Race and Ethnicity Commons^™

Explaining Racial/Ethnic Disparities In Use Of High-Volume Hospitals: Decision-Making Complexity And Local Hospital Environments, Karl Kronebusch, Bradford H. Gray, Mark Schlesinger

Publications and Research

Racial/ethnic minorities are less likely to use higher-quality hospitals than whites. We propose that a higher level of informationrelated complexity in their local hospital environments compounds the effects of discrimination and more limited access to services, contributing to racial/ethnic disparities in hospital use. While minorities live closer than whites to high-volume hospitals, minorities also face greater choice complexity and live in neighborhoods with lower levels of medical experience. Our empirical results reveal that it is generally the overall context associated with proximity, choice complexity, and local experience, rather than differential sensitivity to these factors, that provides a partial explanation of …

“In Light Of Real Alternatives”: Negotiations Of Fertility And Motherhood In Morocco And Oman, Victoria E. Mohr

Student Publications

Many states in the Arab world have undertaken wide-ranging family planning polices in the last two decades in an effort to curb high fertility rates. Oman and Morocco are two such countries, and their policies have had significantly different results. Morocco experienced a swift drop in fertility rates, whereas Oman’s fertility has declined much more slowly over several decades. Many point to the more conservative religious and cultural context of Oman for their high fertility rates, however economics and the state of biomedical health care often present a more compelling argument for the distinct differences between Omani and Moroccan family …

Syrian Refugee Families’ Awareness Of The Health Risks Of Child Marriage And What Organizations Offer Or Plan In Order To Raise Awareness, Rachel Fowler

Independent Study Project (ISP) Collection

The hypothesis of the study assumes: If Syrian refugee families understood the health risks involved with child marriage and the severity of these risks, they would be less likely to choose to marry off their daughter under the age of 18. If these families had more health educational programs and had more access to these programs, these programs would influence their decision towards avoiding child marriage for their daughter(s).

According to UNICEF, one-third of registered marriages among Syrian refugees in Jordan between January and March 2014 involved girls under the age of 18. Child marriage puts girls at risk of …

Agency Of The South Sudanese: Compensating For Health Care In Mungula Refugee Settlement, Lauren Schmidt

Independent Study Project (ISP) Collection

In reaction to the endemic violence, which has forced many South Sudanese to flee their homes and seek refuge within Uganda’s borders, the researcher spent the practicum interning with the Uganda Red Cross Society (URCS) in Mungula refugee settlement, under academic advisor Steven Mawa. As the organization is the leading health provider in the settlement, the researcher gained insight into the provision of social services to the population, which allowed an extensive study on the ability of the South Sudanese to compensate for shortages in care and various complications associated with doing so.

The researcher sought to entertain these inquiries …

Resisting Pressure From Peers To Engage In Sexual Behavior: What Communication Strategies Do Early Adolescent Latino Girls Use?, Anne E. Norris, Jonathan Pettigrew, Michelle Miller-Day, Michael L. Hecht, Janet Hutchison, Kristi Campoe

Communication Faculty Articles and Research

A content analysis of early adolescent = 12.02 years) Latino girls’ (n = 44) responses to open-ended questions embedded in an electronic survey was conducted to explore strategies girls may use to resist peer pressure with respect to sexual behavior. Analysis yielded 341 codable response units, 74% of which were consistent with the REAL typology (i.e., refuse, explain, avoid, leave) previously identified in adolescent substance use research. However, strategies reflecting a lack of resistance (11%) and inconsistency with communication competence (e.g., aggression) were also noted (15%). Frequency of particular strategies varied depending on the situation described in the open-ended …

“Work What You Got”: Political Participation And Hiv-Positive Black Women’S Work To Restore Themselves And Their Communities, Monica L. Melton

Journal of Interdisciplinary Feminist Thought

Black women’s rates of HIV/AIDS infection have skyrocketed in comparison to other racial and ethnic groups over the past thirty years. Despite these rates, HIV-positive Black women’s perspectives are rarely sought regarding best practices to eradicate and interrupt HIV/AIDS among African American women, even though historically Black women have often proved phenomenal agents of social change. HIV-positive Black women’s activism has been understudied and input from the community in crisis has rarely been deemed as valuable to public health officials in HIV/AIDS prevention and interventions. Through the narratives of thirty HIV-positive Floridian Black women, I present HIV-positive Black women’s political …

