Abstract P169: Ethnic Disparities In Short- And Long-term Prognosis After A First Cardiovascular Hospitalization

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Louise Van Oeffelen ◽  
Charles Agyemang ◽  
Carla Koopman ◽  
Karien Stronks ◽  
Michiel Bots ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Ethnic Minority Groups ◽  
Readmission Rates ◽  
Majority Population ◽  
Short And Long Term ◽  
Migrant Groups ◽  
Long Term Mortality

Introduction: Ethnic disparities in prognosis after a cardiovascular event have been reported. We investigated differences in mortality and readmission after a first hospital admission for total cardiovascular disease (CVD), AMI, CVA, peripheral arterial disease (PAD), and congestive heart failure (CHF) between several ethnic minority groups and the Dutch majority population. Methods: A nationwide prospective cohort of CVD patients hospitalized between 1998 and 2010 was constructed (N=776,574). Differences in short- and long-term mortality and readmission (0-28 days after admission and 28 days-5 years after admission respectively) between first generation ethnic minority groups (henceforth: migrants) and the Dutch majority population were calculated using multivariable Cox proportional hazard models . Results: In particular mortality after AMI and CVA was higher in migrants compared to the Dutch majority population, except for Moroccans. Short- (HR 1.36; 1.07-1.74) and long-term ( HR 1.45; 1.20-1.75) mortality after CVD was the highest in Chinese migrants. Short-term readmission rates were similar between migrants and the Dutch majority population, except after AMI where mainly lower rates were found (HR:0.37-1.26). Long-term readmission rates were also similar to the Dutch majority population, except after CHF where readmission rates were lower (HR varies between 0.67-0.95), and after AMI where readmission rates for AMI were higher (HR varies between 1.24-1.83). Conclusion: Short- and long-term mortality after CVD is higher in migrant groups than in the Dutch majority population, except after CHF. Differences in readmission rates were more similar to the Dutch majority population, with some fluctuations between sub diseases and migrant groups.

scholarly journals Exploring the Dimensionality of Ethnic Minority Adaptation in Britain: An Analysis across Ethnic and Generational Lines

Sociology ◽  
2015 ◽  
Vol 51 (3) ◽  
pp. 626-645 ◽  
Author(s):  
Laurence Lessard-Phillips
Keyword(s):  
Ethnic Minority ◽  
Empirical Evidence ◽  
Minority Groups ◽  
Evidence Base ◽  
Group Differences ◽  
Ethnic Minority Groups ◽  
Trade Offs ◽  
Number Of Factors ◽  
Different Dimensions

In this article I explore the dimensionality of the long-term experiences of the main ethnic minority groups (their adaptation) in Britain. Using recent British data, I apply factor analysis to uncover the underlying number of factors behind variables deemed to be representative of the adaptation experience within the literature. I then attempt to assess the groupings of adaptation present in the data, to see whether a typology of adaptation exists (i.e. whether adaptation in different dimensions can be concomitant with others). The analyses provide an empirical evidence base to reflect on: (1) the extent of group differences in the adaptation process, which may cut across ethnic and generational lines; and (2) whether the uncovered dimensions of adaptation match existing theoretical views and empirical evidence. Results suggest that adaptation should be regarded as a multi-dimensional phenomenon where clear typologies of adaptation based on specific trade-offs (mostly cultural) appear to exist.

Ethnic Disparities in Dental Caries among Six-Year-Old Children in the Netherlands

2016 ◽  
Vol 50 (5) ◽  
pp. 489-497 ◽  
Author(s):  
Justin T. van der Tas ◽  
Lea Kragt ◽  
Jaap J.S. Veerkamp ◽  
Vincent W.V. Jaddoe ◽  
Henriette A. Moll ◽  
...  
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
Ethnic Minority ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Caries Experience ◽  
Caries Prevalence ◽  
Ethnic Minority Groups ◽  
Oral Health Behaviour ◽  
Dutch Children

