scholarly journals Racial, Rural, and Regional Disparities in Diabetes-Related Lower-Extremity Amputation Rates, 2009–2017

2021 ◽  
Author(s):  
Marvellous A. Akinlotan ◽  
Kristin Primm ◽  
Jane N. Bolin ◽  
Abdelle L. Ferdinand Cheres ◽  
JuSung Lee ◽  
...  
Keyword(s):  
Native Americans ◽  
Lower Extremity ◽  
Metropolitan Areas ◽  
The United States ◽  
Annual Percent Change ◽  
Minor Amputation ◽  
Increased Risk ◽  
Asian Pacific ◽  
A Minor ◽  
Racial Ethnic

Objective <p>To examine <a>the racial/ethnic, rural-urban, and regional variations in the trends of diabetes-related lower extremity amputations (LEA) among hospitalized U.S. adults from 2009-2017</a>.</p> <p>Research Design and Methods </p> <p>We used the National Inpatient Sample (NIS) (2009-2017) to identify trends in LEA rates among those primarily hospitalized with diabetes in the United States. We conducted multivariable logistic regressions to identify individuals at risk of LEA based on their race/ethnicity, census region location (North, Midwest, South and West) and rurality of residence.</p> <p>Results</p> <p>From 2009 to 2017, the rates of minor LEAs increased across all racial/ethnic, rural/urban, and census region categories. <a>The increase in minor LEAs was driven by Native Americans (Annual Percent Change (APC)=7.1%, p < 0.001) and Asian/Pacific Islanders (APC=7.8%, p < 0.001). Residents of Non-Core </a>(APC=5.4%, p < 0.001) and Large Central Metropolitan areas (APC=5.5%, p < 0.001), experienced the highest increases over time in minor LEA rates. Whites, residents of the Midwest, Non-Core and Small Metropolitan areas experienced a significant increase in major LEAs. Regression findings showed that Native Americans and Hispanics were more likely to have a minor or major LEA, compared to Whites. The odds of a major LEA increased with rurality and was also higher among residents of the South, compared to those of the Northeast. A steep decline in major to minor amputation ratios was observed, especially among Native Americans.</p> <p> </p> <p>Conclusions </p> <p>Despite increased risk of diabetes-related lower limb amputations in underserved groups, our findings are promising when the major to minor amputation ratio is considered.</p>

scholarly journals Racial, Rural, and Regional Disparities in Diabetes-Related Lower-Extremity Amputation Rates, 2009–2017

2021 ◽  
Author(s):  
Marvellous A. Akinlotan ◽  
Kristin Primm ◽  
Jane N. Bolin ◽  
Abdelle L. Ferdinand Cheres ◽  
JuSung Lee ◽  
...  
Keyword(s):  
Native Americans ◽  
Lower Extremity ◽  
Metropolitan Areas ◽  
The United States ◽  
Annual Percent Change ◽  
Minor Amputation ◽  
Increased Risk ◽  
Asian Pacific ◽  
A Minor ◽  
Racial Ethnic

Objective <p>To examine <a>the racial/ethnic, rural-urban, and regional variations in the trends of diabetes-related lower extremity amputations (LEA) among hospitalized U.S. adults from 2009-2017</a>.</p> <p>Research Design and Methods </p> <p>We used the National Inpatient Sample (NIS) (2009-2017) to identify trends in LEA rates among those primarily hospitalized with diabetes in the United States. We conducted multivariable logistic regressions to identify individuals at risk of LEA based on their race/ethnicity, census region location (North, Midwest, South and West) and rurality of residence.</p> <p>Results</p> <p>From 2009 to 2017, the rates of minor LEAs increased across all racial/ethnic, rural/urban, and census region categories. <a>The increase in minor LEAs was driven by Native Americans (Annual Percent Change (APC)=7.1%, p < 0.001) and Asian/Pacific Islanders (APC=7.8%, p < 0.001). Residents of Non-Core </a>(APC=5.4%, p < 0.001) and Large Central Metropolitan areas (APC=5.5%, p < 0.001), experienced the highest increases over time in minor LEA rates. Whites, residents of the Midwest, Non-Core and Small Metropolitan areas experienced a significant increase in major LEAs. Regression findings showed that Native Americans and Hispanics were more likely to have a minor or major LEA, compared to Whites. The odds of a major LEA increased with rurality and was also higher among residents of the South, compared to those of the Northeast. A steep decline in major to minor amputation ratios was observed, especially among Native Americans.</p> <p> </p> <p>Conclusions </p> <p>Despite increased risk of diabetes-related lower limb amputations in underserved groups, our findings are promising when the major to minor amputation ratio is considered.</p>

