scholarly journals Contribution of Socioeconomic, Lifestyle, and Medical Risk Factors to Disparities in Dementia and Mortality

2020 ◽  
Author(s):  
Jordan Weiss
Keyword(s):  
Risk Factors ◽  
The United States ◽  
Competing Risk ◽  
Extensive Literature ◽  
Medical Risk ◽  
Risk Of Death ◽  
Medical Risk Factors ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender

Extensive literature in the United States documents racial/ethnic and gender disparities in the incidence and prevalence of dementia yet few studies have examined how race/ethnicity and gender intersect to shape inequalities in the risk of dementia. Moreover, few studies have examined heterogeneity in the contribution of known risk factors to dementia across these demographic strata while properly accounting for the semi-competing risk of death. To better characterize sources of inequality in the risk of dementia, I calculated the proportion of dementia cases attributable to socioeconomic, lifestyle, and medical risk factors across demographic strata using data from the US Health and Retirement Study and a multistate framework that accounts for the semi-competing risk of death. Socioeconomic resources contributed to the largest number of dementia cases but the magnitude of this contribution varied across strata defined by race/ethnicity and gender. The greatest potential for dementia prevention was observed among non-Hispanic black and Hispanic men and women, supporting an intersectionality approach, and underscoring the need for culturally sensitive intervention and public health initiatives to address the growing burden of dementia.

scholarly journals State-level prevalence estimates of latent tuberculosis infection in the United States by medical risk factors, demographic characteristics and nativity

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249012
Author(s):  
Ali Mirzazadeh ◽  
James G. Kahn ◽  
Maryam B. Haddad ◽  
Andrew N. Hill ◽  
Suzanne M. Marks ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
National Level ◽  
The United States ◽  
Demographic Characteristics ◽  
Medical Risk ◽  
Medical Risk Factors ◽  
Disease Case ◽  
Ltbi Prevalence ◽  
Race Ethnicity

Introduction Preventing tuberculosis (TB) disease requires treatment of latent TB infection (LTBI) as well as prevention of person-to-person transmission. We estimated the LTBI prevalence for the entire United States and for each state by medical risk factors, age, and race/ethnicity, both in the total population and stratified by nativity. Methods We created a mathematical model using all incident TB disease cases during 2013–2017 reported to the National Tuberculosis Surveillance System that were classified using genotype-based methods or imputation as not attributed to recent TB transmission. Using the annual average number of TB cases among US-born and non-US-born persons by medical risk factor, age group, and race/ethnicity, we applied population-specific reactivation rates (and corresponding 95% confidence intervals [CI]) to back-calculate the estimated prevalence of untreated LTBI in each population for the United States and for each of the 50 states and the District of Columbia in 2015. Results We estimated that 2.7% (CI: 2.6%–2.8%) of the U.S. population, or 8.6 (CI: 8.3–8.8) million people, were living with LTBI in 2015. Estimated LTBI prevalence among US-born persons was 1.0% (CI: 1.0%–1.1%) and among non-US-born persons was 13.9% (CI: 13.5%–14.3%). Among US-born persons, the highest LTBI prevalence was in persons aged ≥65 years (2.1%) and in persons of non-Hispanic Black race/ethnicity (3.1%). Among non-US-born persons, the highest LTBI prevalence was estimated in persons aged 45–64 years (16.3%) and persons of Asian and other racial/ethnic groups (19.1%). Conclusions Our estimations of the prevalence of LTBI by medical risk factors and demographic characteristics for each state could facilitate planning for testing and treatment interventions to eliminate TB in the United States. Our back-calculation method feasibly estimates untreated LTBI prevalence and can be updated using future TB disease case counts at the state or national level.

Structured Inequality in the United States: Discussions on the Continuing Significance of Race, Ethnicity and Gender

2000 ◽  
Vol 28 (3) ◽  
pp. 266
Author(s):  
Jeralynn Sittig Cossman ◽  
Adalberto Aguirre ◽  
David V. Baker
Keyword(s):  
United States ◽  
The United States ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender

#MeToo will sustain demands for US corporate diversity

2021 ◽  
Keyword(s):  
Gender Diversity ◽  
The United States ◽  
Workplace Culture ◽  
Content Type ◽  
Technology Sector ◽  
Corporate Diversity ◽  
Race Ethnicity ◽  
And Gender ◽  
Central Pillar ◽  
Ethnicity And Gender

Significance That turned the eleven-year-old MeToo movement into a central pillar of a broader drive in the United States to address gender, race and social inequality. Since then, the technology sector has become a bit more hospitable to women but still has much to do on employment and workplace culture. Impacts COVID-19 has stalled some of the momentum to #MeToo reforms. The tech sector's persistent poor gender diversity potentially hurts industry competitiveness. Few US states have yet extended sexual harassment protections to cover race, ethnicity and gender identity.

scholarly journals CITY-LEVEL ADULT STROKE PREVALENCE IN RELATION TO REMOTE SENSING DERIVED PM2.5 ADJUSTING FOR UNHEALTHY BEHAVIORS AND MEDICAL RISK FACTORS

