Social and Behavioral Sciences Commons^™

Does Using Sofa Score For Ventilator Triage Among Covid 19 Patients Result In Suboptimal Allocation Of Medical Ventilators For The Bipoc Population?, Alexandrea Mp Masocco, Elisabeth Michel, Ebbin Dotson

Journal of Health Disparities Research and Practice

Introduction: Since the COVID-19 pandemic in the United States, Black, and Latinx populations have been disproportionately affected by the COVID-19 pandemic. It can be inferred with high confidence that those most vulnerable are the least likely to receive essential care. Kidney transplant allocation and COVID-19 triage protocols share commonalities in that both protocols involve using multivariate scored criteria with objective and subjective inputs. As such, the similar conclusion in outcomes is concerning. It is worth questioning whether the racial inequalities demonstrated in the COVID-19 pandemic related to access to life-saving ventilators were associated with triage protocols.

Methodology: Using an exploratory …

What’S Next For Tobacco Control Efforts? Health Equity Related Lessons Learned From A National Qualitative Study On Tobacco Control And Prevention, Courtney A. Parks, Hollyanne E. Fricke, Alethea Chiappone, Jennie L. Hill, Amy L. Yaroch

Journal of Health Disparities Research and Practice

Context: Despite gains in the tobacco prevention and control movement, tobacco products remain a threat, with specific populations at greater risk.

Objective: The purpose of this paper is to examine the role that leaders in the tobacco prevention and control movement have played in progress achieved to date and identify recommendations for the future using a health equity framework. The purpose of this paper is to examine the role that leading organizations in the tobacco prevention and control movement have played in progress achieved to date, identify future recommendations within the context of current public health priorities (e.g., obesity prevention), …

Obesity, Age, And African American Males: The Impact Of Food Security On Cardiovascular Health Outcomes, Tangela G. Towns, Richard G. Moye, Antonius D. Skipper, Daniel J. Rose

Journal of Health Disparities Research and Practice

Although prevalence of food insecurity has declined over the last 5 years, food insecurity for African Americans and single individuals is increasing. The purpose of this paper is to examine the male-specific associations between food insecurity and cardiovascular-related health outcomes. We examine the relationship between single, African American male adults and food security, kidney disease risk, diabetes, and related comorbidities using the NHANES dataset (2013-2014). We build multivariate logistic regression models to estimate the association between gender, race, and food insecurity using stratified data from the 2013-2014 National Health and Nutrition Examination Survey.

Ethnic Disparities In Mental Health Among Asian Americans: Evidence From A National Sample, Fang Gong, Jun Xu

Journal of Health Disparities Research and Practice

Asian Americans have become the fastest-growing racial group in the United States, yet their health profiles are still under-explored. In particular, the existing research on Asian American mental health has not devoted adequate attention to the enormous ethnic heterogeneity of the group. Grounded upon theoretical frameworks of the tri-racial system and a contextual approach, we examined ethnic disparities in Asian American mental health using data from the National Latino and Asian American Study (NLAAS). We focused on ethnic membership, immigration-related factors, socioeconomic status, and social support as the main correlates of multiple outcomes, including self-rated mental health, psychological distress, and …

Personal Internalization Of A Confederate Monument Removal Event Associated With Increased Depression, Anxiety, And Stress Among University Students, Erika M. Redding, Yucheng Hou, Riley E. Mulhern

Journal of Health Disparities Research and Practice

This study sought to determine the association between racialized events relating to the removal of a Confederate monument and mental health outcomes among students at a Southern state-university in the United States. After the removal of a Confederate monument located on the university’s campus, racialized protests and violent clashes with police forces ensued. To assess the impact of these events on student mental health outcomes, a cross-sectional survey was disseminated to 10,000 current students. Student mental health was measured using the 21-item Depression, Anxiety, and Stress Scale (DASS). The key exposure, personal internalization of the event, was measured using the …

Perceptions And Determinants Of Partnership Trust In The Context Of Community-Based Participatory Research, Arelis Moore De Peralta, Julie Smithwick, Myriam E. Torres

Journal of Health Disparities Research and Practice

Trust is difficult to conceptualize and define because of its diverse applications in different disciplines. Historic mistrust between vulnerable communities and researchers based on past adverse experiences can negatively affect the ability to collaborate and conduct effective research with such populations. Community Based-Participatory Research (CBPR) is a collaborative approach to research that can reduce historic mistrust and health disparities among minority populations. Although how trust development occurs in CBPR partnerships has been explored, there is a need to determine how to move from one stage to the next in fostering and maintaining that trust. The present study contributes to this …

