Ethnicity & Disease最新文献_第8页

The Intersection of Social Behavior, Population Health, and Inherited Traits. 社会行为、人口健康和遗传特征的交叉。

IF 3.2 3区医学 Q2 Medicine

Ethnicity & Disease

Pub Date : 2022-04-21 DOI: 10.18865/ed.32.2.73

Roland J. Thorpe, Jr., H. Jones

Ethn Dis. 2022;32(2):73-74; doi:10.18865/ed.32.2.73

Ethn Dis。2022年；32（2）：73-74；doi:10.18865/ed.32.2.73

引用次数: 0

Integrating Population Health Strategies into Primary Care: Impact on Outcomes and Hospital Use for Low-Income Adults. 将人口健康战略纳入初级保健:对低收入成年人结果和医院使用的影响。

IF 3.2 3区医学 Q2 Medicine

Ethnicity & Disease

Pub Date : 2022-04-21 DOI: 10.18865/ed.32.2.91

H. Kitzman, Kristen Tecson, Abdullah Mamun, Briget da Graca, Samrat Yeramaneni, Kenneth Halloran, Donald Wesson

ObjectiveOur objectives were two-fold: 1) To evaluate the benefits of population health strategies focused on social determinants of health and integrated into the primary care medical home (PCMH) and 2) to determine how these strategies impact diabetes and cardiovascular disease outcomes among a low-income, primarily minority community. We also investigated associations between these outcomes and emergency department (ED) and inpatient (IP) use and costs.DesignRetrospective cohort.SettingCommunity-based PCMH: Baylor Scott & White Health and Wellness Center (BSW HWC).Patients/ParticipantsAll patients who attended at least two primary care visits at BSW HWC within a 12-month time span from 2011-2015.MethodsOutcomes for patients participating in PCMH only (PCMH) as compared to PCMH plus population health services (PCMH+PoPH) were compared using electronic health record data.Main OutcomesDiastolic and systolic blood pressure, hemoglobin A1c, ED visits and costs, and IP hospitalizations and costs were examined.ResultsFrom 2011-2015, 445 patients (age=46±12 years, 63% African American, 61% female, 69.5% uninsured) were included. Adjusted regression analyses indicated PCMH+PoPH had greater improvement in diabetes outcomes (prediabetes HbA1c= -.65[SE=.32], P=.04; diabetes HbA1c= -.74 [SE=.37], P<.05) and 37% lower ED costs than the PCMH group (P=.01). Worsening chronic disease risk factors was associated with 39% higher expected ED visits (P<.01), whereas improved chronic disease risk was associated with 32% fewer ED visits (P=.04).ConclusionsIntegrating population health services into the PCMH can improve chronic disease outcomes, and impact hospital utilization and cost in un- or under-insured populations.

我们的目标有两个:1)评估关注健康的社会决定因素并将其纳入初级保健医疗之家(PCMH)的人口健康策略的效益;2)确定这些策略如何影响低收入、主要是少数民族社区的糖尿病和心血管疾病结局。我们还调查了这些结果与急诊科(ED)和住院病人(IP)使用和费用之间的关系。DesignRetrospective队列。以社区为基础的PCMH:贝勒斯科特和怀特健康和保健中心(BSW HWC)。患者/参与者2011-2015年12个月内至少两次在BSW HWC进行初级保健访问的所有患者。方法采用电子健康记录数据对仅参加PCMH (PCMH)与PCMH加人口健康服务(PCMH+PoPH)患者的结果进行比较。主要结果:检查了舒张压和收缩压、血红蛋白A1c、ED就诊次数和费用、IP住院次数和费用。结果2011-2015年共纳入445例患者(年龄46±12岁，63%为非裔美国人，61%为女性，69.5%未参保)。调整后的回归分析表明，PCMH+PoPH对糖尿病结局有更大的改善(糖尿病前期HbA1c= - 0.65 [SE=。32], P = .04点;糖尿病HbA1c= -。74 (SE =。[37]， P< 0.05)， ED费用比PCMH组低37% (P= 0.01)。慢性疾病危险因素恶化与预期ED就诊增加39%相关(P< 0.01)，而慢性疾病风险改善与预期ED就诊减少32%相关(P= 0.04)。结论将人口健康服务纳入PCMH可改善慢性病转归，并影响未参保或参保不足人群的医院使用率和费用。

{"title":"Integrating Population Health Strategies into Primary Care: Impact on Outcomes and Hospital Use for Low-Income Adults.","authors":"H. Kitzman, Kristen Tecson, Abdullah Mamun, Briget da Graca, Samrat Yeramaneni, Kenneth Halloran, Donald Wesson","doi":"10.18865/ed.32.2.91","DOIUrl":"https://doi.org/10.18865/ed.32.2.91","url":null,"abstract":"Objective\u0000Our objectives were two-fold: 1) To evaluate the benefits of population health strategies focused on social determinants of health and integrated into the primary care medical home (PCMH) and 2) to determine how these strategies impact diabetes and cardiovascular disease outcomes among a low-income, primarily minority community. We also investigated associations between these outcomes and emergency department (ED) and inpatient (IP) use and costs.\u0000\u0000\u0000Design\u0000Retrospective cohort.\u0000\u0000\u0000Setting\u0000Community-based PCMH: Baylor Scott & White Health and Wellness Center (BSW HWC).\u0000\u0000\u0000Patients/Participants\u0000All patients who attended at least two primary care visits at BSW HWC within a 12-month time span from 2011-2015.\u0000\u0000\u0000Methods\u0000Outcomes for patients participating in PCMH only (PCMH) as compared to PCMH plus population health services (PCMH+PoPH) were compared using electronic health record data.\u0000\u0000\u0000Main Outcomes\u0000Diastolic and systolic blood pressure, hemoglobin A1c, ED visits and costs, and IP hospitalizations and costs were examined.\u0000\u0000\u0000Results\u0000From 2011-2015, 445 patients (age=46±12 years, 63% African American, 61% female, 69.5% uninsured) were included. Adjusted regression analyses indicated PCMH+PoPH had greater improvement in diabetes outcomes (prediabetes HbA1c= -.65[SE=.32], P=.04; diabetes HbA1c= -.74 [SE=.37], P<.05) and 37% lower ED costs than the PCMH group (P=.01). Worsening chronic disease risk factors was associated with 39% higher expected ED visits (P<.01), whereas improved chronic disease risk was associated with 32% fewer ED visits (P=.04).\u0000\u0000\u0000Conclusions\u0000Integrating population health services into the PCMH can improve chronic disease outcomes, and impact hospital utilization and cost in un- or under-insured populations.","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41640643","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}

