Journal of Racial and Ethnic Health Disparities最新文献

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Multimorbidity Patterns, Hospital Uses and Mortality by Race and Ethnicity Among Oldest-Old Patients. 按种族和民族划分的高龄患者多病模式、医院使用情况和死亡率。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-02-21 DOI: 10.1007/s40615-024-01929-x
Jinmyoung Cho, Heather Allore, Gelareh Rahimighazikalayeh, Ivana Vaughn
{"title":"Multimorbidity Patterns, Hospital Uses and Mortality by Race and Ethnicity Among Oldest-Old Patients.","authors":"Jinmyoung Cho, Heather Allore, Gelareh Rahimighazikalayeh, Ivana Vaughn","doi":"10.1007/s40615-024-01929-x","DOIUrl":"10.1007/s40615-024-01929-x","url":null,"abstract":"<p><strong>Backgrounds: </strong>Adults aged 85 years and older (\"oldest-old\") are perceived as survivors resilient to age-related risk factors. Although considerable heterogeneity has been often observed in this population, less is known about the unmet needs in health and healthcare service utilization for diverse patients in healthcare systems. We examined racial-ethnic variation in patterns of multimorbidity associated with emergency department (ED), clinic visits, and mortality among the oldest-old patients with multimorbidity.</p><p><strong>Methods: </strong>Administrative and clinical data from an integrated healthcare system for five years included 25,801 oldest-old patients with two or more chronic conditions. Hierarchical cluster analysis identified patterns of multimorbidity by four racial-ethnic groups (White, Black, Hispanic, & Other). Clusters associated with ED and clinic visits, and mortality were analyzed using generalized estimation equations and proportional hazards survival model, respectively.</p><p><strong>Results: </strong>Hypothyroidism, Alzheimer's disease and related dementia, bone & joint conditions, metabolism syndrome, and pulmonary-vascular clusters were commonly observed across the groups. While most clusters were significantly associated with ED and clinic visits among White patients, bone & joint conditions cluster was the most significantly associated with ED and clinic visits among Black (RR = 1.32, p <.01 for ED; RR = 1.67, p <.0001 for clinic) and Hispanic patients (RR = 1.36, p <.0001 for ED; RR = 1.39, p <.0001 for clinic). Similar patterns were observed in the relationship between multimorbidity clusters and mortality.</p><p><strong>Conclusions: </strong>Patterns of multimorbidity and its significant association with the uses of ambulatory and emergency care varied by race-ethnicity. More studies are needed to explore barriers when minoritized patients are faced with the use of hospital services.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":"919-928"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912911","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
Using Geographic Disaggregation to Compare Tuberculosis Epidemiology Among American Indian and Alaska Native Persons-USA, 2010-2020. 利用地理分类比较美国印第安人和阿拉斯加原住民的结核病流行情况--美国,2010-2020 年。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-02-09 DOI: 10.1007/s40615-024-01919-z
Yuri P Springer, J Steve Kammerer, Derrick Felix, Katherine Newell, Megan L Tompkins, Jamie Allison, Louisa J Castrodale, Bruce Chandler, Kathryn Helfrich, Michelle Rothoff, Joseph B McLaughlin, Benjamin J Silk
{"title":"Using Geographic Disaggregation to Compare Tuberculosis Epidemiology Among American Indian and Alaska Native Persons-USA, 2010-2020.","authors":"Yuri P Springer, J Steve Kammerer, Derrick Felix, Katherine Newell, Megan L Tompkins, Jamie Allison, Louisa J Castrodale, Bruce Chandler, Kathryn Helfrich, Michelle Rothoff, Joseph B McLaughlin, Benjamin J Silk","doi":"10.1007/s40615-024-01919-z","DOIUrl":"10.1007/s40615-024-01919-z","url":null,"abstract":"<p><strong>Background: </strong>American Indian and Alaska Native (AIAN) populations are frequently associated with the highest rates of tuberculosis (TB) disease of any racial/ethnic group in the USA. We systematically investigated variation in patterns and potential drivers of TB epidemiology among geographically distinct AIAN subgroups.</p><p><strong>Methods: </strong>Using data reported to the National Tuberculosis Surveillance System during 2010-2020, we applied a geographic method of data disaggregation to compare annual TB incidence and the frequency of TB patient characteristics among AIAN persons in Alaska with AIAN persons in other states. We used US Census data to compare the prevalence of substandard housing conditions in AIAN communities in these two geographic areas.