Medicine and Health Sciences Commons^™

Covid-19 Severity Among American Indians And Alaska Natives In 16 States - January 1, 2020, To March 31, 2021, Jessica Arrazola, Scott Erickson, Chiao Wen Lan, Adrian Dominguez, Sujata Joshi, Andria Apostolou, Ashley Busacker, David Casey, Christiana Coyle, Kathryn Helfrich, Jennifer Kraszewski, Thomas Kim, Genelle Lamont, Richard Leman, Pamela Lemaster, Nick Lehnertz, Mike Mannell, Dakota Matson, Alex Merrill, Tracy Miller, Benjamin Schram, Ozair Naqvi, Samantha Rice, Samantha Hyde-Rolland, Alyssa Rowell, Dean Seneca, Victoria Warren-Mears, Laura Williamson

Journal of Health Disparities Research and Practice

Objective: To compare rates and risk factors of severe COVID-19-related outcomes between American Indian/Alaska Native (AI/AN) and non-Hispanic White people (NHW).

Methods: Aggregate Social Vulnerability Index (SVI), COVID-19-related risk factor, hospitalization, and mortality data were obtained from 16 states for January 1, 2020-March 31, 2021. Generalized estimating equation Poisson regression models calculated age-adjusted cumulative incidences, incidence ratios (IR), and 95% confidence intervals (CI) comparing AI/AN and NHW persons by age, sex, and county-level SVI status.

Results: Race data were missing for 42.7% of COVID-19 cases, 24.7% of hospitalizations, and 10.1% of deaths. Risk of AI/AN COVID-19 mortality …

Association Between Diagnosed Anxiety And Depression And Exposure To Life Stressors During The Covid-19 Pandemic, Emily Hallgren Phd, Don E. Willis Phd, Brett Rowland Ma, James P. Selig Phd, Pearl A. Mcelfish Phd

Journal of Health Disparities Research and Practice

Research suggests that mental health disorders heighten the risk of exposure to life stressors. Drawing on a sample of 754 adults from a survey distributed at six primary care clinics, we examine whether adults who reported ever being diagnosed with depression or anxiety were more likely to experience an employment disruption, a housing disruption, and/or report more COVID-19-related stressors during the COVID-19 pandemic. Individuals who reported ever being diagnosed with depression reported a greater burden (B=.75) of COVID-19-related stressors. Those who reported ever being diagnosed with anxiety had higher odds of experiencing an employment disruption (OR=1.90) and a housing disruption …

Social Support Needs Of Minority Breast Cancer Patients: Significance Of Racial Homogeneity And Kin Composition Of Social Networks, Ganga Vijayasiri, Garth H. Rauscher, Ifeanyi Beverly Chukwudozie, Richard T. Campbell, Richard Warnecke

Journal of Health Disparities Research and Practice

Social support from family and friends assists breast cancer patients navigate a life crisis, but more needs to be understood about specific social network characteristics that can benefit breast cancer patients. To address this need, the primary aim of this study was to identify social network factors that facilitate or reduce social support. Given racially patterned gaps in social support among breast cancer patients, a secondary goal was to identify network characteristics that are linked to gaps in support. We examined these research questions using data from a sample of 915 breast cancer patients (NHWhite=373; NHBlack=377; Hispanic=165) and 4,021 of …

Can Community Gardens With Workshops Increase Gardening Behavior? A Navajo Wellness Collaboration, Kevin A. Lombard Phd, India J. Ornelas Phd, Desiree Deschenie, Felix Nez, Sonia Bishop, Katie Osterbauer Ms, Eileen Rillamas-Sun Phd, Shirley A.A. Beresford Phd

Journal of Health Disparities Research and Practice

This paper seeks to evaluate the potential efficacy of a community gardening intervention on the Navajo Nation to increase gardening and healthy eating behaviors, which are potentially important in preventing obesity and related health conditions. Rates of obesity are high among American Indians, including those living on Navajo Nation land. Eating fresh fruits and vegetables is part of healthy eating. However, availability and access to fresh fruits and vegetables are severely limited on the Navajo Nation, due to distance and cost. One way to increase both availability and consumption of fresh fruits and vegetables is through community gardening, yet …

Health Disparities And Covid-19 Pandemic: Increasing Clinical Research Participation Among African Americans, Kashica J. Webber-Ritchey, Abbi D. Lane-Cordova

Journal of Health Disparities Research and Practice

Health disparities in African Americans is a persistent issue. Higher rates and severity of the novel coronavirus-19 [COVID-19] among African Americans only widens health disparities. Effective COVID-19 treatment options are imperative, requiring representation of African Americans in clinical research. However, low participation and under-representation of African Americans is complex in nature. This article describes health disparities, the impact of COVID-19, and participation in clinical research among African Americans. We offer strategies for researchers to enhance the inclusion of African Americans. We also offer strategies in conducting clinical research during COVID-19.

