Abstract 10079: Socioeconomic Status and the Development of Atrial Fibrillation in Hispanics, African Americans and non-Hispanic Whites

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Eric Shulman ◽  
Philip Aagaard ◽  
Faraj Kargoli ◽  
Ethan Hoch ◽  
Scott Schafler ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
New York ◽  
Socioeconomic Status ◽  
African Americans ◽  
New York State ◽  
Rank Test ◽  
Cox Regression Analysis ◽  
York State ◽  
Log Rank Test ◽  
Race Ethnicity

Introduction: Atrial fibrillation (AF) is the most common arrhythmia and is associated with significant morbidity and mortality. Despite having a higher burden of traditional AF risk factors, African American and Hispanic minorities have a lower incidence of AF when compared to non-Hispanic Whites, referred to as the “racial paradox.” Hypothesis: We investigated if socioeconomic status (SES) could be an explanatory factor for the “racial paradox.” Methods: An ECG/EMR database from a tertiary-care center in New York State was interrogated for individuals free of AF for development of subsequent AF from 2000-2013. SES was assessed per zip code via a log composite of six measures Z-scored to the New York State average (income; value of housing unit; percentage of receiving interest/dividend/rental income; education; percentage completed college; individuals in professional positions). SES was reclassified into decile groups (1 lowest and 10 highest). The Log-Rank test was used to determine difference in survival times to develop AF by race/ethnicity stratified by SES decile. Cox regression analysis controlling for all baseline differences was used to estimate the independent predictive ability of SES for AF. P-trend was calculated by race/ethnicity to determine if there was a trend by SES decile to develop AF. Results: We identified 48,631 persons (43% Hispanic, 37% African Americans and 20% non-Hispanic White, mean age 59 years, mean follow-up of 3.2 years) of which 4,556 AF cases occurred. Hispanics and African Americans had lower AF risk than Whites in all SES deciles (p-value < 0.001 by Log Rank Test). Higher SES was borderline associated with lower AF risk (HR=0.990, 95% CI 0.980-1.001, p=0.061). P-trend analysis was not significant by any race/ethnic group by SES deciles for AF (Figure 1). Conclusions: Our study suggests that non-Hispanic Whites are at higher risk for AF compared to non-Whites, and this is independent of socioeconomic status.

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.

scholarly journals 2625. Incidence of Bronchiolitis Requiring Hospitalization in the First 2 years of Life Among Healthy Term Infants with Different Races/Ethnicities: A Population-based Longitudinal Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S914-S915
Author(s):  
Kengo Inagaki ◽  
Chad Blackshear ◽  
Charlotte V Hobbs
Keyword(s):  
New York ◽  
Socioeconomic Status ◽  
Proportional Hazards ◽  
New York State ◽  
Multivariable Analysis ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Indigenous Populations ◽  
Term Infants ◽  
Race Ethnicity

Abstract Background Race/ethnicity is currently not considered a risk factor for bronchiolitis, except for indigenous populations in western countries. We sought to determine the incidence of hospitalization with bronchiolitis among different races/ethnicities, because such information can lead to more tailored preventive care. Methods We performed a population-based longitudinal observational study using the State Inpatient Database from New York state. Infants born between 2009 and 2013 at term without comorbidities were followed for the first 2 years of life, up to 2015. We calculated incidence among different race/ethnicity groups, and evaluated risks by developing Cox proportional hazards regression models. Results Of 877,465 healthy term infants, 10 356 infants were hospitalized with bronchiolitis. Overall, incidence was 11.8 per 1,000 births. Substantial difference in infants born in different seasons was observed (Figure 1). The incidence in non-Hispanic white, non-Hispanic black, Hispanic, and Asian infants was 8.6, 15.4, 19.1, and 6.5 per 1,000 births, respectively (table). On multivariable analysis adjusting for socioeconomic status, the risks remained substantially high among non-Hispanic black (hazard ratio [HR] 1.42, 95% confidence interval [CI]: 1.34–1.51) and Hispanic infants (HR 1.77, 95% CI: 1.67–1.87), particularly beyond 2–3 months of age, whereas Asian race was protective (HR 0.62, 95% CI: 0.56–0.69) (Figure 2, 3). Conclusion The risks of bronchiolitis hospitalization in the first 2 years of life was substantially higher among infants with non-Asian minority infants, particularly beyond 2–3 months of age. Further research efforts to identify effective public health interventions in each race/ethnic groups with varied socioeconomic status, such as improvement in access to care and anticipatory guidance, is warranted to overcome health disparity. Disclosures All authors: No reported disclosures.

