher rates of 3.9%, 3.6%, and 3.1%, respectively. Notably, Black BC survivors with recurrent breast cancer exhibit a median survival time of 1.8 years compared with 3.6 years observed for White BC survivors. Current recommendations from the U.S. Preventative Services Task Force and the American College of Radiology advocate for surveillance through annual mammography and routine clinical visits following breast-conserving surgery and lumpectomies. However, there are gaps in the data available regarding disparities in the utilization of surveillance mammography by race/ethnicity. Thus, the goal of this study is to estimate race/ethnic disparities in surveillance mammography utilization and its impact on survival among breast cancer survivors at a large comprehensive cancer center. Methods: A retrospective cohort study of female breast cancer survivors ≥19 years diagnosed and/or treated at the Duke Cancer Institute (DCI) between 2014 and 2022 was conducted. Data was abstracted on patient socio-demographics, cancer type (invasive ductal and ductal in situ carcinomas) and utilization of surveillance mammography within 2-5 years post initial breast cancer diagnosis. Chi-squared testing will be used to analyze rates of mammography surveillance receipt among different races presenting with BC at DCI. Kaplan-Meier estimates will be used for analysis on survival. Results: A total of 10,904 women with a mean age of 43.7 years were included in the study. The study cohort is comprised of 69% non-Hispanic (NH) White, 24% NH Black, 2.2% Hispanic, 0.5% NH Native American, 1% NH other, and 3.2% NH Asian women. There were 1,791 cases of ductal in situ carcinomas and 9,113 invasive ductal carcinoma cases. NH Black women had the lowest 5-year relative survival rate (81.5%) of all represented racial groups: NH White 89.1%, Hispanic 95.3%, NH Native 87.8%, Asian 97.9%, and NH Other 88.0%. Ongoing analysis will be completed to estimate disparities in the use of post-treatment surveillance mammography amongst breast cancer survivors. Conclusions: This study will inform efforts to increase post-treatment surveillance and improve adherence to survivorship guidelines with the ultimate goal of reducing mortality disparities among breast cancer survivors. Citation Format: Jasmine G. Wilkerson, Frances Wang, Yadurshini Raveendran, Tomi Akinyemiju. Racial disparities in receipt of surveillance mammography after breast cancer diagnosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3474.
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Zheng, Yiyang. "Impact of American Education System under the Covid-19 Pandemic Period." Lecture Notes in Education Psychology and Public Media 7, no. 1 (2023): 97–103. http://dx.doi.org/10.54254/2753-7048/7/20220737.
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With the specific change of COVID-19 influence, our society was facing a huge challenge in operating the several concepts, especially in educational field. This paper observes the extremely effects of the pandemic on the American educational system during the current three years, suggesting the specific changes in students achievement gaps, inequality of school resources, variety of pedagogical approaches and impacts on students mental and physical health. Besides, it also focuses on the differences of school structure, including class structure and teachers attitude to see if it mainly affect students learning under such unnormal circumstance. The results shows that the pandemic of COVID-19 definitely brought negative impacts on learners, especially for low-income families. Students with weak educational treatments before. For example, Hispanic, Black, and indigenous will face the increasing possibilities of loosing their educational chances due to the lack of school resources, difficulties in accepting new techniques and other problems that happened during the pandemic period. Based on these findings, our government can absolutely understand the problems and teaching needs faced by students under COVID-19 period, and better make corresponding plans to help more children get effective learning opportunities in a fair and equitable way.
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Jelinek, Ryan, Deepti Pandita, Mark Linzer, Jeremy Bikah Bi Nguema Engoang, and Holly Rodin. "An Evidence-Based Roadmap for the Provision of More Equitable Telemedicine." Applied Clinical Informatics 13, no. 03 (2022): 612–20. http://dx.doi.org/10.1055/s-0042-1749597.
