Black Male Population Research Articles

Beyond monolithic threat: Understanding risk typology in court-involved Black male youth

Black male youth are at greatest risk of disparate contact and detention in the U.S. juvenile justice system. This study aims to identify recidivism risk/need patterns among African American male youth in the Ohio juvenile justice system, utilizing cluster analysis of risk assessment data from the Ohio Youth Assessment System-Disposition (OYAS-DIS). We found four distinct risk patterns and accompanying recidivism rates in the Black male youth population. Two of the clusters exhibited moderate levels of risk. However, they had significantly different recidivism outcomes, suggesting certain combinations of risk factors have more or less impact the propensity for crime in the Black male sample. Implications for policy and practice are discussed, as well as future directions for research.

Barber Knowledge and Recommendations for Pseudofolliculitis Barbae

This survey study describes an opportunity for a partnership between barbers and dermatologists to identify, evaluate, and treat pseudofolliculitis barbae in the Black male population.

Abstract B107: Disparities in lung cancer screening rates: A retrospective observational study

Abstract Introduction: Lung cancer is a leading cause of cancer deaths worldwide. Despite advances in cancer care, the low five-year survival rate for lung cancer is due to late-stage diagnoses. Early detection through lung cancer screening is vital for improving patient outcomes. However, racial disparities persist, with Black individuals experiencing higher rates and advanced stages of the disease. This retrospective study assessed racial and gender disparities in lung cancer screening rates among different racial groups at WakeMed Health and Hospital outpatient primary care clinics. Study design: The study utilized data from the lung cancer screening registry, focusing on the period between Jan 1st 2017 and May 15th 2023. The data was obtained from the EPIC electronic medical record system and exported to Excel. We implemented filters to narrow down the patient population that met the U.S. Preventive Services Task Force inclusion criteria for lung cancer screening. Eligible patients for lung cancer screening are those aged 50 to 80 years, either current smokers or individuals who quit smoking within the past 15 years and have a smoking history of at least 20 pack years. The study focused on three racial groups: Asian, Black, and White populations. Results: Among the 2,098 patients who met the inclusion criteria, 15.5% were Black (n=326), 0.01% were Asian (n=23), and 83.4% were White (n=1,749). The screening rates for lung cancer were calculated for each racial group. The Asian population had a screening rate of 26% (6 out of 23 patients), the Black population had a rate of 32% (103 out of 326 patients), and the White population had a rate of 31% (543 out of 1,749 patients). Among the Asian population, the screening rate for Asian males was 20% (4 out of 20 patients), while for Asian females, it was relatively higher at 67% (2 out of 3 patients). For the Black male population, the screening rate was 31% (52 out of 167 patients), while among females, it was 32% (51 out of 159 patients). Among the White population, white males were screened at a rate of 33% (313 out of 962 patients), while among females, it was slightly lower at 29% (230 out of 787 patients). Conclusion: The findings reveal no significant difference in lung cancer screening rates between racial groups or genders. Caution must be exercised when interpreting the findings for the Asian population due to the small sample size. Further research using a larger and more diverse dataset is necessary to draw more robust conclusions regarding potential disparities in lung cancer screening rates. This study underscores the importance of improving overall lung cancer screening rates, as the majority of the eligible population did not receive screening. Efforts will be made to implement interventions that enhance lung cancer screening rates, ensuring timely detection and improving patient outcomes. Addressing disparities in lung cancer screening access and utilization is crucial for achieving equitable healthcare and reducing the burden of lung cancer on vulnerable populations. Citation Format: Giuseppina Jacob, Amanpreet Dhaliwal, Praveen Namireddy. Disparities in lung cancer screening rates: A retrospective observational study [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B107.