引用次数: 1

Poverty, Comorbidity, and Ethnicity: COVID-19 Outcomes in a Safety Net Health System. 贫困、合并症和种族:安全网卫生系统中的COVID-19结果。

IF 3.4 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ethnicity & Disease

Pub Date : 2022-04-21 eCollection Date: 2022-01-01 DOI: 10.18865/ed.32.2.113

Joseph P Smith, Amy B Kressel, Randall W Grout, Bree Weaver, Megan Cheatham, Wanzhu Tu, Ruohong Li, David W Crabb, Lisa E Harris, William G Carlos

Objective: To determine if race-ethnicity is correlated with case-fatality rates among low-income patients hospitalized for COVID-19.

Research design: Observational cohort study using electronic health record data.

Patients: All patients assessed for COVID-19 from March 2020 to January 2021 at one safety net health system.

Measures: Patient demographic and clinical characteristics, and hospital care processes and outcomes.

Results: Among 25,253 patients assessed for COVID-19, 6,357 (25.2%) were COVID-19 positive: 1,480 (23.3%) hospitalized; 334 (22.6%) required intensive care; and 106 (7.3%) died. More Hispanic patients tested positive (51.8%) than non-Hispanic Black (31.4%) and White patients (16.7%, P<.001]. Hospitalized Hispanic patients were younger, more often uninsured, and less likely to have comorbid conditions. Non-Hispanic Black patients had significantly more diabetes, hypertension, obesity, chronic kidney disease, and asthma (P<.05). Non-Hispanic White patients were older and had more cigarette smoking history, COPD, and cancer. Non-Hispanic White patients were more likely to receive intensive care (29.6% vs 21.1% vs 20.8%, P=.007) and more likely to die (12% vs 7.3% vs 3.5%, P<.001) compared with non-Hispanic Black and Hispanic patients, respectively. Length of stay was similar for all groups. In logistic regression models, Medicaid insurance status independently correlated with hospitalization (OR 3.67, P<.001) while only age (OR 1.076, P<.001) and cerebrovascular disease independently correlated with in-hospital mortality (OR 2.887, P=.002).

Conclusions: Observed COVID-19 in-hospital mortality rate was lower than most published rates. Age, but not race-ethnicity, was independently correlated with in-hospital mortality. Safety net health systems are foundational in the care of vulnerable patients suffering from COVID-19, including patients from under-represented and low-income groups.

目的探讨低收入COVID-19住院患者的种族与病死率是否相关。研究设计:使用电子健康记录数据的观察性队列研究。2020年3月至2021年1月在一个安全网卫生系统评估的所有COVID-19患者。测量患者人口统计学和临床特征，以及医院护理过程和结果。结果25253例新冠肺炎患者中，新冠肺炎阳性6357例(25.2%)，住院1480例(23.3%);334例(22.6%)需要重症监护;106例(7.3%)死亡。西班牙裔患者(51.8%)高于非西班牙裔黑人(31.4%)和白人(16.7%)，P< 0.001。住院的西班牙裔患者更年轻，更经常没有保险，并且不太可能有合并症。非西班牙裔黑人患者有更多的糖尿病、高血压、肥胖、慢性肾病和哮喘(P< 0.05)。非西班牙裔白人患者年龄较大，有更多的吸烟史、慢性阻塞性肺病和癌症。与非西班牙裔黑人和西班牙裔患者相比，非西班牙裔白人患者接受重症监护的可能性更高(29.6% vs 21.1% vs 20.8%， P= 0.007)，死亡的可能性更高(12% vs 7.3% vs 3.5%， P< 0.001)。所有组的住院时间相似。在logistic回归模型中，医疗补助状况与住院率独立相关(OR 3.67, P<.001)，而只有年龄(OR 1.076, P<.001)和脑血管疾病与住院死亡率独立相关(OR 2.887, P=.002)。结论观察到的COVID-19住院死亡率低于大多数公布的死亡率。年龄与住院死亡率独立相关，但与种族无关。安全网卫生系统是护理COVID-19弱势患者的基础，包括代表性不足和低收入群体的患者。

