0377 A Strengths-Based Approach to Examine Obstructive Sleep Apnea in Black and White Patients

Abstract Introduction The majority of studies on race/ethnic disparities in OSA are derived from a deficit-based perspective (i.e. >BMI, non-adherence to PAP). It would prove useful to identify which aspects are protective to inform potential treatment approaches. We focused on two potential factors: resilience and social support, in patients newly diagnosed with OSA. Given the high prevalence of insomnia complaints in patients with OSA, insomnia was our outcome of interest. Methods 91 patients newly diagnosed with OSA provided demographic and socioeconomic status, sleep measures (Epworth, DBAS), resilience (Connor Davidson Resiliency Scale), social support (MOS Social Support Scale) and completed the Insomnia Severity Index. The cross-sectional associations between ISI, race/ethnicity, resilience, social support and their interaction effects were examined using linear regression models with covariate adjustment for participant age, sex and BMI. We ascertained total ISI score and individual items. Results The sample was 34.1% black (n=31), mean age of 57.6 years, SD=13.6, 64.8% male (n=59), and mean BMI of 32.4, SD=7.04. Mean sleep duration (as reported by sleep diary) was 6.64, SD=1.35. Black, white differences were not observed for sleepiness (M=8.60; 10.43, p=0.11) or DBAS (M=4.61; M=5.04, p=0.30). Blacks, reported clinically significant insomnia (M=15.00, SD=7.17) compared to whites (M=12.02, SD=6.83, p=0.05). On the individual ISI items, blacks were significantly more likely to endorse difficulty falling asleep (M=1.58, SD=1.54; M=0.75, SD=0.93,p=0.002) and waking up too early (M=2.09, SD=1.26; M=1.45, SD=0.93,p=0.021) compared to whites. Resilience (M=30.04, SD=6.42) and social support scores (M=74.13, SD=21.36) did not differ by race/ethnicity. In adjusted linear analysis, resilience had significant effect on ISI score (b=-0.36, SE=0.12, p=0.003) but not social support (b=-0.06, SE=0.08, p=0.31). Conclusion In this study we did not observe race/ethnic differences for sleepiness and dysfunctional beliefs about sleep. With respect to the protective factors, race/ethnic differences were not observed. Resilience, not social support, was related to insomnia complaints. Future studies should examine a variety of factors that may serve black and other racial/ethnic groups with OSA, and help elucidate protective processes. Support K23HL125939

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RACE/ETHNICITY AND U.S. ADULT MORTALITY

Du Bois Review Social Science Research on Race ◽

10.1017/s1742058x11000051 ◽

2011 ◽

Vol 8 (1) ◽

pp. 5-24 ◽

Cited By ~ 46

Author(s):

Robert A. Hummer ◽

Juanita J. Chinn

Keyword(s):

Ethnic Differences ◽

Mexican Americans ◽

Mexican Immigrants ◽

Ethnic Disparities ◽

Adult Mortality ◽

Social Resources ◽

Socioeconomic Resources ◽

Race Ethnicity ◽

Racial Ethnic ◽

Lower Mortality Risk

AbstractAlthough there have been significant decreases in U.S. mortality rates, racial/ethnic disparities persist. The goals of this study are to: (1) elucidate a conceptual framework for the study of racial/ethnic differences in U.S. adult mortality, (2) estimate current racial/ethnic differences in adult mortality, (3) examine empirically the extent to which measures of socioeconomic status and other risk factors impact the mortality differences across groups, and (4) utilize findings to inform the policy community with regard to eliminating racial/ethnic disparities in mortality. Relative Black-White differences are modestly narrower when compared to a decade or so ago, but remain very wide. The majority of the Black-White adult mortality gap can be accounted for by measures of socioeconomic resources that reflect the historical and continuing significance of racial socioeconomic stratification. Further, when controlling for socioeconomic resources, Mexican Americans and Mexican immigrants exhibit significantly lower mortality risk than non-Hispanic Whites. Without aggressive efforts to create equality in socioeconomic and social resources, Black-White disparities in mortality will remain wide, and mortality among the Mexican-origin population will remain higher than what would be the case if that population achieved socioeconomic equality with Whites.

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RACE-ETHNICITY AND HOPELESSNESS IN OLDER AMERICANS: WHO’S AT GREATEST RISK AND WHY?

