Journal articles on the topic '920503 Health Related to Specific Ethnic Groups'
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Jacobs, Simone, Carol J. Boushey, Adrian A. Franke, Yurii B. Shvetsov, Kristine R. Monroe, Christopher A. Haiman, Laurence N. Kolonel, Loic Le Marchand, and Gertraud Maskarinec. "A priori-defined diet quality indices, biomarkers and risk for type 2 diabetes in five ethnic groups: the Multiethnic Cohort." British Journal of Nutrition 118, no. 4 (August 28, 2017): 312–20. http://dx.doi.org/10.1017/s0007114517002033.
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AbstractDietary indices have been related to risk for type 2 diabetes (T2D) predominantly in white populations. The present study evaluated this association in the ethnically diverse Multiethnic Cohort and examined four diet quality indices in relation to T2D risk, homoeostatic model assessment-estimated insulin resistance (HOMA-IR) and biomarkers of dyslipidaemia, inflammation and adipokines. The T2D analysis included 166 550 white, African American, Native Hawaiian, Japanese American and Latino participants (9200 incident T2D cases). Dietary intake was assessed at baseline using a quantitative FFQ and T2D status was based on three self-reports and confirmed by administrative data. Biomarkers were assessed about 10 years later in a biomarker subcohort (n 10 060). Sex- and ethnicity-specific hazard ratios were calculated for the Healthy Eating Index-2010 (HEI-2010), the alternative HEI-2010 (AHEI-2010), the alternate Mediterranean diet score (aMED) and the Dietary Approaches to Stop Hypertension (DASH). Multivariable-adjusted means of biomarkers were compared across dietary index tertiles in the biomarker subcohort. The AHEI-2010, aMED (in men only) and DASH scores were related to a 10–20 % lower T2D risk, with the strongest associations in whites and the direction of the relationships mostly consistent across ethnic groups. Higher scores on the four indices were related to lower HOMA-IR, TAG and C-reactive protein concentrations, not related to leptin, and the DASH score was directly associated with adiponectin. The AHEI-2010 and DASH were directly related to HDL-cholesterol in women. Potential underlying biological mechanisms linking diet quality and T2D risk are an improved lipid profile and reduced systemic inflammation and, with regards to DASH alone, an improved adiponectin profile.
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Johnson, Kimberly J., and S. Hannah Lee. "Factors Associated With Volunteering Among Racial/Ethnic Groups: Findings From the California Health Interview Survey." Research on Aging 39, no. 5 (December 15, 2015): 575–96. http://dx.doi.org/10.1177/0164027515618243.
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The present study investigated how volunteering was influenced by individual resources and social capital among four racial/ethnic groups of adults aged 50 and older. The data came from the California Health Interview Survey, a statewide sample that includes non-Hispanic Whites ( n = 18,927), non-Hispanic Asians ( n = 2,428), non-Hispanic Blacks ( n = 1,265), and Hispanics ( n = 3,799). Logistic regression models of volunteering were estimated to explore the effects of human and social capital within and across the racial/ethnic groups. Compared to Whites, racial/ethnic minority adults volunteered less. Although education was a significant predictor of volunteering across all groups, the findings indicated group-specific factors related to human and social capital. Results showed similarities and differences associated with volunteer participation among diverse racial/ethnic groups. The findings underscore the importance of understanding ways of creating inclusive opportunities for civic engagement among an increasingly diverse population.
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Kastrup, M. C., and M. Schouler-Ocak. "Refugees and asylum seekers in Europe." Die Psychiatrie 12, no. 04 (October 2015): 241–46. http://dx.doi.org/10.1055/s-0038-1669606.
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Summary Background: European countries are the main receiving countries of immigrants such as refugees and asylum seekers belonging to ethnic minority groups due to a global increase in social and political instability as well as socio-economic conflicts. Both the number of ethnic minority groups and the number of people with mental disorders are therefore growing significantly. The current healthcare services are not prepared for this specific population of mentally ill immigrants or ethnic minority groups. Mental health care for immigrant patients is lacking in cultural competence and legislation related to access to and utilisation of health services varies from country to country. Aim: This article attempts to give an overview of the current mental health situation of ethnic minority groups, especially refugees and asylum seekers, in Europe.
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Emerson, Scott Daniel, Anita Minh, and Martin Guhn. "Ethnic density of regions and psychiatric disorders among ethnic minority individuals." International Journal of Social Psychiatry 64, no. 2 (December 18, 2017): 130–44. http://dx.doi.org/10.1177/0020764017747909.
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Background: Ethnic minorities form an increasingly large proportion of Canada’s population. Living in areas of greater ethnic density may help protect mental health among ethnic minorities through psychosocial pathways such as accessibility to culturally appropriate provision of mental health care, less discrimination and a greater sense of belonging. Mood and anxiety disorders are common psychiatric disorders. Aim: This study examined whether ethnic density of regions was related to mood and anxiety disorders among ethnic minorities in Canada. Method: Responses by ethnic minority individuals to the 2011–2014 administrations of the Canadian Community Health Survey ( n = 33,201) were linked to health region ethnic density data. Multilevel logistic regression was employed to model the odds of having mood and/or anxiety disorders associated with increasing region-level ethnic density and to examine whether sense of community belonging helped explain variance in such associations. Analyses were adjusted for individual-level demographic factors as well as region-level socio-economic factors. Results: Higher ethnic density related to lower odds of mood and/or anxiety disorders for Canadian-born (but not foreign-born) ethnic minorities. Sense of community belonging did not help explain such associations, but independently related to lower odds of mood and/or anxiety disorders. These findings remained after adjusting for regional population density and after excluding (rural/remote) regions of very low ethnic density. Conclusion: Ethnic density of regions in Canada may be an important protective factor against mental illness among Canadian-born ethnic minorities. It is important to better understand how, and for which specific ethno-cultural groups, ethnic density may influence mental health.
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Ajilore, Olugbenga, and Fafanyo Asiseh. "Ethnic Differences in the Influence of Peers on Weight-Related Behavior." Review of Black Political Economy 45, no. 1 (March 2018): 69–90. http://dx.doi.org/10.1177/0034644618770759.
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There is no doubt that peers have an influence on individual weight gain. This article seeks to find if the influence of peers is consistent across ethnic groups or whether certain groups are influenced more by their peers than other groups. Studies in the peer effects literature primarily focus on identifying the direct impact of peers on individual behavior. The difficulty in isolating the direct behavioral effect of peers on individual’s behavior is that there are several mechanisms driving the correlation between individual’s outcomes and peer group outcomes. We model peer effects using an identification strategy that exploits network structure and incorporates group-specific fixed effects to control for confounding effects. Using data taken from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we find that peer effects exist across all genders and ethnic groups, but it is more prevalent for Hispanic youth with respect to sedentary activities. The findings also show that having male peers is associated with lower exercise for both young males and young females. The implications of this study are that reducing obesity through encouraging healthy behaviors should not only focus on individual factors but also on the role of peers as well as gender and ethnic differences in the design of such programs.
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Magadi, John Paul, and Monica Akinyi Magadi. "Ethnic inequalities in patient satisfaction with primary health care in England: Evidence from recent General Practitioner Patient Surveys (GPPS)." PLOS ONE 17, no. 12 (December 21, 2022): e0270775. http://dx.doi.org/10.1371/journal.pone.0270775.
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Aims and objectives This paper aims to improve understanding of factors that contribute to persistent ethnic disparities in patient satisfaction in England. The specific objectives are to (i) examine ethnic differences in patient satisfaction with their primary care in England; and (ii) establish factors that contribute to ethnic differences in patient satisfaction. Data and methods The study is based on secondary analysis of recent General Practitioner Patient Survey (GPPS) datasets of 2019, 2020 and 2021. Descriptive bivariate analysis was used to examine ethnic differences in patient satisfaction across the three years. This was followed with multilevel linear regression, with General Practice (GP) at level-1 and Clinical Commissioning Group (CCG) at level-2 to identify factors contributing to ethnic differences in patient satisfaction. Results The findings show consistent negative correlations between the proportion of patients reporting good (very or fairly good) overall experience and each of the ethnic minority groups. Further examination of the distribution of patient satisfaction by ethnicity, based on combined ethnic minority groups, depicted a clear negative association between ethnic minority group and patient satisfaction at both GP and CCG levels. Multilevel regression analysis identified several service-related factors (especially ease of using GP website and being treated with care and concern) that largely explained the ethnic differences in patient satisfaction. Of all factors relating to patient characteristics considered in the analysis, none was significant after controlling for GP service-related factors. Conclusions Ethnic minority patients in England continue to consistently report lower satisfaction with their primary health care in recent years. This is largely attributable to supply (service related) rather than demand (patient characteristics) factors. These findings have important implications for health care system policy and practice at both GP and CCG levels in England.
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Kroll, Mary E., Jennifer J. Kurinczuk, Jennifer Hollowell, Alison Macfarlane, Yangmei Li, and Maria A. Quigley. "Ethnic and socioeconomic variation in cause-specific preterm infant mortality by gestational age at birth: national cohort study." Archives of Disease in Childhood - Fetal and Neonatal Edition 105, no. 1 (May 23, 2019): 56–63. http://dx.doi.org/10.1136/archdischild-2018-316463.
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ObjectiveTo describe ethnic and socioeconomic variation in cause-specific infant mortality of preterm babies by gestational age at birth.DesignNational birth cohort study.SettingEngland and Wales 2006–2012.SubjectsSingleton live births at 24–36 completed weeks’ gestation (n=256 142).Outcome measuresAdjusted rate ratios for death in infancy by cause (three groups), within categories of gestational age at birth (24–27, 28–31, 32–36 weeks), by baby’s ethnicity (nine groups) or area deprivation score (Index of Multiple Deprivation quintiles).ResultsAmong 24–27 week births (5% of subjects; 47% of those who died in infancy), all minority ethnic groups had lower risk of immaturity-related death than White British, the lowest rate ratios being 0.63 (95% CI 0.49 to 0.80) for Black Caribbean, 0.74 (0.64 to 0.85) for Black African and 0.75 (0.60 to 0.94) for Indian. Among 32–36 week births, all minority groups had higher risk of death from congenital anomalies than White British, the highest rate ratios being 4.50 (3.78 to 5.37) for Pakistani, 2.89 (2.10 to 3.97) for Bangladeshi and 2.06 (1.59 to 2.68) for Black African; risks of death from congenital anomalies and combined rarer causes (infection, intrapartum conditions, SIDS and unclassified) increased with deprivation, the rate ratios comparing the most with the least deprived quintile being, respectively, 1.54 (1.22 to 1.93) and 2.05 (1.55 to 2.72). There was no evidence of socioeconomic variation in deaths from immaturity-related conditions.ConclusionsGestation-specific preterm infant mortality shows contrasting ethnic patterns of death from immaturity-related conditions in extremely-preterm babies, and congenital anomalies in moderate/late-preterm babies. Socioeconomic variation derives from congenital anomalies and rarer causes in moderate/late-preterm babies. Future research should examine biological origins of extremely preterm birth.
