Abstract 19514: Race and Willingness to Participate in Cardiovascular Clinical Research

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Xiaotao Zhang ◽  
Lydia A Bazzano ◽  
Stephen G Gavin ◽  
Stephanie Gaudreau ◽  
Joseph Breault
Keyword(s):  
Marital Status ◽  
Household Income ◽  
Odds Ratio ◽  
Consent Form ◽  
Willingness To Participate ◽  
Median Household Income ◽  
Cardiovascular Research ◽  
Large Community ◽  
Academic Center ◽  
Age And Sex

African Americans (AA) are underrepresented in clinical trials in the United States for a variety of reasons. The majority of studies examining this issue were conducted >10 years ago and since then, efforts have been implemented to improve AA enrollment in research. We took advantage of the cardiovascular research data of a large community academic center in New Orleans, Louisiana to examine whether race was associated with participation in cardiovascular research. We used a nested case control design with 80% power to detect a doubling in odds of non-participation. Individuals could be included if they were offered participation in any of the 4 largest studies conducted in 2012, were White or AA and were American citizens (n=974). Median income household income was inferred using postal codes. Cases were defined as individuals who declined to participate and did not sign a consent form. Controls were defined as individuals who agreed to participate and signed a consent form. We identified 100 cases and selected 200 controls matched on age (within 1 year) and sex using a random selection algorithm. Of the 974 eligible for analysis, mean (SD) age was 65 (14) years, median household income in thousands was 51.92 (19.9), and 65.3% were men. Of those who agreed to participate, 32.2% were AA while of those who refused, 31.0% were AA. The unadjusted Mantel-Haenszel odds ratio for non-participation by race was 1.06 (95% CI: 0.60 to 1.94) for AA individuals compared to their White age and sex matched counterparts. Using multivariable conditional logistic regression, the odds ratio for participation in a study was 1.04 (95% CI: 0.56 to 1.92) for AA as compared to their White age and sex matched counterparts, after adjustment for median household income, employment, and marital status. Our findings suggest that, at a large community academic center, race does not significantly affect willingness to participate in cardiovascular research independent of age, gender, socioeconomic and marital status.

Social determinants of health and their impact on postcolectomy surgery readmissions: a multistate analysis, 2009–2014

2019 ◽  
Vol 8 (16) ◽  
pp. 1365-1379 ◽  
Author(s):  
Hyun S Park ◽  
Robert S White ◽  
Xiaoyue Ma ◽  
Briana Lui ◽  
Kane O Pryor
Keyword(s):  
New York ◽  
Household Income ◽  
Odds Ratio ◽  
Insurance Status ◽  
Median Income ◽  
Median Household Income ◽  
Discharge Data ◽  
Black Patients ◽  
Race Ethnicity ◽  
Income Quartile

Aim: To examine the effect of race/ethnicity, insurance status and median household income on postoperative readmissions following colectomy. Patients & methods: Multivariate analysis of hospital discharge data from California, Florida, Maryland and New York from 2009 to 2014. Primary outcomes included adjusted odds of 30- and 90-day readmissions following colectomy by race, insurance status and median income quartile. Results: Total 330,840 discharges included. All 30-day readmissions were higher for black patients (adjusted odds ratio [aOR]: 1.07). Both 30- and 90-day readmissions were higher for Medicaid (aOR: 1.30 and 1.26) and Medicare (aOR: 1.30 and 1.29). The 30- and 90-day readmissions were lower in the highest income quartiles. Conclusion: Race, insurance status and median household income are all independent predictors of disparity in readmissions following colectomy.

scholarly journals Higher Socioeconomic Status Is Associated with Improved Overall Survival in Adults with Philadelphia Chromosome Negative Acute Lymphoblastic Leukemia: A Population Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4780-4780
Author(s):  
Anita J Kumar ◽  
Tobi Henzer ◽  
Angie Mae Rodday ◽  
Marlise R. Luskin ◽  
Wendy Stock ◽  
...  
Keyword(s):  
Marital Status ◽  
Household Income ◽  
Research Funding ◽  
Cox Regression ◽  
Lymphoblastic Leukemia ◽  
Philadelphia Chromosome ◽  
Median Household Income ◽  
Genetics Research ◽  
The Impact ◽  
Hispanic White

