non-Hispanic White Americans Research Articles

Racial Differences in Discrepancies Between Subjective Ratings and Objective Assessments of Hearing Impairment.

To better understand racial/ethnic disparities in hearing aid use, we examined racial differences in discrepancies between subjective hearing ratings and objective hearing tests as a potential source of this disparity. A cross-sectional assessment was conducted using the data from the Health and Retirement Study (HRS). Our analytic sample included 2,568 participants aged 50 and older: 1,814 non-Hispanic White Americans and 754 non-Hispanic Black Americans. Discordant groups were identified based on self-ratings of hearing abilities (positive versus negative) and objective hearing test results (normal versus hearing loss). Analysis of HRS data revealed that approximately 73% of participants with objectively measured hearing loss reported positive hearing ratings. False positive hearing rates were found to be 80% among Black older adults and 70% among their White counterparts. Odds for false positive hearing ratings were significantly greater for Black older adults, men, those with less than a high school education, more health conditions and depressive symptoms, and current smoking. Racial differences were maintained after adjustment for these covariates. While cost of hearing aids has been a predominant explanation of low hearing aid use in Black Americans, false positive perceptions of hearing abilities may also play a significant role as a psychosocial mechanism. Future studies examining racial/ethnic differences in possible psychosocial mechanisms for discrepancies between objective and subjective hearing could guide the development and evaluation of culturally appropriate educational interventions.

A COMMUNITY-ENGAGED APPROACH TO CULTURAL ADAPTATION OF BEHAVIORAL INTERVENTIONS: ENGAGING LATINOS IN RESEARCH

Abstract Latinos are 1.5 times more likely to develop Alzheimer’s disease and related dementias (ADRD) than non-Hispanic white Americans. Latinos also have the highest prevalence of caring for a loved one with ADRD. They spend more time in caregiving-related activities, have limited social support and access to quality dementia care, and have significantly worse physical and mental health. The paucity of culturally congruent interventions to improve Latino ADRD caregivers’ psychological well-being continues to perpetuate poorer outcomes and disparities among Latino caregivers. While several effective psychoeducation and skill-building caregiver programs have been developed, these interventions lack representation of Latino caregivers. Thus, culturally attuned adaptations and implementation of available interventions for Latinos are needed to address this critical gap. This study engaged community-dwelling older Latinos, including Latino caregivers, and Latino community organization leaders, to collaborate in cultural adaptation of the Tele-Savvy program and clinical trial design. Employing community-engaged approaches, we combined a staged cultural adaptation framework and a locally developed training program to engage Latinos in caregiving research. Nine Latino community members served on a community advisory board (CAB). Members first engaged in a training program to develop knowledge about ADRD and skills in conducting research and cultural adaptation. Following the training, members engaged in cultural adaptation of Tele-Savvy and the design of a future clinical trial to test the adapted intervention with Latino ADRD caregivers. We will discuss preliminary findings from the cultural adaptation work with CAB members and future directions to inform the testing of the adapted Tele-Savvy and its refinement.

The onset presentation of multiple sclerosis differs in Hispanic/Latinx Americans compared with non-Hispanic White Americans

Background: Little is known about how multiple sclerosis (MS) presents in Hispanic/Latinx (HL) people with MS (pwMS). Objective: Compare age at onset (AAO) and onset severity between HL versus non-Hispanic White (NHW) pwMS. Methods: A cross-sectional study leveraged the MS PATHS registry spanning seven US tertiary care institutions. HL was subcategorized as HL White (HLW) and HL Other (HLO; all other races). Multivariable models examined relationships between ethnoracial variables and AAO and self-reported presenting disease course. Models were repeated restricting to those born ⩾1970. Results: The study population included 8231 pwMS, including 540 HL (200 HLW, 340 HLO). The sex distribution did not differ across ethnoracial subgroups. From the statistical models (1) HLO pwMS had an earlier AAO and a higher prevalence of initial progressive disease course than NHW pwMS; (2) among all HL pwMS, irrespective of race, AAO did not differ by sex or between relapsing and progressive MS at onset. In younger HLO adults (born ⩾1970), those with progressive MS at onset had an earlier AAO than those with relapsing MS; and (3) in HL pwMS there was no sex-bias in presenting disease course. Discussion: Distinct differences in the presentation of MS in HL compared with NHW individuals were observed.

