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1.
Sch Psychol ; 36(5): 303-312, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34591585

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic swept the nation by surprise, leaving a deep-seated impact on individuals' social, mental, and physical health. Despite there being disparities between Black and White/non-Hispanic individuals, minimal research has been conducted to explore the effects of the virus on marginalized groups. This study aimed to investigate Black adolescents' perceptions of their experiences with COVID-19, including the challenges they encountered, the coping strategies they employed, and their use of religious/spiritual and school-based support. Twelve Black youth between the ages of 12 and 18 years were interviewed during the early stages of the pandemic (June and July of 2020). Participants struggled with adjusting to the changes in their daily routines, navigating virtual learning, and emerging mental health difficulties (e.g., anxiety). To cope with these challenges, participants relied on emotion and problem-focused coping strategies, including strategies that were religious/spiritual in nature. Participants also relied on social support from family, school personnel, and their religious community, though they lamented about the varied support received from the latter two. Findings from this research support calls for mental health providers to employ culturally affirming mental health services and engage in interagency collaboration to support Black youth. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Adaptação Psicológica , Comportamento do Adolescente/etnologia , Afro-Americanos/etnologia , Sintomas Comportamentais/psicologia , COVID-19 , Religião e Psicologia , Apoio Social , Adolescente , Criança , Feminino , Humanos , Masculino , Instituições Acadêmicas , Estados Unidos/etnologia
3.
Fertil Steril ; 116(2): 279-280, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34353569

RESUMO

The goal of this Views and Reviews is to let colleagues and leaders well versed in the African American experience in reproductive medicine address the problems of racism affecting our trainees and patients and, more significantly, propose solutions. The areas in reproductive medicine that will be explored from the African American perspective include the pipeline of providers, health disparities, and access to infertility treatment.


Assuntos
Afro-Americanos , Disparidades em Assistência à Saúde , Racismo , Medicina Reprodutiva , Afro-Americanos/etnologia , Afro-Americanos/história , Educação de Pós-Graduação em Medicina/ética , Educação de Pós-Graduação em Medicina/história , Educação de Pós-Graduação em Medicina/organização & administração , Educação de Pós-Graduação em Medicina/tendências , Escravização/ética , Escravização/história , Feminino , Acesso aos Serviços de Saúde/ética , Acesso aos Serviços de Saúde/história , Disparidades em Assistência à Saúde/ética , Disparidades em Assistência à Saúde/história , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Infertilidade/etnologia , Infertilidade/história , Infertilidade/terapia , Masculino , Relações Médico-Paciente/ética , Racismo/ética , Racismo/história , Racismo/prevenção & controle , Medicina Reprodutiva/educação , Medicina Reprodutiva/ética , Medicina Reprodutiva/história , Medicina Reprodutiva/tendências , Fatores Socioeconômicos
4.
J Fam Pract ; 70(5): 252, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34410918

RESUMO

THE COMPARISON: A) Pink scaling plaques and erythematous erosions in the antecubital fossae of a 6-year-old White boy. B) Violaceous, hyperpigmented, nummular plaques on the back and extensor surface of the right arm of a 16-month-old Black girl. C) Atopic dermatitis and follicular prominence/accentuation on the neck of a young Black girl.


Assuntos
Braço/anormalidades , Dermatite Atópica/etnologia , Exantema/complicações , Afro-Americanos/etnologia , Braço/fisiopatologia , Criança , Dermatite Atópica/diagnóstico , Exantema/etnologia , Feminino , Humanos , Lactente , Masculino
5.
Nurs Res ; 70(5S Suppl 1): S63-S72, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34074962

