scholarly journals Racial Composition Over the Lifecourse: Examining Separate and Unequal Environments and the Risk for Heart Disease for African American Men

2015 ◽  
Vol 25 (3) ◽  
pp. 295 ◽  
Author(s):  
Keon L. Gilbert, DrPH ◽  
Keith Elder, PhD ◽  
Sarah Lyons, MS ◽  
Kimberly A. Kaphingst, ScD ◽  
Melvin Blanchard, MD ◽  
...  
Keyword(s):  
High School ◽  
African American ◽  
Life Course ◽  
Junior High School ◽  
African American Men ◽  
Primary Care Clinic ◽  
Racial Composition ◽  
Convenience Sample ◽  
Care Clinic ◽  
The Life Course

<strong>Purpose: </strong>Studies have demonstrated the effects of segregated social and physi­cal environments on the development of chronic diseases for African Americans. Studies have not delineated the effects of segregated environments specifically on the health of African American men over their lifetime. This study examines the relation­ship between life course measures of racial composition of social environments and diagnosis of hypertension among African American men.<p><strong>Design: </strong>We analyzed cross-sectional data from a convenience sample of African American men seeking health care services in an outpatient primary care clinic serving a medically underserved patient population (<em>N</em>=118). Multivariable logistic regression analyses were used to examine associations between racial composition of multiple environments across the life course (eg, junior high school, high school, neighbor­hood growing up, current neighborhood, place of employment, place of worship) and hypertension diagnosis.</p><p><strong>Results: </strong>The majority (86%) of participants were not currently in the workforce (retired, unemployed, or disabled) and more than half (54%) reported an annual household income of &lt;$9,999; median age was 53. Results suggest that African American men who grew up in mostly Black neighbor­hoods (OR=4.3; <em>P</em>=.008), and worked in mostly Black environments (OR=3.1; <em>P</em>=.041) were more likely to be diagnosed with hypertension than those who did not.</p><p><strong>Conclusion: </strong>We found associations between mostly Black residential and work­place settings and hypertension diagnoses among African American men. Findings sug­gest exposure to segregated environments during childhood and later adulthood may impact hypertension risk among African American men over the life course. <em>Ethn Dis</em>. 2015;25(3):295-304.</p>

scholarly journals Emerging Adulthood: An Intersectional Examination of the Changing Life Course

2019 ◽  
Vol 15 (4) ◽  
pp. 14-33
Author(s):  
Shauna A. Morimoto
Keyword(s):  
High School ◽  
High School Students ◽  
Emerging Adulthood ◽  
Life Course ◽  
School Students ◽  
Identity Exploration ◽  
Race And Gender ◽  
Adult World ◽  
And Gender ◽  
The Life Course

This article draws on qualitative data of U.S. high school students considering their place in the adult world; the purpose is to investigate Jeffrey Arnett’s (2000) concept of “emerging adulthood” as a new stage of life course. Drawing on interviews and observational data collected around the time when Arnett’s notion of emerging adulthood started to take hold, I use intersectional interpretive lens in order to highlight how race and gender construct emerging adulthood as high school students move out of adolescence. I consider Arnett’s thesis twofold. First, when emerging adulthood is examined intersectionally, young people reveal that – rather than being distinct periods that can simply be prolonged, delayed, or even reached – life stages are fluid and constantly in flux. Second, since efforts to mitigate against uncertain futures characterizes the Millennial generation, I argue that the process of guarding against uncertainty reorders, questions or reconfigures the characteristics and stages that conventionally serve as markers of life course. I conclude that the identity exploration, indecision, and insecurity associated with emerging adulthood can also be understood as related to how the youth reveal and reshape the life course intersectionally.

African-American versus White Children and the Transition into Junior High School

1991 ◽  
Vol 99 (4) ◽  
pp. 481-520 ◽  
Author(s):  
Roberta G. Simmons ◽  
Ann Black ◽  
Yingzhi Zhou
Keyword(s):  
High School ◽  
African American ◽  
Junior High School ◽  
Junior High ◽  
White Children

Prevalence of advance care planning in a resident run clinic in an underserved community.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24067-e24067
Author(s):  
Swetha Ann Alexander ◽  
Vinay Mathew Thomas ◽  
David Wu ◽  
Radhika Kulkarni ◽  
William Rabitaille
Keyword(s):  
Primary Care ◽  
African American ◽  
Advance Care Planning ◽  
Primary Care Clinic ◽  
Retrospective Chart Review ◽  
Care Planning ◽  
Care Clinic ◽  
Underserved Community ◽  
Advance Care ◽  
End Stage