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Korzenny, Felipe, Joyce McClure, and Barbara Rzyttki. "Ethnicity, Communication, and Drugs." Journal of Drug Issues 20, no. 1 (January 1990): 87–98. http://dx.doi.org/10.1177/002204269002000106.
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This study explored the degree to which different patterns of communication media exposure are associated with attitudes and behaviors related to drug usage, across four main diverse ethnic groups in the U.S.: whites, blacks, Hispanics and Asians. It was expected that members of these different groups would exhibit diverse patterns of correlation between their media habits and their drug attitudes and behaviors. By means of a quota sample, 171 personal interviews were completed with 45 white, 42 Hispanic, 43 Asian, and 41 black respondents in the Bay Area of San Francisco in the Fall of 1986. Of particular importance was that television exposure, Rock exposure, print and interpersonal channels behaved differently across ethnic groups. The most striking differences occurred when examining the associations between exposure to specific television shows and attitudes towards drugs and adventurous experimentation. Black and white respondents exhibited sharp contrasts which deserve careful scrutiny and understanding.
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Desai, Sheila, Mary Huynh, and Heidi E. Jones. "Differences in Abortion Rates between Asian Populations by Country of Origin and Nativity Status in New York City, 2011–2015." International Journal of Environmental Research and Public Health 18, no. 12 (June 8, 2021): 6182. http://dx.doi.org/10.3390/ijerph18126182.
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Despite the size of the Asian population in New York City (NYC) and the city’s robust abortion surveillance system, abortion-related estimates for this population have not been calculated previously. This study examined the use of abortion services among specific Asian groups in NYC from 2011–2015. Using NYC surveillance data, we estimated abortion rates for Asians, disaggregated by five country of origin groups and nativity status, and for other major racial/ethnic groups. We compared rates between groups and over time. From 2014–2015, the abortion rate for Asian women in NYC was 12.6 abortions per 1000 women aged 15–44 years, lower than the rates for other major racial/ethnic groups. Among country of origin groups, Indian women had the highest rate (30.5 abortions per 1000 women), followed by Japanese women (17.0), Vietnamese women (13.0), Chinese women (8.8), and Korean women (5.1). Rates were higher for U.S.-born Asian groups compared to foreign-born groups, although the differential varied by country of origin. The abortion rate declined or remained steady for nearly all Asian groups from 2011–2015. These findings reinforce the importance of disaggregating data on this population at multiple levels and begin to provide much-needed evidence on the use of abortion services among Asian groups.
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Kroll, Mary E., Maria A. Quigley, Jennifer J. Kurinczuk, Nirupa Dattani, Yangmei Li, and Jennifer Hollowell. "Ethnic variation in unexplained deaths in infancy, including sudden infant death syndrome (SIDS), England and Wales 2006–2012: national birth cohort study using routine data." Journal of Epidemiology and Community Health 72, no. 10 (July 4, 2018): 911–18. http://dx.doi.org/10.1136/jech-2018-210453.
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BackgroundUnexplained deaths in infancy comprise ‘sudden infant death syndrome’ (SIDS) and deaths without ascertained cause. They are typically sleep-related, perhaps triggered by unsafe sleep environments. Preterm birth may increase risk, and varies with ethnicity. We aimed to compare ethnic-specific rates of unexplained infant death, explore sociodemographic explanations for ethnic variation, and examine the role of preterm birth.MethodsWe analysed routine data for 4.6 million live singleton births in England and Wales 2006–2012, including seven non-White ethnic groups ranging in size from 29 313 (Mixed Black-African-White) to 180 265 (Pakistani). We calculated rates, birth-year-adjusted ORs, and effects of further adjustments on the χ2 for ethnic variation.ResultsThere were 1559 unexplained infant deaths. Crude rates per 1000 live singleton births were as follows: 0.1–0.2 for Indian, Bangladeshi, Pakistani, White Non-British, Black African; 0.4 for White British; 0.6–0.7 for Mixed Black-African-White, Mixed Black-Caribbean-White, Black Caribbean. Birth-year-adjusted ORs relative to White British ranged from 0.38 (95% CI 0.24 to 0.60) for Indian babies to 1.73 (1.21 to 2.47) for Black Caribbean (χ2(10 df)=113.6, p<0.0005). Combined adjustment for parents’ marital/registration status and mother’s country of birth (UK/non-UK) attenuated the ethnic variation. Adjustments for gestational age at birth, maternal age and area deprivation made little difference.ConclusionSubstantial ethnic disparity in risk of unexplained infant death exists in England and Wales. Apparently not attributable to preterm birth or area deprivation, this may reflect cultural differences in infant care. Further research into infant-care practices in low-risk ethnic groups might enable more effective prevention of such deaths in the general population.
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Cruz, I., C. Serna, M. Rué, J. Real, L. Galván, and J. Pifarré. "Comparative exposure to antipsychotic medications in immigrant and native-born populations of a Spanish health region." European Psychiatry 27, no. 7 (October 2012): 477–82. http://dx.doi.org/10.1016/j.eurpsy.2011.02.007.
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AbstractBackgroundRaised rates of psychoses among ethnic minorities have been reported. Exposure to antipsychotic medications can give information on mental illness management and ethnic-related differences.ObjectiveTo compare exposure to antipsychotic medications in immigrant and native-born populations in Spain.MethodDescriptive cross-sectional study of the dispensation of antipsychotic medications to the population aged 15 to 64 years, in a Spanish Health Region during 2008.Results1.9% of the native-born population was exposed to antipsychotic medications as compared to 0.4% of the immigrant population. Native-born women were exposed from 1.8 to 5.3 times more and native-born men from 3.6 to 6.3 times more than immigrants of the same gender. The least exposed were persons from Eastern Europe and men from sub-Saharan Africa. Active ingredients prescribed were similar between the two groups. Of the immigrant group, 15.7% were admitted to a psychiatric ward as compared to 6.4% of the native-born population. In the former, non-specific diagnoses were predominant.ConclusionsAll immigrant groups had lower exposure to antipsychotic medications, were admitted to inpatient care more often and had less specific diagnoses. Both diagnostic processes and adherence to treatment need improvement in the regional immigrant population.
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Akutsu, Phillip, Garyn Tsuru, and Joyce Chu. "Pre-Intake Attrition or Non-Attendance of Intake Appointments at an Ethnic-Specific Mental Health Program for Asian American Children and Adolescents." AAPI Nexus Journal: Policy, Practice, and Community 8, no. 2 (2010): 39–61. http://dx.doi.org/10.36650/nexus8.2_39-61_akutsuetal.
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This study examines the relationship of client demographic, clinical, client-therapist match, and service program factors to the rate of pre-intake attrition or the non-attendance of intake appointments for 236 Asian American children and adolescents (18 years and younger) at an Asian-oriented ethnic-specific mental health program. The results showed that urgency status or the need for the earliest intake appointment, ethnic match with the prescreening interviewer, and the assignment of the prescreening interviewer as the intake therapist were significantly related to attendance of intake appointments for Asian American children and adolescents. In contrast, older age was found to reduce the likelihood of intake attendance for Asian American youth clients. Specific implications of these results to program evaluation and service improvements in mental health care delivery to Asian American youth groups will be discussed.
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Van Os, J., D. J. Castle, N. Takei, G. Der, and R. M. Murray. "Psychotic illness in ethnic minorities: clarification from the 1991 census." Psychological Medicine 26, no. 1 (January 1996): 203–8. http://dx.doi.org/10.1017/s0033291700033845.
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SynopsisAge and sex-adjusted first admission rates for operationally-defined schizophrenia and other non-affective psychosis in different ethnic groups were calculated over the period 1988–1992 in a defined catchment area in South London. Standardized rates for schizophrenia, corrected for age- and gender-related under-reporting in the 1991 census and a 20% underestimate of the size of the ethnic minority populations in the area, were not only higher in the Afro-Caribbean group (SMR: 3·1; 95% Cl: 2·0–4·7), but also in the African group (SMR: 4·2; 95% Cl: 2·8–6·2). It was further found that higher rates were not specific to schizophrenia. These findings suggest that some common factor associated with ethnic minority membership is important in producing an excess of psychotic illness.
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Zahodne, Laura. "BIOPSYCHOSOCIAL RISK AND RESILIENCE PATHWAYS IN DEMENTIA INEQUALITIES." Innovation in Aging 6, Supplement_1 (November 1, 2022): 113. http://dx.doi.org/10.1093/geroni/igac059.451.
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Abstract In the United States, racial/ethnic inequalities in Alzheimer's disease and related dementias persist even after controlling for socioeconomic factors and physical health. Persistent and unexplained disparities suggest: (1) there are unrecognized dementia risk factors that are socially patterned and/or (2) known dementia risk factors exhibit differential impact across social groups. This talk will present data from multiple longitudinal studies of brain and cognitive aging to support each possibility. On average, marginalized racial/ethnic groups are more likely than non-Latinx Whites to experience structural and interpersonal discrimination, social and economic constraints, as well as barriers to accessing high quality education. However, these same groups also show evidence of greater psychosocial resilience that is linked to better late-life cognitive health. This talk will demonstrate how specific psychosocial factors can contribute to or offset dementia disparities, illustrate major challenges to this work, and introduce new data collection efforts to advance the field.
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Revollo, H. W., A. Qureshi, F. Collazos, and M. Casas. "The impact of social context on the acculturative process: acculturative stress in Latin American immigrants." European Psychiatry 26, S2 (March 2011): 474. http://dx.doi.org/10.1016/s0924-9338(11)72181-2.