Demystifying Male Emotional Development: Exploring the Implications of Forced Gender Roles on Black American Males

Statements like “ boys do not cry” and other teaching modalities of emotional blandness can negatively affect the Black American male population with lower emotional development in adulthood. The focus of this study was to understand the extent of self-described societal-forced gender roles in childhood on the emotional development of Black American adult men. A total of 35 participants were interviewed using a qualitative study to further explore these experiences. After analysis, this study determined gender roles and emotional maturity affected later development. Key themes included feeling inept, stigma, lack of understanding, and loneliness. The participants discussed how frustrating it could be to be considered less of a man by society. These frustrations can lead to increased medical issues such as cardiovascular disease and increased behavioral health issues such as substance use, anxiety, depression, and issues within intimate relationships, as women may be expecting more than they can give. Professionals can utilize the findings of the study to further develop processes to teach emotional development in Black American children and assist adult males with their journey toward emotional maturity.

State-Level Cardiovascular Mortality Rates Among Hispanic, Non-Hispanic Black, and Non-Hispanic White Populations, 1990 to 2019

Cardiovascular disease (CVD) is the leading cause of death in the US, with considerable variation by both state and race and ethnicity group. Consistent, comparable measures of mortality by specific CVD cause at the state level and by race and ethnicity have not previously been available and are necessary for supporting policy decisions aimed at reducing health inequities. To quantify and describe levels and trends of mortality due to overall CVD and its component causes for 3 mutually exclusive race and ethnicity groups and by state. This cross-sectional study used Census data, population surveys, and US vital registration records to estimate cause-specific cardiovascular mortality by state and by the following race and ethnicity groups, defined by the US Office of Management and Budget: Hispanic of any race, non-Hispanic Black (hereafter, Black), and non-Hispanic White (hereafter, White). Data were analyzed from January 2020 to September 2022. State of residence at time of death; Hispanic ethnicity and Black or White race. CVD death counts and mortality rates. An estimated 25 397 029 persons died of cardiovascular diseases from 1990 to 2019. The mean (SD) age of individuals was 78.20 (14.01); 13 087 290 individuals (51.53%) were female and 12 309 739 (48.47%) were male; 2 921 650 (11.50%) were Black, 1 159 498 (4.57%) were Hispanic, and 21 315 880 (83.93%) were White. Age-standardized CVD mortality per 100 000 persons in 2019 was 194.4 (95% uncertainty interval [UI], 172.7 to 207.4), 107.7 (95% UI, 92.9 to 121.4), and 153.8 (95% UI, 133.8 to 163.8) among Black, Hispanic, and White populations, respectively. The median (IQR) percentage change across states was smaller for 2010 to 2019 compared with 1990 to 2000 for both White female and White male populations (-6.8 [-10.1 to -4.3] vs -10.2 [-12.9 to -5.9] and -4.6 [-8.6 to -2.5] vs -16.5 [-19.3 to -15.4]). For the Black and Hispanic groups, the percentage change (IQR) was larger for the female populations for the latter time period (-15.1 [-18.9 to -11.7] vs -12.6 [-19.6 to -7.8] and -23.5 [-29.2 to -18.5] vs -8.2 [-17.8 to 5.96]). The converse was observed among male individuals in both groups, with smaller percentage change (IQR) values in 2010 to 2019 compared with 1990 to 2000 (-13.1 [-18.7 to -8.6] vs -18.6 [-25.5 to -14.7] among the Black male population and -20.4 [-25.6 to -15.6] vs -21.5 [-31.1 to -5.7] among the Hispanic male population). There was substantial variability at the state level for death due to total CVD and component causes in 2019 and changes in CVD mortality from 1990 through 2019. The findings of this study indicate that CVD mortality varied widely by state and race and ethnicity group. Changes over the time period were not consistent for all groups and varied by cardiovascular subcause. These results highlight ongoing health disparities in cardiovascular mortality.

