Ethnic Group Differences Research Articles

Racial and ethnic group differences in service utilization in children with autism spectrum disorder: The role of parental stigma.

Racial and ethnic disparities in service utilization in autism are widely documented. Autism-related parental stigma may play a role if parents from racial/ethnic minoritized backgrounds experience dual stigma from autism and from membership in a marginalized group. This study examines racial/ethnic differences in autism-related stigma and compares the impact of stigma on service utilization in a large, diverse sample of US-based parents of autistic children (final sample = 764; White 41.6%, Black 16.6%, Latino/a/x/Hispanic 20.9%, Asian 7.5%, Multiracial 9.6%, Native American 1.8%, Pacific Islander 0.5%, Middle Eastern 0.2%, and Other 0.2%). Parents completed online surveys assessing affiliate and community stigma, service utilization, and perceived unmet treatment needs. Small but significant racial/ethnic group differences emerged in some aspects of stigma and service utilization. Specifically, Asian and Latino/a/x parents were less likely to fully engage in recommended services; Asian parents endorsed less service availability; Latino/a/x and multiracial parents reported more unmet needs; and Asian and White parents reported significantly more affiliate stigma. There was little indication that stigma contributed to racial/ethnic differences in service utilization, except for Asian families. Results indicate that socioeconomic factors interact with race/ethnicity to impact service use and stigma.

Examining Whether Patient Portal and Video Visit Use Differs by Race and Ethnicity Among Older Adults in a US Integrated Health Care Delivery System: Cross-Sectional Electronic Health Record and Survey-Based Study.

Health care systems are increasingly encouraging patients to use patient portals and participate in video visits. However, there is limited information about how portal use differs among older adults. This study aimed to understand how patient portal and video visit use differed by age, race, and ethnicity among older adult patients with access to the same digital health resources. This cross-sectional study used electronic health record and survey data for adults aged 65 to 85 years who were members of a large Northern California health care delivery system throughout 2019 and 2020. The electronic health record cohort (N=471,152) included 320,686 White, 35,892 Black, 44,922 Latino, 20,786 Chinese, 28,732 Filipino, 8473 South Asian, 6716 Japanese, 2930 Vietnamese, and 2015 Korean adults. Racial and ethnic group and age group (65 to 75 years vs 76 to 85 years) differences in having a patient portal account by December 2020, the performance of 2 portal activities (sending ≥1 message to a clinician in 2019 or 2020 and viewing ≥1 laboratory test result in 2020), and having ≥1 video visit during 2020 were examined. Modified log-Poisson regression was used to examine prevalence ratios for portal and video visit use, comparing racial and ethnic groups to White adults and Asian ethnic groups to Chinese adults after adjusting for sex and age. Data from a 2020 member survey were used to compare internet use factors among 2867 White, 306 Black, 343 Latino, 225 Chinese, and 242 Filipino adults. Black, Latino, and Filipino adults were less likely to have a patient portal account than White adults, and Filipino adults were less likely to have a patient portal account than Chinese adults. Black, Latino, Filipino, Korean, Vietnamese, and South Asian adults were less likely to have sent messages and viewed test results than White adults, while Chinese and Japanese adults' use of these features was similar to that of White adults. Filipino, Vietnamese, and Korean adults were less likely to have performed the aforementioned activities than Chinese adults. Video visit use was lower among Black and Latino adults and higher among Chinese and South Asian adults compared with White adults (aged 76 to 85 years) and lower among Filipino, Korean, and Vietnamese adults compared to Chinese adults. Survey data suggested that underlying differences in internet use may partially explain the lower use of messaging by Black, Latino, and Filipino adults compared with White and Chinese adults. Patient portal and video visit use differed by race, ethnicity, and age group among older adult patients with access to the same patient portal. Internet use factors may contribute to these differences. Differences in patient portal and video visit use across Asian subgroups underscore the importance of disaggregating use data by Asian ethnicity.

