non-Hispanic White Communities Research Articles

Trends in US Pediatric Asthma Hospitalizations, by Race and Ethnicity, 2012-2020.

Some racial and ethnic minority communities have long faced a higher asthma burden than non-Hispanic White communities. Prior research on racial and ethnic pediatric asthma disparities found stable or increasing disparities, but more recent data allow for updated analysis of these trends. Using 2012-2020 National Inpatient Sample data, we estimated the number of pediatric asthma hospitalizations by sex, age, and race and ethnicity. We converted these estimates into rates using data from the US Census Bureau and then conducted meta-regression to assess changes over time. Because the analysis spanned a 2015 change in diagnostic coding, we performed separate analyses for periods before and after the change. We also excluded 2020 data from the regression analysis. The number of pediatric asthma hospitalizations decreased over the analysis period. Non-Hispanic Black children had the highest prevalence (range, 9.8-36.7 hospitalizations per 10,000 children), whereas prevalence was lowest among non-Hispanic White children (range, 2.2-9.4 hospitalizations per 10,000 children). Although some evidence suggests that race-specific trends varied modestly across groups, results overall were consistent with a similar rate of decrease across all groups (2012-2015, slope = -0.83 [95% CI, -1.14 to -0.52]; 2016-2019, slope = -0.35 [95% CI, -0.58 to -0.12]). Non-Hispanic Black children remain disproportionately burdened by asthma-related hospitalizations. Although the prevalence of asthma hospitalization is decreasing among all racial and ethnic groups, the rates of decline are similar across groups. Therefore, previously identified disparities persist. Interventions that consider the specific needs of members of disproportionately affected groups may reduce these disparities.

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.

Lack of racial and ethnic disparities in mortality in minority patients hospitalised with COVID-19 in a mid-Atlantic healthcare system

IntroductionIn the USA, minoritised communities (racial and ethnic) have suffered disproportionately from COVID-19 compared with non-Hispanic white communities. In a large cohort of patients hospitalised for COVID-19 in a healthcare...

Spatial patterns of suicide in Texas: The potential confounding effect of race and ethnicity composition

In the United States, suicide rates are much higher among non-Hispanic Whites than any other racial or ethnic group. However, the impact of this pattern for spatial analysis remains unclear. This article explores the relationship among race and ethnicity, suicide mortality, and space in Texas. We compare traditional age-adjusted mortality rates with standardized mortality ratios created using indirect race or ethnicity rate adjustment. Both measurements are compared in three different contexts: choropleth maps, Getis–Ord Gi* hot spot analysis, and location-allocation modeling. Results show dramatic changes across all three methods after race or ethnicity adjustment. Regions of higher-than-expected suicide mortality shift from the non-Hispanic White-dominated north to the majority-Hispanic south. Accordingly, the p-median location-allocation model moves selected service sites closer to minority strongholds in large urban areas and along the Texas–Mexico border. A closer look at individual counties shows that minority-majority counties may have suicide rates two to three times the state average (given the population composition) yet remain hidden by traditional rate calculation methods. Failing to account for race and ethnicity effects will inevitably draw attention and resources to non-Hispanic White communities. At a time when governments are making investments in both mental health and diversity initiatives, this hidden bias must be addressed.

Undue Burden the Medical School Application Process Places on Low-Income Latinos

Undue Burden the Medical School Application Process Places on Low-Income Latinos

Abstract 005: Violent Crime, Physical Inactivity, And Obesity: Examining Differences In Spatial Relationships By Racial/ethnic Composition Of Community Residents

Introduction: Violent crime (e.g., homicide, aggravated assault) is a major public health issue that disproportionately affects communities of color in large urban centers. Studies have reported that residents in high crime communities are less likely to engage in physical activity. There is limited understanding of how violent crime influences physical inactivity and obesity at the community level. We aimed to address this gap by examining differences in spatial relationships between violent crime rate, physical inactivity, and obesity by racial/ethnic composition of community residents in Chicago, IL. Hypothesis: We assessed the hypothesis that violent crime rate is associated with the prevalence of physical inactivity and obesity at the census tract level in Chicago, IL. Methods: We conducted an ecological assessment of 2018 census tract data obtained from various sources. We used data from the City of Chicago to calculate per capita violent crime rate (number of incidents per 1,000 residents) for all census tracts (N = 801). Data on physical inactivity and obesity prevalence (%) were acquired from the CDC. Socio-demographic data (i.e., % Non-Hispanic (NH) White, % NH Black, % Hispanic, median household income) were obtained from the census bureau. We examined spatial lag and error models to determine if violent crime rate is associated with % physical inactivity and % obesity after controlling for socio-demographic characteristics and amenity availability (i.e., per capita outdoor parks and grocery stores). Stratified models were examined to identify differences in associations among majority NH White, NH Black, and Hispanic census tracts (defined as ≥ 50% representation). Results: NH Black census tracts (n = 278) had significantly higher rates of violent crime, physical inactivity, and obesity than Hispanic (n = 169) and NH White tracts (n = 240). Overall, violent crime rate was positivity associated with % physical inactivity (p<0.001) but not % obesity (p=0.77) in Chicago after controlling for covariates. Stratified models revealed that violent crime rate was positively associated with % physical inactivity (p<0.001) and % obesity (p=0.01) among NH Black tracts. Violent crime rate was not associated with % physical inactivity or % obesity among Hispanic and NH White census tracts. Conclusions: Racial/ethnic composition of residents appears to influence census-tract level associations between violent crime rate, physical inactivity, and obesity. Violent crime appears to be more relevant to physical inactivity and obesity in Chicago’s NH Black communities compared to Hispanic and NH White communities.

