Journal of Racial and Ethnic Health Disparities最新文献

筛选
英文 中文
Spatial and Racial/Ethnic Variation in the Prevalence of Cesarean Delivery in a South Carolina Medical Center. 南卡罗来纳州一家医疗中心剖腹产率的空间和种族/族裔差异。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-18 DOI: 10.1007/s40615-024-02218-3
Jeffrey T Howard, Sam Lawton, Dulaney Wilson, Amartha Gore, Latha Hebbar, Christine Morton, Christopher Goodier, Myrtede Alfred
{"title":"Spatial and Racial/Ethnic Variation in the Prevalence of Cesarean Delivery in a South Carolina Medical Center.","authors":"Jeffrey T Howard, Sam Lawton, Dulaney Wilson, Amartha Gore, Latha Hebbar, Christine Morton, Christopher Goodier, Myrtede Alfred","doi":"10.1007/s40615-024-02218-3","DOIUrl":"https://doi.org/10.1007/s40615-024-02218-3","url":null,"abstract":"<p><strong>Introduction: </strong>While racial/ethnic disparities in cesarean delivery have been noted in the literature, less is known about the intersection between individual-level race/ethnicity and community-level social vulnerability as factors in cesarean delivery. The goal was to use medical record data from a large medical center combined with census tract-level data to examine patterns of social vulnerability, racial population distribution, and prevalence of cesarean delivery.</p><p><strong>Methods: </strong>Data were obtained from electronic medical records of patients from a large medical center in South Carolina from 2019 to 2020. The outcome variable was cesarean delivery (yes/no), and covariates included the year of delivery; age of patient; race/ethnicity; spoken language; BMI categories; clinical indications of anemia, hypertension, preeclampsia, and diabetes; and census tract Social Vulnerability Index (SVI). Generalized linear mixed models for multilevel binary logistic regression were used to test the main hypothesis that the census tract level Social Vulnerability Index is positively associated with cesarean delivery.</p><p><strong>Results: </strong>Among a total of 5011 patients, we found that non-Hispanic Black mothers were more likely to have cesarean deliveries compared with non-Hispanic White mothers. After controlling for census tract-level SVI, the individual-level race/ethnicity association was no longer significant. Significant spatial autocorrelation across census tracts was evident for cesarean delivery prevalence, non-Hispanic Black population, and SVI. A high prevalence of cesarean delivery tended to cluster with high SVI and a high non-Hispanic Black population.</p><p><strong>Conclusions: </strong>We found that non-Hispanic Black mothers were more likely to have cesarean deliveries, which was explained by census tract differences in the SVI.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
"First, Trust Needs to Develop": Hematologists' Perspectives on Factors Influencing Black Persons' Participation in Clinical Trials. "首先,需要建立信任":血液学专家对影响黑人参与临床试验的因素的看法。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-18 DOI: 10.1007/s40615-024-02205-8
Shakira J Grant, Milenka Jean-Baptiste, Jiona A Mills, Paul Mihas
{"title":"\"First, Trust Needs to Develop\": Hematologists' Perspectives on Factors Influencing Black Persons' Participation in Clinical Trials.","authors":"Shakira J Grant, Milenka Jean-Baptiste, Jiona A Mills, Paul Mihas","doi":"10.1007/s40615-024-02205-8","DOIUrl":"https://doi.org/10.1007/s40615-024-02205-8","url":null,"abstract":"<p><strong>Background: </strong>Cancer clinical trials are crucial for treatment standards and innovation but lack racial-ethnic diversity. Understanding physician perspectives on recruiting participants is critical due to their role in decision-making about trial candidacy and enrollment.</p><p><strong>Methods: </strong>From August 2021 to January 2022 we recruited 13 Academic hematologists experienced with treating blood cancers and enrolling clinical trial participants. Each hematologist participated in a 60-75-minute semistructured interview and completed a sociodemographic survey. Using the National Institute on Minority Health and Health Disparities multilevel model as a framework, we characterized hematologists' perceived barriers to clinical trial participation among Black persons. ATLAS.ti v9 and later v 23.2.1 was used for project management and to facilitate data analysis using the Sort and Sift, Think and Shift approach (ResearchTalk Inc).</p><p><strong>Results: </strong>All hematologists were White, with 70% being male. Three factors influenced their perspectives on enrolling Black individuals in clinical trials: individual attitudes and beliefs, such as perceptions that Black or socioeconomically disadvantaged persons will be less willing or less compliant with the requirements for trial participation and follow-up. The need to build trusting relationships between themselves and patients prior to discussing clinical trials and the prevailing legacy of medical mistrust among the Black community. Trust was found to be the underlying factor in determining communication between hematologists and Black persons about clinical trials across all three levels.</p><p><strong>Conclusion: </strong>This study highlights how hematologists' attitudes, beliefs, biases, and views on trust in patient relationships influence their communication with Black individuals about clinical trials. It emphasizes the need for further research to develop interventions that address the lack of racial and ethnic diversity in trials.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Barriers and Facilitators to the Success of Black Academic Physicians. 黑人学术医生成功的障碍和促进因素。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-17 DOI: 10.1007/s40615-024-02201-y
