Racial and ethnic disparities in nasopharyngeal cancer with an emphasis among Asian Americans.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 118-118
Author(s):  
Qian Wang ◽  
Hui Xie ◽  
Changchuan Jiang ◽  
Yaning Zhang ◽  
Yannan Li ◽  
...  
Keyword(s):  
Sample Size ◽  
Asian Americans ◽  
Care Delivery ◽  
Nasopharyngeal Cancer ◽  
Ethnic Disparities ◽  
Racial Group ◽  
Japanese Americans ◽  
Low Grade ◽  
Specific Mortality ◽  
Race Ethnicity

118 Background: Nasopharyngeal cancer (NPC) is characterized by a distinct geographic distribution which reflects genetic predispositions, with highest incidence in Southeastern Asia and Southern China. It continues to cause a significant health burden among Asian Americans (AAs), which is a fast growing but understudied racial group. Prior studies investigating NPC combined all AA groups which may mask heterogeneities among AA subgroups. We aimed to examine the disparities in NPC by dividing AAs into four major ethnic groups - Chinese, Filipinos, Vietnamese, and Japanese Americans. Methods: NPC cases were identified from the Surveillance, Epidemiology, and End Result (SEER) 18 database from 1975-2016. Information regarding age, sex, race/ethnicity, education, income, % of foreign born, marital status, region of SEER registry, stage, histology, grade, surgery, chemotherapy, and radiation therapy were extracted. Multivariate-adjusted Cox proportional hazard regression and Fine-Gray sub-distribution hazard models were used to calculate overall and cause-specific mortality. SEER*Stat was used to calculated age-adjusted incidence. Results: Among a total of 11,737 NPC patients, 42.2% were non-Hispanic White (NHW), 10.7% non-Hispanic Black (NHB), 7.1% Hispanics, 18.9% Chinese, 7.6% Filipinos, 4.8% Vietnamese, 1.0% Japanese and 7.7% other Asians. AAs continue to have the highest NPC incidence among all racial groups despite of an overall decreasing trend. Japanese were significantly more likely to be diagnosed at localized stage, having low grade tumor and having keratinizing squamous cell carcinoma histology compared to other AAs. Compared to NHW, Filipino Americans had decreased mortality (HR = 0.90; 95%CI:0.84-0.98). Chinese (HR = 0.95; 95%CI: 0.90-1.01), and Vietnamese (HR = 0.94; 95%CI: 0.86-1.03) also observed marginally reduced mortality but not Japanese Americans (HR = 1.09; 95%CI: 0.90-1.32). No differences in NPC-specific mortality by race/ethnicity groups were found. In addition, Chinese, Filipino and Vietnamese Americans with NPC were less likely to die of other cancer and cardiovascular disease than NHW, but no such differences were observed among NHB, Hispanics or Japanese Americans. Conclusions: Asian Americans have been historically studied as one single racial group mostly due to limited sample size, despite that it is consistent of a diverse population with different genetic makeup, socioeconomic status, cultural background, health behaviors, and health care access. Our novel finding that significant disparities exist within AA NPC patients in regard to demographic and clinical features, overall and cause-specific mortality underlines the importance of adequate AA-subgroup specific sample size in future studies in order to understand the prognostic role of ethnicity in NPC, and advocates more ethnically and culturally tailored cancer care delivery.

scholarly journals Race and ethnicity on MS presentation and disease course

2020 ◽  
Vol 26 (5) ◽  
pp. 561-567
Author(s):  
Lilyana Amezcua ◽  
Jacob L McCauley
Keyword(s):  
African Americans ◽  
Race And Ethnicity ◽  
Ethnic Disparities ◽  
European Ancestry ◽  
Mortality Trends ◽  
Ethnic Populations ◽  
Specific Mortality ◽  
Future Challenges ◽  
Race Ethnicity ◽  
Racial Ethnic