Demographic Characteristics and County-level Indicators of Social Vulnerability in Salmonellosis Outbreaks Linked to Ground Beef—United States, 2012–2018

Ground beef is a common source of US Salmonella illnesses and outbreaks. However, the demographic and socioeconomic factors that are related to risk in ground beef-associated outbreaks of Salmonella infections are poorly understood. We describe the individual-level demographic characteristics and county-level indicators of social vulnerability for people infected with Salmonella linked to outbreaks associated with ground beef in the United States during 2012–2018. Non-Hispanic (NH) White and NH American Indian/Alaska Native persons, and people living in nonmetropolitan areas, were overrepresented among people in salmonellosis outbreaks linked to ground beef. Case patients disproportionately resided in counties with high social vulnerability, suggesting that one or more community social risk factors may contribute to or be associated with some food safety risks. Collecting and analyzing socioeconomic and demographic characteristics of people in outbreaks can help identify disparities in foodborne disease, which can be further characterized and inform equity-focused interventions.

Psychological distress in Asian American informal caregivers: an analysis by disaggregated ethnic groups

ABSTRACT Background: Despite Asians being the fastest-growing ethnic group in the US, most studies have focused on Asian Americans as an aggregate racial/ethnic group. The burden of mental health problems is increasing among caregivers due to population aging, yet little is known about the distress experienced by Asian caregivers when examined by disaggregated ethnic groups. Methods: Using 2019–2020 California Health Interview Survey data, we examined disparities in psychological well-beings between non-Hispanic White and Asian American adult caregivers, with an emphasis on understudied Asian ethnic groups. Psychological distress was measured using the Kessler 6 scale, with scores ≥6 indicating mental distress and ≥13 indicating serious mental illness. Multivariable logistic regression adjusted for socio-demographics, physical health, caregiving relationship, intensity of care, and care recipients’ characteristics. Results: The study included 8,722 caregivers (mean age, 58.7 years; 61.3% women; 14.1% Asian [379 Chinese, 260 Filipino, 167 Japanese, 138 South Asian, 105 Korean, 101 Vietnamese, 78 other Asian], 85.9% White). Overall, 26.8% had mental distress, and 8.5% had serious mental illness. Compared to White caregivers, Korean American caregivers had higher odds of mental distress (Odds Ratio [OR], 2.37; 95% CI, 1.47–3.82) and serious mental illness (OR, 2.15; 95% CI, 1.17–3.92), while Chinese (OR, 0.72; 95% CI, 0.55–0.95) and Japanese (OR, 0.67; 95% CI, 0.45–0.99) American caregivers had lower odds of mental distress. Korean American caregivers had the highest prevalence of mental distress (43.1%) and serious mental illness (15.3%), compared with White and other Asian American caregivers. Conclusion: Disaggregating data reveals significant mental health disparities among ethnic subgroups of Asian American caregivers. Tailored resources should address the distinct needs of ethnic subgroups of Asian American caregivers, considering language barriers, acculturation, and cultural norms that may exacerbate psychological distress.

Analysis of Lung Cancer Incidence in Non-Hispanic Black and White Americans using a Multistage Carcinogenesis Model.

There are complex and paradoxical patterns in lung cancer incidence by race/ethnicity and gender; compared to non-Hispanic White (NHW) males, non-Hispanic Black (NHB) males smoke fewer cigarettes per day and less frequently but have higher lung cancer rates. Similarly, NHB females are less likely to smoke but have comparable lung cancer rates to NHW females. We use a multistage carcinogenesis model to study the impact of smoking on lung cancer incidence in NHB and NHW individuals in the Multiethnic Cohort Study (MEC). The effects of smoking on the rates of lung tumor initiation, promotion, and malignant conversion, and the incidence of lung cancer in NHB versus NHW adults in the MEC were analyzed using the Two-Stage Clonal Expansion (TSCE) model. Maximum likelihood methods were used to estimate model parameters and assess differences by race/ethnicity, gender, and smoking history. Smoking increased promotion and malignant conversion but did not affect tumor initiation. Non-smoking-related initiation, promotion, and malignant conversion and smoking-related promotion and malignant conversion differed by race/ethnicity and gender. Non-smoking-related initiation and malignant conversion were higher in NHB than NHW individuals, whereas promotion was lower in NHB individuals. Findings suggest that while smoking plays an important role in lung cancer risk, background risk not dependent on smoking also plays a significant and under-recognized role in explaining race/ethnicity differences. Ultimately, the resulting TSCE model will inform race/ethnicity-specific lung cancer natural history models to assess the impact of preventive interventions on US lung cancer outcomes and disparities by race/ethnicity.

