scholarly journals Factors Underlying Racial Disparities in Sepsis Management

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 133
Author(s):  
Matthew DiMeglio ◽  
John Dubensky ◽  
Samuel Schadt ◽  
Rashmika Potdar ◽  
Krzysztof Laudanski
Keyword(s):  
Racial Disparities ◽  
Racial Differences ◽  
Minority Groups ◽  
The United States ◽  
Racial Groups ◽  
Sepsis Management ◽  
Treatment Protocols ◽  
Common Causes ◽  
Standardized Treatment ◽  
Wide Variability

Sepsis, a syndrome characterized by systemic inflammation during infection, continues to be one of the most common causes of patient mortality in hospitals across the United States. While standardized treatment protocols have been implemented, a wide variability in clinical outcomes persists across racial groups. Specifically, black and Hispanic populations are frequently associated with higher rates of morbidity and mortality in sepsis compared to the white population. While this is often attributed to systemic bias against minority groups, a growing body of literature has found patient, community, and hospital-based factors to be driving racial differences. In this article, we provide a focused review on some of the factors driving racial disparities in sepsis. We also suggest potential interventions aimed at reducing health disparities in the prevention, early identification, and clinical management of sepsis.

scholarly journals Factors Underlying Racial Disparities in Sepsis Management

2018 ◽  
Author(s):  
Matthew DiMeglio ◽  
John Dubensky ◽  
Samuel Schadt ◽  
Rashmika Potdar ◽  
Krzysztof Laudanski
Keyword(s):  
Racial Disparities ◽  
Racial Differences ◽  
Minority Groups ◽  
The United States ◽  
Racial Groups ◽  
Sepsis Management ◽  
Treatment Protocols ◽  
Common Causes ◽  
Standardized Treatment ◽  
Wide Variability

Sepsis, a syndrome characterized by systemic inflammation during infection, continues to be one of the most common causes of patient mortality in hospitals across the United States. While standardized treatment protocols have been implemented, wide variability in clinical outcomes persist across racial groups. Specifically, Black and Hispanic populations are frequently associated with higher rates of morbidity and mortality in sepsis compared to the Caucasian population. While this is often attributed to systemic bias against minority groups, a growing body of literature has found patient, community, and hospital-based factors to be driving racial differences. In this article, we provide a focused review on some of the factors driving racial disparities in sepsis. We also suggest potential interventions aimed at reducing health disparities in the prevention, early identification, and clinical management of sepsis.

Abstract 491: Racial Disparities in the Trends of Acute Myocardial Infarction Outcomes Among Medicaid Patients, 2007-2011

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Oluwole M Adegbala ◽  
Akintunde Akinjero ◽  
Samson Alliu ◽  
Adeyinka C Adejumo ◽  
Emmanuel Akintoye ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
African Americans ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Racial Disparities ◽  
Racial Differences ◽  
Length Of Hospital Stay ◽  
The United States ◽  
Racial Groups

Background: Although, in-hospital mortality from acute myocardial infarction (AMI) have declined in the United States recently, there is a gap in knowledge regarding racial differences in this trend. We sought to evaluate the effect of race on the trends in outcomes after Acute Myocardial Infarction among Medicaid patients in a nationwide cohort from 2007-2011 Methods: We extracted data from the Nationwide Inpatient Sample (NIS) for all hospitalizations between 2007 and 2011 for Medicaid patients aged 45 years or older with principal diagnosis of AMI using ICD-9-CM codes. Primary outcome of this study was all cause in-hospital mortality. We then stratified hospitalizations by racial groups; Whites, African Americans and Hispanics, and assessed the time trends of in-hospital mortality before and after multivariate analysis. Results: The overall mortality from AMI among Medicaid patients declined during the study period (8.80% in 2007 to 7.46% in 2011). In the adjusted models, compared to 2007, in-hospital mortality from AMI for Medicaid patients decreased across the 3 racial groups; Whites (aOR= 0.88, CI=0.70-0.99), African Americans (aOR=0.76, CI=0.57-1.01), Hispanics (aOR=0.87, CI=0.66-1.25). While the length of hospital stay declined significantly among African American and Hispanic with 2 days and 1.76 days decline respectively, the length of stay remained unchanged for Whites. There was non-significant increase in the incidence of stroke across the various racial groups; Whites (aOR= 1.23, CI=0.90 -1.69), African Americans (aOR=1.10, CI=0.73 -1.64), Hispanics (aOR=1.03, CI=0.68-1.55) when compared to 2007. Conclusion: In this study, we found that in-hospital mortality from AMI among Medicaid patients have declined across the racial groups. However, while the length of stay following AMI declined for African Americans and Hispanics with Medicaid insurance, it has remained unchanged for Whites. Future studies are necessary to identify determinants of these significant racial disparities in outcomes for AMI.

