IMPACT OF RACE, ETHNICITY AND SOCIO-ECONOMIC STATUS ON HEALTH DISPARITIES

Background: Gestational hypertension (GHTN) remains a compelling clinical and public health problem. It can increase risks of intrauterine growth restriction, low-birth weight, and stillbirth. Little is known about whether racial and ethnic minorities and lower socio-economic status (SES) population groups are more vulnerable to GHTN. Hypothesis: We hypothesized that racial and ethnic disparities in GHTN exist beyond the scope of SES-related health disparities. Methods: A case-control study of GHTN was conducted using the data of 114,298 births in the year 2010 in Ohio. The comprehensive births data were obtained from Ohio Department of Health. Cases were identified as those with GHTN. Controls were identified as those without GHTN. Mothers utilizing Medicaid or the Federal Special Supplemental Nutrition Program for Women, Infants and Children were considered of low SES. Odds ratios of GHTN in relation to mother’s race, ethnicity, and SES were obtained using multivariable logistic regression (SAS software), adjusting for known confounders - gestational age, mother’s age, pre-pregnancy and pregnancy smoking status, pre-pregnancy or gestational diabetes, and plurality. Results: GHTN was statistically significantly associated with maternal race and ethnicity, even after adjustment for SES. Compared to non-Hispanic whites, non-Hispanic blacks were more likely to develop GHTN (adjusted OR = 1.867, 95% CI 1.663–2.096, p<0.001), while Asian women were less likely to develop GHTN (adjusted OR = 0.538, 95% CI 0.426–0.679, p<0.001). Hispanic white women were less likely to develop GHTN than non-Hispanic white women, although the difference between them did not reach a conventional p<0.05 level of statistical significance (adjusted OR = 0.651, 95% CI 0.395–1.076, p=0.09). Adjusted for maternal race, ethnicity, age, and known clinical confounders, women of lower SES were more likely to develop GHTN (adjusted OR = 1.475, 95% CI 1.32–1.647, p<0.001). Conclusions: Non-Hispanic black women are at the highest risk of developing GHTN, while Asian women are at the lowest. The Hispanic paradox phenomenon extends to the issue of GHTN. Racial and ethnic disparities cannot be attributed to low SES only; other mechanisms need to be investigated further.

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Race/ethnicity, gender, socio‐economic status: research exploring their effects on child health: a subject review

Ambulatory Child Health ◽

10.1111/j.1467-0658.2000.093-7.pp.x ◽

2000 ◽

Vol 6 (4) ◽

pp. 284-284

Author(s):

Richard Reading

Keyword(s):

Child Health ◽

Economic Status ◽

Socio Economic Status ◽

Race Ethnicity

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Screening for health literacy at an urban academic cancer center.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e19034 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e19034-e19034

Author(s):

Amy Leader ◽

Lauren Waldman ◽

Liana Yocavitch ◽

Ayako Shimada ◽

Rebecca Cammy ◽

...

Keyword(s):

African American ◽

Health Literacy ◽

Economic Status ◽

Cancer Center ◽

Socio Economic Status ◽

Low Health Literacy ◽

The Mean ◽

Race Ethnicity ◽

Literacy Scores ◽

High Health Literacy

e19034 Background: Low health literacy is more prevalent among older adults and minority populations, and it has been linked to excess health care utilization and poor health outcomes in cancer patients. Screening for health literacy may improve communication and care, such that discussions and information can be tailored to patient need. The purpose of this study was to describe health literacy levels and correlates among patients at an urban, NCI-designated cancer center. Methods: In September 2019, we began health literacy screening for each newly diagnosed, English-speaking cancer patient. Patients were categorized as having low, medium, or high health literacy using the BRIEF health literacy screener; results are visible in the EMR. For this analysis, we included patient age, gender, insurance type, race/ethnicity, and socio-economic status (SES), which was calculated using an Area Deprivation Index (ADI) ranging from 0 (no deprivation) to 100 (extreme deprivation). Data was summarized using descriptive statistics; ANOVA and Chi-squared tests investigated associations between patient’s health literacy levels and potential correlates. Results: Among 284 patients, 68%, (n = 195) were Caucasian, 25% (n = 70) were African American and 7%, (n = 19) identified as Hispanic, Asian American or some other race. Seventy-five percent (n = 211) were male; the mean age was 63 years (SD: 12). The mean ADI was 42 (SD: 28), indicating a low to moderate SES. Seventy percent (n = 200) had a high health literacy score, 20% (n = 57) had a medium score, and 10% (n = 27) had a low health literacy score. Only a patient’s race/ethnicity and the ADI were significantly associated with their health literacy score. Seventy-seven percent of Caucasian patients had high health literacy scores compared to 59% of African American patients and 48% patients of Hispanic, Asian or some other origin (P < .001). Patients with low health literacy had an ADI score (65.1) that was almost double the score of patients with high health literacy scores (38.5) (p < .001). Conclusions: Roughly one-third of patients seen at this urban cancer center did not have a high health literacy score. Socio-economic status was a stronger correlate to health literacy than patient age, marital status, or insurance type. EMRs should capture a patient’s SES in some manner, as this is strongly associated with health literacy.

