scholarly journals Divorce, Economic Resources, and Survival Among Older Black and White Women

2020 ◽  
Author(s):  
Joseph D. Wolfe ◽  
Mieke Beth Thomeer
Keyword(s):  
Black Women ◽  
Racial Differences ◽  
White Women ◽  
Proportional Hazards ◽  
Economic Resources ◽  
Economic Losses ◽  
Housing Wealth ◽  
Net Worth ◽  
Black And White ◽  
Inequalities In Mortality

Objective: This study identifies which midlife economic resources reduce the association between divorce and mortality risk among older Black and White women. Background: Despite evidence that divorce reduces longevity due to economic losses, research has not established which among several common economic resources related to divorce are most important for older women’s survival. There is also relatively little research on why marital inequalities in mortality are smaller among older Black women. Drawing from diverse areas of scholarship, we hypothesize that group differences in multiple economic resources explain this finding. Method: Fractional logistic regression and Gompertz proportional hazards models were estimated with data from the NLS-MW (N=4,668; nlsinfo.org) to examine the associations between divorce, economic resources, and mortality among older Black and White women (born 1923-1937). Results: Divorced White women had significantly less housing and financial wealth than their continuously married counterparts, and Both Black and White divorcées had less vehicle wealth and higher probabilities of indebtedness. With respect to survival, net worth and housing wealth accounted for the largest reductions in marital and racial differences in survival. Conclusion: Findings suggest that wealth—home wealth in particular—is key to understanding the greater longevity of married White women compared to Black women and divorced White women. Interventions aimed at reducing health disparities must first address the social practices creating economic inequalities.

Abstract MP008: Racial Differences in Total, Free, and Bioavailable 25(OH)D and PTH Levels and CVD Risk Among Postmenopausal Women

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Xi Zhang ◽  
Wanzhu Tu ◽  
Lesley Tinker ◽  
JoAnn E Manson ◽  
Simin Liu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cohort Study ◽  
Black Women ◽  
Postmenopausal Women ◽  
Racial Differences ◽  
White Women ◽  
Sitting Time ◽  
Cvd Risk ◽  
Black And White ◽  
Circulating Levels

Background: Recent evidence suggests that racial differences in circulating levels of free or bioavailable 25(OH)D rather than total 25(OH)D may explain the apparent racial disparities in cardiovascular disease(CVD).However, few prospective studies have directly tested this hypothesis. Objective: Our study prospectively examined black white differences in the associations of total, free, and bioavailable 25(OH)D, vitamin D binding protein (VDBP), and parathyroid hormone (PTH) levels at baseline with incident CVD in a large, multi-ethnic, geographically diverse cohort of postmenopausal women. Method: We conducted a case-cohort study among 79,705 black and non-Hispanic white postmenopausal women aged 50 to 79 years and free of CVD at baseline in the Women’s Health Initiative Observational Study (WHI-OS). We included a randomly chosen subcohort of 1,300 black and 1,500 white noncases at baseline and a total of 550 black and 1,500 white women who developed incident CVD during the follow up. We directly measured circulating levels of total 25(OH)D, VDBP (monoclonal antibody assay), albumin, and PTH and calculated free and bioavailable vitamin D levels. Weighted Cox proportional hazards models were used while adjusting for known CVD risk factors. Results: At baseline, white women had higher mean levels of total 25(OH)D and VDBP and lower mean levels of free and bioavailable 25(OH)D and PTH than black women (all P values < 0.0001). White cases had lower levels of total 25(OH)D and VDBP and higher levels of PTH than white noncases, while black cases had higher levels of PTH than black noncases (all P values < 0.05). There was a trend toward an increased CVD risk associated with low total 25(OH)D and VDBP levels or elevated PTH levels in both US black and white women. In the multivariable analyses, the total, free, and bioavailable 25(OH)D, and VDBP were not significantly associated with CVD risk in black or white women. A statistically significant association between higher PTH levels and increased CVD risk persisted in white women, however. The multivariate-adjusted hazard ratios [HRs] comparing the extreme quartiles of PTH were 1.37 (95% CI: 1.06-1.77; P-trend=0.02) for white women and 1.12 (95% CI: 0.79-1.58; P-trend=0.37) for black women. This positive association among white women was also independent of total, free, and bioavailable 25(OH)D or VDBP. There were no significant interactions with other pre-specified factors, including BMI, season of blood draw, sunlight exposure, recreational physical activity, sitting time, or renal function. Interpretation: Findings from a large multiethnic case-cohort study of US black and white postmenopausal women do not support the notion that circulating levels of vitamin D biomarkers may explain black-white disparities in CVD but indicate that PTH excess may be an independent risk factor for CVD in white women.

