Major Racial Groups Research Articles

The (In)significance of Race in Singapore’s Immigration Context: Accounts of Self-Differentiation by Academically Elite Students

ABSTRACT In order to counter low birthrates, the Singapore state recruits top-performing students from China and Vietnam with scholarships to augment the local talent pool. Another criterion is that most immigrants must be ethnically Chinese, so as to fit into Singapore’s majority racial group. This study examines whether and how race (or other factors) might contribute to (dis)affiliation amongst academically elite students in Singapore. Drawing on life history interviews and focus group discussions with top-performing students in Singapore, I investigate how informants engaged in self-differentiation. Instead of race, informants positioned themselves and others along a Singaporean/non-Singaporean polarity, using nationality and time of entry as markers of cultural and structural difference. Chinese linguistic practices were perceived as deficits and impediments to being localised amongst them. The state’s assumption—that immigrants can fit in locally just because they fit official racial categories—does not consider how cultural practices are re-valued when transported to a different space.

1077 The Association Between Sleep Problems And Risk-taking Behavior Differs Between Racial Majority And Minority Groups

Abstract Introduction Individuals with Post-Traumatic Stress Disorder (PTSD) often experience poor sleep quality and elevated self-destructive behaviors. Among healthy individuals, poor sleep quality can lead to increased risk-taking behavior through decreased inhibition and/or increased willingness to take risks. However, it is unclear whether racial/ethnic background may influence this relationship, in particular among individuals with PTSD. We examined whether the relationship between sleep quality and risk propensity would differ between majority and minority racial groups in individuals with PTSD. Methods Seventy-six individuals (61.8% female; mean age=31.7, SD=8.8) with a clinical diagnosis of PTSD were administered the Functional Outcomes of Sleep Questionnaire (FOSQ) as a measure of sleep-related functional impairment of daily activities, and the Evaluation of Risk (EVAR) Scale as a measure of risk-taking propensity. Forty-seven individuals identified with the majority racial group (Caucasian) and 29 individuals identified themselves within the minority. Results There were no significant group differences for FOSQ and total EVAR risk-taking scores. However, the strength of association between measures differed significantly between groups (Z=1.95, p=.051). For the racial/ethnic majority, functional impairments due to lack of sleep were positively associated with risk-taking propensity (r=.460, p=.001); this relationship was not present for the minority group (r=.016, p=.936). Conclusion Self-reported functional impairments due to sleep loss significantly correlated with risk-taking propensity for those who identified themselves as part of the majority racial group but not for individuals who identified as part of a racial minority. Findings suggest that broad conclusions regarding the association between sleep disruption and risk-taking may not apply equally across racial/ethnic groups and such factors should be considered when evaluating studies of sleep and risk behaviors. Whether these differing effects are due to cultural factors or stable differences in biology is not known and will require additional research. Support W81XWH-14-1-0570

Predictive Utility of Polygenic Risk Scores for Coronary Heart Disease in Three Major Racial and Ethnic Groups

Because polygenic risk scores (PRSs) for coronary heart disease (CHD) are derived from mainly European ancestry (EA) cohorts, their validity in African ancestry (AA) and Hispanic ethnicity (HE) individuals is unclear. We investigated associations of "restricted" and genome-wide PRSs with CHD in three major racial and ethnic groups in the U.S. The eMERGE cohort (mean age 48 ± 14 years, 58% female) included 45,645 EA, 7,597 AA, and 2,493 HE individuals. We assessed two restricted PRSs (PRSTikkanen and PRSTada; 28 and 50 variants, respectively) and two genome-wide PRSs (PRSmetaGRS and PRSLDPred; 1.7M and 6.6M variants, respectively) derived from EA cohorts. Over a median follow-up of 11.1 years, 2,652 incident CHD events occurred. Hazard and odds ratios for the association of PRSs with CHD were similar in EA and HE cohorts but lower in AA cohorts. Genome-wide PRSs were more strongly associated with CHD than restricted PRSs were. PRSmetaGRS, the best performing PRS, was associated with CHD in all three cohorts; hazard ratios (95% CI) per 1 SD increase were 1.53 (1.46-1.60), 1.53 (1.23-1.90), and 1.27 (1.13-1.43) for incident CHD in EA, HE, and AA individuals, respectively. The hazard ratios were comparable in the EA and HE cohorts (pinteraction = 0.77) but were significantly attenuated in AA individuals (pinteraction= 2.9× 10-3). These results highlight the potential clinical utility of PRSs for CHD as well as the need to assemble diverse cohorts to generate ancestry- and ethnicity PRSs.

