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1.
Am J Mens Health ; 15(2): 15579883211005617, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33845678

RESUMEN

Black Americans remain disproportionately affected by the COVID-19 pandemic. Emerging data suggests that employment in certain occupations (e.g., essential; frontline) may place individuals at higher-risk for contracting COVID-19. The current investigation examined how Black American fathers' COVID-19 perceived work risk was associated with their individual well-being (COVID-19 diagnosis; depressive and anxiety symptoms; sleep disturbance; sleep quality) as well as spillover into family contexts. Participants were 466 Black American fathers (M = 36.63; SD = 11.00) who completed online surveys in June-July 2020. Adjusted binomial logistic and multiple regressions were estimated to examine how fathers' work context was associated with COVID-19 health outcomes, psychological functioning, sleep health, and family stress. Descriptive analyses revealed that 32% of fathers reported a personal diagnosis of COVID-19 and 21% indicated that an immediate family member had been diagnosed. Adjusted binomial logistic regression analyses revealed that fathers working in higher-risk contexts for contracting COVID-19 had a greater odds ratio for both a personal (OR: 1.68, 95% CI: 1.05, 2.68) and an immediate family member diagnosis (OR: 2.58, 95% CI: 1.52, 4.36). Working in a higher-risk context for contracting COVID-19 was associated with poorer psychological functioning, greater sleep disturbance, and higher levels of family discord. Findings suggest that Black fathers working in higher risk contexts may be at risk for COVID-19 exposure and infection. Further, this study indicates that these effects extend to their own well-being, including mental and sleep health as well as increased family stress.


Asunto(s)
Afroamericanos/psicología , /transmisión , Padre/psicología , Ocupaciones , Adulto , Ansiedad/psicología , Depresión/psicología , Humanos , Masculino , Pandemias , Factores de Riesgo , Trastornos del Sueño-Vigilia/psicología , Determinantes Sociales de la Salud , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Estados Unidos/epidemiología
2.
West Afr J Med ; 38(4): 342-346, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33901181

RESUMEN

Background and objectives: Osteoporosis is a bone disease characterized by reduced bone density (and microarchitecture damage) prevalent in post-menopausal women, who are prone to fragility fractures. There is paucity of data regarding the prevalence of osteoporosis in Nigerian women. This study was carried out to evaluate the frequency of osteoporosis among Nigerian women with degenerative skeletal diseases and fractures who visited our hospital so as to suggest prevention and early treatment in order to reduce the occurrence of fragility fractures. Methods: Women aged 50 years and older, who visited the hospital with degenerative skeletal diseases and fractures during the study period were recruited. Their ages, diagnosis, Bone Mineral Density (BMD), T-score and interpretation were recorded in an anonymous database. Results: The ages of the 173 patients evaluated ranged between 51 and 89 years, of which 111 (64.1%) were aged between 61 and 80 years. The most common diagnosis was degenerative lumbar spine disease in 37.0% of patients, but only 13.9% had fractures. Knee and hip osteoarthritis (OA) accounted for fewer cases (22.5% and 3.5% respectively). Using WHO criteria for diagnosing osteoporosis, 35 (20.2%) of the patients had osteoporosis, while 82 (47.4%) had low BMD, 52 (30.1%) were normal and 4 (2.3%) had high BMD. Conclusions: In this study, the frequency of osteoporosis increased with age and was higher among patients with a combination of cervical and lumbar degenerative disease, followed by fractures. We, therefore, recommend routine screening of women aged 50 and above with degenerative spine disease and fractures.


Asunto(s)
Osteoporosis , Fracturas de la Columna Vertebral , Afroamericanos , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Vértebras Lumbares , Persona de Mediana Edad , Nigeria/epidemiología , Osteoporosis/epidemiología
3.
Artículo en Inglés | MEDLINE | ID: mdl-33800177

RESUMEN

To compare African American (AA) and non-Hispanic White men living in same residential areas for the associations between educational attainment and household income with perceived discrimination (PD). The National Survey of American Life (NSAL), a nationally representative study, included 1643 men who were either African American (n = 1271) or non-Hispanic White (n = 372). We compared the associations between the two race groups using linear regression. In the total sample, high household income was significantly associated with lower levels of PD. There were interactions between race and household income, suggesting that the association between household income and PD significantly differs for African American and non-Hispanic White men. For non-Hispanic White men, household income was inversely associated with PD. For African American men, however, household income was not related to PD. While higher income offers greater protection for non-Hispanic White men against PD, African American men perceive higher levels of discrimination compared to White males, regardless of income levels. Understanding the role this similar but unequal experience plays in the physical and mental health of African American men is worth exploring. Additionally, developing an enhanced understanding of the drivers for high-income African American men's cognitive appraisal of discrimination may be useful in anticipating and addressing the health impacts of that discrimination. Equally important to discerning how social determinants work in high-income African American men's physical and mental health may be investigating the impact of the mental health and wellbeing of deferment based on perceived discrimination of dreams and aspirations associated with achieving high levels of education and income attainment of Black men.


