scholarly journals Inequalities in Hypertension and Diabetes in Canada: Intersections between Racial Identity, Gender, and Income

2017 ◽  
Vol 27 (4) ◽  
pp. 371 ◽  
Author(s):  
Thierry Gagné ◽  
Gerry Veenstra
Keyword(s):  
Racial Identity ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Canadian Community Health Survey ◽  
The United States ◽  
Unequal Distribution ◽  
Community Health Survey ◽  
Using Data

<p>A growing body of research from the United States informed by intersectionality theory indicates that racial identity, gender, and income are often entwined with one another as determinants of health in unexpectedly complex ways. Research of this kind from Canada is scarce, however. Using data pooled from ten cycles (2001- 2013) of the Canadian Community Health Survey, we regressed hypertension (HT) and diabetes (DM) on income in subsamples of Black women (n = 3,506), White women (n = 336,341), Black men (n = 2,806) and White men (n = 271,260). An increase of one decile in income was associated with lower odds of hypertension and diabetes among White men (ORHT = .98, 95% CI (.97, .99); ORDM = .93, 95% CI (.92, .94)) and White women (ORHT = .95, 95% CI (.95, .96); ORDM = .90, 95% CI (.89, .91)). In contrast, an increase of one decile in income was not associated with either health outcome among Black men (ORHT = .99, 95% CI (.92, 1.06); ORDM = .99, 95% CI (.91, 1.08)) and strongly associated with both outcomes among Black women (ORHT = .86, 95% CI (.80, .92); ORDM = .83, 95% CI (.75, .92)). Our findings highlight the complexity of the unequal distribution of hypertension and diabetes, which includes inordinately high risks of both outcomes for poor Black women and an absence of associations between income and both outcomes for Black men in Canada. These results suggest that an intersectionality framework can contribute to uncovering health inequalities in Canada.</p><p><em>Ethn Dis.</em>2017;27(4):371-378; doi:10.18865/ ed.27.4.371. </p>

scholarly journals Differential reporting of discriminatory experiences in Brazil and the United States

2017 ◽  
Vol 33 (suppl 1) ◽  
Author(s):  
Sarah Burgard ◽  
Debora de Pina Castiglione ◽  
Katherine Y. Lin ◽  
Aline A. Nobre ◽  
Estela M. L. Aquino ◽  
...  
Keyword(s):  
Black Men ◽  
White Women ◽  
White Men ◽  
The United States ◽  
Group Differences ◽  
National Comparison ◽  
Nationally Representative ◽  
Using Data ◽  
Gender Groups ◽  
College Educated

Abstract: There has been little cross-national comparison of perceived discrimination, and few studies have considered how intersectional identities shape perception of discriminatory treatment in different societies. Using data from the ELSA-Brasil, a study of Brazilian civil servants, and the Americans’ Changing Lives Study, a nationally-representative sample of U.S. adults, we compare reports of lifetime discrimination among race-by-gender groups in each society. We also consider whether educational attainment explains any group differences, or if differences across groups vary by level of education. Results reveal higher lifetime discrimination experiences among Black respondents in both countries, especially Black men, than among Whites, and lower reports among White women than White men. Brown men and women also reported higher levels than White men in Brazil. For all race-by-gender groups in both countries, except Brazilian White men, reports of discrimination were higher among the more educated, though adjusting for educational differences across groups did not explain group differences. In Brazil, we found the greatest racial disparities among the college educated, while U.S. Black men were more likely to report discrimination than White men at all levels of education. Results reveal broad similarities across countries, despite important differences in their histories, and an intersectional approach contributed to identification of these similarities and some differences in discrimination experiences. These findings have implications for social and public health surveillance and intervention to address the harmful consequences of discrimination.

scholarly journals BLACK–WHITE MARITAL MATCHING: RACE, ANTHROPOMETRICS, AND SOCIOECONOMICS

2016 ◽  
Vol 82 (4) ◽  
pp. 399-421 ◽  
Author(s):  
Pierre-André Chiappori ◽  
Sonia Oreffice ◽  
Climent Quintana-Domeque
Keyword(s):  
Black Women ◽  
Black Men ◽  
White Women ◽  
Panel Study ◽  
Marriage Market ◽  
White Men ◽  
Socioeconomic Characteristics ◽  
The Us ◽  
Using Data ◽  
Exchange Hypothesis

Abstract:We analyze the interaction of black–white race with physical and socioeconomic characteristics in the US marriage market, using data from the Panel Study of Income Dynamics. We estimatewho inter-racially marries whomalong anthropometric and socioeconomic characteristics dimensions. The black women who inter-marry are the thinner and more educated in their group; instead, white women are the fatter and less educated; black or white men who inter-marry are poorer and thinner. While women in “mixed” couples find a spouse who is poorer but thinner than if they intra-married, black men match with a white woman who is more educated than if they intra-married, and a white man finds a thinner spouse in a black woman. Our general findings are consistent with the “social status exchange” hypothesis, but the finding that black men who marry white women tend to be poorer than black men who marry black women isnot.

