Journal of Racial and Ethnic Health Disparities最新文献

Objectives: Using a sociocultural coping framework, we examined stressors and coping strategies among N = 65 Black adults with varying levels of cultural mistrust, which is defined as an attitudinal response to racism.

Method: We conducted an abductive structural tabular thematic analysis on short-form qualitative responses to a Black mental health survey.

Results: Participants reported several stressors (e.g., family, finances, occupation) and primarily active coping strategies including institutional mechanisms, such as religion.

Conclusion: Findings suggest that Black adults, regardless of cultural mistrust levels, actively cope despite stressors informed by their sociocultural context (e.g., race, gender, socioeconomic status) and barriers to treatment. Considering these factors, providers can work to enhance the established coping mechanisms, while integrating them into culturally responsive care, rather than remove them.

Objectives: Racial and ethnic minorities face disparities in access to paid family and medical leave (PFML) and workplace flexibility compared to non-Hispanic white workers. This study examines a new layer of inequity: citizenship status. Understanding citizenship-based disparities can inform policy changes to increase access to these benefits for all workers.

Study design: This cross-sectional analysis of the American Time Use Survey (2017-2018) focused on Hispanics, non-Hispanic Asians, and non-Hispanic White workers (N = 8602).

Methods: We used weighted multivariate logistic regressions to investigate inequities in access to PFML and workplace flexibility across racial, ethnic, and citizenship categories. All models controlled for demographic, socioeconomic, and employment characteristics and included state fixed effects.

Results: Despite overall low access (51.9% for PFML, 56.7% for flexible work hours, and 30.2% for work-from-home options), the study revealed significant disparities across race/ethnicity and citizenship status. In the fully adjusted models, non-citizen White (OR = 0.51, 95% CI = 0.28-0.93), US citizen Hispanic (OR = 0.65, 95% CI = 0.53-0.81), non-citizen Hispanic (OR = 0.37, 95% CI = 0.25-0.56), citizen Asian (OR = 0.59, 95% CI = 0.42-0.82), and non-citizen Asian workers (OR = 0.51, 95% CI = 0.31-0.85) had statistically significant lower odds of reporting access to paid family and medical leave compared to citizen White workers. In addition, non-citizen Hispanic workers had the lowest predicted probabilities of reporting being able to work from home.

Conclusions: This study underscores the need for equitable workplace policies. Addressing the unique challenges faced by different racial/ethnic and citizenship groups is crucial to achieving health equity.

Background and aims: To identify demographic predictors, with a focus on race and socioeconomic status, for advanced treatment modality, mortality, and increased length of stay (LOS) in upper gastrointestinal (GI) hemorrhage treatment.

Methods: Hospitalizations with acute upper GI hemorrhage from 2016 to 2021 were identified in the Healthcare Cost and Utilization Project's National Inpatient Sample. Cases were divided into interventional radiology (IR) and non-IR (endoscopic) treatments. Statistical analyses calculated significant odds ratios via 95% confidence intervals. The primary outcome of interest was mortality rate. The secondary outcome of interest was the mean LOS. Confounding factors affecting mortality were also examined.

Results: There was no significant difference in likelihood of an IR procedure or mortality between White patients and both Non-Hispanic (NH) Black and Hispanic patients. NH Black patients had significantly longer LOS in days compared to White patients (12.61 vs 9.57) that persisted when matching for age and sex (13.78 vs 9.92), socioeconomic status (12.94 vs 10.07), chronic comorbidities (11.33 vs 8.88), blood transfusions (14.46 vs 10.21), and vasopressor use (14.43 vs 10.29) (p < 0.001). These LOS differences were not seen under matching conditions post-COVID-19.

Conclusion: This study presents racial disparities in LOS following acute upper GI hemorrhage, but no differences in advanced treatment utilization or mortality. Confounders were responsible for LOS differences in non-IR treatment, but NH Black patients had persistently longer LOS than White patients after IR treatment.