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IntroductionThe relationship between immigration and mental health may in part be affected by factors related to social context in general and in relation to specific ethnic groups in specific social contexts. A growing body of research is exploring the impact of neighborhood context on the well-being of immigrants. The specifics, however, have yet to be identified.AimTo analyze the impact of social context on stress and acculturative stress in a hospitalised Latin American immigrant sample.MethodsThe study was part of a larger project concerning stress, coping, and psychosocial well being in Latin American immigrants hospitalised in both internal medicine and obstetrics in a large public hospital in Barcelona (Spain). 290 participants were evaluated with the PSS-10 for general stress, the BISS for acculturative stress and a sociodemographic questionnaire elaborated ad hoc for social context.ResultsNeighborhood socioeconomic level is related to general stress and acculturative stress. A lower socioeconomic level is associated with higher levels of stress and acculturative stress. High levels of ethnic density of Latin American immigrants is moderately associated with lower levels of homesickenss and intercultural contact stress, but are not related with perceived discrimination.ConclusionsSocial context is an important factor that should be considered in the acculturative process of Latin American immigrants and its impact on their mental health status. A low socioeconomic neighborhood level increases levels of stress and acculturative stress, increasing the risk of psychosocial distress.Own group ethnic density would appear to function as a protective factor.
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Weinberger, Andrea H., Marc L. Steinberg, Sarah D. Mills, Sarah S. Dermody, Jaimee L. Heffner, Amanda Y. Kong, Raina D. Pang, and Rachel L. Rosen. "Assessing Sex, Gender Identity, Sexual Orientation, Race, Ethnicity, Socioeconomic Status, and Mental Health Concerns in Tobacco Use Disorder Treatment Research: Measurement Challenges and Recommendations From a Society for Research on Nicotine and Tobacco Pre-conference Workshop." Nicotine & Tobacco Research 24, no. 5 (October 8, 2021): 643–53. http://dx.doi.org/10.1093/ntr/ntab201.
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Abstract This paper reports on topics discussed at a Society for Research on Nicotine and Tobacco pre-conference workshop at the 2019 annual Society for Research on Nicotine and Tobacco meeting. The goal of the pre-conference workshop was to help develop a shared understanding of the importance of several tobacco-related priority groups in tobacco use disorder (TUD) treatment research and to highlight challenges in measurement related to these groups. The workshop focused on persons with minoritized sex, gender identity, and sexual orientation identities; persons with minoritized racial and ethnic backgrounds; persons with lower socioeconomic status (SES); and persons with mental health concerns. In addition to experiencing commercial tobacco-related health disparities, these groups are also underrepresented in tobacco research, including TUD treatment studies. Importantly, there is wide variation in how and whether researchers are identifying variation within these priority groups. Best practices for measuring and reporting sex, gender identity, sexual orientation, race, ethnicity, SES, and mental health concerns in TUD treatment research are needed. This paper provides information about measurement challenges when including these groups in TUD treatment research and specific recommendations about how to measure these groups and assess potential disparities in outcomes. The goal of this paper is to encourage TUD treatment researchers to use measurement best practices in these priority groups in an effort to conduct meaningful and equity-promoting research. Increasing the inclusion and visibility of these groups in TUD treatment research will help to move the field forward in decreasing tobacco-related health disparities. Implications: Tobacco-related disparities exist for a number of priority groups including, among others, women, individuals with minoritized sexual and gender identities, individuals with minoritized racial and ethnic backgrounds, individuals with lower SES, and individuals with mental health concerns. Research on TUD treatments for many of these subgroups is lacking. Accurate assessment and consideration of these subgroups will provide needed information about efficacious and effective TUD treatments, about potential mediators and moderators, and for accurately describing study samples, all critical elements for reducing tobacco-related disparities, and improving diversity, equity, and inclusion in TUD treatment research.
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Weinberger, Andrea H., Marc L. Steinberg, Sarah D. Mills, Sarah S. Dermody, Jaimee L. Heffner, Amanda Y. Kong, Raina D. Pang, and Rachel L. Rosen. "Assessing Sex, Gender Identity, Sexual Orientation, Race, Ethnicity, Socioeconomic Status, and Mental Health Concerns in Tobacco Use Disorder Treatment Research: Measurement Challenges and Recommendations From a Society for Research on Nicotine and Tobacco Pre-conference Workshop." Nicotine & Tobacco Research 24, no. 5 (October 8, 2021): 643–53. http://dx.doi.org/10.1093/ntr/ntab201.
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Abstract This paper reports on topics discussed at a Society for Research on Nicotine and Tobacco pre-conference workshop at the 2019 annual Society for Research on Nicotine and Tobacco meeting. The goal of the pre-conference workshop was to help develop a shared understanding of the importance of several tobacco-related priority groups in tobacco use disorder (TUD) treatment research and to highlight challenges in measurement related to these groups. The workshop focused on persons with minoritized sex, gender identity, and sexual orientation identities; persons with minoritized racial and ethnic backgrounds; persons with lower socioeconomic status (SES); and persons with mental health concerns. In addition to experiencing commercial tobacco-related health disparities, these groups are also underrepresented in tobacco research, including TUD treatment studies. Importantly, there is wide variation in how and whether researchers are identifying variation within these priority groups. Best practices for measuring and reporting sex, gender identity, sexual orientation, race, ethnicity, SES, and mental health concerns in TUD treatment research are needed. This paper provides information about measurement challenges when including these groups in TUD treatment research and specific recommendations about how to measure these groups and assess potential disparities in outcomes. The goal of this paper is to encourage TUD treatment researchers to use measurement best practices in these priority groups in an effort to conduct meaningful and equity-promoting research. Increasing the inclusion and visibility of these groups in TUD treatment research will help to move the field forward in decreasing tobacco-related health disparities. Implications: Tobacco-related disparities exist for a number of priority groups including, among others, women, individuals with minoritized sexual and gender identities, individuals with minoritized racial and ethnic backgrounds, individuals with lower SES, and individuals with mental health concerns. Research on TUD treatments for many of these subgroups is lacking. Accurate assessment and consideration of these subgroups will provide needed information about efficacious and effective TUD treatments, about potential mediators and moderators, and for accurately describing study samples, all critical elements for reducing tobacco-related disparities, and improving diversity, equity, and inclusion in TUD treatment research.
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Milovanska-Farrington, Stefani. "The Effect of COVID-19 as an Economic Shock on the Gender and Ethnic Gap in Labour Market Outcomes." Studies in Microeconomics 9, no. 2 (October 11, 2021): 227–55. http://dx.doi.org/10.1177/23210222211046411.
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With more than 29 million confirmed cases of COVID-19 in the USA and 119 million cases worldwide, the pandemic has affected companies, households and the global economy. We explore the effect of the economic shock which resulted from this specific health event on labour market outcomes, and the changes in labour market disparities between ethnic groups and genders. The results provide evidence of an adverse effect of COVID-19 on labour market outcomes of all demographic groups, a widening gap between the employment prospects of minorities and whites, but no change in the earnings gaps between ethnic groups. We also do not find a deterioration of the differentials between genders, except the increase in the difference in the duration of unemployment between women and men with children. The findings have implications related to the priorities of policy decision-makers when implementing policies to combat ethnic and gender gaps in the labour market. JEL Classification: J70, J71, J01, J15, J23
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Dewes, Ofa, Robert Scragg, and C. Raina Elley. "The association between church attendance and obesity-related lifestyle behaviours among New Zealand adolescents from different Pacific ethnic groups." Journal of Primary Health Care 5, no. 4 (2013): 290. http://dx.doi.org/10.1071/hc13290.
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INTRODUCTION: Obesity is disproportionately prevalent among Pacific population groups in New Zealand. Lifestyle behaviours of excessive consumption of high energy, unhealthy foods and inadequate physical activity are risk factors for obesity that can be modified. AIM: To identify and describe the risk factors for and protective factors against obesity among Pacific Island (PI) adolescents who attend church and compare them with PI adolescents who do not attend church. METHODS: We investigated the lifestyle behaviours of 2495 PI adolescents at six secondary schools in Auckland, New Zealand (NZ), 77% of whom attend a church or other place of worship. The cross-sectional survey was undertaken in 2005. Structured individual interviews and anthropometric measurements were undertaken. RESULTS: Church attendees had a higher mean body mass index (BMI) compared with non-attendees (BMI 27.4 vs BMI 26.6), adjusted for age, gender and PI ethnicity (p=0.01). The weight status of attendees was associated with less healthy breakfast and lunch sources, lower levels of physical activity, and limited knowledge of the risk factors for obesity (p<0.05) DISCUSSION: Culturally appropriate and ethnic-specific weight management interventions, including monitoring and policy development programmes, are needed urgently to change pro-obesity lifestyle behaviours in PI adolescents and to avoid the burgeoning future obesity-related illnesses that would otherwise result. The church may be an important venue and change agent in the prevention of obesity for this population. KEYWORDS: Adolescents; church; health behaviors; obesity; Oceanic ancestry group; Pacific Islands
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Den, V. G. "FOOD CULTURE OF LITTLE INDIGENOUS PEOPLES AS A SOURCE OF FOOD ECOLOGY IN THE FAR EASTERN REGION." Humanities And Social Studies In The Far East 18, no. 3 (2021): 74–78. http://dx.doi.org/10.31079/1992-2868-2021-18-3-74-78.
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The article analyzes the issues related to the nutritional ecology of the small indigenous peoples of the Far East of Russia. Research showed that nutrition is the most specific aspect of the culture of various ethnic groups. It was found that food, including fresh products of plant and animal origin, simultaneously serves as a source of energy replenishment for life support and health maintenance
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Landman, J., and JK Cruickshank. "A review of ethnicity, health and nutrition-related diseases in relation to migration in the United Kingdom." Public Health Nutrition 4, no. 2b (April 2001): 647–57. http://dx.doi.org/10.1079/phn2001148.
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AbstractObjectives:To identify lessons from and gaps in research on diet-disease links among former migrants in the United Kingdom (UK).Results:Migrant status and self-identified ethnicity do not match so these terms mask differences in social, nutritional and health status within and between population groups. Some former migrants differ in causes of death from the general population, e.g.: fewer coronary heart disease deaths among Caribbean-born; fewer cancer deaths among Caribbean, South Asian- and East African-born adults. Irish- and Scottish-born have higher mortality from all causes. Experience of risk factors differ also, e.g.: higher prevalences of hypertension and diabetes in Caribbean- and South Asian-born adults than representative samples of the general population; obesity and raised waist-hip circumference ratios in South Asian, African-Caribbean and some Irish-born adults. Former migrants experience long-term disadvantage, associated with more self-defined illness and lower reported physical activity. Nutrient intake data from the few, recent, small-scale studies must be interpreted with caution due to methodological diversity. However, second generation offspring of former migrants appear to adopt British dietary patterns, increasing fat and reducing vegetable, fruit and pulse consumption compared with first generation migrants.Conclusions:There is insufficient evidence on why some former migrants but not others experience lower specific mortality than the general population. Dietary intake variations provide important clues particularly when examined by age and migration status. Majority ethnic and younger migrant groups could raise and sustain high fruit and vegetable intakes but lower proportions of fat, by adopting many dietary practices from older migrants. Objective measures of physical activity and longitudinal studies of diets among different ethnic groups are needed to explain diversity in health outcomes and provide for evidence-based action.