Representing race: the race spectrum subjectivity of diversity in film

ABSTRACT In order to understand how people from all major racial groups in the United States feel about racial representation in film, this study employed Q methodology to assess the motivations, attitudes, and opinions of individuals on this issue. Four factors were identified: (1) balanced critics, (2) storyline devotees, (3) tolerant learners, (4) grounded advocates. These four groups of people with common opinions on diversity in film represent a spectrum on perceptions of race, from colourblind to anti-racist. Variation in factor differences are explained through the lens of symbolic interactionism. In three of the four groups, individuals indicated a desire for more racially diverse film casts. The fourth group did not oppose racial representation in film, rather, these individuals were more concerned about the quality of the storyline. Implications for Hollywood’s incorporation of racially diverse casts are discussed.

“Mixed” Drinking Motivations: A Comparison of Majority, Multiracial, and Minority College Students

Social exclusion is associated with substance use, but the specific link between majority and minority racial group membership and substance use is unknown. We examined how social exclusion among racial majority (White), Multiracial, and racial minority (Native American, Latino, Asian, and Black) college students relates to self-reported alcohol use and motivations. Using the AlcoholEdu for College™ survey, Study 1a reports five factors related to motives for initiating or inhibiting alcohol use. Study 1b analyzes majority, Multiracial, and minority college students’ comparative endorsement of these motivations. Study 2 compares these factors with established belonging scales using a separate undergraduate sample. White, Multiracial, Native American, and Latino students displayed the highest proportion of problematic alcohol use. White students endorsed belonging-based drinking motivations, while Multiracial and Asian students endorsed motivations similar to both majority and minority groups. Native American, Latino, and Black students endorsed abstaining motivations more than other groups.

The Unique Case of Minneapolis–St. Paul, MN: Locational Attainments and Segregation in the Twin Cities

The Minneapolis–St. Paul Metropolitan Area has a rapidly growing foreign-born population in part due to its high levels of refugee reception and migrants drawn to the burgeoning high-tech and manufacturing industries. As a result, the Twin Cities are unique in that every major racial group has a sizable foreign-born segment with a wide range of U.S. entry experiences and thus the area offers an opportunity to investigate the dynamics of locational attainments and segregation of a highly diverse non-White population. Accordingly, we examine the residential outcomes of Blacks, Latinos and Asians, investigate how nativity, socioeconomic gains, and acculturation translate into residential contact with Whites, and draw the link between these micro-level locational attainments and overall segregation patterns for the area. We find Latinos and Asians experience traditional spatial assimilation dynamics but a different pattern is seen for Blacks wherein foreign-born Blacks are less segregated than U.S.-born Blacks, reversing the expected role of nativity and acculturation and suggesting a more complicated story of ethnic stratification and assimilation supported by the segmented assimilation framework.

Assessing Health Needs in African American Churches: A Mixed-Methods Study.

Among major racial and ethnic groups in the USA, African Americans are the most religious, and faith-based organizations play an important role in health promotion for African Americans. This study aimed to assess health needs in African American churches using a mixed-methods approach. Based on quantitative and qualitative data collected from eight African American churches in Nebraska in 2017, the most prevalent chronic conditions among participating African American church members (n = 388) included hypertension (60.8%), allergies (41.0%), arthritis (36.4%), high cholesterol (35.8%), and diabetes (28.1%). Significant predictors of fair or poor health were identified as male sex, unemployment, delayed utilization of health care in the past 12months due to cost, lower frequency of church attendance, and feeling down, depressed, or hopeless in the past 2weeks. Pastors from participating churches identified cost as one of the primary barriers to providing church-based health services. There were substantial unmet health needs in African American faith communities, especially in the areas of chronic disease prevention and management, and churches would need more support to realize their full potential in faith-based health promotion.

