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2.
Soc Sci Med ; 268: 113554, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33308911

RESUMEN

OBJECTIVES: To quantify the contribution variation in socioeconomic status in predicting the distribution of COVID-19 cases and deaths. METHODS: Analyses used incidence data on daily COVID + case counts from all counties from the initial wave of infections, merged with data from the U.S. census data to measure county-level SES and confounders. Multivariable analyses relied on survival analyses and Poisson regression to examine timing of county-level index cases and of COVID-19 incidence and mortality in infected counties to examine the spread and severity of COVID-19 while adjusting for adjusted for Black race, Hispanic ethnicity, age, gender, and urbanicity. Effect moderation by social distancing parameters was examined. RESULTS: Results indicate that higher SES was associated with earlier incidence of index cases, but that as social distancing took place inequalities in SES inverted so that growth in incidence was slower in higher SES counties, where case-fatality rates were lower. CONCLUSIONS: This study is the first to date to show what happens when an opportunistic disease that could affect anyone meets the American system of inequality and is powerfully shaped by it.


Asunto(s)
/epidemiología , Disparidades en el Estado de Salud , Afroamericanos/estadística & datos numéricos , Anciano , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Incidencia , Masculino , Factores Socioeconómicos , Estados Unidos/epidemiología
3.
J Surg Res ; 257: 246-251, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32862052

RESUMEN

BACKGROUND: Training diverse house staff, including those who are underrepresented in medicine, is vital to provide high-quality patient care for the communities that we serve. In 2018, the Accreditation Council for Graduate Medical Education announced new common program requirements for systematic efforts to recruit and retain a diverse workforce. However, questions remain about how to implement such efforts. MATERIALS AND METHODS: Electronic Residency Application Service (ERAS) data from eight residency programs spanning two recruitment cycles (2017-2018, 2018-2019) was reviewed. The number of candidates at each stage in the process (applicant, invited to interview, interviewed, and matched) was examined by self-identified race or ethnicity. These data were presented to residency program directors at our Graduate Medical Education committee meeting before the next recruitment cycle. Data were analyzed following the 2019-20 residency match. Odds ratios and Pearson's chi-squared test were used to assess statistical significance. RESULTS: A total of 10,445 and 10,982 medical students applied to our 8 core residency programs in 2017 and 2018, respectively. Medical students who applied and self-identified as Asian, Black or African American, and Hispanic or Latino or Spanish origin had lower odds of being invited to interview than those who self-identified as White. After data presentation, the odds of inviting Black or African American applicants to interview increased significantly. The odds of attending an interview once invited were the same across groups. CONCLUSIONS: Sharing ERAS data patterns with residency program directors was associated with a significant year over year change in interviewee diversity. Structured analysis of institutional ERAS data can provide insight into the resident selection process and may be a useful tool to improve house staff diversity.


Asunto(s)
Diversidad Cultural , Fuerza Laboral en Salud/organización & administración , Internado y Residencia/estadística & datos numéricos , Grupos Minoritarios/estadística & datos numéricos , Selección de Personal/organización & administración , Estudiantes de Medicina/estadística & datos numéricos , Afroamericanos/estadística & datos numéricos , Americanos Asiáticos/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Estudios de Factibilidad , Fuerza Laboral en Salud/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Humanos , Internado y Residencia/organización & administración , Solicitud de Empleo , Selección de Personal/estadística & datos numéricos , Estados Unidos
4.
J Surg Res ; 257: 486-492, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32916501

RESUMEN

BACKGROUND: There are well-documented disparities in outcomes for injured Black and Hispanic patients in the United States. However, patient level characteristics cannot fully explain the differences in outcomes and system-level factors, including the trauma center designation of the hospital to which a patient presents, may contribute to their worse outcomes. We aim to determine if Black and Hispanic patients are more likely to be undertriaged, compared with white patients. METHODS: This is a retrospective, cross-sectional, population-based study that uses data from the 2014 Agency for Healthcare Research and Quality Healthcare Costs and Utilization Project State Inpatient Databases. We included data from all states with available State Inpatient Databases data that included both race and hospital characteristics needed for analysis (n = 18). Logistic regression was used to identify predictors of severely injured (Injury Severity Score ≥16) patients being brought to a trauma center. RESULTS: We identified 70,970 severely injured trauma patients with complete data. Non-Hispanic White represented 74.1% of the study population, 9.8% were non-Hispanic Black, and 9.7% were Hispanic. After adjustment for other demographic and injury characteristics, Non-Hispanic Black and Hispanic patients were more likely to be undertriaged, compared with white patients (odds ratio, 1.20; 95% confidence interval, 1.12-1.29 and odds ratio, 1.39; 95% confidence interval, 1.29-1.48, respectively). Male sex and older age were associated with higher odds of undertriage, whereas urban residence, high injury severity, and penetrating injury were associated with lower odds of undertriage. CONCLUSIONS: Severely injured Black and Hispanic trauma patients are more likely to be undertriaged than otherwise similar white patients. The factors that contribute to racial and ethnic disparities in receiving trauma center care need to be identified and addressed to provide equitable trauma care.


