Ethnic Disparities In Prevalence Research Articles

Racial and ethnic disparities in prevalence and correlates of depressive symptoms and suicidal ideation among adults in the United States, 2017–2020 pre-pandemic

BackgroundThis study aims to estimate the pre-COVID-19 pandemic prevalence of mild, major depressive symptoms, and suicide ideation among U.S. adults and evaluate their correlates and racial/ethnic disparities. MethodsThis is a cross-sectional analysis of a nationally representative sample of adults ≥20 years from the National Health and Nutrition Examination Survey study 2017–2020 Pre-Pandemic. Overall and racial/ethnic-specific weighted prevalence and 95%CI of mild and major depressive symptoms and suicidal ideation assessed by the Patient Health Questionnaire-9 were calculated. Multivariable logistic regression modelings were used to examine overall and racial/ethnic-specific correlates. ResultsData on 7917 US adults (Weighted N = 210,200,829; 51.8 % females) were analyzed. The prevalence of mild, major depressive symptoms, and suicidal ideation was 8.5 %, 16.5 %, and 3.2 %, respectively. Overall, consistent correlates for all three conditions included smoking, short/long sleep duration, and obesity. Females, non-Hispanic Blacks, low family-poverty-income ratio, prolonged sitting time, and a history of cardiovascular disease were consistent correlates for mild and major depressive symptoms. Younger age, never married/living without a partner, physical inactivity, drinking alcohol, and a history of diabetes were related to major depressive symptoms. Never married/living without a partner and having a low family-poverty-income ratio correlate with suicide ideation. Having cancer diagnosis was only negatively associated with major depressive symptoms in non-Hispanic Blacks. Females, current smoking, short/long sleep duration, and having cardiovascular disease were correlated with suicidal ideation among Hispanics. ConclusionsThe prevalence of mild, major depressive symptoms, and suicidal ideation were high among U.S. adults. Unique correlates were identified among different racial and ethnic groups.

Ethnic disparities in prevalence of chronic non-communicable diseases and its multimorbidity among older adults in rural southwest China

BackgroundAs the population ages, chronic non-communicable diseases (NCDs) multimorbidity has emerged as a major public health issue globally. This study examines ethnic disparities in prevalence of NCDs and its multimorbidity among rural southwest Chinese older adults.MethodsA cross-sectional survey was conducted in rural southwest population aged ≥ 60 years consisting of 5,642 consenting participants of Han and three ethnic minority groups (Dai, Ha Ni, and Bai). Information about participants’ demographic characteristics and lifestyle behaviors was obtained using a standard questionnaire. Anthropometric measurements including height, weight, and waist circumference, fasting blood sugar and blood pressure measurement, as well as post-bronchodilator spirometry test were recorded for each participant.ResultsThe age-standardized prevalence of five common chronic NCDs– hypertension, diabetes, coronary heart disease (CHD), stroke, chronic obstructive pulmonary disease (COPD) – and its multimorbidity was 72.8%, 15.9%, 4.0%, 10.0%, 9.8%, and 27.6%, respectively. Bai participants had both the highest overall and sex-specific prevalence rates of hypertension, diabetes, stroke, and COPD, whereas Han participants had the highest rates of CHD (P < 0.01). The results of multivariate logistic regression analysis indicated that female and older participants had a higher probability of chronic NCDs multimorbidity than their counterparts (P < 0.01). Bai ethnic minority participants were more likely to have NCDs multimorbidity while Ha Ni and Dai ethnic minority participants were less likely to have NCD multimorbidity relative to the Han participants (P < 0.05). Older adults with a higher level of education and family history of chronic NCDs, and who were also current smokers, current drinkers, obese, centrally obese, and physically inactive had a greater probability of developing chronic NCDs multimorbidity (P < 0.01).ConclusionsEthnicity and individual demographic and lifestyle factors significantly impact prevalence of chronic NCDs multimorbidity. Future chronic NCDs prevention and control strategies must be tailored to address ethnicity, and culturally tailored lifestyle interventions may reduce the prevalence of chronic NCDs multimorbidity in rural southwest China.

Prevalence and descriptive epidemiology of Turner syndrome in the United States, 2000-2017: A report from the National Birth Defects Prevention Network.

