Racial and Ethnic Distribution of Inflammatory Bowel Disease in the United States

2021 ◽  
Author(s):  
Edward L Barnes ◽  
William B Nowell ◽  
Shilpa Venkatachalam ◽  
Angela Dobes ◽  
Michael D Kappelman
Keyword(s):  
United States ◽  
Ethnic Groups ◽  
Ethnic Diversity ◽  
The United States ◽  
Research Network ◽  
Patient Centered ◽  
Black Patients ◽  
Hispanic Patients ◽  
National Patient ◽  
Relative Prevalence

Abstract Background The current burden of Crohn’s disease (CD) and ulcerative colitis (UC) in minority populations is largely unknown. We sought to evaluate the relative prevalence of CD and UC across racial and ethnic groups within the National Patient-Centered Clinical Research Network (PCORnet). Methods We queried electronic health records from 337 centers from January 2013 to December 2018. We compared the relative prevalence of CD and UC across racial/ethnic groups to the general PCORnet populations using χ 2 and univariable logistic regression. Results Among 39,864,077 patients, 114,168 had CD, and 98,225 had UC. Relative to the overall PCORnet population, Black adult patients were significantly less likely than White patients to have a diagnosis of CD (odds ratio [OR], 0.53; 95% CI, 0.52–0.54) or UC (OR, 0.41; 95% CI, 0.40–0.43). Pediatric Black patients were also less likely to have a diagnosis of CD (OR, 0.41; 95% CI, 0.39–0.43) or UC (OR, 0.38; 95% CI, 0.35–0.41). Adult Hispanic patients were less likely to have a diagnosis of CD (OR, 0.33; 95% CI, 0.32–0.34) or UC (OR, 0.45; 95% CI, 0.44–0.46) compared with non-Hispanic patients. Similarly, pediatric Hispanic patients were less likely to have a diagnosis of CD (OR, 0.34; 95% CI, 0.32–0.36) or UC (OR, 0.50; 95% CI, 0.47–0.53). Conclusions Despite the increasing racial and ethnic diversity in the United States, these data suggest that CD and UC are modestly less prevalent among patients of non-White races and Hispanic ethnicity.

LINKING BLACKNESS OR ETHNIC OTHERING?

2010 ◽  
Vol 7 (2) ◽  
pp. 335-355 ◽  
Author(s):  
Shayla C. Nunnally
Keyword(s):  
United States ◽  
African Americans ◽  
Racial Discrimination ◽  
Ethnic Groups ◽  
Racial Socialization ◽  
Ethnic Diversity ◽  
The United States ◽  
West Indians ◽  
Linked Fate ◽  
Major Predictor

AbstractDawson (1994) submits Black linked fate is a major predictor of Black political behavior. This theory conjectures that the experiences of African Americans with race and racial discrimination in the United States unify their personal interests under a rubric of interests that are best for the Black racial group. With increasing Black ethnic diversity in the United States, however, it becomes important to ascertain how African Americans perceive linkages across Black ethnic groups. This study examines African Americans' linkages with West Indian and African peoples in the United States, referred to here as diasporic linked fate. The study tests the influence of parent-child, intra-racial socialization messages on these linkages. Results suggest that, while a majority of African Americans acknowledge Black linked fate, they distinguish these linkages based on ethnicity and have more tenuous linkages with West Indians and Africans in the United States. While intra-racial socialization messages offer some import in explaining perceived differences in Black ethnic groups' living experiences, more frequent experiences with racial discrimination, and membership in a Black organization offer more import in explaining diasporic linked fate.

scholarly journals 1665. Using Electronic Health Records to Describe TB in Community Health Settings: a Cohort Analysis in a Large Safety-Net Population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S819-S820
Author(s):  
Jonathan Todd ◽  
Jon Puro ◽  
Matthew Jones ◽  
Jee Oakley ◽  
Laura A Vonnahme ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Electronic Health Records ◽  
Safety Net ◽  
The United States ◽  
Research Network ◽  
Health Records ◽  
Treatment Regimens ◽  
Data Source ◽  
Electronic Health

