scholarly journals A review of disparities in access to infertility care and treatment outcomes among Hispanic women

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Allison S. Komorowski ◽  
Tarun Jain
Keyword(s):  
Treatment Outcomes ◽  
White Women ◽  
Hispanic Women ◽  
Insurance Coverage ◽  
Vitro Fertilization ◽  
Societal Factors ◽  
Receive Treatment ◽  
To Receive ◽  
Hispanic White

AbstractHispanic women have lower rates of use of infertility services than non-Hispanic White women. There are many barriers that impede access to infertility care including economic, geographic, cultural, and societal factors and there are disparities in treatment outcomes. Hispanic women are less likely to seek infertility care than non-Hispanic White women and even after infertility evaluation, Hispanic women are less likely to receive treatment for their infertility. Lower use of infertility treatments among Hispanic women is unlikely to be driven solely by economic factors. There is disappointingly little data on in-vitro fertilization treatment outcomes including the population of Hispanic women, and existing data has yielded conflicting results. Incomplete and variable reporting of race data across clinics raises the potential for misclassification bias and invalid study conclusions. Addressing disparities in access to reproductive medicine in the Hispanic population will required a multifaceted approach including expanded insurance coverage, improved education for both patients and providers, and additional research on barriers to care.

scholarly journals Ambient air pollutant exposure and in vitro fertilization treatment outcomes in Zhengzhou, China

2021 ◽  
Vol 214 ◽  
pp. 112060
Author(s):  
Wei Dai ◽  
Hao Shi ◽  
Zhiqin Bu ◽  
Yiping Yu ◽  
Zhimin Sun ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Treatment Outcomes ◽  
Ambient Air ◽  
Air Pollutant ◽  
Vitro Fertilization

Associations between in vitro fertilization (IVF) insurance coverage and cumulative number of children

2012 ◽  
Vol 98 (3) ◽  
pp. S96-S97
Author(s):  
E.S. Jungheim ◽  
L. Pollack ◽  
G.A. Macones ◽  
R.R. Odem ◽  
K. Omurtag ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Insurance Coverage ◽  
Cumulative Number ◽  
Vitro Fertilization ◽  
Number Of Children

Racial and Ethnic Disparities in Peripartum Hysterectomy Risk and Outcomes

2021 ◽  
Author(s):  
Margaret H. Bogardus ◽  
Timothy Wen ◽  
Cynthia Gyamfi-Bannerman ◽  
Jason D. Wright ◽  
Dena Goffman ◽  
...  
Keyword(s):  
Black Women ◽  
Race And Ethnicity ◽  
White Women ◽  
Hispanic Women ◽  
Intraoperative Complications ◽  
Ethnic Disparities ◽  
Peripartum Hysterectomy ◽  
Increased Risk ◽  
Surgical Site Complications ◽  
Hispanic White

Objective This study aimed to determine whether race and ethnicity contribute to risks associated with peripartum hysterectomy. Study Design This retrospective cross-sectional study utilized the 2000–2014 Nationwide Inpatient Sample to analyze risk of peripartum hysterectomy and associated severe maternal morbidity, mortality, surgical injury, reoperation, surgical-site complications, and mortality by maternal race and ethnicity. Race and ethnicity were categorized as non-Hispanic white, non-Hispanic black, Hispanic, other, and unknown. Multivariable log-linear regression models including patient, clinical, and hospital risk factors were performed with adjusted risk ratios (aRRs) and 95% confidence intervals (CIs). Results Of 59,854,731 delivery hospitalizations, there were 45,369 peripartum hysterectomies (7.6 per thousand). Of these, 37.8% occurred among non-Hispanic white, 13.9% among non-Hispanic black, and 22.8% among Hispanic women. In adjusted analyses, non-Hispanic black (aRR: 1.21, 95% CI: 1.17–1.29) and Hispanic women (aRR: 1.25, 95% CI: 1.22–1.29) were at increased risk of hysterectomy compared with non-Hispanic white women. Risk for severe morbidity was increased for non-Hispanic black (aRR: 1.25, 95% CI: 1.19–1.33), but not for Hispanic (aRR: 1.02, 95% CI: 0.97–1.07) women. Between these three groups, risk for intraoperative complications was highest among non-Hispanic white women, risk for reoperation was highest among Hispanic women, and risk for surgical-site complications was highest among non-Hispanic black women. Evaluating maternal mortality, non-Hispanic black women (RR: 3.83, 95% CI: 2.65–5.53) and Hispanic women (RR: 2.49, 95% CI: 1.74–3.59) were at higher risk than non-Hispanic white women. Conclusion Peripartum hysterectomy and related complications other than death differed modestly by race. In comparison, mortality differentials were large supporting that differential risk for death in the setting of this high-risk scenario may be an important cause of disparities. Key Points

scholarly journals Factors beyond insurance coverage that are associated with in vitro fertilization dropout