Abstract LB-159: The bench with bedside initiative: A “trans-relational” approach to translational research

Abstract Translational research necessitates the use of human specimens. As per the regulations for the protection of human subjects, study participants (SP) are not required to be informed of the outcomes of research. While individual results should mostly not be reported back to patients to avoid anxiety and misinterpretation of yet to be proven data, general research results should be delivered back to the study participants. It can be argued that SP/researcher relationships are inadequately developed in most cases and that research lacks in transparency. As such, The Bench with Bedside Initiative™ (TBBI) was launched to serve as a trans-relational approach to conducting translational research, where scientists at the bench collaborate and engage with SP at the bedside. As an initial effort of TBBI™ social media and grass roots efforts were used to identify breast cancer survivors to donate blood for a blood-based biomarker study. A web-based survey (https://thebenchwithbedsideinitiative.usc.edu/) was used to determine eligibility and perceptions for enhanced involvement. The study was described to the future SP as a long-term collaboration with the lead researcher where data transparency would be integral to the study design. A total of 316 women completed the survey in a three-month period. When asked, 85% of survey takers said they would be very interested in getting updates on the use of their samples and 100% said they want to know the outcomes of the research. Furthermore, 76% said they had a moral and ethical right to learn the fate of their sample. A total of 86% of survey takers said they would be interested in building a relationship with the research scientist. Among the most widely used words in the comment box were empowering, involvement, hope, future, important, progress, and information. Of 316 women, 132 were deemed eligible to donate blood. As part of TBBI™ 59 eligible SP travelled to meet the PI and under informed consent donated blood in the PI’s lab. SP represented every major racial and ethnic group and socioeconomic background. SP came from 30 cities and traveled an average of 50 miles and as far as 675 miles. The use of biospecimens and associated data for research entails significant ethical obligations to the individuals from whom those specimens were obtained. Researchers owe it to themselves and to their SP to provide information as soon as it becomes available. While the long-term outcomes are yet to be determined, the perceived benefits to a trans-relational approach to conducting human research include diversification of study participants, ease of long-term follow-up, improved clinical trial enrollment, better accountability of resources, and not least of all is providing a lot of hope to those we are trying the hardest to help. Citation Format: Bodour Salhia. The bench with bedside initiative: A “trans-relational” approach to translational research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-159.

Public Support for Increasing Women and Minority MPs

AbstractMost democracies fail to provide equal representation and tend to have an overrepresentation of men from the upper class and the majority racial or ethnic group. We investigate public support for increasing the number of women and indigenous Māori members of parliament (MPs) in the New Zealand Parliament, both in general and through specific mechanisms such as quotas and reserved seats. We offer three explanations: descriptive (group identity), substantive (issue alignment), and symbolic (socioeconomic and political equity concerns). Using data from the 2014 New Zealand Election Study, we found that shared identity (descriptive) matters for all measures of increased representation, but especially for Māori respondent support of increased Māori MPs. Support for increasing the proportion of Māori MPs is also strongly driven by substantive concerns, as measured by support for keeping the Treaty of Waitangi in law. Support for increasing the number of women MPs is driven most strongly by symbolic concerns (measured as increased government social spending and efforts to reduce income differences). Overall, respondents favor retaining the current number of reserved seats for Māori MP representation, whereas informal efforts (rather than quotas) are strongly preferred for increasing the number of women MPs.

Racial Disparities in Body Composition of Preterm Infants (P21-049-19)

