scholarly journals Prevalence of Chronic Conditions and Multimorbidities in a Geographically Defined Geriatric Population With Diverse Races and Ethnicities

2016 ◽  
Vol 30 (3) ◽  
pp. 421-444 ◽  
Author(s):  
Eunjung Lim ◽  
Krupa Gandhi ◽  
James Davis ◽  
John J. Chen
Keyword(s):  
Ethnic Differences ◽  
Chronic Conditions ◽  
Ethnic Disparities ◽  
Prevalence Rates ◽  
Older Individuals ◽  
Multivariable Logistic Regression Model ◽  
Geriatric Population ◽  
Race Ethnicity ◽  
Racial Ethnic

Objective: The objective of this study is to examine racial/ethnic differences in prevalence of chronic conditions and multimorbidities in the geriatric population of a state with diverse races/ethnicities. Method: Fifteen chronic conditions and their dyads and triads were investigated using Hawaii Medicare 2012 data. For each condition, a multivariable logistic regression model was used to investigate differences in race/ethnicity, adjusting for subject characteristics. Results: Of the 84,212 beneficiaries, 27.8% were Whites, 54.6% Asians, and 5.2% Hispanics. Racial/ethnic disparities were prevalent for most conditions. Compared with Whites, Asians, Hispanics, and Others showed significantly higher prevalence rates in hypertension, hyperlipidemia, diabetes, and most dyads or triads of the chronic conditions. However, Whites had higher prevalence rates in arthritis and dementia. Discussion: Race/ethnicity may need to be considered when making clinical decisions and developing health care programs to reduce health disparities and improve quality of life for older individuals with chronic conditions.

scholarly journals RACE/ETHNICITY AND U.S. ADULT MORTALITY

2011 ◽  
Vol 8 (1) ◽  
pp. 5-24 ◽  
Author(s):  
Robert A. Hummer ◽  
Juanita J. Chinn
Keyword(s):  
Ethnic Differences ◽  
Mexican Americans ◽  
Mexican Immigrants ◽  
Ethnic Disparities ◽  
Adult Mortality ◽  
Social Resources ◽  
Socioeconomic Resources ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Lower Mortality Risk

AbstractAlthough there have been significant decreases in U.S. mortality rates, racial/ethnic disparities persist. The goals of this study are to: (1) elucidate a conceptual framework for the study of racial/ethnic differences in U.S. adult mortality, (2) estimate current racial/ethnic differences in adult mortality, (3) examine empirically the extent to which measures of socioeconomic status and other risk factors impact the mortality differences across groups, and (4) utilize findings to inform the policy community with regard to eliminating racial/ethnic disparities in mortality. Relative Black-White differences are modestly narrower when compared to a decade or so ago, but remain very wide. The majority of the Black-White adult mortality gap can be accounted for by measures of socioeconomic resources that reflect the historical and continuing significance of racial socioeconomic stratification. Further, when controlling for socioeconomic resources, Mexican Americans and Mexican immigrants exhibit significantly lower mortality risk than non-Hispanic Whites. Without aggressive efforts to create equality in socioeconomic and social resources, Black-White disparities in mortality will remain wide, and mortality among the Mexican-origin population will remain higher than what would be the case if that population achieved socioeconomic equality with Whites.

scholarly journals Racial and Ethnic Differences in Risk and Protective Factors of Dementia and CIND in the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 666-666
Author(s):  
Nasim Ferdows ◽  
Maria Aranda
Keyword(s):  
Protective Factors ◽  
Ethnic Differences ◽  
Cardiovascular Health ◽  
Ethnic Disparities ◽  
Risk And Protective Factors ◽  
The United States ◽  
Older Individuals ◽  
Assessment Protocol ◽  
Dementia Prevalence ◽  
Racial Ethnic

Abstract Recent population-based studies have shown declines in dementia prevalence in high-income countries, suggesting that improved population cardiovascular health and rising levels of education in the past 25 year were associated with reduction of dementia risks. However, in the US, there are variations in educational attainment, prevalence and management of chronic diseases, and behaviors associated with poor cardiovascular health among racial and ethnic groups. We performed a retrospective analysis of 3,495 older individuals (65+) in 2016 who participated in Harmonized Cognitive Assessment Protocol (HCAP) subsample of the Health and Retirement Study (HRS), to examine racial/ethnic differences in risk and protective factors associated with dementia and cognitive impairment. Linking HCAP to HRS, we traced individuals back to 2000 and created a longitudinal data of HCAP population (2000-2016). We found that racial/ethnic differences in risk and in protective factors throughout the life-course were associated with racial and ethnic disparities in dementia prevalence.