Sex Differences In Risk Factors For Oral And Pharyngeal Cancer Among Puerto Rican Adults, Maira A. Castaneda-Avila, Cynthia Perez, Jose Vivaldi, Elba C. Díaz, Hilmaris Centeno, Ana P. Ortiz

Journal of Health Disparities Research and Practice

Background: Oral and pharyngeal cancer (OPC) is a frequent type of cancer in Puerto Rico, with the risk being higher in men relative to women. We assessed differences in OPC risk factors implicated in these sex disparities.

Methods: We analyzed data of 740 adult participants (40-65 years) from the San Juan Overweight Adults Longitudinal Study (SOALS). A comprehensive questionnaire was administered to collect information on sociodemographic characteristics, cigarette smoking, binge drinking, oral high-risk HPV infection, fruit and vegetable consumption, sexual behavior, and oral hygiene practices. A full-mouth periodontal examination was also performed. Sixteen OPC known and potential risk factors were …

Does Age Affect The Association Between Race/Ethnicity And Hpv Screening: A Retrospective Cohort Study Of United States Women, Keila L. Marlin, Mph, Larissa R. Brunner Huber, Ph.D.

Journal of Health Disparities Research and Practice

Many studies have demonstrated disparities in awareness of and knowledge about human papillomavirus (HPV) among young, immigrant, and minority populations. Yet, there is a lack of existing research that has investigated the role of race/ethnicity and HPV screening, and how it varies by age. The purpose of this study was to evaluate this association using 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. This study included 120,646 women who self-reported information on race/ethnicity, HPV screening, and age. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CIs). A stratified analysis was conducted to determine if age …

Substance Abuse Treatment In Correctional Versus Non-Correctional Settings: Analysis Of Racial/Ethnic And Gender Differences, George Pro, Ricky Camplain, Samantha Sabo, Julie Baldwin, Paul A. Gilbert

Journal of Health Disparities Research and Practice

Background

Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants …

"Courage 2 Test": An Evaluation Of A Social Media Marketing Campaign To Increase Hiv Testing Among Young Black Men, Jamal T. Jones, Laura F. Salazar, Richard A. Crosby

Journal of Health Disparities Research and Practice

The purpose of this study was to evaluate a social media marketing (SMM) campaign designed to increase HIV testing among young Black men attending a public university in Atlanta, GA. “Courage 2 Test” was a three-month SMM campaign (launched from February 2017 to April 2017) that included targeted Facebook and Instagram advertisements to encourage HIV testing. Students completed an online survey via two cross-sectional samples (n=106 at baseline and n=98 post campaign). Campaign evaluation involved assessing the effects of campaign exposure and the pre/post-grouping variable on ever testing for HIV and testing for HIV in the previous six months via …

Social Vs. Practical Problems In Attaining A Colonoscopy: Different Patient Profiles?, Barbara A. Curbow, Evelyn C. King-Marshall, Nora Mueller, Travis Hyams, Shahnaz Sultan, Thomas J. George Jr

Journal of Health Disparities Research and Practice

Background: Colonoscopy is an effective procedure for identifying precancerous polyps and cancerous lesions, but it is unlike other cancer screening tools in that it requires sedation and thus assistance from at least one other individual. The intent of this paper was to identify logistical problems in completing the colonoscopy and to examine their relationships with sociodemographic characteristics.