Abstract Background Over 80% of tuberculosis (TB) cases in the United States are attributed to reactivation of latent TB infection (LTBI). Eliminating TB in the United States requires expanding identification and treatment of LTBI. Centralized electronic health records (EHRs) are an unexplored data source to identify persons with LTBI. We explored EHR data to evaluate TB and LTBI screening and diagnoses within OCHIN, Inc., a U.S. practice-based research network with a high proportion of Federally Qualified Health Centers. Methods From the EHRs of patients who had an encounter at an OCHIN member clinic between January 1, 2012 and December 31, 2016, we extracted demographic variables, TB risk factors, TB screening tests, International Classification of Diseases (ICD) 9 and 10 codes, and treatment regimens. Based on test results, ICD codes, and treatment regimens, we developed a novel algorithm to classify patient records into LTBI categories: definite, probable or possible. We used multivariable logistic regression, with a referent group of all cohort patients not classified as having LTBI or TB, to identify associations between TB risk factors and LTBI. Results Among 2,190,686 patients, 6.9% (n=151,195) had a TB screening test; among those, 8% tested positive. Non-U.S. –born or non-English–speaking persons comprised 24% of our cohort; 11% were tested for TB infection, and 14% had a positive test. Risk factors in the multivariable model significantly associated with being classified as having LTBI included preferring non-English language (adjusted odds ratio [aOR] 4.20, 95% confidence interval [CI] 4.09–4.32); non-Hispanic Asian (aOR 5.17, 95% CI 4.94–5.40), non-Hispanic black (aOR 3.02, 95% CI 2.91–3.13), or Native Hawaiian/other Pacific Islander (aOR 3.35, 95% CI 2.92–3.84) race; and HIV infection (aOR 3.09, 95% CI 2.84–3.35). Conclusion This study demonstrates the utility of EHR data for understanding TB screening practices and as an important data source that can be used to enhance public health surveillance of LTBI prevalence. Increasing screening among high-risk populations remains an important step toward eliminating TB in the United States. These results underscore the importance of offering TB screening in non-U.S.–born populations. Disclosures All Authors: No reported disclosures

scholarly journals Complementary and Integrative Health Knowledge and Practice in Primary Care Settings: A Survey of Primary Care Providers in the Northwestern United States

2021 ◽  
Vol 10 ◽  
pp. 216495612110233
Author(s):  
Malaika R Schwartz ◽  
Allison M Cole ◽  
Gina A Keppel ◽  
Ryan Gilles ◽  
John Holmes ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Health Knowledge ◽  
Care Delivery ◽  
Primary Care Providers ◽  
The United States ◽  
Research Network ◽  
Care Providers ◽  
Integrative Health ◽  
And Training

Background The demand for complementary and integrative health (CIH) is increasing by patients who want to receive more CIH referrals, in-clinic services, and overall care delivery. To promote CIH within the context of primary care, it is critical that providers have sufficient knowledge of CIH, access to CIH-trained providers for referral purposes, and are comfortable either providing services or co-managing patients who favor a CIH approach to their healthcare. Objective The main objective was to gather primary care providers’ perspectives across the northwestern region of the United States on their CIH familiarity and knowledge, clinic barriers and opportunities, and education and training needs. Methods We conducted an online, quantitative survey through an email invitation to all primary care providers (n = 483) at 11 primary care organizations from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). The survey questions covered talking about CIH with patients, co-managing care with CIH providers, familiarity with and training in CIH modalities, clinic barriers to CIH integration, and interest in learning more about CIH modalities. Results 218 primary care providers completed the survey (45% response rate). Familiarity with individual CIH methods ranged from 73% (chiropracty) to 8% (curanderismo). Most respondents discussed CIH with their patients (88%), and many thought that their patients could benefit from CIH (41%). The majority (89%) were willing to co-manage a patient with a CIH provider. Approximately one-third of respondents had some expertise in at least one CIH modality. Over 78% were interested in learning more about the safety and efficacy of at least one CIH modality. Conclusion Primary care providers in the Northwestern United States are generally familiar with CIH modalities, are interested in referring and co-managing care with CIH providers, and would like to have more learning opportunities to increase knowledge of CIH.

