Ethnicity and Disease最新文献

{"title":"A Study to Compare a CHW-Led Versus Physician-Led Intervention for Prostate Cancer Screening Decision-Making among Black Men","authors":"N. Martínez-López, D. Makarov, Jerry Thomas, Shannon E Ciprut, Theodore Hickman, Helen Cole, Michael Fenstermaker, H. Gold, S. Loeb, J. Ravenell","doi":"10.18865/1722","DOIUrl":"https://doi.org/10.18865/1722","url":null,"abstract":"\u0000 \u0000 Prostate cancer is the second leading cause of cancer deaths among men in the United States and harms Black men disproportionately. Most US men are uninformed about many key facts important to make an informed decision about prostate cancer. Most experts agree that it is important for men to learn about these problems as early as possible in their lifetime.\u0000 \u0000 \u0000 \u0000 To compare the effect of a community health worker (CHW)-led educational session with a physician-led educational session that counsels Black men about the risks and benefits of prostate-specific antigen (PSA) screening.\u0000 \u0000 \u0000 \u0000 One hundred eighteen Black men recruited in 8 community-based settings attended a prostate cancer screening education session led by either a CHW or a physician. Participants completed surveys before and after the session to assess knowledge, decisional conflict, and perceptions about the intervention. Both arms used a decision aid that explains the benefits, risks, and controversies of PSA screening and decision coaching.\u0000 \u0000 \u0000 \u0000 There was no significant difference in decisional conflict change by group: 24.31 physician led versus 30.64 CHW led (P=.31). The CHW-led group showed significantly greater improvement on knowledge after intervention, change (SD): 2.6 (2.81) versus 5.1 (3.19), P<.001). However, those in the physician-led group were more likely to agree that the speaker knew a lot about PSA testing (P<.001) and were more likely to trust the speaker (P<.001).\u0000 \u0000 \u0000 \u0000 CHW-led interventions can effectively assist Black men with complex health decision-making in community-based settings. This approach may improve prostate cancer knowledge and equally minimize decisional conflict compared with a physician-led intervention.\u0000","PeriodicalId":315728,"journal":{"name":"Ethnicity and Disease","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124456467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Correlates of HIV-Associated Health Behaviors in a Population-Based Sample of Puerto Rican Adults, 2019","authors":"German Rivera-Castellar, Brandi E Moore, F. Kapadia","doi":"10.18865/1721","DOIUrl":"https://doi.org/10.18865/1721","url":null,"abstract":"\u0000 \u0000 High incidence and prevalence of HIV persist in Puerto Rico. To inform HIV prevention efforts, this study examines factors linked to HIV-associated behaviors in the territory.\u0000 \u0000 \u0000 \u0000 Using data from the 2019 Behavioral Risk Factor Surveillance System, multivariable logistic regression models were constructed to explore factors related to HIV-associated behaviors.\u0000 \u0000 \u0000 \u0000 Among Puerto Rican residents (n=4446), 5.6% reported engaging in ≥1 HIV-associated behavior (past 12 months), and 39.2% had never been tested for HIV. Reporting HIV-associated behaviors was associated with male sex (adjusted odds ratio [aOR], 1.74; 95% confidence interval [CI], 1.30-2.33), higher household income (aOR, 1.71; 95% CI, 1.14-2.58), heavy alcohol use (aOR, 2.67; 95% CI, 1.68-4.25), and ever receiving an HIV test (aOR, 2.00; 95% CI, 1.40-2.86) in a multivariable model. Conversely, being married (aOR, 0.51; 95% CI, 0.35-0.72), having a recent routine checkup (aOR, 0.48; 95% CI, 0.32-0.72), and reporting 0 days of poor mental health (aOR, 0.61; 95% CI, 0.45-0.81) were associated with decreased odds of engaging in HIV-associated behaviors.\u0000 \u0000 \u0000 \u0000 Future surveys should incorporate measures of social and structural determinants that would provide greater context for understanding behavioral factors associated with HIV vulnerability as well as for developing appropriate HIV interventions in Puerto Rico.