Due to limited information and published research, health disparities among bi and multiracial (B/MR) groups are not as understood as other racial groups. Without this knowledge and ability to allocate resources as needed, this is another racial group that could suffer from poorer health outcomes. As a result, participants (n = 15) were placed in focus groups or individual interviews with ten qualitative questions. Each participant then completed an anonymous quantitative survey assessing their health-related behaviors. Quantitative results included 40% (n = 6) of participants who tried cigarettes, 53% (n = 8) who tried electronic vapor products, and only 20% (n = 3) of participants who got the recommended hours of sleep nightly. Qualitative results include themes of situational identity, White assimilation, and pressure to explain their identity. Many participants dealt with the insensitivity that one side of their family exhibited towards the other side of their identity through inappropriate jokes and comments. Lastly, there were expectations from both family and friends to act a certain way. Researchers identified three major categories that the participant's influences fell into. Genetics, Culture/Heritage, and the Environment are the aforementioned categories that can work together or stand alone to influence behaviors that can ultimately affect health outcomes. While these results are based on a small sample size (n = 15) of undergraduate B/MR students, it does suggest that researchers should complete a more extensive survey on this racial group to verify these findings.

Introduction: Although racial-ethnic residential segregation (RRS) is hypothesized to contribute to sleep disparities by concentrating poverty and impairing sleep among minoritized racial-ethnic groups, feelings of belonging within relatively homogenous neighborhoods may be protective against poor sleep. Yet, empirical studies are sparse.

Methods: To investigate RRS-sleep health associations and determine potential modifiers among US adults, we linked National Health Interview Survey data (2011-2017) to 2012 and 2017 American Community Survey census tract-level data. We used the local Getis-Ord G_i* statistic to categorize RRS (high, medium, low [reference]). Using survey-weighted, Poisson regression with robust variance, we estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for self-reported sleep health measures. We also performed Wald tests for interactions by race-ethnicity, sex/gender, race-ethnicity-by-sex/gender intersectional category, and neighborhood-level poverty.

Results: Among 126,539 participants (mean age ± SE = 46 ± 0.1 years), high RRS was most common among non-Hispanic (NH)-Black (38%), followed by NH-Asian and non-Mexican Latine (34%), Mexican Latine (30%), and NH-White adults (17%). Across races-ethnicities and sexes/genders (both p-interaction > 0.05), high vs. low RRS was associated with a 6% lower prevalence of short sleep duration (< 7-h: PR = 0.94 [95% CI:0.91-0.97]), an 11% lower prevalence of long sleep duration (> 9-h: PR = 0.89 [0.80-0.99]), and a 2% higher prevalence of restorative sleep (PR = 1.02 [1.01-1.04]). Associations with a lower prevalence of trouble falling asleep were stronger among men vs. women. Race-ethnicity-by-sex/gender group membership and neighborhood-level poverty modified associations with sleep duration and quality without consistent patterns.

Conclusion: RRS was associated with more favorable sleep health among US adults with variation by key modifiers (e.g., sex). Strategies that leverage potentially protective social factors while promoting equitable resources across diverse neighborhoods may help address sleep health disparities.

Objective: This study evaluates Black and AIAN individuals' self-reported history of being screened for firearm access by healthcare providers, and identifies factors that influence screening.

Methods: A cross-sectional, nationally representative survey of included 3015 Black and 527 AIAN adults in the US. Participants were recruited via probability-based sampling.

Results: Among Black participants, 13.1% and among AIAN participants, 18.4% reported being screened for firearm access. Of the participants who reported being screened, most have been by mental healthcare providers or primary care physicians. Factors associated with higher screening odds in Black adults included history of suicidal ideation or mental health treatment, current firearm access, younger age, and having children at home. For AIAN participants, a lifetime history of mental health treatment or identifying as female increased screening odds.

Conclusion: Black adults report infrequently being screened for firearm access by healthcare providers. Identifying screening barriers and fostering discussions on firearm safety in healthcare settings are important next steps for firearm injury prevention efforts.

Background: Insufficient research has been done on NASH-related cirrhosis mortality and potential racial disparities in mortality rates.

Objective: This study aims to analyze racial differences in mortality rates among patients with non-alcoholic fatty liver disease (NAFLD), non-alcoholic fatty liver (NAFL), and non-alcoholic steatohepatitis (NASH), hypothesizing that hazard ratios for mortality among patients with NAFLD, NAFL, and NASH would be significantly different for Mexican American patients compared to other racial groups.

Methods: Data from NHANES III (1988-1994) representing the U.S. population were analyzed. Bivariate analysis and Cox proportional hazards models were employed to determine mortality rates and predictors across different racial/ethnic groups, adjusting for variables age, gender, smoking status (current, former, non-smoker), BMI (normal, overweight, obese), and a series of biomarkers.