scholarly journals Geographic Differences in the Dietary Quality of Food Purchases among Participants in the Nationally Representative Food Acquisition and Purchase Survey (FoodAPS)

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1233 ◽  
Author(s):  
Maya Vadiveloo ◽  
Elie Perraud ◽  
Haley W. Parker ◽  
Filippa Juul ◽  
Niyati Parekh
Keyword(s):  
Diet Quality ◽  
Ethnic Disparities ◽  
Healthy Eating Index ◽  
The South ◽  
Food Acquisition ◽  
The West ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Racial Ethnic

Objective grocery transactions may reflect diet, but it is unclear whether the diet quality of grocery purchases mirrors geographic and racial/ethnic disparities in diet-related diseases. This cross-sectional analysis of 3961 households in the nationally representative Food Acquisition and Purchase Survey evaluated geographic and racial/ethnic disparities in grocery purchase quality. Respondents self-reported demographics and recorded purchases over 7 days; the Healthy Eating Index (HEI) 2015 assessed diet quality. Survey-weighted multivariable-adjusted regression determined whether there were geographic and racial/ethnic differences in HEI-15 scores. Respondents were, on average, 50.6 years, non-Hispanic white (NHW) (70.3%), female (70.2%), and had attended some college (57.8%). HEI-15 scores differed across geographic region (p < 0.05), with the highest scores in the West (57.0 ± 0.8) and lowest scores in the South (53.1 ± 0.8), and there was effect modification by race/ethnicity (p-interaction = 0.02). Regionally, there were diet disparities among NHW and non-Hispanic black (NHB) households; NHWs in the South had HEI-15 scores 3.2 points lower than NHWs in the West (p = 0.003). Southern NHB households had HEI-15 scores 8.1 points lower than Western NHB households (p = 0.013). Racial/ethnic disparities in total HEI-15 by region existed in the Midwest and South, where Hispanic households in the Midwest and South had significantly lower diet quality than NHW households. Heterogeneous disparities in the diet quality of grocery purchases by region and race/ethnicity necessitate tailored approaches to reduce diet-related disease.

scholarly journals Racial-Ethnic Differences in Health-Related Quality of Life among Adults and Children with Glomerular Disease

2021 ◽  
pp. 1-13
Author(s):  
Jill R. Krissberg ◽  
Margaret E. Helmuth ◽  
Salem Almaani ◽  
Yi Cai ◽  
Daniel Cattran ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Disease Severity ◽  
Ethnic Differences ◽  
Glomerular Disease ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Race Ethnicity ◽  
Racial Ethnic

<b><i>Introduction:</i></b> Disparities in health-related quality of life (HRQOL) have been inadequately studied in patients with glomerular disease. The aim of this study was to identify relationships among race/ethnicity, socioeconomic status, disease severity, and HRQOL in an ethnically and racially diverse cohort of patients with glomerular disease. <b><i>Methods:</i></b> Cure Glomerulonephropathy (CureGN) is a multinational cohort study of patients with biopsy-proven glomerular disease. Associations between race/ethnicity and HRQOL were determined by the following: (1) missed school or work due to kidney disease and (2) responses to Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires. We adjusted for demographics, socioeconomic status, and disease characteristics using multivariable logistic and linear regression. <b><i>Results:</i></b> Black and Hispanic participants had worse socioeconomic status and more severe glomerular disease than white or Asian participants. Black adults missed work or school most frequently due to kidney disease (30 vs. 16–23% in the other 3 groups, <i>p</i> = 0.04), and had the worst self-reported global physical health (median score 44.1 vs. 48.0–48.2, <i>p</i> &#x3c; 0.001) and fatigue (53.8 vs. 48.5–51.1, <i>p</i> = 0.002), compared to other racial/ethnic groups. However, these findings were not statistically significant with adjustment for socioeconomic status and disease severity, both of which were strongly associated with HRQOL in adults. Among children, disease severity but not race/ethnicity or socioeconomic status was associated with HRQOL. <b><i>Conclusions:</i></b> Among patients with glomerular disease enrolled in CureGN, the worse HRQOL reported by black adults was attributable to lower socioeconomic status and more severe glomerular disease. No racial/ethnic differences in HRQOL were observed in children.