\u0000","PeriodicalId":315728,"journal":{"name":"Ethnicity and Disease","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116893411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Black:White Health Inequalities, Genes Versus Environment—A New Chapter?","authors":"Richard Cooper","doi":"10.18865/1731","DOIUrl":"https://doi.org/10.18865/1731","url":null,"abstract":"","PeriodicalId":315728,"journal":{"name":"Ethnicity and Disease","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125418942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Social Determinants of Health Variables in Advanced Analytic and Artificial Intelligence Models for Cardiovascular Disease Risk and Outcomes: A Targeted Review","authors":"J. Snowdon, Elisabeth L Scheufele, Jill Pritts, Phuong-Tu Le, G. Mensah, Xinzhi Zhang, I. Dankwa-Mullan","doi":"10.18865/1704","DOIUrl":"https://doi.org/10.18865/1704","url":null,"abstract":"\u0000 \u0000 Predictive models incorporating relevant clinical and social features can provide meaningful insights into complex interrelated mechanisms of cardiovascular disease (CVD) risk and progression and the influence of environmental exposures on adverse outcomes. The purpose of this targeted review (2018–2019) was to examine the extent to which present-day advanced analytics, artificial intelligence, and machine learning models include relevant variables to address potential biases that inform care, treatment, resource allocation, and management of patients with CVD.\u0000 \u0000 \u0000 \u0000 PubMed literature was searched using the prespecified inclusion and exclusion criteria to identify and critically evaluate primary studies published in English that reported on predictive models for CVD, associated risks, progression, and outcomes in the general adult population in North America. Studies were then assessed for inclusion of relevant social variables in the model construction. Two independent reviewers screened articles for eligibility. Primary and secondary independent reviewers extracted information from each full-text article for analysis. Disagreements were resolved with a third reviewer and iterative screening rounds to establish consensus. Cohen's kappa was used to determine interrater reliability.\u0000 \u0000 \u0000 \u0000 The review yielded 533 unique records where 35 met the inclusion criteria. Studies used advanced statistical and machine learning methods to predict CVD risk (10, 29%), mortality (19, 54%), survival (7, 20%), complication (10, 29%), disease progression (6, 17%), functional outcomes (4, 11%), and disposition (2, 6%). Most studies incorporated age (34, 97%), sex (34, 97%), comorbid conditions (32, 91%), and behavioral risk factor (28, 80%) variables. Race or ethnicity (23, 66%) and social variables, such as education (3, 9%) were less frequently observed.\u0000 \u0000 \u0000 \u0000 Predictive models should adjust for race and social predictor variables, where relevant, to improve model accuracy and to inform more equitable interventions and decision making.\u0000","PeriodicalId":315728,"journal":{"name":"Ethnicity and Disease","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115940968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Metabolic Health Disparities Affecting the Rio Grande Valley Mexican American Population: Seeking Answers Using Animal Models","authors":"J. López-Alvarenga, Cordelia G. Rasa, J. Banu, Shizue Mito, A. Chavez, S. Reyna","doi":"10.18865/1669","DOIUrl":"https://doi.org/10.18865/1669","url":null,"abstract":"Mexican Americans living in the Rio Grande Valley (RGV) have a high prevalence of type 2 diabetes (T2D). The US–Mexico border frontier has a unique blended culture of American lifestyle and Mexican traditions. Some examples of the cultural traditions are the food and the use of herbal medicine, but these traditions are in danger of disappearing after a very short number of generations living in the United States. This article describes the use of animal models under experimental conditions to solve practical questions (etiology or treatment). We performed studies with murine (ie, mouse and rat) models to elucidate the characteristics of medicinal plants that modulate glucose metabolism and inflammation and protect from bone loss, complications related to T2D. The University of Texas Rio Grande Valley researchers also have collaborated with the University of Texas Health Science Center at San Antonio researchers in performing studies in nonhuman primates (NHP) (ie, baboon) to understand the effect of T2D and diets on organs and tissues. With the new knowledge gained from the use of animal models (murine and NHP), new therapies are discovered for the prevention and treatment of T2D and its related complications, such as bone loss and nonalcoholic fatty liver disease, all of which the Mexican American and other human populations are at high risk of developing.","PeriodicalId":315728,"journal":{"name":"Ethnicity and Disease","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124451803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race and Remdesivir: Examination of Clinical Outcomes in a Racially and Ethnically Diverse Cohort in New York City","authors":"Ofole Mgbako, M. Mehta, Donald E Dietz, Matthew Neidell, Simian Huang, J. Zucker, Sherif M Shoucri, C. Kubin, D. Castor","doi":"10.18865/1653","DOIUrl":"https://doi.org/10.18865/1653","url":null,"abstract":"\u0000 \u0000 To compare clinical characteristics and examine in-hospital length of stay (LOS) differences for COVID-19 patients who received remdesivir, by race or ethnicity.