Cross-Cohort Evidence of Disparities in Service Receipt for Speech or Language Impairments

2017 ◽  
Vol 84 (1) ◽  
pp. 27-41 ◽  
Author(s):  
Paul L. Morgan ◽  
George Farkas ◽  
Marianne M. Hillemeier ◽  
Hui Li ◽  
Wik Hung Pun ◽  
...  
Keyword(s):  
United States ◽  
Special Education ◽  
The United States ◽  
Language Impairments ◽  
Odds Ratios ◽  
White Children ◽  
English Speaking ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
To Receive

We examined the extent to which disparities in the receipt of special education services for speech or language impairments (SLIs) on the basis of race, ethnicity, or language use by kindergarten—when the delivery of these services might be expected to be most effective—have changed over a 12-year period in the United States. Logistic regression modeling of 2 nationally representative cohorts ( N = 16,800 and 12,080) indicated that children who are Black (covariate-adjusted odds ratios = 0.39 and 0.54) or from non-English-speaking households (covariate-adjusted odds ratios = 0.57 and 0.50) continue to be less likely to receive services for SLIs. Hispanic children are now less likely to receive these services (covariate adjusted odds ratio = 0.54) than otherwise similar non-Hispanic White children. Disparities in special education service receipt for SLIs attributable to race, ethnicity, and language presently occur in the United States and are not explained by many potential confounds.

scholarly journals Real-World Utilization of Oral Anticancer Agents Costs in Older Adults with Metastatic Renal Cell Carcinoma in the United States

Kidney Cancer ◽  
2021 ◽  
pp. 1-13
Author(s):  
Lauren E. Wilson ◽  
Lisa Spees ◽  
Jessica Pritchard ◽  
Melissa A. Greiner ◽  
Charles D. Scales ◽  
...  
Keyword(s):  
United States ◽  
Anticancer Agents ◽  
Patient Characteristics ◽  
The United States ◽  
Socioeconomic Indicators ◽  
Economic Implications ◽  
Southern Us ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Oral Anticancer Agents

Background: Substantial racial and socioeconomic disparities in metastatic RCC (mRCC) have persisted following the introduction of targeted oral anticancer agents (OAAs). The relationship between patient characteristics and OAA access and costs that may underlie persistent disparities in mRCC outcomes have not been examined in a nationally representative patient population. Methods: Retrospective SEER-Medicare analysis of patients diagnosed with mRCC between 2007–2015 over age 65 with Medicare part D prescription drug coverage. Associations between patient characteristics, OAA receipt, and associated costs were analyzed in the 12 months following mRCC diagnosis and adjusted to 2015 dollars. Results: 2,792 patients met inclusion criteria, of which 32.4%received an OAA. Most patients received sunitinib (57%) or pazopanib (28%) as their first oral therapy. Receipt of OAA did not differ by race/ethnicity or socioeconomic indicators. Patients of advanced age (>  80 years), unmarried patients, and patients residing in the Southern US were less likely to receive OAAs. The mean inflation-adjusted 30-day cost to Medicare of a patient’s first OAA prescription nearly doubled from $3864 in 2007 to $7482 in 2015, while patient out-of-pocket cost decreased from $2409 to $1477. Conclusion: Race, ethnicity, and socioeconomic status were not associated with decreased OAA receipt in patients with mRCC; however, residing in the Southern United States was, as was marital status. Surprisingly, the cost to Medicare of an initial OAA prescription nearly doubled from 2007 to 2015, while patient out-of-pocket costs decreased substantially. Shifts in OAA costs may have significant economic implications in the era of personalized medicine.