Innovation in Aging ◽

10.1093/geroni/igz038.1631 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S436-S436

Author(s):

Uchechi Mitchell

Keyword(s):

Ethnic Differences ◽

Structural Factors ◽

Linear Regression Models ◽

Older Americans ◽

Poverty Status ◽

Blacks And Whites ◽

Race Ethnicity ◽

Racial Ethnic ◽

Retirement Study ◽

Over Time

Abstract Racial and ethnic minorities are more likely to experience adversity throughout their lives, which puts them at greater risk feelings of despair and powerlessness. This study uses data from 5,500 respondents from the Health and Retirement Study to assess racial/ethnic differences in hopelessness and test whether older blacks and Hispanics experience greater increases in hopelessness as they age. Hopelessness was assessed using 4-items that capture the extent to which a person has a negative outlook towards the future and believes they are powerlessness to overcome the obstacles they face; it is measured at three time points: 2006/2008, 2010/2012 and 2014/2016. Linear regression models were used to assess differences in hopelessness by race/ethnicity and linear mixed models were used to assess racial/ethnic differences in trajectories of hopelessness over time. Older blacks and Hispanics were more likely to report feelings of hopelessness at each timepoint of the study. Differences between blacks and whites were completely explained by differences in education and poverty status, while differences between Hispanics and whites remained. Although minority elders had higher levels of hopelessness at each time point, older whites experienced steeper increases in hopelessness over time. These findings suggest that structural factors influence feelings of hopelessness among minority elders. However, older blacks and Hispanics may develop resilience to hopelessness as they age.

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0373 Blacks with Obstructive Sleep Apnea Report Greater Nighttime Insomnia Symptoms than Whites, but Don’t Endorse Daytime Impairment

SLEEP ◽

10.1093/sleep/zsaa056.370 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A143-A143

Author(s):

N J Williams ◽

M Butler ◽

J Roseus ◽

A Barnes ◽

J Blanc ◽

...

Keyword(s):

Linear Regression ◽

Repeated Measures ◽

Newly Diagnosed ◽

Sleep Complaints ◽

Obstructive Sleep ◽

Daytime Impairment ◽

Racial Ethnic ◽

Insomnia Complaints ◽

Insomnia Symptoms ◽

Insomnia Severity

Abstract Introduction Few studies have assessed insomnia severity in racial/ethnic minority patients with OSA. In recognition of the burden of OSA in blacks compared to whites, the current study sought to examine insomnia symptoms in a sample of black and white patients newly diagnosed with OSA, prior to treatment, at 3 and 6 months. Methods 94 patients newly diagnosed with OSA provided demographics (age, sex, race/ethnicity), socioeconomic status, and completed the well-known and validated Insomnia Severity Index (ISI). To assess insomnia complaints, we ascertained total ISI score, nighttime sleep complaints, and daytime impairment. Linear regression and repeated measures analysis were conducted. Results Mean age was 57.43 years ±13.55; 63.8% were men and 35% were black. Mean BMI was 32.35±7.04and 35% were diagnosed with hypertension. The mean ISI score for the total sample was 13.06±7.06. The total ISI was significantly higher in blacks than whites, respectively (M=15.00±7.17; M=12.02±6.83, p<0.05) indicating moderate clinical insomnia in blacks, but not whites. In covariate-adjusted linear regression, nighttime complaints were statistically more pronounced in blacks (b=1.71, SE=0.82, p<0.05) and women (b=2.05, SE=0.72, p<0.01). There were no significant racial/ethnic differences with daytime impairment, but gender differences in daytime impairment remained (b=2.93, SE=1.04 p<0.01). Results from repeated measures effects of race over time revealed that blacks had higher nighttime complaints across all time-points (b=2.51, SE=1.10, p<0.05), but we did not observe a race-by-time interaction effect (b=-0.89, SE=0.50). Conclusion For the first time, we observed that overall ISI score and nighttime complaints are more pronounced in blacks than whites. Notably, only women endorsed complaints of daytime impairment. Findings from the study may contribute to understanding who will need treatment for relief of insomnia complaints. Support K23HL125939

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Coping mediates the association between gender and depressive symptomatology in adolescence

International Journal of Behavioral Development ◽

10.1177/0165025415616202 ◽

2016 ◽

Vol 41 (2) ◽

pp. 185-197 ◽

Cited By ~ 11

Author(s):

Ashley M. Malooly ◽

Kaitlin M. Flannery ◽

Christine McCauley Ohannessian

Keyword(s):

