scholarly journals Evaluation of Markers of Bone Turnover During Lactation in African-Americans: A Comparison With Caucasian Lactation

2013 ◽  
Vol 98 (2) ◽  
pp. 523-532 ◽  
Author(s):  
Raquel M. Carneiro ◽  
Linda Prebehalla ◽  
Mary Beth Tedesco ◽  
Susan M. Sereika ◽  
Caren M. Gundberg ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Bone Turnover ◽  
African American Women ◽  
Bottle Feeding ◽  
American Women ◽  
Amino Terminal ◽  
Markers Of Bone Turnover ◽  
Caucasian Women ◽  
Hormonal Milieu

Abstract Context: The African-American skeleton is resistant to PTH; whether it is also resistant to PTHrP and the hormonal milieu of lactation is unknown. Objectives: The objective of the study was to assess bone turnover markers in African-Americans during lactation vs Caucasians. Design and Participants: A prospective cohort study with repeated measures of markers of bone turnover in 60 African-American women (3 groups of 20: lactating, bottle feeding, and healthy controls), compared with historic Caucasian women. Setting: The study was conducted at a university medical center. Outcome Measures: Biochemical markers of bone turnover and calcium metabolism were measured. Results: 25-Hydroxyvitamin D (25-OHD) and PTH were similar among all 3 African-American groups, but 25-OHD was 30%–50% lower and PTH 2-fold higher compared with Caucasians (P < .001, P < .002), with similar 1,25 dihydroxyvitamin D [1,25(OH)2D] values. Formation markers [amino-terminal telopeptide of procollagen-1 (P1NP) and bone-specific alkaline phosphatase (BSAP)] increased significantly (2- to 3-fold) in lactating and bottle-feeding African-American women (P1NP, P < .001; BSAP, P < .001), as did resorption [carboxy-terminal telopeptide of collagen-1 (CTX) and serum amino-terminal telopeptide of collagen 1 (NTX), both P < .001]. P1NP and BSAP were comparable in African-American and Caucasian controls, but CTX and NTX were lower in African-American vs Caucasian controls. African-American lactating mothers displayed quantitatively similar increases in markers of bone formation but slightly lower increases in markers of resorption vs Caucasians (P = .036). Conclusions: Despite reported resistance to PTH, lactating African-American women have a significant increase in markers of bone resorption and formation in response the hormonal milieu of lactation. This response is similar to that reported in Caucasian women despite racial differences in 25-OHD and PTH. Whether this is associated with similar bone loss in African-Americans as in Caucasians during lactation is unknown and requires further study.

Ethnic disparity of treatment initiation in women diagnosed with breast cancer.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 189-189
Author(s):  
M. Omaira ◽  
M. Mozayen ◽  
R. Mushtaq ◽  
K. Katato
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African Americans ◽  
African American Women ◽  
Treatment Initiation ◽  
Age At Diagnosis ◽  
Significant Delay ◽  
American Women ◽  
Caucasian Women ◽  
The Impact

189 Background: Despite the major advances in early detection and treatment of breast cancer (BC), African American women, continued to have a higher mortality rates than Caucasians. Many studies have failed to identify a key factor to explain racial disparities in breast cancer outcome. These disparities persist even after controlling for insurance and socioeconomic settings. Data about delays in treatment initiation are limited and inconclusive. We intend to compare the time from diagnosis to the initiation of treatment between African American and Caucasian women diagnosed with BC in a single community-based cancer registry. Methods: Women aged 18 to 64 years with breast cancer were identified, between 1993 and 2009, using data from the Tumor Registry at Hurley Medical Center in Flint, Michigan. Patient’s characteristics obtained include age at diagnosis, race, stage, date of diagnosis, and date of treatment initiation. All patients were previously insured or became insured after diagnosis. Time from diagnosis to the initiation of treatment was calculated in days and compared between African American and Caucasian women using t-test. Results: A total of 1016 patients have been identified with diagnosis of BC. 23 patients were excluded due to missing data. 993 patients were analyzed. African Americans were 355 (36%), Caucasians 617 (62%), and other ethnicities 21 (2%). Mean age at diagnosis was (48.9) for African Americans versus (51.45) for Caucasians (p = 0.005). African American women were more likely to present with advanced stage (III, IV) than Caucasians (18% versus 12%, p = 0.009). African American women had significant delay in the treatment initiation of BC compared to Caucasians (31.11 versus 21.52 days, p < 0.0001). Conclusions: African American women were diagnosed with breast cancer at younger age and more advanced disease than Caucasians. African American women experienced significant delay in the initiation of therapy after diagnosis compared to Caucasians. However, the impact of an average delay of 10 days in treatment on overall survival is unknown. The exact explanation of this disparity is yet to be determined.

scholarly journals Africultural Coping Systems Inventory: Psychometrics in a Clinical Sample of African American Women

