Demographic Groups Research Articles

Child Ability and Parental Attributions: Development and Validation of the Reasons for Children's Behavior Scale.

Parent attributions for children's behavior affect parenting practices and emotional reactions. The current study aimed to create a new measure of parental attributions, called the Reasons for Children's Behavior (RCB), to capture how parents take developmental ability into account when making attributions for specific behaviors. A 224-item survey was completed by 836 participants, including original items and established parent attribution and parenting construct scales. Exploratory factor analyses and item-response theory analyses were utilized to develop the RCB, which includes 30 items comprising seven subscales. The RCB demonstrated an extremely stable factor structure, high levels of internal consistency across 25 demographic groups, reasonable test-retest correlations across 2 weeks, appropriate convergent and discriminant validity, and unique predictive validity (i.e., incremental validity). The RCB offers researchers and clinicians a novel tool to better understand how parent attributions for child behavior impact parenting and larger family dynamics.

Preferred sources of information on diabetes prevention programmes: a population-based cross-sectional study in Poland.

This study aimed to analyse preferred sources of information on diabetes prevention programmes and to identify sociodemographic determinants influencing these preferences among adults in Poland. A cross-sectional survey was carried out between 15 and 18 September 2023 using a computer-assisted web interview. A self-prepared questionnaire included 10 questions on sources of information on type 2 diabetes prevention. Data were obtained from 1046 adults (18-82 years); 53.4% were females. Most respondents preferred email communication (46.4%), followed by a doctor or nurse (33.5%), and a letter or leaflet directly delivered to the mailbox (25.8%) for type 2 diabetes mellitus (DM2) prevention information. Younger respondents were more likely to indicate mass media (OR=1.81, 95% CI=1.12 to 2.95, p=0.01) and digital media (OR=1.65, 95% CI=1.02 to 2.67, p=0.04) as a source of information on DM2 prevention. Those who had higher education (OR=1.51, 95% CI=1.16 to 1.96, p=0.002), as well as those with chronic diseases (OR=1.50, 95% CI=1.14 to 1.97, p=0.004), were more likely to indicate digital media. Out of 10 different variables analysed in this study, passive occupational status (OR=1.43, 95% CI=1.04 to 1.96, p=0.03) as well as having chronic diseases (OR=1.51, 95% CI=1.16 to 1.96, p=0.002) were associated with higher odds of indicating healthcare workers as a preferred source of information. Marital status, having children, place of residence, household characteristics and financial status do not significantly decide communication preferences. Communication on DM2 prevention should be adjusted to public preferences and expectations. Tailoring interventions to different demographic groups can enhance outreach and engagement. Email emerged as a popular choice, suggesting the potential of digital communication in preventive health programmes.

Gender and race disparities in the prevalence of chronic kidney disease among individuals with hypertension in the United States, 2001–2016

BackgroundChronic kidney disease (CKD) is a common complication among individuals with hypertension. We aimed to identify the prevalence of CKD and the sex and race disparities within the hypertensive population in the United States from 2001–2016.MethodsA total of 16,148 participants with hypertension were included, representing 561,909,480 individuals from the U.S. population between 2001 and 2016, as documented in the National Health and Nutrition Examination Survey. The prevalence of albuminuria and CKD stage were assessed using survey-weighted general linear regression analysis. Heterogeneity in the CKD stage among the hypertensive population, stratified by sex and race, was identified through survey-weighted logistic regression analysis.ResultsOverall, the prevalence of albuminuria remained stable (p for trend = 0.3196), and changes in the CKD stage were minimal (p for trend > 0.05) from 2001–2016. In the analysis of CKD stage heterogeneity by sex and race, the prevalence of CKD was higher among women than men and higher among individuals of other races combined than non-Hispanic Whites, but the differences were not statistically significant.ConclusionThe overall CKD stage within the hypertensive population plateaued between 2001 and 2016. Our findings highlight the importance of continuous monitoring and potential refinement of renoprotection strategies in individuals with hypertension to mitigate the persistent burden of CKD and address health disparities among different demographic groups.

Feedback Loop Failure Modes in Medical Diagnosis: How Biases Can Emerge and Be Reinforced.