Results: The prevalence of liver diseases in the sample was: NAFLD (12.1%), NAFL (20.0%), and NASH (3.1%). Deceased patients with NASH had the highest weighted mortality rate (50.6%), followed by NAFLD (39.1%) and NAFL (35.5%). Compared to White patients, Black and Mexican American patients exhibited lower mortality rates for NAFLD. Mexican American patients also had lower mortality rates for NFAL and NASH. White patients showed higher hazard ratios (HR) for NAFLD and NAFL compared to Black and Mexican-American patients. However, for NASH, there were no significant differences in HR between racial/ethnic groups.

Conclusions: Despite higher prevalence rates among Mexican American and Black patients, their mortality rates for NAFLD, NAFL, and NASH were comparable or lower than those for Whites. This highlights the need for further research to inform better management and treatment strategies.

The COVID-19 pandemic led to substantial forgone care. However, relatively few studies have investigated the mental health consequences of forgone care experiences on older adults and how these associations vary by race and ethnicity during this period. This study analyzed US older adults aged 55 or older from the Health, Ethnicity, and Pandemic Survey (N = 883; average age = 65), a nationally representative survey conducted in late 2020. Weighted OLS regression was used to examine the association between measures of forgone care and mental health outcomes. Results showed that experiences of forgone care were prevalent and similar across racial and ethnic groups, with some variations across types of missed care. Furthermore, forgone care and missing various types of care during the COVID-19 pandemic were associated with higher psychological distress and poorer sleep quality, with some variations by race and ethnicity. Black older adults who had forgone care and missed more types of care showed even poorer sleep than their White counterparts. Additionally, missing chronic care, mental care, and preventative care, but not other types of care, was associated with greater psychological distress and poorer sleep for all racial and ethnic groups. However, Black older adults who missed chronic care had even poorer sleep than Whites. Findings emphasize the need to support all older adults' healthcare access of various types during the pandemic and the importance of focusing on specific racial and ethnic groups such as Black older adults who were more affected by forgone care.

Home visiting programs (HVPs) provide services to pregnant individuals and parents of young children to improve families' health and well-being. However, little is known about these families' social contexts. This study explores the social networks and dietary intake of mothers enrolled in a HVP, focusing on health support and health undermining. Cross-sectional data from 76 mothers enrolled in a HVP in Los Angeles County were collected by interview, using validated measures. Almost all mothers (95.7%) had one or more health supporters, while 55.1% had one or more health underminers. Some key findings related to health support were that mothers with higher income had more health supporters in their network (b = 1.36, p = 0.03), and network members were more likely to be health supporters if they were a romantic partner (OR = 3.41, p < 0.001), a resource-based connection (OR = 3.46, p < 0.01), or if they lived in the same neighborhood as the mother (OR = 1.68, p < 0.05). Further, having a health supporter who lived in the same neighborhood was associated with consuming more (1 + daily servings) vegetables (OR = 3.0, p < 0.05) and no sugar-sweetened beverages (OR = 0.29, p < 0.05). There were fewer findings related to health undermining: network members more likely to be underminers were romantic partners (OR = 8.93, p < .0001), and those perceived as having overweight or obesity (OR = 3.98, p < 0.001), but health undermining did not predict dietary intake. Overall, a broad set of network features were linked with health support, and given that some types of support were linked with better diet, network-based diet interventions leveraging health support may be effective in this priority population.

Objectives: Qualitative research was undertaken to determine the perceptions and treatment-seeking behaviors of the Irula tribal populations in Tamil Nadu, India, and to explore the depth, diversity, and complexity of viral hepatitis.

Methods: An in-depth interview (IDI) was conducted among the eligible respondents. A purposive sampling technique was used to obtain the study subjects. The IDI was conducted among the community leader, male and female participants, and other representatives, e.g., ward members (Panchayat). We gathered data regarding the perceptions of viral hepatitis and behavioral intentions. Thematic analysis was used to generate the results of the qualitative research.

Results: Four themes emerged from the codes of the current qualitative study: (1) the general perception, transmission, and treatment of viral hepatitis; (2) stigma and discrimination; (3) health-seeking behavior towards viral hepatitis; and (4) morbidity patterns were significant themes. Most of the nomadic tribes hold incorrect perceptions regarding viral hepatitis and liver cancer risk, and women were reported to have a higher perceived risk than men.

Conclusion: The participants displayed high hope and confidence, which motivated them to participate actively in viral hepatitis prevention activities. Programs and policies geared towards enhancing viral hepatitis prevention in this sub-population may consider sociocultural factors observed to influence prevention behaviors.