</p><p><strong>Results: </strong>The average annual age-adjusted TB incidence among AIAN persons in Alaska was 21 times higher than among AIAN persons in other states. Compared to AIAN TB patients in other states, AIAN TB patients in Alaska were associated with significantly higher frequencies of multiple epidemiologic TB risk factors (e.g., attribution of TB disease to recent transmission, previous diagnosis of TB disease) and significantly lower frequencies of multiple clinical risk factors for TB disease (e.g., diagnosis with diabetes mellitus, end-stage renal disease). Occupied housing units in AIAN communities in Alaska were associated with significantly higher frequencies of multiple measures of substandard housing conditions compared to AIAN communities in other states.</p><p><strong>Conclusions: </strong>Observed differences in patient characteristics and substandard housing conditions are consistent with contrasting syndromes of TB epidemiology in geographically distinct AIAN subgroups and suggest ways that associated public health interventions could be tailored to improve efficacy.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":"798-809"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Racial Disparities in COVID-19 Severity Are Partially Mediated by Chronic Stress-Evidence from a Large Integrated Healthcare System. COVID-19 严重程度的种族差异部分受慢性压力的影响--来自一个大型综合医疗保健系统的证据。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-01-31 DOI: 10.1007/s40615-024-01920-6
Miranda M Montoya, Jennifer C Gander, Shakira F Suglia, Bennett McDonald, Shivani A Patel, Teaniese Davis, Rachel E Patzer, Ram Jagannathan, Larissa Teunis, Jessica L Harding
{"title":"Racial Disparities in COVID-19 Severity Are Partially Mediated by Chronic Stress-Evidence from a Large Integrated Healthcare System.","authors":"Miranda M Montoya, Jennifer C Gander, Shakira F Suglia, Bennett McDonald, Shivani A Patel, Teaniese Davis, Rachel E Patzer, Ram Jagannathan, Larissa Teunis, Jessica L Harding","doi":"10.1007/s40615-024-01920-6","DOIUrl":"10.1007/s40615-024-01920-6","url":null,"abstract":"<p><strong>Background: </strong>Racial and ethnic minorities have experienced a disproportionate burden of severe COVID-19. Whether chronic stress, also disproportionately experienced by racial and ethnic minorities, explains this excess risk is unknown.</p><p><strong>Methods: </strong>We identified 9577 adults (≥ 18 years) diagnosed with COVID-19 from January 1, 2020, through September 30, 2021, enrolled in Kaiser Permanente Georgia (KPGA) with complete biomarker data. Self-reported race (Black or White) was defined from electronic medical records. Chronic stress, defined as allostatic load (AL), a composite score (scale 0-7) based on seven cardio-metabolic biomarkers, was categorized as below (low AL) or above (high AL) the median. Severe COVID-19 was defined as hospitalization or mortality within 30 days of COVID-19 diagnosis. The association between race, AL, and severe COVID-19 was assessed using multivariable Poisson regression. The mediating effect of AL was assessed using the Valeri and VanderWeele method. All results were expressed as risk ratios (RRs) with 95% confidence intervals.</p><p><strong>Results: </strong>Overall, Black (vs. White) KPGA members had an 18% excess risk of AL (RR: 1.18, 95%CI: 1.14-1.23) and a 24% excess risk of severe COVID-19 (RR: 1.24, 95%CI: 1.12, 1.37). AL explained 23% of the Black-White disparities in severe COVID-19.</p><p><strong>Conclusions: </strong>In our study, chronic stress, characterized by AL, partially mediated Black-White disparities in severe COVID-19 outcomes.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":"810-818"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139642434","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
Prevalence and Spatial Autocorrelation of Tuberculosis in Indigenous People in Brazil, 2002-2022. 2002-2022 年巴西土著居民肺结核患病率和空间自相关性》(Prevalence and Spatial Autocorrelation of Tuberculosis in Indigenous People in Brazil, 2002-2022)。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-02-01 DOI: 10.1007/s40615-024-01924-2
Maurício Polidoro, Daniel Canavese de Oliveira
{"title":"Prevalence and Spatial Autocorrelation of Tuberculosis in Indigenous People in Brazil, 2002-2022.","authors":"Maurício Polidoro, Daniel Canavese de Oliveira","doi":"10.1007/s40615-024-01924-2","DOIUrl":"10.1007/s40615-024-01924-2","url":null,"abstract":"<p><p>Tuberculosis (TB) among indigenous populations in Brazil poses a multifaceted public health challenge influenced by geographical, social, institutional, economic, and cultural factors. This study scrutinized the prevalence and spatial distribution of TB among Brazilian indigenous communities from 2002 to 2022. Employing a cross-sectional and descriptive approach, we analyzed data from the Notifiable Diseases Information System (SINAN) and conducted spatial autocorrelation tests to identify clusters and outliers. The findings uncovered substantial disparities in TB prevalence between the North and Central-West regions, in contrast to the South and Southeast, mirroring social, economic, and cultural inequalities in Brazil. It is concluded that public health strategies should not only consider the epidemiological aspects of TB but also encompass social and environmental determinants, notably the impact of climate change. Holistic and context-sensitive approaches are imperative for addressing TB within indigenous communities, underscoring the need for adaptive and culturally sensitive interventions in the public health landscape.