Medical diagnosis in practice connects to research through continuous feedback loops: Studies of diagnosed cases shape our understanding of disease, which shapes future diagnostic practice. Without accounting for an imperfect and complex diagnostic process in which some cases are more likely to be diagnosed correctly (or diagnosed at all), the feedback loop can inadvertently exacerbate future diagnostic errors and biases. A feedback loop failure occurs if misleading evidence about disease etiology encourages systematic errors that self-perpetuate, compromising future diagnoses and patient care. This article defines scenarios for feedback loop failure in medical diagnosis. Through simulated cases, we characterize how disease incidence, presentation, and risk factors can be misunderstood when observational data are summarized naive to biases arising from diagnostic error. A fourth simulation extends to a progressive disease. When severe cases of a disease are diagnosed more readily, less severe cases go undiagnosed, increasingly leading to underestimation of the prevalence and heterogeneity of the disease presentation. Observed differences in incidence and symptoms between demographic groups may be driven by differences in risk, presentation, the diagnostic process itself, or a combination of these. We suggested how perceptions about risk factors and representativeness may drive the likelihood of diagnosis. Differing diagnosis rates between patient groups can feed back to increasingly greater diagnostic errors and disparities in the timing of diagnosis and treatment. A feedback loop between past data and future medical practice may seem obviously beneficial. However, under plausible scenarios, poorly implemented feedback loops can degrade care. Direct summaries from observational data based on diagnosed individuals may be misleading, especially concerning those symptoms and risk factors that influence the diagnostic process itself. Current evidence about a disease can (and should) influence the diagnostic process. A feedback loop failure may occur if biased "evidence" encourages diagnostic errors, leading to future errors in the evidence base.When diagnostic accuracy varies for mild versus severe cases or between demographic groups, incorrect conclusions about disease prevalence and presentation will result without specifically accounting for such variability.Use of demographic characteristics in the diagnostic process should be done with careful justification, in particular avoiding potential cognitive biases and overcorrection.

Building an inclusive ecosystem for minority and women entrepreneurs: A case study of Columbus

We all agree that it is essential to build an inclusive entrepreneurship ecosystem for all kinds of people, particularly minority and women entrepreneurs, as the past studies are clear to demonstrate underperformance of those demographic groups. At the same time, we are only beginning to understand what kind of systemic barriers exist for women or minority entrepreneurs at the regional system level. Furthermore, it requires a different set of knowledge about how we can practically create an inclusive ecosystem. This paper applies the concept of equity planning for the context of economic development. This paper examines a case study of the City of Columbus, Ohio, in 2018–2019 in which the City Government actively promoted to build an inclusive ecosystem for women and minority entrepreneurs. We induce five essential steps that we could learn from this inclusionary practice which provide tangible implications for other city governments, nonprofit organizations, foundations, and other stakeholders of local entrepreneurship systems.

RURAL WOMEN PERCEPTIONS OF DIGITAL MEDIA INFLUENCE ON AWARENESS CREATION ABOUT MATERNAL HEALTH INFORMATION IN PUNJAB, PAKISTAN

In rural settings, access to maternal health information is often limited, contributing to disparities in maternal healthcare utilization and outcomes. The main objective of the study is to find the rural women perceptions of digital media influence on awareness creation about maternal health information in Punjab, Pakistan. This cross-sectional study was conducted at the University of Lahore from August 2023 to January 2024. Data was collected from 350 participants using convenience sampling methods. Data collection involved the administration of structured surveys to participants, either in-person or through electronic means, depending on their accessibility and preferences. The survey instrument was designed to capture demographic information, including age, education level, household income, and parity, as well as assess participants' access to digital media, frequency of usage, preferred platforms, and perceived usefulness of digital media for obtaining maternal health information. Data was collected from 350 participants. The mean age of the participants was 32.9±6.5 years Education levels varied, with 60% having primary education, 30% secondary, and 10% tertiary education. Regarding household income, 70% fell below the poverty line, while 30% were above it. Participants reported relatively high mean scores for their engagement with digital media platforms. Social media received the highest mean score of 3.8, followed by search engines with a mean score of 3.5, and maternal health websites/apps with a slightly lower mean score of 3.2. It is concluded that digital media, particularly social media platforms, play a significant role in providing access to maternal health information among rural women, despite variations in access and perceived usefulness across demographic groups.

