scholarly journals Characteristics and Outcomes of Latinx Patients With COVID-19 in Comparison With Other Ethnic and Racial Groups

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Saef Izzy ◽  
Zabreen Tahir ◽  
David J Cote ◽  
Ali Al Jarrah ◽  
Matthew Blake Roberts ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Asian American ◽  
Age Groups ◽  
Racial Groups ◽  
Icu Admission ◽  
Younger Age ◽  
Multivariable Regression ◽  
The Impact ◽  
White Patients

Abstract Background There is a limited understanding of the impact of coronavirus disease 2019 (COVID-19) on the Latinx population. We hypothesized that Latinx patients would be more likely to be hospitalized and admitted to the intensive care unit (ICU) than White patients. Methods We analyzed all patients with COVID-19 in 12 Massachusetts hospitals between February 1 and April 14, 2020. We examined the association between race, ethnicity, age, reported comorbidities, and hospitalization and ICU admission using multivariable regression. Results Of 5190 COVID-19 patients, 29% were hospitalized; 33% required the ICU, and 4.3% died. Forty-six percent of patients were White, 25% Latinx, 14% African American, and 3% Asian American. Ethnicity and race were significantly associated with hospitalization. More Latinx and African American patients in the younger age groups were hospitalized than whites. Latinxs and African Americans disproportionally required the ICU, with 39% of hospitalized Latinx patients requiring the ICU compared with 33% of African Americans, 24% of Asian Americans, and 30% of Whites (P < .007). Within each ethnic and racial group, age and male gender were independently predictive of hospitalization. Previously reported preexisting comorbidities contributed to the need for hospitalization in all racial and ethnic groups (P < .05). However, the observed disparities were less likely related to reported comorbidities, with Latinx and African American patients being admitted at twice the rate of Whites, regardless of such comorbidities. Conclusions Latinx and African American patients with COVID-19 have higher rates of hospitalization and ICU admission than White patients. The etiologies of such disparities are likely multifactorial and cannot be explained only by reported comorbidities.

Post-Slavery? Post-Segregation? Post-Racial? A History of the Impact of Slavery, Segregation, and Racism on the Education of African Americans

2015 ◽  
Vol 117 (14) ◽  
pp. 53-74
Author(s):  
Christopher M. Span
Keyword(s):  
African American ◽  
African Americans ◽  
Educational Experiences ◽  
Source Analysis ◽  
Secondary Source ◽  
Archival Data ◽  
Historical Overview ◽  
Colonial Era ◽  
History Of ◽  
The Impact

This chapter details how slavery, segregation, and racism impacted the educational experiences of African Americans from the colonial era to the present. It offers a historical overview of the African American educational experience and uses archival data and secondary source analysis to illustrate that America has yet to be a truly post-slavery and post-segregation society, let alone a post-racial society.

scholarly journals African American Health and Posttraumatic Slave Syndrome: A Terror Management Theory Account

2018 ◽  
Vol 50 (1) ◽  
pp. 45-65 ◽  
Author(s):  
Michael J. Halloran
Keyword(s):  
African American ◽  
African Americans ◽  
Terror Management Theory ◽  
Terror Management ◽  
Well Being ◽  
Cultural Trauma ◽  
Management Theory ◽  
American People ◽  
Posttraumatic Slave Syndrome ◽  
The Impact

The aim of this article is to explicate a terror management theory (TMT) analysis of the poor social and psychological well-being of African Americans by drawing upon a model of cultural trauma to explain the antecedents and effects of posttraumatic slave syndrome. Cultural trauma is defined as a state that occurs when a people’s cultural worldview has been destabilized to the point where it does not effectively meet its TMT function of providing a buffer against basic anxiety and uncertainty. The article outlines how the impact of slavery was a significant trauma to African American people, which was carried forward through successive generations; providing an explanation of their current anxiety-related conditions, poor health, and maladaptive behaviors. Findings from health and justice research and qualitative data from narratives of African Americans are presented to substantiate the adaptation of a model of cultural trauma for understanding the contemporary situation of African Americans.