Barbara Jerome, Magali Fassiotto, Yvonne Bonnie Maldonado, Tamara Dunn
{"title":"Barriers and Facilitators to the Success of Black Academic Physicians.","authors":"Barbara Jerome, Magali Fassiotto, Yvonne Bonnie Maldonado, Tamara Dunn","doi":"10.1007/s40615-024-02201-y","DOIUrl":"https://doi.org/10.1007/s40615-024-02201-y","url":null,"abstract":"<p><p>Despite efforts to recruit and retain Black physicians, Black individuals continue to be underrepresented in medicine in the USA. Although numerous studies have investigated the experiences of academic physicians from racial/ethnic backgrounds underrepresented in medicine, the experience of Black academic physicians, who may face additional unique challenges, remains underinvestigated. Using a qualitative research design, we investigate barriers to and facilitators of success and well-being of Black faculty at one academic medical center through interviews of 30 Black faculty members. Overall, ten themes emerged as barriers or facilitators to faculty success and well-being. Significant barriers include continued lack of representation; devaluing of research in community health and health disparities, as well as other diversity-related activities; and both overt and implicit discrimination, which contribute to feelings of isolation and disrespect. Facilitators include having a community to maintain sense of belonging, financial support for health disparities and diversity-related contributions, and collaboration with peers. Good mentorship and sponsorship as well as an institutional culture that supports inclusion can play significant roles as facilitators, whereas the lack of these factors can present substantial barriers. Institutional policies and external socio-political factors have a major influence on both the barriers and facilitators to the success and well-being of Black faculty. Our study has put a clearer focus on barriers that are unique to or more pronounced among Black faculty and the facilitators that may serve to mitigate these barriers. These findings can inform the design of interventions to recruit and retain Black faculty in medicine.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Longitudinal Impact of Family, Religious, and School Support on the Mental Health of Filipino and Korean American Youth Across Adolescence. 家庭、宗教和学校支持对菲律宾裔和韩裔美国青少年青春期心理健康的纵向影响》(The Longitudinal Impact of Family, Religious, and School Support on the Mental Health of Filipino and Korean American Youth Across Adolescence)。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-16 DOI: 10.1007/s40615-024-02200-z
Michael Park, In Young Park, Yoonsun Choi, Julia R Henly
{"title":"The Longitudinal Impact of Family, Religious, and School Support on the Mental Health of Filipino and Korean American Youth Across Adolescence.","authors":"Michael Park, In Young Park, Yoonsun Choi, Julia R Henly","doi":"10.1007/s40615-024-02200-z","DOIUrl":"https://doi.org/10.1007/s40615-024-02200-z","url":null,"abstract":"<p><p>Asian Americans, currently the most rapidly expanding racial group in the USA, are experiencing persistent mental health inequities. These inequities are particularly pronounced during adolescence, highlighting the critical need for dedicated focus on this demographic. Social support is a key shield against mental distress among these adolescents, yet little research has examined the collective impact of multiple sources of support over time, across developmental stages, and for different ethnic subgroups. Drawing on the integrated conceptual framework, this longitudinal study is the first to our knowledge to examine how support from families, religious organizations, and schools together predicts mental health over time across adolescents' developmental stages. We further examined how these relationships may be moderated by age groups, distinguishing between the early adolescence cohort and the middle adolescence cohort. Data were from the Midwest Longitudinal Study of Asian American Families (MLSAAF) project that survey-interviewed 378 Filipino American and 408 Korean American adolescents (M<sub>age</sub> = 15 years). Findings reveal that family support consistently buffers against mental distress throughout adolescence for both groups. Religious support distinctly aids Filipino American early adolescents, while school support notably benefits early adolescents regardless of ethnicity. These findings emphasize the universal protective effects of social support, while also highlighting the nuanced ways that developmental stage and ethnicity may influence how different sources of support impact mental health. This underscores the need for developmentally and culturally sensitive mental health strategies for Asian American adolescents.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Climate Change, Racism, and Food Insecurity: Cyclical Impacts of Stressors Exacerbate Health Disparities. 气候变化、种族主义和粮食不安全:压力的周期性影响加剧了健康差异。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-16 DOI: 10.1007/s40615-024-02202-x