Abstract Background: Socioeconomic status (SES) and other non-disease (social and demographic) characteristics are known to predict overall survival (OS) in children with acute lymphoblastic leukemia (ALL) (Petridou et al. Ann Oncol 2015). Less is known about the impact of these factors on survival of adults with ALL. We studied which non-biological risks impact OS in adults with Philadelphia chromosome negative (Ph negative) ALL, with emphasis on the impact of SES on survival. Methods: We assembled data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER-18) registry from 2000 to 2014. This registry covers 27.8% of the US population. We identified patients 18-69 years old diagnosed with Ph negative ALL between 2000-2012 using ICD-O-3 codes. We merged data with the Federal Information Processing Standards county codes and designated patients as metropolitan or non-metropolitan based on state and country 2013 rural-urban continuum codes. We assigned county-level median household income using the Census American Community Survey (www.census.gov). Descriptive statistics were calculated for age at diagnosis, sex, race/ethnicity, marital status, insurance status,median household income, and status with respect to the 200% of the federal poverty line (FPL). We stratified the population by age: 18-39 years (adolescent and young adult, or AYA, cohort) and 40-69 years (adult cohort). We also identified 3 eras of interest: 2000 to 2003, 2004 to 2007, and 2008 to 2012. Multivariable Cox proportional hazards (PH) regression assessed predictors of OS, with separate models for AYAs and adults. Analyses were performed using SAS. Results: In total, 5,858 patients met criteria for analysis. Median age was 41.4 years (25-75th%: 26.9-54.8), with 45.8%patients in the AYA cohort. 57.8% of patients were male, and half were non-Hispanic white (50.8%). Over 90% of all patients lived in metropolitan counties. One-third (35%) of patients lived below the 200% FPL. Median household income was $55,901 (25-75th%: $51,389-67,677). 49% of patients had missing data about insurance, so we omitted this variable from analysis. ALL lineage was B cell in 57%, T-cell in 10%, and unspecified in 33% of cases. 52% were married overall with more AYAs (61.3%) not married compared to older adults (34%). In Cox regression model for AYAs, higher median income was associated with better OS (HR=0.95 for every $10,000 above national household income, p=0.03). We also found that later era of diagnosis (2008-2012 vs. 2000-2003) was associated with better OS (HR=0.70, p<0.001), while older age (HR=1.04, p<0.0001), unspecified lineage (vs. B-cell, HR=1.20, p=0.04), and all races compared to non-Hispanic white were associated with poorer OS with the exception of Asian/Pacific Islander: American Indian (HR=2.82, p<0.001), Hispanic (HR=1.58, p<0.001), and non-Hispanic black (HR=1.50, p<0.001). Sex, marital status, and rural residence were not associated with OS in the AYA cohort. In the adult cohort, in a Cox regression model, patients with higher income had better OS (HR=0.95 for every $10,000 above median national household income, p=0.001). We also found that later era of diagnosis (2008-2012 and 2004-2007 vs. 2000-2003), and non-metropolitan geography (HR=0.81, p<0.001) predicted better OS, while older age (HR=1.03, p<0.0001), Hispanic race (HR=1.16, p=0.03), male sex (HR=1.09, p=0.03), and non-married status conferred poorer OS (HR=1.31, p<0.0001) (Table). Conclusion: We identify non-biological predictors of OS in adults with ALL in a large population-based registry. Notably, higher SES portends better OS in both AYAs and older adults with ALL, consistent with findings in the pediatric literature. Marital status affects OS only in older patients, while race/ethnicity in AYAs greatly impacts OS. All ages had improved OS in more recent years, suggesting that all age cohorts are benefitting from new ALL treatment approaches. Our findings of the impact of SES on OS call for more investigation and action to improve social support and possibly adherence in the adult population. Table. Table. Disclosures Kumar: Seattle Genetics: Research Funding. Rodday:Seattle Genetics: Research Funding. Stock:Jazz Pharmaceuticals: Consultancy. Parsons:Seattle Genetics: Research Funding.