Fairness Testing of Machine Translation Systems

Machine translation is integral to international communication and extensively employed in diverse human-related applications. Despite remarkable progress, fairness issues persist within current machine translation systems. In this paper, we propose FairMT, an automated fairness testing approach tailored for machine translation systems. FairMT operates on the assumption that translations of semantically similar sentences, containing protected attributes from distinct demographic groups, should maintain comparable meanings. It comprises three key steps: (1) test input generation, producing inputs covering various demographic groups; (2) test oracle generation, identifying potential unfair translations based on semantic similarity measurements; and (3) regression, discerning genuine fairness issues from those caused by low-quality translation. Leveraging FairMT, we conduct an empirical study on three leading machine translation systems—Google Translate, T5, and Transformer. Our investigation uncovers up to 832, 1,984, and 2,627 unfair translations across the three systems, respectively. Intriguingly, we observe that fair translations tend to exhibit superior translation performance, challenging the conventional wisdom of a fairness-performance trade-off prevalent in the fairness literature.

Empowering Sustainable Healthcare: The Role of Health Literacy

The imperative of sustainability in healthcare is becoming more pressing due to global health crises, climate change, and the rising burden of chronic diseases. Sustainability in healthcare involves social, economic, and environmental dimensions, each important for equitable and robust healthcare delivery. Health literacy may play a central role in embracing all three dimensions, bridging the gap between complex health information and individuals’ capability to understand and use it effectively: In fact, as a factor influencing the link between adverse social and economic conditions and subsequent health issues, health literacy could represent a practical target for mitigating health disparities within various demographic groups, thereby enhancing social sustainability. Furthermore, when people possess a solid understanding of their health conditions and the necessary steps for health management, they can contribute to a reduction in generated healthcare costs. Finally, health literacy and environmental health literacy equips individuals and communities with the knowledge and skills to understand how environmental factors affect health and empowers them to take proactive measures to protect the environment, potentially reducing the environmental impact of healthcare services. Therefore, integrating health literacy into education curricula and healthcare professional training is crucial for promoting sustainability. Despite some known barriers to the advancement and improvement of health literacy, such as limited awareness of its importance, the collaboration between academia, healthcare institutions, and community organizations is a path to follow to overcome these challenges.

Aspartame exposures in the US population: Demonstration of a novel approach for exposure estimates to food additives using NHANES data.

Exposure to food additives is widespread but up-to-date and accurate intake estimates are rarely available. The safety of the food additive aspartame is the subject of recent controversy and intake estimates for this nonnutritive sweetener are typically derived from surrogates such as diet soda consumption. We describe an approach for developing nationally representative dietary exposure estimates for food additives that combines intake from dietary recalls and grocery purchasing information. We combined NielsenIQ Homescan Consumer Panel purchasing data with the USDA Global Branded Food Products database and the National Health and Nutrition Examination Survey to estimate aspartame intake and prevalence of consumption for the US population. We examined points of departure for aspartame from CompTox Chemicals Dashboard to provide context for exposures and potential effects. Mean, 90th percentile, and 95th percentile aspartame intake estimates are below the acceptable daily intake (50 mg/kg/day) and are lower than estimates from previous decades. Groups with the highest aspartame intakes are non-Hispanic whites, 60- to 69-year-olds, and individuals on diabetic diets. Aspartame exposure is highly prevalent (62.6%) in the US including sensitive populations such as pregnant women and children. Exposure to the widely consumed food additive aspartame is not well characterized, and concerns about potential health effects remain despite assurances of safety when consumed under conditions of intended use. This work provides current intake estimates for the US population with important comparisons across demographic groups and individuals on special diets. The approach includes ingredient statement and grocery purchasing data to capture all aspartame-containing products, beyond diet soda, in intake estimates. This framework also has the potential for application to other food ingredients.

Eating Disorder Treatment Access in the United States: Perceived Inequities Among Treatment Seekers.

Although eating disorders are associated with high rates of psychological and physical impairments and mortality, only about 20% of individuals with eating disorders receive treatment. No study has comprehensively assessed treatment access for those with these disorders in the United States. The authors examined access to eating disorder treatments and how it might vary among some populations. Seekers of treatment for eating disorders (N=1,995) completed an online assessment of clinical demographic and anthropometric characteristics, barriers to eating disorder treatment access, and eating disorder symptomatology. Analyses were conducted to identify treatment access barriers, compare barriers to treatment access across demographic groups, and investigate relationships between barriers to treatment access and eating disorder symptoms. Financial barriers (e.g., lack of insurance coverage) were the most frequently reported barrier to treatment access. Participants with historically underrepresented identities and with a diagnosis of other specified feeding or eating disorder (OSFED) reported more barriers related to financial challenges, geographic location, eating disorder identification, sociocultural factors, and treatment quality compared with those with historically represented identities (e.g., White and cisgender persons). Higher frequencies of reported barriers to treatment access were associated with more severe eating disorder symptoms and poorer illness trajectories. Financial barriers were the most significant impediment to accessing treatment among individuals seeking eating disorder treatment. Barriers to treatment access disproportionally affected underrepresented groups and those with an OSFED diagnosis.

