Examining Race Differences in Blood Pressure Control among People with Chronic Kidney Disease

Of Chronic Kidney Disease (CKD) patients, 20% of them also have hypertension (HTN). African Americans (AA) are known to be more at risk of CKD development and poor HTN control compared to Whites, largely due to their higher prevalence of diabetes and HTN. While those health conditions are a known risk factor to CKD, it is less clear if there is a race difference in HTN control among CKD patients. Using a combined 1999-2014 data set from The National Health and Nutrition Examination Survey (NHANES), we sought to determine if there is an association between race and HTN control among CKD patients. A smaller portion of AA CKD patients (58.2% vs 71.6%; p\u3c0.001) had controlled hypertension than White CKD patients. After adjusting for age, AA had a lower odds of having their hypertension controlled (odds ratio (OR) = 0.58; 95% confidence interval (CI): 0.37-0.92) relative to whites. When adjusting for social factors and medical conditions, we observed that hypertensive African Americans with CKD had similar odds of having their hypertension controlled (OR=0.55; 95% CI= 0.25-1.23) relative their White peers. Social factors and medical conditions account for the race difference in hypertension control among CKD patients. Strategies to control hypertension among AA patients with CKD must include not only efforts for proper health care to treat and control medical conditions, such as diabetes and stroke, but to address social factors. The results highlight the importance of creating interventions specifically focused on chronic disease prevention and management for African American adults to attempt to delay the onset or impede the progression of CKD

Race and “Hotspots” of Preventable Hospitalizations

Abstract Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH spatial clusters were observed among the total population with an average PH rate of 3,046.6 per 100,000 population. Among whites, the average PH rate was 3,339.9 per 100,000 in 11 PH spatial clusters. Only five PH spatial clusters were observed among African Americans with a higher average PH rate (3,710.8 per 100,000). The locations and other characteristics of PH spatial clusters differed by race. These results can be used to target resources to areas with high PH rates. Because PH spatial clusters are observed in differing locations for African Americans, approaches that include cultural tailoring may need to be specifically targeted

A Review of Economic Opportunity and Criminal Justice Programs for Boys and Men of Color

The authors review the evidence on programs and other interventions to address incarceration and lack of economic opportunity for boys and men of color. In addition, the authors review programs and interventions published in the scientific literature as well as reports, white papers, briefs, and other documents from the gray literature. They conclude with recommendations for action and for research

Achieving mental health equity in Black male suicide prevention

Despite a steady decrease in suicide rates in the United States, the rate among Black males has increased in recent decades. Moreover, suicide is now positioned as the third leading cause of death in this population, signaling a public health crisis. Enhancing the ability for future suicide prevention scholars to fully characterize and intervene on suicide risk factors is an emerging health equity priority, yet there is little empirical evidence to robustly investigate the alarming trends in Black male suicide. We present fundamental areas of expansion in suicide prevention research focused on establishing culturally responsive strategies to achieve mental health equity. Notably, we identify gaps in existing research and offer future recommendation to reduce suicide death among Black males. Our perspective aims to present important and innovative solutions for ensuring the inclusion of Black males in need of suicide prevention and intervention efforts

Navigating Black Aging: The Biological Consequences of Stress and Depression

OBJECTIVES: Black persons in the US are more likely to suffer from social inequality. Chronic stress caused by social inequality and racial discrimination results in weathering of the body that causes physiological dysregulation and biological age being higher than chronological age (accelerated aging). Depression has been linked to both racial discrimination and accelerated aging and accelerated aging has been demonstrated to be higher in Black than White persons, on average. However, we know little about accelerated aging across the life course in Black Americans. METHODS: We used mixed effects growth models to measure biological age acceleration, measured with cardiometabolic markers, over a 20-year period in Black participants of the Coronary Artery Risk Development in Young Adults Study (CARDIA) who were aged 27 - 42 years at analytic baseline. We included an interaction between depressive symptoms and time to determine whether risk of depression was associated with a faster rate of biological aging. RESULTS: We found that the rate of biological aging increased over a 20-year span and that those at risk for depression had a faster rate of biological aging than those not at risk. We also found that various social factors were associated with biological age acceleration over time. DISCUSSION: Given the known association between perceived racial discrimination and depressive symptoms, we provide a novel instance of the long-term effects of social inequality. Specifically, biological age acceleration, a marker of physiological dysregulation, is associated with time among Black persons and more strongly associated among those with depressive symptoms

Racial Residential Segregation and Race Differences in Ideal Cardiovascular Health among Young Men

