Immigration and Health Disparities

Mapping Intimacies ◽

10.1093/obo/9780195389678-0311 ◽

2022 ◽

Keyword(s):

United States ◽

Health Disparities ◽

Health Outcomes ◽

Immigrant Health ◽

Limited English Proficiency ◽

Service Use ◽

The United States ◽

Health Risk Behaviors ◽

Health Concern ◽

Increased Risk

Migration continues to be an important component of globalization. With global movement comes migrants’ vulnerability, and the consequent intersection with health and health disparities. The immigrant population in the United States is expected to increase to about eighty-one million by 2050. This ongoing demographic transformation suggests that the health status, health risk behaviors, and health disparities of immigrants and their offspring may play a significant role in shaping the health outcomes of the American population. Immigrants are particularly considered a vulnerable population because of insufficient access to and utilization of health care, limited English proficiency, low socioeconomic status, immigrant status, stigmatization, marginalization, and increased risk for poor physical, psychological, and social health outcomes, especially among the working poor. These factors undoubtedly have detrimental effects on the health and health disparities of immigrants and their children. These social, environmental, and behavioral occurrences or life experiences accumulate over time to improve or jeopardize an individual’s health. Similarly, immigration policies have a tremendous impact on immigrant health disparities, especially during periods of strict and intense enforcement in the United States. Nativity has become a prominent domain in health disparities research. Given that nativity, racial, and ethnic health disparities continue to be a major public health concern, social work scholars and practitioners continue to work toward eliminating health disparities among population subgroups, including immigrants. Included in these discussions are immigrant health service use, immigrant health effects, salmon bias, and determinants of immigrant health. Also important in working with immigrants are problems with accessibility to health services.

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Cortisol and Racial Health Disparities Affecting Black Men in Later Life: Evidence From MIDUS II

American Journal of Men s Health ◽

10.1177/1557988319870969 ◽

2019 ◽

Vol 13 (4) ◽

pp. 155798831987096 ◽

Cited By ~ 2

Author(s):

Julie Ober Allen ◽

Daphne C. Watkins ◽

Linda Chatters ◽

Arline T. Geronimus ◽

Vicki Johnson-Lawrence

Keyword(s):

United States ◽

Health Disparities ◽

Psychological Distress ◽

Health Outcomes ◽

Black Men ◽

White Men ◽

Later Life ◽

The United States ◽

Racial Health Disparities ◽

Medical Morbidity

In the United States, Black men have poorer overall health and shorter life spans than most other racial/ethnic groups of men, largely attributable to chronic health conditions. Dysregulated patterns of daily cortisol, an indicator of hypothalamic–pituitary–adrenal (HPA) axis stress–response functioning, are linked to poor health outcomes. Questions remain regarding whether and how cortisol contributes to Black–White differences in men’s health. This exploratory study compared early day changes in cortisol levels (diurnal cortisol slopes from peak to pre-lunch levels) and their associations with medical morbidity (number of chronic medical conditions) and psychological distress (Negative Affect Scale) among 695 Black and White male participants in the National Survey of Midlife in the United States (MIDUS II, 2004–2009). Black men exhibited blunted cortisol slopes relative to White men (−.15 vs. −.21, t = −2.97, p = .004). Cortisol slopes were associated with medical morbidity among Black men ( b = .050, t = 3.85, p < .001), but not White men, and were unrelated to psychological distress in both groups. Findings indicate cortisol may contribute to racial health disparities among men through two pathways, including the novel finding that Black men may be more vulnerable to some negative health outcomes linked to cortisol. Further, results suggest that while cortisol may be a mechanism of physical health outcomes and disparities among older men, it may be less important for their emotional health. This study increases understanding of how race and male sex intersect to affect not only men’s lived experiences but also their biological processes to contribute to racial health disparities among men in later life.