Dietary patterns in ethnic minority groups: data analysis of vegetable intake from ‘Understanding Society’ (the UK Household Longitudinal Study)

The UK population is ageing and becoming more ethnically diverse(1). Nutrition is a key modifiable determinant of healthy ageing but there is little published data of dietary patterns in ethnic minority groups. The reasons for poor dietary habits of older adults from ethnic minority groups could be attributed to cost of living, language barriers, age, availability of traditional foods(2). As part of a larger research study to improve nutritional health in older adults (TANGERINE: nuTritional heAlth aNd aGeing in oldER ethnIc miNoritiEs), the aim of this study was to investigate vegetable intake in different older ethnic groups compared with a white (British) reference population.We used food frequency questionnaire (FFQ) data drawn from Wave 2 (2010-2012) and Wave 13 (2021-2022) of Understanding Society, a UK household panel survey(3). We calculated the proportions of vegetable intake by ethnic group for each wave, weighted for population representativeness, and used (weighted) logistic regression for intake (everyday vs less than every day) to adjust for potential confounders. Data from the WHO food insecurity questionnaire in wave 13 was used to evaluate the ethnic group differences in food insecurity.The percentage vegetable intake at least every day was reduced between Waves 2 and 13 in all ethnic groups. At both Waves all ethnic groups, except Indian ethnicity have lower vegetable intakes than white (British) reference group. The age and sex adjusted odds ratios (OR) (95% confidence intervals) at Wave 2 were 0.60 (0.51, 0.71) for Caribbean, 0.67 (0.56, 0.79) for African, 0.36 (0.28, 0.44) for Pakistani, 0.78 (0.62, 0.98) for Bangladeshi and 1.10 (0.94, 1.28) for Indian. The differences could be largely explained by lower income and greater area deprivation for Bangladeshi, less so for Caribbean, African and Pakistani groups. Results were similar for Wave 13. All ethnic groups, except Indian had higher odds of greater food insecurity than the white (British) reference group, largely attributed to income and area deprivation, for example, the OR for Pakistani group compared with white (British) reference group decreased from 1.74 (1.18, 2.56) to 1.05 (0.70, 1.58). However, for the African group, the OR remained greater than white reference population at 2.55 (1.73, 3.76) even after accounting for socioeconomic position.The findings suggest differences in vegetable intake between different ethnic groups which have been maintained between 2010-2012 and 2021-2022 and may be explained to some extent by socioeconomic disadvantage. Whilst we used cross-sectional analyses of self-reported data, there remains a need for further large-scale studies using longitudinal and experimental designs in older ethnic groups considering socioeconomic position, recognising the importance of heterogeneity and the need to analyse ethnic groups individually, rather than as a group for measurements of dietary intake.

Do immigrant women spend more time on unpaid labor? Generational differences by race, ethnicity, and household composition in household work within the United States

ABSTRACT Despite relative progress, it is an overt fact that women still take on the heavier burden of unpaid work in the household compared to men in the United States. Our study expands the horizons of previous studies by looking at women specifically and analyzes how women’s performance of unpaid labor differentiates based on various contexts such as generational status, household composition, race, and ethnicity. Using the pooled cross-sectional data from the 2011-2021 American Time Use Survey (ATUS), we test hypotheses derived from an absolute resources perspective and a structural perspective to examine migrant generational differences among married, cohabiting, and single women as well as investigate the intra-group differences of racial and ethnic groups. From our descriptive analysis and ordinary least squares (OLS) regression analyses, we find support for the structural perspective for housework, as the generational differences remain even after controlling for socioeconomic factors, but only for first-generation married women. However, socioeconomic factors account for the differences between cohabiting or single first-generation women, which is supported by the absolute resources perspective. Our intra-group analysis by racial and ethnic groups yielded similar findings but found that Hispanic and Asian first-generation women take on a larger proportion of housework, relative to later-generation women.

