Race and Ethnicity Commons^™

A Surgical Desirability Of Outcome Ranking (Door) Reveals Complex Relationships Between Race/Ethnicity, Insurance Type, And Neighborhood Deprivation, Michael A Jacobs, Susanne Schmidt, Daniel E Hall, Karyn B Stitzenberg, Lillian S Kao, Bradley B Brimhall, Chen-Pin Wang, Laura S Manuel, Hoah-Der Su, Jonathan C Silverstein, Paula K Shireman

Faculty, Staff and Student Publications

Objective: Develop an ordinal Desirability of Outcome Ranking (DOOR) for surgical outcomes to examine complex associations of Social Determinants of Health.

Background: Studies focused on single or binary composite outcomes may not detect health disparities.

Methods: Three health care system cohort study using NSQIP (2013-2019) linked with EHR and risk-adjusted for frailty, preoperative acute serious conditions (PASC), case status and operative stress assessing associations of multilevel Social Determinants of Health of race/ethnicity, insurance type (Private 13,957; Medicare 15,198; Medicaid 2835; Uninsured 2963) and Area Deprivation Index (ADI) on DOOR and the binary Textbook Outcomes (TO).

Results: Patients living in highly …

Human Zoo Healthcare At The 1904 World’S Fair, Angel Blake

Undergraduate Research Symposium

Human Zoo Healthcare at the 1904 World’s Fair

Were precautions taken or put into place for the Human Zoo performers at the 1904 World’s Fair? This topic has been overlooked and understudied by historians, there are few articles written and we do not know the true death toll which shows the racism towards these indigenous peoples. The research for this project was conducted at the State Historical Society of Missouri, the St. Louis Mercantile Library, Newspapers.com, Archives.com, St. Louis Public Library, and the Missouri Historical Society, including research on primary sources such as official World’s Fair committee meeting minutes, hospital …

Asian Americans Have Relatively Low Anxiety But Experienced Large Increases In Anxiety Between 2020 And 2022, Tianqi Zhou

Population Health Research Brief Series

Anxiety has harmful effects on physical health. This new data slice uses data from the 2020-2022 National Health Interview Surveys to measure the anxiety levels among adults ages 18+ by race and ethnicity in the United States. Results show that Asian adults have lower average anxiety levels than other ethnoracial groups, but they experienced the largest increase in average anxiety levels between 2020 and 2022.

Hidradenitis Suppurativa Disease Severity And Outcomes Among Black Patients From Low-Income Neighborhoods At A Tertiary Care Hospital: A Retrospective Review, Anna M. Catinis, Olivia A. Gioe, Caroline Savoie, Erika Rosen, Deborah Hilton

School of Medicine Faculty Publications

Hidradenitis suppurativa (HS) is a debilitating, inflammatory condition of apocrine sweat glands. Black patients are disproportionately affected, a finding largely attributed to lower socioeconomic status (SES) in the literature; yet, most HS studies include majority White cohorts. We present, to our knowledge, the first retrospective review of an entirely Black patient population living in low-income neighborhoods diagnosed with hidradenitis suppurativa (HS) to identify potentially modifiable factors related to disease severity and outcomes. We reviewed charts of Black patients with an encounter for HS from 2010-2020 in the New Orleans University Medical Center database. Hurley stage III (HSt III) disease was …

Perceived Neighborhood Disorder And Type 2 Diabetes Disparities In Hispanic, Black, And White Americans, Min Ying Yu, Alfredo J. Velasquez, Belinda Campos, Jennifer W. Robinette

Psychology Faculty Articles and Research

Introduction: Approximately 32 million Americans have type 2 diabetes, and that number continues to grow. Higher prevalence rates are observed among certain subgroups, including members of marginalized racial/ethnic groups as well as residents of disordered neighborhoods (i.e., those with more trash and vandalism). Institutionalized discriminatory practices have resulted in disproportionate representation of marginalized racial/ethnic groups in disordered neighborhoods compared to non-Hispanic Whites. These neighborhood disparities may partially contribute to health disparities, given that signs of neighborhood disorder often relate to a general withdrawal from the neighborhood, minimizing opportunities for both physical and social engagement. Yet, research suggests variability across …

