BCHS 2524- Overview of Minority Health and Health Disparities in the US

Understanding health disparities involves a critical analysis of historical, political, economic, social, cultural, and environmental conditions that have produced an inequitable health status for racial and ethnic minorities in the United States. While we also recognize that disparities exist along socio-economic status, gender, sexual orientation and other factors, this class will focus on disparities in racial and ethnic minority communities. Issues of gender, SES and other factors will be examined as they intersect race and ethnicity, and further influence disparities in health. Minority health and health disparities have gained considerable attention from the recent publication of Healthy People 2010 Report, which lists as its two goals: 1) improve the quality of life for all citizens, and 2) eliminate health disparities. The purpose of this class is to introduce basic issues that underlie health disparities. We will gain a better understanding of the relationships of social and environmental phenomena and the health of minority communities. This course will include current literature and foster discussions that will examine health disparities, explore social and environmental determinants of those disparities, critically review measurement issues, and determine public health’s response to these disparities. Students should seek to critically reflect on their personal and professional roles in eliminating health disparities. By the end of the course, students will be able to

Overview of Minority Health and Health Disparities in the US

Understanding health disparities involves a critical analysis of historical, political, economic, social, cultural, and environmental conditions that have produced an inequitable health status for racial and ethnic minorities in the United States. While we also recognize that disparities exist along socio-economic status, gender, sexual orientation and other factors, this class will focus on disparities in racial and ethnic minority communities. Issues of gender, SES and other factors will be examined as they intersect race and ethnicity, and further influence disparities in health. Minority health and health disparities have gained considerable attention from the recent publication of Healthy People 2010 Report, which lists as its two goals: 1) improve the quality of life for all citizens, and 2) eliminate health disparities. The purpose of this class is to introduce basic issues that underlie health disparities. We will gain a better understanding of the relationships of social and environmental phenomena and the health of minority communities. This course will include current literature and foster discussions that will examine health disparities, explore social and environmental determinants of those disparities, critically review measurement issues, and determine public health’s response to these disparities. Students should seek to critically reflect on their personal and professional roles in eliminating health disparities. By the end of the course, students will be able to

A Meta-Analysis of Social Capital and Health

BACKGROUND: Social capital is the term used to describe the results of social relationships formed by reciprocal exchanges among members of social networks such as religious, political, and other kinds of organizations. Research about this complex, widely debated concept has focused on cognitive and structural measures formed around several broad constructs: sense of community; trust and reciprocity; social support; social networks; participation; and collective efficacy. These constructs can be analyzed using individual, ecological, and multilevel analyses. However, the social capital literature provides little evidence about the relationship between social capital and health or the causes and consequences of this relationship. This lack can be attributed to definition and measurement issues within the literature, which also sustain the question of what the health benefits are from social capital. METHODS: Using a meta-analysis to examine the breadth of the social capital literature, I seek to characterize the literature and provide an overall estimated effect size that statistically describes the relationship between social capital and health. RESULTS: Meta-analysis of studies cited in the literature shows a modest positive relationship between social capital and self-reported health, social capital and all-cause mortality, and also significant, previously unexamined differences among the studies themselves: first, whether they reported an effect size or if an effect size was estimated; and second, there was a marginal difference in whether they focused on self-reported health or all-cause mortality. CONCLUSIONS: There is a modest positive association between social capital and health which suggests unexplained factors that drive the relationship between social capital and health. PUBLIC HEALTH SIGNIFICANCE: The results of this study indicate a need for social capital research to clearly define its constructs and measures and to provide more evidence about the relationship between social capital and health. Future research should identify micro- to macro-level factors that can influence this relationship. Such evidence can guide the design of future studies that seek to increase the stock of social capital for individuals and communities

African American prostate cancer survivorship: Exploring the role of social support in quality of life after radical prostatectomy

PURPOSE: The aim of this study was to explore the African American prostate cancer survivorship experience following radical prostatectomy and factors contributing to quality of life during survival. DESIGN: African American men who were part of a larger prostate cancer cohort were invited to participate in a focus group. Eighteen open-ended questions were designed by the study team and an experienced moderator to elicit participants\u27 survivorship experiences. RESULTS: Twelve men consented to participate in the study. Emergent themes included views of prostate cancer in the African American community, perceptions of normalcy, emotional side effects following radical prostatectomy, and social support involvement and impact during recovery. CONCLUSIONS: Previous findings suggest that African American men may experience more distress than Caucasian men when facing typical prostate cancer side effects. Traditional masculine role norms and negative perceptions of disease disclosure in the African American community could be contributing to the distress reported by some in this study. Strengthening social support systems by promoting more prosocial coping and help-seeking behaviors early in the survivorship journey may help bypass the detrimental health effects associated with masculine role identification, resulting in improved quality of life throughout the lengthy survival period anticipated for these men