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":"865-872"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650992","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
Widening Disparities in COVID-19 Mortality and Life Expectancy Among 15 Major Racial and Ethnic Groups in the United States, 2020-2021. 2020-2021 年美国 15 个主要种族和族裔群体 COVID-19 死亡率和预期寿命差距的扩大。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-03-07 DOI: 10.1007/s40615-024-01966-6
Gopal K Singh, Hyunjung Lee
{"title":"Widening Disparities in COVID-19 Mortality and Life Expectancy Among 15 Major Racial and Ethnic Groups in the United States, 2020-2021.","authors":"Gopal K Singh, Hyunjung Lee","doi":"10.1007/s40615-024-01966-6","DOIUrl":"10.1007/s40615-024-01966-6","url":null,"abstract":"<p><p>Persistent and often widening racial/ethnic and socioeconomic inequalities in health have long existed in the US. Although racial/ethnic disparities in COVID-19 mortality are well documented, COVID-19 mortality risks and resultant reductions in life expectancy during the pandemic for detailed racial and ethnic groups in the US, including Asian and Hispanic subgroups, are not known. We used 2020-2021 US mortality data to estimate age-adjusted COVID-19 mortality rates, life expectancy, and the consequent declines in life expectancy due to COVID-19 overall and for the 15 largest racial/ethnic groups. We used standard life table methodology, cause-elimination life tables, and inequality indices to analyze trends in racial/ethnic disparities. The number of COVID-19 deaths increased from 350,827 in 2020 to 416,890 in 2021. COVID-19 death rates varied 7-fold among the racial/ethnic groups; Japanese and Chinese had the lowest mortality rates and Mexicans and American Indians/Alaska Natives (AIANs) had the highest rates. In 2021, life expectancy ranged from 70.3 years for Blacks and 70.6 years for AIANs to 85.2 years for Japanese and 87.7 years for Chinese. The life-expectancy gap was wide- 22.4 years in 2020 and 23.2 years in 2021. COVID-19 mortality had the greatest impact in reducing the life expectancy of Mexicans (3.53 years in 2020 and 3.78 years in 2021), Central/South Americans (4.86 years in 2020 and 3.50 years in 2021), and AIANs (2.51 years in 2020 and 2.38 years in 2021). Racial/ethnic inequalities in COVID-19 mortality, life expectancy, and resultant reductions in life expectancy during the pandemic widened between 2020 and 2021.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":"1323-1332"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140059717","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
Examining Race-Based and Gender-Based Discrimination, Trust in Providers, and Mental Well-Being Among Black Women. 研究黑人妇女中基于种族和性别的歧视、对医疗服务提供者的信任以及心理健康。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-02-12 DOI: 10.1007/s40615-024-01913-5
Yendelela L Cuffee, Portia A Jackson Preston, Suzanne Akuley, Rachel Jaffe, Sharina Person, Jeroan J Allison
{"title":"Examining Race-Based and Gender-Based Discrimination, Trust in Providers, and Mental Well-Being Among Black Women.","authors":"Yendelela L Cuffee, Portia A Jackson Preston, Suzanne Akuley, Rachel Jaffe, Sharina Person, Jeroan J Allison","doi":"10.1007/s40615-024-01913-5","DOIUrl":"10.1007/s40615-024-01913-5","url":null,"abstract":"<p><strong>Objectives: </strong>To examine experiences of discrimination among Black women, and to determine if experiencing race- and gender-based discrimination is associated with mental well-being and trust.</p><p><strong>Methods: </strong>Data from the TRUST study were used to examine experiences of discrimination among 559 Black women with hypertension receiving healthcare at a safety-net hospital in Birmingham, Alabama. A three-level variable was constructed to combine the race-based and gender-based measures of the Experiences of Discrimination scale. Linear regression was used to examine the association between experiences of discrimination with mental well-being and trust.