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U.S. Minorities No Strangers to Health Ills
No full textThough minorities in the United States face an array of challenges, chief among them may be personal health and well-being.
African Americans, Hispanic Americans and other minority groups are more likely than whites to develop a number of chronic and deadly diseases, according to mounting evidence.
Infant mortality, obesity, diabetes, cancer, cardiovascular disease and communicable diseases are among the wide range of health issues for which minorities find themselves at greater risk than whites, according to the U.S. Centers for Disease Control and Prevention.
The evidence of health disparities would be easy to ignore were they not so well-documented," said Stephen B. Thomas
Racial disparities in organ donation and why.
No full textPURPOSE OF REVIEW: High prevalence of comorbidities such as diabetes, hypertension, obesity, hepatitis B and C, in minority groups, results in racial minorities being disproportionally represented on transplant waiting lists. Organ transplantation positively impacts patient survival but greater access is limited by a severe donor shortage.
RECENT FINDINGS: Unfortunately, minority groups also suffer from disparities in deceased and living donation. African-Americans comprise 12.9% of the population and 34% of the kidney transplant waiting list but only 13.8% of deceased donors. Barriers to minority deceased donation include: decreased awareness of transplantation, religious or cultural distrust of the medical community, fear of medical abandonment and fear of racism. Furthermore, African-Americans comprise only 11.8% of living donors. Barriers to minority living donation include: unwillingness to donate, medical comorbid conditions, trust or fear of medical community, loss to follow-up, poor coping mechanisms, financial concerns, reluctance to ask family members and friends, fear of surgery, and lack of awareness about living donor kidney transplantation.
SUMMARY: Transplant center-based education classes significantly and positively impact African-American concerns and beliefs surrounding living donation. Community and national strategies utilizing culturally sensitive communication and interventions can ameliorate disparities and improve access to transplantation
Persistence in breast cancer disparities between African Americans and whites in Wisconsin.
No full textBACKGROUND: Breast cancer (BC) mortality is higher in African American women compared to white women despite having a lower incidence. The reasons for this remain unclear, despite decades of research. Reducing BC health disparities is a priority but has had limited success.
OBJECTIVE: To assess progress in eliminating breast cancer-related health disparities in Wisconsin by comparing trends in breast cancer outcomes in African American and white women from 1995 to 2006 and comparing results nationally.
METHODS: Age-adjusted breast cancer (BC) incidence and stage data from the Wisconsin Cancer Reporting System and age-adjusted mortality data from National Center of Health Statistics were used to evaluate trends in incidence and mortality from 1995 to 2006 for African Americans and whites. The relative disparity was evaluated by rate ratios. Trends in distribution of in situ vs malignant disease were examined. National trend data were obtained from the National Cancer Institute (NCI) Surveillance, Epidemiology and End Results (SEER) database.
RESULTS: Age-adjusted incidence decreased 10% in Wisconsin compared to 7% nationally. Incidence of BC was lower in African American compared to white women. BC mortality in African American women declined in Wisconsin, but remained higher than white females. Age-adjusted mortality in Wisconsin declined approximately 23%, matching national trends. Non age-adjusted stage data trended toward a decrease in malignant, but increased in situ disease.
CONCLUSIONS: Despite an overall reduction in BC mortality from 1995 to 2006, a persistent disparity in mortality remains for African American women, demonstrating no significant progress in reducing BC health disparities
Even a little too much ‘sugar’ in your blood is bad
No full textI always look forward to attending the National Medical Association’s annual convention and this year was no exception. The theme for this year’s convention, ‘Health Equity: Lead, Reform, Deliver’, is very timely as we try to address health disparities with the era of health care reform
National Stakeholder Strategy for Achieving Health Equity
No full textThe National Stakeholder Strategy for Achieving Health Equity provides a common set of goals and objectives for public and private sector initiatives and partnerships to help racial and ethnic minorities -- and other underserved groups -- reach their full health potential.
