Racial/Ethnic Variations in Social Determinants of Mental Health Among Medicare Advantage Beneficiaries

2021 ◽  
pp. 073346482110393
Author(s):  
Taehyun Kim ◽  
Kellee White ◽  
Eva DuGoff
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Ethnic Groups ◽  
American Indians ◽  
Social Determinants ◽  
Poor Mental Health ◽  
Native Hawaiians ◽  
Race Ethnicity ◽  
Ethnic Variations ◽  
Racial Ethnic

Objectives: We examine associations between social determinants and mental health and assess how the associations vary by race/ethnicity using a large, diverse sample of older adults. Method: A retrospective study of 444,057 older adults responding to the Medicare Health Outcomes Survey in 2015–2017 was conducted. Using a multilevel linear regression, we examined the associations between the self-reported number of unhealthy days due to mental health and social determinants, stratified by race/ethnicity. Results: Health factors were most strongly associated with unhealthy days across all racial/ethnic groups. Strength of other factors varied by race/ethnicity. Social/economic factors had stronger associations among Whites, Asians, and multiracial individuals, while such factors were not significant for American Indians/Alaska Natives and Native Hawaiians/Other Pacific Islanders. Discussion: We found varying degrees of associations between social determinants and poor mental health by racial/ethnic groups. These results suggest that homogeneous interventions may not meet the mental health needs of all.

Racial/ethnic variation in incidence rates for anal cancer in New Mexico.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 601-601
Author(s):  
Diaa Osman ◽  
Bridget N. Fahy ◽  
Jessica Belmonte ◽  
Angela W. Meisner ◽  
Charles Wiggins
Keyword(s):  
New Mexico ◽  
Ethnic Groups ◽  
American Indians ◽  
Anal Cancer ◽  
Cancer Incidence ◽  
Incidence Rates ◽  
Core Areas ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Cancer Incidence Rates

601 Background: Anal cancer comprises only 2.5% of all digestive system malignancies in the United States; only 8200 new cases are diagnosed annually, nevertheless, an increasing incidence rate has been noted. The goal of this study is to describe the incidence rates of anal cancer in New Mexico. New Mexico is a unique, mainly rural state, with unique demographics consisting of a large mix of patients being primarily Non-Hispanic White, Hispanics or Native Americans. Methods: All incident cases of anal cancer diagnosed among New Mexico residents during the twenty-year period 1995-2014 were identified from the population-based New Mexico Tumor Registry. Average annual age-adjusted incidence rates (US 2000 standard) were calculated by the direct method for non-Hispanic whites, Hispanics and American Indians. Incidence rates for non-Hispanic whites in nine core areas of the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program served as the comparison. Results: A total of 556 anal cancers were diagnosed among New Mexico residents during the study period, an average of approximate 28 cancers annually. Anal cancer incidence rates per 100,000 were highest for non-Hispanic whites (1.80, 95% Confidence Interval (CI) 1.62-1.98) in New Mexico, which were similar to rates for non-Hispanic whites (1.70, 95% CI 1.66-1.74) in nine core areas of the SEER Program. Statistically significant lower rates were observed in New Mexico Hispanics (0.92, 95% CI 0.76-1.11) and American Indians (0.75, 95% CI 0.45-1.16). Females had higher rates than males in each of these three racial/ethnic groups. Incidence rates increased from 1995-2004 to 2005-2014 for all race/ethnic groups, with the largest increase observed in Hispanic females. Conclusions: Anal cancer incidence rates vary by race/ethnicity and sex in New Mexico. Further research is needed to characterize time trends in incidence and to identify factors that may account for observed differences in incidence rates by race/ethnicity and sex in New Mexico.

Race/Ethnicity and Mental Health in the First Decade of the 21st Century

2012 ◽  
Vol 110 (2) ◽  
pp. 645-662 ◽  
Author(s):  
Beth Spenciner Rosenthal ◽  
W. Cody Wilson
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Ethnic Groups ◽  
Empirical Studies ◽  
Geographical Location ◽  
Social Demography ◽  
Race Ethnicity ◽  
Mean Differences ◽  
Racial Ethnic ◽  
Historical Epoch

