scholarly journals Racial Differences in Clinical Phenotype and Hospitalization of Blastomycosis Patients

2019 ◽  
Vol 6 (11) ◽  
Author(s):  
Jennifer L Anderson ◽  
Holly M Frost ◽  
Jennifer P King ◽  
Jennifer K Meece
Keyword(s):  
Ethnic Groups ◽  
Racial Differences ◽  
Alaska Native ◽  
Race And Ethnicity ◽  
Clinical Presentation ◽  
Fungal Infections ◽  
Therapeutic Monitoring ◽  
Asian Patients ◽  
Hispanic White ◽  
Marshfield Clinic

Abstract Background Dimorphic fungal infections, such as blastomycosis, cause significant morbidity and mortality. Historically, blastomycosis studies have focused on non-Hispanic whites, which limits our understanding of the clinical presentation and outcomes for patients of other races and ethnicities. We evaluated whether clinical presentation and disease severity varied across racial and ethnic groups. Methods Blastomycosis patients were identified from Marshfield Clinic Health System and data were abstracted from electronic medical records. Blastomyces genotyping was performed for cases with available isolates. Bivariate analyses (χ 2 tests/analysis of variance) assessed associations of race and/or ethnicity, Blastomyces spp, and hospitalization status with demographics and clinical presentation. Multivariable logistic regression was used to evaluate the association of race and/or ethnicity and hospitalization. Results In total, 477 patients were included. Age differences were observed across race and ethnicity categories (P < .0001). Non-Hispanic whites were oldest (median, 48 years; interquartile range [IQR], 31–62) and Asians were youngest (26 years; IQR, 19–41). Non-Hispanic whites (55%) and African Americans (52%) had underlying medical conditions more frequently than Hispanic whites (27%) and Asians (29%). Odds of hospitalization were 2 to 3 times higher for Hispanic whites (adjusted odds ratio [aOR], 2.9; 95% confidence interval [CI], 1.2–1.7), American Indian or Alaska Native (AIAN) (aOR, 2.4; 95% CI, 1.0–5.5), and Asian (aOR, 1.9; 95% CI, 1.0–3.6) patients compared with non-Hispanic white patients. Ninety percent of Blastomyces dermatitidis infections occurred in non-Hispanic whites, whereas blastomycosis in Hispanic whites, AIAN, and Asian patients was frequently caused by Blastomyces gilchristii (P < .0001). Conclusions Hispanic whites, AIAN, and Asian blastomycosis patients were younger and healthier but more frequently hospitalized. Patients in these racial and ethnic groups may need more aggressive treatment and closer therapeutic monitoring.

scholarly journals 259. Racial Differences in Clinical Phenotype and Hospitalization of Blastomycosis Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S144-S144
Author(s):  
Jennifer L Anderson ◽  
Holly M Frost ◽  
Jennifer P King ◽  
Jennifer K Meece
Keyword(s):  
Ethnic Groups ◽  
Racial Differences ◽  
Clinical Presentation ◽  
Fungal Infections ◽  
Therapeutic Monitoring ◽  
Alaskan Native ◽  
Asian Patients ◽  
Caucasian Patients ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Background Dimorphic fungal infections, such as blastomycosis, cause significant morbidity and mortality. Most studies describing blastomycosis have focused on non-Hispanic Caucasians and our understanding of the clinical presentation and outcomes for patients of other race/ethnicities is limited. We evaluated whether clinical presentation and disease severity varied across racial/ethnic groups. Methods Blastomycosis patients were identified from Marshfield Clinic Health System and patient data were abstracted from electronic medical records. Blastomyces genotyping was performed for cases with available isolates. Univariate analyses using χ 2 tests and multivariate logistic regression modeling were used to determine the association of race/ethnicity with clinical presentation. Significance was defined as P ≤ 0.05. Results In total 477 patients were included.Age differences were observed across race/ethnicity categories (P < 0.0001). Non-Hispanic, Caucasians were oldest (47 years, SD 20) and Asians were the youngest (30 years, SD 18). Underlying medical conditions were more common in non-Hispanic Caucasians (55%) and African Americans (AA) (52%) than Hispanic Caucasians (27%) and Asians (29%, P = 0.0002). Risk for hospitalization was highest for Hispanic Caucasian (aOR 2.9, 95% CI 1.2–1.7), American Indian Alaskan Native (AIAN) (aOR = 2.4; 95% CI 1.0–5.5), and Asian (aOR = 1.9; 95% CI 1.0–3.6) patients when compared with non-Hispanic Caucasian patients. Ninety percent of B. dermatitidis infections occurred in non-Hispanic Caucasians whereas blastomycosis in Hispanic Caucasian, AIAN, and Asian patients was frequently caused by B. gilchristii (P < 0.0001). Conclusion Hispanic Caucasian, AIAN, and Asian blastomycosis patients were younger and healthier, but more frequently hospitalized. Patients in these racial/ethnic groups may need more aggressive treatment and closer therapeutic monitoring. Underlying host factors along with organism virulence likely play a role in these differences. Disclosures All authors: No reported disclosures.