scholarly journals Making cell culture more physiological: a call for a more comprehensive assessment of racial disparities in endothelial cell culture studies

2020 ◽  
Vol 318 (2) ◽  
pp. C238-C241 ◽  
Author(s):  
Austin T. Robinson ◽  
Marc D. Cook ◽  
Abbi D. Lane-Cordova
Keyword(s):  
Cell Culture ◽  
Endothelial Cell ◽  
Racial Disparities ◽  
Racial Differences ◽  
White Women ◽  
Microvascular Complications ◽  
The United States ◽  
Culture Studies ◽  
Endothelial Cell Function ◽  
Endothelial Cell Culture

In the United States, cardiovascular diseases (CVDs) are the leading cause of death and disproportionately affect ethnic and racial minority populations. Black individuals are more likely to develop advanced CVD and microvascular complications resulting in end-organ damage. Endothelial cell dysfunction leads to microvascular and macrovascular dysfunction and is predictive of the development of CVD. Black versus white racial disparities in in vivo and in vitro studies of endothelial cell function are well documented. However, race-related disparities in maternal environment and lifestyle may be a major unconsidered factor in racial differences in endothelial cell culture studies. Further, rates of hypertensive disorders of pregnancy are higher in black versus white women. These pregnancy complications may result in placental dysfunction, including excess production of inflammatory and antiangiogenic molecules that impair endothelial function. Therefore, studies that include other ethnic and racial minorities are needed, in addition to a more thorough characterization of endothelial cell donors and targeted cell culture studies (e.g., genotyping) to generate information that can be translated into effective preventive or treatment strategies for ethnic/racial disparities in CVD.

scholarly journals Yellow in Black and White: Representasi Identitas Asia oleh Rich Brian dalam Musik Hip-Hop di Amerika Serikat

2021 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Nokia Putri Andika Lainsyamputty
Keyword(s):  
Hip Hop ◽  
Minority Groups ◽  
The United States ◽  
Racial Groups ◽  
Asian Race ◽  
Black And White ◽  
Analysis Process ◽  
The Us ◽  
Stuart Hall ◽  
Chinese Descent

AbstractThe representation of the Asian race in the US music industry is still relatively small. However, Rich Brian, a person of Chinese descent with Indonesian nationality, succeeded in his career by carrying out the hip-hop genre that was firmly rooted in African-American (black) racial groups in the United States, a country which was dominated by Caucasian (white) races. This study aims to uncover how Brian represented his identity in the US hip-hop music scene using Stuart Hall's circuit of culture theory. The object of this research is the lyrics of several songs in Rich Brian's album. Through the analysis process, it was found that Brian did not cover the nationality and race identity he had. He precisely positioned himself on the spectrum of social identity. This then affects the representation of identity that he does in his songs, including revolving around the theme of the meaning of identity and stereotypes of the Asian race, as well as the struggles experienced by Asians who are part of minority groups in the United States.AbstrakRepresentasi ras Asia dalam industri musik Amerika Serikat masih tergolong sedikit. Namun Rich Brian, seseorang keturunan Tionghoa dan berkewarganegaraan Indonesia, berhasil berkarir dengan mengusung genre hip-hop yang berakar kuat pada kelompok ras Afrika-Amerika (black), di negara Amerika Serikat yang didominasi oleh ras kaukasian (white). Penelitian ini bertujuan untuk mengungkap bagaimana Brian merepresentasikan identitasnya dalam skena musik hip-hop Amerika Serikat menggunakan teori sirkuit budaya oleh Stuart Hall. Objek dalam penelitian ini berupa lirik dari beberapa lagu dalam album milik Rich Brian. Melalui proses analisis, didapati bahwa Brian tidak menutupi identitas kewarganegaraan dan ras yang ia miliki. Ia justru memosisikan dirinya pada spektrum identitas sosial. Hal ini kemudian memengaruhi representasi identitas yang ia lakukan dalam lagu-lagunya, diantaranya berkisar pada tema pemaknaan identitas dan stereotip dari ras Asia, serta perjuangan yang dialami oleh orang Asia yang merupakan bagian dari kelompok minoritas di Amerika Serikat.

