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1
Sridhar, Gayathri, Saba W. Masho, Tilahun Adera, Viswanathan Ramakrishnan, and John D. Roberts. "Do African American Men Have Lower Survival From Prostate Cancer Compared With White Men? A Meta-analysis." American Journal of Men's Health 4, no. 3 (May 18, 2010): 189–206. http://dx.doi.org/10.1177/1557988309353934.
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Prostate cancer is the second leading cause of cancer-related mortality in men. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of articles published from 1968 to 2007 assessing survival from prostate cancer was conducted. Analysis of unadjusted studies reported that African American men have an increased risk of all-cause mortality (hazard ratio [HR] = 1.47, 95% confidence interval [CI] = 1.31-1.65, p < .001). However, examination of adjusted studies identified no difference (HR = 1.07, 95% CI = 0.94-1.22, p = .308). No statistically significant difference was observed in prostate cancer—specific survival in both analyses using unadjusted (HR = 1.11, 95% CI = 0.94-1.31, p = .209) and adjusted studies (HR = 1.15, 95% CI = 0.95-1.41, p = .157). This meta-analysis concludes that there are no racial differences in the overall and prostate cancer—specific survival between African American and White men.
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Klebaner, Daniella, Patrick Travis Courtney, and Brent S. Rose. "Effect of healthcare system on prostate cancer-specific mortality in African American and non-Hispanic white men." Journal of Clinical Oncology 39, no. 6_suppl (February 20, 2021): 23. http://dx.doi.org/10.1200/jco.2021.39.6_suppl.23.
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23 Background: Disparities in prostate cancer-specific mortality (PCSM) between African American and non-Hispanic White (White) patients have been attributed to biological differences; however, recent data suggest poorer outcomes may be related to barriers to medical care from the healthcare system in which patients receive care. We sought to evaluate potential drivers of disparities by comparing outcomes between African American and White men in the Surveillance, Epidemiology and End Results (SEER) national cancer registry and a relatively equal-access healthcare system, the Veterans Health Administration (VHA). Methods: We identified African American and White patients diagnosed with prostate cancer between 2004-2015 in the SEER and VHA databases. We analyzed metastatic disease at diagnosis with multivariable logistic regression, and PCSM with cumulative incidence analysis and sequential competing-risks regression adjusting for disease and sociodemographic factors. Results: The SEER cohort included 306,609 men (57,994 [18.9%] African American and 248,615 [81.1%] White) with a median follow-up of 5.3 years (interquartile range [IQR] 2.6-8.1 years), and the VHA cohort included 90,749 men (27,412 [30.2%] African American and 63,337 [69.8%] White) with a median follow-up of 4.7 years (IQR 2.4-7.6 years). In SEER, African American men were significantly more likely to present with metastatic disease (African American 4.3% versus White 3.0%, p< 0.001; multivariable odds ratio [OR] 1.25, 95% confidence interval [CI] 1.19-1.32, p< 0.001), whereas in the VHA, African American men were not significantly more likely to present with metastatic disease (African-American 3.2% versus White 3.3%, p= 0.26; multivariable OR 1.07, 95% CI 0.98-1.17, p= 0.12). In SEER, the 8-year cumulative incidence of PCSM was significantly higher for African American compared with White men (6.9% versus 5.1%, p< 0.001), whereas in the VHA, African American compared with White men did not have a significantly higher 8-year cumulative incidence of PCSM (5.5% versus 5.4%, p= 0.93). African American race was significantly associated with an increased risk of PCSM in SEER (univariable subdistribution hazard ratio [SHR] 1.39, 95% CI 1.33-1.45, p< 0.001), but was not significantly associated with PCSM on uni- and multivariable regression in the VHA. When adjusted for disease characteristics at diagnosis in SEER, disease extent, PSA, and Gleason score contributed to 85% of the risk of PCSM for African American men (adjusted SHR 1.06, 95% CI 1.02-1.12, p= 0.008). Conclusions: Racial disparities in PCSM were present in a national cohort, SEER, but not as pronounced in a relatively equal-access healthcare system, the VHA, potentially due to differences in metastatic disease at diagnosis among African American and White men between cohorts. These findings may be attributable to reduced barriers to care in the VHA.
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Lu-Yao, Grace L., Dirk Moore, Yong Lin, Kitaw Demissie, Weichung Shih, Peter C. Albertsen, Robert S. DiPaola, and Siu-Long Yao. "Racial differences in survival outcomes among men with localized prostate cancer." Journal of Clinical Oncology 31, no. 6_suppl (February 20, 2013): 98. http://dx.doi.org/10.1200/jco.2013.31.6_suppl.98.
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98 Background: This study addresses whether the recent favorable survival trends observed among contemporary prostate cancer patients can be extended to African American men who have historically suffered excess prostate cancer mortality. Methods: The study cohort consisted of men over age 65, who resided in the SEER catchment area and were diagnosed with T1-T2 prostate cancer (ICD-O-3 code C61.9) during the period 1992-2005. In order to quantify race-specific prostate cancer mortality, separate competing risk models were fit separately for Whites and Blacks. Results: This study includes 35,509 white men and 5,256 black men who received conservative management for localized prostate cancer. The median age of the patients is 76 years at diagnosis and the median follow-up is 106 months. Overall, African Americans have slightly higher adjusted prostate cancer mortality than Whites (hazard ratio [HR] =1.16; 95% confidence interval [C.I.] 1.03 – 1.29). The racial difference was more pronounced in men with moderately differentiated cancer (HR=1.24, 95% CI 1.05 – 1.45), compared to poorly differentiated cancer (HR=1.00, 95% C.I. 0.85 – 1.18). Further analyses by comorbidity status and income level revealed that African Americans and Whites have similar excellent prostate cancer survival if they lived in areas with incomes above the median. Conclusions: African Americans diagnosed in the contemporary PSA era have similarly excellent survival outcomes as their white counterparts if they lived in areas with incomes above the median. Further studies should be conducted to confirm these findings and assess care and health habits that may improve cancer control and outcomes among African Americans.
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Parikh, Ravi Bharat, Sumedha Chhatre, S. Bruce Malkowicz, Bingnan Li, and Ravishankar Jayadevappa. "Racial disparities in survivorship care adherence among Medicare beneficiaries with prostate cancer." Journal of Clinical Oncology 37, no. 7_suppl (March 1, 2019): 72. http://dx.doi.org/10.1200/jco.2019.37.7_suppl.72.
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72 Background: African-American men with prostate cancer have higher cancer-related and all-cause mortality than their Caucasian counterparts. Differences in adherence to guideline-based survivorship care may contribute to these disparities. Methods: Using the SEER-Medicare database, we conducted a retrospective cohort study of men ≥66 years old treated for localized prostate cancer between 2008 and 2011 who had at least two visits with a specialist or primary care physician after diagnosis. Patients were followed until 2013. We calculated rates of bone mineral density screening (among men treated with androgen deprivation therapy) and colorectal cancer screening after diagnosis, stratified by race and provider seen. We analyzed the association between continuity of care (CoC) and adherence to colorectal cancer screening after calculating a CoC index. Results: Among 107262 men with localized prostate cancer, adherence to colorectal cancer and bone mineral density screening was higher for Non-Hispanic White and Hispanic men compared to African-American men (Table). Adherence to screening was slightly higher for men who followed with primary care physicians compared to specialists. After adjusting for relevant covariates and number of providers, higher CoC with primary care physicians was associated with improved adherence to colorectal screening among Non-Hispanic Whites (OR = 1.25, 95% CI = 1.11-1.40), African-Americans (OR = 1.39, CI = 1.05-1.84) and Hispanics (OR = 2.74, CI = 1.27-5.90). However, higher CoC with specialists was significantly associated with colon cancer screening only among African Americans (OR 1.59, 95% CI 1.25-2.04). Conclusions: Among a large cohort of men with localized prostate cancer, the association between CoC and guideline-based survivorship care varied by type of provider and by racial and ethnic group. [Table: see text]
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Parikh, Ravi Bharat, Kyle William Robinson, Sumedha Chhatre, Elina Medvedeva, S. Bruce Malkowicz, and Ravishankar Jayadevappa. "Racial disparities in definitive treatment and long-term mortality among US veterans with high-risk localized prostate cancer." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e19037-e19037. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e19037.
