scholarly journals Racial Disparities in Context: Student-, School-, and County-Level Effects on the Likelihood of Obesity among Elementary School Students

2017 ◽  
Vol 4 (2) ◽  
pp. 245-260
Author(s):  
Joy Rayanne Piontak ◽  
Michael D. Schulman
Keyword(s):  
Childhood Obesity ◽  
Racial Disparities ◽  
Racial Differences ◽  
The United States ◽  
School Level ◽  
Racial Composition ◽  
County Level ◽  
School Students ◽  
Logistic Regression Models ◽  
The Impact

Childhood obesity rates in the United States have risen since the 1980s and are especially high among racial minorities. Researchers document differentials in obesity rates by race, socioeconomic status, school characteristics, and place. In this study, the authors examine the impact of race on the likelihood of obesity at the student, school, and county levels and the interactions between student race and school racial composition. The data are from 74,661 third to fifth grade students in 317 schools in 38 North Carolina counties. Multilevel logistic regression models showed that racial differences in the likelihood of obesity persisted even when racial composition and socioeconomic disadvantage at the school level were controlled. The differences between white and nonwhite students slightly decreased once school-level measures were added. The magnitude of the effects of student-level race on the relative odds of obesity varied according to the racial composition of the school. These student- and school-level results held even when county-level race and socioeconomic variables were controlled. The results show that contextual factors at the school and county levels are important social determinants of racial disparities in the likelihood of childhood obesity.

Abstract MP35: The American Heart Association’s Life’s Simple 7 and Mortality by Race and Sex in the U.S.: the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Mary Cushman ◽  
Suzanne E Judd ◽  
Virginia J Howard ◽  
Neil A Zakai ◽  
Brett Kissela ◽  
...  
Keyword(s):  
Racial Differences ◽  
Mortality Risk ◽  
Lower Risk ◽  
Population Sample ◽  
White Men ◽  
The United States ◽  
Risk Of Death ◽  
Life’S Simple 7 ◽  
Life's Simple 7 ◽  
The Impact

Background: The Life’s Simple 7 (LSS) metric is being used by AHA to track the cardiovascular health of the United States population and move toward a 2020 impact goal for improvement. Levels of LSS are associated with mortality risk but there are limited data on whether this association differs by race or sex. Hypothesis: There will be sex and race differences in the association of LSS with mortality in the REGARDS cohort study. Methods: We studied 29,692 REGARDS participants; a population sample of black and white men and women aged 45-98 from across the US, enrolled in 2003-7. Extensive baseline risk factor data were measured in participants’ homes. The 7 LSS components (blood pressure, cholesterol, glucose, body-mass index, smoking, physical activity, diet) were each scored in AHA-defined categories of poor (0 points), intermediate (1 point) and ideal (2 points), and were summed to yield scores ranging from poor for all (0) to ideal for all (14). With 6.4 years follow up there were 3709 deaths. Results: The LSS score was normally distributed with mean (SD) of 7.9 (2.0) in whites and 6.9 (2.0) in blacks. The age, region, income and education adjusted hazard ratio (HR) of death for a 1-unit worse LSS score, stratified by race and sex, are shown in the table. Race and sex interactions were tested individually in separate models. While better scores for LSS were strongly associated with lower mortality, associations differed by race and sex, being weaker in blacks than whites and in men than women. Conclusion: There were large associations of LSS with mortality risk in the REGARDS national sample; 1 point difference in score, corresponding to movement from poor to intermediate or intermediate to ideal for 1 of the 7 factors, was associated with a 16% lower risk of death in white women, 14% lower risk in white men or black women, but only an 11% lower risk in black men. Observed differences in the association of LSS with mortality by race and sex should be considered in efforts to gauge the impact of LSS interventions on health disparities.

