Greater Racial Diversity Research Articles

Understanding Nonprofit Financial Health: Exploring the Effects of Economic Recession and Environmental Factors (2007–2012)

During an economic recession, the gaps between community service demands and available resources for nonprofits widen. Nonprofits with financial vulnerability cut back on their services or activities when facing a turbulent economic downturn. To make sense of such situations, drawn from organizational ecology theory, we examine the relationships between environmental factors and a nonprofit’s financial health and the moderating role of the Great Recession of 2008 on their relationship. Employing IRS 990 and US census data (2007–2012) on counties, our longitudinal analysis finds that: 1) nonprofits’ county-level environmental factors, i.e., service demand and available resources, are associated with their financial health; 2) the impact of economic recession on nonprofits’ financial health is particularly severe in communities with greater racial diversity; and 3) nonprofits located in communities with more resources are more likely to be financially healthy and are less affected by the economic recession in the long term.

Clinical and Metabolic Characterization of Adults With Type 2 Diabetes by Age in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) Cohort

OBJECTIVE Differences in type 2 diabetes phenotype by age are described, but it is not known whether these differences are seen in a more uniformly defined adult population at a common early stage of care. We sought to characterize age-related clinical and metabolic characteristics of adults with type 2 diabetes on metformin monotherapy, prior to treatment intensification. RESEARCH DESIGN AND METHODS In the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE), participants were enrolled who had type 2 diabetes duration <10 years, had HbA1c 6.8–8.5%, and were on metformin monotherapy. Participants were randomly assigned to one of four additional glucose-lowering medications. We compared baseline clinical and metabolic characteristics across age categories (<45, 45 to <55, 55 to <65, and ≥65 years) using ANOVA and Pearson χ2 tests. RESULTS Within the GRADE cohort (n = 5,047), we observed significant differences by age, with younger adults having greater racial diversity, fewer medications for common comorbidities, lower prevalence of CVD, higher weight and BMI, and more pronounced hyperglycemia and diabetic dyslipidemia and with metabolic profile indicating lower insulin sensitivity (inverse fasting insulin [1/(fasting insulin)], HOMA of steady-state insulin sensitivity, Matsuda index) and inadequate β-cell response (oral disposition index) (P < 0.05 across age categories). CONCLUSIONS Clinical and metabolic characteristics of type 2 diabetes differ by age within the GRADE cohort. Younger adults exhibit more prominent obesity-related characteristics, including higher obesity levels and lower insulin sensitivity and β-cell compensation. Given the increasing burden of type 2 diabetes and complications, particularly among younger populations, these age-related distinctions may inform risk factor management approaches and treatment priorities. Further study will determine whether age-related differences impact response to therapy.

Spatial and temporal pattern of cannabis use disorder in California 2010-2019

As cannabis use is being legalized in an increasing number of states, it is important to understand the changing dynamic of the risk in cannabis use disorder (CUD). Shape-based time-series clustering was used to identify ZIP Code Tabulation Areas (ZCTAs) with similar changing pattern in CUD over time. We conducted a cross-sectional logistic regression analysis to investigate the most recent ZCTA socio-demographic characteristics in relation to the changing CUD rates. The emergency discharge rates generally increased during 2010-2016. Increase during 2017-2019 was found in Sacramento and Santa Barbara County. Approximately 13% of ZCTAs showed an increasing trend of hospitalization discharge during 2017-2019. Males and non-Hispanic Black had larger increase than other groups during 2017-2019. The recent growing trend was found associated with greater racial diversity and rural ZCTAs. The findings from this study hold promise for local public health officials to adjust the cannabis intervention strategies in target districts and improve overall health outcomes.

Female Officers in Use-of-Force Encounters: An Examination of Potential Correlates

With the changing landscape of women in policing, the representation of female police officers has increased. However, there is limited understanding of how these encounters vary with the presence of a female officer. The present study utilized data from three large, geographically diverse police agencies to evaluate situational, officer, and suspect characteristics of use-of-force incidents that are associated with the presence and involvement of a female officer. Analyses examining both multiple officer/suspect and single officer/suspect incidents indicate many situational similarities between incidents with at least one female officer present or involved and incidents with no female officers. However, the probability of female officer presence/involvement increases for incidents involving display of a taser, officer injuries, greater racial diversity among the officers, and female suspects. Additional findings and research implications are discussed.

