Marital Status and Sexually Transmitted Infections Among African Americans

This article assesses the relationship between low marriage rates and racial disparities in sexually transmitted infection (STI) rates. Data from the 2002 National Survey of Family Growth was used to examine the prevalence of sexual risk behaviors by marital status. Logistic regression was used to examine whether racial differences in marriage patterns help account for racial disparities in STI rates. Results indicate that the 12-month prevalence of multiple partners and high-risk partnerships was lowest among currently married, intermediate among cohabiting, and highest among formerly and never-married respondents. Of all racial/ethnic groups, African Americans were least likely to be married. In multiple logistic analyses adjustment for marriage attenuated the association between race and STI risk behaviors for African Americans. Low marriage rates may be an important contributing factor to racial/ethnic disparities in STI rates, particularly for African Americans.

Download Full-text

Racial/Ethnic Variability in Diabetes Mellitus among United States Residents Is Unexplained by Lifestyle, Sociodemographics and Prognostic Factors

ISRN Public Health ◽

10.5402/2012/408079 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8

Author(s):

Laurens Holmes ◽

Jobayer Hossain ◽

Doriel Ward ◽

Franklin Opara

Keyword(s):

Diabetes Mellitus ◽

African Americans ◽

Marital Status ◽

Racial Differences ◽

Ethnic Disparities ◽

Physical Activities ◽

Prevalence Odds Ratio ◽

Ethnic Variability ◽

Race Ethnicity ◽

Racial Ethnic

Background. The mortality and prevalence of diabetes mellitus (DM) vary across racial/ethnic groups with African Americans/blacks being disproportionately affected. However, it is unclear to what extent such disparities persist after the adjustment for covariates related to race/ethnicity and/or DM in the population. We aimed to assess racial/ethnic disparities in DM and to determine which covariates account for the observed racial/ethnic variabilities. Materials and Methods. We utilized a large cross-sectional survey of the US noninstitutionalized residents (n=30,852) to investigate the racial/ethnic disparities in diabetes mellitus, and the degree in which the disparities are explained by the relevant covariates. Pearson’s chi-square was used to examine study variables by race/ethnicity, while logistic regression was used to assess the effect of race/ethnicity and other covariates on DM prevalence. Results. There were statistically significant ethnic/racial differences with respect to income, education, marital status, smoking, alcohol, physical activities, body mass index, and age, P<0.05, but not insurance coverage, P>0.05. Race/ethnicity was a single independent predictor of DM, with African Americans (non-Hispanic blacks) more likely to be diagnosed for DM compared with non-Hispanic whites, prevalence odds ratio (POR) 1.45, 95% confidence interval (CI) 1.30–1.62, while Hispanics were less likely to be diagnosed, POR = 0.98, 95% CI 0.87–1.09. Similarly, after controlling for potential confounders, the racial/ethnic variability in DM between AA/blacks and non-Hispanic whites persisted, adjusted POR = 1.30, 95% CI 1.15–1.47. Conclusions. Racial/ethnic variability exists in DM prevalence and is unexplained by racial/ethnic variance in education, income, marital status, smoking, alcohol, physical activities, age, and sex.

Download Full-text

Racial/ethnic disparities in HER2-positive breast cancer in the era of adjuvant trastuzmab.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.28_suppl.139 ◽

2015 ◽

Vol 33 (28_suppl) ◽

pp. 139-139

Author(s):

Vincent Caggiano ◽

Carol Parise

Keyword(s):

Breast Cancer ◽

African Americans ◽

Racial Disparities ◽

Ethnic Disparities ◽

Her2 Positive ◽

Her2 Positive Breast Cancer ◽

Risk Of Mortality ◽

Early Cohort ◽

Racial Ethnic ◽

Positive Breast Cancer

139 Background: Racial/ethnic disparities in breast cancer survival have been well-documented. Trastuzumab was FDA approved for adjuvant treatment of HER2-positive breast cancer in November, 2006 and has improved survival in these patients. The purpose of this study is to determine if racial disparities have changed in patients who were diagnosed with HER2 positive breast cancer in 2007-2012 when compared with patients who were diagnosed in 2000-2006. Methods: Using the California Cancer Registry, we identified 32,597 cases of first primary female invasive HER2-postive breast cancer. Cases were divided into two cohorts: Early - diagnosed in 2000-2006; Late - diagnosed in 2007-2012. Kaplan-Meier 6-year survival and Cox regression analysis was conducted to assess risk of mortality of African Americans, Hispanics, Asian/Pacific Islanders, and American Indians when compared with whites. Analyses were conducted separately for each cohort and adjusted for stage at diagnosis, grade, age, and socioeconomic status. Hazard ratios and 95% confidence intervals were reported. Use of trastuzumab was not documented. Results: When combining all HER2-positive subtypes (ER+/PR+/HER2+, ER-/PR+/HER2+, ER+/PR-/HER2+, ER-/PR-/HER2+), blacks had an increased risk of mortality (HR = 1.32; 95% CI: 1.16-1.49), in the early cohort but there were no differences for any other race. There were no differences in mortality by race/ethnicity in the late cohort. Separation of the HER2-positive subtypes showed that African Americans with the ER+/PR+/HER2+ subtype had higher mortality than whites (HR = 1.43; 95% CI: 1.17-1.75) in the early cohort but there was no difference in the late cohort. There were no racial disparities within either of the cohorts for the ER-/PR-/HER2+ subtype. Conclusions: Although we were unable to document use of anti-HER2 treatment, the era of adjuvant trastuzumab appears to have attenuated the black/white disparity in HER2 positive breast cancer.

