Factors Associated With Racial and Ethnic Diversity Among Heart Failure Trial Participants: A Systematic Bibliometric Review

Background: Heart failure has a disproportionate burden on patients who are Black, Indigenous, and people of color (BIPOC), but not much is known about representation of these groups in randomized controlled trials (RCTs). We explored temporal trends in and RCT factors associated with the reporting of race and ethnicity data and the enrollment of BIPOC in heart failure RCTs. Methods: We searched MEDLINE, EMBASE, and CINAHL for heart failure RCTs published in journals with an impact factor ≥10 between January 1, 2000 and June 17, 2020. We used the Cochran-Armitage and Jonchkeere-Terpstra tests to examine temporal trends, and multivariable regression to assess the association between trial characteristics and outcomes. Results: Of 414 RCTs meeting inclusion criteria, only 157 (37.9% [95% CI, 33.2%–2.8%]) reported race and ethnicity data. Among 158 200 participants in these 157 RCTs, 29 512 (18.7% [95% CI, 18.5%–18.9%]) were BIPOC. There was a temporal increase in reporting of race and ethnicity data (29.5% in 2000–2003 to 54.7% in 2016–2020, P <0.001) and in enrollment of BIPOC (14.4% in 2000–2003 to 22.2% in 2016–2020, P =0.038). Trial leadership by a woman was independently associated with twice the odds of reporting race and ethnicity data (odds ratio, 2.0 [95% CI, 1.1–3.8]; P =0.028) and an 8.4% increase (95% CI, 1.9%–15.0%; P =0.013) in BIPOC enrollment. Conclusions: A minority of heart failure RCTs reported race and ethnicity data, and among these, BIPOC were under-enrolled relative to disease distribution. Both reporting of race and ethnicity as well as enrollment of BIPOC increased between 2000 and 2020. After multivariable adjustment, trials led by women had greater odds of reporting race and ethnicity and enrolling BIPOC. REGISTRATION: URL: https://www.crd.york.ac.uk/PROSPERO/ ; Unique identifier: CRD42021237497.

Major Discrimination, Race-Ethnicity, and Inflammation Among Older Adults

This study examines the relationship between self-reported instances of major discrimination and inflammation among older adults, and explores whether this relationship varies in accordance with race/ethnicity. Data from 2006/2008 Health and Retirement Study was used to collect measures of self-reported instances of major discrimination and high-risk C-reactive protein (CRP), which was assayed from blood samples. Modified Poisson regression with robust standard errors was applied to estimate the prevalence ratios of self-reported instances of major discrimination, as it relates to high-risk CRP (CRP ≥ 22 kg/m2), and test whether this relationship varies by race/ethnicity. Respondents who experienced any instances of major discrimination had a higher likelihood of high-risk CRP (prevalence ratio [PR]: 1.14, 95% confidence interval [CI] = 1.07–1.22) than those who did not report experiencing any instances of major discrimination. This relationship was weaker for blacks than whites (PR: 0.81, 95% CI = 0.69–0.95).

Ethnic Identity and Local Politics: Study on Regional Head Election in Merauke Regency 2020

In the Regional Head Election of Merauke Regency, there was a contestation between tribes to win the candidate. In this contestation, there was a conflict between ethnic groups, namely the indigenous Papuans and migrants. This study aims to discuss the political struggle of the Merauke Regency to get political support through entities. This study uses an analytical approach to research from several emerging factors such as ethnicity. Data collection was obtained from online media reporting writers, interview websites, and research reports. This study found that identity cannot be separated in the Merauke district, where politics is considered to have its positives and negatives. The positive is to ensure that ethnic immigrants in the Merauke district respect indigenous peoples as owners of territory. The negative is that there is no right to become regent for the immigrant tribes in the Merauke district even though they have fulfilled the requirements as a leader. There are no rules regarding who has the right to lead in special autonomy in the Papua region. This case raises many things related to Papuans in Indonesia in particular.Pada Pemilihan Kepala daerah Kabupaten Merauke terjadi kontestasi antar suku untuk memenangkan kandidatnya. Pada kontestasi ini terjadi konflik antar suku yaitu suku asli papua dan suku pendatang Penelitian ini bertujuan membahas pertarungan politik kabupaten Merauke untuk mendapatkan dukungan politik melaui entnisitas. Penelitian ini menggunakan pendekatan kualitatif dengan penelitian analitis dari beberapa factor yang muncul seperti etnisitas. Pengumpulan data diperoleh penulis dari pemberitaan media online, website wawancara, dan laporan riset. Penelitian ini menemukan identitas tidak dapat terlepas di kabupaten Merauke dengan politik dianggap memiliki positif dan negatifnya. Positifnya adalah memastikan bahwa suku pendatang yang berada di kabupaten Merauke menghargai masyarakat adat sebagai pemilik atas wilayah. Negatifnya adalah tidak adanya hak untuk menjadi bupati bagi suku pendatang yang ada dikabupaten Merauke meskipun telah memenuhi syarat sebagai seorang pemimpin. Tidak adanya aturan terkait siapa yang berhak memimpin dalam otonomi khusus di wilayah papua. Kasus ini memunculkan banyak penafsiran terkait kekhususan orang-orang papua di Indonesia.

