Race, Place, and Obesity: The Complex Relationships Among Community Racial/Ethnic Composition, Individual Race/Ethnicity, and Obesity in the United States

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.

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Infant Mortality among Adolescent Mothers in the United States: A 5-Year Analysis of Racial and Ethnic Disparities

American Journal of Perinatology ◽

10.1055/s-0040-1714678 ◽

2020 ◽

Author(s):

Matthew D. Moore ◽

Anne E. Brisendine ◽

Martha S. Wingate

Keyword(s):

United States ◽

Preterm Birth ◽

Infant Mortality ◽

Ethnic Disparities ◽

The United States ◽

Racial And Ethnic Disparities ◽

Postneonatal Mortality ◽

Maternal Characteristics ◽

Race Ethnicity ◽

Racial Ethnic

Objective This study was aimed to examine differences in infant mortality outcomes across maternal age subgroups less than 20 years in the United States with a specific focus on racial and ethnic disparities. Study Design Using National Center for Health Statistics cohort-linked live birth–infant death files (2009-2013) in this cross-sectional study, we calculated descriptive statistics by age (<15, 15–17, and 18–19 years) and racial/ethnic subgroups (non-Hispanic white [NHW], non-Hispanic black [NHB], and Hispanic) for infant, neonatal, and postneonatal mortality. Adjusted odds ratios (aOR) were calculated by race/ethnicity and age. Preterm birth and other maternal characteristics were included as covariates. Results Disparities were greatest for mothers <15 and NHB mothers. The risk of infant mortality among mothers <15 years compared to 18 to 19 years was higher regardless of race/ethnicity (NHW: aOR = 1.40, 95% confidence interval [CI]: 1.06–1.85; NHB: aOR = 1.28, 95% CI: 1.04–1.56; Hispanic: aOR = 1.36, 95%CI: 1.07–1.74). Compared to NHW mothers, NHB mothers had a consistently higher risk of infant mortality (15–17 years: aOR = 1.12, 95% CI: 1.03–1.21; 18–19 years: aOR = 1.21, 95% CI: 1.15–1.27), while Hispanic mothers had a consistently lower risk (15–17 years: aOR = 0.72, 95% CI: 0.66–0.78; 18–19 years: aOR = 0.74, 95% CI: 0.70–0.78). Adjusting for preterm birth had a greater influence than maternal characteristics on observed group differences in mortality. For neonatal and postneonatal mortality, patterns of disparities based on age and race/ethnicity differed from those of overall infant mortality. Conclusion Although infants born to younger mothers were at increased risk of mortality, variations by race/ethnicity and timing of death existed. When adjusted for preterm birth, differences in risk across age subgroups declined and, for some racial/ethnic groups, disappeared. Key Points

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Racial/Ethnic Disparities in Lost Earnings From Cancer Deaths in the United States

JNCI Cancer Spectrum ◽

10.1093/jncics/pkaa038 ◽

2020 ◽

Vol 4 (5) ◽

Cited By ~ 1

Author(s):

Jingxuan Zhao ◽

Kimberly D Miller ◽

Farhad Islami ◽

Zhiyuan Zheng ◽

Xuesong Han ◽

...

Keyword(s):

United States ◽

Economic Burden ◽

Ethnic Disparities ◽

The United States ◽

Pacific Islanders ◽

Equal Access ◽

Years Of Life Lost ◽

Cancer Death ◽

Race Ethnicity ◽

Racial Ethnic

Abstract Background Little is known about disparities in economic burden due to premature cancer deaths by race or ethnicity in the United States. This study aimed to compare person-years of life lost (PYLLs) and lost earnings due to premature cancer deaths by race/ethnicity. Methods PYLLs were calculated using recent national cancer death and life expectancy data. PYLLs were combined with annual median earnings to generate lost earnings. We compared PYLLs and lost earnings among individuals who died at age 16-84 years due to cancer by racial/ethnic groups (non-Hispanic [NH] White, NH Black, NH Asian or Pacific Islander, and Hispanic). Results In 2015, PYLLs due to all premature cancer deaths were 6 512 810 for NH Whites, 1 196 709 for NH Blacks, 279 721 for NH Asian or Pacific Islanders, and 665 968 for Hispanics, translating to age-standardized lost earning rates (per 100 000 person-years) of $34.9 million, $43.5 million, $22.2 million, and $24.5 million, respectively. NH Blacks had higher age-standardized PYLL and lost earning rates than NH Whites for 13 of 19 selected cancer sites. If age-specific PYLL and lost earning rates for NH Blacks were the same as those of NH Whites, 241 334 PYLLs and $3.2 billion lost earnings (22.6% of the total lost earnings among NH Blacks) would have been avoided. Disparities were also observed for average PYLLs and lost earnings per cancer death for all cancers combined and 18 of 19 cancer sites. Conclusions Improving equal access to effective cancer prevention, screening, and treatment will be important in reducing the disproportional economic burden associated with racial/ethnic disparities.