Background: Race disparities in cardiovascular disease (CVD) related morbidity and mortality are evident among men. While previous studies show health in young adulthood and racial residential segregation (RRS) are important factors for CVD risk, these factors have not been widely studied in male populations. We sought to examine race differences in ideal cardiovascular health (CVH) among young men (ages 24–34) and whether RRS influenced this association. Methods: We used cross-sectional data from young men who participated in Wave IV (2008) of the National Longitudinal Survey of Adolescent to Adult Health (N = 5080). The dichotomous outcome, achieving ideal CVH, was defined as having ≥4 of the American Heart Association’s Life’s Simple 7 targets. Race (Black/White) and RRS (proportion of White residents in census tract) were the independent variables. Descriptive and multivariate analyses were conducted. Results: Young Black men had lower odds of achieving ideal CVH (OR = 0.67, 95% CI = 0.49, 0.92) than young White men. However, RRS did not have a significant effect on race differences in ideal CVH until the proportion of White residents was ≥55%. Conclusions: Among young Black and White men, RRS is an important factor to consider when seeking to understand CVH and reduce future cardiovascular risk

Religious Coping and Types and Sources of Information Used in Making Prostate Cancer Treatment Decisions.

Treatment experiences for prostate cancer survivors can be challenging and dependent on many clinical and psychosocial factors. One area that is less understood is the information needs and sources men utilize. Among these is the influence of religion as a valid typology and the value it may have on treatment decisions. The objective of this study was to assess the relationship between race, religion, and cancer treatment decisions in African American men compared with White men. Data were from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 877 African American and White men. The main dependent variables sought respondents’ use of resources or advisors when making treatment decisions. Questions also assessed men perceptions of prostate cancer from the perspective of religious coping. After adjusting for age, marital status, education, and insurance status, race differences in the number of sources utilized were partially mediated by cancer was a punishment from God (β = −0.46, SE = 0.012, p \u3c .001), cancer was a test of faith (β = −0.49, SE = 0.013, p \u3c .001), and cancer can be cured with enough prayer (β = −0.47, SE = 0.013, p \u3c .001). Similarly, race differences in the number of advisors utilized in making the treatment decision were partially mediated by cancer was a punishment from God (β = −0.39, SE = 0.014, p = .006), and cancer was a test of faith (β = −0.39, SE = 0.014, p = .006). Religious views on prostate cancer may play an important role in explaining race differences in information used and the number of advisors utilized for treatment decision making for prostate cancer

Weight Status: A Predictor of the Receipt of and Interest in Health Promotion Information among College Students

Background: Negative health behaviors such as consumption of excess calories, low intake of fruits and vegetables, sedentariness and weight gain are associated with entry into college. Purpose: To determine if weight status is associated with students’ receipt of health promotion (nutrition, physical activity and stress reduction) information, and students’ interest in receiving these types of information from their college or university. Methods: Data from the Spring 2011 ACHA-NCHA II dataset was used to complete secondary data analyses. Students (N=116,254) from 148 postsecondary institutions completed the Spring 2011 ACHA-NCHA II survey. Logistic regression was used to examine the effect of BMI category on receipt of, and interest in receiving, health promotion information. Results: Approximately 32% of respondents were overweight or obese. Students in the obese class III category were the least likely to receive health promotion information and least likely to be interested in receiving the information. Conclusion: Weight status based on BMI classification is a weak predictor of the dissemination of health promotion information. The largest gaps related to the dissemination appear to be among obese students. Future research is needed to determine factors contributing to the observed gaps and strategies should be developed to reach underserved groups

Understanding the relationship between alcohol outlet density and life expectancy in Baltimore City: The role of community violence and community disadvantage

This research investigated the relationship between alcohol outlet density (AOD) and life expectancy, as mediated by community violence and community disadvantage. We used linear regression models to assess bivariate and multivariate relationships. There was a negative bivariate association between liquor store density and average life expectancy (β = â 7.3370, p < 0.001). This relationship was partially attenuated when controlling for community disadvantage and fully attenuated when controlling for community violence. Bars/taverns (i.e., onâ premise) were not associated with average life expectancy (β = â 0.589, p = 0.220). Liquor store density is associated with higher levels of community disadvantage and higher rates of violence, both of which are associated with lower life expectancies. Future research, potential intervention, and current related policies are discussed.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146620/1/jcop22099_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146620/2/jcop22099.pd

Beyond Race and Gender: Measuring Behavioral and Social Indicators of Pain Treatment Satisfaction in Older Black and White Cancer Patients

There are a number of factors that influence compliance with prescribed plans of care. However, there remains a need to identify the collective source health, behavioral, and social constructs have on treatment satisfaction. This study aimed to identify indicators of pain treatment satisfaction among older adults receiving outpatient treatment from a comprehensive cancer center in the southeast region of the United States. Data included a sample of 149 Black and White patients diagnosed with cancer, with the majority being White (85%) and female (57%). Patients were surveyed on questions assessing pain treatment satisfaction, pain severity, and additional social characteristics. A series of multivariate models were specified, whereby patients reporting multiple chronic conditions, poor communication, and perceived discrimination were less satisfied with treatment. Positive communication, higher self-efficacy, and fewer perceived discriminatory acts were significant among the female patients only. These findings suggest the need to develop clinical models that assess how these factors influence the degree of treatment satisfaction, while providing a comprehensive mechanism by which to service the long-term needs of older adults