Journal of Racial and Ethnic Health Disparities最新文献

Background: Black women are disproportionately affected by overweight and obesity. One theory that may have utility in increasing the amount of exercise among Black women is self-determination theory, a psychology-based theory commonly used to investigate motivation in the context of exercise. The objective of this study was to determine whether motivation towards exercise behavior differs between younger and older Black women.

Methods: A cross-sectional study was conducted by administering a survey to Black women in the Midwestern United States to elicit factors which may impact their motivation to exercise. The survey consisted of questions to gather sociodemographic information as well as responses to the Behavioral Regulations in Exercise Questionnaire (BREQ-2). Responses on the BREQ-2 were utilized to derive the Relative Autonomy Index (RAI) which is a direct measure of self-determination that provides insight into the extent of an individual's motivation to exercise. Multiple linear regression was utilized to determine if age was predictive of relative RAI scores after adjusting for marital status and receipt of a memorable message regarding health.

Results: Mean RAI scores among respondents at least 40 years old were significantly higher in comparison to the RAI among respondents younger than 40. When adjusting for marital status and receipt of a memorable message regarding health, women at least 40 had a mean RAI score approximately 4.2 points higher than those under age 40. Women at least 40 years of age also had significantly higher scores on the identified regulation and intrinsic regulation subscales of the BREQ-2 questionnaire when compared to women younger than 40 after adjusting for marital status and recalling a memorable message related to health.

Conclusion: These findings suggest that exercise motivations differ among age groups of Black women. Additionally, these results highlight the importance of understanding exercise motivations to further improve health outcomes.

Introduction: Tobacco regulatory policies are generally intended to apply to all segments of the population and to be equitable. Results from clinical trials on switching from commercial cigarettes to reduced nicotine cigarettes have included black populations but race-specific findings are not widely reported.

Methods: Data were pooled from two parallel randomized controlled trials of gradually reduced nicotine in cigarettes from 11.6 mg per cigarette down to 0.2 mg nicotine (very low nicotine content; VLNC) vs. usual nicotine content (UNC) cigarettes (11.6 mg) over an 18-week period in smokers with low socioeconomic status (SES) and mental health conditions, respectively. We used linear regression to determine the potential effects of cigarettes and biomarker reductions (blood cotinine and exhaled carbon monoxide) when using VLNC study cigarettes. An intention-to-treat (ITT) analysis included all randomized participants regardless of adherence to the protocol. A secondary compliance analysis compared control subjects (11.6 mg cigarettes) only to those switched to low nicotine cigarettes who were biochemically determined to be compliant to exclusively using VLNC cigarettes.

Results: Both Black and White VLNC smokers had significantly lower plasma cotinine and exhaled carbon monoxide compared to those randomized to UNC cigarettes. The treatment × race interaction term was not significant for the outcome measures in both the ITT and secondary compliance analyses, except for cotinine in the ITT analysis (Whites: - 190 ng/mL vs. Blacks: - 118 ng/mL; p = 0.05).

Conclusions: A reduced nicotine regulation for cigarettes would result in substantial reduction in exposure to nicotine and toxicants in Black and White smokers.

Purpose: To examine the association between adherence to sleep, dietary, screen time, and physical activity (PA) (8-5-2-1-0) guidelines and risk of high body mass index (BMI ≥ 85 percentile) among U.S. adolescents and to assess for racial inequities and age-varying effects in these associations.

Methods: Data from the 2019 Youth Risk Behavior Surveillance System survey were used to conduct multivariable logistic regression models and moderation analysis by race/ethnicity and age using time-varying varying effect models (TVEM) and estimate associations of interest.

Results: Of the 13,518 adolescents aged ≥ 14 years, only 0.5% met all guidelines. Adolescents adhering to sleep guidelines had a 21% reduction in their odds of having a high BMI (OR 0.79, 95% CI 0.67-0.93). Those adhering to PA guidelines had a 34% reduction in their odds of having a high BMI (OR 0.66, 95% CI 0.56-0.79), and those adhering to screen time guidelines had a 17% reduction in their odds of having a high BMI (OR 0.83, 95% CI 0.72-0.95). TVEM showed associations between adherence to sleep and screen time guidelines with high BMI fluctuate and are at specific ages. TVEM revealed substantial racial/ethnic differences in the age-varying association between adherence to 8-5-2-1-0 guidelines and high BMI throughout adolescence.

Conclusions: Associations between adherence to sleep and screen time guidelines and high BMI fluctuate with age, highlighting the need for nuanced interventions targeting 24-h movement guidelines (sleep, PA, and screen time) across adolescence, particularly given racial/ethnic disparities.