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Differential Association of HIV Funding With HIV Mortality by Race/Ethnicity, United States, 1999-2017

Public Health Reports ◽

10.1177/0033354920912716 ◽

2020 ◽

Vol 135 (1_suppl) ◽

pp. 149S-157S

Author(s):

Benedict I. Truman ◽

Ramal Moonesinghe ◽

Yolanda T. Brown ◽

Man-Huei Chang ◽

Jonathan H. Mermin ◽

...

Keyword(s):

United States ◽

The United States ◽

Rate Of Change ◽

Fiscal Year ◽

Death Rates ◽

Black Residents ◽

Race Ethnicity ◽

Hiv Funding ◽

Racial Ethnic ◽

Hispanic White

Objective Federal funds have been spent to reduce the disproportionate effects of HIV/AIDS on racial/ethnic minority groups in the United States. We investigated the association between federal domestic HIV funding and age-adjusted HIV death rates by race/ethnicity in the United States during 1999-2017. Methods We analyzed HIV funding data from the Kaiser Family Foundation by federal fiscal year (FFY) and US age-adjusted death rates (AADRs) by race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, and Asian/Pacific Islander and American Indian/Alaska Native [API+AI/AN]) from Centers for Disease Control and Prevention WONDER detailed mortality files. We fit joinpoint regression models to estimate the annual percentage change (APC), average APC, and changes in AADRs per billion US dollars in HIV funding, with 95% confidence intervals (CIs). For 19 data points, the number of joinpoints ranged from 0 to 4 on the basis of rules set by the program or by the user. A Monte Carlo permutation test indicated significant ( P < .05) changes at joinpoints, and 2-sided t tests indicated significant APCs in AADRs. Results Domestic HIV funding increased from $10.7 billion in FFY 1999 to $26.3 billion in FFY 2017, but AADRs decreased at different rates for each racial/ethnic group. The average rate of change in AADR per US billion dollars was −9.4% (95% CI, −10.9% to −7.8%) for Hispanic residents, −7.8% (95% CI, −9.0% to −6.6%) for non-Hispanic black residents, −6.7% (95% CI, −9.3% to −4.0%) for non-Hispanic white residents, and −5.2% (95% CI, −7.8% to −2.5%) for non-Hispanic API+AI/AN residents. Conclusions Increased domestic HIV funding was associated with faster decreases in age-adjusted HIV death rates for Hispanic and non-Hispanic black residents than for residents in other racial/ethnic groups. Increasing US HIV funding could be associated with decreasing future racial/ethnic disparities in the rate of HIV-related deaths.

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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

10.1101/2021.01.28.21249411 ◽

2021 ◽

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 ◽

Estimation Uncertainty ◽

Race Ethnicity ◽

Using Data ◽

Rate Ratios ◽

Racial Ethnic

AbstractThe 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 December 30, 2020. Using a novel Monte Carlo simulation procedure to quantify estimation uncertainty, 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, observed 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.

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Trends in Cigar Use in the United States, 2002–2016: Diverging Trends by Race/Ethnicity

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz060 ◽

2019 ◽

Vol 22 (4) ◽

pp. 583-587 ◽

Cited By ~ 1

Author(s):

Andrea H Weinberger ◽

Cristine D Delnevo ◽

Jiaqi Zhu ◽

Misato Gbedemah ◽

Joun Lee ◽

...

