Journal of Racial and Ethnic Health Disparities最新文献

Background: Black women are underrepresented in health-related research. Consulting Black women in the creation of recruitment materials may help increase their representation in research studies, but few of these recruitment materials have been evaluated. This manuscript reports on the impact of two ads (one featuring older women and one featuring younger women) created through multiple focus group sessions with Black women. The purpose of the ads were to recruit Black women to participate in an online research study about HIV prevention and pre-exposure prophylaxis, PrEP.

Materials and methods: Questions about the ads were embedded in the eligibility screener for inclusion in the online parent research study. Respondents were asked which ad they saw, what they liked about it, and what about the ad piqued their interest in the study.

Results: In total, 301 Black women completed the eligibility screener for the online study and answered questions pertaining to the two ads. Most participants reported seeing the ad with younger women (260/301, 86.4%). Representation of Black women (n = 70), ad design (n = 64), relevance to Black women and the Black community (n = 60), and comprehensiveness of ad content (n = 38) were the top 4 ad features respondents liked. Relevance to Black women and the Black community (n = 104) as well as ad content (n = 54) (i.e., study purpose, location, duration, images, incentive) were the top two reasons provided about ads that piqued respondent's interest in the online study.

Conclusion: Findings showcase how recruitment ads informed by Black women could help increase their interest and participation in research.

Objectives: Due to stigmatization associated with the COVID-19 pandemic, certain groups were believed to be the cause of COVID-19 and thus experienced COVID-19-related racism through direct interpersonal and vicarious experiences. This study used quantitative and qualitative responses to examine whether the prevalence of experiencing these types of racism varied across racial and ethnic groups.

Study design: This cross-sectional study included 5,480 participants in the REACH-US (Race-Related Experiences Associated with COVID-19 and Health in the United States) study, which is a nationally representative survey administered to 5,500 U.S. adults from January 26, 2021-March 3, 2021.

Methods: COVID-19-related racism was measured using single items about whether participants: 1.) experienced racism because they were thought to belong to a group more likely to get COVID-19 (direct); 2.) witnessed racism against others who were thought to belong to a group more likely to get COVID-19 (vicarious). Logistic regression examined differences in experiencing COVID-19-related racism across racial and ethnic groups, adjusting for sociodemographic characteristics. Themes emerged from open-ended descriptions of racism experiences coded in a thematic analysis and were reported across racial and ethnic groups.

Results: Overall, 6.4% and 15.9% of adults experienced direct and vicarious COVID-19-related racism, respectively. All racial and ethnic groups (except Hispanic/Latino English Language Preference) were significantly more likely than White adults to experience direct (AORs: 2.06-4.92) and vicarious (AORs: 1.63-3.02) COVID-19-related racism. Racial and ethnic differences were observed across thematic domains of type of mistreatment and settings where racism occurred.

Conclusions: Direct and vicarious COVID-19-related racism were more prevalent among marginalized racial and ethnic groups, comprised various types of mistreatment, and occurred across multiple settings, thus highlighting the need for integrated efforts to reduce and prevent racism.

Background: Herein, we report the characterization of four cohorts of breast cancer patients including (1) non-Hispanic Whites in Florida, (2) non-Hispanic Blacks in Florida, (3) Hispanics in Florida, and (4) Hispanics in Puerto Rico.

Methods: Data from female breast cancer patients were collected from cancer registry (n = 9361) and self-reported patient questionnaires (n = 4324). Several statistical tests were applied to identify significant group differences.

Results: Breast cancer patients from Puerto Rico were least frequently employed and had the lowest rates of college education among the groups. They also reported more live births and less breastfeeding. Both Hispanic groups reported a higher fraction experiencing menstruation at age 11 or younger (Floridian Hispanics [38%] and Puerto Ricans [36%]) compared to non-Hispanic Whites (20%) and non-Hispanic Blacks (22%). Non-Hispanic Black and Puerto Rican women were significantly older at breast cancer diagnosis than their non-Hispanic White and Floridian Hispanic counterparts. The Puerto Rican and non-Hispanic Black groups more frequently had pathology stage T2 or higher primary breast tumors at diagnosis (non-Hispanic Whites [29%], non-Hispanic Blacks [39%], Floridian Hispanics [33%], Puerto Ricans [46%]). The Puerto Rican (73%, 95% CI [66, 82]) and non-Hispanic Black (79%, 95% CI [75, 84]) groups demonstrate reduced 5-year survival compared to non-Hispanic Whites (89%, 95% CI [86, 92]) and Floridian Hispanics (89%, 95% CI [86, 90]).