7442 Racial Disparities On Outcomes Of Hypoglycemia

Abstract Disclosure: S. Neupane: None. B. Neupane: None. S. Karki: None. U. Farooq: None. M. Quartuccio: None. Introduction: Numerous studies have been conducted on the differences in racial and ethnic groups' access to healthcare; some groups face greater challenges when it comes to insurance coverage and other healthcare services compared to others. Risk factors that may contribute to hypoglycemia include advanced age, concomitant conditions, aggressive hyperglycemia therapy, etc. Research on racial differences in hypoglycemia is limited. Objective:To investigate potential disparities in mortality rates, length of stay (LOS), and overall hospitalization costs between the white and black populations with the diagnosis of hypoglycemia. Methods: Using the National Inpatient Sample (NIS) for the years 2017 through 2020, we carried out a retrospective cohort study of adult patients (age >18) with a primary diagnosis of hypoglycemia. The disease and outcome codes were chosen using the International Classification of Diseases (ICD-10). The analysis was conducted using STATA. Adjusting for potential variables and calculating the adjusted odds ratio(aOR) were done using multivariate regression analysis. The student t-test was utilized to compare continuous variables, while the Fisher exact test was employed to compare proportions. Mortality was the primary outcome of the study; other secondary outcomes included LOS, total hospitalization costs, acute coronary syndrome (ACS), septic shock, pulmonary edema, acute respiratory failure (ARF), mechanical ventilation, acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and cerebrovascular accidents (CVA). Results: There was a total of 804,164 patients with the diagnosis of hypoglycemia; out of them, 515,264 were white, 200,955 were black, and the rest were from other races besides white and black. Blacks had increased LOS than whites by 0.53 days, (6.92 days vs. 7.87 days, p<0.001) and rates of mechanical ventilation (11.96% vs.10.05%, p<0.001). There were other significant outcomes in rates of acute coronary syndrome (1.59% vs.1.38%, p<0.001), septic shock (10.07% vs. 9.90%, p=0.028), and ARF (16.10% vs. 15.27%, p<0.001) on white compared to black population. There was no significant difference in the outcomes of mortality rates, total hospitalization costs, pulmonary edema, ARDS, AKI, and CVA in white compared to black population. Conclusion: In comparison to the black population, the white population had an increase in rates of ACS, septic shock, and ARF. The overall rate of LOS and mechanical ventilation was higher in the black population than in the white population. The rates of mortality, total hospital costs, pulmonary edema, ARDS, AKI, and CVA did not differ between the two groups. To prevent poorer outcomes, more research is needed to understand the pathophysiology and underlying reasons for racial differences in hypoglycemia. Presentation: 6/1/2024

Individual, household, and socio-economic predictors of COVID-19 testing and vaccination outcomes: a whole population linked data analysis

ObjectiveThe COVID-19 pandemic has exposed numerous social inequities in health outcomes across nations, despite early warnings of their potential. Poorer outcomes for ethnic minorities, and to a lesser extent Indigenous peoples, have been widely reported, and may be explained in part by household conditions and poorer socio-economic circumstances. This study aimed to identify the effects of diverse individual and social conditions on COVID-19 outcomes within the New Zealand population. MethodWe conducted a whole population analysis of the association between individual (e.g. ethnicity, disability status), household (e.g. household composition), and socio-economic (e.g. crowding, housing quality, income) factors and four COVID-19 health outcomes – infection, hospitalisation, mortality, and vaccination status. We constructed variables of interest from linked administrative data in New Zealand’s Integrated Data Infrastructure, and examined associations within the 2018 Census usually resident population (analysis Ns = 518,571 - 3,216,696). ResultsAnalyses showed that Māori (the Indigenous people of New Zealand) and Pacific peoples, an ethnic minority, experienced worse outcomes than other New Zealanders across all COVID-19 outcomes. These ethnic group differences were persistent, yet reduced, when accounting for household and socio-economic variables. Factors including disability status, high housing mobility, poor quality housing, and household crowding were also widely predictive of worse outcomes. ConclusionEthnic inequity in a range of COVID-19 outcomes is present in a country where the overall impacts of the pandemic were relatively limited. Individual, household, and socio-economic factors are associated with diverse COVID-19 outcomes, and policy amenable factors may help explain the presence of ethnic inequities.