American Indian, Alaska Native, Native Hawaiian, and Pacific Islander Children's Body Mass Index: Diminished Returns of Parental Education and Family Income.

Socioeconomic status (SES) is associated with several health-related outcomes, such as obesity and body mass index (BMI). However, we do not know whether SES is associated differently with children's BMI from American Indian and Alaska Native and Native Hawaiian and Pacific Islander (AIAN/NHPI) families when compared to non-Hispanic White (NHW) families. To compare AIAN/NHPI and NHW families for associations between parental education, family income, and children's BMI in the United States (U.S). This cross-sectional investigation used the Adolescent Brain Cognitive Development (ABCD) study data. Participants (n = 8580) included 63 AIAN/NHPI and 8517 NHW children between ages 9 and 10. The independent variables were parental education and family income. The primary outcome was BMI. Race was the moderator. Age, sex, and family structure were covariates. Mixed-effects regression models were used for data analysis. In the pooled sample, higher parental education and family income were associated with lower children's BMI. We found interactions between race and parental education and family income indicating weaker associations between parental education and family income and children's BMI in AIAN/NHPI families than in NHW families. The salience of parental education and family income as social determinants of children's BMI is diminished for AIAN/NHPI families than NHW families. As a result, AIAN/NHPI children with high SES remain at risk for high BMI, while high-SES NHW children show the lowest BMI. Future research should test if obesogenic environments, food options, and physical activity-friendly neighborhoods can explain higher-than-expected BMI in high-SES AIAN/NHPI children. In other terms, more research is needed to understand if residential segregation, discrimination, and historical trauma explain the observed differences in the social patterning of childhood BMI in AIAN/NHPI and NHW communities.

Racial Disparities in Postpartum Pain Management

(Obstet Gynecol. 2019;134:1147–1153) There has been a rising trend of opioid misuse among non-Hispanic white communities in recent years, and researchers have noted that adults from predominantly white communities were more likely to receive a prescription for opioids than adults from more diverse areas. Previous studies have indicated that there are disparities between minority patients and non-Hispanic white patients in regards to pain treatment, where minority individuals with similar conditions and pain levels are being prescribed less opioid medications. Not much analysis has been performed in the postpartum pain management arena, but these investigators hypothesized that a similar imbalance is present for postpartum patients in minority communities. They conducted this study to assess racial and ethnic differences in patients’ postpartum pain levels, inpatient opioid disbursement, and number of opioid prescriptions upon discharge from the hospital.

Major League Soccer Provides a Captive Audience for Promoting Bystander CPR and AED Use Among Hispanics

ObjectiveRates of bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use are lower in Hispanic compared to non-Hispanic white communities. Novel instructional methods that focus on population subgroups most likely to benefit must be explored. The purpose of this study was to determine the feasibility, efficiency, and participant demographics of 10-minute educational intervention on bystander CPR and AED use delivered at a pre-match festival for Major League Soccer (MLS) fans. MethodsResults are reported with descriptive statistics. The primary outcomes included: (1) Training efficiency index for cardiac arrest (TEICA) defined as persons trained/volunteer hours; (2) cardiac arrest training yield (CATY) defined as percent participation by the target audience; and (3) percent of participants of Hispanic origin. Our secondary outcome was average post intervention knowledge survey score. ResultsCATY was 16% and TEICA was 3.81. Survey participation was 48.3% and 38.9% of survey participants were Hispanic. Average knowledge score post training was 87.5%. ConclusionSoccer matches may be a suitable setting for provision of CPR and AED training to Hispanics. This intervention gives insight into a novel way of providing health education to Hispanics that can be applied to other behaviors.

Employee and customer handling of nicotine-containing e-liquids in vape shops.