scholarly journals Cardiovascular Health at the Intersection of Race and Gender: Life-Course Processes to Reduce Health Disparities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 506-507
Author(s):  
Chioun Lee ◽  
Soojin Park ◽  
Jennifer Boylan
Keyword(s):  
Black Women ◽  
Black Men ◽  
White Women ◽  
Cardiovascular Health ◽  
White Men ◽  
The United States ◽  
Economic Security ◽  
Race And Gender ◽  
And Gender ◽  
Unmeasured Confounders

Abstract Objective: Higher cardiovascular health (CVH) scores are significantly associated with reductions in aging-related disease and mortality but racial minorities exhibit poor CVH. We examine the degree to which (a) disparities in CVH exist at the intersection of race and gender and (b) CVH disparities would be reduced if marginalized groups had the same levels of resources and adversities as privileged groups. Methods: We used biomarker subsamples from the Midlife in the United States (MIDUS) core study and Refresher studies (N=1,948). Causal decomposition analysis was implemented to test hypothetical interventions to equalize the distribution of early-life adversities (ELAs), perceived discrimination, or adult SES between marginalized and privileged groups. We conducted sensitivity analyses to determine to what degree unmeasured confounders would invalidate our findings. Results: White women have the highest CVH score, followed by White men, Black men, and Black women. Intervening on ELAs reduces the disparities: White men vs. Black women (30% of reduction) and White women vs. Black women (15%). Intervening on adult SES provides large disparity reductions: White men vs. Black men (79%), White men vs. Black women (70%), White women vs. Black men (25%), and White women vs. Black women (32%). Among these combinations, interventions on ELAs and adult SES are robust to unmeasured confounders. However, intervening on discrimination makes little change in initial disparities. Discussion: Economic security in midlife for Blacks helps reduce racial disparities in cardiovascular health. Preventing exposure to ELAs among Black women may reduce their vulnerability to cardiovascular disease, compared to Whites.

Abstract 15642: Race Sex Disparities in Atherosclerotic Cardiovascular Disease in Hospitalized Patients With Diabetes, 2005-2015 Potential Warning Signs for Future U.S. Public Health

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Gursukhman Sidhu ◽  
Charisse J Ward ◽  
Keith Ferdinand
Keyword(s):  
Cardiovascular Disease ◽  
Renal Failure ◽  
Black Women ◽  
Black Men ◽  
Odds Ratio ◽  
White Men ◽  
The United States ◽  
Atherosclerotic Cardiovascular Disease ◽  
Secondary Diagnosis ◽  
The U.S

Introduction: Despite a recent gradually slowing and perhaps recent increase in the burden of atherosclerotic cardiovascular disease (ASCVD) related hospitalization in the United States population with diabetes, it is unclear whether the prior downward trend was uniform or there was an unbalanced division amongst sex and race. Methods: Adults aged ≥40 years old with comorbid diabetes as a secondary diagnosis were identified using the U.S. 2005-2015 National (Nationwide) Inpatient Sample (NIS) data. The prevalence of other modifiable cardiovascular risk factors (hypertension, dyslipidemia, smoking/substance abuse, obesity, and renal failure), procedures like major amputations in the secondary diagnosis field and their association with ASCVD (acute coronary syndrome (ACS), coronary artery disease (CAD), stroke, or peripheral arterial disease (PAD)) as the first-listed diagnosis were determined. Complex samples multivariate regression was used to determine the odds ratio (O.D.) with 95% confidence limits (C.L.s). Sex and race risk-adjusted ASCVD related in-hospital mortality rates were estimated. Results: The rate of total ASCVD hospitalizations adjusted to the U.S. census population increased by 5.7% for black men compared to 4% for black women cumulatively compared to a stable downtrend in white men and white women. There was a higher odd of an ASCVD hospitalizations if there was comorbid hypertension (Odds Ratio (OR 1.29; 95% Confidence Interval (CI) 95% 1.28 - 1.31), dyslipidemia (OR 2.03; 95% CI 2.01 - 2.05), renal failure (OR 1.84; 95% CI 1.82 - 1.86), and smoking/substance use disorder (OR 1.31; 95% CI 1.29 - 1.33). When compared to white men, black men (OR 1.43; 95% CI 1.3 - 1.57) and black women (OR 1.15; 95% CI 1.04 - 1.27) had a higher likelihood of undergoing a major limb amputation during an ASCVD hospitalization. Conclusions: Blacks with diabetes continue to have a higher hospitalizations burden with a concomitant disparity in procedures and outcomes.

