Abstract MP32: Race-sex differences in hyperlipidemia awareness, treatment and control in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Monika M Safford ◽  
Paul Muntner ◽  
Raegan Durant ◽  
Stephen Glasser ◽  
Christopher Gamboa ◽  
...  
Keyword(s):  
Sex Differences ◽  
Black Women ◽  
Black Men ◽  
Racial Differences ◽  
White Women ◽  
White Men ◽  
Risk Category ◽  
Chd Risk ◽  
And Control ◽  
Risk Categories

Introduction: To identify potential targets for eliminating disparities in cardiovascular disease outcomes, we examined race-sex differences in awareness, treatment and control of hyperlipidemia in the REGARDS cohort. Methods: REGARDS recruited 30,239 blacks and whites aged ≥45 residing in the 48 continental US between 2003-7. Baseline data were collected via telephone interviews followed by in-home visits. We categorized participants into coronary heart disease (CHD) risk groups (CHD or risk equivalent [highest risk]; Framingham Coronary Risk Score [FRS] >20%; FRS 10-20%; FRS <10%) following the 3 rd Adult Treatment Panel. Prevalence, awareness, treatment and control of hyperlipidemia were described across risk categories and race-sex groups. Multivariable models examined associations for hyperlipidemia awareness, treatment and control between race-sex groups compared with white men, adjusting for predisposing, enabling and need factors. Results: There were 11,677 individuals at highest risk, 847 with FRS >20%, 5791 with FRS 10-20%, and 10,900 with FRS<10%; 43% of white men, 29% of white women, 49% of black men and 43% of black women were in the highest risk category. More high risk whites than blacks were aware of their hyperlipidemia but treatment was 10-17% less common and control was 5-49% less common among race-sex groups compared with white men across risk categories. After multivariable adjustment, all race-sex groups relative to white men were significantly less likely to be treated or controlled, with the greatest differences for black women vs. white men (Table). Results were similar when stratified on CHD risk and area-level poverty tertile. Conclusion: Compared to white men at similar CHD risk, fewer white women, black men and especially black women who were aware of their hyperlipidemia were treated and when treated, they were less likely to achieve control, even after adjusting for factors that influence health services utilization.

scholarly journals COPD in a Population-Based Sample of Never-Smokers: Interactions among Sex, Gender, and Race

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Esme Fuller-Thomson ◽  
Rachel S. Chisholm ◽  
Sarah Brennenstuhl
Keyword(s):  
Black Women ◽  
Black Men ◽  
Racial Differences ◽  
White Women ◽  
Insurance Coverage ◽  
White Men ◽  
Population Based ◽  
Behavioral Risk ◽  
Gender And Race ◽  
Never Smokers

This observational epidemiological study investigates sex/gender and racial differences in prevalence of COPD among never-smokers. Data were derived from the 2012 Center for Disease Control’s Behavioral Risk Factor Surveillance System. The sample consisted of 129,535 non-Hispanic whites and blacks 50 years of age and older who had never smoked. Descriptive and multivariable analyses were conducted, with the latter using a series of logistic regression models predicting COPD status by sex/gender and race, adjusting for age, height, socioeconomic position (SEP), number of household members, marital status, and health insurance coverage. Black women have the highest prevalence of COPD (7.0%), followed by white women (5.2%), white men (2.9%), and black men (2.4%). Women have significantly higher odds of COPD than men. When adjusting for SEP, black and white women have comparably higher odds of COPD than white men (black women OR = 1.66; 99% CI = 1.46, 1.88; white women OR = 1.49; 99% CI = 1.37, 1.63), while black men have significantly lower odds (OR = 0.62; 99% CI = 0.49, 0.79). This research provides evidence that racial inequalities in COPD (or lack thereof) may be related to SEP.