Mustard Gas and American Race-Based Human Experimentation in World War II

2008 ◽  
Vol 36 (3) ◽  
pp. 517-521 ◽  
Author(s):  
Susan L. Smith
Keyword(s):  
World War Ii ◽  
Racial Differences ◽  
Cultural Beliefs ◽  
The United States ◽  
Chemical Warfare ◽  
Human Experimentation ◽  
United States Government ◽  
Mustard Gas ◽  
World War ◽  
The Impact

During World War II, scientists funded by the United States government conducted mustard gas experiments on 60,000 American soldiers as part of military preparation for potential chemical warfare. One aspect of the chemical warfare research program on mustard gas involved race-based human experimentation. In at least nine research projects conducted during the 1940s, scientists investigated how so-called racial differences affected the impact of mustard gas exposure on the bodies of soldiers. Building on cultural beliefs about “race,” these studies occurred on military bases and universities, which became places for racialized human experimentation.

scholarly journals Factors Underlying Racial Disparities in Sepsis Management

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 133
Author(s):  
Matthew DiMeglio ◽  
John Dubensky ◽  
Samuel Schadt ◽  
Rashmika Potdar ◽  
Krzysztof Laudanski
Keyword(s):  
Racial Disparities ◽  
Racial Differences ◽  
Minority Groups ◽  
The United States ◽  
Racial Groups ◽  
Sepsis Management ◽  
Treatment Protocols ◽  
Common Causes ◽  
Standardized Treatment ◽  
Wide Variability

Sepsis, a syndrome characterized by systemic inflammation during infection, continues to be one of the most common causes of patient mortality in hospitals across the United States. While standardized treatment protocols have been implemented, a wide variability in clinical outcomes persists across racial groups. Specifically, black and Hispanic populations are frequently associated with higher rates of morbidity and mortality in sepsis compared to the white population. While this is often attributed to systemic bias against minority groups, a growing body of literature has found patient, community, and hospital-based factors to be driving racial differences. In this article, we provide a focused review on some of the factors driving racial disparities in sepsis. We also suggest potential interventions aimed at reducing health disparities in the prevention, early identification, and clinical management of sepsis.

Differences in Career Satisfaction, Work–life Balance, and Stress by Gender in a National Survey of Pharmacy Faculty

2018 ◽  
Vol 33 (4) ◽  
pp. 415-419 ◽  
Author(s):  
Eric J. Ip ◽  
Tristan A. Lindfelt ◽  
Annie L. Tran ◽  
Amanda P. Do ◽  
Mitchell J. Barnett
Keyword(s):  
Career Satisfaction ◽  
Pharmacy Practice ◽  
The United States ◽  
Work Life ◽  
School Level ◽  
Work Life Balance ◽  
Academic Rank ◽  
Life Balance ◽  
Web Based ◽  
The Impact

Introduction The percentage of women pharmacy students and pharmacy faculty has greatly increased over the last 40 years. However, it is not known whether gender differences exist in terms of career satisfaction, work–life balance, and stress in the pharmacy academia workplace. Methods Results from a national web-based survey administered to American Association of Colleges of Pharmacy (AACP) members were utilized. Bivariate analyses were conducted to compare differences among faculty according to gender (men vs women). A series of multivariate models controlling for demographic and other faculty and school-level factors were created to explore the impact of gender on satisfaction with current position, satisfaction with work–life balance, and perceived stress. Results Among the 802 survey respondents, 457 (57.0%) women were more likely to be younger, hold a lower academic rank, and be in a pharmacy practice department, relative to 345 (43.0%) men. In adjusted results, men pharmacy faculty were more likely to report being extremely satisfied with their current job, more likely to report being extremely satisfied with their work–life balance, and score lower on a standardized stress measure relative to women. Conclusion While primarily descriptive, the results suggest women pharmacy faculty in the United States are less satisfied with their current academic position, less satisfied with their current work–life balance, and have higher stress levels compared to men even after controlling for age, academic rank, and department (along with other factors). Further research is needed to explore and address causes of the observed gender-related differences among pharmacy faculty.

scholarly journals Self-care perspective taking and empathy in a student-faculty book club in the United States

2020 ◽  
Vol 17 ◽  
pp. 22
Author(s):  
Rebecca Henderson ◽  
Melanie Gross Hagen ◽  
Zareen Zaidi ◽  
Valentina Dunder ◽  
Edlira Maska ◽  
...  
Keyword(s):  
United States ◽  
Perspective Taking ◽  
Book Club ◽  
Positive Impact ◽  
Self Care ◽  
The United States ◽  
School Students ◽  
Informal Curriculum ◽  
Meaningful Relationships ◽  
The Impact