Video and phone visit use differed by language preference among U.S. Latino and Chinese adults during the first 9 months of the COVID-19 pandemic: a cross-sectional electronic health record study

BackgroundDuring the first nine months of the COVID-19 emergency, patients were encouraged to use virtual versus clinic visits if in-person care was not deemed necessary by clinical staff. This study examined the association of spoken language preference and ethnicity with use of video versus phone virtual visits by US Latino and Chinese adult patients who got care in the same healthcare system.MethodsWe analyzed electronic health record data for four groups of adults aged 26-85y who had ≥ 1 primary or specialty care outpatient clinician visits during April-December 2020: 80,869 Latino adults preferring Spanish (LEP Latino); 214,765 Latino adults preferring English (non-LEP Latino); 23,430 Chinese adults preferring a Chinese dialect (LEP Chinese); and 49,710 Chinese adults preferring English (non-LEP Chinese). Prevalence of the following utilization outcomes were compared by language preference (LEP/non-LEP) within ethnicity and by ethnicity within language preference for four age subgroups (26-39y, 40-64y, 65-75y, and 76-85y): ≥ 1 virtual (video or phone) visit, ≥ 1 video visit, ≥ 1 phone visit, ≥ 1 clinic visit, video visits only, and phone visits only. We also compared ethnicity x language group differences within age subgroups using absolute difference and adjusted prevalence ratios derived from modified log-Poisson regression models that controlled for age and sex.ResultsAmong virtual users, LEP Latino and Chinese adults were significantly less likely to use video visits and more likely to use phone visits than non-LEP Latino and Chinese adults in the same age strata. The LEP/non-LEP difference in video visit use was significantly larger among Latino than Chinese patients, with no similar ethnic group difference observed for phone visits. Within the LEP and non-LEP language groups, Chinese adults were significantly more likely than Latino adults to use video visits and less likely to use phone visits.ConclusionsDuring the first nine months of the COVID-19 pandemic, uptake of video and phone virtual visits by Latino and Chinese adults significantly differed by LEP/non-LEP status within ethnicity and by ethnicity within LEP/non-LEP language group. These findings underscore the importance of disaggregating data by ethnicity and language preference when attempting to understand and study patient use of different virtual visit modalities.

General mental ability testing and adverse impact in the United Kingdom: a meta-analysis with more than two million observations

ABSTRACT We review ethnic group differences on high-stakes General Mental Ability (GMA) tests based on 21st century UK data. Thereafter, we meta-analyse scores on 23 occupational, public sector, educational, military, or general-public selection tests, with a sample size exceeding two million. Relative to White GMA, the grand meta-analytic effect sizes (Cohen’s d) by major ethnic groups were: Mixed d = .14 (k = 24, N = 67,114), Blacks d = .65 (k = 32, N = 112,975), Asians d = .33 (k = 32, N = 311,695), and Other d = .49 (k = 24, N = 42,846). Further, although Chinese residents outscored White British residents (d = −.15, k = 20, N = 18,897), all other Asian ethnic groups scored slightly to substantially lower. For example, South Asians as a whole averaged d = .37; k = 13, N = 67,566. By subgroups, these averages were: Indians (d = .17, k = 10, N = 28,236), Pakistanis (d = .49, k = 9, N = 19,371), and Bangladeshi (d = .55, k = 7, N = 19,772). Implications for practice and theory are discussed.

Estimating dementia incidence in insured older Asian Americans and Pacific Islanders in California: an application of inverse odds of selection weights.

Literature shows heterogeneous age-standardized dementia incidence rates across US Asian American, Native Hawaiian, and Pacific Islanders (AANHPI), but no estimates of population-representative dementia incidence exist due to lack of AANHPI longitudinal probability samples. We compared harmonized characteristics between AANHPI Kaiser Permanente Northern California members (KPNC cohort) and the target population of AANHPI 60+ with private or Medicare insurance using the California Health Interview Survey. We used stabilized inverse odds of selection weights (sIOSW) to estimate ethnicity-specific crude and age-standardized dementia incidence rates and cumulative risk by age 90 in the target population. Differences between the KPNC cohort and target population varied by ethnicity. sIOSW eliminated most differences in larger ethnic groups; some differences remained in smaller groups. Estimated crude dementia incidence rates using sIOSW (versus unweighted) were similar in Chinese, Filipinos, Pacific Islanders and Vietnamese, and higher in Japanese, Koreans, and South Asians. Unweighted and weighted age-standardized incidence rates differed for South Asians. Unweighted and weighted cumulative risk were similar for all groups. We estimated the first population-representative dementia incidence rates and cumulative risk in AANHPI ethnic groups. We encountered some estimation problems and weighted estimates were imprecise, highlighting challenges using weighting to extend inferences to target populations.

