Blacks Research Articles

PSA Levels and Mortality in Prostate Cancer Patients

IntroductionProstate cancer (PC) is the second most common cancer among men around the world. Several smaller studies have explored the relationship between elevated PSA and mortality, but results have been conflicting. Additionally, studies have shown that Black men are more likely to be diagnosed with PC at late-stages and may have a twofold increase in mortality risk. This study aims to evaluate the relationship between PSA levels and mortality in patients with PC and differences between Black versus White patients. MethodsIn this retrospective study, the TriNetX database, was used to extract de-identified EMRs of 198,083 patients. Patients were included if they were diagnosed with PC and had obtained a PSA level (measured in ng/mL) within 6 months prior to diagnosis. Cohorts were separated into 7 groups based on intervals of PSA, ranging from < 2 to ≥ 500 and compared to a control cohort with a PSA of 4 to 20 for differing 2-year mortality rates. A subgroup analysis was performed to compare mortality differences between Black and White patients. A posthoc analysis evaluated 5- and 10-year mortality amongst all patients with PC. ResultsAfter propensity matching, mortality risk was significantly lower for patients with PSA < 2 (5.9% vs. 7.5%; RR 0.784; P < .001) when compared to the control cohort. Mortality was significantly higher for all other subsequent PSA intervals > 20, with the lowest risk ratios at PSA 20-100 (24.1% vs. 10.0%; RR 2.419; P < .001) and highest at PSA 200 to 500 (50.4% vs. 10.8%; RR 4.673; P < .001). The sub-group analysis showed that when compared to White patients, Black patients with PSA < 20 had similar mortalities, but had significantly lower 2-year mortality rates at PSA levels ≥ 20. The posthoc analysis of PSA levels and 5- and 10-year mortality of all patients with PC showed similar trends to the 2-year outcomes. ConclusionThis study found that prostate cancer patients with significantly elevated PSA levels have a greater mortality, and Black patients have lower 2-year mortality rates than their White counterparts when matched for PSA levels greater than 20.

Social Determinants of Health and Healthcare Utilization Disparities among Older Adults with and Without Cognitive Impairment.

The purpose of this study was to determine the healthcare utilization patterns in a national sample of older adults across several social determinants of health factors (ethnicity, gender, race, education) with normal and dementia/impaired cognition. We used datasets from the Health and Retirement Study (HRS, 2018) to evaluate healthcare utilization, including metrics such as hospital and nursing home stays, hospice care, and number of visits to the doctor. Logistic models were used to predict healthcare utilization separately in those with normal cognition and dementia. Our final sample comprised 15,607 adults (mean age: 65.2 normal cognition, mean age 71.5 dementia). Hispanics with normal cognition were less likely to stay in a hospital than non-Hispanic respondents (OR: 0.52-0.71, p<0.01). Being female was associated with a higher risk for shorter nursing home days (OR: 1.41, p<0.01) and doctor visits (OR: 1.63-2, p<0.01) in cognitively normal older adults. Being female was associated with a lower risk for hospital stay in those with dementia (OR: 0.50-0.78, p<0.01). Respondents identifying as Black or other races with dementia were less likely to experience nursing home days (OR: 0.42, p<0.04). Black respondents with normal cognition were less likely to experience doctor visits (OR: 0.32-0.37, p<0.01). Those with more than a high school education in both groups were more likely to experience doctors' visits. The study points to the continued disparities in healthcare utilization linked to participants' social determinants of health factors and cognition.

Advancing Black Men’s Type 2 Diabetes Healthcare Through Addressing Gender-centered Social Norms, Cognitive Scripts, and Manhood: An Integrated Public Health Approach for Reducing T2D Disparities

ABSTRACT In the United States, the burden of type 2 diabetes (T2D) health complications and outcomes is higher in Black men, and the diabetes disparities are escalating. Previous evidence-based research underscored the need to explore gender-specific experiences of chronic illness in social-cultural, historical, and clinical contexts. Our community-engaged qualitative study focused on learning from the live experiences of Black men (n = 15) in the Arkansas Delta area. Applying a narrative approach, we explored and learned from the participants about their perception of the consequences of T2D on manhood and the usefulness of T2D management instructions. Findings indicate that an integrated public health approach contextualizes social-cultural norms, cognitive scripts, and gender-centered expressions of manhood, a promising direction in T2D healthcare; social support is essential for emotional and physical help in continued T2D management; and connecting with Black men and their insights are vital to develop relevant and appropriate guidelines for T2D management care.

Longitudinal Increases in Time to Surgery for Patients with Breast Cancer: A National Cohort Study.