Prevalence of Total Daily Walking Among US Adults, 2002–2003

2008 ◽  
Vol 5 (3) ◽  
pp. 337-346 ◽  
Author(s):  
Jared P. Reis ◽  
Caroline A. Macera ◽  
Barbara E. Ainsworth ◽  
Deborah A. Hipp
Keyword(s):  
United States ◽  
Body Mass Index ◽  
Random Sample ◽  
Leisure Time ◽  
The United States ◽  
Time Activity ◽  
Representative Random Sample ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Weekly Frequency

Background:Walking for exercise is a popular leisure-time activity pursuit among US adults; however, little information is available about total daily walking.Methods:A nationally representative random sample of 10,461 US adults (4438 men and 6023 women) was surveyed via telephone between 2002 and 2003. Weekly frequency and daily duration of walking for all purposes in bouts of at least 10 min were measured. Regular walking was defined as walking ≥5 d/wk, ≥30 min/d.Results:Overall, 49% of adults (51% of men and 47% of women) were regular walkers, and approximately 17% reported no walking. Regular walking was significantly higher in employed adults and decreased with increasing age in women and body mass index in both sexes. Total walking was significantly higher among adults with lower levels of educational attainment and did not vary significantly by race/ethnicity.Conclusions:These results affirm the popularity of walking in the United States.

scholarly journals COVID-19 Vaccine Acceptability and Inequity in the United States: Results from a nationally representative survey

2021 ◽  
Author(s):  
Dustin Gibson ◽  
Smisha Agarwal ◽  
Ankita Meghani ◽  
Rupali J. Limaye ◽  
Alain Labrique
Keyword(s):  
United States ◽  
Influenza Vaccine ◽  
Online Survey ◽  
The United States ◽  
Demographic Characteristics ◽  
Third Party ◽  
Sample Population ◽  
Nationally Representative ◽  
To Receive ◽  
Racial Ethnic

AbstractBackgroundAt the time of this survey, September 1st, there were roughly 6 million COVID-19 cases and 176,771 deaths in the United States and no federally approved vaccine. The objective of this study was to explore the willingness to accept a COVID-19 vaccine in the United States and describe variability in this acceptability by key racial, ethnic and socio-demographic characteristics.MethodsThis was a cross-sectional digital survey that sampled participants from a nationally-representative panel maintained by a third party, Dynata. Dynata randomly sampled their database and emailed web-based surveys to United States residents ensuring the sample was matched to US Census estimates for age, race, gender, income, and Census region. Participants were asked how willing or unwilling they would be to: 1) receive a COVID-19 vaccine as soon as it was made publicly available, and 2) receive the influenza vaccine for the upcoming influenza season. Participants could respond with extremely willing, willing, unwilling, or extremely unwilling. For those who reported being unwilling to receive a COVID-19 vaccine, reasons for this hesitancy were captured. All participants were asked about where they obtain vaccine-related information, and which sources they trust most. Univariable and multivariable logistic regressions were conducted to examine the association of all demographic characteristics with willingness to receive COVID-19 vaccine.FindingsFrom September 1st to September 7, 2020, 1592 respondents completed the online survey. Overall, weighted analyses found that only 58.9% of the sample population were either willing or extremely willing to receive a COVID-19 vaccine as soon as it was made publicly available. In comparison, 67.7% of the respondents were willing or extremely willing to take the influenza vaccine. By gender, 66.1% of males and 51.5% of females were willing to receive a COVID-19 vaccine. Males were significantly more willing to receive a COVID-19 vaccine (adjusted odds ratio (OR)=1.98, 95% CI: 1.56, 2.53; p<0.001) than females. Blacks were the least willing racial/ethnic group (48.8%) Blacks, (aOR=0.59, 95%CI: 0.43, 0.80; p<0.001) were significantly less willing, than whites, to receive a COVID-19 vaccine. There were numerous reasons provided for being unwilling to receive a COVID-19 vaccine. The most common reason was concern about the vaccine’s safety (36.9%), followed by concerns over its efficacy (19.1%).InterpretationIn conclusion, we found that a substantial proportion (41%) of United States residents are unwilling to receive a COVID-19 vaccine as soon as one is made publicly available. We found that vaccine acceptance differs by sub-populations. In addition to sub-group differences in willingness to receive the vaccine, respondents provided a variety of reasons for being unwilling to receive the vaccine, driven by various sources of vaccine information (and misinformation). This compounds the challenge of delivering a safe and efficacious COVID-19 vaccine at a population level to achieve herd immunity. A multi-pronged and targeted communications and outreach effort is likely needed to achieve a high level of immunization coverage.

