Impact of patient-provider race/ethnicity and gender concordance on cancer screening: Findings from medical expenditure panel survey.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 1547-1547
Author(s):  
Jyoti Malhotra ◽  
David Rotter ◽  
Jennifer Tsui ◽  
Adana Llanos ◽  
Bijal A Balasubramanian ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Gender Concordance ◽  
Screening Adherence ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender ◽  
Racial Ethnic

1547 Background: Racial/ethnic minority groups experience lower rates of cancer screening compared to non-Hispanic (NH) whites. Previous studies evaluating the role of patient-provider race/ethnicity and gender concordance in cancer screening have been inconclusive. Methods: We conducted a cross-sectional study of 18,690 patient-provider pairs using the 2003-2010 Medical Expenditure Panel Survey (MEPS) data. We assessed association between patient-provider race/ethnicity and gender concordance and, screening adherence for breast, cervical, and colorectal cancer using American Cancer Society guidelines. Separate multivariable logistic regression adjusting for demographics, self-reported health and MEPS survey year were conducted to examine relationships of interest. Results: Seventy percent of patients were NH-white, 15% were NH-black and 15% were Hispanic. Patients adherent to cancer screening were more likely to be non-Hispanic, better educated, married, wealthier, and privately insured. Among NH-black and NH-whites, patient-provider racial/ethnic concordance was not associated with screening adherence. Among Hispanics, patient-provider racial/ethnic discordant pairs had higher colorectal cancer screening rates as compared to concordant pairs (OR 1.48; 95% CI 1.28-1.71). This association was significant even on adjusting for gender concordance and survey language (English vs. Spanish). Conversely, patient-provider gender discordance was associated with lower rates of breast (OR 0.81; 95% CI 0.74-0.89), cervical (OR 0.79; 95% CI 0.72-0.87) and colorectal cancer (OR 0.86; 95% CI 0.80-0.93) screening adherence in all patients. This association was also significant on restricting analysis to racial/ethnic concordant pairs. Conclusions: Patient-provider gender concordance positively impacts adherence to cancer screening and this finding may guide future interventions. Patient-provider racial/ethnic concordance is not associated with screening adherence among whites and blacks but Hispanic patients seen by Hispanic providers have lower colorectal cancer screening rates. This counter-intuitive finding requires further study.

Relationships Among Race/Ethnicity, Gender, and Mental Health Status in Patient–Provider Interactions

2018 ◽  
Vol 29 (3) ◽  
pp. 131-141
Author(s):  
Shreyasi Deb ◽  
Nancy A. Miller
Keyword(s):  
Mental Health ◽  
Medical Expenditure Panel Survey ◽  
Policy Support ◽  
Medical Expenditure ◽  
Multivariate Techniques ◽  
Process Measures ◽  
National Quality ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender

Patient–provider interactions are associated with improved health outcomes and are of particular importance to individuals with mental health disabilities. We examine the relation between having a severe mental health–related disability (SMD) and patient–provider interactions and whether this is moderated by patient race/ethnicity and gender. We pooled Medical Expenditure Panel Survey data over multiple years and used multivariate techniques to examine the relation between having a SMD, race/ethnicity and gender and four measures of patient/provider interactions (e.g., being treated with respect). Adults with SMD had significantly higher relative risks (RRs) of reporting poorer interactions across measures. Although some effects of race/ethnicity and gender were observed, they did not moderate SMD. Individuals with Medicaid coverage or no health insurance had higher RRs of poorer interactions, while individuals with a person as a usual source of care had lower RRs. Incorporating these process measures of care into national quality initiatives may foster improved interactions. Continued policy support of models of care such as medical homes may enhance interactions as well.

scholarly journals Colorectal cancer screening prevalence and predictors among Asian American subgroups using Medical Expenditure Panel Survey National Data

Cancer ◽  
2018 ◽  
Vol 124 ◽  
pp. 1543-1551 ◽  
Author(s):  
Angela U. Sy ◽  
Eunjung Lim ◽  
Lana Sue Ka’opua ◽  
Merle Kataoka-Yahiro ◽  
Yumiko Kinoshita ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Asian American ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Panel Survey ◽  
National Data

scholarly journals Race/Ethnicity, Gender, Weight Status, and Colorectal Cancer Screening

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Heather Bittner Fagan ◽  
Ronald E. Myers ◽  
Constantine Daskalakis ◽  
Randa Sifri ◽  
Arch G. Mainous ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Weight Status ◽  
Normal Weight ◽  
Crc Screening ◽  
Interview Survey ◽  
Multivariable Analyses ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender ◽  
The Impact

Background. The literature on colorectal cancer (CRC) screening is contradictory regarding the impact of weight status on CRC screening. This study was intended to determine if CRC screening rates among 2005 National Health Interview Survey (NHIS) respondent racial/ethnic and gender subgroups were influenced by weight status.Methods. Univariable and multivariable logistic regression analyses were performed to determine if CRC screening use differed significantly among obese, overweight, and normal-weight individuals in race/ethnic and gender subgroups.Results. Multivariable analyses showed that CRC screening rates did not differ significantly for individuals within these subgroups who were obese or overweight as compared to their normal-weight peers.Conclusion. Weight status does not contribute to disparities in CRC screening in race/ethnicity and gender subgroups.