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Tomasi, Ana-Marija, Shameran Slewa-Younan, Renu Narchal, and Pilar Rioseco. "Professional Mental Health Help-Seeking Amongst Afghan and Iraqi Refugees in Australia: Understanding Predictors Five Years Post Resettlement." International Journal of Environmental Research and Public Health 19, no. 3 (February 8, 2022): 1896. http://dx.doi.org/10.3390/ijerph19031896.
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The current longitudinal study sought to identify predictors of professional help seeking for mental health problems amongst Afghan and Iraqi refugees five years post-settlement utilising the Building a New Life in Australia dataset (BNLA). Data were collected via face-to-face or phone interviews across five waves from October 2013 to March 2018. Afghan and Iraqi born refugees numbering 1180 and over 18 years of age with a permanent humanitarian visa were included in this study. The results suggest differences in help-seeking behaviors amongst the two ethnic groups. Amongst the Afghan sample, older adults with high psychological distress were more likely to seek help, while living in regional Australia, not requiring interpreters, and knowing how to find out information about government services were related to lower likelihood of help-seeking. Within the Iraqi sample, poor overall health and knowing how to find out about services were related to a greater likelihood of help-seeking, while fewer financial hardships decreased the likelihood of help-seeking. Amongst those with probable PTSD, disability was associated with an increased likelihood of help-seeking while experiencing fewer financial hardships and living in regional Australia resulted in a lower likelihood of help-seeking in this group. These results have implications for promotional material and mental health interventions, suggesting that more integrated services tailored to specific characteristics of ethnic groups are needed.
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Khamis, Zahraa I., Xiaodong Pang, Zihan Cui, Qing-Xiang Amy Sang, and Jinfeng Zhang. "Cytochrome P450-2D6: A novel biomarker in liver cancer health disparity." PLOS ONE 16, no. 10 (October 1, 2021): e0257072. http://dx.doi.org/10.1371/journal.pone.0257072.
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Liver cancer morbidity and mortality rates differ among ethnic groups. In the United States, the burden of liver cancer in Asian Americans (AS) is higher compared to Caucasian Americans (CA). Research on liver cancer health disparities has mainly focused on environmental and socioeconomic factors yet has ignored the genotypic differences among various racial/ethnic groups. This lack of molecular level understanding has hindered the development of personalized medical approaches for liver cancer treatment. To understand the genetic heterogeneity of liver cancer between AS and CA, we performed a systematic analysis of RNA-seq data of AS and CA patients from The Cancer Genome Atlas (TCGA). We used four differential gene expression analysis packages; DESeq2, limma, edgeR, and Superdelta2, to identify the differentially expressed genes. Our analysis identified cytochrome P450-2D6 enzyme (CYP2D6) as the gene with the greatest differential expression with higher levels in AS compared to CA. To scrutinize the underlying mechanism of CYP2D6, Ingenuity Pathway Analysis (IPA) and Cytoscape were conducted and found hepatocyte nuclear factor-4α (HNF4A) and interleukin-6 (IL6) in direct association with CYP2D6. IL6 is downregulated in AS compared to CA, while HNF4A is not significantly different. Herein, we report that CYP2D6 may serve as a putative biomarker in liver cancer health disparities. Its negative association with IL6 proclaims an intricate relationship between CYP2D6 and inflammation in the ethnic differences seen in AS and CA liver cancer patients. The goal of the present study was to understand how genetic factors may contribute to the interethnic variability of liver cancer prevalence and outcomes in AS and CA patients. Identifying ethnic-specific genes may help ameliorate detection, diagnosis, surveillance, and treatments of liver cancer, as well as reduce disease-related incidence and mortality rates in the vulnerable population.
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Im, Eun-Ok, Sun Ju Chang, Wonshik Chee, and Eunice Chee. "Attitudes of women in midlife to web-based interventions for promoting physical activity." Journal of Telemedicine and Telecare 18, no. 7 (October 2012): 419–22. http://dx.doi.org/10.1258/jtt.2012.120514.
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We explored the attitudes of women at midlife to web-based interventions for promoting physical activity. 145 women volunteered to participate in one of four online forums. The forums were for four major racial/ethnic groups. 90 volunteers were recruited for the online forums (29 Whites, 23 Hispanics, 21 African Americans, and 17 Asians). Two sets of topics on attitudes to physical activity and racial/ethnic contexts were used. Each topic had some introductory questions and related prompts, and these were posted on the online forum sites in a serial fashion during the six-month period. We used a thematic analysis. Four major themes emerged: (1) ‘a matter of the source of the information’; (2) ‘I can pace myself’; (3) ‘lack of interpersonal interactions’; and (4) ‘culture-specificity and low cost.’ The women in all ethnic groups thought that the source of the information was much more important than the medium of the information (e.g. web-based, booklet or face-to-face). They liked the self-controllability in web-based interventions. They preferred web-based interventions to other types of interventions because of easy accessibility, but they were concerned about lack of interpersonal interaction. None of the White or African American women indicated the need for culture-specificity in web-based interventions, but Hispanic and Asian women indicated that culture-specific interventions should be provided. Web-based interventions appear to have several advantages over conventional approaches to promoting physical activity.
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Gerassi, Lara B., and Stephanie Skinkis. "An Intersectional Content Analysis of Inclusive Language and Imagery Among Sex Trafficking-Related Services." Violence and Victims 35, no. 3 (June 1, 2020): 400–417. http://dx.doi.org/10.1891/vv-d-18-00204.
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The extent to which services are available for and inclusive of diverse survivors of sex trafficking remains understudied. This content analysis in a U.S. Midwestern region designated as a hub explores the availability of sex trafficking-specific organizations and perceived inclusivity of organizations regarding diverse identities (including Lesbian, Gay, Bisexual, Trans, or Queer [LGBTQ]+ and racial/ethnic groups). 186 regional organizations were analyzed, of which only 7 were trafficking specific. Of nontrafficking organizations (n = 179), less than 12% (n = 21) stated that they provided services to individuals who identify as LGBTQ+, 6% (n = 10) included LGBTQ+ symbols/language, 36% (n = 65) featured perceived People of Color (POC). Lack of inclusive language, photos, and symbols may contribute to trafficking survivors who identify as POC, English language learners, or as LGBTQ+ feeling as though services do not apply to them. Implications are discussed.
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Cheadle, Jacob E., Bridget J. Goosby, Joseph C. Jochman, Cara C. Tomaso, Chelsea B. Kozikowski Yancey, and Timothy D. Nelson. "Race and ethnic variation in college students’ allostatic regulation of racism-related stress." Proceedings of the National Academy of Sciences 117, no. 49 (November 23, 2020): 31053–62. http://dx.doi.org/10.1073/pnas.1922025117.
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Racism-related stress is thought to contribute to widespread race/ethnic health inequities via negative emotion and allostatic stress process up-regulation. Although prior studies document race-related stress and health correlations, due to methodological and technical limitations, they have been unable to directly test the stress-reactivity hypothesis in situ. Guided by theories of constructed emotion and allostasis, we developed a protocol using wearable sensors and daily surveys that allowed us to operationalize and time-couple self-reported racism-related experiences, negative emotions, and an independent biosignal of emotional arousal. We used data from 100 diverse young adults at a predominantly White college campus to assess racism-related stress reactivity using electrodermal activity (EDA), a biosignal of sympathetic nervous system activity. We find that racism-related experiences predict both increased negative emotion risk and heightened EDA, consistent with the proposed allostatic model of health and disease. Specific patterns varied across race/ethnic groups. For example, discrimination and rumination were associated with negative emotion for African American students, but only interpersonal discrimination predicted increased arousal via EDA. The pattern of results was more general for Latinx students, for whom interpersonal discrimination, vicarious racism exposure, and rumination significantly modulated arousal. As with Latinx students, African students were particularly responsive to vicarious racism while 1.5 generation Black students were generally not responsive to racism-related experiences. Overall, these findings provide support for allostasis-based theories of mental and physical health via a naturalistic assessment of the emotional and sympathetic nervous system responding to real-life social experiences.
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Hata, Janice, and Adam Burke. "A Systematic Review of Racial and Ethnic Disparities in Maternal Health Outcomes among Asians/Pacific Islanders." Asian/Pacific Island Nursing Journal 5, no. 3 (December 7, 2020): 139–52. http://dx.doi.org/10.31372/20200503.1101.
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Efforts to improve women’s health and to reduce maternal mortality worldwide have led to a notable reduction in the global maternal mortality ratio (MMR) over the past two decades. However, it is clear that maternal health outcomes are not equitable, especially when analyzing the scope of maternal health disparities across “developed” and “underdeveloped” nations. This study evaluates recent MMR scholarship with a particular focus on the racial and ethnic divisions that impact on maternal health outcomes. The study contributes to MMR research by analyzing the racial and ethnic disparities that exist in the US, especially among Asian and Pacific Islander (API) subgroups. The study applies exclusionary criteria to 710 articles and subsequently identified various maternal health issues that disproportionately affect API women living in the US. In applying PRISMA review guidelines, the study produced 22 peer-reviewed articles that met inclusionary and exclusionary criteria for this review. The data analysis identified several maternal health foci: obstetric outcomes, environmental exposure, obstetric care and quality measures, and pregnancy-related measures. Only eight of the 22 reviewed studies disaggregated API populations by focusing on specific subgroups of APIs, which signals a need to re-conceptualize marginalized API communities’ inclusion in health care systems, to promote their equitable access to care, and to dissolve health disparities among racial and ethnic divides. Several short- and long-term initiatives are recommended to develop and implement targeted health interventions for API groups, and thus provide the groundwork for future empirically driven research among specific API subgroups in the US.
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Bhanu, Cini, Dipesh P. Gopal, Kate Walters, and Umar A. R. Chaudhry. "Vaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review." PLOS Medicine 18, no. 11 (November 4, 2021): e1003826. http://dx.doi.org/10.1371/journal.pmed.1003826.