Disproportionality in Special Education: A Synthesis of International Research and Trends

2018 ◽  
Vol 52 (3) ◽  
pp. 163-173 ◽  
Author(s):  
North Cooc ◽  
Elisheba W. Kiru
Keyword(s):  
United States ◽  
Special Education ◽  
Children With Disabilities ◽  
The United States ◽  
Indigenous Populations ◽  
Cultural Barriers ◽  
Policy Recommendations ◽  
Student Groups ◽  
English Speaking ◽  
Special Education Identification

Access to schooling and special education services remains a challenge for many children with disabilities around the world. In the United States, much attention has focused on disproportionality—the over- and underrepresentation of student groups within special education. In this study, to contextualize and better understand the scope and factors associated with disproportionality in the United States and abroad, we synthesized literature on special education disproportionality in international contexts and identified trends across student groups and countries, including the ways in which scholars have examined this topic. Results show that studies focused mainly on the overrepresentation of ethnic minority, immigrant, and Indigenous populations in European or English-speaking nations. Nearly all studies emphasized structural inequalities in society over cultural barriers as mechanisms contributing to disproportionality. Policy recommendations, however, were more likely to focus on improving the special education identification process. The review has implications for research, practice, and policy to improve education for children with disabilities in the United States and abroad.

scholarly journals Youth Access to School Salad Bars in the United States—2011 to 2014

2016 ◽  
Vol 32 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Brenna K. VanFrank ◽  
Stephen Onufrak ◽  
Diane M. Harris
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Regression Models ◽  
The United States ◽  
Logistic Regression Models ◽  
Multivariable Logistic Regression ◽  
Let's Move ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Over Time

Purpose: To examine differences in students’ access to school salad bars across sociodemographic groups and changes in availability over time. Design: Nonexperimental. Setting: Nationally representative 2011 and 2014 YouthStyles surveys. Participants: A total of 833 (2011) and 994 (2014) US youth aged 12 to 17 years. Measures: Youth-reported availability of school salad bars. Analysis: Multivariable logistic regression models were used to assess differences in school salad bar availability by sociodemographics and changes in availability from 2011 to 2014. Results: Youth-reported salad bar availability differed by age in 2011 and race/ethnicity in 2014, but not by sex, income, metropolitan residence, or region in either year. Salad bars were reported by 62% of youth in 2011 and 67% in 2014; the increase was not statistically significant ( P = .07). Significant increases from 2011 to 2014 were noted among youth aged 12 to 14 years (56%-69%; P < .01), youth of non-Hispanic other races (60%-85%; P < .01), and youth in the Midwest (58%-72%; P = .01). Conclusion: These results suggest that youth-reported access to school salad bars does not differ significantly across most sociodemographic groups. Although overall salad bar availability did not increase significantly from 2011 to 2014, some increases were observed among subgroups. Continued efforts to promote school salad bars through initiatives such as Let’s Move Salad Bars to Schools could help increase access for the nearly one-third of US youth reporting no access.

scholarly journals Racial and Ethnic Disparities in the Refusal of Surgical Treatment in Women 40 Years and Older With Breast Cancer in the United States Between 2010 and 2017

2022 ◽  
Author(s):  
Pierre Fwelo ◽  
Zenab Yusuf ◽  
Abigail Adjei ◽  
Gabriel Huynh ◽  
Xianglin Du
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Surgical Treatment ◽  
Black Women ◽  
Ethnic Disparities ◽  
Breast Conserving Surgery ◽  
The United States ◽  
Recommended Treatment ◽  
Race Ethnicity ◽  
To Receive

