scholarly journals The association of birthweight and the racial disparity in hypertension among black and white medicaid beneficiaries

2000 ◽  
Vol 13 (6) ◽  
pp. S38
Author(s):  
D Lackland
Keyword(s):  
Racial Disparity ◽  
Black And White ◽  
Medicaid Beneficiaries

Racial Disparity in Immediate Breast Reconstruction; a Gap That is not Closing

2021 ◽  
pp. 229255032110555
Author(s):  
Mahdi Malekpour ◽  
Sean Devitt ◽  
Joseph DeSantis ◽  
Christian Kauffman
Keyword(s):  
Propensity Score ◽  
Breast Reconstruction ◽  
Racial Disparity ◽  
Standard Of Care ◽  
Immediate Breast Reconstruction ◽  
P Value ◽  
National Cancer Database ◽  
Black Females ◽  
Black And White ◽  
Significant Difference

Background: Immediate breast reconstruction (IBR) is offered as part of the standard-of-care to females undergoing mastectomy. Racial disparity in IBR has been previously reported with a longstanding call for its elimination, though unknown if this goal is achieved. The aim of this study was to examine the current association between race and IBR and to investigate whether racial disparity is diminishing. Methods: Data was extracted from the National Cancer Database (NCDB) from 2004 to 2016. All variables in the database were controlled so that the comparison would be made solely between Black and White females. We also analyzed the trend in racial disparity to see if there has been a change from 2004 to 2016 after several calls for healthcare equality. Results: After propensity score matching, 69,084 White females were compared to 69,084 Black females. There was a statistically significant difference between the rate of IBR and race (23,386 [33.9%] in White females vs 20,850 [30.2%] in Black females, P-value  < .001). Despite a twofold increase in the rate of IBR in both White and Black females, a persistent gap of about 4% was observed over the study period, which translates to more than 2,500 Black females not receiving IBR. Conclusions: Using the NCDB database, a racial disparity was identified for IBR between White and Black females from 2004 and 2016. Unfortunately, the gap between the groups remained constant over this 13-year period.

Estimated Cardiovascular Risk and Guideline-Concordant Primary Prevention With Statins: Retrospective Cross-Sectional Analyses of US Ambulatory Visits Using Competing Algorithms

2019 ◽  
Vol 25 (1) ◽  
pp. 27-36
Author(s):  
Kathleen A. Fairman ◽  
David Romanet ◽  
Nicole K. Early ◽  
Kellie J. Goodlet
Keyword(s):  
Primary Prevention ◽  
Racial Disparity ◽  
Task Force ◽  
Demographic Data ◽  
Statin Treatment ◽  
Office Visits ◽  
Cross Sectional ◽  
Black And White ◽  
Nationally Representative ◽  
White Patients

Introduction: The 2013 pooled cohort equations (PCE) may misestimate cardiovascular event (CVE) risk, particularly for black patients. Alternatives to the original PCE (O-PCE) to assess potential statin benefit for primary prevention—a revised PCE (R-PCE) and US Preventive Services Task Force (USPSTF) algorithms—have not been compared in contemporary US patients in routine office-based practice. Methods: We performed retrospective, cross-sectional analysis of a nationally representative, US sample of office visits made from 2011 to 2014. Sampling criteria matched those used for PCE development: aged 40 to 79 years, black or white race, no cardiovascular disease. Original PCE, R-PCE, and USPSTF algorithms were applied to biometric and demographic data. Outcomes included estimated 10-year CVE risk, percentage exceeding each algorithm’s statin-treatment threshold (>7.5% risk for O-PCE and R-PCE, and >10% O-PCE plus >1 risk factor for USPSTF), and percentage prescribed statin therapy. Results: In 12 556 visits (representing 285 330 123 nationwide), 10.8% of patients were black, 27.1% had diabetes, and 15.7% were current smokers. Replacing O-PCE with R-PCE decreased mean (95% confidence interval [CI]) estimated CVE risk from 12.4% (12.0%-12.7%) to 8.5% (8.2%-8.8%). Significant ( P < 0.05) racial disparity in the rate of CVE risk >7.5% was identified using O-PCE (black and white patients [95% CI], respectively: 58.8% [54.6%-62.9%] vs 52.8% [51.1%-54.4%], P = .006) but not R-PCE (41.6% [37.6%-45.7%] vs 39.9% [38.3%-41.5%], P = .448). Revised PCE and USPSTF recommendations were concordant for 90% of patients. Significant racial disparity in guideline-concordant statin prescribing was found using O-PCE (black and white patients, respectively, 35.0% [30.5%-39.9%] vs 41.8% [39.9%-44.4%], P = .013), but not R-PCE (40.6% [35.0%-46.6%] vs 43.0% [40.0%-45.9%], P = .482) or USPSTF recommendations (39.0% [33.8%-44.5%] vs 44.4% [41.5%-47.5%], P = .073). Conclusions: Use of an alternative to O-PCE may reduce racial disparity in estimated CVE risk and may facilitate shared decision-making about primary prevention.

