Social and Behavioral Sciences Commons^™

Environmentally Marginalized Populations: The "Perfect Storm" For Infectious Disease Pandemics, Including Covid-19, Gabriella Y. Meltzer, Oyemwenosa Avenbuan, Christina Awada, Oluwakemi B. Oyetade, Tricia Blackman, Simona Kwon Drph, Mph, Esther Erdei Phd, Judith T. Zelikoff Phd

Journal of Health Disparities Research and Practice

COVID-19 has exacted a severe toll on the United States population’s physical and mental health and its effects have been felt most severely among people of color and low socioeconomic status. Using illustrative case studies, this commentary argues that in addition to COVID-19 health disparities created by psychosocial stressors such as the inability to socially distance and access quality healthcare, environmental justice communities have the additional burden of disproportionate exposure to toxic contaminants that contribute to their higher risk of COVID-19. Environmental contaminants including heavy metals and persistent organic pollutants found contaminating their nearby environments can alter the immune response, …

Risk Factors Associated With Opioid Use Among African American Faith-Based Populations, Kelsey Christensen Ma, Jannette Berkley-Patton Phd, Alexandria Bauer Phd, Carole Bowe Thompson, Tacia Burgin

Journal of Health Disparities Research and Practice

African Americans (AAs) in the Midwest are more likely to die from an opioid overdose compared to Whites, despite lower rates of use. Little is known about factors related to opioid use among AAs residing in the Midwest, particularly church-affiliated AAs. AAs have the highest rate of church attendance among all racial/ethnic groups, and the Black Church may be an appropriate setting for prevention efforts. The present study sought to better understand factors related to opioid use among Midwestern church-affiliated AAs to inform future faith-based interventions. This study examined predictors of opioid use (ever) using survey data from Taking It …

A Lung Cancer Screening Personalized Decision-Aid Improves Knowledge And Reduces Decisional Conflict Among A Diverse Population Of Smokers At An Urban Academic Medical Center, Madeline Kaufman, Nilan Schnure, Andrea Nicholson, Frank Leone, Carmen Guerra

Journal of Health Disparities Research and Practice

Introduction: Few lung cancer screening decision aids have been tested in diverse populations. The study objective was to determine whether the online decision aid www.shouldiscreen.com impacts knowledge of and decisional conflict around lung cancer screening in a diverse population.

Methods: Eligible patients had significant smoking histories, were at increased risk for lung cancer (ages 45-80, >20 pack-years, smoking within last 15 years) and had no history of prior lung cancer or screening. Data was collected and analyzed in 2017.

Results: 40 patients were enrolled: 80% were female, 62.5% black, 33% white, and 48% had a high school …

The Right To Vote, The Right To Health: Voter Suppression As A Determinant Of Racial Health Disparities, Anna K. Hing

Journal of Health Disparities Research and Practice

Civic participation is beneficial to one’s health. Conversely, being unable to participate, such as being unable to vote, may be detrimental for health. Barriers that prevent voting and civic participation, which constitute voter suppression, disproportionately impact people of color. Therefore, voter suppression may explain intractable racial health disparities. However, few studies have examined the connection between voter suppression and health. In consideration of the frequent, and increasing, reports of voter suppression in recent elections, including the rise in voter identification laws, the reduction in early voting opportunities, and the closing of polling places, the field of public health should address …

Healthcare Access And Utilization By Transgender Populations: A United States Transgender Survey Study, Axenya Kachen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Transgender communities in the United States are highly marginalized and have been systematically and infrastructurally ignored due to the widespread fundamental belief that gender exists as a binary classification. The dichotomous theoretical framework of sex and gender prevented public recognition of this community as a population of interest for public health research and targeted intervention. Sexual and gender minority (SGM) populations have fought for basic human rights, including access to affordable healthcare. The National Center for Transgender Equality (NCTE) was founded in 2003 to advocate for the advancement of equality for transgender people. In 2015, the NCTE conducted the United …