ObjectivesAt term-equivalent age, preterm infants have higher % body fat (%BF) than infants born at term. This difference in %BF is often the result of exposure to enriched postnatal diets prescribed to promote rapid weight gain among preterm infants. Because rapid weight gain during infancy and obesity are more prevalent among blacks than among whites, racial disparities in the development of adiposity expressed as %BF need to be explored. The purpose of this study was to compare %BF in two major racial groups using normative data as reference. MethodsWe analyzed data from a prospective study that assessed body composition in preterm infants using air displacement plethysmography (PeaPod®). After stratifying data according to race, we analyzed differences between mean %BF values of preterm infants at the time of hospital discharge and compared these differences to existing references of %BF in preterm infants. A linear regression analysis was performed to account for differences in baseline characteristics. ResultsWe assessed body composition in 84 preterm infants, of which 47 were black and 37 were white. Mean birthweight was 1471 g and median gestational age was 30 weeks. In preterm infants assessed at the time of hospital discharge, mean %BF was 14.6 ± 3.6 (14.5 ± 2.9 in white infants and 14.6 ± 4.1 in black infants; P = 0.90). The measured %BF at the time of hospital discharge was higher than the expected %BF at equivalent postmenstrual age (mean difference: 4.7 ± 3.5; P < 0.05). After adjustment for BW, GA, sex, and length of hospital stay, this difference between measured and expected %BF was not significantly higher among black infants compared to white infants (5.1 vs. 4.2; P = 0.28). ConclusionsBlack race is not associated with higher %BF at the time of hospital discharge in preterm infants. If racial disparities in body composition exist among former preterm infants, those differences may occur after hospital discharge. Both black and white preterm infants exposed to enriched postnatal diets develop higher than expected %BF by the time of hospital discharge. Funding SourcesNone.

The Impact of a Community Fruit and Vegetable Voucher Program (Vouchers 4 Veggies) on Improvements in Dietary Intake and Food Security (P04-013-19)

ObjectivesVouchers 4 Veggies (V4V) is a transformative healthy food voucher program aimed at increasing access to and affordability of healthy food in the most vulnerable communities. Between 2015–2018, over 2600 ethnically diverse low-income individuals were enrolled in the program with the goal to increase their fruit and vegetable intake, improve food security status and change health perception. MethodsV4V partners with local community-based organizations and clinics that serve as voucher distribution sites as well as neighborhoods stores, grocery stores, and famer’s markets where participants can redeem their vouchers. Participants receive $20-$40 worth of vouchers per month for 6 months. Data for this evaluation were collected using pre- and post- surveys (at 0 and 4–6 months) that included a validated fruit and vegetable intake screener, the USDA 7-item food security screener, demographic questions and health perception questions. ResultsData from 862 matched surveys indicate that mean fruit and vegetable intake increased from 2.49 to 3.52 servings daily, corresponding to a 1.03 servings increase after six months in the program (0.89,1.77; P < .001). In addition, V4V participants’ food security scores improved, decreasing 0.88 points (−1.07, −0.71; P < 0.001) on a 6 point scale (0 being the most food secure and 6 being very food insecure), from a mean of 5.53 to 4.65 using the USDA validated 6-item scale. When stratified by race, food security improved significantly for all major racial groups except Black/African Americans. Finally, participants reported a statistically significant improvement in self-reported health status (P < 0.001), with a 14% change in status from poor/fair health to good/very good/excellent health. ConclusionsThis evaluation suggests that a modest supplement for fruits and vegetables may be able to improve dietary intake, support food security, and improve health perception among vulnerable residents of San Francisco. More research is needed to understand differences in maintaining long-term health and behavior changes among program participants. Funding SourcesV4V received funding from the SF Department of Public Health, Hellman Foundation, AARP Foundation, and Kaiser Permanente Community Benefits Program.

Racial and ethnic differences in the results of multigene panel testing of inherited cancer predisposition genes in breast cancer patients.

