Racial Differences in Do-Not-Resuscitate Orders among Pediatric Surgical Patients in the United States

Academics largely define gentrification based on changes in the class demographics of neighborhood residents from predominately low-income to middle-class. This ignores that gentrification always occurs in spaces defined by both class and race. In this article, I use the lens of racial capitalism to theorize gentrification as a racialized, profit-accumulating process, integrating the perspective that spaces are always racialized to class-centered theories. Using the prior literature on gentrification in the United States, I demonstrate how the concepts of value, valuation, and devaluation from racial capitalism explain where and how gentrification unfolds. Exposure to gentrification varies depending on a neighborhood’s racial composition and the gentrification stakeholders involved, which contributes to racial differences in the scale and pace of change and the implications of those changes for the processes of displacement. Revising our understanding of gentrification to address the racialization of space helps resolve seemingly contradictory findings across qualitative and quantitative studies.

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Prehospital Do-Not-Resuscitate Orders: A Survey of State Policies in the United States

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00040577 ◽

1993 ◽

Vol 8 (4) ◽

pp. 317-322 ◽

Cited By ~ 16

Author(s):

James G. Adams

Keyword(s):

United States ◽

District Of Columbia ◽

The United States ◽

Prehospital Setting ◽

Do Not Resuscitate ◽

Working Groups ◽

Prehospital Emergency ◽

State Regional ◽

Legal Opinion ◽

Dnr Orders

AbstractIntroduction:Many states in the United States ‘have developed policies that enable prehospital emergency medical services (EMS) providers to withhold cardiopulmonary resuscitation (CPR) in the terminally ill. Several states also have policies that enable the implementation of do-not-resuscitate (DNR) orders.Objectives:1) assess which states have statutes governing DNR orders for the prehospital setting; 2) determine which states authorize DNR orders in ways other than by specific state statue; and 3) define those states that had regional protocols which address prehospital DNR orders.Methods:Survey of the state EMS directors in each of the 50 U.S. states, the District of Columbia, and Puerto Rico.Results:As of 1992, specific legislation authorizing the implementation of DNR orders was in place in 11 states. In addition, six others have a legal opinion or policy allowing the implementation of DNR orders. Fourteen additional states have either working groups or legislation pending that address prehospital DNR orders. In only five were there no existing regional protocols for implementation of DNR orders in the prehospital setting.Conclusions:There exists great variation in legal authorization by states for implementation of DNR orders in the prehospital setting. Despite the existence of enabling legislation, many state, regional, or local EMS systems have implemented policies dealing with DNR orders.

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Racial Differences in Disease Presentation and Management of Intracranial Meningioma

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1676788 ◽

2018 ◽

Vol 80 (06) ◽

pp. 555-561

Author(s):

C. Lane Anzalone ◽

Amy E. Glasgow ◽

Jamie J. Van Gompel ◽

Matthew L. Carlson

Keyword(s):

United States ◽

Overall Survival ◽

Racial Differences ◽

Tumor Size ◽

The United States ◽

Intracranial Meningioma ◽

Multivariable Model ◽

Asian Populations ◽

Hispanic Patients ◽

The Impact

Objective/Hypothesis The aim of the study was to determine the impact of race on disease presentation and treatment of intracranial meningioma in the United States. Study Design This study comprised of the analysis of a national population-based tumor registry. Methods Analysis of the surveillance, epidemiology, and end results (SEER) database was performed, including all patients identified with a diagnosis of intracranial meningioma. Associations between race, disease presentation, treatment strategy, and overall survival were analyzed in a univariate and multivariable model. Results A total of 65,973 patients with intracranial meningiomas were identified. Of these, 45,251 (68.6%) claimed white, 7,796 (12%) black, 7,154 (11%) Hispanic, 4,902 (7%) Asian, and 870 (1%) patients reported “other-unspecified” or “other-unknown.” The median annual incidence of disease was lowest among black (3.43 per 100,000 persons) and highest among white (9.52 per 100,000 persons) populations (p < 0.001). Overall, Hispanic patients were diagnosed at the youngest age and white patients were diagnosed at the oldest age (mean of 59 vs. 66 years, respectively; p < 0.001). Compared with white populations, black, Hispanic, and Asian populations were more likely to present with larger tumors (p < 0.001). After controlling for tumor size, age, and treatment center in a multivariable model, Hispanic patients were more likely to undergo surgery than white, black, and Asian populations. Black populations had the poorest disease specific and overall survival rates at 5 years following surgery compared with other groups. Conclusion Racial differences among patients with intracranial meningioma exist within the United States. Understanding these differences are of vital importance toward identifying potential differences in the biological basis of disease or alternatively inequalities in healthcare delivery or access Further studies are required to determine which factors drive differences in tumor size, age, annual disease incidence, and overall survival between races.

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