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e19037 Background: Equal access to care may mediate racial disparities among men with localized prostate cancer. We examined the association between African-American race and long-term mortality among men with high-risk prostate cancer in a large equal-access health system. Methods: In this retrospective cohort study, we used the VA Corporate Data Warehouse to identify African-American (AA) and non-Hispanic White Veterans diagnosed with high-risk (prostate-specific antigen [PSA] ≥ 20 ng/mL, Gleason 8-10, or stage ≥ cT2c) localized prostate cancer between January 1st, 2001 and December 31st, 2011 and followed through January 1st, 2019. Veterans who did not receive continuous VA care were excluded. We used descriptive statistics to compare type of therapy received and multivariable Cox proportional hazards regressions to estimate the association between mortality and race. Cox models were adjusted for age, pre-treatment PSA, year of diagnosis, enrollment priority (an individual-level proxy for income and disability need), marital status, Elixhauser comorbidity index, and primary treatment. Results: Among 14,877 Veterans (median age 67 years [interquartile range [IQR] 62-75]), 4,160 (28.0%) were AA. Median followup was 9.0 years (IQR 6.1-11.4). Compared to White men, AA men were more likely to have PSA ≥ 20 (49.9% vs. 40.9%), be unmarried (59.3% vs. 43.3%), have ≥3 comorbidities (46.4% vs. 41.0%), and have high disability and income need (22.0% vs. 18.6%) (all p < 0.001). Over time, AA Veterans were consistently less likely to receive prostatectomy (18.9% vs. 24.9%). Crude mortality rates were 50.6 and 61.6 deaths per 1000 patient-years for AA and White Veterans, respectively. After adjusting for all covariates, AA Veterans had lower all-cause mortality (adjusted hazard ratio [aHR] 0.83, 95% CI 0.79-0.88, p < 0.001) compared to White Veterans. This association was consistent across pre-specified subgroups (Table). Conclusions: Among men with high-risk prostate cancer who received continuous care within a large equal-access health system, African-Americans had lower all-cause mortality compared to Whites. Equal access to care may mitigate or reverse traditional racial disparities in mortality among men with prostate cancer. [Table: see text]
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Hawkins, Jaclynn, Karen Gilcher, Claudia Schwenzer, and Michael Lutz. "Investigating Racial Differences among Men in COVID-19 Diagnosis, and Related Psychosocial and Behavioral Factors: Data from the Michigan Men’s Health Event." International Journal of Environmental Research and Public Health 18, no. 6 (March 22, 2021): 3284. http://dx.doi.org/10.3390/ijerph18063284.
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Extant research is growing in its ability to explain sex differences in novel coronavirus 2019 (COVID-19) diagnosis and mortality. Moving beyond comparisons based on biological sex is now warranted to capture a more nuanced picture of disparities in COVID-19 diagnosis and mortality specifically among men who are more likely to die of the illness. The objective of this study was to investigate racial disparities in COVID-19-related psychosocial, behavior and health variables among men. The present study utilizes a sample of 824 men who participated in a free health event held in a Midwestern state. Chi-square analysis showed that African American men were more likely to report an adverse impact of COVID-19 based on several factors including experiencing more COVID-19-related medical issues (χ2 = 4.60 p = 0.03); higher COVID-19 diagnosis (χ2 = 4.60 p = 0.02); trouble paying for food (χ2 = 8.47, p = 0.00), rent (χ2 = 12.26, p = 0.00), medication (χ2 = 7.10 p = 0.01) and utility bills (χ2 = 19.68, p = 0.00); higher fear of contracting COVID-19 (χ2 = 31.19, p = 0.00); and higher rates of death of close friends and family due to COVID (χ2 = 48.85, p = 0.00). Non-Hispanic white men reported more increased stress levels due to COVID-19 compared to African American men (χ2 = 10.21, p = 0.01). Regression analysis showed that race was a significant predictor of self-reported COVID-19 diagnosis (OR = 2.56, p < 0.05) after controlling for demographic characteristics. The results showed that compared to non-Hispanic White men, African American men were more likely to report an adverse impact of COVID-19 based on several factors including experiencing more COVID-19-related medical issues; higher COVID-19 diagnosis; trouble paying for food, rent, medication and utility bills; higher fear of contracting COVID-19; and higher rates of death of close friends and family due to COVID. Interestingly, non-Hispanic white men reported more increased stress levels due to COVID-19 compared to African American men.
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Singleton, Alyson L., Brandon D. Marshall, Xiao Zang, Amy S. Nunn, and William C. Goedel. "1701. Added Benefits of Pre-exposure Prophylaxis Use on HIV Incidence with Minimal Changes in Efficiency in the Context of High Treatment Engagement among Men Who Have Sex with Men." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S833. http://dx.doi.org/10.1093/ofid/ofaa439.1879.
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Abstract Background Although there is ongoing debate over the need for substantial increases in PrEP use when antiretroviral treatment confers the dual benefits of reducing HIV-related morbidity and mortality and the risk of HIV transmission, no studies to date have quantified the potential added benefits of PrEP use in settings with high treatment engagement across variable sub-epidemics in the United States. Methods We used a previously published agent-based network model to simulate HIV transmission in a dynamic network of 17,440 Black/African American and White MSM in Atlanta, Georgia from 2015 to 2024 to understand how the magnitude of reductions in HIV incidence attributable to varying levels of PrEP use (0–90%) changes in potential futures where high levels of treatment engagement (i.e. the UNAIDS ‘90-90-90’ goals and eventual ‘95-95-95’ goals) are achieved and maintained, as compared to current levels of treatment engagement in Atlanta (Figure 1). Model inputs related to HIV treatment engagement among Black/African American and White men who have sex with men in Atlanta. A comparison of current levels of treatment engagement (Panel A) to treatment engagement at ‘90-90-90’ (Panel B) and ‘95-95-95’ goals (Panel C). Results Even at achievement and maintenance of ‘90-90-90’ goals, 75% PrEP coverage reduced incidence rates by an additional 67.9% and 74.2% to 1.53 (SI: 1.39, 1.70) and 0.355 (SI: 0.316, 0.391) per 100 person-years for Black/African American and White MSM, respectively (Figure 2), compared to the same scenario with no PrEP use. Additionally, an increase from 15% PrEP coverage to 75% under ‘90-90-90’ goals only increased person-years of PrEP use per HIV infection averted, a measure of efficiency of PrEP, by 8.1% and 10.5% to 26.7 (SI: 25.6, 28.0) and 73.3 (SI: 70.6, 75.7) among Black/African American MSM and White MSM, respectively (Figure 3). Overall (Panel A) and race-stratified (Panel B and Panel C) marginal changes in HIV incidence over ten years among Black/African American and White men who have sex with men in Atlanta across scenarios of varied levels of treatment engagement among agents living with HIV infection and levels of pre-exposure prophylaxis use among HIV-uninfected agents. Note: All changes are calculated within each set of treatment scenarios relative to a scenario where no agents use pre-exposure prophylaxis. Person-years of pre-exposure prophylaxis use per HIV infection averted among Black/African American (Panel A) and White (Panel B) men who have sex with men in Atlanta across scenarios of varied levels of treatment engagement among agents living with HIV infection and levels of pre-exposure prophylaxis use among HIV-uninfected agents. Note: The number of HIV infections averted is calculated within each set of treatment scenarios relative to a scenario where no agents use pre-exposure prophylaxis. Conclusion Even in the context of high treatment engagement, substantial expansion of PrEP use still contributes to meaningful decreases in HIV incidence among MSM with minimal changes in person-years of PrEP use per HIV infection averted, particularly for Black/African American MSM. Disclosures All Authors: No reported disclosures
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Walter, Rayford, Jennifer Jordan, Mandeep Takhar, Mohammed Alshalalfa, Darlene Dai, Nicholas Erho, Mark Greenberger, Randy Bradley, and Elai Davicioni. "Genomic variations associated with prostate cancer in large cohort of African American men." Journal of Clinical Oncology 36, no. 6_suppl (February 20, 2018): 20. http://dx.doi.org/10.1200/jco.2018.36.6_suppl.20.
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20 Background: Racial disparities in prostate cancer (PCa) incidence and mortality are well known. PCa is known to be more aggressive in African American men (AAM) in terms of higher incidence and mortality rates. Here we validate a tumor gene expression pan-cancer race model in men with PCa and further characterize genomic differences that may contribute to disparate clinical outcomes Methods: We obtained de-identified genome-wide expression profiles from clinical use of the Decipher RP test in 9,953 men from the GRID registry database. A subset of men (n = 313) had known race status. A pan-cancer race model, developed to predict patient AAM race from analysis of gene expression patterns in 4,162 tumors from retrospective cohorts with known race status was applied to the prospective cohort for race prediction. Gene expression data was used to define genomic differences. Results: The race model has an AUC of 0.98 discriminating EAM from AAM in independent PCa cohort. The model was then applied to the 9,640 GRID patients with unknown race status and classified 6,831 as EAM, 1,058 as AAM with 1,751 as having indeterminate race. Characterizing the molecular subtypes, we found known and predicted AAM to be enriched with SPINK1+ tumors (21% and 24%, respectively) compared to predicted EAM (8%). In contrast, while ERG+ was found 22% and 19% in known and predicted AAM, respectively compared to 46% in predicted EAM. Based on PAM50 prostate cancer classifier, 61% of AAM were classified as basal-like tumors, whereas 41% were basal-like in EAM. Similarly, 28% of AAM had low AR-A while only 11% of EAM had low AR-A. AAM tumors had higher levels of immune infiltration signatures as well as higher scores for inflammatory and interferon gamma responses, and Interleukin 6 (IL6) signaling activity scores. AAM had lower DNA repair and glycolysis pathway activity compared to EAM Conclusions: Known and predicted AAM, were enriched with SPINK1+ tumors, higher immune infiltration and activation but lower ERG+, DNA repair and AR activity tumors. Using such large GRID data with known race, we will further understand the underlying causes associated with prostate cancer racial disparities which could lead to personalized diagnosis and treatment.
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Winkfield, K. M., M. Chen, D. E. Dosoretz, S. A. Salenius, M. J. Katin, R. Ross, and A. V. D’Amico. "Race and survival following brachytherapy-based treatment for men with localized or locally advanced adenocarcinoma of the prostate." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): 5068. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.5068.