Abstract 4137928: Race-Dependent Association of Inflammation and Cholesterol with Cardiovascular Mortality in US Population

Background: Inflammation and cholesterol jointly contribute to cardiovascular disease and mortality. The relative contributions of inflammation and cholesterol to the risk of future cardiovascular events might shift according to pre-existing traits of each individual. Whether the association of inflammation and cholesterol with cardiovascular mortality differ by race remains unclear. Method: We sampled 12,726 participants from NHAENS III who were categorized as non-Hispanic White, non-Hispanic Black or Mexican Americans. In all race groups, we used the Cox proportional hazard regression model to relate log-transformed CRP and LDL-C levels to CVD deaths. All models simultaneously included CRP and LDL-C, and were adjusted for age, current smoking, hypertension, diabetes mellitus, body mass index, lipid-lowering medications, total cholesterol and family income. Results: 12,726 participants (53.4% female, mean age 46.8 ± 19.7 years) including 5648 non-Hispanic White (44.4%), 3484 non-Hispanic Black (27.4%) and 3594 Mexican-American (28.2%) were followed up for a median 26.3 years , and 1905 cardiovascular deaths were documented. After adjusting for cardiometabolic risk factors, per 1 SD increase in log-transformed CRP was associated with 14% (HR 1.14 [95% CI, 1.08-1.21], P < 0.001) and 13% (HR 1.13 [95% CI, 1.04-1.23], P = 0.001) higher risk of CVD mortality in non-Hispanic White and non-Hispanic Black respectively, while the association was neutral in Mexican American. Notably, per 1 SD increase in LDL-C was not associated with CVD mortality in all race groups (P > 0.05 for all). Conclusion: After a follow up of median 26.3 years, we found that, in non-Hispanic White and Black individuals, but not in Mexican American, inflammatory was a stronger predictor of cardiovascular mortality, compared to cholesterol.

Abstract 4134863: Major Cardiovascular Events Following Non-Cardiovascular Surgeries in Minority Patients Compared to White Patients

Introduction: Racial disparities are pervasive in cardiovascular outcomes. Although disparities following cardiovascular surgery have been extensively studied, fewer current, nationwide reports exist for postoperative outcomes in non-cardiovascular surgery. Research Aim: To investigate the incidence of 30-day post-operative major adverse cardiac, cerebral and thrombotic events (MACCTE) following non-cardiovascular surgeries in non-White patients as compared to White patients. Methods: This retrospective cohort study used the 2018-2022 National Surgical Quality Improvement Program database. Patients aged 18 or older who underwent non-cardiovascular surgeries (general, gynecology, neurosurgery, orthopedics, otolaryngology, plastics, thoracic, urology, obstetrics, and interventional radiology) were included. Race/ethnicity was categorized as non-Hispanic White (Whites), Hispanic, non-Hispanic Asian (Asians), non-Hispanic Black or African American (Blacks), and non-Hispanic Others. MACCTE was defined as a composite of death, MI, cardiac arrest, stroke, PE, or DVT. Five multivariable logistic regression models were used to hierarchically adjust for age, gender, ASA class, surgical subspecialty, operation time, transfer status, and all other comorbidities. Results: Among the 3,775,920 patients: 70.9% were Whites, 11.8% Hispanics, 4.1% Asians, 11.6% Blacks, 1.5% of Other race, 58.9% female, and 46.7% had an ASA classification of 3 or greater. The MACCTE incidence was 1.95% overall and 2.01% in Whites, 1.27% Hispanics, 1.48% Asians, 2.11% Blacks, and 1.69% Others. Compared to Whites, Blacks had higher incidences of cardiac arrest (0.40% vs. 0.23%), stroke (0.17% vs. 0.15%), PE (0.47% vs. 0.34%), and DVT (0.55% vs. 0.48%), and Asians (0.18% vs 0.15%) and Others (0.21% vs. 0.15%) had a higher incidence of stroke (p<0.001). With Whites as reference, the crude odds ratios, OR (95% CI) were 0.63 (0.61-0.65) in Hispanics, 0.73 (0.70-0.76) Asians, 1.05 (1.03-1.07) Blacks, and 0.84 (0.78-0.89) Others. The fully adjusted model odds ratios, OR (95% CI) were 0.88 (0.82-0.95) Hispanics, 0.89 (0.80-1.00) Asians, 1.11 (1.04-1.18) Blacks, and 0.80 (0.69-0.94) Others. Conclusion: Black patients experienced a higher MACCTE risk compared to Whites, even after adjustment for age, sex, ASA class, type of surgical procedure, and other comorbidities. These findings emphasize the importance of implementing comprehensive measures to prevent excess risk and promote equitable surgical care.

B cell immune repertoire sequencing in tobacco cigarette smoking, vaping, and chronic obstructive pulmonary disease in the COPDGene cohort.

