Health Disparities and the Heterogeneity of Blacks/African Americans in the United States: Why Should We Care?

2019 ◽  
Vol 21 (4) ◽  
pp. 492-495 ◽  
Author(s):  
Ann Oyare Amuta-Jimenez ◽  
Wura Jacobs ◽  
Gabrielle Smith
Keyword(s):  
Health Disparities ◽  
African Americans ◽  
Scientific Evidence ◽  
The United States ◽  
Health Interventions ◽  
Sociocultural Factors ◽  
Black Immigrants ◽  
Public Health Interventions ◽  
Black African ◽  
Health And Mortality

Each year, millions of dollars are spent on research and public health interventions targeted toward reducing health disparities primarily among the “Black/African Americans” community, yet the progress made lags far behind the amount of money and effort spent. We hypothesize that part of the problem is that sociocultural factors play a significant role in disease prevention. Most studies and programs aggregate “Black immigrants” (BIs) and “African Americans” (AAs) as “Black/African American.” This categorization assumes that the sociocultural determinants that influence BIs are the same as for AAs. BIs have health and mortality profiles that vary from AAs. This commentary aims to (1) introduce this idea in more depth and provide a brief scope of the problem, (2) provide scientific evidence of noteworthy differences between AAs and BIs in areas of sociodemographics, health behaviors, and health outcomes, (3) discuss implications of considering the Black/AA group as homogeneous and provide recommendations for disaggregation.

Two Peas in a Pod? An Exploratory Examination Into Cancer-Related Psychosocial Characteristics and Health Behaviors Among Black Immigrants and African Americans

2019 ◽  
Vol 46 (6) ◽  
pp. 1035-1044 ◽  
Author(s):  
Ann Oyare Amuta-Jimenez ◽  
Nafissatou Cisse-Egbounye ◽  
Wura Jacobs ◽  
Gabrielle P. A. Smith
Keyword(s):  
United States ◽  
African American ◽  
African Americans ◽  
Health Behaviors ◽  
Health Care Providers ◽  
The United States ◽  
Black Immigrants ◽  
Care Providers ◽  
Psychosocial Characteristics ◽  
Black African

Introduction. Most studies lump Black immigrants (BIs) and African Americans (AAs) as “Black/African American” during investigation. Such categorization assumes that the sociocultural determinants that influence BIs are the same as for AAs. This study attempts to disentangle the AA and BI subgroups to recognize the differences in cancer-related psychosocial characteristics and health behaviors. Methods. Merged data from the Health Information National Survey (2011–2017) were used. Two groups were created: those who identified as AA and those who identified as AA but were born outside the United States (BI). Between-group differences were assessed with Mann–Whitney U and chi-square tests. Results. Positive communication patterns with health care providers were significantly higher among AAs ( M [mean] = 3.41, SD [standard deviation] = 0.68) compared with BIs ( M = 3.28, SD = 0.71) ( p = .004). A greater proportion of BIs indicated that their health was excellent (14.2%), compared with AAs (7.9%). AAs reported higher cancer family history (75.1%) than BIs (46.5%). More AAs had smoked at least 100 cigarettes in their lifetime (41.5%) than BIs (16.7%). BIs consumed significantly more fruits each day ( M = 2.77, SD = 1.43) than AAs ( M = 2.40, SD = 1.44) ( p < .001). BIs also reported more physical activity ( M = 2.62, SD = 2.15) than AAs ( M = 2.37, SD = 2.18) ( p = .030). AA women were more likely to have had a pap smear test ( M = 2.07, SD = 1.44) compared with BI women ( M = 1.73, SD = 1.21) ( p = .002). Discussion. Evidence suggests the need to disentangle the “Black/African American” ethnic grouping. Lumping the BI populations together with the AAs, who have been in the United States for generations, may limit the ability to uncover and consequently address culturally driven disease prevention efforts and promote understanding of the biological, environmental, and psychosocial risk factors within Black heterogeneous populations.

scholarly journals Delayed Interventions, Low Compliance, and Health Disparities Amplified the Early Spread of COVID-19

2020 ◽  
Author(s):  
Aliea M. Jalali ◽  
Sumaia G. Khoury ◽  
JongWon See ◽  
Alexis M. Gulsvig ◽  
Brent M. Peterson ◽  
...  
Keyword(s):  
Public Health ◽  
Health Disparities ◽  
State Level ◽  
The United States ◽  
Health Interventions ◽  
Systematic Evaluation ◽  
Public Health Interventions ◽  
Multivariate Statistical ◽  
The Us ◽  
At Home

