Asian And Pacific Islander Research Articles

MP77-05 PROSTATE CANCER TRENDS AMONG INDIVIDUAL ASIAN AND PACIFIC ISLANDERS (AAPI) POPULATIONS IN HAWAII

You have accessJournal of UrologyCME1 Apr 2023MP77-05 PROSTATE CANCER TRENDS AMONG INDIVIDUAL ASIAN AND PACIFIC ISLANDERS (AAPI) POPULATIONS IN HAWAII Lauren Muramoto, Brenda Hernandez, and Tom Feng Lauren MuramotoLauren Muramoto More articles by this author , Brenda HernandezBrenda Hernandez More articles by this author , and Tom FengTom Feng More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003351.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Asians and Pacific Islanders (AAPIs) are often grouped together as a single racial demographic when reporting prostate cancer trends despite the heterogeneity within this community. Hawaii’s multi-ethnic community poses a unique environment to study the epidemiology of prostate cancer. We examine differences in incidence and mortality of prostate cancer among AAPIs within Hawaii. METHODS: Data were obtained from the Hawaii Tumor Registry Cancer at a Glance 2014-2018 report. All reported rates were age adjusted per 100,000 to the 2000 US standard population. Differences in incidence and mortality rates were compared among the major AAPI groups: Chinese, Filipino, Japanese, and Native Hawaiian. RESULTS: Prostate cancer is the most common cancer diagnosed in men in Hawaii with an incidence of 22.8% and responsible for 9.6% of cancer related deaths from 2014-2018. Incidence rates among the four major AAPI groups were not statistically different (Figure 1a). Despite this, mortality rates were significantly lower in Chinese (5.5 per 100,000) and Japanese (8.7) compared to Filipinos (16.4) and native Hawaiians (21.6, p<0.05, Figure 1b). Native Hawaiians had the lowest incidence rate (80.2) but had the highest mortality rates among Asians (21.6 per 100,000). Filipinos, despite having similar incidence as Chinese and Japanese, had much higher mortality rates (p<0.05) and the highest proportion of advanced prostate cancer 34.7% at diagnosis. CONCLUSIONS: Hawaii’s diversity plays an important role in reporting cancer incidence and mortality among AAPI. Differences could be related to access to care, genetics, education level or lifestyle related exposures. These data support the need to disaggregate AAPI subpopulations to better understand individual prostate cancer risk profiles. Further research is needed to determine these differing factors among AAPI ethnicities affect prostate cancer risk and outcomes. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1103 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lauren Muramoto More articles by this author Brenda Hernandez More articles by this author Tom Feng More articles by this author Expand All Advertisement PDF downloadLoading ...

Disparities in Hepatocellular Carcinoma Outcomes Among Subgroups of Asians and Pacific Islanders: A SEER Database Study.

Hepatocellular carcinoma (HCC) is highly prevalent in Asians and Pacific Islanders (API) but this heterogenous group is often aggregated into a single category, despite vast differences in culture, socioeconomic status, education, and access to care among subgroups. There remains a significant knowledge gap in HCC outcomes among different subgroups of API. The Surveillance, Epidemiology, and End Results (SEER) database was accessed, and site/ICD codes were used to identify HCC patients during 2010-2019 who were API ethnicity. Data collected: demographics, socioeconomic status, tumor characteristics, treatment, and survival. Subgroup analyses were performed among different Asian ethnicities in a secondary analysis. 8,249 patients were identified/subdivided into subgroups of Asian ethnicities and Other Pacific Islanders (NHOPI) groups. The median age was 65years for Asians and 62years for NHOPI (p < 0.01), and significant differences were found in income (p < 0.01). A higher proportion of NHOPI lived in rural areas compared to Asians (8.1 vs. 1.1%, p < 0.01). There were no statistically significant differences in tumor size, stage, pre-treatment AFP level, or surgical treatments between the two groups. However, Asians had higher overall median survival than NHOPI (20months v 12months, p < 0.01). Secondary analyses among different subgroups of Asian ethnicities revealed significant differences in tumor size and staging, surgical resection, transplant rates, and median survival. While API had similar tumor characteristics and treatment, Asians had much higher survival than NHOPI. Socioeconomic differences and access to care may contribute to these differences. This study also found significant survival disparities within API ethnicities.

MP33-17 EXAMINING SURVIVAL OUTCOMES BY RACE AND ETHNICITY IN TESTIS CANCER: A REVERSE HISPANIC PARADOX?