2018 ◽  
Vol XLII-3 ◽  
pp. 579-582
Author(s):  
Z. Hu
Keyword(s):  
Risk Factors ◽  
Remote Sensing ◽  
Linear Regression ◽  
Ambient Air ◽  
The United States ◽  
Ambient Air Pollution ◽  
Medical Risk ◽  
Medical Risk Factors ◽  
Stroke Prevalence

This research explores the use of PM2.5 gird derived from remote sensing for assessing the effect of long-term exposure to PM2.5 (ambient air pollution of particulate matter with an aerodynamic diameter of 2.5 μm or less) on stroke, adjusting for unhealthy behaviors and medical risk factors. Health data was obtained from the newly published CDC “500 Cities Project” which provides city- and census tract-level small area estimates for chronic disease risk factors, and clinical preventive service use for the largest 500 cities in the United States. PM2.5 data was acquired from the “The Global Annual PM2.5 Grids from MODIS, MISR and SeaWiFS Aerosol Optical Depth (AOD), V1 (1998–2012)” datasets. Average PM2.5 were calculated for each city using a GIS zonal statistics function. Map data visualization and pattern comparison, univariate linear regression, and a multivariate linear regression model fitted using a generalized linear model via penalized maximum likelihood found that long-term exposure to ambient PM2.5 may increase the risk of stroke. Increasing physical activity, reducing smoking and body weight, enough sleeping, controlling diseases such as blood pressure, coronary heart disease, diabetes, and cholesterol, may mitigate the effect. PM2.5 grids derived from moderate resolution satellite remote sensing imagery may offer a unique opportunity to fill the data gap due to limited ground monitoring at broader scales. The evidence of raised stroke prevalence risk in high PM2.5 areas would support targeting of policy interventions on such areas to reduce pollution levels and protect human health.

Abstract 9: The Relationship Between Patient Diversity and Warfarin Use in Atrial Fibrillation: A Ten-Year Perspective (2000-2010) on Cardiovascular Outcomes

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Michael H Kim ◽  
Gary Puckrein ◽  
Qiang Cai ◽  
Liou Xu
Keyword(s):  
Atrial Fibrillation ◽  
Stroke Risk ◽  
Cardiovascular Outcomes ◽  
Medicare Beneficiaries ◽  
Chads2 Score ◽  
Gender And Race ◽  
Risk Of Death ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender

Background: Anticoagulants are effective in stroke prevention in patients with atrial fibrillation (AF). Warfarin’s comparative effectiveness in AF Medicare beneficiaries by race/ethnicity and gender is not well described. Methods: Medicare claims data for years 2000-2010 were used to calculate: 1) AF per annum prevalence (N > 1.9 million); and 2) rates of new AF cases (first Medicare reimbursement for AF), hospitalization, and mortality. Three 20 % samples of AF beneficiaries for years 2000 (n=266K), 2005 (n=316K), and 2007 (n=311K) were used to calculate warfarin use and stroke (ischemic) rates. Consistent with prior study methods, INR test claims were used as a surrogate for warfarin use with a greater than 95 % precision rate and specificity. New AF cases were extracted from each of the three sample cohorts (mean 72K cases each) and continuous survival analyses conducted to assess warfarin’s relationship to stroke, mortality, and hospitalization after adjustment for CHADS2 score, age, gender, and race/ethnicity. Results: AF prevalence and warfarin use increased while stroke and mortality rates declined across gender and race/ethnicity from 2000 to 2010. Survival analysis comparing Blacks, Hispanics, and Asians to Whites showed: 1) even when adjusted for warfarin use, Blacks were 40 % (p<0.0001) more likely to have a stroke; 2) in 2007 Hispanics had a 35 % (p<0.01) higher prevalence of stroke and warfarin use did not reduce their stroke risk; and 3) Asians had better outcomes. Warfarin did not reduce stroke risk in women as well as in men, but women using warfarin had a lower risk of death and hospitalization than men. While there was a >70% (p<0.0001) reduction in mortality for warfarin users (Blacks still had a 25 % (p<0.0001) higher mortality risk than Whites after adjusting for warfarin use). 5-year survival rate for all AF beneficiaries was about 50 %. Conclusions: Significant differences in key metrics between race/ethnicity and gender exist. Across all metrics, Blacks had worse outcomes with less warfarin use and comparatively worse outcomes even when on warfarin. Patient diversity should be a focus for future trials in AF-related cardiovascular outcomes.