Racial Disparities in Pregnancy-associated Intimate Partner Homicide

2021 ◽  
pp. 088626052199083
Author(s):  
Aaron J. Kivisto ◽  
Samantha Mills ◽  
Lisa S. Elwood
Keyword(s):  
Black Women ◽  
Ethnic Minority ◽  
Racial Disparities ◽  
White Women ◽  
The United States ◽  
Intimate Partner ◽  
Intimate Partner Homicide ◽  
Homicide Victimization ◽  
Increased Risk ◽  
Racial Ethnic

Pregnancy-associated femicide accounts for a mortality burden at least as high as any of the leading specific obstetric causes of maternal mortality, and intimate partners are the most common perpetrators of these homicides. This study examined pregnancy-associated and non-pregnancy-associated intimate partner homicide (IPH) victimization among racial/ethnic minority women relative to their non-minority counterparts using several sources of state-level data from 2003 through 2017. Data regarding partner homicide victimization came from the National Violent Death Reporting System, natality data were obtained from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and relevant sociodemographic information was obtained from the U.S. Census Bureau. Findings indicated that pregnancy and racial/ethnic minority status were each associated with increased risk for partner homicide victimization. Although rates of non-pregnancy-associated IPH victimization were similar between Black and White women, significant differences emerged when limited to pregnancy-associated IPH such that Black women evidenced pregnancy-associated IPH rates more than threefold higher than that observed among White and Hispanic women. Relatedly, the largest intraracial discrepancies between pregnant and non-pregnant women emerged among Black women, who experienced pregnancy-associated IPH victimization at a rate 8.1 times greater than their non-pregnant peers. These findings indicate that the racial disparities in IPH victimization in the United States observed in prior research might be driven primarily by the pronounced differences among the pregnant subset of these populations.

Abstract 19212: Racial Differences in Clinical Outcomes and Resource Utilization Associated With Heart Failure Hospitalizations in the United States: A Nationwide Analysis From 2011-2012

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Nilay Kumar ◽  
Rohan Khera ◽  
Neetika Garg
Keyword(s):  
Heart Failure ◽  
Native Americans ◽  
Hospital Mortality ◽  
Racial Differences ◽  
Resource Utilization ◽  
The United States ◽  
Primary Diagnosis ◽  
Hospital Charges ◽  
Nationally Representative ◽  
Racial Ethnic

Background and objectives: Heart failure (HF) incidence is higher among Blacks compared to Whites. There is a paucity of recent data on racial differences in in-hospital mortality and resource utilization in a nationally representative, multiracial cohort of HF hospitalizations. Hypothesis: There are significant racial-ethnic differences in HF hospitalization outcomes. Methods: We used the 2011-2012 Nationwide/National Inpatient Sample to identify hospitalizations with a primary diagnosis of HF using relevant ICD-9 codes. Outcomes of interest were in-hospital mortality, length of stay (LOS) and mean inflation adjusted charges. The effect of race on outcomes was ascertained using logistic or linear regression. Results: 375,740 primary HF hospitalizations representing 1.8 million hospitalizations nationwide were included. Mean age was 72.6 (SD 14.6) years and 50.1% were females. After adjusting for age, sex, hypertension, diabetes, APR-DRG mortality risk and socioeconomic status, in-hospital mortality was significantly lower for Blacks (OR 0.69, 95% CI 0.64 - 0.74; p<0.001), Hispanics (OR 0.82, 95% CI 0.75 - 0.91; p<0.001) and Asians or Pacific Islanders (OR 0.85, 95% CI 0.73 - 0.99; p=0.04) compared to Whites. Average inflation adjusted charges were significantly higher for all minorities compared to Whites except for Native Americans for whom charges were significantly lower than Whites (p<0.05 for Black, Hispanic, Asian, NA or Others vs. Whites). LOS was modestly higher for Blacks or Other races vs. Whites (p=0.01 B vs. W and Others vs. W) and lower for Native Americans vs. Whites (p<0.001). Conclusions: Blacks, Hispanics and Asians hospitalized for HF are significantly less likely to die in the hospital compared to Whites. Hospital charges for racial-ethnic minorities are significantly higher compared to Whites. The reasons for racial differences in HF hospitalization outcomes require further investigation.

scholarly journals Racial/Ethnic Disparities in Mortality: Contributions and Variations by Rurality in the United States, 2012–2015