Cigarette smoking (CS) impairs B cell function and antibody production, increasing infection risk. The impact of e-cigarette use ('vaping') and combined CS and vaping ('dual-use') on B cell activity is unclear. To examine B cell receptor sequencing (BCR-seq) profiles associated with CS, vaping, dual-use, COPD-related outcomes, and demographic factors. BCR-seq was performed on blood RNA samples from 234 participants in the COPDGene study. We assessed multivariable associations of B cell function measures (immunoglobulin heavy chain (IGH) subclass expression and usage, class-switching, V-segment usage, and clonal expansion) with CS, vaping, dual-use, COPD severity, age, sex, and race. We adjusted for multiple comparisons using the Benjamini-Hochberg method, identifying significant associations at 5% FDR and suggestive associations at 10% FDR. Among 234 non-Hispanic white (NHW) and African American (AA) participants, CS and dual-use were significantly positively associated with increased secretory IgA production, with dual-use showing the strongest associations. Dual-use was positively associated with class switching and B cell clonal expansion, indicating increased B cell activation, with similar trends in those only smoking or only vaping. We observed significant associations between race and IgG antibody usage. AA participants had higher IgG subclass proportions and lower IgM usage compared to NHW participants. CS and vaping additively enhance B cell activation, most notably in dual-users. Self-reported race was strongly associated with IgG isotype usage. These findings highlight associations between B cell activation and antibody transcription, suggesting potential differences in immune and vaccine responses linked to CS, vaping, and race.

Differential Item Functioning and Clinical Utility of the Subjective Memory Complaints Questionnaire in a Multi-Ethnic Cohort

Introduction: This study evaluated the psychometric properties of the Subjective Memory Complaints Questionnaire (SMCQ) in a non-Hispanic White (NHW) and Mexican American (MA) sample from Texas in the USA. Methods: Data were obtained from the Health and Aging Brain Study – Health Disparities (HABS-HD; N = 1,691, age = 66.5 ± 8.7, education = 12.4 ± 4.8, 60.6% female, 33.2% MA Spanish speaking). Unidimensionality of the SMCQ was evaluated with confirmatory factor analysis. Differential item functioning (DIF) of the SMCQ was assessed across age, sex, education, and ethnicity/language using item response theory/logistic ordinal regression. Associations of the SMCQ in relation to cognitive status, Alzheimer’s disease (AD) blood-based biomarkers, and psychological distress were examined. Results: The SMCQ showed excellent fit in a single-factor model (CFI = 0.97, TLI = 0.97, RMSEA [95% CI] = 0.05 [0.04, 0.05], SRMR = 0.07). Significant item-level DIF was detected by education level and ethnicity/language, but not by age or sex; when detected, DIF was not salient (i.e., adverse). The SMCQ was associated with greater psychological distress, worse Clinical Dementia Rating scores, and greater disease burden as measured by total tau and neurofilament light. Conclusions: Practically negligible item-level bias was identified across education and ethnicity/language. Detected DIF can be described as benign, indicating that some items manifested differently between groups but had minimal impact on measurement properties. These results demonstrate that the SMCQ performs appropriately across demographic variables. Our findings also provide support for the associations of SMCQ scores with self-reported mood, cognitive status, and AD blood-based biomarkers.

Abstract C092: Transcriptome analysis of human endogenous retroviral elements in tumor microenvironment of prostate cancer patients of different ancestry

Abstract Background: Prostate cancer (PCa) poses unique challenges for Non-Hispanic Black Americans (BA), who often face poorer outcomes than Non-Hispanic White Americans (WA). Even after adjusting for socioeconomic factors, BAs are diagnosed younger and experience more severe clinical effects, potentially due to the tumor microenvironment. Within PCa, Endogenous Retroviruses (ERVs) have been shown to regulate immune response genes and have prognostic value in PCa. Despite constituting 8% of the human, ERVs' role in the tumor microenvironment remains incompletely understood. These findings highlight the need to target microenvironment dysregulation in solid tumor therapies, especially for ERV expression in prostate cancer. Methods: Using RNA-sequencing, we investigated the expression of ERVs in BA (n=18) and WA (n=14) tumor adjacent stroma (TAS) samples. We analyzed reads by mapping them to the human genome (hg38). We then used bedtools and data from the Human Endogenous Retrovirus database (HERVd) to calculate the number of reads at each ERV locus (n=519,060). Differentially expressed ERV elements were then identified in an Audic Claverie Test (fold- change cutoff of 2 and padj < 0.05). The expression of protein-coding genes in the same BA (n=18) and WA (n=14) TAS samples was investigated using RNA-sequencing. Regulation of significant ERV elements were compared to the regulation of nearby immune response genes between the two races. We developed primary stroma (carcinoma associated fibroblast, CAFs) culture of different races with PCa using fresh prostatectomy tissues. To investigate the biological functions of ERVs in CAFs, we developed FANA oligonucleotides (synthetic single- stranded nucleic acid analogs that can modulate gene expression by enzymatic degradation of a target RNA) and corresponding primers to knock down specific ERV sequences near key immune response genes in prostate cancer. Results: We examined 32 prostatectomy specimens of BA (n=18) and WA (n=14) PCa. Of the 5,786 statistically significant differentially expressed ERV elements between BA and WA TAS that were identified, 3,274 elements had an increase in ERV expression for BA TAS, and 2,512 elements had a decrease in ERV expression for BA TAS. 61 MER41 elements were found to be differentially expressed between the two races. The MER family sequences contain binding sites for transcription factors that are crucial in cancer, such as STAT1. This transcription factor can regulate genes involved in cell proliferation, apoptosis, and DNA repair. MER41 is in close proximity (within 5000 base pairs) to IFNA6, an immune response gene. We found both MER41 and IFNA6 to be downregulated in BA TAS, as compared to their WA counterparts. We developed FANA oligonucleotides to knockdown MER41E, MER61-Int, HERVL-Int, MLT1A, and LTR61E1 to investigate their effect on nearby gene expression. Conclusion: The CAF models from PCa patients of different races can be used to explore the biological function of ERV inactivation on anti-tumor immune response genes within the tumor microenvironment. Citation Format: Tara S. K. Jennings, Vinay Kumar, Anton N. Nguyen, Michael M. Ittmann, Patricia Castro, Farah Rahmatpanah. Transcriptome analysis of human endogenous retroviral elements in tumor microenvironment of prostate cancer patients of different ancestry [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C092.