The Value and Interpretation of Race and Ethnicity Data in the Era of Global Migration: A Change Is in Order

Human migration and travel are leading to increasingly diverse populations throughout the world. Data collection practices need to adapt to these changes to expand our understanding of health disparities and to optimize the efforts to address health equity, particularly during public health emergencies such as the current COVID-19 pandemic. Race and ethnicity classifications in the United States have failed to evolve since the 1970s despite an increasingly diverse population. Current commonly collected categories are inadequate to accurately describe the economic, educational, and sociopolitical circumstances of different groups. Further, these categories lend little practical information to inform health policy. More predictive and actionable variables should be routinely collected to improve appropriateness and timeliness of health interventions. The immediate adoption of the collection of primary/preferred language and country of birth/origin by public health organizations, health systems, and clinical providers would be a concrete and valuable first step.

Promoting Representation Through Data: The Case For More Comprehensive Ethnicity Data In Australia

What if data used to inform knowledge is incomplete or false, leading to misunderstandings about the social world? In Australia, what is known about ethnic diversity is based on an outdated definition and inadequate measure of multiculturalism. This article explores how gaps in data can lead to and further entrench disempowerment. Using a sociodemographic approach, this paper examines the ways in which data can create and maintain poor representation; via collection, analysis and infrastructure. This paper demonstrates that what is counted matters for equality, and lays out what is necessary to help promote ethnic diversity through data collection.

A Systematic Review of Passing as Non-Autistic in Autism Spectrum Disorder

While long described in anecdotal accounts of the lived experiences of autistic individuals, the phenomenon of behaving in ways that appear inconsistent with the presence of autism (or passing as non-autistic; PAN) has recently seen a dramatic increase in scrutiny in the published scientific literature. Increased research attention has coincided with a proliferation of methods, definitions, measures, and population assumptions associated with PAN. To date, however, no review has sought to systematically identify and synthesize the literature on PAN. This systematic review reflects the state of the PAN literature as of May 2020. Ninety articles were screened, 66 were identified for evaluation, and 46 met inclusion criteria and were reliably coded for study characteristics and participant characteristics. Results reveal that the PAN literature includes a relatively even mix of qualitative, quantitative, and mixed-method studies, and that a variety of terms are used for PAN (with masking and camouflage being the most frequent). Sample sizes varied widely (from one to 832 participants), with 63.06% of participants being categorized as autistic. Nearly all studies reported methods for confirming autism diagnoses, with community and clinical diagnoses being most common. The majority of studies reported participant gender, with slightly more females included than males on average, but fewer than half of all studies compared PAN across genders. Nearly all studies reported participant age, demonstrating a wide range of 2 to 79 years, with a mean age of 23.85. Conversely, only 23.91% of studies provided participant race or ethnicity data. Nearly all studies formally or informally excluded participants with intellectual disability. Finally, measures of internalizing symptoms, which are often thought to be linked to PAN, were reported in only 17.4% of studies. Implications for gaps in understanding of PAN and future directions for the field are discussed.

Use of Zip Code Based Aggregate Indicators to Assess Race Disparities in COVID-19

Objective: In the first six months of the pandemic, information on race and ethnic­ity was missing for half of the US COVID-19 cases. Combining case ascertainment with census-based zip code indicators may iden­tify COVID-19 race-ethnicity disparities in the absence of individual-level data.Design: Ecological retrospective study for the period March-July 2020.Setting: Population-based investigation, Al­legheny County, Pennsylvania.Participants: All COVID-19 cases, adjusted for zip code area population, in the early period of the pandemic.Main Outcome Measures: Monthly COVID-19 incidence and requests for hu­man services by zip code level indicators of race-ethnicity and poverty.Results: In the early period of the pan­demic, COVID-19 incidence was higher in zip codes with a greater proportion of racial and ethnic minorities. Zip codes with the highest quartile of minority residents (>25.1% of population) had a COVID-19 incidence of 60.1 (95% CI: 51.7-68.5) per 10,000 in this period; zip codes with the lowest quartile of minority residents (<6.3%) had an incidence of 31.3 (95% CI: 14.4-48.2). Requests for human services during this period (volume of 211 calls and county services) confirm these disparities.Conclusion: Use of census-defined race-ethnicity proportions by zip code offers a way to identify disparities when individual race-ethnicity data are unavailable.Ethn Dis. 2021;31(3):399-406; doi:10.18865/ed.31.3.399