2020 ◽  
Vol 46 (6-7) ◽  
pp. 457-481
Author(s):  
Natalie N. Watson-Singleton ◽  
Devon LoParo ◽  
Yara Mekawi ◽  
Joya N. Hampton-Anderson ◽  
Nadine J. Kaslow
Keyword(s):  
African American ◽  
African Americans ◽  
African American Women ◽  
Low Income ◽  
Clinical Sample ◽  
Reliability And Validity ◽  
General Factor ◽  
American Women ◽  
Structure Reliability ◽  
Clinical Counseling

The Africultural Coping Systems Inventory (ACSI) assesses African Americans’ culturally relevant stress coping strategies. Although its factor structure, reliability, and validity of the scores have been examined across ethnic groups of African descent, psychometric properties have not been investigated in an African American clinical sample. Thus, it is unclear if the ACSI is useful for research with African Americans with distress. To assess the ACSI’s psychometrics, we used data from 193 low-income African American women who in the past year encountered interpersonal trauma and attempted suicide. We tested four models: one-factor, four-factor, four-factor hierarchical, and bifactor. None of the models were optimal, suggesting possible revisions to ACSI items. Yet the bifactor model provided a better fit than other models with items loading onto a general factor and onto specific factors. Internal consistency of the scores was above the recommended criterion (i.e., .70), and the ACSI general factor was related to depressive symptoms, suicidal ideation (but not alcohol abuse), providing some support for its concurrent validity. Future directions, limitations, and clinical-counseling implications are discussed.

Mammography screening and detection of early stage breast cancer in Hispanic and African American women at a Minnesota safety net healthcare system.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18074-e18074
Author(s):  
Daniel Fellows Pease ◽  
David T. Gilbertson ◽  
Andres Wiernik
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
Healthcare System ◽  
Early Stage ◽  
Screening Mammography ◽  
Advanced Stage ◽  
American Women ◽  
Younger Age ◽  
Caucasian Women

e18074 Background: Approximately 12% of breast cancer cases occur in women younger than 50 years, per SEER data from 2012. Hispanic women are known to present at a younger age and African American women with more advanced stage disease. In this study, we describe the impact of age and race on the initial presentation of breast cancer among minority women treated at the Hennepin Healthcare System (HHS) in the state of Minnesota. Methods: A single-institution retrospective analysis of data from our electronic health record of all breast cancer diagnoses from 2010-2015. Cases were compared by age ( < 50 or > 50 years), race (Caucasian, African American, Hispanic, other), stage (AJCC 7th edition), and method of diagnosis (self-reported mass or screening mammography). Results: A total of 315 breast cancer diagnoses occurred at HHS from 2010-2015. In our cohort, 29% of all breast cancer cases were diagnosed in women < 50yrs. Hispanic and African American women had higher rates of diagnosis at < 50yrs compared to Caucasian women (38.9% vs 37.1% vs 18.1 respectively, p < 0.05). Early stage cancer (stage 0 or I) accounted for most diagnoses in those > 50yrs (54.8%), while advanced stage (stage II-IV) was more prevalent in the < 50yrs age group (59.5%) (p < 0.05). Of all women diagnosed with breast cancer, 63% presented with a self-reported mass and 37% were diagnosed by screening mammography. Hispanics and African American women had a higher rate of presentation with a self-reported mass (74% and 66% respectively) compared to Caucasian women (55%). Women with breast cancer < 50yrs were more likely to present with a self-reported mass than women > 50yrs (80% vs 55%, p < 0.05). 92% of Hispanic and 80% of African American women < 50yrs presented with a self-reported mass, compared to 62% of Caucasian women (p = 0.095). Conclusions: At our institution, Hispanic and African American women are diagnosed at a significantly younger age than Caucasian women, and those diagnosed at a younger age have more advanced disease. Presenting with a self-reported mass is very common for young non-Caucasian women. Whether screening mammography can be better utilized to change these trends requires further study.

Ethnic differences in in vitro glyceride synthesis in subcutaneous and omental adipose tissue

2002 ◽  
Vol 283 (5) ◽  
pp. E988-E993 ◽  
Author(s):  
J. F. Bower ◽  
S. Vadlamudi ◽  
H. A. Barakat
Keyword(s):  
Adipose Tissue ◽  
African American ◽  
African American Women ◽  
Ethnic Differences ◽  
American Woman ◽  
Morbidly Obese ◽  
American Women ◽  
Omental Adipose Tissue ◽  
Caucasian Women