</p><p><strong>Results: </strong>Women who reported no experiences of race- or gender-based discrimination were older and reported higher mental well-being scores and greater trust. Fifty-three percent of study participants reported experiencing discrimination. Compared to participants who did not experience race- or gender-based discrimination, participants reporting experiences of race- or gender-based discrimination and those reporting experiencing both race- and gender-based discrimination were more likely to report poorer mental health.</p><p><strong>Conclusion: </strong>Reported experiences of gender- and/or race-based discrimination in this study were associated with lower mental health scores and less trust in health care providers. Our findings highlight the importance of examining experiences of discrimination among Black women, and the role of discrimination as a stressor and in reducing trust for providers. Incorporating an understanding and acknowledgement of experiences of discrimination into interventions, programs, and during clinical encounters may foster more trusting relationships between providers and patients.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":"732-739"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perceived Experiences of racism in Relation to Genome-Wide DNA Methylation and Epigenetic Aging in the Black Women's Health Study. 黑人妇女健康研究》中感知到的种族主义经历与全基因组 DNA 甲基化和表观遗传衰老的关系。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-02-07 DOI: 10.1007/s40615-024-01915-3
Edward A Ruiz-Narváez, Yvette Cozier, Gary Zirpoli, Lynn Rosenberg, Julie R Palmer
{"title":"Perceived Experiences of racism in Relation to Genome-Wide DNA Methylation and Epigenetic Aging in the Black Women's Health Study.","authors":"Edward A Ruiz-Narváez, Yvette Cozier, Gary Zirpoli, Lynn Rosenberg, Julie R Palmer","doi":"10.1007/s40615-024-01915-3","DOIUrl":"10.1007/s40615-024-01915-3","url":null,"abstract":"<p><strong>Background: </strong>African American women have a disproportionate burden of disease compared to US non-Hispanic white women. Exposure to psychosocial stressors may contribute to these health disparities. Racial discrimination, a major stressor for African American women, could affect health through epigenetic mechanisms.</p><p><strong>Methods: </strong>We conducted an epigenome-wide association study (EWAS) to examine the association of interpersonal racism (in daily life and in institutional settings) with DNA methylation in blood in 384 participants of the Black Women's Health Study (BWHS). We also evaluated whether a greater number of perceived experiences of racism was associated with epigenetic aging as measured using different methylation clocks. Models were adjusted for chronological age, body mass index, years of education, neighborhood SES, geographic region of residence, alcohol drinking, smoking, and technical covariates.</p><p><strong>Results: </strong>Higher scores of racism in daily life were associated with higher methylation levels at the cg04494873 site in chromosome 5 (β = 0.64%; 95% CI = 0.41%, 0.87%; P = 6.35E-08). We also replicated one CpG site, cg03317714, which was inversely associated with racial discrimination in a previous EWAS among African American women. In the BWHS, higher scores of racism in daily life were associated with lower methylation levels at that CpG site (β = -0.94%; 95% CI = -1.37%, -0.51%; P = 2.2E-05). Higher racism scores were associated with accelerated epigenetic aging in more than one methylation clock.</p><p><strong>Conclusions: </strong>Exposure to discriminatory events may affect the epigenome and accelerate biological aging, which may explain in part the earlier onset of disease in African American women.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":"754-763"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Community-Based Reproductive Health Care Model Effectively Enhances Reproductive Health Among Lahu Women in Northern Thailand. 基于社区的生殖健康护理模式有效提高了泰国北部拉祜族妇女的生殖健康水平。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-02-29 DOI: 10.1007/s40615-024-01959-5
Soontaree Suratana, Waraporn Boonchiang, Tawatchai Apidechkul, Warangkana Naksen, Thanatchaporn Mulikaburt, Pimpisa Chomsri, Mullika Matrakul
{"title":"A Community-Based Reproductive Health Care Model Effectively Enhances Reproductive Health Among Lahu Women in Northern Thailand.","authors":"Soontaree Suratana, Waraporn Boonchiang, Tawatchai Apidechkul, Warangkana Naksen, Thanatchaporn Mulikaburt, Pimpisa Chomsri, Mullika Matrakul","doi":"10.1007/s40615-024-01959-5","DOIUrl":"10.1007/s40615-024-01959-5","url":null,"abstract":"<p><strong>Background: </strong>Inadequate and delayed access to sexual and reproductive health services among the Hill Tribe population can be attributed to the intersection of socioeconomic challenges and distinct cultural practices. To address this limitation and create a tailored model capable of addressing it, this study assesses the effectiveness of the Community-Based Reproductive Health Care Model (CRHC) in enhancing reproductive health knowledge, attitudes, and practices among Lahu women, a prominent hill tribe population in Northern Thailand.