White Americans Research Articles

Race and Sex Differences in the Association of Bystander CPR for Cardiac Arrest.

Bystander cardiopulmonary resuscitation (CPR) is associated with higher survival for out-of-hospital cardiac arrest, but whether its association with survival differs by patients' sex and race and ethnicity is less clear. Within a large US registry, we identified 623 342 nontraumatic out-of-hospital cardiac arrests during 2013 to 2022 for this observational cohort study. Using hierarchical logistic regression, we examined whether there was a differential association between bystander CPR and survival outcomes by patients' sex and race and ethnicity, overall and by neighborhood strata. Mean age was 62.1±17.1 years, and 35.9% were women. Nearly half of patients (49.8%) were non-Hispanic White; 20.6% were non-Hispanic Black; 7.3% were Hispanic; 2.9% were Asian; and 0.4% were Native American. Overall, 58 098 (9.3%) survived to hospital discharge. Although bystander CPR was associated with higher survival in each race and ethnicity group, the association of bystander CPR compared with patients without bystander CPR in each racial and ethnic group was highest in individuals who were White (adjusted odds ratio [OR], 1.33 [95% CI, 1.30-1.37]) and Native American (adjusted OR, 1.40 [95% CI, 1.02-1.90]) and lowest in individuals who were Black (adjusted OR, 1.09 [95% CI, 1.04-1.14]; Pinteraction<0.001). The adjusted OR for bystander CPR compared with those without bystander CPR for Hispanic patients was 1.29 (95% CI, 1.20-1.139), for Asian patients, it was 1.27 (95% CI, 1.12-1.42), and for those of unknown race, it was 1.31 (95% CI, 1.25-1.36). Similarly, bystander CPR was associated with higher survival in both sexes, but its association with survival was higher in men (adjusted OR, 1.35 [95% CI, 1.31-1.38]) than women (adjusted OR, 1.15 [95% CI, 1.12-1.19]; Pinteraction<0.001). The weaker association of bystander CPR in Black individuals and women was consistent across neighborhood race and ethnicity and income strata. Similar results were observed for the outcome of survival without severe neurological deficits. Although bystander CPR was associated with higher survival in all patients, its association with survival was weakest for Black individuals and women with out-of-hospital cardiac arrest.

“Will they assume I’m racist?” How racial ingroup members’ stereotypical behavior impacts White Americans’ interracial interaction experiences

Three studies ( N = 1,427) examine White Americans’ threat and stress appraisals and coping strategies in imagined inter- and intraracial interactions when a nearby White person does something racist. White individuals report heightened concern about being stereotyped as racist (i.e., metastereotyping) following an ingroup member’s stereotype-confirming (vs. neutral) behavior (Studies 1–3). Moreover, across studies, these heightened metastereotypes predict greater anxiety, which in turn predicts anticipated coping strategies (e.g., increased motivation to disprove the stereotype). Additionally, relative to imagined interactions with a White partner, these consequences of witnessing a White person’s anti-Black bias are significantly stronger with a Black or Latinx (Studies 1 and 2) but not an Asian (Study 3, preregistered) interaction partner. This work highlights how an ingroup member’s racist behavior is a situational stressor for White people during intergroup encounters, engendering coping strategies to protect the self and manage the ensuing interaction.

Malleable national collective memories among Black and White Americans.

How do groups remember their shared past? Are there individual differences within a group? How easy is it to change collective memories? The present article addresses these questions by focusing on differences within national subgroups, exploring how national collective memories might differ for Black and White Americans, how individual differences and external influences might moderate or alter any differences, and the temporal extent of any changes that might occur due to external influences. Across four studies, participants were asked to identify the five "most important" events in U.S. history and then asked about their political ideology and racial and national identification, though not in every study. Although individual differences emerged, Black and White participants differed in the types of events they identified as important in U.S. history, with Black participants identifying more race-relevant events than White participants and White participants identifying more traditional founding events than Black participants. As to changes in collective memory, in response to a minimal identity salience manipulation, the murder of George Floyd, and July 4th celebrations, national collective memories evidenced malleability only after the murder of George Floyd. In this instance, the mention of race-relevant events increased, even as the frequency of mention of traditional founding events remained stable. The observed increase in race-relevant events was temporary, however. Findings are discussed in relation to contemporary discussions on collective memory, especially with respect to group differences, individual differences within groups, and mnemonic inertia. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Differences in familiarity with oral immunotherapy among caregivers of White and Black children with food allergy

