Non-white Minorities Research Articles

The association between chronic kidney disease and tuberculosis; a comparative cohort study in England

BackgroundPeople with end-stage kidney disease have an increased risk of active tuberculosis (TB). Previous systematic reviews have demonstrated that patients with chronic kidney disease (CKD) have increased risk of severe community-acquired infections. We investigated the association between CKD (prior to renal replacement therapy) and incidence of TB in UK General Practice.MethodsUsing the UK Clinical Practice Research Datalink, 242,349 patients with CKD (stages 3-5) (estimated glomerular filtration rate < 60 mL/min/1.73 m2 for ≥3 months) between April 2004 and March 2014 were identified and individually matched (by age, gender, general practice and calendar time) to a control from the general population without known CKD. The association between CKD (overall and by stage) and incident TB was investigated using a Poisson regression analysis adjusted for age, gender, ethnicity, socio-economic status, chronic obstructive pulmonary disease (COPD) and diabetes.ResultsThe incidence of TB was higher amongst patients with CKD compared to those without CKD: 14.63 and 9.89 cases per 100,000 person-years. After adjusting for age, gender, ethnicity, socio-economic status, diabetes and COPD, the association between CKD and TB remained (adjusted rate ratio [RR] 1.42, 95% confidence interval [CI] 1.01–1.85). The association may be stronger amongst those from non-white ethnic minorities (adjusted RR 2.83, 95%CI 1.32–6.03, p-value for interaction with ethnicity = 0.061). Amongst those with CKD stages 3–5, there was no evidence of a trend with CKD severity.ConclusionsCKD is associated with an increased risk of TB diagnosis in a UK General Practice cohort. This group of patients should be considered for testing and treating for latent TB.

Global and localized neighborhood effects on public transit ridership in Baton Rouge, Louisiana

This study examines what socio-demographic and spatial factors explain the variation of public transit ridership in a medium-size city in southern U.S. – Baton Rouge, Louisiana. In order to gain a sharper spatial resolution in the analysis, the ecological inference method is used to disaggregate socio-demographic data from the census block group level to the census block level. Monte Carlo simulation and transit schedule data are used to improve the estimation of travel time by private vehicle and public transit, respectively, also at the census block level. The semi-parametric geographically-weighted regression (SGWR) is used to identify, among significant variables, what are global factors and what are local factors. The results indicate that neighborhoods with higher concentrations of non-White minorities, recent immigrants and carless households have positive global effects on public transit ridership. The effects by neighborhood median income, public transit to private vehicle commuting time ratio, and accessibility to employment via public transit are localized or vary across the study area, and some of these variables even show opposite effects in specific pockets in contrast to their area-wide average effects.

The Opioid Crisis Viewed Through the Lens of a Black and White Camera

The United States’ opioid epidemic is a national public health emergency. As opioid use has not been shielded from health care disparities furthered by economic, gender, race, and sex biases, discrepancies in the rates of abuse and access to treatment exist among non-white minorities. This narrative literature review is an evaluation of the literature centered on minority racial disparities in opioid use, abuse, and care in the United States. Racial disparities in prescribing opioid-containing compounds are staggering among non-white individuals. A historical review of opioid regulatory control is offered as an explanation for the cognitive biases demonstrated by clinicians. Governmental regulation is among the polyfactorial roots of racial inequity in the opioid epidemic. Literature describing physician bias and portrayals of racial and sexual disparities in opioid abuse disorders are presented. As part of the national response to this evident disparity, addressing these issues will be an important factor in curbing this epidemic and tools to assist in mitigating these obstacles are presented.

Cultural dance significantly improves hypertension management

Abstract Hypertension (HT), uncontrolled blood pressure (&amp;gt;140/90 mmHg), is the leading preventable cause of premature death globally and a major risk factor for coronary heart disease, stroke, and other conditions. European and African regions have the highest prevalence rates at about 40% of adults. The U.S. has comparable rates and disturbing disparities in non-White minority groups. Native Hawaiians (NH), an indigenous U.S. population, are 70% more likely to have HT; 4 times more likely to have coronary heart disease or stroke than Whites. Hula, the cultural dance of NH, offers promise of a culturally responsive strategy for HT control. We conducted a randomized clinical trial with a waitlist control to test the impact of a hula-based cultural dance intervention (CDI) on systolic blood pressure (SBP) in 263 NH with HT. All participants received HT education (e.g. diet, exercise, medication) during 3 1-hr sessions over 2 weeks, then randomly assigned to CDI (n = 131) or waitlist control (WC; n = 132). The CDI received 6 months of hula (2 1-hr sessions/week x 3 months, then 1 lesson/mth x 3 months with self-directed practice), with group activities to reinforce HT education. WC only received the initial HT education, then offered hula after the study. Assessments were done at 0-, 3- and 6-month, with 12-month for CDI only. Baseline characteristics were balanced between groups, except for weight. Adjusting for weight and baseline SBP in intent-to-treat analysis, CDI achieved significant reductions (p &amp;lt; .05) in SBP (-15.3 mmHg; SE = 1.6) compared to WC (-11.8 mmHg, SE = 1.7). From 6 to 12 months, CDI maintained their SBP (mean change: 1.47 mmHg, SE = 1.26; p = .16) improvements at 12 months. CDI were more likely to achieve SBP reduction ≥ 10 mmHg than WC, 60% vs 48% (p = .03), respectively. A CDI based on the NH cultural dance significantly improved HTN management in NH with uncontrolled SBP. Improvements were comparable to the best proven non-medication treatment of HT. Key messages Improving elevated blood pressure control with at-risk populations can be effectively and innovatively achieved by utilizing culturally responsive strategies, such as cultural dance interventions. Leveraging and aligning community strengths and health objectives leads to innovation and empowerment.