RESUMO

BACKGROUND: Mass incarceration of Black fathers and mothers in the United States has had an undeniably negative effect on the health and well-being of their children, families, and communities. Nearly 1 in every 9 Black youth in the United States has had an incarcerated parent compared to 1 in every 17 White youth. To mitigate the consequences of such historical and structural racism, family and community protective factors that promote health and flourishing in Black youth need exploration. OBJECTIVES: The aim of this study was to understand the associations of protective family, school, and neighborhood factors of overall health and flourishing in Black youth ever exposed to parental incarceration. METHODS: Using the 2016-2019 National Survey of Children's Health, secondary data analyses were conducted of Black youth ages 6-17 years exposed to parental incarceration (n = 839). Multivariable logistic regression models predicted the associations among protective family and community factors and two child outcomes of interest: overall good health status and flourishing. Overall good health status was measured dichotomously comparing children in "good, very good, or excellent" health to children in "fair or poor" health. Flourishing was measured as a count score using three survey questions designed to assess the child's curiosity and discovery about learning, resilience, and self-regulation. Protective factors of interest included family resilience and connectedness, neighborhood support and safety, and school safety. Other child and caregiver demographics and health characteristics were also included as covariates. RESULTS: Across all models, higher levels of family connectedness were associated with greater odds of having overall good health and flourishing in Black youth exposed to parental incarceration after adjusting for covariates and neighborhood and school protective characteristics. No significant associations were found between neighborhood or school protective factors and either outcome. DISCUSSION: To achieve health equity and maximize opportunities for all youth, we must remove the obstacles and consequences of mass incarceration. Improving the health and flourishing of Black youth who have had incarcerated parents requires greater investment in structural supports to bolster family connectedness and better evidence on how to support families affected by mass incarceration and structural racism.


Assuntos
Afro-Americanos/psicologia , Promoção da Saúde/métodos , Relações Pais-Filho , Fatores de Proteção , Adaptação Psicológica , Adolescente , Afro-Americanos/etnologia , Afro-Americanos/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Promoção da Saúde/estatística & dados numéricos , Humanos , Masculino , Prisioneiros/estatística & dados numéricos , Inquéritos e Questionários
6.
Nurs Res ; 70(5S Suppl 1): S53-S62, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34173375

RESUMO

BACKGROUND: Although stress is an established contributor to obesity (in general population studies), mechanisms to explain this association in African American women that incorporate culturally relevant frameworks have received little attention. OBJECTIVE: To investigate how stress is associated with body mass index (BMI) in this population, we examined multivariate models of BMI predicted by race-related, gender-related, and generic stressful life events and by use of food to cope with stress. We hypothesized that the three types of stressful life events would be indirectly associated with BMI through using food to cope with stress. METHODS: Psychometrically robust measures were included in surveys administered to a socioeconomically diverse sample of 189 African American women aged 21-78 years. Hypotheses were tested using structural equation modeling. We examined race-related, gender-related, and generic stressful life events as latent constructs indicated by exposure to and appraisal of potential stressors predicting a mediator, using food to cope, which predicted BMI; this model also included direct paths from the three latent stressful life event constructs to BMI. RESULTS: Almost every participant reported using food in some way to cope with stress; 33% and 42% met established criteria for overweight and obesity, respectively. The race-related stressful life event construct was the only latent construct predicting using food to cope with stress, and using food to cope with stress predicted BMI. A significance test of indirect effects demonstrated that the race-related stressful life event construct was indirectly associated with BMI through the mediator, using food to cope. DISCUSSION: Culturally relevant stress exposures and stress-related eating are important areas of foci for tackling overweight, obesity, and related health inequities in African American women. Findings highlight the importance of developing more complex models to understand the stress-related factors that elevate risk for overweight and obesity in this population.


Assuntos
Afro-Americanos/psicologia , Cultura , Comportamento Alimentar/psicologia , Estresse Psicológico/complicações , Adaptação Psicológica , Adulto , Afro-Americanos/etnologia , Afro-Americanos/estatística & dados numéricos , Idoso , Índice de Massa Corporal , Feminino , Humanos , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
7.
Nurs Res ; 70(5S Suppl 1): S13-S20, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34173373

RESUMO

BACKGROUND: Patterns of food security persistently vary by race, yet limited research has examined how community-specific experiences of race and racism are associated with nutritional outcomes. OBJECTIVES: This analysis describes a novel approach for classifying experiences of race and racism and explores the relationship between identified classes and measures of food security and diet quality. METHODS: Cross-sectional self-reported survey data from 306 African American adults living in two urban midwestern cities were collected in 2017-2018. Measures of racialized experiences assessed consciousness of race, perceived discrimination, and health effects of perceived discrimination. Food security was measured with a six-item screener and diet quality with the Healthy Eating Index-2010. Latent class analysis was used to generate racialized classes. Bivariate analyses were conducted to examine differences in class membership by sociodemographics and nutrition outcomes. RESULTS: Participants were majority women who were receiving Supplemental Nutrition Assistance Program benefits. Three racialized classes were identified: Class 1 reported few racialized experiences (42.8% of the sample), Class 2 was racially conscious with few experiences of discrimination (45.1%), and Class 3 was both racially conscious and affected by racialized actions (12.1%). Racialized classes were significantly different in mean household income, level of education, home ownership, and job loss in the past year. Class 3 was the least represented among those that were food secure and the most represented among those that were very low food secure. There were no differences by class in Healthy Eating Index-2010 scores. DISCUSSION: Findings offer an innovative method for measuring exposures to racism and for assessing its relationship to food security. Findings highlight heterogeneity of racialized experiences in similar contexts as well as potential root cause targets such as wages, education, home ownership, and employment that may be modulated to mitigate the effects of racism on food insecurity.


