scholarly journals Racial/Ethnic Disparities in Hospital Admissions from COVID-19 and Determining the Impact of Neighborhood Deprivation and Primary Language.

2020 ◽  
Author(s):  
Nicholas E Ingraham ◽  
Laura N. Purcell ◽  
Basil S. Karam ◽  
R. Adams Dudley ◽  
Michael G. Usher ◽  
...  
Keyword(s):  
Minority Groups ◽  
The United States ◽  
Competing Risk ◽  
Minority Populations ◽  
Primary Language ◽  
Neighborhood Deprivation ◽  
English Speaking ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

Background Despite past and ongoing efforts to achieve health equity in the United States, persistent disparities in socioeconomic status along with multilevel racism maintain disparate outcomes and appear to be amplified by COVID-19. Objective Measure socioeconomic factors and primary language effects on the risk of COVID-19 severity across and within racial/ethnic groups. Design Retrospective cohort study. Setting Health records of 12 Midwest hospitals and 60 clinics in the U.S. between March 4, 2020 to August 19, 2020. Patients PCR+ COVID-19 patients. Exposures Main exposures included race/ethnicity, area deprivation index (ADI), and primary language. Main Outcomes and Measures The primary outcome was COVID-19 severity using hospitalization within 45 days of diagnosis. Logistic and competing-risk regression models (censored at 45 days and accounting for the competing risk of death prior to hospitalization) assessed the effects of neighborhood-level deprivation (using the ADI) and primary language. Within race effects of ADI and primary language were measured using logistic regression. Results 5,577 COVID-19 patients were included, 866 (n=15.5%) were hospitalized within 45 days of diagnosis. Hospitalized patients were older (60.9 vs. 40.4 years, p<0.001) and more likely to be male (n=425 [49.1%] vs. 2,049 [43.5%], p=0.002). Of those requiring hospitalization, 43.9% (n=381), 19.9% (n=172), 18.6% (n=161), and 11.8% (n=102) were White, Black, Asian, and Hispanic, respectively. Independent of ADI, minority race/ethnicity was associated with COVID-19 severity; Hispanic patients (OR 3.8, 95% CI 2.72-5.30), Asians (OR 2.39, 95% CI 1.74-3.29), and Blacks (OR 1.50, 95% CI 1.15-1.94). ADI was not associated with hospitalization. Non-English speaking (OR 1.91, 95% CI 1.51-2.43) significantly increased odds of hospital admission across and within minority groups. Conclusions Minority populations have increased odds of severe COVID-19 independent of neighborhood deprivation, a commonly suspected driver of disparate outcomes. Non-English-speaking accounts for differences across and within minority populations. These results support the continued concern that racism contributes to disparities during COVID-19 while also highlighting the underappreciated role primary language plays in COVID-19 severity across and within minority groups.

A Review of the Validity of Juvenile Risk Assessment Across Race/Ethnicity

2018 ◽  
Author(s):  
Christina Campbell ◽  
William Miller
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Ethnic Minorities ◽  
Minority Groups ◽  
Critical Role ◽  
The United States ◽  
Risk Assessments ◽  
Assessment Instruments ◽  
Race Ethnicity ◽  
Racial Ethnic

Juvenile risk assessment instruments have provided juvenile courts with the opportunity to make standardized decisions concerning sentences and intervention needs. Risk assessments have replaced the reliance on professional decision-making practices in which court officials relied on their hunches or previous experience to determine what to do with youth once they became involved in corrections. A primary goal of juvenile risk assessment is to improve case management and help courts focus resources on juveniles who exhibit the greatest intervention needs. Further, juvenile risk assessments play a critical role in estimating which juveniles will likely reoffend by identifying factors that increase the propensity of future offending. Although some researchers believe that the implementation of standardized juvenile risk assessments is a good strategy for reducing biased decision-making for racial/ethnic minorities, other researchers have called into question the extent to which risk assessments overestimate risk for certain juveniles, especially those in minority groups who have a history of being marginalized due to their race, culture, or ethnicity. This article provides an overview of how well juvenile risk assessment instruments predict future delinquency across race and ethnicity. The review suggests that in general, risk assessments do a good job in predicting recidivism across racial/ethnic groups for diverse populations inside and outside the United States. However, there is still some room for improvement concerning the assessment of risk and needs for ethnic minorities. In addition, while there are some studies that do not report the predictive validity of risk assessment scores across race/ethnicity, risk assessments overall seem to be a promising effort to correctly classify and/or identify juveniles who are at greatest risk for future recidivism.