Unveiling Power Dynamics: Diversity Interpretations, Management Practices, and Inclusion Perceptions in the Workplace

The current diversity management literature highlights a lack of empirical investigations into nuanced diversity characteristics within specific contexts, with a predominant focus on the USA, Europe, and Asia. This article addresses these gaps by exploring the intricate relationship between interpretations of workforce diversity dimensions and ensuing diversity management practices, shaping perceptions of inclusion or exclusion. Workplace diversity is viewed subjectively, influenced by contextual factors like industry and location. A case study was conducted in June 2022 within a Japanese automotive company, gathering qualitative data through techniques such as semi-structured in-depth interviews and non-participant observations were made during two guided visits. AtlasTi was utilized for the analysis of results. Findings reveal that socio-economic differences' interpretation is swayed by power imbalances in labor relationships. Diversity management practices aligned with the dominant group exacerbate inequality among demographic groups, establishing metaphorical «glass ceilings» for minorities and fostering exclusion perceptions. Considering the case study’s limitations, the research contributes to the diversity management discourse, prompting a reevaluation of practices to mitigate unintentional inequality perpetuation in the workplace.

Navigating Grant Program Representative Bias: Insights from Paycheck Protection Program for Hospitality SMEs and Entrepreneurs

Allocation of public funding, such as those of government grants, can be influenced by subjective factors, similar to biases that research has found in commercial business lending based on organizational and ownership factors. However, there is limited research that has investigated biases in grant programs. Using data from the Paycheck Protection Program in the United States this study examined whether biases existed in grant programs for hospitality businesses. Results of regression analyses indicate that hospitality businesses received greater total loan amounts and smaller loan amounts per employee than businesses in other industries. Additionally, male business owners, White business owners, and corporations received greater loan amounts compared to other demographic groups. This study contributes to extending the current literature on commercial lending by enhancing our understanding of representative biases in government-directed lending programs for businesses.

Influence of Chatbot on Consumer Purchase Intention

This research explores the intricate relationship between chatbot interactions and consumer behaviour in online service delivery and decision-making processes. The study employs a mixed-methods approach, combining quantitative surveys and qualitative interviews, to investigate the impact of chatbots on purchase intention. Through a comprehensive sampling strategy targeting diverse online shoppers, the research aims to provide insights into various aspects of chatbot interactions across different demographic groups and product categories. Analysis tools such as Pearson correlation coefficients and significance testing reveal nuanced relationships between variables, highlighting factors influencing consumer perceptions and behaviour regarding chatbots. Findings suggest that age plays a role in the perceived need for assistance with chatbots, emphasizing the importance of demographic considerations in understanding user experiences. Overall, this research contributes valuable insights into optimizing chatbot functionalities to enhance consumer trust, satisfaction, and purchase intention, paving the way for more personalized and effective chatbot experiences in diverse cultural contexts. Keywords: Chatbots, Purchase Intention, Consumer Behavior, Online Service Delivery, Trust, Transparency, User Expectations, Cultural Considerations, Interactivity, User Control, Design Elements, Customer Satisfaction

Development and validation of the Enright Forgiveness Inventory 30-item version in Argentina

AbstractResearch on forgiveness has received growing academic interest. The Enright Forgiveness Inventory (EFI) is one of the most widely used interpersonal forgiveness measures in the world. However, its validation study had not been conducted in Latin America. This study aimed to investigate the structural validity of the EFI 30-item version (EFI-30) in Argentina. An online survey was administrated including the EFI-30 and a social desirability scale, as well as demographic questions. A convenience sample (N = 472) was recruited. All participants were originally from Argentina, and 47.2% were married or cohabiting in a relationship. Factor analysis was used to evaluate structural validity. Part of the EFI-30 is a single-item forgiveness question that was used to examine the inventory’s convergent validity. Other conventional psychometric tests were also performed to validate the previous analyses. The results confirmed the six-factor structure of the EFI-30, namely, positive affect, negative affect, positive behaviour, negative behaviour, positive cognition, and negative cognition. Findings are consistent with previous validation studies across countries. The strong scalability of the Argentine EFI-30 provides multiple avenues for future research. The study might be replicated among other demographic groups (e.g., adolescents) in Argentina.