Racial differences in suicide deaths after cancer diagnosis: A SEER-based analysis of 2,336,949 patients.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 244-244
Author(s):  
Yu-Wei Chen ◽  
Chao-Ping Wu ◽  
Yu-Han Chiu ◽  
Angela Y. Chang ◽  
Chen-Hao Chen ◽  
...  
Keyword(s):  
African American ◽  
Racial Differences ◽  
Cancer Diagnosis ◽  
Alaska Native ◽  
Suicide Mortality ◽  
P Value ◽  
Asian Pacific Islander ◽  
Asian Pacific ◽  
After Cancer ◽  
Hispanic White

244 Background: Risk of suicide is increased after cancer diagnosis. Our study aims to investigate the racial differences on risk of suicide after cancer diagnosis in a nationwide cohort of U.S. patients. Methods: Patients ≥ 18 years and diagnosed with breast (n = 616,099; 26.4%), lung (n = 585,978; 25.0%), colorectal (n = 429,060; 18.4%), or prostate cancer (n = 705,812; 30.2%) from 1988-2010 in Surveillance, Epidemiology and End Results Program (SEER) were identified. A Cox-proportional hazard model was used to compare the suicide mortality of the races (Hispanic white, African American, Asian/Pacific Islander, American Indian/Alaska Native) to non-Hispanic white patients adjusting for age, sex, marital status, household income, education level and cancer sites. Results: A total of 2,336,949 patients were identified, and there were 3,406 suicide death events. Fifty percent of suicide deaths were within 32 months after cancer diagnosis (interquartile range: 66 months). After a median follow-up of 49 months, the suicide mortality was lower in African American (HR: 0.29, 95% CI: 0.25-0.35, p value <.0001), Hispanic white (HR: 0.49, 95% CI: 0.41-0.58, p value <.0001), Asian/Pacific Islander (HR: 0.67, 95% CI: 0.57-0.79, p value<.0001). The suicide mortality was the same comparing American Indian/Alaska Native to non-Hispanic white patients (HR: 1.01, 95% CI: 0.62-1.65, p value: 0.97). Conclusions: After adjusting for sociodemographic factors, non-Hispanic white cancer patients still had higher risk of suicide death after cancer diagnosis. Future studies should address the racial differences of psychological stress after cancer diagnosis. [Table: see text]

Abstract MP45: Racial Differences in Adult Moyamoya Disease: Clinical Presentation, Angiographic Characteristics, and Outcomes After Revascularization

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Allan R Wang ◽  
Yiping Li ◽  
Gary K STEINBERG
Keyword(s):  
Racial Differences ◽  
Moyamoya Disease ◽  
Clinical Presentation ◽  
Clinic Visit ◽  
External Carotid Artery ◽  
Warning Signs ◽  
External Carotid ◽  
Asian Patients ◽  
Asian Pacific ◽  
Adult Moyamoya Disease