Mendelian Randomization With Incomplete Measurements On The Exposure In The Hispanic Community Health Study/Study Of Latinos, Yilun Li, Kin Yau Wong, Annie Green Howard, Penny Gordon-Larsen, Heather M Highland, Mariaelisa Graff, Kari E North, Carolina G Downie, Christy L Avery, Bing Yu, Kristin L Young, Victoria L Buchanan, Robert Kaplan, Lifang Hou, Brian Thomas Joyce, Qibin Qi, Tamar Sofer, Jee-Young Moon, Dan-Yu Lin

Faculty, Staff and Student Publications

Mendelian randomization has been widely used to assess the causal effect of a heritable exposure variable on an outcome of interest, using genetic variants as instrumental variables. In practice, data on the exposure variable can be incomplete due to high cost of measurement and technical limits of detection. In this paper, we propose a valid and efficient method to handle both unmeasured and undetectable values of the exposure variable in one-sample Mendelian randomization analysis with individual-level data. We estimate the causal effect of the exposure variable on the outcome using maximum likelihood estimation and develop an expectation maximization algorithm for …

The Role Of Research In Enabling Systemic Racism In Tobacco Use In Black/African American Communities, Sophia Rodriquez, Heal-Va Lab Working Group, Mignonne Guy Phd

IRBEH/Spit for Science Publications and Presentations

No abstract provided.

Primary Care Physician Trust: The Importance Of Early Medical Intervention For African American Children With Asthma, Harrish Ganesh

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Asthma is a prevalent condition characterized by an individual’s airway becoming inflamed, constricted, and leads to the formation of mucus and difficulty breathing. Nearly 27 million individuals are currently diagnosed with Asthma in the United States, and African Americans are 40% more likely to be diagnosed with asthma than Caucasians. This literature review analyzed multifaceted barriers that restrict African American asthmatic children from gaining consistent asthma treatment. Some of these barriers range from historical racial discrimination that leads to parental mistrust to financial and educational barriers that result in inconsistent pediatric care for asthmatic children. The combination of the above …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Implementing Social Determinants Of Health Data Collection In A Large Urban Pediatric Hospital Setting, Stormee Williams, Kristina Hill, Barry Owen, Forest Melton

Research

No abstract provided.

Autopathography Across Media: Trauma And Fluid Embodied Subjectivity, He (Kristen) Shen

Honors Theses

Illness memoirs with first-person point of view have gained more attention in recent years among medical sociologists and anthropologists. Different from traditional “case histories”written by doctors that are in danger of ignoring patients’ voices, autopathograhical works delineate narrators’ transformative experiences of persons to patients, emphasizing the importance of gaining social understanding of illness. Focusing on three works within the category of autopathography across genres and media forms in the late 1950s and contemporary periods, The Cancer Journals (1980) written by Audre Lorde, The Collected Schizophrenias (2019) written by Esmé Weijun Wang, and The Diving Bell and the Butterfly (2007) directed …

Health Consequences Of Racial Disparity In Access To Abortion: A Systematic Review, Lacy M. Frye, Calvin Odhiambo

University of South Carolina Upstate Student Research Journal

Prior to the 2022 Dobbs decision, Black women already experienced negative maternal health outcomes at an alarmingly disparate rate in comparison to White women. Given that the Dobbs decision emboldens state power to enforce abortion restrictions or protections, there has been significant strides made in both directions. Nonetheless, within states where reproductive rights have been significantly eroded, the heightened abortion restrictions may compound the limited access that Black women previously had before Dobbs. This, in turn will exacerbate the already disparate negative maternal outcomes that Black women experience. However, research on the relationship between the lack of access to abortion …

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

"Why Does This Have To Be So Hard?": Perinatal Experiences From An Ecological Systems Approach, Caitlin Senk