Building Health Equity One Institution At A Time: The Research Infrastructure In Minority Institutions Project, Laura H. D'Anna, Dennis G. Fisher, Lyka Eunice F. Trinidad, Carol Canjura, Jefferson L. Wood

Journal of Health Disparities Research and Practice

Developing a well-trained workforce interested in, and prepared for, conducting health equity research is an important national priority. Scientists from Minority-Serving Institutions (MSIs) bring unique perspectives and experiences with racial, ethnic and social inequities in health and health status but often lack access to training and mentoring opportunities, which is crucial for increasing the diverse pool of investigators who are adequately prepared to conduct health disparities research and to compete for National Institutes of Health research funding. The focus of the California State University, Long Beach (CSULB) Research Infrastructure in Minority Institutions (RIMI) Project was to: (a) enhance CSULB’s infrastructure …

Healthy Lifestyle Behaviors And Disparities Between The United States Mainland Compared To Puerto Rico, Guam, And United States Virgin Islands (I. E., United States Territories), Wendell C. Taylor, Dena Shugart, Raheem J. Paxton

Journal of Health Disparities Research and Practice

Background: No studies have compared the lifestyle behaviors between Puerto Rico, Guam, and the U. S. Virgin Islands to that of the United States mainland. Documenting and addressing health disparities between these geographically and culturally distinct areas are important public health objectives. Differences in health status between and among the United States mainland and territories merit systematic and careful analyses. Methods: Four key healthy lifestyle characteristics include tobacco use, body mass index, physical activity, and fruit/vegetable consumption. Data from the 2009 Behavioral Risk Factor Surveillance System (N=420,481) were used to examine United States mainland and territorial differences among the four …

Medical Mistrust, Hiv-Related Conspiracy Beliefs, And The Need For Cognitive Closure Among Urban-Residing African American Women: An Exploratory Study, Jennifer Rae Myers Phd, Kelsey Ball Phd, Sharlene L. Jeffers Ma, William B. Lawson Md, Phd, Dlfapa,Pa

Journal of Health Disparities Research and Practice

Despite advances regarding access to care and overall treatment, medical mistrust remains an important factor regarding clinical research participation as well as prevention/treatment-seeking behaviors among African American women. Such attitudes may be a result of psychosocial variables such as HIV-related conspiracy endorsement as well as a need for cognitive closure (NFCC) that reinforces their beliefs of interpersonal and institutional discrimination. To explore how well these psychosocial factors predict medical mistrust, thirty-five urban-residing African American women completed a demographics survey, the Medical Mistrust Index (MMI), a HIV-related conspiracy beliefs survey, and the Need for Closure Scale (NFCS). Results showed that the …

Higher Quality At Lower Cost: Community Health Worker Interventions In The Health Care Innovation Awards, Caitlin Cross-Barnet, Sarah Ruiz, Megan Skillman, Rina Dhopeshwarkar, Rachel Singer, Rachel Carpenter, Suzanne Campanella, Maysoun Freij, Lynne Snyder, Erin Colligan

Journal of Health Disparities Research and Practice

Background: Published evidence regarding cost savings, reduced utilization, and improved quality associated with employing community health workers (CHWs) is largely lacking. This paper presents findings from the Centers for Medicare & Medicaid Services Health Care Innovation Awards (HCIA), with a focus on six diverse programs that employ CHWs. We examine outcomes associated with programs incorporating CHWs into care teams for a broad age range of patients with various health issues such as cancer, asthma, and complex conditions.