Vonoprazan: A systematic review of an alternative to proton pump inhibitors

Vonoprazan is a novel potassium-competitive acid blocker (P-CAB) that works through a reversible potassium-specific competitive mechanism to inhibit active proton pumps directly. In contrast to standard proton pump inhibitors, vonoprazan does not require acid activation or any time constraints for its administration. As a result of its rapid onset and prolonged action, vonoprazan is a suitable option for PPI. In this study, we compare the efficacy of vonoprazan and PPIs in treating Gastroesophageal Reflux Disease (GERD), H. pylori, and post-endoscopic submucosal dissection (ESD) bleeding and ulcers. A PRISMA-guided systematic review was conducted on Pubmed. It included English or Portuguese articles published in the last five years describing adult patients treated with vonoprazan and/or PPI for GERD, H. pylori, or post-endoscopic dissection of the gastroesophageal submucosa bleeding and ulcers. There were six articles on GERD. Half suggested vonoprazan was superior to PPIs, while the other half considered it non-inferior or of comparable efficacy. There were 19 articles on H. pylori eradication, and vonoprazan outperformed PPI in 68,42% (13/19) of them. Vonoprazan was more effective than PPIs in 8 of the 13 studies chosen for post-ESD and ulcer prevention. As a result, in most studies, vonoprazan is either superior or not inferior to PPIs. However, the racial bias of the results is a significant limitation, as many of these studies were conducted in the Japanese population. More research on greater racial diversity is required. Nonetheless, in the current scenario, vonoprazan is a potential alternative pharmacological treatment for post-ESD bleeding and ulcers, GERD, and H. pylori.

The Forward Movement: Amplifying Black Voices on Race and Orthopaedics-No Room for Bystanders.

The Forward Movement: Amplifying Black Voices on Race and Orthopaedics-No Room for Bystanders.

Abstract 137: Lack of Racial Diversity in Cardiopulmonary Resuscitation Training Films: A Cross-sectional Analysis

Introduction: Minorities are less likely to be CPR-trained, and less likely to receive bystander CPR compared to whites. Hypothesis: We hypothesized that modern CPR training films demonstrate poor racial diversity and therefore poor relevance to minority communities. Methods: Using the query “how to do CPR” in Google and YouTube, 350 and 500 films were reviewed. Exclusion criteria included: pre-2015, non-English, non-instructional, pediatric or animal victims, duplicates, parity, or in-hospital cardiac arrest. For each film, 4 racially-diverse evaluators identified the race of the instructor, rescuer, victim, and manikin as “white” or “non-white.” Films were scored on 6 aspects of CPR instruction: scene safety, check responsiveness, activate Emergency Medical Services, proper hand position, accurate rate, and appropriate depth of compressions. Similarly, the race of characters in CPR training films from the American Heart Association (AHA) and American Red Cross (ARC) were analyzed by one self-identified non-white evaluator. Results: Of 72 online films meeting the criteria, 50 used a human instructor (76% white); 19 showed a human victim (84% white); 70 depicted a human rescuer (74% white); and 58 featured a manikin (95% white) (p<0.0001 for all, white v. non-white). Only 10 of 72 films (14%) taught hands-only CPR, featured AT LEAST ONE non-white character, and were of high-quality ( > 5 aspects of CPR instruction). Inter-rater reliability was high (>0.775). We also reviewed 7 ARC and 7 AHA adult CPR training films (2015 or later). Four of 7 AHA films (57%) and 2 of 7 ARC films (29%) featured at least one non-white character (Figure 1). Conclusion: We identified only 10 online high-quality films teaching hands-only CPR which feature at least one non-white character. CPR instructional films from the AHA and ARC showed greater racial diversity. Improved racial representation in CPR training films is important to increase relevance to under-trained minority communities.