Vape shops sell electronic cigarettes and related products such as e-liquids, which may contain nicotine. Direct contact with nicotine can lead to adverse health effects, and few regulations exist on how nicotine is handled in vape shops. This study examined how customers and employees come into contact with, and handle, nicotine-containing e-liquids in vape shops with the goal of informing potential future regulation of nicotine handling in vape shops. Data were collected from 77 vape shops in the Los Angeles basin. Characteristics of the shops were documented by employee interviews and in store observations. Data collection was focused on shops located in areas with high concentrations of communities of interest; 20 shops from African-American communities, 17 from Hispanic communities, 18 from Korean communities, and 22 from non-Hispanic White communities. Half of the vape shops allowed customers to sample e-liquids with nicotine. Most of the shops (83%) provided self-service sampling stations for customers. A majority of shop employees (72%) reported that spills of e-liquids containing nicotine had occurred in the past. While 64% of the shops provided safety equipment, only 34% provided equipment for proper nicotine handling. Furthermore, 62% of shop employees reported handling nicotine without gloves or other safety equipment. Regulation on the handling of nicotine by customers and vape shop employees is important to prevent unsafe practices and subsequent injury. The frequent occurrence of spills and limited availability of safety equipment in vape shops highlights the need for the creation and enforcement of regulations to protect employees and customers. Appropriate safety training and equipment should be provided to employees to prevent accidental exposure to nicotine. Information on ways to safely handle nicotine should be communicated to vape shop employees and customers.

Geographic Factors and Human Papillomavirus (HPV) Vaccination Initiation among Adolescent Girls in the United States.

This study is among the first to explore geographic factors that may be associated with human papillomavirus (HPV) vaccine uptake in the United States. Data from the 2011 and 2012 National Immunization Survey-Teen for 20,565 female adolescents aged 13 to 17 years were analyzed to examine associations of HPV vaccine initiation (receipt of at least one dose) with ZIP code-level geographic factors. Logistic regression including individual and geographic factors was used to estimate the odds of HPV vaccine initiation. Approximately 53% of girls initiated the HPV vaccine in both years. Girls in high poverty communities had higher HPV vaccine initiation compared with those in low poverty communities [61.1% vs. 52.4%; adjusted OR (AOR), 1.18; 95% confidence intervals (CI), 1.04-1.33]. Initiation was higher among girls in communities where the majority of the population was Hispanic (69.0% vs. 49.9%; AOR, 1.64; 95% CI, 1.43-1.87) or non-Hispanic mixed race (60.4% vs. 49.9%; AOR, 1.30; 95% CI, 1.17-1.44) compared with majority non-Hispanic white communities. Interactions between individual-level race/ethnicity and community racial-ethnic composition indicated significantly higher odds of initiation among Hispanic girls living in Hispanic communities compared with Hispanic girls living in predominantly non-Hispanic White (NHW) (AOR, 2.23; 95% CI, 1.87-2.65) or non-Hispanic Black (NHB) (AOR, 1.90; 95% CI, 1.20-3.04) communities, respectively. Initiation rates of HPV vaccination among teen girls were highest in the poorest communities and among Hispanics living in communities where the racial-ethnic composition was predominantly Hispanic or mixed race. Given low HPV vaccination rates in the United States, these results provide important evidence to inform public health interventions to increase HPV vaccination.

Measurement of Wildlife Value Orientations Among Diverse Audiences: A Multigroup Confirmatory Factor Analysis Among Hispanic and Non-Hispanic White Communities

ABSTRACTWildlife value orientations (WVOs) are increasingly being used to describe broad societal shifts that are altering the way people perceive wildlife. Concurrent with these shifts is a diversification of cultural heritages that complicate comparisons of WVOs across cultures. Yet, when measuring WVOs across cultures, differences in WVOs may be genuine variations between the populations, or may be artifacts of the measurement instrument. Therefore, there is a need to determine if various cultures interact with the instrument uniformly. Three multiple group confirmatory factor analyses (MGCFA) examined how ethnicity, acculturation, and language spoken are related to a WVO scale’s performance within Hispanic and non-Hispanic white communities. Results of each MGCFA support the cross-cultural stability of the WVO factor structure. Additional cross-cultural WVO research is needed to expand the construct and assist natural resource practitioners in understanding diverse constituencies, but conducting a MGCFA analysis should be a necessary precondition when comparing WVOs across cultures.

Marketing activities of vape shops across racial/ethnic communities.