Longer time to surgery (TTS) isassociated with worse survival in patients with breast cancer. Whether this associationhas encouraged more prompt care delivery remains unknown. The National Cancer Database was used to identify patients ≥18 years of agediagnosed with clinical stage 0-III breast cancer between 2006 and 2019 for whom surgery was the first mode of treatment.A linear-by-linear test fortrend assessed median TTS acrossthe interval. Adjusted linear regression modelingwas used to examineTTS trends across patient subgroups. Overall, 1,435,584 patients met the inclusion criteria. The median age was 63 years (interquartile range [IQR] 53-72), 84.3% of patients were White, 91.1% were non-Hispanic, and 99.2% were female. The median TTS in 2006 was 26 days (IQR 16-39) versus39 days in 2019(IQR 27-56)[p<0.001]. In a multivariable linear regression model, TTS increased significantly, with an annualincrease of 0.83 days(95% confidence interval 0.82-0.85; p<0.001).A consistent, significant increase in TTS was observed on subgroup analyses by surgery type, reconstruction, patient race, hospital type, and disease stage. Black race, Hispanic ethnicity, and having either Medicaid or being uninsured were significantly associated with prolonged TTS, as were mastectomy and reconstructive surgery. Despiteevidence that longer TTS is associated with poorer outcomes in patients with breast cancer, TTS has steadily increased, which may be particularly detrimental to marginalized patients. Further studies are needed to ensure the delivery of timely care to all patients.

Race, policing, and Black males in Canadian society

ABSTRACT The relationship between law enforcement and Black people in North America is governed by fear and suspicion, leading to inequitable legal outcomes. The ongoing policing crisis for Black males in Toronto, Canada is downplayed by a self-perception of Canadian “innocence” based on a multicultural identity. I argue that the crisis is rooted in a Eurocentric, dehumanizing view of Black masculinity as violent and criminal. I demonstrate how this narrative is perpetuated by Toronto law enforcement and the news media. I propose that embracing Black masculinity as fully human will free both victims and perpetrators from the harms of racial profiling.

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.

T146 - The Role of Past Substance Use on ART Adherence Among Black People With HIV

T146 - The Role of Past Substance Use on ART Adherence Among Black People With HIV

Erotic Black Diaspora

“The Erotic Black Diaspora: From Your Hands to Mine” is a theoretical exploration of how the erotic informs Black feminist politics, kinship, love, and spirituality throughout the African diaspora. Through an interdisciplinary approach rooted in literary studies, history, African and African diaspora studies, women’s and gender studies, and Black queer studies, as well as archival research, a close reading of letters sent to Black feminist, writer, and poet Audre Lorde reveals how the erotic functions within Black feminist spaces, particularly in the late 1970s–mid 1980s. In using Audre Lorde’s definition of the erotic, as she defines it in “Uses of the Erotic: The Erotic as Power,” this paper argues that the Erotic Black Diaspora is a way of reading Black feminist love, language, and action. Recognizing the diversity within Afro-diasporic experiences, the Erotic Black Diaspora privileges the erotic (platonic and/or romantic) feelings and expressions across continents cultivated between same-sex-loving and queer individuals throughout the African diaspora. Positioning Black feminist archives, in particular correspondence sent between Black feminist foremothers, as a counter-archive to institutions of oppression informs one’s understanding of the ethics of Black feminist politics, love, spirituality, and community building.

Racism Learnt and Unlearnt

For centuries, Africans migrated to India in different phases resulting in a significant presence of the African diaspora in this country. The term “African diaspora” gained currency only in the mid-nineteenth century in connection with the study of the people of African origin dispersed all over the world. But in countries like India, the African presence dates as far back as the period of the Indian Ocean slave trade. Historically, India and Africa have shared cordial political and economic relations. Their shared history of anti-colonial struggle, the mutual reverence for political leaders like Mahatma Gandhi and Nelson Mandela, and India’s support for postapartheid South Africa might indicate the peaceful coexistence of Indians and Africans in present-day India. But the on the ground reality hits differently, as depicted in “The Shade of You” by Anushree Majumdar, published in Eleven Ways to Love: Essays by Penguin India. Majumdar thinks herself a modern and enlightened woman until she gets into a relationship with Bryan Ochieng, a Kenyan studying in Delhi. As she gradually explores her relationship with Bryan, she comes to know about different aspects of racism that the African diaspora faces in Delhi in a more intimate way. Getting mocked and ridiculed for dating a black man in the public space makes her critique the racist attitude of her fellow Delhiites. She realizes that Indians have deeply internalized the colonial legacy of racism and colorism. She understands that, since our very childhood, we embrace a culture informed by racist ideology unconsciously. Indians are satisfied with the tokenist acceptance of black culture by celebrating black footballers and pop artists, but they would never let African diasporic people come closer as family and friends. This mindset has sufficiently exoticized and otherized Africans in India. Her proximity to Bryan reveals to her how ignorant she has been about Bryan’s culture despite her love of selective parts of Kenyan culture. The presence of Bryan and his Kenyan friends in her life offers her moments of self-reflexivity. She comes to question how much she has been able to unlearn her racial prejudices, and the answer forces her to confront an aspect of her race–intolerant subjectivity so far buried under her conscious race-sensitive self. Her self-realization makes her feel uncomfortable and apologetic. She feels that the self-realization that has dawned upon her is not enough to help her in the unlearning process overnight. She fails to maintain a long-term relationship with Bryan given their seemingly unbridgeable cultural gap at that point in time. But Bryan’s entry into her life marks the beginning of her anti-racism journey in the true sense of the term and it continues. Years later, she finds that she has become a better version of herself who is no longer troubled by the hidden guilt and shame associated with her relationship with an African.