The lack of United States population-based data on Turner syndrome limits assessments of prevalence and associated characteristics for this sex chromosome abnormality. Therefore, we collated 2000-2017 data from seven birth defects surveillance programs within the National Birth Defects Prevention Network. We estimated the prevalence of karyotype-confirmed Turner syndrome diagnosed within the first year of life. We also calculated the proportion of cases with commonly ascertained birth defects, assessed associations with maternal and infant characteristics using prevalence ratios (PR) with 95% confidence intervals (CI), and estimated survival probability. The prevalence of Turner syndrome of any pregnancy outcome was 3.2 per 10,000 female live births (95% CI=3.0-3.3, program range: 1.0-10.4), and 1.9 for live birth and stillbirth (≥20 weeks gestation) cases (95% CI=1.8-2.1, program range: 0.2-3.9). Prevalence was lowest among cases born to non-Hispanic Black women compared to non-Hispanic White women (PR=0.5, 95% CI=0.4-0.6). Coarctation of the aorta was the most common defect (11.6% of cases), and across the cohort, individuals without hypoplastic left heart had a five-year survival probability of 94.6%. The findings from this population-based study may inform surveillance practices, prenatal counseling, and diagnosis. We also identified racial and ethnic disparities in prevalence, an observation that warrants further investigation.

Prevalence and treatment differences between Vietnamese and American children with attention-deficit/hyperactivity disorder

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common and pervasive childhood disorders worldwide. Although the United States is currently leading in prevalence of this disorder, the research demonstrates that racial and ethnic disparities in prevalence and treatment exist in the United States. However, some American minorities do not represent a full range of socioeconomic levels as they exist in their countries of origin, e.g., Vietnam. Thus, we compared children with ADHD ages 5 to 17 in Vietnam and the United States to examine the prevalence and treatment differences between the two countries. The data were obtained via interviews of professionals, Centers for Disease Control and Prevention website, and other studies. Notable differences were found between the two countries with regard to the prevalence rates of ADHD in children, gender differences, availability of the diagnostical and treatment services for ADHD, kinds of treatments used, and cultural factors responsible for the differences in the two countries. Vietnam is a predominantly rural society with a lack of awareness of the problem of ADHD and with a lack of treatment facilities and governmental support as compared to the United States. Suggestions were made to improve the diagnosis, treatment, and treatment outcomes for the children with ADHD in Vietnam.

Racial and Ethnic Differences in Rates and Age of Diagnosis of Autism Spectrum Disorder

This cohort study uses electronic health record data to assess racial and ethnic disparities in prevalence or median age of diagnosis of autism spectrum disorder in children.

Ethnic disparities in prevalence and patterns of smoking and nicotine dependence in rural southwest China: a cross-sectional study

ObjectivesThis study examines ethnic disparities in prevalence and patterns of smoking and nicotine dependence in rural southwest China.DesignThis was a cross-sectional design.SettingThis study was conducted in rural Yunnan Province of...

Ethnic disparities in prevalence and clustering of cardiovascular disease risk factors in rural Southwest China

BackgroundThis study examines how prevalence and clustering of cardiovascular disease (CVD) risk factors differ by ethnicity and socioeconomic status (SES) among rural southwest Chinese adults.MethodsA cross-sectional survey of 7027 adults aged ≥35 years of Han and four ethnic minority group descent (Na Xi, Li Shu, Dai, and Jing Po) was used to derive prevalence of tobacco smoking and exposure to secondhand smoke (SHS) as well as alcohol consumption and physical activity data. Anthropometric measurements were also taken, including height, weight, and waist and hip circumference, as well as blood pressure (BP) and fasting blood glucose (FBG) measurements.ResultsCurrent smoking and drinking status were the top two CVD risk factors in the study population. Dai ethnic minority participants had the highest prevalence of hypertension, obesity, and central obesity, whereas Jing Po ethnic minority participants had the highest prevalence of current smoking status, SHS exposure, and current drinking status (P < 0.01). Han participants had the highest prevalence of diabetes and physical inactivity (P < 0.01). 11.1% of all participants did not have any of the studied CVD risk factors, while 68.6% of Han, 60.2% of Na Xi, 50.7% of Li Shu, 82.2% of Dai, and 73.0% of Jing Po participants had clustering of two or more CVD risk factors. Prevalence of CVD risk factor clusters increased with age (P < 0.01). Males and individuals with lower education levels and lower annual household income were more likely to have CVD risk factors than their counterparts (P < 0.01).ConclusionClustering of CVD risk factors is common in rural southwest China. Ethnicity and individual SES significantly impact prevalence of CVD risk factors and their clustering.