{"title":"Poverty, Comorbidity, and Ethnicity: COVID-19 Outcomes in a Safety Net Health System.","authors":"Joseph P Smith, Amy B Kressel, Randall W Grout, Bree Weaver, Megan Cheatham, Wanzhu Tu, Ruohong Li, David W Crabb, Lisa E Harris, William G Carlos","doi":"10.18865/ed.32.2.113","DOIUrl":"10.18865/ed.32.2.113","url":null,"abstract":"Objective: To determine if race-ethnicity is correlated with case-fatality rates among low-income patients hospitalized for COVID-19.Research design: Observational cohort study using electronic health record data.Patients: All patients assessed for COVID-19 from March 2020 to January 2021 at one safety net health system.Measures: Patient demographic and clinical characteristics, and hospital care processes and outcomes.Results: Among 25,253 patients assessed for COVID-19, 6,357 (25.2%) were COVID-19 positive: 1,480 (23.3%) hospitalized; 334 (22.6%) required intensive care; and 106 (7.3%) died. More Hispanic patients tested positive (51.8%) than non-Hispanic Black (31.4%) and White patients (16.7%, P<.001]. Hospitalized Hispanic patients were younger, more often uninsured, and less likely to have comorbid conditions. Non-Hispanic Black patients had significantly more diabetes, hypertension, obesity, chronic kidney disease, and asthma (P<.05). Non-Hispanic White patients were older and had more cigarette smoking history, COPD, and cancer. Non-Hispanic White patients were more likely to receive intensive care (29.6% vs 21.1% vs 20.8%, P=.007) and more likely to die (12% vs 7.3% vs 3.5%, P<.001) compared with non-Hispanic Black and Hispanic patients, respectively. Length of stay was similar for all groups. In logistic regression models, Medicaid insurance status independently correlated with hospitalization (OR 3.67, P<.001) while only age (OR 1.076, P<.001) and cerebrovascular disease independently correlated with in-hospital mortality (OR 2.887, P=.002).Conclusions: Observed COVID-19 in-hospital mortality rate was lower than most published rates. Age, but not race-ethnicity, was independently correlated with in-hospital mortality. Safety net health systems are foundational in the care of vulnerable patients suffering from COVID-19, including patients from under-represented and low-income groups.","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9037656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43508708","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}

引用次数: 0

Using COVID-19 Surveillance Systems to Identify and Monitor Disparities: Best Practices and Recommendations. 使用新冠肺炎监测系统识别和监测差异：最佳实践和建议。

IF 3.4 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ethnicity & Disease

Pub Date : 2022-04-21 eCollection Date: 2022-01-01 DOI: 10.18865/ed.32.2.151

Nina T Harawa, Bita Amani, Consuela Abotsi-Kowu, Ezinne Nwankwo, Chandra L Ford

Inadequate attention to racial health equity is a common challenge to effective, reliable monitoring and mitigation of COVID-19 disparities. Efforts to monitor and mitigate COVID-19 disparities continue to be hampered by inadequacies in how surveillance systems collect, tabulate, and report COVID-19-related outcomes. We conducted environmental scans of existing public health surveillance systems and reporting standards, literature reviews, focus groups with surveillance experts, and consultations with the Centers for Disease Control and Prevention (CDC) and an expert panel on surveillance to identify and explore strengths, weaknesses, and gaps in how existing systems monitor COVID-19 and their implications for addressing disparities in related outcomes. We present recommendations based on these reviews and propose a core minimum set of health indicators and best-practice standards for reporting these indicators by COVID-19 surveillance systems to monitor racial/ethnic and other disparities in the pandemic. These recommendations are relevant to monitoring disparities in the ongoing COVID-19 pandemic and may inform monitoring of future epidemics. This discussion is part of an effort by Project REFOCUS to develop syndemic surveillance systems for monitoring the intersecting pandemics of COVID-19 and racism.

对种族卫生公平重视不足，是有效、可靠监测和缓解COVID-19差异的共同挑战。由于监测系统在收集、制表和报告COVID-19相关结果方面存在不足，监测和缓解COVID-19差异的努力继续受到阻碍。我们对现有公共卫生监测系统和报告标准进行了环境扫描，进行了文献综述，与监测专家进行了焦点小组讨论，并与疾病控制和预防中心(CDC)和监测专家小组进行了磋商，以确定和探索现有系统监测COVID-19的优势、弱点和差距，以及它们对解决相关结果差异的影响。我们根据这些审查提出了建议，并提出了一套核心的最低限度健康指标和COVID-19监测系统报告这些指标的最佳实践标准，以监测大流行中的种族/民族和其他差异。这些建议与监测当前COVID-19大流行中的差异有关，并可为监测未来流行病提供参考。本次讨论是“重新聚焦项目”努力的一部分，该项目旨在开发传染病监测系统，以监测COVID-19大流行病与种族主义的交叉。

{"title":"Using COVID-19 Surveillance Systems to Identify and Monitor Disparities: Best Practices and Recommendations.","authors":"Nina T Harawa, Bita Amani, Consuela Abotsi-Kowu, Ezinne Nwankwo, Chandra L Ford","doi":"10.18865/ed.32.2.151","DOIUrl":"10.18865/ed.32.2.151","url":null,"abstract":"Inadequate attention to racial health equity is a common challenge to effective, reliable monitoring and mitigation of COVID-19 disparities. Efforts to monitor and mitigate COVID-19 disparities continue to be hampered by inadequacies in how surveillance systems collect, tabulate, and report COVID-19-related outcomes. We conducted environmental scans of existing public health surveillance systems and reporting standards, literature reviews, focus groups with surveillance experts, and consultations with the Centers for Disease Control and Prevention (CDC) and an expert panel on surveillance to identify and explore strengths, weaknesses, and gaps in how existing systems monitor COVID-19 and their implications for addressing disparities in related outcomes. We present recommendations based on these reviews and propose a core minimum set of health indicators and best-practice standards for reporting these indicators by COVID-19 surveillance systems to monitor racial/ethnic and other disparities in the pandemic. These recommendations are relevant to monitoring disparities in the ongoing COVID-19 pandemic and may inform monitoring of future epidemics. This discussion is part of an effort by Project REFOCUS to develop syndemic surveillance systems for monitoring the intersecting pandemics of COVID-19 and racism.","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9037655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47745260","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}

