White Americans Research Articles

Tumor Cell Stemness and Stromal Cell Features Contribute to Oral Cancer Outcome Disparity in Black Americans.

Black Americans (BAs) with head and neck cancer (HNC) have worse survival outcomes compared to the White patients. While HNC disparities in patient outcomes for BAs have been well recognized, the specific drivers of the inferior outcomes remain poorly understood. Here, we investigated the biologic features of patient tumor specimens obtained during the surgical treatment of oral cancers and performed a follow-up study of the patients' post-surgery recurrences and metastases with the aim to explore whether tumor biologic features could be associated with the poorer outcomes among BA patients compared with White American (WA) patients. We examined the tumor stemness traits and stromal properties as well as the post-surgery recurrence and metastasis of oral cancers among BA and WA patients. It was found that high levels of tumor self-renewal, invasion, tumorigenesis, metastasis, and tumor-promoting stromal characteristics were linked to post-surgery recurrence and metastasis. There were more BA than WA patients demonstrating high stemness traits and strong tumor-promoting stromal features in association with post-surgery tumor recurrences and metastases, although the investigated cases displayed clinically comparable TNM stages and histological grades. These findings demonstrated that the differences in tumor stemness and stromal property among cancers with comparable clinical diagnoses contribute to the outcome disparity in HNCs. More research is needed to understand the genetic and molecular basis of the biologic characteristics underlying the inferior outcomes among BA patients, so that targeting strategies can be developed to reduce HNC disparity.

King warns the nation: white America, the political economy, the age of Obama

The author contends that white America’s resistance to black advancement is the primary cause for the current racism and resistance to democracy and democratic institutions. Beyond Martin Luther King Jr.’s life and witness, white America has mutated into the political economy that has hybridized surrogates, namely, neofascism and neoliberalism, philosophical constructs that represent the Theo political right and the Theo political left. Strikingly, the political economy and its hybridized surrogates and paralleling philosophical constructs have come to maturity during the age of Obama, which provides a narrative for this article.

The Boundaries of “Women of Color”: The Political Implications of Non-Hispanic Whites’ Perceptions of Women of Color

ABSTRACT Women candidates are increasingly referred to as “women of color.” But who the public sees as women of color is unclear. We ask how non-Hispanic whites, who are still the largest voting group, perceive which racial/ethnic groups of women are included in the “women of color” group. We find heterogeneity in who white Americans believe are “women of color” – differences that are connected to political support for women of color candidates. We analyze how these views about the boundaries around women of color are informed by political party affiliation, as different ideas about who constitutes the “women of color” group are related to stereotypes and perceptions of group threat.

Trends in Diverticular Disease Hospitalizations and Racial Disparities in Outcomes Across the United States.

Objective This study evaluated trends and racial disparities in hospitalization, clinical outcomes, and resource utilization for diverticular disease (DD) between 2017 and 2020. Methods We performed a retrospective analysis using the NISdatabase from 1 January 2017 to 31 December2020to study hospitalizations for DD (CCSRcode: DIG013). Our primary outcomes were hospitalization rates, all-cause mortality, total charges, and length of stay. Secondary outcomes included in-hospital complicationsand discharge status. Outcomes were stratified by race and ethnicity (White, Black, Hispanic, Asian or Pacific Islanders and Native Americans). Data were weighted and adjusted for clustering, stratification, and other relevant factors. The normality of the continuous data distribution was confirmed usingKolmogorov-Smirnov, and descriptive statistics were used to summarizevariables. Demographic characteristics were compared usingχ² and Student's t-test, with significance set at P<0.05. We usedstepwise multivariable logistic regressionto estimateadjusted odds ratios for studyoutcomes by race and ethnicity, controlling for demographic and clinical factorsand correcting for multicollinearity. Missing data were treated with multiple imputations, trend analyses were performed using Jonckheere-Terpstra tests, and costs were adjusted for inflation using the GDPprice index. Analyses were conducted with Stata 17MP. Results A total of 1,266,539 hospitalizations for DD were included for analysis. Approximately953,220 (75.3%) were White patients and 313,319 (24.7) did not belong to the White race. Atotal of 747,868 (59%) were women compared to 518,671 (41%) men. Compared to patients who were not of the White race, White patients were younger(63.5 vs. 66.8 years; p<0.001). Hospitalizations for DD increased by 1.2% from 323,764 to 327,770 hospitalizations (2017-2019) and decreased by 11.8% from 327,770 to 289,245 admissions in 2020. Mortality rates were higher among White patients than in those not of the White race (16,205 (1.7%) vs 5,013 (1.6%)).However, no significant difference was observed in mortality odds between both sets of patients (aOR, 0.953; 95% CI 0.881-1.032; P=0.237).Mortality rates showed an uptrend over the study period (4,850 (1.5%) in 2017 to 5,630 (1.9%) in 2020; Ptrend<0.001).DD accounted for 7,016,718 hospital days, 2,102,749 procedures, and US$ 6.8 billion in hospital costs. Mean hospital costs increased from US$54,705 to US$72,564 over the study period (P<0.000). Patients who were not of the White race incurred higher mean hospital charges than White patients ($67,635 ± $6,700 vs $59,103 ± $3,850; P<0.001). Black race correlated with lower odds of bowel perforation, routine home discharge, and bowel resection (P<0.001). Conclusion During the study period, hospitalization and mortality rates and resource utilization for DD increased. Patients from other racesincurred higher hospital costs than White patients. White Americans were more likely to be discharged to skilled nursing, intermediate care, and other facilities. Additionally, White patients were less likely to develop bowel abscesses compared to patients who were not White. Compared to White American patients, Black patients had fewer DD hospitalizations complicated by bowel perforations or requiring bowel resections. In contrast, DD admissions among Hispanic patients were more likely to require bowel resections than those among White American patients.