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5068 Purpose: We investigated whether race was associated with risk of death following brachytherapy-based treatment for localized prostate cancer. Methods: The study cohort was comprised of 4,880 men with clinical stage T1–3N0M0 prostate cancer and minimum follow-up of 2 years who underwent brachytherapy-based treatment at 20 centers within the 21st Century Oncology consortium. A Cox regression multivariable analysis was used to evaluate the risk of death in African-American (AA) and Hispanic (H) men as compared to Caucasian men adjusting for age, pretreatment PSA, Gleason score, clinical T stage, year and type of treatment, and comorbidity level. Results: After a median follow-up of 5 years, there were 924 deaths. AA and H race were significantly associated with an increased risk of ACM (adjusted hazard ratio [AHR] 1.42 and 1.66, [95% confidence interval (CI): 1.01 to 1.99 and 1.14 to 2.41]; p = 0.045 and 0.008, respectively). As shown in the table , other factors significantly associated with an increased risk of death included age (p<0.001), PSA (p = 0.02), Gleason score 8 to 10 (p = 0.001), year of brachytherapy (p<0.001), and presence of 2 or more significant comorbidities (p = 0.003). The risk of ACM was decreased following trimodality therapy (p = 0.02). Conclusions: African-American and Hispanic race as compared to white race appear to confer a higher risk of mortality following brachytherapy-based treatment in men with localized or locally advanced prostate cancer. [Table: see text] No significant financial relationships to disclose.
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Marar, Mallika, Ronac Mamtani, Vivek Narayan, Neha Vapiwala, and Ravi Bharat Parikh. "Racial disparities in utilization and effectiveness of first-line therapies in metastatic castrate-resistant prostate cancer." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e17541-e17541. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e17541.
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e17541 Background: Prospective evidence suggests that abiraterone use is associated with improved progression-free survival in African-American (AA) men with metastatic castrate-resistant prostate cancer (mCRPC) compared to white men. It is unclear whether race-based differences in treatment utilization and effectiveness exist for men with newly diagnosed mCRPC treated in real-world clinical practice. Methods: In this retrospective cohort study, we used the Flatiron Health electronic health record-derived de-identified database to identify patients with mCRPC who received first-line (1L) systemic therapy between 2012 and 2018. We used multivariable logistic regression analysis to examine differences in utilization of abiraterone, enzalutamide, and docetaxel between AA and white men. We then used Fine-Gray models with death as a competing risk to assess treatment-specific associations between race and time to next therapy (TTNT) – a proxy for progression-free survival. Finally, we used multivariable Cox proportional hazards analyses to assess for treatment-specific racial disparities in all-cause mortality. All analyses were adjusted for age, Elixhauser comorbidity index, baseline steroid or opioid use (a proxy for disease aggressiveness), performance status, insurance status, and (if significant) an interaction term for race and age. Results: Of 3,808 mCRPC patients in the cohort, 2,165 (68.7%) were white and 404 (10.6%) were AA. At time of metastatic diagnosis, AA men were younger (69 vs. 75, p < 0.001) and more likely to have PSA value greater than 50 (57.9% vs. 42.6%, p < 0.001) compared to white men. Median follow up was 15 months. There were no significant racial differences in 1L utilization, TTNT, or all-cause mortality associated with abiraterone, enzalutamide, or docetaxel use (Table). Conclusions: In this large real-world analysis of men with mCRPC who received 1L therapy, we found no significant treatment-specific differences in utilization, TTNT, or all-cause mortality between AA and white men. Long-term prospective evidence is needed to justify differential treatment selection for AA men with mCRPC. [Table: see text]
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Parikh, Ravi Bharat, Joseph J. Gallo, John Cashy, Kyle William Robinson, Vivek Narayan, Yu-Ning Wong, Ravishankar Jayadevappa, and Sumedha Chhatre. "Racial disparities in depression incidence, management, and mortality after prostate cancer diagnosis." Journal of Clinical Oncology 39, no. 6_suppl (February 20, 2021): 201. http://dx.doi.org/10.1200/jco.2021.39.6_suppl.201.
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201 Background: Depressive disorder is a common cause of morbidity among men with prostate cancer (PC) and may contribute to known racial disparities in PC outcomes. We estimated the incidence, management, and impact of depressive disorder (depression) on overall mortality among African American (AA) and non-Hispanic White (W) Veterans with localized PC. Methods: In this retrospective cohort study, we used linked administrative, survey, and electronic health record data from the Veterans Health Administration (VA) Corporate Data Warehouse to identify AA and W Veterans with no preexisting depression who were diagnosed with localized PC between January 1, 2004 and December 31, 2013. Patients were followed through December 31, 2019. The primary outcomes were incident depression (defined from diagnosis codes and PHQ-2 and -9 screenings between six months to five years after PC diagnosis), receipt of anti-depressant therapy, and all-cause mortality. We used logistic and Cox regression models, adjusted for sociodemographic factors, PSA, Gleason score, and prostate cancer treatment, to estimate associations with all outcomes, using race-by-depression and race-by-treatment interaction terms to investigate racial disparities. Results: Among 32,194 Veterans diagnosed with localized prostate cancer (median age 67 years [interquartile range [IQR] 62 to 73 years], median follow-up 9.9 years [IQR 8.0 to 12.1 years]), 8,177 (25.4%) were AA. Overall, 8,285 (25.7%) Veterans were diagnosed with depression after PC diagnosis, and 2,525 (30.5%) of depressed Veterans received an antidepressant. Compared to Veterans without depression, Veterans with incident depression had higher all-cause mortality (adjusted hazard ratio [aHR] 1.30 [95% CI 1.25-1.35]). Race moderated all outcomes: AAs were more likely than Ws to be diagnosed with depression. However, among those with depression, AAs were less likely than Ws to receive an antidepressant. Interaction analyses showed that the HR of all-cause mortality associated with depression among AAs was significantly greater than that of Ws. Antidepressant receipt was not associated with improved mortality (aHR 1.05 [95% CI 0.97-1.13]); this finding was not moderated by race. Conclusions: Depression was common among men with prostate cancer within a large equal-access health care system, and African American men had more adverse depression-related outcomes than White men. Identifying and managing incident depression should be a key target of efforts to improve prostate cancer outcomes and disparities. [Table: see text]
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Assari, Shervin, James Smith, and Mohsen Bazargan. "Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women." International Journal of Environmental Research and Public Health 16, no. 10 (May 14, 2019): 1670. http://dx.doi.org/10.3390/ijerph16101670.
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Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations—a phenomenon known as “the sponge hypothesis.” However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective. To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods. This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results. In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion. Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity.
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Knights, Sheena, Susana Lazarte, Radhika Kainthla, Demi Krieger, Mitu Bhattatiry, Elizabeth Chiao, Ank E. Nijhawan, and Ank E. Nijhawan. "329. Health Disparities Among HIV-Positive Patients with Kaposi’s Sarcoma." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S175. http://dx.doi.org/10.1093/ofid/ofz360.402.
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Abstract Background Kaposi’s sarcoma (KS) is an AIDS-related condition that is mediated by HHV-8. Although incidence and mortality of KS in the United States have decreased over time since the advent of HAART, there may be disparities in mortality based on geographic location and race/ethnicity, particularly African-American men in the South. Methods A retrospective electronic medical record review was conducted using integrated inpatient and outpatient data in EPIC from PHHS. We included all individuals with a diagnosis of HIV and Kaposi’s sarcoma between January 1, 2009 and December 31, 2018 based on ICD-9/10 codes. We collected demographic information, HIV history, variables related to HIV and KS diagnosis, treatment and outcomes data for each patient. We calculated hazard ratios using Cox proportional hazards modeling. Results We identified 252 patients with KS. 95% of patients were male, and the majority were MSM (men who have sex with men; 77% of all patients). 35% of patients were Hispanic, 34% were African-American and 31% were Caucasian. Over half (56%) of patients were funded through Ryan White or were uninsured. The median CD4 count and viral load at the time of cancer diagnosis were 44 and 73,450, respectively. 24% of patients were confirmed to have died by the end of the study time frame. However, due to loss to follow-up, 35% of the cohort had an unknown vital status at the time of the final chart review. Variables most strongly associated with mortality were >2 hospitalizations in the first 6 months of cancer diagnosis (aHR=4.93, P = 0.0003), IV drug use (aHR=3.61, P = 0.0009), and T1 stage of KS (aHR= 2.13, P = 0.0264). African American patients had lower survival than Caucasian or Hispanic patients, with a 5-year survival of 69%, 81% and 80% respectively, although this did not reach statistical significance (aHR 1.77, P = 0.1396). Conclusion We describe a large cohort of patients with HIV and HHV-8-related disease, who are predominantly of minority race/ethnicity, uninsured, and have advanced HIV disease. Factors associated with mortality include Black/African-American ethnicity, number of hospitalizations, IV drug use and T1 stage of KS. Our mortality analysis is limited due to high lost to follow-up rates, so we suspect overall mortality in our cohort is higher than currently reported. Disclosures Ank E. Nijhawan, MD, MPH, Gilead Sciences, Inc.: Research Grant.
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Cintron-Garcia, Juan, Lakshmi Priyanka Pappoppula, Ashkan Shahbandi, Takefumi Komiya, and Achuta Guddati. "Analysis of race and gender disparities in incidence-based mortality in patients diagnosed with thyroid cancer from 2000 to 2014." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e18570-e18570. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e18570.