Comparison of State-of-the-Art Neural Network Survival Models with the Pooled Cohort Equations for Cardiovascular Disease Risk Prediction

BackgroundThe Pooled Cohort Equations (PCEs) are race- and sex-specific Cox proportional hazards (PH)-based models used for 10-year atherosclerotic cardiovascular disease (ASCVD) risk prediction with acceptable discrimination. In recent years, neural network models have gained increasing popularity with their success in image recognition and text classification. Various survival neural network models have been proposed by combining survival analysis and neural network architecture to take advantage of the strengths from both. However, the performance of these survival neural network models compared to each other and to PCEs in ASCVD prediction is unknown.MethodsIn this study, we used 6 cohorts from the Lifetime Risk Pooling Project (with 5 cohorts as training/internal validation and one cohort as external validation) and compared the performance of the PCEs in 10-year ASCVD risk prediction with an all two-way interactions Cox PH model (Cox PH-TWI) and three state-of-the-art neural network survival models including Nnet-survival, Deepsurv, and Cox-nnet. For all the models, we used the same 7 covariates as used in the PCEs. We fitted each of the aforementioned models in white females, white males, black females, and black males, respectively. We evaluated models’ internal and external discrimination power and calibration.ResultsThe training/internal validation sample comprised 23216 individuals. The average age at baseline was 57.8 years old (SD = 9.6); 16% developed ASCVD during average follow-up of 10.50 (SD = 3.02) years. Based on 10 × 10 cross-validation, the method that had the highest C-statistics was Deepsurv (0.7371) for white males, Deepsurv and Cox PH-TWI (0.7972) for white females, PCE (0.6981) for black males, and Deepsurv (0.7886) for black females. In the external validation dataset, Deepsurv (0.7032), Cox-nnet (0.7282), PCE (0.6811), and Deepsurv (0.7316) had the highest C-statistics for white male, white female, black male, and black female population, respectively. Calibration plots showed that in 10 × 10 validation, all models had good calibration in all race and sex groups. In external validation, all models overestimated the risk for 10-year ASCVD.ConclusionsWe demonstrated the use of the state-of-the-art neural network survival models in ASCVD risk prediction. Neural network survival models had similar if not superior discrimination and calibration compared to PCEs.

Unveiling the Mask: Navigating the Depths of Black Men’s Mental Health

The objective of this article is to address the existing informational gap about the mental health of Black males. This article examines the phenomenon of intergenerational trauma among Black males, explores the historical events that have contributed to the emergence of hurdles faced by this demographic, and sheds light on the prevailing mental health diagnoses widespread within the Black male population. By consistently restating the established facts presented in this article and providing potential solutions, it is anticipated that this will attract the interest of mental health experts, educators in the field of social work, and policymakers. By fostering collaboration among academics, practitioners, and educators, a collective effort may be made to enhance our understanding of the mental health of Black males and identify strategies to effectively address their specific needs.

Drug Overdose Deaths Among Non-Hispanic Black Men in the U.S.: Age-Specific Projections Through 2025

Fatal drug overdoses have risen sharply in the U.S. since 2015, reaching their highest levels during the pandemic. Non-Hispanic Black men have been disproportionately harmed by this latest surge; overdose mortality per 100,000 has increased fourfold since 2015. Whether the mortality rate will continue to climb is unknown. In this study, we addressed the narrower question of which age groups are likely to experience a significant increase or decrease in the burden of drug overdose deaths through 2025, based on foreseeable changes in the age structure of the Black male population. We used the 2020 and provisional 2021 age-specific mortality rates from the Centers for Disease Control WONDER (Wide-Ranging Online Data for Epidemiologic Research) database and the standard population balancing equation to project overdose deaths in 2025. Overdose deaths were identified by ICD-10 codes. We bracketed the projections between 2 plausible alternatives: a pessimistic forecast based on time series extrapolations and an optimistic forecast that assumes success nationally in lowering overdose deaths through prevention, treatment, and harm reduction initiatives. Among Black men aged 31-47 years, overdose deaths in 2025 are expected to increase by 440 or 11% (95% CI=8%, 14%) relative to 2020. By contrast, overdose deaths among younger Black men aged 19-30 years are expected to decline by 160 or -9% (95% CI= -15%, -5%). Among older Black men aged 48-64 years, overdose deaths are also expected to decline by 330 or -7% (95% CI= -10%, -4%). Similar results were found using 2021 provisional mortality rates. Overdose deaths are predicted to increase significantly over current levels among Black men in their 30s and 40s. Local policy makers should direct harm reduction resources, such as naloxone kits, syringes, and fentanyl test strips, to places frequented by Black men in this age group. Outreach messaging should be tailored to resonate with men of middle age. Equally urgent is the scaling up of nonstigmatizing, evidence-based drug treatment and recovery support services in Black neighborhoods.