Asunto(s)
Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Disparidades en Atención de Salud/etnología , Hispanoamericanos/estadística & datos numéricos , Triaje/estadística & datos numéricos , Heridas y Traumatismos/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Estados Unidos/epidemiología , Adulto Joven
5.
Ann Epidemiol ; 53: 56-62.e2, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32927056

RESUMEN

PURPOSE: To evaluate associations between counties' COVID-19 cases and racial-ethnic and nativity composition, considering heterogeneity across Latin American-origin subgroups and regions of the United States. METHODS: Using county-level data and multilevel negative binomial models, we evaluate associations between COVID-19 cases and percentages of residents that are foreign-born, Latinx, Black, or Asian, presenting estimates for all counties combined and stratifying across regions. Given varying risk factors among Latinx, we also evaluate associations for percentages of residents from specific Latin American-origin groups. RESULTS: Percentage of foreign-born residents is positively associated with COVID-19 case rate (IRR = 1.106; 95% CI: 1.074-1.139). Adjusted associations for percentage Latinx are nonsignificant for all counties combined, but this obscures heterogeneity. Counties with more Central Americans have higher case rates (IRR = 1.130; 95% CI: 1.067-1.197). And, in the Northeast and Midwest, counties with more Puerto Ricans have higher case rates. Associations with percentage Asians are nonsignificant after adjusting for percentage foreign-born. With the confirmation of prior evidence, the percentage of Black residents is positively and robustly associated with COVID-19 case rate (IRR = 1.031; 95% CI: 1.025-1.036). CONCLUSIONS: Counties with more immigrants, as well as more Central American or Black residents, have more COVID-19 cases. In the Northeast and Midwest, counties with more Puerto Rican residents also have more COVID-19 cases.


Asunto(s)
/etnología , Emigrantes e Inmigrantes/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Disparidades en el Estado de Salud , Disparidades en Atención de Salud/etnología , Características de la Residencia/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Gobierno Local , Masculino , Persona de Mediana Edad , Pandemias , Clase Social , Estados Unidos/epidemiología , Adulto Joven
6.
J Surg Res ; 257: 128-134, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32823010

RESUMEN

BACKGROUND: Despite increasing the number of women and ethnic minority groups in surgery, the academic advancement of such individuals within surgical fields lags behind Caucasian men. We sought to identify gender and ethnic inequalities in the receipt of surgical society research grants for young faculty investigators and compare the scholarly productivity of these groups. MATERIALS AND METHODS: In this cross-sectional and retrospective study, the gender and race of surgical society grant recipients were determined from surgical society Web sites. Surgical society grants aimed at providing research grants for junior faculty investigators were analyzed. Using the Scopus database, each recipient's scholarly productivity was determined by means of h-index, a standardized measure of the quantity and impact of an individual's published articles. We generated descriptive statistics to compare the gender, race, and h-index of grant recipients in the years 2006-2008 and 2016-2018. RESULTS: Between 2006 and 2008, there were 68 research grant recipients. Of these recipients, 79% were men and 21% were women. The racial breakdown was 54% Caucasian men, 22% Asian men, 1.4% African American men, 1.4% Hispanic men, 12% Caucasian women, 7% Asian Women, and 1.4% African American women. The average h-index of the male and female recipients is 25 (±14) and 24 (±14), respectively (P = 0.81). Between 2016 and 2018, there were 113 research grant recipients. Of these recipients, 66% were men and 34% were women. The racial breakdown was 47% Caucasian men, 16% Asian men, 3.5% African American men, 1% Hispanic men, 26% Caucasian women, 3.5% Asian women, and 3.5% African American women. The average h-index of the male and female recipients is 12 (±8) and 9 (±6), respectively (P = 0.046). Caucasian women had the only statistically significant change in the proportion of grant recipients from 2006-2008 to 2016-2018, with an increase from 12% to 26% (P = 0.02). CONCLUSIONS: Most surgical society research grants for young investigators continue to be awarded to Caucasian men, with Caucasian women earning a distant second in the 2016-2018 cohort. Ethnic minorities continue to be awarded less research grants than Caucasian recipients. Overall, the average h-index of women was less than men. This study highlights the persistent need for surgical societies to consider gender and ethnic disparities when awarding junior investigator grants, including barriers minority groups may face in achieving the same h-index as Caucasian men.