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Addressing Health Disparities in the Undergraduate Curriculum: An Approach to Develop a Knowledgeable Biomedical Workforce

CBE—Life Sciences Education ◽

10.1187/cbe.14-06-0101 ◽

2014 ◽

Vol 13 (4) ◽

pp. 636-640 ◽

Cited By ~ 11

Author(s):

Rocio Benabentos ◽

Payal Ray ◽

Deepak Kumar

Keyword(s):

United States ◽

Health Disparities ◽

Health Outcomes ◽

Healthcare System ◽

Undergraduate Students ◽

Life Sciences ◽

Undergraduate Curriculum ◽

The United States ◽

Undergraduate Institutions ◽

Minority Serving Institutions

Disparities in health and healthcare are a major concern in the United States and worldwide. Approaches to alleviate these disparities must be multifaceted and should include initiatives that touch upon the diverse areas that influence the healthcare system. Developing a strong biomedical workforce with an awareness of the issues concerning health disparities is crucial for addressing this issue. Establishing undergraduate health disparities courses that are accessible to undergraduate students in the life sciences is necessary to increase students’ understanding and awareness of these issues and motivate them to address these disparities during their careers. The majority of universities do not include courses related to health disparities in their curricula, and only a few universities manage them from their life sciences departments. The figures are especially low for minority-serving institutions, which serve students from communities disproportionally affected by health disparities. Universities should consider several possible approaches to infuse their undergraduate curricula with health disparities courses or activities. Eliminating health disparities will require efforts from diverse stakeholders. Undergraduate institutions can play an important role in developing an aware biomedical workforce and helping to close the gap in health outcomes.

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Patient Health Outcomes following Dialysis Facility Closures in the United States

Journal of the American Society of Nephrology ◽

10.1681/asn.2021020244 ◽

2021 ◽

Vol 32 (10) ◽

pp. 2613-2621

Author(s):

Jingbo Niu ◽

Maryam K. Saeed ◽

Wolfgang C. Winkelmayer ◽

Kevin F. Erickson

Keyword(s):

United States ◽

Health Outcomes ◽

The United States ◽

Content Type ◽

Rate Difference ◽

Risk Of Death ◽

Increased Risk ◽

Dialysis Facility ◽

Matched Comparison ◽

Hospital Days

BackgroundOngoing changes to reimbursement of United States dialysis care may increase the risk of dialysis facility closures. Closures may be particularly detrimental to the health of patients receiving dialysis, who are medically complex and clinically tenuous.MethodsWe used two separate analytic strategies—one using facility-based matching and the other using propensity score matching—to compare health outcomes of patients receiving in-center hemodialysis at United States facilities that closed with outcomes of similar patients who were unaffected. We used negative binomial and Cox regression models to estimate associations of facility closure with hospitalization and mortality in the subsequent 180 days.ResultsWe identified 8386 patients affected by 521 facility closures from January 2001 through April 2014. In the facility-matched model, closures were associated with 9% higher rates of hospitalization (relative rate ratio [RR], 1.09; 95% confidence interval [95% CI], 1.03 to 1.16), yielding an absolute annual rate difference of 1.69 hospital days per patient-year (95% CI, 0.45 to 2.93). Similarly, in a propensity-matched model, closures were associated with 7% higher rates of hospitalization (RR, 1.07; 95% CI, 1.00 to 1.13; P=0.04), yielding an absolute rate difference of 1.08 hospital days per year (95% CI, 0.04 to 2.12). Closures were associated with nonsignificant increases in mortality (hazard ratio [HR], 1.08; 95% CI, 1.00 to 1.18; P=0.05 for the facility-matched comparison; HR, 1.08; 95% CI, 0.99 to 1.17; P=0.08 for the propensity-matched comparison).ConclusionsPatients affected by dialysis facility closures experienced increased rates of hospitalization in the subsequent 180 days and may be at increased risk of death. This highlights the need for effective policies that continue to mitigate risk of facility closures.

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Treat Sexual Stigma to Heal Health Disparities: Improving Sexual Minorities’ Health Outcomes

Policy Insights from the Behavioral and Brain Sciences ◽

10.1177/2372732220942250 ◽

2020 ◽

Vol 7 (2) ◽

pp. 205-213

Author(s):

Jes L. Matsick ◽

Britney M. Wardecker ◽

Flora Oswald

Keyword(s):

Social Psychology ◽

United States ◽

Health Disparities ◽

Sexual Orientation ◽

Health Outcomes ◽

Empirical Evidence ◽

The United States ◽

Policy Implications ◽

Sexual Stigma ◽

Physical Health Problems

Despite recent strides toward equality in the United States, lesbian, gay, bisexual, transgender, and queer (LGBTQ) people continue to report experiences of sexual stigma and psychological and physical health problems. This article reviews empirical evidence of sexual stigma and sexual orientation-based health disparities. The current framework proposes that sexual orientation does not cause health disparities; homophobic individuals and societies do. Social psychology, recognizing the power of the situation, suggests that changing the stigmatizing environments for LGBTQ people can effectively reduce health disparities. The science has policy implications—notably, for audiences at three levels (intraindividual, interpersonal, and institutional)—and provides recommendations for mitigating sexual stigma and improving health.