Development and validation of the white critical consciousness index

This study details the development and validation of the White Critical Consciousness Index (WhiCCI) as a tool for measuring the critical consciousness (CC) of white Americans. We argue that CC, when viewed from the vantage point of Freire’s oppressor, must be measured differently. Therefore, new items were developed using insights from the CC and white anti-racist allyship literature to accommodate difference in CC measurement. Using exploratory and confirmatory factor analysis, this study analyzes data from over 2000 more privileged white Americans and arrives at an instrument aligned with the tripartite model of CC: Critical Reflection, Critical Motivation, and Critical Action.

Barack Obama: Negotiating Blackness, Race, and Colour in a White America

Barack Obama: Negotiating Blackness, Race, and Colour in a White America

Manifestation and Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease in a Predominately African American Population at a Multi-Specialty Healthcare Organization.

African Americans (AA) have a high incidence of risk factors associated with MASLD (metabolic dysfunction-associated steatotic liver disease); the AA population has a lower incidence of MASLD and MASH (metabolic-associated steatotic hepatitis) than Caucasian and Hispanic Americans (non-AA). We investigated if underlying risk factor variation between AA and non-AA individuals could provide a rationale for the racial diversity seen in MASLD/MASH. Using ICD-10 codes, patients from 2017 to 2020 with MASLD/MASH were identified and confirmed to have either MASLD or MASH. Despite the large (>80%) AA population in our clinics, only 54% of the MASLD/MASH patients were African American. When the non-invasive NAFLD Fibrosis Scores (NFS) evaluated at early diagnosis were compared to the most recent values, the only increase in fibrosis score by NFS over time was in non-AA MASH patients. The increase in fibrosis only in non-AA MASLD patients is consistent with racial disparity in the disease progression in non-AA as compared to AA patients. Even with the large proportion of AA patients in our study, there was no significant racial disparity in the earliest assessment of either risk factors, laboratory values, or fibrosis scores that would account for racial disparity in the development and progression of MASLD.

Prevalence and characteristics of osseous bridging between vertebral bodies in the cervical spine: A skeletal study.

Osseous bridging (OB) in three or more segments of motions (SOMs) of the mobile spine was initially defined as diffuse idiopathic skeletal hyperostosis (DISH), located particularly in the thoracic spine (T-spine). This pathological phenomenon is often characterized by calcification and ossification, which take place simultaneously or separately. The soft tissues, mainly ligaments and entheses, are calcified, with bone formation not originating from the anterior longitudinal ligament (ALL). DISH formation can involve osteophytes, which are created by the ossification process and can involve soft tissue such as the ALL. The ALL can also be calcified. Until recently, the prevalence of DISH in the general population was considered low (0%-5%) and rare in the cervical spine (C-spine). In a cross-sectional observational skeletal study, we investigated the prevalence and location of C-spine OB between vertebral bodies with fewer than three SOMs. We tested a large sample (n = 2779) of C-spines housed in the Cleveland Museum of Natural History (Ohio, USA). The human sources of the samples had died between the years 1912 and 1938 and represented both sexes and two different ethnic groups: Black Americans and White Americans. The process development can be seen on the ALLs as calcification, osteophytosis, and candle-shaped. Among all of the specimens, 139 (5%) were affected by OB, mostly in one SOM. Prevalence tended to be higher in women, White Americans, and the older age group. The levels most affected were C3-C4, followed by C2-C3 and subsequently, C5-C6. OB involving two consecutive SOMs was found only at C5-C7. We believe it is important to respond to the presence of a single SOM with a presumptive diagnosis of OB and to follow up, identify whether the diagnosis is correct, and take preventive action if possible. There is a need for updated diagnostic criteria and research approaches that reflect contemporary lifestyle factors and their impact on spine health.