The aim of this study was to investigate potential differences in caries prevalence of children from ethnic minority groups compared to native Dutch children and the influence of socio-economic status (SES) and parent-reported oral health behaviour on this association. The study had a cross-sectional design, embedded in a population-based prospective multi-ethnic cohort study. 4,306 children with information on caries experience, belonging to 7 different ethnic groups, participated in this study. The decayed, missing, and filled teeth (dmft) index was assessed at the age of 6 and categorized in two ways for analysis: children without caries (dmft = 0) versus any caries experience (dmft >0) and children without caries (dmft = 0) versus children with mild caries (dmft = 1-3) or severe caries (dmft >3). Compared to native Dutch children, children with a Surinamese-Hindustani, Surinamese-Creole, Turkish, Moroccan, and Cape Verdean background had significantly higher odds for dental caries. Especially the Surinamese-Hindustani, Turkish, and Moroccan group had significantly higher odds for severe dental caries. Household income and educational level of the mother explained up to 43% of the association between ethnicity and dental caries, whereas parent-reported oral health behaviour did not mediate the association. Alarming disparities in caries prevalence between different ethnic (minority) groups exist, which cannot be fully explained by social inequalities. Public health strategies can apply this new knowledge and specifically focus on the reduction of ethnic disparities in oral health. More research is needed to explain the high caries prevalence among different ethnic minority groups.

Ethnic Disparities in Dental Caries among Adolescents in China

2020 ◽  
pp. 002203452097654
Author(s):  
S.C. Wu ◽  
X.X. Ma ◽  
Z.Y. Zhang ◽  
E.C.M. Lo ◽  
X. Wang ◽  
...  
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
Ethnic Minority ◽  
Minority Groups ◽  
Negative Binomial ◽  
Economic Status ◽  
Ethnic Disparities ◽  
Caries Experience ◽  
Ethnic Minority Groups ◽  
Sugary Beverages

Comprehensive research on ethnic disparities in dental caries in China is limited. The aims of this cross-sectional study were to compare the levels of dental caries in adolescents between the Han ethnic group and ethnic minority groups in China and to explore the risk indicators for dental caries within ethnic subgroups. Data from the Fourth National Oral Health Survey in 2015, which covered all 31 province-level administrative divisions in mainland China, were used. The dental caries status in the permanent dentition of adolescents aged 12, 13, 14, and 15 y was measured using the decayed, missing, and filled teeth (DFMT) score, and sociodemographic characteristics and oral health–related behaviors were also collected. A total of 118,601 adolescents were included, with ethnic minority groups accounting for 13.15%. Of the Han and minority groups, the standardized prevalence of dental caries experience was 40.58% and 47.67%, and the mean DMFT scores were 0.97 and 1.28, respectively. According to the multivariate zero-inflated negative binomial regression analysis, the caries status of minorities was more severe than Han adolescents (adjusted prevalence rate ratio [PRR], 1.14; 95% confidence interval [CI], 1.10–1.18). This disparity was greater among adolescents who lived in rural areas, had mid-level economic status, and frequently consumed sugary beverages. After propensity score matchings, Uygur (PRR, 1.44; 95% CI, 1.25–1.67), Tibetan (PRR, 1.39; 95% CI, 1.3–1.48), and Yi (PRR, 1.24; 95% CI, 1.04–1.48) adolescents were significantly more likely to have caries than Han adolescents. Subgroup analyses revealed that gender, age, location of residence, economic status, region, consumption of sweet snacks and sugary beverages, and dental visit pattern were significantly associated with dental caries within ethnic minorities.

scholarly journals Psychoses sans Frontieres: towards an interdisciplinary understanding of psychosis risk amongst migrants and their descendants

2018 ◽  
Vol 28 (2) ◽  
pp. 146-152 ◽  
Author(s):  
J. Dykxhoorn ◽  
J. B. Kirkbride
Keyword(s):  
Mental Health ◽  
Ethnic Minority ◽  
Psychotic Disorders ◽  
Minority Groups ◽  
Public Mental Health ◽  
Population Based ◽  
Ethnic Minority Groups ◽  
Region Of Origin ◽  
Psychosis Risk ◽  
Migrant Groups

