Researching Health Inequities among African Americans: The Imperative to Understand Social Class

2005 ◽  
Vol 35 (3) ◽  
pp. 485-498 ◽  
Author(s):  
M. Norman Oliver ◽  
Carles Muntaner
Keyword(s):  
African American ◽  
Health Disparities ◽  
Burden Of Illness ◽  
Geographic Location ◽  
Health Inequities ◽  
Mortality Rates ◽  
Incidence And Mortality ◽  
Gender Education ◽  
Race Ethnicity ◽  
African American Health

Racial and ethnic inequities in health abound in many disease categories. African-American communities suffer from an increased burden of illness, with higher incidence and mortality rates and more severe morbidity in cerebrovascular disease, heart disease, several cancers, diabetes, and many other ailments. Healthy People 2010, the federal government's health plan, calls for eliminating health disparities by race, ethnicity, gender, education, income, disability, geographic location, or sexual orientation. Research aimed at increasing our understanding of these health disparities and designing and evaluating interventions to improve African-American health is hampered by a liberal, classless approach. The authors argue for a theoretical framework in this research that recognizes that class exploitation sets the stage for and interacts with racial discrimination to determine racial inequities in health.

scholarly journals Global Trends and Prostate Cancer: A Review of Incidence, Detection, and Mortality as Influenced by Race, Ethnicity, and Geographic Location

2018 ◽  
Vol 12 (6) ◽  
pp. 1807-1823 ◽  
Author(s):  
Harold Evelyn Taitt
Keyword(s):  
Prostate Cancer ◽  
Treatment Guidelines ◽  
Disease Incidence ◽  
Specific Antigen ◽  
Geographic Location ◽  
Mortality Rates ◽  
European Ancestry ◽  
Psa Testing ◽  
Incidence And Mortality ◽  
Race Ethnicity

Although research has reported that prostate cancer (PCa) incidence and mortality rates are among the highest for African Americans, the data is inconclusive regarding PCa rates in native African men, Black men residing in other countries, and men in Asia, Europe, and the Americas. Data reveals that prostate-specific antigen (PSA) testing and disease incidence have risen significantly in developing and Asian countries, and PCa has become one of the leading male cancers in many of those nations. The objective of this study was to review published peer-reviewed studies that address PCa in different regions of the world to get a better understanding of how PCa incidence, prevalence, detection, and mortality are influenced by race, ethnicity, and geography. A secondary goal was to compare PCa data from various world regions to contextualize how disproportionate the incidence and mortality rates are among men from the African diaspora versus men of European, Hispanic, and Asian descent, as well as to highlight the need for more robust screening and treatment guidelines in developing countries. There are differences in incidence and mortality rates between men of African, Asian, Hispanic, and European ancestry, confirming the involvement of genetic factors. However, differences between men of the same race and ethnicity who live in different countries suggest that environmental factors may also be implicated. Availability and access to diagnostic and health-care services as well as recommendations regarding PCa testing vary from country to country and contribute to the variability in incidence and mortality rates.

scholarly journals Prostate Cancer Incidence and Mortality in Barbados, West Indies

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Anselm J. M. Hennis ◽  
Ian R. Hambleton ◽  
Suh-Yuh Wu ◽  
Desiree H.-A. Skeete ◽  
Barbara Nemesure ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Cancer Incidence ◽  
West Indies ◽  
African American Men ◽  
Mortality Rates ◽  
Prostate Cancer Incidence ◽  
White American ◽  
Incidence And Mortality ◽  
The Us

We describe prostate cancer incidence and mortality in Barbados, West Indies. We ascertained all histologically confirmed cases of prostate cancer during the period July 2002 to December 2008 and reviewed each death registration citing prostate cancer over a 14-year period commencing January 1995. There were 1101 new cases for an incidence rate of 160.4 (95% Confidence Interval: 151.0–170.2) per 100,000 standardized to the US population. Comparable rates in African-American and White American men were 248.2 (95% CI: 246.0–250.5) and 158.0 (95% CI: 157.5–158.6) per 100,000, respectively. Prostate cancer mortality rates in Barbados ranged from 63.2 to 101.6 per 100,000, compared to 51.1 to 78.8 per 100,000 among African Americans. Prostate cancer risks are lower in Caribbean-origin populations than previously believed, while mortality rates appeared to be higher than reported in African-American men. Studies in Caribbean populations may assist understanding of disparities among African-origin populations with shared heredity.

scholarly journals Discrimination, Stress, and Health Across the Life Course

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 580-581
Author(s):  
Roland Thorpe ◽  
Carl Hill
Keyword(s):  
African American ◽  
Health Disparities ◽  
Depressive Symptoms ◽  
Life Course ◽  
Mortality Data ◽  
Using Data ◽  
The Life Course ◽  
The Impact ◽  
Everyday Discrimination ◽  
African American Health

Abstract There is a paucity of research that seeks to understand why race disparities in health across the life course remain elusive. Two such explanations that have been garnering attention is stress and discrimination. This symposium contains papers seeking to address the impact of discrimination or stress on African American health or health disparities across the life course. First, Nguyen and colleagues examine 1) the associations between discrimination and objective and subjective social isolation and 2) how these associations vary by age in using data from the National Survey of American Life. Discrimination was positively associated with being subjectively isolated from friends only and family only. This relationship varied by age. Discrimination did not predict objective isolation. Second, Brown examines evidence of the black-white paradox in anxiety and depressive symptoms among older adults using data from 6,019 adults ages 52+ from the 2006 HRS. After adjusting for socioeconomic factors, everyday discrimination, chronic conditions, and chronic stress, there are no black-white differences in anxiety and depressive symptoms. Third, Cobb and colleagues investigate the joint consequences of multiple dimensions of perceived discrimination on mortality risk using mortality data from the 2006-2016 HRS. The authors report the number of attributed reasons for everyday discrimination is a particularly salient risk factor for mortality in later life. This collection of papers provides insights into how discrimination or stress impacts African American health or health disparities in middle to late life.

