Largest Minority Population Research Articles

Genetic profile and survival outcomes in a modern cohort of patients with biliary tract cancers (BTC): Single center experience in New York City.

e16157 Background: BTCs are the second most common primary hepatobiliary malignancy with rising incidence and mortality worldwide. Individual characterization of BTCs at a genomic level is critical to tailor management strategies. Currently available data stem from studies in predominantly White populations. We conducted a retrospective study to determine the demographic, clinical and survival profiles of patients with BTCs seen in our center, who had been tested for genomic alterations. Methods: We identified 69 patients with BTCs diagnosed between 2015-2022 who had tissue-based genomic results available. Chi-square test was used to compare frequency distributions. Univariate analysis with cox regression model and multivariate cox proportional hazards test were conducted. Kaplan-Meier curves were used to assess overall survival (OS). Results: Median age at diagnosis was 67 years and median follow-up time was 15.5 months. Racial and ethnic minority populations were highly represented with 41% Hispanic, 29% Black and 17% White patients. ECOG performance status (PS) ranged between 0-2 at diagnosis. Most patients (40%) had stage IV BTC, with intrahepatic cholangiocarcinoma (CCA) being most prevalent (48%). On univariate modeling, variables associated with a shorter OS were age (HR 1.03, 95% CI 1.00-1.07, p = 0.05) and ECOG PS of 2 (HR 7.03, 95% CI 1.49-33.3, p = 0.014). In a multivariate model, ECOG PS 2 was independently associated with a shorter OS. The most common mutations (N, %) found on NGS were TP53 (28, 41%), KRAS (13, 19%), ARID1A (11, 16%), PIK3CA (9, 13%), ERBB2 (5, 7%) and FGFR2 (5, 7%). Median tumor mutation burden (TMB) was 4 Mut/Mb, with 18.9% having hypermutated (≥10 Mut/Mb) BTCs. Potentially actionable targets were found in 40 (58%) patients, 5.8% of which received targeted therapies with a median OS of 27 months (median OS of entire cohort was 22.8 months). KRAS mutation was significantly less common in intrahepatic CCA compared to the other BTC subtypes (p = 0.016). Race or ethnicity were not found to have a significant association with mutation frequency (Table). TP53 and ARID1A mutations were associated with a trend towards reduced OS in univariable analysis, with HR = 1.46 (p = 0.29) and HR = 1.64 (p = 0.28) respectively. Conclusions: Extensive genomic diversity was observed among BTC patients in our center which serves a large minority population. Studies with larger sample size are required to expand our understanding of the genomic spectrum in BTCs, its therapeutic and survival implications. [Table: see text]

Skilled Nursing Facility Performance and Readmission Rates Under Value-Based Purchasing

The new Medicare Skilled Nursing Facility Value-Based Purchasing program (SNF VBP) seeks to improve patient outcomes by awarding financial incentives or penalties based on 30-day hospital readmission rates. Skilled nursing facilities (SNFs) can avoid a penalty through low baseline readmission rates or improvement over time. To assess the baseline performance and improvement over time of SNFs in the SNF VBP program. This cross-sectional study examined readmission rates, financial penalties and incentives, and facility and patient characteristics associated with these outcomes at 14 959 US SNFs that received Medicare payments between January 1, 2015, and December 31, 2019. Outcomes were readmission rates and financial penalties by facility. The SNFs were classified as improvers in the analysis if they had better improvement scores than baseline scores under the program and achievers if they had higher baseline scores than improvement scores. Of 14 959 SNFs studied, 1849 (12.3%) were assigned their improvement score as their performance score in the first year of the program. Of these, 1167 (63.1%) received a financial penalty, whereas 374 (20.2%) received a bonus. Only 52 facilities that performed poorly at baseline (0.3% of all SNFs and 0.7% of below-median performers) were able to improve enough to avoid a financial penalty, despite large improvements in readmission rates. Improver SNFs treated larger racial minority populations (mean [SD], 74.57% [23.42%] White in the improver group vs 79.15% [22.18%] in the achiever group) and were located in counties with larger minority populations (mean [SD], 15.48% [14.05%] Black in the improver group vs 11.57% [12.72%] Black in the achiever group). The most important predictors of improvement were related to SNF finances, such as operating margin (mean [SD], -0.74 [13.87]) and occupancy rates (mean [SD], 79.93 [14.81]). This cross-sectional study suggests that the SNF VBP program did not offer a viable path for nearly all low-performing SNFs to avoid financial penalties through improved readmission rates.

