Effect of Race/ethnicity, Insurance Status, and Area Deprivation on Hip Fracture Outcomes Among Older Adults in the United States

2021 ◽  
pp. 105477382110612
Author(s):  
Chiyoung Lee ◽  
Eleanor Schildwachter McConnell ◽  
Sijia Wei ◽  
Tingzhong (Michelle) Xue ◽  
Hideyo Tsumura ◽  
...  
Keyword(s):  
Hip Fracture ◽  
The United States ◽  
The Other ◽  
Area Deprivation ◽  
Insurance Status ◽  
Post Discharge ◽  
Black Patients ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Deprived Areas

This retrospective cohort study used electronic health records to explore the effect of race/ethnicity, insurance status, and area deprivation on post-discharge outcomes in older patients undergoing hip fracture surgery between 2015 and 2018 ( N = 1,150). Inverse probability of treatment weight-adjusted regression analysis was used to identify the effects of the predictors on outcomes. White patients had higher 90- and 365-day readmission risks than Black patients and higher all-period readmissions than the Other racial/ethnic (Hispanic, Asian, American Indian, and Multicultural) group ( p < .000). Black patients had a higher risk of 30- and 90-day readmission than the Other racial/ethnic group ( p < .000). Readmission risk across 1-year follow-up was generally higher among patients from less deprived areas than more deprived areas ( p < .05). The 90- and 365-day mortality risk was lower for patients from less deprived areas (vs. more deprived areas) and patients with Medicare Advantage (vs. Medicare), respectively ( p < .05). Our findings can guide efforts to identify patients for additional post-discharge support. Nevertheless, the findings regarding readmission risks contrast with previous knowledge and thus require more validation studies.

scholarly journals Race/Ethnicity, Enrichment/Fortification, and Dietary Supplementation in the U.S. Population, NHANES 2009–2012

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1005 ◽  
Author(s):  
Angela M. Malek ◽  
Jill C. Newman ◽  
Kelly J. Hunt ◽  
Bernadette P. Marriott
Keyword(s):  
The United States ◽  
The Other ◽  
Income Poverty ◽  
Dietary Intakes ◽  
Health And Nutrition ◽  
Income Ratio ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Iron And Calcium ◽  
The U.S

In the United States (U.S.), food fortification and/or enrichment and dietary supplement (DS) use impacts nutrient intakes. Our aim was to examine race/ethnicity and income (Poverty Income Ratio, PIR) differences in meeting the Dietary Reference Intakes based on estimated dietary intakes among the U.S. population age ≥2 years (n = 16,975). Two 24-hour recalls from the National Health and Nutrition Examination Survey (NHANES) cycles 2009–2012 were used to estimate the intake of 15 nutrients as naturally occurring, enriched/fortified, and plus DSs. Across racial/ethnic groups and within PIR categories, significant differences were observed in the %< Estimated Average Requirement (EAR) for vitamin A following enrichment/fortification (E/F) and for vitamin B12 and riboflavin following both E/F and DS use when comparing non-Hispanic blacks, Hispanics, and the other race/ethnicity group to non-Hispanic whites. The %<EAR for iron and calcium also differed depending on race/ethnicity within PIR category (p < 0.05). The %<EAR was significantly lower for vitamin D after E/F for Hispanics, and after E/F combined with DS use for vitamins C and B6 for Hispanics and the other race/ethnicity group than non-Hispanic whites. Non-Hispanic blacks were inadequate in all nutrients examined except vitamin C based on the %<EAR than individuals of other races/ethnicities. Differences in the tolerable upper intake level (UL) of nutrients, especially folate and zinc, also varied by race/ethnicity and PIR category.

scholarly journals A Differential Item Functional Analysis by Age of Perceived Interpersonal Discrimination in a Multi-racial/ethnic Sample of Adults

2015 ◽  
Vol 25 (4) ◽  
pp. 479
Author(s):  
Sherry Owens ◽  
Alfgeir Kristjansson ◽  
Haslyn E.R. Hunte
Keyword(s):  
African Americans ◽  
The United States ◽  
The Other ◽  
Racial Groups ◽  
Asian Studies ◽  
Item Functioning ◽  
Multiple Indicator ◽  
Race Ethnicity ◽  
Interpersonal Discrimination ◽  
Racial Ethnic