Assuntos
Afro-Americanos/estatística & dados numéricos , Segurança Alimentar/normas , Adulto , Afro-Americanos/etnologia , Afro-Americanos/psicologia , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Estudos Transversais , Escolaridade , Feminino , Segurança Alimentar/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Ohio , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários
8.
Nurs Res ; 70(5S Suppl 1): S31-S42, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34173379

RESUMO

BACKGROUND: Exposure to racism and associated adversities, such as poverty, is hypothesized to contribute to racial inequities in health via stress and immune pathways. Furthermore, the effects of adversity may be more salient during sensitive developmental periods. Our study examined racial differences in stress and immune biomarkers during adolescence and the effects of exposure to economic adversity at distinct developmental time periods and cumulatively in accounting for potential racial differences. METHODS: Secondary analysis of the Adolescent Health and Development in Context study was conducted. Data were derived from self-administered surveys; interviews; smartphone-based, geographic-explicit ecological momentary assessment; stress biomarkers (evening salivary cortisol over six nights and hair cortisol); and immune biomarkers (salivary shedding of Epstein-Barr virus [EBV] DNA among EBV-positive adolescents). Current socioeconomic status measures included annual household income and caregiver education. Caregivers also reported experiences of bankruptcy, difficulty paying bills, receipt of food stamps/Supplemental Nutrition Assistance Program/electronic benefit transfer, and job loss when the child was of ages birth-5 years, 6-10 years, and 11 years or older. An affirmative response to any item was defined as exposure to economic adversity for that developmental time period (yes/no). A cumulative economic adversity measure was calculated as the sum of exposures across developmental periods (0 = never exposed to 3 = exposed across all time periods). Descriptive and multivariable regression analyses were conducted, accounting for covariates. RESULTS: Black/African American adolescents had higher salivary cortisol concentration, higher hair cortisol concentration, and an increased odd of salivary shedding of EBV DNA compared to White adolescents. Racial differences were not attenuated by the current socioeconomic status or economic adversity (developmental period or cumulatively). DISCUSSION: Our study provides evidence that stress and immune biomarkers differ by race as early as adolescence and may be one pathway through which racism and associated adversities contribute to racial health inequities. Further research on the contribution of multiple adversities beyond poverty to racial inequities in physiological stress and health is critical for informing effective prevention and intervention efforts.


Assuntos
Biomarcadores/análise , Classe Social , Adolescente , Afro-Americanos/etnologia , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Criança , Feminino , Herpesvirus Humano 4/imunologia , Herpesvirus Humano 4/patogenicidade , Humanos , Hidrocortisona/análise , Masculino , Ohio , Saliva/metabolismo , População Urbana/estatística & dados numéricos
9.
Neurology ; 97(8): e825-e835, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34088871

RESUMO

OBJECTIVE: The associations of Lewy bodies (LBs) with olfactory dysfunction, parkinsonism, and higher odds of dementia were assessed in Black and White community-dwelling elders and racial differences in these associations were tested. METHODS: Black decedents (n = 81) were matched 2-to-1 by age, sex, years of education, and follow-up time in the study with White decedents (n = 154) from 4 longitudinal studies of dementia and aging. Participants underwent uniform clinical examination and cognitive, motor, and olfactory testing. LBs were detected in 7 brain regions by α-synuclein immunohistochemistry and racial differences in their association with olfaction, parkinsonism, and odds of dementia were determined using regression analyses. RESULTS: The mean scores of the odor test, global parkinsonism signs, and global cognition were lower in Black than White decedents; the frequency of dementia was similar in both groups. The frequency of LBs was similar in Black and White decedents (∼25%), as was the frequency of LBs in individual brain regions, while the mean LB counts/mm2 were similar in all regions except the cingulate cortex, which showed higher mean LB counts in Black decedents. In regression analyses, LBs were associated with impaired olfaction (-2.23, 95% confidence interval [CI] -3.45 to -1.01) and higher odds of dementia (odds ratio 3.0, 95% CI 1.10-8.17) in both racial groups; an association with parkinsonism was stronger in Black than White decedents. CONCLUSIONS: The frequency, distribution, and clinical manifestations of LBs are similar in Black and White elders.


