non-Hispanic Black Males Research Articles

Gender Disparities

Significant gaps exist in health care regarding gender in the United States. Health status, social roles, culturally patterned behavior and access to health care can be influenced by gender. Women have been the primary users of health care and minority women usually have received poorer quality care than Non-Hispanic White (NHW) females. The objectives of this study were to identify gender, racial and ethnic disparities in access to substance abuse treatment in a Texas hospital. Secondary data collected on 1,309 subjects who underwent detoxification were studied. Gender, race/ethnicity, drug of abuse, relapse and financial classification were included in the analysis. Results indicate Hispanic females and Non-Hispanic Black (NHB) females were about 5 and 3.5 more likely than NHW females to use Medicaid services respectively (p < .05). NHW and NHB males were more likely to use Medicare than females (p < .05). NHB and Hispanic females were 5.8 and 2.1 times more likely to receive care for abuse of cocaine when compared to NHW females respectively (p < .05). Hispanic females were 2.3 times more likely to relapse than Non-Hispanic females, and uninsured NHB females were 7.1 times at a higher risk to abuse multiple drugs compare to NHW females (p < .05). Socio-economic factors, lower labor force participation rates, and less financial independence can explain females utilizing more often Medicaid regardless of their race/ethnicity. These results can be also explained by aggressive case management utilization, socio cultural barriers and/or discriminatory practices, both intentional and unintentional.

Correlates of bone mineral density in men of African ancestry: The Tobago Bone Health Study

Correlates of BMD were examined in a cross-sectional analysis of men of West African ancestry. BMD, measured at the total hip and the femoral neck subregion, was associated with age, anthropometric, lifestyle, and medical factors in multiple linear regression models. These models explained 25-27% of the variability in total hip and femoral neck BMD, respectively, and 13% of the variability in estimated volumetric BMD. To examine the correlates of bone mineral density (BMD) in men of West African ancestry. Two thousand five hundred and one men aged 40 to 93 years were recruited from the Caribbean Island of Tobago. Participants completed a questionnaire and physical examination. We measured hip BMD and body composition, using DXA. Volumetric BMD was estimated as bone mineral apparent density (BMAD). BMD was 10% and 20% higher in African Caribbean males compared to U.S. non-Hispanic black and white males, respectively. In multiple linear regression models, greater lean mass, history of working on a fishing boat or on a farm, frequent walking, and self-reported diabetes were significantly associated with higher BMD. Fat mass, history of farming, and self-reported hypertension were also associated with higher BMAD. Older age, mixed African ancestry, and history of a fracture were associated with lower BMD and BMAD. Lean body mass explained 20%, 18% and 6% of the variance in BMD at the total hip, femoral neck and BMAD, respectively. African Caribbean males have the highest BMD on a population level ever reported. Lean mass was the single most important correlate. Variability in BMD/BMAD was also explained by age, mixed African ancestry, anthropometric, lifestyle, and medical factors.

Rapid HIV Testing Among Racial/Ethnic Minority Men at Gay Pride Events—Nine U.S. Cities, 2004-2006

In the United States, human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) disproportionately affect men from racial/ethnic minority groups. Approximately half of the HIV/AIDS cases among non-Hispanic black and Hispanic males reported by 33 states using name-based HIV surveillance during 2001-2005 were among men who have sex with men (MSM). Each year, approximately 100 gay pride events are held in cities across the United States to celebrate diversity, demonstrate solidarity of the gay community, and heighten awareness of topics of importance to the gay community. These events are attended by several hundred to several hundred thousand MSM. Certain gay pride events are focused on celebrating solidarity in the minority gay community and are attended primarily by MSM from racial/ethnic minority groups. These events offer an opportunity for community-based organizations (CBOs) and health departments to provide HIV-prevention education and outreach. In 2004, CBOs and health departments, with technical assistance from CDC, began conducting rapid behavioral assessments at gay pride events and at minority gay pride events. This report describes the results of assessments and rapid HIV testing conducted at 11 events in nine U.S. cities during 2004-2006; most of these events were attended primarily by MSM from racial/ethnic minority groups. A total of 543 attendees who participated in the assessments reported at the time of the event that they had not had HIV infection diagnosed previously. Of these, 133 (24%) were tested for HIV during the event, and eight (6%) of those tested during the event had a positive rapid test result. All eight were subsequently confirmed to be HIV positive by Western blot testing. Testing at gay pride events provides an opportunity to identify new HIV infections among MSM outside of health-care settings, particularly those from racial/ethnic minority groups.

