scholarly journals Geographic and Regional Variability in Racial and Ethnic Disparities in Stroke Thrombolysis in the United States

Stroke ◽  
2021 ◽  
Author(s):  
Deji Suolang ◽  
Bridget J. Chen ◽  
Nae-Yuh Wang ◽  
Rebecca F. Gottesman ◽  
Roland Faigle
Keyword(s):  
United States ◽  
Ethnic Disparities ◽  
The United States ◽  
South Atlantic ◽  
Pacific Region ◽  
The South ◽  
Atlantic Region ◽  
North Central ◽  
South Atlantic Region ◽  
Racial Ethnic

Background and Purpose: Intravenous thrombolysis (IVT) after ischemic stroke is underutilized in racially/ethnically minoritized groups. We aimed to determine the regional and geographic variability in racial/ethnic IVT disparities in the United States. Methods: Acute ischemic stroke admissions between 2012 and 2018 were identified in the National Inpatient Sample. Multivariable logistic regression was used to test the association between IVT and race/ethnicity, stratified by geographic region and controlling for demographic, clinical, and hospital characteristics. Results: Of the 545 509 included cases, 47 031 (8.6%) received IVT. Racially/ethnically minoritized groups had significantly lower adjusted odds of IVT compared with White people in the South Atlantic region (odds ratio [OR], 0.86 [95% CI, 0.82–0.91]), the East North Central region (OR, 0.91 [95% CI, 0.85–0.97]) and the Pacific region (OR, 0.90 [95% CI, 0.85–0.96]). In the South Atlantic region, IVT use in racial/ethnic minority groups was below the national average of all racial/ethnic minority patients ( P =0.002). Compared with White patients, Black patients had lower odds of IVT in the Middle Atlantic region (OR, 0.84 [95% CI, 0.78–0.91]), the South Atlantic region (OR, 0.78 [95% CI, 0.74–0.82]), and the East North Central region (OR, 0.86 [95% CI, 0.79–0.93]). In the South Atlantic region, this difference was below the national average for Black people ( P <0.001). Hispanic patients had significantly lower use of IVT only in the Pacific region (OR, 0.92 [95% CI, 0.85–0.99]), while Asian/Pacific Islander patients had lower odds of IVT in the Mountain (OR, 0.76 [95% CI, 0.59–0.98]) and Pacific region (OR, 0.89 [95% CI, 0.82–0.97]). Conclusions: Racial/ethnic disparities in IVT use in the United States vary by region. Geographic hotspots of lower IVT use in racially/ethnically minoritized groups are the South Atlantic region, driven predominantly by lower use of IVT in Black patients, and the East North Central and Pacific regions.

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.

scholarly journals Racial/Ethnic Disparities in ART Adherence in the United States

2012 ◽  
Vol 60 (5) ◽  
pp. 466-472 ◽  
Author(s):  
Jane M. Simoni ◽  
David Huh ◽  
Ira B. Wilson ◽  
Jie Shen ◽  
Kathy Goggin ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Disparities ◽  
The United States ◽  
Art Adherence ◽  
Racial Ethnic

Infant Mortality among Adolescent Mothers in the United States: A 5-Year Analysis of Racial and Ethnic Disparities

2020 ◽  
Author(s):  
Matthew D. Moore ◽  
Anne E. Brisendine ◽  
Martha S. Wingate
Keyword(s):  
United States ◽  
Preterm Birth ◽  
Infant Mortality ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial And Ethnic Disparities ◽  
Postneonatal Mortality ◽  
Maternal Characteristics ◽  
Race Ethnicity ◽  
Racial Ethnic