Antibiotic Use in Urban Whites and Blacks: The Minnesota Heart Survey

1992 ◽  
Vol 26 (10) ◽  
pp. 1292-1295 ◽  
Author(s):  
Sandra L. Melnick ◽  
J. Michael Sprafka ◽  
David L. Laitinen ◽  
Roberd M. Bostick ◽  
John M. Flack ◽  
...  
Keyword(s):  
Black Women ◽  
Black Men ◽  
Racial Differences ◽  
White Women ◽  
Response Rate ◽  
White Men ◽  
Female Gender ◽  
Antibiotic Use ◽  
Population Based ◽  
Drug Classes

OBJECTIVE: To assess racial differences in the use of antibiotics, including penicillins, erythromycins, tetracyclines, sulfas, and cephalosporins. DESIGN: Population-based surveys, conducted from 1985 to 1987. SETTING: The seven-county metropolitan area of Minneapolis-St. Paul, MN. PARTICIPANTS: 3127 whites (response rate 68 percent) and 1047 blacks (response rate 65 percent), aged 35–74 years. RESULTS: White women (26 percent of 1625) were more likely to report having taken an antibiotic in the past year than were white men (18 percent of 1502), black women (18 percent of 590), or black men (15 percent of 457). Reported antibiotic usage decreased with increasing age. Black men were more likely than white men to report the use of tetracyclines or sulfas; otherwise, white men reported higher usage prevalences. White women reported higher usage prevalences of all drug classes than black women. CONCLUSIONS: Significant independent predictors of antibiotic use were younger age, white race, and female gender. Potential explanations for these differences include differences in patient access, physician-prescribing behaviors, or both.

Abstract 045: Race-Sex Differences in Risk for Incident Acute Coronary Heart Disease in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Monika M Safford ◽  
Paul Muntner ◽  
Christopher Gamboa ◽  
Ronald Prineas ◽  
Todd Brown ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Sex Differences ◽  
Heart Disease ◽  
Black Men ◽  
Racial Differences ◽  
White Men ◽  
Men And Women ◽  
Chd Risk ◽  
Chd Risk Factors

National death certificate data suggest that racial disparities in acute coronary heart disease (CHD) mortality widened over the past decade for both men and women. To better understand this disparity, we examined black:white race-sex differences in overall, fatal and nonfatal acute CHD incidence in a large national biracial cohort. REGARDS is following 30,239 community-dwellers age ≥;45 years recruited between 2003-7 from 48 states. Recruitment was designed to balance race and sex; the final sample was 55% female and 41% black. Participants are telephoned every 6 months for CVD endpoints, with retrieval of medical records, death certificates, interviews with next-of-kin, and expert adjudication following national consensus recommendations. Acute CHD was defined as definite or probable myocardial infarction (MI) or acute CHD death. Among participants free of CHD at baseline, we examined black:white hazards for incident overall acute CHD, and, separately, fatal and nonfatal acute CHD for men and women through 2008, adjusting incrementally for sampling, sociodemographics and CHD risk factors. The study sample numbered 24,431 with mean age 64.1 (SD±9.3). Over a mean follow-up of 3.4 (maximum 5.9) years, 48.7% (55/113) of black men, 33.0% (38/115) of black women, 23.0% (46/200) of white men and 24.1% (21/87) of white women died at their presentation of acute CHD. Black:white hazard ratios for overall, fatal and nonfatal acute CHD from incrementally adjusted models stratified on sex are presented in the Table. Black men and women had over twice the age-adjusted hazard of incident fatal acute CHD compared to whites, not entirely explained by excess risk factor burden among blacks. Although socio-economic and CHD risk factors among blacks continue to be major contributors to fatal incident acute CHD, known risk factors did not fully explain the disparity between black and white men; causes of the elevated risk among black men need to be better understood if widening CHD mortality disparities are to be reversed.