\u0000 \u0000 \u0000 \u0000 Retrospective descriptive analysis comparing cumulative LOS as a proxy of recovery time.\u0000 \u0000 \u0000 \u0000 A large academic medical center serving a minoritized community in Northern Manhattan, New York City.\u0000 \u0000 \u0000 \u0000 Inpatients (N=1024) who received remdesivir from March 30, 2020–April 20, 2021.\u0000 \u0000 \u0000 \u0000 We conducted descriptive analyses among patients who received remdesivir. Patients were described by proxies of social determinants of health (SDOH): race and ethnicity, residence, insurance coverage, and clinical characteristics. We calculated median hospital LOS as the cumulative incidence of hospitalized patients who were discharged alive, and tested differences between groups by using the Gray test. Patients who died or were discharged to hospice were censored at 29 days.\u0000 \u0000 \u0000 \u0000 The primary outcome was hospital LOS. The secondary outcome was in-hospital mortality.\u0000 \u0000 \u0000 \u0000 Median LOS was 11.9 days (95% CI, 10.8-13.2) overall, with Black patients having the shortest (10.0 days, 95% CI, 8.0-13.2) and Asian patients having the longest (16.2 days, 95% CI, 8.3-27.2) LOS. A total of 214 patients (21%) died or were discharged to hospice, ranging from 16.5% to 23.7% of patients who identified as Black and Other (multiracial, biracial, declined), respectively.\u0000 \u0000 \u0000 \u0000 COVID-19 has disproportionately burdened communities of color. We observed no difference in median LOS between racial or ethnic groups, which supports the notion that the heterogeneous effect of remdesivir in the literature may be explained in part by underrecruitment or participation of Black, Hispanic, and Asian patients in clinical trials.\u0000","PeriodicalId":315728,"journal":{"name":"Ethnicity and Disease","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131126261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Public Health Surveillance and Health Equity: Cause for Concern","authors":"C. Ford","doi":"10.18865/2022-2024","DOIUrl":"https://doi.org/10.18865/2022-2024","url":null,"abstract":"","PeriodicalId":315728,"journal":{"name":"Ethnicity and Disease","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120990450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Diabetic Retinopathy with Chronic Kidney Disease Progression in Latinos with Type 2 Diabetes","authors":"Ariel E. Figueroa, N. Roy, A. Millan-Ferro, Paolo S. Silva, S. Rosas","doi":"10.18865/1683","DOIUrl":"https://doi.org/10.18865/1683","url":null,"abstract":"\u0000 \u0000 Diabetes remains a leading cause of blindness and kidney failure in the United States. Latinos are at increased risk for type 2 diabetes, and microvascular complications such as diabetic retinopathy (DR) and chronic kidney disease (CKD). We evaluated the association of DR with decline in kidney function in Latinos with type 2 diabetes with or without CKD in a multispecialty clinic.\u0000 \u0000 \u0000 \u0000 This is a retrospective cohort study of 351 self-identified Latino individuals with type 2 diabetes enrolled in the Latino Diabetes Initiative at Joslin Diabetes Center. Baseline demographic factors including age, sex, comorbidities, and laboratory values such as A1c and albuminuria were evaluated as predictors of kidney outcomes. The annualized change in estimated glomerular filtration rate (eGFR) was evaluated with a linear regression model. We used logistic regression to evaluate whether DR was associated with development of rapid progressors (>3 mL/min/y eGFR loss) and 30% change in eGFR per year.\u0000 \u0000 \u0000 \u0000 DR was present in 39.2% of the cohort with mild nonproliferative DR (NPDR) in 57.1%, moderate to severe NPDR in 27.8%, and proliferative DR in 15.0%. Those with DR had a longer duration of type 2 diabetes (P<.001), higher albuminuria (P=.003), and lower baseline eGFR (P=.001). We found that individuals with moderate to severe NPDR and proliferative DR had a significant decline in GFR (coefficient −6.32; 95% CI, −11.40 to −1.23) and −7.82 (−14.99 to −0.65), compared with individuals without DR.\u0000 \u0000 \u0000 \u0000 The presence of DR is a marker for increased eGFR loss, emphasizing the need for routine retinal examinations as part of comprehensive diabetes care. Individuals with DR should be considered at high risk for GFR loss.\u0000","PeriodicalId":315728,"journal":{"name":"Ethnicity and Disease","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123614235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing National Institutes of Health Prevention Research on Leading Causes of Death Focused on Racial or Ethnic Minority Populations, Fiscal Years 2016-2020","authors":"Luis F. Ganoza, J. Alvidrez, Charlene A. Liggins","doi":"10.18865/1718","DOIUrl":"https://doi.org/10.18865/1718","url":null,"abstract":"\u0000 \u0000 To characterize the National Institutes of Health (NIH) prevention research portfolio on leading causes of death focused on racial or ethnic minority populations.