<p> We investigated whether individual items on the nine item William’s Perceived Every­day Discrimination Scale (EDS) functioned differently by age (&lt;45 vs ≥45) within five racial groups in the United States: Asians (<em>n</em>=2,017); Hispanics (n=2,688); Black Caribbeans (<em>n</em>=1,377); African Americans (<em>n</em>=3,434); and Whites (<em>n</em>=854). We used data from the 2001-2003 National Survey of American Lives and the 2001- 2003 National Latino and Asian Studies. Multiple-indicator, multiple-cause models (MIMIC) were used to examine differential item functioning (DIF) on the EDS by age within each racial/ethnic group. Overall, Asian and Hispanic respondents reported less discrimination than Whites; on the other hand, African Americans and Black Caribbeans reported more discrimination than Whites. Regardless of race/ethnicity, the younger respondents (aged &lt;45 years) reported less discrimination than the older respondents (aged ≥45 years). In terms of age by race/ethnicity, the results were mixed for 19 out of 45 tests of DIF (40%). No differences in item function were observed among Black Caribbeans. “Being called names or insulted” and others acting as “if they are afraid” of the respondents were the only two items that did not exhibit dif­ferential item functioning by age across all racial/ethnic groups. Overall, our findings suggest that the EDS scale should be used with caution in multi-age multi-racial/ethnic samples. <em>Ethn Dis</em>.2015;25(4):479-486; doi:10.18865/ed.25.4.479</p>

scholarly journals Racial, ethnic and socioeconomic disparities in patients undergoing left atrial appendage closure

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318650
Author(s):  
Robbie Sparrow ◽  
Shubrandu Sanjoy ◽  
Yun-Hee Choi ◽  
Islam Y Elgendy ◽  
Hani Jneid ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Left Atrial Appendage ◽  
Kidney Injury ◽  
Complication Rates ◽  
Left Atrial Appendage Closure ◽  
Black Patients ◽  
Comorbidity Burden ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Major Adverse Events

ObjectiveThis manuscript aims to explore the impact of race/ethnicity and socioeconomic status on in-hospital complication rates after left atrial appendage closure (LAAC).MethodsThe US National Inpatient Sample was used to identify hospitalisations for LAAC between 1 October 2015 to 31 December 2018. These patients were stratified by race/ethnicity and quartiles of median neighbourhood income. The primary outcome was the occurrence of in-hospital major adverse events, defined as a composite of postprocedural bleeding, cardiac and vascular complications, acute kidney injury and ischaemic stroke.ResultsOf 6478 unweighted hospitalisations for LAAC, 58% were male and patients of black, Hispanic and ‘other’ race/ethnicity each comprised approximately 5% of the cohort. Adjusted by the older Americans population, the estimated number of LAAC procedures was 69.2/100 000 for white individuals, as compared with 29.5/100 000 for blacks, 47.2/100 000 for Hispanics and 40.7/100 000 for individuals of ‘other’ race/ethnicity. Black patients were ~5 years younger but had a higher comorbidity burden. The primary outcome occurred in 5% of patients and differed significantly between racial/ethnic groups (p<0.001) but not across neighbourhood income quartiles (p=0.88). After multilevel modelling, the overall rate of in-hospital major adverse events was higher in black patients as compared with whites (OR: 1.60, 95% CI 1.22 to 2.10, p<0.001); however, the incidence of acute kidney injury was higher in Hispanics (OR: 2.19, 95% CI 1.52 to 3.17, p<0.001). No significant differences were found in adjusted overall in-hospital complication rates between income quartiles.ConclusionIn this study assessing racial/ethnic disparities in patients undergoing LAAC, minorities are under-represented, specifically patients of black race/ethnicity. Compared with whites, black patients had higher comorbidity burden and higher rates of in-hospital complications. Lower socioeconomic status was not associated with complication rates.

scholarly journals 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

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.