scholarly journals Racial disparities in hospitalization expenditures of older adults in Singapore

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 957-957
Author(s):  
Cynthia Chen ◽  
Xueying Guo ◽  
Hwee Lin Wee ◽  
Kelvin Bryan Tan
Keyword(s):  
Older Adults ◽  
Racial Disparities ◽  
Ethnic Groups ◽  
Chronic Diseases ◽  
Racial Differences ◽  
World Population ◽  
Racial Groups ◽  
Ageing Society ◽  
Targeted Interventions ◽  
Aged Society

Abstract The World Population Prospects 2019 reports that the proportion of people who aged 65 and above takes up 9 per cent globally in 2019, reaching up to 16 per cent by 2050. Asia has the fastest rise: from 1 in 9 people aged 65 and above to 1 in 4 in 2050. Rapid growth in older adults has strong implications for diseases and healthcare expenditure. For Singapore, the transition from ‘ageing society’ (7% seniors) in 1999 to ‘super-aged society’ (20% seniors) in 2026 is projected to take 27 years, much faster than Japan’s 36 years. We used the Singapore Multi-Ethnic Cohort (MEC) of 14,465 subjects aged 21 to 94, and the Future Elderly Model (FEM) microsimulation model to project disease burden and hospitalization expenditures to 2050. We found that Chinese females had the highest life expectancy of 86.0 years, followed by Indian and Malay females with 80.4 and 75.6 years respectively. In all racial groups, women lived longer than men by 5-7 years. Cumulative hospitalization expenditures of older adults aged 51+ was US$69,500 for Chinese, US$67,600 for Malays and US$86,100 for Indians; US$71,200 for males and US$70,700 for females. The increased hospitalization spending for all three ethnic groups was due to the underlying manifestation of chronic diseases, including diabetes, hypertension, heart disease and stroke. Variations in environmental risk factors such as diet, cigarette smoking and physical activity across ethnic groups may contribute to racial differences in chronic diseases and disability. Therefore, targeted interventions are needed to reduce racial disparities.

Nativism and Religion in America

2017 ◽  
Author(s):  
Rodger M. Payne
Keyword(s):  
United States ◽  
Racial Differences ◽  
Religious Identity ◽  
Minority Groups ◽  
World Order ◽  
American Exceptionalism ◽  
The United States ◽  
Promised Land ◽  
Anti Semitism ◽  
Antebellum Era