Considerable evidence suggests that there are ethnic differences in lipid metabolism between African American and Caucasian women, which may result in increased synthesis of fat in adipose tissue. The purpose of this study was to measure the in vitro rates of [14C]glucose incorporation into the glyceride-glycerol backbone of triglycerides (TG) and diglycerides (DG) in abdominal subcutaneous (SAT) and omental adipose tissue (OAT). Morbidly obese [African American ( n = 15): body mass index (BMI) = 45 ± 2.3; Caucasian ( n = 18): BMI = 51 ± 2.3] and preobese [African American ( n = 7): BMI = 27 ± 1.0; Caucasian ( n = 7): BMI = 25 ± 1.0] women were examined in this study. There were no significant differences in the rates of synthesis of either TG or DG in SAT of either preobese or obese women. On the other hand, both preobese and obese African American women had higher rates of synthesis of TG in OAT compared with their Caucasian counterparts. This increase in TG synthesis in OAT was not due to differences in cell size or rates of reesterification. Thus African American woman have an increased capacity to synthesize TG in OAT compared with Caucasian women, which may contribute to the higher prevalence of obesity in African American women.

scholarly journals A Dream Deferred: African American Women’s Diminished Socioeconomic Returns of Postponing Childbearing from Teenage to Adulthood

2020 ◽  
Vol 1 (2) ◽  
pp. 62-76 ◽  
Author(s):  
Shervin Assari ◽  
Shanika Boyce ◽  
Mohsen Bazargan ◽  
Cleopatra H. Caldwell
Keyword(s):  
African American ◽  
African Americans ◽  
Marital Status ◽  
African American Women ◽  
Social Mobility ◽  
White Women ◽  
The United States ◽  
Continuous Measure ◽  
American Women ◽  
Upward Social Mobility

Background: Brookings Institution has identified postponing childbirth from teenage to adulthood as a major strategy that is needed for upward social mobility of women. However, according to the Minorities’ Diminished Returns (MDRs), the associations between aspirations, investments, behaviors, and socioeconomic position (SEP) may be diminished for marginalized groups such as African Americans. Objective: To extend the existing knowledge on the MDRs, the current study had two aims: First to compare White and African American women for the association between postponing childbearing to adulthood and SEP in a national sample of American women. Second, to test correlates of postponing childbearing to adulthood and SEP at birth with long term outcomes 15 years later when the child was 15 years old. Methods: For this longitudinal study, data came from the Fragile Families and Child Well-being Study (FFCWS), a national longitudinal prospective study in the United States (US) that followed an ethnically diverse sample of women from childbirth for 15 years from 1998 to 2016. For the first aim, this study included 2679 women composed of 723 Whites and 1956 African Americans. For the second aim, among 1842 individuals who had available data 15 years later, we measured various economic, behavioral, and mental health outcomes when the child was 15 years old. For aim 1 we ran linear regression. Postponing childbearing to adulthood was the independent variable. The dependent variable, SEP (poverty) was treated as a continuous measure with higher score indicating more poverty. Confounders included marital status and delivery characteristics. For the aim 2, we ran Pearson correlation test (exploratory analysis) to test if baseline SEP correlates with future outcomes. Results: Postponing childbearing from adolescence to adulthood was associated with higher SEP in adulthood, net of all confounders including marital status and education. We found a significant interaction between postponing childbearing from adolescence to adulthood and race on SEP, suggesting that the economic reward of postponing childbearing may be weaker for African American women than for White women. Conclusions: Although postponing the age at childbirth is a recommended strategy for women who wish to maximize their chance of upward social mobility, this strategy may be associated with smaller economic returns for African American women than White women. The results can also be interpreted as MDRs in investments in terms of a postponing childbearing. In a fair society, the same investment should be similarly rewarded across diverse racial groups. In the reality, however, the US society differently rewards White and African American women who postpone childbearing. Research should explore the roles of social stratification, blocked opportunities, and concentrated poverty in explaining the unequal return of such an investment for African American and White women.

Health Portals and Menu-Driven Identities

2011 ◽  
pp. 1549-1557
Author(s):  
Lynette Kvasny
Keyword(s):  
African American ◽  
Health Disparities ◽  
African Americans ◽  
African American Women ◽  
Health Information ◽  
The Internet ◽  
American Women ◽  
The Government ◽  
The U.S ◽  
Cultural Inclusiveness