SARS-CoV-2 Transmission Dynamics in Households With Children, Los Angeles, California.

Objectives: Studies of household transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) focused on households with children are limited. We investigated household secondary attack rate (SAR), transmission dynamics, and contributing factors in households with children.Materials and Methods: In this prospective case-ascertained study in Los Angeles County, California, all households members were enrolled if ≥1 member tested positive for SARS-CoV-2 by polymerase chain reaction (PCR). Nasopharyngeal PCRs, serology, and symptom data were obtained over multiple visits.Results: A total of 489 individuals in 105 households were enrolled from June to December 2020. The majority (77.3%) reported a household annual income of <$50,000, and most (92.9%) were of Hispanic/Latinx ethnicity. Children <18 years old accounted for 46.9% index cases, of whom 45.3% were asymptomatic. Household index cases were predominantly children during low community transmission and adults during the high community transmission period (χ2 = 7.647, p = 0.0036. The mean household SAR was 77.0% (95% CI: 69.4–84.6%). Child and adult index cases both efficiently transmitted SARS-CoV-2 within households [81.9%, (95% CI: 72.1–91.9%) vs. 72.4% (95% CI: 59.8–85.1%), p = 0.23]. Household income and pets were significantly associated with higher SAR in the multivariable analysis of household factors (p = 0.0013 and 0.004, respectively).Conclusions: The SAR in households with children in an urban setting with a large ethnic minority population is much higher than previously described. Children play important roles as index cases. SAR was disproportionately impacted by household income. Vaccination and public health efforts need special focus on children and vulnerable communities to help mitigate SARS-CoV-2 spread.

Rural, Underserved, and Minority Populations' Perceptions of COVID-19 Information, Testing, and Vaccination: Report from a Southern State.

The purpose of this project was to survey rural, minority, and underserved Alabamians regarding their perceptions of COVID-19 information, testing, and vaccination. Community health workers surveyed 3721 individuals from October 20-December 31, 2020. Participants came from 46 of Alabama's 67 counties (35 rural and 11 urban counties) and were largely Black (69.6%), female (56.5%), and between the ages of 40-59 years (34.8%). The majority of respondents reported that recommendations from public health agencies were easy to understand, information on COVID-19 was easy to find, and they felt confident in keeping themselves safe from infection. Most also reported they would get tested for COVID-19 if they had been exposed to someone who tested positive. Hesitancy to receive a COVID-19 vaccine was very high among all respondents; only 38.7% said they would be vaccinated. Significant differences by sex, race/ethnicity, age, and/or rural/urban status were seen for all survey items. Findings from this survey differ from other published studies and will be of interest to states with large rural, underserved, and minority populations as they tailor messaging for those most vulnerable. Findings also are now validated by Alabama's poor response to vaccine administration, which falls far short of the national vaccination rate, putting Alabamians at even greater risk. Building vaccine confidence among low vaccine populations remains challenging yet is imperative, especially for those populations with preexisting economic, social, and physical conditions that place them at continued high risk for COVID-19 infection.

Social and Cultural Challenges in Caring for Latinx Individuals With Kidney Failure in Urban Settings

Latinx individuals with end-stage kidney disease (ESKD) constitute 19% of US patients receiving in-center scheduled hemodialysis. Compared with non-Latinx White patients, Latinx individuals often face poor economic, environmental, and living circumstances. The challenges for health care professionals engendered by these circumstances when Latinx individuals present with ESKD and possible solutions have not been well described. To examine the perceptions of interdisciplinary health care professionals who work in dialysis centers in urban settings with large racial and ethnic minority populations about how social challenges affect the care of Latinx patients with ESKD. This qualitative study administered semistructured interviews of interdisciplinary health care professionals at 4 urban dialysis centers in Denver, Colorado, from April 1 to June 30, 2019. Interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis. Themes and subthemes of barriers to care. Thirty interdisciplinary dialysis center health care professionals (23 [77%] female; mean [SD] age, 42.0 [11.6] years) participated. Four themes were identified. The first 3 themes and their respective subthemes (in parentheses) describe challenges to kidney care: compromised quality of care attributable to communication and cultural barriers (language interpretation by telephone, in-person language interpretation, burden of ad hoc interpretation, low-quality health care, lack of language- and culturally concordant materials, and health literacy levels), difficulty with health care access (unreliable transportation, economic instability, and loss of insurance benefits), and concerns about patient psychosocial well-being (social isolation, hopelessness, stigma of illness, and balancing personal social challenges). The fourth theme describes solutions to improve care (culturally responsive care, patient empowerment and activation, supporting primary caregivers, and peer support with navigation of the health care system). This study's findings suggest that dialysis center policies are needed that require high-quality language interpretation and the availability of culturally concordant educational materials. Community-based interventions that improve patient activation and provide peer support as well as culturally responsive care may improve the care of Latinx patients with ESKD receiving in-center scheduled hemodialysis.