Effect of waist circumference on reference intervals of liver-related enzyme tests in apparently healthy adult Mexican Americans, black and white Americans

Background: We used a more comprehensible and more physiologically valid indicator of obesity-related liver disease, waist circumference (WC), rather than BMI to study the effect of obesity on liver enzymes, easily measurable surrogates of liver disease. Methods: WC, liver enzymes and pertinent demographic data were abstracted from NHANES III. After exclusion criteria were applied, we stratified the populations by sex and ethnicity and graphed the percentage of elevated enzymes per WC interval. Results: There was a significant relationship between enzyme activity and WC ( p < 0.001 for ALT, p < 0.01 for ALP, p < 0.01 for AST, p = 0.02 for GGT and p < 0.05 for LD), and the relationship was stronger in females ( p < 0.002) and Mexican Americans ( p < 0.001). The enzyme–WC relationship is much weaker in non-Hispanic black females and males. Conclusion: As increases in liver enzyme activity can indicate potentially reversible liver disease, our graphs should be used by physicians to motivate obese, apparently healthy Mexican American and non-Hispanic white patients with elevated liver enzymes to reduce their WC.

Patterns of cancer incidence among US Hispanics/Latinos, 1995–2000

Current and comprehensive data on cancer incidence in US Latinos has been limited. Using a standardized approach to uniformly assign Hispanic/Latino race/ethnicity to cancer records, data from 15 central cancer registries, representing more than 85% of the US Latino population, were included in the analysis. Average annual age-adjusted incidence rates and standard errors were calculated for Hispanic, non-Hispanic white and non-Hispanic black males and females. To compare cancer incidence among Hispanic and non-Hispanic populations, standardized incidence ratios (SIRs) also were calculated. Latino populations had overall lower incidence for all cancers combined and the four leading cancers (breast, prostate, lung and colorectal) than non-Hispanic populations, however, cancers of lesser impact in non-Hispanic populations (liver, gallbladder, stomach, penis and cervix) were more commonly diagnosed among Latinos. Understanding the patterns of cancer incidence in this diverse racial/ethnic minority group can serve to both stimulate research into the unique behaviors, exposures and genetics that drive cancer risk among Latinos and to direct prevention and control efforts tailored to this population.

Dietary factors associated with obesity differ across ethnic groups in a national sample

Disparities in rates of obesity across age, gender, and ethnic groups exist but reasons for these discrepancies have not been well established. A likely set of determinants associated with obesity are dietary factors. A secondary data analysis of the 1999–2000 and 2001–2002 National Health and Nutrition Examination Survey (NHANES) was conducted on a sample representing Mexican-American, Non-Hispanic White (NHW), and Non-Hispanic Black (NHB) males and females ages 20 to 85. Bivariate analyses were performed comparing various dietary factors with body mass index (BMI kg/m2) for subsets of respondents in 10 year age groups. BMI was calculated using measured heights (m) and weights (kg) and a one day 24-hour dietary recall was used to calculate nutrient intakes. Preliminary findings indicate that for Mexican-American males and females between the ages of 30 to 39 and 40 to 49, lower intakes of calcium are significantly related (p <.05) to higher BMI values. This is also the case for the 30 to 39 age cohort of NHW females (p <.05) but not for NHW males. BMI in NHW and NHB males, in the 30 to 39 and 50 to 59 age cohorts, is positively associated (p <.05) with intake of cholesterol. These results indicate that differences in dietary factors across gender and age groups may play an important role in obesity among these three ethnic groups. To effectively address the development of obesity in different ethnic groups it may be necessary to develop interventions that target dietary factors specific to each group. Funding for this research is provided by the University of North Carolina at Greensboro.