AbstractUnderstanding the excess risk of psychotic disorders in migrant and ethnic minority groups has long been an important research focus in psychiatric epidemiology and public mental health. Heterogeneity between migrant groups based on the region of origin, minority status and other socioeconomic factors may provide clues as to the underlying aetiological mechanisms explaining this risk, as well as informing our general understanding of psychotic disorders. Nonetheless, disentangling the mechanisms underlying this association has been the focus of more speculation and theory to date than empirical research. Now more than ever, we need to move beyond studies which demonstrate excess rates in migrant and ethnic minority groups to novel population-based studies which identify the determinants and mechanisms through which this risk is shaped. In this paper, we review the main hypotheses proposed to explain these disparities and the current level of support for them. We then highlight recent evidence from epidemiology and neuroscience which provides important new clues in our understanding of the aetiology of psychotic disorders. We concluded with suggestions for future interdisciplinary research to prevent this public mental health inequality within a generation.

Abstract WMP90: Race/Ethnic Disparities in Short and Long Term Mortality Among Medicare Beneficiaries in Florida and Puerto Rico: Data from the Florida Puerto Rico Collaboration to Reduce Stroke Disparities (FL-PR CReSD) Study - the NINDS Stroke Prevention Intervention Research Program

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hannah Gardener ◽  
Erica C Leifheit-Limson ◽  
Judith Lichtman ◽  
Yun Wang ◽  
Kefeng Wang ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Hospital Mortality ◽  
Acute Stroke ◽  
Ethnic Disparities ◽  
Stroke Care ◽  
Medicare Beneficiaries ◽  
Acute Stroke Care ◽  
Short And Long Term ◽  
Long Term Mortality

Background: Race/ethnic disparities in acute stroke care may impact stroke outcomes. We compared short- and long-term mortality by race/ethnicity among Medicare beneficiaries in Get With The Guidelines (GWTG) hospitals participating in the NINDS-funded prospective Florida Puerto Rico Collaboration to Reduce Stroke Disparities Registry (GWTG/CReSD), GWTG hospitals not in the Registry (GWTG/non-CReSD), and non-GWTG hospitals not in the Registry (non-GWTG/non-CReSD). Methods: The population included Medicare beneficiaries age 65+ in FL and PR, hospitalized from 2010-2013 with ischemic stroke (ICD-9 433, 434, 436; N=105,205, mean age=80 years, 54% women). We used mixed logistic models adjusted for demographic and clinical characteristics to assess race/ethnic differences in in-hospital, 30-day, and 1-year mortality, stratifying by hospital type (GWTG/CReSD, GWTG/non-CReSD, non-GWTG/non-CReSD). Results: In the 62 GWTG/CReSD hospitals (N=44013, 84% non-Hispanic White (NHW), 9% NH-Black (NHB), 4% FL-Hispanic (FLH), 1% PR-Hispanic (PRH)), NHB had lower 30-day mortality vs NHW (10% vs 12%; OR 0.86, 95% CI 0.77-0.97), but higher 1-year mortality (22% vs 20%; OR 1.13, 95% CI 1.04-1.23); there were no race/ethnic disparities for in-hospital mortality (NHB=6%, NHW=5%, FLH=7%, PRH=12%). However, in 74 GWTG/non-CReSD hospitals (N=46770, 88% NHW, 8% NHB, 2% FLH, 0% PRH), FLH (5%) and NHB (4%) had higher in-hospital mortality vs NHW (3%). For 113 non-GWTG/non-CReSD hospitals (N=14422, 78% NHW, 7% NHB, 5% FLH, 8% PRH), in-hospital mortality was higher for PRH (17%) and NHB (8%) vs NHW (5%). In-hospital and 1-year mortality were lower in CReSD and in GWTG/non-CReSD vs in non-GWTG/non-CReSD hospitals. Conclusions: FL and PR Medicare beneficiaries treated for stroke in GWTG hospitals (both GWTG/CReSD and GWTG/non-CReSD) had lower mortality vs those treated in non-GWTG hospitals; however, there were less race/ethnic disparities in in-hospital mortality for stroke patients treated at GWTG/CReSD hospitals, which are focused on reducing disparities in acute stroke care. Findings underscore the benefits of quality improvement programs, particularly those focusing on race/ethnic disparities.