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 …

Nutrient And Food Group Intakes Of Low-Income Pregnant Women By Race/Ethnicity, Alla M. Hill, Danielle L. Nunnery Phd, Rdn, Ldn, Alice Ammerman Drph, Jigna M. Dharod Phd

Journal of Health Disparities Research and Practice

In an exploratory study, a convenience sample of 148 pregnant women was recruited from a WIC clinic in the southeast region of the U.S. to: 1) Examine and compare daily nutrient and food group intakes of WIC pregnant women to national guidelines, and; 2) Determine racial/ethnic differences in nutrient and food group intakes among WIC pregnant women. Women were selected for the study if they were: ≥ 18 y, in 2^nd trimester of pregnancy, and if they spoke English or Spanish as a first language. Upon recruitment, participants were interviewed to collect information on their socio-demographics, including race/ethnicity. Additionally, …

Exploring The Cultural Perceptions Of Physical Activity Among Transnational Nigerian Immigrants, Kelechi D. Ibe-Lamberts, Daudet Ilunga Tshiswaka, Abi Fapohunda

Journal of Health Disparities Research and Practice

Background: Transnational Nigerian Immigrants, as other Transnational African Immigrants, are a subset of African immigrants with the unique ability to sustain multi-national ties. These ties could potentially affect health behavior choices and participation in physical activity. Physical Activity has the potential to improve health and prevent chronic diseases; however, there is a lack of literature regarding physical activity and its determinants within the Transnational African Immigrant population in general. This study investigated the cultural factors that shape Transnational Nigerian Immigrants’ perceptions and attitudes towards physical activity.

Methods: Semi-structured, individual interviews supported by photo-elicitation were conducted on 24 Transnational …

Tumor Biology And Racial Disparities In Reconstruction After Mastectomy: A Seer Database Analysis, Sarah J. Ullrich, Michael C. Smith, Paul J. Chung, Sara Y. Kim, Gainosuke Sugiyama

Journal of Health Disparities Research and Practice

Introduction:

Significant disparities in immediate breast reconstruction after mastectomy have persisted, and may even be increasing, despite large-scale efforts to minimize them, such as the Women’s Health and Cancer Rights Act of 1998. Immediate breast reconstruction has been shown to lead to higher rates of surgical satisfaction, minimize delay in post-operative cancer treatment, and improve the quality of life and overall well-being of mastectomy patients. However only 25-40% of eligible women in the United States receive reconstruction. The rate of reconstruction is even lower in African American and Hispanic women compared to White women. To better understand this disparity, …

Disentangling The Effects Of Acculturation And Duration In The United States On Latina Immigrant Maternal Overweight And Macrosomia, Miguel Ceballos, Andrea Cantarero, Shanell Sanchez

Journal of Health Disparities Research and Practice

A significant body of research on minority health shows that while Latina immigrants experience unexpectedly favorable outcomes in maternal and infant health in the United States, this advantage deteriorates with increased duration of residency. This study assesses the relationship between excessively high birth weight (macrosomia), maternal weight, and length of residency in the United States. A sample of Mexican immigrant women living in two Midwestern communities in the United States is used to analyze the effects of duration in the United States, acculturation on birth outcomes, and maternal overweight once controlling for social, behavioral, and environmental mediators of health status. …

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 …

Perceptions Of Chronic Disease Among Older African Americans: A Qualitative Analysis, Karon Phillips, Charles Rogers, Adrienne Morgan

Journal of Health Disparities Research and Practice

Research has documented that African Americans suffer disproportionately from chronic diseases when compared to the general population. Yet, limited research examines older African Americans’ perceptions about having chronic diseases. Accordingly, the first aim of the study provided insight into this disparity with the intent of revealing how older African Americans feel about their overall health, and how much they understand about their individual chronic disease(s). The second aim was to gather information about strategies and coping mechanisms older African Americans use to manage their chronic diseases. The purpose of this aim was to determine if any of the strategies they …

An Ambivalent Embrace: Service Needs And Gaps For Asian Immigrants In New Destinations, John J. Chin

Journal of Health Disparities Research and Practice

Asian immigrants to the U.S. are settling in "new destinations," but there has been little research on their health care and social service needs. Our analysis of Census data to identify cities with the fastest Asian immigrant population growth (1990-2000) yielded 33 smaller cities in 13 states. The cities ranged in population from 7,677 to 86,660; were spread across 13 states in the Northeast, South, and Midwest regions of the US; and varied widely demographically. Pilot surveys conducted in 2009 indicated that, although many residents had positive attitudes towards immigrants, many were also concerned about job competition and dilution of …