Abstract 10: Metabolically Healthy Obesity Over 25 Years in the Coronary Artery Risk Development in Young Adults (CARDIA) Study: Race and Sex Differences

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Sarah M Camhi ◽  
Aviva Must ◽  
Philimon N Gona ◽  
Arlene Hankinson ◽  
Andrew Odegaard ◽  
...  
Keyword(s):  
Young Adults ◽  
Sex Differences ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Time Points ◽  
Metabolically Healthy ◽  
Baseline Bmi

Background: Obesity is heterogeneous condition with phenotypic variation. Metabolically healthy obese (MHO) may represent an unstable phenotype which changes over time. MHO duration, or the length of time in MHO, is not well characterized. The purpose is to quantify MHO duration over 25 years and explore possible race/sex differences. Methods: Young adults (baseline ages 18-30 yrs) from CARDIA were included if they were non-obese at baseline, developed obesity (BMI ≥30kg/m 2 ) at any follow-up exam (yrs 7, 10, 15, 20 and 25), and had complete data for metabolic status, age, race and sex (n=702). MHO was defined as obese (BMI ≥30 kg/m 2 ) and having either 0 or 1 risk factor of the following: ≥SBP/DBP 130/85 mmHg; glucose ≥100 mg/dL; triglycerides (≥150 mg/dL); and HDL-C (men <40, women <50 mg/dL). Obese individuals with ≥2 risk factors were classified as metabolically unhealthy obese (MUO). MHO duration (yrs) and obesity duration (yrs) were estimated for subsequent time-points; and a duration sum was calculated for the follow-up period. For two time-points in which a person remained MHO and obese, a duration for that period was assigned. If they transitioned to MUO or non-obese, then the midpoint of the time period was estimated as MHO duration (yrs). MHO duration was also expressed as the percentage (%) of the total obesity duration. Multivariable adjusted ANCOVA was used to compare MHO duration (%) between race and sex groups (black men, white men, black women and white women), adjusting for baseline age, baseline BMI status (normal weight or overweight). Results: The eligible CARDIA sample was 55% black, 71% women and had a mean (± SD) baseline age of 25.0 ± 3.7 yrs. Duration of obesity was 12.3 ± 6.8 yrs, MHO duration (yrs) was 6.2 ± 5.4 yrs (range: 0 years to 19 yrs), and MHO duration (%) was 51.9 ± 34.8%. After adjusting for age and baseline BMI, MHO duration (%, mean ± SE) was significantly higher in women compared to men within race (black women n=292: 56.3 ± 2.0% vs. black men n=91: 43.3 ± 3.6%, p=0.001; white women n=206: 56.1 ± 2.4% vs. white men n=113: 39.7 ± 3.2%, p <0.0001). No significant differences were found between race groups within gender (black men vs. white men or black women vs. white women). Conclusion: MHO status is a transient phenotype accounting for only approximately half of obesity duration. Women have longer MHO duration compared to men, but differences by race were not apparent. Future research is needed to explore possible modifiable predictors and/or determinants of longer MHO duration in order to maintain a healthy cardiometabolic phenotype, even in the presence of obesity.

Abstract MP050: Race and Gender Group Specific Trends in Length of Stay for Acute Myocardial Infarction: The Atherosclerosis Risk in Communities (ARIC) study, 1987–2008

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Laura R Loehr ◽  
Xiaoxi Liu ◽  
C. Baggett ◽  
Cameron Guild ◽  
Erin D Michos ◽  
...  
Keyword(s):  
Black Women ◽  
Length Of Stay ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Quadratic Term ◽  
Race And Gender ◽  
Insurance Type ◽  
And Gender ◽  
Aric Study

Introduction: Since the 1980’s, length of stay (LOS) for acute MI (AMI) has declined in the US. However, little is known about trends in LOS for non-white racial groups and whether change in LOS is related to insurance type or hospital complications. Methods: We determined 22 year trends in LOS for nonfatal (definite or probable) AMI among black and white residents age 35–74 in 4 US communities (N=396,514 in 2008 population) under surveillance in the ARIC Study. Events were randomly sampled and independently validated using a standardized algorithm. All analyses accounted for sampling scheme. We excluded MI events which started after admission (n=1,677), events within 28 days for the same person (n=3,817), hospital transfers (n=571), and those with LOS=0 or LOS >66 (top 0.5% of distribution, N= 144) leaving 22,258 weighted events for analysis. The average annual change in log LOS was modeled using weighted linear regression with year as a quadratic term. All models adjusted for age and secondary models adjusted for insurance type (Medicare, Medicaid, private, or other), and complications during admission (cardiac arrest, cardiogenic shock, or heart failure). Results: The average age-adjusted LOS from 1987 to 2008 was reduced by 5 days in black men (9.5 to 4.5 days); 4.6 days in white women (9.4 to 4.8 days); 4 days in white men (8.3 to 4.3 days) and 3.6 days in black women (9.0 to 5.4 days). Between 1987 and 2008, the age-adjusted average annual percent change (with 95% CI) in LOS was largest for white men at −4.40 percent per year (−4.91, −3.89) followed by −3.89 percent (−4.52, −3.26) for white women, −3.72 percent (−4.46, −2.89) for black men, and −2.94 percent (−3.92, −1.96) for black women (see Figure). Adjustment for insurance type, and complications did not change the pattern by race and gender. Conclusions: Between 1987 and 2008, LOS for AMI declined significantly and similarly in men and women, blacks and whites. These changes appear independent of differences in insurance type and hospital complications among race-gender groups.