Impact of Ethnicity On Incidence and Survival Among Adults with Acute Lymphoblastic Leukemia in the United States; Insights From 2005 SEER Data.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3069-3069
Author(s):  
Casey L O'Connell ◽  
Pedram Razavi ◽  
Roberta McKean-Cowdin ◽  
Malcolm C. Pike
Keyword(s):  
T Cell ◽  
B Cell ◽  
Ethnic Groups ◽  
Lymphoblastic Leukemia ◽  
The United States ◽  
Incidence Rates ◽  
The Us ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

Abstract Abstract 3069 Poster Board III-6 Background Acute lymphoblastic leukemia (ALL) is an aggressive malignancy whose incidence declines through adolescence and then increases steadily with age. Prognosis appears to be inversely related to age among adults. We sought to explore the impact of race/ethnicity on incidence and survival among adults with ALL in the United States (US). Methods We examined trends in incidence and survival among adults with ALL in the US using the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program which includes data from 17 SEER registries. We calculated the incidence rates for the most recent time period (2001-2005) because the classification for ALL subtypes was more complete during this time. For the survival analysis we used the data collected between 1975 and 2005. We categorized race/ethnicity into 5 mutually exclusive categories: non-Hispanic whites (NHW), Hispanic whites (HW), African Americans (AA), Asian/Pacific Islanders (API) and American Indians/Native Alaskans (AI/NA). Hispanic ethnicity was defined using SEER's Hispanic-origin variable which is based on the NAACCR Hispanic Identification Algorithm (NHIA); 11 patients dually coded as black and Hispanic were included in the AA group for our analyses. Few ALL cases were identified among AI/NA, so that group is not represented in the final analyses. We included ALL cases coded in the SEER registry using the International Classification of Disease for Oncology (ICD-0-3) as 9827-9829 and 9835-9837. We excluded cases of Burkitt's leukemia (n=228), cases that were not confirmed by microscopic or cytologic tests (n=132), cases that were reported only based on autopsy data (n=3) and cases whose race/ethnicity were unknown (n=20). The average annual incidence rates per 100,000 for 2001-2005, age-adjusted to the 2000 US standard population were calculated using SEER*Stat Version 6.4.4 statistical software. We used multivariate Cox hazard models stratified by SEER registry and age category to estimate the hazard ratios (HR) and 95% confidence intervals (95% CI) for relative survival of adult ALL cases across race/ethnicity, sex and cell of origin (B- or T-cell). All models were adjusted for the diagnosis era, and use of non-CNS radiation. The model also included an interaction term for age and diagnosis era. We performed a separate stratified analysis of the impact of race/ethnicity on survival within age subgroups (20-29, 30-39, 40-59, 60-69, 70+). Results The highest incidence rate (IR) of ALL was observed for HW (IR: 1.60; 95% CI: 1.43-1.79). HW had a significantly higher IR across all age categories as compared to the other racial/ethnic groups, while AA had the lowest IR. In particular, the observed rate of B-cell ALL among HW (IR 0.77; 95% CI 0.69-0.87) was more than twice that of NHW (IR: 0.29; 95% CI: 0.27-0.32) and more than three times the rate observed among AA (IR: 0.20; 95% CI: 0.15-0.26). In contrast, we did not observe statistically significant variability in the rates of T-cell ALL across race/ethnic groups (overall IR: 0.12; 95% CI: 0.11-0.14). Survival was significantly poorer among AA (HR: 1.26; 95% CI: 1.09-1.46), HW (HR: 1.21; 95% CI: 1.09-1.46), and API (HR: 1.18; 95% CI: 1.06-1.32) compared to NHW with all subtypes of ALL. Among adults younger than 40 with B-cell ALL, survival was significantly poorer among AA (HR: 1.60; 95% CI:1.021-2.429) and HW (HR: 1.53; 95% CI:1.204-1.943) with a non-signficant trend among API (HR: 1.22; 95% 0.834-1.755) compared to NHW. Survival differences between the different racial/ethnic groups were no longer statistically significant among adults with B-cell ALL over the age of 40. For T-cell ALL, survival was significantly poorer among AA (HR: 1.61; 95% CI: 1.22-2.10), HW (HR: 1.49; 95% CI: 1.14-1.93) and API (HR: 1.57; 95% CI: 1.13-2.13), as compared to NHW. A similar survival pattern by age (adults above and below age 40 years) was observed for T-cell as described for B-cell, with AA under 40 having a particularly dismal prognosis (HR: 2.89; 95% CI 1.96-4.17) compared to NHW. Conclusions The incidence rate of B-cell ALL among adults in the US is higher among HW than other ethnic groups. Survival is significantly poorer among AA and HW than among NHW under the age of 40 with B-cell ALL. Survival is also significantly poorer among AA, HW and API than among NHW with T-cell ALL in adults under 40. Survival trends appear to converge after the age of 40 among all racial/ethnic groups. Disclosures No relevant conflicts of interest to declare.