Epidemiologic Trends of Cutaneous T-Cell Lymphoma in Arkansas Reveals Demographic Disparities.

Simple SummaryCutaneous T-cell lymphomas (CTCLs) are rare non-Hodgkin’s lymphomas characterized by skin-homing T-cells, most represented by mycosis fungoides (MF) and Sézary syndrome (SS). While national statistics exist, a detailed demographic analysis for CTCL has not been reported in most states. With fluctuating population demographics in the United States, we present an updated epidemiologic analysis for two common variants of CTCL. We compared the CTCL patient population from a tertiary referral center at the University of Arkansas for Medical Sciences to the national Surveillance, Epidemiology, and End Results (SEER) database to gain insight into trends in prevalence and incidence, and to understand the underlying disparities. Our retrospective analysis revealed demographic disparities, among young black males, in the Arkansas CTCL population, which were similarly identified in the total United States CTCL population. In addition, we mapped out the geographic distribution of CTCL patients in Arkansas to identify possible environmental associations to CTCL. Our epidemiologic analysis of a tertiary academic center in relation to national data may provide greater insight into the various determinants that influence the disparities of CTCL.Accurate demographic data are critical for comprehending and treating cutaneous T-cell lymphoma (CTCL). Our research aimed to determine the demographics and incidence trends of CTCL patients in Arkansas compared to those of the national CTCL population to recognize the underlying disparities. We collected data from 143 CTCL patients at the University of Arkansas for Medical Sciences (UAMS) and national CTCL patient data from the Surveillance, Epidemiology, and End Results (SEER) database. Our analysis revealed that males are affected more than females across all ages and races. CTCL incidence and mortality data show that CTCL has a steady increase at the national level and in Arkansas while disproportionately affecting the young black male population. In Arkansas, more than one-third of black patients presented at an advanced stage (IIB+) compared to one-fifth in the white population, and the mean age of death was more than a decade younger for black (60 years) than for white patients (74.6 years). Nationally, black male patients had the greatest mortality rate (0.5) compared to 0.32 for white males. CTCL is 2.23 and 2.38 times more prevalent in urban versus rural areas in Arkansas and nationally, respectively. Most Arkansas patients reside near major interstates and chemical-emitting sites. In conclusion, our demographic analysis of Arkansas and national CTCL patients verifies recent trends toward more aggressive presentations in young black male patients, and our geographic findings suggest possible environmental risk factors.

A Survey Exploring Gendered Racism Experienced by Junior Doctors Working in Psychiatry

AimsTo measure rates of racism experienced and witnessed by Junior Doctors working at Derbyshire Healthcare NHS Foundation Trust.MethodsSurveys were sent out via e-mail and WhatsApp to all Junior Doctors from 22 November 2021 to 1 December 2021.Questions asked about personal experiences of racism, witnessing racism to/from patients and/or staff whilst working in Derbyshire, knowledge of how to report incidents and if routinely reported. Doctor race and gender recorded.Results88 Junior Doctors contacted. Response rate 55% (48 out of 88). 63% female, 35% male and 2% gender undisclosed. 37.5% White, 12.5% Black, 37.5% Asian, 6.3% Mixed-race, 4.2% Arab or other ethnic group and 2% Race undisclosed. 13% of doctors experienced racism from staff: 75% of the Black female population, 50% of the Black male population, 8% of the Asian female population and 17% of the Asian male population. 27% of doctors experienced racism from patients: 50% Black female population, 50% Black male population, 58% Asian female population, 16% Asian male population, 100% Mixed-race female population and 1 Race unspecified male. 13% of doctors witnessed racism from staff to other staff: 75% Black female population, 50% Black male population, 11% Asian female population and 16% Asian male population. 63% of doctors witnessed racism from patients towards staff: 75% Black female population, 50% Black male population, 67% Asian female population, 33% Asian male population, 100% of the Mixed-race population, 58% White female population, 83% of the White male population and by 1 male Race unspecified. Two reports of racism witnessed from staff towards patients. 50% of doctors do not know how to report racism. 54% of doctors would report racism if they knew how.ConclusionBlack, Asian, and Minority Ethnic (BAME) Junior Doctors are disproportionately affected by racism with female gender as an additional vulnerability. Mixed-race females, Asian females, and Black doctors gave highest reported experience of racism from patients. Black doctors gave a higher reported experience of racism from staff and reported witnessing the most racism from staff towards other staff. Mixed-race and White male doctors represent a high number of those that witness patients be racist towards staff. Additional support is required in encouraging allyship, confidence and ability to report racism.