Ethnic disparity in prevalence and associated risk factors of myopia in adolescents

To examine ethnic disparity in prevalence and associated factors of myopia in adolescents using the Unites States National Health and Nutrition Examination Survey (NHANES) dataset. Participants who were aged 12-19 years were included from NHANES (1999-2008). Logistic regression analyses were applied to identify risk factors associated with myopia after stratification by race. A total of 9,960 participants were included in the prevalence analysis, and 6,571 in the risk factor analysis. Other race (excluded Mexican American, other Hispanic, non-Hispanic white, non-Hispanic black) participants had the highest frequency of myopia (42.77%). Multivariate analyses of the whole population suggested that the odds of myopia were significantly lower in participants with household smokers (odds ratio [OR]=0.79, 95% confidence interval [CI]: 0.66-0.97), and significantly greater in Mexican American race (OR=1.28, 95% CI: 1.01-1.62), other Hispanic (OR=1.79, 95% CI: 1.10-2.92) and in participants with senior high school graduate education (OR=1.79, 95% CI: 1.01-3.18), watched 2 hours of television daily (OR=1.27, 95% CI: 1.02-1.59), used the computer for 1 hour daily (OR=1.276, 95% CI: 1.02-1.57). When examined by race/ethnicity, 1 hour of computer use increased the odds of myopia in the non-Hispanic White group, in Mexican Americans a higher family poverty income ratio and 2 hours of television time was associated with myopia, and in the Other Hispanic group, a higher family poverty income ratio was associated with myopia, while males and those with a higher sugar had a lower risk of myopia. Risk factors for myopia vary with race/ethnicity.

Growing ethnic disparities in prevalence of overweight and obesity in children 2-15 years in the Netherlands.

Overweight and obesity rates stabilized or declined in the largest ethnic groups in the Netherlands, while reports on thinness are conflicting. Ethnic inequalities in time trends are unknown. The aim of this study was to examine (differences in) trends in overweight (including obesity), obesity, severe obesity and thinness in children of Dutch, Turkish, Moroccan and South Asian descent. A retrospective cross-sectional study based on 135 150 height and weight measurements, taken between 2007 and 2015 in 77 058 children, aged 2-15 years, living in the city of The Hague (the Netherlands). Trends were determined with logistic regression. An interaction term was added to the model to test for effects of ethnicity on time trends. In Dutch children, overweight, obesity and severe obesity rates declined between 2007 and 2015, while overweight remained stable in Turkish, Moroccan and South Asian children. Turkish children showed a decrease in obesity (OR 0.981; 95% confidence interval 0.965-0.998), and Moroccan children in severe obesity (OR 0.918; 95% CI 0.877-0.962). South Asian children had the highest overweight and obesity rates of all ethnic groups (32.7 and 21.5% in 2015, respectively). Thinness rates were generally low and only decreased in South Asian children (0.940; 95% CI 0.886-0.997). Ethnic inequalities in overweight and obesity rates widened since 2007, despite a decline in overweight and/or obesity in most ethnic groups. Ethnic specific interventions are highly needed, especially for South Asian children.

Autism Spectrum Disorder Among US Children (2002-2010): Socioeconomic, Racial, and Ethnic Disparities.

To describe the association between indicators of socioeconomic status (SES) and the prevalence of autism spectrum disorder (ASD) in the United States during the period 2002 to 2010, when overall ASD prevalence among children more than doubled, and to determine whether SES disparities account for ongoing racial and ethnic disparities in ASD prevalence. We computed ASD prevalence and 95% confidence intervals (CIs) from population-based surveillance, census, and survey data. We defined SES categories by using area-level education, income, and poverty indicators. We ascertained ASD in 13 396 of 1 308 641 8-year-old children under surveillance. The prevalence of ASD increased with increasing SES during each surveillance year among White, Black, and Hispanic children. The prevalence difference between high- and low-SES groups was relatively constant over time (3.9/1000 [95% CI = 3.3, 4.5] in 2002 and 4.1/1000 [95% CI = 3.6, 4.6] in the period 2006-2010). Significant racial/ethnic differences in ASD prevalence remained after stratification by SES. A positive SES gradient in ASD prevalence according to US surveillance data prevailed between 2002 and 2010, and racial and ethnic disparities in prevalence persisted during this time among low-SES children.

Racial and Ethnic Disparities in Prevalence and Care of Patients With Type 2 Diabetes.