Being a member of global community: the effect of Chinese brand origin salience on global identity perceptions and brand evaluations

PurposeGiven that Chinese brands and products are widespread in the global market, this paper aims to examine the effect of Chinese brand origin salience (vs not) on brand evaluations by increasing global identity perceptions, and figuring out the moderating role of uncertainty avoidance.Design/methodology/approachThree experiments were conducted in different product categories to test the effect of Chinese brand origin salience. Study 1 and Study 2 collected data from different countries (i.e. Japan and the USA) with varying levels of uncertainty avoidance. In Study 3, the data were collected from the single-country sample, including participants from cultural backgrounds with high (Asian Americans) and low (Caucasian Americans) uncertainty avoidance.FindingsChinese brand origin salience positively influences brand evaluations via increased global identity perceptions. In addition, uncertainty avoidance plays a moderating role in the process. Specifically, the favorable effect of Chinese brand origin salience on brand evaluations will be attenuated among consumers with high (vs low) uncertainty avoidance.Originality/valueThis paper demonstrates that Chinese brand origin salience can enhance brand evaluations beyond prior work focusing on the negative stereotypes of Chinese brands and their imitation of Western brands. Importantly, Chinese brands have become an important part of the global community as Chinese brand origin salience can evoke consumers’ global identity.

Impact of racial disparities in follow-up and quality of colonoscopy on colorectal cancer outcomes.

The benefits of colorectal cancer (CRC) screening programs rely on completing follow-up colonoscopy when a noncolonoscopy test is abnormal and on quality of colonoscopy screening as measured by the endoscopists' adenoma detection rate. Existing data demonstrate substantially lower follow-up colonoscopy rates and adenoma detection rate for Black Americans than White Americans. However, the contributions of racial differences in follow-up colonoscopy and adenoma detection rate on CRC outcomes have not been rigorously evaluated. We used established and validated CRC-Adenoma Incidence and Mortality (CRC-AIM) model as our analysis platform, with inputs from published literature that report lower follow-up colonoscopy rates and adenoma detection rate in Black adults compared with White adults (15% and 10% lower, respectively). We simulated screening with annual fecal immunochemical test, triennial multitarget stool DNA, and colonoscopy every 10 years between ages 45 and 75 years using real-world utilization of the screening modalities vs no screening. We reported lifetime outcomes per 1000 Black adults. Elimination of Black-White disparities in follow-up colonoscopy rates would reduce CRC incidence and mortality by 5.2% and 9.3%, respectively, and improve life-years gained with screening by 3.4%. Elimination of Black-White disparities in endoscopists' adenoma detection rate would reduce CRC incidence and mortality by 9.4% and improve life-years gained by 3.7%. Elimination of both disparities would reduce CRC incidence and mortality by 14.6% and 18.7%, respectively, and improve life-years gained by 7.1%. This modeling study predicts eliminating racial differences in follow-up colonoscopy rates, and quality of screening colonoscopy would substantially reduce Black-White disparities in CRC incidence and mortality.

The Great Flood: Race-Moderated Associations between Social Work Students’ Protective Mechanisms and Adaptive Coping

Abstract The postdisaster experiences of 167 social work students in the aftermath of the Great Flood of 2016 were examined. Using a cross-sectional survey design and validated self-report measures, the current study examined the association between students’ protective factors (hope, altruism, spiritual support; at 8, 20, and 12 items, respectively) and six adaptive coping mechanisms, and further sought to determine whether such associations varied according to students’ race (white vs. African American). Six hierarchical multiple linear regression analyses were conducted using each of the adaptive coping strategies (acceptance, active coping, positive reframing, self-distraction, planning, and venting). Results showed that students’ race moderated the associations between altruism and active coping, spiritual support and active coping, spiritual support and self-distraction, altruism and planning, spiritual support and planning, and altruism and venting. The decomposition of the significant interactions indicated that the effect of altruism on active coping, planning, and venting was greater among white than among African American participants; the effect of spiritual support on active coping, self-distraction, and planning was greater among African American than among white participants. Recommendations include educating all students about risks incurred when working with traumatized populations. Research examining postdisaster coping responses of social workers can inform culturally responsive supervision approaches.

