scholarly journals RISK FACTORS FOR DISENROLLMENT AMONG HOME HOSPICE PATIENTS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S791-S791
Author(s):  
Elizabeth A Luth ◽  
David Russell
Keyword(s):  
Risk Factors ◽  
Ethnic Minority ◽  
Functional Status ◽  
Minority Groups ◽  
Hospice Care ◽  
Multinomial Logistic Regression ◽  
Ethnic Disparities ◽  
Dementia Diagnosis ◽  
Hospice Patients ◽  
Racial Ethnic

Abstract Hospice delivers care to a substantial and growing number of individuals with primary and comorbid dementia diagnoses. Dementia diagnosis and racial/ethnic minority status are risk factors for hospice disenrollment. However, little research examines racial/ethnic disparities and other risk factors for hospice disenrollment among hospice patients with dementia. This paper uses multinomial logistic regression to explore sociodemographic and functional status risk factors for hospice disenrollment among 3,949 home hospice recipients with primary or comorbid dementia. Results indicate that patients with a primary dementia diagnosis, racial/ethnic minority groups, and those higher functional status have elevated risk of disenrollment due to hospitalization, disqualification, and electively leaving hospice care. Additional research is needed to understand why primary dementia diagnosis and underrepresented racial/ethnic status are associated with multiple kinds of hospice disenrollment so that hospice practice can be tailored to respond to the needs of these individuals.

scholarly journals Risk Factors for Death Among Hospitalized Patients Aged 21–64 Years Diagnosed with COVID-19—New York City, March 13–April 9, 2020

2021 ◽  
Author(s):  
Dena Bushman ◽  
Alexander Davidson ◽  
Preeti Pathela ◽  
Sharon K. Greene ◽  
Don Weiss ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
Social Services ◽  
Minority Groups ◽  
Conditional Logistic Regression ◽  
Ethnic Disparities ◽  
Logistic Regression Models ◽  
Residential Neighborhood ◽  
And Control ◽  
Racial Ethnic

Abstract Background COVID-19 mortality studies have primarily focused on persons aged ≥ 65 years; less is known about decedents aged <65 years. Methods We conducted a case-control study among NYC residents aged 21–64 years hospitalized with COVID-19 diagnosed March 13–April 9, 2020, to determine risk factors for death. Case-patients (n=343) were hospitalized decedents with COVID-19 and control-patients (n=686) were discharged from hospitalization with COVID-19 and matched 2:1 to case-patients on age and residential neighborhood. Conditional logistic regression models were adjusted for patient sex, insurance status, and marital status. Matched adjusted odds ratios (aORs) were calculated for selected underlying conditions, combinations of conditions, and race/ethnic group. Results Median age of both case-patients and control-patients was 56 years (range: 23–64 years). Having ≥ 1 selected underlying condition increased odds of death 4.45-fold (95% CI: 2.33–8.49). Patients with diabetes; morbid obesity; heart, kidney, or lung disease; cancer; neurologic/neurodevelopmental conditions; mental health conditions; or HIV had significantly increased odds of death. Compared with having neither condition, having both diabetes and obesity or diabetes and heart disease was associated with approximately threefold odds of death. Five select underlying conditions were more prevalent among non-Hispanic Black control-patients than among control-patients of other races/ethnicities. Conclusions and Relevance Selected underlying conditions were risk factors for death, and most prevalent among racial/ethnic minorities. Social services; health care resources, including vaccination; and tailored public health messaging are important for COVID-19 prevention. Strengthening these strategies for racial/ethnic minority groups could minimize COVID-19 racial/ethnic disparities.

scholarly journals Eradicating Racism: An Endocrine Society Policy Perspective

2022 ◽  
Author(s):  
Ruban Dhaliwal ◽  
Rocio I Pereira ◽  
Alicia M Diaz-Thomas ◽  
Camille E Powe ◽  
Licy L Yanes Cardozo ◽  
...  
Keyword(s):  
Health Disparities ◽  
Ethnic Minority ◽  
Healthcare System ◽  
Health Professionals ◽  
Minority Groups ◽  
Ethnic Minority Groups ◽  
Minority Communities ◽  
Endocrine Society ◽  
Policy Perspective ◽  
Racial Ethnic

