Higher Proportion Of Blacks Research Articles

Alcohol Retail Density and Demographic Predictors of Health Disparities: A Geographic Analysis

We examined whether the geographic density of alcohol retailers was greater in geographic areas with higher levels of demographic characteristics that predict health disparities. We obtained the locations of all alcohol retailers in the continental United States and created a map depicting alcohol retail outlet density at the US Census tract level. US Census data provided tract-level measures of poverty, education, crowding, and race/ethnicity. We used multiple linear regression to assess relationships between these variables and retail alcohol density. In urban areas, retail alcohol density had significant nonlinear relationships with Black race, Latino ethnicity, poverty, and education, with slopes increasing substantially throughout the highest quartile for each predictor. In high-proportion Latino communities, retail alcohol density was twice as high as the median density. Retail alcohol density had little or no relationship with the demographic factors of interest in suburban, large town, or rural census tracts. Greater density of alcohol retailers was associated with higher levels of poverty and with higher proportions of Blacks and Latinos in urban census tracts. These disparities could contribute to higher morbidity in these geographic areas.

Complementary and Alternative Medicine for Mental Disorders Among African Americans, Black Caribbeans, and Whites

This study examined racial and ethnic differences in the use of complementary and alternative medicine (CAM) for the treatment of mental and substance use disorders. Data were from the National Survey of American Life (NSAL) and the National Comorbidity Survey-Replication (NCS-R). The analytic sample included 631 African Americans and 245 black Caribbeans from the NSAL and 1,393 non-Hispanic whites from the NCS-R who met criteria for a mood, anxiety, or substance use disorder in the past 12 months. Logistic regression was used to examine racial and ethnic differences in the use of any CAM and in the use of CAM only versus the use of CAM plus services in another treatment sector. Thirty-four percent of respondents used some form of CAM. Whites were more likely than blacks to use any CAM, although there was no racial or ethnic difference in CAM use only versus CAM use plus traditional services. A higher proportion of blacks than whites used prayer and other spiritual practices. Among those with a mood disorder, black Caribbeans were less likely than African Americans to use any CAM. Findings of this study were similar to those of previous studies that examined physical illness in relation to CAM use in terms of its overall prevalence, the predominant use of CAM in conjunction with traditional service providers, and racial and ethnic differences in the use of CAM. The use of prayer was a major factor in differences between blacks and whites in CAM use; however, there were also differences among black Americans that warrant further research.

Patterns of Single and Multiple Claims of Epididymitis Among Young Privately-Insured Males in the United States, 2001 to 2004

Patterns of Single and Multiple Claims of Epididymitis Among Young Privately-Insured Males in the United States, 2001 to 2004

What Enhances Underrepresented Minority Recruitment to Dental Schools?

This study examined the factors influencing the proportion of underrepresented minority students (URM) in dental schools. Using a comprehensive recruitment model, it considered the relative importance of community characteristics (population demographics, oral health policies, dental care system, and university environment), dental school characteristics (Pipeline-supported, mission, and financing), and community-based dental education (CBDE) characteristics of the dental school on recruitment of URM students. Data come from a national survey of dental school seniors and a variety of publicly available sources. Three outcome variables measure URM recruitment: percent URM, percent Hispanic, and percent African American in the first year of dental school. Multivariable results revealed that the most important factors predicting a higher percent URM in first-year classes were a higher proportion of URM clinical faculty and graduating students' perceptions that their clinical rotation experience improved their ability to care for diverse groups. For percent Hispanic in the first year, a higher proportion of URM clinical faculty and students spending more time in clinical rotations predicted greater Hispanic recruitment. Graduating students' perceptions that they were less prepared to treat diverse groups were directly associated with the proportion of Hispanic students in the class. For a higher percent of African Americans in the first-year class, the most important factors were a higher proportion of blacks in the county, support from the national Pipeline program, and graduating students' perceptions of better preparedness to integrate cultural differences into treatment planning. Higher total financial aid awarded by the school was negatively associated with recruitment of African Americans. Results suggest some improved URM recruitment strategies for dental schools.