Conclusions: These findings demonstrate that Puerto Rican breast cancer patients suffer significant breast cancer health disparities relative to non-Hispanic Whites and Hispanics from Florida similar to the disparities observed for non-Hispanic Blacks. Future work must seek to better understand and address these disparities.

Dollar stores are the fastest-growing type of food retailer in the United States, prompting policy action across the country related to their perceived negative impact on the communities they serve. However, there is little existing research that explores community member perceptions of dollar stores, which is critical to inform new, equitable policies. To address this gap in Baltimore City, Maryland, where dollar store density is high, we aimed to describe community member perceptions of dollar stores in terms of their role in the broader community. We used thematic analysis to construct themes from community member in-depth interviews (n = 16) and one community member workshop (n = 21) to understand how dollar stores are viewed in the context of the broader Baltimore City community. Six key themes were generated: (1) dollar stores contribute to neighborhood "blight," (2) better retail is needed, (3) dollar stores meet certain community needs, (4) dollar stores do not invest enough in the community, (5) dollar stores vary in location and stock depending on race-based neighborhood qualities, and (6) product quality is low. Overall, participants acknowledged that dollar stores meet certain needs in communities in which there are few alternative retail options, but many did not view them as a benefit and desired to have other retailers instead. Participants also discussed the lack of dollar store investment in the communities they serve, and the low quality of food and non-food products offered. Future policy development should include community member perspectives to understand local context and align policies with community priorities.

Background: Prior research has linked personal network characteristics with cancer screening uptake including Papanicolaou (Pap) screening, but less is known about the experiences of Black immigrant women (BIW) in the USA. We examined the relationship between network characteristics and Pap screening among BIW and explored how their network members influence their cancer related knowledge and prevention behaviors.

Methods: A mixed methods study of BIW, aged 21-65 years, in southeastern US included a cross-sectional survey (N = 204) and in-depth individual interviews (N = 13). We examined whether high-social connectedness, contact frequency, and social support were associated with Pap screening, using multivariable logistic regression models. Thematic analysis further assessed the roles of personal network factors on BIW's cancer preventive behaviors.

Results: Pap screening was more likely among BIW with high- versus low-social connectedness (OR: 2.68, CI: 1.12, 6.46). However, the impact of high-social connectedness was attenuated, after adjusting for demographic factors and health insurance. Our qualitative findings revealed that both BIW and their personal networks had limited knowledge on cancer and related prevention measures. Close network members, particularly mother-figures, provided support for BIW's care seeking efforts, including cancer screening, although some participants mentioned a lack of screening support.

Conclusion: These findings suggest that Black immigrant communities may benefit from tailored cancer prevention interventions among close network members, to improve knowledge and support for cancer control behaviors.

Disparities in regional anesthesia may limit patients' access to appropriate care. We reviewed literature from 2013 to 2023 regarding health disparities in regional anesthesia. While there were some exceptions, patients belonging to racial/ethnic minority groups and those with lower socioeconomic status did not receive regional anesthesia as frequently as their White or higher-income peers. As regional anesthesia continues to emerge as a preferred method of managing chronic pain conditions and providing surgical anesthesia, it is essential to ensure that it is provided equitably across the patient population.

Sickle cell disease (SCD) is a genetic blood disorder presenting a substantial public health challenge. India, holding the second-highest prevalence globally, exhibits diverse clinical manifestations. The recently launched National SCD Elimination Mission (NSEM) in India has contributed to an increased identification of cases. The national program should extend its services beyond screening and clinical management. The outcome of the disease is influenced by a multitude of factors impacting healthcare utilization, with stigma emerging as a major influencer. Addressing stigma at the right time is crucial to comprehensive disease care. Understanding and quantifying the type and level of stigma in the ecosystem are fundamental steps toward tackling this pressing issue, necessitating the development of a scale. The existing three scales developed and utilized in African and American contexts may not be suitable for the Indian SCD community due to phenotypic, socio-cultural, and contextual variations. Therefore, developing, modifying, and creating a locally applicable scale is imperative. This protocol paper outlines the process of developing, refining, and evaluating the Indian Council of Medical Research (ICMR)-SCD Stigma Scale for India (ISSSI), which will be developed by Indian researchers led by the ICMR.

