Eliminating Racial/Ethnic Health Disparities: Reconsidering Comparative Approaches

The focus on eliminating racial/ethnic health disparities has brought critical attention to the poor health status of minority populations. Assessing the health outcomes of racial minority groups by comparing them to a racial majority standard is valuable for identifying and monitoring health inequities, but may not be the most effective approach to identifying strategies that can be used to improve minority health outcomes. Health promotion planning models and public health history both suggest that minority health promotion is more likely to be derived from interventions rooted in culturally and historically grounded contextual factors. In this essay, we highlight limitations of comparative approaches to minority health research and argue that integrating emic (or within-group) approaches may facilitate research and interventions more consonant with national goals to promote health and reduce disparities than comparative approaches

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Eliminating Racial/Ethnic Health Disparities: Reconsidering Comparative Approaches

The focus on eliminating racial/ethnic health disparities has brought critical attention to the poor health status of minority populations. Assessing the health outcomes of racial minority groups by comparing them to a racial majority standard is valuable for identifying and monitoring health inequities, but may not be the most effective approach to identifying strategies that can be used to improve minority health outcomes. Health promotion planning models and public health history both suggest that minority health promotion is more likely to be derived from interventions rooted in culturally and historically grounded contextual factors. In this essay, we highlight limitations of comparative approaches to minority health research and argue that integrating emic (or within-group) approaches may facilitate research and interventions more consonant with national goals to promote health and reduce disparities than comparative approaches

DIETARY BEHAVIOR AMONG AFRICAN AMERICANS: ASSESSING CULTURAL IDENTITY AND HEALTH CONSCIOUSNESS

The present study utilized the African selfconsciousness (ASC) construct as an index of African-American cultural identity, and explored its association with health consciousness and dietary behavior. One hundred ninety- seven African-American adults residing in a Southeastern community participated in the study. Results demonstrated few, but significant, correlations between cultural identity and health consciousness. A similar relationship was observed between cultural identity and dietary behavior. Further, after statistically controlling for health consciousness, cultural identity contributed unique variance to dietary behavior. These ®ndings represent preliminary evidence suggesting the general viability of cultural models in explaining African American health behavior. More importantly, the study offers avenues for additional research on the complex roles played by culture and cultural identity in African-American dietary behavior

Marijuana use and health behaviors in a US clinic sample of patients with sickle cell disease.

IntroductionAs marijuana use becomes more common, it is essential clinicians understand the relationship between marijuana use and health behaviors.MethodsUsing a retrospective cohort of adolescents and adults with sickle cell disease (SCD) stratified into a young ( = 25 years), we conducted multiple linear regression examining relationship of marijuana use (independent variable) on each dependent variable (SCD self-management score and pain management).ResultsAmong young cohort, 16.9% used marijuana compared to 21.8% of older cohort. The younger cohort reporting marijuana use had lower mean self-care scores (β = -2.74;p = 0.009) and were more likely to have admissions to the hospital for pain (β = 0.87;p = 0.047) compared to non-users. In contrast, the older cohort reporting marijuana use had more days treating pain at home (β = 0.44;p = 0.035).ConclusionsOnly a minority of patients with SCD reported lifetime marijuana use. Among those reporting marijuana use, there were different associations with self-care and health-related behaviors by age. The older cohort who endorsed marijuana use reported more days of treating pain at home, although this did not translate into increased acute care visits for pain crisis. Among youth, endorsing marijuana use was associated with worse SCD self-care