Christina Ek, James R Hébert, Daniela B Friedman, Dwayne E Porter
{"title":"Climate Change, Racism, and Food Insecurity: Cyclical Impacts of Stressors Exacerbate Health Disparities.","authors":"Christina Ek, James R Hébert, Daniela B Friedman, Dwayne E Porter","doi":"10.1007/s40615-024-02202-x","DOIUrl":"https://doi.org/10.1007/s40615-024-02202-x","url":null,"abstract":"<p><strong>Introduction: </strong>Disadvantaged populations have higher rates of chronic disease, including heart disease, cancer, and diabetes. Race, ethnicity, lower socioeconomic status, and poverty all contribute to these disproportionate rates. Other factors, including systemic racism, climate change, poor diet, lack of food access, and epigenetic influences, that are distributed and experienced differently across vulnerable populations also play a significant role in the development of chronic diseases. This comprehensive review of contributors to chronic diseases emphasizes a unique focus on these identified emerging factors.</p><p><strong>Methods: </strong>An ad hoc literature review using OVID Medline and Web of Science was conducted.</p><p><strong>Results: </strong>Findings from prior studies indicate that multiple stressors, both in isolation and in combination, and their negative impacts on both physical and mental health of minorities are exacerbated by climate change.</p><p><strong>Discussion: </strong>Various stressors dramatically increase chronic disease risk in minority groups. Recommendations for future research to elucidate the impacts of climatic, racial, and dietary adversity with minority populations are presented. Further study in this area is critical for achieving the UN Sustainable Development Goals and improving public health outcomes.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Handoffs and Equity: Impact of a Patient Distribution Model on Handoffs for Black Patients. 交接与公平:病人分配模式对黑人病人交接的影响。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-15 DOI: 10.1007/s40615-024-02196-6
Ethan Molitch-Hou, Thomas J Best, Ellis Green, Khanh T Nguyen, Grace LaShore, Matthew T Cerasale
{"title":"Handoffs and Equity: Impact of a Patient Distribution Model on Handoffs for Black Patients.","authors":"Ethan Molitch-Hou, Thomas J Best, Ellis Green, Khanh T Nguyen, Grace LaShore, Matthew T Cerasale","doi":"10.1007/s40615-024-02196-6","DOIUrl":"https://doi.org/10.1007/s40615-024-02196-6","url":null,"abstract":"<p><strong>Background: </strong>Hospital medicine patient distribution models (PDM) assign patients to inpatient services on hospital admission. Models balance tradeoffs including patient handoffs, physician wellness, subspecialty care, and other factors to ensure optimal outcomes; however, equity is rarely considered. Handoffs during inpatient care can result in medical error and worse patient outcomes. This study evaluates the impact of a PDM that prioritizes use of specialty care services and an overflow service (OS) during high census on racial inequities in handoff frequency.</p><p><strong>Methods: </strong>A single-center retrospective cohort study of inpatient encounters on hospital medicine services from July 2017 to December 2019 was conducted. The primary exposures included being discharged by a general medicine service (GMS) or cared for by an OS. The primary outcome was handoffs per day of stay, analyzed by multivariable regression adjusted for age, gender, race, ethnicity, insurance, discharge from GMS, and care from OS.</p><p><strong>Results: </strong>A total of 4165 inpatient hospitalizations with the majority of their stay on a hospital medicine service were reviewed. Patients discharged by GMS (78.2% vs. 58.1%, p < .001) and cared for by OS (78.7% vs. 67.0%, p < .001) were more likely to identify as Black. Multivariable analysis showed a handoff risk ratio of 1.53 (p < .001) for OS patients and 1.06 (p = .01) if discharged from GMS, but race alone did not significantly affect risk of handoffs.</p><p><strong>Conclusion: </strong>The PDM prioritization drove increased handoffs disproportionately for Black patients. Multivariable analysis showed that race alone did not contribute to increased handoffs suggesting the creation of a systemic bias in patient care.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Pilot Study Exploring the Feasibility of Virtual Written Exposure Therapy with Underserved Black Perinatal Women. 探索虚拟书面暴露疗法对缺乏服务的黑人围产期妇女可行性的试点研究。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-14 DOI: 10.1007/s40615-024-02203-w