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e18570 Background: Well-differentiated thyroid cancer has better outcomes compared to anaplastic thyroid cancer. The incidence of well-differentiated thyroid cancer is higher in women whereas it is approximately the same in both genders for anaplastic thyroid cancer. The variability of incidence-based mortality across gender in the context of race has not been studied. This study analyzes the rates of incidence-based mortality among both the genders in four racial groups. Methods: The Surveillance, Epidemiology, and End Results Database was queried to conduct a nation-wide analysis for the years 2000 to 2016. Incidence-based mortality for all stages of well-differentiated and undifferentiated thyroid cancer was queried and the results were grouped by race (Caucasian/White, African American/Black, American Indian/Alaskan native and Asian/Pacific Islander) and gender. All stages and ages were included in the analysis. T-test was used to determine statistically significant difference between various subgroups. Results: Incidence-based mortality rates (per 100000) for well-differentiated and undifferentiated thyroid cancer for all races and both the genders are shown in the table below. The incidence-based mortality rates for both genders is approximately the same despite a 2-3:1 difference in incidence. Anaplastic thyroid cancer has a higher mortality rate in Caucasian and Asian/pacific Islander women compared to men despite an equal ratio of incidence. As expected, the mortality rates of anaplastic thyroid cancer were significantly higher compared to well-differentiated cancer across all races and genders. Also, Asian/Pacific Islander women have a higher rate of mortality compared to both the genders of Caucasian and African American races. Conclusions: Incidence-based mortality for anaplastic thyroid cancer is higher in women in all races whereas there is no difference in mortality between men and women for well-differentiated thyroid cancer. This is divergent from the incidence ratios noted in these malignancies. In the context of increasing incidence of thyroid cancer for the past few decades, this data suggests that additional resources may be devoted to decreasing the disparity of mortality in this gender. [Table: see text]
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Mahal, Amandeep R., Brandon Arvin Virgil Mahal, Paul L. Nguyen, and James B. Yu. "Outcomes for men under 65 with high-risk prostate cancer with Medicaid versus private insurance." Journal of Clinical Oncology 35, no. 6_suppl (February 20, 2017): 198. http://dx.doi.org/10.1200/jco.2017.35.6_suppl.198.
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198 Background: Increased Medicaid coverage, due to the Affordable Care Act, has been hypothesized to reduce racial disparities. We therefore examined the association between private insurance vs. Medicaid, race, and outcomes for the treatment of high-risk prostate cancer (CaP) among men < 65 years old. Methods: The Surveillance, Epidemiology, and End Results Program identified 116,853 men < 65 diagnosed with CaP from 2007-2011. Multivariable logistic regression modeled the association between insurance status (IS) and stage at presentation. Among men with high-risk CaP, the associations between IS and receipt of definitive therapy (DT) and prostate cancer-specific mortality (PCSM) were determined using multivariable logistic and Fine and Gray competing-risks regression models, respectively. Results: Compared to privately insured men, those with Medicaid were more likely to present with metastatic disease (Mets) (adjusted odds ratio (AOR) 5.79; 95% confidence interval (CI) 5.25-6.40; P < 0.001). Among men with high-risk disease, men with Medicaid were less likely to receive DT (AOR 0.55; 95% CI 0.51-0.60; P < 0.001) and had increased PCSM (adjusted hazard ratio (AHR) 1.8; 95% CI 1.27-2.54; P = 0.001). There were significant interactions (INT) between race and Medicaid for the outcomes of PCSM (PINT= 0.05) and Mets (PINT= 0.003). Specifically, gaps in PCSM and Mets were observed among privately insured men, with increased PCSM (AHR 1.51; 95% CI 1.18-1.94; P = 0.001) and Mets (AOR 1.33; 95% CI 1.20-1.48; P < 0.001), while there were no observed disparities among men with Medicaid with regards to PCSM (AHR 0.72; 95% CI 0.34-1.52; P = 0.387) and Mets (AOR 1.03 95% CI 0.86-1.24; P = 0.730). Conclusions: Among men with CaP, African American men are more likely to present with Mets, less likely to receive DT, and have increased PCSM compared to non-black men. These disparities are observed in heterogeneous privately insured cohorts. However, among men with Medicaid, outcomes were equally worse. Furthermore, there was a significant INT between race and IS, indicating more-than-additive effects. Our study suggests that while increased access to Medicaid could act to reduce disparities seen in CaP, outcomes need to be improved overall.
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Tracy, Russell P., Anne B. Newman, Jeff D. Williamson, Tamara B. Harris, and Steve R. Cummings. "Interleukin-6 and heart rate in a population-based sample:." Circulation 103, suppl_1 (March 2001): 1348. http://dx.doi.org/10.1161/circ.103.suppl_1.9999-22.
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0022 Inflammatory cytokines enhance the spontaneous beating rate of cardiac myocytes. We hypothesize that higher levels of interleukin-6 (IL-6) may be associated with a higher resting heart rate in a population-based sample. IL-6 (mean±SEM 2.39±0.5 ng/ml, range 0.21-15.96 ng/ml, n=2824) was measured in Health ABC, a cohort study of 3075 well functioning older adults living in Memphis, TN, and Pittsburgh, PA (age 73.6±0.3 years, 51.5% women, 41.7% African American). Heart rate was calculated from electrocardiogram strips recorded at the baseline clinic visit after 15 min resting in supine position. Participants with arrhythmias or conduction anomalies were excluded. After adjustment for demographics, body-mass index, smoking, history of cardiovascular disease, and use of digoxin, beta-blockers, calcium antagonists, anti-inflammatory drugs and antiarrhythmic drugs, higher log (IL-6) was significantly correlated with a higher heart rate (β=.17, p<0.001, n=2377). Such an association was significant in all race and gender strata (white men β=0.17, p<0.001; white women β=0.13, p=0.001; black men β=0.18, p<0.001; black women β=0.18, p<0.001). The overall il-6/heart rate association was even more evident when the analyses were restricted to the participants who had no history of cardiovascular disease and were not using any these cardiovascular drugs (β=0.21, p<0.001, n=1196). The table shows heart rate according to IL-6 quintiles. Circulating IL-6 was strongly and independently correlated with resting heart rate. Circulating IL-6 is a possible biological mediator that may contribute to explain the increased mortality associated with high heart rate. Table 1.
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Baniya, Ganesh, and Joseph Oppong. "Spatial Analysis of Prostate Cancer in Texas Counties." Innovation in Aging 4, Supplement_1 (December 1, 2020): 148. http://dx.doi.org/10.1093/geroni/igaa057.483.
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Abstract Prostate cancer (PCa) is the most common cancer in American men, with estimated 191,930 new cases and about 33,330 deaths for 2020 (American Cancer Society (ACS), 2020). In Texas, there were 10,660 new cases and 1,900 deaths from prostate cancer in 2019 and only about 53.6% of men had ever talked to a healthcare professional about the advantages of the PSA test (Texas Department of State Health Services, 2018). The incidence of PCa is about 60% higher in blacks than in whites for unknown reasons (ACS, 2019), and once cancer has reached to its latent state, other comorbidities such as low sexual satisfaction, urinary incontinence and obstruction, and bowel dysfunction can decrease the quality of life even after surgery. A four-fold, worldwide increase in males above 65 years is expected by 2050 (Ferlay et al., 2010). Thus, with an increasing elderly population, the percentage of men needing new diagnoses and effective treatment will also rise. Previous studies have identified increasing age, African ancestry, a family history of the disease, and certain inherited genetic conditions as significant risk factors for prostate cancer (ACS, 2019). This study examined the geography and change at county-level PCa mortality rates in Texas from 1999-2009 using Texas vital web dataset in relation to smoking, race/ethnicity, obesity, alcohol consumption, and insurance coverage. Results showed that PCa is concentrated mostly in the western, eastern and central parts of TX and is positively correlated with smoking, obesity, PCP per 100,000 and negatively related to alcohol consumption and percent uninsured.
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Thorpe, Roland J., Janice V. Bowie, Shondelle M. Wilson-Frederick, Kisha I. Coa, and Thomas A. LaVeist. "Association Between Race, Place, and Preventive Health Screenings Among Men." American Journal of Men's Health 7, no. 3 (November 26, 2012): 220–27. http://dx.doi.org/10.1177/1557988312466910.
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African American men consistently report poorer health and have lower participation rates in preventive screening tests than White men. This finding is generally attributed to race differences in access to care, which may be a consequence of the different health care markets in which African American and White men typically live. This proposition is tested by assessing race differences in use of preventive screenings among African American and White men residing within the same health care marketplace. Logistic regression was used to examine the association between race and physical, dental, eye and foot examinations, blood pressure and cholesterol checks, and colon and prostate cancer screenings in men in the Exploring Health Disparities in Integrated Communities in Southwest Baltimore Study. After adjusting for covariates, African American men had greater odds of having had a physical, dental, and eye examination; having had their blood pressure and cholesterol checked; and having been screened for colon and prostate cancer than White men. No race differences in having a foot examination were observed. Contrary to most findings, African American men had a higher participation rate in preventive screenings than White men. This underscores the importance of accounting for social context in public health campaigns targeting preventive screenings in men.
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Assari, Shervin, Susan D. Cochran, and Vickie M. Mays. "Money Protects White but Not African American Men against Discrimination: Comparison of African American and White Men in the Same Geographic Areas." International Journal of Environmental Research and Public Health 18, no. 5 (March 8, 2021): 2706. http://dx.doi.org/10.3390/ijerph18052706.