Assuntos
Afro-Americanos/etnologia , Tonsila do Cerebelo/patologia , Córtex Cerebral/patologia , Grupo com Ancestrais do Continente Europeu/etnologia , Corpos de Lewy/patologia , Doença por Corpos de Lewy/etnologia , Transtornos do Olfato/etnologia , Substância Negra/patologia , Idoso , Idoso de 80 Anos ou mais , Autopsia , Feminino , Humanos , Doença por Corpos de Lewy/complicações , Doença por Corpos de Lewy/patologia , Doença por Corpos de Lewy/fisiopatologia , Estudos Longitudinais , Masculino , Transtornos do Olfato/etiologia , Transtornos do Olfato/fisiopatologia , Índice de Gravidade de Doença , Estados Unidos/etnologia
11.
J Nurs Adm ; 51(6): 310-317, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33989239

RESUMO

OBJECTIVE: To determine if Black nurses are more likely to report job dissatisfaction and whether factors related to dissatisfaction influence differences in intent to leave. BACKGROUND: Minority nurses report higher job dissatisfaction and intent to leave, yet little is known about factors associated with these differences in community settings. METHOD: Cross-sectional analysis of 11 778 nurses working in community-based settings was conducted. Logistic regression was used to estimate the association among race, job satisfaction, and intent to leave. RESULTS: Black nurses were more likely to report job dissatisfaction and intent to leave. Black nurses' intent to leave decreased in adjusted models that accounted for dissatisfaction with aspects of their jobs including salary, advancement opportunities, autonomy, and tuition benefits. CONCLUSION: Nurse administrators may find opportunities to decrease intent to leave among Black nurses through focused efforts to target areas of dissatisfaction.


Assuntos
Diversidade Cultural , Intenção , Satisfação no Emprego , Enfermeiras e Enfermeiros/psicologia , Afro-Americanos/etnologia , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , California/etnologia , Estudos Transversais , Florida/etnologia , Humanos , Modelos Logísticos , New Jersey/etnologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Pennsylvania/etnologia , Reorganização de Recursos Humanos/estatística & dados numéricos , Inquéritos e Questionários , Local de Trabalho/psicologia , Local de Trabalho/normas , Local de Trabalho/estatística & dados numéricos
12.
Neurology ; 97(7): e684-e694, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34045272

RESUMO

OBJECTIVE: To investigate sex and race differences in the association between fasting blood glucose (FBG) and risk of ischemic stroke (IS). METHODS: This prospective longitudinal cohort study included adults age ≥45 years at baseline in the Reasons for Geographic And Racial Differences in Stroke Study, followed for a median of 11.4 years. The exposure was baseline FBG (mg/dL); suspected IS events were ascertained by phone every 6 months and were physician-adjudicated. Cox proportional hazards were used to assess the adjusted sex/race-specific associations between FBG (by category and as a restricted cubic spline) and incident IS. RESULTS: Of 20,338 participants, mean age was 64.5 (SD 9.3) years, 38.7% were Black, 55.4% were women, 16.2% were using diabetes medications, and 954 IS events occurred. Compared to FBG <100, FBG ≥150 was associated with 59% higher hazards of IS (95% confidence interval [CI] 1.21-2.08) and 61% higher hazards of IS among those on diabetes medications (95% CI 1.12-2.31). The association between FBG and IS varied by race/sex (hazard ratio, FBG ≥150 vs FBG <100: White women 2.05 [95% CI 1.23-3.42], Black women 1.71 [95% CI 1.10-2.66], Black men 1.24 [95% CI 0.75-2.06], White men 1.46 [95% CI 0.93-2.28], p FBG×race/sex = 0.004). Analyses using FBG splines suggest that sex was the major contributor to differences by race/sex subgroups. CONCLUSIONS: Sex differences in the strength and shape of the association between FBG and IS are likely driving the significant differences in the association between FBG and IS across race/sex subgroups. These findings should be explored further and may inform tailored stroke prevention guidelines.