You have accessJournal of UrologyCME1 Apr 2023MP33-17 EXAMINING SURVIVAL OUTCOMES BY RACE AND ETHNICITY IN TESTIS CANCER: A REVERSE HISPANIC PARADOX? Michael Rezaee, Maximilian Pallauf, Pranjal Agrawal, Roy Elias, Sean Fletcher, Yasser Ged, and Nirmish Singla Michael RezaeeMichael Rezaee More articles by this author , Maximilian PallaufMaximilian Pallauf More articles by this author , Pranjal AgrawalPranjal Agrawal More articles by this author , Roy EliasRoy Elias More articles by this author , Sean FletcherSean Fletcher More articles by this author , Yasser GedYasser Ged More articles by this author , and Nirmish SinglaNirmish Singla More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003266.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The incidence of testis cancer among Hispanic men in the United States is increasing. Prior research has demonstrated that Hispanic patients exhibit a survival benefit for many medical conditions, a phenomenon known as the “Hispanic Paradox.” However, this paradox may not extend to testis cancer. We sought to examine survival outcomes in testis cancer by race using a large national sample. METHODS: A population-based retrospective cohort study of testis cancer patients was performed using Surveillance, Epidemiology, and End Results (SEER) data for the years 2000 through 2019. Cox proportional hazards models were used to examine the relationship between race/ethnicity and testis cancer-specific survival, both overall and by histologic type (seminoma vs. nonseminomatous germ cell tumors [NSGCT]). All models were adjusted for age, stage, receipt of postoperative radiation or chemotherapy, year of diagnosis, income, marital status, and rural status. RESULTS: The final analytic cohort consisted of 18,600 patients, of whom 66.8% were Non-Hispanic White (NHW), 2.2% Non-Hispanic Black (NHB), 24.9% Hispanic (all races), and 6.1% Non-Hispanic Asian or Pacific Islander (API). Median follow up was 92 months. Death from testis cancer occurred in 2.7% of patients. A greater proportion of Hispanics were diagnosed at an age less than 30 years (54.4%) and with initial metastatic disease (15.2%) compared to other groups. Hispanics experienced significantly worse cancer-specific survival (hazard ratio [HR] = 1.8, 95% CI: 1.5-2.2) compared to NHW patients overall (Figure 1). When stratified by tumor type, cancer-specific survival was significantly worse for Hispanics (HR = 1.8, 95% CI: 1.4-2.2) and API’s (HR = 1.6, 95% CI: 1.1-2.5) with NSGCTs. No difference was observed in cancer-specific survival by race/ethnicity for seminoma patients, however. CONCLUSIONS: Contrary to the Hispanic paradox reported across many medical conditions, cancer-specific survival is significantly worse for Hispanic men with testis cancer, particularly among those with NSGCT tumors. Future investigation of both public health and biological factors is needed to identify actionable drivers for this observed difference. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e457 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Rezaee More articles by this author Maximilian Pallauf More articles by this author Pranjal Agrawal More articles by this author Roy Elias More articles by this author Sean Fletcher More articles by this author Yasser Ged More articles by this author Nirmish Singla More articles by this author Expand All Advertisement PDF downloadLoading ...

Early onset of nasopharyngeal cancer in Asian/Pacific Islander Americans revealed by age-specific analysis.

Incidence of nasopharyngeal cancer is substantially higher in Asian/Pacific Islanders (APIs) than other racial groups. Examining age-specific incidence patterns by racial group and histology could inform disease etiology. We analyzed data from 2000 through 2019 from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program to compare age-specific incidence rates of nasopharyngeal cancer in non-Hispanic (NH) Blacks, NH APIs, and Hispanics to NH Whites using incidence rate ratios with 95% confidence intervals (CIs). NH APIs showed the highest incidence of nasopharyngeal cancer across all histologic subtypes and almost all age groups. The racial differences were most pronounced in the age 30-39 group; relative to NH Whites, NH APIs were 15.24 (95% CI: 11.69-20.05), 17.26 (95% CI: 12.56-24.07), and 8.91 (95% CI: 6.79-11.48) times as likely to have differentiated non-keratinizing, undifferentiated non-keratinizing, and keratinizing squamous cell tumors, respectively. These findings suggest an earlier onset of nasopharyngeal cancer among NH APIs, which highlight unique early life exposure to critical nasopharyngeal cancer risk factors as well as genetic predisposition in this high-risk population.

COVID-19 pandemic's disproportionate impact on childhood bereavement for youth of color: Reflections and recommendations.