Keyword(s):

United States ◽

Black Women ◽

Ethnic Group ◽

Ethnic Groups ◽

Ethnic Differences ◽

Mixed Race ◽

The United States ◽

Race Ethnicity ◽

Racial Ethnic ◽

Over Time

Abstract Introduction Although there are racial/ethnic differences in cigarette use, little is known about how non-cigarette tobacco use differs among racial/ethnic groups. This study investigated trends in cigar use from 2002 to 2016, by racial/ethnic group, in nationally representative US data. Methods Data were drawn from the 2002–2016 National Survey on Drug Use and Health public use data files (total analytic sample n = 630 547 including 54 060 past-month cigar users). Linear time trends of past-month cigar use were examined by racial/ethnic group (Non-Hispanic [NH] White, NH Black, Hispanic, NH Other/Mixed Race/Ethnicity) using logistic regression models. Results In 2016, the prevalence of past-month cigar use was significantly higher among NH Black respondents than among other racial/ethnic groups (ps < .001). Cigar use was also higher among NH White respondents than among Hispanic and NH Other/Mixed Race/Ethnicity respondents. The year by racial/ethnic group interaction was significant (p < .001). Past-month cigar use decreased significantly from 2002 to 2016 among NH White and Hispanic respondents (ps = .001), whereas no change in prevalence was observed among NH Black (p = .779) and NH Other/Mixed Race/Ethnicity respondents (p = .152). Cigar use decreased for NH White men (p < .001) and did not change for NH White women (p = .884). Conversely, cigar use increased for NH Black women (p < .001) and did not change for NH Black men (p = .546). Conclusions Cigar use remains significantly more common among NH Black individuals in the United States and is not declining among NH Black and NH Other/Mixed Race/Ethnicity individuals over time, in contrast to declines among NH White and Hispanic individuals. Implications This study identified racial/ethnic differences in trends in past-month cigar use over 15 years among annual cross-sectional samples of US individuals. The highest prevalence of cigar use in 2016 was found among NH Black individuals. In addition, cigar use prevalence did not decline from 2002 to 2016 among NH Black and NH Other/Mixed Race/Ethnicity groups over time, in contrast to NH White and Hispanic groups. Further, cigar use increased over time for NH Black women. Targeted public health and clinical efforts may be needed to decrease the prevalence of cigar use, especially for NH Black individuals.

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Health Care Use and Outcomes in Assisted Living Communities: Race, Ethnicity, and Dual Eligibility

Medical Care Research and Review ◽

10.1177/10775587211050189 ◽

2021 ◽

pp. 107755872110501

Author(s):

Helena Temkin-Greener ◽

Yunjiao Mao ◽

Brian McGarry ◽

Sheryl Zimmerman ◽

Yue Li

Keyword(s):

United States ◽

Assisted Living ◽

Fixed Effects ◽

The United States ◽

Health Care Use ◽

Fee For Service ◽

Term Care ◽

Race Ethnicity ◽

Dual Eligibility ◽

Racial Ethnic

Assisted Living (AL) has become an important residential long-term care option in the United States, yet very little is known about the nature and quality of care received in this setting by racial/ethnic minorities or residents dually eligible for Medicare and Medicaid. Using calendar year 2018 Medicare data, we identified 255,564 fee-for-service Medicare beneficiaries age 55+ who resided in 24,108 ALs across the United States. We fit several logistic regression models with individual-level covariates and AL-level fixed effects, to examine the association between race/ethnicity and dual status with inpatient hospital admission, 30-day readmission, emergency room use, and nursing home placement. Significant variations in these measures were found both within and across ALs for racial/ethnic minority and dual residents. Our results suggest that disparities in outcomes are most significant by dual eligibility status rather than by race/ethnicity alone. These findings provide important implications for providers, policy makers, and researchers.

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Contextualized Effects of Racial/Ethnic Matching Between Students and Teachers in Urban, Suburban, and Rural High Schools

Teachers College Record ◽

10.1177/016146812012201110 ◽

2020 ◽

Vol 122 (11) ◽

pp. 1-34

Author(s):

Sung Tae Jang

Keyword(s):