A rural-urban political divide among whom? Race, ethnicity, and political behavior across place

ABSTRACT Over the past 30 years, the United States has developed a rural-urban political divide, as rural voters have become increasingly reliable Republican voters while long-term patterns of Democratic voting in the largest cities have also consolidated in many smaller cities and suburbs as well. Yet, although 1 in 4 rural dwellers now identify as people of color, research on the rural-urban divide has either mostly centered on the behavior and attitudes of non-Hispanic whites, or assumed that nonwhites have exhibited similar behavior to whites. Does this political cleavage exist among people of color? We find that the growing rural-urban divide is driven primarily by white Americans, while rural people of color differ much less, if at all, from their urban counterparts in voting behavior. In addition to highlighting the need for more research on the politics of rural people of color, our findings raise concerns about the political representation of rural Black Americans and Latinos.

The Effects of Morally Reframed Messages on White Individuals' Attitudes Toward White Privilege.

Many White Americans are unaware of or tend to deny the existence of White privilege. One potential explanation for this denial is the belief that America functions as a meritocracy. Prior research suggests that morally reframed messages can change individuals' beliefs when the reframed messages align with their personal moral values. Contributing to the literature on morally reframed messages, the current pair of studies challenged individuals' beliefs about meritocracy in order to promote their awareness of White privilege. After demonstrating that morally reframed messages about America as a meritocracy can meaningful reflect five distinct moral foundations (i.e., Harm/Care, Fairness/Reciprocity, Loyalty/Betrayal, Authority/Respect, Purity/Sanctity), the current studies revealed that individuals who endorsed the moral values of Authority/Respect, Loyalty/Betrayal, and Purity/Sanctity (the binding foundations) reported stronger beliefs in meritocracy and less awareness of White privilege, whereas individuals who endorsed the moral values of Harm/Care and Fairness/Reciprocity (individualizing foundations) reported weaker beliefs in meritocracy and greater awareness of White privilege (Studies 1 and 2). Although the morally reframed messages promoted individuals' White privilege awareness compared to a control message (Study 2), the effectiveness of the messages was not enhanced when the messages aligned with individuals' moral values (Studies 1 and 2). The current pair of studies is the first to examine if individuals' endorsement of the five moral foundations can be used to change their beliefs about White privilege.

Stockholm3 in a Multiethnic Cohort for Prostate Cancer Detection (SEPTA): A Prospective Multicentered Trial.

Asian, Black, and Hispanic men are underrepresented in prostate cancer (PCa) clinical trials. Few novel prostate cancer biomarkers have been validated in diverse cohorts. We aimed to determine if Stockholm3 can improve prostate cancer detection in a diverse cohort. An observational prospective multicentered (17 sites) clinical trial (2019-2023), supplemented by prospectively recruited participants (2008-2020) in a urology clinic setting included men with suspicion of PCa and underwent prostate biopsy. Before biopsy, sample was collected for measurement of the Stockholm3 risk score. Parameters include prostate-specific antigen (PSA), free PSA, KLK2, GDF15, PSP94, germline risk (single-nucleotide polymorphisms), age, family history, and previous negative biopsy. The primary endpoint was detection of International Society of Urological Pathology (ISUP) Grade ≥2 cancer (clinically significant PCa, csPC). The two primary aims were to (1) demonstrate noninferior sensitivity (0.8 lower bound 95% CI noninferiority margin) in detecting csPC using Stockholm3 compared with PSA (relative sensitivity) and (2) demonstrate superior specificity by reducing biopsies with benign results or low-grade cancers (relative specificity). A total of 2,129 biopsied participants were included: Asian (16%, 350), Black or African American (Black; 24%, 505), Hispanic or Latino and White (Hispanic; 14%, 305), and non-Hispanic or non-Latino and White (White; 46%, 969). Overall, Stockholm3 showed noninferior sensitivity compared with PSA ≥4 ng/mL (relative sensitivity: 0.95 [95% CI, 0.92 to 0.99]) and nearly three times higher specificity (relative specificity: 2.91 [95% CI, 2.63 to 3.22]). Results were consistent across racial and ethnic subgroups: noninferior sensitivity (0.91-0.98) and superior specificity (2.51-4.70). Compared with PSA, Stockholm3 could reduce benign and ISUP 1 biopsies by 45% overall and between 42% and 52% across racial and ethnic subgroups. In a substantially diverse population, Stockholm3 significantly reduces unnecessary prostate biopsies while maintaining a similar sensitivity to PSA in detecting csPC.