Black–white differences in health-related quality of life among older adults

Very little information exists on racial differences in quality of life among older adults. In this paper, we examine black-white differences in health-related quality of life (HRQOL) and identify factors that may account for these differences. The participants were 5,986 community-dwelling persons age 65+ (62% black at baseline) from the Chicago Health and Aging Project. Poor HRQOL was defined as having 14 or more self-reported physically or mentally unhealthy days over the past 30 days. A higher proportion of blacks (11.0%) than whites (9.7%) reported poor HRQOL. After adjusting for age and sex, blacks had increased odds of reporting poor HRQOL compared with whites (odds ratio [OR] = 1.72; 95% CI: 1.50-1.98). The black-white differences in HRQOL tended to increase with age (p < 0.05) and were greater among females (p < 0.05). Lifetime socioeconomic status, summary measures of medical conditions, and cognitive function accounted for most of the black-white difference (OR = 1.06; 95% CI: 0.89-1.27). Our results suggest that racial differences in HRQOL are associated with the combined effects of social disadvantage, poor physical health, and lower cognitive function.

End Stage Renal Disease: Racial Differences

Objectives: The prevalence and aetiological of end stage renal disease (ESRD) differ from race to race and from location to location even among people of the same race. There is paucity of data on the comparison of ESDR in whites and blacks living in their native environment. The study was undertaken to retrospectively define the differences in manifestation of ESRD in whites and blacks in their natural environment. Methods: Case records of consecutive patients in chronic renal failure that were seen at the University of Ilorin Teaching Hospital, Ilorin, Nigeria and Guy's Hospital, London, England over a four year (1996 to 1999) and two year periods respectively were reviewed. Data collected included data on sex, age, race, aetiology and usual features of ESRD. Results: A total of 127 blacks (76 males, 51 females) and 125 Caucasians (74 males, 51 females) were recruited and categorized into groups. The commonest disease causing ESRD in Caucasians was diabetic nephropathy [(DN), 26.4%] followed by chronic glomerulonephritis [(CGN), 16.8%] and hypertensive nephrosclerosis [(HTN), 10.6%]. Amongst blacks, however, CGN (38.6%) was the commonest cause, followed by HTN (26%) and DN (7.05%). In 14% and 9% of blacks and whites respectively, the cause of ESRD was unknown. Most blacks with CGN and HTN reached ESRD in the 2nd and 3rd decades; in any case earlier than whites. DN was thrice commoner in whites with the majority in the 5th and 6th decades in both races. Conclusion: This study tends to validate the notion that the spectrum of renal diseases in the tropics is generally the same as in the temperate environments, but the prevalence, natural history and major Aetiological factors do vary from race to race and in location. Diabetic nephropathy which was thought to be rare in blacks is becoming a major problem. It is disturbing that a high proportion of blacks reached ESRD within their 2nd to 4th decades when they are still very productive. Key Words: ESRD, Race, Prevalence, Aetiology Orient Journal of Medicine Vol.15(1&2) 2003: 24-31

Labor Market Dropouts and Trends in the Wages of Black and White Men

There is continuing debate over whether and to what degree estimations of black-white wage convergence are biased because they leave labor market dropouts out of the picture. If a high proportion of blacks become discouraged and cease searching for jobs, and if those dropouts have, on average, poor job prospects, the average wage of black workers who remain in the labor market will be an upwardly biased estimate of the average wage across the population. This paper introduces a simple method of imputing wages to non-workers. When non-workers are accounted for in the calculations, real wage growth for prime age black men over the 1969–98 period is reduced approximately 40%, and black-white wage convergence is reduced by approximately one-third. The author finds that a source of bias as important as falling employment rates is the growing gap between wages of workers and potential wages of non-workers.

Labor Market Dropouts and Trends in the Wages of Black and White Men

There is continuing debate over whether and to what degree estimations of black-white wage convergence are biased because they leave labor market dropouts out of the picture. If a high proportion of blacks become discouraged and cease searching for jobs, and if those dropouts have, on average, poor job prospects, the average wage of black workers who remain in the labor market will be an upwardly biased estimate of the average wage across the population. This paper introduces a simple method of imputing wages to non-workers. When non-workers are accounted for in the calculations, real wage growth for prime age black men over the 1969-98 period is reduced approximately 40%, and black-white wage convergence is reduced by approximately one-third. The author finds that a source of bias as important as falling employment rates is the growing gap between wages of workers and potential wages of non-workers.