Abstract A133: The Church Study: Bridging the gap in colorectal cancer screening of Black patients

Abstract Introduction: Colorectal cancer (CRC) is the second leading cause of cancer death in the US, disproportionately affecting Black Americans with a 25% higher risk and 40% greater mortality than non-Hispanic White Americans. Data on CRC screening preferences among Black patients is limited. We conducted a survey to evaluate CRC screening preferences and barriers to screening after a culturally tailored educational talk among Black churchgoers. Aim: The aim of this study is to assess the preferences and barriers to CRC screening among Black Americans, utilizing culturally tailored educational interventions to enhance screening uptake. Methods: Participants aged 45-85, at average CRC risk, were recruited from three predominantly Black churches in disadvantaged areas of Atlanta, excluding high-risk individuals and those outside the age range. CRC education, vetted for cultural sensitivity, was provided. Informed consent was waived by Morehouse IRB but ensured through educational sessions with opportunities for questions. A 30-question survey covered Demographics, Medical History, Screening Experience, and Preferences. Participants received a $25 Amazon gift card post-survey. Descriptive statistics were applied to demographics and CRC screening preferences, categorized per NCCN guidelines. Results: Out of 101 participants, 64% preferred blood-based screenings and 19% preferred fecal-based testing. Over 73% reported being up-to-date with CRC screening, with more than 61% having a colonoscopy as their most recent CRC screening test. Additionally, 30% of participants were willing to be CRC awareness advocates. Healthcare provider access was high, with 94% reporting having a primary care provider. Trust in providers was approximately 92%, with 4% expressing distrust and 4% uncertain. Conclusions: Despite being in underserved areas, participants reported no significant barriers to CRC screening, with most up-to-date on prevention. Their active participation and willingness to advocate underscore the effectiveness of church settings in health education for Black communities. Preferences for blood-based screenings indicate openness to less invasive options, highlighting the need for tailored interventions. High trust in healthcare providers challenges the narrative of mistrust among African Americans, demonstrating that culturally sensitive, community-focused engagement enhances preventive health participation. The willingness of 30% to become CRC awareness advocates demonstrates strong potential for community-driven health initiatives. Citation Format: Toni M. Jackson, John Onyekaba, Kingsley K. Njoku, Ankita Shah, Carrie Smith, Chima Amadi, Kapil Chandora, Daniela Ortegasantori, Hafsa Gundroo, Temitope Tobun, Daniel Hommes, Julia Liu. The Church Study: Bridging the gap in colorectal cancer screening of Black patients [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A133.

Abstract A011: PVT1 risk variant rs127920247 for colorectal cancer is shared by African American and Hispanic colorectal cancer patients

