Addressing Health Disparities in the Undergraduate Curriculum: An Approach to Develop a Knowledgeable Biomedical Workforce

Disparities in health and healthcare are a major concern in the United States and worldwide. Approaches to alleviate these disparities must be multifaceted and should include initiatives that touch upon the diverse areas that influence the healthcare system. Developing a strong biomedical workforce with an awareness of the issues concerning health disparities is crucial for addressing this issue. Establishing undergraduate health disparities courses that are accessible to undergraduate students in the life sciences is necessary to increase students’ understanding and awareness of these issues and motivate them to address these disparities during their careers. The majority of universities do not include courses related to health disparities in their curricula, and only a few universities manage them from their life sciences departments. The figures are especially low for minority-serving institutions, which serve students from communities disproportionally affected by health disparities. Universities should consider several possible approaches to infuse their undergraduate curricula with health disparities courses or activities. Eliminating health disparities will require efforts from diverse stakeholders. Undergraduate institutions can play an important role in developing an aware biomedical workforce and helping to close the gap in health outcomes.

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Cortisol and Racial Health Disparities Affecting Black Men in Later Life: Evidence From MIDUS II

American Journal of Men s Health ◽

10.1177/1557988319870969 ◽

2019 ◽

Vol 13 (4) ◽

pp. 155798831987096 ◽

Cited By ~ 2

Author(s):

Julie Ober Allen ◽

Daphne C. Watkins ◽

Linda Chatters ◽

Arline T. Geronimus ◽

Vicki Johnson-Lawrence

Keyword(s):

United States ◽

Health Disparities ◽

Psychological Distress ◽

Health Outcomes ◽

Black Men ◽

White Men ◽

Later Life ◽

The United States ◽

Racial Health Disparities ◽

Medical Morbidity

In the United States, Black men have poorer overall health and shorter life spans than most other racial/ethnic groups of men, largely attributable to chronic health conditions. Dysregulated patterns of daily cortisol, an indicator of hypothalamic–pituitary–adrenal (HPA) axis stress–response functioning, are linked to poor health outcomes. Questions remain regarding whether and how cortisol contributes to Black–White differences in men’s health. This exploratory study compared early day changes in cortisol levels (diurnal cortisol slopes from peak to pre-lunch levels) and their associations with medical morbidity (number of chronic medical conditions) and psychological distress (Negative Affect Scale) among 695 Black and White male participants in the National Survey of Midlife in the United States (MIDUS II, 2004–2009). Black men exhibited blunted cortisol slopes relative to White men (−.15 vs. −.21, t = −2.97, p = .004). Cortisol slopes were associated with medical morbidity among Black men ( b = .050, t = 3.85, p < .001), but not White men, and were unrelated to psychological distress in both groups. Findings indicate cortisol may contribute to racial health disparities among men through two pathways, including the novel finding that Black men may be more vulnerable to some negative health outcomes linked to cortisol. Further, results suggest that while cortisol may be a mechanism of physical health outcomes and disparities among older men, it may be less important for their emotional health. This study increases understanding of how race and male sex intersect to affect not only men’s lived experiences but also their biological processes to contribute to racial health disparities among men in later life.

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A Conceptual Framework for Understanding How and Why People Take Antibiotics Without a Prescription

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.591 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s93-s93

Author(s):

Larissa Grigoryan ◽

Osvaldo Alquicira ◽

Susan Nash ◽

Melanie Goebel ◽

Barbara Trautner

Keyword(s):