BackgroundPotential racial and ethnic disparities related to oral immunotherapy (OIT) have not been fully described among children with food allergy (FA). ObjectiveTo characterize the differences in attitudes toward, familiarity with, and utilization of OIT among non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic or Latino (H/L) caregivers of children with FA. MethodsSurveys were administered to the caregivers of children enrolled in Food Allergy Outcomes Related to White and African American Racial Differences, a prospective, multisite cohort of children with FA. The distribution of responses by caregiver-reported race and ethnicity was described using an analysis of variance for continuous outcomes and χ2 tests for categorical outcomes. A logistic regression model was used to determine associations between familiarity with OIT as a treatment option and various other covariates. ResultsThe NHB and H/L respondents were more frequently not familiar with OIT compared with NHW responders (54.3% and 62.5% vs 9.2%, P < .001). This finding remained true, even after adjusting for household income (odds ratio: 0.1, 95% CI: 0.1-0.4 for NHB participants and odds ratio: 0.1, 95% CI: 0.0-0.3 for H/L participants). NHB and H/L participants more frequently reported that they had never heard of OIT before the survey compared with NHW participants (76.7% and 50.0% vs 26.7%, P < .001). None of the NHB and H/L respondents initiated OIT compared with 14.8% of NHW participants (P < .001). ConclusionIn the Food Allergy Outcomes Related to White and African American Racial Differences cohort, familiarity with OIT was lower among caregivers of minoritized racial and ethnic groups, even after adjusting for household income.

A Cross-Sectional Study Examining Andrews' Analysis in Caucasian and African American Subjects

Andrews' analysis is a commonly utilized instrument to aid in esthetic positioning of the anteroposterior position of the maxillomandibular complex; however, there is limited data regarding use in non-Caucasian subjects. The purpose of this study was to document laypersons preferences of anteroposterior position of the maxillomandibular complex in relation to Andrews' lateral profile analysis in African American (AA) and Caucasian subjects. A cross-sectional study was implemented to evaluate the esthetics of AA and Caucasian subjects. Photographs were taken and simulated with anteroposterior maxillomandibular complex positioning in varying relationships to Andrews' goal anterior line limit. A survey was then designed to select the preferred simulation of the facial profile of each subject. The independent variable was the race of the study subjects. The main outcome was the layperson's preferred lateral facial profile for each subject. The covariates included age, race, sex, education level, income, of the laypersons. A proportion test was used to decide which profile was preferred. Logistic regression analyses were conducted to assess the association between the preference and respondent demographics. P<.05 was considered significant. A total of 264 surveys were distributed, and 250 complete surveys were utilized (response rate=95%). Respondents were majority male (51.2%), aged 35-44 (37.2%), college-educated (57.2%), earning between $20,000 and $50,000 annually (44%), and identified as Caucasian (77.2%). For the female subjects, the respondents preferred+4 and+6mm anterior to goal anterior line limit with 54.2% for the Caucasian and 65.9% for the AA subjects (difference=11.7%; 95% CI:2.7 to 20.7%; P=.008). For the males, 47.4% of the respondents chose 0mm and+2mm for the AA subject, while only 24.9% preferred+2mm for the Caucasian male (difference=22.5%; 95% CI: 13.8 to 31.1%; P<.0001). Respondent demographics were not found to influence selection. The preferred facial profile as judged by laypersons differs between Caucasian and AA subjects when defined through Andrews' analysis.

Reducing Racial Disparities at End-of-life: Using Narratives to Build Trust and Promote advance Care Planning.

Black Americans are less likely than White Americans to have advance directives, die while receiving hospice services, or have their end-of life wishes honored. The root causes of disparities include imbalance of resources, lack of trust in health care institutions, lack of adequate education regarding end-of-life options, communication differences of health care providers with black vs white patients, variable access to hospice services in different communities, and poorer pain management for Black patients compared to White patients. Because root causes are numerous, comprehensive solutions are required. When advance care planning is in place, people are more likely to choose care focused on priorities and comfort than on seeking aggressive, sometimes futile, interventions in the last weeks of life. One important component of the solution should include listening to narrative stories of Black people as they encounter life-limiting diagnoses. Gathering the stories about life events and how strength was found through adversities can be a tool for growing trusting relationships and engaging in shared decision-making. Health care professionals should invite Black patients with serious illnesses to explore the sources of their strengths and identify their core values to work toward developing directives for the nature and place of their end-of-life and help to mitigate disparities in high quality end-of-life care.

White Americans report more positive than negative affect after writing a personal diversity statement.

White Americans report more positive than negative affect after writing a personal diversity statement.

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.