Immigration and Neighborhood Change: Methodological Possibilities for Future Research

2017 ◽  
Vol 16 (3) ◽  
pp. 244-251 ◽  
Author(s):  
Ariela Schachter ◽  
Max Besbris
Keyword(s):  
United States ◽  
Rental Housing ◽  
The United States ◽  
Neighborhood Change ◽  
Future Research ◽  
Online Data ◽  
Race Ethnicity ◽  
The Impact ◽  
Housing Options ◽  
Racial Ethnic

The recent settlement of immigrant populations into a wider range of geographies and communities across the United States raises new questions about the dynamics of residential segregation and complicates assumptions about how neighborhoods change—or don't—and why. While multiple theories attempt to explain the relationship between race/ethnicity, immigration, and neighborhood change, sociological examinations have been limited by the lack of systematic and frequently collected data. That is, the residential churn of neighborhoods, particularly in the market for rental housing where racial/ethnic minorities and immigrants predominate, often outpaces analysts’ ability to gather cross–neighborhood and cross–city data. In this essay we describe how online sources can help answer questions about race/ethnicity, immigration, and neighborhoods by providing large amounts of readily updatable data. An array of platforms designed to provide homeseekers with information about their housing options can also be used by sociologists for making claims about neighborhood change across multiple geographies. We review recent research that uses online data and describe an ongoing study by the authors that examines trends in the settlement patterns of immigrants and the rental housing market across the 50 largest MSAs in the United States. Online data sources can more accurately capture immigration and neighborhood processes, yielding better theories about the impact of immigration on neighborhood change.

scholarly journals Race/ethnicity in systemic AL amyloidosis: perspectives on disease and outcome disparities

2020 ◽  
Vol 10 (11) ◽  
Author(s):  
Andrew Staron ◽  
Lawreen H. Connors ◽  
Luke Zheng ◽  
Gheorghe Doros ◽  
Vaishali Sanchorawala
Keyword(s):  
Minority Groups ◽  
Ethnic Disparities ◽  
Sociodemographic Factors ◽  
Al Amyloidosis ◽  
Advocacy Groups ◽  
Disease Characteristics ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic ◽  
Hispanic White

Abstract In marked contrast to multiple myeloma, racial/ethnic minorities are underrepresented in publications of systemic light-chain (AL) amyloidosis. The impact of race/ethnicity is therefore lacking in the narrative of this disease. To address this gap, we compared disease characteristics, treatments, and outcomes across racial/ethnic groups in a referred cohort of patients with AL amyloidosis from 1990 to 2020. Among 2416 patients, 14% were minorities. Non-Hispanic Blacks (NHBs) comprised 8% and had higher-risk sociodemographic factors. Hispanics comprised 4% and presented with disproportionately more BU stage IIIb cardiac involvement (27% vs. 4–17%). At onset, minority groups were younger in age by 4–6 years. There was indication of more aggressive disease phenotype among NHBs with higher prevalence of difference between involved and uninvolved free light chains >180 mg/L (39% vs. 22–33%, P = 0.044). Receipt of stem cell transplantation was 30% lower in Hispanics compared to non-Hispanic White (NHWs) on account of sociodemographic and physiologic factors. Although the age/sex-adjusted hazard for death among NHBs was 24% higher relative to NHWs (P = 0.020), race/ethnicity itself did not impact survival after controlling for disease severity and treatment variables. These findings highlight the complexities of racial/ethnic disparities in AL amyloidosis. Directed efforts by providers and advocacy groups are needed to expand access to testing and effective treatments within underprivileged communities.

scholarly journals The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States