When do neighborhoods matter? The role of race and neighborhood peers

This study explores racial differences in the effect of neighborhood income on children’s test scores, self-esteem, and behavior, using data from both the Census and the Panel Study of Income Dynamics Child Development Supplement. This study finds that as neighborhood income increases, test scores and behavior improve significantly for white children but not for black children. Increased neighborhood income affects only black children when there is a high-proportion of blacks in the neighborhood. For white children, an increase in the number of neighborhood peers known by name increases the effects of neighbors’ income. In addition, neighborhood effects are strongest for children who have lived in their neighborhoods for three or more years. This study makes progress toward explaining the mechanisms by which neighborhoods affect children and how these mechanisms differ by race.

Potential Consequences of Raising the Social Security Eligibility Age on Low-Income Older Workers

To examine the potential consequences of raising the Social Security retirement age on future cohorts of low-income elders, this study, based on data from the Health and Retirement Study, 1992–1994, identifies factors that may hinder or facilitate continuous employment among older workers born between 1931 and 1941. Specifically, following the analysis of labor-force participation rates and self-reported reasons for non-work, multivariate logistic regression models tested the relationship between individual strengths and constraints, social-structural opportunities and constraints, and economic need variables and the likelihood of work. The findings show that for both men and women, having disabilities was the most significant predictor of non-work. Racial differences, especially in men's labor-force participation rates, appeared to be due in large part to significant racial differences in disability rates. A higher proportion of blacks and Hispanics than whites also reported that they were unemployed. Based on the findings, raising the Social Security eligibility age is likely to result in increased numbers of Disability Insurance (DI) claimants, and the fiscal impact of such an increase needs to be examined. The need to assist unemployed older persons is also discussed.

Race, ethnicity, and access to ambulatory care among US adolescents.

Improving the health of minority adolescents will require a better understanding of factors that influence their access to and use of health care. This study describes the differences in health care access and use among White, Black and Hispanic adolescents and evaluates how such differences are influenced by insurance. We used data on 7465 10- to 17-year-olds included in the child health supplement to the 1988 National Health Interview Survey. Much higher proportions of Blacks (16%) and Hispanics (28%) than of Whites (11%) were uninsured. Despite having worse reported health status, Black and Hispanic adolescents made notably fewer doctor visits in the past year than their White peers, and were more apt to lack usual sources of routine and acute care as well as continuity between sources of care. Having health insurance was associated with greater increase in access and usage measures for minority youth than for White youth. However, racial differences persisted even after adjusting for health insurance, family income, need, and other factors. Minority adolescents are particularly vulnerable to the problems of health care access that affect all youth. While health insurance is especially important for increasing appropriate health care use among minority youth, nonfinancial methods of enabling more equitable use also deserve further study.

Rate of venereal disease goinfections in women with vaginal candidiasis: Michigan medicaid

This study was designed to address a concern about the conversion of vaginal imidazoles from prescription only to over-the-counter OTC status. The Food and Drug Administration (FDA) was concerned that women may misdiagnose a venereal disease as candidiasis and delay effective medical therapy for the venereal disease by using the OTC product. We conducted an epidemiology study in Michigan Medicaid (1984) to determine the rate of venereal disease in women with vaginal candidiasis. The Medicaid population was selected because it was high-risk markers for sexually transmitted diseases (STD) — low socioeconomic status and a high proportion of blacks. We used the medical and pharmaceutical claims of a 5% random sample of 98,020 women aged from 10 to 60 years with vaginal infections, who were continuously enroled in Medicaid and had no other known medical insurance. We defined a candidiasis episode as beginning with a diagnosis or prescription for candidiasis and followed by a 2 week study period. We excluded episodes with antibiotic therapy or venereal disease in the preceding 2 weeks. The study population included 2518 women with 3507 candidiasis episodes. We used a conservative approach in defining venereal disease to include Trichomonas, chancroid, gonorrhoea, herpes, syphilis, pelvic inflammatory disease (PID) and non-specific or unidentified STD. These venereal diseases were identified by diagnosis, specific prescription medication or antibiotic therapy for the disease during the 2 week study period. The incidence rate of venereal coinfections was 15.3% and the prevalence rate was 17.0%, predominantly Trichomonas, non-specific or unidentified STD and PID. The prevalence rate varied with age (10–19 years and 20–40 years) and race (white and black women) from 12.6 to 20.8%. These prevalence rates are probably an overestimate for the general United States population because of the high-risk population in Michigan Medicaid and the conservative approach used to identify venereal disease. In 1990 after reviewing this study and clinical trial data, the FDA approved prescription vaginal candidiasis medications for OTC use.