The military oral health care system as a model for eliminating disparities in oral health

Healthy People (HP) 2010 is a national health promotion and disease prevention initiative of the U.S. Department of Health and Human Services. The HP 2010 report highlighted a range of racial/ethnic disparities in dental health. A substantial portion of these disparities appear to be explained by differences in access to care. Members of the U.S. military have universal access to care that also has a compulsory component. The authors conducted a study to investigate the extent to which disparities in progress toward achievement of HP 2010 objectives were lower among the military population and to compare the oral health of the military population with that of the civilian population. The participants in this study were non-Hispanic white and non-Hispanic black males aged 18 to 44 years. They were drawn from the Tri-Service Comprehensive Oral Health Survey (10,869 including 899 recruits who participated in the TSCOHS Recruit Study) and the Third National Health and Nutrition Examination Survey (4,779). We found no disparities between black and white adults in untreated caries and recent dental visit rates in the military population. Disparities in missing teeth were much lower among military personnel than among civilians. A universal access-to-care system that incorporated an aspect of compulsory treatment displayed little to no racial disparity in relevant oral health outcomes. This demonstrates that it is possible for large, diverse populations to have much lower levels of disparities in oral health even when universal access to care is not provided until the patient is 18 or 19 years of age.

Perfluorochemicals in Pooled Serum Samples from United States Residents in 2001 and 2002

Manufacturers have used perfluorochemicals (PFCs) since the 1950s in many industrial and consumer products, including protective coatings for fabrics and carpet, paper coatings, insecticide formulations, and surfactants. Some PFCs are persistent ubiquitous contaminants in the environment and in humans. Exposures to PFCs result in potential developmental and other adverse effects in animals. The sources of human exposure to PFCs and the potential health risks associated with exposure are still unclear, and differences in patterns of human exposure may vary. We measured the serum concentrations of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA; C8), perfluorohexane sulfonic acid (PFHxS), and 8 other PFCs in 54 pooled serum samples collected from 1832 participants of the 2001-2002 National Health and Nutrition Examination Survey. Participants were 12 years of age and older. The pools represented three major racial groups/ethnicities (non-Hispanic blacks, non-Hispanic whites, and Mexican Americans), four age categories (12-19 years, 20-39 years, 40-59 years, and 60 years and older), and both genders. PFCs were extracted from 100 microL of serum using on-line solid-phase extraction coupled to isotope dilution-high performance liquid chromatography-tandem mass spectrometry. The limits of detection ranged from 0.05 ng/mL to 0.2 ng/mL. The concentrations of most PFCs were similar among the four age groups. For PFOS, the estimated least-squares mean (LSM) concentrations among non-Hispanic white males (40.19 ng/mL) and females (23.97 ng/mL) were greater than among non-Hispanic black males (18.27 ng/mL) and females (17.93 ng/mL) or Mexican American males (13.71 ng/mL) and females (10.40 ng/ mL). Similarly, for PFOA, the LSM concentrations among non-Hispanic white males (6.98 ng/mL) and females (3.97 ng/ mL) were greater than among non-Hispanic black males (3.62 ng/mL) and females (2.85 ng/mL) or Mexican American males (2.89 ng/mL) and females (2.08 ng/mL). Non-Hispanic whites had also greater LSM concentrations of PFHxS than non-Hispanic blacks and Mexican Americans. These findings indicate different patterns of human exposure to PFCs among the population groups examined and stress the importance of conducting research to identify the environmental sources and pathways of human exposure to PFCs.

Vitamin C deficiency and depletion in the United States: the Third National Health and Nutrition Examination Survey, 1988 to 1994.

We sought to determine prevalence rates of vitamin C deficiency and depletion in the United States. We used data from the Third National Health and Nutrition Examination Survey to assess intake of dietary, supplemental, and serum vitamin C. Mean intakes and serum levels of vitamin C were normal; however, vitamin C deficiency and depletion were common (occurring among 5%-17% and 13%-23% of respondents, respectively). Smokers, those who did not use supplements, and non-Hispanic Black males had elevated risks of vitamin C deficiency, while Mexican Americans had lower risks. Health professionals should recommend consumption of vegetables and fruits rich in vitamin C and should recommend supplementation for individuals at risk of vitamin C deficiency.

Recruiting Black/African American men for research on prostate cancer prevention.