Abstract The Endocrine Society recognizes racism as a root cause of the health disparities that affect racial/ethnic minority communities in the United States and throughout the world. In this policy perspective, we review the sources and impact of racism on endocrine health disparities and propose interventions aimed at promoting an equitable, diverse, and just healthcare system. Racism in the healthcare system perpetuates health disparities through unequal access and quality of health services, inadequate representation of health professionals from racial/ethnic minority groups, and the propagation of the erroneous belief that socially constructed racial/ethnic groups constitute genetically and biologically distinct populations. Unequal care, particularly for common endocrine diseases such as diabetes, obesity, osteoporosis, and thyroid disease, results in high morbidity and mortality for individuals from racial/ethnic minority groups, leading to a high socioeconomic burden on minority communities and all members of our society. As health professionals, researchers, educators, and leaders, we have a responsibility to take action to eradicate racism from the healthcare system. Achieving this goal would result in high-quality health care services that are accessible to all, diverse workforces that are representative of the communities we serve, inclusive and equitable workplaces and educational settings that foster collaborative teamwork, and research systems that ensure that scientific advancements benefit all members of our society. The Endocrine Society will continue to prioritize and invest resources in a multifaceted approach to eradicate racism, focused on educating and engaging current and future health professionals, teachers, researchers, policy makers, and leaders.

scholarly journals Mental well-being of patients from ethnic minority groups during critical care: a qualitative ethnographic study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e014075 ◽  
Author(s):  
Rose Lima Van Keer ◽  
Reginald Deschepper ◽  
Luc Huyghens ◽  
Johan Bilsen
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Critical Care ◽  
Ethnic Minority ◽  
Healthcare Professionals ◽  
Minority Groups ◽  
Mental Health Problems ◽  
Well Being ◽  
Ethnic Minority Groups ◽  
Mental Well Being

ObjectivesTo investigate the state of the mental well-being of patients from ethnic minority groups and possible related risk factors for the development of mental health problems among these patients during critical medical situations in hospital.DesignQualitative ethnographic design.SettingOneintensive care unit (ICU) of a multiethnic urban hospital in Belgium.Participants84 ICU staff members, 10 patients from ethnic-minority groups and their visiting family members.ResultsPatients had several human basic needs for which they could not sufficiently turn to anybody, neither to their healthcare professionals, nor to their relatives nor to other patients. These needs included the need for social contact, the need to increase comfort and alleviate pain, the need to express desperation and participate in end-of-life decision making. Three interrelated risk factors for the development of mental health problems among the patients included were identified: First, healthcare professionals’ mainly biomedical care approach (eg, focus on curing the patient, limited psychosocial support), second, the ICU context (eg, time pressure, uncertainty, regulatory frameworks) and third, patients’ different ethnocultural background (eg, religious and phenotypical differences).ConclusionsThe mental state of patients from ethnic minority groups during critical care is characterised by extreme emotional loneliness. It is important that staff should identify and meet patients’ unique basic needs in good time with regard to their mental well-being, taking into account important threats related to their own mainly biomedical approach to care, the ICU’s structural context as well as the patients’ different ethnocultural background.

Abstract 13150: Racial/Ethnic Disparities of the Impact of the COVID-19 Pandemic Out-of-Hospital Cardiac Arrest (OHCA) in Texas

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Summer Chavez ◽  
Ryan Huebinger ◽  
Kevin Schulz ◽  
Hei Kit Chan ◽  
Micah Panczyk ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Admission ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Mixed Effect ◽  
Neurological Outcomes ◽  
Random Intercept ◽  
Hispanic Patients ◽  
The Impact ◽  
Racial Ethnic

