How much would family and medical leave cost workers in the US? Racial/ethnic variation in economic hardship under unpaid and paid policies

Introduction As coronavirus disease 2019 (COVID-19) hit the US, there was widespread and urgent implementation of telemedicine programs nationwide without much focus on the impact on patient populations with known existing healthcare disparities. To better understand which populations cannot access telemedicine during the coronavirus disease 2019 pandemic, this study aims to demographically describe and identify the most important demographic predictors of telemedicine visit completion in an urban health system. Methods Patient de-identified demographics and telemedicine visit data ( N = 362,764) between March 1, 2020 and October 31, 2020 were combined with Internal Revenue Service 2018 individual income tax data by postal code. Descriptive statistics and mixed effects logistic regression were used to determine impactful patient predictors of telemedicine completion, while adjusting for clustering at the clinical site level. Results Many patient-specific demographics were found to be significant. Descriptive statistics showed older patients had lower rates of completion ( p < 0.001). Also, Hispanic patients had statistically significant lower rates ( p < 0.001). Overall, minorities (racial, ethnic, and language) had decreased odds ratios of successful telemedicine completion compared to the reference. Discussion While telemedicine use continues to be critical during the coronavirus disease 2019 pandemic, entire populations struggle with access—possibly widening existing disparities. These results contribute large datasets with significant findings to the limited research on telemedicine access and can help guide us in improving telemedicine disparities across our health systems and on a wider scale.

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Explaining Racial/Ethnic Variation in Partnered Women’s and Men’s Housework

Journal of Family Issues ◽

10.1177/0192513x12437705 ◽

2012 ◽

Vol 34 (3) ◽

pp. 394-427 ◽

Cited By ~ 21

Author(s):

Vanessa R. Wight ◽

Suzanne M. Bianchi ◽

Bijou R. Hunt

Keyword(s):

Ethnic Groups ◽

Explanatory Power ◽

National Sample ◽

Household Composition ◽

Ethnic Variation ◽

American Time Use Survey ◽

Housework Time ◽

Time Use Survey ◽

Time Availability ◽

Racial Ethnic

Using a national sample of 12,424 partnered women and 10,721 partnered men from the 2003-2006 American Time Use Survey, this article examines racial/ethnic variation in women’s and men’s housework time and its covariates. The ratio of women’s to men’s housework hours is greatest for Hispanics and Asians and smallest for Whites and Blacks. White and Hispanic women’s housework hours are associated with household composition and employment suggesting that the time availability perspective is a good predictor for these women, but may have less explanatory power for other race/ethnic groups of women. Relative resources also have explanatory power for White women’s housework time but are weak predictors for women of Other race/ethnicities. Time availability and relative resource measures show some association with White men’s housework time but are generally poor predictors among other race/ethnic groups of men, suggesting that traditional models of housework allocation do not “fit” all groups equally.

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Racial/ethnic differences in inpatient mortality and use of institutional postacute care following subarachnoid hemorrhage

Journal of Neurosurgery ◽

10.3171/2013.7.jns13544 ◽

2013 ◽

Vol 119 (6) ◽

pp. 1627-1632 ◽

Cited By ~ 9

Author(s):

Blessing N. R. Jaja ◽

Gustavo Saposnik ◽

Rosane Nisenbaum ◽

Benjamin W. Y. Lo ◽

Tom A. Schweizer ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Ethnic Groups ◽

Ethnic Differences ◽

Institutional Care ◽

Inpatient Mortality ◽

Risk Of Death ◽

The Us ◽

Hispanic Patients ◽

Racial Ethnic ◽

White Patients

Object The goal of this study was to determine racial/ethnic differences in inpatient mortality rates and the use of institutional postacute care following subarachnoid hemorrhage (SAH) in the US. Methods A cross-sectional study of hospital discharges for SAH was conducted using the Nationwide Inpatient Sample for the years 2005–2010. Discharges with a principal diagnosis of SAH were identified and abstracted using the appropriate ICD-9-CM diagnostic code. Racial/ethnic groups were defined as white, black, Hispanic, Asian/Pacific Islander (API), and American Indian. Multinomial logistic regression analyses were performed comparing racial/ethnic groups with respect to the primary outcome of risk of in-hospital mortality and the secondary outcome of likelihood of discharge to institutional care. Results During the study period, 31,631 discharges were related to SAH. Race/ethnicity was a significant predictor of death (p = 0.003) and discharge to institutional care (p ≤ 0.001). In the adjusted analysis, compared with white patients, API patients were at higher risk of death (OR 1.34, 95% CI 1.13–1.59) and Hispanic patients were at lower risk of death (OR 0.84, 95% CI 0.72–0.97). The likelihood of discharge to institutional care was statistically similar between white, Hispanic, API, and Native American patients. Black patients were more likely to be discharged to institutional care compared with white patients (OR 1.27, 95% CI 1.14–1.40), but were similar to white patients in the risk of death. Conclusions Significant racial/ethnic differences are present in the risk of inpatient mortality and discharge to institutional care among patients with SAH in the US. Outcome is likely to be poor among API patients and best among Hispanic patients compared with other groups.