The impact of a time target on older patients attending the emergency department

2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A2.1-A2
Author(s):  
Sue Mason
Keyword(s):  
Emergency Department ◽  
Older Patients ◽  
Age Groups ◽  
Unintended Consequences ◽  
Older Patient ◽  
Younger Patients ◽  
Patient Level ◽  
Level Data ◽  
Younger Age ◽  
The Impact

IntroductionThe 4 h emergency standard for English acute trusts was introduced in 2003 and became full established by 2008 at 98% for all Emergency Department (ED) patients to be seen and discharged. This study examined the impact of the target for older patients attending departments.MethodsRoutine patient level data was received from 15 English EDs representing 774 095 individual patient attendances during May and June for 2003 to 2006. The data were used to determine the distribution of the total time spent in the EDs. Attendances were compared for older patients (65 years and above) with younger age groups.ResultsA total of 145 596 attendances were for patients aged 65+ years (18.9%). Across each year analysed, these older patients have a significantly longer median total time in the ED than those younger than 65 years (162 min vs 103 min, p<0.001). In addition, older patients are significantly more likely to leave the emergency department in the last 20 min prior to 4 h (12.4% vs 5.2% in those <65 years, p<0.001). This proportion is growing year on year in both the admitted and discharged categories of patients. Finally, older patients are significantly more likely to breach the 4-h than their younger counterparts (16.6% vs 6.3%, p<0.001).ConclusionsThere are some unintended consequences of introducing the 4 h target in UK emergency departments. While the target has reduced overall time in departments, the older patient appears to be disadvantaged relative to younger patients. Older patients are more likely to be ‘rushed through’ to other unmonitored areas of the hospital just prior to the target or to breach the target altogether. This finding calls in to question the benefits that the target is conveying for individual patients, and especially the most vulnerable in society.

Public Opinion toward Equal Opportunity Issues: The Role of Attitudinal and Demographic Forces among African Americans

1992 ◽  
Vol 35 (4) ◽  
pp. 705-720 ◽  
Author(s):  
Terri Susan Fine
Keyword(s):  
African American ◽  
African Americans ◽  
Equal Opportunity ◽  
Opinion Dynamics ◽  
Policy Support ◽  
African American Community ◽  
Social Changes ◽  
Disadvantaged Populations ◽  
The Impact

This paper explores African American opinion toward equal opportunity issues using a demographic-attitudinal focus. Previous explorations have focused on black-white opinion comparisons. In this analysis, attitudinal forces, particularly core values, are identified as playing an influential role in policy support. Further, these patterns of values tend to reflect those expressed by whites on similar questions: the more individualistic and conservative one is, the less likely one is to support government intervention on African Americans behalf. In responding to questions concerning governmental responsibility, higher SES African Americans express stronger support than do their lower SES counterparts. This finding suggests that those who are experiencing “glass ceilings” are concerned about government guarantees of equal opportunity, despite their individualistic beliefs. This is inconsistent with previous explorations that analyze these beliefs among disadvantaged populations. The implications of social changes in the African American community and the impact of these changes on opinion dynamics are discussed.

scholarly journals African-American race and mortality in interstitial lung disease: a multicentre propensity-matched analysis

2018 ◽  
Vol 51 (6) ◽  
pp. 1800255 ◽  
Author(s):  
Ayodeji Adegunsoye ◽  
Justin M. Oldham ◽  
Shashi K. Bellam ◽  
Jonathan H. Chung ◽  
Paul A. Chung ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Interstitial Lung Disease ◽  
Propensity Score ◽  
Lung Disease ◽  
Survival Time ◽  
Sensitivity Analyses ◽  
Younger Age ◽  
All Cause Mortality ◽  
African American Race

We studied whether African-American race is associated with younger age and decreased survival time at diagnosis of interstitial lung disease (ILD).We performed a multicentre, propensity score-matched analysis of patients with an ILD diagnosis followed at five US hospitals between 2006 and 2016. African-Americans were matched with patients of other races based on a time-dependent propensity score calculated from multiple patient, physiological, diagnostic and hospital characteristics. Multivariable logistic regression models were used. All-cause mortality and hospitalisations were compared between race-stratified patient cohorts with ILD, and sensitivity analyses were performed.The study included 1640 patients with ILD, 13% of whom were African-American, followed over 5041 person-years. When compared with patients of other races, African-Americans with ILD were younger at diagnosis (56 years versus 67 years), but in the propensity-matched analyses had greater survival (hazard ratio 0.46, 95% CI 0.28–0.77; p=0.003) despite similar risk of respiratory hospitalisations (relative risk 1.04, 95% CI 0.83–1.31; p=0.709), and similar GAP-ILD (gender–age–physiology-ILD) scores at study entry. Sensitivity analyses in a separate cohort of 9503 patients with code-based ILD diagnosis demonstrated a similar association of baseline demographic characteristics with all-cause mortality.We conclude that African-Americans demonstrate a unique phenotype associated with younger age at ILD diagnosis and perhaps longer survival time.

