{"title":"Racial and Ethnic Disparities in COVID-19: Rate Ratios Provide an Incomplete Picture of US Trends, April 2020 - March 2021.","authors":"Xinzhi Zhang, C. Stoney, G. Mensah","doi":"10.18865/ed.32.2.109","DOIUrl":"https://doi.org/10.18865/ed.32.2.109","url":null,"abstract":"Recent increasing rates of COVID-19 cases, hospitalizations, and deaths among non-Hispanic Whites have led to declining rate ratios at a time of continuing high burden of COVID-19 in American Indian/Alaska Native, Asian/Pacific Islander, African American, and Hispanic/Latino populations. The use of all epidemiological tools, including rate ratios and actual rates per 100,000 population, provides a more comprehensive assessment of the magnitude and trends of racial and ethnic disparities in COVID-19.","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"32 2 1","pages":"109-112"},"PeriodicalIF":3.2,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47514542","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}
Ethnicity & DiseasePub Date : 2022-01-20eCollection Date: 2022-01-01DOI: 10.18865/ed.32.1.61
Owen Garrick, Ruben Mesa, Andrea Ferris, Edward S Kim, Edith Mitchell, Otis W Brawley, John Carpten, Keith D Carter, Joseph Coney, Robert Winn, Stephanie Monroe, Fabian Sandoval, Edith Perez, Mitzi Williams, Evan Grove, Quita Highsmith, Nicole Richie, Susan M Begelman, Asha S Collins, Jamie Freedman, Melissa S Gonzales, Gerren Wilson
{"title":"Advancing Inclusive Research: Establishing Collaborative Strategies to Improve Diversity in Clinical Trials.","authors":"Owen Garrick, Ruben Mesa, Andrea Ferris, Edward S Kim, Edith Mitchell, Otis W Brawley, John Carpten, Keith D Carter, Joseph Coney, Robert Winn, Stephanie Monroe, Fabian Sandoval, Edith Perez, Mitzi Williams, Evan Grove, Quita Highsmith, Nicole Richie, Susan M Begelman, Asha S Collins, Jamie Freedman, Melissa S Gonzales, Gerren Wilson","doi":"10.18865/ed.32.1.61","DOIUrl":"https://doi.org/10.18865/ed.32.1.61","url":null,"abstract":"<p><p>Well-characterized disparities in clinical research have disproportionately affected patients of color, particularly in underserved communities. To tackle these barriers, Genentech formed the External Council for Advancing Inclusive Research, a 14-person committee dedicated to developing strategies to increase clinical research participation. To help improve the recruitment and retention of patients of color, this article chronicles our efforts to tangibly address the clinical research barriers at the system, study, and patient levels over the last four years. These efforts are one of the initial steps to fully realize the promise of personalized health care and provide increased patient benefit at less cost to society. Instead of simply acknowledging the problem, here we illuminate the collaborative and multilevel strategies that have been effective in delivering meaningful progress for patients.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"32 1","pages":"61-68"},"PeriodicalIF":3.2,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8785867/pdf/ethndis-32-61.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39741484","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}
Patanjali de la Rocha, May Sudhinaraset, Nicole V Jones, Catherine Kim, Alejandra Cabral, Bita Amani
{"title":"A Qualitative Analysis on Sexual and Reproductive Health Needs and Issues During COVID-19 Using a Reproductive Justice Framework.","authors":"Patanjali de la Rocha, May Sudhinaraset, Nicole V Jones, Catherine Kim, Alejandra Cabral, Bita Amani","doi":"10.18865/ed.32.4.357","DOIUrl":"https://doi.org/10.18865/ed.32.4.357","url":null,"abstract":"<p><p>The COVID-19 pandemic exacerbated existing health inequities, further exposing the challenges in meeting the sexual and reproductive health (SRH) needs, particularly for Black, Indigenous and People of Color (BIPOC). We interviewed 11 key informants through three focus groups to explore barriers and pathways to SRH care for BIPOC during COVID-19 in the United States. Reimagining reproductive health practices requires holistic practices and multisector pathways, a comprehensive reproductive justice approach. This includes interventions across the sexual and reproductive health continuum. Using a deductive-dominant approach grounded in reproductive justice values, we explore themes around SRH during COVID-19. Five themes for advancing reproductive justice were identified: \"supremacy of birth\"; police violence as a determinant of SR mental health; addressing quality of care outside of hospital settings; digital redlining; and centering joy, liberation, and humanity.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"32 4","pages":"357-372"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9590595/pdf/ethndis-32-357.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9327808","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}
Johanna Seiden, Samantha Lessen, Natalie T Cheng, Benjamin W Friedman, Daniel L Labovitz, Charles C Esenwa, Ava L Liberman