The strategy -- a product of the National Partnership for Action (NPA) -- incorporates ideas, suggestions and comments from thousands of individuals and organizations across the country. Local groups can use the National Stakeholder Strategy to identify which goals are most important for their communities and adopt the most effective strategies and action steps to help reach them
Fast Food Restaurants and Food Stores: Longitudinal Associations With Diet in Young to Middle-aged Adults: The CARDIA Study
No full textBACKGROUND: A growing body of cross-sectional, small-sample research has led to policy strategies to reduce food deserts -neighborhoods with little or no access to healthy foods-by limiting fast food restaurants and small food stores and increasing access to supermarkets in low-income neighborhoods.
METHODS: We used 15 years of longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of US young adults (aged 18-30 years at baseline) (n = 5115), with linked time-varying geographic information system-derived food resource measures. Using repeated measures from 4 examination periods (n = 15 854 person-examination observations) and conditional regression (conditioned on the individual), we modeled fast food consumption, diet quality, and adherence to fruit and vegetable recommendations as a function of fast food chain, supermarket, or grocery store availability (counts per population) within less than 1.00 km, 1.00 to 2.99 km, 3.00 to 4.99 km, and 5.00 to 8.05 km of respondents' homes. Models were sex stratified, controlled for individual sociodemographic characteristics and neighborhood poverty, and tested for interaction by individual-level income.
RESULTS: Fast food consumption was related to fast food availability among low-income respondents, particularly within 1.00 to 2.99 km of home among men (coefficient, 0.34; 95% confidence interval, 0.16-0.51). Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake, and relationships between grocery store availability and diet outcomes were mixed.
CONCLUSION: Our findings provide some evidence for zoning restrictions on fast food restaurants within 3 km of low-income residents but suggest that increased access to food stores may require complementary or alternative strategies to promote dietary behavior change
Instability Overlooked: Evidence for the Importance of Household Roster Data Collection and Matching Over Time
No full textMany studies on instability examine changes in relationships and household composition by using measures such as “are you married?” or “how many children in this household?” and then comparing the answers across time. Instability is determined from changes noted in respondents‟ answers and conclusions are made based on the impact of instability, or the lack thereof. However, these measures are one-dimensional; they do not capture the types of changes that may have occurred between waves. For example, respondents may be married at both waves, but to different people. This misconception calls for a more nuanced examination of households and relationships of members at each point in time. Data from the Making Connections Survey are used to compare different methods of measuring instability in relationships, number of adults, and number of children across waves. The data include a household roster that collects demographic information about each member of the household, as well as their relationship to the respondent. Moreover, household members on the roster are matched across waves and each person is given a unique identifier. This makes it is possible to tell changes in household composition and relationships on an individual basis, instead of relying on singular measures. Findings show that when longitudinal studies closely examine household rosters and link household members over time to measure instability, instead of using only single measures - a significantly greater proportion of change is captured. This study is important because it illustrates the importance of more detailed data collection on household members, and considering the fluid nature of especially poor families, the extent to which instability is overlooked by the usual measures. Finally this study provides evidence suggesting that conventional methods of capturing instability related to people in a household should be revisited
Hypertension and the Hmong Community: Using the Health Belief Model for Health Promotion
No full textHmong Americans are a minority population with a hypertensive health problem that is often undiagnosed and not medically managed. Vulnerable populations, such as ethnic minorities, are susceptible to poor health because of their unique perception of disease and treatment. Healthy People 2010 has goals that include promoting quality of life and eliminating health disparities. The Health Belief Model recognizes an individual’s perceived susceptibility to disease, perceived severity of disease, perceived benefits of certain behaviors in reducing disease, and perceived barriers, such as cost, to preventive action. Nurses and other health care professionals are in a unique position to promote health in these vulnerable populations by using the Health Belief Model. Health promotion includes identifying barriers, empowering individuals through knowledge, as well as encouraging and educating positive health behaviors
