scholarly journals California Autism Prevalence by County and Race/Ethnicity: Declining Trends Among Wealthy Whites

2020 ◽  
Vol 50 (11) ◽  
pp. 4011-4021 ◽  
Author(s):  
Cynthia Nevison ◽  
William Parker
Keyword(s):  
Rate Of Change ◽  
County Level ◽  
Lower Income ◽  
California Department ◽  
Private Care ◽  
Opting Out ◽  
White Parents ◽  
Race Ethnicity ◽  
Year 2000 ◽  
Autism Prevalence

Abstract County-level ASD prevalence was estimated using an age-resolved snapshot from the California Department of Developmental Services (DDS) for birth years 1993–2013. ASD prevalence increased among all children across birth years 1993–2000 but plateaued or declined thereafter among whites from wealthy counties. In contrast, ASD rates increased continuously across 1993–2013 among whites from lower income counties and Hispanics from all counties. Both white ASD prevalence and rate of change in prevalence were inversely correlated to county income from birth year 2000–2013 but not 1993–2000. These disparate trends within the dataset suggest that wealthy white parents, starting around 2000, may have begun opting out of DDS in favor of private care and/or making changes that effectively lowered their children’s risk of ASD.

County-level USA: No Robust Relationship between Geoclimatic Variables and Cognitive Ability

2020 ◽  
Author(s):  
Bryan J Pesta ◽  
John Fuerst ◽  
Emil O. W. Kirkegaard
Keyword(s):  
Cognitive Ability ◽  
Climate Models ◽  
Cold Weather ◽  
Regression Equations ◽  
County Level ◽  
Spatial Lag ◽  
Average Temperature ◽  
Wrong Direction ◽  
Race Ethnicity ◽  
Demographic Covariates

Using a sample of ~3,100 U.S. counties, we tested geoclimatic explanations for why cognitive ability varies across geography. These models posit that geoclimatic factors will strongly predict cognitive ability across geography, even when a variety of common controls appear in the regression equations. Our results generally do not support UV radiation (UVR) based or other geoclimatic models. Specifically, although UVR alone predicted cognitive ability at the U.S. county-level (β = -.33), its validity was markedly reduced in the presence of climatic and demographic covariates (β = -.16), and was reduced even further with a spatial lag (β = -.10). For climate models, average temperature remained a significant predictor in the regression equation containing a spatial lag (β = .35). However, the effect was in the wrong direction relative to typical cold weather hypotheses. Moreover, when we ran the analyses separately by race/ethnicity, no consistent pattern appeared in the models containing the spatial lag. Analyses of gap sizes across counties were also generally inconsistent with predictions from the UVR model. Instead, results seemed to provide support for compositional models.

Impact of the Year 2000 Medicare Policy Change on Older Patient Enrollment to Cancer Clinical Trials

2006 ◽  
Vol 24 (1) ◽  
pp. 141-144 ◽  
Author(s):  
Joseph M. Unger ◽  
Charles A. Coltman ◽  
John J. Crowley ◽  
Laura F. Hutchins ◽  
Silvana Martino ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Policy Change ◽  
Positive Impact ◽  
The United States ◽  
Older Patient ◽  
Treatment Trials ◽  
Race Ethnicity ◽  
Method Of Payment ◽  
Medicare Policy ◽  
Year 2000

Purpose A prior analysis by the Southwest Oncology Group (SWOG) showed that women and African American patients were adequately represented on cancer clinical treatment trials but that older patients were substantially underrepresented. Twenty-five percent of patients ≥ 65 years old were enrolled onto SWOG trials from 1993 to 1996, whereas 63% of all patients with cancer were ≥ 65 years old. Recognition of this under-representation led to a change in Medicare policy in 2000 to include coverage of routine patient care costs of clinical trials. We conducted an updated analysis of accrual trends. Methods The proportions of enrollment onto SWOG treatment trials by sex, race/ethnicity, and age (≥ 65 years) were computed for the years 1997 to 2000; corresponding rates in the United States were derived from US Census and National Cancer Institute Surveillance, Epidemiology, and End Results data. Additionally, method of payment data were analyzed over time (1993 to 2003) to assess whether patterns in method of payment changed with the new Year 2000 Medicare policy on clinical trials coverage. Results The results showed continued adequate representation by sex and race/ethnicity. Older patient accrual on SWOG trials increased significantly since 2000, with 31% of patients ≥ 65 years old enrolled from 1997 to 2000 and 38% enrolled from 2001 to 2003 (v 25% from 1993 to 1996). The percentage of patients using Medicare plus supplemental insurance also increased beginning in 2000, whereas the percentage of patients using Medicare alone remained the same. Conclusion Method of payment analyses provided evidence that the Year 2000 Medicare policy change had a positive impact, but only for those patients with supplemental private coverage of coinsurance costs. Improvements in the Medicare payment structure could further increase older patient participation in clinical trials.