Racial heterogeneity of HIV antigenemia in people with HIV infection.

We compared the prevalence of HIV p24 antigenemia in black and white US patients with HIV infection. The prevalence of HIV antigenemia increased with severity of HIV disease (P less than 0.001). In all clinical categories, whites were more likely to be HIV-antigenemic than blacks (overall prevalence 38 versus 18%; P less than 0.01). Anti-p24 antibodies were detected in a higher proportion of blacks (84%) than whites (65%; P = 0.02). Blacks had significantly higher total serum immunoglobulin levels than whites (median 3.8 versus 3.2 mg/dl; P less than 0.00001). Racial differences in HIV antigen expression may result from differences in humoral response to HIV infection. These differences should be considered when HIV antigen is used as a surrogate marker in clinical trials.

The Skills Reinforcement Project (SRP): An Academic Program for High Potential Minority Youth

Forty-five sixth-grade students from Pasadena Unified School District who had scored in the 80–96 percentiles on the California Achievement Test (CAT) participated in a Skills Reinforcement Project (SRP) designed to increase achievement in mathematics and language arts. A matched Comparison Group also participated in this study. The subjects' ethnic, racial and socioeconomic composition mirrored the overall population of the Pasadena Unified School District which has a high proportion of blacks and Hispanics, as well as socioeconomically disadvantaged children. The SRP had three phases of academic instruction—classes on Saturdays in the spring and fall and a two-week summer residential component. Both the SRP and Comparison Groups were pretested and posttested with the CAT, with the SRP Group making significantly greater gains in mathematics, but not in reading. As a result, many SRP students qualified for screening into Pasadena Public Schools' program for the gifted without recourse to affirmative action measures.

The Employment of Central City Male Youth: Nonlinear Effects of Racial Composition

We test for linear and nonlinear effects of the racial composition of a youth's city on his probability of employment. The sample, extracted from 1980 Public Use Census data, consists of black and white male youths, aged 17‐20, residing in central cities. Controlling for a number of individual and city characteristics, we find that the absolute and relative probabilities of employment for young black men are hurt by being in a city with a higher proportion of blacks, up to a tipping point of about 50 percent black. Thereafter, blacks' absolute and relative employment odds are positively associated with the proportion black. This is consistent with the nonlinear version of the competition thesis proposed by Blalock (1957) and Lieberson (1980), and with economists' notion of employment discrimination based on the tastes of customers and coworkers.

The Employment of Central City Male Youth: Nonlinear Effects of Racial Composition

We test for linear and nonlinear effects of the racial composition of a youth's city on his probability of employment. The sample, extracted from 1980 Public Use Census data, consists of black and white male youths, aged 17‐20, residing in central cities. Controlling for a number of individual and city characteristics, we find that the absolute and relative probabilities of employment for young black men are hurt by being in a city with a higher proportion of blacks, up to a tipping point of about 50 percent black. Thereafter, blacks' absolute and relative employment odds are positively associated with the proportion black. This is consistent with the nonlinear version of the competition thesis proposed by Blalock (1957) and Lieberson (1980), and with economists' notion of employment discrimination based on the tastes of customers and coworkers.

