Ethnicity & Disease最新文献

Background: Post-coronavirus disease 2019 (COVID-19) syndrome, or long COVID, has a variety of symptoms, but little is known about the condition. This study evaluated the association between individual factors, social determinants of health, and the likelihood of long COVID by assessing internet usage as an indicator of viable access to telehealth.

Methods: Data from the 2022 National Health Interview Survey identified adults who (1) reported a previous COVID-19-positive test and/or diagnosis and (2) experienced long COVID. A 2-stage selection model predicted COVID-19 infection in the first stage and long COVID in the second stage. To test the potential use of telehealth, binary dependent variable regression evaluated internet usage among respondents with long COVID.

Results: About 40% (N=10,318) of respondents had tested positive/been diagnosed with COVID-19, but less than 20% of them (N=1797) had long COVID. Although older respondents were less likely to have COVID (odds ratio [OR]=0.48; 95% confidence interval [CI]=0.44, 0.53), they were more likely to experience long COVID (OR=1.63; CI=1.37, 1.93). Relative to White individuals, Black individuals were less likely to have COVID (OR=0.78; CI=0.69, 0.89) but significantly more likely (OR=1.21; CI=1.09, 1.64) to experience long COVID. Long COVID was also more likely among low-income earners (first income-to-poverty ratio quartile OR=1.40, CI=1.14, 1.72; second income-to-poverty ratio OR=1.37, CI=1.14, 1.64) and those without a college degree (OR=1.42; CI=1.01, 1.66). There were no statistically significant differences in internet access between racial, geographic, or income groups.

Conclusion: Long COVID is significantly more likely among Black individuals and low-income households than among their counterparts, but with few recourses available, telehealth service delivery could be a feasible intervention mechanism.

Objective: In this study, we examined associations between county-level measures of structural racism and county-level cancer incidence and mortality rates between race groups while accounting for factors associated with cancer rates and county-level measures of environmental burden.

Methods: To explore this relationship, we conducted multiple linear regression analyses. Data for these analyses came from an index of county-level structural racism and publicly available data on 2015 to 2019 age-adjusted cancer rates from the US Cancer Statistics Data Visualization Tool, 2019 County Health Rankings and Roadmaps, the Environmental Protection Agency's 2006 to 2010 Environmental Quality Index, and 2015 to 2019 estimates from the US Census American Community Survey.

Results: County-level structural racism was associated with higher county cancer incidence rates among Black (adjusted incidence rate: 17.4, 95% confidence interval [95% CI]: 9.3, 25.5) and Asian/Pacific Islander populations (adjusted incidence rate: 9.3, 95% CI: 1.8, 16.9) and higher mortality rates for American Indian/Alaskan Native (adjusted mortality rate [AMR]: 17.4, 95% CI: 4.2, 30.6), Black (AMR: 11.9, 95% CI: 8.9, 14.8), and Asian/Pacific Islander (AMR: 4.7, 95% CI: 1.3, 8.1) populations than White populations.

Conclusion: Our findings highlight the detrimental impact of structural racism on cancer outcomes among minoritized populations. Strategies aiming to mitigate cancer disparities must embed processes to recognize and address systems, policies, laws, and norms that create and reproduce patterns of discrimination.

Objective: Intersectionality approaches to examining differences in Parkinson's disease (PD) based on racialized group, gender identity, and socioeconomic status (SES) are not well covered in the literature. Additionally, the differences in daily cognitive activities for persons diagnosed with PD by racialized group, gender, and SES are undetermined. This study was conducted to explore the differences in PD daily cognitive activities for diverse racialized groups by gender and SES.

Methods: This study was a secondary analysis of the Michael J. Fox Foundation's Fox Insight online clinical dataset. Persons with PD were partitioned into 16 racialized by gender groups (Black women, Indigenous men, Latina/x women, Asian men, etc.) that were used in within-group comparisons of low-, middle-, and high-SES-a new variable comprising education and income.

Results: Intersectional analyses revealed most items differed between low-SES and high-SES except for items associated with Black and Indigenous men, for whom significant differential item functioning was found between mid-SES and high-SES.

Conclusions: These findings revealed that within-group differences exist and may be missed in research in which social factors are adjusted for instead of included in the model.

Background: Social support is associated with improved clinical outcomes but is understudied among US immigrants. We examined two types of social support, perceived health provider support and community support, and characterized perceptions of social support among US immigrants compared with nonimmigrants.

