scholarly journals Demographics and Incident Location of Gunshot Wounds at a Single Level I Trauma Center

2021 ◽  
Vol 14 ◽  
Author(s):  
Blair Benton ◽  
David Watson ◽  
Elizabeth Ablah ◽  
Kelly Lightwine ◽  
Ronda Lusk ◽  
...  
Keyword(s):  
African American ◽  
Racial Differences ◽  
Low Income ◽  
Trauma Center ◽  
Ethnic Disparities ◽  
Gunshot Wounds ◽  
Lengths Of Stay ◽  
Level I ◽  
Geographical Maps ◽  
National Trends

Introduction:  Little is known surrounding the demographic and geospatial factors of firearm-related traumas in the Midwest Region.  The purpose of this study was to describe the overall incidence of firearm-related traumas and examine any racial/ethnic disparities that may exist. Methods:  A retrospective review was conducted of all patients 14 years or older who were admitted with a gunshot wound (GSW) to a Level I trauma center between 2016 and 2017.  Results:  Forty-nine percent of patients were Caucasian, 26.5% African American, and 19.6% Hispanic/Latino.  Hispanic/Latino patients were the youngest (25.8 ± 8.8) and Caucasians were the oldest (34.3 ± 14.1, P = 0.002).  Compared to Caucasian patients, African American (42.0%) and Hispanic/Latino (54.1%) patients were more likely to be admitted to the intensive care unit (ICU) (P = 0.034) and experienced longer ICU lengths of stay (2.5 ± 6.3 and 2.4 ± 4.7, P = 0.031, respectively).  African American patients (96.0%) experienced more assaults while Caucasians were more likely to receive gunshot wounds accidentally (26.9%, P = 0.001).  More African American (86.0%) and Hispanic/Latino (89.2%) patients were injured with a handgun and Caucasians sustained the highest number of shotgun/rifle related injuries (16.1%, P = 0.012).  Most GSWs occurred in zip codes 67202, 67203, 67213, 67211, and 67214.  Geographical maps indicated that GSWs were concentrated in low-income areas and areas with high minority populations.                                                                                                                                                                                              Conclusions:  Racial differences were noted, however, unlike national trends, most of our patients were older Caucasian males.

scholarly journals 448. Disproportionate Burden of COVID-19 on Latinx Residents among Hospitalized Patients at San Francisco’s Public Health Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S292-S292
Author(s):  
Vivek Jain ◽  
Lillian B Brown ◽  
Carina Marquez ◽  
Luis Rubio ◽  
Natasha Spottiswoode ◽  
...  
Keyword(s):  
Public Health ◽  
African American ◽  
San Francisco ◽  
Ethnic Disparities ◽  
Food Service ◽  
Lengths Of Stay ◽  
Hospital Deaths ◽  
Health Hospital ◽  
Disproportionate Burden ◽  
Overall Mortality

Abstract Background San Francisco implemented one of the earliest shelter-in-place public health mandates in the U.S., with flattened curves of diagnoses and deaths. We describe demographics, clinical features and outcomes of COVID-19 patients admitted to a public health hospital in a high population-density city with an early containment response. Methods We analyzed inpatients with COVID-19 admitted to San Francisco General Hospital (SFGH) from 3/5/2020–5/11/2020. SFGH serves a network of >63,000 patients (32% Latinx/24% Asian/19% African American/19% Caucasian). Demographic and clinical data through 5/18/2020 were abstracted from hospital records, along with ICU and ventilator utilization, lengths of stay, and in-hospital deaths. Results Of 157 admitted patients, 105/157 (67%) were male, median age was 49 (range 19-96y), and 127/157 (81%) of patients with COVID-19 were Latinx. Crowded living conditions were common: 60/157 (38%) lived in multi-family shared housing, 12/1578 (8%) with multigenerational families, and 8/157 (5%) were homeless living in shelters. Of 102 patients with ascertained occupations, most had frontline essential jobs: 23% food service, 14% construction/home maintenance, and 10% cleaning. Overall, 86/157 (55%) of patients lived in neighborhoods home to majority Latinx and African-American populations. Overall, 45/157 (29%) of patients needed ICU care, and 26/157 (17%) required mechanical ventilation; 20/26 (77%) of ventilated patients were successfully extubated, and 137/157 (87%) were discharged home. Median hospitalization duration was 4 days (IQR, 2–10), and only 6/157 (4%) patients died in hospital. Conclusion In San Francisco, where early COVID-19 mitigation was enacted, we report a stark, disproportionate COVID-19 burden on Latinx patients, who accounted for 81% of hospitalizations despite making up only 32% of the patient base and 15% of San Francisco’s total population. Latinx inpatients frequently lived in high-density settings, increasing household risk, and frequently worked essential jobs, potentially limiting the opportunity to effectively distance from others. We also report here favorable clinical outcomes and low overall mortality. However, an effective COVID-19 response must urgently address racial and ethnic disparities. Disclosures All Authors: No reported disclosures