Abstract Background: Colorectal cancer, one of the most lethal and prevalent cancers across the world, is in large part due to genetic mutations. The plasmacytoma variant translocation 1 (PVT1) gene has an established association with many cancers, including colorectal cancer. There is increasingly abundant data on the mechanisms of action of PVT1 leading to the initiation and progression of these cancers. Identifying PVT1 variants linked to cancer may lead to uncovering their utility as diagnostic or prognostic biomarkers. The All of Us Research hub contains a diverse set of data from hundreds of thousands of participants. Stratifying and comparing risk variants across racial and ethnic demographics may provide insight into disparities underlying disparate incidence of colorectal cancer amongst minoritized and medically underserved communities. The All of Us database provides a novel opportunity to study PVT1 variation in a large cohort of patients from racial backgrounds with demonstrated greater incidence, prevalence, and worse outcomes from colorectal cancer. Methods: We conducted a retrospective cohort study of patients in the All of Us Research hub. The cohort studied comprised 930 patients ranging in age from 18 to 70 years with colorectal cancer, and no additional cancer diagnosis noted. Racial and ethnic backgrounds were selected if there were at least 100 patients of identified background with colorectal cancer. These consisted of patients of: African American, non-Hispanic white, and Hispanic backgrounds. We extracted data from short-read whole genome sequencing. A filtered matrix was built comparing the genetic sequence of our cohort of cancer patients to the reference genome GRCh38. We then stratified the different variants by allelic frequency across the sample cohort to report the variants with the greatest frequencies. All analyses were conducted using Python on Jupyter Notebook in the All of Us Research platform. Results: The top 5 PVT1 variants with the greatest frequency in patients of the three chosen racial and ethnic backgrounds were identified and compared to find commonalities. Rs127920247 was a PVT1 risk variant shared by African American and Hispanic patients as the 2nd highest risk variant for both. The most frequent risk variants for each group is as follows: Rs128085054 for African Americans, Rs128139524 for Non-Hispanic White Americans, and Rs127870242 for Hispanic Americans. Conclusion: PVT1 risk variants in colorectal cancer can be uncovered from data in the All of Us Research hub. Thus, genetic risk variants for cancers can be uncovered from analysis of data available in the All of Us Research hub. Identification of specific PVT1 variants similarly prevalent in colorectal cancer amongst distinct racial and ethnic communities is a significant first step towards developing them as potential diagnostic or prognostic tools. Citation Format: Sujay Singh, Olorunseun Ogunwobi. PVT1 risk variant rs127920247 for colorectal cancer is shared by African American and Hispanic colorectal cancer patients [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A011.

Racial and Ethnic Differences in the Prevalence of Severe Aortic Stenosis by Echocardiography.

Understanding the burden of aortic stenosis (AS) across diverse racial and ethnic populations is important to ensure equitable resource allocation. This study explored whether severe AS rate varies by race and ethnicity. The rates of severe AS, stratified by race and ethnicity, were calculated among 615,038 adults with a transthoracic echocardiogram. Logistic regression analysis was performed to identify factors associated with severe AS. Severe AS rates ranged from 0.08% in adults < 50 years old to 3.8% in those ≥ 90 years old. Compared to non-Hispanic White and Asian American [adjusted odds ratio (aOR) = 0.47, 95% confidence interval (CI): 0.42-0.53] and non-Hispanic Black (aOR = 0.44, 95% CI: 0.39-0.50) patients were less likely to have severe AS, whereas Hispanic patients (aOR = 0.91, 95% CI: 0.87-0.98) had near similar likelihood. Age was the strongest risk factor for severe AS (compared to age < 50 years, aOR = 21.8, 95% CI: 17.8-26.6 for age 80-89 years, and aOR = 43.8, 95% 35.5-54.0 for age ≥ 90 years). Additional factors associated with severe AS included male sex (aOR = 1.38, 95% CI: 1.30-1.46) and diabetes (aOR = 1.23, 95% CI: 1.15-1.31). Asian American and non-Hispanic Black adults had lower rates of severe AS compared to White and Hispanic patients. The rate of severe AS progressively increases with age in all racial and ethnic groups, with higher rates in men compared with women. With a demographic shift toward an aging and more diverse population, the burden of AS is anticipated to rise. Ensuring adequate allocation of resources to meet the evolving needs of a diverse population remains a shared health care imperative.

Racial and ethnic composition of peer recovery community members and barriers to acquiring funding for organizations in the ecosystem of recovery

IntroductionOrganizations in the “ecosystem of recovery”—most often non-profits led and staffed by individuals with lived substance use disorder (SUD) experience—offer peer services, group counseling, and a wide variety of programs to help those struggling with SUD. The efforts of such organizations are effective in transitioning those suffering from SUD into long-term recovery. Despite well-established evidence depicting inequitable access to SUD treatment between BIPOC and non-Hispanic White Americans, there has been no empirical undertaking of whether organizations in the ecosystem of recovery face barriers to fund their operations based on the racial and ethnic composition of their community members. MethodsIn this 2022 needs assessment, “Optimizing Recovery Funding,” we combined the results of quantitative and qualitative data for a mixed methods analytic approach. The study employs bivariate descriptive statistics and inferences along with thematic analyses. From an initial list of 537 organizations across U.S. states and territories, 145 leaders of these organizations comprise our survey analytic sample. A total of 85 leaders participated in one of 16 focus groups, with 10 based on geography and 6 based on population identity. This needs assessment produced comprehensive data on the operations of organizations in the ecosystem of recovery. ResultsA lack of training and existing organizational funding, as well as non-inclusive language in funding requests for proposals contributed to some organizations' decisions not to pursue certain grants and funding mechanisms. There were no statistical differences in applying for, nor success in receiving, federal and state funding between organizations serving predominantly BIPOC community members and those serving mostly non-Hispanic White community members. However, there were key instances of—at times inexplicable—inequity in funding outcomes. ConclusionsAll leaders of organizations in the ecosystem of recovery who participated in the needs assessment made it clear that there are fundamental issues to accessing peer recovery operational and programmatic funding. Innovative strategies for developing inclusive and culturally responsive funding approaches that prioritize organizations predominantly serving historically marginalized communities are needed.