AbstractThe United States (US) public health interventions were rigorous and rapid, yet failed to arrest the spread of the Coronavirus Disease 2019 (COVID-19) pandemic as infections spread throughout the US. Many factors have contributed to the spread of COVID-19, and the success of public health interventions depends on the level of community adherence to preventative measures. Public health professionals must also understand regional demographic variation in health disparities and determinants to target interventions more effectively. In this study, a systematic evaluation of three significant interventions employed in the US, and their effectiveness in slowing the early spread of COVID-19 was conducted. Next, community-level compliance with a state-level stay at home orders was assessed to determine COVID-19 spread behavior. Finally, health disparities that may have contributed to the disproportionate acceleration of early COVID-19 spread between certain counties were characterized. The contribution of these factors for the disproportionate spread of the disease was analyzed using both univariate and multivariate statistical analyses. Results of this investigation show that delayed implementation of public health interventions, a low level of compliance with the stay at home orders, in conjunction with health disparities, significantly contributed to the early spread of the COVID-19 pandemic.

Disparities in Health Between Black and White Americans: Current Knowledge and Directions for Future Research

2018 ◽  
pp. 456-478
Author(s):  
Thomas E. Fuller-Rowell ◽  
David S. Curtis ◽  
Adrienne M. Duke
Keyword(s):  
Health Disparities ◽  
Current Knowledge ◽  
Public Investment ◽  
The United States ◽  
Future Research ◽  
Sociocultural Factors ◽  
White Americans ◽  
Biological Mechanisms ◽  
Black And White ◽  
Racial Ethnic

Conceptual frameworks for racial/ethnic health disparities are abundant, but many have received insufficient empirical attention. As a result, there are substantial gaps in scientific knowledge and a range of untested hypotheses. Particularly lacking is specificity in behavioral and biological mechanisms for such disparities and their underlying social determinants. Alongside lack of political will and public investment, insufficient clarity in mechanisms has stymied efforts to address racial health disparities. Capitalizing on emergent findings from the Midlife in the United States (MIDUS) study and other longitudinal studies of aging, this chapter evaluates research on health disparities between black and white US adults. Attention is given to candidate behavioral and biological mechanisms as precursors to group differences in morbidity and mortality and to environmental and sociocultural factors that may underlie these mechanisms. Future research topics are discussed, emphasizing those that offer promise with respect to illuminating practical solutions to racial/ethnic health disparities.

Recent Attitudes toward ADHD in the Broader Community: A Systematic Review

2021 ◽  
pp. 108705472110036
Author(s):  
Matthew Bisset ◽  
Leanne Winter ◽  
Christel M. Middeldorp ◽  
David Coghill ◽  
Nardia Zendarski ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Social Distance ◽  
Mental Health Literacy ◽  
The United States ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Negative Attitudes ◽  
Community Attitudes ◽  
Standardized Protocol

Objective: This review aimed to understand the broader community’s attitudes toward ADHD, which could facilitate public health interventions to improve outcomes for individuals with ADHD. Methods: A standardized protocol identified peer-reviewed studies focusing on attitudes of broader community samples, published from January 2014 to February 2020 (inclusive). Results: A total of 1,318 articles were screened and 10 studies were included, examining attitudes of broader community samples from Australia, Sweden, Germany, Finland, Korea, Indonesia, and the United States. Findings revealed that broader community samples displayed varying degrees of ADHD-related knowledge, negative attitudes (that ADHD is over-diagnosed; that pharmacological treatment is not acceptable; that those with ADHD are more likely to exhibit poor behavior), and a desire for maintaining social distance from individuals with ADHD. Conclusion: Findings suggest that community attitudes are generally negative toward those with ADHD. Targeted mental health literacy could provide an important avenue for improving the broader community’s attitudes toward those with ADHD.

Syphilis epidemiology and public health interventions in Western Australia from 1991 to 2009

Sexual Health ◽  
2012 ◽  
Vol 9 (3) ◽  
pp. 272 ◽  
Author(s):  
Kellie S. H. Kwan ◽  
Carolien M. Giele ◽  
Heath S. Greville ◽  
Carole A. Reeve ◽  
P. Heather Lyttle ◽  
...  
Keyword(s):  
Public Health ◽  
Western Australia ◽  
Aboriginal People ◽  
Congenital Syphilis ◽  
The United States ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Sex With Men ◽  
Notification Data ◽  
The Impact