2021 ◽  
Vol 18 (4) ◽  
pp. 1384
Author(s):  
Whitney E. Zahnd ◽  
Cathryn Murphy ◽  
Marie Knoll ◽  
Gabriel A. Benavidez ◽  
Kelsey R. Day ◽  
...  
Keyword(s):  
Access To Care ◽  
Ethnic Minority ◽  
Data Access ◽  
The United States ◽  
Cancer Disparities ◽  
Treatment Modalities ◽  
Minority Populations ◽  
Race Ethnicity ◽  
Ethnic Minority Populations ◽  
Racial Ethnic

One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There is a critical need for additional research to understand the disparities experienced by all rural racial/ethnic minority populations. We propose that policies aim to increase access to care and healthcare resources for these communities. Further, that observational and interventional research should more effectively address the intersections of rurality and race/ethnicity through reduced structural and interpersonal biases in cancer care, increased data access, more research on newer cancer screening and treatment modalities, and continued intervention and implementation research to understand how evidence-based practices can most effectively reduce disparities among these populations.

Abstract P059: Multiple Cause-of-Death Analysis Reveals Under Reporting of Disease Burden for Diabetes

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Katherine G Hastings ◽  
Jiaqi Hu ◽  
Nadejda Marques ◽  
Eric J Daza ◽  
Mark Cullen ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Minority Populations ◽  
Race Ethnicity ◽  
Underlying Cause Of Death ◽  
The Impact ◽  
Racial Ethnic ◽  
The U.S

Introduction: Despite being considerably under reported as the underlying cause of death on death certificates, and consequently on mortality figures, diabetes is among the ten leading causes of death in the U.S. A multiple cause-of-death analysis shows the extent to which diabetes is associated with other leading causes of death. Hypothesis: Analysis of multiple-cause-of-death will confirm prevalence rates of diabetes among racial/ethnic minority populations, demonstrate the impact of diabetes in association with other causes of death, and highlight variations of burden of disease among different racial/ethnic groups. Methods: Causes of death were identified using the Multiple Cause Mortality Files of the National Center for Health Statistics from 2003 to 2012. Age-adjusted mortality rates were calculated for diabetes both as the underlying cause of death (UCD) and as multiple causes of death (MCD) by racial/ethnic groups (NHWs, Blacks, Asians, and Hispanic/Latinos). Frequencies and proportions were calculated by race/ethnicity groups. Linear regression model was used for number of causes per death. Results: A total of 2,335,198 decedents had diabetes listed as MCD in the U.S. national death records from 2003-2012. Mortality rates of diabetes as MCD were 3.4 times than UCD for Asians, 2.9 times for Blacks, 2.9 times for Hispanics and 3.7 times for NHWs (Figure). Minority populations had higher proportion of deaths with diabetes reported as MCD than NHWs (1.7 times higher for Hispanics, 1.5 times higher for Blacks and Asians). Adjusting for age, gender, and race/ethnicity, there were 1.7 more causes per death co-occurred for diabetes decedents compared to decedents who died due to all other causes (95% CI: 1.714, 1.718). Conclusions: Our findings underscore the importance of a multiple-cause-of-death approach in the analyses for a more comprehensive understanding of the impact of diabetes.

scholarly journals Population Age-Ineligible for COVID-19 Vaccine in the United States: Implications for State, County, and Race/Ethnicity Vaccination Targets

2021 ◽  
Author(s):  
Elizabeth B. Pathak ◽  
Janelle Menard ◽  
Rebecca Garcia
Keyword(s):  
American Indians ◽  
Minority Groups ◽  
Vaccine Coverage ◽  
The United States ◽  
Census Bureau ◽  
Vaccine Hesitancy ◽  
Race Ethnicity ◽  
Us Census ◽  
Racial Ethnic ◽  
The U.S

ABSTRACTBackgroundWe examined the geographic and racial/ethnic distribution of the SARS-CoV-2 vaccine age-ineligible population (0-15 years old) in the U.S., and calculated the proportion of the age-eligible population that will need to be vaccinated in a given geo-demographic group in order to achieve either 60% or 75% vaccine coverage for that population as a whole.MethodsUS Census Bureau population estimates for 2019 were used to calculate the percent vaccine ineligible and related measures for counties, states, and the nation as a whole. Vaccination targets for the 30 largest counties by population were calculated. Study measures were calculated for racial/ethnic populations at the national (n=7) and state (n=6) levels.ResultsPercent of population ineligible for vaccine varied widely both geographically and by race/ethnicity. State values ranged from 15.8% in Vermont to 25.7% in Utah, while percent ineligible of the major racial/ethnic groups was 16.4% of non-Hispanic whites, 21.6% of non-Hispanic Blacks, and 27.5% of Hispanics. Achievement of total population vaccine coverage of at least 75% will require vaccinating more than 90% of the population aged 16 years and older in 29 out of 30 of the largest counties in the U.S.ConclusionsThe vaccine-ineligibility of most children for the next 1-2 years, coupled with reported pervasive vaccine hesitancy among adults, especially women and most minorities, means that achievement of adequate levels of vaccine coverage will be very difficult for many vulnerable geographic areas and for several racial/ethnic minority groups, particularly Hispanics, Blacks, and American Indians.