Interpersonal Relationships And Social Support In Transitioning Narratives Of Black Transgender Women In Detroit, Louis F. Graham, Halley P. Crissman, Jack Tocco, Laura Hughes, Rachel C. Snow, Mark B. Padilla

Louis F Graham

Social support has been shown to play a key role in overcoming adversities associated with marginalized identities, yet there is a dearth of information regarding the role of social networks in the gender transition process, particularly in ethnic minority transgender communities. This study uses life history narratives, and a modified grounded theory analysis, to explore the impact of interpersonal relationships on the gender transition process of Black transgender women in Detroit, Michigan. The following interpersonal interactions were significant: family reactions to self-recognition of femininity, coming out as gay prior to transgender identity disclosure, contact with an out transwoman, emotional and …

Black Is Decidedly Not Just Black: A Case Study On Hiv Among African-Born Populations Living In Massachusetts, Chioma Nnaji, Nzinga Metzger

Trotter Review

Black or African American is a racial category that includes the descendants of enslaved Africans as well as members of foreign-born black communities who migrated to the United States from places abroad, such as Africa, the Caribbean, and Latin America. Grouping native-born and foreign-born blacks into a single homogeneous racial category may make it easier to track disease and health outcomes; however, it masks the different cultural experiences, histories, languages, social and moral values, and expectations that influence health beliefs, attitudes, practices, and behaviors. It also ignores such factors as migration, which forces foreign-born populations to examine both their traditional …

Hiv/Sti Risk Factors Among African-American Students Attending Predominantly White Universities, Marya L. Shegog, Lisa Lindley, Melva Thompson-Robinson, David Simmons, Donna Richter

David Simmons

Introduction: The majority of African American college students in the U.S. attend predominantly white institutions (PWIs). However, there is minimal research examining this population’s HIV/STI risk behaviors. The purpose of this investigation was to assess HIV/STI behavioral risk factors among African American college students (aged 18 – 24years) attending PWIs. (n = 2,568) Methods: Backwards step-wise logistic regression analyses were conducted to determine factors associated with a positive HIV/STI diagnosis (past year) among sexually active African American college students who participated in the Spring, 2006 National College Health Assessment. Findings: Nine factors were significantly associated with an HIV/STI diagnosis among …

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 …

Asthma Management: An Ecosocial Framework For Disparity Research, Robin A. Evans-Agnew

Robin A Evans-Agnew

Background: Asthma management disparities (AMD) between African and White Americans are significant and alarming. Various determinants have been suggested by research frameworks that affect the unfair distribution of resources for asthma management to groups who are more or less advantaged socially. Ecosocial models organize determinants into individual/family, healthcare, community, and sociocultural levels. Multilevel interventions can affect AMD through simultaneous actions on different levels and pathways between determinants. Objective: Provide a comprehensive summary of the known determinants of AMD. Method: Peer reviewed research frameworks of AMD from 1998-2009 were retrieved from PubMed/ Web of Science databases using (“Socioeconomic Factors”[Mesh] OR (“Healthcare …

Underrepresented Minorities In Medical School Admissions, Margaret A. Hadinger Edd, Ms

Department of Education

No abstract provided.

Lean Body Mass May Explain Apparent Racial Differences In Carotid Intima-Media Thickness In Obese Children., Shahryar M. Chowdhury, Melissa H. Henshaw, Brad Friedman, J Philip Saul, Girish S. Shirali, Janet Carter, Bryana M. Levitan, Tom Hulsey

Manuscripts, Articles, Book Chapters and Other Papers

Background: Racial differences in carotid intima-media thickness (cIMT) have been suggested to be associated with the disproportionally high prevalence of cardiovascular disease in black adults. The objective of this study was to evaluate the effects of cardiovascular risk factors on the racial differences seen in cIMT in obese children.

Methods: Obese subjects aged 4 to 21 years were recruited prospectively. Height, weight, blood pressure, fasting insulin, glucose, lipid panel, high-sensitivity C-reactive protein, and body composition by dual-energy x-ray absorptiometry were obtained. B-mode carotid imaging was analyzed by a single blinded physician.