The Relationship among Emotional Stability Personality Traits, Self-efficacy and Organizational Commitments of Managers and Subordinates in Nepalese Saving and Credit Cooperatives

The Saving and Credit Cooperative is a member-owned financial institution. The primary goal is to mobilize funds to improve the members' and society's socioeconomic position to generate profit within the community and its members. We examined the relationship between emotional stability (neuroticism), affective commitment, normative commitment, and continuance commitment of managers of saving and credit cooperatives in Kathmandu District. Likewise, the study investigated managerial-level employees’ self-efficacy and affective commitment. The study found the differences in commitment levels of managerial-level ethnic groups of SACCOS. The study found differences in organizational commitment levels between managerial-level employees and subordinates of SACCOS. The study has used three standardized questionnaires: The mini-IPIP Scale, the General Perceived Self-efficacy Scale, and the Organizational Commitment Scale. A purposive sampling method was administered (N=826). The data was collected from 206 SACCOS in the Kathmandu District. The samples were 189 managers and 637 subordinates of SACCOS respectively. A descriptive analysis was performed as well as Spearman’s Rank Correlation Coefficient, the Mann-Whitney U Test, and the Kruskal-Wallis H test were used to carry out the statistical analysis of the data. Emotional stability personality trait was negatively correlated with affective commitment and however, continuance, & normative commitment were insignificant. The results showed the differences in organizational commitment between the managerial position and subordinates. The organizational commitment did not find differences in ethnic groups of SACCOS.

Ethnic Group Differences in the Timing of Autism Diagnosis, Intellectual Disability, and Educational Placement of Autistic Children in Singapore.

Given Singapore's distinct multicultural identity, this study examined the hypotheses that there may be ethnic group differences in diagnosis and outcomes in autistic children in Singapore. Retrospective data were obtained from medical records of all children born between 2008 and 2011 who were diagnosed with clinical or confirmed autism. One-way ANOVAs and regression analyses were used to analyze data. Data from 2577 medical records were extracted. There were more boys (82.5%) and ethnic group distribution was Chinese (67%), Malay (14%), Indian (10%), and Others (10%). Chinese children were more likely to present at a developmental clinic with concerns 3-4months younger compared to Malay children and those from Other Races (F(3, 2038) = 9.58, p < .001, Cohen's F = 0.12). Chinese children were also more likely to receive an autism diagnosis approximately 3months younger compared to Malay children. Fewer autistic Chinese children were diagnosed with co-occurring intellectual disability (13.1%) while there were almost twice more Malay children than expected with co-occurring intellectual disability (29.9%) (χ2 (3) = 55.17, p < .001). There are correspondingly more Malay children on the autism spectrum who attend special education schools. Possible confounding variables such as household income level and mother's level of education were identified in some of these findings. Several significant ethnic group differences in autistic children in Singapore exist that warrant more investigation into possible causes and support systems needed, with implications for other ethnically diverse nations.

Http://ejournal.ukm.my/ebangi/article/view/66930/14895

Youth exposure to financial literacy information has become common in today's digital age, providing students with early financial management skills for a lifetime of well-being. However, easy access to technology and information doesn't always translate into financial literacy skills for today's students. This study aims to comprehensively understand financial literacy among undergraduates at Universiti Sains Malaysia, describing gender and ethnic group differences. It applied the theory of embeddedness to explain financial literacy variations across family backgrounds, friend networks, gender, and ethnicity. A single-stage non-probability sampling method was used. Employing purposive and quota sampling, ten informants from diverse backgrounds were interviewed. Grounded theory with open coding, axial coding, and selective coding was employed for data analysis. The findings show that undergraduate financial literacy is primarily shaped by family and social networks, where young individuals continuously develop and enhance their financial knowledge. The findings implied that educators and policymakers can customize strategies for young individuals, aligning financial literacy promotion with real-life experiences of young people which can contribute to long-term solutions for reducing youth bankruptcy.