Multiple sclerosis (MS) has a strong racial and ethnic component and disproportionately affects whites of European background. Recent incidence reports suggest an increasing rate of MS among African Americans compared with whites. Despite this recent increase in MS in African Americans, Hispanics and Asians are significantly less likely to develop MS than whites of European ancestry. MS-specific mortality trends demonstrate distinctive disparities by race/ethnicity and age, suggesting that there is an unequal burden of disease. Inequalities in health along with differences in clinical characteristics that may be genetic, environmental, and social in origin may be contributing to disease variability and be suggestive of endophenotypes. The overarching goal of this review was to summarize the current understanding on the variability of disease that we observe in selected racial and ethnic populations: Hispanics and African Americans. Future challenges will be to unravel the genetic, environmental, and social determinants of the observed racial/ethnic disparities.

scholarly journals Lack of racial and ethnic-based differences in acute care delivery in intracerebral hemorrhage

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Chun Mei Su ◽  
Andrew Warren ◽  
Cassie Kraus ◽  
Wendy Macias-Konstantopoulos ◽  
Kori S. Zachrison ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Acute Care ◽  
English Language ◽  
Care Delivery ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Ethnic Disparities ◽  
Scan Time ◽  
Care Processes ◽  
Race Ethnicity

Abstract Background and aim Early diagnosis and treatment of intracerebral hemorrhage (ICH) is thought to be critical for improving outcomes. We examined whether racial or ethnic disparities exist in acute care processes in the first hours after ICH. Methods We performed a retrospective review of a prospectively collected cohort of consecutive patients with spontaneous primary ICH presenting to a single urban tertiary care center. Acute care processes studied included time to computerized tomography (CT) scan, time from CT to inpatient bed request, and time from bed request to hospital admission. Clinical outcomes included mortality, Glasgow Outcome Scale, and modified Rankin Scale. Results Four hundred fifty-nine patients presented with ICH between 2006 and 2018 and met inclusion criteria (55% male; 75% non-Hispanic White [NHW]; mean age of 73). In minutes, median time to CT was 43 (interquartile range [IQR] 28, 83), time to bed request was 62 (IQR 33, 114), and time to admission was 142 (IQR 95, 232). In a multivariable analysis controlling for demographic factors, clinical factors, and disease severity, race/ethnicity had no effect on acute care processes. English language, however, was independently associated with slower times to CT (β = 30.7 min, 95% CI 9.9 to 51.4, p = 0.004) and to bed request (β = 32.8 min, 95% CI 5.5 to 60.0, p = 0.02). Race/ethnicity and English language were not independently associated with worse outcome. Conclusions We found no evidence of racial/ethnic disparities in acute care processes or outcomes in ICH. English as first language, however, was associated with slower care processes.

Outcome Disparities In Multiple Myeloma: A SEER-Based Comparative Analysis of Hispanic Patients

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 396-396
Author(s):  
Sikander Ailawadhi ◽  
Dongyun Yang ◽  
Edmund Ho ◽  
Pedram Razavi ◽  
Asher A. Chanan-Khan
Keyword(s):  
Multiple Myeloma ◽  
Ethnic Disparities ◽  
Age At Diagnosis ◽  
Younger Age ◽  
Specific Mortality ◽  
Hispanic Patients ◽  
Ethnic Subgroup ◽  
Race Ethnicity ◽  
Epidemiological Characteristics ◽  
Overall Mortality