{"title":"Factors Associated with Anticoagulation Initiation for New Atrial Fibrillation in an Urban Emergency Department.","authors":"Johanna Seiden, Samantha Lessen, Natalie T Cheng, Benjamin W Friedman, Daniel L Labovitz, Charles C Esenwa, Ava L Liberman","doi":"10.18865/ed.32.4.325","DOIUrl":"https://doi.org/10.18865/ed.32.4.325","url":null,"abstract":"<p><strong>Objective: </strong>To explore factors associated with anticoagulation (AC) initiation after atrial fibrillation (AF) diagnosis.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Urban medical center.</p><p><strong>Patients: </strong>Adults with emergency department (ED) diagnosis of new onset AF from 1/1/2017-1/1/2020 discharged home.</p><p><strong>Methods: </strong>We compared patients initiated on AC, our primary outcome, to those not initiated on AC. Stroke, major bleeding, and AC initiation within 1 year of visit were secondary outcomes. We hypothesized that minority race and non-English language preference are associated with failure to initiate AC.</p><p><strong>Results: </strong>Of 111 patients with AF, 88 met inclusion criteria. Mean age was 65 (SD 15); 47 (53%) were women. 49 (56%) patients were initiated on AC. Age (61 vs 68 years; P=.02), non-English language (28% vs 10%; P=.03), leaving ED against medical advice (AMA) (36% vs 14%; P=.04), and CHA<sup>2</sup>DS<sup>2</sup>-VASc score of 1 (41% vs 6%; P<=.001) were associated with no AC initiation. There were no associations between patient-reported race/ethnicity and AC. Cardiology consultation (83.67% vs 30.78%; P<.0001) and higher median CHA<sup>2</sup>DS<sup>2</sup>-VASc score (3[2-4]) vs. 2[1-4]; P=.047) were associated with AC. Of 73 patients with follow-up data at 1 year, 2 (8%) not initiated on AC had strokes, 2 (4%) initiated on AC had major bleeds, and 15 (62.5%) not initiated on AC in the ED subsequently were initiated on AC.</p><p><strong>Conclusion: </strong>More than half of ED patients with new AF eligible for AC were initiated on it. Work to improve AC utilization among patients with new AF who left AMA from ED and those who prefer to communicate in a non-English language may be warranted.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"32 4","pages":"325-332"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9590604/pdf/ethndis-32-325.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9327811","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}
Danting Yang, Abram L Wagner, Sherri Sheinfeld Gorin
{"title":"Perceived Severity of COVID-19 in a Longitudinal Study in Detroit, Michigan.","authors":"Danting Yang, Abram L Wagner, Sherri Sheinfeld Gorin","doi":"10.18865/ed.32.3.231","DOIUrl":"https://doi.org/10.18865/ed.32.3.231","url":null,"abstract":"<p><strong>Objective: </strong>To slow down the spread of SARS-CoV-2, many countries have instituted preventive approaches (masks, social distancing) as well as the distribution of vaccines. Adherence to these preventive measures is crucial to the success of controlling the pandemic but decreased perceptions of disease severity could limit adherence. The aim of our study was to observe changes in perceived personal severity and perceived community severity; the study also explored their predictors.</p><p><strong>Methods: </strong>In a longitudinal study from an address-based probability survey in Detroit, we asked participants to rate their perceived severity of COVID-19 for themselves and for their community. In our analysis, 746 participants were queried across 5 waves of the Detroit Metro Area Communities Study surveys from March 31 to October 27 in 2020. We tested for trends in changes of self-reported perceived severity for themselves and for their community; we assessed the effects of different predictors of the two severities through mixed effects logistic regression models.</p><p><strong>Results: </strong>Our results highlight that the overall levels of perceived community and personal severity were decreasing over time even though both severities were fluctuating with rising confirmed case counts. Compared with non-Hispanic (NH) White Detroiters, NH Black Detroiters reported a higher perceived personal severity (OR: 5.30, 95% CI: 2.97, 9.47) but both groups reported similar levels of perceived community severity. We found steeper declines in perceived severity in NH White than NH Black Detroiters over time; the impact of education and income on perceived severity was attenuated in NH Black Detroiters compared with NH White Detroiters.</p><p><strong>Conclusions: </strong>Our findings suggested that perceived severity for COVID-19 decreased through time and was affected by different factors among varied racial/ethnic groups. Future interventions to slow the pace of the pandemic should take into account perceived personal and community severities among varied ethnic/racial subgroups.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"32 3","pages":"231-238"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9311308/pdf/ethndis-32-231.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9103829","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}