The Politics of White Racial Identity and Vote Choice in the 2018 Midterm Elections

ObjectivesThis article examines the role of white racial identity or white racial group consciousness in the vote choice of whites for the U.S. House of Representatives in the 2018 midterm elections.MethodsData from the 2018 American National Election Study (ANES) Pilot Study are analyzed using a logistic regression model.ResultsWhite racial consciousness was a significant predictor of U.S. House vote choice in 2018, even after controlling for other relevant explanatory variables such as racial resentment, party identification, and ideology. The effects were especially evident for two quintessential swing groups: independents and moderates.ConclusionIn the first national election of the Trump era, white racial group consciousness became a relevant electoral cleavage and determinant of white vote choice at the subpresidential level. Given the rhetoric and action of Trump as president, the Republican Party has morphed into a white identity political party, not dissimilar to populist right‐wing parties in Europe. While this might reap electoral benefits for the Republican Party in jurisdictions with smaller minority populations, it is likely to cost the party support where there is greater racial diversity. In the long term, the politics of white identity is likely to be an impediment to the Republican Party's ability to expand its electoral base.

Network, clinical and sociodemographic features of cognitive phenotypes in temporal lobe epilepsy

This study explored the taxonomy of cognitive impairment within temporal lobe epilepsy and characterized the sociodemographic, clinical and neurobiological correlates of identified cognitive phenotypes. 111 temporal lobe epilepsy patients and 83 controls (mean ages 33 and 39, 57% and 61% female, respectively) from the Epilepsy Connectome Project underwent neuropsychological assessment, clinical interview, and high resolution 3T structural and resting-state functional MRI. A comprehensive neuropsychological test battery was reduced to core cognitive domains (language, memory, executive, visuospatial, motor speed) which were then subjected to cluster analysis. The resulting cognitive subgroups were compared in regard to sociodemographic and clinical epilepsy characteristics as well as variations in brain structure and functional connectivity. Three cognitive subgroups were identified (intact, language/memory/executive function impairment, generalized impairment) which differed significantly, in a systematic fashion, across multiple features. The generalized impairment group was characterized by an earlier age at medication initiation (P < 0.05), fewer patient (P < 0.001) and parental years of education (P < 0.05), greater racial diversity (P < 0.05), and greater number of lifetime generalized seizures (P < 0.001). The three groups also differed in an orderly manner across total intracranial (P < 0.001) and bilateral cerebellar cortex volumes (P < 0.01), and rate of bilateral hippocampal atrophy (P < 0.014), but minimally in regional measures of cortical volume or thickness. In contrast, large-scale patterns of cortical-subcortical covariance networks revealed significant differences across groups in global and local measures of community structure and distribution of hubs. Resting-state fMRI revealed stepwise anomalies as a function of cluster membership, with the most abnormal patterns of connectivity evident in the generalized impairment group and no significant differences from controls in the cognitively intact group. Overall, the distinct underlying cognitive phenotypes of temporal lobe epilepsy harbor systematic relationships with clinical, sociodemographic and neuroimaging correlates. Cognitive phenotype variations in patient and familial education and ethnicity, with linked variations in total intracranial volume, raise the question of an early and persisting socioeconomic-status related neurodevelopmental impact, with additional contributions of clinical epilepsy factors (e.g., lifetime generalized seizures). The neuroimaging features of cognitive phenotype membership are most notable for disrupted large scale cortical-subcortical networks and patterns of functional connectivity with bilateral hippocampal and cerebellar atrophy. The cognitive taxonomy of temporal lobe epilepsy appears influenced by features that reflect the combined influence of socioeconomic, neurodevelopmental and neurobiological risk factors.

Association of group composition diversity and performance outcomes in a pre-clerkship team-based learning program

Introduction: Team-based learning (TBL) is an important curricular component of medical education. TBL sessions are evaluated based on individual readiness assurance test (IRAT) and group readiness assurance test (GRAT) scores. Previous research in non-medical professional settings has shown that group composition diversity is positively correlated with group outcomes.Methods: We conducted a retrospective analysis examining the relationship between TBL outcomes and group composition diversity in a class of first year medical students. Group composition diversity was quantified for age, gender, race, ethnicity, and socioeconomic status and correlated with TBL outcomes. A survey about perception of diversity was administered to the study cohort.Results: Racial heterogeneity was found to have a positive correlation with GRAT scores (p < 0.05). Group heterogeneity was not found to be associated with individual outcomes. Additionally, groups with higher racial and ethnic diversity reported a higher level of perceived diversity and were more likely to attribute positive group outcomes to diversity of their group.Discussion: These study findings suggest that greater racial diversity in a group is associated with higher group evaluation outcomes in the medical education TBL environment. These findings may have implications for TBL group design and medical school admissions.