Asunto(s)
Investigación Biomédica/estadística & datos numéricos , Cirugía General/educación , Grupos Minoritarios/estadística & datos numéricos , Investigadores/estadística & datos numéricos , Apoyo a la Investigación como Asunto/estadística & datos numéricos , Éxito Académico , Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Estudios Transversales , Eficiencia , Grupos Étnicos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Estudios Retrospectivos , Factores Sexuales , Sociedades Médicas/estadística & datos numéricos
7.
Support Care Cancer ; 29(1): 97-105, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32314052

RESUMEN

BACKGROUND: Optimal hepatitis C virus (HCV) screening strategies for cancer patients have not been established. We compared the performance of selective HCV screening strategies. METHODS: We surveyed patients presenting for first systemic anticancer therapy during 2013-2014 for HCV risk factors. We estimated the prevalence of positivity for HCV antibody (anti-HCV) and examined factors associated with anti-HCV status using Fisher's exact test or Student's t test. Sensitivity was calculated for screening patients born during 1945-1965, patients with ≥ 1 other risk factor, or both cohorts ("combined screening"). RESULTS: We enrolled 2122 participants. Median age was 59 years (range, 18-91); 1138 participants were women. Race/ethnicity distribution was white non-Hispanic, 76% (n = 1616); Hispanic, 11% (n = 233); black non-Hispanic, 8% (n = 160); Asian, 4% (n = 78); and other, 2% (n = 35). Primary cancer distribution was non-liver solid tumor, 78% (n = 1664); hematologic cancer, 20% (n = 422); and liver cancer, 1% (n = 28). Prevalence of anti-HCV was 1.93% (95% CI, 1.39%-2.61%). Over 28% of patients with detectable HCV RNA were unaware of infection. Factors significantly associated with anti-HCV positivity included less than a bachelor's degree, birth in 1945-1965, chronic liver disease, injection drug use, and blood transfusion or organ transplant before 1992. A total of 1315 participants (62%), including 39 of 41 with anti-HCV, reported ≥ 1 risk factor. Sensitivity was 80% (95% CI, 65-91%) for birth-cohort-based, 68% (95% CI, 52-82%) for other-risk-factor-based, and 95% (95% 83-99%) for combined screening. CONCLUSION: Combined screening still missed 5% of patients with anti-HCV. These findings favor universal HCV screening to identify all HCV-infected cancer patients.


Asunto(s)
Hepacivirus/inmunología , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C/diagnóstico , Neoplasias Hepáticas/tratamiento farmacológico , Tamizaje Masivo/métodos , Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Estudios Transversales , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hepatitis C/etnología , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , ARN Viral/sangre , Factores de Riesgo , Adulto Joven
8.
MMWR Morb Mortal Wkly Rep ; 69(48): 1807-1811, 2020 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-33270609

RESUMEN

By June 2020, Marshallese and Hispanic or Latino (Hispanic) persons in Benton and Washington counties of Arkansas had received a disproportionately high number of diagnoses of coronavirus disease 2019 (COVID-19). Despite representing approximately 19% of these counties' populations (1), Marshallese and Hispanic persons accounted for 64% of COVID-19 cases and 57% of COVID-19-associated deaths. Analyses of surveillance data, focus group discussions, and key-informant interviews were conducted to identify challenges and propose strategies for interrupting transmission of SARS-CoV-2, the virus that causes COVID-19. Challenges included limited native-language health messaging, high household occupancy, high employment rate in the poultry processing industry, mistrust of the medical system, and changing COVID-19 guidance. Reducing the COVID-19 incidence among communities that suffer disproportionately from COVID-19 requires strengthening the coordination of public health, health care, and community stakeholders to provide culturally and linguistically tailored public health education, community-based prevention activities, case management, care navigation, and service linkage.