Risk For Cardiovascular Disease In Blacks With Hiv/Aids In America: A Systematic Review And Meta-Analysis, Calvin Odhiambo, Jessica Davis, Bernard Omolo

Journal of Health Disparities Research and Practice

Cardiovascular disease (CVD) related to HIV infection is becoming a major public health concern in the United Stated. Epidemiologic studies show that prolonged use of Highly Active Antiretroviral Therapy, HIV/AIDS itself, and a combination of traditional vascular risk factors increase the risk for CVD among people with HIV/AIDS. However, little is known about any racial disparities in the risk for CVD in the HIV/AIDS population. We conducted a systematic review and meta-analysis of literature on HIV/AIDS and CVD (June 1, 2010-July 31, 2014) through MEDLINE to examine whether and how HIV-positive African Americans are disproportionately affected by CVD compared to …

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 …

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 …

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, …

Hispanic Representation In A Longitudinal Birth Cohort Study, Julie Postma, Lisa R. Younglove, Kerry Brooks, Tamara Odom-Maryon, Shirley Beresford, Thomas Burbacher, Phillip Butterfield, Patricia Butterfield, Nicole Cederblom, Kimberly Grant, Elaine M. Faustman

Journal of Health Disparities Research and Practice

Background: The purpose of this paper is to report: 1) strategies used to engage Hispanic women and their families in a longitudinal birth cohort study, and 2) comparisons of Hispanic and non-Hispanic groups that received those strategies. This paper augments the current literature by reporting methods and results specific to a subpopulation of Hispanic women, that of self-identified Mexican women. Comparisons between Hispanic and non-Hispanic groups that received those strategies will build the evidence base that supports effective outreach and engagement strategies.

Methods: Cultural responsiveness theory was used to structure outreach and engagement, including: 1) assembling a culturally competent team; …

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Journal of Health Disparities Research and Practice

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

Gathering Perspectives On Extended Family Influence On African American Children's Physical Activity, Natasha A. Brown, Katherine Clegg Smith, Rachel L.J. Thornton, Janice V. Bowie, Pamela J. Surkan, Darcy A. Thompson, David M. Levine

Journal of Health Disparities Research and Practice

Background: The family environment is a key determinant of children’s physical activity. The importance of the extended African American family is well established, but there is little research on its influence on school age children’s physical activity. Methods: We recruited eight families in which grandparents and other adult relatives played a central role in child supervision. Semi-structured interviews with parents, other adult relatives, and children revealed various perspectives on the influences of culture and families on children’s weight-related behaviors. Results: Children were between the ages of 6 and 11, and five of the families resided in neighborhoods in which at …

Cultural Competence: New Conceptual Insights Into Its Limits And Potential For Addressing Health Disparities, Shireen S. Rajaram, Susan Bockrath

Journal of Health Disparities Research and Practice

The increasing interest in the role of racism and racialization in health disparities, calls for exploring new paradigms in addressing and eliminating health disparities related to race/ethnicity. Cultural competence is conceptualized as one of the keys ways to address racial/ethnic disparities in public health and healthcare. However, for cultural competence to fulfill this role, it requires a critical understanding of the underlying socio-political and economic processes of power, privilege and institutional racism that create, support and maintain existing health disparities. This paper outlines how the concept of cultural competence can be made more robust, by incorporating concepts such as Public …

Are There Gender Differences In Perceived Sexual Self-Efficacy Among African-American Adolescents?, Michelle L. Redmond, Rhonda K. Lewis

Journal of Health Disparities Research and Practice

Background: African American adolescents accounted for more than half of all HIV/AIDS cases in 2009. Behavioral Strategies are needed to help lessen the incidence of HIV/AIDS among this population.

Purpose: The aim of his study was to examine sexual self-efficacy practices and beliefs among African American adolescents. We also examined gender differences between African American adolescents to better understand their perceptions of sexual self-efficacy, condom use intention, and other safer sex practices and beliefs.

Methods: A cross-sectional study was conducted with 214 African American adolescents using survey instruments to examine their beliefs, perception and intentions on the use of condoms, …

Strategic Planning For Recruitment And Retention Of Older African Americans In Health Promotion Research Programs, Laura Dreer, Cynthia Owsley, June Weston

Journal of Health Disparities Research and Practice

The purpose of this study was to 1) describe a strategic plan for recruitment and retention used in conducting eye health education research with African-Americans living in urban and rural areas of Alabama and 2) characterize recruitment and retention patterns for this project.