It’s a Vibe: understanding the graduate school experiences of Black male engineering faculty

PurposeIn spite of ongoing and recent initiatives aimed at broadening participation in engineering, the representation of diverse groups of learners in engineering graduate programs in the USA remains a challenge. Foregrounding the voices of 26 Black male engineering faculty, this study aims to investigate how institutions might recruit and retain more Black men in engineering graduate programs.Design/methodology/approachFor this study, inductive thematic analysis was used.FindingsThe authors show that three themes, namely, representation as an asset, invested mentors and faculty, and supportive peer networks described as the “Vibe” manifest as crucial elements for successful recruitment and retention of Black men in engineering graduate programs.Originality/valueThese findings are meant to augment the conversation around diversity, equity and inclusion in engineering graduate programs and to address a dearth of published research on the Black male engineering population. This work is also meant to help institutions conceptualize ways to create a “Vibe” that might be transferable to their institution’s sociocultural context.

A glimpse into the future of esophageal carcinoma in the United States: Predicting the future incidence based on the current epidemiological data.

248 Background: Esophageal carcinoma is the 6th most common cause of death worldwide. While squamous cell carcinoma (SCC) was the most common among the histologic subtypes in the 20th century, recent reports have demonstrated an increased incidence of adenocarcinoma in both Eastern and Western world. With this changing paradigm of esophageal carcinoma, it is important to estimate the future burden of esophageal carcinoma by histology, age, sex, and race, that could help plan prevention, control, and treatment strategies for this cancer. Methods: We used Surveillance, Epidemiology, and End Results (SEER) 14 registries to obtain incidence data from 2000 to 2016. We applied age-period-cohort models to estimate future esophageal carcinoma incidence rates and the estimated disease burden by multiplying incidence forecasts by corresponding US Census population projections. Results: Our estimate suggests that the incidence (per 100,000 persons) of esophageal adenocarcinoma is increasing in people within the age group of 40-65 years. Our prediction showed that the incidence will increase from 2.12 in 2021 to 2.82 in 2030 (3.2% per year, 95% CI –2.3% to 9.1%, p=0.26). Notably, we noticed a similar marginal increase in incidence among Asians, Black, and Whites in the 40-65 years age group (3.1%, 3.2%, and 4.2%, per year, respectively). White males aged >65 years had the highest incidence of esophageal adenocarcinoma (17.34 in 2021), and incidence decreased 1.3% per year. We noticed a marginally decreased incidence in Black male (-1.1% per year, p=0.71) and Asian male (-3.9% per year, p=0.17) population aged >65 years. Interestingly, we found a decrease in the incidence of SCC in the current age groups 40-65 (-2.7% per year, p=0.31) and >65 years (-4.6% per year, p=0.081). We observed that Asians had the greatest decrease in incidence (-4.3% per year) as compared to that of Blacks (-4.2% per year) and Whites (-2.9% per year), although there was no statistically significant difference in the annual decrease among races. Conclusions: In our study of esophageal cancer, we predict an increased incidence of adenocarcinoma histology subtype in the younger age group (40-65 years) while the SCC subtype will have a decreased trend. Strategies to prevention esophageal adenocarcinoma, including dietary changes, should preferentially target patients <65 years of age.[Table: see text]