Methods: We conducted cross-sectional data analysis on self-reported data from Health Information National Trends Survey 5, Cycle 2. Population-level estimates were obtained using jack-knife replicate weights.

Results: Immigrant status was not associated with perceived health care provider support or community support. However, compared with nonimmigrants, US immigrants were more likely to report rarely (adjusted odds ratio [aOR]=3.07) or never (aOR=3.18) having access to emotional support.

Conclusions: Further research that incorporates nuanced factors (eg, time since arrival) that may influence social support in diverse US immigrant groups is needed to determine the impact of social support on health outcomes in an underserved and often overlooked population.

Objective: To examine the emotional distress situation among hospitality industry workers and their access to and use of health care including telehealth services during the COVID-19 pandemic.

Methods: A survey was administered on the Qualtrics platform both in English and Spanish from November 18, 2020, to November 30, 2020, through the Culinary Workers Union in Nevada. A total of 1182 union members participated in the survey, of whom 892 completed the survey. Descriptive and multivariable regression analyses were conducted.

Results: Among 892 respondents, 78% were people of color; 71% were laid off or furloughed during the COVID-related shutdown, but most had access to health care. Further, 78.8% experienced at least 2 or more signs of emotional distress during the pandemic. Females and unemployment status were positively associated with experiencing emotional distress. About 43.5% received care through telehealth, although most did not prefer telehealth (74.2%). Only 18.3% of non-telehealth users were interested in telehealth and 15.0% had never heard about telehealth.

Conclusions: Health insurance coverage is essential for access to health services regardless of employment status. Strengthening mental health services, including psychological counselling for hospitality workers, is needed in such public health emergency situations as the ongoing COVID-19 pandemic.

Background: The immigration enforcement system has significant effects on the health of immigrants, their families, and society. Exposure to the immigration enforcement system is linked to adverse mental health outcomes, which may have been exacerbated by sustained immigration enforcement activities during the COVID-19 pandemic.

Objectives: This study was conducted to investigate the association between exposure to immigration enforcement and the mental health of undocumented young adults in California during the COVID-19 pandemic.

Methods: Data are from the COVID-19 BRAVE (Building Community Raising All Immigrant Voices for Health Equity) Study, a community-engaged cross-sectional survey of the impacts of the COVID-19 pandemic on undocumented immigrants in California. A total of 366 undocumented immigrants between 18 and 39 years of age completed the online survey, which was conducted between September 2020 and February 2021. Multivariable logistic regression models were fit to examine the association between immigration enforcement exposure and depression.

Results: Almost all participants (91.4%) disclosed exposure to the immigration enforcement system, with most reporting an average of 3.52 (SD=2.06) experiences. Multivariate analyses revealed that an increase in the immigration enforcement exposure score was significantly associated with higher odds of depression (adjusted odds ratio [aOR]=1.24; 95% confidence interval [CI]: 1.10, 1.40), and women were 92% more likely to report depression than were men (aOR=1.92; 95% CI: 1.12, 3.31). Those who reported deportation fears were significantly more likely to be depressed (aOR=1.24; 95% CI: 1.10, 1.40).

Conclusions: Researchers should consider the mental health implications of a punitive immigration enforcement system, and policymakers should examine the impacts of immigration policies on local communities.

Background: Although small, the African immigrant population is one of the fastest growing immigrant populations in the United States. Emerging research indicates a high prevalence of noncommunicable preventable chronic conditions in this population. Like other African Americans, African immigrants are mistrustful of the health care system, hampering efforts for prevention and intervention research.

Purpose: To describe our experiences conducting 2 studies in an African immigrant community, discuss the lessons learned, and provide advice to researchers interested in conducting research in similar populations.

Design: The 2 published studies for which we derive lessons learned for this paper were a cross-sectional study and a qualitative study using focus group interviews. Participants included Zimbabwean immigrants in the Eastern United States recruited at religious festivals and community events. The 2 studies enrolled a total of 135 participants.

Results: Of our recruitment goal of 120 in the first study, we enrolled only 98 despite numerous efforts. However, after strategically partnering with a community advisory board (CAB), in the second study, we met our recruitment goal within 4 months. With the CAB, we recruited a larger proportion of men (38% versus 24%). Without the CAB, 350 individuals agreed to participate, but only 98 (28%) returned the questionnaire, whereas with the CAB, 40 agreed to participate, and 37 (93%) successfully completed the study.

