scholarly journals Racial/Ethnic Differences in Poststroke Rehabilitation Outcomes

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Charles Ellis ◽  
Hyacinth I. Hyacinth ◽  
Jamie Beckett ◽  
Wuwei Feng ◽  
Marc Chimowitz ◽  
...  
Keyword(s):  
Ethnic Differences ◽  
Ethnic Disparities ◽  
Publishing Research ◽  
Functional Improvement ◽  
Stroke Survivors ◽  
Lower Efficiency ◽  
Stroke Incidence ◽  
Rehabilitation Outcomes ◽  
Blacks And Whites ◽  
Racial Ethnic

Background. Significant racial and ethnic disparities in stroke incidence, severity, and morbidity have been consistently reported; however, less is known about potential differences in poststroke rehabilitation outcomes.Objective. To examine racial and ethnic differences in poststroke rehabilitation outcomes.Methods. We completed an in-depth search of Medline and several major journals dedicated to publishing research articles on stroke, rehabilitation, and racial-ethnic patterns of disease over a 10-year period (2003–2012). We identified studies that reported rehabilitation outcomes and the race or ethnicity of at least two groups.Results. 17 studies involving 429,108 stroke survivors met inclusion criteria for the review. The majority (94%) of studies examined outcomes between Blacks and Whites. Of those studies examining outcomes between Blacks and Whites, 59% showed that Blacks were generally less likely to achieve equivalent functional improvement following rehabilitation. Blacks were more likely to experience lower FIM gain or change scores (range: 1–60%) and more likely to have lower efficiency scores (range: 5–16%) than Whites.Conclusions. Black stroke survivors appear to generally achieve poorer functional outcomes than White stroke survivors. Future studies are warranted to evaluate the precise magnitude of these differences, whether they go beyond chance, and the underlying contributory mechanisms.

scholarly journals Geographic Regional Variation in Patterns of Racial and Ethnic Disparities in Late-Life Depression

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 168-168
Author(s):  
Chirag Vyas ◽  
Charles Reynolds ◽  
David Mischoulon ◽  
Grace Chang ◽  
Olivia Okereke
Keyword(s):  
Native American ◽  
Ethnic Differences ◽  
Ethnic Disparities ◽  
Late Life ◽  
Geographic Region ◽  
Omega 3 ◽  
Late Life Depression ◽  
Item Level ◽  
Racial Ethnic ◽  
Hispanic White

Abstract There is evidence of racial/ethnic disparities in late-life depression (LLD) burden and treatment in the US. Geographic region may be a novel social determinant; yet, limited data exist regarding the interplay of geographic region with racial/ethnic differences in LLD severity, item-level symptom burden and treatment. We conducted a cross-sectional study among 25,503 men aged 50+ years and women aged 55+ years in VITAL-DEP (VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention), an ancillary study to the VITAL trial. Racial/ethnic groups included Non-Hispanic White, Black, Hispanic, Asian, and other groups (Native American/Alaskan Native and other/multiple/unspecified-race/ethnicity). We assessed depression status using: the Patient Health Questionnaire-8 (PHQ-8); self-reported clinician/physician diagnosis of depression; medication and/or counseling treatment for depression. In the full sample, Midwest region was significantly associated with 12% lower severity of LLD, compared to Northeast region (rate ratio (RR) (95% confidence interval (CI)): 0.88 (0.83-0.93)). However, racial/ethnic differences in LLD varied by region. For example, in the Midwest, Blacks and Hispanics had significantly higher depression severity compared to non-Hispanic Whites (RR (95% CI): for Black, 1.16 (1.02-1.31); for Hispanic, 2.03 (1.38-3.00)). Furthermore, in multivariable-adjusted logistic regression models, minority vs. non-Hispanic White adults had 2- to 3-fold significantly higher odds of several item-level symptoms across all regions, especially in the Midwest and Southwest. Finally, among those endorsing PHQ-8≥10, Blacks had 60-80% significantly lower odds of depression treatment, compared to non-Hispanic Whites, in all regions. In summary, we observed significant geographic variation in patterns of racial/ethnic disparities in LLD outcomes. This requires further longitudinal investigation.