Background: Minority communities are disproportionately impacted by COVID-19. In Michigan in 2024, 59% of Latinx residents, 46% of Black residents, and 57% of White residents have received at least one dose of the vaccine. However, just 7% of Black residents and 6% of Latinx residents report being up-to-date per CDC definition, versus 13% of White residents. Drawing from protection motivation theory, we aimed to identify barriers to COVID-19 vaccination.

Methods: Interviews with 24 Black and 10 Latinx Michigan residents self-reported as not up-to-date (n = 15) or up-to-date (n = 19) on COVID-19 vaccines were conducted in 2022-2023. We used a community-based participatory approach in collaboration with 16 leaders from 15 organizations to develop research questions, interview protocols, and methods for data collection and analysis. Thematic coding of interviews was conducted.

Results: Findings indicate participants' lack of confidence in the COVID-19 vaccine's efficacy, with those not up-to-date expressing greater doubt. Participants were also concerned about vaccine benefits versus risks, safety, and side effects. Distrust in medicine, confusion about public health guidelines, and conspiracy theories were often reported. Younger unvaccinated individuals cited low health risk as reason to remain unvaccinated. Many participants felt that health education, especially through medical professionals, was beneficial.

Conclusion: There is great need for more data to make informed decisions given ongoing lack of understanding of the public health benefits of COVID-19 vaccination. Identifying drivers of vaccine uptake, particularly boosters, in communities of color and developing age-appropriate and culturally responsive interventions to increase vaccination rates are of utmost importance.

Background: Food and beverage (F&B) marketing practices that contradict health guidelines are particularly concerning for children and adolescents, who are developmentally more susceptible than adults to persuasive advertising and to Black communities, due to ethnically-targeted marketing, contributing to higher rates of obesity and other diet-related chronic diseases. Accordingly, here we evaluated Operation Good Food and Beverages (OGF&B), an online social marketing campaign calling for shifting toward more marketing of healthier F&B to Black youth and Black communities.

Methods: OGF&B was developed and implemented by a multidisciplinary team of academic, advocacy, and advertising partners and active for four months in 2022 during the COVID-19 pandemic. Primary campaign components were social media content (e.g., TikTok, Instagram), and an informational website with a signable petition and a social media toolkit. Our mixed-methods evaluation used qualitative data to contextualize quantitative metrics like online impressions, website visits, and petition signatures. Qualitative data consisted of analysis of social media content and thematic elements from 15 interviews with campaign advisors, youth consultants, and influencers.

Results: The campaign achieved 3,148,869 impressions, 3,799 unique website visits, and 1,077 petition signatures. Instagram Reels and content featuring people had higher engagement. Instagram Reels received more likes than static posts or TikTok videos. Interviewees who participated mentioned personal values and community welfare as key motivations. Social media influencers who declined participation noted time constraints and lack of compensation as barriers.

Conclusion: Despite pandemic-related restrictions that precluded in-person engagement, this brief campaign implementation period provided useful insights for leveraging OGF&B or similar campaigns.

Background: In the U.S., Black children have disproportionately elevated rates of pediatric morbidity compared with White children, but data are lacking for other countries. We studied the extent to which Black Haitians were at risk of pediatric morbidity in Canada.

Methods: We analyzed a retrospective cohort of 736,498 children born in Quebec between 2008 and 2020. We identified Black Haitians using the mother tongue and birth country of parents. The outcome was mortality or hospitalization for infectious diseases, allergy, cancer, and other morbidity between birth and 12 years of age. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for these outcomes, comparing Haitians with non-Haitians in Cox regression models adjusted for patient characteristics.

Results: Compared with non-Haitians, Haitians tended to have a greater risk of pediatric mortality, especially before age 2 years (HR 1.56, 95% CI 1.00-2.45). However, Haitian children had a lower risk of hospitalization than non-Haitian children (HR 0.61, 95% CI 0.59-0.63). Haitians were less likely to be hospitalized for infectious diseases, allergies, appendicitis, cancers, fractures, dental caries, and ophthalmologic conditions. Hospitalization rates were low throughout childhood, even though Haitian children were more likely to be born preterm, develop severe neonatal morbidity, and have other adverse outcomes at birth.

Conclusion: Haitian children have an elevated risk of neonatal morbidity and early childhood mortality, but lower risk of hospitalization compared with non-Haitians in Canada. The reasons for the disparity are unclear, but greater effort is needed to address potential gaps in healthcare among Black children.