“Is my University White?” Exploring the role and influence of a University’s Culture on the experiences of Black Undergraduate Students in the UK

Abstract This paper explores the long-standing attainment gap between Black male students relative to other student populations, within Higher Education Institutions in the United Kingdom. This paper attempts to develop a contextual understanding of the parallel relationship between the social and academic culture at universities in the UK, as well as identifies the barriers which affect Black male students’ academic engagement. The purpose of this study is to answer the questions, “What is the Black male student experience at one university in the UK?” and “Which attitudes and practices at this university promote diversity and inclusivity and which hinder this?” The research was conducted via interview to gain a better understanding and acknowledgement of the multiple truths grounding this subject matter (Jones, 2015). The main participants were four Black male undergraduate home students, and four White academic staff members, at a University in the United Kingdom. This paper concludes by recognising that the meanings and attitudes attached to the attainment gap vary significantly. The key recommendations identified were the importance of raising Black representation within the staff, as well as developing a racially conscious atmosphere, in order to develop a sense of inclusion and belonging within the Black male student population.

"Know your epidemic, know your response": Epidemiological assessment of the substance use disorder crisis in the United States.

The United States (U.S.) is currently experiencing a substance use disorders (SUD) crisis with an unprecedented magnitude. The objective of this study was to recognize and characterize the most vulnerable populations at high risk of SUD mortality in the U.S., and to identify the locations where these vulnerable population are located. We obtained the most recent available mortality data for the U.S. population aged 15-84 (2005-2017) from the Centers for Diseases and Prevention (CDC). Our analysis focused on the unintentional substance poisoning to estimate SUD mortality. We computed health-related comorbidities and socioeconomic association with the SUD distribution. We identified the most affected populations and conducted a geographical clustering analysis to identify places with increased concentration of SUD related deaths. From 2005-2017, 463,717 SUD-related deaths occurred in the United States. White population was identified with the highest SUD death proportions. However, there was a surge of the SUD epidemic in the Black male population, with a sharp increase in the SUD-related death rate since 2014. We also found that an additional average day of mental distress might increase the relative risk of SUD-related mortality by 39%. The geographical distribution of the epidemic showed clustering in the West and Mid-west regions of the U.S. In conclusion, we found that the SUD epidemic in the U.S. is characterized by the emergence of several micro-epidemics of different intensities across demographic groups and locations within the country. The comprehensive description of the epidemic presented in this study could assist in the design and implementation of targeted policy interventions for addiction mitigation campaigns.

Economic growth as an underlying probable systemic driver for childhood obesity in South Africa: A Joinpoint regression and ecological analysis over 10 years.

Childhood obesity has become a global public health problem and is a known risk factor for type 2 diabetes, cardiovascular disease, hypertension, stroke, myocardial infarction and various cancers in later adulthood.Associations between adult obesity and economic growth, technological changes, socioeconomic status and economic inequities have been reported, but limited data are available for children and adolescents in countries that are undergoing an epidemiological health transition exhibiting both under- and overnutrition. To demonstrate childhood obesity trends and explore their associations with economic growth in South Africa (SA). This was a retrospective review and analysis of obesity and economic growth trends in SA. Data for obesity levels were obtained from national surveys conducted in SA youths in 2002, 2008 and 2012. Economic growth indicators (EGIs), namely gross domestic product (GDP) per capita, household final consumption expenditure and Gini coefficient, were obtained from the World Bank and IHS Global Insight databases. Obesity trends for 2002 - 2012 are presented by gender and ethnicity. Annual percentage changes (APCs) in obesity prevalence were computed to assess obesity trends using the linear Joinpoint regression. An overall increase in obesity prevalence over time from 3.8% to 6.0% was observed. Females had higher levels across all time points. APCs in both males (7.8%; 95% confidence interval (CI) 0.3 - 15.9; p=0.01) and females (3.1%; 95% CI -14.7 - 24.7; p=0.30) were observed. Among black Africans, coloureds and whites, females had higher obesity levels than males for the three time points. For males, the prevalence of obesity was highest in whites and Asians/Indians, whereas coloureds and blacks had lower levels across all time points. However, the black male population had the highest APC increase (9.4%; 95% CI -23.0 - 55.3; p=0.20). The prevalence of obesity was positively and inversely associated with GDP per capita and the Gini coefficient, respectively. An increase in childhood and adolescent obesity over time was observed, while trend associations between obesity and EGIs exist.