Sex and Race Differences in the Risk of Ischemic Stroke Associated With Fasting Blood Glucose in REGARDS

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012296
Author(s):  
Tracy E. Madsen ◽  
D. Leann Long ◽  
April P. Carson ◽  
George Howard ◽  
Dawn O. Kleindorfer ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Blood Glucose ◽  
Black Women ◽  
Racial Differences ◽  
White Women ◽  
Proportional Hazards ◽  
Fasting Blood Glucose ◽  
Cox Proportional Hazards ◽  
Race Differences ◽  
Prospective Longitudinal

Background:To investigate sex and race differences in the association between fasting blood glucose (FBG) and risk of ischemic stroke (IS).Methods:This prospective longitudinal cohort study included adults age ≥45 years at baseline in the Reasons for Geographic And Racial Differences in Stroke Study, followed for a median of 11.4 years. The exposure was baseline FBG (mg/dL); suspected IS events were ascertained by phone every 6 months and were physician-adjudicated. Cox proportional hazards were used to assess the adjusted sex/race-specific associations between FBG (by category and as a restricted cubic spline) and incident IS.Results:Of 20,338 participants, mean age was 64.5(SD 9.3) years, 38.7% were Black, 55.4% were women, 16.2% were using diabetes medications, and 954 IS events occurred. Compared to FBG <100, FBG ≥150 was associated with 59% higher hazards of IS (95%CI 1.21-2.08) and 61% higher hazards of IS among those on diabetes medications (95%CI 1.12-2.31). The association between FBG and IS varied by race/sex (HR, FBG ≥ 150 vs. FBG <100: White women 2.05 (95% CI 1.23-3.42), Black women 1.71 (95%CI 1.10-2.66), Black men 1.24 (95%CI 0.75-2.06), White men 1.46 (95%CI 0.93-2.28), pFBG*race/sex=0.004). Analyses using FBG splines suggest that sex was the major contributor to differences by race/sex subgroups.Conclusions:Sex differences in the strength and shape of the association between FBG and IS are likely driving the significant differences in the association between FBG and IS across race/sex subgroups. These findings should be explored further and may inform tailored stroke prevention guidelines.

scholarly journals Racial Differences in Depression Trajectories among Older Women

2011 ◽  
Vol 52 (4) ◽  
pp. 444-459 ◽  
Author(s):  
Naomi J. Spence ◽  
Daniel E. Adkins ◽  
Matthew E. Dupre
Keyword(s):  
Socioeconomic Status ◽  
Depressive Symptoms ◽  
Black Women ◽  
Physical Health ◽  
Racial Differences ◽  
White Women ◽  
Later Life ◽  
Theoretical Frameworks ◽  
Growth Curve Models ◽  
Black And White

Despite recent increases in life course research on mental illness, important questions remain about the social patterning of, and explanations for, depression trajectories among women in later life. The authors investigate competing theoretical frameworks for the age patterning of depressive symptoms and the physical health, socioeconomic, and family mechanisms differentiating black and white women. Using data from the National Longitudinal Survey of Mature Women, the authors use linear mixed (growth curve) models to estimate trajectories of distress for women aged 52 to 81 years ( N = 3,182). The results demonstrate that: (1) there are persistently higher levels of depressive symptoms among black women relative to white women throughout later life; (2) physical health and socioeconomic status account for much of the racial gap in depressive symptoms; and (3) marital status moderates race differences in distress. The findings highlight the importance of physical health, family, and socioeconomic status in racial disparities in mental health.