Factors Associated with the Decision to Complete Bariatric Metabolic Surgery among a Racially and Ethnically Diverse Sample of Adults: A Classification and Regression Tree Analysis.

Less than 50% of eligible candidates who are referred complete Bariatric Metabolic Surgery (BMS). The factors influencing the decision to complete BMS, particularly how these factors vary across different racial and ethnic groups, remain largely unexplored. This prospective cohort study included adult patients referred to a bariatric surgeon or obesity medicine program between July 2019-September 2022. Sociodemographic characteristics, body mass index (BMI), anxiety, depression, body appreciation, and patient-physician relationship information were collected via survey and electronic health records. The association between BMS completion and potential decision-driving factors was examined using Classification and Regression Tree (CART) analysis. A total of 406 BMS -eligible patients participated in the study (mean [SD] age: 47.5 [11.6] years; 87.2% women; 18.0% Hispanic, 39% non-Hispanic Black [NHB], and 39% non-Hispanic White [NHW]; mean [SD] BMI: 45.9 [10.1] kg/m2). A total of 147 participants (36.2%) completed BMS. Overall, the most influential factor driving the decision to complete BMS was younger age (< 68.4years), higher patient satisfaction, and BMI (≥ 38.0kg/m2). Hispanic participants prioritized age (< 55.4years), female sex, and body appreciation. For NHB participants, the highest ranked factors were age < 56.3years, BMI ≥ 35.8kg/m2, and higher patient satisfaction. For NHW patients, the most influential factors were age (39.1 to 68.6years) and higher body appreciation. These findings highlight racial and ethnic group differences in the factors motivating individuals to complete BMS. By acknowledging these differences, healthcare providers can support patients from different backgrounds more effectively in their decision-making process regarding BMS.

Sociodemographic characteristics and longitudinal progression of multimorbidity: A multistate modelling analysis of a large primary care records dataset in England.

Multimorbidity, characterised by the coexistence of multiple chronic conditions in an individual, is a rising public health concern. While much of the existing research has focused on cross-sectional patterns of multimorbidity, there remains a need to better understand the longitudinal accumulation of diseases. This includes examining the associations between important sociodemographic characteristics and the rate of progression of chronic conditions. We utilised electronic primary care records from 13.48 million participants in England, drawn from the Clinical Practice Research Datalink (CPRD Aurum), spanning from 2005 to 2020 with a median follow-up of 4.71 years (IQR: 1.78, 11.28). The study focused on 5 important chronic conditions: cardiovascular disease (CVD), type 2 diabetes (T2D), chronic kidney disease (CKD), heart failure (HF), and mental health (MH) conditions. Key sociodemographic characteristics considered include ethnicity, social and material deprivation, gender, and age. We employed a flexible spline-based parametric multistate model to investigate the associations between these sociodemographic characteristics and the rate of different disease transitions throughout multimorbidity development. Our findings reveal distinct association patterns across different disease transition types. Deprivation, gender, and age generally demonstrated stronger associations with disease diagnosis compared to ethnic group differences. Notably, the impact of these factors tended to attenuate with an increase in the number of preexisting conditions, especially for deprivation, gender, and age. For example, the hazard ratio (HR) (95% CI; p-value) for the association of deprivation with T2D diagnosis (comparing the most deprived quintile to the least deprived) is 1.76 ([1.74, 1.78]; p < 0.001) for those with no preexisting conditions and decreases to 0.95 ([0.75, 1.21]; p = 0.69) with 4 preexisting conditions. Furthermore, the impact of deprivation, gender, and age was typically more pronounced when transitioning from an MH condition. For instance, the HR (95% CI; p-value) for the association of deprivation with T2D diagnosis when transitioning from MH is 2.03 ([1.95, 2.12], p < 0.001), compared to transitions from CVD 1.50 ([1.43, 1.58], p < 0.001), CKD 1.37 ([1.30, 1.44], p < 0.001), and HF 1.55 ([1.34, 1.79], p < 0.001). A primary limitation of our study is that potential diagnostic inaccuracies in primary care records, such as underdiagnosis, overdiagnosis, or ascertainment bias of chronic conditions, could influence our results. Our results indicate that early phases of multimorbidity development could warrant increased attention. The potential importance of earlier detection and intervention of chronic conditions is underscored, particularly for MH conditions and higher-risk populations. These insights may have important implications for the management of multimorbidity.