Methods: This mixed-methods study used data from claims and site visits to assess the effectiveness of CHW programs. In difference-in-differences analyses of Medicare …

Racial/Ethnic Disparities In Diabetes Care And Outcomes: A Mixed Methods Study, Yhenneko J. Taylor, Marion E. Davis, Rohan Mahabaleshwarkar, Melanie D. Spencer

Journal of Health Disparities Research and Practice

Limited research has examined racial/ethnic differences in diabetes care and outcomes among primary care patients. This study examined racial/ethnic differences in diabetes care and outcomes among an ambulatory patient population and explored patient perceptions of the patient-provider relationship to inform strategies to improve care delivery. Using data from 62,149 adults with diabetes who received care within Atrium Health in 2013, regression models assessed associations between race/ethnicity and the following outcomes: glycated hemoglobin (HbA1c) tests, low density lipoprotein (LDL) and blood pressure (BP) screening, foot and eye exams, and HbA1c, LDL, and BP control. Eleven patients with diabetes and uncontrolled hypertension …

Alternative Financial Services And Health Status In U.S. Metropolitan Statistical Areas, Courtney Hundley, Richard W. Wilson 8520196, John Chenault

Journal of Health Disparities Research and Practice

Abstract

Alternative financial services (AFS) such as, payday lenders, pawn brokers, tax refund loans, and check cashers are more prevalent in minority and lower income neighborhoods. These are neighborhoods also found to have disparities in health, compared to more affluent neighborhoods and communities. The focus of this paper is to determine if any relationship exists between use of AFS and health disparities.

Using data from a survey performed by the Federal Deposit Insurance Corporation (FDIC), we compared four banking variables to several measures of health for 85 metropolitan statistical areas (MSA) across the nation. The four banking variables all related …

Household Financial Assets Inequity And Health Disparities Among Young Adults: Evidence From The National Longitudinal Study Of Adolescent To Adult Health, Shiyou Wu, Xiafei Wang, Qi Wu, Kathleen Mullan Harris

Journal of Health Disparities Research and Practice

Introduction: Research has established a strong relationship between financial resources and health outcomes. Yet, little is known about the effects of assets disparities on health outcomes, especially during the critical period when adolescents transition to adults.

Methods: Using data from the National Longitudinal Study of Adolescent to Adult Health (n = 10,861), this study investigated the relationships between three household total assets value groups (low, moderate, and high assets) and three net worth groups (negative, neutral, and positive) on young adults’ general health, obese, and depression.

Results: Both assets and debts were related to young adults’ health status, …

Integrating Students Into Interdisciplinary Health And Health Disparities Research Teams, Tanya M. Coakley, Allyson Kelley, Robin Bartlett, Terri Shelton, Schenita D. Randolph, Debra C. Wallace

Journal of Health Disparities Research and Practice

Major initiatives by the U.S. Department of Health and Human Services as well as the World Health Organization have produced a large and compelling body of evidence on how to reduce health disparities, which entails having a clear understanding of how social factors shape health and healthcare outcomes. Specifically, there is a need for healthcare professionals to understand social determinants of health (e.g., low socioeconomic status, lack of health insurance, and poor education) and how these lead to disparities in health for people of minority racial and ethnic groups. Little is known about how students are developed as health disparities …

Calidad De Vida: An Exploratory Investigation Of Latino Breast Cancer Survivors And Intimate Partners, Sejal Barden, Daniel Gutierrez, Jessica Gonzalez, Shainna Ali

Journal of Health Disparities Research and Practice

Advances in addressing psychosocial issues related to cancer treatment and prevention are not reaching all survivors equally. Latina breast cancer survivors and intimate partners are underrepresented in psychosocial interventions, and there is a scarcity of research on the influence of cancer on Latino couples’ quality of life. The purpose of this manuscript is to present findings from a trans-linguistic, dyadic qualitative research study aimed at exploring the influence of cancer on quality of life for Latina breast cancer survivors and their intimate partners. Results highlight several areas that are helpful and hindering to supporting survivorship.