scholarly journals Health Care Segregation, Physician Recommendation, and Racial Disparities in BRCA1/2 Testing Among Women With Breast Cancer

2016 ◽  
Vol 34 (22) ◽  
pp. 2610-2618 ◽  
Author(s):  
Anne Marie McCarthy ◽  
Mirar Bristol ◽  
Susan M. Domchek ◽  
Peter W. Groeneveld ◽  
Younji Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Racial Disparities ◽  
Racial Differences ◽  
White Women ◽  
Physician Recommendation ◽  
Study Objective ◽  
Black And White ◽  
Physician Characteristics ◽  
White Patients

Purpose Racial disparities in BRCA1/2 testing have been documented, but causes of these disparities are poorly understood. The study objective was to investigate whether the distribution of black and white patients across cancer providers contributes to disparities in BRCA1/2 testing. Patients and Methods We conducted a population-based study of women in Pennsylvania and Florida who were 18 to 64 years old and diagnosed with invasive breast cancer between 2007 and 2009, linking cancer registry data, the American Medical Association Physician Masterfile, and patient and physician surveys. The study included 3,016 women (69% white, 31% black), 808 medical oncologists, and 732 surgeons. Results Black women were less likely to undergo BRCA1/2 testing than white women (odds ratio [OR], 0.40; 95% CI, 0.34 to 0.48; P < .001). This difference was attenuated but not eliminated by adjustment for mutation risk, clinical factors, sociodemographic characteristics, and attitudes about testing (OR, 0.66; 95% CI, 0.53 to 0.81; P < .001). The care of black and white women was highly segregated across surgeons and oncologists (index of dissimilarity 64.1 and 61.9, respectively), but adjusting for clustering within physician or physician characteristics did not change the size of the testing disparity. Black women were less likely to report that they had received physician recommendation for BRCA1/2 testing even after adjusting for mutation risk (OR, 0.66; 95% CI, 0.54 to 0.82; P < .001). Adjusting for physician recommendation further attenuated the testing disparity (OR, 0.76; 95% CI, 0.57 to 1.02; P = .06). Conclusion Although black and white patients with breast cancer tend to see different surgeons and oncologists, this distribution does not contribute to disparities in BRCA1/2 testing. Instead, residual racial differences in testing after accounting for patient and physician characteristics are largely attributable to differences in physician recommendations. Efforts to address these disparities should focus on ensuring equity in testing recommendations.

Standpoints and Situatedness: Examining the Perception of Benevolent Sexism in Black and White Undergraduate Women and Men

2022 ◽  
pp. 036168432110431
Author(s):  
Tangier M. Davis ◽  
Isis H. Settles ◽  
Martinque K. Jones
Keyword(s):  
Racial Identity ◽  
Black Women ◽  
Racial Differences ◽  
White Women ◽  
Cultural Factors ◽  
Benevolent Sexism ◽  
Gender Group ◽  
Black And White ◽  
Undergraduate Women ◽  
The Relationship

Racial differences in benevolent sexism have been underexplored. To address this gap, we used standpoint theory as a framework to examine race-gender group differences in the endorsement of benevolent sexism and how cultural factors (i.e., egalitarianism, religiosity, and racial identity) and inequality factors (i.e., experiences with racial discrimination and support for social hierarchies) might mediate this relationship. Among 510 Black and white undergraduate women and men, we found racial differences, such that Black women and men had higher endorsement of benevolent sexism than white women and men. Further, there was a gender difference for only white participants, with white men endorsing these attitudes more than white women. For Black women, religiosity and racial identity mediated the relationship between their race-gender group and greater benevolent sexism compared to white women, but only religiosity mediated the relationship for Black men. Neither inequality mediator accounted for benevolent sexism differences; however, both were associated with white women’s lower benevolent sexism, as was egalitarianism. Given these findings, we discuss implications for benevolent sexism theory, the possibility that cultural factors may shape Black women and men’s standpoint by establishing group-based norms and expectations around benevolently sexist behavior, and suggest culturally appropriate methods to reduce sexism.