Physician Role in Physical Activity for African-American Males Undergoing Radical Prostatectomy for Prostate Cancer

Purpose Physical activity is recognized as a complementary therapy to improve physical and physiological functions among prostate cancer survivors. Little is known about communication between health providers and African-American prostate cancer patients, a high risk population, regarding the health benefits of regular physical activity on their prognosis and recovery. This study explores African-American prostate cancer survivors’ experiences with physical activity prescription from their physicians. Methods Three focus group interviews were conducted with 12 African-American prostate cancer survivors in May 2014 in St. Louis, MO. Participants’ ages ranged from 49 to 79 years, had completed radical prostatectomy, and their time out of surgery varied from 7 to 31 months. Results Emerged themes included physician role on prescribing physical activity, patients’ perceived barriers to engaging in physical activity, perception of normalcy following surgery, and specific resources survivors’ sought during treatment. Of the 12 men who participated, 8 men (67%) expressed that their physicians did not recommend physical activity for them. Although some participants revealed they were aware of the importance of sustained physical activity on their prognosis and recovery, some expressed concerns that urinary dysfunction, incontinence, and family commitments prevented them from engaging in active lifestyles. Conclusions Transitioning from post radical prostatectomy treatment to normal life was an important concern to survivors. These findings highlight the importance of physical activity communication and prescription for prostate cancer patients

Weight Status and High Blood Pressure Among Low-Income African American Men

Obesity is a biological risk factor or comorbidity that has not received much attention from scientists studying hypertension among African American men. The purpose of this study was to examine the relationship between weight status and high blood pressure among African American men with few economic resources. The authors used surveillance data collected from low-income adults attending community- and faith-based primary care clinics in West Tennessee to estimate pooled and group-specific regression models of high blood pressure. The results from group-specific logistic regression models indicate that the factors associated with hypertension varied considerably by weight status. This study provides a glimpse into the complex relationship between weight status and high blood pressure status among African American men. Additional research is needed to identify mechanisms through which excess weight affects the development and progression of high blood pressure

Community-Guided Focus Group Analysis to Examine Cancer Disparities

Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) is a systems-change intervention addressing disparities in treatment initiation and completion and outcomes for early stage Black and White breast and lung cancer patients. Using a community-based participatory research approach, ACCURE is guided by a diverse partnership involving academic researchers, a non-profit community-based organization, its affiliated broader-based community coalition, and providers and staff from two cancer centers

Visible and Invisible Trends in Black Men's Health: Pitfalls and Promises for Addressing Racial, Ethnic, and Gender Inequities in Health

Over the past two decades, there has been growing interest in improving black men's health and the health disparities affecting them. Yet, the health of black men consistently ranks lowest across nearly all groups in the United States. Evidence on the health and social causes of morbidity and mortality among black men has been narrowly concentrated on public health problems (e.g., violence, prostate cancer, and HIV/AIDS) and determinants of health (e.g., education and male gender socialization). This limited focus omits age-specific leading causes of death and other social determinants of health, such as discrimination, segregation, access to health care, employment, and income. This review discusses the leading causes of death for black men and the associated risk factors, as well as identifies gaps in the literature and presents a racialized and gendered framework to guide efforts to address the persistent inequities in health affecting black men

A review of wheat diseases – a field perspective

Wheat is one of the primary staple foods throughout the planet. Significant yield gains in wheat production over the past 40 years have resulted in a steady balance of supply versus demand. However, predicted global population growth rates and dietary changes mean that substantial yield gains over the next several decades will be needed to meet this escalating demand. A key component to meeting this challenge is better management of fungal incited diseases, which can be responsible for 15%–20% yield losses per annum. Prominent diseases of wheat that currently contribute to these losses include the rusts, blotches and head blight/scab. Other recently emerged or relatively unnoticed diseases, such as wheat blast and spot blotch, respectively, also threaten grain production. This review seeks to provide an overview of the impact, distribution and management strategies of these diseases. In addition, the biology of the pathogens and the molecular basis of their interaction with wheat are discussed