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Prevalence and patterns of cooking dinner at home in the USA: National Health and Nutrition Examination Survey (NHANES) 2007–2008

Public Health Nutrition ◽

10.1017/s1368980013002589 ◽

2013 ◽

Vol 17 (5) ◽

pp. 1022-1030 ◽

Cited By ~ 53

Author(s):

Senbagam Virudachalam ◽

Judith A Long ◽

Michael O Harhay ◽

Daniel E Polsky ◽

Chris Feudtner

Keyword(s):

National Health ◽

Economic Status ◽

Household Wealth ◽

Nutrition Examination Survey ◽

Foreign Born ◽

Socio Economic Status ◽

Health And Nutrition ◽

The Usa ◽

Race Ethnicity ◽

At Home

AbstractObjectiveTo measure the prevalence of cooking dinner at home in the USA and test whether home dinner preparation habits are associated with socio-economic status, race/ethnicity, country of birth and family structure.DesignCross-sectional analysis. The primary outcome, self-reported frequency of cooking dinner at home, was divided into three categories: 0–1 dinners cooked per week (‘never’), 2–5 (‘sometimes’) and 6–7 (‘always’). We used bivariable and multivariable regression analyses to test for associations between frequency of cooking dinner at home and factors of interest.SettingThe 2007–2008 National Health and Nutrition Examination Survey (NHANES).SubjectsThe sample consisted of 10 149 participants.ResultsAmericans reported cooking an average of five dinners per week; 8 % never, 43 % sometimes and 49 % always cooked dinner at home. Lower household wealth and educational attainment were associated with a higher likelihood of either always or never cooking dinner at home, whereas wealthier, more educated households were more likely to sometimes cook dinner at home (P < 0·05). Black households cooked the fewest dinners at home (mean = 4·4, 95 % CI 4·2, 4·6). Households with foreign-born reference persons cooked more dinners at home (mean = 5·8, 95 % CI 5·7, 6·0) than households with US-born reference persons (mean = 4·9, 95 % CI 4·7, 5·1). Households with dependants cooked more dinners at home (mean = 5·2, 95 % CI 5·1, 5·4) than households without dependants (mean = 4·6, 95 % CI 4·3, 5·0).ConclusionsHome dinner preparation habits varied substantially with socio-economic status and race/ethnicity, associations that likely will have implications for designing and appropriately tailoring interventions to improve home food preparation practices and promote healthy eating.

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Food shopping behaviours and exposure to discrimination

Public Health Nutrition ◽

10.1017/s136898001300075x ◽

2013 ◽

Vol 17 (5) ◽

pp. 1167-1176 ◽

Cited By ~ 28

Author(s):

Shannon N Zenk ◽

Amy J Schulz ◽

Barbara A Israel ◽

Graciela Mentz ◽

Patricia Y Miranda ◽

...

Keyword(s):

African American ◽

Food Environment ◽

Economic Status ◽

Grocery Store ◽

Food Environments ◽

Cross Sectional ◽

Socio Economic Status ◽

Food Shopping ◽

Unfair Treatment ◽

Race Ethnicity

AbstractObjectiveThe present study examined food shopping behaviours, particularly distance to grocery shop, and exposure to discrimination.DesignCross-sectional observational study utilizing data from a community survey, neighbourhood food environment observations and the decennial census.SettingThree communities in Detroit, Michigan, USA.SubjectsProbability sample of 919 African-American, Latino and white adults in 146 census blocks and sixty-nine census block groups.ResultsOn average, respondents shopped for groceries 3·1 miles (4·99 km) from home, with 30·9 % shopping within 1 mile (1·61 km) and 22·3 % shopping more than 5 miles (8·05 km) from home. Longer distance to shop was associated with being younger, African-American (compared with Latino), a woman, higher socio-economic status, lower satisfaction with the neighbourhood food environment, and living in a neighbourhood with higher poverty, without a large grocery store and further from the nearest supermarket. African-Americans and those with the lowest incomes were particularly likely to report unfair treatment at food outlets. Each mile (1·61 km) increase in distance to shop was associated with a 7 % increase in the odds of unfair treatment; this relationship did not differ by race/ethnicity.ConclusionsThe study suggests that unfair treatment in retail interactions warrants investigation as a pathway by which restricted neighbourhood food environments and food shopping behaviours may adversely affect health and contribute to health disparities. Efforts to promote ‘healthy’ and equitable food environments should emphasize local availability and affordability of a range of healthy food products, as well as fair treatment while shopping regardless of race/ethnicity or socio-economic status.

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