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To compare African American (AA) and non-Hispanic White men living in same residential areas for the associations between educational attainment and household income with perceived discrimination (PD). The National Survey of American Life (NSAL), a nationally representative study, included 1643 men who were either African American (n = 1271) or non-Hispanic White (n = 372). We compared the associations between the two race groups using linear regression. In the total sample, high household income was significantly associated with lower levels of PD. There were interactions between race and household income, suggesting that the association between household income and PD significantly differs for African American and non-Hispanic White men. For non-Hispanic White men, household income was inversely associated with PD. For African American men, however, household income was not related to PD. While higher income offers greater protection for non-Hispanic White men against PD, African American men perceive higher levels of discrimination compared to White males, regardless of income levels. Understanding the role this similar but unequal experience plays in the physical and mental health of African American men is worth exploring. Additionally, developing an enhanced understanding of the drivers for high-income African American men’s cognitive appraisal of discrimination may be useful in anticipating and addressing the health impacts of that discrimination. Equally important to discerning how social determinants work in high-income African American men’s physical and mental health may be investigating the impact of the mental health and wellbeing of deferment based on perceived discrimination of dreams and aspirations associated with achieving high levels of education and income attainment of Black men.
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Gangaraju, Radhika, Insu Koh, Marguerite R. Irvin, Leslie A. Lange, Damon E. Houghton, Diego A. Herrera, Monika Safford, Mary Cushman, Smita Bhatia, and Neil A. Zakai. "Peripheral Blood Cytopenia and Subsequent Risk of Cardiovascular Disease and Mortality." Blood 134, Supplement_1 (November 13, 2019): 5002. http://dx.doi.org/10.1182/blood-2019-125956.
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INTRODUCTION: African-Americans (blacks) have higher risk of stroke and coronary heart disease (CHD) - collectively referred to here as cardiovascular disease (CVD), than Caucasian-Americans (whites). Though partly explained by traditional cardiovascular risk factors, half of the excess risk in blacks is not explained by known risk factors. Recent data suggest increased risk of CVD and mortality in individuals with clonal hematopoiesis, which often presents as cytopenia. Using peripheral blood cytopenia as a marker of clonal hematopoiesis, we examined the association between cytopenia and risk of CVD and mortality in blacks and whites. METHODS: The REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study enrolled 30,239 US black and white adults between 2003 and 2007 (41% black). Socio-demographics and medical history were obtained by telephone interview, and laboratory studies (including complete blood count [CBC]) and physical exam from an in-home visit at baseline. Participants or their proxies were contacted every 6 months to ascertain CVD events, hospitalizations or deaths, and medical records were reviewed to confirm these events. Cytopenia was defined using thresholds in Table 1 as presence of 2 or more of the following: i) hemoglobin in age-, sex-, and race-specific lowest 5th percentile; ii) white cell count in race-specific lowest 5th percentile; iii) platelet count in lowest 5th percentile, and iv) macrocytosis (MCV >98fL). Participants with pre-baseline history of stroke (for analyses including stroke or CVD mortality) or CHD (for analyses including CHD or CVD mortality) and those with missing CBC were excluded. Cox proportional hazards models were used to calculate hazard ratios (HRs) of incident CVD and mortality associated with cytopenia. Models adjusted for socio-demographics (Model 1), Framingham stroke or CHD risk factors (Model 2), and estimated glomerular filtration rate and C-reactive protein (Model 3) were used. Differences in the association of cytopenia with outcomes by race were tested using cross-product interaction terms, using a p of <0.1 for interaction. RESULTS: The study included 19,544 participants who were followed for a median of ~9 years. There were 798 (4.3% of those at risk) incident stroke cases and 727 (4.3%) incident CHD cases; 1033 (5.3%) died of CVD, and 3933 (20.1%) died of all-causes. Cytopenia was present in 378 (1.9%) participants, ranging from 0.9% to 3.5% in blacks, 1.4 to 3.9% in whites, 1.6 to 3.9% in men, and 0.9 to 1.8% in women, with increasing prevalence by age. There was no association between cytopenia and stroke or CHD risk in any model. However, cytopenia was associated with increased risk of all-cause mortality (HR=1.73, 95%CI: 1.34-2.22), and CVD mortality (HR=1.56, 95% CI: 1.11-2.19) in the extended risk factor Model 3 and also in CVD risk factor adjusted model (Model 2), with little evidence of confounding (Table 2). While the race by cytopenia interaction term was not significant in any model for incident CHD or mortality, the interaction for cytopenia by race for stroke was statistically significant (p-interaction=0.08) in Model 2. The HR of stroke for cytopenia in blacks was 0.86 (95%CI: 0.46-1.61), and for whites was 1.96 (95%CI: 1.0-3.82). CONCLUSION: In this large biracial cohort, cytopenia was associated with increased all-cause and CVD mortality. Cytopenia was a race-specific risk factor for stroke affecting white Americans but not black Americans. With growing knowledge on the role of clonal hematopoiesis in CVD risk and mortality, further work is needed to determine if our phenotype of cytopenia is accurate in classifying clonal hematopoiesis and for determining the mortality risk. Given these findings, assessing clonal hematopoiesis and outcomes related to clonal hematopoiesis in diverse populations is critical to understanding the interactions between somatic mutations in hematopoietic cells and CVD/mortality risk. Disclosures Safford: Amgen: Research Funding.
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Cross, Chaundre K., Delray Shultz, S. Bruce Malkowicz, William C. Huang, Richard Whittington, John E. Tomaszewski, Andrew A. Renshaw, Jerome P. Richie, and Anthony V. D’Amico. "Impact of Race on Prostate-Specific Antigen Outcome After Radical Prostatectomy for Clinically Localized Adenocarcinoma of the Prostate." Journal of Clinical Oncology 20, no. 12 (June 15, 2002): 2863–68. http://dx.doi.org/10.1200/jco.2002.11.054.
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PURPOSE: To compare prostate-specific antigen (PSA) outcome after radical prostatectomy (RP) for prostate cancer in African-American and white men using previously established risk groups. PATIENTS AND METHODS: Between 1989 and 2000, 2,036 men (n = 162 African-American men, n = 1,874 white men) underwent RP for clinically localized prostate cancer. Using pretreatment PSA, Gleason score, clinical T stage, and percentage of positive biopsy specimens, patients were stratified into low- and high-risk groups. For each risk group, PSA outcome was estimated using the actuarial method of Kaplan and Meier. Comparisons of PSA outcome between African-American and white men were made using the log-rank test. RESULTS: The median age and PSA level for African-American and white men were 60 and 62 years old and 8.8 and 7.0 ng/mL, respectively. African-Americans had a statistically significant increase in PSA (P = .002), Gleason score (P = .003), clinical T stage (P = .004), and percentage of positive biopsy specimens (P = .04) at presentation. However, there was no statistical difference in the distribution of PSA, clinical T stage, or Gleason score between racial groups in the low- and high-risk groups. The 5-year estimate of PSA outcome was 87% in the low-risk group for all patients (P = .70) and 28% versus 32% in African-American and white patients in the high-risk group (P = .28), respectively. Longer follow-up is required to confirm if these results are maintained at 10 years. CONCLUSION: Even though African-American men presented at a younger age and with more advanced disease compared with white men with prostate cancer, PSA outcome after RP when controlled for known clinical predictive factors was not statistically different. This study supports earlier screening in African-American men.
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Chapagain, Rajendra Prasad. "African American Women, Racism and Triple Oppression." Interdisciplinary Journal of Management and Social Sciences 1, no. 1 (October 1, 2020): 113–17. http://dx.doi.org/10.3126/ijmss.v1i1.34615.
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African American women have been made multiple victims: racial discrimination by the white community and sexual repression by black males of their own community. They have been subjected to both kind of discrimination - racism and sexism. It is common experience of black American women. Black American women do have their own peculiar world and experiences unlike any white or black men and white women. They have to fight not only against white patriarchy and white women's racism but also against sexism of black men within their own race. To be black and female is to suffer from the triple oppression- sexism, racism and classicism.
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Mincey, Krista, Moya Alfonso, Amy Hackney, and John Luque. "Understanding Masculinity in Undergraduate African American Men." American Journal of Men's Health 8, no. 5 (December 18, 2013): 387–98. http://dx.doi.org/10.1177/1557988313515900.
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This study reports findings on views of masculinity with undergraduate Black men, which included interviews and focus groups ( N = 46) with participants ranging in age from 18 to 22 years. Specifically, this study explored how Black men define being a man and being a Black man. Undergraduate Black males at a historically Black college and university ( N = 25) and a predominately White institution ( N = 21) in the Southeastern United States were recruited to participate in this study. Through the use of thematic analysis, findings indicated that three levels of masculinity exist for Black men: what it means to be a man, what it means to be a Black man, and who influences male development. Implications and recommendations for future research and practice are discussed.
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Banerjee, Mousumi, Isaac J. Powell, Julie George, Debjit Biswas, Fernando Bianco, and Richard K. Severson. "Prostate specific antigen progression after radical prostatectomy in African-American men versus White men." Cancer 94, no. 10 (May 14, 2002): 2577–83. http://dx.doi.org/10.1002/cncr.10535.
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Porch, Tichelle C., Caryn N. Bell, Janice V. Bowie, Therri Usher, Elizabeth A. Kelly, Thomas A. LaVeist, and Roland J. Thorpe. "The Role of Marital Status in Physical Activity Among African American and White Men." American Journal of Men's Health 10, no. 6 (July 8, 2016): 526–32. http://dx.doi.org/10.1177/1557988315576936.