Asunto(s)
/etnología , Brotes de Enfermedades , Hispanoamericanos/estadística & datos numéricos , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Adolescente , Adulto , Anciano , Arkansas/epidemiología , Técnicas de Laboratorio Clínico , Femenino , Disparidades en el Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
9.
MMWR Morb Mortal Wkly Rep ; 69(48): 1812-1816, 2020 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-33270613

RESUMEN

Persons identifying as Hispanic or Latino (Hispanic) represent the second largest racial/ethnic group in the United States (1), yet understanding of the impact of coronavirus disease 2019 (COVID-19) in this population is limited. To evaluate COVID-19 health disparities in the community and inform public health, health system, and community-based interventions, local public health authorities analyzed the sociodemographic characteristics of persons who were diagnosed, hospitalized, and who died with COVID-19 in Denver, Colorado. During the first 7 months of the COVID-19 epidemic in Denver (March 6-October 6, 2020) the majority of adult COVID-19 cases (54.8%), hospitalizations (62.1%), and deaths (51.2%) were among persons identifying as Hispanic, more than double the proportion of Hispanic adults in the Denver community (24.9%) (1). Systemic drivers that influence how Hispanic persons live and work increase their exposure risks: compared with non-Hispanic persons, Hispanic persons with COVID-19 in Denver reported larger household sizes and were more likely to report known exposures to household and close contacts with COVID-19, working in an essential industry, and working while ill. Reducing the disproportionate incidence of COVID-19 morbidity and mortality among Hispanic persons will require implementation of strategies that address upstream social and environmental factors that contribute to an increased risk for both infection and transmission and that facilitate improved access to culturally congruent care.


Asunto(s)
/etnología , Disparidades en el Estado de Salud , Hispanoamericanos/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Adolescente , Adulto , Anciano , Colorado/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Adulto Joven
10.
Natl Vital Stat Rep ; 69(12): 1-45, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33270553

RESUMEN

Objectives-This report presents complete period life tables for the United States by Hispanic origin, race, and sex, based on age-specific death rates in 2018. Methods-Data used to prepare the 2018 life tables are 2018 final mortality statistics; July 1, 2018 population estimates based on the 2010 decennial census; and 2018 Medicare data for persons aged 66-99. The methodology used to estimate the life tables for the Hispanic population remains unchanged from that developed for the publication of life tables by Hispanic origin for data year 2006. The methodology used to estimate the 2018 life tables for all other groups was first implemented with data year 2008. In 2018, all 50 states and the District of Columbia reported deaths by race based on the 1997 Office of Management and Budget revised standards for the classification of federal data on race and ethnicity. As a result, race-specific life tables for 2018 presented in this report are based on the new standard and show estimates for single-race groups. These estimates are not completely comparable with those of previous years, which are based on bridged-race groups. To show trends and document the impact of changing to the 1997 standards, life expectancy estimates for 2006-2018 are reported for bridged-race categories that were in use starting with data year 2000. Results-In 2018, the overall expectation of life at birth was 78.7 years, increasing from 78.6 in 2017. Between 2017 and 2018, life expectancy at birth increased by 0.1 year for males (76.1 to 76.2) and females (81.1 to 81.2). In 2018, life expectancy at birth was 81.8 for the Hispanic population, 78.6 for the non-Hispanic single-race white population, and 74.7 for the non-Hispanic single-race black population.


Asunto(s)
Esperanza de Vida/tendencias , Tablas de Vida , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Grupos Étnicos/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Esperanza de Vida/etnología , Masculino , Persona de Mediana Edad , Distribución por Sexo , Estados Unidos/epidemiología , Adulto Joven
12.
PLoS One ; 15(11): e0240822, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33147232