Race, Gender, and Statistical Representation: Predatory Mortgage Lending and the US Community Reinvestment Movement

2007 ◽  
Vol 39 (9) ◽  
pp. 2139-2166 ◽  
Author(s):  
Elvin K Wyly ◽  
Mona Atia ◽  
Elizabeth Lee ◽  
Pablo Mendez
Keyword(s):  
Data Collection ◽  
Mortgage Lending ◽  
Predatory Lending ◽  
Statistical Representation ◽  
Public Data ◽  
Race Ethnicity ◽  
And Gender ◽  
Collection Practices ◽  
Ethnicity And Gender ◽  
Racial Ethnic

American mortgage markets, once arenas of discrimination by exclusion, now operate as venues of segmentation and discrimination by inclusion: credit is widely available, but its terms vary enormously. One market segment involves sophisticated predatory practices in which certain groups of borrowers are targeted for high-cost credit that strips out home equity and worsens the risks of delinquency, default, and foreclosure. Unfortunately, it has become more difficult to measure inequalities of predatory lending: race–ethnicity and gender are ‘disappearing’ from the main public data source used to study, organize, and mobilize on issues of lending inequalities. In this paper, we present a mixed-methods case study of statistical representation of homeowners and homebuyers marginalized by race, ethnicity, and gender. A theoretical examination of official data-collection practices is followed by a discussion of alternative meanings of racial–ethnic and gender nondisclosure. Interviews with a sample of homeowners and homebuyers in the Washington, DC, area reveal some respondent ambivalence about the details of data-collection practices, but provide no consistent support for the idea that nonreporting is solely a matter of individual choice. Econometric analyses indicate that nondisclosure is driven primarily by lending-industry practices, with the strongest disparate impacts in African-American suburbs. Predatory lending is producing ambivalent spaces of racial-ethnic and gender invisibility, requiring new strategies in the reinvestment movement.

scholarly journals Who Gets Ahead and Who Falls Behind During the Transition to High School? Academic Performance at the Intersection of Race/Ethnicity and Gender

2018 ◽  
Vol 65 (2) ◽  
pp. 154-173 ◽  
Author(s):  
April Sutton ◽  
Amy G Langenkamp ◽  
Chandra Muller ◽  
Kathryn S Schiller
Keyword(s):  
High School ◽  
High School Transition ◽  
School Transition ◽  
Black Boys ◽  
Transition To High School ◽  
Gender Stratification ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender ◽  
Racial Ethnic

Abstract Academic stratification during educational transitions may be maintained, disrupted, or exacerbated. This study marks the first to use national data to investigate how the transition to high school (re)shapes academic status at the intersection of race/ethnicity and gender. We seek to identify the role of the high school transition in shaping racial/ethnic and gender stratification by contextualizing students’ academic declines during the high school transition within the longer window of their educational careers. Using Add Health, we find that white and black boys experience the greatest drops in their grade point averages (GPAs). We also find that the maintenance of high academic grades between the eighth and ninth grades varies across racial/ethnic and gender subgroups; higher-achieving middle school black boys experience the greatest academic declines. Importantly, we find that white and black boys also faced academic declines before the high school transition, whereas their female student peers experienced academic declines only during the transition to high school. We advance current knowledge on educational stratification by identifying the transition to high school as a juncture in which boys’ academic disadvantage widens and high-achieving black boys lose their academic status at the high school starting gate. Our study also underscores the importance of adopting an intersectional framework that considers both race/ethnicity and gender. Given the salience of high school grades for students’ long-term success, we discuss the implications of this study for racial/ethnic and gender stratification during and beyond high school.

scholarly journals Building Teachers’ Trust in Principals: Exploring the Effects of the Match Between Teacher and Principal Race/Ethnicity and Gender and Feelings of Trust

2019 ◽  
Vol 29 (1) ◽  
pp. 25-53 ◽  
Author(s):  
Kristina F. Brezicha ◽  
Edward J. Fuller
Keyword(s):  
North Carolina ◽  
Educational Leaders ◽  
School Life ◽  
Preparation Programs ◽  
Principal Preparation Programs ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender ◽  
The Relationship ◽  
Racial Ethnic

Trusting relationships play a crucial role in all aspects of school life. This study builds on this understanding by exploring the role gender and race/ethnicity plays in establishing trust between teachers and principals. Utilizing statewide working conditions survey administered in North Carolina, we employ both descriptive and analytic methods to examine the relationship between the racial/ethnic and gender match between teachers and principals and teachers’ trust in their principal. Our analyses indicate that race matters in establishing trust between teachers and principals. We suggest implications for educational leaders and principal preparation programs.

scholarly journals A Remote Instructor Like Me: Student–Teacher Congruence in Online, High School Courses

AERA Open ◽  
2021 ◽  
Vol 7 ◽  
pp. 233285842110187
Author(s):  
Jennifer Darling-Aduana
Keyword(s):  
Online Course ◽  
Educational Benefits ◽  
Online High School ◽  
Marginalized Groups ◽  
Improved Outcomes ◽  
Unique Nature ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender ◽  
Racial Ethnic

Students belonging to marginalized groups experience positive impacts when taught by a teacher of the same race, ethnicity, and gender. The unique nature of standardized, asynchronous online course taking allows for greater separation of any possible educational benefits of student versus teacher-driven mechanisms contributing to these improved outcomes. Using a student-by-course fixed effect strategy on data from a large urban school district, I examined associations between whether students experienced racial/ethnic or gender congruence with their remote instructor and both engagement and learning outcomes. Students who identified as Black demonstrated higher rates of engagement, although no difference in achievement, within lessons taught by a same-race remote instructor. I find that representation is associated with engagement even when instructors follow closely scripted lessons, representation occurs in only small doses, and instruction occurs in an impersonal setting.

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