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Historical Differences In School Term Length And Measured Blood Pressure: Contributions To Persistent Racial Disparities Among Us-Born Adults, Sze Yan Liu, Jennifer M. Manly, Benjamin Capistrant, M Maria Glymour

Sze Yan Liu

Abstract

Introduction

Legally mandated segregation policies dictated significant differences in the educational experiences of black and white Americans through the first half of the 20^th century, with markedly lower quality in schools attended by black children. We determined whether school term length, a common marker of school quality, was associated with blood pressure and hypertension among a cohort of older Americans who attended school during the de jure segregation era.

Methods

National Health and Nutrition Examination Survey I and II data were linked to state level historical information on school term length. We used race and gender-stratified linear regression …

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

Janelle K. Bryan

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 …

Identifying Disparities In Colorectal Cancer Screening Rates In Milwaukee-Based Academic And Nonacademic Clinics, Jasmine Wiley, Jonathan J. Blaza, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns, Shelby L. Pischke, Tracy L. Greiten

Will Lehmann, MD

Background: The Institute for Healthcare Improvement’s Triple Aim focuses on improving the patient’s experience of care, improving population health and reducing the per capita cost of health care. Health care systems and providers continuously seek to improve quality of care through understanding what percentage of their patients are achieving quality-of-care standards for various indicators, including immunizations, tobacco cessation, asthma and cancer screening. As health care moves toward reimbursing for value-based care, deepening our understanding of patient population characteristics within each of these conditions is vital to continuous quality improvement.

Purpose: To determine if there are race/ethnicity/age/preferred language (REAL) disparities in …

Identifying Disparities In Colorectal Cancer Screening Rates In Milwaukee-Based Academic And Nonacademic Clinics, Jasmine Wiley, Jonathan J. Blaza, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns, Shelby L. Pischke, Tracy L. Greiten

Aurora Family Medicine Residents

Background: The Institute for Healthcare Improvement’s Triple Aim focuses on improving the patient’s experience of care, improving population health and reducing the per capita cost of health care. Health care systems and providers continuously seek to improve quality of care through understanding what percentage of their patients are achieving quality-of-care standards for various indicators, including immunizations, tobacco cessation, asthma and cancer screening. As health care moves toward reimbursing for value-based care, deepening our understanding of patient population characteristics within each of these conditions is vital to continuous quality improvement.

Purpose: To determine if there are race/ethnicity/age/preferred language (REAL) disparities in …

Racial And Ethnic Disparities In Treatment Of Dementia Among Medicare Beneficiaries, Ilene H. Zuckerman, Priscilla T. Ryder, Linda Simoni-Wastila, Thomas Shaffer, Masayo Sato, Lirong Zhao, Bruce Stuart

Priscilla T. Ryder

Objectives—Numerous studies have documented disparities in health care utilization between non-Hispanic White and minority elders. We investigated differences in anti-dementia medication use between non-Hispanic White and minority community-dwelling Medicare beneficiaries with dementia. Methods—Using multivariate analysis with generalized estimating equations, we estimated prevalence ratios (PRs) for anti-dementia medication use by race/ethnicity for 1,120 beneficiaries with dementia from years 2001 through 2003 of the Medicare Current Beneficiary Survey. Results—After adjusting for demographics, socioeconomics, health care access and utilization, comorbidities, and service year, we found that anti-dementia medication use was approximately 30% higher among non-Hispanic Whites compared to other racial/ethnic groups (PR = …

Research With Communities To Improve Health And Reduce Health Disparities, Elmer R. Freeman

Elmer Freeman

No abstract provided.

To The Bitter End: Disparities In End-Of-Life Care, Alberto Coustasse, Theresa Quiroz, Sue G. Lurie

Alberto Coustasse, DrPH, MD, MBA, MPH

Although technological advancements have provided the means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient, bioethical, legal, and moral concerns related to disparities in care still arise in the United States. These concerns call into question the necessity to continue life-sustaining or palliative care treatments when patients and/or families are faced with end-of-life decisions. This study will focus on various historical, clinical cultural, and ethical issues that have placed this dilemma into a controversial public spectrum, by using case studies retrieved from referenced literature, which illustrate disparities …

E-Health Innovations, Collaboration, And Healthcare Disparities: Developing Criteria For Culturally Competent Evaluation, Gonzalo Bacigalupe, Sabrina Askari