The COVID-19 pandemic devastated public welfare worldwide, bringing excess deaths connected to causes such as homicide, substance abuse, and heart disease. In the U.S., these mortality increases disproportionally impacted communities of color and contributed to a rise in bereavement among adults and children. The death of an important person is one of the most frequently reported disruptive childhood experiences. According to 2023 Childhood Bereavement Estimation Model (CBEM) results, one in 14 U.S. children will experience the death of a parent by age 18. The current study analyzes the impact of the pandemic on childhood bereavement due to parent death by comparing CBEM results for 2021 and 2020 to the average of annual results for 2016 through 2019 for combined U.S. Census race and Hispanic origin categories. Analyses demonstrate that more than 700,000 U.S. children were newly bereaved due to a parent's death in 2020 and 2021. 2020 increases were observed for each race and Hispanic origin population, ranging from 14.9% to 72.4% compared to the 2016-2019 annual average. Hispanic Asian Pacific Islander and Hispanic Black youth experienced the largest percentage increases, while non-Hispanic white youth experienced the smallest. The results contribute to the growing evidence documenting longstanding and enduring disparities in critical U.S. health outcomes based on race and Hispanic origin. Recommendations for the scale and focus of efforts to understand and address bereavement in a way that accommodates the rising need for support in diverse populations to help all bereaved children find hope and healing are offered.

‘People of Color’ as a category and identity in the United States

ABSTRACT Although the category ‘people of color’ has not been adopted by the U. S. Census, it has assumed critical importance in public and social-scientific understanding of population change. But do Americans understand it as a neutral demographic category or a political identity? We provide the first U.S. national estimates for self-identification as a person of color (PoC ID). We also measure dissonance between individuals’ self-identification and the reflected appraisals of others, as well as where Americans draw the boundaries around PoC. PoC ID ranges from 95% among Blacks to 61% among Asian Americans and Pacific Islanders and 45% among Hispanics. Liberalism significantly increases PoC ID among AAPI, while conservatism reduces PoC ID among Hispanics, but political ideology is unassociated with PoC ID among Blacks. Stronger ethnic group consciousness raises PoC ID among all three groups. Demographic factors (particularly gender, age, and nativity) also influence PoC ID and PoC ID dissonance, but effects vary sharply in direction and significance from one group to another. Our estimate that only 27% of American adults self-identify as PoC suggests caution in assuming that growing populations of Hispanics and Asians will necessarily lead to a national majority who see themselves as people of color.

Trends in Smoking-Specific Lung Cancer Incidence Rates Within a US Integrated Health System, 2007-2018

At least 10%of lung cancers arise in adults who have never used tobacco. Data remain inconclusive on whether lung cancer incidence has been increasing among adults who have never used tobacco. How have age-adjusted incidence rates of lung cancer changed temporally, especially among adults who have never used tobacco? Trends in lung cancer incidence were examined using linked electronic health record and cancer registry data on a dynamic cohort of adults≥ 30 years of age at risk of incident lung cancer between January 1, 2007, and December 31, 2018, from an integrated health-care system in northern California. Truncated age-adjusted lung cancer incidence rates and average annual percentage change (AAPC) in rates were estimated, overall and separately for adults who have ever and never used tobacco by age, sex, and race or ethnicity. The cohort included 3,751,348 adults (52.5%female, 48.0%non-Hispanic White, 63.1%have never used tobacco), among whom 18,627 (52.7%female, 68.6%non-Hispanic White, 15.4%have never used tobacco) received a diagnosis of lung cancer. The overall lung cancer incidence rate declined from 91.1 to 63.7 per 100,000 person-years between 2007 and 2009 and between 2016 and 2018 (AAPC, -3.9%; 95%CI, -4.2%to -3.6%). Among adults who have ever used tobacco, incidence rates declined overall from 167.0 to 113.4 per 100,000 person-years (AAPC, -4.2%; 95%CI, -4.4%to -3.9%) and, to varying degrees, within all age, sex, and racial or ethnic groups. Among adults who have never used tobacco, incidence rates were relatively constant, with 3-year-period estimates ranging from 19.9 to 22.6 per 100,000 person-years (AAPC, 0.9%; 95%CI, -0.3%to 2.1%). Incidence rates for adults who have never used tobacco seemed stable over time, within age, sex, and racial or ethnic groups, except for those of Asian and Pacific Islander (API) origin (AAPC, 2.0%; 95%CI, 0.1%-3.9%), whose rates were about twice as high compared with their counterparts. These observed trends underscore the need to elucidate further the cause of lung cancer in adults who have never used tobacco, including why incidence is higher and rising in API adults who have never used tobacco.