Asunto(s)
Afroamericanos , Renta , Hombres , Racismo , Grupo de Ascendencia Continental Europea , Humanos , Masculino , Salud Mental , Estados Unidos
4.
Artículo en Inglés | MEDLINE | ID: mdl-33807211

RESUMEN

(1) Polybrominated diphenyl ethers (PBDEs) were widely produced in the United States until 2004 but remain highly persistent in the environment. The potential for PBDEs to disrupt normal neuroendocrine pathways resulting in depression and other neurological symptoms is largely understudied. This study examined whether PBDE exposure in pregnant women was associated with antenatal depressive symptomatology. (2) Data were collected from 193 African American pregnant women at 8-14 weeks gestation. Serum PBDEs and depressive symptoms were analyzed and a mixture effect was calculated. (3) Urban pregnant African American women in the Southeastern United States had a high risk of depression (27%) compared to the National average. Increased levels of PBDEs were found. BDE-47 and -99 exposures are significantly associated with depressive symptomatology in the pregnant cohort. The weighted body burden estimate of the PBDE mixture was associated with a higher risk of mild to moderate depression using an Edinburgh Depression Scale cutoff score of ≥10 (OR = 2.93; CI 1.18, 7.82). (4) Since antenatal depression may worsen in postpartum, reducing PBDE exposure may have significant clinical implications.


Asunto(s)
Éteres Difenilos Halogenados , Mujeres Embarazadas , Afroamericanos , Carga Corporal (Radioterapia) , Femenino , Éteres Difenilos Halogenados/análisis , Humanos , Embarazo , Sudeste de Estados Unidos , Estados Unidos/epidemiología
6.
Sci Rep ; 11(1): 8738, 2021 04 22.
Artículo en Inglés | MEDLINE | ID: mdl-33888833

RESUMEN

Factors contributing to racial inequities in outcomes from coronavirus disease 2019 (COVID-19) remain poorly understood. We compared by race the risk of 4 COVID-19 health outcomes--maximum length of hospital stay (LOS), invasive ventilation, hospitalization exceeding 24 h, and death--stratified by Elixhauser comorbidity index (ECI) ranking. Outcomes and ECI scores were constructed from retrospective data obtained from the Cerner COVID-19 De-Identified Data cohort. We hypothesized that racial disparities in COVID-19 outcomes would exist despite comparable ECI scores among non-Hispanic (NH) Blacks, Hispanics, American Indians/Alaska Natives (AI/ANs), and NH Whites. Compared with NH Whites, NH Blacks had longer hospital LOS, higher rates of ventilator dependence, and a higher mortality rate; AI/ANs, higher odds of hospitalization for ECI = 0 but lower for ECI ≥ 5, longer LOS for ECI = 0, a higher risk of death across all ECI categories except ECI ≥ 5, and higher odds of ventilator dependence; Hispanics, a lower risk of death across all ECI categories except ECI = 0, lower odds of hospitalization, shorter LOS for ECI ≥ 5, and higher odds of ventilator dependence for ECI = 0 but lower for ECI = 1-4. Our findings contest arguments that higher comorbidity levels explain elevated COVID-19 death rates among NH Blacks and AI/ANs compared with Hispanics and NH Whites.


Asunto(s)
Afroamericanos/estadística & datos numéricos , /epidemiología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Adulto , Anciano , Femenino , Disparidades en el Estado de Salud , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Respiración Artificial/estadística & datos numéricos , Estudios Retrospectivos , Estados Unidos/etnología
7.
Environ Sci Process Impacts ; 23(4): 621-632, 2021 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-33908986