Ferdinand KC, Nasser SA. Racial/ethnic disparities in prevalence and care of patients with type 2 diabetes mellitus. Curr Med Res Opin 2015;31:913–923 This article is a narrative review of the epidemiological data available on diabetes prevalence and care and of studies indexed in PubMed involving trials that evaluated treatments for type 2 diabetes in racial minority populations. The authors examined data from the Centers for Disease Control and Prevention and from the National Health and Nutrition Examination Survey. Table 1 provides a summary of demographic data (1–7). Because of the difficulties in gathering data for all three large racial and ethnic minorities in the United States, disparities are presented solely for African Americans compared to whites and for Hispanics compared to whites. The prevalence of diagnosed type 2 diabetes by racial/ethnic group is as follows: Asians 9.0%, African Americans 13.2%, Hispanic 12.8%, and non-Hispanic whites 7.6%. There is a wide variation in prevalance in the Native American population (e.g., 6.0% in Alaskan Natives and 24.1% in southern Arizona Native American groups) and among Hispanics (e.g., 8.5% in Central/South Americans, 9.3% in Cubans, 13.9% in Mexican Americans, and 14.8% in Puerto Ricans) (8). View this table: TABLE 1. Summary of Disparities Data Presented in the Article Reviewed (1–7) Objective. The purpose of this study was to identify and describe all clinical drug trials for type 2 diabetes that included Asians, African Americans, or Hispanics. Design. The authors conducted a literature review of studies indexed in MEDLINE and accessed through PubMed. Methods. The authors searched …

Racial and ethnic disparities in substance use disorders and outcomes in elderly prostate cancer patients

ABSTRACTSubstance use among cancer patients is an important psychosocial comorbidity. Currently, there is a paucity of information regarding racial disparity in substance use among cancer patients. The objective of this study was to analyze racial and ethnic disparity in prevalence of substance use and its effects on outcomes in Medicare elderly with advanced prostate cancer using Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data. We used ICD-9 diagnosis codes to identify substance use disorder. Outcomes were health service use, cost, and mortality. Prevalence of substance use varied among White, African American, and Hispanic patients with advanced-stage prostate cancer. Racial and ethnic disparity existed in the association between substance use and outcomes. A multidisciplinary coordinated care approach is essential to address racial and ethnic disparities in substance use among prostate cancer patients and to achieve optimal clinical management and improved outcomes of care.

Ethnic Differences in Prevalence and Location of Colorectal Adenoma: Possible Link between Hispanic Advantage and Vitamin D Status

Purpose: Ethnic differences in the incidence of colorectal cancer (CRC) and colorectal adenoma (CRA) are well documented. The majority of these studies have been focused on black-white disparities for CRC, however research on CRA prevalence among Hispanics is lacking. The objective of this study is to evaluate ethnic disparities in prevalence of CRA and its possible mechanism, particularly for Hispanics. Methods: In this retrospective case-control study in a suburban community of New York State, 1,656 patients who underwent complete colonoscopies from 2007 to 2011 were enrolled. 1,340 pathologically confirmed adenoma cases and 316 adenoma-free controls were analyzed for the association of CRA overall or by location with ethnicity, using multivariate logistic regression analyses after adjusting for other risk factors. A secondary analysis assessed a possible link between vitamin D status and observed ethnic differences using a subset of subjects with serum 25-hydroxyvitamin D level available.Table: [1957] Association between ethnicity and colorectal adenoma by locationResults: The study participants consisted of 45% Hispanics, 17% non-Hispanic whites, 32% non-Hispanic blacks and 6% others. Of 1656 patients, 316 (19%) were diagnosed with adenomas, 142 (8.6%) proximal adenomas, 93 (5.6%) distal adenomas, 37 (2.2%) rectal adenomas and 44 (2.7%) were found to have adenomas at multiple sites. The prevalence of CRA for Hispanics was lower than non-Hispanic whites and blacks (14.8% vs 22.5%; adjusted OR, 0.67; 95% CI, 0.47-0.96; P<0.01), while no differences were noted between whites and blacks. The reduced CRA prevalence among Hispanics vs. non-Hispanics was more pronounced for proximal adenoma (5.3% vs 11.2%; adjusted OR, 0.42; 95% CI, 0.26-0.70; P<0.001), but not significant for adenoma at other locations. In a subset of patients (n=128), we found higher serum 25-hydroxyvitamin D levels among Hispanics than non-Hispanics, as well as in controls than adenoma cases. Conclusion: Our data suggest a distinction between Hispanics and non-Hispanics in the risk of CRA. The lower adenoma rates, particularly proximal adenoma rates, for Hispanics might be partially attributed to better vitamin D status. These findings might be community-specific, thus additional multi-center studies are needed.

