Facilitators and barriers to accessing hepatitis B care in the postpartum period among foreign-born New Yorkers: a qualitative analysis of case notes.

BACKGROUND: Approximately 241,000 people are living with hepatitis B in New York City. Among those living with hepatitis B, pregnant people are particularly at risk for elevated viral load due to changes in immune response and require prompt linkage to health care. The New York City Department of Health and Mental Hygiene's Viral Hepatitis Program implemented a telephone-based patient navigation intervention for people living with hepatitis B in the postpartum period to connect them with hepatitis B care. METHODS: During the intervention, patient navigators called participants to inquire about their past experience with receiving care, available supports, and barriers to care, and worked with them to develop a plan with participants for linkage to hepatitis B care. The information collected during initial assessments and follow-up interactions were recorded as case notes. In this qualitative study, researchers conducted a thematic analysis of 102 sets of case notes to examine facilitators and barriers to accessing hepatitis B care among the intervention participants, all of whom were foreign-born and interested in receiving hepatitis B patient navigation services. RESULTS: The qualitative analysis illustrated the various ways in which patient navigators supported access to hepatitis B care. Findings suggest that receiving care through a preferred provider was a central factor in accessing care, even in the presence of significant barriers such as loss of health insurance and lack of childcare during appointments. Expectations among family members about hepatitis B screening, vaccination and routine clinical follow up were also identified as a facilitator that contributed to participants' own care. CONCLUSIONS: This study suggests that while there are numerous barriers at the personal and systemic levels, this patient navigation intervention along with the identified facilitators supported people in accessing hepatitis B care. Other patient navigation initiatives can incorporate the lessons from this analysis to support people in connecting to a preferred provider.

Associations Between Food Insufficiency and Health Conditions Among New York City Adults, 2017-2018.

Food insecurity, a critical social determinant of health, has been measured nationwide in the United States for years. This analysis focuses on food insufficiency, a more severe form of food insecurity, in New York City (NYC) and its association with self-reported physical and mental health conditions. Data from the 2017-2018 NYC Community Health Survey were used to estimate the prevalence of food insufficiency citywide, by neighborhood, and across selected socioeconomic characteristics. Multivariable logistic regression was used to explore the associations between food insufficiency and hypertension, diabetes obesity, and depression, adjusting for selected sociodemographic characteristics. Approximately 9.4% (95% CI:8.8-10.0%]) of adult New Yorkers aged 18 + reported food insufficiency, with neighborhood variation from 1.7% (95% CI:0.5-6.2%) to 19.4% (95% CI:14.2-25.8%). Food insufficiency was more prevalent among Latinos/as (16.9%, 95% CI:15.5-18.3%, p < 0.001), Black (10.1%, 95% CI:8.8-11.5%, p < 0.001) and Asian/Pacific Islanders (6.6%, 95% CI:5.4-8.1%, p = 0.002) compared to White New Yorkers (4.2%, 95% CI:3.5-5.1%). Prevalence of food insufficiency was higher among NYC adults with less than a high school education, (19.6%, 95% CI:17.7-21.6%), compared to college graduates (3.8%, 95% CI:3.2-4.4%, p < 0.001). In the adjusted logistic regression model, food insufficiency was associated with diabetes (OR = 1.36; 95% CI:1.12-1.65), hypertension (OR = 1.58; 95% CI:1.32-1.89]) and depression (OR = 2.98; 95% CI:2.45-3.59), but not with obesity (OR = 0.99; 95% CI:0.84-1.21). Our findings highlight food insufficiency at an important intersection of inequity and disease burden which is critical to informing public health interventions in the context of a large, densely populated metropolis like NYC.

Parental Race/Ethnicity and Adverse Birth Outcomes in New York City: 2000-2010.

OBJECTIVES: To examine the association of maternal race/ethnicity only and parental race/ethnicity jointly with adverse birth outcomes (low birth weight, small for gestational age, preterm birth, and infant mortality) among New York City women. METHODS: We used Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene birth- and death-linked data from 2000 to 2010 (n = 984 807) to quantify the association of maternal race/ethnicity and parental race/ethnicity concordance or discordance with each outcome. RESULTS: By maternal race/ethnicity, infants of non-Hispanic Black, Hispanic, and Asian women had risks of adverse birth outcomes between 10% and 210% greater than infants of non-Hispanic White women. Infants of non-Hispanic Black, Asian, and Hispanic couples exhibited higher risk of adverse birth outcomes than infants of non-Hispanic White couples. Moreover, parental racial/ethnic discordance was associated with an increased risk of adverse birth outcomes, with highest risks for pairings of Asian men with non-Hispanic White, non-Hispanic Black, and Hispanic women, and of Asian women with non-Hispanic Black and Hispanic men. CONCLUSIONS: Parental race/ethnicity discordance may add stress to women during pregnancy, affecting birth outcomes. Thus, parental race/ethnicity should be considered when examining such outcomes.

Self-reported diabetes in Hispanic subgroup, non-Hispanic black, and non-Hispanic white populations: National Health Interview Survey, 1997-2005.