Abstract Purpose Although surgical resection is the main modality of treatment for breast cancer, some patients elect to refuse the recommended surgery. We assessed racial and ethnic differences in women 40 years and older who received or refused to receive surgical treatment for breast cancer in the United States and whether racial disparities in mortality were affected by their differences in the prevalence of refusal for surgical treatmentMethods We studied 277,127 women with breast cancer using the Surveillance, Epidemiology, and End Results (SEER) data and performed multivariable logistic regressions to investigate the association between surgery status of breast cancer and race/ethnicity. Additionally, we performed Cox logistic regression analyses to determine the predictors of mortality outcomes. Results Of 277,127 patients with breast cancer, 1,468 (0.53%) refused to receive the recommended surgical treatment in our cohort. Non-Hispanic Black women were 112% more likely to refuse recommended surgical treatment for breast cancer compared to their non-Hispanic White counterparts [adjusted odds ratio: 2.12, 95% confidence interval (CI)=1.82-2.47]. Women who underwent breast conserving surgery [hazards ratio (HR): 0.15, 95% CI: 0.13-0.16] and mastectomy (HR:0.21, 95% CI: 0.18-0.23) had lower hazard ratios of mortality as compared to women who refused the recommended treatment after adjusting for covariates. Conclusion Race/ethnicity was associated with refusal for recommended surgery, especially among non-Hispanic Black women. Also, surgery refusal was associated with a higher risk of all-cause and breast cancer-related mortality. These disparities stress the need to tailor interventions aimed at raising awareness of the importance of following physician recommendations among minorities.

Barriers to Health Care Among Adults With Minoritized Identities in the United States, 2013–2017

2020 ◽  
Vol 110 (6) ◽  
pp. 857-862
Author(s):  
Stephanie M. Hernandez ◽  
P. Johnelle Sparks
Keyword(s):  
United States ◽  
Health Care ◽  
Access To Health Care ◽  
The United States ◽  
Barriers To Health Care ◽  
Access To Health ◽  
Interview Survey ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Barriers To Health

Objectives. To examine the relationship between minoritized identity and barriers to health care in the United States. Methods. Nationally representative data collected from the 2013 to 2017 waves of the National Health Interview Survey were used to conduct descriptive and logistic regression analyses. Men and women were placed in 1 of 4 categories: no minoritized identities, minoritized identities of race/ethnicity (MIoRE), minoritized identities of sexuality (MIoS), or minoritized identities of both race/ethnicity and sexuality (MIoRES). Five barriers to health care were considered. Results. Relative to heterosexual White adults and after controlling for socioeconomic status, adults with MIoRE were less likely to report barriers, adults with MIoS were more likely to report barriers, and adults with MIoRES were more likely to report barriers across 2 of the study measures. Conclusions. Barriers to care varied according to gender, minoritized identity, and the measure of access to health care itself. Public Health Implications. Approaching health disparities research using an intersectional lens moves the discussion from examining individual differences to examining the role of social structures such as the health care system in maintaining and reproducing inequality.

scholarly journals Associations of Race/Ethnicity and Other Demographic and Socioeconomic Factors with Vaccination During the COVID-19 Pandemic in the United States

2021 ◽  
Author(s):  
Daniel Kim
Keyword(s):  
United States ◽  
Socioeconomic Factors ◽  
Vaccine Dose ◽  
The United States ◽  
Adverse Outcomes ◽  
Vaccine Hesitancy ◽  
Vaccine Initiation ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Socioeconomic Data