Conclusion: Conducting health-related research in immigrants requires strategic partnerships with the community to build strong relationships between the research team and the target community. By nurturing these relationships, research teams can effectively access this hard-to-reach population and achieve high participation.

Intracranial volume (ICV) reflects maximal brain development and is associated with later-life cognitive abilities. We quantified ICV among first- and second-generation Hispanic and Latino adults from the Study of Latinos-Investigation of Cognitive Aging - MRI (SOL-INCA-MRI), estimated ICV heritability, and tested its associations with previously reported genetic variants, both individually and as a genetic risk score (GRS). We also estimated the association of ICV with early life environmental measures: nativity or age of immigration and parental education. The estimated heritability of ICV was 19% (95% CI, 0.1%-56%) in n=1781 unrelated SOL-INCA-MRI individuals. Four of 10 tested genetic variants were associated with ICV and an increase of 1 SD of the ICV-GRS was associated with an increase of 10.37 cm³ in the ICV (95% CI, 5.29-15.45). Compared to being born in the continental United States, immigrating to the United States at age 11 years or older was associated with 24 cm³ smaller ICV (95% CI, -39.97 to -8.06). Compared to both parents having less than high-school education, at least 1 parent completing high-school education was associated with 15.4 cm³ greater ICV (95% CI, 4.46-26.39). These data confirm the importance of early life health on brain development.

Objective: Entertainment-education interventions remain underutilized in sexual and reproductive health (SRH) despite evidence that they can be effective and place a low burden on staff. This study explores perceived facilitators and barriers for implementing an entertainment-education video intervention for 18- to 19-year-old African American and Latina women in SRH clinics.

Design: Cross-sectional online survey (n=100) and telephone interviews (n=19) were completed May through August 2018.

Setting: SRH clinics were located across 32 US states and 1 Canadian province.

Participants: SRH clinic staff were diverse in type of clinic, role, and geography and were recruited using purposive sampling.

Methods: Bivariate analyses were used for quantitative data, and thematic analysis was used for qualitative data.

Main outcome measures: Intervention acceptability, perceived feasibility, and likely uptake were assessed using agreement statements (survey) and open-ended questions (interviews and survey).

Results: Interviewed clinic staff described the intervention as engaging, educational, and promising for improving client SRH knowledge and behaviors. Nearly all (95%) survey respondents said showing the video would be feasible. Most (56%) indicated likely uptake, which was significantly associated with perceived feasibility (P=.000), acceptability (P≤.001), and working at a public health clinic (P=.023). Implementation barriers included the video's potential relevance to only certain clients and the need for additional information or staff and/or management buy-in.

Conclusions: This is the first study to assess perceived implementation facilitators and barriers of an entertainment-education video intervention among SRH clinic staff. The intervention was well received, with certain barriers potentially alleviated by offering information about entertainment-education and multiple implementation methods. These findings can help improve dissemination efforts for video-based entertainment-education interventions in clinics serving young women of color.

Background: The root causes of coronavirus disease 2019 (COVID-19) disparities include longstanding systemic racial bias in economic advancement and care delivery, discrimination, lack of access, and social determinants of health. To address these causes, research institutions and health care systems must shift their lens from one that focuses solely on changing behaviors among underserved and vulnerable populations to one that is inward facing.

Methods: We worked with a community advisory board and an African American church that has partnered on research for more than a decade to identify community norms, needs, and key resources needed for establishing community-academic partnerships for COVID-19 testing. Participants were purposefully sampled with equal representation from 3 groups: (1) church members and leaders, (2) academic or organization researchers with experience in community-engaged research, and (3) community members with experience participating in community-engaged research. Participants engaged in a hands-on exercise in the church basement as part of a town hall-style meeting.

Results: Active discussion led to the identification of business model components salient to COVID-19 testing in an underserved Baltimore community, predominantly made up of African Americans. Our discussion identified key partners, activities, resources, costs, value propositions, community relationships, community groups, communication channels, and outputs for community buy-in.

Conclusion: Developing the business case for mutual trustworthiness to be better prepared for future pandemics and public health crises may foster more sustainable community-academic partnerships. Using a Business Model Canvas, we delineate the major components, activities, and value propositions that are needed to achieve authentic community-academic partnerships to advance health equity.