Antioch University Dissertations & Theses

This study examines the lived experience of the perinatal population to understand how they can be supported from the lens of different ecological systems and what counselors can do to better serve people with uteruses during their perinatal experience. Furthermore, this study aims to utilize an inclusive framework for capturing the perinatal experience of people with uteruses and to explore barriers and facilitators to care through an ecological systems framework. Fifteen participants who have experienced infertility, conception, pregnancy, miscarriage, childbirth, stillbirth, and postpartum were recruited through various means throughout the United States. Thematic analysis was used, with semi-structured interviews and …

Patient Perceptions On The Advancement Of Noninvasive Prenatal Testing For Sickle Cell Disease Among Black Women In The United States, Shameka P Thomas, Faith E Fletcher, Rachele Willard, Tiara Monet Ranson, Vence L Bonham

Center for Medical Ethics and Health Policy Staff Publications

Background: Noninvasive prenatal testing (NIPT) designed to screen for fetal genetic conditions, is increasingly being implemented as a part of routine prenatal care screening in the United States (US). However, these advances in reproductive genetic technology necessitate empirical research on the ethical and social implications of NIPT among populations underrepresented in genetic research, particularly Black women with sickle cell disease (SCD).

Methods: Forty (N = 40) semi-structured interviews were conducted virtually with Black women in the US (19 participants with SCD; 21 participants without SCD) from June 2021 to January 2022. We employed a qualitative approach to examine the …

The Impact Of Race On Pancreatic Cancer Treatment And Survival In The Nationwide Veterans Affairs Healthcare System, Natalia Khalaf, Ann Xu, Theresa Nguyen Wenker, Jennifer R Kramer, Yan Liu, Hardeep Singh, Hashem B El-Serag, Fasiha Kanwal

Faculty, Staff and Students Publications

OBJECTIVES: Among patients with pancreatic cancer, studies show racial disparities at multiple steps of the cancer care pathway. Access to healthcare is a frequently cited cause of these disparities. It remains unclear if racial disparities exist in an integrated, equal access public system such as the Veterans Affairs healthcare system.

METHODS: We identified all patients diagnosed with pancreatic adenocarcinoma in the national Veterans Affairs Central Cancer Registry from January 2010 to December 2018. We examined the independent association between race and 3 endpoints: stage at diagnosis, receipt of treatment, and survival while adjusting for sociodemographic factors and medical comorbidities.

RESULTS: …

A Phenomenological Exploration Of Intracommunity Attitudinal And Experiential Barriers To The Utilization Of Psychotherapeutic Services In Bipoc Populations, Jade Turner

Calvert Undergraduate Research Awards

This study used Interpretative Phenomenological Analysis to explore the role that intracommunity attitudes and beliefs and negative mental healthcare experiences play in determining treatment-seeking behavior in BIPOC communities. Through in-depth semistructured interviews, five participants shared their perspectives and experiences, providing rich and nuanced insight into the subjective landscape of mental healthcare avoidance among racial and ethnic minority populations. The analysis revealed five overarching themes (pray it away, isolated and invisible, fear, perceived importance of racial matching, and therapeutic experiences profoundly impact treatment-seeking) shedding light on the nuanced ways in which BIPOC individuals make sense of and navigate mental health within …

Work As A Social Determinant Of Maternal Health: A Qualitative Exploration Of College-Educated Black Women’S Experiences At Work During Pregnancy And Postpartum, Serwaa S Omowale, Laurenia C Mangum, Andrea Joseph-Mccatty, Cherell Cottrell-Daniels, Kaiya A Farris, Rashon King, Brittany C Slatton

Faculty, Staff and Student Publications

BACKGROUND: Black women are disproportionately impacted by higher rates of maternal mortality in the United States (US). Limited research has focused on adverse maternal health outcomes among college-educated Black women, although research has found these outcomes persistent among this population.