Social Support ◽

Ethnic Differences ◽

Depressive Symptomatology ◽

African American Adolescents ◽

Dispositional Coping ◽

Instrumental Social Support ◽

Race Ethnicity ◽

Emotional Social Support ◽

Racial Ethnic

Previous studies have found evidence for gender and racial/ethnic differences in depressive symptoms in adolescence; however, the mechanisms driving this relationship are poorly understood. The goal of this study was to examine the role of individual differences in dispositional coping in the relationships between gender and depressive symptomatology, and race/ethnicity and depressive symptomatology. Surveys were administered to 905 15- and 17-year-old adolescents (mean age 16.10, SD = .67; 54% girls, n = 485) in the spring of 2007, 2008, and 2009. Girls reported more depressive symptomatology than boys and endorsed a greater disposition for the following coping strategies in comparison to boys: emotional social support, instrumental social support, and venting emotions. When race/ethnicity was examined, African-American adolescents reported a greater tendency toward using religious coping than Caucasian and Hispanic adolescents. Dispositional coping preferences also were found to mediate the relationships between gender and depressive symptomatology. These findings indicated that a preference for venting emotions may be particularly problematic when endorsed by girls, whereas instrumental social support may be particularly helpful for girls.

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Prevalence of Chronic Conditions and Multimorbidities in a Geographically Defined Geriatric Population With Diverse Races and Ethnicities

Journal of Aging and Health ◽

10.1177/0898264316680903 ◽

2016 ◽

Vol 30 (3) ◽

pp. 421-444 ◽

Cited By ~ 7

Author(s):

Eunjung Lim ◽

Krupa Gandhi ◽

James Davis ◽

John J. Chen

Keyword(s):

Ethnic Differences ◽

Chronic Conditions ◽

Ethnic Disparities ◽

Prevalence Rates ◽

Older Individuals ◽

Multivariable Logistic Regression Model ◽

Geriatric Population ◽

Race Ethnicity ◽

Racial Ethnic

Objective: The objective of this study is to examine racial/ethnic differences in prevalence of chronic conditions and multimorbidities in the geriatric population of a state with diverse races/ethnicities. Method: Fifteen chronic conditions and their dyads and triads were investigated using Hawaii Medicare 2012 data. For each condition, a multivariable logistic regression model was used to investigate differences in race/ethnicity, adjusting for subject characteristics. Results: Of the 84,212 beneficiaries, 27.8% were Whites, 54.6% Asians, and 5.2% Hispanics. Racial/ethnic disparities were prevalent for most conditions. Compared with Whites, Asians, Hispanics, and Others showed significantly higher prevalence rates in hypertension, hyperlipidemia, diabetes, and most dyads or triads of the chronic conditions. However, Whites had higher prevalence rates in arthritis and dementia. Discussion: Race/ethnicity may need to be considered when making clinical decisions and developing health care programs to reduce health disparities and improve quality of life for older individuals with chronic conditions.

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EPID-19. RACIAL/ETHNIC DISPARITIES IN TREATMENT PATTERN AND TIME TO TREATMENT FOR ADULTS WITH GLIOBLASTOMA IN THE US

Neuro-Oncology ◽

10.1093/neuonc/noaa215.337 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii82-ii82

Author(s):

Quinn Ostrom ◽

Nirav Patil ◽

Gino Cioffi ◽

Jill S Barnholtz-Sloan

Keyword(s):

Access To Health Care ◽

Ethnic Disparities ◽

Treatment Pattern ◽

Linear Regression Models ◽

Time To Treatment ◽

Survival Difference ◽

Race Ethnicity ◽

Receive Treatment ◽

Asian Pacific ◽

To Receive

Abstract BACKGROUND Race/ethnicity have been previously shown to significantly affect survival after diagnosis with glioblastoma, but the cause of this survival difference is not known. The aim of this study was to examine variation in treatment pattern and time to treatment by race/ethnicity, and the extent to which this affects survival. METHODS Data were obtained from the National Cancer Database (NCDB) for adults >= 40 with glioblastoma (histologic codes 9440–9442 and topographical codes C71.0–C71.9) from 2004–2016 (N=117,710). Treatment patterns and time to treatment by race/ethnicity were compared using univariable and multivariable logistic and linear regression models, respectively. Models were adjusted for age, sex, insurance status, pre-existing comorbidities, type of treating institution, and distance to institution. RESULTS Black non-Hispanics (BNH) were 17% less likely to receive radiation (p=1.47x10-8) and 32% less likely to receive chemotherapy (p=1.10x10-31) than White non-Hispanics (WNH). Among those that did receive treatment, it took 3.3 additional days on average for BNH to receive radiation (p=2.12x10-11) and 4.6 additional days to receive chemotherapy in comparison to WNH (p=4.14x10-10). Hispanics were 21% less likely to receive radiation (p=4.79x10-12), and 23% less likely to receive chemotherapy (p=7.51x10-14) than WNH. Among those that did receive treatment, it took 3.3 additional days on average for Hispanics to receive radiation (p=4.07x10-9) and 4 additional days to receive chemotherapy in comparison to WNH (p=1.51x10-6). There were no significant differences in time to surgery, or in to treatment for Asian Pacific Islanders or American Indian/Alaska Natives. CONCLUSIONS Both likelihood of receiving treatment and time to radiation and chemotherapy vary significant between BNH and Hispanics as compared to WNH, and this difference is not fully explained by comorbidities or access to health care.

