Medicine and Health Commons^™

Eliminating Racial/Ethnic Health Disparities: Reconsidering Comparative Approaches, Shawn M. Bediako, Derek M. Griffith

Journal of Health Disparities Research and Practice

The focus on eliminating racial/ethnic health disparities has brought critical attention to the poor health status of minority populations. Assessing the health outcomes of racial minority groups by comparing them to a racial majority standard is valuable for identifying and monitoring health inequities, but may not be the most effective approach to identifying strategies that can be used to improve minority health outcomes. Health promotion planning models and public health history both suggest that minority health promotion is more likely to be derived from interventions rooted in culturally and historically grounded contextual factors. In this essay, we highlight limitations of …

Increasing Rate Of Pneumonia Hospitalizations Among Older American Indian And Alaska Native Adults, Robert C. Holman, Krista L. Yorita, Rosalyn J. Singleton, James E. Cheek, Edna L. Paisano, Jay C. Butler, Larry J. Anderson, Alicia M. Fry

Journal of Health Disparities Research and Practice

Objective: To examine rates and trends of pneumonia hospitalization among older American Indian and Alaska Native (AI/AN) adults.

Methods: Pneumonia hospitalizations for older AI/AN adults ≥65 years of age living in the Alaska and Southwest Indian Health Service (IHS) regions during 1988 through 2002 from the IHS hospital discharge data were analyzed.

Results: The average annual hospitalization rate for first-listed pneumonia for older AI/AN adults in both the Alaska and the Southwest regions has increased (15.3 and 23.0 in 1988-1990 to 25.9 and 28.8 in 2000-2002 per 1,000 population, respectively), with the greatest increase seen among older AI/AN adults in …

Elevated Depressive Symptoms In A Community Sample Of African-Americans And Whites, Robert J. Jagers, Fernando A. Wagner, Pamela E. Scott-Johnson, Yan Wang, Dorothy C. Browne

Journal of Health Disparities Research and Practice

This study examined demographic and psychosocial correlates of elevated depressive symptoms among African-Americans and Whites from comparable socioeconomic and neighborhood backgrounds. 851 African-Americans and 597 Whites from adjacent census tracts were interviewed using previously validated indicators of depressive symptoms, social support, religious practices and various demographic characteristics. More Whites than African-Americans reported elevated depressive symptoms and the groups also differed on several demographic variables and psychosocial variables. Employment, marital status and age were salient demographic covariates for African Americans, while income was for Whites. For both groups, social support and church attendance were inversely associated with depressive symptoms. Prayer was …

Hungry For Respect: Discrimination Among Adults Using Emergency Food Services, Gilbert C. Gee, Kathryn J. Lively, Larissa Larsen, Jennifer Keith, Jana Stone, Kara Macleod

Journal of Health Disparities Research and Practice

Objectives: We examined how adults using emergency food services report discrimination and how these reports may be associated with well-being.

Methods: Data come from a survey (n=318) and from five focus groups of adults using emergency food services, conducted between 2003-2004. The survey included measures derived from the Everyday Discrimination Scale and the Centers for Epidemiologic Studies Depression Scale (CES-D). Focus groups were analyzed with content analysis.

Results: The survey data suggest that everyday discrimination was associated with the CES-D, conditional on covariates. Focus group data are consistent with the survey results and suggest several avenues for future research, including …

Who Cares For The Sick Kids? Parents’ Access To Paid Time To Care For A Sick Child, Kristin Smith, Andrew P. Schaefer

Carsey Publications

This brief analyzes employed parents’ access to five or more paid sick days annually to care for a sick child in 2008. Using data from the 2008 National Study of the Changing Workforce collected by the Families and Work Institute (the most recent data available in the series), authors Kristin Smith and Andrew Schaefer analyze differences in access between employed mothers and fathers by demographic and work-related characteristics. They report that, in 2008, more than one-half—52 percent—of employed parents lacked access to at least five paid sick days to care for a sick child, and lower-earning parents had the least …

The Long-Term Impact Of War On Health And Wellbeing In Northern Vietnam: Some Glimpses From A Recent Survey, Bussarawan Teerawichitchainan, Kim Korinek

Research Collection School of Social Sciences

War is considered one of the most intransigent obstacles to development; yet, the long-run effects of war on individual health have rarely been examined in the context of developing countries. Based on unique data recently collected as a pilot follow-up to the Vietnam Longitudinal Survey, this study examines health status of northern Vietnamese war cohorts (those who entered adulthood during the Vietnam War and now represent Vietnam’s older-adult population). To ascertain whether and how war impacts old-age physical and mental health, we compare multi-dimensional measures of health among war survivors, including civilians, combatants, noncombatants, and nonveterans involved in militia activities. …