Assuntos
Afro-Americanos/etnologia , Glicemia/metabolismo , Grupo com Ancestrais do Continente Europeu/etnologia , AVC Isquêmico/sangue , AVC Isquêmico/epidemiologia , Adulto , Idoso , Feminino , Humanos , AVC Isquêmico/etnologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores Raciais , Fatores Sexuais , Estados Unidos/epidemiologia
13.
J Fam Psychol ; 35(2): 138-148, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33871275

RESUMO

Cultural factors influence the development of all children. Yet, current knowledge of explicit cultural socialization processes in childhood remains limited, mainly by failing to incorporate the experiences of young children. To address this critical gap, the authors introduce the OMERS-Peds task, an observational measurement designed to systematically identify and compare the content of cultural messages passed down from caregivers to offspring during early school age years. The OMERS-Peds was administered to mothers and children (n = 275) from three diverse racial/ethnic backgrounds (African American (n = 153), Hispanic (n = 61), and non-Hispanic White (n = 61)) within the longitudinal Multidimensional Assessment of Preschoolers (MAPS) Study. The OMERS-Peds coding system was used to rate how strongly families endorsed 5 key constructs: family culture, religion, identity, ethnicity, and race. A series of χ2 statistic tests were used to compare scores across racial/ethnic backgrounds, and within families (between children and their mothers). Analyses revealed that in the cultural socialization conversations occurring in early childhood, parents and children prioritize talking about their family's culture and religion. Independent of their racial/ethnic backgrounds, mothers and children seldom discussed race and ethnicity. Contrary to research with older children, differences were mainly identified within families, rather than across racial/ethnic groups. Findings support the need to include children's perspectives in the assessments of cultural socialization, as opposed to relying primarily on parent reports, and highlight the importance of having an observational methodology that allows researchers to examine parent-child bidirectional interactions during early school age years in a systematic manner. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Afro-Americanos/etnologia , Técnicas de Observação do Comportamento , Comunicação , Grupo com Ancestrais do Continente Europeu/etnologia , Hispano-Americanos , Relações Mãe-Filho/etnologia , Socialização , Adulto , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Observação
14.
Transl Behav Med ; 11(3): 785-792, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-33769536

RESUMO

Widespread uptake of the COVID-19 vaccine is critical to halt the pandemic. At present, little is known about factors that will affect vaccine uptake, especially among diverse racial/ethnic communities that have experienced the highest burden of COVID. We administered an online survey to a Qualtrics respondent panel of women ages 27-45 years (N = 396) to assess vaccine intentions and attitudes, and trusted vaccine information sources. 56.8% intended to be vaccinated and 25.5% were unsure. In bivariate analyses, a greater percentage of non-Latina White (NLW) and Chinese women reported that they would be vaccinated, compared with Latina and non-Latina Black (NLB) women (p < 0.001). Those who were uninsured, unemployed and those with lower incomes were less likely to say that they would be vaccinated. In analyses stratified by race/ethnicity, NLB women remained significantly less likely to report that they would be vaccinated compared with NLW women (adjusted odds ratio: 0.47; 95% confidence interval: 0.23, 0.94), controlling for age, marital status, income, education, employment, and insurance status. When analyses were additionally controlled for beliefs in vaccine safety and efficacy, racial/ethnic differences were no longer significant (adjusted odds ratio: 0.64; 95% confidence interval: 0.31, 1.34). Given that NLB women were less likely to report the intention to be vaccinated, targeted efforts will be needed to promote vaccine uptake. It will be critical to emphasize that the vaccine is safe and effective; this message may be best delivered by trusted community members.


Assuntos
Afro-Americanos/etnologia , Americanos Asiáticos/estatística & dados numéricos , Vacinas contra COVID-19 , Grupo com Ancestrais do Continente Europeu/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispano-Americanos/estatística & dados numéricos , Vacinação em Massa/etnologia , Adulto , Feminino , Humanos , Intenção , Pessoa de Meia-Idade , Estados Unidos/etnologia , Mulheres
16.
Ann Behav Med ; 55(3): 179-191, 2021 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-33724334