2019 ◽  
Vol 16 (3) ◽  
pp. 436 ◽  
Author(s):  
Jeffrey Hall ◽  
Ramal Moonesinghe ◽  
Karen Bouye ◽  
Ana Penman-Aguilar
Keyword(s):  
Rural Areas ◽  
Ethnic Disparities ◽  
The United States ◽  
Mortality Rates ◽  
Malignant Neoplasms ◽  
Ethnic Populations ◽  
Asian Pacific Islanders ◽  
Race Ethnicity ◽  
Asian Pacific ◽  
Racial Ethnic

The value of disaggregating non-metropolitan and metropolitan area deaths in illustrating place-based health effects is evident. However, how place interacts with characteristics such as race/ethnicity has been less firmly established. This study compared socioeconomic characteristics and age-adjusted mortality rates by race/ethnicity in six rurality designations and assessed the contributions of mortality rate disparities between non-Hispanic blacks (NHBs) and non-Hispanic whites (NHWs) in each designation to national disparities. Compared to NHWs, age-adjusted mortality rates for: (1) NHBs were higher for all causes (combined), heart disease, malignant neoplasms, and cerebrovascular disease; (2) American Indian and Alaska Natives were significantly higher for all causes in rural areas; (3) Asian Pacific islanders and Hispanics were either lower or not significantly different in all areas for all causes combined and all leading causes of death examined. The largest contribution to the U.S. disparity in mortality rates between NHBs and NHWs originated from large central metropolitan areas. Place-based variations in mortality rates and disparities may reflect resource, and access inequities that are often greater and have greater health consequences for some racial/ethnic populations than others. Tailored, systems level actions may help eliminate mortality disparities existing at intersections between race/ethnicity and place.

Racial and Ethnic Differences in Incidence and Disease Specific Survival of Multiple Myeloma- New Mexico Tumor Registry Based Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 46-47
Author(s):  
Shashank R Cingam ◽  
Martha Mapalo ◽  
Meisner L Angela ◽  
Charles Wiggins ◽  
Leslie A. Andritsos
Keyword(s):  
Multiple Myeloma ◽  
New Mexico ◽  
Native Americans ◽  
The United States ◽  
Disease Specific Survival ◽  
Related Factors ◽  
Tumor Registry ◽  
Hispanic Females ◽  
Racial Ethnic ◽  
Disease Specific

Background: Multiple Myeloma is a plasma cell neoplasm which is characterized by an increase in monoclonal proteins or light chains and end-organ damage. Multiple Myeloma accounts for 1.8% of all new cancer cases in the United States, with an estimated 32,110 new cases annually. In population-based studies, African Americans have a higher incidence of Myeloma and inferior outcomes when compared to Caucasians. Disparities in the incidence of Myeloma for other races in the United States also exist but are not well studied.(1). Analyses of Surveillance, Epidemiology, and End Results program (SEER) data showed that Hispanics had poor or delayed access to novel agents and transplant, and poor overall survival.(2). Data for Native Americans was not reported due to small or insignificant numbers. New Mexico is a majority minority state, with approximately 1 million Hispanics residing in the state, constituting 49.1% of the total population and the largest statewide percentage of Hispanic residents nationally. (3) New Mexico also has a sizable population of 219,237 Native Americans, who make-up nearly 10.5% of the state's entire population. (3) Hence, the significant minority population in New Mexico allows the comparison of incidence between racial and ethnic subgroups as well as disease specific survival of Myeloma in New Mexico residents using the New Mexico Tumor Registry. Methods: We utilized data from the New Mexico Tumor Registry to study patients with a documented diagnosis of Myeloma. Descriptive statistics including the incidence rates of myeloma and Kaplan-Meier product-limit methods to assess cause-specific survival for incident myeloma cases diagnosed among New Mexico residents during the time period 2008-2017. Other variables including transplantation rates were also studied but are not reported in this abstract. Results: Men had higher incidence of Myeloma compared to females (p&lt;0.01) and Hispanic females had a higher incidence compared to Non-Hispanic white females (p&lt;0.05). The incidence of Myeloma (for both sexes) was slightly increased in Hispanics (5.6 /per 100,000, CI- 5.1,6.2) and Native Americans (6.3/per 100,000, CI- 5.1,7.7) compared to Non- Hispanic Caucasians (5.1/per 100,000, CI- 4.7,5.5). (Fig. 1) However, these differences were not statistically significant. The incidence of multiple myeloma has been stable for all racial-ethnic group examined during 1981-2017. (Fig. 2) Modest differences in survival among Non-Hispanic whites, Hispanics, and American Indians were not statistically significant (log-rank test, p=0.3907). (Fig.3) Conclusion: Racial-ethnic differences in incidence and disease specific survival of Multiple Myeloma were evident but were not statistically significant in New Mexico, except incidence of Multiple Myeloma among Hispanic females compared to Non-Hispanic white females. Further study of disease-related factors (high risk disease, mutational profiles, stage at diagnosis) and patient-related factors (access to standard treatments, transplantation or clinical trials) may be needed to understand these differences and better care for the patients. Disclosures Andritsos: Innate Pharma: Consultancy, Honoraria.