引用次数: 0

Perceived Susceptibility to Chronic Kidney Disease and Hypertension Self-Management among Black and White Live Kidney Donors. 黑人和白人活体肾脏捐献者对慢性肾脏疾病和高血压自我管理的易感性。

IF 3.2 3区医学 Q2 Medicine

Ethnicity & Disease

Pub Date : 2022-04-21 DOI: 10.18865/ed.32.2.101

K. Gianaris, Grecia B. Vargas, Morgan Johnson, Yifan Yu, Elena Wilson, Jamilah A. Perkins, A. Jackson, L. E. Boulware, A. Massie, Macey L. Levan, D. Segev, Tanjala S. Purnell

BackgroundDespite the societal benefits of live kidney donation, Black donors may be more likely than White donors to develop hypertension (HTN) and chronic kidney disease after donation. Among live kidney donors diagnosed with post-donation HTN, little is known about potential racial/ethnic differences in HTN self-care behaviors and perceived susceptibility to developing kidney disease.MethodsWe ascertained electronic medical records and phone survey data from live donors enrolled in the multi-center Wellness and Health Outcomes of LivE Donors (WHOLE-Donor) Hypertension Care Study between May 2013 and April 2020. Using multivariable logistic regression models performed January through June 2021, we examined potential associations of donor race/ethnicity with perceived susceptibility to kidney disease and self-care behaviors (ie, Behavioral Risk Factor Surveillance System measure assessing self-reported actions to control high blood pressure).ResultsThe study included 318 US-based live kidney donors who developed post-donation HTN (57.6% female; 78.9% White; 18.6% Black; and mean age 46.7 years at donation). Black donors were equally as likely as White donors to report being moderately or strongly concerned about developing kidney disease (adjusted odds ratio, aOR: 1.27, 95%CI: .66, 2.14, P=.57). Donors with diabetes were more likely than those without diabetes (aOR: 2.43, 95%CI: 1.03, 5.01, P=.04), while donors aged >50 years were less likely than younger donors (aOR: .39, 95%CI: .18, .85, P=.02) to report being moderately or strongly concerned about kidney disease. Overall, 87% of donors reported taking at least one action to help control blood pressure, with no significant differences by sociodemographic factors.ConclusionsWe found no substantial differences in perceived susceptibility to kidney disease among Black and White donors, despite published evidence that Black donors may experience greater risk of developing kidney disease than White donors. Behavioral interventions to enhance knowledge about future disease risk, attitudes, and self-care strategies among living kidney donors may be beneficial.

背景尽管活体肾脏捐赠具有社会效益，但黑人捐赠者在捐赠后可能比白人捐赠者更容易患上高血压和慢性肾脏疾病。在被诊断为捐赠后HTN的活体肾脏捐献者中，人们对HTN自我照顾行为和易患肾脏疾病的潜在种族/民族差异知之甚少。方法我们确定了2013年5月至2020年4月期间参加live捐献者（全捐献者）高血压护理研究的活体捐献者的电子医疗记录和电话调查数据。使用2021年1月至6月进行的多变量逻辑回归模型，我们研究了供体种族/民族与肾脏疾病易感性和自我护理行为（即行为危险因素监测系统评估自我报告的控制高血压的行为）的潜在关联（57.6%为女性；78.9%为白人；18.6%为黑人；平均捐赠年龄46.7岁）。黑人捐赠者与白人捐赠者报告中度或高度关注肾脏疾病的可能性相同（调整后的比值比，aOR:1.27，95%CI:.66,2.14，P=.57）。患有糖尿病的捐赠者比没有糖尿病的捐赠者更有可能（aOR:2.43，95%CI:1.03,5.01，P=.04），而年龄＞50岁的捐献者报告中度或重度关注肾脏疾病的可能性低于年轻捐献者（aOR:.39，95%CI:.18，.85，P=0.02）。总体而言，87%的献血者报告至少采取了一种行动来帮助控制血压，社会人口因素没有显著差异。结论我们发现黑人和白人捐赠者对肾脏疾病的易感性没有显著差异，尽管已发表的证据表明，黑人捐赠者可能比白人捐赠者患肾脏疾病的风险更大。行为干预可以增强活体肾脏捐献者对未来疾病风险、态度和自我护理策略的了解，这可能是有益的。