Recent empirical studies on mental health generally report racial/ethnic differences in depression rates but typically do not control for potential confounding by sample contextual variations in historical epoch, geographical location, and social demography. An empirical study of race/ethnicity differences in psychological distress is reported as an attempt to control these contexts by using a sample that is homogeneous in age, historical epoch, geography, and social demography (954 youth ages 18–19 living in a single, large urban community). No mean differences in psychological distress were observed among four racial/ethnic groups: Asians, African Americans, Latinos, and non-Hispanic Whites. A second analysis compared 17 different racial/ethnic groups defined in terms of family national origin. No differences in psychological distress were found among these groups. The findings are consistent with the view that race/ethnicity itself is not related to disparities in mental health.

scholarly journals Medical and Mental Health Comorbidities Among Minority Racial/Ethnic Groups in the United States

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Naheed Ahmed ◽  
C. Andrew Conway
Keyword(s):  
Mental Health ◽  
United States ◽  
Psychological Distress ◽  
American Indians ◽  
Heart Attack ◽  
The United States ◽  
Cross Sectional ◽  
History Of ◽  
Race Ethnicity ◽  
Racial Ethnic

Objective. To examine the prevalence of and the association between comorbid disorders and race/ethnicity in the United States. Methods. Using cross-sectional data from the 2012 National Behavioral Risk Factor Surveillance System [N=45,207,844], we examined comorbidity of psychological distress with self-reported diagnosis of diabetes, angina, and with history of heart attack and stroke. Logistic regression was used to examine between group differences by race/ethnicity. Results. Unadjusted results indicate that American Indian [OR 4.01, 95%CI: 1.78, 9.04] and Hispanic [OR 1.55, 95%CI: 1.04, 2.33] participants were more likely to have psychological distress and history of heart attack in comparison to Whites. American Indians were more likely to have psychological distress with angina [OR 3.82, 95%CI: 1.92, 7.63], and with history of stroke [OR 4.25, 95%CI: 2.16-8.26] in unadjusted results when compared to White participants. Conclusions. Our results suggest that racial/ethnic minority groups are more likely to suffer from comorbid mental health and medical conditions, which may be a result of stress arising from discrimination and historical oppression of these populations.

scholarly journals Racial Disparities in Virologic Failure and Tolerability During Firstline HIV Antiretroviral Therapy

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Priya Bhagwat ◽  
Shashi N Kapadia ◽  
Heather J Ribaudo ◽  
Roy M Gulick ◽  
Judith S Currier
Keyword(s):  
Antiretroviral Therapy ◽  
Adverse Events ◽  
Socioeconomic Factors ◽  
Ethnic Groups ◽  
Virologic Failure ◽  
Virologic Suppression ◽  
Factors Associated ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

Abstract Background Racial/ethnic disparities in HIV outcomes have persisted despite effective antiretroviral therapy. In a study of initial regimens, we found viral suppression varied by race/ethnicity. In this exploratory analysis, we use clinical and socioeconomic data to assess factors associated with virologic failure and adverse events within racial/ethnic groups. Methods Data were from AIDS Clinical Trial Group A5257, a randomized trial of initial regimens with either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir (each combined with tenofovir DF and emtricitabine). We grouped participants by race/ethnicity and then used Cox-proportional hazards regression to examine the impact of demographic, clinical, and socioeconomic factors on the time to virologic suppression and time to adverse event reporting within each racial/ethnic group. Results We analyzed data from 1762 participants: 757 self-reported as non-Hispanic black (NHB), 615 as non-Hispanic white (NHW), and 390 as Hispanic. The proportion with virologic failure was higher for NHB (22%) and Hispanic (17%) participants compared with NHWs (9%). Factors associated with virologic failure were poor adherence and higher baseline HIV RNA level. Prior clinical AIDS diagnosis was associated with virologic failure for NHBs only, and unstable housing and illicit drug use for NHWs only. Factors associated with adverse events were female sex in all groups and concurrent use of medications for comorbidities in NHB and Hispanic participants only. Conclusions Clinical and socioeconomic factors that are associated with virologic failure and tolerability of antiretroviral therapy vary between and within racial and ethnic groups. Further research may shed light into mechanisms leading to disparities and targeted strategies to eliminate those disparities.