Mainstream Flavor: Ethnic Cuisine and Assimilation in the United States

2020 ◽  
Vol 8 (1) ◽  
pp. 64-85
Author(s):  
Anna Boch ◽  
Tomás Jiménez ◽  
Katharina Roesler
Keyword(s):  
United States ◽  
Ethnic Groups ◽  
Cultural Change ◽  
Culture Change ◽  
Contextual Factors ◽  
The United States ◽  
Factors Associated ◽  
Assimilation Process ◽  
Restaurant Reviews ◽  
Mexican Populations

Assimilation theories posit that cultural change is part and parcel of the assimilation process. That change can register in the symbols and practices that individuals invoke as part of an ethnic experience. But cultural change also includes the degree to which the mainstream takes up those symbols and practices as part of its composite culture. We develop a way to examine whether cuisine, an important component of ethnic culture, is part of the mainstream’s composite culture and the contextual factors associated with the presence of ethnic cuisine in the composite culture. We begin with a comparison of 761,444 reviews of Mexican, Italian, Chinese, and American restaurants across the United States from Yelp!, an online customer review platform. We find that reviews of Mexican restaurants mention ethnicity and authenticity much more than reviews of Italian and American restaurants, but less than reviews of Chinese restaurants, suggesting intermediate mainstreaming of Mexican cuisine. We then examine Mexican restaurant reviews in the 82 largest U.S. core-based statistical areas (CBSAs) to uncover the contextual factors associated with Mexican cuisine’s local mainstream presence. We find that Mexican food is less defined in ethnic terms in CBSAs with larger and more culturally distinct Mexican populations and at less-expensive restaurants. We argue that regional versions of the composite culture change as ethnic groups come to define a region demographically and culturally.

scholarly journals Trends in survival of patients with Burkitt lymphoma/leukemia in the USA: an analysis of 3691 cases

Blood ◽  
2013 ◽  
Vol 121 (24) ◽  
pp. 4861-4866 ◽  
Author(s):  
Luciano J. Costa ◽  
Ana C. Xavier ◽  
Amy E. Wahlquist ◽  
Elizabeth G. Hill
Keyword(s):  
United States ◽  
Young Adults ◽  
Burkitt Lymphoma ◽  
Unmet Need ◽  
The United States ◽  
The Past ◽  
Black Patients ◽  
Key Points ◽  
The Usa

Key Points Survival of patients with BL improved substantially in the United States during the past decade, mainly among young adults. Survival of patients with BL remains relatively low, particularly for older and black patients, identifying an unmet need.

The Other America

2020 ◽  
Author(s):  
Harris Beider ◽  
Kusminder Chahal
Keyword(s):  
United States ◽  
Civil Rights ◽  
Working Class ◽  
Ethnic Diversity ◽  
The United States ◽  
Race Identity ◽  
2016 Election ◽  
White Working Class ◽  
Mainstream Society ◽  
The Right

Widely stereotyped as anti-immigrant, against civil-rights, or supporters of Trump and the right, can the white working class of the United States really be reduced to a singular group with similar views? This book begins with an overview of how the term “white working class” became weaponized and used as a vessel to describe people who were seen to be “deplorable.” The national narrative appears to credit (or blame) white working-class mobilization across the country for the success of Donald Trump in the 2016 US elections. Those who take this position see the white working class as being problematic in different ways: grounded in norms and behaviors that seem out of step with mainstream society; at odds with the reality of increased ethnic diversity across the country and especially in cities; blaming others for their economic plight; and disengaged from politics. Challenging populist views about the white working class in the United States, the book showcases what they really think about the defining issues in today's America—from race, identity, and change to the crucial on-the-ground debates occurring at the time of the 2016 U.S. election. As the 2020 presidential elections draw near, this is an invaluable insight into the complex views on 2016 election candidates, race, identity and cross-racial connections.

Trends in the Contribution of Emergency Departments to the Provision of Hospital-Associated Health Care in the USA

2017 ◽  
Vol 48 (2) ◽  
pp. 267-288 ◽  
Author(s):  
David Marcozzi ◽  
Brendan Carr ◽  
Aisha Liferidge ◽  
Nicole Baehr ◽  
Brian Browne
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Emergency Departments ◽  
The United States ◽  
National Hospital ◽  
Patient Centered ◽  
National Hospital Discharge Survey ◽  
Delivery Of Care ◽  
The Usa

Traditional approaches to assessing the health of populations focus on the use of primary care and the delivery of care through patient-centered homes, managed care resources, and accountable care organizations. The use of emergency departments (EDs) has largely not been given consideration in these models. Our study aimed to determine the contribution of EDs to the health care received by Americans between 1996 and 2010 and to compare it with the contribution of outpatient and inpatient services using National Hospital Ambulatory Medical Care Survey and National Hospital Discharge Survey databases. We found that EDs contributed an average of 47.7% of the hospital-associated medical care delivered in the United States, and this percentage increased steadily over the 14-year study period. EDs are a major source of medical care in the United States, especially for vulnerable populations, and this contribution increased throughout the study period. Including emergency care within health reform and population health efforts would prove valuable to supporting the health of the nation.