Contemporary patterns of racial/ethnic disparities in surgical treatment and overall survival for localized resectable non-small cell lung cancer in the United States.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e20057-e20057
Author(s):  
Oladimeji Akinboro ◽  
Stanley Madu Nwabudike ◽  
Michael Voisine ◽  
Kevan L. Hartshorn ◽  
Marjory Charlot
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Native Americans ◽  
Ethnic Groups ◽  
The United States ◽  
Pacific Islanders ◽  
Small Cell Lung ◽  
Stage Ia ◽  
Iiia Nsclc ◽  
Racial Ethnic

e20057 Background: Racial disparities in the surgical treatment of early stage lung cancers are well documented for African-Americans relative to Whites. However, there is a paucity of contemporary data regarding lung cancer treatment disparities for other minority racial/ethnic groups. We sought to compare: i) contemporary rates of surgery, ii) and overall survival (OS) for resectable non-small cell lung cancer (NSCLC), across several minority populations in the United States (US). Methods: We identified new diagnoses of stages IA-IIIA NSCLC (AJCC7) from 2010-2015 among adults (20 years+) in the Surveillance, Epidemiology, and End Results (SEER) 18 registry. We compared rates of surgery +/- radiotherapy (RT) for stage IA NSCLC, and surgery +/- RT +/- chemotherapy for stages IB–IIIA NSCLC, among the following racial/ethnic groups: Non-Hispanic Whites (whites), Non-Hispanic Blacks (blacks), Hispanics, Asians or Pacific Islanders, and American Indians/Alaska Natives (native Americans). We also calculated and compared 5-year OS rates across these groups. Results: There were 339,912 cases of newly-diagnosed stages IA, IB, IIA, IIB, and IIIA NSCLC identified for analysis. Receipt of surgical treatment +/- RT for stage IA NSCLC was lower in blacks (63.5%), and native Americans (64.2%) than whites (69.4%), as well as for stage IIB NSCLC (whites 66.7%; blacks 56.7%; native Americans 55.6%). Blacks had lower rates of surgery relative to whites across the other NSCLC stages studied but no disparities were noted for Hispanics and Asians/Pacific Islanders. 5-year age-adjusted OS for stage IA-IIIA NSCLC were significantly lower for native Americans (62.3%, 95% CI 58.1%, 66.3%) and blacks (68.1%; 95% CI 67.4, 68.9%) relative to whites (69.2%; 95% CI 69.0%, 69.5%) with relative risks of 1.11 (95% CI 1.04, 1.19) and 1.02 (95% CI 1.01, 1.03), respectively. This inferior OS persisted for blacks even among those treated with cancer-directed surgery. Conclusions: Disparities in rates of surgical treatment and OS for resectable NSCLC persist for blacks and native Americans. Although it is unclear if inferior OS outcomes for blacks are solely attributable to lower rates of surgery, systems-based interventions are needed to help ensure equal and optimal receipt of surgery for resectable NSCLC across all racial/ethnic groups in the US.

scholarly journals Measuring the missing: greater racial and ethnic disparities in COVID-19 burden after accounting for missing race/ethnicity data

2020 ◽  
Author(s):  
Katie Labgold ◽  
Sarah Hamid ◽  
Sarita Shah ◽  
Neel R. Gandhi ◽  
Allison Chamberlain ◽  
...  
Keyword(s):  
Ethnic Disparities ◽  
Case Fatality ◽  
The United States ◽  
Infection Rates ◽  
Bias Adjustment ◽  
Social Inequities ◽  
Increased Risk ◽  
Race Ethnicity ◽  
The Difference ◽  
Racial Ethnic

AbstractBlack, Hispanic, and Indigenous persons in the United States have an increased risk of SARS-CoV-2 infection and death from COVID-19, due to persistent social inequities. The magnitude of the disparity is unclear, however, because race/ethnicity information is often missing in surveillance data. In this study, we quantified the burden of SARS-CoV-2 infection, hospitalization, and case fatality rates in an urban county by racial/ethnic group using combined race/ethnicity imputation and quantitative bias-adjustment for misclassification. After bias-adjustment, the magnitude of the absolute racial/ethnic disparity, measured as the difference in infection rates between classified Black and Hispanic persons compared to classified White persons, increased 1.3-fold and 1.6-fold respectively. These results highlight that complete case analyses may underestimate absolute disparities in infection rates. Collecting race/ethnicity information at time of testing is optimal. However, when data are missing, combined imputation and bias-adjustment improves estimates of the racial/ethnic disparities in the COVID-19 burden.