Abstract Abstract 396 Background: Study of ethnic disparities in various malignancies has revealed variation in clinical outcomes. In multiple myeloma (MM) patients, such an analysis has not yet been undertaken for patients with Hispanics decent. Since this is the fastest growing ethnic subgroup in the United States, we sought to define the epidemiological characteristics as well as disease related outcome of Hispanics with MM. Methods: The Surveillance Epidemiology and End Results (SEER) 17 Registry data (1973-2007) was utilized. Patients with confirmed diagnosis of MM were eligible for this analysis. To avoid bias of under representation, analysis was restricted to adults (>18 yr) with a diagnosis date of 1992 or later. Cases that received a diagnosis at death certificate or autopsy, no follow-up records, as well as lacking documentation on age at diagnosis, sex, or race/ethnicity were excluded. Cox proportional hazards models, adjusted for confounding variables, were used to evaluate association between patient characteristics and survival. All statistical tests were two-sided with a significance level of 0.05. Analysis was performed utilizing the SAS software (v9.2). Results: The final analysis included 37,963 MM patients (20,498 males; 54%, 17,465 females; 46%). The studied age-group cohorts included: 18–44 yrs (1,453; 4%), 45–54 yrs (4,495; 12%), 55–64 yrs (7,974; 21%), 65–74 yrs (11,146; 29%), and ≥75 yrs (12,895; 34%). Patients were stratified by race/ethnicity: White (25,753; 68%), African-American (6,595; 17%), Hispanic (3,475; 9%), Asian (1,961; 5%), and Native American (179; 0.5%). For survival analysis, Native Americans were excluded due to their small numbers. Patients were also stratified based on year of diagnosis (before or after 2002) to study the impact of novel agents on MM treatment. To investigate the effect of geographical location on disease outcome, patients were stratified across regional registries within the SEER 17. Mean age at diagnosis for Hispanics was significantly younger than W (64.2 yr Vs. 69.3 yr; p<0.001). Within the Hispanics, males (53%) had a younger age at diagnosis (mean 63.4 yr) than females (47%) (mean 65 yr). Survival analysis revealed that for all patients, females had an overall reduced mortality than males (HR 0.905; CI 0.882, 0.929; p <0.001), although there was no gender difference in MM-specific mortality (p=0.1). Amongst the different age cohorts, overall as well as MM-specific mortality was highest in patients ≥75 yrs (p<0.001). Patients diagnosed after 2002 had a significantly lower overall (HR 0.9; CI 0.874, 0.927; p<0.001) and MM-specific mortality (HR 0.845; CI 0.816, 0.875; p<0.001) than those diagnosed prior. Hispanics had higher overall mortality than all the other racial subgroups (HR 1.068; CI 1.019, 1.120; p=0.006), although the difference in MM-specific mortality was not significant (HR 1.039; CI 0.983, 1.097). In a multivariate model using gender, age, marital status, year of diagnosis and race, significant interactions were noted between race, age and survival showing that Hispanics ≥75 yr had higher overall and MM-specific mortality (p<0.001) than other age-stratified racial cohorts. There was no significant difference in mortality when comparing Hispanic patients in the different geographical regions. Conclusions: Studies of ethnic disparities are important for evaluating disease characteristics and management needs of specific patient populations as well as optimal triaging of healthcare resources. There is limited data to define MM characteristics and survival outcome in Hispanics. Here we present epidemiological characteristics and survival outcomes for MM in this fast growing ethnic subgroup. We observed significantly younger age at MM diagnosis for Hispanics. Hispanic MM patients had higher overall mortality than all other racial subgroups. Furthermore, we noted that the effect of race on survival depends on patient's age, with Hispanic patients ≥75 yrs having a significantly higher overall and MM-specific mortality. These results will help in better understanding of ethnic influences on disease biology and clinical behavior. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Race/ethnicity-associated blood DNA methylation differences between Japanese and European American women: an exploratory study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Min-Ae Song ◽  
Anna Eames Seffernick ◽  
Kellie J. Archer ◽  
Kellie M. Mori ◽  
Song-Yi Park ◽  
...  
Keyword(s):  
Gene Expression ◽  
Dna Methylation ◽  
Liver Disease ◽  
A Priori ◽  
Ethnic Disparities ◽  
Buffy Coat ◽  
Japanese Americans ◽  
Blood Levels ◽  
Nucleotide Polymorphisms ◽  
Race Ethnicity