RESUMEN

Hydraulic fracturing of deep shale formations generates large volumes of wastewater that must be managed through treatment, reuse, or disposal. Produced wastewater liberates formation-derived radionuclides and contains previously uncharacterized organohalides thought to be generated within the shale well, both posing unknown toxicity to human and ecological health. Here, we assess the toxicity of 42 input media and produced fluid samples collected from four wells in the Utica formation and Marcellus Shale using two distinct endpoint screening assays. Broad spectrum acute toxicity was assessed using a bioluminescence inhibition assay employing the halotolerant bacterium Aliivibrio fischeri, while predictive mammalian cytotoxicity was evaluated using a N-acetylcysteine (NAC) thiol reactivity assay. The acute toxicity and thiol reactivity of early-stage flowback was higher than later produced fluids, with levels diminishing through time as the natural gas wells matured. Acute toxicity of early stage flowback and drilling muds were on par with the positive control, 3,5-dichlorophenol (6.8 mg L-1). Differences in both acute toxicity and thiol reactivity between paired natural gas well samples were associated with specific chemical additives. Samples from wells containing a larger diversity and concentration of organic additives resulted in higher acute toxicity, while samples from a well applying a higher composition of ammonium persulfate, a strong oxidizer, showed greater thiol reactivity, predictive of higher mammalian toxicity. Both acute toxicity and thiol reactivity are consistently detected in produced waters, in some cases present up to nine months after hydraulic fracturing. These results support that specific chemical additives, the reactions generated by the additives, or the constituents liberated from the formation by the additives contribute to the toxicity of hydraulic fracturing produced waters and reinforces the need for careful consideration of early produced fluid management.


Asunto(s)
Fracking Hidráulico , Contaminantes Químicos del Agua , Afroamericanos , Humanos , Gas Natural , Yacimiento de Petróleo y Gas , Aguas Residuales , Contaminantes Químicos del Agua/análisis , Contaminantes Químicos del Agua/toxicidad
10.
AIDS Educ Prev ; 33(2): 143-157, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33821677

RESUMEN

Black sexual minority men (BSMM) and Black transgender women (BTW) have disproportionately high HIV prevalence, making HIV testing critical for treatment and prevention. Racism and homophobia may be barriers to testing among BSMM/BTW, particularly in the context of previous incarceration. We analyzed a subsample (n = 655) of HIV-negative, previously incarcerated BSMM/BTW in the HIV Prevention Trials Network 061 study, generating prevalence ratios and interaction terms testing associations between experienced racism and homophobia with past-year HIV testing. Both racism (aPR = 0.83, 95% CI [0.70, 0.98]) and homophobia (aPR: 0.68, 95% CI [0.48, 0.98]) were associated with lower testing, although their interaction was associated with unexpectedly higher testing (Interaction aPR = 1.77, 95% CI [1.25, 2.49]). Among BSMM/BTW with a history of incarceration, racism and homophobia are barriers to HIV testing. Positive interactions between racism and homophobia could be explained by numerous factors (e.g., resilience, coping) and warrants further study.


Asunto(s)
Afroamericanos/psicología , Infecciones por VIH/diagnóstico , Homofobia , Homosexualidad Masculina/psicología , Racismo , Personas Transgénero/psicología , Adaptación Psicológica , Adulto , Estudios de Cohortes , Discriminación en Psicología , Femenino , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Homosexualidad Masculina/etnología , Humanos , Masculino , Resiliencia Psicológica
11.
AIDS Educ Prev ; 33(2): 158-168, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33821680

RESUMEN

Cigarette smoking remains disproportionately prevalent and is increasingly a cause of death and disability among people with HIV (PWH). Many PWH are interested in quitting, but interest in and uptake of first-line smoking cessation pharmacotherapies are varied in this population. To provide current data regarding experiences with and perceptions of smoking cessation and cessation aids among PWH living in Durham, North Carolina, the authors conducted five focus group interviews (total n = 24; 96% African American) using semistructured interviews. Interviews were recorded, transcribed, coded, and thematically analyzed. Major themes included ambivalence and/or lack of interest in cessation; presence of cessation barriers; perceived perceptions of ineffectiveness of cessation aids; perceived medication side effects; and conflation of the harms resulting from use of tobacco products and nicotine replacement therapy. Innovative and effective interventions must account for the aforementioned multiple barriers to cessation as well as prior experiences with and misperceptions regarding cessation aids.