scholarly journals Racial Disparities in Virologic Failure and Tolerability During Firstline HIV Antiretroviral Therapy

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Priya Bhagwat ◽  
Shashi N Kapadia ◽  
Heather J Ribaudo ◽  
Roy M Gulick ◽  
Judith S Currier
Keyword(s):  
Antiretroviral Therapy ◽  
Adverse Events ◽  
Socioeconomic Factors ◽  
Ethnic Groups ◽  
Virologic Failure ◽  
Virologic Suppression ◽  
Factors Associated ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

Abstract Background Racial/ethnic disparities in HIV outcomes have persisted despite effective antiretroviral therapy. In a study of initial regimens, we found viral suppression varied by race/ethnicity. In this exploratory analysis, we use clinical and socioeconomic data to assess factors associated with virologic failure and adverse events within racial/ethnic groups. Methods Data were from AIDS Clinical Trial Group A5257, a randomized trial of initial regimens with either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir (each combined with tenofovir DF and emtricitabine). We grouped participants by race/ethnicity and then used Cox-proportional hazards regression to examine the impact of demographic, clinical, and socioeconomic factors on the time to virologic suppression and time to adverse event reporting within each racial/ethnic group. Results We analyzed data from 1762 participants: 757 self-reported as non-Hispanic black (NHB), 615 as non-Hispanic white (NHW), and 390 as Hispanic. The proportion with virologic failure was higher for NHB (22%) and Hispanic (17%) participants compared with NHWs (9%). Factors associated with virologic failure were poor adherence and higher baseline HIV RNA level. Prior clinical AIDS diagnosis was associated with virologic failure for NHBs only, and unstable housing and illicit drug use for NHWs only. Factors associated with adverse events were female sex in all groups and concurrent use of medications for comorbidities in NHB and Hispanic participants only. Conclusions Clinical and socioeconomic factors that are associated with virologic failure and tolerability of antiretroviral therapy vary between and within racial and ethnic groups. Further research may shed light into mechanisms leading to disparities and targeted strategies to eliminate those disparities.

scholarly journals Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

2021 ◽  
Vol 18 (6) ◽  
pp. 2921
Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  
Keyword(s):  
United States ◽  
District Of Columbia ◽  
Ethnic Disparities ◽  
The United States ◽  
Attributable Mortality ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Degree Of Association ◽  
Racial Ethnic

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

Overeducation and the Earnings of Black, Hispanic, and White Male Workers

1988 ◽  
Vol 31 (2) ◽  
pp. 190-212 ◽  
Author(s):  
Richard R. Verdugo ◽  
Naomi Turner Verdugo
Keyword(s):  
United States ◽  
Mexican Americans ◽  
Minority Groups ◽  
Puerto Ricans ◽  
White Male ◽  
The United States ◽  
Using Data ◽  
The Impact ◽  
Male Workers ◽  
White Minority

This study addresses two issues: (1) the impact of overeducation on the earnings of male workers in the United States, and (2) white-minority earnings differences among males. Given that educational attainment levels are increasing among workers, there is some suspicion that earnings returns to education are not as great as might be expected. This topic is examined by including an overeducation variable in an earnings function. Regarding the second issue addressed in this article, little is actually known about white-minority differences because the bulk of such research compares whites and blacks. By including selected Hispanic groups in this analysis (Mexican Americans, Puerto Ricans, Cubans, and Other Hispanics) we are able to assess white-minority earnings differences to a greater degree. Using data from a 5% sample of the 1980 census to estimate an earnings function, we find that overeducated workers earn less than either undereducated or adequately educated workers. Second, we find that there are substantial earnings differences between whites and minorities, and, also, between the five minority groups examined.

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