Abstract Background Racial/ethnic disparities in health reflect a combination of genetic and environmental causes, and DNA methylation may be an important mediator. We compared in an exploratory manner the blood DNA methylome of Japanese Americans (JPA) versus European Americans (EUA). Methods Genome-wide buffy coat DNA methylation was profiled among healthy Multiethnic Cohort participant women who were Japanese (JPA; n = 30) or European (EUA; n = 28) Americans aged 60–65. Differentially methylated CpGs by race/ethnicity (DM-CpGs) were identified by linear regression (Bonferroni-corrected P < 0.1) and analyzed in relation to corresponding gene expression, a priori selected single nucleotide polymorphisms (SNPs), and blood biomarkers of inflammation and metabolism using Pearson or Spearman correlations (FDR < 0.1). Results We identified 174 DM-CpGs with the majority of hypermethylated in JPA compared to EUA (n = 133), often in promoter regions (n = 48). Half (51%) of the genes corresponding to the DM-CpGs were involved in liver function and liver disease, and the methylation in nine genes was significantly correlated with gene expression for DM-CpGs. A total of 156 DM-CpGs were associated with rs7489665 (SH2B1). Methylation of DM-CpGs was correlated with blood levels of the cytokine MIP1B (n = 146). We confirmed some of the DM-CpGs in the TCGA adjacent non-tumor liver tissue of Asians versus EUA. Conclusion We found a number of differentially methylated CpGs in blood DNA between JPA and EUA women with a potential link to liver disease, specific SNPs, and systemic inflammation. These findings may support further research on the role of DNA methylation in mediating some of the higher risk of liver disease among JPA.

Racial and ethnic disparities in the survival of adolescents and young adults (AYA) with acute myeloid leukemia (AML).

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 297-297
Author(s):  
Urshila Durani ◽  
Adam C Bartley ◽  
Ronald S. Go
Keyword(s):  
Care Delivery ◽  
Lymphoblastic Leukemia ◽  
Ethnic Disparities ◽  
National Cancer Data Base ◽  
Cancer Data ◽  
The Us ◽  
Ethnic Subgroups ◽  
Race Ethnicity ◽  
Socio Demographic Factors ◽  
Patient Care Delivery

297 Background: Unlike acute lymphoblastic leukemia, no studies have examined the effect of race on survival among AML in AYA using national data. Methods: We studied patients in the US National Cancer Data Base aged 15-39 diagnosed with AML from 2001-2011 (excluding acute promyelocytic leukemia). AMLs harboring inv(16) or t(8;21) were defined as good-risk. We examined overall survival (OS) according to race/ethnicity and survival trends over three time-periods: 2001-2004, 2005-2008, and 2009-2011. Results: We identified 8,986 patients, with a mean follow-up of 37 months. The median OS according to race/ethnicity was 56, 49, 41, and 22 months for Asians/Pacific Islanders (A/PI), Hispanics, Whites, and Blacks respectively (P < 0.001). OS improved over time among Whites only, with respective median OS of 31, 43, and 49 months (P < 0.001). Multivariate analysis adjusting for socio-demographics, travel distance, and AML type, showed that, compared to Whites, Blacks had a significantly worse and Hispanics a significantly better OS (Table). Conclusions: We found significant disparities in OS among racial/ethnic subgroups in AYA with AML despite adjustment for socio-demographic factors. Blacks had the worse and Hispanics the best outcome. In the past decade, OS improved only among the Whites. Further studies should examine provider and patient care delivery factors that may contribute to these disparities. [Table: see text]

172 Sleep Disparities in Preschool-Aged Children

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A70-A70
Author(s):  
Jennifer Holmes ◽  
Olivia Hanron ◽  
Rebecca Spencer
Keyword(s):  
Sleep Duration ◽  
Ethnic Disparities ◽  
Data Race ◽  
Older Children ◽  
Hispanic Children ◽  
Sleep Habits ◽  
Chi Square ◽  
White Children ◽  
Race Ethnicity ◽  
And Gender