Abstract P352: Racial/Ethnic Differences in Cardiovascular Disease Outcomes among Patients with Hypertension or Type 2 Diabetes

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jia Pu ◽  
Sukyung Chung ◽  
Beinan Zhao ◽  
Vani Nimbal ◽  
Elsie J Wang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Asian Indian ◽  
Ethnic Differences ◽  
Elevated Risk ◽  
Stroke Incidence ◽  
Men And Women ◽  
Hazard Ratios ◽  
Race Ethnicity ◽  
Racial Ethnic

Background: This study assesses racial/ethnic differences in CVD outcomes among patients with hypertension (HTN) or type 2 diabetes (T2DM) across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese), Mexican, non-Hispanic black (NHB), and non-Hispanic White (NHW) in a large, mixed payer ambulatory care setting in northern California. Study Design: We estimated the rate of CVD incidence among adult patients with HTN (N=171,864) or T2DM (N=10,570), or both (N=36,589) using electronic health records between 2000-2013. Average follow-up was 4.5 years. CVD, including CHD (410-414), PVD (415, 440.2, 440.3, 443.9, 451, 453), and stroke (430-434), was defined by ICD-9 codes; HTN and T2DM were defined by ICD-9 codes, medication history, or two or more elevated blood pressure measures/abnormal glucose lab test results. Cox proportional hazard models were used to estimate hazard ratios for CHD, PVD, and stroke across race/ethnicity. Results: Among these patients, 10.5% developed CVD by the end of year 2013 (5.4% CHD, 3.4%PVD, 3.6% stroke). There was a gender difference in the risk of incident CHD. Among males, the age-adjusted hazard ratios for CHD were significantly higher for Asian Indians (HR: 1.3, 95% CI: 1.2-1.5) and significantly lower for Chinese (HR: 0.6, CI: 0.5-0.7) and Japanese (HR: 0.8, CI: 0.6-0.9) compared to NHWs. Among females, the age-adjusted hazard ratios for CHD were significantly higher for Mexican (HR: 1.3, CI: 1.1-1.5) and NHBs (HR: 1.7, CI: 1.4-2.0) and significantly lower for Chinese (HR: 0.6, CI: 0.5-0.7) and Japanese (HR: 0.5, CI: 0.4-0.7). NHB men and women also had significantly higher age-adjusted hazard ratios for PVD (men: HR: 1.5, CI: 1.2-1.9; women: HR: 1.6, CI: 1.3-1.9) and stroke (men: HR: 1.3, CI: 1.1-1.7; women: HR: 1.3, CI: 1.1-1.6) compared to NHWs. The age-adjusted hazard ratios for PVD and stroke were lower or equivalent to NHWs for all Asian subgroups and Mexican men and women. Patients with both HTN and T2DM were at elevated risk to develop CVD compared to patients with only one of the two conditions, regardless of their race/ethnicity. Conclusions: Compared to previous studies, we found less racial/ethnic variation in CVD outcomes, in particular stroke, among patients with HTN or T2DM. Our finding suggests the higher stroke incidence rates in several races/ethnicities are likely to be explained by the higher prevalence of HTN and T2DM among these groups. However, Asian Indian men and NHB and Mexican women with HTN or T2DM were at elevated risk for CHD compared to NHWs. Since the majority of patients in the study cohort had health insurance, further studies are needed to better understand the reasons for the observed racial/ethnic differences beyond disparities in access to health care. Special attention needs to be paid to patients with multiple conditions.