Finding George Freeman: a ‘Liberated African’ in Berkshire in the Age of Abolition

ABSTRACT This article comprises a biography of George Freeman, an African boy ‘liberated’ from enslavement in West Africa and relocated to the countryside of Berkshire, UK. The article contributes to scholarship on the long-term presence and lived experiences of Black people in Britain, using digital humanities techniques and parochial records from the county of Berkshire to map the presence of Black people (and other minority ethnicities) in rural English counties. It also uses Freeman’s biography to engage in wider discussions concerning the precarious experiences of ‘Liberated Africans’. These two research areas are combined to construct Freeman’s biography as a global microhistory, adding to the growing scholarship that aims to overcome these areas of archival silence within histories of slavery and abolition.

Asian = machine, Black = animal? The racial asymmetry of dehumanization.

How different racial minorities experience racism differently remains underexplored in existing research. Here, we show that Asian and Black people are often dehumanized differently. Twelve studies spotlight a racial asymmetry in dehumanization using a wide array of methods (experimental, archival, and computational) and data sources (online samples, word embeddings, and U.S. Bureau of Labor Statistics data): Whereas Black people are more often subjected to animalistic dehumanization, Asian people are predominantly subjected to mechanistic dehumanization. We demonstrate this asymmetry from the vantage point of victims (Studies 1a and 1b) and perpetrators (Studies 2a-2d). We further document the prevalence of this asymmetry across diverse domains, from everyday language (Study 3) to perceptions in the realms of romantic relationships (Study 4a), crime rates (Study 4b), and business skills (Study 4c). Finally, we demonstrate the asymmetry's real-world consequences in labor market segregation (Studies 5 and 6). Our findings shed light on the distinct experiences of racism encountered by different racial groups and, more critically, introduce a framework that unifies and integrates scattered empirical observations on perceptions of Asian people. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Creating pedagogical possibilities through media representations of “the talk” in civics classrooms

Millions of people learn lessons about citizenship and belonging from the media they consume each day. In this study, we examined the knowledges about citizenship that are conveyed through media representations of “the talk,”—the conversations Black families have with their children about navigating interactions with police in an antiBlack society. Our findings revealed that “the talk,” as an informal curriculum, can educate people on why antiBlack police violence occurs and can provide guidance to Black people on how to survive police interactions. Additionally, we found that the Black families in this study use “the talk” to name and challenge dominant narratives about policing and police officers. Although many civics curricula and state standards continue to remain race-evasive, antiBlack, and riddled with white supremacy, we contend that incorporating media representations of “the talk” into civics instruction can create pedagogical possibilities for educators to teach about the racialized realities of citizenship experienced by Black people in the United States.

Evaluating equity-promoting interventions to prevent race-based inequities in influenza outcomes.