The Impact of Race/Ethnicity on the Outcomes of Burn Patients: A Systematic Review of the Literature

2021 ◽  
Author(s):  
Jasmine Peters ◽  
Mariel S Bello ◽  
Leigh Spera ◽  
T Justin Gillenwater ◽  
Haig A Yenikomshian
Keyword(s):  
Systematic Review ◽  
Native American ◽  
The United States ◽  
Current Status ◽  
Surgical Trauma ◽  
Insurance Status ◽  
Inclusion Criteria ◽  
Burn Care ◽  
Race Ethnicity ◽  
The Impact

Abstract Racial and ethnic disparities are endemic to the United States and are only beginning to attract the attention of researchers. With an increasingly diverse population, focused and tailored medicine to provide more equitable care is needed. For surgical trauma populations, this topic is a small but expanding field and still rarely mentioned in burn medicine. Disparities in prevention, treatment, and recovery outcomes between different racial and ethnic minorities who are burned are rarely discussed. The purpose of this study is to determine the current status of identified disparities of care in the burn population literature and areas of future research. A systematic review was conducted of literature utilizing PubMed for articles published between 2000-2020. Searches were used to identify articles that crossed the burn term (burn patient OR burn recovery OR burn survivor OR burn care) and a race/ethnicity and insurance status-related term (race/ethnicity OR African-American OR Black OR Asian OR Hispanic OR Latino OR Native American OR Indigenous OR Mixed race OR 2 or more races OR socioeconomic status OR insurance status). Inclusion criteria were English studies in the US that discussed disparities in burn injury outcomes or risk factors associated with race/ethnicity. 1,169 papers were populated, 55 were reviewed, and 36 articles met inclusion criteria. Most studies showed minorities had poorer inpatient and outpatient outcomes. While this is a concerning trend, there is a paucity of literature in this field and more research is needed to create culturally-tailored medical care and address the needs of disadvantaged burn survivors.

Factor Structure for Chronic Stress Before and During Pregnancy by Racial/Ethnic Group

2018 ◽  
Vol 41 (5) ◽  
pp. 704-727 ◽  
Author(s):  
Sangmi Kim ◽  
Eun-Ok Im ◽  
Jianghong Liu ◽  
Connie Ulrich
Keyword(s):  
New York ◽  
Chronic Stress ◽  
Physical Violence ◽  
The United States ◽  
Birth Certificates ◽  
Specific Factor ◽  
Pregnancy Risk ◽  
Chronic Stressors ◽  
Race Ethnicity ◽  
Racial Ethnic

This study aimed to explore race/ethnicity-specific dimensionalities of chronic stress before and during pregnancy for non-Hispanic (N-H) White, N-H Black, Hispanic, and Asian women in the United States. This study analyzed the data among 6,850 women from the New York City and Washington State Pregnancy Risk Assessment Monitoring System (2004-2007) linked with birth certificates. Separate exploratory factor analysis was conducted by race/ethnicity using a maximum-likelihood extraction method with 26 chronic stress items before and during pregnancy. Correlations and internal consistency reliabilities among items and latent factors determined race/ethnicity-specific factor structures of chronic stress. Chronic stress was race/ethnicity-distinctive and multidimensional with low correlations among the factors ( r = .07-.28, p < .05). Despite financial hardship, perceived isolation, and physical violence underlying chronic stress among the racial/ethnic groups, intergroup variations existed under each group’s cultural or sociopolitical contexts. This study could help develop targeted strategies to intervene with women’s chronic stressors before childbirth.

scholarly journals The Differential Incidence and Severity of Food Insecurity by Racial, Ethnic, and Immigrant Groups over the Great Recession in the United States

2018 ◽  
Vol 108 ◽  
pp. 379-383 ◽  
Author(s):  
Alfonso Flores-Lagunes ◽  
Hugo B. Jales ◽  
Judith Liu ◽  
Norbert L. Wilson
Keyword(s):  
Food Insecurity ◽  
Great Recession ◽  
Decomposition Analysis ◽  
The United States ◽  
Structural Factors ◽  
Immigrant Status ◽  
The Great Recession ◽  
Extensive And Intensive Margins ◽  
Race Ethnicity ◽  
Racial Ethnic

We document the differences in food insecurity incidence and severity by race/ethnicity and immigrant status over the Great Recession. We show that the disadvantaged groups with a higher incidence of food insecurity do not necessarily have a higher severity of food insecurity, which underscores the importance of examining both the extensive and intensive margins of food insecurity. Our decomposition analysis indicates that the contribution of compositional and structural factors to the observed differences in exposure to food insecurity is heterogeneous across these groups and over the Great Recession. Finally, SNAP does not seem to fundamentally change the patterns documented.