Black representation and the popular legitimacy of the Federal Reserve

The Federal Reserve has started paying closer attention to matters of race over the last decade. The central bank has increasingly emphasized the distinct economic challenges facing racial minorities, and its leadership has become more racially diverse. This paper applies theories of descriptive and substantive representation to understand how these shifts are likely to impact the popular legitimacy of the Federal Reserve. We hypothesize that greater Black descriptive and substantive representation improves Black Americans' confidence in the Federal Reserve. We also anticipate that political ideology moderates how white Americans respond to the increases in Black representation within the Federal Reserve, with white conservatives responding less favorably to these changes than more left-leaning whites. Analysis of data from two original survey experiments with separate samples of 3000 Americans, split evenly between Black and white respondents, supports our expectations. Information about substantive and descriptive representation at the Fed has a strong impact on Black Americans' perceptions of the institution. We also find that these changes at the Fed boost white liberals' views of the Fed but have little impact on white conservatives’ attitudes about the central bank.

Racial Disparities in Plasma Cytokine and Microbiome Profiles.

Many health issues prevalent in African American (AA) populations are associated with chronic inflammation and related health conditions, including autoimmune diseases, infectious diseases, neurologic disorders, metabolic syndromes, and others. The current study aims to understand plasma microbiome translocation as a potential trigger for chronic inflammation. In this study, 16 Caucasian American (CA) and 22 African American (AA) healthy individuals were recruited. Microbial DNA was isolated from the plasma samples and sequenced via microbial 16S rRNA V3-4 sequencing. The plasma levels of 33 cytokines and chemokines were evaluated. The proinflammatory microbiomes were verified using human THP-1 cells in vitro. The plasma levels of IL-6, IL-15, MIP-1α, MIP-1β, and MIP-3α were higher in the AA people, whereas IL-1α and IL-27 were elevated in the CA people. The plasma microbiomes exhibited eight bacterial genera/phyla differentially enriched in the CA and AA people. Given the critical role of IL-6 in chronic inflammation and associated diseases, we identified five bacteria genera significantly associated with IL-6. The abundance of Actinomyces was positively correlated with the plasma IL-6 level (r = 0.41, p = 0.01), while the abundance of Kurthia (r = -0.34, p = 0.04), Noviherbaspirillum (r = -0.34, p = 0.04), Candidatus Protochlamydia (r = -0.36, p = 0.03), and Reyranella (r = -0.39, p = 0.02) was negatively correlated with this. Finally, the THP-1 cells treated with heat-killed bacteria produced higher levels of IL-6 in vitro in response to the Actinomyces species compared to the species in the genus either uncorrelated or negatively correlated with IL-6. This is the first study to report potential blood microbiome translocation as a driver for persistently elevated IL-6 levels in the periphery in healthy AA versus CA people. Understanding the plasma microbiome linked to the IL-6 levels in people with different racial backgrounds is essential to unraveling the therapeutic approaches to improve precision medicine.

White America Then and Now through Anne Sexton’s Transformations: A Close Reading

White America Then and Now through Anne Sexton’s Transformations: A Close Reading

Ethnic bias, economic achievement and trust between large ethnic groups: A study in Germany and the U.S

Evidence for ingroup bias is extensive, yet the distinct patterns of discrimination among dominant ethnic groups in the diverse societies of modern industrial nations such as the United States and Germany remain largely unexplored. Incentivized trust games in nationally-representative samples from both countries reveal biases of roughly equal size by non-Hispanic White Americans, Hispanic Americans, and African Americans against each outgroup. In Germany, the majority demonstrates twice as much bias against Turkish minorities compared to Eastern Europeans. Interestingly, both minority groups send similar amounts to ethnic Germans and members of their own groups. We examine the notion that outgroup discrimination by majority group members stems from stereotypes of minorities as economically unsuccessful, employing trust games with high-income counterparts. We find that majority senders’ bias against minority receivers declines when receivers are known to have high incomes, in line with that idea. Interestingly, some minority groups, especially Turkish descendants, display a negative propensity to transfer to rich members of their ingroup in comparison with outgroup members, relative to baseline. While we focus on differences in sending by ethnic pairing, we note that all participants send less to second movers identified as high income, and discuss possible explanations. We estimate that four-fifths of the observed ingroup bias is taste-based rather than due to expected trustworthiness differences. This estimation is robust to identifying the purely altruistic component of trust game sending toward each ethnic group, including one's own.