Gonzalo Bacigalupe, EdD, MPH

E-Health alters how health care clinicians, institutions, patients, caregivers, families, advocates, and researchers collaborate. Few guidelines exist to evaluate the impact of social technologies on furthering family health and even less on their capacity to ameliorate health disparities. Health social media tools that help develop, sustain, and strengthen the collaborative health agenda may prove useful to ameliorate health care inequities; the linkage should not, however, be taken for granted. In this article we propose a classification of emerging social technologies in health care with the purpose of developing evaluative criteria that assess their ability to foster collaboration and positively impact …

The Boston Puerto Rican Health Study, A Longitudinal Cohort Study On Health Disparities In Puerto Rican Adults: Challenges And Opportunities, Katherine L. Tucker, Josiemer Mattei, Sabrina E. Noel, Bridgette M. Collado, Jackie Mendez, Jason Nelson, John Griffith, Jose M. Ordovas, Luis M. Falcon

Katherine L. Tucker

Background The Boston Puerto Rican Health Study is an ongoing longitudinal cohort study designed to examine the role of psychosocial stress on presence and development of allostatic load and health outcomes in Puerto Ricans, and potential modification by nutritional status, genetic variation, and social support. Methods Self-identified Puerto Ricans, aged 45-75 years and residing in the Boston, MA metro area, were recruited through door-to-door enumeration and community approaches. Participants completed a comprehensive set of questionnaires and tests. Blood, urine and salivary samples were extracted for biomarker and genetic analysis. Measurements are repeated at a two-year follow-up. Results A total of …

Applying Innovative Approaches To Address Health Disparities In Native Populations: An Assessment Of The Crow Men’S Health Project, Paul Lachapelle, Tim Dunnagan, James Real Bird

Tim Dunnagan

Using a Community-Based Participatory Research approach, the Crow Men's Health Project is a partnership between university researchers and men of the Crow Indian Reservation to address health disparities, particularly cancer risk, screenings and treatments. The objective in using this approach is to establish trust, share power, foster co-learning, and ultimately address community-identified needs and health problems. However, application within the context of Native American communities has only recently been studied with only a paucity of evaluative research on the quality and outcome of partnerships. This research details the accomplishments to date of this partnership. The findings and implications of the …

Exposing Racial Discrimination: Implicit & Explicit Measures – The My Body, My Story Study Of 1005 Us-Born Black & White Community Health Center Members, Nancy Krieger, Pamela D. Waterman, Anna Kosheleva, Jarvis T. Chen, Dana R. Carney, Kevin W. Smith, Gary G. Bennett, David R. Williams, Elmer Freeman, Beverley Russell, Gisele Thornhill, Kristin Mikolowsky, Rachel Rifkin, Latrice Samuel

Elmer Freeman

Background: To date, research on racial discrimination and health typically has employed explicit self-report measures, despite their potentially being affected by what people are able and willing to say. We accordingly employed an Implicit Association Test (IAT) for racial discrimination, first developed and used in two recent published studies, and measured associations of the explicit and implicit discrimination measures with each other, socioeconomic and psychosocial variables, and smoking. Methodology/Principal Findings: Among the 504 black and 501 white US-born participants, age 35-64, randomly recruited in 2008-2010 from 4 community health centers in Boston, MA, black participants were over 1.5 times more …

Policy Needs Assessment For Communities Survey Instrument, Michael A. Preston, Glen P. Mays, Ronda S. Henry-Tillman

Michael Preston

This survey instrument was designed to understand the resources used and the extent of involvement in policy and civic engagement by community residents and leaders.

A New Application Of Spatiotemporal Analysis For Detecting Demographic Variations In Aids Mortality: An Example From Florida, Yuwen Chiu, Chiehwen Ed Hsu

Chiehwen Ed Hsu

The purpose of the present study was to characterize, geographically and temporally, the patterns of acquired immune deficiency syndrome (AIDS) death disparity in 67 Florida jurisdictions, and to determine if the detected trends varied according to age, race, and sex. The space-time scan statistic proposed by Kulldorff et al was used to examine the excess AIDS deaths that occurred between 1987 and 2004. Results were geographically referenced in maps using EpiInfo and EpiMap made available by the Centers for Disease Control. Miami-Dade and the nearby counties including Broward, Martin, and Palm Beach are the most likely clusters (observed/expected: 1505.16) with …