Analysis of the Cultural Characteristics of Loanwords in International Chinese Textbooks

There is an increasingly urgent need for international students to learn and use loanwords in intercultural communication. Chinese loanwords in international Chinese textbooks have certain research value. With the textbook Development Chinese Intermediate synthesis as the investigation object and the Xinhua Dictionary of Loanable Words as the retrieval tool, the analysis of the Chinese loanwords is conducted by data analysis. It is found that the number of Chinese loanwords in the textbook is considerable, rich in etymology and diverse in parts of speech. Chinese loanwords have cultural characteristics, which can see the development and evolution of Chinese, understand the language and cultural differences of different ethnic groups, reduce the adverse factors of international Chinese teaching, and promote the effective development of cross-cultural exchanges.

COVID-19 vaccines for children: Racial and ethnic disparities in New York City

Vaccination is an indispensable tool to reduce negative outcomes due to COVID-19. Although COVID-19 disproportionately affected lower income and Black and Hispanic communities, these groups have had lower population-level uptake of vaccines. Using detailed cross-sectional data, we examined racial and ethnic group differences in New York City schoolchildren becoming fully vaccinated (two doses) within 6months of vaccine eligibility. We matched school enrollment data to vaccination data in the Citywide Immunization Registry, a census of all vaccinations delivered in New York City. We used ordinary least squares regression models to predict fully vaccinated status, with key predictors of race and ethnicity using a variety of different control variables, including residential neighborhood or school fixed effects. We also stratified by borough and by age. The sample included all New York City public school students enrolled during the 2021-2022 school year. Asian students were most likely to be vaccinated and Black and White students least likely. Controlling for student characteristics, particularly residential neighborhood or school attended, diminished some of the race and ethnicity differences. Key differences were also present by borough, both overall and by racial and ethnic groups. In sum, racial and ethnic disparities in children's COVID-19 vaccination were present. Vaccination rates varied by the geographic unit of borough; controlling for neighborhood characteristics diminished some disparities by race and ethnicity. Neighborhood demographics and resources, and the attributes, culture and preferences of those who live there may affect vaccination decisions and could be targets of future efforts to increase vaccination rates.

Early emergence of racial and ethnic differences in sleep health among toddlers living in low-income families

Emerging evidence suggests racial and ethnic and socioeconomic differences in children's sleep health, yet few have examined these differences among very young children. The purpose of this study is to identify potential racial, ethnic, and sociodeomographic factors associated with multiple dimensions of sleep health in toddlers living in very low-income families. Sample included 110 racially and ethnically diverse dyads with toddlers aged 12-15months living in low-income families. Actigraph data (9 days and nights), caregiver completed sleep diaries, Brief Infant Sleep Questionnaire-extended, and caregiver-reported socioeconomic characteristics were collected. Toddlers' average sleep duration (10.25hours; SD=0.76)was less than the age-based recommendations. There were significant race and ethnic differences in toddler's actigraph-measured bedtime (p<.001) and variability in bedtimes (p=.004). Non-LatinX White toddlers had earlier bedtimes and less variability than Black and LatinX children. These between-group differences remained statistically significant after controlling for measured socioeconomic variables (p's<0.001). Within racial and ethnic group differences in bedtime and bedtime variability by education, employment, and marital status were identified with medium to large effect sizes. Racial and ethnic between-group differences in sleep occurred as early as 12months of age and were not explained by sociodemographic variables (eg,income-to-needs, education, housing). Further research is necessary to determine structural and contextual factors that explain the racial and ethnic differences in sleep health in early childhood. Identifying these factors may inform the development of socially and culturally tailored interventions to reduce sleep health disparities.

Ethnic group differences in patient satisfaction with GP services: findings from the New Zealand Attitudes and Values Study.