Black/African American men die of prostate cancer at a greater rate relative to other males. During the period from 1992 to 1998, prostate cancer incidence rates in the United States were 234.2 per 100,000 persons among non-Hispanic black males and 144.6 per 100,000 persons among white males. The reasons for these increased rates of prostate cancer among black males are largely unknown, but increased mortality is associated with late detection. The authors conducted a longitudinal study of black men that investigated prostate cancer prevention behaviors within this population. The purpose of the current article is to identify successful recruitment strategies that were reported by participants in this study of prevention behaviors. Qualitative research methods were used to elucidate men's thoughts, attitudes, beliefs, and practices regarding prostate cancer prevention behaviors and to identify strategies for attracting black men to research programs and retaining them in these programs. Ethnocentric recruitment strategies that were identified included the development of tailored printed materials; the use of targeted locations; and a personalized, participatory approach for engaging potential participants. We contacted 498 black men and enrolled a cohort of 277 non-Hispanic black males (75% of whom were recruited within a 9-week period) in the current study. Unlike other studies that reported difficulty in recruiting African American men, the current study did not encounter such difficulties. The authors attribute their success to culturally attractive Afrocentric materials; cultural sensitivity; a caring, professional, personalized ethnic approach; respect; and participatory involvement of the target population. Nonetheless, the authors did encounter barriers, such as lack of physician interest and lack of trust in quality medical care. These barriers must be overcome before black males can be engaged and retained in research studies on prostate cancer prevention.

Race/ethnic differences in health care use for orofacial pain among older adults.

The purpose of this study was to describe race/ethnic differences in the use of formal health care services for painful oral symptoms by older adults. We also considered the sex of the respondent rather than assuming that males and females within a specific racial group would use health care services similarly. To our knowledge, these specific utilization patterns have never been reported before in the pain literature.Telephone interviews were conducted on a stratified random sample of 1,636 community dwelling older (65+) north Floridians. A total of 5,860 households were contacted and screened, with 75.3% participating to the point where their eligibility for the study could be determined. Overall race/ethnic differences in patterns of health care use for orofacial pain were not found. However, when we stratified race/ethnicity by sex, Black females (37.6%) were the least likely to have visited a health care provider, followed by non-Hispanic White females (47.2%), non-Hispanic White males (49.3%), and Black males (62.7%). Point estimates of odds ratio, adjusting for financial differences, indicate that more non-Hispanic White males (OR=1.79) and Black males (OR=2.74) visited a health care provider than Black females. Our results also suggest that for older Black adults, financial constraints have a more significant impact on decisions about health care for orofacial pain than they do for non-Hispanic Whites. For non-Hispanic White respondents, characteristics of the pain symptoms were significant determinates of health care use for their painful oral symptoms. Pain at its worst was a positive predictor for four of the five analyses (jaw joint pain, painful oral sores, temperature sensitivity, and toothache pain). The duration variable (years with pain) was a negative predictor of health care use. This is consistent with the conclusion that individuals seek care early in the course of the symptom, i.e. an active care seeking phase, make emotional or physical adjustments, and then resign themselves to the symptoms.

Serum total homocysteine concentrations in adolescent and adult Americans: results from the third National Health and Nutrition Examination Survey

The elevation of circulating total homocysteine concentrations in a fasting state is associated with an increased risk of occlusive vascular disease. The primary goals of this study were to describe the distribution of serum total homocysteine concentrations in the United States and to test for differences in homocysteine concentrations among sex, age, and race-ethnicity categories. Using surplus sera from phase 2 of the third National Health and Nutrition Examination Survey, we measured serum total homocysteine concentrations for a nationally representative sample of 3766 males and 4819 females aged > or = 12 y. Age-adjusted geometric mean total homocysteine concentrations were 9.6 and 7.9 mmol/L in non-Hispanic white males and females, 9.8 and 8.2 mmol/L in non-Hispanic black males and females, and 9.4 and 7.4 mmol/L in Mexican American males and females, respectively. Age-adjusted geometric mean total homocysteine concentrations were significantly lower in females than in males in each race-ethnicity group (P < 0.01) and were significantly lower in Mexican American females than in non-Hispanic white and non-Hispanic black females (P < 0.01). There was a significant age-sex interaction (P < 0.01), reflecting the fact that homocysteine concentrations in females tended to diverge from those in males at younger ages and converge with those in males at older ages. The first data on homocysteine concentrations in a nationally representative sample of Americans confirm the age and sex differences reported previously in nonrepresentative samples. These data also indicate that differences between Mexican American and non-Hispanic females may influence circulating homocysteine concentrations.

Color or Culture?: Wage Differences among Non-Hispanic Black Males, Hispanic Black Males and Hispanic White Males

The analysis of the determinants of wage differences between Hispanic black, Hispanic white and non-Hispanic black males undertaken in this research does not support the contention that cultural differences are more significant than color differences in the generation of racial wage gaps.