RESUMEN

BACKGROUND: Social determinants of health (SDoHs) and social risks (SRs) have been associated with adverse health and healthcare utilization and racial/ethnic disparities. However, there is limited information about the prevalence of SRs in non-"safety net" adult populations and how SRs differ by race/ethnicity, age, education, and income. METHODS: We analyzed weighted survey data for 16,247 White, 1861 Black, 2895 Latino, 1554 Filipino, and 1289 Chinese adults aged 35 to 79 who responded to the 2011 or 2014/2015 Kaiser Permanente Northern California Member Health Survey. We compared age-standardized prevalence estimates of SDoHs (education, household income, marital status) and SRs (financial worry, cost-related reduced medication use and fruit/vegetable consumption, chronic stress, harassment/discrimination, health-related beliefs) across racial/ethnic groups for ages 35 to 64 and 65 to 79. RESULTS: SDoHs and SRs differed by race/ethnicity and age group, and SRs differed by levels of education and income. In both age groups, Blacks, Latinos, and Filipinos were more likely than Whites to be in the lower income category and be worried about their financial situation. Compared to Whites, cost-related reduced medication use was higher among Blacks, and cost-related reduced fruit/vegetable consumption was higher among Blacks and Latinos. Younger adults were more likely than older adults to experience chronic stress and financial worry. Racial/ethnic disparities in income were observed within similar levels of education. Differences in prevalence of SRs by levels of education and income were wider within than across racial/ethnic groups. CONCLUSIONS: In this non-"safety net" adult health plan population, Blacks, Latinos, and Filipinos had a higher prevalence of social risks than Whites and Chinese, and prevalence of social risks differed by age group. Our results support the assessment and EHR documentation of SDoHs and social risks and use of this information to understand and address drivers of racial/ethnic disparities in health and healthcare use.


Asunto(s)
Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Planificación en Salud/estadística & datos numéricos , Encuestas Epidemiológicas/estadística & datos numéricos , Determinantes Sociales de la Salud/etnología , Determinantes Sociales de la Salud/estadística & datos numéricos , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , California , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Disparidades en el Estado de Salud , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Prevalencia
13.
Prev Med ; 141: 106299, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33129909

RESUMEN

The 2019 Coronavirus Disease (COVID-19) pandemic has triggered stay-at-home orders in 43 states since March 19, 2020. Evidence is limited on how these orders affect peoples' behaviors and mental distress. We used a nationally representative survey of 1094 American adults collected between March 19 and March 31, 2020 to compare risk-reduction behaviors and mental distress in states with and without orders. Risk reduction behaviors included hand washing, wearing face mask and social distancing, and the mental distress was assessed by the four-item version of the Patient Health Questionnaire (PHQ-4). We predicted the probability of a person adopting risk reduction behaviors and the mental distress status using the number of days since their state issued the order relative to those in the non-order states, controlling for COVID-19 prevalence in the state, self-reported symptoms and demographic characteristics. The analysis was conducted in April 2020. Results show that the probability of adopting risk reduction behaviors increased between 8 (avoidance of people with high risk, 87% to 95%) and 27 (use of face mask, 18% to 45%) percentage points in the response period. Mental distress increased by 1.0 point on the PHQ-4 score (from 2.4 to 3.5 point) in the first week and started to drop afterwards. In summary, stay-at-home orders were associated with a differential increase in risk-reduction behaviors. People's mental distress rose in the first week under order and dropped afterwards. While in need for confirmation in longitudinal data, these results suggest that residents are responsive to orders.


Asunto(s)
/prevención & control , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Cuarentena/psicología , Cuarentena/estadística & datos numéricos , Conducta de Reducción del Riesgo , Adolescente , Adulto , Grupo de Ascendencia Continental Africana/psicología , Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Grupo de Ascendencia Continental Europea/psicología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/psicología , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Autoinforme , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto Joven
14.
CBE Life Sci Educ ; 19(4): ar59, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33215970

RESUMEN

The evolution education experiences of students of color represent an emerging area of research, because past inquiries indicate these students have differential outcomes, such as lower evolution acceptance and severe underrepresentation in evolutionary biology. Religion is often an important support for students of color who are navigating a science, technology, engineering, and mathematics culture that privileges White nonreligious students. For instance, religion helps mitigate the negative effects of racism, but religious students are also more likely to experience conflict when learning evolution. In this nationwide study, we examined the extent to which strong religiosity among students of color can explain their lower evolution acceptance. We surveyed students in 77 college biology courses across 17 states and found that Black/African American students tend to be more religious and less accepting of evolution than any other racial/ethnic identity group and that Hispanic students tend to be slightly more religious and slightly less accepting of evolution than White students. Importantly, we find that religious background is an important factor associated with Black and Hispanic students' lower levels of evolution acceptance. This study suggests that the biology community should become more inclusive of Christian religious students if it wishes to foster inclusive evolution education for Black and Hispanic students.