To identify key predictors of general practitioner (GP) satisfaction and increase insight into the mechanisms behind ethnic health inequities in New Zealand. Regression analyses were conducted using data from the 2019 New Zealand Attitudes and Values Study (n=38,465). Initially, Māori and Asian peoples showed lower, and Pasifika peoples showed no significant difference in GP satisfaction level relative to New Zealand (NZ) Europeans. However, after accounting for differences in patient-perceived GP cultural respect and GP ethnic similarity, Māori and Pasifika peoples showed higher and Asian peoples showed no difference in GP satisfaction level relative to NZ Europeans. These effects continued to hold when adjusting for a range of demographic factors. Subsequent regression analyses were conducted to investigate the impact of GP perceptions, GP satisfaction and demographic factors on healthcare access satisfaction and health status across ethnic groups. For all ethnic groups, GP satisfaction was the strongest predictor of satisfaction with access to healthcare. Higher GP satisfaction was also a significant predictor of higher self-rated health and lower psychological distress. Lack of GP cultural respect is a key contributor to lower GP satisfaction among ethnic minorities, which can further exacerbate inequities in healthcare access and health outcomes. Interventions to enhance GPs' provision of culturally respectful and safe healthcare services may help reduce ethnic health inequities and improve population health.

The Ossetian-Ingush conflict against the background of the geopolitical situation in the world and in the Caucasus region in the early 1990s

The article examines the Ossetian-Ingush confl ict in the context of the geopolitical upheavals of the early 1990s, the collapse of the Soviet Union. The deepest political crisis that engulfed the Russian Federation as the successor to the USSR led to numerous armed clashes between diff erent ethnic groups. In this context, the Caucasus region stands out because, in addition to the political transformations that took place in the country, some peoples of this region were subjected to repression during the Stalinist regime, which largely determines the scale and severity of armed clashes. The Ossetian-Ingush conflict is a vivid example of this, refl ecting the contradictory interethnic situation in the regions of the post-Soviet space. In addition, the geopolitical situation in the Caucasus in the early 1990s. It was formed under the infl uence of large world states, which this region was attracted by its geographical location, the presence of natural resources and large industrial enterprises. Russia considered the existing ethnic contradictions from the point of view of geopolitical risks, given that neighboring states pursuing their own interests could use armed confl icts, mainly on interethnic and religious grounds, as a convenient excuse for external intervention. In the analysis of the escalation of the Ossetian-Ingush confl cts, a signifi cant amount of normative legal acts is used, the results of which led to the conclusion that neither the regional nor the federal authorities took proper measures to prevent interethnic clashes on their territory. Th e article reveals in detail the reasons and motives that played a key role in building Russia’s policy towards the warring parties in the framework of the Ossetian-Ingush conflict.

Genetic Ancestry of 1127 Brazilian Breast Cancer Patients and Its Correlation With Molecular Subtype and Geographic Region

Breast cancer molecular subtypes show significant differences in different ethnic groups in the United States, but no study has evaluated genetic ancestry in breast cancer in Brazilian women. Breast cancer patients from distinct parts of Brazil were evaluated. Molecular subtypes were determined by immunohistochemistry. Genetic ancestry was evaluated using a panel of 46 AIMs (ancestry informative markers), which classified genetic ancestry as European, African, Asian, and Amerindian. PCR products were subjected to capillary electrophoresis and analyzed using GeneMapper 4.0 software. Ancestry was evaluated with Structure v.2.3.3 software. Ancestry was tested for correlations with geographic region and molecular subtype. The chi-square test and ANOVA with Bonferroni adjustment were applied. Genetic ancestry and clinical data were evaluated in 1127 patients. Higher rates of self-reported white ethnicity, European ancestry, and HER-2-luminal tumors were identified in the South region, which may influence age at diagnosis and result in a higher rate of early tumors. Conversely, higher rates of African ancestry in the North and Northeast regions, self-reported nonwhite ethnicity, HER-2+tumors, and triple-negative tumors were noted. Triple-negative and HER-2+tumors were associated with higher advanced and metastatic disease rates at diagnosis, with triple-negative tumors being more frequent in young women. Differences in genetic ancestry, self-reported ethnicity, and molecular subtype were found between Brazilian demographic regions. Knowledge of these features may contribute to a better understanding of age at diagnosis and the molecular distribution of breast cancer in Brazil.