Seasonal influenza hospitalizations pose a considerable burden in the United States, with BIPOC (Black, Indigenous, and other People of Color) communities being disproportionately affected. To determine and quantify the effects of different types of mitigation strategies on inequities in influenza outcomes (symptomatic infections and hospitalizations). In this simulation study, we fit a race-stratified agent-based model of influenza transmission to demographic and hospitalization data of the United States. We consider five racial-ethnic groups: non-Hispanic White persons, non-Hispanic Black persons, non-Hispanic Asian persons, non-Hispanic American Indian or Alaska Native persons, and Hispanic or Latino persons. We tested five idealized equity-promoting interventions to determine their effectiveness in reducing inequity in influenza outcomes. The interventions assumed (i) equalized vaccination rates, (ii) equalized comorbidities, (iii) work-risk distribution proportional to the distribution of the population, (iv) reduced work contacts for all, or (v) a combination of equalizing vaccination rates and comorbidities and reducing work contacts. Reduction in symptomatic or hospitalization risk ratios, defined as the ratio of the number of symptomatic infections (hospitalizations respectively) in each age- and racial-ethnic group and their corresponding white counterpart. We also evaluated the reduction in the absolute mean number of symptomatic infections or hospitalizations in each age- and racial-ethnic group compared to the fitted scenario (baseline). Our analysis suggests that symptomatic infections were equalized and reduced (by up to 17% in BIPOC adults aged 18-49) by strategies reducing work contacts or equalizing vaccination rates. Reducing comorbidities resulted in significant decreases in hospitalizations, with a reduction of over 40% in BIPOC groups. All tested interventions reduced the inequity in influenza hospitalizations in all racial-ethnic groups, but interventions reducing comorbidities in marginalized populations were the most effective. Notably, these interventions resulted in better outcomes across all racial-ethnic groups, not only those prioritized by the interventions. In this simulation modeling study, equalizing vaccination rates and reducing number of work contacts (which are relatively simple strategies to implement) reduced the both the inequity in hospitalizations and the absolute number of symptomatic infections and hospitalizations in all age and racial-ethnic groups. Question: What interventions might be effective in reducing the observed race-based disparities in seasonal influenza hospitalizations in the United States (US)?Findings: Simulated interventions equalizing comorbidity rates by in marginalized racial-ethnic groups would prevent up to 40% hospitalizations in these groups. Increasing vaccination rates among marginalized communities or reducing work contacts would reduce hospitalizations by over 10% and 20%, respectively, in most racial-ethnic groups and would similarly reduce symptomatic infections.Meaning: Increasing vaccination rates among marginalized communities, decreasing comorbidities in these groups, or reducing work contacts would help reduce the race-based disparities in seasonal influenza hospitalizations in the US.

Seeing change in seafood: examining impacts of globalization and climate change on mid-atlantic black american foodways

ABSTRACT Foodways develop as human communities adapt to changing geographic, environmental, and economic circumstances. In this paper, we examine seafood foodways in an urban Black American community in the Mid-Atlantic region of the United States and place those foodways in the context of two northward migrations. The first is the Great Migration, one of the largest human migration events ever—when Black Americans emigrated from the southern United States during the middle of the twentieth century. The second is the more recent and ongoing northward range shifts of marine species along the eastern United States seaboard related to climate change. As fish species continue to move north, availability of culturally familiar seafood species in the region is changing. We use interviews to characterize the culture of seafood consumption among Black residents of Philadelphia, descendants of those that came during the Great Migration. In parallel, we draw upon Atlantic fisheries data, to examine the case of whiting (Merluccius bilinearis), documenting the simultaneous changing abundance and catch of this species over the last two decades. This study illuminates challenges that both globalization and climate change pose for food systems and foodways. Keywords: fish, foodways, Merluccius bilinearis, Philadelphia, silver hake, silver trout, whiting

Food insecurity and diabetes management among adults of African descent: A systematic review.

This systematic review explores the established causal link between food insecurity and cardiometabolic conditions among adults of African descent. Specifically, this study examined the relationship between food insecurity and the management of type 2 diabetes, highlighting the prevalence of food insecurity among individuals of African descent with type 2 diabetes. Original English papers were meticulously searched in databases including PubMed, CINAHL, PsycINFO, Medline, Cochrane, Embase and Web of Science. The Cochrane Risk of Bias Tool for quantitative studies and COReQ for qualitative studies were employed to assess biases. Three independent reviewers meticulously evaluated and synthesized results, reaching a consensus. Among the 198 studies identified, 14 met the inclusion criteria for data extraction and analysis, which were conducted independently by three reviewers. The findings indicate that individuals of African descent are more likely to experience food insecurity compared to their White counterparts and are also more prone to diabetes risk factors or the presence of diabetes. This study underscores a higher prevalence of food insecurity and type 2 diabetes among adults of African descent, suggesting that ethnicity and food insecurity play significant roles in diabetes management. Future research should prioritize interventions aimed at reducing these disparities.

Evidence-based Prostate Cancer Screening Interventions for Black Men: A Systematic Review.