Prevalence of type 2 diabetes and impaired fasting glucose: cross-sectional study of multiethnic adult population at the United States-Mexico border

To estimate prevalence of type 2 diabetes (diabetes) and impaired fasting glucose (IFG) in the border region between the United States of America and Mexico, by ethnic origin and country of residence; identify risk factors associated with both conditions; and explore the extent to which these factors account for cross-border or ethnic disparities in prevalence. From April 2001 to November 2002, Phase I of the U.S.-Mexico Border Diabetes Prevention and Control Project, a prevalence study of diabetes and its risk factors, was conducted at the U.S.-Mexico border using multistage cluster sampling. A questionnaire was administered on diabetes (self-reported) and lifestyle and a physical examination and blood sample were obtained. A total of 4,027 adults participated in the study: 2,120 Hispanics from the Mexican side of the border and 1,437 Hispanics and 470 non-Hispanics (of whom 385 were classified as "white") from the U.S. side of the border. The age-adjusted prevalence of self-reported and unrecognized diabetes in Hispanics was 15.4% (16.6% on the Mexican side of the border and 14.7% on the U.S. side). The age-adjusted prevalence of IFG was similar on both sides of the border (14.1% on the Mexican side and 13.6% on the U.S. side). Established risk factors for diabetes (e.g., age, obesity, and family history) were relevant and there was an inverse relationship between diabetes and education and socioeconomic level. While diabetes prevalence is high on both sides of the U.S.-Mexico border, one-third of the cases remain undiagnosed, suggesting a need for development and implementation of a public health program for prevention, diagnosis, and control of diabetes in the region.

Education and physical activity mediate the relationship between ethnicity and cognitive function in late middle-aged adults

Objective. Minority status has been implicated as a risk factor for disparate scores on cognitive function tests in older adults. Research on ethnicity and cognitive function has yielded socioeconomic status, particularly education, as a primary reason for the discrepancy. Other factors, such as physical activity may provide insight into the relationship. Despite this knowledge, few studies have thoroughly examined the mediating characteristics of education or physical activity in the relationship between ethnicity and cognitive function in younger aged groups. Most research conducted focuses only on older adults during a time when degeneration of brain tissue may complicate the exploration of the relationships among ethnicity and cognitive function. The current research will expand existing knowledge about education, physical activity, and cognitive function in minority groups. Design. The study presents data from the Health and Retirement Study, a nationally representative sample of late middle-aged White, Black, and Hispanic adults (n=9204, mean age±SD = 55.8±3.1). Regression and mediation testing determined the mediating effects of education and physical activity in the relationship between ethnicity and cognitive function. Results. Significant association between White ethnicity and higher scores on cognitive tests was evident as early as late middle age. The magnitude of the association significantly diminished on adjusting for education and leisure time physical activity. Conclusion. Our data suggest a potential mediating role of education and physical activity on the ethnic differences in cognitive tests in late middle-aged White, Black, and Hispanic adults. Our findings suggest a need for studies to understand if adult education and culturally appropriate physical activity interventions in middle age influence ethnic disparities in prevalence of cognitive impairment in old age.

Ethnic disparities in prevalence and impact of risk factors of chronic kidney disease

There is substantial heterogeneity in literature regarding the epidemiology for chronic kidney disease (CKD) in different Asian populations. We aimed to assess the prevalence and risk factors of CKD in a multi-ethnic Asian population in Singapore. We examined 4499 participants of Chinese, Malay and Indian ethnicity, aged 24-95 years, who participated in the Singapore Prospective Study Program. CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m(2) or the presence of micro/macroalbuminuria. The age, sex-standardized prevalence of CKD was 12.8% (11.4%, 18.6% and 17.6% in Chinese, Malays and Indians). Older age and the presence of diabetes, hypertension and dyslipidaemia were significantly associated with CKD in all ethnic groups. Clinical, metabolic, socioeconomic and behavioral factors accounted for 68% and 78% of excess risk of CKD in Malays and in Indians, respectively. Diabetes (45%) and dyslipidaemia (16%) among Malays and hypertension among Indians (23%) had greater population-attributable risk of CKD. The prevalence of CKD is high in all three major Asian ethnic groups, in particular Malays and Indians, but risk factors are similar to those reported from previous studies in Western populations. The association of modifiable risk factors with CKD emphasizes the need to screen and treat high-risk populations for early detection and prevention of CKD.

Race, Ethnicity and Social Class and the Complex Etiologies of Asthma

Asthma is a common but complex respiratory disease caused by the interaction of genetic and environmental factors. Significant racial and ethnic disparities in prevalence, mortality and drug response have been described. These disparities may be explained by racial and ethnic-specific variation in genetic, environmental, social and psychological risk factors. In addition, race, ethnicity and social class are important proxies for unmeasured factors that influence health outcomes. Herein, we review salient differences in the etiologies of asthma by race, ethnicity and social class, and argue for their continued use as variables in asthma research.