Download Full-text

Patients fifty years and older attending two sexually transmitted disease clinics in Baltimore, Maryland

International Journal of STD & AIDS ◽

10.1177/0956462416646687 ◽

2016 ◽

Vol 28 (4) ◽

pp. 330-344 ◽

Cited By ~ 5

Author(s):

Susan A Tuddenham ◽

Kathleen R Page ◽

Patrick Chaulk ◽

Erika B Lobe ◽

Khalil G Ghanem

Keyword(s):

Sexually Transmitted Infections ◽

Older Women ◽

Risk Behaviors ◽

Sexually Transmitted Disease ◽

Older Patients ◽

Transmitted Disease ◽

Transmitted Infection ◽

Younger Patients ◽

Sexually Transmitted ◽

Younger Men

Many individuals remain sexually active into their eighth decade. Surveillance data suggest that rates of sexually transmitted infections in older patients are increasing. We compared demographics, risk behaviors, and predictors of acute infections in patients 50 years and older versus younger patients attending sexually transmitted disease clinics in Baltimore, Maryland. This was a retrospective study from a large electronic database of visits to two urban sexually transmitted disease clinics between 2005 and 2010. Proportions were compared using the Chi square test. Logistic regression was used to assess predictors of acute sexually transmitted infections in older versus younger groups. It was found that patients over 50 were more likely than younger patients to report never using condoms (32.6% [CI 0.31–0.34] versus 24.1% [CI 0.23–0.25]). The overall prevalence of acute sexually transmitted infections was 18.1% (CI 0.17–0.19) in older and 25.8% (CI 0.25–0.27) in younger patients. Older women were more likely to be diagnosed with trichomoniasis (21.5% [CI 18.6–24.5] versus 13.1% [CI 11.5–14.8]). Black race was predictive of having an acute sexually transmitted infections in younger men (OR 2.2 [CI 1.47–3.35]) and women (OR 2.7 [CI 1.34–5.30]) but not in older men (OR 1.2 [CI 0.79–1.73]) or women (OR 1.2 [CI 0.43–3.15]). Older age was associated with a decreased risk of acute STI diagnosis in younger men and older women only, while having had sex for money or drugs in the past month was predictive only in younger women. Reporting symptoms and increasing numbers of sexual partners in the last six months was predictive of acute sexually transmitted infection diagnosis in all age groups. Older patients seeking care at sexually transmitted disease clinics engage in important risk behaviors. Race, a factor predictive of acute sexually transmitted infections in younger patients is not a significant predictor of sexually transmitted infections in older persons.

Download Full-text

Pan cancer analysis of the intra-tumoral microbiome’s correlation with racial disparities.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.2519 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 2519-2519

Author(s):

Wei Tse Li ◽

Matthew Uzelac ◽

Jaideep Chakladar ◽

Lindsay M. Wong ◽

Aditi Gnanasekar ◽

...

Keyword(s):