Updated racial disparities in incidence, clinicopathological features and prognosis of hypopharyngeal squamous carcinoma in the United States.

This study was to determine the racial disparities in incidence, clinicopathological features and prognosis of hypopharyngeal squamous cell carcinoma (HPSCC) in the US. The National Program of Cancer Registries and Surveillance, Epidemiology, and End Results (SEER) database was used to determine racial disparity in age adjusted incidence rate (AAIR) of HPSCC and its temporal trend during 2004-2019. Using the separate SEER 17 database, we further evaluated racial disparity in clinicopathological features, and in prognosis using Kaplan-Meier curves and Cox proportional hazard models. HPSCC accounted for 95.8% of all hypopharyngeal cancers and occurred much more frequently in males. Its incidence decreased in both male and females, in male non-Hispanic white (NHW), non-Hispanic black (NHB) and Hispanic as well as female NHW and NHB during the study period. NHB had the highest, whereas non-Hispanic Asian or Pacific Islanders (API) had comparable and the lowest incidence in both males and females. Among 6,172 HPSCC patients obtained from SEER 17 database, 80.6% were males and 83.9% were at the advanced stages III/IV. Five-year cancer specific and overall survival rates were 41.2% and 28.9%, respectively. NHB patients were more likely to be younger, unmarried, from the Southern region, larger sized tumor, and at the stage IV, but less likely to receive surgery. They also had higher proportions of dying from HPSCC and all causes. Multivariate analyses revealed that NHB with HPSCC at the locally advanced stage had both significantly worse cancer specific and overall survival compared with NHW, but not at early stage (I/II) or distant metastatic stage. Hispanic patients had significantly better prognosis than NHW at locally advanced and metastatic stages. NHW and API had comparable prognoses. HPSCC displays continuously decreased incidence and racial disparity. The majority of the disease is diagnosed at the advanced stage. NHB have the highest burden of HPSCC and a worse prognosis. More studies are needed to curtail racial disparity and improve early detection.

Vigilance and Protection: How Asian and Pacific Islander, Black, Latina, and Middle Eastern Women Cope with Racism.

Research is needed to fully investigate the differential mechanisms racial and ethnic groups use to deal with ongoing intersectional racism in women's lives. The aim of this paper was to understand how Asian American and Pacific Islander, Black, Latina, and Middle Eastern women experience racism-from personal perceptions and interactions to coping mechanisms and methods of protection. A purposive sample of 52 participants participated in 11 online racially/ethnically homogeneous focus groups conducted throughout the USA. A team consensus approach was utilized with codebook development and thematic analysis. The findings relate to personal perceptions and interactions related to race and ethnicity, methods of protection against racism, vigilant behavior based on safety concerns, and unity across people of color. A few unique concerns by group included experiences of racism including physical violence among Asian American Pacific Islander groups, police brutality among Black groups, immigration discrimination in Latina groups, and religious discrimination in Middle Eastern groups. Changes in behavior for safety and protection include altering methods of transportation, teaching their children safety measures, and defending their immigration status. They shared strategies to help racial and ethnic minorities against racism including mental health resources and greater political representation. All racial and ethnic groups discussed the need for unity, solidarity, and allyship across various communities of color but for it to be authentic and long-lasting. Greater understanding of the types of racism specific groups experience can inform policies and cultural change to reduce those factors.

The History of Yellow Peril and the Model Minority Myth in Relation to AAPI-Hate in 2020

In this paper, we discuss the relationship between the yellow peril stereotype along with the model minority myth and how they influence the recent Asian American and Pacific Islander (AAPI) Hate in 2020. We first delve into the treatment of Asian Americans during the interwar years, specifically the immigration center Angel Island. Using oral histories we collected from outside sources and books, we discuss the social and legal treatments of the Asian immigrants both in the immigration center and in the country. Next, we discuss the origins of the model minority myth that date back to the 1960s to 70s using newspaper articles and interviews conducted during the time period. We also explore the formation of the Asian American identity and movement in the 1960s and 70s through newspaper articles that demonstrate the community’s pushback to white supremacy and dismantling harmful prejudices against Asian Americans. From this historical lens, we connect the formation and continuation of the yellow peril and model minority stereotypes to the Asian American hate of 2020 through current interviews and podcasts with Asian Americans. This reemergence of hate against the Asian American community demonstrates the stereotypes’ long-lasting effects. Simultaneously, the AAPI protests evidence that Asian Americans continue to fight back against their mistreatment as a continuation of the Asian American Movement that started in the late 1960s. These historical and modern events assist our discussion of the Asian-American community’s relationship with white supremacy in order to fight back against the discrimination we face today.