Angela Neal-Barnett, Robert E Stadulis, Eniolufolake E Ayoade, Alexis McGhee-Dinvaut
{"title":"A Pilot Study Exploring the Feasibility of Virtual Written Exposure Therapy with Underserved Black Perinatal Women.","authors":"Angela Neal-Barnett, Robert E Stadulis, Eniolufolake E Ayoade, Alexis McGhee-Dinvaut","doi":"10.1007/s40615-024-02203-w","DOIUrl":"https://doi.org/10.1007/s40615-024-02203-w","url":null,"abstract":"<p><p>In the USA, Black pregnant women are at the highest risk for maternal morbidity. They also experience the highest rates of trauma exposure and posttraumatic stress disorder (PTSD). PTSD takes a toll on Black women's mental and physical health, placing them at risk for maternal morbidity. It increases several mental health symptoms such as suicidality, anxiety, re-living the trauma, and numbness. These mental health conditions adversely affect health behaviors, including those essential for maternal health, such as attending prenatal and postpartum appointments. Furthermore, untreated PTSD is associated with higher blood pressure, increasing Black mothers' risk of pre-eclampsia. For a variety of reasons including cultural mistrust, stigma, transportation, time constraints, and access to care, PTSD is frequently underassessed and undertreated among Black perinatal women. Written exposure therapy (WET) is a state-of-the-art brief treatment for PTSD. In this study, we explored the initial feasibility of the virtual delivery of WET to reduce PTSD symptoms among Black perinatal women. Results found the virtual delivery of WET to be feasible. Symptom reduction for PTSD in participants was 50-100% during follow-up, suggesting potential effectiveness of the intervention. Implications for virtual delivery of WET in reducing risk for Black maternal morbidity are discussed.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethnic-Specific Threshold Analysis and BMI and Waist Circumference Cutoffs for Cardiovascular Disease and Subjective Wellbeing: Results using Data from the UK Biobank. 针对心血管疾病和主观幸福感的特定种族阈值分析及体重指数和腰围临界值:使用英国生物库数据得出的结果。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-11 DOI: 10.1007/s40615-024-02193-9
Mubarak Patel, Mohammed Aadil Buchya, Olalekan Uthman
{"title":"Ethnic-Specific Threshold Analysis and BMI and Waist Circumference Cutoffs for Cardiovascular Disease and Subjective Wellbeing: Results using Data from the UK Biobank.","authors":"Mubarak Patel, Mohammed Aadil Buchya, Olalekan Uthman","doi":"10.1007/s40615-024-02193-9","DOIUrl":"https://doi.org/10.1007/s40615-024-02193-9","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to identify ethnicity-specific BMI and waist circumference cutoffs for cardiovascular disease (CVD) and to define optimal thresholds for CVD risk and subjective wellbeing (SWB) through predictive modelling, to inform precise public health initiatives.</p><p><strong>Methods: </strong>We used data from 296,767 UK Biobank participants and adjusted logistic and linear regression models for CVD and SWB, respectively, complemented by receiver operating characteristic analysis, to explore optimal risk thresholds of CVD in six different ethnic groups and to calculate ethnicity-specific cutoffs of BMI and waist circumference (WC) to further elucidate the relationships between demographic factors and cardiovascular risk among diverse populations.</p><p><strong>Results: </strong>The logistic regression model of CVD revealed moderate discriminative ability (AUROC ~ 64-65%) across ethnicities for CVD status, with sensitivity and specificity values indicating the model's predictive accuracy. For SWB, the model demonstrated moderate performance with an AUROC of 63%, supported by significant variables that included age, BMI, WC, physical activity, and alcohol intake. Adjusted-incidence rates of CVD revealed the evidence ethnic-specific CVD risk profiles with Whites, South Asians and Blacks demonstrating higher predicted CVD events compared to East Asians, mixed and other ethnic groups.</p><p><strong>Conclusion: </strong>Alterations of ethnicity-specific BMI and waist circumference are required to ensure ethnic minorities are provided with proper mitigation of cardiovascular risk, addressing the disparities observed in CVD prevalence and outcomes across diverse populations. This tailored approach to risk assessment can facilitate early detection, intervention and management of CVD, ultimately improving health outcomes and promoting health equity. The moderate accuracy of predictive models underscores the need for further research to identify additional variables that may enhance predictive accuracy and refine risk assessment strategies.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COVID-19 Deaths and Minority Health Social Vulnerability, in the U.S., January 1, 2020 through June 24, 2023. COVID-19 2020 年 1 月 1 日至 2023 年 6 月 24 日美国的死亡人数和少数民族健康社会脆弱性。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-11 DOI: 10.1007/s40615-024-02192-w