Modeling the Impact of Restricting Sugar‐Sweetened Beverages from SNAP Purchases on Children's Consumption and Risk of Dental Caries and Obesity

To evaluate the theoretical impact of restricting sugar‐sweetened beverage (SSB) purchases in the Supplemental Nutrition Assistance Program (SNAP) on calorie intake, dental caries, and obesity risk in children.Using SNAP participation and dietary consumption data from a nationally representative sample of children (ages 0 to 19) completing the National Health and Nutrition Examination Survey (2009‐2014, N = 9,753), we constructed a stochastic microsimulation model to evaluate the effectiveness of restricting SSB purchases in SNAP on childhood obesity and dental caries among children enrolled in the SNAP. We simulated the population over a 10‐year period to be consistent with policy planning horizons, and to minimize longitudinal uncertainty in our estimates. From the simulation, we assessed changes in SSB consumption, total daily calorie intake, body mass index (BMI), prevalence of obesity, and the incidence of dental caries given observed SSB consumption rates and differences in disease risks within the SNAP population as compared to the general US population. Sensitivity analyses were conducted to assess whether variations in food substitution patterns and SNAP enrollment rates could alter the benefits of the proposed program.Hypothetical cohort of US children aged less than 19 years, stratified by age, gender, race/ethnicity, income, and SNAP enrollment status.SSB consumption among the target SNAP participants was 105.2 grams/person/day (95% CI: 64.8, 145.6) higher than non‐SNAP participants, and restricting SSB purchases in SNAP would result in an estimated 108.3 grams lower SSB consumption per day (95% CI: −150.6, −66.0). The most SSB consumption reduction was observed among non‐Hispanic Black male population given higher baseline SSB consumption level. If SSB was substituted for 100% fruit juice and milk based on a recent review, a restriction on SSB purchases would be expected to reduce calorie intake by a net average of 16.9 kcal/person/day (95% CI: −18.4, −14.3) among SNAP participants, resulting in a 1.2 kg/m‐ (95% CI: −1.5, −0.8) decrease in BMI. Obesity prevalence would not be expected to decrease significantly based on this change in BMI, −4.7 percentage point (95% CI: −14.1, 4.7). The anticipated decrease in dental caries incidence averaged 49.0 per 10,000 (95% CI: −52.2, −45.8), 0.9% decline from baseline. When SSB was substituted for other most typically purchased food items by the SNAP participants, such as meat, vegetables, and frozen prepared foods, the participants consumed 5.1 more kcals/person/day (95% CI: 4.70, 5.54), but BMI or obesity prevalence among the participants was not significantly impacted by this change.Restricting SSB purchases in SNAP would be expected to significantly lower the risk of dental caries and BMI among children. However, it would not be expected to have a significant effect on obesity due to food substitutions.Children enrolled in the SNAP are at a higher risk of poor diet, including higher SSB consumption compared with non‐SNAP participants. Restricting SSB purchases in SNAP could potentially promote healthier diet, and significantly reduce dental caries—one of the most common chronic diseases of childhood in the United States.

Epidemiological and geospatial profile of the prescription opioid crisis in Ohio, United States

The underlying reasons behind the unprecedented increase of the mortality rates due to the opioid epidemics in the United States are still not fully uncovered. Most efforts have been focused on targeting opioids, but there is little information about vulnerable populations at high risk of opioid abuse and death. In this study, we used data from the Ohio Department of Health for deaths caused by prescription opioids from 2010–2017 to analyze the spatiotemporal dynamics of the opioid overdose epidemic. Our results showed a rapid increase in prescription opioid death rates among the white male population aged 30–39 but also a considerable increase among the black male population with an exponential growth trend. Our geospatial analysis suggests that the increasing rates of the opioid overdose epidemic in Ohio were driven by the epidemic hotspot areas. Our findings highlight the relevance of prioritizing public health measures targeting specific locations and vulnerable populations to mitigate the current opioids crisis.