scholarly journals Imagining Her Future: Diversity in Mothers’ Socialization Goals for Their Adolescent Daughters

2017 ◽  
Vol 48 (4) ◽  
pp. 593-610 ◽  
Author(s):  
Jennifer Ramirez ◽  
Linda Oshin ◽  
Stephanie Milan
Keyword(s):  
United States ◽  
African American ◽  
Ethnic Groups ◽  
Low Income ◽  
The United States ◽  
Social Traits ◽  
Socialization Goals ◽  
Racial Ethnic ◽  
Q Sort

According to developmental niche theory, members of different cultural and ethnic groups often have distinct ideas about what children need to become well-adapted adults. These beliefs are reflected in parents’ long-term socialization goals for their children. In this study, we test whether specific themes that have been deemed important in literature on diverse families in the United States (e.g., Strong Black Woman [SBW], marianismo, familismo) are evident in mothers’ long-term socialization goals. Participants included 192 mothers of teenage daughters from a low-income city in the United States (58% Latina, 22% African American, and 20% European American [EA]/White). Socialization goals were assessed through a q-sort task on important traits for a woman to possess and content analysis of open-ended responses about what values mothers hoped they would transmit to their daughters as they become adults. Results from ANCOVAs and logistic regression indicate significant racial/ethnic differences on both tasks consistent with hypotheses. On the q-sort task, African American mothers put more importance on women possessing traits such as independence than mothers from other racial/ethnic groups. Similarly, they were more likely to emphasize self-confidence and strength in what they hoped to transmit to their daughters. Contrary to expectation, Latina mothers did not emphasize social traits on the q-sort; however, in open-ended responses, they were more likely to focus on the importance of motherhood, one aspect of marianismo and familismo. Overall, results suggest that these mothers’ long-term socialization goals incorporate culturally relevant values considered important for African American and Latino families.

scholarly journals Inequities in Diabetic Ketoacidosis Among Patients With Type 1 Diabetes and COVID-19: Data From 52 US Clinical Centers

2020 ◽  
Author(s):  
Osagie Ebekozien ◽  
Shivani Agarwal ◽  
Nudrat Noor ◽  
Anastasia Albanese-O’Neill ◽  
Jenise C Wong ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
The United States ◽  
Cross Sectional Study ◽  
Multivariable Logistic Regression Analysis ◽  
Cross Sectional ◽  
Black Patients ◽  
Hispanic Patients ◽  
White Patients

Abstract Objective We examined whether diabetic ketoacidosis (DKA), a serious complication of type 1 diabetes (T1D) was more prevalent among Non-Hispanic (NH) Black and Hispanic patients with T1D and laboratory-confirmed coronavirus disease 2019 (COVID-19) compared with NH Whites. Method This is a cross-sectional study of patients with T1D and laboratory-confirmed COVID-19 from 52 clinical sites in the United States, data were collected from April to August 2020. We examined the distribution of patient factors and DKA events across NH White, NH Black, and Hispanic race/ethnicity groups. Multivariable logistic regression analysis was performed to examine the odds of DKA among NH Black and Hispanic patients with T1D as compared with NH White patients, adjusting for potential confounders, such as age, sex, insurance, and last glycated hemoglobin A1c (HbA1c) level. Results We included 180 patients with T1D and laboratory-confirmed COVID-19 in the analysis. Forty-four percent (n = 79) were NH White, 31% (n = 55) NH Black, 26% (n = 46) Hispanic. NH Blacks and Hispanics had higher median HbA1c than Whites (%-points [IQR]: 11.7 [4.7], P < 0.001, and 9.7 [3.1] vs 8.3 [2.4], P = 0.01, respectively). We found that more NH Black and Hispanic presented with DKA compared to Whites (55% and 33% vs 13%, P < 0.001 and P = 0.008, respectively). After adjusting for potential confounders, NH Black patients continued to have greater odds of presenting with DKA compared with NH Whites (OR [95% CI]: 3.7 [1.4, 10.6]). Conclusion We found that among T1D patients with COVID-19 infection, NH Black patients were more likely to present in DKA compared with NH White patients. Our findings demonstrate additional risk among NH Black patients with T1D and COVID-19.

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