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Background Older adults from minority ethnic backgrounds are at increased risk of contracting COVID-19 and developing severe infection and have increased risk of mortality. Whilst an age-based vaccination approach prioritising older groups is being implemented worldwide, vaccine hesitancy is high amongst minority ethnic groups. Methods and findings We conducted a systematic review and convergent synthesis to systematically examine perceptions of vaccinations amongst older adults from minority ethnic backgrounds. We included studies that reported on perceptions, beliefs, and attitudes towards vaccinations in older adults aged ≥65 years from a minority ethnic background. We excluded studies of vaccinations in investigation or development, studies focused on specific medical conditions, studies where ethnic background or age group was unidentifiable, systematic reviews, editorials, and conference abstracts. We searched MEDLINE, Embase, Virtual Health Library, Web of Science, Cochrane Library, medRxiv, and PROSPERO databases from inception to 15 July 2021. Risk of bias for studies was assessed using the Mixed Methods Appraisal Tool. The quality of evidence of collective outcomes was estimated using the Grading of Recommendations Assessment, Development and Evaluation–Confidence in the Evidence from Reviews of Qualitative research (GRADE–CERQual) framework. A total of 28 eligible studies conducted between 1997 and 2020 were included in the final analysis (17 quantitative surveys, 8 focus group or interview studies, 2 mixed methods studies, and 1 case–control study). The majority were US studies in English or Spanish, except for 6 studies set in Hong Kong, 2 studies in Japan, 1 study in Brazil, and 1 multi-centre study (including China, Indonesia, Turkey, South Korea, Greece, UK, Brazil, and Nigeria). In total, 28,262 individuals with an estimated mean age of 69.8 years were included, 63.2% of whom were female. We summarised the common concepts and themes across studies and populations using a convergent synthesis analysis. Thirteen themes categorised as barriers or facilitators were identified and grouped into structural factors—healthcare provider and system related, patient related, and policy and operational—and were analysed by minority ethnic group. The main limitation of the study was the predominance of studies from the US and East Asia. Conclusions In this systematic review, we found that factors influencing vaccination uptake involve healthcare provider and system, patient-related, and governance-level factors that are specific to the older ethnic minority community being served. The evidence included in this review is supported by high or moderate certainty and can be translated to practice and policy. A tailored, multi-level approach combining increased education, access, and culturally competent discussions with trusted healthcare professionals to address health beliefs can maximise the potential impact of widespread vaccination policies.
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Kong, Dexia, Man Guo, Melissa Simon, and XinQi Dong. "Immigration-Related Factors and Depression Help-Seeking Among Older Chinese Americans." Innovation in Aging 5, Supplement_1 (December 1, 2021): 148. http://dx.doi.org/10.1093/geroni/igab046.570.
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Abstract Asian Americans have the lowest mental health service utilization rate among all racial/ethnic groups. One important yet understudied aspect of this group’s mental health service use is its potential associations with immigration-related factors such as migration reasons, years in U.S., acculturation, and ethnic enclave residence. Using data from the Population-based Study of Chinese Elderly in Chicago (collected 2013-2015, N=3,123), this study investigates whether and how immigration-related factors shape mental health service utilization. Four categories of help-seeking behaviors for depressive symptoms were examined, including not seeking help (23.5%), seeking help from informal source(s) only (40%), seeking help from both informal and formal sources (28.7%), and seeking help from formal source(s) only (8.8%). Results of logistic regressions showed that U.S. Chinese older adults who migrated for family reasons were less likely to seek help from informal sources only than those who migrated for other reasons [Odds Ratio (OR)=0.64, 95% Confidence Interval (CI)=0.42-0.99). Less acculturated older immigrants (OR = 0.88, 95% CI = 0.79-0.97) and those who lived in Chinatown (OR = 2.34, 95% CI = 1.21-4.52) were more likely to seek help from formal sources only (relative to not seeking any help). Our findings showed that majority of the older Chinese Americans with depressive symptoms either did not seek help or sought help from informal sources only. Their help-seeking behaviors were shaped by their migration and acculturation experiences. Leveraging informal support networks and ethnicity-specific resources in Chinatown represent a culturally appropriate approach to facilitate mental health help-seeking among U.S. Chinese older adults.
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Leavey, Gerard, Kate Loewenthal, and Michael King. "Pastoral care of mental illness and the accommodation of African Christian beliefs and practices by UK clergy." Transcultural Psychiatry 54, no. 1 (January 24, 2017): 86–106. http://dx.doi.org/10.1177/1363461516689016.
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Faith-based organisations, especially those related to specific ethnic or migrant groups, are increasingly viewed by secular Western government agencies as potential collaborators in community health and welfare programmes. Although clergy are often called upon to provide mental health pastoral care, their response to such problems remains relatively unexamined. This paper examines how clergy working in multiethnic settings do not always have the answers that people want, or perhaps need, to problems of misfortune and suffering. In the UK these barriers can be attributed, generally, to a lack of training on mental health problems and minimal collaboration with health services. The current paper attempts to highlight the dilemmas of the established churches’ involvement in mental health care in the context of diversity. We explore the inability of established churches to accommodate African and other spiritual beliefs and practices related to the etiology and treatment of mental health problems.
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Yedjou, Clement, Ariane Mbemi, Felicite Noubissi, Solange Tchounwou, Nole Tsabang, Marinelle Payton, Lucio Miele, and Paul Tchounwou. "Prostate Cancer Disparity, Chemoprevention, and Treatment by Specific Medicinal Plants." Nutrients 11, no. 2 (February 4, 2019): 336. http://dx.doi.org/10.3390/nu11020336.
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Prostate cancer (PC) is one of the most common cancers in men. The global burden of this disease is rising. Its incidence and mortality rates are higher in African American (AA) men compared to white men and other ethnic groups. The treatment decisions for PC are based exclusively on histological architecture, prostate-specific antigen (PSA) levels, and local disease state. Despite advances in screening for and early detection of PC, a large percentage of men continue to be diagnosed with metastatic disease including about 20% of men affected with a high mortality rate within the African American population. As such, this population group may benefit from edible natural products that are safe with a low cost. Hence, the central goal of this article is to highlight PC disparity associated with nutritional factors and highlight chemo-preventive agents from medicinal plants that are more likely to reduce PC. To reach this central goal, we searched the PubMed Central database and the Google Scholar website for relevant papers. Our search results revealed that there are significant improvements in PC statistics among white men and other ethnic groups. However, its mortality rate remains significantly high among AA men. In addition, there are limited studies that have addressed the benefits of medicinal plants as chemo-preventive agents for PC treatment, especially among AA men. This review paper addresses this knowledge gap by discussing PC disparity associated with nutritional factors and highlighting the biomedical significance of three medicinal plants (curcumin, garlic, and Vernonia amygdalina) that show a great potential to prevent/treat PC, as well as to reduce its incidence/prevalence and mortality, improve survival rate, and reduce PC-related health disparity.
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von Unger, Hella, Penelope Scott, and Dennis Odukoya. "Constructing im/migrants and ethnic minority groups as ‘carriers of disease’: Power effects of categorization practices in tuberculosis health reporting in the UK and Germany." Ethnicities 19, no. 3 (February 27, 2019): 518–34. http://dx.doi.org/10.1177/1468796819833426.
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Migration- and ethnicity-related categories are a core feature of public health systems internationally, particularly in health reporting on communicable infectious diseases. The specific categories and classifications used differ from country to country and are subject to controversy and change. The article compares categorization practices in health reporting in the UK and Germany with regard to tuberculosis. Tuberculosis has been framed as a ‘migrants’ disease’ in recent decades and new categories were introduced to collect and report epidemiological data. We reconstruct the genesis, change and power effects of categories related to im/migrants and ethnic minority groups. In both countries, migration-related categorizations entail constructions of im/migrants as ‘carriers of disease’. However, the categories also connect with discourses on human rights, prevention, treatment and care for migrants as vulnerable groups. While this ambivalent role of migration-related categories is not unique to health statistics, the potential contribution to processes of ‘othering’ and politics of exclusion seem particularly imminent in the context of communicable diseases such as tuberculosis. Ethnicity categories used in the UK, but not in Germany, also contribute to othering through racialization and culturalization, yet at the same time provide opportunities for community participation in the discourse.
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Nguyen, Thu T., Nikki Adams, Dina Huang, M. Maria Glymour, Amani M. Allen, and Quynh C. Nguyen. "The Association Between State-Level Racial Attitudes Assessed From Twitter Data and Adverse Birth Outcomes: Observational Study." JMIR Public Health and Surveillance 6, no. 3 (July 6, 2020): e17103. http://dx.doi.org/10.2196/17103.
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Background In the United States, racial disparities in birth outcomes persist and have been widening. Interpersonal and structural racism are leading explanations for the continuing racial disparities in birth outcomes, but research to confirm the role of racism and evaluate trends in the impact of racism on health outcomes has been hampered by the challenge of measuring racism. Most research on discrimination relies on self-reported experiences of discrimination, and few studies have examined racial attitudes and bias at the US national level. Objective This study aimed to investigate the associations between state-level Twitter-derived sentiments related to racial or ethnic minorities and birth outcomes. Methods We utilized Twitter’s Streaming application programming interface to collect 26,027,740 tweets from June 2015 to December 2017, containing at least one race-related term. Sentiment analysis was performed using support vector machine, a supervised machine learning model. We constructed overall indicators of sentiment toward minorities and sentiment toward race-specific groups. For each year, state-level Twitter-derived sentiment data were merged with birth data for that year. The study participants were women who had singleton births with no congenital abnormalities from 2015 to 2017 and for whom data were available on gestational age (n=9,988,030) or birth weight (n=9,985,402). The main outcomes were low birth weight (birth weight ≤2499 g) and preterm birth (gestational age <37 weeks). We estimated the incidence ratios controlling for individual-level maternal characteristics (sociodemographics, prenatal care, and health behaviors) and state-level demographics, using log binomial regression models. Results The accuracy for identifying negative sentiments on comparing the machine learning model to manually labeled tweets was 91%. Mothers living in states in the highest tertile for negative sentiment tweets referencing racial or ethnic minorities had greater incidences of low birth weight (8% greater, 95% CI 4%-13%) and preterm birth (8% greater, 95% CI 0%-14%) compared with mothers living in states in the lowest tertile. More negative tweets referencing minorities were associated with adverse birth outcomes in the total population, including non-Hispanic white people and racial or ethnic minorities. In stratified subgroup analyses, more negative tweets referencing specific racial or ethnic minority groups (black people, Middle Eastern people, and Muslims) were associated with poor birth outcomes for black people and minorities. Conclusions A negative social context related to race was associated with poor birth outcomes for racial or ethnic minorities, as well as non-Hispanic white people.