scholarly journals Comparative effectiveness of sitagliptin vs sulphonylureas in older people

2019 ◽  
Vol 48 (5) ◽  
pp. 725-732
Author(s):  
Manuj Sharma ◽  
Irwin Nazareth ◽  
Irene Petersen
Keyword(s):  
Older People ◽  
Comparative Effectiveness ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Age Groups ◽  
Evidence Base ◽  
Lower Proportion ◽  
Multivariate Adjustment ◽  
Younger Age ◽  
Multivariable Regression

Abstract Background two common anti-diabetic treatments used are sitagliptin and sulphonylureas however evidence examining their comparative effectiveness in older people is limited. Objective to evaluate effectiveness of sitagliptin vs sulphonylureas when added to metformin in older (aged ≥75) vs younger people (18–75). Design retrospective cohort study. Setting UK Primary Care. Subjects 2,904 individuals prescribed sitagliptin (223 aged≥75) and 13,683 prescribed sulphonylureas (1,725 aged ≥75). Methods multivariable regression to analyse difference in HbA1c and weight, 12 months after add-on initiation and proportion achieving different glycaemic targets. Results after multivariate adjustment to remove baseline differences, the HbA1c after 12 months of treatment was on average 1 mmol/mol (95%CI −0.7 to 2.8) higher with sitagliptin vs sulphonylureas in older people though this was not statistically significant. The weight however, was significantly lower −1.4 kg (95%CI −2.1 to −0.7) with sitagliptin vs sulphonylureas. A lower proportion prescribed sitagliptin vs sulphonylureas recorded HbA1c < 48 mmol/mol by study end: Odds Ratio 0.63 (95%CI 0.42–0.95). In younger people, similar HbA1c reductions were also observed with both treatments, however weight after 12 months was even lower with sitagliptin vs sulphonylureas: −2.3 kg (95%CI −2.5 to −2.0). Conclusions similar HbA1c reduction was observed when sitagliptin or sulphonylureas were added to metformin in older and younger age-groups. Sitagliptin use led to modest comparative weight loss. There may be greater risk of over-treatment with sulphonylureas evidenced by greater proportion recording HbA1c < 48 mmol/mol by study end. This evidence supporting use of sitagliptin when add-on therapy is selected in older adults should be considered alongside the wider evidence-base and patient-preference.

scholarly journals Housing Insecurity and the Emotional and Physical Health of African Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 335-336
Author(s):  
Aarti Bhat ◽  
August Jenkins ◽  
David Almeida
Keyword(s):  
African American ◽  
African Americans ◽  
Negative Affect ◽  
Physical Health ◽  
The United States ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
African American Adults ◽  
The Impact

Abstract Housing insecurity—or limited and/or unreliable access to quality housing— is a potent on-going stressor that can adversely impact individual well-being. This study extends previous research by investigating the impact of housing insecurity on both the emotional and physical health of aging African American adults using the Midlife in the United States (MIDUS) Refresher oversample of African Americans collected from 2012-2013 (N = 508; M age = 43.02; 57% women). Participants reported on their negative affect, number of chronic health conditions experienced in the last year, and experiences of housing insecurity since the 2008 recession (e.g., homelessness, threatened with foreclosure or eviction, lost home). Negative affect and chronic conditions, respectively, were regressed on housing insecurity, and the potential moderating effect of age was tested. Results showed that housing insecurity was associated with more negative affect (B = 0.05, SE = 0.03, p = .002) and chronic health conditions (B = 0.26, SE = 0.03, p &lt; .001). Additionally, the association between housing insecurity and negative affect was moderated by age (B = -0.11, SE = 0.00, p = .019), such that the effect of housing insecurity on negative affect was stronger for younger adults than for older adults. These results suggest that experiences of insecure housing leave African American adults vulnerable to compromised emotional and physical health, however, the negative effects of housing insecurity may attenuate with age.

Sign in / Sign up

Export Citation Format

Share Document