Hispanic Threat and Police Strength in U.S. Municipalities: The Moderating Influences of Nativity and Region

AbstractA key question of research on crime control is whether the level of police strength in cities primarily represents citizens’ collective interest in cutting crime, or whites’ interest in exerting control over minority populations in a racially divided society. Minority threat theories maintain that whites and police authorities seek to protect their interests by mobilizing their political power to enhance police strength in cities with relatively large minority populations. Research testing this hypothesis examines the relationships of percent black and percent Hispanic to the strength of police departments. Studies of blacks support minority threat theories, but the limited research on Hispanics does not. We extend research on Hispanics by incorporating nativity and region into an analysis of cities of 100,000 or more population in 2010. Noteworthy findings include complex interactions involving those predictors. Percent native-born Hispanic has a stronger negative relationship with police strength at higher levels of Hispanic-white residential segregation, but only in southwestern cities. Percent black is associated with increased police strength at higher levels of black-white segregation, but only in non-southwestern cities. These findings indicate that nativity, segregation, and regional context may jointly shape the mobilization of coercive crime control, sometimes in unexpected ways.

A time-varying vulnerability index for COVID-19 in New Mexico, USA using generalized propensity scores

The coronavirus disease (COVID-19) pandemic has highlighted systemic inequities in the United States and resulted in a larger burden of negative social outcomes for marginalized communities. New Mexico, a state in the southwestern US, has a unique population with a large racial minority population and a high rate of poverty that may make communities more vulnerable to negative social outcomes from COVID-19. To identify which communities may be at the highest relative risk, we created a county-level vulnerability index. After the first COVID-19 case was reported in New Mexico on March 11, 2020, we fit a generalized propensity score model that incorporates sociodemographic factors to predict county-level viral exposure and thus, the generic risk to negative social outcomes such as unemployment or mental health impacts. We used four static sociodemographic covariates important for the state of New Mexico—population, poverty, household size, and minority population—and weekly cumulative case counts to iteratively run our model each week and normalize the exposure score to create a time-varying vulnerability index. We found the relative vulnerability between counties varied in the first eight weeks from the initial COVID-19 case before stabilizing. This framework for creating a location-specific vulnerability index in response to an ongoing disaster may be used as a quick, deployable metric to inform health policy decisions such as allocating state resources to the county level.

European transport simulator modeling of JET-ILW baseline plasmas: predictive code validation and DTE2 predictions

The European transport simulator is a fusion machine simulator useful for making predictions of high-performance fusion plasmas, in particular for DT reactors. Recent developments introducing self-consistent simulations of combined RF + NBI heating schemes in which majority, minority and beam ions are simultaneously heated is documented. The predictive simulations are first validated by comparison with the experimental data on a DD JET baseline plasma. In order to prepare the next JET DTE2 experimental campaign, extrapolations of fusion performance on DT plasma from DD plasma are made with a particular focus on ion cyclotron resonance heating (ICRH) computation. Traditional ion cyclotron range of frequency heating models do not permit the study of Coulomb collisional interaction of various ion species simultaneously including neutral beam injection ions, and generally forces one to consider only minority populations. Accounting for multi-population interaction is made possible here by solving coupled sets of Fokker–Planck equations for all ion species adopting the non-linear collision operator for arbitrary distribution functions, accounting for effects, such as the self-collisions of majority (or large minority) populations. To answer the question whether H minority scheme or 3He minority ICRH scheme is better for boosting the DT fusion performance, minority concentration scans are produced.

Counties with High COVID-19 Incidence and Relatively Large Racial and Ethnic Minority Populations - United States, April 1-December 22, 2020.