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Abstract Objective During the coronavirus disease 2019 pandemic, as a safety-net organization with a substantial percentage of patients of color and with limited English proficiency (LEP), we were wary of furthering health disparities in our community. We analyzed gaps in telemedicine (telephone and video) delivery in our communities, quantified the effects of our tests of change, and began the process of accumulating evidence to create a road map for other organizations. Methods We leveraged Lean problem-solving strategies to identify modifiable gaps across multiple domains that could inhibit equity in telemedicine. We implemented tests of change across domains of community engagement, technology, education, and access. We observed the proportion of telemedicine encounters across races and languages between April and November, 2020. Regression analyses tested the impact of race and language on telemedicine controlling for age, gender, insurance, and time. Results Several rounds of changes and enhancements were associated with changes in telemedicine use of +5.5% (p < 0.0001) for Hispanic, +4.0% (p < 0.0001) for Spanish-speaking, −2.1% for Black (p < 0.05), and −4.4% for White patients (p < 0.001). African-American, Hispanic, and non-English-speaking patients had between 2.3 and 4.6 times the odds of preferring telephone to video encounters (p < 0.0001), with increases in preferences for video use over time (p < 0.05). Conclusion Our roadmap to improve equitable delivery of telemedicine was associated with a significant improvement in telemedicine use among certain minority populations. Most populations of color used telephone more often than video. This preference changed over time and with equity-focused changes in telemedicine delivery.
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Linde, Sebastian, and Leonard E. Egede. "Trends in charges and association with defaults on medical payments in uninsured Americans: a disproportionate burden in ethnic minorities – a retrospective observational study." BMJ Open 12, no. 5 (2022): e054494. http://dx.doi.org/10.1136/bmjopen-2021-054494.
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ObjectiveTo evaluate whether medical event charges are associated with uninsured patients’ probability of medical payment default and whether there exist racial/ethnic disparity gaps in medical payment defaults.DesignWe use logistic regression models to analyse medical payment defaults. Our adjusted estimates further control for a rich set of patient and medical visit characteristics, region and time fixed effects.SettingUninsured US adult (non-elderly) population from 2002 to 2017.ParticipantsWe use four nationally representative samples of uninsured patients from the Medical Expenditure Panel Survey across office-based (n=39 967), emergency (n=3269), outpatient (n=1739) and inpatient (n=340) events.Primary and secondary outcome measuresPayment default, medical event charges and medical event payments.ResultsRelative to uninsured non-Hispanic white (NHW) patients, uninsured non-Hispanic black (NHB) patients are 142% (p<0.01) more likely to default on medical payments for office-based visits, 27% (p<0.05) more likely to default on emergency department visit payments and 82% (p<0.1) more likely to default on an outpatient visit bill. Hispanic patients are 46% (p<0.01) more likely to default on an office-based visit, but 25% less likely to default on emergency department visit payments than NHW patients. Within our fully adjusted model, we find that racial/ethnic disparities persist for office-based visits. Our results further suggest that the probabilities of payment defaults for office-based, emergency and outpatient visits are all significantly (p<0.01) and positively associated with the medical event charges billed.ConclusionsMedical event charges are found to be broadly associated with payment defaults, and we further note disproportionate payment default disparities among NHB patients.
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Knippen, Kerri Lynn, Jiunn-Jye Sheu, Reena Oza-Frank, Kimberly McBride, and Joseph Dake. "Predictors of Health-Protective Behavior and Glycemia After Gestational Diabetes, NHANES 2007-2014." Diabetes Educator 45, no. 4 (2019): 408–19. http://dx.doi.org/10.1177/0145721719848447.