Attitudes of Southern Democratic Party Activists Toward Jesse Jackson: The Effects of the Local Context

This article examines the effect of the racial composition of the local context on the attitudes of southern Democratic Party activists toward the 1984 Jesse Jackson presidential candidacy. Relying on a survey of delegates to the 1984 North Carolina Democratic Party state convention, the analysis finds that white activists were more likely to have a negative attitude toward the Jackson candidacy when they were from a county that had a higher proportion of blacks. This relationship occurs because the racial composition of the local context affects both the conservatism of white activists, especially on racially related issues, and the assessment these activists have of the likely effects of the Jackson candidacy. Most important are beliefs that white activists have about the impact of the Jackson candidacy on the mobilization of black voters and on the generation of intra-party conflict.

THE COURT DISPOSAL AND REMANDS OF WHITE, AFRO-CARIBBEAN, AND ASIAN MEN (LONDON, 1983)

This is an analysis of the outcome of prosecutions of white, black, and Asian males aged 17—25 in London in 1983, and also of remands by the police, the magistrates, and the Crown Court. Of those dealt with in the magistrates' courts, differences between the races regarding offences, acquittals, and sentences are small. Crown Court data also revealed only slight differences between blacks and whites. However, a higher proportion of blacks than whites were tried and sentenced in the Crown Court, pos sible reasons for which are discussed. The overall outcome was that a higher proportion of blacks than whites was acquitted, and also more received custodial sentences. At each stage of the proceedings more blacks than whites or Asians were remanded in custody (as opposed to bail) by the police and the courts. These findings may account for the reported over-representation of blacks in custody.

Multiple myeloma: epidemiological features in a well-defined population in Burgundy, France.

Epidemiological features of multiple myeloma were studied over a seven-year period (1980-86) in the department of Côte d'Or (population 478,000). The crude annual incidence rates were 3.7/100,000 for males and 4.0/100,000 for females. The corresponding age-standardized rates were 2.5 and 2.1. The sex ratio was 1.2. Cumulative rates were 0.3% for both sexes. Age and specific incidence were low before 50 and increased with advancing age up to 85 years in males and females. There was no significant variation in incidence over the seven-year period. The risk of multiple myeloma was slightly higher in urban than in rural areas (the variations were not significant). The period between the beginning of the symptoms and the diagnosis was often short, less than one month in 56% of the cases. When compared to other population based registries the incidence rates are similar to those reported all over the world (except for registries with a high proportion of blacks in the population). Cases have been staged according to Durie and Salmon classification: 32% of the cases were classified as Stage I. This result suggests that globally cases diagnosed in a well-defined population are less severe than those reported in hospital statistics. Survival showed significant differences: there were better rates for patients under 75 and for patients at stage I and II compared with stage III patients. Percentage and morphology of plasma cells also influenced prognosis.

The seasonal risk of pediatric/juvenile acute lymphocytic leukemia in the United States

Acute lymphocytic leukemia (ALL) occurring in pediatric and juvenile patients of nine U.S.A. locations during 1973 through 1980 was investigated by epidemiologic methodology. Time series periodic regression analysis of the monthly cumulative risk for ages 0–19 years revealed evidence of trimodal periodicity at seven of the nine locations tested. Combined analyses revealed a significant effect of latitude in causing asynchrony of the trimodal patterns observed. The average risk maxima occurred in April, August, and December for U.S.A. locations with latitude above 40 ° (Seattle, Nebraska, Iowa, Detroit, and Connecticut), and in February, July, and October for other locations (San Francisco, Utah, New Mexico, and Atlanta). Because periodic regression analysis is a complex method, independent validation tests were performed to supplement the original results. Here, the best Symmetric trimodal sine curve model of each location was utilized to predict the average pattern among the remaining locations of similar latitude. These validation tests supported the existence of similar trimodal patterns for all of the southern locations, and all of the northern locations except Connecticut. The observed peaks in monthly ALL risk coincide with seasonal elevations in the rates of allergenic and infectious diseases, elements of which are capable of promoting lymphocytic proliferation and transformation. Annual disease rates were significantly lower in populations with a high proportion of Blacks or American Indians compared to predominantly Caucasian populations. The possibility that seasonal factors (environmental allergens and/or infectious agents) promote leukomogenesis via indirect mechanisms is briefly discussed.