Abstract MP050: Race and Gender Group Specific Trends in Length of Stay for Acute Myocardial Infarction: The Atherosclerosis Risk in Communities (ARIC) study, 1987–2008

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Laura R Loehr ◽  
Xiaoxi Liu ◽  
C. Baggett ◽  
Cameron Guild ◽  
Erin D Michos ◽  
...  
Keyword(s):  
Black Women ◽  
Length Of Stay ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Quadratic Term ◽  
Race And Gender ◽  
Insurance Type ◽  
And Gender ◽  
Aric Study

Introduction: Since the 1980’s, length of stay (LOS) for acute MI (AMI) has declined in the US. However, little is known about trends in LOS for non-white racial groups and whether change in LOS is related to insurance type or hospital complications. Methods: We determined 22 year trends in LOS for nonfatal (definite or probable) AMI among black and white residents age 35–74 in 4 US communities (N=396,514 in 2008 population) under surveillance in the ARIC Study. Events were randomly sampled and independently validated using a standardized algorithm. All analyses accounted for sampling scheme. We excluded MI events which started after admission (n=1,677), events within 28 days for the same person (n=3,817), hospital transfers (n=571), and those with LOS=0 or LOS >66 (top 0.5% of distribution, N= 144) leaving 22,258 weighted events for analysis. The average annual change in log LOS was modeled using weighted linear regression with year as a quadratic term. All models adjusted for age and secondary models adjusted for insurance type (Medicare, Medicaid, private, or other), and complications during admission (cardiac arrest, cardiogenic shock, or heart failure). Results: The average age-adjusted LOS from 1987 to 2008 was reduced by 5 days in black men (9.5 to 4.5 days); 4.6 days in white women (9.4 to 4.8 days); 4 days in white men (8.3 to 4.3 days) and 3.6 days in black women (9.0 to 5.4 days). Between 1987 and 2008, the age-adjusted average annual percent change (with 95% CI) in LOS was largest for white men at −4.40 percent per year (−4.91, −3.89) followed by −3.89 percent (−4.52, −3.26) for white women, −3.72 percent (−4.46, −2.89) for black men, and −2.94 percent (−3.92, −1.96) for black women (see Figure). Adjustment for insurance type, and complications did not change the pattern by race and gender. Conclusions: Between 1987 and 2008, LOS for AMI declined significantly and similarly in men and women, blacks and whites. These changes appear independent of differences in insurance type and hospital complications among race-gender groups.

Abstract MP32: Race-sex differences in hyperlipidemia awareness, treatment and control in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Monika M Safford ◽  
Paul Muntner ◽  
Raegan Durant ◽  
Stephen Glasser ◽  
Christopher Gamboa ◽  
...  
Keyword(s):  
Sex Differences ◽  
Black Women ◽  
Black Men ◽  
Racial Differences ◽  
White Women ◽  
White Men ◽  
Risk Category ◽  
Chd Risk ◽  
And Control ◽  
Risk Categories

Introduction: To identify potential targets for eliminating disparities in cardiovascular disease outcomes, we examined race-sex differences in awareness, treatment and control of hyperlipidemia in the REGARDS cohort. Methods: REGARDS recruited 30,239 blacks and whites aged ≥45 residing in the 48 continental US between 2003-7. Baseline data were collected via telephone interviews followed by in-home visits. We categorized participants into coronary heart disease (CHD) risk groups (CHD or risk equivalent [highest risk]; Framingham Coronary Risk Score [FRS] >20%; FRS 10-20%; FRS <10%) following the 3 rd Adult Treatment Panel. Prevalence, awareness, treatment and control of hyperlipidemia were described across risk categories and race-sex groups. Multivariable models examined associations for hyperlipidemia awareness, treatment and control between race-sex groups compared with white men, adjusting for predisposing, enabling and need factors. Results: There were 11,677 individuals at highest risk, 847 with FRS >20%, 5791 with FRS 10-20%, and 10,900 with FRS<10%; 43% of white men, 29% of white women, 49% of black men and 43% of black women were in the highest risk category. More high risk whites than blacks were aware of their hyperlipidemia but treatment was 10-17% less common and control was 5-49% less common among race-sex groups compared with white men across risk categories. After multivariable adjustment, all race-sex groups relative to white men were significantly less likely to be treated or controlled, with the greatest differences for black women vs. white men (Table). Results were similar when stratified on CHD risk and area-level poverty tertile. Conclusion: Compared to white men at similar CHD risk, fewer white women, black men and especially black women who were aware of their hyperlipidemia were treated and when treated, they were less likely to achieve control, even after adjusting for factors that influence health services utilization.

scholarly journals Cardiovascular Health Score and Lifetime Risk of Cardiovascular Disease