2017 ◽  
Vol 108 (3) ◽  
pp. e42-e43
Author(s):  
D.E. Broughton ◽  
A. Eskew ◽  
M. Schulte ◽  
K. Omurtag ◽  
E. Jungheim
Keyword(s):  
In Vitro Fertilization ◽  
Insurance Coverage ◽  
Vitro Fertilization

Disparities at the Intersection of Race and Ethnicity: Examining Trends and Outcomes in Hispanic Women With Breast Cancer

2020 ◽  
pp. OP.20.00381
Author(s):  
Cosette D. Champion ◽  
Samantha M. Thomas ◽  
Jennifer K. Plichta ◽  
Edgardo Parrilla Castellar ◽  
Laura H. Rosenberger ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Racial Differences ◽  
White Women ◽  
Hispanic Women ◽  
Hazard Ratio ◽  
Tumor Subtype ◽  
Hispanic Patients ◽  
Race Ethnicity ◽  
Hispanic White

PURPOSE: We sought to examine tumor subtype, stage at diagnosis, time to surgery (TTS), and overall survival (OS) among Hispanic patients of different races and among Hispanic and non-Hispanic (NH) women of the same race. METHODS: Women 18 years of age or older who had been diagnosed with stage 0-IV breast cancer and who had undergone lumpectomy or mastectomy were identified in the National Cancer Database (2004-2014). Tumor subtype and stage at diagnosis were compared by race/ethnicity. Multivariable linear regression and Cox proportional hazards modeling were used to estimate associations between race/ethnicity and adjusted TTS and OS, respectively. RESULTS: A total of 44,374 Hispanic (American Indian [AI]: 79 [0.2%]; Black: 1,011 [2.3%]; White: 41,126 [92.7%]; Other: 2,158 [4.9%]) and 858,634 NH women (AI: 2,319 [0.3%]; Black: 97,206 [11.3%]; White: 727,270 [84.7%]; Other: 31,839 [3.7%]) were included. Hispanic Black women had lower rates of triple-negative disease (16.2%) than did NH Black women (23.5%) but higher rates than did Hispanic White women (13.9%; P < .001). Hispanic White women had higher rates of node-positive disease (23.2%) versus NH White women (14.4%) but slightly lower rates than Hispanic (24.6%) and NH Black women (24.5%; P < .001). Hispanic White women had longer TTS versus NH White women regardless of treatment sequence (adjusted means: adjuvant chemotherapy, 42.71 v 38.60 days; neoadjuvant chemotherapy, 208.55 v 201.14 days; both P < .001), but there were no significant racial differences in TTS among Hispanic patients. After adjustment, Hispanic White women (hazard ratio, 0.77 [95% CI, 0.74 to 0.81]) and Black women (hazard ratio, 0.75 [95% CI, 0.58 to 0.96]) had improved OS versus NH White women (reference) and Black women (hazard ratio, 1.15 [95% CI, 1.12 to 1.18]; all P < .05). CONCLUSION: Hispanic women had improved OS versus NH women, but racial differences in tumor subtype and nodal stage among Hispanic women highlight the importance of disaggregating racial/ethnic data in breast cancer research.

Factors That Influence the Decision to Receive Treatment for Proliferative Diabetic Retinopathy

1997 ◽  
Vol 23 (6) ◽  
pp. 653-655 ◽  
Author(s):  
Philip L. Reno ◽  
Cynthia L. Arfken ◽  
Joan M. Heins ◽  
Edwin B. Fisher
Keyword(s):  
Gender Differences ◽  
Diabetic Retinopathy ◽  
Patient Education ◽  
Proliferative Diabetic Retinopathy ◽  
Health Professionals ◽  
White Women ◽  
Diabetes Educator ◽  
Receive Treatment ◽  
And Gender ◽  
To Receive

Educational messages aimed at health professionals have stressed the importance of regular eye examinations for people with diabetes and the value of early treatment. To investigate whether the messages need to be expanded or tailored in a specific way, we asked people with diabetes (N=37) to describe their reactions to the diagnosis of proliferative diabetic retinopathy and the factors that influenced their decision to seek treatment. The findings reaffirm the importance of the physician's recommendation in pursuing treatment. Furthermore, a constructive response (eg, "knew it had to be taken care of ") to the diagnosis was associated with prior knowledge of the consequences of proliferative diabetic retinopathy. Minimal racial and gender differences were observed. White women reported being influenced by the experiences of others, and African Americans reported being influenced by the diabetes educator. These findings emphasize the importance of providing patient education not only following a diagnosis but also in anticipation of probable complications.

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