{"title":"Perceived Susceptibility to Chronic Kidney Disease and Hypertension Self-Management among Black and White Live Kidney Donors.","authors":"K. Gianaris, Grecia B. Vargas, Morgan Johnson, Yifan Yu, Elena Wilson, Jamilah A. Perkins, A. Jackson, L. E. Boulware, A. Massie, Macey L. Levan, D. Segev, Tanjala S. Purnell","doi":"10.18865/ed.32.2.101","DOIUrl":"https://doi.org/10.18865/ed.32.2.101","url":null,"abstract":"Background\u0000Despite the societal benefits of live kidney donation, Black donors may be more likely than White donors to develop hypertension (HTN) and chronic kidney disease after donation. Among live kidney donors diagnosed with post-donation HTN, little is known about potential racial/ethnic differences in HTN self-care behaviors and perceived susceptibility to developing kidney disease.\u0000\u0000\u0000Methods\u0000We ascertained electronic medical records and phone survey data from live donors enrolled in the multi-center Wellness and Health Outcomes of LivE Donors (WHOLE-Donor) Hypertension Care Study between May 2013 and April 2020. Using multivariable logistic regression models performed January through June 2021, we examined potential associations of donor race/ethnicity with perceived susceptibility to kidney disease and self-care behaviors (ie, Behavioral Risk Factor Surveillance System measure assessing self-reported actions to control high blood pressure).\u0000\u0000\u0000Results\u0000The study included 318 US-based live kidney donors who developed post-donation HTN (57.6% female; 78.9% White; 18.6% Black; and mean age 46.7 years at donation). Black donors were equally as likely as White donors to report being moderately or strongly concerned about developing kidney disease (adjusted odds ratio, aOR: 1.27, 95%CI: .66, 2.14, P=.57). Donors with diabetes were more likely than those without diabetes (aOR: 2.43, 95%CI: 1.03, 5.01, P=.04), while donors aged >50 years were less likely than younger donors (aOR: .39, 95%CI: .18, .85, P=.02) to report being moderately or strongly concerned about kidney disease. Overall, 87% of donors reported taking at least one action to help control blood pressure, with no significant differences by sociodemographic factors.\u0000\u0000\u0000Conclusions\u0000We found no substantial differences in perceived susceptibility to kidney disease among Black and White donors, despite published evidence that Black donors may experience greater risk of developing kidney disease than White donors. Behavioral interventions to enhance knowledge about future disease risk, attitudes, and self-care strategies among living kidney donors may be beneficial.","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42677142","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}

引用次数: 0

Social Engagement and Mental Health Symptoms Across Asian American Ethnic Groups During the COVID-19 Pandemic. 新冠肺炎大流行期间亚裔美国人群体的社会参与和心理健康症状

IF 3.2 3区医学 Q2 Medicine

Ethnicity & Disease

Pub Date : 2022-04-21 DOI: 10.18865/ed.32.2.131

J. Islam, Iman Awan, F. Kapadia

BackgroundTo examine social engagement and mental health symptoms during the COVID-19 pandemic across Asian American (AA) ethnic groups.MethodsData from three waves of the nationally representative COVID-19 Household Impact Survey (4/20/2020-6/8/2020) were used to describe social engagement and mental health symptoms during the pandemic. Associations between mental health and social engagement were assessed via multinomial logistic regression.ResultsIn this sample of 312 AAs (36.9% Chinese American, 30.9% South Asian American, 20.1% Filipino/Vietnamese American, and 12.0% Japanese/Korean American), daily communication with neighbors declined for Chinese, South Asian and Filipino/Vietnamese Americans but increased for Japanese/Korean Americans (P=.012) whereas communication with friends/family increased only for Filipino/Vietnamese, Japanese/Korean and South Asian Americans (P<0.001). Differences in self-reported symptoms of anxiety, depression, loneliness, and hopelessness were observed across AA ethnic groups. In adjusted models, lower social engagement was associated with frequent (3-4 days/week) depressive symptoms during the preceding week (cOR:3.26, 95%CI:1.01-10.5). This association was heightened for Asian men (cOR:14.22, 95%CI:3.62-55.8).ConclusionsHeterogeneity of social engagement and mental health symptoms across AA ethnicities was observed. Understanding associations between social engagement and mental health within different communities is necessary to provide culturally and linguistically appropriate mental health treatment and care.

背景研究新冠肺炎大流行期间亚裔美国人（AA）族群的社会参与和心理健康症状。方法使用三波具有全国代表性的新冠肺炎家庭影响调查（2020年4月20日至2020年6月8日）的数据来描述疫情期间的社会参与和心理健康症状。心理健康与社会参与之间的关系通过多项逻辑回归进行评估。结果在312名AAs（36.9%的华裔美国人、30.9%的南亚裔美国人、20.1%的菲律宾裔/越南裔美国人和12.0%的日裔/韩裔美国人）的样本中，华裔、南亚裔和菲律宾裔/越南裔美国人与邻居的日常沟通有所下降，而日裔/朝鲜裔美国人与朋友/家人的沟通有所增加（P=.012），日本/韩国和南亚裔美国人（P<0.001）。在AA种族中观察到焦虑、抑郁、孤独和绝望的自我报告症状的差异。在调整后的模型中，较低的社交参与度与前一周频繁（3-4天/周）的抑郁症状相关（cOR:3.26，95%CI:1.01-10.5）。亚洲男性的这种关联性更高（cOR:14.22，95%CI:3.62-55.8）。结论AA种族的社交参与和心理健康症状存在异质性。了解不同社区的社会参与与心理健康之间的联系，对于提供文化和语言上合适的心理健康治疗和护理是必要的。