Objective This study was aimed to examine differences in infant mortality outcomes across maternal age subgroups less than 20 years in the United States with a specific focus on racial and ethnic disparities. Study Design Using National Center for Health Statistics cohort-linked live birth–infant death files (2009-2013) in this cross-sectional study, we calculated descriptive statistics by age (<15, 15–17, and 18–19 years) and racial/ethnic subgroups (non-Hispanic white [NHW], non-Hispanic black [NHB], and Hispanic) for infant, neonatal, and postneonatal mortality. Adjusted odds ratios (aOR) were calculated by race/ethnicity and age. Preterm birth and other maternal characteristics were included as covariates. Results Disparities were greatest for mothers <15 and NHB mothers. The risk of infant mortality among mothers <15 years compared to 18 to 19 years was higher regardless of race/ethnicity (NHW: aOR = 1.40, 95% confidence interval [CI]: 1.06–1.85; NHB: aOR = 1.28, 95% CI: 1.04–1.56; Hispanic: aOR = 1.36, 95%CI: 1.07–1.74). Compared to NHW mothers, NHB mothers had a consistently higher risk of infant mortality (15–17 years: aOR = 1.12, 95% CI: 1.03–1.21; 18–19 years: aOR = 1.21, 95% CI: 1.15–1.27), while Hispanic mothers had a consistently lower risk (15–17 years: aOR = 0.72, 95% CI: 0.66–0.78; 18–19 years: aOR = 0.74, 95% CI: 0.70–0.78). Adjusting for preterm birth had a greater influence than maternal characteristics on observed group differences in mortality. For neonatal and postneonatal mortality, patterns of disparities based on age and race/ethnicity differed from those of overall infant mortality. Conclusion Although infants born to younger mothers were at increased risk of mortality, variations by race/ethnicity and timing of death existed. When adjusted for preterm birth, differences in risk across age subgroups declined and, for some racial/ethnic groups, disappeared. Key Points

Racial/Ethnic Disparities in Antenatal Depression in the United States: A Systematic Review

2016 ◽  
Vol 20 (9) ◽  
pp. 1780-1797 ◽  
Author(s):  
Soumyadeep Mukherjee ◽  
Mary Jo Trepka ◽  
Dudith Pierre-Victor ◽  
Raed Bahelah ◽  
Tenesha Avent
Keyword(s):  
United States ◽  
Systematic Review ◽  
Ethnic Disparities ◽  
The United States ◽  
Antenatal Depression ◽  
Racial Ethnic

scholarly journals Racial/ethnic disparities in sleep duration and sleep disturbances among pregnant and non‐pregnant women in the United States

2020 ◽  
Vol 29 (5) ◽  
Author(s):  
Lydia Feinstein ◽  
Ketrell L. McWhorter ◽  
Symielle A. Gaston ◽  
Wendy M. Troxel ◽  
Katherine M. Sharkey ◽  
...  
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Sleep Duration ◽  
Sleep Disturbances ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial Ethnic

scholarly journals Performance of Landscape Roses Grown with Minimal Input in the North-central, Central, and South-central United States

2017 ◽  
Vol 27 (5) ◽  
pp. 718-730 ◽  
Author(s):  
David C. Zlesak ◽  
Randy Nelson ◽  
Derald Harp ◽  
Barbara Villarreal ◽  
Nick Howell ◽  
...  
Keyword(s):  
United States ◽  
National Level ◽  
The United States ◽  
The South ◽  
Flower Number ◽  
North Central ◽  
The North ◽  
South Central ◽  
Central United States ◽  
Plant Hardiness