scholarly journals Inequalities in Hypertension and Diabetes in Canada: Intersections between Racial Identity, Gender, and Income

2017 ◽  
Vol 27 (4) ◽  
pp. 371 ◽  
Author(s):  
Thierry Gagné ◽  
Gerry Veenstra
Keyword(s):  
Racial Identity ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Canadian Community Health Survey ◽  
The United States ◽  
Unequal Distribution ◽  
Community Health Survey ◽  
Using Data

<p>A growing body of research from the United States informed by intersectionality theory indicates that racial identity, gender, and income are often entwined with one another as determinants of health in unexpectedly complex ways. Research of this kind from Canada is scarce, however. Using data pooled from ten cycles (2001- 2013) of the Canadian Community Health Survey, we regressed hypertension (HT) and diabetes (DM) on income in subsamples of Black women (n = 3,506), White women (n = 336,341), Black men (n = 2,806) and White men (n = 271,260). An increase of one decile in income was associated with lower odds of hypertension and diabetes among White men (ORHT = .98, 95% CI (.97, .99); ORDM = .93, 95% CI (.92, .94)) and White women (ORHT = .95, 95% CI (.95, .96); ORDM = .90, 95% CI (.89, .91)). In contrast, an increase of one decile in income was not associated with either health outcome among Black men (ORHT = .99, 95% CI (.92, 1.06); ORDM = .99, 95% CI (.91, 1.08)) and strongly associated with both outcomes among Black women (ORHT = .86, 95% CI (.80, .92); ORDM = .83, 95% CI (.75, .92)). Our findings highlight the complexity of the unequal distribution of hypertension and diabetes, which includes inordinately high risks of both outcomes for poor Black women and an absence of associations between income and both outcomes for Black men in Canada. These results suggest that an intersectionality framework can contribute to uncovering health inequalities in Canada.</p><p><em>Ethn Dis.</em>2017;27(4):371-378; doi:10.18865/ ed.27.4.371. </p>

scholarly journals Identity and the Legislative Decision Making Process: A Case Study of the Maryland State Legislature

2011 ◽  
Vol 34 (1) ◽  
pp. 45-68 ◽  
Author(s):  
Nadia Brown
Keyword(s):  
Decision Making ◽  
Black Women ◽  
African American Women ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
State Legislature ◽  
Men And Women ◽  
Women Legislators ◽  
Men I

Both politicians and the mass public believe that identity influences political behavior yet, political scientists have failed to fully detail how identity is salient for all political actors not just minorities and women legislators. To what extent do racial, gendered, and race/gendered identities affect the legislation decision process? To test this proposition, I examine how race and gender based identities shape the legislative decisions of Black women in comparison to White men, White women, and Black men. I find that Black men and women legislators interviewed believe that racial identity is relevant in their decision making processes, while White men and women members of the Maryland state legislature had difficulty deciding whether their identities mattered and had even more trouble articulating how or why they did. African American women legislators in Maryland articulate or describe an intersectional identity as a meaningful and significant component of their work as representatives. More specifically, Black women legislators use their identity to interpret legislation differently due to their race/gender identities.

scholarly journals Sagittal Abdominal Diameter and its Socioeconomic Correlates: Perspective of Sex Differences