Abstract Introduction Sleep is known to be associated with socioeconomic status (SES) in older children and adults with those from lower SES households often experiencing poorer sleep quality. Whether this disparity exists in early childhood is relatively unknown, despite being an important age marked by sleep transitions and the establishment of lifelong sleep habits. Furthermore, it is a critical period for cognitive development and learning, which are supported by sleep. Here, we explore associations between sleep and SES in a preschool population. We hypothesized that children from lower SES households would exhibit shorter overnight sleep, longer and more frequent naps, and shorter 24-hr sleep. Additionally, we considered racial and ethnic disparities in sleep which can be confounded with SES in some samples. Methods Child (n=441; M age=51.9mo; 45.4% female) sleep was measured objectively using actigraph watches, worn for 3-16 days (M=9.5 days). Caregivers reported child demographics and household data. Race/ethnicity of our sample was 72% White, 10.2% Black, 17.8% other or more than one race, and 28.4% identified as Hispanic. 20.1% of our sample was categorized as low SES. Effects of SES and race/ethnicity on continuous sleep measures were assessed using multiple regression models, with age and gender as covariates. Nap habituality was assessed using chi-square tests. Results Lower SES was associated with shorter nighttime sleep duration, longer nap duration, and shorter 24-hr sleep duration (p’s&lt;.001). Children from lower SES households were also more likely to nap habitually (p=.04) as were Hispanic children (p&lt;.001). Hispanic children also tended to have longer nap bouts (p=.002). Hispanic and Black children on average had shorter overnight sleep durations than White children (p’s&lt;.04), but their 24-hr sleep did not differ. Conclusion SES-related sleep disparities were present in this preschool population, with lower SES children exhibiting poorer sleep. When controlling for SES, Hispanic children tended to sleep less overnight which was compensated for by longer, more frequent naps. This underscores the necessity of naps for some children to achieve adequate sleep. Future directions will explore the relationship between parenting factors and sleep, such as bedtime routines and parent knowledge surrounding child sleep needs. Support (if any) NIH R01 HL111695

scholarly journals Participant education, spousal education and dementia risk in a diverse cohort of members of an integrated health care delivery system in Northern California

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e040233
Author(s):  
Paola Gilsanz ◽  
Elizabeth Rose Mayeda ◽  
Chloe W Eng ◽  
Oanh L Meyer ◽  
M Maria Glymour ◽  
...  
Keyword(s):  
Care Delivery ◽  
Health Indicators ◽  
Health Care Delivery System ◽  
College Degree ◽  
Dementia Risk ◽  
Education College ◽  
Race Ethnicity ◽  
Participant Education ◽  
Spousal Education

ObjectiveThe role of spousal education on dementia risk and how it may differ by gender or race/ethnicity is unknown. This study examines the association between one’s own education separate from and in conjunction with spousal education and risk of dementia.DesignCohort.SettingKaiser Permanente Northern California (KPNC), an integrated health care delivery system.Participants8835 members of KPNC who were aged 40–55, married and reported own and spousal education in 1964–1973.Primary outcome measureDementia cases were identified through medical records from 1 January 1996 to 30 September 2017.MethodsOwn and spousal education was self-reported in 1964–1973 and each was classified as four indicator variables (≤high school, trade school/some college, college degree and postgraduate) and as ≥college degree versus <college degree. Age as timescale weighted Cox proportional hazard models adjusted for demographics and health indicators evaluated associations between participant education, spousal education and dementia risk overall and by gender and race/ethnicity.ResultsThe cohort was 37% non-white, 46% men and 30% were diagnosed with dementia during follow-up from 1996 to 2017 (mean follow-up=12.7 years). Greater participant education was associated with lower dementia risk independent of spousal education, demographics and health indicators. Greater spousal education was associated with lower dementia adjusting for demographics but became non-significant after further adjustment for participant education. The same pattern was seen for spousal education ≥college degree (not adjusting for participant education HRspousal education≥college degree=0.83 (95% CI: 0.76 to 0.90); adjusting for participant education HRspousal education≥college degree=0.92 (95% CI: 0.83 to 1.01)). These associations did not vary by gender or race/ethnicity.ConclusionIn a large diverse cohort, we found that higher levels of participant’s own education were associated with lower dementia risk regardless of spousal education. An inverse association between spousal education and dementia risk was also present, however, the effects became non-significant after adjusting for participant education.

scholarly journals Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

2021 ◽  
Vol 18 (6) ◽  
pp. 2921
Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  
Keyword(s):  
United States ◽  
District Of Columbia ◽  
Ethnic Disparities ◽  
The United States ◽  
Attributable Mortality ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Degree Of Association ◽  
Racial Ethnic

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

Racial/Ethnic Disparities in Hypertension Prevalence, Awareness, Treatment, and Control in the United States, 2013 to 2018

Hypertension ◽  
2021 ◽  
Author(s):  
Rahul Aggarwal ◽  
Nicholas Chiu ◽  
Rishi K. Wadhera ◽  
Andrew E. Moran ◽  
Inbar Raber ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Disparities ◽  
The United States ◽  
Self Report ◽  
Similar Treatment ◽  
Hypertension Prevalence ◽  
Health And Nutrition ◽  
Race Ethnicity ◽  
And Control ◽  
White Adults