Applying the Health Belief Model to Characterize Racial/Ethnic Differences in Digital Conversations Related to Depression Pre– and Mid–COVID-19 (Preprint)

2021 ◽  
Author(s):  
Ruby Castilla-Puentes ◽  
Jacqueline Pesa ◽  
Caroline Brethenoux ◽  
Patrick Furey ◽  
Liliana Gil Valletta ◽  
...  
Keyword(s):  
Health Belief Model ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Health Belief ◽  
Depression Symptoms ◽  
Seeking Help ◽  
Key Drivers ◽  
Race Ethnicity ◽  
Belief Model ◽  
Racial Ethnic

BACKGROUND The prevalence of depression symptoms in the United States is >3 times higher mid–COVID-19 versus pre-pandemic. Racial/ethnic differences in mindsets around depression and the potential impact of the COVID-19 pandemic are not well characterized. OBJECTIVE To describe attitudes, mindsets, key drivers, and barriers related to depression pre– and mid–COVID-19 by race/ethnicity using digital conversations about depression mapped to health belief model (HBM) concepts. METHODS Advanced search, data extraction, and AI-powered tools were used to harvest, mine, and structure open-source digital conversations of US adults who engaged in conversations about depression pre– (February 1, 2019-February 29, 2020) and mid–COVID-19 pandemic (March 1, 2020-November 1, 2020) across the internet. Natural language processing, text analytics, and social data mining were used to categorize conversations that included a self-identifier into racial/ethnic groups. Conversations were mapped to HBM concepts (ie, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy). Results are descriptive in nature. RESULTS Of 2.9 and 1.3 million relevant digital conversations pre– and mid–COVID-19, race/ethnicity was determined among 1.8 million (62%) and 979,000 (75%) conversations pre– and mid–COVID-19, respectively. Pre–COVID-19, 1.3 million conversations about depression occurred among non-Hispanic Whites (NHW), 227,200 among Black Americans (BA), 189,200 among Hispanics, and 86,800 among Asian Americans (AS). Mid–COVID-19, 736,100 conversations about depression occurred among NHW, 131,800 among BA, 78,300 among Hispanics, and 32,800 among AS. Conversations among all racial/ethnic groups had a negative tone, which increased pre– to mid–COVID-19; finding support from others was seen as a benefit among most groups. Hispanics had the highest rate of any racial/ethnic group of conversations showing an avoidant mindset toward their depression. Conversations related to external barriers to seeking treatment (eg, stigma, lack of support, and lack of resources) were generally more prevalent among Hispanics, BA, and AS than among NHW. Being able to benefit others and building a support system were key drivers to seeking help or treatment for all racial/ethnic groups. CONCLUSIONS Applying concepts of the HBM to data on digital conversation about depression allowed organization of the most frequent themes by race/ethnicity. Individuals of all groups came online to discuss their depression. There were considerable racial/ethnic differences in drivers and barriers to seeking help and treatment for depression pre– and mid–COVID-19. Generally, COVID-19 has made conversations about depression more negative, and with frequent discussions of barriers to seeking care. These data highlight opportunities for culturally competent and targeted approaches to address areas amenable to change that might impact the ability of people to ask for or receive mental health help, such as the constructs that comprise the HBM.

scholarly journals Opioid Epidemic in the United States: Empirical Trends, and A Literature Review of Social Determinants and Epidemiological, Pain Management, and Treatment Patterns

2019 ◽  
Vol 8 (2) ◽  
pp. 89-100 ◽  
Author(s):  
Gopal K Singh ◽  
Isaac E. Kim, Jr. ◽  
Mehrete Girmay ◽  
Chrisp Perry ◽  
Gem P. Daus ◽  
...  
Keyword(s):  
Pain Management ◽  
Social Determinants ◽  
Drug Overdose ◽  
The United States ◽  
Opioid Epidemic ◽  
The Us ◽  
Drug Overdoses ◽  
Race Ethnicity ◽  
Overdose Mortality ◽  
Racial Ethnic