Methods: All eligible patients (n = 2500) from two academic-affiliated colonoscopy centers (one free standing, one hospital-based) were invited to participate in an onsite, pre-colonoscopy survey; patients agreeing to participate (n = 1841, RR = 73.6%) received a $5.00 gift card. Multiple correspondence …

Comparison Of Compliance With Cervical Cancer Screening Among Women Aged 18 And Above In Arkansas And The United States, Sarah N. O'Connor, Jun Tao, L. Joseph Su

Journal of Health Disparities Research and Practice

Introduction: Cervical cancer preys on women without access to preventative screening. Any woman who has developed an invasive case of cervical cancer should be regarded as a failure of screening. Disparities in access to screening, triage, and treatment fuel an uneven distribution in the burden of cervical cancer within the United States; weighing unusually heavy on the Southern States like Arkansas. The purpose of this study was to evaluate demographic and behavioral risk factors for cervical cancer and identify potential barriers which may influence the likelihood of complying with current Pap test recommendations on a state level, in Arkansas, and …

Prehypertensive Risk Among African-American Undergraduates: Do The Extra Pounds Really Matter?, Cecile N. Yancu, Amber Debono, Anna K. Lee, Correll Mcrae, Daphne Witherspoon

Journal of Health Disparities Research and Practice

The objective of this study is to examine prehypertension among young African American adults and evaluate the predictive value of easily obtained standard measures of adiposity. Data for this study of 155 primarily African-American undergraduates was collected between April 2010-11. Participants provided family health history and anthropometric measures, including body weight, body mass index (BMI), and waist to hip (WHR) ratio. Percentages were calculated for demographics. The average systolic blood pressure measured over two time periods within a single semester generated prehypertension rates. Univariate and multivariate logistic regression examined the impact of BMI, WHR, weight, and family medical history on …

Racial Disparities In Breast Cancer Survival: The Mediating Effects Of Macro-Social Context And Social Network Factors, Ganga Vijayasiri, Yamile Molina, Ifeanyi B. Chukwudozie, Silvia Tejeda, Heather Pauls, Garth Rauscher, Richard T. Campbell, Richard B. Warnecke

Journal of Health Disparities Research and Practice

ABSTRACT

This study attempts to clarify the associations between macro-social and social network factors and continuing racial disparities in breast cancer survival. The study improves on prior methodologies by using a neighborhood disadvantage measure that assesses both economic and social disadvantage and an ego-network measurement tool that assesses key social network characteristics. Our population-based sample included 786 breast cancer patients (nHWhite=388; nHBlack=398) diagnosed during 2005-2008 in Chicago, IL. The data included census-derived macro-social context, self-reported social network, self-reported demographic and medically abstracted health measures. Mortality data from the National Death Index (NDI) were used to determine 5-year survival.

Based on …

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Journal of Health Disparities Research and Practice

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in …

Human Papillomavirus Infections In The Southern And Other United States Regions, Dudith Pierre-Victor, Mary Jo Trepka, Dionne Stephens, Tan Li, Timothy Page, Purnima Madhivanan

Journal of Health Disparities Research and Practice

Human papillomavirus (HPV) infection is the most common sexually transmitted infection worldwide and has been linked to several cancers, including cervical cancer. In the United States, the Southern region has a disproportionate burden of cervical cancer, and research about the epidemiology of HPV in the region is scarce. This study estimates the prevalence and correlates of HPV infection among 14–59 year-old females.

Data from 4,250 females aged 14–59 years collected during the 2007–2010 National Health and Nutrition Examination Survey (NHANES) were used. We estimated the prevalence of HPV infection for the South and the rest of the country. We performed …

Graduating Into Lower Risk: Chlamydia And Trichomonas Prevalance Among Community College Students And Graduates, Janet E. Rosenbaum

Journal of Health Disparities Research and Practice

Background: Community colleges enable youth from economically disadvantaged and minority populations to access college and may enable social mobility including improved health outcomes. However, educational health disparities studies rarely assess the health outcomes for community college graduates.

Methods: Chlamydia and trichomonas prevalence were assessed with nucleic acid based tests in a nationally representative sample of 6233 high school graduates (ages 18–25) from five educational levels: young adults without post-secondary credentials who were not enrolled in college, community college students, 4-year college students, associate’s degree, and bachelor’s degree. To reduce confounding between educational attainment and STI status, we used full matching …

Effectiveness Of A Federal Healthy Start Program In Reducing Infant Mortality, Ronee E. Wilson, Hamisu M. Salihu, Jason L. Salemi, Priyanshi Patel, Rana Daas, Estrellita "Lo" Berry

Journal of Health Disparities Research and Practice

Objective: Infant mortality is an important indicator of the health status of a community. In this analysis, we aimed to evaluate temporal changes in infant mortality rates (IMR) in the Central Hillsborough Healthy Start (CHHS) program service area in Tampa, Florida compared to rates in the rest of Hillsborough County and the state.