The databases PubMed, Ovid MEDLINE, CINAHL Plus, and PsychInfo were utilized to examine peer-reviewed publications between 2017 and 2023. Data extracted included implementation plans, outcome measures, intervention details, and results of the study. The Critical Appraisal Skills Programme was used to assess the quality of the evidence presented. Of the 206 full-text articles assessed, three were included in this review. Educational interventions about prostate cancer knowledge with shared and informed decision-making (IDM) features, as well as counseling, treatment options, and healthcare navigation information, may increase prostate cancer screening participation among Black men. Additionally, health partner educational interventions may not improve IDM related to screening participation. The quality of the evidence presented in each article was valid and potentially impactful to the community. Black men face various social determinants of health barriers related to racism, discrimination, cost of health services, time away from work, and lack of trust in the healthcare system when making health-related decisions, including prostate cancer screening participation. A multifactorial intervention approach is required to address these inequities faced by Black men especially as prostate cancer is curable when diagnosed at an earlier stage.

A morphoscopic exploration of cranial sexual dimorphism among modern South Africans using computed tomography scans.

Continual re-evaluation of standards for forensic anthropological analyses are necessary, particularly as new methods are explored or as populations change. Indian South Africans are not a new addition to the South African population; however, a paucity of skeletal material is available for analysis from medical school collections, which has resulted in a lack of information on the sexual dimorphism in the crania. For comparable data, computed tomography scans of modern Black, Coloured and White South Africans were included in addition to Indian South Africans. Four cranial morphoscopic traits, were assessed on 408 modern South Africans (equal sex and population distribution). Frequencies, Chi-squared tests, binary logistic regression and random forest modelling were used to assess the data. Males were more robust than females for all populations, while White South African males were the most robust, and Black South African females were the most gracile. Population differences were noted among most groups for at least two variables, necessitating the creation of populations-specific binary logistic regression equations. Only White and Coloured South Africans were not significantly different. Indian South Africans obtained the highest correct classifications for binary logistic regression (94.1%) and random forest modelling (95.7%) and Coloured South Africans had the lowest correct classifications (88.8% and 88.0%, respectively). This study provides a description of the patterns of sexual dimorphism in four cranial morphoscopic traits in the current South African population, as well as binary logistic regression functions for sex estimation of Black, Coloured, Indian and White South Africans.

The Impact of Race and Socioeconomic Status on Transplant Accessibility and Outcomes: A Literature Review

Due to the high demand but low supply of donor organs, issues of organ allocation arise as patients on the waitlist are prioritized to determine who gets the next available organ. This literature review will review articles related to the racial and socioeconomic disparities in organ transplants and how they affect transplant access and outcomes. Patients of Black and minority (Hispanic and Native American) races had significantly lower rates of organ transplants as well as worse transplant outcomes including graft failure and post-operative complications (Bryce et al., 2009). Similarly, patients from lower socioeconomic status (SES) backgrounds (i.e. poverty or lack of private/commercial insurance) had lower rates of organ transplant surgeries but there has been no significant research done on the effect that SES specifically has on transplant outcomes. Further directions for future research should be investigating the role of SES on transplant outcomes. The findings of this literature review highlight the need for measures to make organ allocation more equitable; this can be done by factoring in the social determinants of health (SDOH) when prioritizing potential organ recipients to compensate for race and SES decreasing accessibility to transplants.

The Effects of Stigma Against HIV and Tuberculosis on Healthcare-Seeking Behavior Among Tibetan Refugees in Dharamshala, India

Patients who experience more severe symptoms of Ulcerative Colitis are associated with having greater socioeconomic challenges or higher social barrier scores (SBS). Inflammatory Bowel Disease describes two conditions, Ulcerative Colitis and Crohn's Disease, characterized by gastrointestinal (GI) tract inflammation. Ulcerative Colitis is a type of Inflammatory Bowel Disease (IBD) characterized by large intestine inflammation. Research has shown that multiple social determinants of health (SDOH) hinder achieving desirable health outcomes in the Inflammatory Bowel Disease community. These include financial strains, poor health literacy, and lack of access to education. Additionally, social barriers disproportionately affect non-Hispanic Black and Hispanic people.

The Effect of Socioeconomic Barriers on Health Outcomes in Patients with Inflammatory Bowel Disease

Patients who experience more severe symptoms of Ulcerative Colitis are associated with having greater socioeconomic challenges or higher social barrier scores (SBS). Inflammatory Bowel Disease describes two conditions, Ulcerative Colitis and Crohn's Disease, characterized by gastrointestinal (GI) tract inflammation. Ulcerative Colitis is a type of Inflammatory Bowel Disease (IBD) characterized by large intestine inflammation. Research has shown that multiple social determinants of health (SDOH) hinder achieving desirable health outcomes in the Inflammatory Bowel Disease community. These include financial strains, poor health literacy, and lack of access to education. Additionally, social barriers disproportionately affect non-Hispanic Black and Hispanic people.