scholarly journals Why Race and Ethnicity Are Not Like Other Risk Factors

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Sean A. Valles
Keyword(s):  
Risk Factors ◽  
Race And Ethnicity ◽  
Social Conditions ◽  
Racial Groups ◽  
Epistemic Humility ◽  
Structural Competency ◽  
Individual Knowledge ◽  
Biological Differences

Since early in the Covid-19 pandemic, there have been wide disparities observed between different US racial groups’ rates of Covid-19 infections and deaths. This challenges physicians and patients to untangle what these race-associated risks mean for an individual patient. I argue that this task of providing individualized risk advice requires physicians to apply two skills: structural competency (an understanding of how societal features affect health, since race-associated risks are the result of social conditions, not innate biological differences) and epistemic humility (being mindful of the limitations of individual knowledge and a habit of working collaboratively to get the knowledge that is needed).

scholarly journals Influence of Race in the Association of Diabetes and Heart Failure

2018 ◽  
Vol 12 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Hou Tee Lu ◽  
Rusli Bin Nordin ◽  
Aizai Azan Bin Abdul Rahim ◽  
◽  
◽  
...  
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Failure ◽  
Racial Differences ◽  
Race And Ethnicity ◽  
Public Health Problem ◽  
Racial Groups ◽  
Global Public Health ◽  
Readmission Rates

Heart failure is a global public health problem with high mortality and readmission rates. Race and ethnicity are useful concepts when attempting to understand differential health risks and health disparities. With cardiovascular diseases accounting for most deaths globally, eliminating racial disparities in cardiac care has become a new challenge in cardiology. Significant racial differences exist in patients with heart failure. African American patients in the US have a significantly higher incidence of heart failure, lower ejection fraction and are younger at presentation compared to White, Hispanic and Chinese American patients. These findings are explained by a higher burden of risk factors such as diabetes mellitus, hypertension, obesity and lower household incomes among African Americans. The authors believe that these findings are applicable to other racial groups across the globe. The prevalence of predisposing risk factors probably has a stronger influence on the incidence of heart failure than the racial factor alone. The interaction between race and diabetes mellitus has important public health implications for the management and prevention of heart failure.

W1279 Race and Ethnicity As Risk Factors for Post-Surgical C. difficile Infection and Its Mortality

2008 ◽  
Vol 134 (4) ◽  
pp. A-671
Author(s):  
Rabin Rahmani ◽  
William Southern ◽  
Igal Khorshidi ◽  
Christopher B. Ibrahim ◽  
Andy J. Thanjan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Race And Ethnicity

Abstract P423: Race and Ethnicity Influence Perihematomal Edema Volume in Supratentorial Intracerebral Hemorrhage

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Julian N Acosta ◽  
Yasheng Chen ◽  
Cameron Both ◽  
Audrey C Leasure ◽  
Fernando Testai ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Race And Ethnicity ◽  
Learning Algorithm ◽  
Multivariable Analysis ◽  
Secondary Brain Injury ◽  
Racial Groups ◽  
Deep Learning Algorithm ◽  
Perihematomal Edema ◽  
Study Participants ◽  
Racial Ethnic