Trajectories of Ethnoracial Diversity in American Communities, 1980-2010.

The ethnoracial makeup of the U.S. population has undergone transformative change during recent decades, with the non-Hispanic white share of the population shrinking while the minority shares expand. Yet this trend toward greater racial diversity is not universal throughout the nation. Here we propose a framework of segmented change, which incorporates both spatial assimilation and ethnic stratification theories, to better understand variation in patterns of diversification across American communities. Our research applies growth mixture models to decennial census data on places for the 1980-2010 period, finding that trajectories of ethnoracial diversity are much more uneven than popularly claimed. Moreover, types of diversity change are stratified by initial racial composition. While places with mostly-white populations in 1980 underwent extensive diversification, places with larger shares of Hispanics and (especially) blacks in 1980 exhibited less uniform movement toward diversity and were more likely to remain racially homogeneous. Analysis of the underlying group-specific pathways of change indicates that the diversification of white communities was driven largely by Hispanic growth; when areas with a black presence did diversify, it occurred via contracting white populations. These racially conditioned and locally variable patterns emphasize the segmented nature of diversity change in American society.

Tackling Inequality: How Nonprofits Leverage Institutions and Community Fabric to Reduce Poverty

Drawing on institutional theory and nonprofit sector research, we examine the institutional infrastructure and the community conditions under which antipoverty nonprofits are more likely to reduce poverty. Using longitudinal data from 246 U.S. communities, we found that the collective action of antipoverty nonprofits alone does not significantly reduce poverty within their communities. However, when nonprofits operate in communities with greater presence of unions, lower levels of educational attainment and higher percentage of immigrant population, antipoverty nonprofits are key enablers of poverty reduction. Contrary to our expectations, neither government presence nor greater racial diversity significantly enhances the effect of nonprofits in poverty reduction. Government action, however, reduces poverty independently from the action of nonprofits. Our results suggests that grand challenges such as inequality are better addressed through the joint work of different organizational actors and institution...

Performance Implications of Diversity and Its Symmetry Across Organizational Levels

We investigate how racial diversity at different levels within organizations as well the firm’s similarity of diversity across hierarchical levels affect firm performance. From a panel sample drawn from the 200 largest U.S. law firms, we find strong evidence that greater racial diversity at each level within the organization and greater symmetry of diversity across levels is positively associated with firm performance. However, we also show that racial diversity is negatively associated with performance at the executive committee level. Our paper provides clear evidence of the benefits of diversity, and symmetry of diversity, but it also warns us about the possible negative performance implications of diversity at the top level of organizations due to tokenism.

Disparate Rates of New-Onset Depression During the Menopausal Transition in 2 Community-based Populations: Real, or Really Wrong?

This study took place in eastern Massachusetts and included respondents from the Harvard Study of Moods and Cycles Cohort 1, enrolled between 1995 and 1997, and the Harvard Study of Moods and Cycles Cohort 2, enrolled between 2005 and 2009. In prospectively assessing rates of new-onset depression in 2 populations of late-reproductive-aged women with no Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) lifetime history of depression, we were surprised to find far lower rates of depression in the population with greater racial diversity and lower socioeconomic status, contrary to what had been reported in the scientific literature. To better understand why these disparate results occurred, we assessed confounding and outcome misclassification as potential explanations for the discrepancy. After determining that these were unlikely explanations for the findings, we explored 2 potential sources of selection bias: one induced by self-referral of healthy participants into the study and the other induced by the design of the study itself. We concluded that both types of selection bias were likely to have occurred in this study and could account for the observed difference in rates.

Health outcomes among non-Caucasian living kidney donors: knowns and unknowns

The growth in living kidney donation has been accompanied by greater racial diversity. Most information on post-donation health comes from single-center studies of dominantly Caucasian cohorts. Recent linkage of U.S. donor registration data with death records demonstrated higher mortality risks among African American donors, but importantly, no differences in death compared with demographically matched, healthy controls. Within the donor population, some recent studies have also identified higher likelihoods of post-donation hypertension, diabetes mellitus and kidney failure in African American and Hispanic donors. Thus, based on concerns for higher risks of long-term end-organ damage, it may be reasonable to consider race within the living donor selection process, such as use of more stringent exclusion criteria among non-Caucasian living donors with baseline elevated blood pressure. Recently identified associations of coding variants in the apolipoprotein L1 (APOL1) gene with nondiabetic renal failure in African Americans raise promise of APOL1 genotyping as a novel tool for risk stratifying African American potential donors, but more data are needed to understand implications for post-donation outcomes. To tailor counseling and informed consent, focused attention to long-term medical outcomes among non-Caucasian living donors is needed, and should include assembly of healthy non-donor controls for assessment of attributable risks of donation.