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Racial differences in physical activity among men are well documented; however, little is known about the impact of marital status on this relationship. Data from the National Health and Examination Survey (NHANES) 1999-2006 was used to determine whether the association of race and physical activity among men varied by marital status. Marital status was divided into two categories: married and unmarried. Physical activity was determined by the number of minutes per week a respondent engaged in household/yard work, moderate and vigorous activity, or transportation (bicycling and walking) over the past 30 days. The sample included 7,131 African American (29%) and White(71%) men aged 18 years and older. All models were estimated using logistic regression. Because the interaction term of race and marital status was statistically significant ( p < .001), the relationship between race, physical activity, and marital status was examined using a variable that reflects the different levels of the interaction term. After adjusting for age, income, education, weight status, smoking status, and self-rated health, African American married men had lower odds (odds ratio = 0.53, 95% confidence interval = [0.46-0.61], p < .001) of meeting federal physical activity guidelines compared with White married men. Possible dissimilarities in financial and social responsibilities may contribute to the racial differences observed in physical activity among African American and White married men.
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Heffernan, Kevin S., Sae Young Jae, Victoria J. Vieira, Gary A. Iwamoto, Kenneth R. Wilund, Jeffrey A. Woods, and Bo Fernhall. "C-reactive protein and cardiac vagal activity following resistance exercise training in young African-American and white men." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 296, no. 4 (April 2009): R1098—R1105. http://dx.doi.org/10.1152/ajpregu.90936.2008.
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African Americans have a greater prevalence of hypertension and diabetes compared with white Americans, and both autonomic dysregulation and inflammation have been implicated in the etiology of these disease states. The purpose of this study was to examine the cardiac autonomic and systemic inflammatory response to resistance training in young African-American and white men. Linear (time and frequency domain) and nonlinear (sample entropy) heart rate variability, baroreflex sensitivity, tonic and reflex vagal activity, and postexercise heart rate recovery were used to assess cardiac vagal modulation. C-reactive protein (CRP) and white blood cell count were used as inflammatory markers. Twenty two white and 19 African-American men completed 6 wk of resistance training followed by 4 wk of exercise detraining (Post 2). Sample entropy, tonic and reflex vagal activity, and heart rate recovery were increased in white and African-American men following resistance training ( P < 0.05). Following detraining (Post 2), sample entropy, tonic and reflex vagal activity, and heart rate recovery returned to baseline values in white men but remained above baseline in African-American men. While there were no changes in white blood cell count or CRP in white men, these inflammatory markers decreased in African-American men following resistance training, with reductions being maintained following detraining ( P < 0.05). In conclusion, resistance training improves cardiac autonomic function and reduces inflammation in African-American men, and these adaptations remained after the cessation of training. Resistance training may be an important lifestyle modification for improving cardiac autonomic health and reducing inflammation in young African-American men.
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Cannon, Clare, Regardt J. Ferreira, and Fred Buttell. "Critical Race Theory, Parenting, and Intimate Partner Violence: Analyzing Race and Gender." Research on Social Work Practice 30, no. 1 (April 29, 2018): 122–34. http://dx.doi.org/10.1177/1049731518772151.
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Purpose: This study sought to investigate similarities and differences among race, gender, parenting attitudes, and conflict negotiation tactics of perpetrators of intimate partner violence in a batterer intervention program. Method: This research utilized a nonequivalent, control group secondary analysis of 238 women and men. Results: Logistic regression indicated the following: (1) An increased likelihood for scoring higher on the Conflict Tactics Scale-2 (CTS-2), Physical Assault subscale, and high-risk Adult–Adolescent Parenting Inventory-2 (AAPI-2) parenting group for those in the African American category compared to the White category; (2) African American women are more likely to be unemployed, score higher on the CTS-2 Physical Assault subscale, and in the high-risk AAPI-2 parenting group than African American men; and (3) White women, compared to White men, are more likely to experience injury and to score in the high-risk AAPI-2 group. Conclusions: Critical race theory provides a necessary understanding of these findings within structural inequality in the United States. Further results and implications are discussed.
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Heffernan, Kevin S., Sae Young Jae, Kenneth R. Wilund, Jeffrey A. Woods, and Bo Fernhall. "Racial differences in central blood pressure and vascular function in young men." American Journal of Physiology-Heart and Circulatory Physiology 295, no. 6 (December 2008): H2380—H2387. http://dx.doi.org/10.1152/ajpheart.00902.2008.
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Young African-American men have altered macrovascular and microvascular function. In this cross-sectional study, we tested the hypothesis that vascular dysfunction in young African-American men would contribute to greater central blood pressure (BP) compared with young white men. Fifty-five young (23 yr), healthy men (25 African-American and 30 white) underwent measures of vascular structure and function, including carotid artery intima-media thickness (IMT) and carotid artery β-stiffness via ultrasonography, aortic pulse wave velocity, aortic augmentation index (AIx), and wave reflection travel time (Tr) via radial artery tonometery and a generalized transfer function, and microvascular vasodilatory capacity of forearm resistance arteries with strain-gauge plethysmography. African-American men had similar brachial systolic BP (SBP) but greater aortic SBP ( P < 0.05) and carotid SBP ( P < 0.05). African-American men also had greater carotid IMT, greater carotid β-stiffness, greater aortic stiffness and AIx, reduced aortic Tr and reduced peak hyperemic, and total hyperemic forearm blood flow compared with white men ( P < 0.05). In conclusion, young African-American men have greater central BP, despite comparable brachial BP, compared with young white men. Diffuse macrovascular and microvascular dysfunction manifesting as carotid hypertrophy, increased stiffness of central elastic arteries, heightened resistance artery constriction/blunted resistance artery dilation, and greater arterial wave reflection are present at a young age in apparently healthy African-American men, and conventional brachial BP measurement does not reflect this vascular burden.
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Su, Dejun, Jim P. Stimpson, and Fernando A. Wilson. "Racial Disparities in Mortality Among Middle-Aged and Older Men." American Journal of Men's Health 9, no. 4 (June 24, 2014): 289–300. http://dx.doi.org/10.1177/1557988314540199.
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Based on longitudinal data from the Health and Retirement Study, this study assesses the importance of marital status in explaining racial disparities in all-cause mortality during an 18-year follow-up among White and African American men aged 51 to 61 years in 1992. Being married was associated with significant advantages in household income, health behaviors, and self-rated health. These advantages associated with marriage at baseline also got translated into better survival chance for married men during the 1992-2010 follow-up. Both marital selection and marital protection were relevant in explaining the mortality advantages associated with marriage. After adjusting for the effect of selected variables on premarital socioeconomic status and health, about 28% of the mortality gap between White and African American men in the Health and Retirement Study can be explained by the relatively low rates of marriage among African American men. Addressing the historically low rates of marriage among African Americans and their contributing factors becomes important for reducing racial disparities in men’s mortality.
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Sanchez-Ortiz, Ricardo F., Patricia Troncoso, Richard J. Babaian, Josep Lloreta, Dennis A. Johnston, and Curtis A. Pettaway. "African-American men with nonpalpable prostate cancer exhibit greater tumor volume than matched white men." Cancer 107, no. 1 (2006): 75–82. http://dx.doi.org/10.1002/cncr.21954.
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Greif, Geoffrey L. "Understanding Older Men and Their Male Friendships: A Comparison of African American and White Men." Journal of Gerontological Social Work 52, no. 6 (July 21, 2009): 618–32. http://dx.doi.org/10.1080/01634370902914711.
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Jackson, Andrew S., Kenneth J. Ellis, Brian K. McFarlin, Mary H. Sailors, and Molly S. Bray. "Cross-validation of generalised body composition equations with diverse young men and women: the Training Intervention and Genetics of Exercise Response (TIGER) Study." British Journal of Nutrition 101, no. 6 (August 15, 2008): 871–78. http://dx.doi.org/10.1017/s0007114508047764.
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Generalised skinfold equations developed in the 1970s are commonly used to estimate laboratory-measured percentage fat (BF%). The equations were developed on predominately white individuals using Siri's two-component percentage fat equation (BF%-GEN). We cross-validated the Jackson–Pollock (JP) generalised equations with samples of young white, Hispanic and African–American men and women using dual-energy X-ray absorptiometry (DXA) as the BF% referent criterion (BF%-DXA). The cross-sectional sample included 1129 women and men (aged 17–35 years). The correlations between BF%-GEN and BF%-DXA were 0·85 for women and 0·93 for men. Analysis of measurement error showed that BF%-GEN underestimated BF%-DXA of men and women by 1·3 and 3·0 %. General linear models (GLM) confirmed that BF%-GEN systematically underestimated BF%-DXA of Hispanic men and women, and overestimated BF%-DXA of African–American men. GLM were used to estimate BF%-DXA from the JP sum of skinfolds and to account for race/ethnic group bias. The fit statistics (R and standard error of the estimate; see) of the men's calibration model were: white, R 0·92, see 3·0 %; Hispanic, R 0·91, see 3·0 %; African–American, R 0·95, see 2·6 %. The women's statistics were: white and African–American, R 0·86, see 3·8 %; Hispanic, R 0·83, see 3·4 %. These results showed that BF%-GEN and BF%-DXA were highly correlated, but the error analyses documented that the generalised equations lacked accuracy when applied to these racially and ethnically diverse men and women. The inaccuracy was linked to the body composition and race/ethnic differences between these Training Intervention and Genetics of Exercise Response (TIGER) study subjects and the men and women used to develop the generalised equations in the 1970s and using BF%-DXA as the referent criterion.