Racial and Ethnic Disparities in Length of Stay for Common Pediatric Diagnoses: Trends From 2016 to 2019.

Inequities in pediatric illness include unequal treatment and outcomes for children of historically marginalized races/ethnicities. Length of stay (LOS) is used to assess health care quality and is associated with higher costs/complications. Studies show LOS disparities for Black and Hispanic children in specific diagnoses, but it is unclear how broadly they exist or how they change over time. We examined the association between race/ethnicity and LOS longitudinally for the most common pediatric inpatient diagnoses. We used the 2016 and 2019 Kids' Inpatient Databases. The 10 most frequent diagnoses in 2016 were determined. For each diagnosis in each year, we assessed the association between race and LOS by fitting a generalized linear mixed effects model with a negative binomial distribution, accounting for clustering and confounding. Using descriptive statistics, we compared associations between the 2 years for trends over time. Our analysis included >450 000 admissions and revealed significantly longer LOS for Black, Hispanic, and/or Asian American or Pacific Islander, Native American, and other children in 8 of the 10 diagnoses in 2016, with mixed changes over time. Three new disparities emerged in 2019. The largest disparities were for Black children in most diagnoses. Kids' Inpatient Database data showed longer LOS for children of historically marginalized race/ethnicity with common pediatric inpatient diagnoses, which largely persisted from 2016 to 2019. There is no plausible biological explanation for these findings, and inequities in social needs, access to care, and quality of care likely contribute. Future directions include further study to understand and address contributing factors.

Expanding the Capacity of Student Affairs Professionals and Faculty: A Case Study of Two Asian American and Native American Pacific Islander-Serving Institutions

This study explores the process in which Asian American and Native American Pacific Islander-Serving Institutions (AANAPISI) build the capacity of Asian American and Pacific Islander (AAPI) student affairs professionals and faculty. Findings suggest that AANAPISIs systematically incorporate multilayered initiatives that validate staff and faculty racialized experiences, while devoting a significant amount of resources to recruit new members into the profession and strengthening their professional competencies. Implications and recommendations are offered to enhance institutional practice.

Association Between Mortality Due to Nasopharyngeal Carcinoma and Race in the United States From 2007 to 2016.

Asians and Pacific Islanders (API) exhibit increased incidence of nasopharyngeal carcinoma (NPC). However, they are often excluded when the disease is studied. Risk-factors and incidence are well-researched while cancer-specific mortality trends remain unclear. We aimed to determine whether insurance status modifies the association between race and cancer-specific mortality in NPC patients. This retrospective cohort study used secondary data analysis from the Surveillance, Epidemiology, and End Results Program database. Patients ≥18 years with histologically confirmed primary NPC from 2007 - 2016 were included. The main outcome assessed was 5-year survival and the main exposure variable was race (API, white, black). Insurance status was classified into uninsured, any Medicaid, and insured (with any insurance). Potential confounders included age, sex, marital status, stage at diagnosis, and surgical treatment. Adjusted Cox regression analysis was used to calculate hazard ratios (HR) and corresponding 95% confidence intervals (CI). 1610 patients were included (72.98% male, 27.02% female). 49.8% were API, 40.5% were Whites, and 9.8% Blacks. Maximum follow-up was 5-years. The adjusted hazards of 5-year cancer-specific death for API and Blacks compared with Whites were 0.77 (95% CI 0.62 - 0.96) and 0.92 (95% CI 0.65 - 1.31), respectively. Cases decreased with age in API and Blacks. 8.2% of cases had localized disease, 45.3% had local spread, and 44.6% had distant metastasis. Insurance status did not modify the association between race and mortality. Race is an important prognostic factor to account for in NPC patients. Investigating risk-factors and subtypes stratified by race may explain our findings.