1514 Background: The prevalence of germline mutations in non-white patients with breast cancer and the germline genetic drivers of breast cancer risk in non-white populations are largely unknown. Methods: The study population included 77,900 women with breast cancer (Non-Hispanic white: 57,003; Black: 6,722; Asian: 4,183; Hispanic: 5,194; Ashkenazi-Jewish: 4,798) who underwent germline multigene panel testing of cancer predisposition genes from March 2012 to December 2016. The prevalence of predisposition gene mutations in racial and ethnic populations relative to non-Hispanic Whites was assessed while accounting for age at diagnosis of breast cancer, family history of breast and ovarian cancer, and estrogen receptor status of breast tumors. Associations between mutations in each gene and breast cancer risk were evaluated using reference controls. Results: The overall frequency of pathogenic mutations in known breast cancer predisposition genes was 9.1% for non-Hispanic Whites, 9.8% for African Americans, 10.2% for Hispanics, 7.6% for Ashkenazi-Jewish, and 7.5% for Asians. BRCA1 mutations were enriched (p &lt; 0.05) and CHEK2 mutations were under-represented in all racial and ethnic populations relative to non-Hispanic Whites. BRCA2 and BARD1 mutations were enriched in African Americans and Hispanics relative to non-Hispanic Whites, whereas PALB2 and RAD51C mutations were enriched in Hispanics. Among genes with mutation counts large enough for assessment, mutations in BARD1, BRCA1, BRCA2, PALB2 and TP53 were significantly associated with clinically relevant increased risks (odds ratio (OR) &gt; 2) of breast cancer across all ethnicities and races. Rates of variants of uncertain significance were highest among Asians (29%), followed by blacks (27%), Hispanics (21%), non-Hispanic whites (16%) and Ashkenazi-Jews (14%). Conclusions: While there is some similarity across ethnic groups, substantial heterogeneity exists in the prevalence of mutations in breast cancer predisposition genes across major racial and ethnic groups in the US population. These findings contribute to our understanding of breast cancer risk and have significant implications for genetic testing, screening, and management of patients with an inherited predisposition to breast cancer, with a need for continued analysis with increased cohort size in ethnic minority groups.

Neighborhood selections by young adults: Evidence from a panel of U.S. adolescents

ABSTRACTThe number of neighborhoods with diverse mixtures of the major ethnic and racial groups is increasing. There is also work that suggests that young adults are more open to integration and that they may be making more integrative choices. In this context, we use data on neighborhood residential mobility from the National Longitudinal Study of Adolescent to Adult Health to compare changes in neighborhood percentage own race from adolescence to young adulthood across race and ethnicity, paying specific attention to how factors in adolescence (parental educational attainment) and young adulthood (income, educational attainment) influence these changes. The focus is on residential selections in the period of most active relocation behavior, the years of leaving home, setting up families and careers, and entering the housing market. We find much more dynamism in the distribution of neighborhood selections than is suggested in previous studies that focus on average outcomes. Specifically, we show that though there is continued sorting into neighborhoods that are reflections of race and ethnicity there is also considerable individual variation. Moving into high and low percentage own-race neighborhoods can be explained by own and parental educational attainment and percentage own race in the adolescent neighborhood.

Alternative Treatment Utilization Before Hysterectomy for Benign Gynecologic Conditions at a Large Integrated Health System

To investigate rates of utilization of alternative treatments before hysterectomy for benign gynecologic indications within a large integrated health care system. Retrospective cohort study of patients who underwent hysterectomies for benign gynecologic conditions between 2012 and 2014 (Canadian Task Force classification II-2). Kaiser Permanente Northern California, a community-based integrated health system. Women who underwent hysterectomy for a benign gynecologic condition between 2012 and 2014. From an eligible cohort of 6892 patients who underwent hysterectomy, a stratified random sample of 1050 patients were selected for chart review. Stratification was based on the proportion of indications for hysterectomy. The primary outcome was the use of alternative treatments before hysterectomy. Alternative treatments included oral hormone treatment, leuprolide, medroxyprogesterone intramuscular injections, a levonorgestrel intrauterine device, hormonal subdermal implants, endometrial ablation, uterine artery embolization, hysteroscopy, and myomectomy. Of the 1050 charts reviewed, 979 (93.2%) met the criteria for inclusion in this study. The predominant indication for hysterectomy was symptomatic myomas (54.4%), followed by abnormal uterine bleeding (29.0%), endometriosis (5.8%), pelvic pain (3.1%), dysmenorrhea (3.4%), and other (4.3%). The major routes of hysterectomy were laparoscopy (68.7%) and vaginal hysterectomy (13.4%). Before hysterectomy, 81.2% of patients tried at least 1 type of alternative treatment (33.8% with 1 treatment and 47.4% with at least 2 treatments), and 99.3% of patients were counseled regarding alternative treatments. Compared with younger women age <40 years, women age 45 to 49 years were less likely to use alternative treatments before hysterectomy (adjusted odds ratio, 0.41; 95% confidence interval, 0.21-0.76). There were no variations in treatment rates by socioeconomic status or between major racial and ethnic groups. The final pathological analysis identified myomas as the most common pathology (n = 637; 65.1%); 96 patients (9.8%) had normal uterine pathology. More than 80% of patients received alternative treatments before undergoing hysterectomy for a benign gynecologic condition. Additional investigation is warranted to assess alternative treatment use as it relates to preventing unnecessary hysterectomies.