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Burr, Jeffrey A., Michael P. Massagli, Jan E. Mutchler, and Amy M. Pienta. "Labor Force Transitions among Older African American and White Men." Social Forces 74, no. 3 (March 1996): 963. http://dx.doi.org/10.2307/2580388.
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Klag, Michael J. "End-stage Renal Disease in African-American and White Men." JAMA 277, no. 16 (April 23, 1997): 1293. http://dx.doi.org/10.1001/jama.1997.03540400043029.
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Burr, J. A., M. P. Massagli, J. E. Mutchler, and A. M. Pienta. "Labor Force Transitions among Older African American and White Men." Social Forces 74, no. 3 (March 1, 1996): 963–82. http://dx.doi.org/10.1093/sf/74.3.963.
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Lease, Suzanne H., Ashley B. Hampton, Kristie M. Fleming, Linda R. Baggett, Sarah H. Montes, and R. John Sawyer. "Masculinity and interpersonal competencies: Contrasting White and African American men." Psychology of Men & Masculinity 11, no. 3 (July 2010): 195–207. http://dx.doi.org/10.1037/a0018092.
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Shrock, Joel. "Desperate Deeds, Desperate Men: Gender, Race, and Rape in Silent Feature Films, 1915–1927." Journal of Men’s Studies 6, no. 1 (October 1997): 69–89. http://dx.doi.org/10.1177/106082659700600104.
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Many of the top-grossing feature films spanning from 1915–1927 utilized rape as a device for defining manhood and thereby establishing power relationships. The images of rape in these silent films idealized the power of respectable white men over the men and women of other classes and races and subordinated the women from their own social station. These movies constructed white men as heroes and guardians of morality and civilization, white women as frail but morally superior figures, and African-American and immigrant men and women as uncontrollable sexual deviants who threatened civilization. These films reflected the fears of the white middle class that massive immigration, waves of black migration to the North, and the increasingly public role of women were irrevocably changing American society and threatening the power of the traditional dominant group in the United States: white middle- and upper-class men.
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Shelbourne, K. Donald, Tinker Gray, and Rodney W. Benner. "Intercondylar Notch Width Measurement Differences between African American and White Men and Women with Intact Anterior Cruciate Ligament Knees." American Journal of Sports Medicine 35, no. 8 (August 2007): 1304–7. http://dx.doi.org/10.1177/0363546507300060.
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Background A recent report of professional women's basketball found that white European American female players were 6.5 times more likely to tear their anterior cruciate ligament than their nonwhite European American counterparts. African Americans accounted for 95% of the nonwhite European American group. Hypothesis African American men and women have wider intercondylar notches than white men and women. Study Design Cohort study (prevalence); Level of evidence, 2. Methods We obtained 45° flexed weightbearing posteroanterior radiographs on 517 patients who had knee problems other than an anterior cruciate ligament injury or arthrosis. One experienced observer measured the intercondylar notch width with no knowledge of race or gender, and the measurements were analyzed based on race and gender. Results The mean intercondylar notch width was 15.5 mm (SD = 2.8; range, 9-22) for African American women and 14.1 mm (SD = 2.5; range, 8-21) for white women; this difference was statistically significant (P = .009). Similarly, the mean intercondylar notch width was 18.0 mm (SD = 3.6; range, 10-27) for African American men and 16.9 mm (SD = 3.1; range, 9-27) for white men; these values were statistically significantly different (P = .003). Conclusion We conclude that African Americans have statistically significantly wider intercondylar notch widths on 45° flexed weightbearing posteroanterior radiographs than whites of the same gender. This relationship may offer an explanation for the difference between races with regard to risk of anterior cruciate ligament tears.
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Clay, PhD, Olivio J., Roland J. Thorpe, Jr., PhD, Larrell L. Wilkinson, PhD, Eric P. Plaisance, PhD, Michael Crowe, PhD, Patricia Sawyer, PhD, and Cynthia J. Brown, MD, MSPH. "An Examination of Lower Extremity Function and Its Correlates in Older African American and White Men." Ethnicity & Disease 25, no. 3 (August 5, 2015): 271. http://dx.doi.org/10.18865/ed.25.3.271.
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<p><strong>Objective: </strong>Maintaining functional status and reducing/eliminating health disparities in late life are key priorities. Older African Americans have been found to have worse lower extremity functioning than Whites, but little is known about potential differences in correlates between African American and White men. The goal of this investigation was to examine measures that could explain this racial difference and to identify race-specific correlates of lower extremity function.</p><p><strong>Methods: </strong>Data were analyzed for a sample of community-dwelling men. Linear regression models examined demographics, medical conditions, health behaviors, and perceived discrimination and mental health as correlates of an objective measure of lower extremity function, the Short Physical Performance Battery (SPPB). Scores on the SPPB have a potential range of 0 to 12 with higher scores corresponding to better functioning.</p><p><strong>Results: </strong>The mean age of all men was 74.9 years (SD=6.5), and the sample was 50% African American and 53% rural. African American men had scores on the SPPB that were significantly lower than White men after adjusting for age, rural residence, marital status, education, and income difficulty (<em>P</em><.01). Racial differences in cognitive functioning accounted for approximately 41% of the race effect on physical function. Additional models stratified by race revealed a pattern of similar correlates of the SPPB among African American and White men.</p><p><strong>Conclusions: </strong>The results of this investigation can be helpful for researchers and clinicians to aid in identifying older men who are at-risk for poor lower extremity function and in planning targeted interventions to help reduce disparities. <em>Ethn Dis.</em>2015;25(3):271- 278.</p>
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Moses, Kelvin A., Alan T. Paciorek, David F. Penson, Peter R. Carroll, and Viraj A. Master. "Impact of Ethnicity on Primary Treatment Choice and Mortality in Men With Prostate Cancer: Data From CaPSURE." Journal of Clinical Oncology 28, no. 6 (February 20, 2010): 1069–74. http://dx.doi.org/10.1200/jco.2009.26.2469.
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Purpose Men diagnosed with prostate cancer have multiple options available for treatment. Previous reports have indicated a trend of differing modalities of treatment chosen by African American and white men. We investigated the role of ethnicity in primary treatment choice and how this affected overall and cancer-specific mortality. Methods By utilizing data abstracted from Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE), patients were compared by ethnicity, primary treatment, number of comorbidities, risk level according to modified D'Amico criteria, age, highest educational level attained, type of insurance, treatment facility, and perception of general health. Multinomial logistic regression analysis was performed to determine the effect of the tested variables on primary treatment and mortality. Results African American men were more likely to receive nonsurgical therapy than white men with equivalent disease characteristics. Whites were 48% less likely than African Americans to receive androgen deprivation therapy (ADT) compared with surgery (P = .02) and were 25% less likely than African Americans to receive radiation therapy compared with surgery (P = .08). Whites with low-risk disease were 71% less likely to receive ADT than African American men with similar disease (P = .01). Adjusted overall and prostate cancer–specific mortality were not significantly different between whites and African Americans (hazard ratios, 0.73 and 0.37, respectively). Risk level, type of treatment, and type of insurance had the strongest effects on risk of mortality. Conclusion There is a statistically significant difference in primary treatment for prostate cancer between African American and white men with similar risk profiles. Additional research on the influence of patient/physician education and perception and the role that socioeconomic factors play in mortality from prostate cancer may be areas of focus for public health initiatives.
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Powell, Isaac J., Mousumi Banerjee, Wael Sakr, David Grignon, David P. Wood, Mary Novallo, and Edson Pontes. "Should African-American men be tested for prostate carcinoma at an earlier age than white men?" Cancer 85, no. 2 (January 15, 1999): 472–77. http://dx.doi.org/10.1002/(sici)1097-0142(19990115)85:2<472::aid-cncr27>3.0.co;2-0.
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Goode-Cross, David T., and Glenn E. Good. "Managing multiple-minority identities: African American men who have sex with men at predominately white universities." Journal of Diversity in Higher Education 2, no. 2 (2009): 103–12. http://dx.doi.org/10.1037/a0015780.
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Hoffnar, Emily, and Michael Greene. "Residential Location and the Earnings of African American Women." Review of Black Political Economy 23, no. 3 (March 1995): 103–11. http://dx.doi.org/10.1007/bf02689994.
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In comparing the earnings of African American women to three reference groups—white women, African American men, and white men—three principal findings emerge. First, African American women residing in the suburbs are worse off than any other suburban group. Second, central city African American women are worse off than any other group of central city residents. Third, while central city residence imposes a statistically significant earnings penalty on men of both races, no such penalty is found for African American or white women. Therefore, African American women will enjoy no earnings advantage if they move to the suburbs. This finding underscores the importance of including women in studies of residential location and the socioeconomic status of African Americans. A narrow focus on male data to inform policy is clearly insufficient.
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Beatty Moody, Danielle L., Shari R. Waldstein, Daniel K. Leibel, Lori S. Hoggard, Gilbert C. Gee, Jason J. Ashe, Elizabeth Brondolo, Elias Al-Najjar, Michele K. Evans, and Alan B. Zonderman. "Race and other sociodemographic categories are differentially linked to multiple dimensions of interpersonal-level discrimination: Implications for intersectional, health research." PLOS ONE 16, no. 5 (May 19, 2021): e0251174. http://dx.doi.org/10.1371/journal.pone.0251174.