OBJECTIVES: This study aimed to fill a critical gap in current research by elucidating the nuanced experiences of college-educated Black women in the workplace during pregnancy and postpartum. By exploring this under-researched area, our study contributes to the academic discourse on Black maternal health disparities within the scope of occupational health. It offers practical insights for enhancing workplace gender equity, …

Perceptions Of Acute Care Telemedicine Among Caregivers For Persons Living With Dementia: A Qualitative Study, Anita Chary, Norvin Hernandez, Ana Paulina Rivera, Vivian Ramont, Tracey Obi, Ilianna Santangelo, Christine Ritchie, Hardeep Singh, Emily Hayden, Aanand D Naik, Shan Liu, Maura Kennedy

Faculty, Staff and Student Publications

Persons living with dementia (PLWD) have high emergency department (ED) utilization. Little is known about using telemedicine with PLWD and caregivers as an alternative to ED visits for minor acute health problems. This qualitative interview-based study elicited caregivers' perspectives about the acceptability of telemedicine for acute complaints. We performed telephone interviews with 28 caregivers of PLWD from two academic EDs, one in the Northeast and another in the South. Using a combined deductive-inductive approach, we coded interview transcripts and elucidated common themes by consensus. All caregivers reported they would need to participate in the telemedicine visit to help overcome communication …

Screening For Food And Nutrition Insecurity In The Healthcare Setting: A Cross-Sectional Survey Of Non-Medicaid Insured Adults In An Integrated Healthcare Delivery System, Carmen Byker Shanks, Nancy P Gordon

Faculty, Staff and Student Publications

OBJECTIVES: Healthcare screening identifies factors that impact patient health and well-being. Hunger as a Vital Sign (HVS) is widely applied as a screening tool to assess food security. However, there are no common practice screening questions to identify patients who are nutrition insecure or acquire free food from community-based organizations. This study used self-reported survey data from a non-Medicaid insured adult population approximately one year after the start of the COVID-19 pandemic (2021). The survey examined the extent to which the HVS measure might have under-estimated population-level food insecurity and/or nutrition insecurity, as well as under-identified food and nutrition insecurity …

Rural Racial Disparities And Barriers In Mammography Utilization Among Medicare Beneficiaries In Texas: A Longitudinal Study, Zhaoli Liu, Yong Shan, Yong-Fang Kuo, Sharon H Giordano

Faculty, Staff and Student Publications

This study examined rural racial/ethnic disparities in long-term mammography screening practices among Medicare beneficiaries. A retrospective longitudinal study was conducted using 100% Texas Medicare data for women aged 65-74 who enrolled in Medicare between 2010-2013. Of the 114,939 eligible women, 21.2% of Hispanics, 33.3% of non-Hispanic Blacks (NHB), and 38.4% non-Hispanic Whites (NHW) in rural areas were regular users of mammography, compared to 33.5%, 44.9%, and 45.3% of their counterparts in urban areas, respectively. Stratification analyses showed rural Hispanics and NHB were 33% (95% CI, 25% - 40%) and 22% (95% CI, 6% - 36%) less likely to be regular …

Secondhand Tobacco Smoke Exposure In Homes And Vehicles In Youth: Disparities Among Racial, And Sexual And Gender Minorities, Rajesh Talluri, Sahil S Shete, Surendra S Shastri, Sanjay Shete

Faculty, Staff and Student Publications

BACKGROUND: Secondhand smoke exposure (SHSe) among youth is a serious public health concern, leading to an increased risk of conditions such as asthma and respiratory infections. However, there is little research on SHSe among vulnerable populations, such as racial and sexual minorities. Understanding the factors associated with youth SHSe in homes and vehicles is crucial to developing better protective policies.