Landscape roses (Rosa sp.) are popular flowering shrubs. Consumers are less willing or able to maintain landscape beds than in years past and require plants that are not only attractive, but well-adapted to regional climatic conditions, soil types, and disease and pest pressures. Marketing and distribution of rose cultivars occurs on a national level; therefore, it is difficult for U.S. consumers in the U.S. Department of Agriculture (USDA) Plant Hardiness Zones 3 to 5 to identify well-adapted, cold-hardy cultivars. Identifying suitable cultivars that have strong genetic resistance to pests and disease and that will tolerate temperature extremes without winter protection in the USDA Plant Hardiness Zones 3 to 5 is of tremendous value to consumers and retailers in northern states. Twenty landscape rose cultivars, primarily developed in north-central North America, were evaluated at five locations in the United States (three in the north-central United States, one in the central United States, and one in the south-central United States) using the low-input, multiyear Earth-Kind® methodology. Six roses had ≥75% plant survival at the end of the study and were in the top 50% of performers for overall mean horticultural rating at each of the three north-central U.S. sites: ‘Lena’, ‘Frontenac’, ‘Ole’, ‘Polar Joy’, ‘Sunrise Sunset’, and ‘Sven’. Five of these six roses met the same criteria at the central United States (exception ‘Lena’) and the south-central United States (exception ‘Polar Joy’) sites. Cultivar, rating time, and their interaction were highly significant, and block effects were not significant for horticultural rating for all single-site analyses of variance. Significant positive correlations were found between sites for flower number, flower diameter, and overall horticultural rating. Significant negative correlations were found between flower number and diameter within each site and also between black spot (Diplocarpon rosae) lesion size from a previous study and overall horticultural rating for three of the five sites. Cane survival ratings were not significantly correlated with overall horticultural rating, suggesting some cultivars can experience severe winter cane dieback, yet recover and perform well. Data from this study benefit multiple stakeholders, including nurseries, landscapers, and consumers, with evidence-based regional cultivar recommendations and breeders desiring to identify regionally adapted parents.

scholarly journals Racial/Ethnic Disparities in Lost Earnings From Cancer Deaths in the United States

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Jingxuan Zhao ◽  
Kimberly D Miller ◽  
Farhad Islami ◽  
Zhiyuan Zheng ◽  
Xuesong Han ◽  
...  
Keyword(s):  
United States ◽  
Economic Burden ◽  
Ethnic Disparities ◽  
The United States ◽  
Pacific Islanders ◽  
Equal Access ◽  
Years Of Life Lost ◽  
Cancer Death ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Background Little is known about disparities in economic burden due to premature cancer deaths by race or ethnicity in the United States. This study aimed to compare person-years of life lost (PYLLs) and lost earnings due to premature cancer deaths by race/ethnicity. Methods PYLLs were calculated using recent national cancer death and life expectancy data. PYLLs were combined with annual median earnings to generate lost earnings. We compared PYLLs and lost earnings among individuals who died at age 16-84 years due to cancer by racial/ethnic groups (non-Hispanic [NH] White, NH Black, NH Asian or Pacific Islander, and Hispanic). Results In 2015, PYLLs due to all premature cancer deaths were 6 512 810 for NH Whites, 1 196 709 for NH Blacks, 279 721 for NH Asian or Pacific Islanders, and 665 968 for Hispanics, translating to age-standardized lost earning rates (per 100 000 person-years) of $34.9 million, $43.5 million, $22.2 million, and $24.5 million, respectively. NH Blacks had higher age-standardized PYLL and lost earning rates than NH Whites for 13 of 19 selected cancer sites. If age-specific PYLL and lost earning rates for NH Blacks were the same as those of NH Whites, 241 334 PYLLs and $3.2 billion lost earnings (22.6% of the total lost earnings among NH Blacks) would have been avoided. Disparities were also observed for average PYLLs and lost earnings per cancer death for all cancers combined and 18 of 19 cancer sites. Conclusions Improving equal access to effective cancer prevention, screening, and treatment will be important in reducing the disproportional economic burden associated with racial/ethnic disparities.

scholarly journals Racial/Ethnic Disparities Among Extremely Preterm Infants in the United States From 2002 to 2016

2020 ◽  
Vol 3 (6) ◽  
pp. e206757 ◽  
Author(s):  
Colm P. Travers ◽  
Waldemar A. Carlo ◽  
Scott A. McDonald ◽  
Abhik Das ◽  
Namasivayam Ambalavanan ◽  
...  
Keyword(s):  
United States ◽  
Preterm Infants ◽  
Ethnic Disparities ◽  
The United States ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Racial Ethnic
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