Mapping The Alignment Of Programmatic Mission, Functions And Outcomes With The Attainment Of Health Equity: An Overview Of The Approach And Initial Outcomes Through The Lens Of The Usda’S Cyfar Scp Program, Onyemaechi Nweke, Kara Ryan, Mpp, Bonita Williams, Phd

Journal of Health Disparities Research and Practice

Eliminating health disparities is a priority across national agenda and initiatives such as the National Partnership for Action to End Health Disparities (NPA), the National Prevention Strategy, and Healthy People 2020. To advance this priority under the NPA, the Federal Interagency Health Equity Team (FIHET), which is an NPA federal cross-sector and collaborative platform, initiated a voluntary pilot “health equity mapping” exercise in 2014. This exercise served as a strategy to clarify the strategic alignment between participant federal partner program missions, goals, and activities, and the goal to end health disparities and promote health equity. The mapping process included an …

Improving Access And Utilization Of Data To Support Research And Programs Intended To Eliminate Disparities And Promote Health Equity, Rosaly Correa-De-Araujo

Journal of Health Disparities Research and Practice

Numerous Federal initiatives are addressing health and health care disparities. The ultimate goal is to achieve “a nation free of disparities in health and health care.” Social determinants of health remain mostly responsible for health/health care disparities among population groups within and between countries. In the United States, there is little evidence that disparities associated with such determinants are decreasing, with only 10% of those associated with race/ethnicity and income having demonstrated improvement in recent years. A variety of data sources are available from the Federal and private sectors to support research on disparities, but no single national survey seems …

Utilizing Title Vi As A Means To Eradicate Health Discrimination, Adrian D. Samuels, Mariah L. Cole

Journal of Health Disparities Research and Practice

Health disparities among people of color are persistent and detrimental to the overall wellness of these groups. Discrimination in the provision of health care services is one of the primary causes of health disparities. Title VI of the Civil Rights Act of 1964’s availability as a tool to prevent discrimination and, in turn, disparities among these groups is underdocumented. The legislative intent of Title VI and the historical context of the law have been helpful in its use outside of the health care arena to prevent discrimination. This sheds light on the ways that the law can influence the health …

Social Determinants Of Health Associated With Hbv Testing And Access To Care Among Foreign-Born Persons Residing In The United States: 2009 - 2012, Kevin M. Greene, Wayne A. Duffus, Jian Xing, Hope King

Journal of Health Disparities Research and Practice

Objectives: To describe how select Social Determinants of Health (SDH) are associated with the burden of hepatitis B virus (HBV) infection among foreign-born persons residing in the United States.

Methods: Multivariate logistic regression was used to examine the Racial and Ethnic Approaches to Community Health (REACH) 2010 Risk Factor Survey data to investigate the independent relationship between SDH and HBV testing and access to care.

Results: HBV infected persons with insurance were more likely to see a physician than those without. Respondents worried about money to pay rent or mortgage were more likely to report HBV infection than …

Child-Mediated Health Communication: A Conceptual Framework For Increasing Stroke Literacy In Hard To Reach Populations, Olajide Williams, Ellyn Leighton-Herrmann, Mindy F. Hecht, Alexandra Desorbo, William Gerin, Monique Hedmann, Rachel Shelton, Benjamin Tolchin, James Noble

Journal of Health Disparities Research and Practice

Effectively engaging economically-disadvantaged ethnic minority communities for promoting health has proved to be challenging for a variety of reasons, including factors related to healthcare access, literacy, inadequate or ineffective cultural appropriateness of materials, and the relatively low priority for health due to competing demands related to economic hardship. We have developed a framework of Child-Mediated Health Communication (CMHC), which focuses on children as channels for carrying out health promotion interventions to parents and other caregivers. CMHC is an innovative, alternative strategy for engaging this underserved population, where traditional methods of health promotion have not been successful. We discuss the theoretical …

Hiv Treatment Outcome Disparities: Using Web-Based Technology To Promote Adherence And Engagement With Care Among African American Patients, Eric Houston, Brenda Wolfe, Alexander K. Tatum, Monique Rucker, Norma Rolfsen, Maryanne Williams, Nancy Glick

Journal of Health Disparities Research and Practice

Ethnic minorities continue to be disproportionately affected by the HIV epidemic and those individuals living with the virus experience differential outcomes in treatment. Technology-based approaches have been used to address a variety of health problems, but few studies have focused on the application of these approaches in addressing HIV treatment disparities. Using a sample of African-American patients identified as lost to follow-up for HIV treatment (n=33), this study examined the feasibility and acceptability of a web-based program designed to assess and improve treatment engagement. Participants were randomly assigned to either the web-based assessment program or the control group. Measures of …

Race, Age, And Neighborhood Socioeconomic Status In Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry, Sheryl L. Coley, Tracy R. Nichols

Journal of Health Disparities Research and Practice

Introduction: Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers.