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Sa, Jaesin, Ches Siyoung Choe, Ches Beom-Young Cho, Jean-Philippe Chaput, Jounghee Lee, and Sungjae Hwang. "Sex and Racial/Ethnic Differences in Suicidal Consideration and Suicide Attempts among US College Students, 2011-2015." American Journal of Health Behavior 44, no. 2 (March 1, 2020): 214–31. http://dx.doi.org/10.5993/ajhb.44.2.9.
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Objectives: In this study, we examined sex and racial/ethnic differences in the prevalence and predictors of suicide consideration and attempts among US college students. Methods: We used multivariable logistic regression to investigate suicide consideration and attempts by sex and race/ethnicity among students (N = 319,342) who completed the American College Health Association-National College Health Assessment from fall 2011 to spring 2015. Results: Overall, the prevalence of suicide consideration and attempts was higher in spring 2015 than fall 2011 (p < .05). Men had higher odds of suicide consideration and attempts than women (p < .001). Blacks, Hispanics, and Asians had higher odds of suicide consideration and attempts compared with Whites (p < .001). Weight-related problems (unhealthy weight, body weight overestimation, and lack of physical activity), sleep problems (insufficient sleep and sleep difficulties), and lower levels of academic performance were associated with both suicide consideration and attempts (p < .05). Conclusions: Our findings indicate a need for sex- and race/ethnicity-specific suicide prevention strategies for college students, specifically men and racial/ethnic minority groups. Furthermore, appropriate weight and sleep management could be considered to help prevent suicide among US college students.
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Redmond, J., L. M. A. Jarjou, B. Zhou, A. Prentice, and I. Schoenmakers. "Ethnic differences in calcium, phosphate and bone metabolism." Proceedings of the Nutrition Society 73, no. 2 (March 12, 2014): 340–51. http://dx.doi.org/10.1017/s0029665114000068.
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The prevalence of osteoporosis and the incidence of age-related fragility fracture vary by ethnicity. There is greater than 10-fold variation in fracture probabilities between countries across the world. Mineral and bone metabolism are intimately interlinked, and both are known to exhibit patterns of daily variation, known as the diurnal rhythm (DR). Ethnic differences are described for Ca and P metabolism. The importance of these differences is described in detail between select ethnic groups, within the USA between African-Americans and White-Americans, between the Gambia and the UK and between China and the UK. Dietary Ca intake is higher in White-Americans compared with African-Americans, and is higher in White-British compared with Gambian and Chinese adults. Differences are observed also for plasma 25-hydroxy vitamin D, related to lifestyle differences, skin pigmentation and skin exposure to UVB-containing sunshine. Higher plasma 1,25-dihydroxy vitamin D and parathyroid hormone are observed in African-American compared with White-American adults. Plasma parathyroid hormone is also higher in Gambian adults and, in winter, in Chinese compared with White-British adults. There may be ethnic differences in the bone resorptive effects of parathyroid hormone, with a relative skeletal resistance to parathyroid hormone observed in some, but not all ethnic groups. Renal mineral excretion is also influenced by ethnicity; urinary Ca (uCa) and urinary P (uP) excretions are lower in African-Americans compared with White-Americans, and in Gambians compared with their White-British counterparts. Little is known about ethnic differences in the DR of Ca and P metabolism, but differences may be expected due to known differences in lifestyle factors, such as dietary intake and sleep/wake pattern. The ethnic-specific DR of Ca and P metabolism may influence the net balance of Ca and P conservation and bone remodelling. These ethnic differences in Ca, P and the bone metabolism may be important factors in the variation in skeletal health.
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Steinbrecher, Astrid, Eva Erber, Andrew Grandinetti, Claudio Nigg, Laurence N. Kolonel, and Gertraud Maskarinec. "Physical Activity and Risk of Type 2 Diabetes Among Native Hawaiians, Japanese Americans, and Caucasians: The Multiethnic Cohort." Journal of Physical Activity and Health 9, no. 5 (July 2012): 634–41. http://dx.doi.org/10.1123/jpah.9.5.634.
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Background:Physical inactivity is an established risk factor for diabetes; however, little is known about this association across ethnic groups with different diabetes risk. Therefore, we evaluated the association between physical activity and diabetes and potential effect modification by ethnicity in the Hawaii component of the Multiethnic Cohort.Methods:Participants, aged 45 to 75 years, were enrolled by completing a questionnaire on demographics, diet, and self-reported weekly hours of strenuous sports, vigorous work, and moderate activity. Among the 74,913 participants (39% Caucasian, 14% Native Hawaiian, 47% Japanese American), 8561 incident diabetes cases were identified by self-report, a medication questionnaire, and through health plan linkages. Cox regression was applied to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) while adjusting for known confounders.Results:Engaging in strenuous sports was inversely related to diabetes risk with HRs (4+ hours/week vs. never) of 0.67 (95%CI: 0.57–0.79) in women and 0.80 (95%CI: 0.72–0.88) in men. In stratified analyses, the inverse association was consistent across ethnic groups. The inverse association of vigorous work with diabetes was limited to men, while beneficial effects of moderate activity were observed only in Caucasians.Conclusions:These findings support a role of high-intensity physical activity and ethnic-specific guidelines in diabetes prevention.
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Rivera-Figueroa, Karla, Nana Yaa A. Marfo, and Inge-Marie Eigsti. "Parental Perceptions of Autism Spectrum Disorder in Latinx and Black Sociocultural Contexts: A Systematic Review." American Journal on Intellectual and Developmental Disabilities 127, no. 1 (January 1, 2022): 42–63. http://dx.doi.org/10.1352/1944-7558-127.1.42.
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Abstract Parents of children with autism spectrum disorder (ASD) face challenges in accessing diagnostic and treatment services; these challenges vary by race, ethnicity, and culture. This systematic review examines parental perceptions of ASD within Latinx and Black American communities. Findings indicate that interconnections with family and religious groups promoted positive coping and describe positive impacts of having a child with ASD. Relative to White families, community members reported reduced access to information and more inaccurate beliefs about ASD, higher levels of ASD-related stigma, and more negative experiences with healthcare providers, which serve to exacerbate healthcare disparities. Conclusions are limited by an underrepresentation of minority groups in research. We call for efforts to address the specific needs of racial and ethnic minorities.
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Zalla, Lauren C., Grace E. Mulholland, Lindsey M. Filiatreau, and Jessie K. Edwards. "Racial/Ethnic and Age Differences in the Direct and Indirect Effects of the COVID-19 Pandemic on US Mortality." American Journal of Public Health 112, no. 1 (January 2022): 154–64. http://dx.doi.org/10.2105/ajph.2021.306541.
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Objectives. To estimate the direct and indirect effects of the COVID-19 pandemic on overall, race/ethnicity‒specific, and age-specific mortality in 2020 in the United States. Methods. Using surveillance data, we modeled expected mortality, compared it to observed mortality, and estimated the share of “excess” mortality that was indirectly attributable to the pandemic versus directly attributed to COVID-19. We present absolute risks and proportions of total pandemic-related mortality, stratified by race/ethnicity and age. Results. We observed 16.6 excess deaths per 10 000 US population in 2020; 84% were directly attributed to COVID-19. The indirect effects of the pandemic accounted for 16% of excess mortality, with proportions as low as 0% among adults aged 85 years and older and more than 60% among those aged 15 to 44 years. Indirect causes accounted for a higher proportion of excess mortality among racially minoritized groups (e.g., 32% among Black Americans and 23% among Native Americans) compared with White Americans (11%). Conclusions. The effects of the COVID-19 pandemic on mortality and health disparities are underestimated when only deaths directly attributed to COVID-19 are considered. An equitable public health response to the pandemic should also consider its indirect effects on mortality. (Am J Public Health. 2022;112(1):154–164. https://doi.org/10.2105/AJPH.2021.306541 )
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Singh, SP, Z. Islam, LJ Brown, R. Gajwani, R. Jasani, F. Rabiee, and H. Parsons. "Ethnicity, detention and early intervention: reducing inequalities and improving outcomes for black and minority ethnic patients: the ENRICH programme, a mixed-methods study." Programme Grants for Applied Research 1, no. 3 (December 2013): 1–168. http://dx.doi.org/10.3310/pgfar01030.
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BackgroundBlack and minority ethnic (BME) service users experience adverse pathways into care. Ethnic differences are evident even at first-episode psychosis (FEP); therefore, contributory factors must operate before first presentation to psychiatric services. The ENRICH programme comprised three interlinked studies that aimed to understand ethnic and cultural determinants of help-seeking and pathways to care.Aims and objectivesStudy 1: to understand ethnic differences in pathways to care in FEP by exploring cultural determinants of illness recognition, attribution and help-seeking among different ethnic groups. Study 2: to evaluate the process of detention under the Mental Health Act (MHA) and determine predictors of detention. Study 3: to determine the appropriateness, accessibility and acceptability of generic early intervention services for different ethnic groups.MethodsStudy 1: We recruited a prospective cohort of FEP patients and their carers over a 2-year period and assessed the chronology of symptom emergence, attribution and help-seeking using semistructured tools: the Nottingham Onset Schedule (NOS), the Emerging Psychosis Attribution Schedule and the ENRICH Amended Encounter Form. A stratified subsample of user–carer NOS interviews was subjected to qualitative analyses. Study 2: Clinical and sociodemographic data including reasons for detention were collected for all MHA assessments conducted over 1 year (April 2009–March 2010). Five cases from each major ethnic group were randomly selected for a qualitative exploration of carer perceptions of the MHA assessment process, its outcomes and alternatives to detention. Study 3: Focus groups were conducted with service users, carers, health professionals, key stakeholders from voluntary sector and community groups, commissioners and representatives of spiritual care with regard to the question: ‘How appropriate and accessible are generic early intervention services for the specific ethnic and cultural needs of BME communities in Birmingham?’ResultsThere were no ethnic differences in duration of untreated psychosis (DUP) and duration of untreated illness in FEP. DUP was not related to illness attribution; long DUP was associated with patients being young (< 18 years) and living alone. Black patients had a greater risk of MHA detention, more criminal justice involvement and more crisis presentations than white and Asian groups. Asian carers and users were most likely to attribute symptoms to faith-based or supernatural explanations and to seek help from faith organisations. Faith-based help-seeking, although offering comfort and meaning, also risked delaying access to medical care and in some cases also resulted in financial exploitation of this vulnerable group. The BME excess in MHA detentions was not because of ethnicity per se; the main predictors of detention were a diagnosis of mental illness, presence of risk and low level of social support. Early intervention services were perceived to be accessible, supportive, acceptable and culturally appropriate. There was no demand or perceived need for separate services for BME groups or for ethnic matching between users and clinicians.ConclusionsStatutory health-care organisations need to work closely with community groups to improve pathways to care for BME service users. Rather than universal public education campaigns, researchers need to develop and evaluate public awareness programmes that are specifically focused on BME groups.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Pedersen, Marlene Rosager Lund, Anne Faber Hansen, and Karsten Elmose-Østerlund. "Motives and Barriers Related to Physical Activity and Sport across Social Backgrounds: Implications for Health Promotion." International Journal of Environmental Research and Public Health 18, no. 11 (May 28, 2021): 5810. http://dx.doi.org/10.3390/ijerph18115810.