An Analysis of Pediatric Gunshot Wounds Treated at a Level I Pediatric Trauma Center

2003 ◽  
Vol 54 (6) ◽  
pp. 1102-1106 ◽  
Author(s):  
Alison K. Snyder ◽  
Li Ern Chen ◽  
Robert P. Foglia ◽  
Patrick A. Dillon ◽  
Robert K. Minkes
Keyword(s):  
Trauma Center ◽  
Pediatric Trauma ◽  
Gunshot Wounds ◽  
Level I ◽  
Pediatric Trauma Center

scholarly journals Health Numeracy Confidence among Racial/ Ethnica Minorities in HINTS 2007: Sociodemographic, Attitudinal, and Knowledge Correlates

1970 ◽  
Vol 20 (2) ◽  
pp. 3-16 ◽  
Author(s):  
Hong Huang ◽  
Yiu Ming Chan ◽  
Dong Feng
Keyword(s):  
Racial Differences ◽  
Ethnic Disparities ◽  
Racial And Ethnic Disparities ◽  
Culturally Appropriate ◽  
Medical Decisions ◽  
Cross Sectional ◽  
Health Numeracy ◽  
Lower Health ◽  
Nationally Representative ◽  
National Trends

Health numeracy skills help people interpret health risks, and make effective medical decisions. Lower health numeracy confidence was observed for blacks and Hispanic groups than whites. Little is known about the important factors that explain racial differences in health numeracy confidence. For this study, we used a nationally representative, cross-sectional data sample of 4,610 U.S. adults from the National Cancer Institute’s 2007 Health Information National Trends Survey. Bivariate (Chi-squares) and multiple logistic regression analyses were conducted to identify the contribution factors that predict health numeracy confidence.Non-linear Fairlie decompositions were used to quantify the factor contributions to racial differences in health numeracy confidence. The priority rankings of the important factors to explain the health numeracy confidence racial and ethnic disparities are different depending on the particular racial and ethnic group. Diverse, culturally appropriate approaches are needed to improve numeracy confidence for specific racial and ethnic groups.

Early Predictors of Massive Transfusion in Patients Sustaining Torso Gunshot Wounds in a Civilian Level I Trauma Center

2010 ◽  
Vol 68 (2) ◽  
pp. 298-304 ◽  
Author(s):  
Christopher J. Dente ◽  
Beth H. Shaz ◽  
Jeffery M. Nicholas ◽  
Robert S. Harris ◽  
Amy D. Wyrzykowski ◽  
...  
Keyword(s):  
Trauma Center ◽  
Massive Transfusion ◽  
Gunshot Wounds ◽  
Early Predictors ◽  
Level I

scholarly journals A primer on hypertension and on the racial / ethnic disparities in diagnosis and management: a comprehensive overview

2021 ◽  
Vol 5 (6) ◽  
pp. 229-239
Author(s):  
Ivy Njoloma ◽  
Nasheria Lewis ◽  
Frantz Sainvil ◽  
George P Einstein ◽  
Andrew Sciranka ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Racial Differences ◽  
Low Income ◽  
Access To Health Care ◽  
African American Men ◽  
Ethnic Disparities ◽  
World Health ◽  
Treatment Of Hypertension ◽  
Adrenergic Blockers

Hypertension is a major cause of premature death worldwide, where it contributes to stroke, cardiovascular and renal disease. Forty percent of adults aged 30-79 years worldwide have hypertension, two-thirds of whom are living in low and middle-income countries. Most adults with hypertension are not fully aware that they have the condition, therefore it often goes ignored and untreated. Of the 1.28 billion people worldwide, who have been reported to have hypertension, data indicates that one in five females and one in four males are included in that estimate. Moreover, data from World Health Organization reports that less than half of adults (42%) with hypertension are diagnosed and treated adequately and approximately only one in five adults (21%) with hypertension have it under adequate control. One of the worldwide goals for non-communicable diseases is to scale back the prevalence of hypertension by 33% between 2010 and 2030. In African Americans, readily available thiazide diuretics or Calcium Channel Blockers (CCBs) have been shown to be more effective in lowering blood pressure than Renin Angiotensin System inhibitors (RAS) or β-adrenergic blockers and are also more effective in reducing cardiovascular disease (CVD) events than RAS inhibitors or adrenergic blockers. The ethnical difference in hypertension and hypertension- related complaint issues are associated with lesser mortality and morbidity pitfalls compared with their white counterparts. These redundant pitfalls from elevated blood pressure have a dramatic effect on life expectancy and career productivity for African American men and women and which is significantly lower than has been reported for Caucasian Americans of either gender. These present challenges remain to be completely understood and give a result to overcome ethnical and racial differences in the frequency and treatment of hypertension. Social determinants of health similar as educational status, access to health care and low income play a crucial part in frequency and blood pressure control rates. Development of appropriate health care programs at the state and public situations to address these issues will be essential to reduce these differences. Thus, the purpose of this paper is to review the prevalence and ethnic disparities in the diagnosis and treatment of hypertension and to suggest steps to improve the outcomes.