Introduction: Racial differences in the clinical presentation, angiographic characteristics, and treatment outcomes of adult moyamoya disease (AMMD) are not well-characterized. Methods: Consecutive patients with AMMD prospectively treated at our institution from 2015-2018 were reviewed. Results: 261 patients with AMMD were enrolled (91 Asian/Pacific Islander, 128 Caucasian, 21 Hispanic, 21 Black). Asian patients were older at first clinic visit (43.6±10.8 vs. white 38.0±10.8, Hispanic 41.0±10.3, black 39.1±9.4; p=0.003). There were no differences in rates of hypertension (p=0.23) or smoking (p=0.36), but Hispanic patients had higher rates of diabetes (38% vs. Asian 16%, Caucasian 11.7%, Black 28.5%; p=0.05). All 7 patients with known familial MMD were Asian (p=0.002). There were no differences between races in terms of ischemic or hemorrhagic presentation; however, Asian patients were less likely to present with sentinel events such as headache (50.5% vs. Caucasian 71%, Hispanic 71.4%, Black 52.4%; p=0.03). On pre-operative angiography, Asians were more likely to have anterior choroidal or posterior communicating artery moyamoya collaterals (44% vs. Caucasian 30%, Hispanic 17%, Black 28.6%; p=0.004) and more extensive external carotid artery supply (4.9±10.6% vs. Caucasian 2.2±6.3%, Hispanic 1.3±4.5%, Black 1.1±3.0%; p=0.05). There were no differences in rates of peri-operative symptomatic infarct (p=0.94) or hemorrhage (p=1.0). After revascularization, moyamoya collaterals were more likely to regress/improve in Asians (59% vs. Caucasian 39.5%, Hispanic 28.6%, Black 33%; p=0.005), remain stable in Caucasians (58.6% vs. Asian 36%, Hispanic 52.4%, Black 56%; p=0.03), and increase/worsen in Hispanics (19% vs. Asian 5%, Caucasian 1.9%, Black 11%; p=0.01). At last follow-up with a mean of 1.91±1.5 years, there were no differences in functional outcomes between races (p=0.94). Conclusions: AMMD patients of Asian descent may present later in the disease course, potentially due to experiencing fewer milder symptoms such as headache that may serve as early warning signs. The effect of revascularization on regression of moyamoya collaterals may differ based on race. The clinical impact of these differences requires further investigation.

scholarly journals Consistent Honor, Persistent Disadvantage: American Indian and Alaska Native Veteran Health in the National Survey of Veterans

2021 ◽  
Vol 33 (7-8_suppl) ◽  
pp. 68S-81S
Author(s):  
Kimberly R. Huyser ◽  
Sofia Locklear ◽  
Connor Sheehan ◽  
Brenda L. Moore ◽  
John S. Butler
Keyword(s):  
Socioeconomic Status ◽  
American Indian ◽  
National Survey ◽  
Alaska Native ◽  
Daily Living ◽  
Disadvantaged Population ◽  
Additional Support ◽  
Fair Poor ◽  
National Survey Of Veterans ◽  
Hispanic White

Objective: To examine self-rated health and activities of daily living (ADLs) limitations among American Indian and Alaska Native (AI/AN) veterans relative to white veterans. Methods: We use the 2010 National Survey of Veterans and limit the sample to veterans who identify as AI/AN or non-Hispanic white. We calculated descriptive statistics, confidence intervals, and used logistic regression. Results: AI/AN veterans are younger, have lower levels of income, and have higher levels of exposure to combat and environmental hazards compared to white veterans. We found that AI/AN veterans are significantly more likely to report fair/poor health controlling for socioeconomic status and experience an ADL controlling for age, health behaviors, socioeconomic status, and military factors. Discussion: The results indicate that AI/AN veterans are a disadvantaged population in terms of their health and disability compared to white veterans. AI/AN veterans may require additional support from family members and/or Veteran Affairs to address ADLs.

scholarly journals Incidence and Trends of the Leading Cancers with Elevated Incidence Among American Indian and Alaska Native Populations, 2012–2016

2020 ◽  
Author(s):  
Stephanie C Melkonian ◽  
Hannah K Weir ◽  
Melissa A Jim ◽  
Bailey Preikschat ◽  
Donald Haverkamp ◽  
...  
Keyword(s):  
American Indian ◽  
Cancer Incidence ◽  
Alaska Native ◽  
Cancer Registries ◽  
Population Based ◽  
Incidence Rates ◽  
Breast Cancers ◽  
Age Adjusted Rates ◽  
Incident Cases ◽  
Hispanic White