Abstract P4-03-24: State variation in racial and ethnic disparities in triple-negative breast cancer rates: NPCR-SEER incidence data, 2015-2019

Abstract Background: Triple-negative breast cancer (TNBC) (i.e., estrogen receptor-negative, progesterone receptor-negative, and human epidermal growth factor receptor type 2-negative) is an aggressive subtype of breast cancer, more frequently diagnosed among non-Hispanic Black women than other racial/ethnic groups in the United States. TNBC risk also varies by location, but limited data exist for state-level variation in the racial/ethnic disparities in TNBC risk. Methods: Data for TNBC diagnosed at all ages during 2015-2019 were obtained from the National Program of Cancer Registries and Surveillance, Epidemiology &amp; End Results for racial/ethnic groups classified as non-Hispanic American Indian/Alaska Native (AIAN), non-Hispanic Asian or Pacific Islander (API), non-Hispanic Black (Black), Hispanic, or non-Hispanic White (White). State-specific incidence rates were available for 8, 23, and 36 states for AIAN, API, and Hispanic women, respectively, and 38 states and Washington, D.C. for Black women and 50 states and Washington, D.C. (hereafter referred to collectively as “states”) for White women. State-specific rates were compared within and between racial/ethnic groups using incidence rate ratios (IRR). Results: Nationally, the age-standardized incidence rate of TNBC was the highest among Black women (25.1 per 100,000), followed by White (12.9 per 100,000), AIAN (11.1 per 100,000), Hispanic (11.1 per 100,000), and API (9.0 per 100,000) women. The highest state-specific rates were found among Black women in Delaware, Missouri, and Louisiana (&amp;gt;30 per 100,000) and the lowest rates were among API women in Oregon and Pennsylvania (&amp;lt; 7 per 100,000). State variations within a population were relatively larger among AIAN (2.8-fold) and Hispanic (2.3-fold) women, and smaller among White women (1.65-fold). Compared with White women, Black women had a higher rate of TNBC in all 39/39 states with the greatest IRRs in Delaware (2.31, 95%CI=1.90-2.81), Missouri (2.28, 95%CI=2.08-2.50), and Louisiana (2.20, 95%CI=2.02-2.38) and the lowest IRRs in Minnesota (1.38, 95%CI=1.12-1.68) and Colorado (1.38, 95%CI=1.12-1.68). In contrast, API women had a lower rate than White women in 22/23 states, except for Nevada, with the lowest IRR in Oregon (0.50, 95%CI=0.34-0.70) and the highest IRR in New York (0.82, 95%CI=0.75-0.90). The rate among Hispanic compared with White women did not differ statistically significantly in 23/36 states but was lower in 12/36 states, with the lowest IRR in Ohio (0.57, 95%CI=0.43-0.74), and higher in Massachusetts (1.21, 95%CI=1.04-1.39). The rate among AIAN compared with White women did not differ in 5/8 states but was lower in Arizona (0.53, 95%CI=0.38-0.73) and North Carolina (0.68, 95%CI=0.46-0.96), and higher in Oklahoma (1.30, 95%CI=1.09-1.54). Conclusions: State variations in TNBC incidence rates both within and between populations are substantial, signifying the important role of potentially modifiable risk factors in determining the risk of TNBC by state and race/ethnicity. This finding highlights the need for more research to identify factors contributing to these variations to develop more effective preventive measures. Meanwhile, to mitigate the impact of the disproportionate burden of TNBC across states and racial/ethnic groups, universal access to screening modalities and timely, guideline-concordant treatments is essential. Citation Format: Hyuna Sung, Daniel Wiese, Ismail Jatoi, Ahmedin Jemal. State variation in racial and ethnic disparities in triple-negative breast cancer rates: NPCR-SEER incidence data, 2015-2019 [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-03-24.

Sense of School Belonging Among Asian American and Pacific Islander Students in U.S. High Schools: A Critical Quantitative Intersectionality Analysis

Background/Context: The sense of belonging to a school is important for students, in terms of various short- and long-term developmental and academic outcomes. The inequities in the sense of school belonging among Asian American and Pacific Islander (AAPI) students may reveal a severe lack of opportunities or serious process gaps for these students. Purpose/Objective: This study investigated the nuances and complexities involved in the sense of school belonging among AAPI students in U.S. high schools, and particularly how such perceptions relate to various demographic characteristics (i.e., ethnicity, gender, socioeconomic status, and immigration status) and their intersectionalities. The study disaggregated this group into subgroups based on their ethnicities, with the aim of challenging the model minority stereotype that generalizes the experiences of AAPI students. Research Design: This study used base-year data of the High School Longitudinal Study of 2009 (HSLS:09) provided by the National Center for Education Statistics (NCES). Linear mixed-effects modeling was used to analyze a nationally representative sample. Multiple statistical interaction terms were used to identify the specific contributions (intersectionality) of AAPI students’ converging demographic characteristics. Findings/Results: This study found that the sense of school belonging was stronger for South Asian students and weaker for East Asian students when compared to the overall level, with other demographic characteristics held constant. The intersectionality model using disaggregated data revealed that the convergence of AAPI students’ ethnicity and gender creates additional nuances in their sense of school belonging, particularly for Southeast Asian and East Asian students. Conclusions/Recommendations: The findings support the call for more accurate narratives and a deeper understanding of intersectionality among AAPI students. The study suggests to policymakers and school leaders that a universal strategy for encouraging students’ sense of school belonging may not effectively address the nuanced intersectional disparities that AAPI students experience. Instead, the intersection of students’ ethnicity and gender indicates that responsive strategies that address their unique needs can better promote their perceptions of belonging to their schools.