Methods: Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial …

Women’S Experiences With Prenatal Care: A Mixed-Methods Study Exploring The Influence Of The Social Determinants Of Health, Karen A. D'Angelo, Janelle K. Bryan, Brenda Kurz

Journal of Health Disparities Research and Practice

Background & Purpose: Racial and ethnic disparities pervade birth outcomes in the United States and the state of Connecticut. While Connecticut’s infant mortality rate is less than the national average, rates for the state’s Black/African American and Hispanic/Latino communities exceed it. This study explored how prenatal care in Connecticut may be enhanced to address these disparities.

Methods: In spring 2013, seven focus groups and two semi-structured interviews were conducted (n=47). Participants also self-administered brief surveys. Recruited by local service providers, participants were 18 or older, pregnant and/or in the first year post-partum at the time. Most self-identified as …

Self-Care And Mobility Disability At Mid-Life In Lucky Few, Early-, And Late-Baby Boom Birth-Cohorts, Carlos Siordia

Journal of Health Disparities Research and Practice

Disability is related in definite ways with makers of social stratum, as it can be influenced by and has the potential to contribute to the production and reproduction of social stratification. Intersectional markers of social stratification processes are ignored determinants of health. The Class, Race, Sex (CRS) hypothesis presented here argues that a low-education, racial-minority, and female disadvantage will compound to affect the prevalence and risks of disability. The evidence presented validates the CRS hypothesis by showing that disability prevalence and risk clusters first by class, race, and then sex. The cross-sectional study of community-dwelling adults in the Unites States, …

Developing Capacity, Skills, And Tobacco Control Networks To Address Tobacco-Related Disparities: Leadership And Advocacy Institute To Advance Minnesota’S Parity For Priority Populations (Laampp), Linda M. Bosma, Raffaele Vacca, Raymond G. Boyle, Jaime L. Martinez, Rod Lew

Journal of Health Disparities Research and Practice

Priority populations disproportionately experience tobacco-related disparities, despite population level declines in tobacco use. The Leadership and Advocacy Institute to Advance Minnesota’s Parity for Priority Populations (LAAMPP) recruits and trains African immigrants/African Americans, Asian Americans/Pacific Islanders, American Indians, Chicano/Latinos, and LGBTQ community members to develop leaders to address tobacco harms in their communities. This paper describes and evaluates the LAAMPP Institute, and discusses lessons learned through the Institute and future directions for community-based tobacco-control efforts.

The mixed-methods evaluation included qualitative key informant interviews with LAAMPP Fellows and community and project contacts, a Skills Assessment Tool, project case studies, and a social …

Development And Implementation Of A Culturally Tailored, Community-Based Intervention To Raise Awareness Of Brain Health Among African Americans, Mary Ann K. Hall, Ashani Johnson-Turbes, Felicia T. Fuller, Petra Niles, Shileah Cantey-Mcdonald

Journal of Health Disparities Research and Practice

African Americans bear a disproportionate burden of age-related cognitive impairment in the United States compared to Whites or Hispanics. African Americans experience greater prevalence, higher risk, and lower rates of treatment and diagnosis for dementia. In response to these health disparities the Alzheimer’s Association developed and implemented the Healthy Brain Initiative (HBI) demonstration project, the first community-level intervention to help reduce health disparities related to cognitive impairment among African Americans. The HBI promotes awareness of brain health, understanding of the heart-brain connection, and seeks to increase African American baby boomers engagement in health-protective behaviors to promote brain and overall health. …