Racial differences in treatment for breast cancer among black and white women in Atlanta

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 603-603
Author(s):  
M. J. Lund ◽  
O. W. Brawley ◽  
J. W. Eley ◽  
K. C. Ward ◽  
J. L. Young ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Racial Differences ◽  
Hormonal Therapy ◽  
White Women ◽  
Treatment Guidelines ◽  
Teaching Hospitals ◽  
Treatment Standards ◽  
Black And White ◽  
Treatment Type

603 Background: Among women with breast cancer, Black women experience a disproportionate excess in mortality, a reflection of their marked poorer survival, which persists even within stage and age groups. Adherence to first course treatment guidelines for breast cancer may not be uniform across racial/ethnic groups and could be a major contributing factor to racial disparities in outcome. In this population-based study, we assessed racial differences in initial treatment of primary invasive breast cancer. Methods: All data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program. The study population included all invasive breast cancers diagnosed during 2000–2001 among Black (n=877) and White (n=2437) female residents of the five Atlanta SEER counties, an area whose population is 36% Black and where several large teaching hospitals are located. Outcome factors included delay in first course treatment, type of treatment, performance of cancer directed surgery, type of surgery, and receipt of chemotherapy, radiotherapy, or hormonal therapy. Racial differences in treatment were analyzed according to their basis for treatment; stage or age at diagnosis and tumor factors. Analyses utilized frequency distributions, χ2 tests of independence, and Cochran-Mantel-Haenszel statistics in and across strata. Results: Black women were more likely to experience delays in treatment, regardless of stage at diagnosis, and 4–5 fold more likely to experience delays greater than 60 days (p<0.001). For local-regional disease, more Black women did not receive cancer directed surgery (14.2% vs. 2.9% of white women, p<0.001), but did receive breast conserving surgery (BCS) equivalently. However, only 61% of Black vs. 72% of White women received radiation with BCS (p<0.001). Black women eligible for hormonal therapy were less likely to receive it (p<0.001). Conclusions: Our findings suggest treatment standards are not adequately or equivalently implemented among Black and White women, even in a metropolitan area where teaching hospitals provide a substantial portion of breast cancer care. Treatment differences can adversely affect outcome and reasons for the differences need to be addressed. No significant financial relationships to disclose.

A Structural Approach to Sexual Attitudes

1988 ◽  
Vol 31 (1) ◽  
pp. 88-121 ◽  
Author(s):  
Judith A. Howard
Keyword(s):  
Sexual Behavior ◽  
Black Women ◽  
Sexual Assault ◽  
Racial Differences ◽  
White Women ◽  
Sexual Attitudes ◽  
Structural Approach ◽  
Sexual Values ◽  
Female Relationships ◽  
Black And White

This article evaluates the utility of cultural and structural perspectives in accounting for interracial patterns in sexual values and attitudes, as reflected in anticipated responses to and definitions of both consensual and nonconsensual sexual behavior, drawn from interviews with 932 adolescents. There were no racial differences in attitudes toward rape or toward male-female relationships. The responses of black and white women to a “classic rape” were very similar, while differences were found in responses to a less stereotypic nonconsensual sexual assault and to a consensual sexual incident. Blacks anticipated more negative reactions from the police and expressed greater distrust of other institutional agencies than did whites. Accordingly, black women were more likely to anticipate turning to their parents or other family members for support. The results are interpreted as supportive of a structural perspective.

Geographical disparities of incidence and prevalence of triple-negative breast cancers: Multistate study data analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12599-e12599
Author(s):  
Hyein Jeon ◽  
Myeong Lee ◽  
Mohammed Jaloudi
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Significant Relationship ◽  
White Women ◽  
Triple Negative ◽  
The State ◽  
Luminal A ◽  
Black Females ◽  
Black And White ◽  
State Effect