Changes in the socioeconomic status of patients receiving TAVR in New York State

2019 ◽  
Vol 35 (1) ◽  
pp. 54-57
Author(s):  
Lisa Q Rong ◽  
Jialin Mao ◽  
Art R Sedrakyan ◽  
Harindra C Wijeysundera ◽  
Ajita Naik ◽  
...  
Keyword(s):  
New York ◽  
Socioeconomic Status ◽  
New York State ◽  
York State

Asthma Hospitalization Rates and Socioeconomic Status in New York State (1987-1993)

1999 ◽  
Vol 36 (3) ◽  
pp. 239-251 ◽  
Author(s):  
Shao Lin ◽  
Edward Fitzgerald ◽  
Syni-An Hwang ◽  
Jean Pierre Munsie ◽  
Alice Stark
Keyword(s):  
New York ◽  
Socioeconomic Status ◽  
New York State ◽  
York State ◽  
Hospitalization Rates ◽  
Asthma Hospitalization

scholarly journals Sickle cell disease incidence among newborns in New York State by maternal race/ethnicity and nativity

2012 ◽  
Vol 15 (3) ◽  
pp. 222-228 ◽  
Author(s):  
Ying Wang ◽  
Joseph Kennedy ◽  
Michele Caggana ◽  
Regina Zimmerman ◽  
Sanil Thomas ◽  
...  
Keyword(s):  
New York ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Disease Incidence ◽  
New York State ◽  
Cell Disease ◽  
York State ◽  
Race Ethnicity ◽  
Maternal Race

scholarly journals 1277. Retention Among Adolescents with Mental Health Diagnoses on Pre-Exposure Prophylaxis (RAMP) Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S460-S460
Author(s):  
Christopher M Mayer ◽  
Ramail D Siddiqui ◽  
Mary Ellen Adams ◽  
Brooke Strauss ◽  
Aneesh Mathur ◽  
...  
Keyword(s):  
Mental Health ◽  
New York ◽  
New York State ◽  
Adolescent Medicine ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Mental Health Diagnoses ◽  
Exposure Prophylaxis

Abstract Background The CDC reported in 2017 that 21% of new HIV diagnoses were composed of persons 13–24 years old. New York State (NYS) is addressing this with the Ending the Epidemic initiative, started in 2014, which emphasized pre-exposure prophylaxis (PrEP) for persons at risk of acquiring HIV. Though PrEP can effectively prevent HIV transmission, NYS minors were only granted capacity to accept PrEP in 2017. The Adolescent Medicine Trials Network found clinicians had varying perceptions on whether mental health diagnoses (MHD) were a barrier to adolescent PrEP utilization. This study aims to test the hypothesis that patients with MHD do not differ in PrEP retention length when compared with adolescents without MHD. Methods This is a retrospective single-center study analyzing self-reported visit data for adolescent enrolled on PrEP (n = 27) in the Capital District, NY. MHD were confirmed with clinician notes and retention to PrEP was defined as attending appointments. Between-group differences were compared using Fisher’s Exact Test (FET). Kaplan–Meier curves were compared using the log-rank test. Results Of the 27 adolescents enrolled on PrEP between Sep 2015-March 2019, most self-identified as males (93%), MSM (85%), white (74%), and 13 (48%) had a MH diagnosis. Anxiety was the most common MHD (69%), followed by depression (38%). The mean age was 20.3 years (16–24). The average PrEP retention for patients with and without MHD were 262±136 and 292±138 days, respectively (P = 0.575). For patients with MHD, follow-up at 1-month, 3-months and 1-year was 10 (77%), 8 (62%), and 5 (39%), respectively. For patients without MHD, follow-up at 1-month, 3-months, and 1-year was 11 (79%), 10 (71%), 5 (36%), respectively. Follow-up between adolescents with and without MHD was compared at 1-month (P = 0.086, FET), 3-months (P = 0.695, FET), and 1-year (P = 1.0, FET). Adolescents’ retention on PrEP was depicted on Kaplan–Meier curves (Figure 1). Log-rank test indicated that PrEP retention is not significantly associated with MHD (χ2(1) = 0.1, P = 0.727). Conclusion Adolescents with and without MHD did not significantly differ in PrEP retention outcomes. The RAMP study elucidates a potentially incorrect provider bias regarding PrEP retention and MHD. Future investigation should be done prospectively with larger sample size. Disclosures All authors: No reported disclosures.

Socioeconomic Status Is an Important Determinant of the Use of Invasive Procedures After Acute Myocardial Infarction in New York State

Circulation ◽  
2000 ◽  
Vol 102 (Supplement 3) ◽  
pp. III-107-III-115 ◽  
Author(s):  
E. F. Philbin ◽  
P. A. McCullough ◽  
T. G. DiSalvo ◽  
G. W. Dec ◽  
P. L. Jenkins ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
New York ◽  
Socioeconomic Status ◽  
Important Determinant ◽  
New York State ◽  
Invasive Procedures ◽  
York State
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