Objectives: Dramatic increases in opioid and drug overdose mortality have occurred in the United States (US) over the past two decades. To address this national public health crisis and identify gaps in the literature, we analyzed recent empirical trends in US drug overdose mortality by key social determinants and conducted a selective review of the recent literature on the magnitude of the opioid crisis facing different racial/ethnic, socioeconomic, and rural-urban segments of the US population. Methods: We used the 1999-2017 mortality data from the US National Vital Statistics System to analyze trends in drug overdose mortality by race/ethnicity, age, and geographic area. Log-linear regression was used to model mortality trends. Using various key words and their combinations, we searched PubMed and Google Scholar for select peerreviewed journal articles and government reports published on the opioid epidemic between 2010 and 2018. Results: Our original analysis and review indicate marked increases in drug overdose mortality overall and by race/ethnicity and geographic regions, with adolescents and young adults experiencing steep increases in mortality between 1999 and 2017. Our selective search yielded 405 articles, of which 39 publications were selected for detailed review. Suicide mortality from drug overdose among teens aged 12-19 increased consistently between 2009 and 2017, particularly among teen girls. The rise of efficient global supply chains has increased opioid prescription use and undoubtedly contributed to the opioid epidemic. Many other important contributing factors to the epidemic include lack of education and economic opportunities, poor working conditions, and low social capital in disadvantaged communities. Conclusions and Global Health Implications: Our analysis and review indicate substantial disparities in drug overdoses and related mortality, pain management, and treatment outcomes according to social determinants. Increases in drug overdoses and resultant mortality are not only unique to the US, but have also been observed in other industrialized countries. Healthcare systems, community leaders, and policymakers addressing the opioidepidemic should focus on upstream structural factors including education, economic opportunity, social cohesion, racial/ethnic disadvantage, geographic isolation, and life satisfaction. Key words: • Opioids • Drug overdose • Mortality • Pain management • Treatment • Race/Ethnicity • Social determinants • Health disparities Copyright © 2019 Singh et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Racial/Ethnic Disparities in Mammogram Frequency Among Women With Intellectual Disability

2019 ◽  
Vol 57 (3) ◽  
pp. 177-187 ◽  
Author(s):  
Evelyn Arana ◽  
Amy Carroll-Scott ◽  
Philip M. Massey ◽  
Nora L. Lee ◽  
Ann C. Klassen ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Black Women ◽  
Medical Record ◽  
Ethnic Groups ◽  
White Women ◽  
Ethnic Disparities ◽  
Medical Record Data ◽  
Record Data ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Little information exists on the associations between intellectual disability (ID) and race/ethnicity on mammogram frequency. This study collected survey and medical record data to examine this relationship. Results indicated that Hispanic and Black women with ID were more likely than White women with ID to have mammograms every 2 years. Participants who live in a state-funded residence, were aged 50+, and had a mild or moderate level of ID impairment were more likely to undergo mammography compared to participants living with family or alone, were <50, and had severe ID impairment. Further research is needed to understand the mechanisms explaining disparities in mammograms between these racial/ethnic groups.

Historical Trauma, Ethnic Experience, and Mental Health in a Sample of Urban American Indians

2019 ◽  
Vol 26 (2) ◽  
pp. 145-156
Author(s):  
Nicholas Guenzel ◽  
Leeza Struwe
Keyword(s):  
Mental Health ◽  
American Indians ◽  
Mental Health Problems ◽  
Psychological Symptoms ◽  
Historical Trauma ◽  
Poor Mental Health ◽  
Self Report ◽  
Data Set ◽  
Effective Care ◽  
Mainstream Society

BACKGROUND: Historical trauma (HT) among American Indians (AIs) has been linked with poor mental health but has been inadequately studied among urban populations. OBJECTIVES: The purpose of this study was to describe historical trauma, historical loss associated thoughts, ethnic experience, and psychological symptoms among a population of urban AIs. METHOD: This was a mixed methods study. In addition to focus groups, survey participants were administered the Historical Losses Scale, the Historical Losses Associated Symptoms Scale, the Scale of Ethnic Experience, and the Achenbach System of Empirically Based Assessment Adult Self-Report. Rates of psychological symptoms were compared with matched controls from a normative data set. RESULTS: Participants reported a strong sense of ethnic identity, a moderate desire to associate with other AIs, moderate comfort within mainstream society, and moderately high perceived discrimination. The most common HT themes were loss of culture, respect by children of traditional ways, and language. Compared with controls, participants had higher rates of aggressive behavior, substance use, thought problems, and obsessive symptoms, but some of these issues are likely explained by cultural factors. A greater number of participants met the clinical threshold for multiple problems compared with controls. CONCLUSIONS: This sample of AIs reported frequent experiences of discrimination. HT is a significant factor in the lives of many urban AIs who also have significantly higher rates of a number of mental health problems. Providers must be aware of these issues to provide the most effective care to AIs.

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