Impact of Race/Ethnicity and County-Level Vulnerability on Receipt of Surgery Among Older Medicare Beneficiaries With the Diagnosis of Early Pancreatic Cancer

Author(s):  
Rosevine A. Azap ◽  
Adrian Diaz ◽  
J. Madison Hyer ◽  
Diamantis I. Tsilimigras ◽  
Rayyan S. Mirdad ◽  
...  
2020 ◽  
Author(s):  
Bryan J Pesta ◽  
John Fuerst ◽  
Emil O. W. Kirkegaard

Using a sample of ~3,100 U.S. counties, we tested geoclimatic explanations for why cognitive ability varies across geography. These models posit that geoclimatic factors will strongly predict cognitive ability across geography, even when a variety of common controls appear in the regression equations. Our results generally do not support UV radiation (UVR) based or other geoclimatic models. Specifically, although UVR alone predicted cognitive ability at the U.S. county-level (β = -.33), its validity was markedly reduced in the presence of climatic and demographic covariates (β = -.16), and was reduced even further with a spatial lag (β = -.10). For climate models, average temperature remained a significant predictor in the regression equation containing a spatial lag (β = .35). However, the effect was in the wrong direction relative to typical cold weather hypotheses. Moreover, when we ran the analyses separately by race/ethnicity, no consistent pattern appeared in the models containing the spatial lag. Analyses of gap sizes across counties were also generally inconsistent with predictions from the UVR model. Instead, results seemed to provide support for compositional models.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Randhir Sagar Yadav ◽  
Durgesh Chaudhary ◽  
Shima Shahjouei ◽  
Jiang Li ◽  
Vida Abedi ◽  
...  

Introduction: Stroke hospitalization and mortality are influenced by various social determinants. This ecological study aimed to determine the associations between social determinants and stroke hospitalization and outcome at county-level in the United States. Methods: County-level data were recorded from the Centers for Disease Control and Prevention as of January 7, 2020. We considered four outcomes: all-age (1) Ischemic and (2) Hemorrhagic stroke Death rates per 100,000 individuals (ID and HD respectively), and (3) Ischemic and (4) Hemorrhagic stroke Hospitalization rate per 1,000 Medicare beneficiaries (IH and HH respectively). Results: Data of 3,225 counties showed IH (12.5 ± 3.4) and ID (22.2 ± 5.1) were more frequent than HH (2.0 ± 0.4) and HD (9.8 ± 2.1). Income inequality as expressed by Gini Index was found to be 44.6% ± 3.6% and unemployment rate was 4.3% ± 1.5%. Only 29.8% of the counties had at least one hospital with neurological services. The uninsured rate was 11.0% ± 4.7% and people living within half a mile of a park was only 18.7% ± 17.6%. Age-adjusted obesity rate was 32.0% ± 4.5%. In regression models, age-adjusted obesity (OR for IH: 1.11; HH: 1.04) and number of hospitals with neurological services (IH: 1.40; HH: 1.50) showed an association with IH and HH. Age-adjusted obesity (ID: 1.16; HD: 1.11), unemployment (ID: 1.21; HD: 1.18) and income inequality (ID: 1.09; HD: 1.11) showed an association with ID and HD. Park access showed inverse associations with all four outcomes. Additionally, population per primary-care physician was associated with HH while number of pharmacy and uninsured rate were associated with ID. All associations and OR had p ≤0.04. Conclusion: Unemployment and income inequality are significantly associated with increased stroke mortality rates.


2018 ◽  
Vol 31 (3) ◽  
pp. 422-451
Author(s):  
Jacqueline G. Lee ◽  
Rebecca L. Richardson

Minority criminal defendants are more likely than White defendants to exercise their right to trial, which is concerning given that research also consistently finds trial sentences to be harsher than those obtained via pleas. However, guilty pleas are not the only disposition available for avoiding a trial; pretrial diversions and case dismissals also serve as mechanisms for trial avoidance. Using hierarchical linear modeling, we find that Black criminal defendants are more likely than Whites to go to trial rather than receive other case disposition. Relationships for Hispanic defendants are less consistent. Fewer county-level effects emerge than expected, providing little to no support for racial threat theory. Results suggest that Black defendants are less often able or willing to avoid a trial, a finding which highlights and perhaps helps to explain racial disparities in final sentencing outcomes.


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