Nativism describes an ideology that favors the rights and privileges of the “native born” population over and against those of “foreign” status, however these categories might be defined and ascribed. In the United States, the term has usually been employed to designate hostility against foreign immigration, although nativist arguments have been used against various internal minority groups as well. Although the term is often used as a synonym for the anti-Catholicism of the antebellum era, nativism has usually focused its apprehensions on ethnic and racial differences rather than religious diversity; since religious identity is often interdependent with racial or ethnic heritage, however, any religious divergence from the dominant white Anglo-Saxon Protestant culture likewise falls under suspicion. While not all forms of religious intolerance in the United States have been grounded in nativist attitudes and activities, the relationship between antipathy toward immigration and antagonism toward certain religions has been a recurrent and resilient theme in American culture. From the various forms of political and social enmity directed against Catholic immigrants during the antebellum era to the passage of Asian “exclusion acts” and the rise of anti-Semitism in the late 19th and early 20th centuries and from attitudes toward the civilizing “mission” of the United States to contemporary expressions of Islamophobia, antagonism toward the foreign Other has often been inseparable from expressions of religious chauvinism and xenophobia. Such chauvinism represents an appropriation of the idea of American exceptionalism by participating in the cultural mythology of the American civil religion, which posits both a divine origin of and special destiny for the United States. Scholars of American religion have long traced this theme of American exceptionalism, particularly as it has been expressed through the way in which Americans have read themselves into the biblical narrative as God’s “new Israel,” as a “shining city on a hill,” or as the location for the realization of the Christian millennial hope of a “new heaven and a new earth.” In less biblical but no less religious terms, the United States has been presented as the reification of a “new world order” (novus ordo seclorum, one of the three Latin mottos included on the Great Seal of the United States) or as offering humanity “the last best hope of earth.” By thus conceptualizing “America” as a type of utopian sacred space, these metaphors have simultaneously created the need for establishing the restrictions that mark one’s inclusion or exclusion in this redemptive process. Through identifying the foreign Other—by ethnicity, race, or religion—nativism has been one way to provide this religious function of defining the symbolic boundaries that keep this new “promised land” pure.

scholarly journals The race paradox in subjective wellbeing among older Americans

2017 ◽  
Vol 39 (3) ◽  
pp. 568-589 ◽  
Author(s):  
FENGYAN TANG ◽  
HEEJUNG JANG ◽  
MARY BETH RAUKTIS ◽  
DONALD MUSA ◽  
SCOTT BEACH
Keyword(s):  
Social Support ◽  
Life Satisfaction ◽  
Racial Differences ◽  
Social Engagement ◽  
Subjective Wellbeing ◽  
The United States ◽  
Future Research ◽  
Racial Groups ◽  
Crossover Effect ◽  
Older Americans

ABSTRACTThis study aims to assess racial differences in subjective wellbeing (SWB) and to examine whether the pathways of social support and social engagement to SWB vary by racial groups in the United States of America. Using a local sample (N = 1,035) and a nationally representative sample of the Health and Retirement Study (N = 7,718), we compared life satisfaction and happiness between non-Hispanic Whites and Blacks aged 55 and over. We evaluated the extent to which race, other socio-demographic characteristics, health, social engagement and social support explained the variances in SWB and examined the moderation effects of race on the relationships of SWB with age, social support and social engagement. Multiple regression analyses showed that non-Hispanic Blacks were at least as satisfied as, and even happier than White peers, after equalising social resources and health variables. Social support was significantly related to SWB, and it seemed that positive support was more important to Whites than to Blacks in predicting life satisfaction. In addition, the racial crossover effect existed, that is, the old-old (80+) Blacks were happier than their White peers. Findings indicate a national trend of the race paradox in SWB and underscore the importance of social support in promoting older adults’ wellbeing. Future research is recommended to investigate other potential mechanisms among Black older Americans to explain their relatively better SWB.

scholarly journals A Brief Literature Review of Juvenile Statistics, A Comparative Analysis of Current Racial Differences Within the Criminal Justice System

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Phillip D. Clingan
Keyword(s):  
United States ◽  
Criminal Justice ◽  
Juvenile Justice ◽  
Racial Disparities ◽  
Criminal Justice System ◽  
Racial Differences ◽  
Racial Disparity ◽  
Justice System ◽  
Juvenile Justice System ◽  
The United States