This study examines the impact of various adversities-including racism, indirect adversity, loss of a loved one, and adverse police contact-on psychological and physical health outcomes such as sleep quality, depressive symptoms, serious illness, and self-reported health. Additionally, it investigates how economic, educational, social, and spiritual capital moderate these effects, with attention to racial differences. Leveraging a sample of 1139 participants from the 1995 Detroit Area Study, analyses reveal nuanced effects of adversity, with the impact being neutralized, attenuated, or amplified by coping capacities. Economic and educational supports generally provide protective health benefits, while social and religious supports reveal complex, sometimes divergent effects. Subgroup analyses reveal racial differences: for instance, Black individuals face a higher likelihood of developing a serious illness in connection with adverse police encounters, and White individuals benefit from liquid assets in buffering depressive symptoms. These findings underscore the need for multifaceted, context-sensitive health interventions and policies that enhance economic stability, educational opportunities, and mental health services, while strengthening social and spiritual support systems to build resilience and mitigate the adverse health effects of these adversities.

Objective: Black individuals carry the greatest burden of maternal mortality, with hypertensive disorders during pregnancy being a significant driving force to this disparity. However, research on maternal health disparities predominantly groups Hispanic Black individuals with all other individuals of Hispanic ethnicity. We hypothesized that this aggregation might obscure the risk patterns of hypertensive disorders in pregnancy for Hispanic-Black and non-Hispanic Black individuals.

Methods: We analyzed a California statewide dataset of vital records linked to hospitalization discharge data for births from 2007 to 2018. Using multivariable logistic regression models adjusted for age, pre-pregnancy BMI, parity, smoking status, diabetes, and chronic renal disease, we compared the odds of hypertensive disorders in pregnancy between Hispanic Black, non-Hispanic Black, and non-Black Hispanic racial-ethnic groups. Hypertensive disorders were categorized into two groups: (1) any hypertensive disorder and (2) chronic hypertension alone, non-severe hypertensive disorders, and severe hypertensive disorders in pregnancy.

Results: Non-Hispanic Black people had 75% increased odds of developing a hypertensive disorder during pregnancy (adjusted odds ratio (aOR); 95% confidence interval (CI): 1.74, 1.78) and Hispanic-Black individuals had a 31% increased odds (95% CI: 1.24, 1.38) as compared with non-Black Hispanic individuals. When considering hypertensive disorders separately, the race-associated differences were largest for chronic hypertension alone, with non-Hispanic Black individuals showing an aOR of 2.35 (95% CI: 2.32, 2.38) and Hispanic-Black individuals an aOR of 1.80 (95% CI: 1.66, 1.95).

Conclusion: Compared with non-Black Hispanic individuals, the prevalence of hypertensive disorders in pregnancy was higher in Black-Hispanic individuals and highest in non-Hispanic Black individuals. Racial/ethnic differences were larger for chronic hypertension alone than for preeclampsia.

Background and objective: Access to personal medical information promotes patient understanding of health issues and enables patient self-advocacy of healthcare needs. The advent of electronic medical record systems and the 2016 21st Century CURES Act promoted and encouraged patient access to personal medical information, yet technology-dependent modalities have often disadvantaged certain communities. We sought to evaluate whether disparities existed in access to patient portals at our institution, the main pediatric care provider in an area serving one million children.

Methods: We evaluated the activation of patient portal accounts at our institution over the past decade (2010-2021). Portal activation data were analyzed by ethnic background and language preference and income information available based on primary home access location. Further, we evaluated portal activation rates over time and across institutional interventions. A logistic regression model was used to identify important demographic associations with portal account status.

Results: Over 1 million patients were served at our pediatric institution over the study period with 47.7% having ever activated their patient portals. Univariate analyses and ultimately logistic regression modeling demonstrated significant differences in portal activation by ethnicity (odds ratio (confidence interval):1.36 (1.34, 1.37)), language preference (1.39 (1.37, 1.40)), and median household income (1.00001 (1.00001, 1.00001)). Interim interventions were successful in improving portal activation rates.

Discussion: Overall, electronic medical record portal activation was less prevalent among Hispanic, non-English speakers, and patients living in communities with lower median household income.

Conclusion: Opportunities for interventions exist to reduce healthcare disparities in these underserved communities.