Race, diversity and pro-social behavior in a segmented society

This paper examines the impact of racial identity on behavior in trust games played by public high school students in South Africa. There is a systematic pattern of distrust towards Black partners, even by Black proposers, partially attributable to mistaken expectations. Non-Black proposers are significantly less likely to engage in a strategic interaction at all when paired with a Black partner, while Black proposers engage in exchange but at lower levels than when paired with non-Blacks. However, greater racial diversity in public schools promotes pro-social behavior towards Black partners.

An Examination of Racial Diversity in Collegiate Football

Anderson (1993) published an in-depth analysis of Division IA football coaching opportunities utilizing a centrality framework and concluded that institutional racial discrimination was restricting Black coaches career opportunities in intercollegiate athletics. The present study aims to provide an update of his study by conducting a 15-year trend analysis of football coaches at the Division IA level, comparing Anderson's (1993) data from 1990 to data from 2005. Data were collected from 116 media guides at the conclusion of the 2005 season, and X² analyses were used to compare data across the two timeframes. The results provide evidence that institutional racism is still potentially an active deterrent to achieving greater racial diversity among Division IA football coaches as head coaches and coordinators.

Does Descriptive Race Representation Enhance Institutional Legitimacy? The Case of the U.S. Courts

In the past two decades, numerous studies have tested empirically the normative theory of descriptive race representation. Here, we focus specifically on one aspect of descriptive representation—the relationship between increased racial representation and institutional legitimacy. Does greater racial diversity within a political institution increase its reservoir of good will? Using a novel experimental design centered on the federal courts, we find that greater descriptive representation for blacks causes increased legitimacy for the institution among African Americans. However, we also find that white support declines under the same experimental condition. In probing our data further, we discover that increased diversity does not impact blacks and whites in the same manner across the ideological spectrum. Rather, a person's ideology mediates how he or she assesses racial diversity on the bench. We conclude by discussing the implications of our findings.

Geographic Recruitment of Breast Cancer Survivors into Community-Based Exercise Interventions

There is increased interest in developing and disseminating health behavior interventions for cancer survivors. Challenges in these efforts include participant burden in traveling to central intervention sites and sustainability. The purpose of this article is to report various methods used to recruit breast cancer survivors into an exercise intervention that attempts to address both of these challenges. Letters were mailed within specific zip codes near community-based intervention sites in cooperation with state cancer registries. Additional recruitment methods included flyers at breast care clinics and support groups, mass media, and conferences. Of the 3200 women who responded, 82% (n = 2625) identified having heard about the study through state or hospital registry and 8% (n = 243) through print and broadcast media. Thirty-five percent (n = 103) of randomized women self-identified as having a minority racial background and 31.9% (n = 94) self-identified as African American. Comparisons of participant age and racial distribution to state cancer registries indicate similar age distribution but greater racial diversity among participants. These results support the use of population-based cancer registries to recruit survivors into community-based interventions and clinical trials.

Willingness to Remain Friends and Attend School with Lesbian and Gay Peers: Relational Expressions of Prejudice Among Heterosexual Youth

In this study, heterosexual students' willingness to remain friends with peers who disclose that they are gay or lesbian and their willingness to attend schools that include gay and lesbian students were examined among two large middle school and high school samples (Sample 1: n = 20,509; 50.7% girls; Sample 2: n = 16,917; 50.2% girls). Boys were less willing than girls to remain friends or attend schools with gay and lesbian peers, as were students in earlier grades than were students in later grades. Further, there was small, yet significant, variability in these scores across schools. Greater racial diversity within the school partially accounted for this school-level variability; students in more racially diverse schools reported greater willingness to remain friends and attend school with gay and lesbian peers. Findings suggest that while intervention programs must continue to address blatant and overt physical aggression against sexual minority youth, there is also a significant need for programming to address the more subtle expressions of sexual prejudice that contribute to unwelcoming and unsafe school climates.