Abstract TP180: Racial/Ethnic Differences in Sleep Duration and Sleep Disturbances Among Stroke Survivors

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Emily Nangle ◽  
Emily Goldmann ◽  
Nina S Parikh ◽  
Noa Appleton ◽  
Bernadette Boden-Albala
Keyword(s):  
Sleep Duration ◽  
Ethnic Differences ◽  
Sleep Disturbances ◽  
Stroke Survivors ◽  
Racial Ethnic

scholarly journals HEADS-UP: Understanding and Problem-Solving

Stroke ◽  
2020 ◽  
Vol 51 (11) ◽  
pp. 3375-3381
Author(s):  
Bruce Ovbiagele
Keyword(s):  
Problem Solving ◽  
Health Equity ◽  
Neurological Disorders ◽  
Underserved Populations ◽  
Early Stage ◽  
Ethnic Disparities ◽  
Grant Writing ◽  
Scientific Content ◽  
Stroke Incidence ◽  
Racial Ethnic

There are substantial and longstanding inequities in stroke incidence, prevalence, care, and outcomes. The Health Equity and Actionable Disparities in Stroke: Understanding and Problem-Solving (HEADS-UP) symposium is an annual multidisciplinary scientific and educational forum targeting major inequities in cerebrovascular disease, with the ultimate objective of helping to bridge major inequities in stroke, and promptly translating scientific results into routine clinical practice, for the benefit of vulnerable and underserved populations. HEADS-UP is a collaborative undertaking by the National Institute of Neurological Disorders and Stroke and the American Stroke Association and is held the day before the annual International Stroke Conference. In 2020, the HEADS-UP focused on the topic of racial/ethnic disparities in stroke and comprised invited lectures on determinants of racial/ethnic inequities in stroke as well as emerging interventions or promising strategies designed to overcome these inequities. Competitively selected travel award scholarships were given to 19 early stage investigators who presented posters at professor moderated sessions; engaged in several career development activities aimed imparting grant writing skills, knowledge about climbing the academic ladder, and striving for work-life balance; and participated in networking events. This Health Equity edition of Focused Updates will feature an overview of the HEADS-UP 2020 symposium proceedings and articles covering the key scientific content of the major lectures delivered during the symposium including the presentation by the award-winning plenary speaker. Starting in 2021, HEADS-UP will expand to include 5 major inequities in stroke (racial/ethnic, sex, geographic, socioeconomic, and global) and seeks to be a viable avenue to meet the health equity goals of the American Heart Association/American Stroke Association, National Institutes of Neurological Disorders and Stroke, and World Stroke Organization.

Dietary Practices Among Stroke-survivors—Racial/Ethnic Differences

2018 ◽  
Vol 27 (11) ◽  
pp. 2926-2931
Author(s):  
Oyinlola T. Babatunde ◽  
Patrick M. Briley ◽  
Brandi M. White ◽  
Xiangming Fang ◽  
Charles Ellis
Keyword(s):  
Ethnic Differences ◽  
Stroke Survivors ◽  
Dietary Practices ◽  
Racial Ethnic

scholarly journals Temporal Trends in Racial and Ethnic Disparities in Sleep Duration in the United States: A National Health Interview Survey Analysis from 2004 to 2018

2021 ◽  
Author(s):  
César Caraballo ◽  
Shiwani Mahajan ◽  
Javier Valero-Elizondo ◽  
Daisy Massey ◽  
Yuan Lu ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Ethnic Differences ◽  
Household Income ◽  
National Health Interview Survey ◽  
Temporal Trends ◽  
Ethnic Disparities ◽  
Short Sleep ◽  
Long Sleep ◽  
Interview Survey ◽  
Racial Ethnic