Results: A total of 120 subjects (46 white, 74 …

Medication Adherence And Intervention To Create Success In Hypertensive African Americans In A Rural Setting, Laneita Davis

DNP Scholarly Projects

Hypertension is a chronic disease that has been a major problem in the African American community for decades. Although numerous research studies have examined interventions to combat this disease, there has been very little research published that focused on African Americans with hypertension in a rural setting. Rural residents experience many difficulties in accessing healthcare services. This difficult access is a disadvantage that results in higher morbidity and mortality rates compared to those of their urban counterparts. Being from a small town in Mississippi, I have witnessed first hand the many barriers that are encountered. Individuals who live in a …

Healthcare Access And Health Outcomes In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

In a publication from the Robert Woods Johnson Foundation, it was recognized that a person’s zip code was a more important predictor of health than their genetic code. Where we live influences not only our access to health care, but other health indicators as well. Clark County has a low primary care physician to population ratio compared to other counties in Nevada and in the US. Clark County also has highest rates of uninsured in the Mountain West and among the highest in the nation.

Southern Nevada fared worse than other Mountain West Metropolitan areas in health indicators and preventative …

Environmental Correlates Of Physical Activity Among African-American Adults, Tim Bungum, Jennifer Pharr, Paulo S. Pinheiro, Maria Azzarelli

Nevada Journal of Public Health

The purpose of this cross-sectional study was to identify perceived environmental correlates of meeting physical activity guidelines among African-American adults living in Southern Nevada. Trained interviewers phoned potential participants who lived in the 12 zip codes of Clark County, Nevada with the highest proportions of African-American residents. Respondents (n=237) answered 52 health-related and demographic questions. Slightly less than 50% of participants met physical activity guidelines. A factor analysis procedure produced two environmental variables, neighborhood safety and environmental supports for physical activity. Age, gender and educational attainment (p<.05) predicted the meeting of those guidelines (R2=.214), while neighborhood support for physical activity, neighborhood safety, and BMI failed to do so. This finding suggests that environmental factors are not strong predictors of physical activity among African- American adults, although environmental supports for physical activity approached significance. Future studies should consider assessing additional aspects of the built environment as an influence on physical activity.

The Unequal Burden Of Debt And Its Impact On Health, Elizabeth Sweet, Zachary Dubois

Office of Community Partnerships Posters

Average household debt in America has tripled in the past 30 years. Much of this burden is unequally borne by racial/ethnic minorities and those with lower incomes, who face discrimination in obtaining loans and must devote more household resources to paying off debts. Being indebted is a strong predictor of suicide, depression, and other adverse mental health outcomes. However, its impact on physical health is underexplored.

Navigating Community Institutions: Black Transgender Women's Experiences In Schools, The Criminal Justice System, And Churches, Louis Graham, Halley Crissman, Jack Tocco, William Lopez, Rachel Snow, Mark Padilla

Louis F Graham

Alcohol Screening And Brief Intervention As Standard Practice In Indian Country, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Bonnie Duran, Catherine N. Dulmus Phd, Amy R. Manning

Brown School Faculty Publications

Alcohol use and the resulting problems associated with high-risk drinking in the American Indian/Native Alaskan (AI/NA) population are well-documented, as alcohol misuse has taken an incredible toll on many AI/NA communities. Presently, both overall health issues and alcohol use occur disproportionately within this population. This article provides an updated overview of the impact of alcohol use in the United States and within AI/NA communities specifically. It also provides recommendations for an alcohol-related screening and brief intervention instrument that social workers can begin using in their practice and can be utilized within the AI/NA community.

Attitudes Toward Sexuality And Sexual Behaviors Of Asian-American Adolescents: Implications For Risk Of Hiv Infection, Connie S. Chan

Connie Chan

Until 1990, Asian Americans represented an ethnic minority group that was perceived to be at lower risk than African Americans or Hispanics/Latinos for HIV infection, the presumed causal agent for AIDS. Reasons cited for this perception include behavioral differences in intravenous drug use, sexual behavioral habits, and underidentification of AIDS cases. However, in urban areas such as San Francisco, Toronto, New York, Boston, Los Angeles, and Seattle, where Asians have immigrated and settled in large numbers, cases of HIV infection and AIDS have begun to increase dramatically, perhaps reflecting the rise in the number of AIDS cases in Asia. In …

Preventing Hiv Among Black Men In College Using A Cbpr Approach, Louis Graham, Robert Aronson, Regina Pulliam, L Mann, Scott Rhodes

Louis Graham

No abstract provided.

