scholarly journals How differential privacy will affect our understanding of health disparities in the United States

2020 ◽  
Vol 117 (24) ◽  
pp. 13405-13412 ◽  
Author(s):  
Alexis R. Santos-Lozada ◽  
Jeffrey T. Howard ◽  
Ashton M. Verdery

The application of a currently proposed differential privacy algorithm to the 2020 United States Census data and additional data products may affect the usefulness of these data, the accuracy of estimates and rates derived from them, and critical knowledge about social phenomena such as health disparities. We test the ramifications of applying differential privacy to released data by studying estimates of US mortality rates for the overall population and three major racial/ethnic groups. We ask how changes in the denominators of these vital rates due to the implementation of differential privacy can lead to biased estimates. We situate where these changes are most likely to matter by disaggregating biases by population size, degree of urbanization, and adjacency to a metropolitan area. Our results suggest that differential privacy will more strongly affect mortality rate estimates for non-Hispanic blacks and Hispanics than estimates for non-Hispanic whites. We also find significant changes in estimated mortality rates for less populous areas, with more pronounced changes when stratified by race/ethnicity. We find larger changes in estimated mortality rates for areas with lower levels of urbanization or adjacency to metropolitan areas, with these changes being greater for non-Hispanic blacks and Hispanics. These findings highlight the consequences of implementing differential privacy, as proposed, for research examining population composition, particularly mortality disparities across racial/ethnic groups and along the urban/rural continuum. Overall, they demonstrate the challenges in using the data products derived from the proposed disclosure avoidance methods, while highlighting critical instances where scientific understandings may be negatively impacted.

2017 ◽  
Vol 48 (4) ◽  
pp. 593-610 ◽  
Author(s):  
Jennifer Ramirez ◽  
Linda Oshin ◽  
Stephanie Milan

According to developmental niche theory, members of different cultural and ethnic groups often have distinct ideas about what children need to become well-adapted adults. These beliefs are reflected in parents’ long-term socialization goals for their children. In this study, we test whether specific themes that have been deemed important in literature on diverse families in the United States (e.g., Strong Black Woman [SBW], marianismo, familismo) are evident in mothers’ long-term socialization goals. Participants included 192 mothers of teenage daughters from a low-income city in the United States (58% Latina, 22% African American, and 20% European American [EA]/White). Socialization goals were assessed through a q-sort task on important traits for a woman to possess and content analysis of open-ended responses about what values mothers hoped they would transmit to their daughters as they become adults. Results from ANCOVAs and logistic regression indicate significant racial/ethnic differences on both tasks consistent with hypotheses. On the q-sort task, African American mothers put more importance on women possessing traits such as independence than mothers from other racial/ethnic groups. Similarly, they were more likely to emphasize self-confidence and strength in what they hoped to transmit to their daughters. Contrary to expectation, Latina mothers did not emphasize social traits on the q-sort; however, in open-ended responses, they were more likely to focus on the importance of motherhood, one aspect of marianismo and familismo. Overall, results suggest that these mothers’ long-term socialization goals incorporate culturally relevant values considered important for African American and Latino families.


2019 ◽  
Vol 15 (1) ◽  
pp. 101-108 ◽  
Author(s):  
Guofen Yan ◽  
Jenny I. Shen ◽  
Rubette Harford ◽  
Wei Yu ◽  
Robert Nee ◽  
...  

Background and objectivesIn the United States mortality rates for patients treated with dialysis differ by racial and/or ethnic (racial/ethnic) group. Mortality outcomes for patients undergoing maintenance dialysis in the United States territories may differ from patients in the United States 50 states.Design, setting, participants, & measurementsThis retrospective cohort study of using US Renal Data System data included 1,547,438 adults with no prior transplantation and first dialysis treatment between April 1, 1995 and September 28, 2012. Cox proportional hazards regression was used to calculate hazard ratios (HRs) of death for the territories versus 50 states for each racial/ethnic group using the whole cohort and covariate-matched samples. Covariates included demographics, year of dialysis initiation, cause of kidney failure, comorbid conditions, dialysis modality, and many others.ResultsOf 22,828 patients treated in the territories (American Samoa, Guam, Puerto Rico, Virgin Islands), 321 were white, 666 were black, 20,299 were Hispanic, and 1542 were Asian. Of 1,524,610 patients in the 50 states, 838,736 were white, 444,066 were black, 182,994 were Hispanic, and 58,814 were Asian. The crude mortality rate (deaths per 100 patient-years) was lower for whites in the territories than the 50 states (14 and 29, respectively), similar for blacks (18 and 17, respectively), higher for Hispanics (27 and 16, respectively), and higher for Asians (22 and 15). In matched analyses, greater risks of death remained for Hispanics (HR, 1.65; 95% confidence interval, 1.60 to 1.70; P<0.001) and Asians (HR, 2.01; 95% confidence interval, 1.78 to 2.27; P<0.001) living in the territories versus their matched 50 states counterparts. There were no significant differences in mortality among white or black patients in the territories versus the 50 states.ConclusionsMortality rates for patients undergoing dialysis in the United States territories differ substantially by race/ethnicity compared with the 50 states. After matched analyses for comparable age and risk factors, mortality risk no longer differed for whites or blacks, but remained much greater for territory-dwelling Hispanics and Asians.