scholarly journals Clinical Implications of Nonbiological Factors With Colorectal Cancer Patients Younger Than 45 Years

2021 ◽  
Vol 11 ◽  
Author(s):  
Qi Liu ◽  
Ruoxin Zhang ◽  
Qingguo Li ◽  
Xinxiang Li
Keyword(s):  
Colorectal Cancer ◽  
Marital Status ◽  
Household Income ◽  
Rank Test ◽  
Clinical Implications ◽  
Insurance Status ◽  
County Level ◽  
Median Household Income ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

BackgroundTo evaluate the clinical implications of non-biological factors (NBFs) with colorectal cancer (CRC) patients younger than 45 years.MethodsIn the present study, we have conducted Cox proportional hazard regression analyses to evaluate the prognosis of different prognostic factors, the hazard ratios (HRs) were shown with 95% confidence intervals (CIs). Kaplan–Meier method was utilized to compare the prognostic value of different factors with the log-rank test. NBF score was established according to the result of multivariate Cox analyses.ResultsIn total, 15129 patients before 45 years with known NBFs were identified from the SEER database. Only county-level median household income, marital status and insurance status were NBFs that significantly corelated with the cause specifical survival in CRC patients aged less than 45 years old (P &lt; 0.05). Stage NBF 1 showed 50.5% increased risk of CRC-specific mortality (HR = 1.505, 95% CI = 1.411-1.606, P &lt; 0.001). Stage NBF 0 patients were associated with significantly increased CRC-specific survival (CCSS) when compared with the stage NBF 1 patients in different AJCC TNM stages.ConclusionsNBF stage (defined by county-level median household income, marital status and insurance status) was strongly related to the prognosis of CRC patients. NBFs should arouse enough attention of us in clinical practice of patients younger than 45 years.

Abstract 20: Patterns of Stroke Center Certification and the Impact on Stroke Mortality in Counties of New York State

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Emily Chapman ◽  
Kurt A Yaeger ◽  
J D Mocco
Keyword(s):  
New York ◽  
Socioeconomic Status ◽  
Household Income ◽  
New York State ◽  
Stroke Care ◽  
Stroke Mortality ◽  
Median Household Income ◽  
Stroke Incidence ◽  
York State ◽  
The Relationship

Introduction: To establish a statewide stroke system in March 2019, New York State (NYS) created the Stroke Designation Program. Stroke centers (SCs) must be certified by a state-approved certifying organization (CO), which is tasked with initial designation and ongoing re-certification. Previous research has found an association at the national level between socioeconomic status and access to higher levels of acute stroke care. Objective: This study characterizes the relationship between socioeconomic status of NYS populations and stroke care level access by comparing median household income and wealth in counties with and without certified SCs. Methods: Population and median household income from the U.S. Census (2010), stroke epidemiological data from the Center for Disease Control, and Area Deprivation Index (ADI) data (ranked within NYS) from the Neighborhood Atlas, a project that quantifies disadvantage by census tract, were collected and averaged for each county. Income has been used to assess local wealth and ADI to analyze community health risks. Certification data were mined from quality check databases for The Joint Commission and Det Norske Veritas, the most commonly used COs. Student’s t-tests compared income and ADI in counties with at least one certified SC to those without. Linear regression characterized the relationship between income and ADI with number of certified SCs, stroke incidence and stroke mortality. Results: All 62 counties in NYS were investigated to yield 40 certified SCs. Counties with at least one certified SC had a significantly higher income ($68,183.63 vs. $57,155.12; p=0.03) and lower ADI (5.90 vs. 7.37; p=0.004) compared to counties with no certified SC. Higher income (p<0.001) and lower ADI (p<0.001) were also associated with more certified SCs. Counties with fewer certified SCs had significantly higher stroke mortality (p<0.001) despite having similar stroke incidence. Conclusion: Socioeconomic heterogeneity in NYS counties is correlated to differential access to certified SCs and quality stroke care, as fewer centers are found in lower-income and disadvantaged communities. Although populations with less access experience stroke at similar rates, this study finds higher death rates in these counties.