INTRODUCTIONThere has been a surge in the number of vape shops in the USA. Research on the marketing practices of e-cigarette manufacturers is scarce and even less known are the practices of vape shop retailers. Past research on tobacco marketing has shown differences in the amount and content of marketing material, based on a community’s demographic profile. This study examined marketing strategies in vape shops and explored differences among vape shops located in communities that differ by ethnic composition.METHODSData was gathered in 2014 from a pilot-study on vape shops (n=77) in Los Angeles, which documented the characteristics of shops through employee interviews and in-store observations. Data were collected from shops located in communities that were predominantly, African-American (n=20), Hispanic (n=17), Korean (n=18), or non-Hispanic White (n=22).RESULTSSixty-one percent of vape shops had advertisements (print ads and posters) for e-cigarettes and 84% offered discounts. Vape shops in Hispanic communities were more likely to have ethnic specific marketing material compared to shops in other communities. All the shops provided customers with free samples, however those in Korean and non-Hispanic White communities had a significantly higher prevalence of customer accessible free samples.CONCLUSIONSVape shop marketing practices differed by ethnic community. A large majority of shops provided free samples to their customers, a practice which is now banned by the FDA. It will be important to monitor how vape shops will adjust their marketing strategy because of this ban. Future research should expand on the findings presented here to provide regulators with further crucial information.

Prevalence of Obesity among Children in Six Chicago Communities: Findings from a Health Survey

We analyzed data from a community health survey to assess levels of obesity and overweight among children in some Chicago communities compared with national U.S. estimates. Data came from the Sinai Improving Community Health Survey, which was conducted via face-to-face interviews with people living in six racially and ethnically diverse Chicago communities during 2002 and 2003. A stratified, three-stage probability study design was employed to obtain a representative sample from each community. Height and weight data reported by the primary caretakers of 501 randomly selected children aged 2-12 years were used to determine age- and gender-specific body mass index (BMI), which was then used to classify weight status (obese > or =95th percentile for age and gender). Compared with 16.8% for the U.S., the prevalence of obesity was 11.8% in a non-Hispanic white community on Chicago's north side, 34.0% in a Mexican American community on the west side, and 56.4% in a non-Hispanic black community on the south side. Surveillance of the childhood obesity epidemic at the local level is limited. Findings describe the extent of disparities in childhood overweight and obesity within one city and how local-level data can shape new initiatives for improved health, one community at a time.

Poverty, time, and place: variation in excess mortality across selected US populations, 1980-1990.

STUDY OBJECTIVE: To describe variation in levels and causes of excess mortality and temporal mortality change among young and middle aged adults in a regionally diverse set of poor local...

Effect of abuse on self-perception of rural Mexican-American and non-Hispanic white adolescents

The prevalence of adolescent abuse has serious community health ramifications because of its associated psychological responses. Theoretical frameworks have described behaviors arising from interpersonal interactions as being affected by self-concept. Therefore, the issue of assessing the self-concept is critical in research and practice for understanding the behavior of abused adolescents. This research arose from clinical practice in a rural Mexican-American and non-Hispanic White community. The practice focused on individual and group counseling for adolescents in abusive relationships. This study proposed to refine the theoretical basis for interventions related to self-concept and woman abuse for rural Mexican-American and non-Hispanic White adolescents.

Recruitment Strategies in the Women’s Health Trial: Feasibility Study in Minority Populations

The Women’s Health Trial:Feasibility Study in Minority Populations (WHT:FSMP) examined the feasibility of recruiting postmenopausal women from a broad range of racial and socioeconomic backgrounds into a primary prevention trial requiring marked reductions in dietary fat. Postmenopausal women aged 50–79 yr who had no history of cardiovascular disease or cancer and who consumed 36% or more total energy from fat qualified to participate. We randomized the women into dietary intervention (60%) or control (40%) groups; we aimed to randomize 750 women in 18 months in each of the three clinical centers. All centers achieved goals for randomization based on ethnicity, and two centers exceeded overall recruitment goals. The greatest source of randomized participants was mass mailing, followed by items in the media, referrals, and community outreach. Recruitment yields were generally similar for the ethnic groups but lower for less-educated participants. The experience of WHT:FSMP indicates that postmenopausal women from the African-American, Hispanic, and non-Hispanic white communities can be recruited into dietary intervention studies for the prevention of disease. Controlled Clinical Trials 1998;19:461–476.

Self-Concept and Woman Abuse: A Rural and Cultural Perspective

The prevalence of woman abuse has serious community health ramifications because of its associated psychological responses. Theoretical frameworks have described behaviors arising from interpersonal interactions as being affected by self-concept. Therefore, assessing self-concept is critical in research and practice for understanding the behavior of abused women and the effects of self-concept on the physical self. This research arose from clinical practice in a rural Mexican American and non-Hispanic white community. The practice focused on individual and group counseling for women and adolescents in abusive relationships. This study was conducted to refine the theoretical basis for interventions related to self-concept and woman abuse for rural Mexican American and non-Hispanic white women.