scholarly journals Maternal Socioeconomic Factors and Racial/Ethnic Differences in Neonatal Anthropometry

2020 ◽  
Vol 17 (19) ◽  
pp. 7323
Author(s):  
Calvin Lambert ◽  
Jessica L. Gleason ◽  
Sarah J. Pugh ◽  
Aiyi Liu ◽  
Alaina Bever ◽  
...  
Keyword(s):  
Marital Status ◽  
Socioeconomic Factors ◽  
Ethnic Differences ◽  
Ethnic Disparities ◽  
Low Risk ◽  
Abdominal Circumference ◽  
Full Time ◽  
Socioeconomic Characteristics ◽  
Race Ethnicity ◽  
Racial Ethnic

Disparities in birthweight by maternal race/ethnicity are commonly observed. It is unclear to what extent these disparities are correlates of individual socioeconomic factors. In a prospective cohort of 1645 low-risk singleton pregnancies included in the NICHD Fetal Growth Study (2009–2013), neonatal anthropometry was measured by trained personnel using a standard protocol. Socioeconomic characteristics included employment status, marital status, health insurance, annual income, and education. Separate adjusted generalized linear models were fit to both test the effect of race/ethnicity and the interaction of race/ethnicity and socioeconomic characteristics on neonatal anthropometry. Mean infant birthweight, length, head circumference, and abdominal circumference all differed by race/ethnicity (p < 0.001). We observed no statistically significant interactions between race/ethnicity and full-time employment/student status, marital status, insurance, or education in association with birthweight, neonatal exam weight, length, or head or abdominal circumference at examination. The interaction between income and race/ethnicity was significant only for abdominal circumference (p = 0.027), with no other significant interactions for other growth parameters, suggesting that racial/ethnic differences in neonatal anthropometry did not vary by individual socioeconomic factors in low-risk women. Our results do not preclude structural factors, such as lifetime exposure to poverty, as an explanation for racial/ethnic disparities.

scholarly journals Diet Quality of Children in the United States by Race/Ethnicity Within Categories of Body Mass Index (P18-110-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jessica Thomson ◽  
Melissa Goodman ◽  
Alicia Landry ◽  
Lisa Tussing-Humphreys
Keyword(s):  
United States ◽  
Ethnic Differences ◽  
Diet Quality ◽  
Mexican Americans ◽  
The United States ◽  
Normal Weight ◽  
Added Sugars ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Objectives To use the Healthy Eating Index-2015 (HEI-2015) to describe the diet quality of children in the United States by race/ethnicity within categories of body mass index (BMI) using a nationally representative sample. Methods Dietary datasets from three cycles of the National Health and Nutrition Examination Survey (2009–2014) were used to calculate HEI-2015 total and component scores using the population ratio method for children 2–18 years of age (N = 8894). Diet quality scores were computed by race/ethnicity (non-Hispanic black, non-Hispanic white, Mexican American, other Hispanic, and other race) within BMI category (normal weight, overweight, and obese). Means and 95% confidence intervals were computed for HEI-2015 total and component scores. Results Significant differences in HEI-2015 mean total scores were present in children with normal weight and overweight, but not obesity. For children with normal weight, the mean total score was significantly higher for Mexican Americans vs non-Hispanic blacks (57.1 vs 53 out of 100 points). For children with overweight, mean total scores were higher for Mexican Americans and other races vs non-Hispanic blacks (59.0 and 60.4 vs 50.3). For children with normal weight, racial/ethnic differences in mean scores were present for all 13 components except for total vegetables. For children with overweight, racial/ethnic differences in mean scores were present for seven components – total fruits, whole fruits, greens and beans, dairy, fatty acids, added sugars, and saturated fats. For children with obesity, racial/ethnic differences were present for two components – refined grains and added sugars. Due to small samples sizes resulting in unreliable estimates, results were not included for the underweight category. Conclusions Although significant diet quality differences were found among races/ethnicities within BMI categories, total diet quality scores were low for all populations of children in this study. These results suggest that efforts are still needed to improve the diet quality of children in the United States, regardless of BMI status. Funding Sources US Department of Agriculture, Agricultural Research Service.

scholarly journals Geographic Differences in the Dietary Quality of Food Purchases Among Participants in the Nationally-Representative Food Acquisition and Purchase Study (FoodAPS) (P04-158-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Maya Vadiveloo ◽  
Elie Perraud ◽  
Haley Parker ◽  
Filippa Juul ◽  
Niyati Parekh
Keyword(s):  
Diet Quality ◽  
Ethnic Disparities ◽  
Dietary Quality ◽  
The South ◽  
Food Acquisition ◽  
The West ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Racial Ethnic