RESUMO

BACKGROUND: High stress prenatally contributes to poor maternal and infant well-being. The coronavirus disease 2019 (COVID-19) pandemic has created substantial stress for pregnant women. PURPOSE: To understand whether stress experienced by women pregnant at the beginning of the pandemic was associated with a greater prevalence of adverse perinatal outcomes. METHODS: Pregnant women across the USA aged ≥18 years old enrolled in a prospective cohort study during the pandemic onset (T1) in April-May 2020. This report focuses on the 1,367 participants who gave birth prior to July-August 2020 (T2). Hierarchical logistic regression models predicted preterm birth, small for gestational age infants, and unplanned operative delivery from T1 stress, sociodemographic, and medical factors. RESULTS: After controlling for sociodemographic and medical factors, preterm birth was predicted by high prenatal maternal stress, delivering an infant small for gestational age was predicted by interpersonal violence and by stress related to being unprepared for birth due to the pandemic, and unplanned cesarean or operative vaginal delivery was predicted by prenatal appointment alterations, experiencing a major stressful life event, and by stress related to being unprepared for birth due to the pandemic. Independent of these associations, African American women were more likely than other groups to deliver preterm. CONCLUSION: Pregnant women who are experiencing high stress during the COVID-19 pandemic are at risk of poorer perinatal outcomes. A longitudinal investigation is critical to determine whether prenatal maternal stress and resulting outcomes have longer-term consequences for the health and well-being of children born in the midst of the current pandemic.


Assuntos
COVID-19 , Recém-Nascido Pequeno para a Idade Gestacional , Complicações do Trabalho de Parto/epidemiologia , Estresse Psicológico/epidemiologia , Adolescente , Adulto , Afro-Americanos/etnologia , Exposição à Violência/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/epidemiologia , Estudos Prospectivos , Estados Unidos/epidemiologia , Adulto Jovem
17.
Drug Alcohol Depend ; 221: 108641, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33652379

RESUMO

BACKGROUND: Compared to white smokers, Black smokers are at disproportionately higher risk for smoking-related disease, despite consuming fewer cigarettes per day (CPD). To examine racial disparities in biobehavioral influences on smoking and disease risk, we analyzed the relationship between self-reported tobacco dependence and intensity of tobacco smoke exposure per cigarette, on the one hand, and intensity of nicotine intake per cigarette, on the other. METHODS: In 270 Black and 516 white smokers, smoke exposure was measured by expired carbon monoxide (CO), and nicotine intake was measured by plasma cotinine (COT) and cotinine+3'-hydroxycotinine ([COT + 3HC]). Using linear regression analyses, we analyzed how the Fagerström Test for Cigarette Dependence (FTCD) predicted intensity of smoke exposure per cigarette (CO/CPD) and intensity of nicotine intake per cigarette (COT/CPD; [COT + 3HC]/CPD), and how race moderated these relations. RESULTS: Overall, Black smokers consumed fewer CPD than white smokers and had higher levels of CO/CPD, COT/CPD, and [COT + 3HC]/CPD. These elevations were most pronounced at lower levels of dependence: amongst Black smokers, FTCD negatively predicted intensity of smoke exposure as measured by CO/CPD (B = -0.12, 95% CI = -0.18, -0.05, p = 0.0003) and intensity of nicotine intake as measured by [COT + 3HC]/CPD (B = -1.31, 95% CI = -2.15, -0.46, p = 0.002). CONCLUSIONS: Low-dependence Black smokers had higher intensities of both smoke exposure and nicotine intake per cigarette compared to similarly dependent white smokers, suggesting that measures of dependence, exposure, and intake underestimate incremental risk of each cigarette to Black smokers.


Assuntos
Afro-Americanos , Monóxido de Carbono/análise , Fumar Cigarros/sangue , Grupo com Ancestrais do Continente Europeu , Nicotina/análise , Poluição por Fumaça de Tabaco/análise , Adulto , Afro-Americanos/etnologia , Fumar Cigarros/etnologia , Cotinina/sangue , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nicotina/administração & dosagem , Fatores Raciais/tendências , Tabagismo/sangue , Tabagismo/diagnóstico , Tabagismo/etnologia
18.
Lupus ; 30(5): 715-724, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33535903