Introduction: Prior research shows a greater disease burden, lower BCPR rates, and worse outcomes in Black and Hispanic patients after OHCA. The CDC has declared that the COVID-19 pandemic has disproportionately affected many racial and ethnic minority groups. However, the influence of the COVID-19 pandemic on OHCA incidence and outcomes in different races and ethnicities is unknown. Purpose: To describe racial/ethnic disparities in OHCA incidence, processes of care and outcomes in Texas during the COVID-19 pandemic. Methods: We used data from the Texas Cardiac Arrest Registry to Enhance Survival (CARES) comparing adult OHCA from the pre-pandemic period (March 11 - December 31, 2019) to the pandemic period (March 11- December 31, 2020). The racial and ethnic categories were White, Black, Hispanic or Other. Outcomes were rates of BCPR, AED use, sustained ROSC, prehospital termination of resuscitation (TOR), survival to hospital admission, survival to discharge and good neurological outcomes. We fit a mixed effect logistic regression model, with EMS agency designated as the random intercept to obtain aORs. We adjusted for the pandemic and other covariates. Results: A total of 8,070 OHCAs were included. The proportion of cardiac arrests increased for Blacks (903 to 1, 113, 24.9% to 25.5%) and Hispanics (935 to 1,221, 25.8% to 27.5%) and decreased for Whites (1 595 to 1,869, 44.0% to 42.1%) and Other (194 to 220, 5.4% to 5.0%) patients. Compared to Whites, Black (aOR = 0.73, 95% CI 0.65-0.82) and Hispanic patients (aOR = 0.78, 95% CI 0.68-0.87) were less likely to receive BCPR. Compared to Whites, Blacks were less likely to have sustained ROSC (aOR = 0.81, 95% CI 0.70-0.93%), with lower rates of survival to hospital admission (aOR = 0.87, 95% CI 0.75-1.0), and worse neurological outcomes (aOR = 0.45, 95% 0.28-0.73). Hispanics were less likely to have prehospital TOR compared to Whites (aOR = 0.86, 95% CI = 0.75-0.99). The Utstein bystander survival rate was worse for Blacks (aOR = 0.72, 95% CI 0.54-0.97) and Hispanics (aOR = 0.71, 95% 0.53-0.95) compared to Whites. Conclusion: Racial and ethnic disparities persisted during the COVID-19 pandemic in Texas.

scholarly journals Trends in age and red blood cell donation habits among several racial/ethnic minority groups in the United States

Transfusion ◽  
2017 ◽  
Vol 57 (7) ◽  
pp. 1644-1655 ◽  
Author(s):  
Mark H. Yazer ◽  
Ralph Vassallo ◽  
Meghan Delaney ◽  
Marc Germain ◽  
Matthew S. Karafin ◽  
...  
Keyword(s):  
United States ◽  
Blood Cell ◽  
Ethnic Minority ◽  
Red Blood Cell ◽  
Minority Groups ◽  
The United States ◽  
Ethnic Minority Groups ◽  
Racial Ethnic

scholarly journals Do sex differences in the prevalence of ECG abnormalities vary across ethnic groups living in the Netherlands? A cross-sectional analysis of the population-based HELIUS study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039091
Author(s):  
Renee Bolijn ◽  
C Cato ter Haar ◽  
Ralf E Harskamp ◽  
Hanno L Tan ◽  
Jan A Kors ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Ethnic Minority ◽  
Ethnic Groups ◽  
South Asian ◽  
Minority Groups ◽  
Population Based ◽  
Secondary Outcome ◽  
Ethnic Minority Groups ◽  
Ecg Abnormalities

ObjectivesMajor ECG abnormalities have been associated with increased risk of cardiovascular disease (CVD) burden in asymptomatic populations. However, sex differences in occurrence of major ECG abnormalities have been poorly studied, particularly across ethnic groups. The objectives were to investigate (1) sex differences in the prevalence of major and, as a secondary outcome, minor ECG abnormalities, (2) whether patterns of sex differences varied across ethnic groups, by age and (3) to what extent conventional cardiovascular risk factors contributed to observed sex differences.DesignCross-sectional analysis of population-based study.SettingMulti-ethnic, population-based Healthy Life in an Urban Setting cohort, Amsterdam, the Netherlands.Participants8089 men and 11 369 women of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin aged 18–70 years without CVD.Outcome measuresAge-adjusted and multivariable logistic regression analyses were performed to study sex differences in prevalence of major and, as secondary outcome, minor ECG abnormalities in the overall population, across ethnic groups and by age-groups (18–35, 36–50 and >50 years).ResultsMajor and minor ECG abnormalities were less prevalent in women than men (4.6% vs 6.6% and 23.8% vs 39.8%, respectively). After adjustment for conventional risk factors, sex differences in major abnormalities were smaller in ethnic minority groups (OR ranged from 0.61 in Moroccans to 1.32 in South-Asian Surinamese) than in the Dutch (OR 0.49; 95% CI 0.36 to 0.65). Only in South-Asian Surinamese, women did not have a lower odds than men (OR 1.32; 95% CI 0.96 to 1.84). The pattern of smaller sex differences in ethnic minority groups was more pronounced in older than in younger age-groups.ConclusionsThe prevalence of major ECG abnormalities was lower in women than men. However, sex differences were less apparent in ethnic minority groups. Conventional risk factors did not contribute substantially to observed sex differences.

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