scholarly journals SARS-CoV-2 Cumulative Incidence and Period Seroprevalence: Results from a Statewide Population-Based Serosurvey in California

2021 ◽  
Author(s):  
Katherine Lamba ◽  
Heather Bradley ◽  
Kayoko Shioda ◽  
Patrick S Sullivan ◽  
Nicole Luisi ◽  
...  
Keyword(s):  
Public Health ◽  
Cumulative Incidence ◽  
Population Based ◽  
Antibody Testing ◽  
California Department ◽  
Incidence Estimate ◽  
Home Based ◽  
Weighted Data ◽  
Race Ethnicity ◽  
California Population

Abstract Background California has reported the largest number of COVID-19 cases of any U.S. state, with more than 3.5 million confirmed as of March 2021. However, the full breadth of SARS-CoV-2 transmission in California is unknown since reported cases only represent a fraction of all infections. Methods We conducted a population-based serosurvey, utilizing mailed, home-based SARS-CoV-2 antibody testing along with a demographic and behavioral survey. We weighted data from a random sample to represent the adult California population and estimated period seroprevalence overall and by participant characteristics. Seroprevalence estimates were adjusted for waning antibodies to produce statewide estimates of cumulative incidence, the infection fatality ratio (IFR), and the reported fraction. Results California’s SARS-CoV-2 weighted seroprevalence during August–December 2020 was 4.6% (95% CI: 2.8–7.4%). Estimated cumulative incidence as of November 2, 2020 was 8.7% (95% CrI: 6.4%–11.5%), indicating 2,660,441 adults (95% CrI: 1,959,218–3,532,380) had been infected. The estimated IFR was 0.8% (95% CrI: 0.6%–1.0%), and the estimated percentage of infections reported to the California Department of Public Health was 31%. Disparately high risk for infection was observed among persons of Hispanic/Latinx ethnicity and people with no health insurance and who reported working outside the home. Conclusions We present the first statewide SARS-CoV-2 cumulative incidence estimate among adults in California. As of November 2020, approximately one in three SARS-CoV-2 infections in California adults had been identified by public health surveillance. When accounting for unreported SARS-CoV-2 infections, disparities by race/ethnicity seen in case-based surveillance persist.

scholarly journals Unmasking Inequality: STEM Course Experience During the COVID-19 Pandemic

2020 ◽  
Author(s):  
Barbara Means ◽  
Julie Neisler
Keyword(s):  
General Pattern ◽  
Lower Income ◽  
Internet Connectivity ◽  
Course Content ◽  
Class Meetings ◽  
Course Experience ◽  
Stem Students ◽  
Race Ethnicity ◽  
Better Than

This report describes the experiences of over 600 undergraduates who were taking STEM courses with in-person class meetings that had to shift to remote instruction in spring 2020 because of COVID-19. Internet connectivity issues were serious enough to interfere with students’ ability to attend or participate in their STEM course at least occasionally for 46% of students, with 15% of students experiencing such problems often or very often. A large majority of survey respondents reported some difficulty with staying motivated to work on their STEM courses after they moved online, with 45% characterizing motivation as a major problem. A majority of STEM students also reported having problems knowing where to get help with the course content after it went online, finding a quiet place to work on the course, and fitting the course in with other family or home responsibilities. Overall, students who reported experiencing a greater number of major challenges with continuing their course after it went online expressed lower levels of satisfaction with their course after COVID-19. An exception to this general pattern, though, was found for students from minoritized race/ethnicity groups, females, and lower-income students. Despite experiencing more challenges than other students did with respect to continuing their STEM courses remotely, these students were more likely to rate the quality of their experiences when their STEM course was online as just as good as, or even better than, when the course was meeting in person.