Asunto(s)
Afroamericanos , Biología , Hispanoamericanos , Religión , Estudiantes , Afroamericanos/estadística & datos numéricos , Biología/educación , Biología/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Humanos , Estudiantes/estadística & datos numéricos , Universidades
15.
Health Educ Behav ; 47(6): 845-849, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33148042

RESUMEN

The COVID-19 pandemic has exposed, and intensified, health inequities faced by Latinx in the United States. Washington was one of the first U.S. states to report cases of COVID-19. Public health surveillance shows that 31% of Washington cases are Latinx, despite being only 13% of the state population. Unjust policies related to immigration, labor, housing, transportation, and education have contributed to both past and existing inequities. Approximately 20% of Latinx are uninsured, leading to delays in testing and medical care for COVID-19, and early reports indicated critical shortages in professional interpreters and multilingual telehealth options. Washington State is taking action to address some of these inequities. Applying a health equity framework, we describe key factors contributing to COVID-19-related health inequities among Latinx populations, and how Washington State has aimed to address these inequities. We draw on these experiences to make recommendations for other Latinx communities experiencing COVID-19 disparities.


Asunto(s)
Infecciones por Coronavirus/etnología , Disparidades en Atención de Salud/etnología , Hispanoamericanos/estadística & datos numéricos , Neumonía Viral/etnología , Betacoronavirus , Barreras de Comunicación , Política de Salud , Accesibilidad a los Servicios de Salud/organización & administración , Vivienda/normas , Humanos , Pandemias , Traducción , Estados Unidos/epidemiología , Washingtón/epidemiología , Trabajo/estadística & datos numéricos
16.
Health Aff (Millwood) ; 39(11): 1926-1934, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33136498

RESUMEN

This study aimed to understand racial/ethnic differences in coronavirus disease 2019 (COVID-19) screening, symptom presentation, hospitalization, and mortality, using data from 31,549 adults tested for COVID-19 between March 1 and July 10, 2020, in Milwaukee and Southeast Wisconsin. Racial/ethnic differences existed in adults who screened positive for COVID-19 (4.5 percent of non-Hispanic Whites, 14.9 percent of non-Hispanic Blacks, and 14.8 percent of Hispanics). After adjustment for demographics and comorbidities, Blacks and Hispanics were more than three times more likely to screen positive and two times more likely to be hospitalized relative to Whites, and Hispanics were two times more likely to die than Whites. Given the long-standing history of structural racism, residential segregation, and social risk in the US and their role as contributors to poor health, we propose and discuss the part these issues play as explanatory factors for our findings.


Asunto(s)
Grupos de Población Continentales , Infecciones por Coronavirus , Grupos Étnicos/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Pandemias , Neumonía Viral , Afroamericanos/estadística & datos numéricos , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Estudios Transversales , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Wisconsin
17.
Artículo en Inglés | MEDLINE | ID: mdl-33138070

RESUMEN

The aim of this study was to evaluate respiratory health problems, including suspected asthma, and healthcare provider utilization among a sample of Latinx hired child farmworkers in rural North Carolina (n = 140). In 2018, a respiratory health questionnaire and breathing tests were collected from Latinx child (11-19 years) farmworkers (35.0% girls and 65.0% boys). Overall, 21.4% of children reported having been told by a medical provider that they had asthma, yet based on a combination of responses to respiratory survey questions, 36.4% or 15% more were identified as having suspected asthma. While 56.4% reported having a regular medical doctor, 38% had not had a medical exam in the past year. Respiratory dysfunction, including suspected, or uncontrolled asthma was prevalent among this group. Latinx children working in agriculture are vulnerable to occupational hazards and exposures and require assurances that they will receive access to high quality healthcare services that include routine respiratory health screenings.