Youths under 18 years get trapped into the Juvenile Justice System after being suspected of committing a delinquent or criminal act. The United States tops in Juvenile arrests in the world. States like West Virginia, Alaska, Oregon, South Dakota, and Wyoming have the highest number of juveniles. However, an estimated 2.1 million youths under 18 years were arrested in the United States during a single year. This paper aims to address the current racial differences that exist within the criminal justice system. By addressing challenges like youths of color are more likely to be committed than white youths into the juvenile system will assist in curbing racial disparity. Statistics reveal that 42% of youths in the placement holdings are black youths, even though black youths make up for 16% of youths all over the United States. In California alone, African American juveniles take 27.5% while whites take up 15%. Even though the system’s laws contain no racial bias, research shows that discrimination can occur where the system allows criminal justice officials discretion in handling offenders. Black youths take up for 15% of the total number of youths in the USA get they have the highest juvenile detentions of 42%, but it is difficult to deny these records since there is evidence like arrest and imprisonment records to back up this claim. The racial disparities exist from targeting the blacks, arrest, sentencing, imprisonment, and release. These actions promote discrimination among the black youths, and black youths are likely to get significant sentencing compared to whites for the same crimes committed. Different states in the United States have different racial disparities, California and Texas, blacks serve long sentences, unlike the whites. There are various causes of racial disparities like; some black residences are known for crime, and they have huge offence rates, unequal access to resources, judicial decisions, and racial prejudice. After the research, it was evident that racial disparity exists, and it can only be corrected by looking at the root cause of the problem widely, which is discrimination. Race plays a significant role when it comes to juvenile detentions. Youths of color are four times more probable to be detained, unlike white youths. The research designed a method of tracking racial disparities via a hypothetical juvenile jurisdiction criminal justice system. The paper will extensively dive into juvenile population characteristics, juvenile justice system structure, law enforcement, juvenile crime, juveniles in court, juveniles on probation by the state, juveniles in the correction by the state and foreign nations, and an analysis of all the findings. The extensive research will be able to answer all the questions to the problem of racial disparity.

scholarly journals Racial Differences in Nutritional Anemias: Analysis of Folate, Vitamin B12, and Iron Deficiencies

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3387-3387
Author(s):  
Miguel Gonzalez Velez ◽  
Carolyn Mead-Harvey ◽  
Heidi E. Kosiorek ◽  
Yael Kusne ◽  
Leslie Padrnos
Keyword(s):  
Vitamin B12 ◽  
Racial Differences ◽  
The United States ◽  
Racial Group ◽  
Serum Folate ◽  
Nutritional Deficiencies ◽  
Racial Groups ◽  
The Us ◽  
Level Analysis ◽  
Prevalence Of Anemia