AbstractBACKGROUNDTo date, there has been limited data available to understand the associations between race/ethnicity and socioeconomic and related characteristics with COVID-19 vaccine initiation and planned vaccination in the United States. To better characterize COVID-19 vaccinations nationally, the present study leveraged nationally-representative data with relatively complete race/ethnicity and socioeconomic data to estimate levels of vaccine initiation and the adjusted relative odds of vaccine initiation and planned vaccination among adults by race/ethnicity and socioeconomic and other characteristics.METHODSUsing pooled cross-sectional data from 66,994 adults aged 18-85 years in nationally-representative surveys by the U.S. Census Bureau administered between January 6, 2021 and January 18, 2021 and multivariable logistic regression, this study estimated the associations between race/ethnicity, education, and pre-pandemic (2019) household income with the self-reported: 1) receipt of ≥1 dose of a COVID-19 vaccine; and 2) either receipt of ≥1 dose of a COVID-19 vaccine or the plan to definitely receive a vaccine once available to the respondent.RESULTSIn Hispanics and Black non-Hispanics, the estimated prevalences of vaccine initiation were 6.1% and 6.2%, respectively, compared to 8.7% in White non-Hispanics and 15.1% in Asian non-Hispanics. Controlling for demographic and socioeconomic factors, Hispanics and Black non-Hispanics were no more or less likely than White non-Hispanics to have received ≥1 vaccine dose. However, for the combined outcome of either vaccine initiation or planned vaccination, Black non-Hispanics were 52% less likely than White non-Hispanics to have reported either outcome (P<.001). Meanwhile, both education and pre-pandemic income levels exhibited evidence of positive dose-response relationships with vaccine initiation (P for linear trend = .01 and <.001, respectively). Substantial (vs. no) financial hardship was linked to 44% lower odds of vaccination (P<.001). The most common reasons for vaccine hesitancy were concerns about side effects and safety.CONCLUSIONSIn this large, nationally-representative study with relatively complete race/ethnicity and socioeconomic data, we find that being Black non-Hispanic and having the least education and income were each independently associated with a markedly lower likelihood of definitely planning to get vaccinated or having been vaccinated. In the ensuing months of the pandemic, addressing racial/ethnic and socioeconomic inequities in vaccination due to differential access and vaccine hesitancy will be critical to mitigate the pandemic’s disproportionately higher risks of infection and adverse outcomes in Black non-Hispanics and socioeconomically disadvantaged groups and to help maximize vaccination coverage nationwide.

Black and White Middle Class Children Who Have Private Health Insurance in the United States

PEDIATRICS ◽  
1999 ◽  
Vol 104 (Supplement_1) ◽  
pp. 151-157 ◽  
Author(s):  
Michael Weitzman ◽  
Robert S. Byrd ◽  
Peggy Auinger
Keyword(s):  
Mental Health ◽  
United States ◽  
Special Education ◽  
Middle Class ◽  
Black Children ◽  
The United States ◽  
Special Education Services ◽  
White Children ◽  
Education Services ◽  
Black And White

Objective. To compare the health, behavior and school problems, and use of medical, mental health, and special education services of privately insured, middle class black and white children in the United States. Design/Methods. Analyses of the Child Health Supplement to the 1988 National Health Interview Survey, with a nationally representative sample of 17 110 children age 0–17 years. Results. Privately insured middle class black children had fewer chronic health conditions, but were less likely to be reported to be in excellent health (46.2% vs 57.3%) and more likely to have had asthma (8.5% vs 5.8%) or to have been of low birth weight (10.7% vs 5.6%). There were no differences in rates of having a usual source of routine care (92.2% vs 93.8%) or of being up to date with well-child care (79.3% vs 78.2%), but black children made fewer physician visits, were less likely to use physicians' offices, were more likely to lack continuity of care, and were twice as likely to use emergency departments. These differences in use of medical services persisted in multivariate analyses and analyses restricted to more affluent children. Despite similar rates of behavior problems, black children were more likely to repeat a grade (20.0% vs 12.3%) and to have been suspended from school (11.3% vs 5.0%). Although significantly fewer black middle class children received mental health or special education services in bivariate analyses, no differences in receipt of these services were noted in multivariate analyses. All differences reported were significant. Conclusions. Among middle class children in the United States, black and white children have similar rates of health and behavior problems, but black children experience substantially increased rates of asthma, low birth weight, and school difficulties. Although not differing in the receipt of mental health or special education services, middle class black children, even in the presence of private health insurance, have markedly different sources and patterns of use of medical services.

scholarly journals Vision Health Disparities in the United States by Race/Ethnicity, Education, and Economic Status: Findings From Two Nationally Representative Surveys

2012 ◽  
Vol 154 (6) ◽  
pp. S53-S62.e1 ◽  
Author(s):  
Xinzhi Zhang ◽  
Mary Frances Cotch ◽  
Asel Ryskulova ◽  
Susan A. Primo ◽  
Parvathy Nair ◽  
...  
Keyword(s):  
United States ◽  
Health Disparities ◽  
Economic Status ◽  
The United States ◽  
Race Ethnicity ◽  
Nationally Representative
Sign in / Sign up

Export Citation Format

Share Document