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Shaping a new generation of Hispanic clinical and translational researchers addressing minority health and health disparities
No full textLongitudinal assessment of urban form and weight gain in African-American women.
No full textBACKGROUND: Numerous cross-sectional studies have found higher levels of obesity among residents of auto-oriented, sprawling areas compared to residents of more urban areas.
PURPOSE: The association between neighborhood urban form and 6-year weight change was prospectively analyzed in the Black Women's Health Study, a cohort study of U.S. black women who enrolled in 1995 and are followed biennially with mailed questionnaires.
METHODS: The analysis included 17,968 women who lived in New York City, Chicago, or Los Angeles and were followed from 1995 to 2001. Factor analysis was used to combine variables describing the urban form of participants' residential neighborhoods into an "urbanicity" score. Mixed linear regression models were used to calculate least-squares means for weight change across quintiles of the urbanicity score. Incidence rate ratios (IRRs) and 95% CIs for incident obesity in relation to the urbanicity score among women who were not obese at baseline were derived from Cox regression models. All results were adjusted for age, region, lifestyle factors, and neighborhood SES. Analyses were conducted in 2008-2010.
RESULTS: In multivariate analysis, mean weight gain for women in the highest quintile of urbanicity score (most urban) was 0.79 kg less than for those in the lowest quintile, with a significant trend (p=0.003). The IRR for incident obesity in the highest quintile relative to the lowest was 0.83 (95% CI=0.71, 0.97), with a significant trend (p=0.042).
CONCLUSIONS: Policies that encourage dense, urban residential development may have a positive role to play in addressing obesity in black women
Competitive Foods, Discrimination, and Participation in the National School Lunch Program
No full textMeals served through the National School Lunch Program (NSLP) must meet rigorous nutritional standards; however, barriers to student participation may limit the program's health and social equity benefits. Unsubsidized meals and food offerings competing with the NSLP offerings in school lunch environments may be lowering qualified student participation either directly or via identification of subsidized low-income students or stigmatization of the NSLP. We document a pilot intervention conducted in San Francisco in 2009 and 2010 that demonstrated gains in NSLP participation after removal of separate competitive à la carte lunch meal offerings. Our observations suggest the need for greater attention to the potential discriminatory effects of competitive foods and to the issue of stigma by school nutrition program administrators, researchers, regulators, and policymakers. (Am J Public Health. Published online ahead of print June 16, 2011:e1-e7. doi:10.2105/AJPH.2011.300134)
Determinants and beliefs of health information mavens among a lower-socioeconomic position and minority population.
No full textPeople of lower-socioeconomic position (SEP) and most racial/ethnic minorities face significant communication challenges which may negatively impact their health. Previous research has shown that these groups rely heavily on interpersonal sources to share and receive health information; however, little is known about these lay sources. The purpose of this paper is to apply the concept of a market maven to the public health sector with the aims of identifying determinants of high health information mavenism among low-SEP and racial/ethnic minority groups and to assess the information they may be sharing based on their own health beliefs. Data for this study were drawn from the baseline survey (n = 325) of a US randomized control intervention study aimed at eliciting an understanding of Internet-related challenges among lower-SEP and minority individuals. Regression models were estimated to distinguish significant determinants of health information mavenism among the sample. Similarly, bivariate and logistic multivariable models were estimated to determine the association between health information mavenism and accurate health beliefs relating to diet, physical activity and smoking. The data illustrate that having a larger social network, being female and being older were important factors associated with higher mavenism scores. Additionally being a moderate consumer of general media as well as fewer years in the US and lower language acculturation were significant predictors of higher mavenism scores. Mavens were more likely than non-mavens to maintain accurate beliefs regarding diet; however, there was no distinction between physical activity and smoking beliefs between mavens and non-mavens. These results offer a unique understanding of health information mavenism which could better leverage word-of-mouth health communication efforts among lower-SEP and minority groups in order to reduce communication inequalities. Moreover, the data indicate that health information mavens may serve as an ideal point of intervention in attempts to modify health beliefs with the goal of reducing health disparities among these populations
Cuts to Community Health Centers Harm Communities of Color the Most
No full textCommunity health centers were a crucial source of health care for more than 20 million people nationwide in 2010, but the centers disproportionately served members from underserved groups such as communities of color and low-income populations
Quality of life among Latina breast cancer patients: a systematic review of the literature
No full textIntroduction
The Latino population is the most rapidly growing ethnic minority in the United States and Latinas have higher rates of advanced breast cancer and more rigorous treatments than White women. However, the literature lacks reviews on quality of life among this population of breast cancer patients.
Methods
A systematic review of the breast cancer quality of life (QOL) literature was conducted among studies that provided a comparison of mental, physical, social, or sexual QOL between Latinas and other racial/ethnic groups. Of the 375 studies reviewed, 20 quantitative studies and two qualitative studies met criteria for inclusion.
Results
Latinas were more likely to report poor mental, physical, and social QOL, relative to non-Latinas. Only four studies assessed sexual QOL, making it difficult to draw any conclusions. Of these four QOL domains, the largest disparity was found in the area of mental health in which Latinas reported poorer QOL compared to non-Latina Whites and Blacks.
Discussion/conclusions
Most quantitative studies revealed either that Latinas consistently evidenced significantly lower QOL than non-Latinas on all measures (6 studies) or reported mixed findings in which Latinas generally demonstrated significantly worse QOL on most, but not all, measures (12 studies) included in the study. Explanatory mechanisms including socio-demographic, treatment-related, and culturally-relevant factors are discussed. Implications for research design, measurement, and clinical work are also included.
Implications for cancer survivors
Although not entirely consistent, data suggest that Latina breast cancer survivors on average experience worse QOL than non-Latina Whites.
Understanding ethnic differences in QOL among breast cancer survivors can inform interventions targeted at improving health status for Latinas
Special considerations on the management of Latino patients with type 2 diabetes mellitus
No full textAbstract available at publisher's website
Research on Syphilis in Guatemala in the 1940s: History, Context, and Contemporary Concerns
No full textResearch on Syphilis in Guatemala in the 1940s: History, Context, and Contemporary Concerns is a Panel Discussion
Welcome: Dr. Donald S. Burke
Panelists: Susan M. Reverby, PhD, Wellesley College, and Sue E. Lederer, PhD, University of Wisconsin Moderator: Alan Meisel, JD, University of Pittsburgh School of Law, Professor of Law and Psychiatry, and Dickie, McCamey & Chilcote Professor of Bioethic
Cigarette smoking interventions among diverse populations
No full textOne of the greatest public health success stories of the past 50 years has been the reduction in cigarette smoking in the United States. Smoking prevalence has decreased by 50% or more in the United States since the 1960s, and although recent reports indicate a plateau in this decline, the long-term downward trend has resulted in an overall smoking prevalence rate of 20.6% in 2009.1 Despite this success, the Healthy People 2010 objective of reducing the prevalence of cigarette smoking among adults to 12% or less has not been realized. This is, in large part, due to the fact that tobacco control efforts have not impacted population subgroups equally. In general, racial/ethnic minority groups and persons of lower socioeconomic status (SES) have not benefited as much as whites and those of higher SES from smoking prevention and cessation programs. If we are to meet the goal of 12% or less smoking prevalence among the overall adult population, more effort is needed to influence tobacco use behaviors among racial/ethnic and low SES population