Background: Serum folate (SF), vitamin B12 (B12), and iron deficiencies (def) are common causes of nutritional anemias. These deficiencies are usually multifactorial, with nutritional and non-nutritional factors playing a role. SF, B12, and iron levels are usually ordered in the setting of anemia, and malnutrition with or without neurologic symptoms. Since folic acid fortification, the prevalence of SF def in the United States (US) is <1% in the general population. B12 def and iron def range between 6-12%, and 1-11% respectively depending on the population studied. The prevalence of nutritional anemias secondary to SF, B12, and/or iron def by racial groups in the US is poorly studied, and most data available focuses on non-Hispanic whites (NHW). We aimed to determine the prevalence of anemia secondary to nutritional deficiencies by racial groups in the US. Methods: We performed a retrospective analysis of patients with SF, B12 and iron levels at Mayo Clinic Arizona between 01/2010 and 10/2018. Race was classified according to the NIH criteria. Normal laboratory values were determined according to our lab reference and the US National Health and Nutrition Examination Survey (NHANES) III. SF levels (mcg/Lt) were defined as deficient <4, normal ≥4.0, and excess ≥20. B12 levels (ng/L) as deficient <150, borderline 150-400, normal >400-900, and excess ≥900. Iron def was determined by ferritin levels (mcg/L) as low <24, normal 24-336, elevated ≥336 for men, low <11, normal 11-307, elevated ≥307 for women. Demographics and clinical variables were compared between groups by chi-square test for frequency data or Kruskal Wallis rank-sum test for continuous variables. Multivariable logistic regression was used for a sample-level analysis adjusting for age and gender and using NHW as a reference group. Results: A total of 79,926 SF, 107,731 B12, and 39,827 ferritin samples from 67,683 patients were analyzed. Demographics and sample analysis are presented in Table 1. In the sample-level analysis, 23,008 (25%) had anemia with higher prevalence in the American Indian/Alaskan Native (AI/AN) 49% and African Americans (AA) 43% (p<0.001). The prevalence of SF def was 446/79,926 (0.6%), B12 def 1,548/107,731 (1.4%), and iron def 5,212/39,827 (13.1%). 23 had concomitant SF and B12 deficiency, 25 SF and iron def, and 144 B12 and iron def. The SF def prevalence by racial groups was: AI/AN 11 (1.9%), AA 19 (1.1%), NHW 378 (0.6%), Hispanic 28 (0.5%), Asian 4 (0.2%). The B12 def prevalence by racial groups was: Asian 89 (3.4%), NHW 1,274 (1.4%), Hispanic 87 (1.3%), AA 30 (1.3%), AI/AN 10 (1.3%). Iron def prevalence by racial groups: AI/AN 71 (20.5%), Asian 198 (17.6%), AA 180 (16.9%), Hispanic 432 (15.6%), NHW 4,161 (12.4%). In the multivariate sample-level analysis, the presence of anemia was higher in the AI/AN (OR: 4.51, 95%CI: 3.70-5.49, p<0.0001), AA (OR 3.34, 95%CI: 2.99-3.74, p<0.0001), Asian (OR 1.52, 95%CI: 1.35-1.73, p<0.0001) and Hispanic racial group (OR 1.41, 95%CI: 1.30-1.52, p<0.0001). SF def was more common in the AI/AN (OR: 2.94, 95%CI: 1.60-5.39, p<0.001) and AA (OR 1.71, 95%CI: 1.08-1.53, p=0.02). B12 def was more common in the Asian racial group (OR: 2.535, 95%CI: 20.03-3.16, p<0.0001). Iron def was more common in the AI/AN (OR: 1.62, 95%CI: 1.21-2.17, p<0.001), Asian (OR 1.31, 95%CI: 1.0-1.57, p=0.003), and AA racial group (OR 1.26, 95%CI: 1.05-1.52, p=0.001). Conclusions: In our cohort, we show that despite the low prevalence of nutritional anemias in the US, racial disparities exist. Major differences were observed in the prevalence of anemia, SF def and iron def especially among AI/AN and AA. These differences may be linked to medical causes, nutritional practices and other social determinants of health. More research regarding the causes of these disparities and its clinical implications on a population level are needed. Targeted strategies to improve folate, B12 and iron intake in at higher risk populations could decrease adverse outcomes and decrease healthcare disparities caused by nutritional anemias. T able 1. Sample-level comparison by race Disclosures No relevant conflicts of interest to declare.

scholarly journals Racial Disparities in COVID-19 and Excess Mortality in Minnesota

2020 ◽  
Author(s):  
Elizabeth Wrigley-Field ◽  
Sarah Garcia ◽  
Jonathon P. Leider ◽  
Christopher Robertson ◽  
Rebecca Wurtz
Keyword(s):  
United States ◽  
Natural History ◽  
Racial Disparities ◽  
Excess Mortality ◽  
Age Distribution ◽  
The United States ◽  
Mortality Rates ◽  
Racial Groups ◽  
Communities Of Color ◽  
History Of

The COVID-19 pandemic has produced vastly disproportionate deaths for communities of color in the United States. Minnesota seemingly stands out as an exception to this national pattern, with white Minnesotans accounting for 80% of the population and 82% of COVID-19 deaths. We examine confirmed COVID mortality alongside deaths indirectly attributable to the pandemic -- ‘excess mortality’ -- in Minnesota. This analysis reveals profound racial disparities: age-adjusted excess mortality rates for whites are exceeded by a factor of 2.8-5.3 for all other racial groups, with the highest rates among Black, Latino, and Native Minnesotans. The seemingly small disparities in COVID deaths in Minnesota reflect the interaction of three factors: the natural history of the disease whose early toll was heavily concentrated in nursing homes; an exceptionally divergent age distribution in the state; and a greatly different proportion of excess mortality captured in confirmed-COVID rates for white Minnesotans compared with most other groups.

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