scholarly journals Food Insecurity in a Low-Income, Predominantly African American Cohort Following the COVID-19 Pandemic

2021 ◽  
Vol 111 (3) ◽  
pp. 494-497
Author(s):  
Tamara Dubowitz ◽  
Madhumita Ghosh Dastidar ◽  
Wendy M. Troxel ◽  
Robin Beckman ◽  
Alvin Nugroho ◽  
...  
Keyword(s):  
African American ◽  
Food Insecurity ◽  
Low Income ◽  
The United States ◽  
Supplemental Nutrition Assistance Program ◽  
Food Bank ◽  
Assistance Program ◽  
Nutrition Assistance ◽  
National Trends ◽  
The Impact

Objectives. To examine the impact of COVID-19 shutdowns on food insecurity among a predominantly African American cohort residing in low-income racially isolated neighborhoods. Methods. Residents of 2 low-income African American food desert neighborhoods in Pittsburgh, Pennsylvania, were surveyed from March 23 to May 22, 2020, drawing on a longitudinal cohort (n = 605) previously followed from 2011 to 2018. We examined longitudinal trends in food insecurity from 2011 to 2020 and compared them with national trends. We also assessed use of food assistance in our sample in 2018 versus 2020. Results. From 2018 to 2020, food insecurity increased from 20.7% to 36.9% (t = 7.63; P < .001) after steady declines since 2011. As a result of COVID-19, the United States has experienced a 60% increase in food insecurity, whereas this sample showed a nearly 80% increase, widening a preexisting disparity. Participation in the Supplemental Nutrition Assistance Program (52.2%) and food bank use (35.9%) did not change significantly during the early weeks of the pandemic. Conclusions. Longitudinal data highlight profound inequities that have been exacerbated by COVID-19. Existing policies appear inadequate to address the widening gap.

scholarly journals Racial and Ethnic Disparities in SARS-CoV-2 Pandemic: Analysis of a COVID-19 Observational Registry for a Diverse U.S. Metropolitan Population

2020 ◽  
Author(s):  
Farhaan S. Vahidy ◽  
Juan Carlos Nicolas ◽  
Jennifer R. Meeks ◽  
Osman Khan ◽  
Stephen L. Jones ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Population Density ◽  
Low Income ◽  
Ethnic Disparities ◽  
Equation Modeling ◽  
Hispanic Ethnicity ◽  
Race Disparities ◽  
Comorbidity Burden ◽  
African American Race

AbstractImportanceDespite emerging reports of poor COVID-19 outcomes among African Americans, data on race and ethnic susceptibility to SARS-CoV-2 infection are limited.ObjectiveTo determine socio-demographic factors associated with higher likelihood of SARS-CoV-2 infection. To explore mediating pathways for race disparities in the SARS-CoV-2 pandemic.DesignCross sectional analysis of COVID-19 Surveillance and Outcomes Registry (CURATOR). Multivariable logistic regression models were fitted to provide likelihood estimates (adjusted Odds Ratios: aOR, 95% confidence intervals: CI) of positive SARS-CoV-2 test. Structural Equation Modeling (SEM) framework was utilized to explore three mediation pathways (low income, high population density, high comorbidity burden) for association between African American race and SARS-CoV-2 infection.SettingA large healthcare system comprising of one central tertiary care, seven large community hospitals and an expansive ambulatory and emergency care network in the Greater Houston area.ParticipantsIndividuals of all ages, races, ethnicities and sex tested for SARS-CoV-2.ExposureSocio-demographic (age, sex, race, ethnicity, household income, residence population density) and comorbidity (hypertension, diabetes, obesity, cardiac disease) factors.Main OutcomePositive reverse transcriptase polymerized chain reaction test for SARS-CoV-2.ResultsAmong 4,513 tested individuals, 754 (16.7%) tested positive. Overall mean (SD) age was 50.6 (18.9) years, 62% females and 26% were African American. African American race was associated with higher comorbidity burden, lower socio-economic status, and higher population density residence. In the fully adjusted model, African American race (vs. White; aOR, CI: 1.84, 1.49–2.27) and Hispanic ethnicity (vs. non-Hispanic; aOR, CI: 1.70, 1.35–2.14) had a higher likelihood of infection. Older individuals and males were also at a higher risk of SARS-CoV-2 infection. The SEM framework demonstrated a statistically significant (p = 0.008) indirect effect of African American race on SARS-CoV-2 infection mediated via a pathway that included residence in densely populated zip code.Conclusions and RelevanceThere is strong evidence of race and ethnic disparities in the SARS-CoV-2 pandemic potentially mediated through unique social determinants of health.Key PointsQuestionDo race and ethnic disparities exist in susceptibility to SARS-CoV-2 infection and how can these disparities be explained?FindingsAfrican American race and Hispanic ethnicity are associated with higher likelihood of SARS-CoV-2 infection even after adjusting for other important socio-demographic and comorbidity factors. Residence in a high-density population area partially mediated higher susceptibility among African Americans.MeaningMinority race and ethnicity increases susceptibility to SARS-CoV-2 infection in a large U.S. Metropolitan area. Though several factors may increase chances of infection among minorities; residence in population dense areas and therefore inability to adequately practice social distancing may explain higher infectivity.