e24067 Background: Advance Care Planning (ACP) ensures that patients receive care that is in line with their values and preferences. ACP is best done in the outpatient setting. Despite recognizing the importance of ACP, the rates of ACP completion continue to be low. We conducted a retrospective study to determine the rates of ACP in a resident run primary care clinic in Hartford, Connecticut, which serves the underserved community. We looked at patient characteristics to find correlation with ACP completion. We also aimed to determine the reasons which could decrease the completion of ACP. Methods: This was a retrospective chart review. Patients who met any of the inclusion criteria [i) Age>65 ii) End stage renal disease on dialysis iii) Metastatic/Recurrent cancer iv) End stage heart failure v) COPD Gold stage D] and were seen in the primary care clinic from September 1, 2019 to December 31, 2019 were selected. Their charts were reviewed to see if ACP was documented during primary care visits over the past two years. The demographics of the patients were noted. Subsequently, a survey was distributed to residents to determine the possible causes of low rates of ACP discussion. Results: The characteristics of the 373 patients included in the study are shown in Table 1. Only 14 (3.8%) of the 373 had documentation of ACP during their primary care visits. The characteristics of the 14 patients in whom ACP was done are as follows: Sex- Female 9/14 (64%); Ethnicity- Hispanic 10/14 (71%), African American 4/14 (29%); Religious Affiliation- Christian 13/14 (93%), None 1/14 (7%); Married/Partner 2/14 (14%). Patient demographics including sex (p 0.6), religious beliefs (p 0.8), and marital status (p 0.6) did not show any correlation with the likelihood of ACP completion. Of the 31 residents who answered the survey, the most commonly listed barriers to ACP completion were the following: lack of time to conduct these discussions (94%), forgetting to conduct ACP discussions (48%), and lack of training (19%). All the residents believed that ACP discussion was beneficial to patients and medical providers. Conclusions: The rates of ACP planning in our clinic are much lower than the national average. African American and Hispanics, who make up the majority of our clinic population, traditionally have had low rates of ACP completion. This is an important issue that needs to be addressed. Advance care planning training should be also be strengthened during residency. [Table: see text]

Abstract P134: Selected Social Determinants Of Health And Hypertension For Patients Of An Urban Community Primary Care Clinic

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Melvin R Echols ◽  
Paula Pollard-Thomas ◽  
Henry Nuss ◽  
Heartley Egwuogu ◽  
Kristen Hobbs ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
African American ◽  
Food Insecurity ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Clinic ◽  
Financial Strain ◽  
Care Clinic ◽  
Stage 1

Background: Hypertension (HTN) is the most potent cardiovascular disease worldwide and a major public health concern in the U.S. Although Social Determinants of Health (SDoH) are associated with HTN, it is unclear whether these indicators are routinely captured in the primary care setting. We sought to examine the prevalence of any HTN and its association with captured SDoH for new patients (pts) presenting to an urban community primary care clinic for 2019 and 2020. Methods and Results: We identified a cohort-based, cross-sectional sample of 2,577 new pts ≥ 18 years of age in a community clinic in Atlanta, GA, between Jan 2019 and Dec 2020. Electronic health records were reviewed to determine the rate of selected SDoH indicators (financial strain, transportation, medical transportation, and food insecurity) captured at any time and the presenting blood pressure for all new patients. Blood pressure was classified as follows: normal, systolic BP/diastolic BP (SBP/DBP) ≤120/80 mmHg, elevated SBP 120-129mmHg and DBP<80mm, stage 1 SBP 130-139mmHg or DBP 80-90mmHg, and stage 2 SBP ≥ 140mmHg+ or DBP 90mmHg+. Likelihood-ratio Chi-square tests were analyzed to detect an association between SDOH and stages of HTN. Of the 2,577 pts seen, 93% were African American, 72% were female, 59% were single, 77% had BMI ≥ 25, and 85% were insured. Only 41% (n=1062) pts had information of at least one SDoH measure in the entire cohort. Of the SDoH domains evaluated, financial strain and food insecurity were more likely in new pts with stage 1 HTN or higher (χ2= 16.0, df=8, p=0.04; χ2= 27.7, df=12, p=0.006). Conclusion: Routine assessments of SDoH for African American pts presenting for new pt visits are suboptimal in the primary care setting. However, financial strain and food insecurity are significantly associated with stage 1 and 2 HTN in this population. Standardization of intake processes is essential to increase the collection of SDoH indicators and may ultimately guide secondary prevention strategies for HTN interventions.

scholarly journals CONTINUITY OF CAREER OVER THE LIFE COURSE ON LIFE SATISFACTION AND DEPRESSIVE SYMPTOMS IN LATER LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S128-S129
Author(s):  
Melanie S Hill ◽  
James E Hill ◽  
Stephanie Richardson ◽  
Jessica Brown ◽  
Jeremy B Yorgason ◽  
...  
Keyword(s):  
High School ◽  
Life Satisfaction ◽  
Depressive Symptoms ◽  
Life Course ◽  
Career Choice ◽  
Early Adulthood ◽  
Later Life ◽  
Well Being ◽  
The Life Course ◽  
The Impact

Abstract Identity scholars have suggested that having a unified sense of past, present, and future is related to positive well-being outcomes (Whitbourne, Sneed & Skultety, 2009). One’s occupation can have a profound influence on an individual’s identity throughout the life course (Nazar & van der Heijden, 2012). Research has looked at career mobility among younger age groups (Baiyun, Ramkissoon, Greenwood, & Hoyte, 2018); however, less is known about the impact of career stability later in life. Consistency in career choice over the life course may have positive outcomes down the line as career becomes part of an individual's identity. The current study uses the Life and Family Legacies dataset, a longitudinal state-representative sample of 3,348, to examine individual’s careers at three points in the life course: high school (projected career choice), early adulthood, and later life. Results revealed that a match of desired career in high school and actual career in early adulthood was not predictive of life satisfaction or depressive symptoms in later life. However, a match of career in early adulthood and later life was significantly related to better life satisfaction and less depressive symptoms, which was explained through higher levels of job satisfaction. This study highlights the importance of acquiring and maintaining a career that is fulfilling to the individual over the course of early adulthood to later life.

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