Asunto(s)
Infecciones por VIH/complicaciones , Fumadores/psicología , Cese del Hábito de Fumar/psicología , Dispositivos para Dejar de Fumar Tabaco/estadística & datos numéricos , Adolescente , Adulto , Afroamericanos , Anciano , Femenino , Grupos Focales , Conductas Relacionadas con la Salud , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , North Carolina , Investigación Cualitativa , Cese del Hábito de Fumar/métodos
12.
J Dent Educ ; 85(4): 448-455, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33826146

RESUMEN

The United States has a history of systemic racism and violence toward minority communities. Unfortunately, the last year has demonstrated that systemic racism, and its consequences, persist. The dental profession has also failed to adequately resolve known issues of racial inequity and systemic racism, with persistent disparities in oral health outcomes for Black Americans compared to all other Americans, underrepresentation of minorities in the profession, and barriers to entry. However, dental education has the opportunity to address these issues. Current accreditation standards do not specifically address racial diversity among the student body, yet it is clear that representation of a population matters and the lack of representation may exacerbate race and racism as public health issues in dentistry. To explore the issue, we curated American Dental Education Association (ADEA) data on the race of students admitted and enrolled into dental programs across the United States. We used data visualization techniques to present the data and study trends. While the number of Black and African American (BAA) enrollees in dental schools has increased between 2000 and 2019, this population continues to make up a disproportionately small percentage of all enrollees, relative to the BAA percentage in the U.S. population. Much of the increase in BAA enrollment is attributable to increased places (due to the opening of new schools and increased class size in established schools) and the rate of acceptance of BAA students has had limited improvement. Very little progress has been accomplished in growing the enrollment of BAA applicants to dental school in 20 years. As a profession, we also fail to grow interest among our graduates in careers that may support historically underrepresented and marginalized racial groups-public health, rural practice, population research, academia, and health policy. This may be a contributing factor to the oral health disparities faced by Black Americans and have implications for dental education.


Asunto(s)
Afroamericanos , Racismo , Diversidad Cultural , Humanos , Grupos Minoritarios , Estudiantes de Odontología , Estados Unidos
13.
Artículo en Inglés | MEDLINE | ID: mdl-33919524

RESUMEN

This study explores African American parents' experiences with using technology to engage their children in meaningful activities (e.g., e-learning) during COVID-19 and its impact on family health. Eleven African American families were recruited through a local health department program from a rural Midwestern community to participate in semi-structured interviews. Majority of participants reported stresses from feelings of "sink or swim" in a digital world, without supports from schools to effectively provide for their children's technology needs. The COVID-19 pandemic underscored the importance of family-school collaborative engagement and empowerment. Digital technology needs to become part of our school education system so that technology use among African Americans is elevated and families protected against future outbreaks. Further research with a more diverse African American sample is needed.


Asunto(s)
Afroamericanos , Niño , Control de Enfermedades Transmisibles , Humanos , Pandemias
14.
Artículo en Inglés | MEDLINE | ID: mdl-33921217

RESUMEN

We characterized vulnerable populations located in areas at higher risk of COVID-19-related mortality and low critical healthcare capacity during the early stage of the epidemic in the United States. We analyze data obtained from a Johns Hopkins University COVID-19 database to assess the county-level spatial variation of COVID-19-related mortality risk during the early stage of the epidemic in relation to health determinants and health infrastructure. Overall, we identified highly populated and polluted areas, regional air hub areas, race minorities (non-white population), and Hispanic or Latino population with an increased risk of COVID-19-related death during the first phase of the epidemic. The 10 highest COVID-19 mortality risk areas in highly populated counties had on average a lower proportion of white population (48.0%) and higher proportions of black population (18.7%) and other races (33.3%) compared to the national averages of 83.0%, 9.1%, and 7.9%, respectively. The Hispanic and Latino population proportion was higher in these 10 counties (29.3%, compared to the national average of 9.3%). Counties with major air hubs had a 31% increase in mortality risk compared to counties with no airport connectivity. Sixty-eight percent of the counties with high COVID-19-related mortality risk also had lower critical care capacity than the national average. The disparity in health and environmental risk factors might have exacerbated the COVID-19-related mortality risk in vulnerable groups during the early stage of the epidemic.


Asunto(s)
Epidemias , Afroamericanos , Disparidades en el Estado de Salud , Humanos , Estados Unidos/epidemiología , Poblaciones Vulnerables
15.
Artículo en Inglés | MEDLINE | ID: mdl-33808216

RESUMEN

The COVID-19 pandemic is a natural disaster of historic proportions with widespread and profound psychological sequelae. African Americans fall ill and die more than whites from COVID and more survivors and loved ones face psychological risk. African Americans also experience greater personal, social, and financial stress even when not personally touched by COVID illness, and they are again vulnerable as COVID diminishes African American community's capacity for mutual support. Enactment of the American Rescue Act of 2021 can moderate if not eliminate African Americans' greater adversity and greater psychological challenge; other provisions can move the mental health treatment system beyond its previous failure to reach African Americans as it constructively responds to the crisis that COVID presents. From outreach through trusted community actors and institutions for meeting African Americans' needs of varying intensity and duration, and by providing a spectrum of evidence supported interventions-culturally adapted as needed-newfound success can mark a turning point toward new approaches and lasting success.