Hope King, Makhabele Nolana Woolfork, Andrea Yunyou, Yuwa Edomwande, Erik Euler, Olivia Almendares, Suresh Nath Neupane, Melissa Briggs Hagen
{"title":"COVID-19 Deaths and Minority Health Social Vulnerability, in the U.S., January 1, 2020 through June 24, 2023.","authors":"Hope King, Makhabele Nolana Woolfork, Andrea Yunyou, Yuwa Edomwande, Erik Euler, Olivia Almendares, Suresh Nath Neupane, Melissa Briggs Hagen","doi":"10.1007/s40615-024-02192-w","DOIUrl":"https://doi.org/10.1007/s40615-024-02192-w","url":null,"abstract":"<p><strong>Background: </strong>Health disparities, leading to worse health outcomes such as elevated COVID-19 mortality rates, are rooted in social and structural factors. These disparities notably impact individuals from lower socioeconomic backgrounds and more socially vulnerable areas. We analyzed the relationship between COVID-19 deaths and social vulnerability using the Minority Health Social Vulnerability Index (MHSVI).</p><p><strong>Methods: </strong>COVID-19 death data in the U.S. was obtained from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, where COVID-19 deaths were defined using the ICD-10 code U07.1. MHSVI composite scores were calculated for 3089 U.S. counties and categorized into social vulnerability quartiles, where values ranged from 0 (lowest vulnerability) to 1 (highest vulnerability). Negative binomial regression was employed to determine death rate ratios for each quartile within each theme. Finally, a multivariate negative binomial regression including all MHSVI sub-themes, excluding the overall index ranking, was used to assess the association between each theme and COVID-19 death rates independently.</p><p><strong>Results: </strong>There were 1,134,272 COVID-19 deaths from January 1, 2020 through June 24, 2023. Adjusted rate ratios for COVID-19 deaths in the overall index ranking were 1.06 (95% CI 0.99-1.13), 1.14 (95% CI 1.06-1.22), and 1.41 (95% CI 1.31-1.52) for the second, third and fourth quartiles, respectively. Sub-themes of socioeconomic status (SES), household characteristics (HC), racial and ethnic minority status (REMS), housing type and transportation (HTT), and medical vulnerability (MV) revealed increasing death rates in higher vulnerability quartiles. The healthcare infrastructure and access (HIA) theme had decreasing death rate ratios of 0.74 (95% CI 0.71-0.78), 0.59 (95% CI 0.56-0.62), and 0.42 (95% CI 0.39-0.44) for the second, third, and fourth quartiles, respectively. Finally, the multivariate analysis showed that the HC, HTT, HIA, and MV themes were associated with COVID-19 deaths (P < 0.05).</p><p><strong>Conclusion: </strong>Counties that were identified as more socially vulnerable experienced higher death rates from COVID-19. These areas may need additional public health and social support during future pandemics.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chronic Physiological Dysregulation and Changes in Depressive Symptoms: Testing Sex and Race as Vulnerability Factors. 慢性生理失调与抑郁症状的变化:将性别和种族作为易感因素进行测试
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2024-10-10 DOI: 10.1007/s40615-024-02189-5
Stacey N Doan, Alexandra S Aringer, Jessica M Vicman, Thomas Fuller-Rowell
{"title":"Chronic Physiological Dysregulation and Changes in Depressive Symptoms: Testing Sex and Race as Vulnerability Factors.","authors":"Stacey N Doan, Alexandra S Aringer, Jessica M Vicman, Thomas Fuller-Rowell","doi":"10.1007/s40615-024-02189-5","DOIUrl":"https://doi.org/10.1007/s40615-024-02189-5","url":null,"abstract":"<p><p>Depression is a growing public health concern that affects approximately 5% of adults in their lifetime (WHO in Depression, 2021). Understanding the biological correlates of depression is imperative for advancing treatment. Of particular interest is allostatic load, a multisystem indicator of chronic physiological dysregulation (McEwen and Seeman in, Ann N Y Acad Sci, 1999). The current longitudinal study examined the association between allostatic load, depressive symptoms, and the moderating roles of sex and race. Participants consisted of 150 young adults (M<sub>age</sub> = 18.81) who reported their demographics and depressive symptoms at T1 and T2, a year and a half later. Allostatic load was computed using indicators of metabolic, cardiovascular, and neuroendocrine functioning. Allostatic load was found to predict changes in depressive symptoms. Moreover, interaction effects models revealed that the associations between allostatic load and depressive symptoms at follow-up were further influenced by sex, such that the relationship was significant for males, with pronounced effects for Black males in particular. Black males may be particularly vulnerable to the mental health consequences of biological dysregulation.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信