Abstract Objectives Grocery purchases may serve as an objective measure of diet, but it is unclear whether the diet quality of grocery purchases reflect geographic and racial/ethnic disparities observed in existing nationally-representative individual-level data. This study evaluated whether geographic and racial/ethnic disparities exist in the dietary quality of grocery purchases in a nationally-representative sample of US households. Methods Grocery purchasing data from 3961 households from the Food Acquisition and Purchase Study (FoodAPS) were used. Demographic data was self-reported, and 7-day dietary data was recorded with scanners; the Healthy Eating Index (HEI) 2015 was used to assess diet quality. Survey-weighted multivariable-adjusted regression with planned contrasts was used to examine whether HEI-15 scores differed according to geographic region (Northeast, West, South, Midwest) and whether there was effect modification by race/ethnicity (Non-Hispanic White (NHW), Non-Hispanic Black (NHB) and Hispanic). Results Primary respondents were, on average, 50.6 years, NHW (70.3%), female (70.2%) and had attended some college (57.8%). The mean HEI-15 score was 54.7, and scores differed by geography (P < 0.05), with the highest scores in the West (57.0 ± 0.8) and lowest scores in the South (53.1 ± 0.8). The influence of region on HEI-15 scores varied by race/ethnicity (p-interaction = 0.015). Among NHW, households in the South had scores that were 3.2-points lower than in the West (50.4 ± 0.7 vs. 53.6 ± 0.8, P = 0.003). Southern NHB households also had lower diet quality than NHB households in the West (48.6 ± 1.5 vs. 56.7 ± 2.7, P = 0.01). Conversely, Hispanic households in the Midwest (47.5 ± 2.0) had lower diet quality than Hispanic households in the South (54.1 ± 0.9, P = 0.02). Diet quality only differed across race/ethnicity (versus the NHW referent group) in the South and Midwest where Hispanic households had higher diet quality than NHW (54.1 ± 0.9 vs. 50.4 ± 0.7, P = 0.007) in the South, but lower diet quality than NHW households in the Midwest (47.5 ± 2.0 vs 52.2 ± 0.6, P = 0.02). Conclusions Disparities in grocery purchase quality exist across US geographic regions and are divergent across racial/ethnic groups, which may reflect issues related to acculturation or environmental-level factors that require further study. Funding Sources This research was supported by the Rhode Island Foundation.

scholarly journals Racial/ethnic differences in health-related quality of life among Hawaii adult population

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Eunjung Lim ◽  
James Davis ◽  
Chathura Siriwardhana ◽  
Lovedhi Aggarwal ◽  
Allen Hixon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
General Health ◽  
Related Quality ◽  
Health Related ◽  
History Of ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Background This study examined racial/ethnic differences in health-related quality of life (HRQOL) among adults and identified variables associated with HRQOL by race/ethnicity. Methods This study was conducted under a cross-sectional design. We used the 2011–2016 Hawaii Behavioral Risk Factor Surveillance System data. HRQOL were assessed by four measures: self-rated general health, physically unhealthy days, mentally unhealthy days, and days with activity limitation. Distress was defined as fair/poor for general health and 14 days or more for each of the other three HRQOL measures. We conducted multivariable logistic regressions with variables guided by Anderson’s behavioral model on each distress measure by race/ethnicity. Results Among Hawaii adults, 30.4% were White, 20.9% Japanese, 16.8% Filipino, 14.6% Native Hawaiian and Pacific Islander (NHPI), 5.9% Chinese, 5.2% Hispanics, and 6.2% Other. We found significant racial/ethnic differences in the HRQOL measures. Compared to Whites, Filipinos, Japanese, NHPIs, and Hispanics showed higher distress rates in general health, while Filipinos and Japanese showed lower distress rates in the other HRQOL measures. Although no variables were consistently associated with all four HRQOL measures across all racial/ethnic groups, history of diabetes were significantly associated with general health across all racial/ethnic groups and history of depression was associated with at least three of the HRQOL measure across all racial/ethnic groups. Conclusions This study contributes to the literature on disparities in HRQOL and its association with other variables among diverse racial/ethnic subgroups. Knowing the common factors for HRQOL across different racial/ethnic groups and factors specific to different racial/ethnic groups will provide valuable information for identifying future public health priorities to improve quality of life and reduce health disparities.