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Reductions in US life expectancy from COVID-19 by Race and Ethnicity: Is 2021 a repetition of 2020?

10.1101/2021.10.17.21265117 ◽

2021 ◽

Author(s):

Theresa Andrasfay ◽

Noreen Goldman

Keyword(s):

Life Expectancy ◽

Race And Ethnicity ◽

Ethnic Disparities ◽

White Population ◽

Widespread Distribution ◽

Life Expectancy At Birth ◽

The Us ◽

The Impact ◽

Racial Ethnic ◽

Black And Latino

COVID-19 had a huge mortality impact in the US in 2020 and accounted for the majority of the 1.5-year reduction in 2020 life expectancy at birth. There were also substantial racial/ethnic disparities in the mortality impact of COVID-19 in 2020, with the Black and Latino populations experiencing reductions in life expectancy at birth over twice the reduction experienced by the White population. Despite continued vulnerability of the Black and Latino populations, the hope was that widespread distribution of effective vaccines would mitigate the overall impact and reduce racial/ethnic disparities in 2021. In this study, we use cause-deleted life table methods to estimate the impact of COVID-19 mortality on 2021 US period life expectancy. Our partial-year estimates, based on provisional COVID-19 deaths for January-early October 2021 suggest that racial/ethnic disparities have persisted and that life expectancy at birth in 2021 has already declined by 1.2 years from pre-pandemic levels. Our projected full-year estimates, based on projections of COVID-19 deaths through the end of 2021 from the Institute for Health Metrics and Evaluation, suggest a 1.8-year reduction in US life expectancy at birth from pre-pandemic levels, a steeper decline than the estimates produced for 2020. The reductions in life expectancy at birth estimated for the Black and Latino populations are 1.6-2.4 times the impact for the White population.

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Peculiarities Of Cultural Interaction In Education: The US Experience

Comparative Professional Pedagogy ◽

10.1515/rpp-2015-0047 ◽

2015 ◽

Vol 5 (2) ◽

pp. 97-101

Author(s):

Olga Baybakova ◽

Larysa Sidun

Keyword(s):

Multicultural Education ◽

Multicultural Society ◽

Cultural Interaction ◽

Religious Groups ◽

Foreign Countries ◽

The Us ◽

The World ◽

The Usa ◽

Social Components ◽

Racial Ethnic

AbstractArticle deals with the problem of multicultural education. Ukraine, being a multicultural society, requires a new conception of the world, aimed at integrating cultures and nations, their further convergence as well as cultural enrichment. In this context the experience of many foreign countries, especially the USA, is very interesting. This country differs from average multicultural nations in a range of peculiarities, one of which is the fact that cultural interaction was not within an individual ethnos, but within immigrants–descendants of different countries, representatives of various cultures. It is underlined that the USA is the country that underwent durable trials in search for the most optimum ways to provide cultural interaction. The most modern response to the cultural diversity at the end of the 20th century in the USA became the policy of multiculturalism. Multiculturalism is considered to be a democratic policy of solving the problem of cultural and social diversity in the society, which includes educational, linguistic, economic and social components and has specific mechanisms of embodiment.The interpretation of multicultural education is proposed as that one, which facilitates the formation in a person of the readiness for activities in a modern socio-cultural environment, preservation of personal identity, aspiration for respect and understanding of other cultural and ethnical communities, the ability to live in peace and harmony with representatives of various racial, ethnic, cultural, religious groups.

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Opioid Epidemic in the United States: Empirical Trends, and A Literature Review of Social Determinants and Epidemiological, Pain Management, and Treatment Patterns

International Journal of MCH and AIDS (IJMA) ◽

10.21106/ijma.284 ◽

2019 ◽

Vol 8 (2) ◽

pp. 89-100 ◽

Cited By ~ 4

Author(s):

Gopal K Singh ◽

Isaac E. Kim, Jr. ◽

Mehrete Girmay ◽

Chrisp Perry ◽

Gem P. Daus ◽

...