{"title":"Social Engagement and Mental Health Symptoms Across Asian American Ethnic Groups During the COVID-19 Pandemic.","authors":"J. Islam, Iman Awan, F. Kapadia","doi":"10.18865/ed.32.2.131","DOIUrl":"https://doi.org/10.18865/ed.32.2.131","url":null,"abstract":"Background\u0000To examine social engagement and mental health symptoms during the COVID-19 pandemic across Asian American (AA) ethnic groups.\u0000\u0000\u0000Methods\u0000Data from three waves of the nationally representative COVID-19 Household Impact Survey (4/20/2020-6/8/2020) were used to describe social engagement and mental health symptoms during the pandemic. Associations between mental health and social engagement were assessed via multinomial logistic regression.\u0000\u0000\u0000Results\u0000In this sample of 312 AAs (36.9% Chinese American, 30.9% South Asian American, 20.1% Filipino/Vietnamese American, and 12.0% Japanese/Korean American), daily communication with neighbors declined for Chinese, South Asian and Filipino/Vietnamese Americans but increased for Japanese/Korean Americans (P=.012) whereas communication with friends/family increased only for Filipino/Vietnamese, Japanese/Korean and South Asian Americans (P<0.001). Differences in self-reported symptoms of anxiety, depression, loneliness, and hopelessness were observed across AA ethnic groups. In adjusted models, lower social engagement was associated with frequent (3-4 days/week) depressive symptoms during the preceding week (cOR:3.26, 95%CI:1.01-10.5). This association was heightened for Asian men (cOR:14.22, 95%CI:3.62-55.8).\u0000\u0000\u0000Conclusions\u0000Heterogeneity of social engagement and mental health symptoms across AA ethnicities was observed. Understanding associations between social engagement and mental health within different communities is necessary to provide culturally and linguistically appropriate mental health treatment and care.","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48956957","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}

引用次数: 2

The Importance of Incorporating Stroke Survivors' Health Perceptions in Addressing Health Care Disparities. 纳入中风幸存者的健康观念在解决医疗保健差距的重要性。

IF 3.2 3区医学 Q2 Medicine

Ethnicity & Disease

Pub Date : 2022-04-21 DOI: 10.18865/ed.32.2.145

Rondalyn R. Dickens, T. Gyang, Sadie B Sanders, Charles Ellis Jr, A. Simpkins

Patient-centered research in determining health care disparities among stroke patients is limited. Several studies have examined patient perceptions in stroke survivors and have utilized the Illness Perceptions Questionnaire-Revised (IPQ-R) and Brief Illness Perceptions Questionnaire (BIPQ), which are validated measures of illness beliefs. Yet, there are several domains these surveys could assess that warrant more investigation, including: perception of medication side effects; acceptance of the stroke diagnosis; consequence and long-term impact of symptoms; the importance of medications in long-term health maintenance; and perception of ease of access to equitable health care. Though these surveys are available, representation of diverse and under-represented groups within stroke surveys utilizing them is low. Also, only a limited number of studies of stroke patients' perceptions have focused on health disparities or specifically beliefs and attitudes of under-represented stroke survivors. Due to insufficient current research, future studies should focus on using these patient perception questionnaires with underrepresented populations. Improvements in this field may allow providers to offer patient-centered care among a diverse population, bridging gaps in health care equity.

以患者为中心的研究在确定中风患者之间的医疗保健差异方面是有限的。几项研究调查了中风幸存者的患者认知，并使用了修订的疾病认知问卷（IPQ-R）和简短的疾病认知调查表（BIPQ），这是对疾病信念的有效测量。然而，这些调查可以评估的几个领域需要更多的调查，包括：药物副作用的感知；接受中风诊断；症状的后果和长期影响；药物在长期健康维护中的重要性；以及容易获得公平医疗保健的观念。尽管这些调查是可用的，但在使用这些调查的中风调查中，不同和代表性不足的群体的代表性很低。此外，只有有限数量的中风患者认知研究关注健康差异，特别是代表性不足的中风幸存者的信念和态度。由于目前的研究不足，未来的研究应侧重于在代表性不足的人群中使用这些患者感知问卷。这一领域的改进可能使提供者能够在不同人群中提供以患者为中心的护理，弥合医疗保健公平方面的差距。

{"title":"The Importance of Incorporating Stroke Survivors' Health Perceptions in Addressing Health Care Disparities.","authors":"Rondalyn R. Dickens, T. Gyang, Sadie B Sanders, Charles Ellis Jr, A. Simpkins","doi":"10.18865/ed.32.2.145","DOIUrl":"https://doi.org/10.18865/ed.32.2.145","url":null,"abstract":"Patient-centered research in determining health care disparities among stroke patients is limited. Several studies have examined patient perceptions in stroke survivors and have utilized the Illness Perceptions Questionnaire-Revised (IPQ-R) and Brief Illness Perceptions Questionnaire (BIPQ), which are validated measures of illness beliefs. Yet, there are several domains these surveys could assess that warrant more investigation, including: perception of medication side effects; acceptance of the stroke diagnosis; consequence and long-term impact of symptoms; the importance of medications in long-term health maintenance; and perception of ease of access to equitable health care. Though these surveys are available, representation of diverse and under-represented groups within stroke surveys utilizing them is low. Also, only a limited number of studies of stroke patients' perceptions have focused on health disparities or specifically beliefs and attitudes of under-represented stroke survivors. Due to insufficient current research, future studies should focus on using these patient perception questionnaires with underrepresented populations. Improvements in this field may allow providers to offer patient-centered care among a diverse population, bridging gaps in health care equity.","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43672518","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}

引用次数: 0

Generation 1.5: Years in the United States and Other Factors Affecting Smoking Behaviors Among Asian Americans. 第1.5代:亚裔美国人在美国的年龄和影响吸烟行为的其他因素。