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Maternal Socioeconomic Factors and Racial/Ethnic Differences in Neonatal Anthropometry

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17197323 ◽

2020 ◽

Vol 17 (19) ◽

pp. 7323

Author(s):

Calvin Lambert ◽

Jessica L. Gleason ◽

Sarah J. Pugh ◽

Aiyi Liu ◽

Alaina Bever ◽

...

Keyword(s):

Marital Status ◽

Socioeconomic Factors ◽

Ethnic Differences ◽

Ethnic Disparities ◽

Low Risk ◽

Abdominal Circumference ◽

Full Time ◽

Socioeconomic Characteristics ◽

Race Ethnicity ◽

Racial Ethnic

Disparities in birthweight by maternal race/ethnicity are commonly observed. It is unclear to what extent these disparities are correlates of individual socioeconomic factors. In a prospective cohort of 1645 low-risk singleton pregnancies included in the NICHD Fetal Growth Study (2009–2013), neonatal anthropometry was measured by trained personnel using a standard protocol. Socioeconomic characteristics included employment status, marital status, health insurance, annual income, and education. Separate adjusted generalized linear models were fit to both test the effect of race/ethnicity and the interaction of race/ethnicity and socioeconomic characteristics on neonatal anthropometry. Mean infant birthweight, length, head circumference, and abdominal circumference all differed by race/ethnicity (p < 0.001). We observed no statistically significant interactions between race/ethnicity and full-time employment/student status, marital status, insurance, or education in association with birthweight, neonatal exam weight, length, or head or abdominal circumference at examination. The interaction between income and race/ethnicity was significant only for abdominal circumference (p = 0.027), with no other significant interactions for other growth parameters, suggesting that racial/ethnic differences in neonatal anthropometry did not vary by individual socioeconomic factors in low-risk women. Our results do not preclude structural factors, such as lifetime exposure to poverty, as an explanation for racial/ethnic disparities.

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Race/ethnic Differences in Post-Stroke Depression (PSD): Findings from the Stroke Warning Information and Faster Treatment (SWIFT) Study

Ethnicity & Disease ◽

10.18865/ed.26.1.1 ◽

2016 ◽

Vol 26 (1) ◽

pp. 1 ◽

Cited By ~ 6

Author(s):

Emily Goldmann ◽

Eric T. Roberts ◽

Nina S. Parikh ◽

Aaron S. Lord ◽

Bernadette Boden-Albala

Keyword(s):

Ethnic Differences ◽

Multinomial Logistic Regression ◽

Prospective Trial ◽

Early Period ◽

Ethnic Disparities ◽

Stroke Patients ◽

Multinomial Logistic Regression Analysis ◽

Post Stroke ◽

Post Stroke Depression ◽

Race Ethnicity

Objectives: Post-stroke depression (PSD) is common and associated with poor stroke outcomes, but few studies have examined race/ethnic disparities in PSD. Given the paucity of work and inconsistent findings in this important area of research, this study aims to examine race/ethnic differences in depression in a multi-ethnic cohort of stroke patients.Design: Longitudinal.Setting: Prospective trial of a post-stroke educational intervention.Patients or Participants: 1,193 mild/moderate ischemic stroke/TIA patients.Main Outcome Measures: We used the Center for Epidemiologic Studies Depression (CES-D) Scale to assess subthreshold (CES-D score 8-15) and full (CES-D score ≥ 16) depression at one month (“early”) and 12 months (“late”) following stroke. Multinomial logistic regression analysis examined the association between race/ethnicity and early and late PSD separately.Results: The prevalence of subthreshold and full PSD was 22.5% and 32.6% in the early period and 22.0% and 27.4% in the late period, respectively. Hispanics had 40% the odds of early full PSD compared with non-Hispanic Whites after adjusting for other covariates (OR=0.40, 95% CI: 0.22, 0.76). Race/ethnicity was not significantly associated with late PSD.Conclusions: Hispanic stroke patients had half the odds of PSD in early period compared with whites, but no difference was found in the later period. Further studies comparing trajectories of PSD between race/ethnic groups may further our understanding of race/ethnic disparities in PSD and help identify effective interventions. Ethn Dis. 2016;26(1):1-8; doi:10.18865/ed.26.1.1