Changes in mortality due to Chronic Liver Diseases (CLD) during the COVID-19 pandemic: Data from the United States' National Vital Statistics System.

We assessed chronic liver disease (CLD)-related mortality in the U.S. using death data (2011-2021) obtained from National Vital Statistics System (NVSS). The average annual percentage change (AAPC) from the models selected by Joinpoint regression analysis over the pre-pandemic (2011-2019) and the 2019-2021 were reported because non-linear trend in death rates were observed over the 2011-2021. Liver-specific death was defined as an underlying cause of death and Chronic liver disease (CLD)-related death was defined as any cause of death. During the pre-pandemic, age-standardized HCC- and cirrhosis-specific death rates were annually increased by AAPC = +1.18% (95% confidence interval, 0.34% to 2.03%) and AAPC = +1.95% (1.56% to 2.35%). In contrast, during the 2019-2021, the AAPC in age-standardized cirrhosis-specific death rate (per 100,000) accelerated by up to AAPC +11.25% (15.23 in 2019 to 18.86 in 2021) whereas that in age-standardized HCC-specific death rate slowed to -0.39 (-1.32% to 0.54%) (3.86 in 2019 to 3.84 in 2021). Compared to HCC-specific deaths, cirrhosis-specific deaths were more likely to be non-Hispanic white (72.4% vs. 62.0%) and non-Hispanic American Indian and Alaska native (AIAN) (2.2% vs. 1.1%) and have NAFLD (45.3% vs. 12.5%) and ALD (27.6% vs. 22.0%). During the 2019-2021, the age-standardized HCV- and HBV-related death rate stabilized, whereas the age-standardized NAFLD- and ALD-related deaths rate increased to 20.16 in 2021 (AAPC = +12.13% [7.76% to 16.68%]) and to 14.95 in 2021 (AAPC = +18.30% [13.76% to 23.03%]), which were in contrast to much smaller incremental increases during the pre-pandemic (AAPC = +1.82% [1.29% to 2.35%] and AAPC = +4.54% [3.97% to 5.11%]), respectively). The most pronounced rise in the age-standardized NAFLD-related death rates during the pandemic was observed among AIAN (AAPC = +25.38%), followed by non-Hispanic White female (AAPC = +14.28%), whereas the age-standardized ALD-related death rates during the pandemic were highest among AIAN (AAPC = +40.65%), followed by non-Hispanic Black female (AAPC = +26.79%). COVID-19 pandemic had a major negative impact on cirrhosis-specific and CLD-related mortality in the U.S. with significant racial and gender disparities.

Proteomic networks and related genetic variants associated with smoking and chronic obstructive pulmonary disease

BackgroundStudies have identified individual blood biomarkers associated with chronic obstructive pulmonary disease (COPD) and related phenotypes. However, complex diseases such as COPD typically involve changes in multiple molecules with interconnections that may not be captured when considering single molecular features.MethodsLeveraging proteomic data from 3,173 COPDGene Non-Hispanic White (NHW) and African American (AA) participants, we applied sparse multiple canonical correlation network analysis (SmCCNet) to 4,776 proteins assayed on the SomaScan v4.0 platform to derive sparse networks of proteins associated with current vs. former smoking status, airflow obstruction, and emphysema quantitated from high-resolution computed tomography scans. We then used NetSHy, a dimension reduction technique leveraging network topology, to produce summary scores of each proteomic network, referred to as NetSHy scores. We next performed a genome-wide association study (GWAS) to identify variants associated with the NetSHy scores, or network quantitative trait loci (nQTLs). Finally, we evaluated the replicability of the networks in an independent cohort, SPIROMICS.ResultsWe identified networks of 13 to 104 proteins for each phenotype and exposure in NHW and AA, and the derived NetSHy scores significantly associated with the variable of interests. Networks included known (sRAGE, ALPP, MIP1) and novel molecules (CA10, CPB1, HIS3, PXDN) and interactions involved in COPD pathogenesis. We observed 7 nQTL loci associated with NetSHy scores, 4 of which remained after conditional analysis. Networks for smoking status and emphysema, but not airflow obstruction, demonstrated a high degree of replicability across race groups and cohorts.ConclusionsIn this work, we apply state-of-the-art molecular network generation and summarization approaches to proteomic data from COPDGene participants to uncover protein networks associated with COPD phenotypes. We further identify genetic associations with networks. This work discovers protein networks containing known and novel proteins and protein interactions associated with clinically relevant COPD phenotypes across race groups and cohorts.