How Do We Grow Grassroots Critiques of the State? A Close Reading of Triple Jeopardy from East Baltimore

How Do We Grow Grassroots Critiques of the State?A Close Reading of Triple Jeopardy from East Baltimore Lenora R. Knowles (bio) When I sit with the images, concepts, and community voices of the Third World Women's Alliance (TWWA) in their Triple Jeopardy newspaper, I am struck by how this movement publication served as a key mechanism for the New York City chapter of the TWWA to grow leadership and critical consciousness of the racial capitalist U.S. state among their base of Third World women and Third World people more generally. In this first issue, the TWWA elucidates how members were teaching and circulating Third World political analysis and movement strategy, along with the meanings and values of Third World movement leadership. As a revised organic intellectual, organizer, and nepantlera,1 I find joy and possibility in the complex process of growing grassroots movement leaders struggling for broadscale social transformation. From its first issue through its last, Triple Jeopardy offers important considerations for doing the relational and processual work of political education and leadership development today. Below, I explore how writers of Triple Jeopardy utilized the rhetorical device of the question as a method for critical inquiry and political education. Moreover, I trace how they mobilized radical critiques of the state at multiple scales, ranging from global regimes of violence to everyday trauma, in order to build political unity. I suggest that these approaches provide invaluable tools for the grassroots base-building and leadership development that I attempt to practice while organizing in East Baltimore. To better understand some of what this first issue teaches us about leadership development, I provide a bit of context for the TWWA (see Springer 2005; Farmer 2017), the stakes of their organizing and theorizing within a Cold War context, and how they conceptualized the role of their [End Page 191] grassroots publication. The TWWA was a radical women of color organizing collective that first took shape in New York through the leadership of Black women organizers Frances Beal and Gwendolyn Patton. The organizational life of the New York–based TWWA spanned roughly from 1969 to 1977; during this time, they created an organizing program and collectivist organizational structure that centered a Third World woman of color politics that was anti-racist, anti-imperialist, and anti-sexist. The collective's effort to develop a united front of Third World women necessitated multimodal work that was deeply personal, epistemic, collective, analytical, and embodied in nature. Their writings and organizing articulated a Third World women's consciousness among working-class women of color. They mobilized members around key local and international campaigns that promoted reproductive justice, opposed the Vietnam War, and resisted police and carceral violence. Their growing numbers demonstrated the resonance of the organization's intersectional analysis and its strategies for organizing among Third World women. In addition, their thriving base spoke to their increased organizational capacity. Thus, we might think about the TWWA's increased grassroots power in terms of its potential threat to the U.S. nation-state's stability and working-class women's allegiance to a U.S. status quo. By 1971 the organization expanded into the West Coast with the formation of the Bay Area and Seattle chapters. The national membership has been estimated to be somewhere around two hundred members. While the NYC chapter mostly organized among Black diasporic and Puerto Rican women, the West Coast chapter expanded the membership of Chicana and Asian American and Pacific Islander women alongside African American women. The NYC chapter mobilized women for the annual International Women's Day and supported local workers' picket lines, as well as protests spearheaded by groups like the Black Panther Party, La Union Latina, and the Campaign to Free Angela Davis. One of their first actions as a collective was participating in the 1970 New York women's strike, during which members publicly delivered a critique of the hegemonic white feminist organizations of the time (TWWA [1974?], 2). The organization challenged state and corporate violence domestically and abroad, most notably in their work to end the country's imperial intervention in Vietnam, state discipline of Black activists, and attacks on Third World Women's reproductive capacity...

Racial and ethnic disparities in COVID-19 vaccine uptake: A mediation framework.