Marital status, educational level and household income explain part of the excess mortality of survey non-respondents

2009 ◽  
Vol 25 (2) ◽  
pp. 69-76 ◽  
Author(s):  
Hanna Tolonen ◽  
Tiina Laatikainen ◽  
Satu Helakorpi ◽  
Kirsi Talala ◽  
Tuija Martelin ◽  
...  
Keyword(s):  
Marital Status ◽  
Educational Level ◽  
Household Income ◽  
Excess Mortality

scholarly journals Risk for mental illness and family composition after migration to Sweden

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251254
Author(s):  
Elisabeth Mangrio ◽  
Karin Sjöström ◽  
Mathias Grahn ◽  
Slobodan Zdravkovic
Keyword(s):  
Mental Illness ◽  
Marital Status ◽  
Odds Ratio ◽  
Cross Sectional Study ◽  
Refugee Status ◽  
Cross Sectional ◽  
Family Structures ◽  
Significant Odds Ratio ◽  
Increased Risk ◽  
Arabic Speaking

Objectives The aim of the present study is to determine how marital status and certain post-migration family structures are associated with the risk of mental illness among recently arrived Arabic- speaking refugees in Sweden. Methods A cross-sectional study was conducted during 2015 and 2016. The study population was recruited by inviting all adult refugees who participated in the mandatory public integration support programme. All refugees that participated had received refugee status. A total of 681 of the invited participants returned the GHQ-12 questionnaires, through which the risk for mental illness was measured and only Arabic- speaking refugees (N = 638) were included in the analyses. Results Marital status per se was not associated with a risk for mental illness. However, for the whole study sample there was a statistical significant odds ratio of 1.72 (95% CI 1.03–2.86). For male Arabic-speaking refugees with a spouse or child left behind in the home country there was a borderline significant increased risk for mental illness, odds ratio = 1. 87 (95% CI 0.99–3.56). The risk for female Arabic-speaking refugees was non-significant, odds ratio = 1.35 (95% CI 0.55–3.33). Conclusions Arabic- speaking refugees who were separated from family members reported an increased risk for mental illness after arriving in the host country. Actions to facilitate family reunion after arriving as a refugee (in Sweden) seems to be an important factor to promote mental health among refugees.

scholarly journals DESCRIPTIVE EPIDEMIOLOGY OF STEPHANOFILARIASIS (HUMPSORE) IN CATTLE

2017 ◽  
Vol 14 (2) ◽  
pp. 167-170
Author(s):  
M. Akter BJVM ◽  
M. K. Hassan ◽  
M. Ahammed ◽  
M. A. Ali ◽  
G. C. Biswas ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Neck Region ◽  
Clinical History ◽  
P Value ◽  
Age Group ◽  
Descriptive Epidemiology ◽  
Direct Examination ◽  
Local Breed ◽  
Female Cattle ◽  
Age And Sex

An epidemiological study was conducted to investigate the epidemiology of humpsore (stephanofilariasis) infection on cattle of different age and sex by collecting information from samples conveniently from different areas of Mymensingh district in Bangladesh. Clinical history and direct examination is done to detect the infection. Out of 503 samples total 43.14% cattle were found stephanofilariasis positive. The prevalence of stephanofilariasis was higher (27.24%) in cattle between 5-10 years old cattle than of less than 5 years (10.93%) and more than 10 years (4.97%) old cattle. Females have shown more positive (36.98%) result than male (male entire= 3.18%, male castrated= 2.98%) that was 6.16% (Odds ratio= 1; P value= 0.987, ?2= 0.003). Local breed shown 36.98% positive to stephanofilariasis followed in descending order by 2.98% in Red Sindhi, 0.99% in Sahiwal, 0.80% in Jersey cross, 0.40% in Holstein cross, Haryana and Red Chittagong breeds and 0.20% in Pabna breed. From the study it is shown that highest (14.1%) prevalence found in the location of neck region of local breed (12.72%) in female cattle (12.52%) and in the age group of 5-10years (9.74%) than other category on the basis of location of lesions.