Importance: Minoritized racial and ethnic groups are generally more likely to experience sleep deficiencies. It is unclear how these sleep duration disparities have changed over recent years. Objective: To determine 15–year trends in the racial and ethnic differences in self–reported sleep duration among adults in the US. Design: Serial cross–sectional study. Setting: National Health Interview Survey from years 2004–2018. Participants: 429,195 non–institutionalized adults. Exposures: Self–reported race, ethnicity, household income, and sex/gender. Main Outcomes: Temporal trends and racial/ethnic differences in short– and long–sleep duration (≤6 and ≥10 hours in a 24–hour period, respectively) and racial/ethnic differences in the relationship between sleep duration and age. Results: The study sample consisted of 429,195 individuals (mean age 46.5 [SE, 0.08] years; 51.7% female) of which 5.1% identified as Asian, 11.8% as Black, 14.7% as Latino/Hispanic, and 68.5% as White. In 2004, the adjusted estimated prevalence of short–sleep duration and long–sleep duration, respectively, were 31.3% and 2.5% among Asian individuals, 35.3% and 6.4% among Black individuals, 27.0% and 4.6% among Latino/Hispanic individuals, and 27.8% and 3.5% among White individuals. Over the study period, there was a significant increase in the short sleep prevalence among Black, Latino/Hispanic, and White individuals (P≤0.02 for each), whereas prevalence of long sleep changed significantly only among Latino/Hispanic individuals (–1.4 points, P=0.01). In 2018, compared with White individuals, short sleep prevalence among Black and Latino/Hispanic individuals was higher by 10.7 points and 2.6 points, respectively (P≤0.02 each), and long sleep prevalence among Black people was significantly higher by 1.4 points (P=0.01). These racial/ethnic disparities were the greatest among women and among those with middle/high household income. Over the study period, Black individuals younger than 60 years old had the highest prevalence of short sleep compared with those of the same age; and Black individuals had a higher long–sleep duration prevalence than White individuals across all age groups. Conclusions: From 2004 to 2018, the prevalence of unrecommended sleep duration was persistently higher among Black individuals. The Black–White disparities were highest among women, individuals who had middle or high income, and among young or middle–aged adults.

scholarly journals RACE/ETHNICITY AND U.S. ADULT MORTALITY

2011 ◽  
Vol 8 (1) ◽  
pp. 5-24 ◽  
Author(s):  
Robert A. Hummer ◽  
Juanita J. Chinn
Keyword(s):  
Ethnic Differences ◽  
Mexican Americans ◽  
Mexican Immigrants ◽  
Ethnic Disparities ◽  
Adult Mortality ◽  
Social Resources ◽  
Socioeconomic Resources ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Lower Mortality Risk

AbstractAlthough there have been significant decreases in U.S. mortality rates, racial/ethnic disparities persist. The goals of this study are to: (1) elucidate a conceptual framework for the study of racial/ethnic differences in U.S. adult mortality, (2) estimate current racial/ethnic differences in adult mortality, (3) examine empirically the extent to which measures of socioeconomic status and other risk factors impact the mortality differences across groups, and (4) utilize findings to inform the policy community with regard to eliminating racial/ethnic disparities in mortality. Relative Black-White differences are modestly narrower when compared to a decade or so ago, but remain very wide. The majority of the Black-White adult mortality gap can be accounted for by measures of socioeconomic resources that reflect the historical and continuing significance of racial socioeconomic stratification. Further, when controlling for socioeconomic resources, Mexican Americans and Mexican immigrants exhibit significantly lower mortality risk than non-Hispanic Whites. Without aggressive efforts to create equality in socioeconomic and social resources, Black-White disparities in mortality will remain wide, and mortality among the Mexican-origin population will remain higher than what would be the case if that population achieved socioeconomic equality with Whites.

scholarly journals RACE-ETHNICITY AND HOPELESSNESS IN OLDER AMERICANS: WHO’S AT GREATEST RISK AND WHY?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S436-S436
Author(s):  
Uchechi Mitchell
Keyword(s):  
Ethnic Differences ◽  
Structural Factors ◽  
Linear Regression Models ◽  
Older Americans ◽  
Poverty Status ◽  
Blacks And Whites ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Retirement Study ◽  
Over Time