Racial disparities in the utilization and outcomes of robotic bariatric surgery: an 8-year analysis of Metabolic and Bariatric Surgery Accreditation Quality Improvement Program data

BackgroundRobotic surgery utilization has been increasing across surgical specialties; however, racial disparities in patient access to care and outcomes have been reported. ObjectivesIn this study, we examined racial disparities in the utilization and outcomes of robotic bariatric surgery over an 8-year period. SettingMetabolic and Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP) centers of excellence across the United States. MethodsThe MBSAQIP database was used to identify adult patients who underwent robotic bariatric surgery between 2015 and 2022. Patients were stratified according to race and ethnicity into non-Hispanic White, non-Hispanic Black or African American (AA), Indigenous, Asian, and Hispanic patients. Multivariable analyses were used to assess predictors of robotic surgery use, odds of minor and major complications, prolonged length of stay (prolonged length of stay (pLOS): ≥3 days), readmissions, reoperations, and mortality within 30 days. ResultsOut of 1,288,359 patients included, robotic surgery was utilized in 196,314 patients (15.2%), with a mean age of 44 ± 12 years and 80.6% females. Rates of robotic surgery increased to 30% by 2022. Compared to White patients, Black/AA patients were more likely to undergo robotic surgery (adjusted odds ratio (aOR) = 1.22, 95% confidence interval (CI) = 1.21-1.24, P < .001). The safety of robotic bariatric surgery improved for both White and Black patients with decreased odds of major complications, readmissions, reoperations, and pLOS over the study period. However, Black/AA patients were more likely to experience minor and major complications, readmissions and have pLOS compared with White patients in 2022 (aOR:1.26, 95% CI:1.19-1.34, P < .001; aOR:1.22, 95% CI:1.06-1.41, P = .006; aOR:1.44, 95% CI:1.28-1.62, P < .001; aOR:2.26, 95% CI:2.06-2.47, P < .001, respectively). ConclusionThe utilization of robotic bariatric surgery has increased significantly over the past 8 years with continued improvements in its safety profile. While Black/AA patients have improved access to robotic surgery, their clinical outcomes continue to be worse than those of White patients. Efforts to address racial disparities in bariatric surgery outcomes must remain a priority to achieve health equity.

Dosage Effects of Anti-prescription Opioid Risk Narratives, Prescription Opioid Misuse Experience, Risk Perceptions, and Message Processing

An online experiment was conducted among a convenience sample of non-Hispanic young Black and White Americans to test the dosage effects of anti-prescription opioid risk narratives (i.e., receiving zero, one, or two different narratives) on negative attitudes toward prescription opioids and intentions to avoid misusing prescription opioids while considering the mediating role of risk perceptions and the moderating role of prescription opioid misuse experience. The study also investigated how the misuse experience may affect risk narrative processing. It detected positive dosage effects on risk perceptions and negative attitudes as well as significant indirect positive dosage effects on the attitudes and behavioral intentions via risk perceptions. Further analysis showed that these positive effects existed only among participants with little experience of misusing prescription opioids. Those with some misuse experience were inclined to engage in defensive processing of the narratives. These findings have a number of theoretical and practical implications.

Race-Ethnicity, Rurality, and Age in Prospective Preferences and Concerns Regarding Closed-Loop Implanted Neural Devices.

Responsive and human-centered neurotechnology development requires attention to public perceptions, particularly among groups underserved by existing treatments. The authors conducted a preregistered nationally representative survey (https://osf.io/ej9h2) using the NORC at the University of Chicago AmeriSpeak panel. One vignette compared an implanted neural device with surgical resection in a scenario involving epilepsy, and another compared an implanted neural device with medications in a scenario involving mood disorders. The survey also contained questions about respondents' confidence that a device would be available if needed and confidence that enough research has been conducted among people like themselves. Responses were entered into nested survey-weighted logistic regression models, including a base demographic model (to test the overall effect of demographic factors) and an adjusted model that also included socioeconomic, religious and political, and health care access predictors. A total of 1,047 adults responded to the survey, which oversampled Black non-Hispanic (N=214), Hispanic (N=210), and rural (N=219) Americans. In the base demographic model, older Americans were more likely to prefer an implanted device in the two scenarios, and non-Hispanic Black Americans were less likely than non-Hispanic White Americans to prefer a device; rural Americans were less confident than urban or suburban Americans in having access, and non-Hispanic Black and rural Americans were less confident that enough research has been conducted among people like themselves. In adjusted models, income was a key mediator, partially explaining the effect of age and the contrast between Black and White non-Hispanic respondents on preferences for a device in the epilepsy scenario and fully explaining the effect of rurality on confidence in access. Demographic differences in prospective preferences and concerns highlight the importance of including members of underserved communities in neurotechnology development.