Introduction: Perihematomal Edema (PHE) is a neuroimaging biomarker of secondary brain injury in patients with spontaneous, non-traumatic intracerebral hemorrhage (ICH). There are limited data on racial/ethnic differences in the development of PHE. This dearth of data is partially driven by the time-consuming process of manually segmenting PHE. Leveraging a validated automated pipeline for PHE segmentation, we evaluated whether race and ethnicity influence baseline PHE volume in patients with ICH. Methods: The Ethnic/Racial Variations in Intracerebral Hemorrhage (ERICH) study is a prospective, multicenter study of ICH that recruited 1,000 adult participants from each of three racial/ethnic groups (non-Hispanic White, non-Hispanic Black, and Hispanic). We applied a previously validated deep learning algorithm to automatically determine PHE volumes on baseline CTs in these study participants. Quality control procedures were used to include only sufficiently accurate PHE measurements. Linear regression was used to identify factors associated with log-transformed PHE volume and to identify differences across Ethnic/Racial groups. Results: Our imaging pipeline provided good quality baseline PHE measurements on 2,008 out of 3,000 ERICH study participants. After excluding infratentorial hemorrhages (273) and those with missing or null baseline ICH volume (49), 1,686 remained for analysis (median age 59 [IQR 51-71], 687 [41%] female sex). Median PHE volume was 12.0 (IQR 4.8-27.1) for whites, 11.9 (IQR 4.5-26.1) for Hispanics and 8.3 (IQR 3.0-19.2) for blacks. Compared to Blacks, Hispanics (beta 0.22; 95%CI 0.11-0.32; p<0.001) and Whites (beta 0.20; 95%CI 0.07-0.33; p=0.003) had higher baseline PHE volumes, in multivariable analysis adjusting for age, sex, ICH location, log-baseline ICH volume, log-baseline intraventricular volume, and systolic blood pressure on admission. Conclusion: Race and ethnicity influence the volume of baseline PHE. Further studies are needed to validate our results and investigate the biological underpinnings of this difference.

Gender

Sociology ◽  
2011 ◽  
Author(s):  
Janeen Baxter ◽  
Heidi Hoffmann
Keyword(s):  
Labor Market ◽  
Social Relationships ◽  
Social Relations ◽  
Race And Ethnicity ◽  
Social Institution ◽  
Social Characteristics ◽  
Men And Women ◽  
The Social ◽  
Unequal Access ◽  
Biological Differences

The term gender refers to the cultural and social characteristics attributed to men and women on the basis of perceived biological differences. In the 1970s, feminists focused on sex roles, particularly the socialization of men and women into distinct masculine and feminine roles and the apparent universality of patriarchy. More recent work has critiqued the idea of two distinct genders, calling into question the notion of gender dichotomies and focusing attention on gender as a constitutive element of all social relationships. Gender has been described as a social institution that structures the organization of other institutions, such as the labor market, families, and the state, as well as the social relations of everyday life. In addition, scholars have pointed to the ways in which gender is constructed by organizations and individual interactions. Gender not only differentiates men and women into unequal groups, it also structures unequal access to goods and resources, often crosscutting and intersecting with other forms of inequality, such as class, race, and ethnicity.

scholarly journals Death Within 1 Month of Diagnosis in Childhood Cancer: An Analysis of Risk Factors and Scope of the Problem

2017 ◽  
Vol 35 (12) ◽  
pp. 1320-1327 ◽  
Author(s):  
Adam L. Green ◽  
Elissa Furutani ◽  
Karina Braga Ribeiro ◽  
Carlos Rodriguez Galindo
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Childhood Cancer ◽  
Race And Ethnicity ◽  
Lymphoblastic Leukemia ◽  
Strong Predictor ◽  
Survival Rates ◽  
Multivariable Analysis ◽  
Early Death ◽  
Hematologic Malignancies

Purpose Despite advances in childhood cancer care, some patients die soon after diagnosis. This population is not well described and may be under-reported. Better understanding of risk factors for early death and scope of the problem could lead to prevention of these occurrences and thus better survival rates in childhood cancer. Methods We retrieved data from SEER 13 registries on 36,337 patients age 0 to 19 years diagnosed with cancer between 1992 and 2011. Early death was defined as death within 1 month of diagnosis. Socioeconomic status data for each individual’s county of residence were derived from Census 2000. Crude and adjusted odds ratios and corresponding 95% CIs were estimated for the association between early death and demographic, clinical, and socioeconomic factors. Results Percentage of early death in the period was 1.5% (n = 555). Children with acute myeloid leukemia, infant acute lymphoblastic leukemia, hepatoblastoma, and malignant brain tumors had the highest risk of early death. On multivariable analysis, an age younger than 1 year was a strong predictor of early death in all disease groups examined. Black race and Hispanic ethnicity were both risk factors for early death in multiple disease groups. Residence in counties with lower than median average income was associated with a higher risk of early death in hematologic malignancies. Percentages of early death decreased significantly over time, especially in hematologic malignancies. Conclusion Risk factors for early death in childhood cancer include an age younger than 1 year, specific diagnoses, minority race and ethnicity, and disadvantaged socioeconomic status. The population-based disease-specific percentages of early death were uniformly higher than those reported in cooperative clinical trials, suggesting that early death is under-reported in the medical literature. Initiatives to identify those at risk and develop preventive interventions should be prioritized.

