Exploring Changes in Racial/Ethnic Disparities of HIV Diagnosis Rates Under the “Ending the HIV Epidemic: A Plan for America” Initiative

Objectives Racial/ethnic disparities in HIV diagnosis rates remain despite the availability of effective treatment and prevention tools in the United States. In 2019, President Trump announced the “Ending the HIV Epidemic: A Plan for America” (EHE) initiative to reduce new HIV infections in the United States at least 75% by 2025 and at least 90% by 2030. The objective of this study was to show the potential effect of the EHE initiative on racial/ethnic disparities in HIV diagnosis rates at the national level. Methods We used 2017 HIV diagnoses data from the Centers for Disease Control and Prevention National HIV Surveillance System. We developed a counterfactual scenario to determine changes in racial/ethnic disparities if the 2017 HIV diagnosis rates were reduced by 75% in the geographic regions targeted by the EHE initiative. We used 4 measures to calculate results: rate ratio, population-attributable proportion (PAP), Gini coefficient, and Index of Disparity. Results The relative measures of racial/ethnic disparity decreased by 9%-21% in the EHE scenario compared with the 2017 HIV diagnoses data. The largest decrease was in the Hispanic/Latino:white rate ratio (−20.6%) and in the black:white rate ratio (−18.2%). The PAP measure decreased by 11.5%. The absolute versions of the Index of Disparity (unweighted and weighted) were approximately 50% lower in the EHE scenario than in the 2017 HIV diagnoses data. Conclusions EHE efforts could reduce but will not eliminate racial/ethnic disparities in HIV diagnosis rates. Efforts to address racial/ethnic disparities should continue, and innovative approaches, specifically those that focus on social and structural factors, should be developed and implemented for populations that are disproportionately affected by HIV in the United States.

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Improved measurement of racial/ethnic disparities in COVID-19 mortality in the United States

10.1101/2020.05.21.20109116 ◽

2020 ◽

Cited By ~ 8

Author(s):

Joshua R. Goldstein ◽

Serge Atherwood

Keyword(s):

United States ◽

New York ◽

National Level ◽

Ethnic Disparities ◽

State Level ◽

The United States ◽

Estimation Methods ◽

Death Rates ◽

Population Distributions ◽

Racial Ethnic

AbstractDifferent estimation methods produce diverging accounts of racial/ethnic disparities in COVID-19 mortality in the United States. The CDC’s decision to present the racial/ethnic distribution of COVID-19 deaths at the state level alongside re-weighted racial/ethnic population distributions—in effect, a geographic adjustment—makes it seem that Whites have the highest death rates. Age adjustment procedures used by others, including the New York City Department of Health and Mental Hygiene, lead to the opposite conclusion that Blacks and Hispanics are dying from COVID-19 at higher rates than Whites. In this paper, we use indirect standardization methods to adjust per-capita death rates for both age and geography simultaneously, avoiding the one-sided adjustment procedures currently in use. Using CDC data, we find age-and-place-adjusted COVID-19 death rates are 80% higher for Blacks and more than 50% higher for Hispanics, relative to Whites, on a national level, while there is almost no disparity for Asians. State-specific estimates show wide variation in mortality disparities. Comparison with non-epidemic mortality reveals potential roles for pre-existing health disparities and differential rates of infection and care.

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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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062921 ◽

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.

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Eliminating Racial/Ethnic Disparities in AIDS Clinical Trials in the United States: A Qualitative Exploration of an Efficacious Social/Behavioral Intervention

Journal of AIDS & Clinical Research ◽

10.4172/2155-6113.1000648 ◽

2017 ◽

Vol 08 (01) ◽

Cited By ~ 1

Author(s):

Amanda Ritchie ◽

Marya Viorst Gwadz ◽

David Perlman ◽

Rebecca De Guzman ◽

Noelle R Leoard ◽

...

Keyword(s):

United States ◽

Clinical Trials ◽

Behavioral Intervention ◽

Ethnic Disparities ◽

The United States ◽

Aids Clinical Trials ◽

Qualitative Exploration ◽

Racial Ethnic

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Racial/Ethnic Disparities in ART Adherence in the United States

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0b013e31825db0bd ◽

2012 ◽

Vol 60 (5) ◽

pp. 466-472 ◽

Cited By ~ 95

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

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

American Journal of Perinatology ◽

10.1055/s-0040-1714678 ◽

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

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

Maternal and Child Health Journal ◽

10.1007/s10995-016-1989-x ◽

2016 ◽

Vol 20 (9) ◽

pp. 1780-1797 ◽

Cited By ~ 26

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

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

Journal of Sleep Research ◽

10.1111/jsr.13000 ◽

2020 ◽

Vol 29 (5) ◽

Cited By ~ 2

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

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Racial/Ethnic Disparities in Pediatric Renal Allograft Survival in the United States: 2000-2011.

Transplantation Journal ◽

10.1097/00007890-201407151-01655 ◽

2014 ◽

Vol 98 ◽

pp. 496

Author(s):

R. Patzer ◽

S. Mohan ◽

N. Kutner ◽

W. McClellan ◽

S. Amaral

Keyword(s):

United States ◽

Renal Allograft ◽

Ethnic Disparities ◽

The United States ◽

Allograft Survival ◽

Racial Ethnic

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

JNCI Cancer Spectrum ◽

10.1093/jncics/pkaa038 ◽

2020 ◽

Vol 4 (5) ◽

Cited By ~ 1

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.

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