METHODS: This study utilized 2020 data from the National Youth Tobacco Survey, a representative sample of middle- and high-school students in the US. The primary outcomes were youth SHSe at home and while riding in a vehicle. Multinomial regression models …

Race, Ethnicity, Language, And The Treatment Of Low-Risk Febrile Infants, Colleen K Gutman, Paul L Aronson, Nidhi V Singh, Michelle L Pickett, Kamali Bouvay, Rebecca S Green, Britta Roach, Hannah Kotler, Jessica L Chow, Emily A Hartford, Mark Hincapie, Ryan St Pierre-Hetz, Jessica Kelly, Laura Sartori, Jennifer A Hoffmann, Jacqueline B Corboy, Kelly R Bergmann, Bolanle Akinsola, Vanessa Ford, Natalie J Tedford, Theresa T Tran, Sasha Gifford, Amy D Thompson, Andrew Krack, Mary Jane Piroutek, Samantha Lucrezia, Sunhee Chung, Nabila Chowdhury, Kathleen Jackson, Tabitha Cheng, Christian D Pulcini, Nirupama Kannikeswaran, Larissa L Truschel, Karen Lin, Jamie Chu, Neh D Molyneaux, Myto Duong, Leslie Dingeldein, Jerri A Rose, Carly Theiler, Sonali Bhalodkar, Emily Powers, Muhammad Waseem, Ahmed Lababidi, Xinyu Yan, Xiang-Yang Lou, Rosemarie Fernandez, K Casey Lion

Faculty, Staff and Students Publications

IMPORTANCE: Febrile infants at low risk of invasive bacterial infections are unlikely to benefit from lumbar puncture, antibiotics, or hospitalization, yet these are commonly performed. It is not known if there are differences in management by race, ethnicity, or language.

OBJECTIVE: To investigate associations between race, ethnicity, and language and additional interventions (lumbar puncture, empirical antibiotics, and hospitalization) in well-appearing febrile infants at low risk of invasive bacterial infection.

DESIGN, SETTING, AND PARTICIPANTS: This was a multicenter retrospective cross-sectional analysis of infants receiving emergency department care between January 1, 2018, and December 31, 2019. Data were analyzed from December 2022 …

The Relationship Of Neighborhood Disadvantage, Biological Aging, And Psychosocial Risk And Resilience Factors In Heart Failure Incidence Among Black Persons: A Moderated Mediation Analysis, Ganga S Bey, James R Pike, Anthony S Zannas, Qian Xiao, Bing Yu, Amil M Shah, Priya Palta

Faculty, Staff and Student Publications

Objectives: Deprived living environments contribute to greater heart failure (HF) risk among non-Hispanic Black persons, who disproportionately occupy disadvantaged neighborhoods. The mechanisms for these effects are not fully explicated, partially attributable to an insufficient understanding of the individual factors that contribute additional risk or resilience to the impact of neighborhood disadvantage on health. The objective of this study was, therefore, to clarify the complex pathways over which such exposures act to facilitate more targeted, effective interventions. Given the evidence for a mediating role of biological age and a moderating role of individual psychosocial characteristics in the neighborhood disadvantage-HF link, we …

The Overture! Then Is Here-And-Now: Hindsight Is Twenty, Twenty?, Elena Kydd

Music Therapy Theses

My existence and presence as a Black woman and graduate scholar in music therapy have allowed me to share my experience of racial trauma and oppression in the hallways of GCSU’s music therapy program. Autoethnography is the method I use to write my thesis on the relationships between Blackness, pedagogy, and music therapy. Thus, I perform an evocative autoethnographic study that allows me to share my personal experience of racial trauma and oppression within the culture of music therapy and to critique the larger social structures of whiteness that disenfranchise and dominate me and other Black student music therapists (SMTs). …

Bridging The Gap: Reducing Disparities In Reproductive Healthcare For Black And White Women, Emma Weiden

Population Health Research Brief Series

A woman’s reproductive healthcare experience in the United States can vary dramatically depending on her race. In 2020, the pregnancy-related mortality rate in the U.S. was 40.8 deaths per 100,000 live births for Black women, which is more than three times the rate among White women (12.7 per 100,000). This brief summarizes disparities in reproductive healthcare outcomes for Black women compared to White women in the U.S., advocates for policy changes, and provides recommendations for addressing racial disparities to create more equitable reproductive healthcare.