scholarly journals Risk factors for early adolescent drug use in four ethnic and racial groups.

1993 ◽  
Vol 83 (2) ◽  
pp. 185-189 ◽  
Author(s):  
W A Vega ◽  
R S Zimmerman ◽  
G J Warheit ◽  
E Apospori ◽  
A G Gil
Keyword(s):  
Risk Factors ◽  
Drug Use ◽  
Early Adolescent ◽  
Racial Groups ◽  
Adolescent Drug Use

Prevalence of High-Risk Food Consumption and Food-Handling Practices among Adults: A Multistate Survey, 1996 to 1997

2000 ◽  
Vol 63 (11) ◽  
pp. 1538-1543 ◽  
Author(s):  
BELETSHACHEW SHIFERAW ◽  
SAMANTHA YANG ◽  
PAUL CIESLAK ◽  
DUC VUGIA ◽  
RUTHANNE MARCUS ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
High Risk ◽  
College Education ◽  
Raw Milk ◽  
Racial Groups ◽  
Food Handling ◽  
Demographic Groups ◽  
Handling Practices ◽  
Food Handling Practices

Risk factors for foodborne diseases include consumption of high-risk foods and unsanitary food-handling practices; however, little is known about the prevalence of these risk factors in the general population. A survey was done in five FoodNet sites (California, Connecticut, Georgia, Minnesota, Oregon) to determine the prevalence of these risk factors in the population. A total of 7,493 adults were interviewed by telephone between 1 July 1996 and 30 June 1997. Results showed that 1.5% drank raw milk, 1.9% ate raw shellfish, 18% ate runny egg, 30% preferred pink hamburger, 93% said they almost always washed their cutting board after cutting raw chicken, and 93% said they almost always washed their hands after handling raw meat or poultry, during 5 days before interview. The results differed by state and demographic group. Consumption of raw shellfish (3.2%) and undercooked hamburger (43%) were more common in Connecticut than other states. Raw milk consumption was more common among people who lived on a farm (8.6%) compared with people who lived in a city or urban area (1.1%). Preference for undercooked hamburger was more common among men (35%), young adults (18 to 25 years, 33%), people with college education (38%), and among people with household income of more than $100,000/year (49%). African-Americans were less likely to prefer undercooked hamburger compared to other racial groups (10% versus 30%). Young adults compared to older adults were less likely to wash their hands after handling raw chicken (88% versus 95%), and men washed their hands less often than women (89% versus 97%). Although there were statistical differences between demographic groups, they are insufficient to warrant targeted educational programs.

scholarly journals Prevalence of Anemia Across Trimesters in Multiethnic Pregnant Women

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 765-765
Author(s):  
Wanhui Kang ◽  
Carrie Irvine ◽  
Eva Pressman ◽  
Kimberly O'Brien
Keyword(s):  
Risk Factors ◽  
Black Women ◽  
Pregnant Women ◽  
White Women ◽  
Late Gestation ◽  
Racial Groups ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
T1 And T2 ◽  
Prevalence Of Anemia