2020 ◽  
Author(s):  
Chang Li ◽  
Marcelline Harris ◽  
Dennis Tsilimingras ◽  
Sophia Liu ◽  
Ying Sheng ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sex Differences ◽  
Black Women ◽  
Body Mass ◽  
Household Income ◽  
White Women ◽  
White Men ◽  
Sagittal Abdominal Diameter ◽  
Birth Place ◽  
The Us

Abstract Background Sagittal abdominal diameter (SAD) is an anthropometric index associated with visceral adiposity. It remains unclear whether SAD and its socio-economic correlates differ in women and men, which limits the epidemiological and clinical applications of the SAD measurement. The aims of this study are to examine the sex differences in SAD and its socio-economic correlates.Methods A complex stratified multistage clustered sampling design was used to select 6,975 men and 7,079 women aged 18 years or more from the National Health Nutrition and Examination Survey 2011-2016, representative of the US civilian non-institutionalized population. SAD was measured in accordance to the standard protocols using a two-arm abdominal caliper. The sex differences in SAD and its socio-economic correlates were evaluated by performing weighted independent t tests and weighted multiple regression. Results SAD was lower in women than in men in the entire sample, as well as in all the subgroups characterized by age, race, birth place, household income, and body mass index except for non-Hispanic blacks and those with household income < $20,000. Adjusted for other characteristics, age, birth place, household income, and body mass index were associated with SAD in both women and men. Black women were associated with higher SAD then white women (p<.0001), and Hispanic and Asian men were associated with lower SAD than white men (both p<.01). Women born in other countries were more likely to have lower SAD than women born in the US (p<.0001), and so were men (p=.0118). Both women and men with a household income of <$75,000 had higher SAD than those with an income of over $75,000. The associations of age, race, and household income with SAD differed in women and men.Conclusion SAD is lower in women than in men, in the general population as well as in the most socio-economic subgroups. While socio-economic correlates of SAD are similar in women and men, the associations of age, race, and household income with SAD vary across sex.

scholarly journals Sagittal Abdominal Diameter and its Socioeconomic Correlates: Perspective of Sex Differences

2020 ◽  
Author(s):  
Chang Li ◽  
Marcelline Harris ◽  
Dennis Tsilimingras ◽  
Sophia Liu ◽  
Ying Sheng ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sex Differences ◽  
Black Women ◽  
Body Mass ◽  
Household Income ◽  
White Women ◽  
White Men ◽  
Sagittal Abdominal Diameter ◽  
Anthropometric Index ◽  
The Us

Abstract Background Sagittal abdominal diameter (SAD) is an anthropometric index associated with visceral adiposity. It remains unclear whether SAD and its socio-economic correlates differ in women and men, which limits the epidemiological and clinical applications of the SAD measurement. The aims of this study are to examine the sex differences in SAD and its socio-economic correlates.Methods A complex stratified multistage clustered sampling design was used to select 6,975 men and 7,079 women aged 18 years or more from the National Health Nutrition and Examination Survey 2011-2016, representative of the US civilian non-institutionalized population. SAD was measured in accordance to the standard protocols using a two-arm abdominal caliper. The sex differences in SAD and its socio-economic correlates were evaluated by performing weighted independent t tests and weighted multiple regression. Results SAD was lower in women than in men in the entire sample, as well as in all subgroups characterized by age, race, body mass index, birth place, and household income except for non-Hispanic blacks and those with household income < $20,000. Adjusted for other characteristics, SAD increased with age and body mass index for both women and men (p<.0001). Compared to white women, Asian women were associated with lower SAD (p=.018), and black women with higher SAD (p<.0001). Compared to white men, Hispanic and Asian men were associated with lower SAD (both p<.0001). Women born in other countries were more likely to have lower SAD than women born in the US (p<.0001), and so were men (p=.0118). Both women and men with a household income of <$75,000 had higher SAD than those with an income of over $75,000.Conclusion SAD is lower in women than in men, in the general population as well as in the most socio-economic subgroups. Socio-economic correlates of SAD were similar in women and men.

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