Serving the unserved: a market segmentation, price discrimination based customer-centeric approach to home loans in india

The housing finance sector in India has witnessed remarkable growth in recent years, yet a significant portion of the population remains excluded from accessing formal home loan facilities. This master thesis report aims to address this gap by proposing a customer-centric approach to home loans, utilizing market segmentation and price discrimination strategies to serve the unserved segment of the market effectively. The study begins by identifying the need to bridge the gap in home loan accessibility and explores the reasons behind the exclusion of certain demographic groups. Through a comprehensive literature review, the report examines existing research on home loans, market segmentation, price discrimination, and customer-centric approaches in the financial services industry. The research methodology employed in this study utilizes a mixed-methods approach, combining qualitative and quantitative techniques to gather insights into the preferences, challenges, and perceptions of potential home loan borrowers. A carefully designed sampling plan ensures the representativeness and reliability of the data collected. Data analysis reveals patterns and trends within the home loan market, shedding light on the effectiveness of different segmentation and pricing strategies in reaching the unserved population. The questionnaire used for data collection is provided in the report, along with a discussion of the limitations, challenges, and barriers encountered during the research process. In conclusion, the report summarizes key findings and recommends strategies for policymakers, financial institutions, and other stakeholders to enhance inclusivity and efficiency in the home loan sector. By adopting a customer-centric approach and leveraging market segmentation and price discrimination techniques, the goal of serving the unserved can be achieved, contributing to greater financial inclusion and societal welfare.

The Prevalence of Anemia Among Vietnamese Children: A Systematic Review and Meta-Analysis.

While anemia constitutes a prevalent health issue among children in Vietnam, comprehensive aggregate data remain scarce. Consequently, the objective of this meta-analysis is to establish the pooled prevalence of anemia in the pediatric population of Vietnam. A comprehensive systematic search of existing prevalence studies was conducted up until June 2022, encompassing databases such as PubMed, Scopus, and the Cochrane Library, as well as reference list analysis. Pooled prevalence estimates, along with 95% confidence intervals (CIs), were calculated using a random-effects model. Publication bias was assessed using the Egger regression test and funnel plot inspection. Subgroup analyses were performed to identify potential variations in anemia prevalence across study groups. The pooled prevalence estimate for anemia among children under 10-year-olds amounted to 35.5% (95% CI = [23.9, 49.1]). Notably, gender-specific analyses unveiled distinct prevalence rates, with 37.8% among males and 33.4% among females. Furthermore, variations in anemia prevalence among Vietnamese children were evident across different demographic strata, encompassing gender, age groups, and rural or poor rural residency. The calculated pooled prevalence of anemia among children in Vietnam revealed a significant burden. Addressing this issue necessitates targeted interventions within specific regions and the implementation of government policies aligned with global targets for the eradication of childhood anemia.

Who Really Represents Me? The Case of Afro-Latinx Bureaucratic Representation in New York City Public Schools

Who Really Represents Me? The Case of Afro-Latinx Bureaucratic Representation in New York City Public Schools

Diagnostic performance of the bioline dengue duo rapid test on symptomatic patients assisted at Armed Forces Hospital (Hfa) in Brasília, Brazil.