Method: We conducted a five-year (2010-2014) trends analysis using birth and infant death data extracted from the Florida Community Health Assessment Resource Tool Set (CHARTS). The number of infant deaths and live births were used to calculate and compare IMRs in the CHHS catchment area to those …

Race And “Hotspots” Of Preventable Hospitalizations, Caryn N. Bell, Janice V. Bowie, Roland J. Thorpe Jr.

Journal of Health Disparities Research and Practice

Abstract

Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH …

Persistence With Mammography Screening And Stage At Breast Cancer Diagnosis Among Elderly Appalachia-West Virginia Women, Ami Vyas, Suresh Madhavan, Usha Sambamoorthi

Journal of Health Disparities Research and Practice

The objective of this study is to evaluate the association between persistence with mammography screening and stage at breast cancer diagnosis in elderly Appalachia-West Virginia women diagnosed with first incident breast cancer. The study utilized West Virginia Cancer Registry-Medicare linked database to identify women age 70 and above diagnosed with first incident breast cancer in 2007. Persistence to mammography screening was defined as having had at least three mammography screenings before breast cancer diagnosis. A multiple logistic regression was conducted to assess the association between persistence with mammography screening and stage at breast cancer diagnosis in these women. Of the …

The Effects Of Insurance Status On Pediatric Traumatic Brain Injury Outcomes: A Literature Review, Anthony Fabio, Austin Murray, Michelle Mellers, Stephen Wisniewski, Michael Bell

Journal of Health Disparities Research and Practice

Objective: To review the literature that describes the effects of insurance status on traumatic brain injury (TBI) outcomes among pediatric patients to understand how policies related to access to health insurance changes TBI outcomes. Method: This review was conducted using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA). A search of OVID Medline was conducted in May of 2016 for all years for peer-reviewed articles that included keywords related to “brain injuries” and “insurance status”. Articles were included if authors conducted a separate analysis of children aged 0 to 18. Articles were excluded if the TBI was the …

Residential Segregation, Neighborhood Social And Physical Context In Obesity Disparities In Hispanic Preschoolers: A Conceptual Model, Catherina Chang Martinez Phd(C), Nasar U. Ahmed Phd, Ruby A. Natale Phd, Psyd

Journal of Health Disparities Research and Practice

During the last decade, there has been a significant inclusion in obesity prevention studies from individual characteristics to household factors then neighborhood factors. The study of place in the context of early childhood obesity studies has been limited to the food and physical built environment. With the persistent disparities in the prevalence of childhood obesity, and Hispanic minorities being increasingly affected, there is a need to reexamine existing models and develop new model conceptual frameworks to examine the role of place and residential segregation in the context of race, ethnicity, social position, and socioeconomic disparities. In the context of place …

Exploring The Life Course Perspective In Maternal And Child Health Through Community-Based Participatory Focus Groups: Social Risks Assessment, Abraham Salinas-Miranda, Lindsey M. King, Hamisu M. Salihu, Estrellita "Lo" Berry, Deborah Austin, Susan Nash, Kenneth Scarborough, Evangeline Best, Lillian Cox, Georgette King, Carrie Hepburn, Conchita Burpee, Eugene Richardson, Marlo Ducket, Richard Briscoe, Julie Baldwin

Journal of Health Disparities Research and Practice

Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas.

Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain …

Gender And Racial/Ethnic Disparities: Cumulative Screening Of Health Risk Indicators In 20-50 Year Olds In The United States, Alissa Cordner, Adrien A. Wilkie, Timothy J. Wade, Edward E. Hudgens, Rebecca J. Birch, Jane E. Gallagher

Journal of Health Disparities Research and Practice

This study explored potential gender and racial/ethnic disparities in overall health risk related to 24 health risk indicators selected across six domains: socioeconomic, health status and health care, lifestyle, nutritional, clinical, and environmental. Using the 2003-2006 National Health and Nutrition Examination Surveys (NHANES), it evaluated cross-sectional data for 5,024 adults in the United States. Logistic regression models were developed to estimate prevalence odds ratios (PORs) adjusted for smoking, health insurance status, and age. Analyses evaluated disparities associated with 24 indicator variables of health risk, comparing females to males and four racial/ethnic groups to non-Hispanic Whites. Non-Hispanic Blacks and Mexican Americans …