IF 3.2 3区医学 Q2 Medicine

Ethnicity & Disease

Pub Date : 2022-04-21 DOI: 10.18865/ed.32.2.75

Lu Shi, M. Mayorga, Dejun Su, Yan Li, Emily Martin, D. Zhang

IntroductionGeneration 1.5, immigrants who moved to a different country before adulthood, are hypothesized to have unique cognitive and behavioral patterns. We examined the possible differences in cigarette smoking between Asian subpopulations who arrived in the United States at different life stages.MethodsUsing the Asian subsample of the 2015 Tobacco Use Supplement to the Current Population Survey, we tested this Generation 1.5 hypothesis with their smoking behavior. This dataset was chosen because its large sample size allowed for a national-level analysis of the Asian subsamples by sex, while other national datasets might not have adequate sample sizes for analysis of these subpopulations. The outcome variable was defined as whether the survey respondent had ever smoked 100 cigarettes or more, with the key independent variable operationalized as whether the respondent was: 1) born in the United States; 2) entered the United States before 12; 3) entered between 12 and 19; and 4) entered after 19. Logistic regressions were run to examine the associations with covariates including the respondent's age, educational attainment, and household income.ResultsAsian men who entered before 12 were less likely to have ever smoked 100 cigarettes than those who immigrated after 19; for Asian women, three groups (born in the United States, entered before 12, entered between 12 and 19) were more likely to have smoked 100 cigarettes than those who immigrated after 19.ConclusionsWhile Asian men who came to the United States before 12 were less at risk for cigarette smoking than those who immigrated in adulthood, the pattern was the opposite among Asian women. Those who spent their childhood in the United States were more likely to smoke than those who came to the United States in adulthood. These patterns might result from the cultural differences between US and Asian countries, and bear policy relevance for the tobacco control efforts among Asian Americans.

第1.5代，即在成年前移居到另一个国家的移民，被认为具有独特的认知和行为模式。我们研究了在不同人生阶段到达美国的亚洲亚人群在吸烟方面可能存在的差异。方法利用2015年当前人口调查烟草使用补充资料中的亚洲亚样本，用他们的吸烟行为来检验这一1.5代假设。之所以选择这个数据集，是因为它的大样本量允许按性别对亚洲亚样本进行国家级分析，而其他国家数据集可能没有足够的样本量来分析这些亚人群。结果变量定义为被调查者是否曾经吸过100支或更多的香烟，关键的自变量被操作为被调查者是否:1)出生在美国;2) 12日前入境美国;3) 12岁至19岁;19岁以后进入大学。运用逻辑回归来检验与协变量的关联，包括受访者的年龄、受教育程度和家庭收入。结果12岁之前移民的亚裔男性比19岁之后移民的亚裔男性吸过100支烟的可能性要小;对于亚洲女性来说，三个群体(出生在美国、12岁之前移民、12岁至19岁之间移民)比19岁以后移民的女性更有可能抽100支烟。结论:12岁以前来美国的亚裔男性吸烟的风险低于成年后移民的男性，而亚裔女性的情况则相反。那些在美国度过童年的人比那些成年后来到美国的人更有可能吸烟。这些模式可能是由美国和亚洲国家之间的文化差异造成的，并与亚裔美国人的烟草控制努力具有政策相关性。

{"title":"Generation 1.5: Years in the United States and Other Factors Affecting Smoking Behaviors Among Asian Americans.","authors":"Lu Shi, M. Mayorga, Dejun Su, Yan Li, Emily Martin, D. Zhang","doi":"10.18865/ed.32.2.75","DOIUrl":"https://doi.org/10.18865/ed.32.2.75","url":null,"abstract":"Introduction\u0000Generation 1.5, immigrants who moved to a different country before adulthood, are hypothesized to have unique cognitive and behavioral patterns. We examined the possible differences in cigarette smoking between Asian subpopulations who arrived in the United States at different life stages.\u0000\u0000\u0000Methods\u0000Using the Asian subsample of the 2015 Tobacco Use Supplement to the Current Population Survey, we tested this Generation 1.5 hypothesis with their smoking behavior. This dataset was chosen because its large sample size allowed for a national-level analysis of the Asian subsamples by sex, while other national datasets might not have adequate sample sizes for analysis of these subpopulations. The outcome variable was defined as whether the survey respondent had ever smoked 100 cigarettes or more, with the key independent variable operationalized as whether the respondent was: 1) born in the United States; 2) entered the United States before 12; 3) entered between 12 and 19; and 4) entered after 19. Logistic regressions were run to examine the associations with covariates including the respondent's age, educational attainment, and household income.\u0000\u0000\u0000Results\u0000Asian men who entered before 12 were less likely to have ever smoked 100 cigarettes than those who immigrated after 19; for Asian women, three groups (born in the United States, entered before 12, entered between 12 and 19) were more likely to have smoked 100 cigarettes than those who immigrated after 19.\u0000\u0000\u0000Conclusions\u0000While Asian men who came to the United States before 12 were less at risk for cigarette smoking than those who immigrated in adulthood, the pattern was the opposite among Asian women. Those who spent their childhood in the United States were more likely to smoke than those who came to the United States in adulthood. These patterns might result from the cultural differences between US and Asian countries, and bear policy relevance for the tobacco control efforts among Asian Americans.","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43742628","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}

引用次数: 1

Accuracy of Perceived Breast Cancer Risk in Black and White Women with an Elevated Risk. 风险升高的黑人和白人女性乳腺癌症风险感知的准确性。

IF 3.2 3区医学 Q2 Medicine

Ethnicity & Disease

Pub Date : 2022-04-21 DOI: 10.18865/ed.32.2.81

Jessica M.L. Young, K. Postula, D. Duquette, Melissa Gutierrez-Kapheim, Vivian Pan, M. Katapodi