\u0000 \u0000 \u0000 \u0000 Longitudinal analysis of NIH-funded prevention research projects from FY2016-FY2020.\u0000 \u0000 \u0000 \u0000 Project characteristics including type of prevention, study design, budget, minority health focus, and causes of death addressed.\u0000 \u0000 \u0000 \u0000 Minority health projects comprised 27.0% of prevention projects and 33.1% of funding across all leading causes of death. Homicide (42.9%), diabetes (36.3%), and stroke (35.5%) had the highest proportion of minority health projects and suicide (20.2%), Alzheimer disease (18.8%), and pneumonia or influenza (8.3%) the lowest. Most minority health projects focused on identifying risk factors or on primary prevention efforts (80.3%). Most projects had an observational design (80.0%), and this predominance was observed for each cause of death. There was a significant correlation between the proportion of minority health projects for cause of death and the ratio of minorities versus non-minorities mortality rate.\u0000 \u0000 \u0000 \u0000 Only about one-fourth of NIH-funded prevention research on leading causes of death focused on racial or ethnic minorities, who currently comprise about 40% of the US population. Only a small fraction of minority health prevention projects included an intervention design, suggesting a limited contribution to the evidence base on effective interventions to address racial or ethnic mortality disparities. Also, we identified that the number of projects increase where mortality rate disparities are higher. This portfolio analysis provides a useful baseline to assess future progress in building the minority health prevention research portfolio, a critical component to promoting health equity in population health.\u0000","PeriodicalId":315728,"journal":{"name":"Ethnicity and Disease","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123932204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Equity-Based Scoring System for Evaluating Surveillance-Related Harm in Public Health Crises","authors":"Bita Amani, Breann McAndrew, Mienah Z Sharif, Jamie Garcia, Ezinne M. Nwankwo, A. Cabral, Consuela Abotsi-Kowu, Hamid Khan, Cindy Le, Monica L. Ponder, C. Ford","doi":"10.18865/2022-2022","DOIUrl":"https://doi.org/10.18865/2022-2022","url":null,"abstract":"\u0000 \u0000 Although surveillance systems used to mitigate disasters serve essential public health functions, communities of color have experienced disproportionate harms (eg, criminalization) as a result of historic and enhanced surveillance.\u0000 \u0000 \u0000 \u0000 To address this, we developed and piloted a novel, equity-based scoring system to evaluate surveillance systems regarding their potential and actual risk of adverse effects on communities made vulnerable through increased exposure to policing, detention/incarceration, deportation, and disruption of access to social services or public resources. To develop the scoring system, we reviewed the literature and surveyed an expert panel on surveillance to identify specific harms (eg, increased policing) that occur through surveillance approaches.\u0000 \u0000 \u0000 \u0000 Scores were based on type of information collected (individual and/or neighborhood level) and evidence of sharing information with law enforcement. Scores were 0 (no risk of harm identified), 1 (potential for risk), 2 (evidence of risk), and U (data not publicly accessible). To pilot the scoring system, 44 surveillance systems were identified between June 2020 and October 2020 through an environmental scan of systems directly related to COVID-19 (n=21), behavioral and health-related services (n=11), and racism and racism-related factors (n=12). A score of 0-2 was assigned to 91% (n=40) of the systems; 9% were scored U; 30% (n=13) scored a 0. Half scored a 1 (n=22), indicating a “potential for the types of harm of concern in this analysis.” “Evidence of harm,” a score of 2, was found for 12% (n=5).\u0000 \u0000 \u0000 \u0000 The potential for surveillance systems to compromise the health and well-being of racialized and/or vulnerable populations has been understudied. This project developed and piloted a scoring system to accomplish this equity-based imperative. The nobler pursuits of public health to improve the health for all must be reconciled with these potential harms.\u0000","PeriodicalId":315728,"journal":{"name":"Ethnicity and Disease","volume":"29 46","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132272077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}