scholarly journals Changing socio-economic and ethnic disparities in influenza/A/H1N1 infection early in the 2009 UK epidemic: a descriptive analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
James D. Munday ◽  
Richard Pebody ◽  
Katherine E. Atkins ◽  
Albert Jan van Hoek
Keyword(s):  
Ethnic Minority ◽  
Influenza A ◽  
Minority Groups ◽  
Descriptive Analysis ◽  
Ethnic Disparities ◽  
Transmission Risk ◽  
Suspected Case ◽  
Ethnic Minority Groups ◽  
Asian Ethnicity ◽  
Influenza A H1n1

Abstract Background Higher incidence of and risk of hospitalisation and death from Influenza A(H1N1)pdm09 during the 2009 pandemic was reported in ethnic minority groups in many high-income settings including in the United Kingdom (UK). Many of these studies rely on geographical and temporal aggregation of cases and can be difficult to interpret due to the spatial and temporal factors in outbreak spread. Further, it can be challenging to distinguish between disparities in health outcomes caused by variation in transmission risk or disease severity. Methods We used anonymised laboratory confirmed and suspected case data, classified by ethnicity and deprivation status, to evaluate how disparities in risk between socio-economic and ethnic groups vary over the early stages of the 2009 Influenza A(H1N1)pdm09 epidemic in Birmingham and London, two key cities in the emergence of the UK epidemic. We evaluated the relative risk of infection in key ethnic minority groups and by national and city level deprivation rank. Results We calculated higher incidence in more deprived areas and in people of South Asian ethnicity in both Birmingham and London, although the magnitude of these disparities reduced with time. The clearest disparities existed in school-aged children in Birmingham, where the most deprived fifth of the population was 2.8 times more likely to be infected than the most affluent fifth of the population. Conclusions Our analysis shows that although disparities in reported cases were present in the early phase of the Influenza A(H1N1)pdm09 outbreak in both Birmingham and London, they vary substantially depending on the period over which they are measured. Further, the development of disparities suggest that clustering of social groups play a key part as the outbreak appears to move from one ethnic and socio-demographic group to another. Finally, high incidence and large disparities between children indicate that they may hold an important role in driving inequalities.

scholarly journals Ethnic disparities in prevalence and patterns of smoking and nicotine dependence in rural southwest China: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028770 ◽  
Author(s):  
Xu-Ming Wang ◽  
Chao Wu ◽  
Allison Rabkin Golden ◽  
Cai Le
Keyword(s):  
Ethnic Minority ◽  
Ethnic Groups ◽  
Nicotine Dependence ◽  
Southwest China ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Lower Probability ◽  
Ethnic Minority Groups ◽  
Cross Sectional ◽  
Current Smoking

ObjectivesThis study examines ethnic disparities in prevalence and patterns of smoking and nicotine dependence in rural southwest China.DesignThis was a cross-sectional design.SettingThis study was conducted in rural Yunnan Province of China.Participants7027 consenting individuals aged ≥35 years among Han majority and four ethnic minority groups (Na Xi, Li Shu, Dai and Jing Po) participated in this study. Information about participants’ demographic characteristics as well as smoking habits and an assessment of nicotine dependence with the Fagerstrom Test for Nicotine Dependence (FTND) was obtained using a standard questionnaire.ResultsMales had significantly higher prevalence of current smoking than females (64.8% and 44.4%, p<0.01). Among current smokers, the prevalence of nicotine dependence was significantly higher in males compared with females (19.9% and 7.1%, p<0.01). Jing Po men and women had the highest prevalence of current smokers (72.2% vs 23.1%, p<0.01), whereas the highest prevalence of nicotine dependence was found in male Dai current smokers and female Li Shu current smokers (44.8% vs 32.5%, p<0.01). Filtered cigarettes were the most popular form of tobacco used across all five ethnic groups. Over 75% of tobacco users initiated smoking and regularly smoked during adolescence, and those of minority ethnicity smoked regularly at a younger age than those of Han descent (p<0.05). Individuals in all five ethnic groups with higher levels of education had a lower probability of current smoking status (p<0.05), whereas a negative association of level of education with nicotine dependence was only observed in current smokers in the Han majority and Dai ethnic minority groups. Among Han majority current smokers, higher annual household income was associated with a higher risk of nicotine dependence (p<0.05).ConclusionFuture interventions to control tobacco use should be tailored to address ethnicity and socioeconomic factors.

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