e12599 Background: Higher prevalence of triple negative breast cancer (TNBC) in black women with associated poor outcomes due to various disparities is well documented within a single state. We examine multiple states to better understand the state effect on such differences in incidence and prevalence of TNBC in black women. Methods: Female patients of ages 19 years old and above with breast cancer from the Surveillance, Epidemiology and End Results (SEER) Program across 13 states (608 counties) from 2015 (n = 66,444) and 2016 (n = 66,122) were examined. The relationships between the proportion of black and white women and the rate of patients with different tumor subtypes (luminal A, luminal B, HR-HER2+, and triple negative) were examined at the county level using ordinary least-square regression models. In parallel, due to consideration of various state-specific healthcare policies, socio-cultural norms, and socio-economic disparities, multi-level regression models were applied to examine the nested, random effect of each state on TNBC prevalence in each county. Bonferroni correction was applied to reduce the Type I error caused by repeated use of the same variables in multiple tests. Results: The baseline breast cancer rates between black and white women were similar in the population (0.171% for black and 0.168% for white). Consistent to previous studies, we demonstrate a significant positive correlation (p < 0.001) in TNBC in black females in both years. Surprisingly, when accounted for the random effects on states, 38.2% (2015) and 34.3% (2016) increase in incidence of TNBC in black females were seen, suggestive of state-specific disparity affecting race-specific health. In 2015, other subtypes of breast cancer in both black and white females did not result in significant relationship. Interestingly, in 2016, there was a significant relationship seen between the TNBC rate in white females and the white female population rate only after adjusting for the state effect (p = 0.026). This indicates the impact of non-biological factors such as state-wide health policies. Additionally, HR-HER2+ black females had a significant relationship against respective population rate only after adjusting for the state effect as well (p = 0.0394). For luminal A white females, a 15% decrease in incidence was seen after adjusting for state effect (p = 0.0424). Conclusions: This is the first known across-state examination of breast cancer subtypes by race with random effects on state. This study shows the role of state-specific factors affecting incidence in black and white females and potentially indicates the importance of state-level management for breast cancer on health disparities in addition to race-driven effects. Further studies are needed to elucidate comparable differences between states affecting the rates of various subtypes of breast cancer and thus health outcomes.

Abstract MP50: Neighborhood Social And Economic Environment And Heart Failure Risk Among Adults With & Without Diabetes: The Reasons For Geographic And Racial Differences In Stroke (regards) Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Gargya Malla ◽  
Andrea Cherrington ◽  
Monika M Safford ◽  
Parag Goyal ◽  
Doyle M Cummings ◽  
...  
Keyword(s):  
Heart Failure ◽  
Racial Differences ◽  
Proportional Hazards ◽  
Signs And Symptoms ◽  
Cox Proportional Hazards ◽  
Economic Environment ◽  
Individual Level ◽  
Black And White ◽  
Regards Study ◽  
Year 2000

Background: Heart failure (HF) mortality rates have been increasing since 2011. Individual-level education and occupation have been inversely associated with HF mortality among those with diabetes mellitus (DM) but not among those without DM. However, less is known about the association between neighborhood social and economic environment (NSEE) and HF risk and whether this association varies by DM status. Methods: This study included 21,244 Black and White adults age >=45 years at baseline (2003-07) from the REGARDS Study. NSEE quartiles were created using z-scores based on 6 census tract variables from year 2000 (% <high school education, % unemployed, % household with <$30,000, % living in poverty, % on public assistance, % without car). Incident HF events (fatal or non-fatal) were adjudicated based on hospitalization with HF signs and symptoms, supportive imaging or biomarkers. Diabetes was defined as fasting glucose >=126 mg/dL or random glucose >=200 mg/dL or use of diabetes medications. Cox proportional hazards regression was used to obtain hazard ratios (95% CI) with HF follow-up through 2016. Results: Mean age was 65 years, 54% were women, 61% were White and 18% had prevalent DM at baseline. During a median 10.1 years, 829 incident HF events occurred. Among adults with DM, neighborhood disadvantage was associated with an increased HF risk , but this association was not statistically significant (Table). Among adults without DM, the risk of HF was higher for participants living in any neighborhood that was not the most advantaged, and the magnitude of association was smiliar across NSEE quartiles. Conclusion: Adults living in disadvantaged neighborhoods had a higher risk of HF, particularly among those without DM. Addressing neighborhood social and economic conditions may be important for HF prevention.

Sign in / Sign up

Export Citation Format

Share Document