Long-standing systemic social, economic, and environmental inequities in the United States have put many communities of color (racial and ethnic minority groups) at increased risk for exposure to and infection with SARS-CoV-2, the virus that causes COVID-19, as well as more severe COVID-19-related outcomes (1-3). Because race and ethnicity are missing for a proportion of reported COVID-19 cases, counties with substantial missing information often are excluded from analyses of disparities (4). Thus, as a complement to these case-based analyses, population-based studies can help direct public health interventions. Using data from the 50 states and the District of Columbia (DC), CDC identified counties where five racial and ethnic minority groups (Hispanic or Latino [Hispanic], non-Hispanic Black or African American [Black], non-Hispanic Asian [Asian], non-Hispanic American Indian or Alaska Native [AI/AN], and non-Hispanic Native Hawaiian or other Pacific Islander [NH/PI]) might have experienced high COVID-19 impact during April 1-December 22, 2020. These counties had high 2-week COVID-19 incidences (>100 new cases per 100,000 persons in the total population) and percentages of persons in five racial and ethnic groups that were larger than the national percentages (denoted as "large"). During April 1-14, a total of 359 (11.4%) of 3,142 U.S. counties reported high COVID-19 incidence, including 28.7% of counties with large percentages of Asian persons and 27.9% of counties with large percentages of Black persons. During August 5-18, high COVID-19 incidence was reported by 2,034 (64.7%) counties, including 92.4% of counties with large percentages of Black persons and 74.5% of counties with large percentages of Hispanic persons. During December 9-22, high COVID-19 incidence was reported by 3,114 (99.1%) counties, including >95% of those with large percentages of persons in each of the five racial and ethnic minority groups. The findings of this population-based analysis complement those of case-based analyses. In jurisdictions with substantial missing race and ethnicity information, this method could be applied to smaller geographic areas, to identify communities of color that might be experiencing high potential COVID-19 impact. As areas with high rates of new infection change over time, public health efforts can be tailored to the needs of communities of color as the pandemic evolves and integrated with longer-term plans to improve health equity.

Do accountable care organizations differ according to physician-hospital integration?: A retrospective observational study.

Physician-hospital integration among accountable care organizations (ACOs) has raised concern over impacts on prices and spending. However, characteristics of ACOs with greater integration between physicians and hospitals are unknown. We examined whether ACOs systematically differ by physician-hospital integration among 16 commercial ACOs operating in Massachusetts.Using claims data linked to information on physician affiliation, we measured hospital integration with primary care physicians for each ACO and categorized them into high-, medium-, and low-integrated ACOs. We conducted cross-sectional descriptive analysis to compare differences in patient population, organizational characteristics, and healthcare spending between the three groups. In addition, using multivariate generalized linear models, we compared ACO spending by integration level, adjusting for organization and patient characteristics. We identified non-elderly adults (aged 18–64) served by 16 Massachusetts ACOs over the period 2009 to 2013.High- and medium-integrated ACOs were more likely to be an integrated delivery system or an organization with a large number of providers. Compared to low-integrated ACOs, higher-integrated ACOs had larger inpatient care capacity, smaller composition of primary care physicians, and were more likely to employ physicians directly or through an affiliated hospital or physician group. A greater proportion of high-/medium-integrated ACO patients lived in affluent neighborhoods or areas with a larger minority population. Healthcare spending per enrollee in high-integrated ACOs was higher, which was mainly driven by a higher spending on outpatient facility services.This study shows that higher-integrated ACOs differ from their counterparts with low integration in many respects including higher healthcare spending, which persisted after adjusting for organizational characteristics and patient mix. Further investigation into the effects of integration on expenditures will inform the ongoing development of ACOs.

Urban Household Transmission of SARS-CoV-2 During Periods of High and Low Community Transmission