</p><p><strong>Methods: </strong>Implementing the CRHC model includes training programs for community influencers and subsequent education for Lahu women using culturally adapted courses. The effectiveness of the model is assessed through pre-test and post-test comparisons of knowledge, attitudes, and practices related to reproductive health care and analyzed using paired t-tests and repeated ANOVA.</p><p><strong>Results: </strong>The scores for knowledge, attitudes, and practices among Lahu women changed from 8.92 ± 2.02, 52.99 ± 5.54, and 27.76 ± 6.67 to 10.47 ± 2.32 (p < 0.001), 56.61 ± 5.54 (p < 0.001), and 29.47 ± 6.76 (p = 0.030), respectively. Significant improvements are observed in these areas, particularly in maternal health practices among pregnant Lahu women (n = 11). This study additionally evaluates the model's impact on the healthcare system by analyzing changes in government performance indexes, showing increased access to high-quality antenatal care and contraceptive usage. This study highlights the challenges faced by hill tribe populations in accessing healthcare, emphasizing the need for tailored reproductive health education and the importance of addressing health insurance barriers.</p><p><strong>Conclusion: </strong>The CRHC model's success illustrates the potential of community-based, culturally sensitive interventions in improving reproductive health outcomes, providing valuable insights for similar interventions in other indigenous or marginalized communities.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":"1268-1277"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Regional and Demographic Disparities in Atrial Fibrillation Mortality in the USA. 美国心房颤动死亡率的地区和人口差异。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-02-01 DOI: 10.1007/s40615-024-01917-1
Unoma Okoli, Ayobami S Ogunsola, Zahira Adeniyi, Aisha Abdulkadir, Susan M DeMetropolis, Eniola A Olatunji, Ibraheem M Karaye
{"title":"Regional and Demographic Disparities in Atrial Fibrillation Mortality in the USA.","authors":"Unoma Okoli, Ayobami S Ogunsola, Zahira Adeniyi, Aisha Abdulkadir, Susan M DeMetropolis, Eniola A Olatunji, Ibraheem M Karaye","doi":"10.1007/s40615-024-01917-1","DOIUrl":"10.1007/s40615-024-01917-1","url":null,"abstract":"<p><strong>Background: </strong>Despite the burden of atrial fibrillation/flutter (AF/AFL) in the USA, an assessment of contemporary mortality trends is scarce in the literature. This study aimed to assess the temporal trends in AF/AFL deaths among US adults by age, sex, race/ethnicity, and census region from 1999 to 2020.</p><p><strong>Methods: </strong>National mortality data was abstracted from the National Center for Health Statistics to identify decedents whose underlying cause of death was cardiovascular disease and multiple cause of death, AF/AFL. Joinpoint regression assessed mortality trends, and we calculated the average percentage changes (APC) and average annual percentage changes in mortality rates. Results were presented as effect estimates and 95% confidence intervals (95% CI).</p><p><strong>Results: </strong>Between 1999 and 2020, 657,126 adults died from AF/AFL in the USA. Contemporary trends have worsened overall except among individuals from the Northeast region for whom the rates have remained stationary since 2015 (APC = 0.1; 95% CI, - 1.0, 1.1). Regional and demographic disparities were observed, with higher rates noted among younger persons below 65 years of age, women (APC = 2.1; 95% CI, 1.7, 2.5), and non-Hispanic Blacks (APC = 4.5; 95% CI, 3.9, 5.2).</p><p><strong>Conclusions: </strong>The temporal trends in AF/AFL mortality in the USA have exhibited a worsening pattern in recent years, with regional and demographic disparities. Further investigations are warranted to explore the determinants of AF/AFL mortality in the US population and identify factors that may explain the observed differences. Understanding these factors will facilitate efforts to promote improved and equitable health outcomes for the population.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":"776-783"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650993","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
Social Statuses, Perceived Everyday Discrimination and Health and Well-being Before and After COVID-19 Pandemic. COVID-19 大流行前后的社会地位、感知到的日常歧视以及健康和福祉。
IF 3.2 3区 医学
Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-02-26 DOI: 10.1007/s40615-024-01930-4
Ye Luo, Jessica Liberman, Savannah R Burke
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