Medicine and Health Sciences Commons^™

An Analysis Of Major Issues For Culturally-Minded Professionals In Women's Health Care, Victoria Clark

Victoria Clark

Influence Of Sense Of Coherence, Spirituality, Social Support And Health Perception On Breast Cancer Screening Motivation And Behaviors In African American Women, Regina Conway-Phillips, Linda W. Janusek

Regina Conway-Phillips

Despite formidable barriers, some African American women (AAW) engage in breast cancer screening (BCS) behaviors. Understanding individual characteristics that allow AAW to overcome barriers to BCS is critical to reduce breast cancer mortality among AAW. A salutogenic model of health was used to evaluate the influence of sense of coherence, social support, spirituality and health perception on BCS motivation and behaviors in AAW, and to determine differences in these factors in AAW who participate in free BCS programs compared to AAW who do not. Findings revealed that greater levels of spirituality were significantly associated with greater motivation to practice BCS. …

Relationship Of Omega-3 Fatty Acids On C-Reactive Protein And Homocysteine In Haitian And African Americans With And Without Type 2 Diabetes, Fatma G. Huffman, Joan A. Vaccaro, Joel C. Exebio, Sahar Ajabshir, Gustavo G. Zarini, Lemia H. Shaban

Joan A. Vaccaro

Background: Omega-3 fatty acids (n-3) may be protective of cardiovascular risk factors for vulnerable populations. The purpose of this study was to assess the association between n-3 with, C-reactive protein (CRP), and homocysteine (HCY) in Black minorities with and without type 2 diabetes.

Methods: A cross-sectional study was conducted with 406 participants: Haitian Americans (HA): n=238. African Americans (AA): n=172. Participants were recruited from a randomly generated mailing lists, local diabetes educators, community health practitioners and advertisements from 2008-2010. Sociodemographics and anthropometrics were collected and used to adjust analyses. All dietary variables were collected using the semi-quantitative food frequency questionnaire …

Ethnic Differences In Insulin Resistance, Adiponectin Levels And Abdominal Obesity: Haitian Americans And African Americans, With And Without Type 2 Diabetes Mellitus, Amanpreet K. Cheena, Gustavo G. Zarini, Joel C. Exebio, Sahar Ajabshir, Lemia Shaban, Janet Antwi, Joan Vaccaro, Fatma G. Huffman

Joan A. Vaccaro

Background: Metabolic outcomes of obesity and its associated disorders may not be equivalent across ethnicity and diabetes status.

Aim: In this paper, we examined the association of abdominal obesity, by ethnicity and diabetes status, for indicators of glucose metabolism in Blacks.

Methods: A cross sectional study was conducted in Haitian Americans (n= 186) and African Americans (n= 148) with and without type 2 diabetes mellitus (T2DM). Student’s t-test and Chi-squared test were used to assess differences in mean and proportion values between ethnicities with and without type 2 diabetes mellitus. Relationship between insulin resistance, ethnicity, diabetes status, abdominal obesity, and …

The Association Of Depression And Perceived Stress With Beta Cell Function Between African And Haitian Americans With And Without Type 2 Diabetes, Fatma G. Huffman, Maria Vallasciani, Joan Vaccaro, Joel C. Exebio, Gustavo G. Zarini, Ali Nayer, Sahar Ajabshir

Joan A. Vaccaro

Background: Diabetes and diabetes-related complications are major causes of morbidity and mortality in the United States. Depressive symptoms and perceived stress have been identified as possible risk factors for beta cell dysfunction and diabetes. The purpose of this study was to assess associations between depression symptoms and perceived stress with beta cell function between African and Haitian Americans with and without type 2 diabetes. Participants and Methods: Informed consent and data were available for 462 participants (231 African Americans and 231 Haitian Americans) for this cross-sectional study. A demographic questionnaire developed by the Primary Investigator was used to collect information …

Racism, Place, And Health Of Urban Black Elders Relationship Of Neighborhood Effects And Reaction To Discrimination On Self-Rated Health, Priscilla Ryder

Priscilla T. Ryder

As a population, older African Americans in the United States have more compromised health in terms of numbers and severity of conditions, ages at onset, and levels of physical function than European Americans of similar ages. Some of the inequality may be due to life-long exposure to institutional, interpersonal, and internalized racism. This monograph describes the results of a survey of African Americans ages 60 years and older living in Baltimore, Maryland. The study sets out to explain differences in self-rated health using report of racism, reaction to unfair treatment, and physical and psychosocial characteristics of participants? neighborhoods. Mental health, …

Why African-American Women Are At Greater Risk For Pregnancy-Related Death, Margaret Harper, Elizabeth Dugan, Mark Espeland, Anibal Martinez-Borges, Cynthia Mcquellon

Elizabeth Dugan

PURPOSE: Our study aim was to identify factors that may contribute to the racial disparity in pregnancy-related mortality.