OBJECTIVES: We estimated the prevalence of self-reported diabetes in Hispanic subgroup (Puerto Rican, Mexican, Mexican American, Cuban, Dominican, Central and South American, and other Hispanic), non-Hispanic black, and non-Hispanic white populations aged 20 years and older. METHODS: Using the National Health Interview Survey 1997-2005, we limited these analyses to 272,041 records of adults aged 20 years and older, including 46,749 records for Hispanic respondents. We used logistic regression to assess the strength of the association between race/ethnicity and self-reported diabetes before and after adjusting for selected characteristics. RESULTS: Compared with non-Hispanic white respondents, Mexican American (odds ratio [OR] = 2.02; 95% confidence interval [CI] 1.75, 2.34), Mexican (OR=1.52; 95% CI 1.31, 1.91), Puerto Rican (OR=1.53; 95% CI 1.23, 1.91), other Hispanic (OR=2.08; 95% CI 1.68, 2.58), and non-Hispanic black (OR=1.47; 95% CI 1.35, 1.61) respondents had greater odds of reporting diabetes. When compared with non-Hispanic white respondents, Mexican American respondents with less than a high school diploma had the lowest odds of reporting diabetes, while those with at least a college degree had greater odds of reporting diabetes. However, Puerto Rican respondents with less than a high school education, Mexican respondents with at least some college education, and other Hispanic respondents with at least a high school diploma/general equivalency diploma had greater odds of reporting diabetes. CONCLUSIONS: Although Hispanic respondents bear a greater burden of diabetes than non-Hispanic white respondents, this burden is unevenly distributed across subgroups. These findings call attention to data disaggregation whenever possible for U.S. racial/ethnic populations classified under categories considered homogeneous.

Self-rated general and oral health in New York City adults: assessing the effect of individual and neighborhood social factors.

UNLABELLED: OBJECTIVE: This study investigates the independent and joint effects of individual and neighborhood socioeconomic characteristics on self-rated general and oral health before and after controlling for selected characteristics in adults aged 18 years and older in New York City. METHODS: Data for 1168 individuals who participated in the 2004 Social Indicators Survey were linked to neighborhood data from the 2000 US Census. Log-binomial regression models fitted using generalized estimating equations were used to calculate prevalence ratios (PR) and 95% confidence intervals (CI). sudaan was used to accommodate the complex sampling design of the survey and the intra-neighborhood correlation of outcomes of individuals residing within the same neighborhoods. RESULTS: After adjusting for selected characteristics, survey participants with 12 years of education or less were almost twice more likely to rate their general health as fair/poor than counterparts with more than 12 years of education [PRs 1.86 (95%CI: 1.16, 3.00) and 1.82 (95%CI: 1.18, 2.82)]. Participants earning <$20,000 (PR: 2.29; 95%CI: 1.23, 4.29) or between $20,000 to $39,999 yearly (PR: 2.24; 95%CI: 1.11, 4.53) were more than twice as likely to rate their general health as fair/poor compared to their counterparts earning over $40,000 yearly. When compared to participants with more than 12 years of education and those reporting an annual income ≥$40,000, the probability of rating oral health as fair/poor was at least 50% greater in participants with <12 years of education (PR: 1.58; 95%CI: 1.11, 2.26) and in participants earning an annual income of <$20,000 (PR: 1.55; 95%CI: 1.10, 2.19). No association was found between neighborhood characteristics for either self-rated general or oral health. CONCLUSIONS: Individual socioeconomic characteristics may be important for both self-rated general and oral health by affecting individuals' behaviors and access to resources.

Racial/ethnic disparities in obesity among US-born and foreign-born adults by sex and education.

This study examines sex and education variations in obesity among US- and foreign-born whites, blacks, and Hispanics utilizing 1997-2005 data from the National Health Interview Survey on 267,585 adults aged > or =18 years. After adjusting for various demographic, health, and socioeconomic factors via logistic regression, foreign-born black men had the lowest odds for obesity relative to US-born white men. The largest racial/ethnic disparity in obesity was between US-born black and white women. High educational attainment diminished the US-born black-white and Hispanic-white disparities among women, increased these disparities among men, and had minimal effect on foreign-born Hispanic-white disparities among women and men. Comprehension of these relationships is vital for conducting effective obesity research and interventions within an increasingly diverse United States.

Carbonizados deoorigen vegetal (cov) para la geeración de antroposoles. obtencción y caracterización fisicoquímica / Chars of vegeablle origin (cov) for anthroposils generation. obtention and pphysicochemical characterization

Se obtuvieron carbonizados de origen vegetal a escala de laboratorio a partir de madera de Eucalyptus globullus, con diferentes condiciones de carbonización. Los carbonizados se caracterizaron fisicoquímicamente mediante análisis próximo, elemental, índice de yodo, capacidad de intercambio catiónico, adsorción de fosfato y pH. Los resultados muestran que los carbonizados obtenidos a 450 °C, con una velocidad de calentamiento de 1,0 °C/min, y con 60 min como tiempo de residencia, presentan un mejor comportamiento en cuanto a la capacidad de intercambio catiónico y adsorción de sales, propiedades importantes para la generación de antroposoles.

Chars of vegetable origin were obtained at laboratory scale starting from Eucalyptus globullus wood, with different carbonization conditions. The chars were characterized physicochemically by proximate and ultimate analysis and determination of iodine index, capacity of cationic exchange, phosphate adsorption and pH. The results show that the chars obtained at 450 °C, with a rate of heating of 1.0 °C/min and with a residence time of 60 min, present better behavior in terms of cationic exchange capacity and adsorption of salts capacity, important properties for the generation of anthroposoils.