Gene Environment Interactions and Predictors of Colorectal Cancer in Family-Based, Multi-Ethnic Groups.

For the personalization of polygenic/omics-based health care, the purpose of this study was to examine the gene–environment interactions and predictors of colorectal cancer (CRC) by including five key genes in the one-carbon metabolism pathways. In this proof-of-concept study, we included a total of 54 families and 108 participants, 54 CRC cases and 54 matched family friends representing four major racial ethnic groups in southern California (White, Asian, Hispanics, and Black). We used three phases of data analytics, including exploratory, family-based analyses adjusting for the dependence within the family for sharing genetic heritage, the ensemble method, and generalized regression models for predictive modeling with a machine learning validation procedure to validate the results for enhanced prediction and reproducibility. The results revealed that despite the family members sharing genetic heritage, the CRC group had greater combined gene polymorphism rates than the family controls (p < 0.05), on MTHFR C677T, MTR A2756G, MTRR A66G, and DHFR 19 bp except MTHFR A1298C. Four racial groups presented different polymorphism rates for four genes (all p < 0.05) except MTHFR A1298C. Following the ensemble method, the most influential factors were identified, and the best predictive models were generated by using the generalized regression models, with Akaike’s information criterion and leave-one-out cross validation methods. Body mass index (BMI) and gender were consistent predictors of CRC for both models when individual genes versus total polymorphism counts were used, and alcohol use was interactive with BMI status. Body mass index status was also interactive with both gender and MTHFR C677T gene polymorphism, and the exposure to environmental pollutants was an additional predictor. These results point to the important roles of environmental and modifiable factors in relation to gene–environment interactions in the prevention of CRC.

Recruiting American Indian/Alaska Native Students to Medical School: A Multi-Institutional Alliance in the U.S. Southwest.

Despite national efforts to diversify the physician workforce, American Indian/Alaska Native (AI/AN) individuals have the least representation of all major racial and ethnic groups. Limited resources at state medical schools present institution-level recruitment challenges. Unified efforts to engage AI/AN students in premedical education activities are needed. The medical schools at the Universities of Arizona (Phoenix and Tucson), Colorado, New Mexico, and Utah identified a collective need to increase student diversity, particularly with regard to AI/AN students. The schools partnered with the Association of American Indian Physicians to support AI/AN students applying to medical school and to grow the overall AI/AN applicant pool. Each year from 2011 to 2016, these institutions hosted a two-day preadmissions workshop (PAW) to prepare participants for applying to medical school. From 2011 to 2016, 130 AI/AN students participated in the PAWs. Of these, 113 were first-time attendees, 15 participated on two separate occasions, and 1 participated on three separate occasions. Nineteen (21%) of the 90 first-time participants from 2011 to 2015 matriculated to a U.S. medical school in the past five years. Twenty-two of 23 participants (96% response rate) in 2016 responded to the postworkshop survey. Results indicated that interview preparation, individual consultation, and writing preparation ranked as the three most beneficial sessions/activities. Standardized evaluation of future PAWs will identify best practices for recruiting AI/AN students to medical school, and future initiatives will include more robust measures of success.