Race, Ethnicity, and Trial Avoidance: A Multilevel Analysis

2018 ◽  
Vol 31 (3) ◽  
pp. 422-451
Author(s):  
Jacqueline G. Lee ◽  
Rebecca L. Richardson
Keyword(s):  
Racial Disparities ◽  
Multilevel Analysis ◽  
Hierarchical Linear Modeling ◽  
County Level ◽  
Racial Threat ◽  
Linear Modeling ◽  
Race Ethnicity ◽  
Black Defendants ◽  
White Defendants ◽  
Threat Theory

Minority criminal defendants are more likely than White defendants to exercise their right to trial, which is concerning given that research also consistently finds trial sentences to be harsher than those obtained via pleas. However, guilty pleas are not the only disposition available for avoiding a trial; pretrial diversions and case dismissals also serve as mechanisms for trial avoidance. Using hierarchical linear modeling, we find that Black criminal defendants are more likely than Whites to go to trial rather than receive other case disposition. Relationships for Hispanic defendants are less consistent. Fewer county-level effects emerge than expected, providing little to no support for racial threat theory. Results suggest that Black defendants are less often able or willing to avoid a trial, a finding which highlights and perhaps helps to explain racial disparities in final sentencing outcomes.

Current and Historical Trends in Diversity by Race, Ethnicity, and Sex Within the US Pathology Physician Workforce

2020 ◽  
Vol 154 (4) ◽  
pp. 450-458
Author(s):  
Marissa J White ◽  
Rhea J Wyse ◽  
Alisha D Ware ◽  
Curtiland Deville
Keyword(s):  
Ethnic Diversity ◽  
Rate Of Change ◽  
Physician Workforce ◽  
Underrepresented Minority ◽  
Historical Trends ◽  
Alaskan Native ◽  
Gender Parity ◽  
The Us ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Objectives This study assessed historical and current gender, racial, and ethnic diversity trends within US pathology graduate medical education (GME) and the pathologist workforce. Methods Data from online, publicly available sources were assessed for significant differences in racial, ethnic, and sex distribution in pathology trainees, as well as pathologists in practice or on faculty, separately compared with the US population and then each other using binomial tests. Results Since 1995, female pathology resident representation has been increasing at a rate of 0.45% per year (95% confidence interval [CI], 0.29-0.61; P < .01), with pathology now having significantly more females (49.8%) compared to the total GME pool (45.4%; P < .0001). In contrast, there was no significant trend in the rate of change per year in black or American Indian, Alaskan Native, Native Hawaiian, and Pacific Islander (AI/AN/NH/PI) resident representation (P = .04 and .02). Since 1995, underrepresented minority (URM) faculty representation has increased by 0.03% per year (95% CI, 0.024-0.036; P < .01), with 7.6% URM faculty in 2018 (5.2% Hispanic, 2.2% black, 0.2% AI/AN/NH/PI). Conclusions This assessment of pathology trainee and physician workforce diversity highlights significant improvements in achieving trainee gender parity. However, there are persistent disparities in URM representation, with significant underrepresentation of URM pathologists compared with residents.

scholarly journals Differential Association of HIV Funding With HIV Mortality by Race/Ethnicity, United States, 1999-2017

2020 ◽  
Vol 135 (1_suppl) ◽  
pp. 149S-157S
Author(s):  
Benedict I. Truman ◽  
Ramal Moonesinghe ◽  
Yolanda T. Brown ◽  
Man-Huei Chang ◽  
Jonathan H. Mermin ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Rate Of Change ◽  
Fiscal Year ◽  
Death Rates ◽  
Black Residents ◽  
Race Ethnicity ◽  
Hiv Funding ◽  
Racial Ethnic ◽  
Hispanic White