Keyword(s):

Pain Management ◽

Social Determinants ◽

Drug Overdose ◽

The United States ◽

Opioid Epidemic ◽

The Us ◽

Drug Overdoses ◽

Race Ethnicity ◽

Overdose Mortality ◽

Racial Ethnic

Objectives: Dramatic increases in opioid and drug overdose mortality have occurred in the United States (US) over the past two decades. To address this national public health crisis and identify gaps in the literature, we analyzed recent empirical trends in US drug overdose mortality by key social determinants and conducted a selective review of the recent literature on the magnitude of the opioid crisis facing different racial/ethnic, socioeconomic, and rural-urban segments of the US population. Methods: We used the 1999-2017 mortality data from the US National Vital Statistics System to analyze trends in drug overdose mortality by race/ethnicity, age, and geographic area. Log-linear regression was used to model mortality trends. Using various key words and their combinations, we searched PubMed and Google Scholar for select peerreviewed journal articles and government reports published on the opioid epidemic between 2010 and 2018. Results: Our original analysis and review indicate marked increases in drug overdose mortality overall and by race/ethnicity and geographic regions, with adolescents and young adults experiencing steep increases in mortality between 1999 and 2017. Our selective search yielded 405 articles, of which 39 publications were selected for detailed review. Suicide mortality from drug overdose among teens aged 12-19 increased consistently between 2009 and 2017, particularly among teen girls. The rise of efficient global supply chains has increased opioid prescription use and undoubtedly contributed to the opioid epidemic. Many other important contributing factors to the epidemic include lack of education and economic opportunities, poor working conditions, and low social capital in disadvantaged communities. Conclusions and Global Health Implications: Our analysis and review indicate substantial disparities in drug overdoses and related mortality, pain management, and treatment outcomes according to social determinants. Increases in drug overdoses and resultant mortality are not only unique to the US, but have also been observed in other industrialized countries. Healthcare systems, community leaders, and policymakers addressing the opioidepidemic should focus on upstream structural factors including education, economic opportunity, social cohesion, racial/ethnic disadvantage, geographic isolation, and life satisfaction. Key words: â€¢ Opioids â€¢ Drug overdose â€¢ Mortality â€¢ Pain management â€¢ Treatment â€¢ Race/Ethnicity â€¢ Social determinants â€¢ Health disparities Copyright Â© 2019 Singh et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract 236: Gender Disparities in Bystander CPR and Defibrillation Persist in Black and Hispanic Neighborhoods in the US

Circulation ◽

10.1161/circ.142.suppl_4.236 ◽

2020 ◽

Vol 142 (Suppl_4) ◽

Author(s):

Audrey L Blewer ◽

Monique A Starks ◽

Carolina Malta Hansen ◽

Marcus E Ong ◽

Anthony J Viera ◽

...

Keyword(s):

Cardiac Arrest ◽

Race And Ethnicity ◽

Gender Disparities ◽

Ethnic Composition ◽

Minority Population ◽

Black Neighborhoods ◽

The Us ◽

Bystander Cpr ◽

To Receive ◽

Racial Ethnic

Introduction: Bystander CPR (B-CPR) and defibrillation for sudden cardiac arrest (SCA) vary by gender with females being less likely to receive these interventions. Despite known differences by race and ethnicity, it is unknown whether gender disparities in B-CPR and defibrillation persist by neighborhood race and ethnicity. Objectives: We examined the likelihood of receiving B-CPR and defibrillation by gender stratified by public location and neighborhood racial/ethnic composition. We hypothesized that in public locations within Black neighborhoods, females will have a lower likelihood of receiving B-CPR compared to males. Methods: We conducted a retrospective cohort study using data from the US Cardiac Arrest Registry to Enhance Survival (CARES) registry. Neighborhoods were classified by census tract based on percent of Black or Hispanic residents using the threshold in the definition of “White flight” where Whites leave a neighborhood when it exceeds >30% of a minority population. We independently modeled the likelihood of receipt of B-CPR and defibrillation by gender stratified by public location and neighborhood racial/ethnic composition controlling for confounding variables. Results: From 2013-2018, CARES collected 350,722 US arrests; after excluding pediatric arrests, those witnessed by EMS, or those that occurred in a healthcare facility, 214,464 were included. Mean age was 64±16 and 65% were male; 39% received B-CPR, 9% received bystander defibrillation prior to 9-1-1 responders arrival, and 18% occurred in the public. In Black neighborhoods, females who had SCA in public locations were 22% less likely to receive B-CPR (OR: 0.78 (0.64-0.95), p=0.01) and 42% less likely to receive defibrillation (OR: 0.58 (0.45-0.74), p<0.01) compared to males. In Hispanic neighborhoods, females who had SCA in public locations were also less likely to receive B-CPR (OR: 0.72 (0.59-0.87), p<0.01) and less likely to receive defibrillation (OR: 0.62 (0.48-0.80), p<0.01) compared to males. Conclusion: Females with public SCA have a decreased likelihood of receiving B-CPR and defibrillation, and these findings persist in Black and Hispanic neighborhoods. This has implications for strategies to reduce disparities around bystander response to SCA.

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