IntroductionPerceived breast cancer risk predicts screening behaviors. However, perceived risk is often inaccurate, notably in Black women, who often underestimate their risk despite having higher disease-specific mortality rates. We examined predictors of perceived breast cancer risk, and its impact on surveillance.MethodsWe used baseline data from a randomized trial targeting unaffected women recruited by relatives with early-onset breast cancer. Data collection occurred between 2012 and 2013. Accuracy of perceived risk was assessed by comparing perceived risk to objective lifetime breast cancer risks, calculated with the Gail and Claus models. A multivariate mixed model regression examined predictors of accuracy of perceived risk. The impact of perceived risk on breast cancer surveillance was assessed with one-way ANOVAS comparing Black to White women.ResultsAmong participants, 21.4% self-identified as Black and 78.6% as White. Overall, 72.9% (n=247/339), 16.2% (n=55/339), and 10.9% (n=37/339) of participants overestimated, accurately perceived, and underestimated, respectively, their lifetime breast cancer risk. Race did not predict the accuracy of risk perception. Younger participants were more likely to overestimate their risk (β=-.455; CI [-.772, -.138]; P=.005). MRI utilization was predicted by a higher objective risk (F 1,263 [= 30.271]; P<.001) and more accurate risk perception (P=.010; Fisher's exact test).ConclusionsMost women with a family history of early-onset breast cancer inaccurately perceived their risk for developing the disease. Younger women were more likely to overestimate their risk. Findings can guide the development of tailored interventions to improve adherence to breast cancer surveillance recommendations.

引言癌症风险可预测筛查行为。然而，感知到的风险往往是不准确的，尤其是在黑人女性中，尽管她们的疾病特异性死亡率较高，但她们往往低估了自己的风险。我们研究了感知乳腺癌症风险的预测因素及其对监测的影响。方法我们使用了一项随机试验的基线数据，该试验针对的是早发性癌症亲属招募的未受影响的女性。数据收集发生在2012年至2013年之间。感知风险的准确性是通过将感知风险与癌症终生客观风险进行比较来评估的，用盖尔和克劳斯模型计算。多元混合模型回归检验了感知风险准确性的预测因素。通过单因素方差分析比较黑人和白人女性，评估感知风险对乳腺癌症监测的影响。结果在参与者中，21.4%的人认为自己是黑人，78.6%的人认为是白人。总体而言，72.9%（n=247/339）、16.2%（n=55/339）和10.9%（n=37/339）的参与者分别高估、准确感知和低估了他们一生癌症的风险。种族并没有预测风险感知的准确性。年轻的参与者更有可能过高估计他们的风险（β=-4.55；CI[-.772，-.138]；P=.005）。MRI利用率通过更高的客观风险（F 1263[=30.271]；P<.001）和更准确的风险感知（P=.010；Fisher精确检验）来预测。结论大多数有早发性癌症家族史的女性对其发展疾病的风险感知不准确。年轻女性更可能高估自己的风险。研究结果可以指导制定量身定制的干预措施，以提高对癌症监测建议的遵守率。

{"title":"Accuracy of Perceived Breast Cancer Risk in Black and White Women with an Elevated Risk.","authors":"Jessica M.L. Young, K. Postula, D. Duquette, Melissa Gutierrez-Kapheim, Vivian Pan, M. Katapodi","doi":"10.18865/ed.32.2.81","DOIUrl":"https://doi.org/10.18865/ed.32.2.81","url":null,"abstract":"Introduction\u0000Perceived breast cancer risk predicts screening behaviors. However, perceived risk is often inaccurate, notably in Black women, who often underestimate their risk despite having higher disease-specific mortality rates. We examined predictors of perceived breast cancer risk, and its impact on surveillance.\u0000\u0000\u0000Methods\u0000We used baseline data from a randomized trial targeting unaffected women recruited by relatives with early-onset breast cancer. Data collection occurred between 2012 and 2013. Accuracy of perceived risk was assessed by comparing perceived risk to objective lifetime breast cancer risks, calculated with the Gail and Claus models. A multivariate mixed model regression examined predictors of accuracy of perceived risk. The impact of perceived risk on breast cancer surveillance was assessed with one-way ANOVAS comparing Black to White women.\u0000\u0000\u0000Results\u0000Among participants, 21.4% self-identified as Black and 78.6% as White. Overall, 72.9% (n=247/339), 16.2% (n=55/339), and 10.9% (n=37/339) of participants overestimated, accurately perceived, and underestimated, respectively, their lifetime breast cancer risk. Race did not predict the accuracy of risk perception. Younger participants were more likely to overestimate their risk (β=-.455; CI [-.772, -.138]; P=.005). MRI utilization was predicted by a higher objective risk (F 1,263 [= 30.271]; P<.001) and more accurate risk perception (P=.010; Fisher's exact test).\u0000\u0000\u0000Conclusions\u0000Most women with a family history of early-onset breast cancer inaccurately perceived their risk for developing the disease. Younger women were more likely to overestimate their risk. Findings can guide the development of tailored interventions to improve adherence to breast cancer surveillance recommendations.","PeriodicalId":50495,"journal":{"name":"Ethnicity & Disease","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45129346","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}

引用次数: 2

What Happens When the Crisis Seemingly Never Ends? Perspectives in Health Communication. 当危机似乎永远不会结束时会发生什么？健康传播的视角。

IF 3.2 3区医学 Q2 Medicine

Ethnicity & Disease

Pub Date : 2022-04-21 DOI: 10.18865/ed.32.2.165

Monica L. Ponder

Ethn Dis. 2022;32(2):165-168; doi:10.18865/ed.32.2.165

Ethn Dis。2022年；32（2）:165-168；doi:10.18865/ed.32.2.165

引用次数: 1