Asunto(s)
Coronavirus , Afroamericanos , Humanos , Salud Mental , Pandemias , Estados Unidos/epidemiología
18.
Artículo en Inglés | MEDLINE | ID: mdl-33803629

RESUMEN

Conceptualized using critical race theory as a theoretical underpinning, this study analyzed the lived experiences of older, rural, African American male prostate cancer (hereafter referenced as PrCA) survivors' faith and health promotion practices within Northeast Louisiana. Qualitative data from journaling, observations, and semi-structured interviews were obtained from ten older, African American male PrCA survivors residing in four rural parishes of Louisiana. The data analysis employed a two-stage approach known as Polkinghorne's analysis of narratives and narrative analysis using an art-based methodological approach. Framed as composite character counterstories, survivors' narratives revealed how survivors made sense of and gave meaning to their PrCA diagnosis, treatment, recovery, and survivorship. Specifically, their counterstories indicate that centering and honoring the unique and often taken-for-granted perspectives of older, rural, African American male PrCA survivors offered a deeper understanding of the multiple factors influencing their quality of life, as well as the sociostructural mechanisms impacting their survivorship care. Faith was examined as both a secular and sacred source of support that these men viewed as central to the acceptance of their diagnosis, treatment, recovery, and survivorship.


Asunto(s)
Supervivientes de Cáncer , Neoplasias de la Próstata , Afroamericanos , Promoción de la Salud , Humanos , Louisiana , Masculino , Investigación Cualitativa , Calidad de Vida , Sobrevivientes
19.
AMA J Ethics ; 23(3): E271-275, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33818380

RESUMEN

The Flexner Report damaged and marginalized historically Black medical schools, which today produce more than their fair share of Black medical graduates. As physicians, graduates of Black medical schools have confronted head-on the inequities of American responses to COVID-19 that the pandemic has laid bare to the world. Black physicians' leadership roles in American health care and in American communities have informed the reimagination of health care and medical education as just and inclusive.


Asunto(s)
Afroamericanos/educación , Racismo/historia , Informe de Investigación , Facultades de Medicina/historia , Historia del Siglo XX , Humanos
20.
BMC Infect Dis ; 21(1): 338, 2021 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-33845781

RESUMEN

BACKGROUND: As COVID-19 vaccine distribution efforts continue, public health workers can strategize about vaccine promotion in an effort to increase willingness among those who may be hesitant. METHODS: In April 2020, we surveyed a national probability sample of 2279 U.S. adults using an online panel recruited through address-based sampling. Households received a computer and internet access if needed to participate in the panel. Participants were invited via e-mail and answered online survey questions about their willingness to get a novel coronavirus vaccine when one became available. The survey was completed in English and Spanish. We report weighted percentages. RESULTS: Most respondents were willing to get the vaccine for themselves (75%) or their children (73%). Notably, Black respondents were less willing than White respondents (47% vs. 79%, p < 0.001), while Hispanic respondents were more willing than White respondents (80% vs. 75%, p < 0.003). Females were less likely than makes (72% vs. 79%, p < 0.001). Those without insurance were less willing than the insured (47% vs. 78%, p < 0.001). Willingness to vaccinate was higher for those age 65 and older than for some younger age groups (85% for those 65 and older vs. 75% for those 50-64, p < 0.017; 72% for those 35-49, p < 0.002; 70% for those 25-34, p = NS and 75% for ages 18-24, p = NS), but other groups at increased risk because of underlying medical conditions or morbid obesity were not more willing to get vaccinated than their lower risk counterparts. CONCLUSIONS: Most Americans were willing to get a COVID-19 vaccine, but several vulnerable populations reported low willingness. Public health efforts should address these gaps as national implementation efforts continue.


Asunto(s)
/administración & dosificación , Vacunación/psicología , Adolescente , Adulto , Afroamericanos , Anciano , Niño , Grupo de Ascendencia Continental Europea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Salud Pública , Encuestas y Cuestionarios , Estados Unidos , Adulto Joven
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