Cancer Disparities In Southeast Asia: Intersectionality And A Call To Action, Erin Jay G. Feliciano, Frances Dominique V. Ho, Kaisin Yee, Joseph A. Paguio, Michelle Ann B. Eala, Janine Patricia G. Robredo, Kenrick Ng, Jasmine Lim, Khin Thuzar Pyone, Catherine A. Peralta, Jerickson Abbie Flores, J. Seth Yao, Patricia Mae G. Santos, Christian Daniel U. Ang, Gideon Lasco, Jeffrey Shi Kai Chan, Gary Tse, Enrico D. Tangco, T. Peter Kingham, Imjai Chitapanarux, Nirmala Bhoo-Pathy, Gerardo D. Legaspi, Edward Christopher Dee

Einstein Health Papers

No abstract provided.

Associations Between Avocado Intake And Measures Of Glucose And Insulin Homeostasis In Hispanic Individuals With And Without Type 2 Diabetes: Results From The Hispanic Community Health Study/Study Of Latinos (Hchs/Sol), Mackenzie K Senn, Mark O Goodarzi, Gautam Ramesh, Matthew A Allison, Mariaelisa Graff, Kristin L Young, Gregory A Talavera, Amanda C Mcclain, Tanya P Garcia, Jerome I Rotter, Alexis C Wood

Faculty, Staff and Students Publications

BACKGROUND AND AIMS: To investigate associations between avocado intake and glycemia in adults with Hispanic/Latino ancestry.

METHODS AND RESULTS: The associations of avocado intake with measures of insulin and glucose homeostasis were evaluated in a cross-sectional analysis of up to 14,591 Hispanic/Latino adults, using measures of: average glucose levels (hemoglobin A1c; HbA1c), fasting glucose and insulin, glucose and insulin levels after an oral glucose tolerance test (OGTT), and calculated measures of insulin resistance (HOMA-IR, and HOMA-%β), and insulinogenic index. Associations were assessed using multivariable linear regression models, which controlled for sociodemographic factors and health behaviors, and which were stratified by …

Low-Dose Aspirin For Primary Prevention Of Cardiovascular Events Comparing East Asians With Westerners: A Meta-Analysis, Rock Bum Kim, Ang Li, Ki-Soo Park, Yune-Sik Kang, Jang-Rak Kim, Eliano P Navarese, Diana A Gorog, Udaya S Tantry, Paul A Gurbel, Jin Yong Hwang, Oh-Young Kwon, Young-Hoon Jeong

Faculty, Staff and Students Publications

BACKGROUND: East Asians have shown different risk profiles for both thrombophilia and bleeding than Western counterparts.

OBJECTIVES: The authors sought to evaluate the effect of low-dose aspirin for primary prevention between these populations.

METHODS: We searched randomized clinical trials (RCTs) for intervention with low-dose aspirin (≤100 mg once daily) in participants without symptomatic cardiovascular disease until December 31, 2021. The number of events between the arms was extracted for analysis. Pooled risk ratios (RRs) and risk differences (RDs) were analyzed in each population. Outcomes included a major adverse cardiovascular event (MACE), cardiovascular death, myocardial infarction, stroke, and major bleeding (intracranial …

Impact Of Receiving Hospital On Out‐Of‐Hospital Cardiac Arrest Outcome: Racial And Ethnic Disparities In Texas, Ryan Huebinger, Marina Del Rios, Benjamin S Abella, Bryan Mcnally, Carrie Bakunas, Richard Witkov, Micah Panczyk, Eric Boerwinkle, Bentley Bobrow

Faculty, Staff and Student Publications

Background Factors associated with out-of-hospital cardiac arrest (OHCA) outcome disparities remain poorly understood. We evaluated the role of receiving hospital on OHCA outcome disparities. Methods and Results We studied people with OHCA who survived to hospital admission from TX-CARES (Texas Cardiac Arrest Registry to Enhance Survival), 2014 to 2021. Using census data, we stratified OHCAs into majority (>50%) strata: non-Hispanic White race and ethnicity, non-Hispanic Black race and ethnicity, and Hispanic or Latino ethnicity. We stratified hospitals into performance quartiles based on the primary outcome, survival with good neurologic outcome. We evaluated the association between race and ethnicity and …