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Addressing disparities among children with cerebral palsy: Optimizing enablement, functioning, and participation

Journal of Pediatric Rehabilitation Medicine ◽

10.3233/prm-210015 ◽

2021 ◽

pp. 1-7

Author(s):

Deirdre Flanagan ◽

Deborah Gaebler ◽

Emma-Lorraine B. Bart-Plange ◽

Michael E. Msall

Keyword(s):

United States ◽

Cerebral Palsy ◽

Health Disparities ◽

Maternal Education ◽

Contextual Factors ◽

The United States ◽

Population Surveillance ◽

Minority Status ◽

Increased Risk ◽

Children With Cerebral Palsy

PURPOSE: Recognizing health disparities among children with cerebral palsy (CP) is necessary for understanding potential risk factors for CP and for implementing early and effective preventative and intervention treatments. However, there is currently little and conflicting evidence regarding the direct impact of contextual factors such as socioeconomic status (SES) for children with CP in the United States. These contextual factors include the complex social determinants of health on prematurity, comprehensive informed obstetric management for minority and vulnerable populations, and cumulative adversity disproportionately experienced by children, by gender, minority status, immigration, poverty, and structural racism. METHODS: This study presents results from a review of health disparities among children with CP, using registry and population surveillance data from Australia, Canada, Scandinavia, the United Kingdom, Ireland, Turkey, and the United States. RESULTS: The review confirmed that there are significant health disparities among children with CP, both in terms of prevalence and severity, based on factors such as SES, neighborhood disadvantage, maternal education, gender, and minority status. CONCLUSION: Strategies need to be implemented in the United States to promote enablement and functioning among children with CP who face additional health disparities. This requires a greater understanding of population groups at increased risk, comprehensive assessment and care for young children with motor delays, and systematic population counts of children and adults with CP using registries and systems of neurodevelopmental surveillance across health, education, and community rehabilitation. These efforts also require sensitivity to structural and persistent racism, stigma, trauma-informed care, and culturally sensitive community engagement. Additional efforts are also required to improve outcomes over the life course for individuals living a life with CP from a framework of enablement, self-direction, equity and social justice.

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Effects of Large-Scale Oceanic Phenomena on Non-Cholera Vibriosis Incidence in the United States: Implications for Climate Change

10.1101/528893 ◽

2019 ◽

Author(s):

Chloë Logar-Henderson ◽

Rebecca Ling ◽

Ashleigh R. Tuite ◽

David N. Fisman

Keyword(s):

Public Health ◽

Climate Change ◽

United States ◽

Large Scale ◽

Disease Incidence ◽

The United States ◽

Ocean Warming ◽

Rate Of Change ◽

Health Concern ◽

Increased Risk

AbstractPurposeEpidemics of diarrhea caused by toxigenic strains of Vibrio cholerae are of global public health concern, but non-cholera Vibrio (NCV) species are also important causes of disease. These pathogens are thermophilic, and climate change could increase the risk of NCV infection. The El Niño Southern Oscillation (ENSO) is a “natural experiment” that may presage ocean warming effects on disease incidence.MethodWe obtained vibriosis case counts in the United States by digitizing annual reports from the U.S. Cholera and Other Vibrio Illness Surveillance system. Trends and environmental impacts (of ENSO and the North Atlantic Oscillation) were evaluated using negative binomial and distributed nonlinear lag models. Associations between latitude and changing risk were evaluated with meta-regression.ResultsTrend models demonstrated significant seasonality (P < 0.001) and a 7% annual increase in disease risk from 1999 to 2014 (annual IRR 1.071, 95% CI 1.061-1.081). Distributed lag models demonstrated increased vibriosis risk following ENSO conditions over the subsequent 12 months (integrated RR 1.940, 95% CI 1.298-2.901). The rate of change in vibriosis risk increased with state latitude (RR per 10° increase 1.066, 95% CI 1.027-1.107).ConclusionVibriosis risk in the United States appears to be impacted by irregular large-scale ocean warming and exhibits a north-south gradient in rate of change as would be expected if changing disease incidence is attributable to ocean warming. Vulnerable populations, which include high-income countries with well-developed public health systems, may experience increased risk of this disease as a result of climate change.

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