2020 ◽  
Vol 13 (7) ◽  
Author(s):  
Joshua D. Bundy ◽  
Hongyan Ning ◽  
Victor W. Zhong ◽  
Amanda E. Paluch ◽  
Donald M. Lloyd-Jones ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
Cardiovascular Health ◽  
United States Public Health ◽  
The United States ◽  
Lifetime Risk ◽  
Men And Women ◽  
Risk Of Death

Background: Long-term risks of cardiovascular disease (CVD) according to levels of cardiovascular health (CVH) have not been characterized in a diverse, representative population. Methods and Results: We pooled individual-level data from 30 447 participants (mean [SD] age, 55.0 [13.9] years; 60.6% women; 31.8% black) from 7 US cohort studies. We defined CVH based on levels of 7 American Heart Association health metrics, scored as ideal (2 points), intermediate (1 point), or poor (0 points). The total CVH score was used to quantify overall CVH as high (12–14 points), moderate (9–11 points), or low (0–8 points). We used a modified Kaplan-Meier analysis, accounting for the competing risk of death, to estimate the lifetime risk of CVD (composite of incident myocardial infarction, stroke, heart failure, or CVD death) separately in white and black men and women free of CVD at index ages of <40, 40 to 59, and ≥60 years. High CVH was more prevalent among women compared with men, white compared with black participants, and in younger compared with older participants. During 538 477 person-years of follow-up, we observed 6546 CVD events. In women aged 40 to 59 years, those with high CVH had lower lifetime risk (95% CI) of CVD (white women, 12.6% [2.6%–22.6%]; black women, 0.0%) compared with moderate (white women, 16.6% [13.0%–20.2%]; black women, 12.7% [6.8%–18.5%]) and low (white women, 33.8% [30.6%–37.1%]; black women, 34.7% [30.4%–39.0%]) CVH strata. Patterns were similar for men and individuals <40 and ≥60 years of age. Conclusions: Higher baseline CVH at all ages in adulthood is associated with substantially lower lifetime risk for CVD compared with moderate and low CVH, in white and black men and women in the United States. Public health and healthcare efforts aimed at maintaining and restoring higher CVH throughout the life course could provide substantial benefits for the population burden of CVD.

scholarly journals Identity and the Legislative Decision Making Process: A Case Study of the Maryland State Legislature

2011 ◽  
Vol 34 (1) ◽  
pp. 45-68 ◽  
Author(s):  
Nadia Brown
Keyword(s):  
Decision Making ◽  
Black Women ◽  
African American Women ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
State Legislature ◽  
Men And Women ◽  
Women Legislators ◽  
Men I

Both politicians and the mass public believe that identity influences political behavior yet, political scientists have failed to fully detail how identity is salient for all political actors not just minorities and women legislators. To what extent do racial, gendered, and race/gendered identities affect the legislation decision process? To test this proposition, I examine how race and gender based identities shape the legislative decisions of Black women in comparison to White men, White women, and Black men. I find that Black men and women legislators interviewed believe that racial identity is relevant in their decision making processes, while White men and women members of the Maryland state legislature had difficulty deciding whether their identities mattered and had even more trouble articulating how or why they did. African American women legislators in Maryland articulate or describe an intersectional identity as a meaningful and significant component of their work as representatives. More specifically, Black women legislators use their identity to interpret legislation differently due to their race/gender identities.

Age-, sex-, and race-related differences in myoglobin concentrations in the serum of healthy persons.

1980 ◽  
Vol 26 (13) ◽  
pp. 1864-1868 ◽  
Author(s):  
I W Chen ◽  
R David ◽  
H R Maxon ◽  
M Sperling ◽  
E A Stein
Keyword(s):  
Black Women ◽  
Black Men ◽  
White Women ◽  
Age Groups ◽  
White Men ◽  
Reference Intervals ◽  
Creatinine Ratio ◽  
Healthy Individuals ◽  
Female Population ◽  
Serum Myoglobin

Abstract A radioimmunoassay was used to study the relation of race, sex, and age to serum myoglobin concentrations in ostensibly healthy individuals: 75 white men, 76 white women, 75 black men, and 66 black women, ranging in age from 20 to 85 years. Mean serum myoglobin values were significantly higher in men than in women in both races (35 vs 31 microgram/L for whites and 44 vs 29 microgram/L for blacks). Black men had higher values than white men, but no corresponding difference was observed in the female population. Except for the group of black men, which consistently had the highest values for serum myoglobin, values were always higher for the older groups (greater than or equal to 50 years) than the younger, irrespective of race or sex. Serum myoglobin and age were significantly and directly correlated only among white men (r = 0.3408 p &lt; 0.01, n = 75). If results were expressed as a myoglobin/creatinine ratio, the distinctions by race, sex, and age were partly eliminated. Reference intervals for serum myoglobin, expressed both ways, are given for different race, sex, and age groups.

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