Schools, Justice, and Immigrant Students: Assimilation, Race, Ethnicity, Gender, and Perceptions of Fairness and Order

2015 ◽  
Vol 117 (7) ◽  
pp. 1-42
Author(s):  
Anthony A. Peguero ◽  
Jennifer M. Bondy
Keyword(s):  
Research Design ◽  
Race And Ethnicity ◽  
Immigrant Students ◽  
Immigrant Youth ◽  
Secondary Data ◽  
Building Blocks ◽  
The United States ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender

Background/Context Students’ perceptions of justice, fairness, and order within their schools are arguably key building blocks of socialization to participation within a democratic society. The ideals of justice, fairness, and order within their schools are particularly imperative because the educational system is founded on a belief of democracy and meritocracy. It is also known that students’ perceptions of school justice can vary by race, ethnicity, and gender. What remains uncertain is how the fastest growing segment of the United States, students in immigrant families, perceive the school justice, fairness, and order within their school. Purpose The aim of this study is to explore if straight-line assimilation, segmented assimilation, and immigrant optimism hypotheses explain the relationships between schools, justice, and immigration, as well as the potential role of gender, race, and ethnicity in immigrant youth perceptions of justice, fairness, and order. Participants/Subjects This study utilizes the Education Longitudinal Study of 2002 (ELS), a nationally representative sample of high school sophomores. Research Design This study's research design includes statistical analysis of secondary data. Findings/Results Findings do suggest that the students’ perceptions of justice, fairness, and order are indeed moderated by immigrant generation, race, ethnicity, and gender. Conclusions/Recommendations Educators and educational researchers who are seeking to better understand the schooling experiences of immigrant youth might benefit from questioning assimilation and Americanization as processes that inevitably promote educational progress. Given that immigrant youth are and have historically been marginalized within U.S. schools, it appears that socialization, Americanization, gender, and immigrant generational status are germane to creating democratic education for all students. Attentiveness to democratic school justice, order, and fairness is, therefore, imperative.

scholarly journals Sociodemographic, behavioral, and medical risk factors associated with visual impairment among older adults: a community-based pilot survey in Southern District of Hong Kong

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Perseus Wing-Fu WONG ◽  
Jordy Kin-Pong LAU ◽  
Bonnie Nga-Kwan CHOY ◽  
Kendrick Co SHIH ◽  
Alex Lap-Ki NG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Hong Kong ◽  
Educational Level ◽  
Community Based ◽  
Medical Risk ◽  
Pilot Survey ◽  
Medical Risk Factors ◽  
And Gender ◽  
Stratified Analysis

Abstract Background The last visual survey of older adults in Hong Kong was a district-level study in 2002, with no assessment of behavioral and medical risk factors for visual impairment (VI). Our objectives were to determine the latest VI prevalence among older adults, significance of any spatial and temporal differences on the prevalence, and any associations of sociodemographic, behavioral and medical risk factors with VI from a multi-perspective analysis. Methods Community-based pilot survey of residents from a suburb of Hong Kong, aged ≥50, using a standardized questionnaire, was conducted in 2016. Results Of the 222 subjects, crude rates of bilateral and unilateral VI were 9.46 and 32.88%, respectively, or corresponding age-and-gender-adjusted rates of 6.89 and 30.5%. Older age and lower educational were associated with higher risk for unilateral VI, while older age, temporary housing, obesity and hyperlipidemia were associated with higher risk for bilateral VI. Smoking and alcohol-drinking status were not associated with unilateral or bilateral VI. Relative changes in ORs of hypertension or educational level on unilateral or bilateral VI were >  10% after adjusting for age. Interaction term between hyperlipidemia and gender or obesity was significant for unilateral VI. Gender, hypertension and cataract were not associated with unilateral or bilateral VI in general population of pooled analysis but were identified as risk factors in specific subgroups of stratified analysis. Refractive error (myopia or hyperopia) was significantly associated with VI in the eye-level analysis after adjusting the inter-eye correlation. Conclusions Sociodemographic and medical risk factors contributed to VI, but behavioral risk factors did not. Sociodemographic disparities of visual health existed. Age was the confounders of the VI-hypertension or VI-educational level relationships. Gender and obesity were more likely to have multiplicative effect on unilateral VI when combined with hyperlipidemia. Stratified analysis should be conducted to provide further insight into the risk factors for VI in specific populations. Uncorrected refractive error remains a significant cause of impaired vision. The spatial and temporal differences in bilateral VI prevalence from the previous local study indicates a territory-wide survey is needed to assess regional differences and overall prevalence of VI in Hong Kong.

Mortality From Forces of Nature Among Older Adults by Race/Ethnicity and Gender

2020 ◽  
pp. 073346482095467
Author(s):  
Rachel M. Adams ◽  
Candace M. Evans ◽  
Mason Clay Mathews ◽  
Amy Wolkin ◽  
Lori Peek
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Alaska Native ◽  
The United States ◽  
Mortality Rates ◽  
Adult Males ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender ◽  
Related Mortality

Older adults are especially vulnerable to disasters due to high rates of chronic illness, disability, and social isolation. Limited research examines how gender, race/ethnicity, and forces of nature—defined here as different types of natural hazards, such as storms and earthquakes—intersect to shape older adults’ disaster-related mortality risk. We compare mortality rates among older adults (60+ years) in the United States across gender, race/ethnicity, and hazard type using the Centers for Disease Control and Prevention’s Wonder database. Our results demonstrate that older adult males have higher mortality rates than females. American Indian/Alaska Native (AI/AN) males have the highest mortality and are particularly impacted by excessive cold. Mortality is also high among Black males, especially due to cataclysmic storms. To address disparities, messaging and programs targeting the dangers of excessive cold should be emphasized for AI/AN older adult males, whereas efforts to reduce harm from cataclysmic storms should target Black older adult males.

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