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RACIAL AND ETHNIC DIFFERENCES BETWEEN GRIP STRENGTH AND FUNCTIONAL LIMITATIONS: RESULTS FROM NHATS 2010-2014

Innovation in Aging ◽

10.1093/geroni/igz038.2520 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S682-S683

Author(s):

Elizabeth Vasquez ◽

Ana R Quiñones ◽

Lenore Gensburg

Keyword(s):

Older Adults ◽

Grip Strength ◽

Ethnic Differences ◽

Functional Limitations ◽

Functional Limitation ◽

Linear Regression Models ◽

Racial And Ethnic Differences ◽

Race Ethnicity ◽

And Gender ◽

Racial Ethnic

Abstract Current research regarding grip strength highlights the robustness of grip strength as a predictor of morbidity and mortality. The aim of this study was to evaluate the association of grip strength over four years with functional limitations among racially/ethnically diverse older adults. We analyzed National Health and Aging Trends Study (NHATS) data 2010-2014. Our sample included 4,413 adults > 65 years old. Functional limitation was defined as a sum of difficulty performing eight ADL/IADLs (range 0-8) at each wave. Grip strength was measured using a digital hand dynamometer and readings were recorded in kilograms (kg) (maximum of 32 kg for men and > 20 kg for women). We estimated stratified linear regression models by race/ethnicity and age, and adjusted for BMI, education, and gender. The majority of the sample was between 65-79 years of age (64%), 55.1% were female and the average BMI was 27.5. We found that differences in ADL/IADL limitations increased and grip strength decreased over the four year period of observation. We also found racial/ethnic differences between waves 1 and 4 with greater ADL/IADL limitations for Hispanics with lower grip strength scores compared to non-Hispanic whites. There were racial/ethnic differences in the association between grip strength and ADL/IADL over time in Non-Hispanic blacks and Hispanics when compared to Non-Hispanic whites. This is an important issue to address since loss of muscle strength in older adults may lead to several negative outcomes such as limited activities of daily living which may affect older adults differentially based on race/ethnicity.

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Disparities by Gender and Race/Ethnicity in Child Maltreatment and Memory Performance

Journal of Interpersonal Violence ◽

10.1177/08862605211015222 ◽

2021 ◽

pp. 088626052110152

Author(s):

Monique J. Brown ◽

Yanping Jiang ◽

Peiyin Hung ◽

Mohammad Rifat Haider ◽

Elizabeth Crouch

Keyword(s):

Sexual Abuse ◽

Child Maltreatment ◽

Memory Performance ◽

Ethnic Disparities ◽

Public Health Issue ◽

Adult Health ◽

Linear Regression Models ◽

Gender And Race ◽

Race Ethnicity ◽

Racial Ethnic

Adverse childhood experiences, which include child maltreatment, are a major public health issue nationally. Child maltreatment has been linked to poorer cognitive functioning, which can start in childhood and persist into adulthood. However, studies examining the potential disparities by gender and race/ethnicity are lacking. The aim of this study was to assess the gender and racial/ethnic disparities in the association between child maltreatment and memory performance. Data were obtained from Waves III and IV of the National Longitudinal Study of Adolescent to Adult Health ( N = 11,624). Weighted multiple linear regression models were used to assess the associations between sexual abuse, physical abuse, neglect, and child maltreatment score and memory. Models were stratified by gender, race, and ethnicity. Men who were exposed to sexual abuse, neglect and two or three child maltreatment types scored one to three points lower (β = –1.44; 95% CI: –2.83, –0.06; β = –2.41; 95% CI: –3.75, –1.08; β = –3.35; 95% CI: –5.33, –1.37; β = –2.31; 95% CI: –3.75, –0.86) in memory performance compared to men who did not report sexual abuse, neglect, or child maltreatment, respectively. Black respondents who were exposed to sexual abuse scored two points lower (β = –1.62; 95% CI: –2.80, –0.44) in memory performance compared to Black respondents who did not report sexual abuse. Among Other race and Hispanic respondents, those who reported neglect scored four points lower (β = –4.06; 95% CI: –6.47, –1.66; β = –4.15; 95% CI: –5.99, –2.30) in memory performance, respectively, compared to their counterparts who did not report neglect. Gender- and racial/ethnic-responsive memory performance interventions addressing child maltreatment may be beneficial for affected populations.

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