Sickle cell disease (SCD) is a major public health concern with significant associated economic costs. Although the disease affects all ethnic groups, about 90% of individuals living with sickle cell disease in the USA are Black/African American. The purpose of this study was to assess the health care discrimination experiences of adults living with SCD and the quality of the relationship with their health care providers. We conducted six focus groups from October 2018 to March 2019 with individuals receiving care at a specialized adult sickle cell program outpatient clinic at a private, nonprofit tertiary medical center and teaching hospital in the northeastern USA. The sample of 18 participants consisted of groups divided by gender and current use, past use, or never having taken hydroxyurea. Ten (56%) participants were males; most were Black/African American (83%) and had an average age of 39.4 years. This study reports a qualitative, thematic analysis of two of 14 areas assessed by a larger study: experiences of discrimination and relationships with providers. Participants described experiences of bias related to their diagnosis of SCD as well as their race, and often felt stereotyped as "drug-seeking." They also identified lack of understanding about SCD and poor communication as problematic and leading to delays in care. Finally, participants provided recommendations on how to address issues of discrimination.

Background: The study was conducted to investigate the relationship between pregnancy-related anxiety levels of primiparae living in an ethnic region and their readiness for postnatal hygienic care of newborns.

Method: The study conducted between February and May 2023 included 201 "18-40-year-old primiparae" who lived in an ethnic region and volunteered to participate in the study. The population of the study consisted of all pregnant women who presented to the Gynecology and Obstetrics Clinic, Pregnancy Outpatient Clinic of a city hospital. The "Pregnant Women Personality and Obstetric Characteristics Form," "Pregnant Women's Readiness for Newborn Hygienic Care Scale," and "Spielberg State-Trait Anxiety Inventory" were used as data collection tools.

Results: The mean age of the 201 primiparae participating in the study was 26.11 ± 3.05 years. Although 71.1% of them felt confident about baby care before the baby was born, 95.5% needed help with baby care after birth. Their readiness for stress and newborn hygienic care was at a "medium" level. There was a statistically significant negative relationship between the scores they obtained from the Pregnant Women's Readiness for Newborn Hygienic Care Scale and Spielberg State-Trait Anxiety Inventory (p = 0.011; r =  - 0.180).

Conclusions: The participating primiparae experienced moderate levels of anxiety, and the increase in their anxiety levels negatively affected their readiness for the hygienic care of their newborn babies. Thus, when primiparae are provided with healthy newborn care, their anxiety levels should.

Discrimination is a salient stressor linked with a variety of health outcomes including depression and anxiety among Middle Eastern and North African Americans (MENA). Among other minoritized racial and ethnic groups, sleep difficulties have been identified as potential mechanisms that explain the relationship between discrimination and mental health. However, this has not been explored within MENA samples. Thus, the focus of this study is to examine if two sleep measures (e.g., sleep disturbance and sleep-related impairment) mediate the relationship between discrimination and two mental health outcomes: depression and anxiety. We recruited 126 MENA adults from across the USA through Prolific. Findings revealed that sleep-related impairment fully mediated the relationship between discrimination and mental health outcomes, whereas sleep disturbances only partially mediated these outcomes. Results suggest sleep difficulties are one pathway that could explain the relationship between discrimination and mental health among MENA. Future work should continue to explore this relationship, as well as investigate discrimination and sleep as possible places of intervention to protect the health of MENA individuals.

Ignoring workplace exposures that occur beyond the local residential context in place-based risk indices like the CDC's Social Vulnerability Index (SVI) likely misclassifies community exposure by under-counting risks and obscuring true drivers of racial/ethnic health disparities. To investigate this hypothesis, we developed several place-based indicators of occupational exposure and examined their relationships with race/ethnicity, SVI, and health inequities. We used publicly available job exposure matrices and employment estimates from the United States (US) Census to create and map six indicators of occupational hazards for every census tract in the US. We characterized census tracts with high workplace-low SVI scores. We used natural cubic splines to examine tract level associations between the percentage of racial/ethnic minorities (individuals who are not non-Hispanic White) and the occupational indicators. Lastly, we stratified each census tract into high/low occupational noise, chemical pollutant, and disease/infection exposure to examine racial/ethnic health disparities to diabetes, asthma, and high blood pressure, respectively, as a consequence of occupational exposure inequities. Our results show that racial/ethnic minority communities, particularly those that are also low-income, experience a disproportionate burden of workplace exposures that may be contributing to racial/ethnic health disparities. When composite risk measures, such as SVI, are calculated using only information from the local residential neighborhood, they may systematically under-count occupational risks experienced by the most vulnerable communities. There is a need to consider the role of occupational justice on nationwide, racial/ethnic health disparities.