Abstract Objectives This study aimed to characterize prevalence and determinants of anemia in a multiethnic cohort of pregnant women. Methods A retrospective medical chart review was undertaken of all deliveries occurring from 2011 to 2020 at Strong Memorial Hospital and Highland Hospital in Rochester, NY. Among a total of 53,642 deliveries, 42,289 occurred to women with no underlying health complications. Anemia was defined using the CDC criteria as &lt; 11g/dL in the first (T1) and third trimesters (T3) and &lt; 10.5 g/dL in the second trimester (T2). Mean Hb concentration was compared between trimesters and racial groups by ANOVA and post-hoc pairwise comparisons. Relationships between prevalence of anemia by trimesters, racial groups, and BMI were examined by chi-square or t-tests. Logistic regression models were conducted to estimate the risk factors associated with anemia. Results Pregnant women had a mean age of 29.8 ± 5.5 y (range: 13−52 y) at delivery. The majority of women (66.8%) self-identified as white, 20.0% as black, 3.8% as Asian, and 9.4% as Other. Mean Hb concentrations significantly differed by trimester [12.6 ± 1.0, 11.5 ± 1.1, and 11.8 ± 1.3 g/dL in T1, T2 and T3, respectively, p &lt; 0.001]. Mean Hb was significantly lower in black women in each trimester by -0.8 (T1), -0.7 (T2), and -1.0 g/dL (T3) compared to white women. White women had the highest Hb concentrations in T1 and T2 (12.8 ± 0.9, 11.8 ± 1.0 g/dL) while Asian women had the highest Hb concentrations in T3 (12.2 ± 1.2 g/dL, n = 1577, p &lt; 0.001). The overall prevalence of anemia was 17.1%, which significantly increased across pregnancy [4.5% (T1), 16.4% (T2) and 25.2% (T3), p &lt; 0.001]. Observed rates of anemia were higher than the estimated NHANES (1999–2006) prevalence in pregnant women. After stratifying by racial groups, higher BMI was significantly associated with a lower prevalence of anemia in T2 and T3 only in black women and in those whose race was categorized as Other. Conclusions The prevalence of anemia was highest in black pregnant women in all trimesters, while it was lowest in white pregnant women in T1 and T2, and in Asians in T3. Risk factors associated with anemia included late gestation or self-reported race as black or Other. Funding Sources None.

scholarly journals Risk Factors for Progression to Alzheimer's Disease in African Americans in a Large National Cohort

2020 ◽  
Author(s):  
Yejin Kim ◽  
Sean I Savitz ◽  
Jessica Lee ◽  
Paul E Schulz ◽  
Luyao Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
African Americans ◽  
Treatment Effect ◽  
Senile Dementia ◽  
P Value ◽  
Racial Groups ◽  
Diagnosis Codes ◽  
National Cohort

Objectives: To investigate risk factors for progression to Alzheimer's disease and related dementias (ADRD) in African Americans and non-Hispanic Caucasians in a large US cohort. Design: A matched case-control design using electronic health records (EHRs) from 2000 - 2017. Setting: Cerner EHRs database covering more than 600 Cerner client hospitals. Participants: 79,120 patients aged 65 and older (#ADRD=39,560, #non ADRD older adults=39,560) from an initial cohort of 49,826,000 patients. Measurements: We converted ICD9 or ICD10 diagnosis codes into PheWas codes to increase clinical relevance. Then we detected ADRD as having both ADRD diagnosis codes and medications. We considered PheWas codes for Alzheimer's disease, dementia with cerebral degenerations, senile dementia, and vascular dementia. We considered ADRD medications including acetylcholine and memantine. Results: Using two-step propensity score matching, we built an African American cohort of 4,429 and a 4,570-person matched Caucasian cohort that was similar in terms of onset age, observation length, sex, and known ADRD risks (diabetes, vascular disease, heart disease, head injury, and obesity). Older African Americans had a statistically significant progression from cerebrovascular risk (transient ischemic attack) to ADRD incidence (treatment effect coefficient = 0.0978, p-value <0.000) whereas the matched Caucasians did not (treatment effect coefficient = 0.403, p-value = 0.196). Conclusion: Our extensive causal analysis using a nationwide EHR discovered disease progression pathways to ADRD. The carefully matched cohorts from different racial groups showed different progression, which partly explains the racial disparities in ADRD incidence.

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