Purpose: We aimed to study the impact of a combined faculty-student book club on education and medical practice as a part of the informal curriculum at the University of Florida College of Medicine in the United States.Methods: Sixteen medical students and 7 faculties who participated in the book club were interviewed through phone and recorded. The interview was then transcribed and entered into the qualitative data analysis program QSR NVivo (QSR International, Burlington, MA, USA). The transcripts were reviewed, and thematic codes were developed inductively through collaborative iteration. Based on these preliminary codes, a coding dictionary was developed and applied to all interviews within QSR Nvivo to identify themes.Results: Four main themes were identified from interviews: The first theme, the importance of literature to the development and maintenance of empathy and perspective-taking, and the second theme, the importance of the book club in promoting mentorship, personal relationships and professional development, were important to both student and faculty participants. The third and fourth themes, the need for the book club as a tool for self-care and the book club serving as a reminder about the world outside of school were discussed by student book club members.Conclusion: Our study demonstrated that an informal book club has a significant positive impact on self-care, perspective-taking, empathy, and developing a “world outside of school” for medical school students and faculty in the United States. It also helps to foster meaningful relationships between students and faculty.

Abstract 17019: Obesity and Cardiovascular Health in Young American Adults

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sarabjeet S Suri ◽  
Vibhu Parcha ◽  
Rajat Kalra ◽  
Garima Arora ◽  
Pankaj Arora
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Cardiovascular Health ◽  
Piecewise Linear ◽  
The United States ◽  
Obesity Prevalence ◽  
Logistic Regression Models ◽  
Prevalence Of Obesity ◽  
Adjusted Logistic Regression ◽  
The Impact

Background: The growing epidemic of obesity in the United States (US) is associated with cardiovascular (CV) morbidity and mortality. We evaluated the impact of the increasing obesity prevalence on the CV health of young American adults. Methods: The age-adjusted weighted prevalence of hypertension, diabetes, and hypercholesterolemia was estimated from the 2008-2018 National Health and Nutrition Examination Survey (NHANES) in American adults aged 18-44 years, stratified by the presence of obesity. The trends were evaluated using a piecewise linear regression approach. The odds for CV risk factors were estimated using multivariable-adjusted logistic regression models. Results: Among 14,919 young adults, the prevalence of obesity was 33.9% (95% CI: 32.6-35.3%). Obese young adults were more likely to be non-Hispanic Blacks and in lower socioeconomic and educational attainment strata (p<0.05 for all). Obese young adults had a greater risk of having hypertension (adjusted odds ratio [aOR]: 3.0 [95% CI: 2.7-3.4]), diabetes (aOR: 4.3 [95% CI: 3.3-5.6]), and hyperlipidemia (aOR: 1.47 [95% CI: 1.3-1.7]). Among obese, hypertension increased from 36.5% (33.9-39.1%) in 2007-2010 to 39.4% (35.6-43.1%) in 2015-2018 (p= 0.07) and diabetes increased from 4.7% (3.6-5.8%) in 2007-2010 to 7.1% (5.3-9.0%) in 2015-2018 (p=0.11). A modest increase in diabetes was seen in non-obese individuals ( Table ). Hypercholesterolemia prevalence remained unchanged from 12.6% (95% CI: 10.6-14.7%) 2007-2010 to 10.9% (95% CI: 9.0-12.8%) in 2015-2018 (p=0.27) among obese young adults. Non-obese young adults showed a decline in hypercholesterolemia from 9.5% (95% CI: 8.0-11.0%) in 2007- 2010 to 7.1% (95% CI: 5.8-8.4%) in 2015-2018 (p=0.002). Conclusions: Nearly one-in-every three young American adults have obesity, which is accompanied by a two-fold higher prevalence of CV risk factors. The CV morbidity in young adults is expected to increase with an increasing prevalence of obesity..

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

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.