Asunto(s)
Agricultura/estadística & datos numéricos , Asma/epidemiología , Trabajo Infantil/estadística & datos numéricos , Agricultores/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Enfermedades Respiratorias/etiología , Adolescente , Niño , Femenino , Humanos , Masculino , North Carolina/epidemiología , Enfermedades Respiratorias/epidemiología , Población Rural , Adulto Joven
18.
MMWR Morb Mortal Wkly Rep ; 69(40): 1437-1442, 2020 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-33031362

RESUMEN

During 2018, estimated incidence of human immunodeficiency virus (HIV) infection among Hispanic and Latino (Hispanic/Latino) persons in the United States was four times that of non-Hispanic White persons (1). Hispanic/Latino men who have sex with men (MSM) accounted for 24% (138,023) of U.S. MSM living with diagnosed HIV infection at the end of 2018 (1). Antiretroviral therapy (ART) adherence is crucial for viral suppression, which improves health outcomes and prevents HIV transmission (2). Barriers to ART adherence among Hispanic/Latino MSM have been explored in limited contexts (3); however, nationally representative analyses are lacking. The Medical Monitoring Project reports nationally representative estimates of behavioral and clinical experiences of U.S. adults with diagnosed HIV infection. This analysis used Medical Monitoring Project data collected during 2015-2019 to examine ART adherence and reasons for missing ART doses among HIV-positive Hispanic/Latino MSM (1,673). On a three-item ART adherence scale with 100 being perfect adherence, 77.3% had a score of ≥85. Younger age, poverty, recent drug use, depression, and unmet needs for ancillary services were predictors of lower ART adherence. The most common reason for missing an ART dose was forgetting; 63.9% of persons who missed ≥1 dose reported more than one reason. Interventions that support ART adherence and access to ancillary services among Hispanic/Latino MSM might help improve clinical outcomes and reduce transmission.


Asunto(s)
Antirretrovirales/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/etnología , Accesibilidad a los Servicios de Salud , Hispanoamericanos/psicología , Homosexualidad Masculina/etnología , Cumplimiento de la Medicación/etnología , Adolescente , Adulto , Hispanoamericanos/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Persona de Mediana Edad , Factores Socioeconómicos , Estados Unidos , Adulto Joven
19.
Natl Vital Stat Rep ; 69(9): 1-11, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33054916

RESUMEN

Objective-This report presents 2017-2018 infant mortality rates in the United States by maternal prepregnancy body mass index, and by infant age at death, maternal age, and maternal race and Hispanic origin. Methods-Descriptive tabulations of infant deaths by maternal and infant characteristics are presented using the 2017-2018 linked period birth/infant death files; the linked period birth/infant death file is based on birth and death certificates registered in all states and the District of Columbia. The 2017 linked birth/infant death file is the first year that national data on maternal prepregnancy body mass index were available. Results-Total infant, neonatal, and postneonatal mortality rates were lowest for infants of women who were normal weight prepregnancy, and then rose with increasing prepregnancy body mass index. Total, neonatal, and postneonatal rates were higher for infants of women who were underweight prepregnancy compared with infants of women who were normal or overweight before pregnancy. Mortality rates for infants of underweight women were generally, but not exclusively, lower than those of infants born to women with obesity. Infants born to women of normal weight generally had lower mortality rates than infants born to women who had obesity prepregnancy for all maternal age and race and Hispanic-origin groups.


Asunto(s)
Índice de Masa Corporal , Mortalidad Infantil/tendencias , Adulto , Grupos de Población Continentales/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Lactante , Mortalidad Infantil/etnología , Edad Materna , Estados Unidos/epidemiología
20.
Natl Vital Stat Rep ; 69(10): 1-12, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33054922

RESUMEN

Objectives-This report describes the methodology used in the preparation of the 2009-2011 decennial life tables for the United States by race, Hispanic origin, and sex based on the age-specific death rates for the period 2009-2011, appearing in the report, "U.S. Decennial Life Tables for 2009-2011, United States Life Tables" (1). Methods-Data used to prepare these life tables include population data by age on the census date April 1, 2010; deaths occurring in the 3-year period 2009-2011 classified by age at death; births for each of the years 2007-2011; and Medicare data for ages 66-99 for the 3 years 2009-2011. The methods used differ from those applied to the 1999-2001 decennial life tables in the estimation of mortality for ages 66 and over. For the total, white, black, non-Hispanic white, and non-Hispanic black populations, the method developed for the U.S. annual life tables beginning with data year 2008 was used. It consists of the application of the Kannisto logistic model to smooth death rates in the age range 85-99 and predict death rates for ages 100-120 (2,3). For the Hispanic population, which is added to the decennial series for the first time with the 2009-2011 set, the method developed for the U.S. annual life tables beginning with data year 2006 was used. This method consists of using the Brass relational logit model to estimate mortality for ages 80-120 (4).


Asunto(s)
Tablas de Vida , Afroamericanos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Censos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Medicare , Estados Unidos/epidemiología
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