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

The Effects Of State Eitc Expansion On Children’S Health, Reagan A. Baughman

Carsey Publications

This brief examines the impact of state-level adoption of Earned Income Tax Credits (EITCs) on a set of health-related outcomes for children, including: (1) health insurance coverage, (2) use of preventive medical and dental care, and (3) health status measures including maternal reports of child health and body mass index. It also considers the possibility that the effect of the EITC on these outcomes may vary depending on where a child lives; families in urban and rural communities have different access to medical care and other resources that promote good health. Author Reagan Baughman reports that the expansion of state …

Feasibility And Acceptability Of An English-As-A-Second Language Curriculum On Hepatitis B For Older Chinese American Immigrants, Gloria D. Coronado, Elizabeth Acorda, H. H. Do, Victoria M. Taylor

Journal of Health Disparities Research and Practice

Asian immigrants to the U.S. have an increased prevalence of hepatitis B virus (HBV) infection compared to native born individuals; an estimated 10 percent of Chinese immigrants are infected with HBV. Using qualitative data from focus groups, we developed an English-as-a-Second Language (ESL) curriculum that aimed to improve knowledge about key hepatitis B facts. The curriculum was pilot-tested among 56 students aged 50 and older from intermediate-level ESL classes at a community-based organization that serves Chinese immigrants. Post-curriculum data showed increases in knowledge that hepatitis B can cause liver cancer (73% at pre-test vs. 91% at post-test; p value = …

Racial And Ethnic Differences In Cardiovascular Disease Risk Factors In U.S. Older Women: Findings From Behavioral Risk Factor Surveillance Survey, 2003 & 2004, Anita K. Kurian, Kristine Lykens, Sejong Bae, Karan P. Singh

Journal of Health Disparities Research and Practice

The purpose of this study was to examine racial and ethnic variations in the modifiable CVD risk factors in older women (65 years and older). The study data was drawn from the merged 2003 and 2004 national Behavioral Risk Factor Surveillance Survey (BRFSS). Multinomial regression analyses for indicator outcome and multiple logistic regression analyses for binary outcomes were performed to determine the relationship between each of the six dependent variable and the independent variables. Compared to older white women, older black women had significantly higher odds of hypertension, diabetes and obesity. No significant association was found between Hispanics and hypertension. …

Evaluating “Not In Mama's Kitchen” Second-Hand Smoke Campaign In Georgia, Jonathan B. Vangeest, Verna L. Welch

Journal of Health Disparities Research and Practice

In 2003-2005, the Association of Black Cardiologists, Inc. initiated the Not in Mama’s Kitchen (NIMK) second-hand smoke (SHS) prevention campaign in Georgia as part of their effort to reduce exposure to SHS in African American communities statewide. This initiative was evaluated using baseline data from pledge cards as well as data from a self-administered mail survey of 1,000 campaign participants. 14,770 Georgians participated in NIMK, signing pledges to make their homes and cars smoke free. Majorities of those surveyed followed through with their pledge, banning tobacco use in their homes (76.1%) and cars (80.2%). The program was cited by 65.4% …

Evaluation Of A Tobacco Educational Intervention For Pregnant Alaska Native Women, Christi A. Patten, Carrie Enoch, Caroline C. Renner, Karin Larsen, Paul A. Decker, Kari J. Anderson, Caroline Nevak, Ann Glasheen, Kenneth P. Offord, Anne Lanier

Journal of Health Disparities Research and Practice

Tobacco cessation interventions developed and evaluated for Alaska Native women do not exist. As part of routine clinical care provided at a prenatal visit, a brief tobacco educational intervention for Alaska Native pregnant women (N=100; mean ± SD age = 25.9±6.2 years; mean 6.3± 2.6 months gestation) was piloted at the Y-K Delta Regional Hospital in Bethel, Alaska. This retrospective study reports on the evaluation of this clinical program. The intervention was consistent with the clinical practice guidelines (i.e., 5 A’s – ask, advise, assess, assist, arrange), with an average duration of 20.2 ± 6.8 minutes. The self-reported tobacco abstinence …

African American Adults’ Experiences With The Health Care System: In Their Own Words, Keri A. Jupka, Nancy L. Weaver, Vetta L. Sanders-Thompson, Nicole M. Caito, Matthew W. Kreuter

Journal of Health Disparities Research and Practice

African Americans suffer a disproportionate burden of death and illness from a number of different chronic diseases. Inequalities in health care practices and poor patient and provider communication between African American patients and health care professionals contribute to these disparities. We describe findings from focus groups with 79 urban African Americans in which the participants discussed their interactions with the healthcare system as well as beliefs and opinions of the healthcare system and professionals. Analysis revealed five major themes: (1) historical and contextual foundations; (2) interpersonal experiences with physicians and other health care workers; (3) discrimination; (4) trust, opinions and …

Examination Of Racial Disparities In Childhood Asthma Management Practices, Crystal N. Piper, Saundra Glover, Kieth Elder, Jong-Deuk Baek

Journal of Health Disparities Research and Practice

Objective: To analyze asthma management plan practices for children with asthma in the United States considering race and other demographic and person-level characteristics.