Afrocentric Norms and Substance Use Behaviors Among Black Young Adults

ABSTRACT Despite not displaying higher overall rates of substance use compared to White Americans, the social consequences of substance use disorders for Black Americans, particularly among Black American men, are more damaging. Furthermore, recent data suggest an uptick in substance use-related deaths among Black Americans, raising serious concerns about a growing health disparity that warrants the need for studies to identify factors associated with prevention. For decades, Black cultural theorists have argued that Afrocentric norms are important buffers against maladaptive behaviors in Black Americans, but the association in the context of substance use is still an emerging area. The present study investigated the associations between Afrocentric norms, Afrocentric self-regard, internalized negative stereotypes, and substance use attitudes and behaviors among Black young adults. Self-report questionnaires were administered to measure internalized negative stereotypes, Afrocentric norms, Afrocentric self-regard, substance use attitudes, and substance use from a sample of Black young adults (N = 619). Favorable attitudes toward substance use were found to be positively associated with internalized negative stereotypes but were inversely associated with Afrocentric norms and Afrocentric self-regard. Similarly, substance use reports within the past 30 days were inversely associated with Afrocentric norms, but the relationship to cannabis use was non-significant. Gender differences between Black men and women were also found. Implications for social work are discussed.

Outcomes of ST-Elevation Myocardial Infarction in Patients With Opioid Dependence: A National Inpatient Sample Study.

ST-segment elevation myocardial infarction (STEMI) is a critical condition characterized by the sudden obstruction of one or more coronary arteries, resulting in diminished blood flow to the heart muscle. This acute ischemic event demands swift and precise intervention to minimize myocardial damage and preserve cardiac function. Opioids, a class of potent analgesic medications, are frequently utilized in the management of STEMI-related chest pain. Despite their efficacy in alleviating discomfort, their use in this context warrants careful consideration due to potential adverse effects and interactions. Methods: In this large nationwide retrospective observational study, we evaluated the effect of opioid dependence on inpatient mortality, length of hospitalization, and cost of hospitalization of patients with STEMI. Data was collected for 2019 from various hospitals across the United States using the National Inpatient Sample (NIS) through the Healthcare Cost and Utilization Project (HCUP). Using the International Classification of Diseases-10 codes (ICD-10), we identified a primary diagnosis of STEMI in patients over the age of 18, as well as a secondary diagnosis of opioid dependence. Complex samples and multivariable logistic and linear regression models were used to determine the association of opioid dependence on inpatient mortality, length of hospitalization, and cost of hospitalization of patients with STEMI. Of the patients who fit our criteria, we identified other comorbidities and diagnoses associated with them as potential confounders including drug abuse, hypertension, diabetes, alcohol use, obesity, peripheral vascular disease, and chronic lung disease. Other confounders thatwere adjusted for include race, Charlson Comorbidity index, median household income,insurance, hospital region in the US, hospital bed size, and teaching status of the hospital. Results: A total of 661,990 patients presented to a hospital with a primary diagnosis of STEMI in 2019. The majority of the patients were malewith a mean age of 62.5+/-3.4 and were Caucasian American. Patients who were opioid dependent were found to be on average younger, earned less than the 25th percentile household income, had a higher history of illicit drug and alcohol use, and had Medicaid. They were also found to have higher rates of chronic lung disease at 39.2%, compared to 21.4.% in patients who were not opioid-dependent. Patients who were not opioid dependent were found to have higher rates of hypertension and type 2 diabetes mellitus. Inpatient mortality and cost of hospitalization in STEMI patients with opioid dependence were not statistically different compared to those who were not opioid dependent. However, STEMI patients who were opioid dependent did have an associated longer length of hospitalization. Conclusion: Opioid use for pain relief in acute coronary syndrome, particularly STEMI, is a mainstay of treatment. Our retrospective cohort dived into assessing the relationship between opioid dependence on its effect on inpatient mortality, length of stay, and cost of hospitalization in STEMI patients. Our study showed that opioid dependence has no significant impact on inpatient mortality. However, it was associated with a longer length of hospital stay in STEMI patients. Further studies may be warranted into the effects of opioid dependence on the length of hospitalization in STEMI patients. .