Abstract Cancer incidence varies among American Indian and Alaska Native (AI/AN) populations, as well as between AI/AN and White populations. This study examined trends for cancers with elevated incidence among AI/AN compared with non-Hispanic White populations and estimated potentially avoidable incident cases among AI/AN populations. Incident cases diagnosed during 2012–2016 were identified from population-based cancer registries and linked with the Indian Health Service patient registration databases to improve racial classification of AI/AN populations. Age-adjusted rates (per 100,000) and trends were calculated for cancers with elevated incidence among AI/AN compared with non-Hispanic White populations (rate ratio &gt;1.0), by region. Trends were estimated using joinpoint regression analyses. Expected cancers were estimated by applying age-specific cancer incidence rates among non-Hispanic White populations to population estimates for AI/AN populations. Excess cancer cases among AI/AN populations were defined as observed minus expected cases. Liver, stomach, kidney, lung, colorectal and female breast cancers had higher incidence rate among AI/AN populations across most regions. Between 2012 and 2016, nearly 5,200 excess cancers were diagnosed among AI/AN populations, with the largest number of excess cancers (1,925) occurring in the Southern Plains region. Culturally informed efforts may reduce cancer disparities associated with these and other cancers among AI/AN populations.

scholarly journals Investigating Racial Differences among Men in COVID-19 Diagnosis and Related Psychosocial and Behavioral Factors: Data from the Michigan Men’s Health Event

2021 ◽  
Vol 18 (6) ◽  
pp. 3284
Author(s):  
Jaclynn Hawkins ◽  
Karen Gilcher ◽  
Claudia Schwenzer ◽  
Michael Lutz
Keyword(s):  
African American ◽  
Racial Differences ◽  
African American Men ◽  
White Men ◽  
Adverse Impact ◽  
Medical Issues ◽  
Stress Levels ◽  
Health Event ◽  
Chi Square Analysis ◽  
Hispanic White

Extant research is growing in its ability to explain sex differences in novel coronavirus 2019 (COVID-19) diagnosis and mortality. Moving beyond comparisons based on biological sex is now warranted to capture a more nuanced picture of disparities in COVID-19 diagnosis and mortality specifically among men who are more likely to die of the illness. The objective of this study was to investigate racial disparities in COVID-19-related psychosocial, behavior and health variables among men. The present study utilizes a sample of 824 men who participated in a free health event held in a Midwestern state. Chi-square analysis showed that African American men were more likely to report an adverse impact of COVID-19 based on several factors including experiencing more COVID-19-related medical issues (χ2 = 4.60 p = 0.03); higher COVID-19 diagnosis (χ2 = 4.60 p = 0.02); trouble paying for food (χ2 = 8.47, p = 0.00), rent (χ2 = 12.26, p = 0.00), medication (χ2 = 7.10 p = 0.01) and utility bills (χ2 = 19.68, p = 0.00); higher fear of contracting COVID-19 (χ2 = 31.19, p = 0.00); and higher rates of death of close friends and family due to COVID (χ2 = 48.85, p = 0.00). Non-Hispanic white men reported more increased stress levels due to COVID-19 compared to African American men (χ2 = 10.21, p = 0.01). Regression analysis showed that race was a significant predictor of self-reported COVID-19 diagnosis (OR = 2.56, p < 0.05) after controlling for demographic characteristics. The results showed that compared to non-Hispanic White men, African American men were more likely to report an adverse impact of COVID-19 based on several factors including experiencing more COVID-19-related medical issues; higher COVID-19 diagnosis; trouble paying for food, rent, medication and utility bills; higher fear of contracting COVID-19; and higher rates of death of close friends and family due to COVID. Interestingly, non-Hispanic white men reported more increased stress levels due to COVID-19 compared to African American men.

Does having insurance affect differences in clinical presentation between Hispanic and non-Hispanic white women with breast cancer?