2021 ◽  
pp. 1-13
Author(s):  
Maria Pisu ◽  
Roy C. Martin ◽  
Liang Shan ◽  
Giovanna Pilonieta ◽  
Richard E. Kennedy ◽  
...  

Background: Use of specialists and recommended drugs has beneficial effects for older adults living with Alzheimer’s disease and related dementia (ADRD). Gaps in care may exist for minorities, e.g., Blacks, and especially in the United States (U.S.) Deep South (DS), a poor U.S. region with rising ADRD cases and minority overrepresentation. Currently, we have little understanding of ADRD care utilization in diverse populations in this region and elsewhere in the U.S. (non-DS), and the factors that adversely impact it. Objective: To examine utilization of specialists and ADRD drugs (outcomes) in racial/ethnic groups of older adults with ADRD and the personal or context-level factors affecting these outcomes in DS and non-DS. Methods: We obtained outcomes and personal-level covariates from claims for 127,512 Medicare beneficiaries with ADRD in 2013–2015, and combined county-level data in exploratory factor analysis to define context-level covariates. Adjusted analyses tested significant association of outcomes with Black/White race and other factors in DS and non-DS. Results: Across racial/ethnic groups, 33%–43% in DS and 43%–50% in non-DS used specialists; 47%–55% in DS and 41%–48% in non-DS used ADRD drugs. In adjusted analyses, differences between Blacks and Whites were not significant. Vascular dementia, comorbidities, poverty, and context-level factor “Availability of Medical Resources” were associated with specialist use; Alzheimer’s disease and senile dementia, comorbidities, and specialist use were associated with drug use. In non-DS only, other individual, context-level covariates were associated with the outcomes. Conclusion: We did not observe significant gaps in ADRD care in DS and non-DS; however, research should further examine determinants of low specialist and drug use in these regions.


Author(s):  
Jennifer C. Lee ◽  
Alexander Lu

Asian Americans currently make up about five percent of the US population and are one of the fastest growing racial/ethnic groups in the United States. The history of Asians in the United States spans more than 200 years. The term “Asian American” covers over twenty nationality groups. It covers a wide variety of identities, languages, cultures, and experiences, yet this diversity has been masked with the assumption of homogeneity and the model minority image. Research within sociology on Asian Americans often focuses on dispelling the model minority myth through the empirical analysis of heterogeneity within the Asian American population, particularly in regard to educational and socioeconomic outcomes. Other sociological research examines contemporary stereotypes and discrimination against Asian Americans as well as the racial stratification of Asian Americans in relation to other racial/ethnic groups in the United States. However, it is important to note that Asian American Studies is an interdisciplinary field, and much sociological work is informed and influenced by multi- and interdisciplinary work. Therefore, although focused primarily on sociological works, this article will include books and articles from other disciplines that have important implications for sociological research.


2019 ◽  
Vol 22 (4) ◽  
pp. 583-587 ◽  
Author(s):  
Andrea H Weinberger ◽  
Cristine D Delnevo ◽  
Jiaqi Zhu ◽  
Misato Gbedemah ◽  
Joun Lee ◽  
...  

Abstract Introduction Although there are racial/ethnic differences in cigarette use, little is known about how non-cigarette tobacco use differs among racial/ethnic groups. This study investigated trends in cigar use from 2002 to 2016, by racial/ethnic group, in nationally representative US data. Methods Data were drawn from the 2002–2016 National Survey on Drug Use and Health public use data files (total analytic sample n = 630 547 including 54 060 past-month cigar users). Linear time trends of past-month cigar use were examined by racial/ethnic group (Non-Hispanic [NH] White, NH Black, Hispanic, NH Other/Mixed Race/Ethnicity) using logistic regression models. Results In 2016, the prevalence of past-month cigar use was significantly higher among NH Black respondents than among other racial/ethnic groups (ps &lt; .001). Cigar use was also higher among NH White respondents than among Hispanic and NH Other/Mixed Race/Ethnicity respondents. The year by racial/ethnic group interaction was significant (p &lt; .001). Past-month cigar use decreased significantly from 2002 to 2016 among NH White and Hispanic respondents (ps = .001), whereas no change in prevalence was observed among NH Black (p = .779) and NH Other/Mixed Race/Ethnicity respondents (p = .152). Cigar use decreased for NH White men (p &lt; .001) and did not change for NH White women (p = .884). Conversely, cigar use increased for NH Black women (p &lt; .001) and did not change for NH Black men (p = .546). Conclusions Cigar use remains significantly more common among NH Black individuals in the United States and is not declining among NH Black and NH Other/Mixed Race/Ethnicity individuals over time, in contrast to declines among NH White and Hispanic individuals. Implications This study identified racial/ethnic differences in trends in past-month cigar use over 15 years among annual cross-sectional samples of US individuals. The highest prevalence of cigar use in 2016 was found among NH Black individuals. In addition, cigar use prevalence did not decline from 2002 to 2016 among NH Black and NH Other/Mixed Race/Ethnicity groups over time, in contrast to NH White and Hispanic groups. Further, cigar use increased over time for NH Black women. Targeted public health and clinical efforts may be needed to decrease the prevalence of cigar use, especially for NH Black individuals.


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