United States ◽

Rural Schools ◽

Self Efficacy ◽

Math Achievement ◽

The United States ◽

Asian Students ◽

Ethnic Matching ◽

Policy Makers ◽

Race Ethnicity ◽

Racial Ethnic

Background/Context Policy makers and scholars have long called for the large-scale recruitment of teachers of color, partly based on evidence highlighting the positive effects of racial/ethnic matching between students and teachers of color on various student experiences and achievements. A more nuanced understanding of racial/ethnic matching effects moderated by contextual factors may help policy makers’ and administrators’ assignment decisions on how to consider student and teacher race/ethnicity. Purpose/Objective/Research Question This study examined the contextualized effects of racial/ethnic matching between high school students and teachers, focusing on the urbanicity of schools in the United States, by asking two main research questions: (1) What are the associations between the racial/ethnic matching of students and teachers, and students’ math achievement and self-efficacy in the United States overall? (2) What are the associations among racial/ethnic matching, math achievement, and math self-efficacy in urban schools, and do these patterns differ for suburban and rural schools? Research Design This study used restricted-use national longitudinal data provided by the NCES High School Longitudinal Study of 2009. A strategy of disaggregating data by schools’ urbanicity and three separate analyses with fixed-effect models for each urbanicity (urban, suburban, and rural) was followed to capture the variations across different schools’ urbanicity and to obtain unbiased estimates of racial/ethnic matching effects. Findings/Results Relatively lower percentages of Black, Hispanic, and Asian students were matched with their same-race/ethnicity math teachers compared with White students in all communities. This study found no supporting evidence for positive associations between racial/ethnic matching and math achievement scores and self-efficacy without considering urbanicity. Within the context of urbanicity, positive associations for math achievement were mainly found in the racial/ethnic matching of Black and Asian students taught by same-race/ethnicity teachers in suburban schools. Conversely, the racial/ethnic matching among Asian students and teachers in rural schools was significantly and negatively associated with both math achievement and self-efficacy. Conclusions/Recommendations By focusing specifically on schools’ urbanicity contexts, policy makers and education leaders should consider the relatively lower percentage of racial/ethnic matching between Black students and teachers in urban and suburban schools, and Hispanic students and teachers in urban and rural schools. As rural Asian populations grow and diversify, Asian teachers from diverse cultural backgrounds are urgently needed in these communities. Contextualized policy solutions that consider school environments and cultural differences and that challenge the one-size-fits-all approach will ultimately better address the specific and diverse needs of students of color living in different communities across the United States.

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Immigration and Neighborhood Change: Methodological Possibilities for Future Research

City and Community ◽

10.1111/cico.12242 ◽

2017 ◽

Vol 16 (3) ◽

pp. 244-251 ◽

Cited By ~ 6

Author(s):

Ariela Schachter ◽

Max Besbris

Keyword(s):

United States ◽

Rental Housing ◽

The United States ◽

Neighborhood Change ◽

Future Research ◽

Online Data ◽

Race Ethnicity ◽

The Impact ◽

Housing Options ◽

Racial Ethnic

The recent settlement of immigrant populations into a wider range of geographies and communities across the United States raises new questions about the dynamics of residential segregation and complicates assumptions about how neighborhoods change—or don't—and why. While multiple theories attempt to explain the relationship between race/ethnicity, immigration, and neighborhood change, sociological examinations have been limited by the lack of systematic and frequently collected data. That is, the residential churn of neighborhoods, particularly in the market for rental housing where racial/ethnic minorities and immigrants predominate, often outpaces analysts’ ability to gather cross–neighborhood and cross–city data. In this essay we describe how online sources can help answer questions about race/ethnicity, immigration, and neighborhoods by providing large amounts of readily updatable data. An array of platforms designed to provide homeseekers with information about their housing options can also be used by sociologists for making claims about neighborhood change across multiple geographies. We review recent research that uses online data and describe an ongoing study by the authors that examines trends in the settlement patterns of immigrants and the rental housing market across the 50 largest MSAs in the United States. Online data sources can more accurately capture immigration and neighborhood processes, yielding better theories about the impact of immigration on neighborhood change.

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Race/Ethnicity over Fifty Years of Structural Differentiation in K–12 Schooling: Period-Specific and Life-Course Perspectives

Annual Review of Sociology ◽

10.1146/annurev-soc-073018-022441 ◽

2020 ◽

Vol 46 (1) ◽

pp. 355-378

Author(s):

Samuel R. Lucas ◽

Santiago J. Molina ◽

John M. Towey

Keyword(s):

United States ◽

Life Course ◽

Ethnic Differences ◽

The United States ◽

Ethnic Inequality ◽

Structural Differentiation ◽

Time Period ◽

Race Ethnicity ◽

K 12 ◽

Racial Ethnic

In the United States, equally performing students of different racial/ethnic groups may have different prospects for enrollment in rigorous curricular positions. Over time, the processes and operation of curricular systems have changed, and those changes may matter for the existence of racial/ethnic differences in access. We first outline dimensions that distinguish forms of in-school structural differentiation. We then use those dimensions to describe in-school structural differentiation at different points in time in the United States. Next, the time-period-specific evidence on racial/ethnic inequality is outlined, thus embedding findings in historical time. Finally, we array findings on racial/ethnic inequality into life-course trajectories for studied cohorts, revealing that different cohorts may have documented differences in their experience with respect to race and curricular placement.

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