Cancer ◽  
2007 ◽  
Vol 109 (10) ◽  
pp. 2093-2099 ◽  
Author(s):  
A. Tyler Watlington ◽  
Tim Byers ◽  
Judy Mouchawar ◽  
Angela Sauaia ◽  
Jenn Ellis
Keyword(s):  
Breast Cancer ◽  
White Women ◽  
Clinical Presentation ◽  
Hispanic White

Scientific Racism in Modern America, 1870s–1990s

Prospects ◽  
1996 ◽  
Vol 21 ◽  
pp. 471-490 ◽  
Author(s):  
Hamilton Cravens
Keyword(s):  
Ethnic Group ◽  
Ethnic Groups ◽  
Race And Ethnicity ◽  
Scientific Discourse ◽  
Cultural Authority ◽  
Group Differences ◽  
Scientific Racism ◽  
National Population

In post-Darwinian times, Americans have usually thought of the national population as divided into many distinct races and ethnic groups. The notions and definitions they have used for a race and an ethnic group have varied from one age to another. Although Americans have not needed the resources of science to believe that some races and ethnic groups are superior to others, in these times science has become a powerful symbol of cultural authority. For the racist, the assistance of science has often been useful. In this essay, it is important to distinguish between the scientific discourse on race and ethnicity whose participants do not necessarily assume that groups differ in value, and that of scientific racism, whose participants might or might not be scientists, but who have consistently assumed that science proves the existence of permanent group differences and legitimates the assertion that some groups are inherently superior to others. Here we shall discuss the latter.

scholarly journals Is the Association of Diabetes With Uncontrolled Blood Pressure Stronger in Mexican Americans and Blacks Than in Whites Among Diagnosed Hypertensive Patients?

2013 ◽  
Vol 26 (11) ◽  
pp. 1328-1334 ◽  
Author(s):  
Xuefeng Liu ◽  
Ping Song
Keyword(s):  
Blood Pressure ◽  
Racial Differences ◽  
Mexican Americans ◽  
The United States ◽  
Linear Regression Models ◽  
Uncontrolled Blood Pressure ◽  
Hypertensive Patients ◽  
Health And Nutrition ◽  
Multistage Design ◽  
Hispanic White

Abstract BACKGROUND Clinical evidence shows that diabetes may provoke uncontrolled blood pressure (BP) in hypertensive patients. However, racial differences in the associations of diabetes with uncontrolled BP outcomes among diagnosed hypertensive patients have not been evaluated. METHODS A total of 6,134 diagnosed hypertensive subjects aged ≥20 years were collected from the National Health and Nutrition Examination Survey 1999–2008 with a stratified multistage design. Odds ratios (ORs) and relative ORs of uncontrolled BP and effect differences in continuous BP for diabetes over race/ethnicity were derived using weighted logistic regression and linear regression models. RESULTS Compared with participants who did not have diabetes, non-Hispanic black participants with diabetes had a 138% higher chance of having uncontrolled BP, Mexican participants with diabetes had a 60% higher chance of having uncontrolled BP, and non-Hispanic white participants with diabetes had a 161% higher chances of having uncontrolled BP. The association of diabetes with uncontrolled BP was lower in Mexican Americans than in non-Hispanic blacks and whites (Mexican Americans vs. non-Hispanic blacks: relative OR = 0.55, 95% confidence interval (CI) = 0.37–0.82; Mexican Americans vs. non-Hispanic whites: relative OR = 0.53, 95% CI = 0.35–0.80) and the association of diabetes with isolated uncontrolled systolic BP was lower in Mexican Americans than in non-Hispanic whites (Mexican Americans vs. non-Hispanic whites: relative OR = 0.62, 95% CI = 0.40–0.96). Mexican Americans have a stronger associaton of diabetes with decreased systolic BP and diastolic BP than non-Hispanic whites, and a stronger association of diabetes with decreased diastolic BP than non-Hispanic blacks. CONCLUSIONS The association of diabetes with uncontrolled BP outcomes is lower despite higher prevalence of diabetes in Mexican Americans than in non-Hispanic whites. The stronger association of diabetes with BP outcomes in whites should be of clinical concern, considering they account for the majority of the hypertensive population in the United States.

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