METHODS: We examined differences in severity of disease, comorbidities, and receipt of care among 608 (304 African-American and 304 white) consecutive patients of non-Hispanic ethnicity with one of three pregnancy-related morbidities (pregnancy-related hypertension, puerperal infection, and hemorrhage) from hospitals selected at random from a statewide region.

RESULTS: African-American women had more severe hypertension, lower hemoglobin concentrations preceding hemorrhage, more antepartum hospital admissions, and a higher rate of obesity. The rate of surgical intervention for hemorrhage was lower among African-Americans, although the severity …

Racial Disparity In Pregnancy-Related Mortality Following A Live Birth Outcome, Margaret Harper, Mark Espeland, Elizabeth Dugan, Robert Meyer, Kathy Lane, Sharon Williams

Elizabeth Dugan

PURPOSE: African-American women have a 2- to 4-fold increased risk of pregnancy-related death compared with Caucasian women. We conducted this study to determine if differences in a combination of socioeconomic and medical risk factors may explain this racial disparity in pregnancy-related death. METHODS: Pregnancy-related deaths of African-American (N=60) and Caucasian (N=47) women were identified from review of pregnancy-associated deaths (N=400) ascertained through cause of death on death certificates, electronic linkage of birth and death files, and review of the hospital discharge database for the State of North Carolina, during the period between 1992 and 1998. Controls (N=3404) were randomly selected …

Racial Differences In Pelvic Anatomy By Magnetic Resonance Imaging, V. Handa, M. Lockhart, J. Fielding, Catherine Bradley, L. Brubaker, G. Cundiff, W. Ye, H. Richter

Catherine S. Bradley

OBJECTIVES: To use static and dynamic magnetic resonance imaging (MRI) to compare dimensions of the bony pelvis and soft tissue structures in a sample of African-American and white women. METHODS: This study used data from 234 participants in the Childbirth and Pelvic Symptoms Imaging Study, a cohort study of 104 primiparous women with an obstetric anal sphincter tear, 94 who delivered vaginally without a recognized anal sphincter tear and 36 who underwent by cesarean delivery without labor. Race was self-reported. At 6-12 months postpartum, rapid acquisition T2-weighted pelvic MRIs were obtained. Bony and soft tissue dimensions were measured and compared …

Colonizing Images And Diagnostic Labels: Oppressive Mechanisms For African American Women's Health, Janette Taylor

Janette Y. Taylor

The purpose of this article is to present colonizing images of African American women and describe how colonizing images and diagnostic labels function together to serve as oppressive mechanisms for African American women's health. The mammy, the matriarch, the welfare mother, the Jezebel, and the Black lady overachiever are representational images of African American women that contribute to how they are viewed and treated within the health care arena.

Race And Colorectal Cancer Disparities: Health-Care Utilization Vs Different Cancer Susceptibilities, Adeyinka Laiyemo, Chyke Doubeni, Paul Pinsky, V. Doria-Rose, Robert Bresalier, Lois Lamerato, E. Crawford, Paul Kvale, Mona Fouad, Thomas Hickey, Thomas Riley, Joel Weissfeld, Robert Schoen, Pamela Marcus, Philip Prorok, Christine Berg

Chyke A. Doubeni

BACKGROUND: It is unclear whether the disproportionately higher incidence and mortality from colorectal cancer among blacks compared with whites reflect differences in health-care utilization or colorectal cancer susceptibility. METHODS: A total of 60, 572 non-Hispanic white and black participants in the ongoing Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial underwent trial-sponsored screening flexible sigmoidoscopy (FSG) without biopsy at baseline in 10 geographically dispersed centers from November 1993 to July 2001. Subjects with polyps or mass lesions detected by FSG were referred to their physicians for diagnostic workup, the cost of which was not covered by PLCO. The records …

Perceptions Of Healthcare, Health Status, And Discrimination Among African-American Veterans, Nathaniel M. Rickles, Silvia Domínguez (1961-), Hortensia Amaro (1950-)

Silvia Domínguez

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans' perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006. Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of …

Perceptions Of Healthcare, Health Status, And Discrimination Among African-American Veterans, Nathaniel M. Rickles, Silvia Domínguez (1961-), Hortensia Amaro (1950-)

Nathaniel Rickles

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans' perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006. Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of …

Perceptions Of Healthcare, Health Status, And Discrimination Among African-American Veterans, Nathaniel M. Rickles, Silvia Domínguez (1961-), Hortensia Amaro (1950-)

Hortensia Amaro

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans' perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006. Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of …