United States ◽

At Risk ◽

Health Disparities ◽

Health Literacy ◽

Conceptual Framework ◽

Healthcare System ◽

Antibiotic Use ◽

The United States ◽

Clinical Encounter ◽

Inadequate Health Literacy

Background: The reported prevalence of nonprescription antibiotic use in the United States varies from 5% among socioeconomically and ethnically diverse primary care patients to 66% among Latino migrant workers. Reports indicate that people obtain and take antibiotics from stores or flea markets in the United States, friends or relatives, and leftover antibiotics from previous prescriptions. This unsafe practice may lead to unnecessary and inappropriate antibiotic use and increases the risk of antibiotic resistance. As groundwork to develop an intervention to decrease nonprescription antibiotic use, we mapped reported drivers of nonprescription use to the Kilbourne conceptual framework for advancing health disparities research. Methods: The Kilbourne framework consists of 3 phases: (1) detection of health disparities and identification of vulnerable populations, (2) understanding why disparities exist, and (3) reducing or eliminating disparities through interventions. We focused on the first 2 phases and mapped the identified drivers of nonprescription antibiotic use onto the key domains of the Kilbourne conceptual framework: patient, healthcare system, and clinical encounter factors. We also conducted brief field research to explore anecdotal reports regarding availability of nonprescription antibiotics in our community. Results: We found 8 studies addressing factors related to nonprescription antibiotic use in the United States. These studies were primarily qualitative and included Spanish-speaking Hispanic and Latino immigrants. Figure 1 shows the proposed factors that may directly or indirectly predict nonprescription antibiotic use. Key potential factors are individual factors, psychosocial factors, resources, healthcare system factors, and clinical-encounter factors. For example, patients with inadequate health literacy may have poor access to care because of difficulty finding providers and choosing or navigating insurance plans; thus, they may be at risk for nonprescription use. At the same time, patients with inadequate health literacy may be at risk for using nonprescription antibiotics for a viral infection because of difficulty understanding medication labels or package inserts. The relevance of resources (availability) to nonprescription antibiotic use was supported by our research team’s purchase of amoxicillin, tetracycline, and metronidazole without prescriptions from a flea market in Houston, Texas. Conclusions: The Kilbourne conceptual framework provides a strong, comprehensive basis for research and intervention in the challenging problem of nonprescription antibiotic use. Ongoing research will test the proposed relationships between patient, healthcare system, and clinical-encounter factors and nonprescription antibiotic use outcomes. We are conducting a survey among both indigent and insured patient populations to identify the relative importance of these factors and to validate our proposed conceptual framework of nonprescription antibiotic use.Funding: This project was supported by grant number R01HS026901 from the Agency.Disclosures: None

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Engaging Actively with Issues in the Responsible Conduct of Science: Lessons from International Efforts Are Relevant for Undergraduate Education in the United States

CBE—Life Sciences Education ◽

10.1187/cbe.13-09-0184 ◽

2013 ◽

Vol 12 (4) ◽

pp. 596-603 ◽

Cited By ~ 3

Author(s):

John D. Clements ◽

Nancy D. Connell ◽

Clarissa Dirks ◽

Mohamed El-Faham ◽

Alastair Hay ◽

...

Keyword(s):

United States ◽

Graduate Students ◽

Learning Strategies ◽

Undergraduate Students ◽

National Research Council ◽

Undergraduate Curriculum ◽

The United States ◽

Faculty Members ◽

Original Research ◽

Responsible Conduct

Numerous studies are demonstrating that engaging undergraduate students in original research can improve their achievement in the science, technology, engineering, and mathematics (STEM) fields and increase the likelihood that some of them will decide to pursue careers in these disciplines. Associated with this increased prominence of research in the undergraduate curriculum are greater expectations from funders, colleges, and universities that faculty mentors will help those students, along with their graduate students and postdoctoral fellows, develop an understanding and sense of personal and collective obligation for responsible conduct of science (RCS). This Feature describes an ongoing National Research Council (NRC) project and a recent report about educating faculty members in culturally diverse settings (Middle East/North Africa and Asia) to employ active-learning strategies to engage their students and colleagues deeply in issues related to RCS. The NRC report describes the first phase of this project, which took place in Aqaba and Amman, Jordan, in September 2012 and April 2013, respectively. Here we highlight the findings from that report and our subsequent experience with a similar interactive institute in Kuala Lumpur, Malaysia. Our work provides insights and perspectives for faculty members in the United States as they engage undergraduate and graduate students, as well as postdoctoral fellows, to help them better understand the intricacies of and connections among various components of RCS. Further, our experiences can provide insights for those who may wish to establish “train-the-trainer” programs at their home institutions.