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Studies have found physical inactivity to be a significant health risk factor and have demonstrated how physical inactivity behaviour varies according to social background. As a result, differences according to social background must be considered when examining motives and barriers related to physical activity and sport. This scoping review examines motives and barriers related to physical activity and sport among people with different social backgrounds, including age, socioeconomic status, gender, ethnic minority background and disability status. A systematic literature search was performed in four scientific databases and yielded 2935 articles of which 58 articles met the inclusion criteria. We identified common motives for physical activity and sport as health benefits, well-being, enjoyment, social interaction, and social support; common barriers as time restrictions, fatigue and lack of energy, financial restrictions, health-related restrictions, low motivation, and shortage of facilities. We also identified several motives and barriers that were specific to or more pronounced among people with different social backgrounds. The knowledge about motives and barriers related to physical activity and sport provided in this article can inform health promotion initiatives that seek to improve public health both in general and when specifically targeting groups of people with different social backgrounds.
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Lucas, Anna, Esther Murray, and Sanjay Kinra. "Heath Beliefs of UK South Asians Related to Lifestyle Diseases: A Review of Qualitative Literature." Journal of Obesity 2013 (2013): 1–13. http://dx.doi.org/10.1155/2013/827674.
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Objective. To review available qualitative evidence in the literature for health beliefs and perceptions specific to UK South Asian adults. Exploring available insight into the social and cultural constructs underlying perceptions related to health behaviours and lifestyle-related disease.Methods. A search of central databases and ethnic minority research groups was augmented by hand-searching of reference lists. For included studies, quality was assessed using a predetermined checklist followed by metaethnography to synthesise the findings, using both reciprocal translation and line-of-argument synthesis to look at factors impacting uptake of health behaviours.Results. A total of 10 papers varying in design and of good quality were included in the review. Cultural and social norms strongly influenced physical activity incidence and motivation as well as the ability to engage in healthy eating practices.Conclusions. These qualitative studies provide insight into approaches to health among UK South Asians in view of their social and cultural norms. Acknowledgement of their approach to lifestyle behaviours may assist acceptability of interventions and delivery of lifestyle advice by health professionals.
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Consedine, Nathan S. "Are We Worrying About the Right Men and Are the Right Men Feeling Worried? Conscious But Not Unconscious Prostate Anxiety Predicts Screening Among Men From Three Ethnic Groups." American Journal of Men's Health 6, no. 1 (August 23, 2011): 37–50. http://dx.doi.org/10.1177/1557988311415513.
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Anxieties regarding cancer and screening have been consistently linked in prostate screening behavior with cancer-related anxieties generally thought to be higher among minority men. To date, however, the literature linking cancer anxieties to screening among diverse men remains predicated on self-reported anxiety. Research has yet to consider how “accurate” the reporting of anxiety may be among distinct groups of men or the possibility that anxiety may influence prostate cancer (PC) screening behavior through conscious and nonconscious channels; the current study tested for discrepancies between self-report and Stroop-ascertained general- and prostate-specific anxiety and their links to screening among 180 U.S.-born African American, U.S.-born European American, and immigrant Jamaican men. Men provided self-report information regarding trait and prostate-related anxiety and completed an emotional Stroop task. Mixed model ANOVAs showed that while U.S.-born African Americans had few discrepancies between self-report and Stroop-ascertained anxiety, Jamaicans reported greater PC anxiety than indicated by Stroop performance, while the opposite was true among U.S.-born Europeans. As expected, self-reported (but not Stroop-ascertained) PC anxiety predicted screening in multivariate analysis. Although men from different age and ethnic groups varied in the discrepancy between self-reported and Stroop-ascertained PC anxiety, the influence of avoidance-producing emotions appears to operate predominantly through conscious channels.
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Galletly, Cherrie, Xiaoli Wu, Zili Han, and Dennis Liu. "M151. DIFFERENCES IN PATTERN OF OBESITY BETWEEN PEOPLE WITH SCHIZOPHRENIA LIVING IN CHINA AND IN AUSTRALIA." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S192—S193. http://dx.doi.org/10.1093/schbul/sbaa030.463.
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Abstract Background People with psychotic disorders, including schizophrenia, suffer premature cardiovascular morbidity and mortality. Obesity is a major factor in cardiometabolic disorders in this population. There has been very little research investigating differences in patterns of obesity in diverse ethnic populations. Guidelines for treatment of complex comorbidities in people with schizophrenia and related psychoses may need to provide specific recomendations for different ethnic groups. Methods The Chinese sample consisted 192 subjects were recruited from the outpatients and inpatients department of the psychiatry department of the third affiliated hospital of Sun Yat-sen. All enrolled subjects were Chinese Han ethnicity, aged 16–45 years, with a diagnosis of schizophrenia according to ICD-10 criteria for schizophrenia, excluding other acute psychiatric disorders. The Australian sample (N=1825) were drawn from the Survey of High Impact Psychosis. BMI and central obesity were measured in all subjects. Results 10.3% of men and 4.7% of women in the China sample were obese (BMI>30). In the Australian sample, 41.6% of men and 50.3% of women were obese. Overall, 7.8% of Chinese sample and 45.1% of the Australian sample were obese. However, amongst the non-obese China sample, 41.7% of men and 53.1% of women had central obesity; the mean for all non-obese Chinese people was 46.7%. 73% of non-obese Australian men and 81.5% of non-obese Australian women had central obesity; the mean for all non-obese Australians was 76%. Discussion Chinese Han people with schizophrenia have much lower rates of obesity than the Australian sample. In both groups, rates of abdominal obesity were higher than rates of obesity as defined by BMI. These ethnic differences may help in understanding the high rates of cardiometabolic disorder in people with psychotic disorders in Western countries. They may also inform interventions to assist Western people with psychoses to maintain better physical health.
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Kaur, Manraj, Anne Klassen, Feng Xie, Charlene Rae, and Andrea Pusic. "Health-related quality of life in the treatment and survivorship phases of breast cancer." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e18621-e18621. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e18621.
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e18621 Background: Understanding the health-related quality of life (HRQOL) of breast cancer during treatment and survivorship is important; however, little data are available - particularly for long-term ( > 5 year) survivors. Health utility scores anchored between 0 (death) and 1 (perfect/best possible health) have been shown to be a good proxy index score of the overall HRQOL. The aim of this study was to estimate the utilities in the treatment and survivorship of breast cancer using validated preference-based measures(PBMs). Methods: Women (18 years or older) with history of breast cancer (on/off treatment) were recruited via Love Research Army (LRA), an online community of women engaged in breast cancer research. Members of the LRA were invited to participate via email and women who self-selected to be eligible were asked to complete clinical and demographics form and two generic PBMs - EQ-5D and Short Form-12 (SF-12), and one cancer-specific PBM-European Organization for Research and Treatment of Cancer-8D (EORTC-8D). Descriptive statistics and non-parametric analysis of variance tests were used to examine differences between the survivorship groups. Results: 1,636 women aged 46 ± 10 years were included in the analysis. Mean age at primary diagnosis was 35 ± 10 years and most patients were diagnosed with breast cancer stage 0-2 (n = 1362, 83.25%). For women currently on treatments, mean utility values were: chemotherapy (EQ-5D = 0.61, SF-6D = 0.67,EORTC-8D = 0.69), radiation(EQ-5D = 0.71, SF-6D = 0.67, EORTC-8D = 0.66), hormone replacement therapy (EQ-5D = 0.82,SF-6D = 0.76,EORTC-8D = 0.85), targeted therapy (EQ-5D = 0.77, SF-6D = 0.74, EORTC-8D = 0.82), and surgery (EQ-5D = 0.81,SF-6D = 0.69, EORTC-8D = 0.78). For women diagnosed with arm lymphedema (n = 182,11%), utility values were EQ-5D = 0.79,SF-6D = 0.74, EORTC-8D = 0.82. Women who were ≤ 5 years post-primary diagnosis reported slightly lower utility values (EQ-5D = 0.82,SF-6D = 0.76,EORTC-8D = 0.84) than women who were 6-10 years (EQ-5D = 0.83,SF-6D = 0.76,EORTC-8D = 0.85; p = 0.117) post-primary diagnosis. However, when utilities for women who were ≤ 5 years post-primary diagnosis were compared to women who were 11 to 15 years (EQ-5D = 0.86,SF-6D = 0.79,EORTC-8D = 0.88) and over 15 years (EQ-5D = 0.86,SF-6D = 0.81,EORTC-8D = 0.89) post-primary diagnosis, the difference was statistically significant (p = 0.000). Women who belonged to non-White ethnic groups, had lower levels of education (Bachelors or less) and reported less than USD 50,000 annual income in the previous year reported lower utility values across all time points, after adjusting for age and cancer stage. Conclusions: This study shows that the HRQOL decline in the first five years post-primary breast cancer diagnosis persists for several years into survivorship. Further, women from ethnic minority groups and lower socioeconomic background have lower HRQOL, irrespective of their age and cancer stage.