scholarly journals RACIAL-ETHNIC DIFFERENCES IN NURSING HOME QUALITY OF LIFE FOR ALZHEIMER’S DISEASE AND DEMENTIA RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S410-S410
Author(s):  
Tetyana P Shippee ◽  
Stephanie Jarosek ◽  
Xuanzi Qin ◽  
Mark Woodhouse
Keyword(s):  
Quality Of Life ◽  
Native American ◽  
Native Americans ◽  
Ethnic Minority ◽  
Care Needs ◽  
Data Set ◽  
Random Intercept ◽  
Asian Pacific ◽  
Racial Ethnic

Abstract Nursing homes (NHs) are often racially segregated, and minority residents admitted to NHs usually have more advanced stages of dementia at the time of admission than their white counterparts, with different care needs. Previous work has shown that racial disparities in NH quality of life (QoL) were partially due to different case mix of white and minority residents; it is unclear if disparities persist when comparing residents with similar ADRD diagnoses. The 2011-2015 Minnesota Resident Quality of Life and Satisfaction with Care Survey data contain in-person resident responses from a random sample of residents of all Medicare/Medicaid certified NHs in the state, about 40% of whom have AD/ADRD. These data were linked to the Minimum Data Set (MDS) and facility characteristics data. The population consists of 25,039 White, 580 Black, 94 Hispanic, 229 Native Americans, and 99 Asian/Pacific Islander NH residents with ADRD residing in 376 NHs. Racial/ethnic minority residents reported significantly lower QoL scores compared to their white counterparts, with the largest disparities in the food and relationships domains. We adjusted for resident (age, marital status, education, sex, length of stay, anxiety/mood disorder, activities of daily living scores) and facility characteristics (proportion of minority residents, ownership, urban vs rural, size, and occupancy ratio) using a multivariate random intercept model. After adjustment, significant differences remained in total QoL score and several QoL domains for Black, Asian and Hispanic residents (no significant differences for Native American residents). Practice guidelines should consider different care needs of racial/ethnic minority NH residents with ADRD.

scholarly journals Racial Disparities in Cardiovascular Complications With Pregnancy-Induced Hypertension in the United States

Hypertension ◽  
2021 ◽  
Author(s):  
Anum S. Minhas ◽  
S. Michelle Ogunwole ◽  
Arthur Jason Vaught ◽  
Pensee Wu ◽  
Mamas A. Mamas ◽  
...  
Keyword(s):  
Black Women ◽  
Cardiovascular Events ◽  
Gestational Hypertension ◽  
The United States ◽  
Cardiovascular Complications ◽  
Pregnancy Induced Hypertension ◽  
Increased Risk ◽  
Induced Hypertension ◽  
Race Ethnicity ◽  
Asian Pacific

Women with pregnancy-induced hypertension, defined as gestational hypertension and preeclampsia/eclampsia, are at increased risk of long-term cardiovascular disease, but less is known about the spectrum of acute cardiovascular outcomes, especially across racial/ethnic groups. We evaluated the risk of cardiovascular events at delivery associated with gestational hypertension and preeclampsia/eclampsia, compared with no pregnancy-induced hypertension, overall and by race/ethnicity. We used the 2016 to 2018 National Inpatient Sample data. International Classification of Diseases , Tenth Revision , Clinical Modification codes identified delivery hospitalizations and clinical diagnoses. Using survey weights, cardiovascular events were examined using logistic regression by pregnancy-induced hypertension status, with subsequent stratification by race/ethnicity. Among 11 304 996 deliveries in 2016 to 2018, gestational hypertension occurred in 614 995 (5.4%) and preeclampsia in 593 516 (5.2%). Black women had higher odds for preeclampsia independent of underlying comorbidities (adjusted odds ratio, 1.45 [95% CI, 1.42–1.49]) and had the highest rates for several complications (peripartum cardiomyopathy, 506; heart failure, 660; acute renal failure, 953; and arrhythmias, 418 per 100 000 deliveries). After adjustment for socioeconomic factors and comorbidities, preeclampsia/eclampsia was associated with increased risk of cardiovascular events in women of all races/ethnicities. However, risk was highest among Asian/Pacific Islander women and lowest among Black women. In sum, while Black women were the most likely to experience preeclampsia, Asian/Pacific women were the most at risk for acute cardiovascular complications during delivery hospitalization.

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