Bladder Cancer ◽

African Americans ◽

Racial Disparities ◽

Racial Differences ◽

Asian Americans ◽

Environmental Influence ◽

Microbial Abundance ◽

Risk Of Death ◽

Incidence And Mortality ◽

Starting Point

2519 Background: Microbiome composition can influence cancer development and is moderated by diet, hygiene, sanitation, and other environmental variables. For example, a Mediterranean diet could increase breast Lactobacillus abundance, while the gut microbiome changes dramatically with fructose intake. Recent studies have revealed correlations between microbial abundance and racial disparities in cancer. Given these reports, it is critical to examine whether environmental influences on the microbiome contribute to racial disparities in cancer incidence and prognosis. Methods: We examined the intra-tumoral microbiome in the lungs, breasts, bladder, colon, rectum, cervix, head and neck, prostate, and pancreas (n = 4,169). Raw tumor RNA sequencing data were downloaded from The Cancer Genome Atlas (TCGA) and aligned to bacterial genomes. Microbial abundance was correlated to race, ethnicity, and prognostic variables (Kruskal-Wallis test or Cox regression, p< 0.05). Results: We identified several microbes correlated with racial disparities for breast and bladder cancer, two microbes for lung squamous cell carcinoma, and one microbe for colon cancer. For breast cancer, African Americans have the highest mortality rate, followed by white Americans and Asian Americans. We found that four microbes, all under the order Burkholderiales, were positively correlated with poor prognosis and were most abundant in African Americans and least abundant in Asian Americans. Therefore, increased abundance of these microbes may contribute to the observed mortality differences between races. For bladder cancer, Asian Americans have the lowest incidence and mortality rates. Seven microbes, including two Geobacillus, two Pseudomonas, and two Burkholderiales, positively correlate with good prognosis and are upregulated in Asian Americans. High Pseudomonas fluorescens abundance is positively correlated with decreased risk of death (HR: 0.57, 95% CI: 0.38-0.85). High abundance of the Burkholderiales R. pickettii (HR: 0.62, 95% CI: 0.42-0.92) and V. paradoxus (HR: 0.59, 95% CI: 0.36-0.98) also exhibit the same trend. Geobacillus and Pseudomonas are both present in food, while Burkholderiales can cause nosocomial infections and are altered by diet. Conclusions: Our study is the most comprehensive to date investigating racial differences in the intra-tumoral microbiome. Our data serve as a starting point for exploring whether environmental influence of microbial abundance contributes to racial disparities in cancer.

Download Full-text

Abstract 491: Racial Disparities in the Trends of Acute Myocardial Infarction Outcomes Among Medicaid Patients, 2007-2011

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.37.suppl_1.491 ◽

2017 ◽

Vol 37 (suppl_1) ◽

Author(s):

Oluwole M Adegbala ◽

Akintunde Akinjero ◽

Samson Alliu ◽

Adeyinka C Adejumo ◽

Emmanuel Akintoye ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

African Americans ◽

Length Of Stay ◽

Hospital Mortality ◽

Racial Disparities ◽

Racial Differences ◽

Length Of Hospital Stay ◽

The United States ◽

Racial Groups

Background: Although, in-hospital mortality from acute myocardial infarction (AMI) have declined in the United States recently, there is a gap in knowledge regarding racial differences in this trend. We sought to evaluate the effect of race on the trends in outcomes after Acute Myocardial Infarction among Medicaid patients in a nationwide cohort from 2007-2011 Methods: We extracted data from the Nationwide Inpatient Sample (NIS) for all hospitalizations between 2007 and 2011 for Medicaid patients aged 45 years or older with principal diagnosis of AMI using ICD-9-CM codes. Primary outcome of this study was all cause in-hospital mortality. We then stratified hospitalizations by racial groups; Whites, African Americans and Hispanics, and assessed the time trends of in-hospital mortality before and after multivariate analysis. Results: The overall mortality from AMI among Medicaid patients declined during the study period (8.80% in 2007 to 7.46% in 2011). In the adjusted models, compared to 2007, in-hospital mortality from AMI for Medicaid patients decreased across the 3 racial groups; Whites (aOR= 0.88, CI=0.70-0.99), African Americans (aOR=0.76, CI=0.57-1.01), Hispanics (aOR=0.87, CI=0.66-1.25). While the length of hospital stay declined significantly among African American and Hispanic with 2 days and 1.76 days decline respectively, the length of stay remained unchanged for Whites. There was non-significant increase in the incidence of stroke across the various racial groups; Whites (aOR= 1.23, CI=0.90 -1.69), African Americans (aOR=1.10, CI=0.73 -1.64), Hispanics (aOR=1.03, CI=0.68-1.55) when compared to 2007. Conclusion: In this study, we found that in-hospital mortality from AMI among Medicaid patients have declined across the racial groups. However, while the length of stay following AMI declined for African Americans and Hispanics with Medicaid insurance, it has remained unchanged for Whites. Future studies are necessary to identify determinants of these significant racial disparities in outcomes for AMI.

Download Full-text

Sentinel Surveillance of Sexually Transmitted Infection/HIV and Risk Behaviors in Vulnerable Populations in 5 Central American Countries

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0b013e318141f913 ◽

2007 ◽

Vol PAP ◽

Cited By ~ 2

Author(s):

Ram??n J Soto ◽

Annette E Ghee ◽

Cesar A Nu??ez ◽

Ruben Mayorga ◽

Kenneth A Tapia ◽

...