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Marks, Suzanne M., Alexey Clara, Amy Parker Fiebelkorn, Xuan Le, Paige A. Armstrong, Stephanie Campbell, Judith Mendel Van Alstyne, et al. "Influenza Vaccination in Health Centers During the Coronavirus Disease 2019 Pandemic—United States, 7–27 November 2020." Clinical Infectious Diseases 73, Supplement_1 (July 15, 2021): S92—S97. http://dx.doi.org/10.1093/cid/ciab318.
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Abstract Background Influenza vaccination is the most effective way to prevent influenza and influenza-associated complications including those leading to hospitalization. Resources otherwise used for influenza could support caring for patients with coronavirus disease 2019 (COVID-19). The Health Resources and Services Administration (HRSA) Health Center Program serves 30 million people annually by providing comprehensive primary healthcare, including influenza vaccination, to demographically diverse and historically underserved communities. Because racial and ethnic minority groups have been disproportionately affected by COVID-19, the objective of this analysis was to assess disparities in influenza vaccination at HRSA-funded health centers during the COVID-19 pandemic. Methods The Centers for Disease Control and Prevention and HRSA analyzed cross-sectional data on influenza vaccinations from a weekly, voluntary health center COVID-19 survey after addition of an influenza-related question covering 7–11 November 2020. Results During the 3-week period, 1126 of 1385 health centers (81%) responded to the survey. Most of the 811 738 influenza vaccinations took place in urban areas and in the Western US region. There were disproportionately more health center influenza vaccinations among racial and ethnic minorities in comparison with county demographics, except among non-Hispanic blacks and American Indian/Alaska Natives. Conclusions HRSA-funded health centers were able to quickly vaccinate large numbers of mostly racial or ethnic minority populations, disproportionately more than county demographics. However, additional efforts might be needed to reach specific racial populations and persons in rural areas. Success in influenza vaccination efforts can support success in severe acute respiratory syndrome coronavirus 2 vaccination efforts.
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Scott, Kate M., John C. Marwick, and Peter R. Crampton. "Utilization of general practitioner services in New Zealand and its relationship with income, ethnicity and government subsidy." Health Services Management Research 16, no. 1 (February 1, 2003): 45–55. http://dx.doi.org/10.1258/095148403762539130.
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The New Zealand primary care system involves user part-charges for general practitioner (GP) care. This study explores the relationship between the use of GP services in New Zealand and government subsidies, income and ethnicity. The study used the 1996/97 New Zealand Health Survey dataset, a nationally representative household survey of health status and health service utilization. Multivariate logistic regression models were used to estimate the likelihood of visiting the GP at least once in 12 months, and the likelihood of frequent visits (at least six visits in 12 months). Adjustment was made for health need (as indicated by global self-reported health status and a number of specific disease and health-related behaviour measures), together with a range of other relevant demographic and socio-economic variables. Following these adjustments, low-income groups and Mäori were found to be significantly less likely to visit the GP at least once in the year, but there were no significant differences across income or ethnic groups in the likelihood of frequent visits. These results suggest that the system of low-income targeted government subsidies reduces, but does not fully compensate for the barrier posed by doctors' fees. Moreover, there appear to be barriers for indigenous groups, in addition to income.
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Linder, Stephanie, Karim Abu-Omar, Wolfgang Geidl, Sven Messing, Mustafa Sarshar, Anne K. Reimers, and Heiko Ziemainz. "Physical inactivity in healthy, obese, and diabetic adults in Germany: An analysis of related socio-demographic variables." PLOS ONE 16, no. 2 (February 9, 2021): e0246634. http://dx.doi.org/10.1371/journal.pone.0246634.
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Background Adults with diabetes or obesity are more likely to be physically inactive than healthy adults. Physical activity is essential in the management of both diseases, necessitating targeted interventions in these groups. This study analysed physical inactivity (defined as not taking part in leisure-time physical activity) in over 100,000 adults in Germany considering their body mass index and the presence of diabetes. Furthermore, the relationship between specific socio-demographic factors with physical inactivity was investigated, particularly focussing diabetic and obese people, to refine the identification of risk-groups for targeted interventions on physical activity promotion. Methods Data from 13 population-based health surveys conducted in Germany from 1997 to 2018 were used. The relevant variables extracted from these datasets were merged and employed in the analyses. We included data from 129,886 individuals in the BMI analyses and 58,311 individuals in the diabetes analyses. Logistic regression analyses were performed to identify the importance of six socio-demographic variables (age, sex/gender, education, income, employment, and migration) for the risk of physical inactivity. Results Obese and diabetic people reported a higher prevalence of physical inactivity than those who were not affected. Logistic regression analyses revealed advanced age, low education level, and low household income as risk factors for physical inactivity in all groups. A two-sided migration background and unemployment also indicated a higher probability of physical inactivity. Conclusion Similar socio-demographic barriers appear to be important determinants of physical inactivity, regardless of BMI status or the presence of diabetes. However, physical activity promoting interventions in obese and diabetic adults should consider the specific disease-related characteristics of these groups. A special need for target group specific physical activity programmes in adults from ethnic minorities or of advanced age was further identified.
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Jayasinghe, Shakeela N., Bernhard H. Breier, Sarah A. McNaughton, Aaron P. Russell, Paul A. Della Gatta, Shaun Mason, Welma Stonehouse, Daniel C. I. Walsh, and Rozanne Kruger. "Dietary Patterns in New Zealand Women: Evaluating Differences in Body Composition and Metabolic Biomarkers." Nutrients 11, no. 7 (July 18, 2019): 1643. http://dx.doi.org/10.3390/nu11071643.
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The combinations of food consumed together (dietary patterns) may have a greater influence on health than nutrients or food groups consumed independently. This study investigated the relationship between dietary patterns, body composition and metabolic biomarkers of premenopausal New Zealand women from three ethnic groups. In total, 408 New Zealand European, Māori and Pacific women aged 16–45 years participated in the Women’s EXPLORE (EXamining Predictors Linking Obesity Related Elements) study. Participants completed a 220-item food frequency questionnaire. Several body composition parameters and metabolic biomarkers were measured. Dietary patterns were extracted by principal component analysis and dietary pattern scores were categorised into tertiles to assess links with other measured parameters. Women with higher scores for the ‘refined and processed’ pattern were younger, had higher body mass index, total body fat, plasma leptin and plasma insulin (p < 0.001), and lower plasma ghrelin levels (p < 0.05) than women with lower scores. In addition, more Māori (51%) and Pacific (68%) women followed the ‘refined and processed’ pattern, while more New Zealand European women (40%) followed the ‘sweet and savoury snacking’ pattern. These data show that dietary pattern analysis is a useful tool to assess links between diet and metabolic health. It further reveals interesting ethnic group-specific differences in dietary pattern use.
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Hohl, Sarah D., Rachel Ceballos, Mary Alice Scott, and Beti Thompson. "Developing a Culturally Informed Survey Instrument to Assess Biomedical Research Participation Among Latinos on the U.S.–Mexico Border." Qualitative Health Research 29, no. 3 (October 10, 2018): 445–54. http://dx.doi.org/10.1177/1049732318801364.
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Racial/ethnic minorities, rural populations, and those with low socioeconomic status income are underrepresented in research in the United States (U.S.). Assessing preferences for recruitment, participation, and the role of beliefs about biomedical research in specific and unique underserved communities represents a potentially critical step in reducing barriers to biomedical research participation. We developed a culturally informed survey to measure factors related to participation, knowledge, expectations, and barriers to biomedical research participation among Latinos living in a U.S. border community. We employed a multidisciplinary team approach to a sequential, three-phase qualitative study that included interviews ( n = 35), focus groups ( n =24), and “think-aloud” cognitive interviews ( n = 5). Our study demonstrates the value of applying multiple qualitative approaches to inform a culturally relevant quantitative survey incorporating words and constructs relevant to the population of interest. The study contributes to qualitative method research paradigms by developing a research protocol that integrates the expertise and perspectives of researchers and community members from multiple disciplines and institutions.
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Chung, J., M. O. Goodman, T. Huang, M. Wallace, S. Bertisch, D. Johnson, and S. Redline. "0363 Racial/Ethnic Differences in Actigraphy, Questionnaire, and Polysomnography-Measured Indicators of Sleep Health and Sleep Quality: The Multi-Ethnic Study of Atherosclerosis." Sleep 43, Supplement_1 (April 2020): A138—A139. http://dx.doi.org/10.1093/sleep/zsaa056.360.
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Abstract Introduction Paradigm shifts in sleep research suggest the importance of considering multi-dimensional sleep health, compared to single metrics, to promote physical and mental well-being and to understand racial/ethnic disparities in sleep. Methods We used data from the Multi-Ethnic Study of Atherosclerosis (MESA; n = 1,740) to create a Sleep Health Score (SHS), including questionnaire (quality, sleepiness); 7-day actigraphy (total sleep time, sleep continuity [sleep maintenance efficiency], timing consistency [midpoint variability], fragmentation, wake after sleep onset, sleep onset latency); and in-home polysomnography (%N3 sleep, %REM sleep, AHI). Sleep parameters were dichotomized based on prior literature or by healthiest quartile(s), with positive values denoting healthier sleep (e.g. Epworth scores < 10). All 11 dichotomized parameters were summed to calculate the SHS (mean=4.9, sd=1.58). We used modified Poisson and linear regression for individual sleep outcomes and the SHS, respectively, adjusting for age and sex. Results The sample was older (mean age=68.28, sd=9.08) and 54% female. SHSs were associated with Black race (β=-0.60 [-0.78, -0.42]) and Hispanic ethnicity (β=-0.40 [-0.59, -0.21]), but not Chinese ethnicity (β=-0.16 [-0.41, 0.08]). Compared to Whites (n=644), Blacks (n=485) showed lower adjusted probability of obtaining favorable levels of: sleep continuity, fragmentation, timing consistency, alertness/sleepiness, and sleep depth (%N3 sleep). Chinese respondents (n=202) had lower probability of obtaining favorable levels of: sleep continuity and timing consistency, but higher probability of quality. Hispanics (n=409) had lower probability of obtaining healthy levels of: sleep continuity, timing consistency, and fragmentation. Neither healthy total sleep time (middle quartiles) nor AHI (<30) differed by race/ethnicity. Conclusion Among MESA-Sleep participants, summary SHSs were lowest in Blacks, followed by Hispanics. Multiple dimensions of sleep - particularly related to continuity and timing consistency - were less favorable across race/ethnic minority groups. A summary SHS may help monitor sleep health across populations, while measurement of specific sleep components may help identify modifiable targets. Support Joon Chung is supported by a T-32 NIH training grant.