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.

A Systematic Review of Parenting Scales Measurement Invariance/Equivalence of by Race and Ethnicity: Recommendations for Inclusive Parenting Research

Assessment ◽  
2021 ◽  
pp. 107319112110386
Author(s):  
Violeta J. Rodriguez ◽  
Dominique L. La Barrie ◽  
Miriam C. Zegarac ◽  
Anne Shaffer
Keyword(s):  
Systematic Review ◽  
Measurement Invariance ◽  
Ethnic Minorities ◽  
Race And Ethnicity ◽  
Parenting Practices ◽  
The United States ◽  
Weak Evidence ◽  
Race Ethnicity ◽  
Development And Validation ◽  
Racial Ethnic

The limited inclusion of racial/ethnic minorities in the development and validation of parenting measures limits our understanding of whether parenting constructs are valid in racial and ethnic minorities. Tests of measurement invariance/equivalence (MI/E) of parenting measures can help evaluate the validity of parenting constructs among racial/ethnic minorities. This systematic review summarized studies on MI/E of parenting constructs by race/ethnicity and evaluated the strength of the evidence. A literature search was conducted using various databases and references to retrieve studies from the United States. Indeed, 10 studies were identified that tested for MI/E of eight parenting scales by race/ethnicity. Only one scale showed moderate evidence of MI/E, five showed weak evidence of MI/E, and two showed no evidence of MI/E. Most studies (80%) used factor analytic methods to test for MI/E, but only two studies (20%) examined all levels of invariance. These findings show that differences exist in how racial/ethnic minorities perceive parenting constructs. Further research is needed to develop more inclusive parenting measures, to protect against the ways in which biased measures may pathologize or misrepresent parenting practices among racial/ethnic minorities.

scholarly journals Racial/Ethnic Disparities in Mortality: Contributions and Variations by Rurality in the United States, 2012–2015

2019 ◽  
Vol 16 (3) ◽  
pp. 436 ◽  
Author(s):  
Jeffrey Hall ◽  
Ramal Moonesinghe ◽  
Karen Bouye ◽  
Ana Penman-Aguilar
Keyword(s):  
Rural Areas ◽  
Ethnic Disparities ◽  
The United States ◽  
Mortality Rates ◽  
Malignant Neoplasms ◽  
Ethnic Populations ◽  
Asian Pacific Islanders ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
Racial Ethnic

The value of disaggregating non-metropolitan and metropolitan area deaths in illustrating place-based health effects is evident. However, how place interacts with characteristics such as race/ethnicity has been less firmly established. This study compared socioeconomic characteristics and age-adjusted mortality rates by race/ethnicity in six rurality designations and assessed the contributions of mortality rate disparities between non-Hispanic blacks (NHBs) and non-Hispanic whites (NHWs) in each designation to national disparities. Compared to NHWs, age-adjusted mortality rates for: (1) NHBs were higher for all causes (combined), heart disease, malignant neoplasms, and cerebrovascular disease; (2) American Indian and Alaska Natives were significantly higher for all causes in rural areas; (3) Asian Pacific islanders and Hispanics were either lower or not significantly different in all areas for all causes combined and all leading causes of death examined. The largest contribution to the U.S. disparity in mortality rates between NHBs and NHWs originated from large central metropolitan areas. Place-based variations in mortality rates and disparities may reflect resource, and access inequities that are often greater and have greater health consequences for some racial/ethnic populations than others. Tailored, systems level actions may help eliminate mortality disparities existing at intersections between race/ethnicity and place.

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