Objectives To describe the epidemiology of congenital and infectious syphilis during 1991–2009, examine the impact of public health interventions and discuss the feasibility of syphilis elimination among Aboriginal people in Western Australia (WA). Methods: WA congenital and infectious syphilis notification data in 1991–2009 and national infectious syphilis notification data in 2005–2009 were analysed by Aboriginality, region of residence, and demographic and behavioural characteristics. Syphilis public health interventions in WA from 1991–2009 were also reviewed. Results: During 1991–2009, there were six notifications of congenital syphilis (50% Aboriginal) and 1441 infectious syphilis notifications (61% Aboriginal). During 1991–2005, 88% of notifications were Aboriginal, with several outbreaks identified in remote WA. During 2006–2009, 62% of notifications were non-Aboriginal, with an outbreak in metropolitan men who have sex with men. The Aboriginal : non-Aboriginal rate ratio decreased from 173 : 1 (1991–2005) to 15 : 1 (2006–2009). Conclusions: These data demonstrate that although the epidemiology of syphilis in WA has changed over time, the infection has remained endemic among Aboriginal people in non-metropolitan areas. Given the continued public health interventions targeted at this population, the limited success in eliminating syphilis in the United States and the unique geographical and socioeconomic features of WA, the elimination of syphilis seems unlikely in this state.

scholarly journals Accurate spatiotemporal mapping of drug overdose deaths by machine learning of drug-related web-searches

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243622
Author(s):  
David S. Campo ◽  
Joseph W. Gussler ◽  
Amanda Sue ◽  
Pavel Skums ◽  
Yury Khudyakov
Keyword(s):  
Public Health ◽  
Machine Learning ◽  
Strong Association ◽  
The United States ◽  
Health Interventions ◽  
Morbidity And Mortality ◽  
Public Health Interventions ◽  
Mortality Trends ◽  
Spatiotemporal Mapping ◽  
Increased Risk

Persons who inject drugs (PWID) are at increased risk for overdose death (ODD), infections with HIV, hepatitis B (HBV) and hepatitis C virus (HCV), and noninfectious health conditions. Spatiotemporal identification of PWID communities is essential for developing efficient and cost-effective public health interventions for reducing morbidity and mortality associated with injection-drug use (IDU). Reported ODDs are a strong indicator of the extent of IDU in different geographic regions. However, ODD quantification can take time, with delays in ODD reporting occurring due to a range of factors including death investigation and drug testing. This delayed ODD reporting may affect efficient early interventions for infectious diseases. We present a novel model, Dynamic Overdose Vulnerability Estimator (DOVE), for assessment and spatiotemporal mapping of ODDs in different U.S. jurisdictions. Using Google® Web-search volumes (i.e., the fraction of all searches that include certain words), we identified a strong association between the reported ODD rates and drug-related search terms for 2004–2017. A machine learning model (Extremely Random Forest) was developed to produce yearly ODD estimates at state and county levels, as well as monthly estimates at state level. Regarding the total number of ODDs per year, DOVE’s error was only 3.52% (Median Absolute Error, MAE) in the United States for 2005–2017. DOVE estimated 66,463 ODDs out of the reported 70,237 (94.48%) during 2017. For that year, the MAE of the individual ODD rates was 4.43%, 7.34%, and 12.75% among yearly estimates for states, yearly estimates for counties, and monthly estimates for states, respectively. These results indicate suitability of the DOVE ODD estimates for dynamic IDU assessment in most states, which may alert for possible increased morbidity and mortality associated with IDU. ODD estimates produced by DOVE offer an opportunity for a spatiotemporal ODD mapping. Timely identification of potential mortality trends among PWID might assist in developing efficient ODD prevention and HBV, HCV, and HIV infection elimination programs by targeting public health interventions to the most vulnerable PWID communities.

A TEST OF THE AFRO CARIBBEAN MODEL MINORITY HYPOTHESIS

2016 ◽  
Vol 13 (1) ◽  
pp. 109-138 ◽  
Author(s):  
Mosi Adesina Ifatunji
Keyword(s):  
Labor Market ◽  
African Americans ◽  
Racial Inequality ◽  
Model Minority ◽  
The United States ◽  
Black Immigrants ◽  
Race And Racism ◽  
Market Outcomes ◽  
Mixed Support ◽  
And Function

AbstractThroughout the twentieth century, Black immigrants from the Caribbean attained greater socioeconomic status than African Americans. Although Black immigrants remain an understudied population, recent studies show that Afro Caribbeans continue to outperform African Americans in the labor market. Given that these groups share a set of racialized physical features, some contend that this gap highlights the role of cultural attributes in the manufacture of Black ethnic and Black-White racial disparities. In this study, I investigate the degree to which cultural attributes associated with a specific form of themodel minority hypothesisare responsible for disparities between African Americans and Afro Caribbeans. I use data from theNational Survey of American Lifein order to test for the relative roles of work ethic, economic autonomy, oppositionality, family structure and function, and racial attitudes in the manufacture of disparate labor market outcomes between African Americans and Afro Caribbeans. I find mixed support for the idea that Afro Caribbeans constitute a model minority vis-à-vis African Americans and that differences in model minority attributes are only partially responsible for these labor market disparities. My findings suggest that racial inequality will not be undone if the racially stigmatized and marginalized simply work harder and complain less about race and racism in the United States.