Objective Federal funds have been spent to reduce the disproportionate effects of HIV/AIDS on racial/ethnic minority groups in the United States. We investigated the association between federal domestic HIV funding and age-adjusted HIV death rates by race/ethnicity in the United States during 1999-2017. Methods We analyzed HIV funding data from the Kaiser Family Foundation by federal fiscal year (FFY) and US age-adjusted death rates (AADRs) by race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, and Asian/Pacific Islander and American Indian/Alaska Native [API+AI/AN]) from Centers for Disease Control and Prevention WONDER detailed mortality files. We fit joinpoint regression models to estimate the annual percentage change (APC), average APC, and changes in AADRs per billion US dollars in HIV funding, with 95% confidence intervals (CIs). For 19 data points, the number of joinpoints ranged from 0 to 4 on the basis of rules set by the program or by the user. A Monte Carlo permutation test indicated significant ( P < .05) changes at joinpoints, and 2-sided t tests indicated significant APCs in AADRs. Results Domestic HIV funding increased from $10.7 billion in FFY 1999 to $26.3 billion in FFY 2017, but AADRs decreased at different rates for each racial/ethnic group. The average rate of change in AADR per US billion dollars was −9.4% (95% CI, −10.9% to −7.8%) for Hispanic residents, −7.8% (95% CI, −9.0% to −6.6%) for non-Hispanic black residents, −6.7% (95% CI, −9.3% to −4.0%) for non-Hispanic white residents, and −5.2% (95% CI, −7.8% to −2.5%) for non-Hispanic API+AI/AN residents. Conclusions Increased domestic HIV funding was associated with faster decreases in age-adjusted HIV death rates for Hispanic and non-Hispanic black residents than for residents in other racial/ethnic groups. Increasing US HIV funding could be associated with decreasing future racial/ethnic disparities in the rate of HIV-related deaths.

scholarly journals County‐Level Factors Associated With Cardiovascular Mortality by Race/Ethnicity

2021 ◽  
Vol 10 (6) ◽  
Author(s):  
Bongeka Z. Zuma ◽  
Justin T. Parizo ◽  
Areli Valencia ◽  
Gabriela Spencer‐Bonilla ◽  
Manuel R. Blum ◽  
...  
Keyword(s):  
Risk Factors ◽  
Healthcare Access ◽  
Ethnic Disparities ◽  
County Level ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White ◽  
Cvd Mortality

Background Persistent racial/ethnic disparities in cardiovascular disease (CVD) mortality are partially explained by healthcare access and socioeconomic, demographic, and behavioral factors. Little is known about the association between race/ethnicity‐specific CVD mortality and county‐level factors. Methods and Results Using 2017 county‐level data, we studied the association between race/ethnicity‐specific CVD age‐adjusted mortality rate (AAMR) and county‐level factors (demographics, census region, socioeconomics, CVD risk factors, and healthcare access). Univariate and multivariable linear regressions were used to estimate the association between these factors; R 2 values were used to assess the factors that accounted for the greatest variation in CVD AAMR by race/ethnicity (non‐Hispanic White, non‐Hispanic Black, and Hispanic/Latinx individuals). There were 659 740 CVD deaths among non‐Hispanic White individuals in 2698 counties; 100 475 deaths among non‐Hispanic Black individuals in 717 counties; and 49 493 deaths among Hispanic/Latinx individuals across 267 counties. Non‐Hispanic Black individuals had the highest mean CVD AAMR (320.04 deaths per 100 000 individuals), whereas Hispanic/Latinx individuals had the lowest (168.42 deaths per 100 000 individuals). The highest CVD AAMRs across all racial/ethnic groups were observed in the South. In unadjusted analyses, the greatest variation ( R 2 ) in CVD AAMR was explained by physical inactivity for non‐Hispanic White individuals (32.3%), median household income for non‐Hispanic Black individuals (24.7%), and population size for Hispanic/Latinx individuals (28.4%). In multivariable regressions using county‐level factor categories, the greatest variation in CVD AAMR was explained by CVD risk factors for non‐Hispanic White individuals (35.3%), socioeconomic factors for non‐Hispanic Black (25.8%), and demographic factors for Hispanic/Latinx individuals (34.9%). Conclusions The associations between race/ethnicity‐specific age‐adjusted CVD mortality and county‐level factors differ significantly. Interventions to reduce disparities may benefit from being designed accordingly.

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