scholarly journals Racial Disparities in Disability Among Older Adults

2014 ◽  
Vol 26 (8) ◽  
pp. 1261-1279 ◽  
Author(s):  
Roland J. Thorpe ◽  
Rachael McCleary ◽  
Jenny R. Smolen ◽  
Keith E. Whitfield ◽  
Eleanor M. Simonsick ◽  
...  
Keyword(s):  
African American ◽  
Health Disparities ◽  
Racial Disparities ◽  
African American Women ◽  
Racial Differences ◽  
Low Income ◽  
White Women ◽  
African American Men ◽  
Urban Sample ◽  
Functional Advantage

Objective: Persistent and consistently observed racial disparities in physical functioning likely stem from racial differences in social resources and environmental conditions. Method: We examined the association between race and reported difficulty performing instrumental activities of daily living (IADL) in 347 African American (45.5%) and Whites aged 50 or above in the Exploring Health Disparities in Integrated Communities–Southwest Baltimore, Maryland Study (EHDIC-SWB). Results: Contrary to previous studies, African Americans had lower rates of disability (women: 25.6% vs. 44.6%, p = .006; men: 15.7% vs. 32.9%; p = .017) than Whites. After adjusting for sociodemographics, health behaviors, and comorbidities, African American women (odds ratio [OR] = 0.32, 95% confidence interval [CI] = [0.14, 0.70]) and African American men (OR = 0.34, 95% CI = [0.13, 0.90]) retained their functional advantage compared with White women and men, respectively. Conclusion: These findings within an integrated, low-income urban sample support efforts to ameliorate health disparities by focusing on the social context in which people live.

Epidemiology, demographics, and outcomes of craniomaxillofacial gunshot wounds in a Level I trauma center

2014 ◽  
Vol 42 (5) ◽  
pp. 403-411 ◽  
Author(s):  
Sunil S. Tholpady ◽  
Patrick DeMoss ◽  
Kariuki P. Murage ◽  
Robert J. Havlik ◽  
Roberto L. Flores
Keyword(s):  
Trauma Center ◽  
Gunshot Wounds ◽  
Level I

scholarly journals Racial Differences in Special Education Identification and Placement: Evidence Across Three States

2019 ◽  
Vol 89 (4) ◽  
pp. 525-553 ◽  
Author(s):  
TODD GRINDAL ◽  
LAURA A. SCHIFTER ◽  
GABRIEL SCHWARTZ ◽  
THOMAS HEHIR
Keyword(s):  
Special Education ◽  
Students With Disabilities ◽  
Racial Differences ◽  
Low Income ◽  
Education System ◽  
Ethnic Disparities ◽  
School Students ◽  
Income Status ◽  
K 12 ◽  
Special Education Identification

In this article, Todd Grindal, Laura Schifter, Gabriel Schwartz, and Thomas Hehir examine race/ethnicity differences in students' special education identification and subsequent placement in segregated educational settings. Using individual-level data on the full population of K–12 public school students in three states, the authors find that racial and ethnic disparities in identification persist within income categories and are stronger for those disabilities that are typically identified in a school setting, such as learning disabilities or emotional disabilities, than those more often identified by a health-care provider, such as blindness or deafness. Also, Black and Hispanic students with disabilities were more likely to be placed in a substantially separate setting, compared to white students, regardless of income status. These results suggest that low-income status is insufficient to explain observed inequalities in the rate at which students of color are identified for special education and placed in substantially separate settings. A better understanding of the ways income status and race contribute to students' interactions with the special education system are critical for building a more equitable and just K–12 education system.

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