An unequal distribution of the human right to health: assessing ethnic health disparities in cardiometabolic disease prevalence among Hawaii’s houseless population

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Nicholas Fancher, Bibek Saha, Kurtis Young, Austin Corpuz, Shirley Cheng, Angelique Fontaine, Teresa Schiff-Elfalan, Jill Omori
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Abstract

Purpose In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular disease, evidence that local health-care systems and governing bodies fail to equally extend the human right to health to all. This study aims to examine whether these ethnic health disparities in cardiovascular disease persist even within an already globally disadvantaged group, the houseless population of Hawaii. Design/methodology/approach A retrospective chart review of records from Hawaii Houseless Outreach and Medical Education Project clinic sites from 2016 to 2020 was performed to gather patient demographics and reported histories of type II diabetes, obesity, hyperlipidemia, hypertension and other cardiovascular disease diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic subgroups. Findings Unexpectedly, the data revealed lower reported prevalence rates of most cardiometabolic diseases among the houseless compared to the general population. However, multiple ethnic health disparities were identified, including higher rates of diabetes and obesity among Native Hawaiians and other Pacific Islanders and higher rates of hypertension among Filipinos and Asians overall. The findings suggest that even within a generally disadvantaged houseless population, disparities in health outcomes persist between ethnic groups and that ethnocultural considerations are just as important in caring for this vulnerable population. Originality/value To the best of the authors’ knowledge, this is the first comprehensive study focusing on ethnic health disparities in cardiovascular disease and the structural processes that contribute to them, among a houseless population in the ethnically diverse state of Hawaii.
健康人权的不平等分配:评估夏威夷无房人口中心脏代谢疾病发病率的种族健康差异
目的 在夏威夷州,菲律宾人和太平洋岛民等少数族裔群体罹患心血管疾病的比例过高,这证明当地的医疗保健系统和管理机构未能平等地向所有人提供健康的人权。本研究旨在探讨,即使在夏威夷无房人口这一已经处于全球劣势的群体中,心血管疾病的这些种族健康差异是否仍然存在。设计/方法/途径对夏威夷无房人口外展和医疗教育项目诊所 2016 年至 2020 年的记录进行了回顾性病历审查,以收集患者的人口统计数据以及 II 型糖尿病、肥胖症、高脂血症、高血压和其他心血管疾病诊断的报告病史。数据显示,与普通人群相比,无家可归者报告的大多数心血管代谢疾病的患病率较低。然而,也发现了多种种族健康差异,包括夏威夷原住民和其他太平洋岛民的糖尿病和肥胖症发病率较高,菲律宾人和亚洲人的高血压发病率总体较高。研究结果表明,即使是在普遍处于不利地位的无房人口中,不同种族群体之间的健康结果仍存在差异,而且在照顾这一弱势群体时,种族文化因素也同样重要。 原创性/价值 据作者所知,这是第一项全面的研究,重点关注夏威夷种族多样化州无房人口在心血管疾病方面的种族健康差异,以及导致这些差异的结构性过程。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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