Background: Household transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) significantly contributes to increased community cases. Methods: We conducted a prospective case-ascertained study to investigate the household secondary attack rate (SAR) and contributing factors in urban Los Angeles, California, USA. Household members were enrolled prospectively if ≥1 member tested positive for SARS-CoV-2 by polymerase chain reaction (PCR). Nasopharyngeal swabs for PCR and symptom data were obtained over multiple longitudinal visits. Serology was obtained at enrollment. Findings: A total of 489 individuals in 105 households were enrolled from June to December 2020. The mean household SAR was 77.7% (95%CI: 71.4-84.0). A third (32.1%) of index cases were asymptomatic. High SAR was associated with both symptomatic and asymptomatic index cases (76.4% [95%CI: 68.8-83.9%] vs. 79.7% [95% CI: 66.2-93.3%], p=0.66). The most common age for index cases was children Children and adults index cases both efficiently transmitted SARS-CoV-2 within households (SAR 74.0% [95%CI: 63.4-84.6%] vs. 81.3% [95%CI: 72.3-90.3%], p=0.49). Hispanic/Latinx ethnicity was significantly associated with higher SAR in the multivariable analysis of household factors (p= 0.030). Interpretation: The SAR in our urban setting with large ethnic minority populations is much higher than previously described. SAR was disproportionately and significantly impacted by Hispanic/Latinx ethnicity. Asymptomatic individuals and children play important roles as index cases. Future vaccination and public health efforts need special focus on these groups to help mitigate SARS-CoV-2 spread.Funding: NIH/NIAID U01AI144616-02S1, Open PhilanthropyDeclaration of Interests: PSP has received consultant fees from Sanofi-Pasteur and Seqirus. She also receives research funding from AstraZeneca for an unrelated study. AG has received consultant fees from Janssen. All other authors have no conflicts of interest to report.Ethics Approval Statement: The study was approved by the Institutional Review Board at Children’sHospital Los Angeles.

Education of French Colonialists with Ethnic Minorities in Cochinchine in the period 1862-1945

In the beginning of the article, we presented the picture of ethnic minorities in Cochinchina and the educational policy of the Nguyen Dynasty to ethnic minorities in Cochinchine before the French colonial invasion as well as the process of invasion and process of imposing a new educational model of French colonialists in Cochinchina. In the main content, the author presents educational policies in general and French policies for ethnic minorities in Cochinchine in particular, expressed in documents and decrees of colonial authorities on goals, manner and measures to be taken. The article also reorganized the implementation of French educational policies in practice for the ethnic minority areas in Cochinchine during the French colonial period, such as the opening of schools, classes, and the process of organizing activities of the French school system, class and results achieved in areas with a large ethnic minority population. The author made the comments and assessments about the results and limitations of the educational policy for ethnic minorities of the French colonialists in Cochinchina from 1862 to 1945.

Ethnicity and Government Provision of Drinking Water Infrastructure in Rural China

What areas of the country does the Chinese government prioritize for drinking water provision infrastructure? Chinese policy prioritizes ethnic minorities and minority autonomous areas due to concerns about inequality and interethnic harmony. However, the implementation is not always equitable or favorable for ethnic minorities. Drawing on a new data set of more than 10,000 drinking water projects, I explore how ethnicity and autonomy influence public goods provision in rural Guizhou Province. I find implementation concerns trump official policy priorities when it comes to drinking water infrastructure. Such facilities are more likely to be built in Han-majority areas, because implementation and project completion are easier for officials. The findings have implications for ethnic politics and public goods provision in nondemocratic contexts. They also demonstrate why regions with larger minority populations are often slower to develop and slower to receive better access to basic public services.

Household fuelwood consumption in western rural China: ethnic minority families versus Han Chinese families

AbstractThis paper examines ethnic differences in fuelwood consumption in rural households, using an original survey dataset from two western Chinese provinces with large ethnic minority populations. We use a Heckman two-stage selection model to explain the quantity of fuelwood consumed conditional on a decision to use fuelwood. We find that ethnic minority families are more likely than majority Han Chinese families to use fuelwood. We also find that a household's off-farm income has a stronger negative effect on the quantity of fuelwood consumed for the ethnic minority families than for the Han Chinese families. In addition, families owning a larger area of forestland are more likely to use fuelwood. Yet the quantity of fuelwood consumed, especially in ethnic minority families, does not increase with owned forestland. Finally, we find that coal, rather than electricity, is a substitute for fuelwood for residential cooking and heating.

The Influence of School-Based Health Center Access on High School Graduation: Evidence From Colorado

PurposeTo examine the association between the introduction of a school-based health center (SBHC) and high school graduation rates. MethodsWe use school-level longitudinal data from Colorado that combines data on the opening of SBHCs in high schools with 4-year high school graduation rates overall and by gender between 2000 and 2018. The analytic sample consists of high schools without an SBHC in 2000 (n = 132). We compare high schools that opened SBHCs over the period to those that did not and run school-level panel fixed effects models to assess the relationship between opening an SBHC and change in high school graduation rates. ResultsSchools that subsequently opened SBHCs had larger minority populations and lower average graduation rates in 2000. Opening an SBHC was associated with a 4.1 percentage point increase in the overall graduation rate (p = .077). The gender-stratified analyses indicate young men’s graduation rates were most sensitive to the presence of an SBHC, increasing 4.8 percentage points (p = .051), compared to young women’s graduation rates increasing 3.0 percentage points (p = .163). ConclusionsOur findings suggest that the benefits of SBHC access may extend beyond health-specific outcomes to graduation rates.