We evaluated the prevalence, awareness, treatment, and control of hypertension (defined as a systolic blood pressure [BP]) ≥140 mm Hg, diastolic BP ≥90 mm Hg, or a self-reported use of an antihypertensive agent) among US adults, stratified by race/ethnicity. This analysis included 16 531 nonpregnant US adults (≥18 years) in the three National Health and Nutrition Examination Survey cycles between 2013 and 2018. Race/ethnicity was defined by self-report as White, Black, Hispanic, Asian, or other Americans. Among 76 910 050 (74 449 985–79 370 115) US adults with hypertension, 48.6% (47.3%–49.8%, unadjusted) have controlled BP. When compared with BP control rates for White adults (49.0% [46.8%–51.2%], age-adjusted), BP control rates are lower in Black (39.2%, adjusted odds ratio [aOR], 0.71 [95% CI, 0.59–0.85], P <0.001), Hispanic (40.0%, aOR, 0.71 [95% CI, 0.58–0.88], P =0.003), and Asian (37.8%, aOR, 0.68 [95% CI, 0.55–0.84], P =0.001) Americans. Black adults have higher hypertension prevalence (45.3% versus 31.4%, aOR, 2.24 [95% CI, 1.97–2.56], P <0.001) but similar awareness and treatment rates as White adults. Hispanic adults have similar hypertension prevalence, but lower awareness (71.1% versus 79.1%, aOR, 0.72 [95% CI, 0.58–0.89], P =0.005) and treatment rates (60.5% versus 67.3%, aOR, 0.78 [95% CI, 0.66–0.94], P =0.010) than White adults. Asian adults have similar hypertension prevalence, lower awareness (72.5% versus 79.1%, aOR, 0.75 [95% CI, 0.58–0.97], P =0.038) but similar treatment rates. Black, Hispanic, and Asian Americans have different vulnerabilities in the hypertension control cascade of prevalence, awareness, treatment, and control. These differences can inform targeted public health efforts to promote health equity and reduce the burden of hypertension in the United States.

scholarly journals Racial and Ethnic Disparities in Maternal Outcomes and the Disadvantage of Peripartum Black Women: A Multistate Analysis, 2007–2014

2018 ◽  
Vol 36 (08) ◽  
pp. 835-848 ◽  
Author(s):  
Virginia Tangel ◽  
Robert S. White ◽  
Anna S. Nachamie ◽  
Jeremy S. Pick
Keyword(s):  
Black Women ◽  
Length Of Stay ◽  
Cesarean Delivery ◽  
White Women ◽  
Average Length ◽  
Ethnic Disparities ◽  
Maternal Outcomes ◽  
Racial And Ethnic Disparities ◽  
Mortality And Morbidity ◽  
Race Ethnicity

Objective Racial and ethnic disparities in obstetric care and delivery outcomes have shown that black women experience high rates of pregnancy-related mortality and morbidity, along with high rates of cesarean delivery, compared with other racial and ethnic groups. We aimed to quantify these disparities and test the effects of race/ethnicity in stratified statistical models by insurance payer and socioeconomic status, adjusting for comorbidities specific to an obstetric population. Study Design We analyzed maternal outcomes in a sample of 6,872,588 delivery records from California, Florida, Kentucky, Maryland, and New York from 2007 to 2014 from the State Inpatient Databases, Healthcare Cost and Utilization Project. We compared present-on-admission characteristics of parturients by race/ethnicity, and estimated logistic regression and generalized linear models to assess outcomes of in-hospital mortality, cesarean delivery, and length of stay. Results Compared with white women, black women were more likely to die in-hospital (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.47–2.45) and have a longer average length of stay (incidence rate ratio: 1.10, 95% CI: 1.09–1.10). Black women also were more likely to have a cesarean delivery (OR: 1.12, 95% CI 1.12–1.13) than white women. These results largely held in stratified analyses. Conclusion In most insurance payers and socioeconomic strata, race/ethnicity alone is a factor that predicts parturient outcomes.

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