scholarly journals Factors Related to Anxiety Events in Parkinson's Patients in Dr. M Djamil Padang

2021 ◽  
Vol 7 (2) ◽  
pp. 242-246
Author(s):  
Yoga Setia Kurniawan ◽  
Yuliarni Syafrita ◽  
Restu Susanti
Keyword(s):  
Marital Status ◽  
Significant Relationship ◽  
Rating Scale ◽  
Univariate Analysis ◽  
P Value ◽  
Research Subjects ◽  
Duration Of Illness ◽  
Hamilton Anxiety Rating Scale ◽  
Age And Sex ◽  
Hamilton Anxiety

Introduction : Anxiety is one of the most non-motorized symptoms in patients with Parkinson's which greatly affects the quality of life, but in clinical practice it is often neglected. Anxiety in patients with Parkinson's can accelerate motor deterioration / disability and also increase mortality. Methods: This cross-sectional study was conducted at the Neurology polyclinic Dr. M Djamil Padang from July to December 2020 in patients who had been diagnosed with Parkinson's Disease (PD) by excluding secondary Parkinson's and a history of stroke. Anxiety was measured using the Hamilton Anxiety Rating Scale (HARS). The research subjects were 60 people. Univariate analysis to present baseline characteristics and bivariate tests assessed factors associated with anxiety and the relationship between variables. A p value <0.05 was considered statistically significant. Results: Most of the subjects were male (55%) with a mean age of 58.05 ± 9.7 years and disease duration of 6.35 ± 5.29 years. By examining the Hamilton Anxiety Rating Scale (HARS), it was obtained 38.3% of Parkinson's sufferers with anxiety. There is a significant relationship between marital status, duration of illness and degree of disease with the incidence of anxiety (p <0.05) and there is no significant relationship between age and sex with the incidence of anxiety in patients with Parkinson's. Conclusion: There is a significant relationship between marital status, duration of illness and degree of disease with the incidence of anxiety in patients with Parkinson's and there is no relationship between age and sex with the incidence of anxiety in patients with Parkinson's.

scholarly journals Do Trees in Halifax Grow on Money?: A Comparison of Urban Tree Canopy Cover and Median Household Income in North End and South End Halifax

2018 ◽  
Vol 14 ◽  
Author(s):  
Kendra Marshman
Keyword(s):  
Population Density ◽  
Household Income ◽  
Urban Forest ◽  
Canopy Cover ◽  
Tree Canopy ◽  
Median Household Income ◽  
Tree Canopy Cover ◽  
Urban Tree Canopy ◽  
Statistics Canada ◽  
North End

Trees in the city provide numerous ecological, health, and social benefits to urban residents. Studies from large North American cities have confirmed a spatial pattern that higher urban forest tree canopy positively correlates with higher levels of affluence. The just distribution of trees will become increasingly important for urban planners and foresters as there is a national trend towards living in cities. This research report investigates the equity of distribution of urban tree canopy cover in two neighbourhoods on the peninsula of Halifax, Nova Scotia. High spatial resolution land cover data from 2007 and 2006 Statistics Canada census data was used to create maps and tables to answer the research question. The socio-economic indicators of median household income and population density are represented based on census tract dissemination areas from the 2006 Statistics Canada long survey. Preliminary results indicate lower median household income and higher population density in the chosen study area of North End Halifax compared to higher median household income and lower population density in the chosen study area of South End Halifax. Tree canopy cover density is slightly lower in North End Halifax (5.3%) than in South End Halifax (7.6%). These preliminary results coincide with findings of other researchers that higher household income and lower population density at the neighbourhood level may result in increased urban forest canopy. However, further research and more reliant tree canopy cover data is needed to determine the accuracy of these findings. 

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