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Treat Sexual Stigma to Heal Health Disparities: Improving Sexual Minorities’ Health Outcomes

Policy Insights from the Behavioral and Brain Sciences ◽

10.1177/2372732220942250 ◽

2020 ◽

Vol 7 (2) ◽

pp. 205-213

Author(s):

Jes L. Matsick ◽

Britney M. Wardecker ◽

Flora Oswald

Keyword(s):

Social Psychology ◽

United States ◽

Health Disparities ◽

Sexual Orientation ◽

Health Outcomes ◽

Empirical Evidence ◽

The United States ◽

Policy Implications ◽

Sexual Stigma ◽

Physical Health Problems

Despite recent strides toward equality in the United States, lesbian, gay, bisexual, transgender, and queer (LGBTQ) people continue to report experiences of sexual stigma and psychological and physical health problems. This article reviews empirical evidence of sexual stigma and sexual orientation-based health disparities. The current framework proposes that sexual orientation does not cause health disparities; homophobic individuals and societies do. Social psychology, recognizing the power of the situation, suggests that changing the stigmatizing environments for LGBTQ people can effectively reduce health disparities. The science has policy implications—notably, for audiences at three levels (intraindividual, interpersonal, and institutional)—and provides recommendations for mitigating sexual stigma and improving health.

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Immigration and Health Disparities

10.1093/obo/9780195389678-0311 ◽

2022 ◽

Keyword(s):

United States ◽

Health Disparities ◽

Health Outcomes ◽

Immigrant Health ◽

Limited English Proficiency ◽

Service Use ◽

The United States ◽

Health Risk Behaviors ◽

Health Concern ◽

Increased Risk

Migration continues to be an important component of globalization. With global movement comes migrants’ vulnerability, and the consequent intersection with health and health disparities. The immigrant population in the United States is expected to increase to about eighty-one million by 2050. This ongoing demographic transformation suggests that the health status, health risk behaviors, and health disparities of immigrants and their offspring may play a significant role in shaping the health outcomes of the American population. Immigrants are particularly considered a vulnerable population because of insufficient access to and utilization of health care, limited English proficiency, low socioeconomic status, immigrant status, stigmatization, marginalization, and increased risk for poor physical, psychological, and social health outcomes, especially among the working poor. These factors undoubtedly have detrimental effects on the health and health disparities of immigrants and their children. These social, environmental, and behavioral occurrences or life experiences accumulate over time to improve or jeopardize an individual’s health. Similarly, immigration policies have a tremendous impact on immigrant health disparities, especially during periods of strict and intense enforcement in the United States. Nativity has become a prominent domain in health disparities research. Given that nativity, racial, and ethnic health disparities continue to be a major public health concern, social work scholars and practitioners continue to work toward eliminating health disparities among population subgroups, including immigrants. Included in these discussions are immigrant health service use, immigrant health effects, salmon bias, and determinants of immigrant health. Also important in working with immigrants are problems with accessibility to health services.

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The Role of Gender and Sensation Seeking in Film Choice

Journal of Media Psychology Theories Methods and Applications ◽

10.1027/1864-1105.20.3.97 ◽

2008 ◽

Vol 20 (3) ◽

pp. 97-105 ◽

Cited By ~ 15

Author(s):

Smita C. Banerjee ◽

Kathryn Greene ◽

Marina Krcmar ◽

Zhanna Bagdasarov ◽

Dovile Ruginyte

Keyword(s):

United States ◽

Undergraduate Students ◽

Sensation Seeking ◽

Negative Mood ◽

Positive Mood ◽

The United States ◽

High Arousal ◽

Subject Design ◽

Happy Mood

This study demonstrates the significance of individual difference factors, particularly gender and sensation seeking, in predicting media choice (examined through hypothetical descriptions of films that participants anticipated they would view). This study used a 2 (Positive mood/negative mood) × 2 (High arousal/low arousal) within-subject design with 544 undergraduate students recruited from a large northeastern university in the United States. Results showed that happy films and high arousal films were preferred over sad films and low-arousal films, respectively. In terms of gender differences, female viewers reported a greater preference than male viewers for happy-mood films. Also, male viewers reported a greater preference for high-arousal films compared to female viewers, and female viewers reported a greater preference for low-arousal films compared to male viewers. Finally, high sensation seekers reported a preference for high-arousal films. Implications for research design and importance of exploring media characteristics are discussed.

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