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Purpose This study examined weight loss behavior and the prevalence of hyperglycemia unawareness (unknown high blood glucose) after gestational diabetes mellitus (GDM), within a nationally, representative sample. This study also examined social-demographic, psychosocial, provider communication, and health care access/utilization factors as predictors of A1C and health-protective behavior after GDM. Methods A secondary analysis of 2007-2014 National Health and Nutrition Examination Surveys (NHANES) data was conducted, including 205 women, aged 20 to 44 years, with a history of GDM, whose last live birth was in the past 10 years, excluding pregnant women and those with diabetes. Weighted bivariate, stepwise linear, and binary logistic regression analyses were conducted to examine correlates of A1C, weight change, weight loss attempt and behavior, diabetes screening, and physical activity. Results Hyperglycemia unawareness was associated with increased A1C and weight gain in the past year. Personal weight loss goal and perception of overweight increased the odds of weight loss attempt. Depressive symptoms were associated with weight gain over the past year. A third of the sample failed to have their glucose tested in the past 3 years. Two-thirds were never told about their personal risk for diabetes, but provider communication increased the odds of meeting weekly activity recommendations and glucose screening. Hispanic women and non-Hispanic black women were less likely to have had glucose screening than non-Hispanic white women. Conclusion Diabetes educators should address gaps in provider communication, while supporting psychosocial needs and reducing disparities to encourage health-protective behavior after GDM. The American Association of Diabetes Educators, 7 Self-Care Behaviors (AADE-7TM) provides an excellent framework for interventions to support health-protective behavior after GDM.
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Lee, Jennifer, and Frank D. Bean. "Redrawing the Color Line?" City & Community 6, no. 1 (2007): 49–62. http://dx.doi.org/10.1111/j.1540-6040.2007.00198.x.
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In 1903, W.E.B. Du Bois prophesied that the “problem of the twentieth–century is the problem of the color line,” by which he meant the tenacious black–white divide that has long characterized the nature of race relations in the United States ([1903] 1997: 45). Nearly a century later, Herbert J. Gans speculated the traditional black–white fault line may soon be replaced by a black–nonblack divide that may be qualitatively different from the black–white divide, but is hardly new for blacks, who are likely to remain at the bottom of America's racial hierarchy. Taking into account the new racial and ethnic diversity of the United States brought about by contemporary immigration, we examine patterns of intermarriage and multiracial identification to assess where color lines are fading most rapidly and where they continue to endure. We adjudicate whether a black–white divide remains the most salient, whether a Hispanic–Anglo divide is imminent, or whether a black–nonblack fault line is emerging, as Gans forecasts.
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Enid Zambrana, Ruth, Gabriel Amaro, Courtney Butler, Melissa DuPont-Reyes, and Deborah Parra-Medina. "Analysis of Latina/o Sociodemographic and Health Data Sets in the United States From 1960 to 2019: Findings Suggest Improvements to Future Data Collection Efforts." Health Education & Behavior 48, no. 3 (2021): 320–31. http://dx.doi.org/10.1177/10901981211011047.
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Introduction. Prior to 1980, U.S. national demographic and health data collection did not identify individuals of Hispanic/Latina/o heritage as a population group. Post-1990, robust immigration from Latin America (e.g., South America, Central America, Mexico) and subsequent growth in U.S. births, dynamically reconstructed the ethnoracial lines among Latinos from about 20 countries, increasing racial admixture and modifying patterns of health disparities. The increasing racial and class heterogeneity of U.S. Latina/os demands a critical analysis of sociodemographic factors associated with population health disparities. Purposes. To determine the state of available Latina/o population demographic and health data in the United States, assess demographic and health variables and trends from 1960 to the present, and identify current strengths, gaps, and areas of improvement. Method. Analysis of 101 existing data sets that included demographic, socioeconomic, and health characteristics of the U.S. Latina/o population, grouped by three, 20-year intervals: 1960–1979, 1980–1999, and 2000–2019. Results. Increased Latina/o immigration and U.S. births between 1960 and 2019 was associated with increases of Latino population samples in data collection. Findings indicate major gaps in the following four areas: children and youth younger than 18 years, gender and sexual identity, race and mixed-race measures, and immigration factors including nativity and generational status. Conclusions. The analysis of existing ethnoracial Latina/o population data collection efforts provides an opportunity for critical analysis of past trends, future directions in data collection efforts, and an equity lens to guide appropriate community health interventions and policies that will contribute to decreasing health disparities in Latina/o populations.