scholarly journals Racial and Ethnic Disparities in the Refusal of Surgical Treatment in Women 40 Years and Older With Breast Cancer in the United States Between 2010 and 2017

2022 ◽  
Author(s):  
Pierre Fwelo ◽  
Zenab Yusuf ◽  
Abigail Adjei ◽  
Gabriel Huynh ◽  
Xianglin Du
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Surgical Treatment ◽  
Black Women ◽  
Ethnic Disparities ◽  
Breast Conserving Surgery ◽  
The United States ◽  
Recommended Treatment ◽  
Race Ethnicity ◽  
To Receive

Abstract Purpose Although surgical resection is the main modality of treatment for breast cancer, some patients elect to refuse the recommended surgery. We assessed racial and ethnic differences in women 40 years and older who received or refused to receive surgical treatment for breast cancer in the United States and whether racial disparities in mortality were affected by their differences in the prevalence of refusal for surgical treatmentMethods We studied 277,127 women with breast cancer using the Surveillance, Epidemiology, and End Results (SEER) data and performed multivariable logistic regressions to investigate the association between surgery status of breast cancer and race/ethnicity. Additionally, we performed Cox logistic regression analyses to determine the predictors of mortality outcomes. Results Of 277,127 patients with breast cancer, 1,468 (0.53%) refused to receive the recommended surgical treatment in our cohort. Non-Hispanic Black women were 112% more likely to refuse recommended surgical treatment for breast cancer compared to their non-Hispanic White counterparts [adjusted odds ratio: 2.12, 95% confidence interval (CI)=1.82-2.47]. Women who underwent breast conserving surgery [hazards ratio (HR): 0.15, 95% CI: 0.13-0.16] and mastectomy (HR:0.21, 95% CI: 0.18-0.23) had lower hazard ratios of mortality as compared to women who refused the recommended treatment after adjusting for covariates. Conclusion Race/ethnicity was associated with refusal for recommended surgery, especially among non-Hispanic Black women. Also, surgery refusal was associated with a higher risk of all-cause and breast cancer-related mortality. These disparities stress the need to tailor interventions aimed at raising awareness of the importance of following physician recommendations among minorities.

scholarly journals 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

2021 ◽  
Vol 18 (6) ◽  
pp. 2921
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 ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Degree Of Association ◽  
Racial Ethnic

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.

Racial/Ethnic Disparities in Hypertension Prevalence, Awareness, Treatment, and Control in the United States, 2013 to 2018

Hypertension ◽  
2021 ◽  
Author(s):  
Rahul Aggarwal ◽  
Nicholas Chiu ◽  
Rishi K. Wadhera ◽  
Andrew E. Moran ◽  
Inbar Raber ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Disparities ◽  
The United States ◽  
Self Report ◽  
Similar Treatment ◽  
Hypertension Prevalence ◽  
Health And Nutrition ◽  
Race Ethnicity ◽  
And Control ◽  
White Adults

We evaluated the prevalence, awareness, treatment, and control of hypertension (defined as a systolic blood pressure [BP]) ≥140 mm Hg, diastolic BP ≥90 mm Hg, or a self-reported use of an antihypertensive agent) among US adults, stratified by race/ethnicity. This analysis included 16 531 nonpregnant US adults (≥18 years) in the three National Health and Nutrition Examination Survey cycles between 2013 and 2018. Race/ethnicity was defined by self-report as White, Black, Hispanic, Asian, or other Americans. Among 76 910 050 (74 449 985–79 370 115) US adults with hypertension, 48.6% (47.3%–49.8%, unadjusted) have controlled BP. When compared with BP control rates for White adults (49.0% [46.8%–51.2%], age-adjusted), BP control rates are lower in Black (39.2%, adjusted odds ratio [aOR], 0.71 [95% CI, 0.59–0.85], P <0.001), Hispanic (40.0%, aOR, 0.71 [95% CI, 0.58–0.88], P =0.003), and Asian (37.8%, aOR, 0.68 [95% CI, 0.55–0.84], P =0.001) Americans. Black adults have higher hypertension prevalence (45.3% versus 31.4%, aOR, 2.24 [95% CI, 1.97–2.56], P <0.001) but similar awareness and treatment rates as White adults. Hispanic adults have similar hypertension prevalence, but lower awareness (71.1% versus 79.1%, aOR, 0.72 [95% CI, 0.58–0.89], P =0.005) and treatment rates (60.5% versus 67.3%, aOR, 0.78 [95% CI, 0.66–0.94], P =0.010) than White adults. Asian adults have similar hypertension prevalence, lower awareness (72.5% versus 79.1%, aOR, 0.75 [95% CI, 0.58–0.97], P =0.038) but similar treatment rates. Black, Hispanic, and Asian Americans have different vulnerabilities in the hypertension control cascade of prevalence, awareness, treatment, and control. These differences can inform targeted public health efforts to promote health equity and reduce the burden of hypertension in the United States.

Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

2021 ◽  
Author(s):  
Kate E Dibble ◽  
Avonne E Connor
Keyword(s):  
United States ◽  
Depressive Symptoms ◽  
Hispanic Women ◽  
Ethnic Disparities ◽  
The United States ◽  
Medically Underserved ◽  
Increased Risk ◽  
Poverty Status ◽  
Race Ethnicity ◽  
Severe Anxiety

Abstract PurposeTo outline the association between race/ethnicity and poverty status and perceived anxiety and depressive symptomologies among BRCA1/2-positive United States (US) women to identify high-risk groups of mutation carriers from medically underserved backgrounds.Methods211 BRCA1/2-positive women from medically underserved backgrounds were recruited through national Facebook support groups and completed an online survey. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for associations between race/ethnicity, poverty status, and self-reported moderate-to-severe anxiety and depressive symptoms.ResultsWomen ranged in age (18–75, M = 39.5, SD = 10.6). Most women were non-Hispanic white (NHW) (67.2%) and were not impoverished (76.7%). Hispanic women with BRCA1/2 mutations were 6.11 times more likely to report moderate-to-severe anxiety (95% CI, 2.16–17.2, p = 0.001) and 4.28 times more likely to report moderate-to-severe depressive symptoms (95% CI, 1.98–9.60, p = < 0.001) than NHW women with BRCA1/2. Associations were not statistically significant among other minority women. Women living in poverty were significantly less likely to report moderate-to-severe depressive symptoms than women not in poverty (aOR, 0.42, 95% CI, 0.18–0.95, p = 0.04).ConclusionHispanic women with BRCA1/2 mutations from medically underserved backgrounds are an important population at increased risk for worse anxiety and depressive symptomology. Our findings among Hispanic women with BRCA1/2 mutations add to the growing body of literature focused on ethnic disparities experienced across the cancer control continuum.

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

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

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

2020 ◽  
Vol 4 (5) ◽  
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.

scholarly journals Religion across Axes of Inequality in the United States: Belonging, Behaving, and Believing at the Intersections of Gender, Race, Class, and Sexuality

Religions ◽  
2020 ◽  
Vol 11 (6) ◽  
pp. 296
Author(s):  
Landon Schnabel
Keyword(s):  
United States ◽  
Black Women ◽  
Sexual Minorities ◽  
The United States ◽  
Racial Groups ◽  
Religion And Spirituality ◽  
College Degree ◽  
Sexual Minority Women ◽  
Intersecting Identities ◽  
Race Ethnicity

Much research considers group differences in religious belonging, behaving, and/or believing by gender, race, ethnicity, class, or sexuality. This study, however, considers all these factors at once, providing the first comprehensive snapshot of religious belonging, behaving, and believing across and within these axes of inequality in the United States. Leveraging unique data with an exceptionally large sample, I explore religion across 40 unique configurations of intersecting identities (e.g., one is non-Latina Black heterosexual college-educated women). Across all measures considered, Black women are at the top—however, depending on the measure, there are different subsets of Black women at the top. And whereas most sexual minorities are among the least religious Americans, Black sexual minorities—and especially those with a college degree—exhibit high levels of religious belonging, behaving, and believing. In fact, Black sexual minority women with a college degree meditate more frequently than any other group considered. Overall, whereas we see clear divides in how religious people are by factors like gender, education, and sexual orientation among most racial groups, race appears to overpower other factors for Black Americans who are consistently religious regardless of their other characteristics. By presenting levels of religious belonging, behaving, and believing across configurations of gender, race, ethnicity, class, and sexuality in the contemporary United States, this study provides a more complex and complete picture of American religion and spirituality.

scholarly journals Surgical treatment of breast cancer among the elderly in the United States

Cancer ◽  
2010 ◽  
Vol 117 (4) ◽  
pp. 698-704 ◽  
Author(s):  
Amy K. Alderman ◽  
Julie Bynum ◽  
Jason Sutherland ◽  
Nancy Birkmeyer ◽  
E. Dale Collins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Surgical Treatment ◽  
The Elderly ◽  
The United States

scholarly journals 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

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.

scholarly journals Racial/Ethnic Disparities in Temporal Trends of Myocardial Infarction Hospitalizations Among Pregnant Women in the United States: 2009-2018

2021 ◽  
Vol 5 (2) ◽  
pp. 200-203
Author(s):  
Deepa Dongarwar ◽  
Brisa Garcia ◽  
Nisha Jacob ◽  
Hamisu Salihu
Keyword(s):  
United States ◽  
Myocardial Infarction ◽  
Pregnant Women ◽  
Race And Ethnicity ◽  
Temporal Trends ◽  
Ethnic Disparities ◽  
The United States ◽  
Entire Study ◽  
Creative Commons ◽  
Race Ethnicity

There has been an increase in the incidence of Myocardial Infarction (MI) among pregnant women in the United States. There have been no studies examining the trends in the rates of gestational MI hospitalizations by race/ethnicity;and therefore, we undertook this study. No prior studies have examined the trends in the rates of gestational MI hospitalizations by race and ethnicity. In this study, we examined temporal trends of MI-related hospitalizations among pregnant women using the Nationwide Inpatient Sample (NIS) dataset from 2009 to 2018. We performed joinpoint regression analyses to assess trends in the rates of MI by race/ethnicity during the study period. Overall, there was an increase in the rates of MI among pregnant women during the study period (from 9.7 per 100,000 hospitalizations in 2009 to 18.1 per 100,000 hospitalizations in 2018) with an average annual percentage change (AAPC) of 7.2, (95% Confidence Interval (CI)=[4.0, 10.5]. The overall rate of MI was highest in non-Hispanic (NH)-Blacks and the greatest increments in rates of MI-related hospitalizations were noted in NH-Blacks during 2013-2018, and in Hispanics during the entire study period (2009-2018). NH-Blacks and Hispanics bear a disproportionately high burden of MI among pregnant women in the US. More worrisome is the first-ever reported finding in this study of a widening Black-White disparity in MI-related hospitalizations over the past decade.   Copyright © Dongarwar et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

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