Abstract Racial and ethnic minorities are more likely to experience adversity throughout their lives, which puts them at greater risk feelings of despair and powerlessness. This study uses data from 5,500 respondents from the Health and Retirement Study to assess racial/ethnic differences in hopelessness and test whether older blacks and Hispanics experience greater increases in hopelessness as they age. Hopelessness was assessed using 4-items that capture the extent to which a person has a negative outlook towards the future and believes they are powerlessness to overcome the obstacles they face; it is measured at three time points: 2006/2008, 2010/2012 and 2014/2016. Linear regression models were used to assess differences in hopelessness by race/ethnicity and linear mixed models were used to assess racial/ethnic differences in trajectories of hopelessness over time. Older blacks and Hispanics were more likely to report feelings of hopelessness at each timepoint of the study. Differences between blacks and whites were completely explained by differences in education and poverty status, while differences between Hispanics and whites remained. Although minority elders had higher levels of hopelessness at each time point, older whites experienced steeper increases in hopelessness over time. These findings suggest that structural factors influence feelings of hopelessness among minority elders. However, older blacks and Hispanics may develop resilience to hopelessness as they age.

scholarly journals Racial/ethnic differences in HIV testing: An application of the health services utilization model

2018 ◽  
Vol 6 ◽  
pp. 205031211878341 ◽  
Author(s):  
Celia C Lo ◽  
Ratonia C Runnels ◽  
Tyrone C Cheng
Keyword(s):  
Health Services ◽  
Hiv Testing ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Health Services Utilization ◽  
Ethnic Disparities ◽  
Hiv Treatment ◽  
Statistical Testing ◽  
Services Utilization ◽  
Racial Ethnic

This study applying the health services utilization model examined the importance of predisposing, enabling, and need variables to the social mechanisms explaining lifetime HIV testing across racial/ethnic groups. Data for the study were derived from the National Health Interview Survey (collected 2013–2014), our final sample numbering 18,574 adults. Four subsamples reflected race/ethnicity: 13,347 Whites, 2267 Blacks, 2074 Hispanics, and 886 Asians. Logistic regression established respondent odds of ever having received HIV testing. Further statistical testing evaluated race/ethnicity’s potential moderating role in HIV testing. The findings generally support a role for Aday’s predisposing, enabling, and need factors in explaining HIV testing. Across the four subsamples, female gender, older age, and sexual minority status consistently increased lifetime HIV testing. However, we found racial/ethnic differences in HIV testing’s associations with these factors and others. Our study made a beginning in the effort to specify mechanisms leading to HIV testing—and reliable diagnosis—among four racial/ethnic groups. Understanding these mechanisms might multiply opportunities to raise testing rates for all, in turn reducing racial/ethnic disparities in HIV treatment.

scholarly journals Racial and Ethnic Differences in Risk and Protective Factors of Dementia and CIND in the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 666-666
Author(s):  
Nasim Ferdows ◽  
Maria Aranda
Keyword(s):  
Protective Factors ◽  
Ethnic Differences ◽  
Cardiovascular Health ◽  
Ethnic Disparities ◽  
Risk And Protective Factors ◽  
The United States ◽  
Older Individuals ◽  
Assessment Protocol ◽  
Dementia Prevalence ◽  
Racial Ethnic

Abstract Recent population-based studies have shown declines in dementia prevalence in high-income countries, suggesting that improved population cardiovascular health and rising levels of education in the past 25 year were associated with reduction of dementia risks. However, in the US, there are variations in educational attainment, prevalence and management of chronic diseases, and behaviors associated with poor cardiovascular health among racial and ethnic groups. We performed a retrospective analysis of 3,495 older individuals (65+) in 2016 who participated in Harmonized Cognitive Assessment Protocol (HCAP) subsample of the Health and Retirement Study (HRS), to examine racial/ethnic differences in risk and protective factors associated with dementia and cognitive impairment. Linking HCAP to HRS, we traced individuals back to 2000 and created a longitudinal data of HCAP population (2000-2016). We found that racial/ethnic differences in risk and in protective factors throughout the life-course were associated with racial and ethnic disparities in dementia prevalence.

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