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Objectives To examine whether intersections of race with other key sociodemographic categories contribute to variations in multiple dimensions of race- and non-race-related, interpersonal-level discrimination and burden in urban-dwelling African Americans and Whites. Methods Data from 2,958 participants aged 30–64 in the population-based Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used to estimate up to four-way interactions of race, age, gender, and poverty status with reports of racial and everyday discrimination, discrimination across multiple social statuses, and related lifetime discrimination burden in multiple regression models. Results We observed that: 1) African Americans experienced all forms of discrimination more frequently than Whites, but this finding was qualified by interactions of race with age, gender, and/or poverty status; 2) older African Americans, particularly African American men, and African American men living in poverty reported the greatest lifetime discrimination burden; 3) older African Americans reported greater racial discrimination and greater frequency of multiple social status-based discrimination than younger African Americans; 4) African American men reported greater racial and everyday discrimination and a greater frequency of social status discrimination than African American women; and, 5) White women reported greater frequency of discrimination than White men. All p’s < .05. Conclusions Within African Americans, older, male individuals with lower SES experienced greater racial, lifetime, and multiple social status-based discrimination, but this pattern was not observed in Whites. Among Whites, women reported greater frequency of discrimination across multiple social statuses and other factors (i.e., gender, income, appearance, and health status) than men. Efforts to reduce discrimination-related health disparities should concurrently assess dimensions of interpersonal-level discrimination across multiple sociodemographic categories, while simultaneously considering the broader socioecological context shaping these factors.
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Rogers, Charles R., Patricia Goodson, Lindsey R. Dietz, and Kola S. Okuyemi. "Predictors of Intention to Obtain Colorectal Cancer Screening Among African American Men in a State Fair Setting." American Journal of Men's Health 12, no. 4 (May 8, 2016): 851–62. http://dx.doi.org/10.1177/1557988316647942.
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Racial disparities in health among African American men in the United States are appalling. African American men have the highest mortality and incidence rates from colorectal cancer compared with all other ethnic, racial, and gender groups. Juxtaposed to their white counterparts, African American men have colorectal cancer incidence and mortality rates 27% and 52% higher, respectively. Colorectal cancer is a treatable and preventable condition when detected early, yet the intricate factors influencing African American men’s intention to screen remain understudied. Employing a nonexperimental, online survey research design at the Minnesota State Fair, the purpose of this study was to explore whether male role norms, knowledge, attitudes, and perceptions influence intention to screen for colorectal cancer among 297 African American men. As hypothesized, these Minnesota men (ages 18 to 65) lacked appropriate colorectal cancer knowledge: only 33% of the sample received a “passing” knowledge score (85% or better). In a logistic regression model, the three factors significantly associated with a higher probability of obtaining colorectal cancer screening were age, perceived barriers, and perceived subjective norms. Findings from this study provide a solid basis for informing health policy and designing health promotion and early-intervention colorectal cancer prevention programs that are responsive to the needs of African American men in Minnesota and beyond.
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Forry, Nicole D., Leigh A. Leslie, and Bethany L. Letiecq. "Marital Quality in Interracial Relationships." Journal of Family Issues 28, no. 12 (December 2007): 1538–52. http://dx.doi.org/10.1177/0192513x07304466.
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African American/White interracial couples are a rapidly growing segment of the population. However, little is known about factors related to marital quality for these couples. The authors examine the relationships between sex role ideology, perception of relationship unfairness, and marital quality among a sample of 76 married African American/White interracial couples from the mid-Atlantic region. The results indicate that interracial couples are similar to same-race couples in some ways. In particular, women, regardless of race, report their marriages to be more unfair to them than do men. Unique experiences in interracial marriages based on one's race or race/gender combination are also identified. African Americans experience more ambivalence about their relationship than their White partners. Furthermore, sex role ideology has a moderating effect on perceived unfairness and marital quality for African American men. Similarities and differences among interracial and same-race marriages are discussed, with recommendations for future research.
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Winterich, Julie A., Sara A. Quandt, Joseph G. Grzywacz, Peter E. Clark, David P. Miller, Joshua Acuña, and Thomas A. Arcury. "Masculinity and the Body: How African American and White Men Experience Cancer Screening Exams Involving the Rectum." American Journal of Men's Health 3, no. 4 (July 22, 2008): 300–309. http://dx.doi.org/10.1177/1557988308321675.
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Past research on prostate and colorectal cancer disparities finds that barriers to screening, such as embarrassment and offensiveness, are often reported. Yet none of this literature investigates why. This study uses masculinity and health theory to examine how men experience two common screenings: digital rectal exams (DREs) and colonoscopies. In-depth interviews were conducted with 64 African American and White men from diverse backgrounds, aged 40 to 64, from North Carolina. Regardless of race or education, men experienced DREs more negatively than colonoscopies because penetration with a finger was associated with a gay sexual act. Some men disliked colonoscopies, however, because they associated any penetration as an affront to their masculinity. Because beliefs did not differ by race, future research should focus on structural issues to examine why disparities persist with prostate and colorectal cancer. Recommendations are provided for educational programs and physicians to improve men’s experiences with exams that involve the rectum.
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Sartor, O., C. L. Bennett, S. Halabi, M. Kattan, and P. Scardino. "Race/ethnicity, literacy, and prostate cancer: Initial findings from the COMPARE registry." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 4620. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.4620.
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4620 Background: Comprehensive Multicenter Prostate Adenocarcinoma Registry (COMPARE) evaluates variations in initial prostate cancer (PCa) therapy according to race/ethnicity. Similar studies for prostate cancer patients with PSA failure following radiation therapy or radical prostatectomy are unreported. Poor health literacy and African American race are predictive of advanced stage prostate cancers at diagnosis. Methods: COMPARE includes 778 men (62% >70 yr; 80% white and 13% AA) with rising PSA post-localized PCa therapy. Median follow-up post-registry entry is 5 months. Enrollment at 146 sites to date: urology (N = 129), radiation oncology (n = 12), other (n = 5). Most sites are private practice (n = 132) vs academic (n = 14). Health literacy was tested with a 7-item validated word recognition test; scores of ≥4 correlate with ≥6th grade literacy. Variations in therapy, both initial and after PSA failure, were assessed as a function of patient/regional factors. Results: Initial therapy included radical prostatectomy (RP) 44.5%, external beam radiation therapy (EBRT) 30.7%, brachytherapy (BT) 13.1%, other (11.5%). Literacy data are available for 725 men, one fifth had poor literacy skills (<4); higher rates of low literacy were present in AA vs white men (p < 0.05). Significant variations in initial care were associated with poor vs normal literacy skills (brachytherapy: 8% vs 16%; radical prostatectomy: 52% vs 44%, p < 0.05). Watchful waiting was the most common management for PSA failure patients, 82% for men aged ≤70 yr and 77% for men >70 yr. Among prostate cancer patients >70 yr, after adjustment for literacy and Gleason score, African American men were only 41% as likely as whites to undergo watchful waiting (95% CI, 19% to 92%). Conclusions: Poor health literacy is common among men with prostate cancer; these men are more likely to receive radical prostatectomy. With men >70 yr with PSA failure post-radical prostatectomy or post-radiation therapy, African American men were 2.5× more likely than white men to choose therapy (primarily castration) over watchful waiting. Findings from smaller cohorts found that urologic symptoms were the most important factor associated with use of castration versus watchful waiting for PSA failure. No significant financial relationships to disclose.
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Johnson-Lawrence, Vicki, Derek M. Griffith, and Daphne C. Watkins. "The Effects of Race, Ethnicity, and Mood/Anxiety Disorders on the Chronic Physical Health Conditions of Men From a National Sample." American Journal of Men's Health 7, no. 4_suppl (April 21, 2013): 58S—67S. http://dx.doi.org/10.1177/1557988313484960.
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Racial/ethnic differences in health are evident among men. Previous work suggests associations between mental and physical health but few studies have examined how mood/anxiety disorders and chronic physical health conditions covary by age, race, and ethnicity among men. Using data from 1,277 African American, 629 Caribbean Black, and 371 non-Hispanic White men from the National Survey of American Life, we examined associations between race/ethnicity and experiencing one or more chronic physical health conditions in logistic regression models stratified by age and 12-month mood/anxiety disorder status. Among men <45 years without mood/anxiety disorders, Caribbean Blacks had lower odds of chronic physical health conditions than Whites. Among men aged 45+ years with mood/anxiety disorders, African Americans had greater odds of chronic physical health conditions than Whites. Future studies should explore the underlying causes of such variation and how studying mental and chronic physical health problems together may help identify mechanisms that underlie racial disparities in life expectancy among men.
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Ferreira, Regardt J., Katie Lauve-Moon, and Clare Cannon. "Male Batterer Parenting Attitudes." Research on Social Work Practice 27, no. 5 (July 9, 2015): 572–81. http://dx.doi.org/10.1177/1049731515592382.
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Objective: The purpose of the study was to investigate the differences between intimate partner violence (IPV) and parenting attitudes by race by comparing demographic, parenting, and IPV indicators for African American and White men. Method: The study employed a nonequivalent, control group design in a secondary analysis of 111 men. Results: Analyses indicated that (1) African American men had more children; (2) chi-square tests revealed no statistically significant differences between African American and Caucasian men with respect to IPV perpetration and parenting attitudes; and (3) a logistic regression model indicated that the number of children and a higher risk category for parenting attitudes were significant predictors of race group membership. Conclusion: These findings reveal that having more children is related to a higher level of stress on intimate partner relationships, and these stressors are not evenly distributed across racial groups. Batterer intervention programs should include parenting skills to help perpetrators better cope with such stresses.