scholarly journals Using network clustering to predict copy number variations associated with health disparities

2014 ◽  
Author(s):  
Yi Jiang ◽  
Hong HQ Qin ◽  
Li Yang
Keyword(s):  
Health Disparities ◽  
African Americans ◽  
Copy Number ◽  
Gene Networks ◽  
The United States ◽  
Copy Number Variations ◽  
Network Clustering ◽  
Network Cluster ◽  
Pathogenic Genes ◽  
Causal Genes

Substantial health disparities exist between African Americans and Caucasians in the United States. Copy number variations (CNVs) are one form of human genetic variations that have been linked with complex diseases and often occur at different frequencies among African Americans and Caucasian populations. Here, we aimed to investigate whether CNVs with differential frequencies can contribute to health disparities from the perspective of gene networks. We inferred network clusters from human gene/protein networks based on two different data sources. We then evaluated each network cluster for the occurrences of known pathogenic genes and genes located in CNVs with different population frequencies, and used false discovery rates to rank network clusters. This approach let us identify five clusters enriched with known pathogenic genes and with genes located in CNVs with different frequencies between African Americans and Caucasians. These clustering patterns predict two candidate causal genes located in four population-specific CNVs that play potential roles in health disparities

scholarly journals Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

2020 ◽  
Author(s):  
Xiaoshuang Liu ◽  
Xiao Xu ◽  
Guanqiao Li ◽  
Xian Xu ◽  
Yuyao Sun ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
The United States ◽  
School Closure ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Health Crisis ◽  
The Us ◽  
Individualized Decision

Abstract Background: The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain.Methods: Based on the reported cases, the effective reproduction number (Rt) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between R t and NPIs through a generalized linear model (GLM). Results: Different NPIs were found to have led to different levels of reduction in Rt. Stay-at-home contributed approximately 51% (95% CI 46%-57%), wearing (face) masks 29% (15%-42%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-14%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 7% (2%-11%).Conclusions: This retrospective assessment of NPIs on Rt has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

scholarly journals Public Health Interventions’ Effect on Hospital Use in Patients With COVID-19: Comparative Study (Preprint)

2020 ◽  
Author(s):  
Xiaofeng Wang ◽  
Rui Ren ◽  
Michael W Kattan ◽  
Lara Jehi ◽  
Zhenshun Cheng ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
New York ◽  
New York State ◽  
The United States ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Social Distancing ◽  
Transmission Rates ◽  
Hospital Use

BACKGROUND Different states in the United States had different nonpharmaceutical public health interventions during the COVID-19 pandemic. The effects of those interventions on hospital use have not been systematically evaluated. The investigation could provide data-driven evidence to potentially improve the implementation of public health interventions in the future. OBJECTIVE We aim to study two representative areas in the United States and one area in China (New York State, Ohio State, and Hubei Province), and investigate the effects of their public health interventions by time periods according to key interventions. METHODS This observational study evaluated the numbers of infected, hospitalized, and death cases in New York and Ohio from March 16 through September 14, 2020, and Hubei from January 26 to March 31, 2020. We developed novel Bayesian generalized compartmental models. The clinical stages of COVID-19 were stratified in the models, and the effects of public health interventions were modeled through piecewise exponential functions. Time-dependent transmission rates and effective reproduction numbers were estimated. The associations of interventions and the numbers of required hospital and intensive care unit beds were studied. RESULTS The interventions of social distancing, home confinement, and wearing masks significantly decreased (in a Bayesian sense) the case incidence and reduced the demand for beds in all areas. Ohio’s transmission rates declined before the state’s “stay at home” order, which provided evidence that early intervention is important. Wearing masks was significantly associated with reducing the transmission rates after reopening, when comparing New York and Ohio. The centralized quarantine intervention in Hubei played a significant role in further preventing and controlling the disease in that area. The estimated rates that cured patients become susceptible in all areas were small (&lt;0.0001), which indicates that they have little chance to get the infection again. CONCLUSIONS The series of public health interventions in three areas were temporally associated with the burden of COVID-19–attributed hospital use. Social distancing and the use of face masks should continue to prevent the next peak of the pandemic.

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