Temporal and spatial trends and determinants of aggressive prostate cancer among Black and White men with prostate cancer

Few studies have reported temporal and spatial trends of aggressive prostate cancer (PC) among black men who are known to have more aggressive disease. We examined these trends for highly aggressive PC at diagnosis among black and white men in Pennsylvania (PA). Men, aged ≥ 40years, with a primary, clinical PC diagnosis were identified from the Pennsylvania Cancer Registry, 2004-2014. Joinpoint analysis was used to evaluate the temporal trend of highly aggressive PC (clinical/pathologic Gleason score ≥ 7 [4 + 3], clinical/pathologic tumor stage ≥ T3, or distant metastasis) and identify change points by race in which annual percent change (APC) was calculated. Logistic regression analyses were used to examine the association between race and highly aggressive PC, after adjusting for covariates with and without spatial dependence. There were 89,133 PC cases, which included 88.7% white and 11.3% black men. The APC of highly aggressive PC was 8.7% from 2011 to 2014 among white men and 3.6% from 2007 to 2014 among black men (p values ≤ 0.01). The greatest odds of having highly aggressive PC among black compared to white men were found in counties where the black male population was ≤ 5.3%. Highly aggressive PC increased for both black and white men in PA between 2004 and 2014. Black men had more aggressive disease, with the greatest odds in counties where the black male population was small. The increase in highly aggressive PC may be due to less screening for PC, resulting in more advanced disease at diagnosis.

RACIAL DISPARITIES IN RURAL-URBAN MORTALITY GAP IN THE UNITED STATES: A 24-YEAR LONGITUDINAL STUDY

Although overall life expectancy in the US has improved rapidly over the course of the 20th century and the racial gap in all-cause mortality has declined in recent decades, geographical disparities in mortality have increased in the last three decades. This research aims to study racial and geographical disparities by comparing the race and sex-specific mortality trends of the US rural and urban populations. We created a longitudinal county level analytic file of the US population 65 years and older, over the period of 1968 to 2015 obtained from CDC-WONDER and Area Health Resources Files. First, we used an OLS regression of age-adjusted mortality rate onto year indicators interaction with race and gender to depict the race and sex-specific trend in age-adjusted mortality rates. We also estimated the change in in mortality rate over time, for each race and gender, relative to values in 1968. Finally, we estimated race and sex specific trend in rural-urban mortality gap using state fixed effects regression. Our results indicate that racial gap in mortality rates has only declined in urban areas. Mortality rates of the whites in rural areas declined more rapidly than their Black counterparts, resulting in a gap that has been widening in the last three decades. The racial gap has increased considerably for males residing in rural counties not adjacent to an urban county. Thus, racial disparity in mortality has increased in rural areas, with a considerable widening between white and black male population living in the more remote rural areas.

Military Veterans and Neighborhood Racial Integration: VA Mortgage Lending Across Three Eras

The military has long been seen as an avenue for increasing racial equality for minorities, especially black Americans. In this article, we examine to what extent military veterans also experience residential integration by looking at neighborhood residential outcomes for black and white men utilizing the popular Veterans Affairs (VA) loan program to purchase a home. We draw on data from the Home Mortgage Disclosure Act (HMDA) to examine residential integration among white and black veteran homebuyers compared to homebuyers utilizing conventional loans over three major lending eras: 1990s, 2000–2007, and 2008–2015. By 2015, a quarter of all home purchase mortgages loans to black men were VA loans even though veterans made up only a tenth of the adult black male population. In our multivariate analyses, we uncover a sizeable combined swing toward neighborhood minority-white integration, 14.4% points, among black and white veterans who use VA loans. Compared to those with conventional loans, black veterans live in neighborhoods with 10% points fewer minorities and, white veterans, 4.4% points fewer whites. Our results illustrate how racial integration in the US military has the potential to foster lasting housing integration among veterans.