Determinants of Glycemic Status Monitoring in Black and White Medicaid Beneficiaries with Diabetes Mellitus

2005 ◽  
Vol 16 (4A) ◽  
pp. 31-49 ◽  
Author(s):  
Robert Morris Mayberry ◽  
Trobiand Davis ◽  
Ernest Alema-Mensah ◽  
Aziz R. Samadi ◽  
Rita Finley ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Status ◽  
Black And White ◽  
Status Monitoring ◽  
Medicaid Beneficiaries

Determinants of Glycemic Status Monitoring in Black and White Medicaid Beneficiaries with Diabetes Mellitus

2005 ◽  
Vol 16 (4) ◽  
pp. 31-49 ◽  
Author(s):  
Robert Morris Mayberry ◽  
Trobiand Davis ◽  
Ernest Alema-Mensah ◽  
Aziz R Samadi ◽  
Rita Finley ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Status ◽  
Black And White ◽  
Status Monitoring ◽  
Medicaid Beneficiaries

College Acceleration for All? Mapping Racial Gaps in Advanced Placement and Dual Enrollment Participation

2021 ◽  
pp. 000283122199113
Author(s):  
Di Xu ◽  
Sabrina Solanki ◽  
John Fink
Keyword(s):  
School Districts ◽  
Advanced Placement ◽  
Racial Disparity ◽  
Dual Enrollment ◽  
The United States ◽  
Equitable Access ◽  
Geographic Variations ◽  
Black And White ◽  
Racial Gaps ◽  
Enrollment Gaps

This article documents the patterns of White-Black and White-Hispanic enrollment gaps in Advanced Placement (AP) and Dual Enrollment (DE) programs across thousands of school districts in the United States by merging several data sources. We show that the vast majority of districts have racial enrollment gaps in both programs, with wider gaps in AP than DE. Results from fractional regression models indicate that geographic variations in these gaps can be explained by both local and state factors. We also find that district-level resources and state policies that provide greater access to AP and DE are also associated with wider racial enrollment gaps, implying that greater resources may engender racial disparity without adequate efforts to provide equitable access and support for minority students.

Abstract 13723: Racial/ethnicity and Education Disparities in Hypertension Among U.s. Adults and the Role of Nutrient Quality -- The International Study on Macro/micronutrients (intermap)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Thanhhuyen T Vu ◽  
Linda VAN HORN ◽  
Queenie M Chan ◽  
Rachel Gibson ◽  
Martha L DAVIGLUS ◽  
...  
Keyword(s):  
Higher Education ◽  
Racial Disparity ◽  
International Study ◽  
Nutrient Quality ◽  
Black And White ◽  
Education Group ◽  
Education Levels ◽  
Race Ethnicity ◽  
Lower Education ◽  
Independent Effects

Background: Limited education and/or being Black are inversely associated with hypertension in the US. Whether nutrient quality influences these associations remains unclear. Methods: Diet and blood pressure (BP) were measured in 2,195 US adults ages 40-59 years between 1996-99 in the INTERMAP study. Hypertension was defined by 2017 standards—SBP/DBP ≥130/80 mmHg or on BP medication. OMNIHEART-like nutrient score defined nutrient quality (see Table footnote). Higher-education was defined as 17+years of school. Results: Participants were 50% female, 56.2% non-Hispanic (NH) White, 17.4% NH-Black, 12.7% Japanese, 13.6% Hispanic, 24% higher-education, and 42% hypertensive. With multiple adjustments without nutrient score, we observed racial disparity on hypertension in NH-Black vs. NH-White across education levels, and it was more pronounced in the higher-education group; i.e., in the lower-education group, compared to NH-White, relative risk—RR (95% CI) of hypertension in NH-Black was 1.4(1.2-1.6); but it was 2.0 (1.5-2.6) in the higher-education group. Education disparity was seen in NH-White—(RR was 42% lower in those with higher vs. lower-education. Added nutrient score slightly attenuated observed associations (see Table). Nutrient score was also independently associated with hypertension; i.e., compared to the 5 th quintile, RR (95%CI) of hypertension in the 1 st quintile was 1.3(1.1-1.5). There were no interactions of nutrient score with race/ethnicity/education. BMI levels attenuated race/ethnicity/education-hypertension relations and diminished the nutrient profile-hypertension relation. Conclusion: Education levels modified racial disparity between NH-Black and White but maintained independent effects on hypertension, especially in NH-White. Differences in nutrient quality did not account for race/ethnicity/education disparities on hypertension, rather independent effects were largely explained by BMI levels.

scholarly journals Histopathologic, Genetic and Molecular Characterization of Endometrial Cancer Racial Disparity

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1900
Author(s):  
Pouya Javadian ◽  
Christina Washington ◽  
Shylet Mukasa ◽  
Doris Mangiaracina Benbrook
Keyword(s):  
Endometrial Cancer ◽  
Black Women ◽  
Racial Disparity ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Significant Differential Expression ◽  
Black And White ◽  
Incidence And Mortality ◽  
Aggressive Histology ◽  
White Patients

In contrast to the decline in incidence and mortality of most other cancers, these rates are rising for endometrial cancer. Black women with endometrial cancer have earlier diagnosis, more aggressive histology, advanced stage and worse outcomes compared with their White counterparts. Socioeconomic status, a higher incidence of aggressive histology, and comorbid conditions are known factors leading to racial disparity in patients with endometrial cancer; nevertheless, they do not account for the entire racial disparity; which emphasizes the roles of molecular, histopathological and genetic factors. We performed a comprehensive review of all published scientific literature up to January 2021 reporting histopathologic, genetic and molecular factors associated with racial disparities in patients with endometrial cancer. The interactions and pathways of molecules reported to have significant differential expression in endometrial cancers from Black and White patients were identified with Ingenuity Pathway Analysis. The majority of studies compared Black and White patients; however, limited data are available for other racial and ethnic groups. Reported differences that could account for the worse survival of Black endometrial cancer patients include more aggressive histopathologies and molecular alterations, including upregulation of molecules driving cell cycle progression, and p53 and HER2/NEU signaling. Several of these molecules are targeted by existing pharmaceuticals. These findings encourage further study and the development of race-specific treatment strategies.

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