Methods: Univariate/Bivariate/Multivariate analysis was performed to examine asthma management plan physician recommendations among children in the United States utilizing secondary data analysis of the 2002 and 2003 National Health Interview Survey.

Results: The majority of the study participants reported not having an asthma management plan at (59.00%). In multivariate analysis using SAS callable SUDAAN, Whites were significantly more likely to have an asthma management plan (OR=1.66, p=.0031).

Conclusion: Findings from this study indicate that Black and Hispanic …

Pastors’ Influence On Research-Based Health Programs In Church Settings, Shirley M. Timmons

Journal of Health Disparities Research and Practice

Churches, in the United States, are recognized essential players in addressing our mounting health and social service needs. Yet, even though they implement a relatively large number of programs, few are research-based. Focus groups were conducted with pastors from 11 Baptist churches in a small Southeastern town to explore factors that influence the implementation of research-based health programs. Transcripts were coded for domains resulting in four themes: congregant needs, shared programming ethics, common understanding of programming processes, and care for the church and congregation. Pastors value research and seek church-based programs that enhance the health of congregants. Yet, future study …

Utilizing Community Resources To Reduce The Presence Of Type 2 Diabetes In Rural Youth, Antonia S. Mead, M. C. Nagy, Stephen Nagy

Journal of Health Disparities Research and Practice

The purpose of this study was to implement a program designed to promote diabetes prevention activities among preadolescents in a rural southern setting using a day camp intervention. Participants in the study were eleven youth from a rural Alabama county who participated in a week-long half-day camp administered by local and community volunteers. Change scores were used to compare pre- to post- to follow-up measures for camp participant responses. Program results consistently demonstrated that the day camp was theoretically sound and that program activities positively impacted behavioral antecedents. This study demonstrated the feasibility of conducting a diabetes prevention day camp …

Hepatitis C Diagnoses In An American Indian Primary Care Population, Hillary E. Norton, John T. Redd, Ralph T. Bryan

Journal of Health Disparities Research and Practice

BACKGROUND: Despite large disparities in the burden of chronic liver disease, data on hepatitis C virus (HCV) infection among American Indians (AIs) are lacking. We reviewed hepatitis C diagnoses in 35,712 AI/AN primary care patients.

MAIN FINDINGS: At least one HCV-associated ICD-9 code was recorded in 251 (1%) patients between October 1, 2001 and September 30, 2003. An HCV enzyme-linked immunoassay (HCVEIA) was sent in 209 (83.0%); 206/209 (99%) were positive. Confirmatory testing was performed in 144/206 (70%) HCV-EIA positive patients; HCV infection was confirmed in 144 (100%). In the 90/144 (63%) charts with risk factor documentation, injection drug use …

Tribally-Driven Participatory Research: State Of The Practice And Potential Strategies For The Future, Patricia Mariella, Eddie Brown, Michael Carter, Vanessa Verri

Journal of Health Disparities Research and Practice

This paper discusses current practice of research with and by American Indian tribal governments in the United States. It begins with a brief overview of Community-Based Participatory Research and compares and contrasts its principles and methods with what this paper terms Tribally-Driven Participatory Research. The paper analyzes current challenges and offers concepts for continuing to improve the effectiveness of Tribally-Driven Participatory Research.

Talking Glossary Of Genomics Terminology: A Genomics Education Module For American Indian Communities, Jill Peters, Pauline Davies, Naomi Lane, Kathryn Coe

Journal of Health Disparities Research and Practice

This paper describes the development of an audio visual genomics glossary that was designed as an education tool for American Indian communities. This “Talking Glossary of Genomics Terminology” is a multimedia DVD that was modeled on the “Talking Glossary of Genetics,” which was developed by the National Human Genome Research Institute (NHGRI). The NHGRI Glossary was modified and expanded with content designed to increase awareness among American Indians about cancer, genomics, and personalized medicine. Partners on the project include the Inter Tribal Council of Arizona, Inc., Phoenix Indian Medical Center, Arizona Cancer Center at the University of Arizona, the Translational …

Beyond The It Magic Bullet: Hiv Prevention Education And Public Policy, Fay C. Payton

Journal of Health Disparities Research and Practice

Analytic applications are vital in the assessments of public health and surveillance as these applications can drive resource allocation, community assessment and public policy. Using a dataset of nearly 90,000 patient hospital encounters, the number of instances with an ICD code of HIV and co-morbidities was identified. Blacks accounted for 75 percent of HIV hospital encounters in the dataset. While business analytic applications informed this study of cross-tabulations and interaction effects among race, age and gender, there appears to be a significant relationship among HIV diagnoses and substance abuse. Payer data is informed by the Healthcare Cost and Utilization Project …