Do Black-White Racial Disparities In Breastfeeding Persist In The Military Community?, Jennifer H. Lundquist, Zhun Xu, Wanda Barfield, Irma Elo

Dr. Jennifer H. Lundquist

Objective: We conduct a comparative analysis of breastfeeding behavior between military and civilian-affiliated mothers. Our focus is on African American mothers among whom breastfeeding rates are lowest. The military context may mitigate conditions associated with low breastfeeding prevalence by a) providing stable employment and educational opportunities to populations who face an otherwise poor labor market and b) providing universal healthcare that includes breastfeeding consultation. Methods: Using Pregnancy Risk Assessment Monitoring System (PRAMS) data for which we received special permission from each state to flag military affiliation, we analyze civilians and military affiliate in breastfeeding initiation using logistic regression and breastfeeding …

Culture, Caregiving, And Health: Exploring The Influence Of Culture On Family Caregiver Experiences, Jennifer Pharr, Carolee Dodge Francis, Christine Terry, Michele Clark

Public Health Faculty Publications

Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups (African American, Asian American, Hispanic American, and European American) for cultural influences on caregiving. Data were collected in Nevada between December 7, 2009, and August 20, 2010. Thirty-five caregivers participated in this …

Development Of An Attribution Of Racial/Ethnic Health Disparities Scale, Robert E. Braun Phd., James H. Price, Jagdish Khubchandani, Erica Payton, Prasum Bhattacharjee

Health and Sport Sciences Faculty Scholarship

The purpose of this study was to develop an Attribution of Racial/Ethnic Health Disparities (AREHD) scale. A convenience sample of undergraduate college students (n = 423) at four Midwestern universities was recruited to respond to the survey. A pilot test with undergraduate students (n = 23) found the survey had good acceptability and readability level (SMOG = 11th grade). Using exploratory factor analysis we found the two a priori subscales were confirmed: individual responsibility and social determinants. Internal reliabilities of the subscales were: individual responsibility (alpha = 0.87) and social determinants (alpha = 0.90). Test–retest stability reliabilities were: individual responsibility …

“Human Betterment”: The Fight For And Against 50 Years Of Sterilization In North Carolina, Kay Bielak Schaffer

Senior Projects Spring 2014

Senior Project submitted to The Division of Social Studies of Bard College.

Lifetime Racism And Blood Pressure Changes During Pregnancy: Implications For Fetal Growth, Clayton J. Hilmert, Tyan Parker Dominguez, Christine Dunkel Schetter, Sindhu K. Srinivas, Laura M. Glynn, Calvin J. Hobel, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Research suggests that exposure to racism partially explains why African American women are 2 to 3 times more likely to deliver low birth weight and preterm infants. However, the physiological pathways by which racism exerts these effects are unclear. This study examined how lifetime exposure to racism, in combination with maternal blood pressure changes during pregnancy, was associated with fetal growth. Methods: African American pregnant women (n = 39) reported exposure to childhood and adulthood racism in several life domains (e.g., at school, at work), which were experienced directly or indirectly, meaning vicariously experienced when someone …

Public Assistance, Drug Testing, And The Law: The Limits Of Population-Based Legal Analysis, Candice T. Player

All Faculty Scholarship

In Populations, Public Health and the Law, legal scholar Wendy Parmet urges courts to embrace population-based legal analysis, a public health inspired approach to legal reasoning. Parmet contends that population-based legal analysis offers a way to analyze legal issues—not unlike law and economics—as well as a set of values from which to critique contemporary legal discourse. Population-based analysis has been warmly embraced by the health law community as a bold new way of analyzing legal issues. Still, population-based analysis is not without its problems. At times, Parmet claims too much territory for the population perspective. Moreover, Parmet urges courts …

Sexual Rights For Marginalized Populations, Louis Graham, Mark Padilla

Louis F Graham