Rebecca E Jones, Lubaba Tasnim, Solveig A Cunningham
{"title":"The Prevalence of Multimorbidity among Foreign-born Adults in the United States.","authors":"Rebecca E Jones, Lubaba Tasnim, Solveig A Cunningham","doi":"10.18865/ed.32.3.213","DOIUrl":"https://doi.org/10.18865/ed.32.3.213","url":null,"abstract":"<p><strong>Objective: </strong>We examined multimorbidity among foreign-born adults in the United States. This population may be particularly affected by chronic conditions and limited health care access.</p><p><strong>Design: </strong>Longitudinal cohort.</p><p><strong>Setting: </strong>United States.</p><p><strong>Participants: </strong>Foreign-born adults at the point of legal permanent residency.</p><p><strong>Main outcome measures: </strong>Multimorbidity defined as two or more of eight chronic conditions (hypertension, diabetes, obesity, arthritis, stroke, cancer, chronic lung disease, and heart problems).</p><p><strong>Methods: </strong>We estimated the prevalence of multimorbidity and patterns over time. Data are from the New Immigrant Survey (NIS), a nationally representative study of adult immigrants at green card status in 2003 (N=8,174) and reinterview in 2008.</p><p><strong>Results: </strong>The prevalence of multimorbidity was 6% in 2003, and 12% in 2008. The most common condition dyad at both time points was hypertension-obesity; the largest increase over time was in combinations that included hypertension, diabetes, and obesity. The odds of having multimorbidity compared to no chronic conditions were higher among older immigrants and those who had seen a doctor in the past year. The odds of gaining one chronic condition over a 5-year period increased with age; 45-65 years: OR 2.8[CI 2.3,3.5]; aged ≥65 years: OR 3.2 CI[2.2,4.7].</p><p><strong>Conclusions: </strong>The prevalence of multimorbidity among immigrants was lower than the prevalence in the overall US population of the same age, consistent with studies showing an immigrant health advantage.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"32 3","pages":"213-222"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9311306/pdf/ethndis-32-213.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9103835","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}
Hillary Nicole A Peregrina, Grace J Yoo, Carissa Villanueva, Maria L G Bayog, Therese Doan, Melinda S Bender
{"title":"Tiwala, Gaining Trust to Recruit Filipino American Families: CARE-T2D Study.","authors":"Hillary Nicole A Peregrina, Grace J Yoo, Carissa Villanueva, Maria L G Bayog, Therese Doan, Melinda S Bender","doi":"10.18865/ed.32.1.49","DOIUrl":"https://doi.org/10.18865/ed.32.1.49","url":null,"abstract":"<p><strong>Objective: </strong>Filipino Americans have greater risk for type 2 diabetes (T2D) and related complications compared to other Asian populations and non-Hispanic Whites. There are few diabetes intervention studies focused on Filipinos and limited evidence regarding the best recruitment strategies for this hard-to-reach population.</p><p><strong>Methods: </strong>This article examined barriers and facilitators to recruitment of Filipino families for the \"Caring for Asian Americans through Research and Education on T2D\" (CARE-T2D) study, which took place in California from June 2018 through June 2019.</p><p><strong>Results: </strong>Recruitment of 50 Filipino dyads (parent with T2D and adult child) were successfully met. Gaining trust through culturally tailored strategies was key in recruiting Filipino participants. Tiwala (gaining trust) strategies involved: 1) using Filipino staff as role models for research engagement and 2) incorporating narrative communications or \"kuwentuhan\" (Filipino cultural storytelling) with recruitment. Other facilitating strategies included in-person presentations at local colleges and organizations, Filipino community leaders' support, snowball sampling, previous study participant listservs, and posting fliers on family/friends' personal social media sites. Barriers to recruitment included research mistrust, confidentiality concerns, and risks of violating cultural values.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first study to recruit Filipino family dyads. Findings will inform researchers and clinicians on how best to recruit Filipino families in community health-related research and public health programs.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"32 1","pages":"49-60"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8785862/pdf/ethndis-32-49.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10366366","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}
Dale Dagar Maglalang, Jaqueline C Avila, Jasjit S Ahluwalia, Cara M Murphy, Adam C Alexander, Nicole L Nollen