Exploring Sexual And Behavioral Health Inequities Among College Students: A Need For Lgb-Specific Risk Reduction, Todd M. Sabato

Journal of Health Disparities Research and Practice

Many studies have examined differences in sexual behavior based upon self-identified sexual orientation, with results often indicating that those with same-sex partners engage in greater risk behaviors than those with opposite sex partners. However, few of those studies consisted of large, national sample studies. To address that gap, the present study examined the relationship between sexual orientation and both behavioral and sexual health outcomes in a national sample of U.S. college students. The Fall 2012 through Spring 2014 American College Health Association National College Health Assessment was used to examine behavioral and sexual health related responses from self-identified heterosexual, gay, …

Overcoming Recruitment Challenges: A Pilot Study In Arab Americans, Nawar M. Shara, Sayf A. Yassin, Soleman H. Abu-Bader, Asqual Getaneh, Shaunagh Browning, Alexander Zeymo, Barbara V. Howard, Zeid Abudiab, Anas Shahrour, Jason G. Umans

Journal of Health Disparities Research and Practice

While diabetes prevalence and cardiovascular risk factors have been increasing among Arab populations worldwide, few studies of Arab Americans have been conducted because of the difficulty in recruiting Arab American participants. Cultural sensitivity and social awareness of different immigrant groups could ensure successful recruitment and retention in clinical studies. While the primary objective of our overall research project was to determine the prevalence of metabolic syndrome in Arab Americans, the focus of this article is to describe the methodology used to overcome challenges in recruiting and enrolling Arab Americans for a community-based study. We used novel methods, including open houses, …

Reducing Disparities By Way Of A Cancer Disparities Research Training Program, Lee S. Caplan, Tabia H. Akintobi, Tandeca K. Gordon, Tiffany Zellner, Selina A. Smith, Daniel S. Blumenthal

Journal of Health Disparities Research and Practice

Background: For minority populations, there is a continuing disparity in the burden of death and illness from cancer. Research to address this disparity should be conducted by investigators who can best understand and address the needs of culturally diverse communities. However, minorities are under-represented in health-related research. The goal of this project was to develop and evaluate an approach to motivating and preparing master’s degree students for careers dedicated to cancer disparities research.

Method: A Cancer Disparities Research Training Program (CDRTP) was initiated in 2010. The program consists of coursework, practicum experiences, and research opportunities. Assessment of the curriculum is …

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, …

Sex Disparities In Access To Acute Stroke Care: Can Telemedicine Mitigate This Effect?, Catherine Wolff, Amelia K. Boehme, Karen Albright, Tzu-Ching Wu, Michael Mullen, Sean Savitz, Charles Branas, James Grotta, Brendan Carr

Journal of Health Disparities Research and Practice

Background: Women have more frequent and severe ischemic strokes than men, and are less likely to receive treatment for acute stroke. Primary stroke centers (PSCs) have been shown to utilize treatment more frequently. Further, as telemedicine (TM) has expanded access to acute stroke care we sought to investigate the association between PSC, TM and access to acute stroke care in the state of Texas.

Methods: Texas hospitals and resources were identified from the 2009 American Hospital Association Annual Survey. Hospitals were categorized as: (1) stand-alone PSCs not using telemedicine for acute stroke care, (2) PSCs using telemedicine for acute stroke …

Epidemiology Of Hiv Among American Indians And Alaska Natives – United States, 2008-2011, Frances J. Walker, Jane M. Kelly, Mona Doshani, Neeraja Saduvala, Joseph Prejean

Journal of Health Disparities Research and Practice

American Indians/Alaska Natives (AI/AN) diagnosed with HIV infection have poorer survivorship and a higher percentage of Stage 3 (AIDS] diagnoses within one year of HIV diagnosis, compared to most race/ethnicity groups. National HIV surveillance data for 2008-2011 were used to determine diagnosis rates of HIV infection, persons living with HIV, and persons with a late diagnosis (Stage 3 within three months of HIV diagnosis) by selected characteristics for AI/AN and a combined other race/ethnicity group. The highest percentages of 862 AI/AN diagnosed with HIV infection were among males (75.7%), AI/AN aged 25-34 years (32.9%), persons living in large metropolitan areas …

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 …