Previous research suggests that racial and ethnic minority groups especially Black Americans showed stronger COVID-19 vaccine hesitancy and resistance, which may result from a lack of trust toward the government and vaccine manufacturers, among other sociodemographic and health factors. The current study explored potential social and economic, clinical, and psychological factors that may have mediated racial and ethnic disparities in COVID-19 vaccine uptake among US adults. A sample of 6078 US individuals was selected from a national longitudinal survey administered in 2020-2021. Baseline characteristics were collected in December 2020, and respondents were followed up to July 2021. Racial and ethnic disparities in time to vaccine initiation and completion (based on a 2-dose regimen) were first assessed with the Kaplan-Meier Curve and log-rank test, and then explored with the Cox proportional hazards model adjusting for potential time-varying mediators, such as education, income, marital status, chronic health conditions, trust in vaccine development and approval processes, and perceived risk of infection. Prior to mediator adjustment, Black and Hispanic Americans had slower vaccine initiation and completion than Asian Americans and Pacific Islanders and White Americans (p's<0.0001). After accounting for the mediators, there were no significant differences in vaccine initiation or completion between each minoritized group as compared to White Americans. Education, household income, marital status, chronic health conditions, trust, and perceived infection risk were potential mediators. Racial and ethnic disparities in COVID-19 vaccine uptake were mediated through social and economic conditions, psychological influences, and chronic health conditions. To address the racial and ethnic inequity in vaccination, it is important to target the social, economic, and psychological forces behind it.

Diverse demands and resources among racially/ethnically diverse caregivers

ABSTRACT Objectives The family caregiver population in the US is growing in conjunction with greater numbers of older adults with serious illness and complex care needs, and is becoming increasingly diverse. This study described and compared resources, demands, and health outcomes among diverse family caregivers by race/ethnicity. Design This study was a cross-sectional secondary analysis of nationally representative data collected for Black/African-American, Asian American & Pacific Islander, Latino/Hispanic and non-Latino/Hispanic white caregivers (n = 2,010) in the Home Alone Revisited Study. We described available resources (e.g. income, paid help, social support) and demands (e.g. medical/nursing task performance) by racial/ethnic group. Using survey-weighted logistic regression, we examined relationships of resources and demands with caregiver outcomes (i.e. heath status; strain; depressive symptoms) by race-ethnicity controlling for socio-demographic variables. Results Distribution of resources and demands was similar by race/ethnicity, except for higher income for non-Latino/Hispanic white caregivers. Nearly half assisted with personal care (47.5%) or medical/nursing tasks (49.7%). Higher social support and satisfaction with social relationships was associated with positive health outcomes regardless of race/ethnicity, while income was consistently associated with positive health outcomes only for non-Latino/Hispanic white caregivers. Medical/nursing task performance was significantly associated with negative health outcomes for Asian American & Pacific Islanders in multivariable models. Discussion Many caregiving demands and tasks are similar by race/ethnicity and represent considerable investment of time, energy and care. Differences in the effects of resources and demands by race/ethnicity should be explored in future research as they may have implications for assessment and planning of culturally and linguistically appropriate interventions.

Disparities in Perceived Availability of Healthful Foods, Dietary Behaviors, Diet Quality, and Obesity Among Mothers from Low-Income Households: Additional Evidence in the Call for Broader Approaches to Obesity Prevention.

To examine racial/ethnic differences in dietary behaviors, diet quality, body mass, and the perceived availability of healthful foods in one's neighborhood among mothers from low-income California households. Cross-sectional telephone surveys of mothers from randomly sampled households with incomes ≤185% federal poverty level in 2018 and 2019 using a validated 24-h dietary recall assessment. Dietary outcomes were cups of fruits and vegetables, ounces of sugar-sweetened beverages, teaspoons of added sugars, and kilocalories consumed the previous day. Diet quality was assessed by calculating Health Eating Index-2015 scores. Supplemental survey items assessed mothers' weight and height. Body mass index (BMI) was calculated with a BMI of 30 or higher considered obese. Perceived availability of fresh fruits and vegetables and healthy foods in general within one's neighborhood was recorded. The analytic sample of 9200 mothers was 66.3% Latina, 17.3% white, 12.6% African American, and 3.8% Asian American, Native Hawaiian, or Pacific Islander (AANHPI). African American mothers consumed the fewest cups of fruits and vegetables and the most teaspoons of added sugars, reported poor diet quality, and had the highest obesity rate, 54.7% versus 46.9% for Latinas, 39.9% for whites, and 23.5% for AANHPIs. Accordingly, a greater proportion of African Americans reported limited availability of fresh fruits and vegetables and healthy foods in general in their neighborhood. Findings are interpreted in light of recent calls for broader approaches to address health disparities, including strategies that focus on inequalities in racial/ethnic socioeconomic status and systemic racism.

Building an Equitable Future Through Data Disaggregation.

Building an Equitable Future Through Data Disaggregation.