Theorizing Gentrification as a Process of Racial Capitalism

2021 ◽  
pp. 153568412110547
Author(s):  
Zawadi Rucks-Ahidiana
Keyword(s):  
United States ◽  
Middle Class ◽  
Racial Differences ◽  
Low Income ◽  
The United States ◽  
Racial Composition ◽  
Qualitative And Quantitative ◽  
Racial Capitalism ◽  
Quantitative Studies ◽  
Prior Literature

Academics largely define gentrification based on changes in the class demographics of neighborhood residents from predominately low-income to middle-class. This ignores that gentrification always occurs in spaces defined by both class and race. In this article, I use the lens of racial capitalism to theorize gentrification as a racialized, profit-accumulating process, integrating the perspective that spaces are always racialized to class-centered theories. Using the prior literature on gentrification in the United States, I demonstrate how the concepts of value, valuation, and devaluation from racial capitalism explain where and how gentrification unfolds. Exposure to gentrification varies depending on a neighborhood’s racial composition and the gentrification stakeholders involved, which contributes to racial differences in the scale and pace of change and the implications of those changes for the processes of displacement. Revising our understanding of gentrification to address the racialization of space helps resolve seemingly contradictory findings across qualitative and quantitative studies.

scholarly journals Making cell culture more physiological: a call for a more comprehensive assessment of racial disparities in endothelial cell culture studies

2020 ◽  
Vol 318 (2) ◽  
pp. C238-C241 ◽  
Author(s):  
Austin T. Robinson ◽  
Marc D. Cook ◽  
Abbi D. Lane-Cordova
Keyword(s):  
Cell Culture ◽  
Endothelial Cell ◽  
Racial Disparities ◽  
Racial Differences ◽  
White Women ◽  
Microvascular Complications ◽  
The United States ◽  
Culture Studies ◽  
Endothelial Cell Function ◽  
Endothelial Cell Culture

In the United States, cardiovascular diseases (CVDs) are the leading cause of death and disproportionately affect ethnic and racial minority populations. Black individuals are more likely to develop advanced CVD and microvascular complications resulting in end-organ damage. Endothelial cell dysfunction leads to microvascular and macrovascular dysfunction and is predictive of the development of CVD. Black versus white racial disparities in in vivo and in vitro studies of endothelial cell function are well documented. However, race-related disparities in maternal environment and lifestyle may be a major unconsidered factor in racial differences in endothelial cell culture studies. Further, rates of hypertensive disorders of pregnancy are higher in black versus white women. These pregnancy complications may result in placental dysfunction, including excess production of inflammatory and antiangiogenic molecules that impair endothelial function. Therefore, studies that include other ethnic and racial minorities are needed, in addition to a more thorough characterization of endothelial cell donors and targeted cell culture studies (e.g., genotyping) to generate information that can be translated into effective preventive or treatment strategies for ethnic/racial disparities in CVD.

Racial and Ethnic Differences in Response to Anticoagulation: A Review of the Literature

2019 ◽  
pp. 089719001989414 ◽  
Author(s):  
Caitlin M. Gibson ◽  
Wei C. Yuet
Keyword(s):  
Racial Differences ◽  
Race And Ethnicity ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Ethnic Disparities ◽  
The United States ◽  
End Points ◽  
Medline Search ◽  
Drug Concentrations ◽  
The Impact

Introduction: Anticoagulants are among the most frequently prescribed medications in the United States. Racial and ethnic disparities in incidence and outcomes of thrombotic disorders are well-documented, but differences in response to anticoagulation are incompletely understood. Objective: The objective of this review is to describe the impact of race and ethnicity on surrogate and clinical end points related to anticoagulation and discuss racial or ethnic considerations for prescribing anticoagulants. Methods: A PubMed and MEDLINE search of clinical trials published between 1950 and May 2018 was conducted using search terms related to anticoagulation, specific anticoagulant drugs, race, and ethnicity. References of identified studies were also reviewed. English-language human studies on safety or efficacy of anticoagulants reporting data for different races or ethnicities were eligible for inclusion. Results: Seventeen relevant studies were identified. The majority of major trials reviewed for inclusion either did not include representative populations or did not report on the racial breakdown of participants. Racial differences in pharmacokinetics, dosing requirements, drug response, and/or safety end points were identified for unfractionated heparin, enoxaparin, argatroban, warfarin, rivaroxaban, and edoxaban. Conclusions: Race appears to influence drug concentrations, dosing, or safety for some but not all direct oral anticoagulants. This information should be considered when selecting anticoagulant therapy for nonwhite individuals.

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