Where you live can impact your cancer risk: a look at multiple myeloma in New York City

PurposeTo visualize variation in multiple myeloma (MM) incidence and mortality rates by race-ethnicity and geographic location and evaluate their correlation with neighborhood-level population covariates within New York City (NYC). MethodsTrends and racial differences in MM incidence and mortality for the United States [Surveillance, Epidemiology, and End Results Cancer Registry (SEER), National Center for Health Statistics], and NYC [New York State Cancer Registry] were compared using Joinpoint regression. Pearson's correlation coefficients measured neighborhood-level MM–covariate relationships (n = 34). ResultsMM incidence rates are double in African-Americans compared with Whites, in SEER-13 areas (rate ratio (RR) = 2.27; 95% confidence interval [CI] = 2.22–2.32) and NYC (RR = 2.11; 95% CI = 2.03–2.20). Incidence rates increased faster in NYC (average annual percentage change difference, −1.1; 95% CI, −2.3 to −0.1). NYC African-American men experienced the steepest increase in mortality rates after 2001. In NYC, strong neighborhood-level correlations exist between incidence and mortality rates and high prevalence of residents of African ancestry, Latin American birth, daily sugary beverage and low fruit and vegetable consumption, and neighborhood walkability. Higher MM mortality also correlates with Hispanic ethnicity, obesity, diabetes, poverty, HIV/AIDS, air benzene concentration, and indoor pesticide use. ConclusionsNYC neighborhoods with large minority populations have higher prevalence of poverty-related factors associated with MM incidence and mortality, warranting public health policies to address exposures and access to care.

Racial demographics and cigarette tax shifting: evidence from scanner data

This paper examines the association between racial demographics and the shifting of cigarette excise taxes to consumer prices. Using scanner data on cigarette sales from 1687 stores across 53 American cities, 2009–2011, we found that cigarette taxes are shifted significantly less to consumer prices in cities with large minority (black and Hispanic) populations. The potential for price search behavior implies that our estimates understate the magnitude of the true relationship between local racial composition and cigarette tax shifting. Our finding suggests that increasing cigarette taxes may not be an effective means of reducing cigarette consumption in high-minority areas.

A call to action: Preparing a disability-competent health care workforce

People with disabilities make up the largest minority population in the country, yet our health care workforce is unprepared to meet their needs. Two initiatives – and the Alliance for Disability in Health Care Education’s Disability Competencies and the Resources for Integrated Care Disability-Competent Care model-provide essential tools to build a health care workforce prepared to meet the health needs of people with disabilities. We note gaps in health education and continuing education curricula, document barriers to progress, and demonstrate how the two initiatives offer a clear roadmap to effect systemic change. Finally, we issue a call to action for health care education, practice, and research to ensure a health care workforce prepared to provide quality health care to people with disabilities.

How structural racism can kill cancer patients: Black patients with breast cancer and other malignancies face historical inequities that are ingrained but not inevitable. In this article, the second of a 2-part series, we explore the consequences of and potential solutions to racism and inequality in cancer care.

How structural racism can kill cancer patients: Black patients with breast cancer and other malignancies face historical inequities that are ingrained but not inevitable. In this article, the second of a 2-part series, we explore the consequences of and potential solutions to racism and inequality in cancer care.

In the EU and NATO but Close to Russia — Post-Crimea Attitudes in Bulgaria and Hungary

AbstractThis article focuses on attitudes towards Russia in Bulgaria and Hungary — two EU and NATO countries with special relations to Russia — in the wake of Russia’s annexation of Crimea and military intervention in support of separatists in the Donbas region of Eastern Ukraine in 2014 and onwards. We begin by putting the relations to Russia in a historical perspective. We then set out to account for support for Russia with the help of survey data from the Post-Crimea Barometer (2015) — a unique survey focusing on geopolitical orientation (East versus West) and attitudes towards Russia in Latvia, Hungary and Bulgaria in a post-Crimea setting. Latvia is a special case because of its large Russian minority population; we therefore confine our comparison to Bulgaria and Hungary. The findings suggest that long-term attachment to Russia is decisive in Bulgaria. In Hungary, long-term attachment to Russia is important, but not sufficient to account for post-Crimea attitudes towards Russia.