Assessment Of The Perceived Role And Function Of A Community Advisory Board In A Nih Center Of Excellence: Lessons Learned, Margaret L. Walsh, Desiree Rivers, Maria Pinzon, Nina Entrekin, Emily M. Hite, Julie A. Baldwin

Journal of Health Disparities Research and Practice

Background: The Community Advisory Board (CAB) was a vital component of the Center for Equal Health. The center addressed health disparities through community-based research and educational outreach initiatives. Objectives: To evaluate the perceived relationship of the CAB and Center, explore members’ perceptions of the CAB’s role, and elicit feedback on how to enhance the relationship between the Center and the CAB. Methods: Ten in-depth, semi-structured interviews were conducted. All interviews were transcribed verbatim and analyzed with a focus on predetermined codes. Results: Main themes focused on perception of CAB roles and need for utilization of board members; overall center challenges; …

Modeling Bmi, Dietary Habits, And Physical Activity Among Ethnically Diverse Urban College Students, Hollie Jones, Nicholas Freudenberg, Lorraine Mongiello

Journal of Health Disparities Research and Practice

Objectives The objective of this research study was to examine the relationship between BMI, physical activity, dietary habits, and student demographic factors (age, ethnicity, income, immigration, and sex). Given the association between overweight and obesity and the inequitable burden of chronic health conditions among ethnic minority populations, a deeper understanding of the socioeconomic, gender, age, and racial/ethnic variation in BMI, physical activity, and dietary habits is needed. The shifting demographics of urban college populations make urban college campuses an important setting for addressing the lifetime health needs of ethnically diverse urban populations.

Methods In this cross-sectional non-experimental study, we used …

Racial/Ethnic Disparities Related To Health Insurance Coverage, Access To Care And Ease In Health Care Services Among Children In 2012 Cchaps Data, Jacquelynn Meeks, Sweety Baidhya

Journal of Health Disparities Research and Practice

nObjective:The aim of this study was to examine racial/ethnic disparities in unmet medical care, dental care and prescription medications and ease of using heath care services.

Methods:This is a cross sectional study of households in a six-county service region in Texas (Tarrant, Johnson, Hood, Parker, Wise and Denton Counties). The participants included the parents/guardians of children aged 1-15 years. In 2012, a total of 8,439 parents completed the survey. In 2012, 4194 completed the version containing the health insurance type and unmet medical, prescription and dental health care and ease/difficulty in access to health care questions.The dependent variables …

Health Disparities Among Racial And Ethnic Minority Firefighters, Walker Sc Poston, Christopher K. Haddock, Sara A. Jahnke, Nattinee Jitnarin, Rena Sue Day, I David Daniels

Journal of Health Disparities Research and Practice

ABSTRACT

Background: Racial/ethnic minorities are substantially underrepresented in the fire service and this situation is unique when compared to similarly mentally and physically demanding and hazardous occupations such as the military and law enforcement. There is little systematic research to provide greater clarity about this significant disparity. The purpose of this study is to examine physical and behavioral health issues of racial/ethnic minority firefighters when compared to their white, non-Hispanic counterparts and potentially identify areas for future research that might assist in improving their substantial underrepresentation.

Materials and Methods: We report the results of a secondary analysis of data combining …

Documenting Nursing And Medical Students’ Stereotypes About Hispanic And American Indian Patients, Meghan G. Bean, Elizabeth S. Focella, Rebecca Covarrubias, Jeff Stone, Gordon B. Moskowitz, Terry A. Badger

Journal of Health Disparities Research and Practice

Objective: Hispanic Americans and American Indians face significant health disparities compared with White Americans. Research suggests that stereotyping of minority patients by members of the medical community is an important antecedent of race and ethnicity-based health disparities. This work has primarily focused on physicians’ perceptions, however, and little research has examined the stereotypes healthcare personnel associate with Hispanic and American Indian patients. The present study assesses: 1) the health-related stereotypes both nursing and medical students hold about Hispanic and American Indian patients, and 2) nursing and medical students’ motivation to treat Hispanic and American Indian patients in an unbiased …