Dengue necessitates accurate diagnosis. Rapid tests such as Bioline™ DENGUE DUO have gained traction, but validation in specific populations is essential. This study aimed to evaluate the performance of the Bioline™ test, alongside assessing the socio-epidemiological profile of symptomatic patients in a Brasília Military Hospital. The serum of 404 symptomatic patients was analyzed by the Bioline™ DENGUE DUO test, followed by Dengue virus detection and discrimination of the four serotypes by RT-qPCR. Accuracy was assessed using parameters including sensitivity (S), specificity (E), positive and negative predictive values (PPV and NPV), and positive (RV +) and negative (RV-) likelihood ratios. The NS1 component exhibited a sensitivity of 70.37%, a specificity of 97.30%, and an overall efficiency of 90.10% when compared to RT-qPCR as the gold standard. The IgM component demonstrated a sensitivity of 26.85%, a specificity of 89.53%, and an overall efficiency of 72.77% when compared to RT-qPCR as the gold standard. The IgG component demonstrated a sensitivity of 23.15%, a specificity of 68.92%, and an overall efficiency of 56.68% when compared to RT-qPCR as the gold standard. Several rapid tests are commercially available. However, considering variations across regions and demographic groups, it is important to question their accuracy in specific populations. Rapid tests are important screening tools, but they can have limitations for the certainty of diagnosis. Bioline™ DENGUE DUO displayed good specificity, but sensitivity was slightly below optimal levels. While helpful for confirming dengue, improvements are needed to effectively rule out the disease.

The Job Satisfaction Variation Due to Socio-Demographic Characteristics: An Indicator for CSR And Alignment with UN SDGs? Evidence in Healthcare Field in Turkey

This study seeks to examine the job satisfaction among different demographic groups of employees in the healthcare sector in Turkey. The study seeks to broaden the scope of job satisfaction by emphasizing its role as an indirect measure of the positive principles and practices that contribute to maintaining a high level of Corporate Social Responsibility (CSR) in line with the United Nations Sustainable Development Goals (UN SDGs) for groups of employees. This paper employed a survey to gather primary data. The survey forms utilized comprise two distinct sections. The initial section of the survey forms was determining the socio-demographic characteristics of the participants. The second portion of the poll utilized the Minnesota work satisfaction survey to measure job satisfaction. T-test and ANOVA are employed to detect disparities among separate employee categories. The findings suggest that there are disparities in the job satisfaction levels among employees belonging to at least two distinct groups with varying educational backgrounds (p > 0.040). Upon analyzing the job satisfaction of the staff based on their job positions, a notable disparity in job satisfaction was observed among at least two distinct employee groups in various roles (p > 0.009). No significant disparities in job satisfaction were seen across the employee groups based on age, marital status, parenting status, work experience, and monthly salary. Simultaneously, the paper establishes a connection between the job satisfaction and a more advanced level of corporate governance focused on CSR and aligned with the UN SDGs. This paper aims to explore the potential use of work satisfaction as an indicator in evaluating CSR and its alignment with the UN SDGs in the future. Received: 17 January 2024 / Accepted: 30 April 2024 / Published: 5 May 2024

Disparities in Multiple Myeloma Mortality Rate Trends by Demographic Status in the USA.

Multiple myeloma (MM) is a hematological malignancy that arises when plasma cells undergo malignant monoclonal proliferation. This study aimed to assess the demographic disparities and temporal trends in the mortality rates of this disease. We employed the Center for Disease Control and Prevention's Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) database. We found that for the overall U.S. population, the age-adjusted mortality rate per 1,000,000 (AAMR) decreased from 1999 to 2020. However, rates differed between demographic groups. In addition, we sought to find a significant average annual percent change (AAPC) in mortality rate from 1999 to 2020 for various demographic populations and compared groups to find disparities in mortality rate trend. In 2020, the AAMR due to MM was 38.0 and for women 24.1. The AAPC in AAMR from 1999 to 2020 in men was -1.0% (95%CI=-1.3 to -0.7) and in women was -1.6% (95%CI=-1.6 to -2.3). A significant difference in trend by sex was found, where women had a higher rate of decline. In 2020, the AAMR for the American Indian or Alaska Native (AI/AN) population was 15.0, the Asian American and Pacific Islander (AAPI) had 14.8, the Black and African American population had an AAMR of 55.6 and the White population had an AAMR of 28.1. The AAPC for the AI/AN population was -2.2% (95%CI=-3.5 to -0.9), for the AAPI population it was -0.9% (95%CI=-1.5 to -0.4), the Black and African American population had -1.5% (95%CI=-2.2 to -0.8) and the AAPC for the White population was -1.1% (95%CI=-1.6 to -0.6). A significant difference in trend of decline was found between the AAPI and Black and African American populations and between the AI/AN and Black and African American populations. When assessing the U.S. by states, the mid-southeast U.S. had the greatest density of the states with high AAMRs. These findings suggest which populations are at increased risk for mortality due to multiple myeloma and where we should apply additional resources and research.