scholarly journals Discrimination, Stress, and Health Across the Life Course

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 189-190
Author(s):  
Roland Thorpe ◽  
Carl V Hill
Keyword(s):  
African American ◽  
Health Disparities ◽  
Life Course ◽  
Racial Discrimination ◽  
Stress Exposure ◽  
Racial Centrality ◽  
The Life Course ◽  
Stress And Health ◽  
Everyday Discrimination ◽  
African American Health

Abstract There is a paucity of research that seeks to understand why race disparities in health across the life course remain elusive. Two such explanations that have been garnering attention is stress and discrimination. This symposium contains papers seeking to address the impact of discrimination or stress on African American health or health disparities across the life course. Brown and colleagues examine the differential effects of chronic stress exposure by means of latent class analysis on mental and physical health in the HRS. Analysis revealed four subgroups, each demonstrated a typological response pattern with the most pronounced health consequences for high stress exposure, appraisal and few or no coping mechanisms. This suggests an alternative approach to examining the stress-health link by using a combined person- and variable-centered approach. Thomas Tobin and colleagues evaluate the life course processes through which early life racial discrimination (ELRD) and racial centrality shape adult allostatic load (AL) among older Blacks in the Nashville Stress and Health Study. Findings indicate that racial centrality is protective against adult high AL for those who experienced racial discrimination as children or adolescents. Cobb and colleagues examine how multiple attributed reasons for everyday discrimination relates to all-cause mortality risk among older Blacks in HRS. The authors report the 3 or more attributed reasons for everyday discrimination is a particularly salient risk factor for mortality in later life. This collection of papers provides insights into how discrimination or stress impacts African American health or health disparities in middle to late life.

scholarly journals COVID-19 and the US response: accelerating health inequities

2020 ◽  
pp. bmjebm-2020-111426 ◽  
Author(s):  
Nneoma E Okonkwo ◽  
Ugochi T Aguwa ◽  
Minyoung Jang ◽  
Iman A Barré ◽  
Kathleen R Page ◽  
...  
Keyword(s):  
Health Disparities ◽  
Native Americans ◽  
Healthcare Access ◽  
Health Indicators ◽  
Health Inequities ◽  
Research Capacity ◽  
Middle Income ◽  
Detention Centers ◽  
Incidence And Mortality ◽  
The Usa

Health inequities have long defined health and the healthcare system in the USA. The clinical and research capacity across the USA is unparalleled, yet compared to other high and even some middle-income countries, the average health indicators of the population remain suboptimal in 2020, a finding at least in part explained by inequity in healthcare access. In this context, COVID-19 has rapidly emerged as a major threat to the public’s health. While it was initially thought that severe acute respiratory syndrome coronavirus 2 would be the great equaliser as it would not discriminate, it is clear that COVID-19 incidence and mortality have rapidly reinforced health disparities drawn by historical and contemporary inequities. Here, we synthesise the data highlighting specific risks among particular marginalised and under-resourced communities including those in jails, prisons and detention centers, immigrants and the undocumented, people with disabilities and people experiencing homelessness across the USA. The drivers of these disparities are pervasive structural risks including limited access to preventive services, inability to comply with physical distancing recommendations, underlying health disparities and intersecting stigmas particularly affecting racial and ethnic minorities across the country, including African Americans, Latinx Americans and Native Americans. Advancing the COVID-19 response, saving lives and restarting the economy necessitate rapidly addressing these inequities rather than ignoring and even reinforcing them.

Examining the Factors Affecting High Diabetes Rates in Southern States: A Brief Report

2021 ◽  
Vol 35 (1) ◽  
pp. 64-68
Author(s):  
Emre Umucu ◽  
Kanako Iwanaga ◽  
Abdalmajeed Alrabiah ◽  
Fong Chan ◽  
Ebonee Johnson ◽  
...  
Keyword(s):  
Public Health ◽  
Health Disparities ◽  
Geographic Location ◽  
Critical Factor ◽  
State Level ◽  
Black African ◽  
Factors Affecting ◽  
Southern States ◽  
Level Data ◽  
Race Ethnicity

PurposeEvidence shows that region of country is a critical factor in understanding diabetes-related health disparities. The purpose of this study was to examine whether geographic location (southern states vs. other states) attenuate or strengthen the relationship between state diabetes rates and (a) race/ethnicity, (b) income, and (c) percentage of physical inactivity.MethodThe state-level data was extracted from multiple public websites. Descriptive statistics and moderation analyses were conducted to test research questions.ResultsResults revealed that the magnitudes of relationship between state diabetes rate and (a) income and (b) percentage of Black/African American were affected by geographic location (southern states vs other states).ConclusionsGiven Southern states have substantial health disparities compared to non-Southern states, key stakeholders and the public health system should emphasize the importance of developing and evaluating effective public health policies based on income, physical activity, and race/ethnicity.

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