RESUMO

OBJECTIVE: To examine the age differences in secular trends in black-white disparities in mortality from systemic lupus erythematosus (SLE) among women in the United States from 1988 to 2017. METHODS: We used mortality data to calculate age-specific SLE and all-causes (as reference) mortality rates and black/white mortality rates ratios among women from 1988 to 2017. Annual percent change was estimated using joinpoint regression analysis. RESULTS: We identified 10,793 and 4,165,613 black women and 19,455 and 31,129,528 white women who died between 1988 and 2017 from SLE and all-causes, respectively. The black/white SLE mortality rate ratio according joinpoint regression model was 6.6, 7.2, 4.4, and 1.4 for decedents aged 0-24, 25-44, 45-64, and 65+ years in 1988 and was 7.2, 5.9, 4.1, and 1.9, respectively in 2017. No significant decline trend was noted and the annual percent change was 0.3%, -0.7%, -0.2%, and 1.0%, respectively. On the contrast, the black/white all-causes mortality rate ratio was 2.0, 2.5, 1.8, and 1.0, respectively in 1988 and was 1.7, 1.3, 1.5, and 0.9, respectively in 2017, a significant decline trend was noted in each age group. CONCLUSIONS: Black adults, youths and adolescents had four to seven times higher SLE mortality rates than their white counterparts and the black-white disparities persisted during the past three decades. On the contrast, black women had less than two times higher all-causes mortality rates than their white counterparts and black-white disparities significantly diminish during the past three decades.


Assuntos
Afro-Americanos/estatística & dados numéricos , Causas de Morte/tendências , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Lúpus Eritematoso Sistêmico/mortalidade , Mortalidade/tendências , Adolescente , Adulto , Afro-Americanos/etnologia , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Lactente , Recém-Nascido , Lúpus Eritematoso Sistêmico/etnologia , Pessoa de Meia-Idade , Fatores Raciais , Análise de Regressão , Fatores de Tempo , Estados Unidos/etnologia , Adulto Jovem
19.
Am J Manag Care ; 27(2): e32-e33, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33577157

RESUMO

The fall season was accompanied by an urgent warning from the CDC of an impending "twindemic" of coronavirus disease 2019 and influenza. Despite the warnings, Black women are not lining up for vaccinations.


Assuntos
Afro-Americanos/etnologia , Disparidades em Assistência à Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Vacinação , Mulheres , Feminino , Humanos , New York , Populações Vulneráveis
20.
Breastfeed Med ; 16(2): 156-164, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33591227

RESUMO

Background: Although breastfeeding is optimal infant nutrition, disparities in breastfeeding persist in the African American population. AMEN (Avondale Moms Empowered to Nurse) launched a Peer-to-Peer support group to increase breastfeeding initiation and duration in an under-resourced African American urban community with low breastfeeding rates. Materials and Methods: A Community-Based Participatory Research (CBPR)-guided project was developed in partnership with a neighborhood church. Using modified Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) peer counseling materials, Avondale neighborhood breastfeeding moms were trained and designated Breastfeeding Champions. Community organizations and partnering agencies helped recruit local mothers. Support groups included childcare, transportation, refreshments, and incentives, plus stipends for Champions. A mixed-methods approach captured participation, feeding intention and practices, and program evaluation using electronic data capture. After adding another neighborhood with low breastfeeding rates, AMEN was modified to "All Moms Empowered to Nurse." Additional Champion moms were trained as Reaching Our Sisters Everywhere (ROSE) Community Transformers. During the COVID-19 pandemic, the group has met weekly by virtual platform. Results: Since May 2017, 67 AMEN support meetings have included 158 participants, with average attendance of 10 (range 5-19) per meeting. In addition to 8 Champions, 110 moms have attended, including 24% expecting mothers. Additional attendees include 13 family support persons, 23 guest speakers, and 12 from community outreach programs. Qualitative feedback from participants has been uniformly positive. Breastfeeding initiation rates have increased 12% in the initial neighborhood. Conclusions: Harnessing strength within the local community, Champion Breastfeeding Moms have successfully launched AMEN breastfeeding support groups in under-resourced African American urban neighborhoods, helping more mothers reach their breastfeeding goals.


Assuntos
Afro-Americanos/etnologia , Aleitamento Materno , Pesquisa Participativa Baseada na Comunidade , Mães/educação , Mães/psicologia , Grupo Associado , Avaliação de Programas e Projetos de Saúde , Adulto , COVID-19/epidemiologia , Feminino , Humanos , Cuidado Pós-Natal , Protestantismo , Apoio Social , Estados Unidos , População Urbana , Populações Vulneráveis/etnologia
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