In this article, we make a case for research which examines the cultural inclusiveness and salience of health portals. We make our case from the standpoint of African-American women. While healthcare should be a ubiquitous social good, health disparities exist among various demographic groups. In fact, health disparities have been placed on the U.S. disease prevention and health promotion agenda. Healthy People 2010 is an initiative sponsored by policy makers, researchers, medical centers, managed care organizations, and advocacy groups across the country. Although there is no consensus regarding what a health disparity is, sponsors agree that “racial and ethnic minorities experience multiple barriers to accessing healthcare, including not having health insurance, not having a usual source of care, location of providers, lack of transportation, lack of child care, and other factors. A growing body of evidence shows that racial and ethnic disparities in health outcomes, healthcare access, and quality of care exist even when insurance, income, and other access-related factors are controlled.”1 In addition to healthcare, African American women have less access to the internet. Even at equivalent income levels, African Americans are less likely than either whites or English speaking Hispanics to go online. Demographically, the composition of populations not online has not changed dramatically since 2000. Overall, 60% of the total U.S. population is online with African Americans making up 11% of the total U.S. population, 8% of the online population, and 14% of the offline population. However, when looking at those who are offline, African Americans are more likely than offline whites or Hispanics to believe that they will eventually go online (Lenhart, 2003). Although online health information is available from multiple sources, we focus solely on those health portals sponsored by the U.S. government. We made this choice based upon some early interviews with physicians and managers at a healthcare facility which serves predominantly African American clients. We learned that most clients exhibited a low degree of trust in information provided by pharmaceutical companies and other sources which seemed too commercial. Instead, clients searched for information from recognizable sources, and tended to use portals and search pages like Yahoo and Google. We found that portals sponsored by U.S. government agencies were received positively by clients. Also, portals like healthfinder.gov and cdc.gov are highly regarded by the Medical Library Association2 . Moreover, the government is entrusted to uphold values of democracy and social justice therefore the health information that they provide should be accessible to a demographically diverse audience. To gain insights into the cultural inclusiveness and salience of health portals, we use Nakumura’s notion of menu-driven identities. For Nakumara (2002), the internet is a discursive place in which identity is enacted. She uses the term “menudriven identities” to signify the ways in which content providers represent identities through the design of the interface and the personalization of content, and users perform their identity as they engage with the content. In what follows, we discuss health disparities and the promise of the internet in redressing inequities. Next, we further explain the ways in which users perform identity and health portals represent identities. We do this by theorizing about the health portals as mediating two-way communication between users and information providers. We conclude with directions for future research.

Health Portals and Menu-Driven Identities

2011 ◽  
pp. 745-751 ◽  
Author(s):  
Lynette Kvasny ◽  
Jennifer Warren
Keyword(s):  
African American ◽  
Health Disparities ◽  
African Americans ◽  
African American Women ◽  
Health Information ◽  
The Internet ◽  
American Women ◽  
The Government ◽  
The U.S ◽  
Cultural Inclusiveness

In this article, we make a case for research which examines the cultural inclusiveness and salience of health portals. We make our case from the standpoint of African-American women. While healthcare should be a ubiquitous social good, health disparities exist among various demographic groups. In fact, health disparities have been placed on the U.S. disease prevention and health promotion agenda. Healthy People 2010 is an initiative sponsored by policy makers, researchers, medical centers, managed care organizations, and advocacy groups across the country. Although there is no consensus regarding what a health disparity is, sponsors agree that “racial and ethnic minorities experience multiple barriers to accessing healthcare, including not having health insurance, not having a usual source of care, location of providers, lack of transportation, lack of child care, and other factors. A growing body of evidence shows that racial and ethnic disparities in health outcomes, healthcare access, and quality of care exist even when insurance, income, and other access-related factors are controlled.”1 In addition to healthcare, African American women have less access to the internet. Even at equivalent income levels, African Americans are less likely than either whites or English speaking Hispanics to go online. Demographically, the composition of populations not online has not changed dramatically since 2000. Overall, 60% of the total U.S. population is online with African Americans making up 11% of the total U.S. population, 8% of the online population, and 14% of the offline population. However, when looking at those who are offline, African Americans are more likely than offline whites or Hispanics to believe that they will eventually go online (Lenhart, 2003). Although online health information is available from multiple sources, we focus solely on those health portals sponsored by the U.S. government. We made this choice based upon some early interviews with physicians and managers at a healthcare facility which serves predominantly African American clients. We learned that most clients exhibited a low degree of trust in information provided by pharmaceutical companies and other sources which seemed too commercial. Instead, clients searched for information from recognizable sources, and tended to use portals and search pages like Yahoo and Google. We found that portals sponsored by U.S. government agencies were received positively by clients. Also, portals like healthfinder.gov and cdc.gov are highly regarded by the Medical Library Association2. Moreover, the government is entrusted to uphold values of democracy and social justice therefore the health information that they provide should be accessible to a demographically diverse audience. To gain insights into the cultural inclusiveness and salience of health portals, we use Nakumura’s notion of menu-driven identities. For Nakumara (2002), the internet is a discursive place in which identity is enacted. She uses the term “menu-driven identities” to signify the ways in which content providers represent identities through the design of the interface and the personalization of content, and users perform their identity as they engage with the content. In what follows, we discuss health disparities and the promise of the internet in redressing inequities. Next, we further explain the ways in which users perform identity and health portals represent identities. We do this by theorizing about the health portals as mediating two-way communication between users and information providers. We conclude with directions for future research.

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