{"title":"The Role of Financial Strain and Educational Attainment on Smoking Abstinence of African Americans and Whites Who Smoke.","authors":"Dale Dagar Maglalang, Jaqueline C Avila, Jasjit S Ahluwalia, Cara M Murphy, Adam C Alexander, Nicole L Nollen","doi":"10.18865/ed.32.3.223","DOIUrl":"https://doi.org/10.18865/ed.32.3.223","url":null,"abstract":"<p><strong>Objective: </strong>To examine if reduced financial strain and higher educational attainment would confer less advantage for successful cessation among African Americans than for White individuals.</p><p><strong>Design: </strong>A secondary data analysis of the Quit2Live study, a smoking cessation intervention for individuals who smoke.</p><p><strong>Setting: </strong>Recruited participants from a metropolitan city in the Midwest.</p><p><strong>Participants: </strong>The sample included 224 African American and 225 White individuals who smoke.</p><p><strong>Main outcome measures: </strong>Our outcome variable was cotinine-verified smoking abstinence at the end-of-treatment (week 12). Our explanatory variables were a combination of financial strain (high, low) and educational attainment (high, low).</p><p><strong>Methods: </strong>We implemented a logistic regression analysis and a two-way interaction of the combined financial strain and educational attainment variable and race on smoking abstinence.</p><p><strong>Results: </strong>About 25% of the study participants were low financial strain and high education, 41% high financial strain and high education, 23% high financial strain and low education, and 11% low financial strain and low education. A greater proportion of African Americans vs Whites were in the high financial strain/low educational attainment category (28% vs 18%, P = .01). Participants with high financial strain and low educational attainment had substantially lower odds of abstinence (OR = .29 [95% CI: .12, .68]) compared to participants with low financial strain and high educational attainment. Contrary to our hypothesis, race did not moderate this association.</p><p><strong>Conclusion: </strong>Findings highlight the constraining role of high financial strain and low educational attainment, irrespective of race, on smoking abstinence among smokers actively engaged in a quit attempt.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"32 3","pages":"223-230"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9311309/pdf/ethndis-32-223.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9103833","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}
Lisa N Mansfield, Savanna L Carson, Yelba Castellon-Lopez, Alejandra Casillas, D'Ann Morris, Ejiro Ntekume, Juan Barron, Keith C Norris, Arleen F Brown
{"title":"Exploring Perspectives on Establishing COVID-19 Vaccine Confidence in Black Communities.","authors":"Lisa N Mansfield, Savanna L Carson, Yelba Castellon-Lopez, Alejandra Casillas, D'Ann Morris, Ejiro Ntekume, Juan Barron, Keith C Norris, Arleen F Brown","doi":"10.18865/ed.32.4.341","DOIUrl":"https://doi.org/10.18865/ed.32.4.341","url":null,"abstract":"<p><strong>Objective: </strong>To explore factors influencing COVID-19 vaccine decision-making among Black adults at high-risk for COVID-19 infection. Despite effective treatment and vaccination availability, Black Americans continue to be disproportionately impacted by COVID-19.</p><p><strong>Design setting and participants: </strong>Using community-engaged qualitative methods, we conducted virtual, semi-structured focus groups with Black residents in Los Angeles County before widespread vaccine rollout. Recruitment occurred through local community partners.</p><p><strong>Main outcome measures: </strong>Themes and subthemes on factors for vaccine confidence and accessibility.</p><p><strong>Methods: </strong>As part of a larger study exploring COVID-19 vaccine decision-making factors among multiethnic groups, two-hour virtual focus groups were conducted between December 15, 2020 and January 27, 2021. Transcripts were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Three focus groups were conducted with 17 Black participants, who were primarily female (n=15), residents of high-poverty zip codes (n=11) and employed full-time (n=6). Black-specific considerations for vaccine confidence and accessibility include: 1) reduced confidence in COVID-19 vaccines due to historical government inaction and racism (existing health inequities and disparities are rooted in racism; historical unethical research practices); 2) misunderstanding of Black communities' vaccine concerns (\"vaccine hesitancy\" as an inaccurate label to describe vaccine skepticism; ignorance to root causes of vaccine skepticism); and 3) recognizing and building on resources (community agency to address COVID-19 vaccine needs adequately).</p><p><strong>Conclusions: </strong>Vaccination campaigns should improve understanding of underlying vaccination concerns to improve vaccine outreach effectiveness and should partner with, provide resources to, and invest in local, trusted Black community entities to improve COVID-19 vaccination disparities.</p>","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":"32 4","pages":"341-350"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9590598/pdf/ethndis-32-341.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9321222","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}