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OBJECTIVES/SPECIFIC AIMS: Research on cancer difference is of significant scientific and practical value. For leukemia, the survival disadvantage of the Blacks has been suggested in multiple studies. However, the existing epidemiologic analysis has multiple technical limitations. The goal of this study is to more accurately quantify so as to better understand different sources of racial differences in leukemia survival. METHODS/STUDY POPULATION: A new statistical method, which is based on robust regression and resampling, is developed. Data are obtained from the SEER (Surveillance, Epidemiology, and End Results) database. Using the “classic” epidemiologic methods as well as the new method, analysis is conducted on the prognosis of 4 leukemia subtypes (ALL, CLL, AML, and CML) for 4 major racial groups (White, non-Hispanic White, Black, and Asian and Pacific Islander). RESULTS/ANTICIPATED RESULTS: After effectively removing differences caused by the observed clinicopathological and demographic factors, the survival disadvantage of the Blacks persists for the following patient groups: ALL and age&gt;14, CLL and age&gt;14, and ALL and age≤14. The quantitative results are significantly different from those from classic epidemiologic analysis. Such observed racial differences are more attributable to the unobserved risk factors and cancer disparity. DISCUSSION/SIGNIFICANCE OF IMPACT: This study provides a more effective and more direct quantification of racial difference in leukemia prognosis. The survival disadvantage of the Blacks which is observed for certain subtypes/age groups deserves further attention but should not be overstated. More data collection and analysis are needed to more accurately decipher racial differences in leukemia and other cancer types.

Systematic Review: Health Promotion and Disease Prevention Among Hmong Adults in the USA.

Although disparities in the burden of disease and illness experienced across major racial and ethnic groups in the USA is well known, little is known about subgroups, including the Hmong population. This review sought to determine the current state of health disparities related to health promotion and disease prevention among Hmong adults from 1975 to 2015. Seventy-one descriptive (qualitative, mixed methods, and quantitative) studies were reviewed. Most focused on two areas: (1) health status (mainly breast and cervical cancers) and (2) health-related behaviors. This literature review confirms the existence of health disparities related to health promotion and disease prevention in the Hmong adult population. Effective intervention relies on identifying these disparities. A possible explanation for these disparities is the lack of health data collected on subgroup populations, which include the Hmong adult population. More research and more comprehensive health policies at the organizational level are needed to allow data to be collected on subgroup populations in order to better understand the social determinants that place the Hmong people at risk.

Corporal Punishment and Child Aggression: Ethnic-Level Family Cohesion as a Moderator.

Ethnicity has been examined as a putative moderator between parents' use of corporal punishment and children's externalizing behaviors. Yet, the reasons for this potential ethnic-level moderator have not been fully examined. The primary objective of this study was to examine whether the effect of corporal punishment on aggression is ethnic-specific using major racial groups inside and outside the U.S. samples and how the mean levels of cohesion in family relationships as found in different ethnic groups moderate the association between mothers' use of corporal punishment and children's aggression. A total of 729 mothers who had children aged 7 to 13 years were sampled from five ethnic groups (i.e., European American, African American, Hispanic American, Korean, and Chinese). Several hypotheses were tested to examine the moderating effect of ethnic-level, family cohesion on the relation of corporal punishment to children's aggression. As expected, the mean level of family cohesion was significantly different across ethnicities. Consistent results across parallel multilevel and fixed effect models showed that high corporal punishment was associated with more aggression in all ethnicities, but there was a significant variation in the association across ethnicities, and the variation was explained by ethnic-level family cohesion. There were weaker associations between corporal punishment and child aggression among ethnic groups with high family cohesion and stronger associations among ethnic groups with low family cohesion. Ethnic/cultural variation in this study emphasizes the importance of understanding family environment of diverse ethnic groups when evaluating the influence of corporal punishment on child behavior in different ethnic/cultural contexts.

What can we learn about changing ethnic diversity from the distributions of mixed-race individuals?

ABSTRACTIt is hypothesized that self-defined mixed-race persons live in residentially mixed areas in the largest metropolitan areas in California. The hypothesis is tested by examining the distribution of mixed-race persons among ethnically and racially diverse and nondiverse neighborhoods in the San Francisco and Los Angeles Metropolitan Areas. The research confirmed that mixed-race individuals are more likely to live in areas with ethnic diversity and that the tendency is greater for the mixed-race population in the San Francisco–Oakland Metropolitan Areas than in the Los Angeles Metropolitan Area. Mixed-race individuals live in neighborhoods which are diverse with mixes of all four major ethnic and racial groups, and in “well-off” (but not the most affluent) neighborhoods. The study also shows that the mixed-race population is youthful. The association of mixed-race individuals and racially integrated neighborhoods will have important implications for the evolving nature of spatial integration in California specifically, and the United States more generally.