We evaluated an eye health education program tailored specifically to older African Americans. InCHARGE was designed to promote eye disease prevention by conveying the personal benefits of annual dilated comprehensive eye care and teaching strategies to minimize barriers to eye care. The InCHARGEÓ program or a social contact control program was delivered at 20 senior centers in …

Trends And Disparities In Tb Among U.S.-Born Black And White Chicago Residents, 1998-2008, Susan A. Lippold, Lori Armstrong, Jennifer M. Carter, Xiomara Hardison

Journal of Health Disparities Research and Practice

ABSTRACT

OBJECTIVE: To describe the decline of tuberculosis (TB) cases among U.S.-born non-Hispanic (NH) black and white Chicago residents.

METHODS: Data from the National TB Surveillance System was used to analyze trends and characteristics of reported TB cases among U.S.-born NH black and U.S.-born NH white Chicago residents from 1998-2008.

RESULTS: Chicago reported a total of 3,821 TB cases over the 11-year time period. Of these, 1,916 were U.S.-born NH black and 235 were U.S.-born NH white. The proportion of cases attributable to U.S.-born NH blacks was 63% (294/469) in 1998 and 34% in 2008 (72/213). Analysis for trends from …

Variance In Patient Access To Support Persons By Race/Ethnicity And Language Preference: An Analysis Of Patient Survey Data, Andrew J. Jager, Matthew K. Wynia

Journal of Health Disparities Research and Practice

Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had …

Lessons Learned From Training Of Promotores De Salud For Obesity And Diabetes Prevention, Erica T. Sosa, Lesli Biediger-Friedman, Zenong Yin

Journal of Health Disparities Research and Practice

Background: Promotores de Salud are impactful in reducing health disparities for Hispanic communities. The purpose of this paper is to present the training process and fidelity of study protocol implementation using a promotora model for community-based diabetes prevention.

Methods: Five Hispanic bilingual promotores were recruited from a Community Health Worker program and received intensive 30-hour promotora training on how to recruit participants, lead group sessions, and support participants making behavior changes. Evaluation of the training included a survey and focus group to assess promotores’ feedback, a post-training knowledge test to assess knowledge acquired during the training and an observational assessment …

Ethnic And Gender Differences In Psychosocial Factors In Native Hawaiian, Other Pacific Islanders, And Asian American Adults With Type 2 Diabetes, Jillian Inouye, Dongmei Li, James Davis, Richard Arakaki

Journal of Health Disparities Research and Practice

This study examined the differences between 207 Asians and Native Hawaiian, other Pacific Islanders (NHOPI) with type 2 diabetes among various psychosocial measures. Responses to five multivariable regression models including the Diabetes Quality of Life Questionnaire (DQOL) and Short Form -36® Health Survey (SF-36) were analyzed. Differences were determined by linear contrasts in the multivariate linear regression models after adjusted for multiple demographic and socioeconomic variables. Compared to Asians, NHOPIs perceived a lower impact of diabetes on their quality of life; highlighting differences in perceptions of self-efficacy and self-care activities. Females did better on their diet while males perceived better …

Housing, The Neighborhood Environment, And Physical Activity Among Older African Americans, Lonnie Hannon Iii, Patricia Sawyer, Richard M. Allman

Journal of Health Disparities Research and Practice

Abstract

This study examines the association of neighborhood environment, as measured by housing factors, with physical activity among older African Americans. Context is provided on the effects of structural inequality as an inhibitor of health enhancing neighborhood environments. The study population included African Americans participating in the UAB Study of Aging (n=433). Participants demonstrated the ability to walk during a baseline in-home assessment. The strength and independence of housing factors were assessed using neighborhood walking for exercise as the outcome variable. Sociodemographic data, co-morbid medical conditions, and rural/urban residence were included as independent control factors. Homeownership, occupancy, and length of …

Racial Disparities In Pain Management In Primary Care, Miriam Ezenwa

Journal of Health Disparities Research and Practice

This descriptive, cross-sectional, secondary data analysis was conducted to examine racial disparities in pain management of primary care patients with chronic nonmalignant pain using chronic opioid therapy. Data from 891 patients, including 201 African Americans and 691 Caucasians were used to test an explanatory model for these disparities. We predicted that: (1) African American patients would report worse pain management and poor quality of life (QOL) than Caucasians; (2) the association between race and pain management would be mediated by perceived discrimination relating to hopelessness; and (3) poor pain management would negatively affect QOL. Results revealed significant differences between African …