Keyword(s):

Risk Behaviors ◽

Vulnerable Populations ◽

Sexually Transmitted Infection ◽

Sentinel Surveillance ◽

Central American ◽

Transmitted Infection ◽

Sexually Transmitted

Download Full-text

Racial disparities in treatment patterns and outcomes among patients with multiple myeloma: a SEER-Medicare analysis

Blood Advances ◽

10.1182/bloodadvances.2019000308 ◽

2019 ◽

Vol 3 (20) ◽

pp. 2986-2994 ◽

Cited By ~ 12

Author(s):

Sikander Ailawadhi ◽

Kejal Parikh ◽

Safiya Abouzaid ◽

Zhou Zhou ◽

Wenxi Tang ◽

...

Keyword(s):

Multiple Myeloma ◽

African Americans ◽

Racial Disparities ◽

Autologous Stem Cell Transplant ◽

Cell Transplant ◽

Linear Regression Models ◽

Novel Therapy ◽

Therapy Initiation ◽

Hispanic Patients ◽

Racial Ethnic

Abstract The objective of the study was to assess racial disparities in the treatment and outcomes among white, African American, and Hispanic patients with multiple myeloma (MM). Patients with an MM diagnosis from the Surveillance Epidemiology and End Results (SEER)–Medicare (2007-2013) database were included. Continuous Medicare enrollment for 6 months before (baseline) and after MM diagnosis was required unless death occurred. Time from MM diagnosis to novel therapy initiation and autologous stem cell transplant (ASCT), overall survival (OS), and MM-specific survival (MSS) was evaluated. Unadjusted and multivariable regressions compared African Americans and Hispanics vs whites. Trends of novel therapy and ASCT use across MM diagnosis years were assessed using linear regression models. The study included 3504 whites, 858 African Americans, and 468 Hispanics. African Americans and Hispanics had a longer time from MM diagnosis to novel therapy initiation vs whites (median: 5.2 and 4.6 vs 2.7 months, respectively). All cohorts had an increasing trend of novel therapy initiation within 6 months of MM diagnosis, particularly whites (all P < .05). Median MSS was significantly longer for African Americans (5.4 years) than whites (4.5 years; P < .05), and was comparable for Hispanics and whites. Median OS was similar overall (2.6-2.8 years). ASCT rate within 1 year of MM diagnosis rose among whites and African Americans (P < .05), but not Hispanics, who were less likely to receive ASCT vs whites. Significant variations in novel therapy and ASCT use were observed among different racial/ethnic groups with MM. Although OS was similar, both African Americans and Hispanics may not be fully benefitting from the introduction of novel therapies, as they receive them later than whites.

Download Full-text

Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review

Nutrition Reviews ◽

10.1093/nutrit/nuz046 ◽

2019 ◽

Cited By ~ 3

Author(s):

Karen R Flórez ◽

Denise D Payán ◽

Kartika Palar ◽

Malcolm V Williams ◽

Bozena Katic ◽

...

Keyword(s):

United States ◽

Systematic Review ◽

African Americans ◽

Ethnic Disparities ◽

The United States ◽

Effect Sizes ◽

Community Based ◽

Vulnerable Communities ◽

Racial Ethnic ◽

The Church

Abstract Context Multilevel church-based interventions may help address racial/ethnic disparities in obesity in the United States since churches are often trusted institutions in vulnerable communities. These types of interventions affect at least two levels of socio-ecological influence which could mean an intervention that targets individual congregants as well as the congregation as a whole. However, the extent to which such interventions are developed using a collaborative partnership approach and are effective with diverse racial/ethnic populations is unclear, and these crucial features of well-designed community-based interventions. Objective The present systematic literature review of church-based interventions was conducted to assess their efficacy for addressing obesity across different racial/ethnic groups (eg, African Americans, Latinos). Data Sources and Extraction In total, 43 relevant articles were identified using systematic review methods developed by the Center for Disease Control and Prevention (CDC)’s Task Force on Community Preventive Services. The extent to which each intervention was developed using community-based participatory research principles, was tailored to the particular community in question, and involved the church in the study development and implementation were also assessed. Data Analysis Although 81% of the studies reported significant results for between- or within-group differences according to the study design, effect sizes were reported or could only be calculated in 56% of cases, and most were small. There was also a lack of diversity among samples (eg, few studies involved Latinos, men, young adults, or children), which limits knowledge about the ability of church-based interventions to reduce the burden of obesity more broadly among vulnerable communities of color. Further, few interventions were multilevel in nature, or incorporated strategies at the church or community level. Conclusions Church-based interventions to address obesity will have greater impact if they consider the diversity among populations burdened by this condition and develop programs that are tailored to these different populations (eg, men of color, Latinos). Programs could also benefit from employing multilevel approaches to move the field away from behavioral modifications at the individual level and into a more systems-based framework. However, effect sizes will likely remain small, especially since individuals only spend a limited amount of time in this particular setting.

Download Full-text