scholarly journals Geographic Regional Variation in Patterns of Racial and Ethnic Disparities in Late-Life Depression

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 168-168
Author(s):  
Chirag Vyas ◽  
Charles Reynolds ◽  
David Mischoulon ◽  
Grace Chang ◽  
Olivia Okereke
Keyword(s):  
Native American ◽  
Ethnic Differences ◽  
Ethnic Disparities ◽  
Late Life ◽  
Geographic Region ◽  
Omega 3 ◽  
Late Life Depression ◽  
Item Level ◽  
Racial Ethnic ◽  
Hispanic White

Abstract There is evidence of racial/ethnic disparities in late-life depression (LLD) burden and treatment in the US. Geographic region may be a novel social determinant; yet, limited data exist regarding the interplay of geographic region with racial/ethnic differences in LLD severity, item-level symptom burden and treatment. We conducted a cross-sectional study among 25,503 men aged 50+ years and women aged 55+ years in VITAL-DEP (VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention), an ancillary study to the VITAL trial. Racial/ethnic groups included Non-Hispanic White, Black, Hispanic, Asian, and other groups (Native American/Alaskan Native and other/multiple/unspecified-race/ethnicity). We assessed depression status using: the Patient Health Questionnaire-8 (PHQ-8); self-reported clinician/physician diagnosis of depression; medication and/or counseling treatment for depression. In the full sample, Midwest region was significantly associated with 12% lower severity of LLD, compared to Northeast region (rate ratio (RR) (95% confidence interval (CI)): 0.88 (0.83-0.93)). However, racial/ethnic differences in LLD varied by region. For example, in the Midwest, Blacks and Hispanics had significantly higher depression severity compared to non-Hispanic Whites (RR (95% CI): for Black, 1.16 (1.02-1.31); for Hispanic, 2.03 (1.38-3.00)). Furthermore, in multivariable-adjusted logistic regression models, minority vs. non-Hispanic White adults had 2- to 3-fold significantly higher odds of several item-level symptoms across all regions, especially in the Midwest and Southwest. Finally, among those endorsing PHQ-8≥10, Blacks had 60-80% significantly lower odds of depression treatment, compared to non-Hispanic Whites, in all regions. In summary, we observed significant geographic variation in patterns of racial/ethnic disparities in LLD outcomes. This requires further longitudinal investigation.

scholarly journals Physical Activity as a Mediator in the Relationship Between Race or Ethnicity and Changes in Multimorbidity

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 342-342
Author(s):  
Jason Newsom ◽  
Emily Denning ◽  
Ana Quinones ◽  
Miriam Elman ◽  
Anda Botoseneanu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sex Education ◽  
Chronic Conditions ◽  
Structural Equation ◽  
Insurance Coverage ◽  
Ethnic Disparities ◽  
Later Life ◽  
Equation Modeling ◽  
The Relationship ◽  
Racial Ethnic

Abstract Racial/ethnic disparities in multimorbidity (≥2 chronic conditions) and their rate of accumulation over time have been established. Studies report differences in physical activity across racial/ethnic groups. We investigated whether racial/ethnic differences in accumulation of multimorbidity over a 10-year period (2004-2014) were mediated by physical activity using data from the Health and Retirement Study (N = 10,724, mean age = 63.5 years). Structural equation modeling was used to estimate a latent growth curve model of changes in the number of self-reported chronic conditions (of nine) and investigate whether the relationship of race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White) to change in the number of chronic conditions was mediated by physical activity after controlling for age, sex, education, marital status, personal wealth, and insurance coverage. Results indicated that Blacks engaged in significantly lower levels of physical activity than Whites (b = -.171, □ = -.153, p &lt; .001), but there were no differences between Hispanics and Whites (b = -.010, □ = -.008, ns). Physical activity also significantly predicted both lower initial levels of multimorbidity (b = -1.437, □ = -.420, p &lt; .001) and greater decline in multimorbidity (b = -.039, □ = -.075, p &lt; .001). The indirect (mediational) effect for the Black vs. White comparison was significant (b = .007, □ = .011, 95% CI [.004,.010]). These results provide important new information for understanding how modifiable lifestyle factors may help explain disparities in multimorbidity in middle and later life, suggesting greater need to reduce sedentary behavior and increase activity.

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