Parkchester: A Bronx Tale of Race and Ethnicity. By Jeffrey S. Gurock (New York, New York University Press, 2019) 308 pp. $30.00

The best way to study cities is through their neighborhoods, which offer the local consequences of national and city-wide policies. Gurock, a historian of New York’s districts and a former resident of Parkchester, provides an excellent analysis of this neighborhood, a unique Bronx area that seemed largely to avoid the conflict and collapse of the rest of the borough in the period from 1940 to 2017. This “apartment village” or “city within a city” of fifty-one buildings had its problems over the years, though not on the level of other Bronx communities. The physical structure declined over time; management under Helmsley neglected the buildings; suburbia beckoned, and a shift to condominiums all altered Parkchester. The East Bronx development, however, never reached the disaster that befell the South Bronx.Gurock uses a variety of research tools to develop his history. Most importantly, his willingness to go back into the neighborhood for oral-history accounts and to seek previous tenants for their recollections provides a sense of being there. His interviews indicate the importance of oral history in understanding neighborhoods. This type of research cannot be done in archives or through statistical analysis. It requires a hands-on approach and an understanding of the community, which Gurock’s approach represents superbly. Furthermore, by delving into the fields of architecture, intergroup relations, urban planning, and economics, Gurock ably fleshes out the history of this unusual housing project.Parkchester was the result of a project undertaken by the Metropolitan Life Insurance Company to build lower-middle and working-class apartments in New York City as an investment and a foray into city planning. During a time of housing shortages due to the Depression and World War II, the city was eager to see private companies enter the housing field. A few years later, Metropolitan also built the better-known Stuyvesant Town in Manhattan. Careful selection of tenants became the hallmark feature in both projects, resulting in a segregationist racial policy regarding who would live in this designed community. The company’s efforts to people the apartments initially with white ethnics excluded many African Americans who would have met the class and employment guidelines. Later, only after court decisions, legislation, and tenant activism forced the landlord to open fully to blacks and Hispanics in 1968 did Parkchester integrate.The enmity between the Irish and Jews, most evident in 1930s and early 1940s New York City, especially in the Bronx, did not appear in Parkchester. Moreover, as non-white minorities made their way into this housing, animosity between blacks and whites was minimal. Although whites eventually left the development, they did not flee en masse. Nor did the gang warfare and large-scale open hostility found even in neighborhoods near Parkchester erupt. In the 1990s, when Parkchester housed mainly African Americans, Africans, Latinos, Afro Caribbeans, and Asians, as well as Muslims and Hindus, the intergroup relations remained peaceful.Why antagonism did not occur is the book’s key question. Part of the answer lies in the willingness of religious leaders to work together. But apparently something special, as Gurock relates, existed in Parkchester. A sense of community, initially nurtured by Metropolitan and continued by others, sustained a neighborliness lacking elsewhere. Tenant associations, organized activities for children, an unarmed security force, and strict rules of behavior added to a peaceful village atmosphere that persisted through extensive population changes. Parkchester remained a highly desirable area with a continuation of the same class and occupational elements that the project had at its beginning. Gurock has provided an outstanding history of an extraordinary Bronx neighborhood. The Bronx tale is clearly about more than conflict and decay.

Racial and Ethnic Disparities in Disease Severity on Admission Chest Radiographs among Patients Admitted with Confirmed Coronavirus Disease 2019: A Retrospective Cohort Study.

BackgroundDisease severity on chest radiographs (CXR) has been associated with higher risk of disease progression and adverse outcomes from COVID-19. Few studies have evaluated COVID-19-related racial/ethnic disparities in radiology.PurposeTo evaluate whether Non-White minority patients hospitalized with confirmed COVID-19 infection presented with increased severity on admission CXR compared with White/Non-Hispanic patients.MethodsSingle-institution, retrospective cohort study approved by the IRB. Patients hospitalized with confirmed COVID-19 infection (3/27/20-4/10/20) were identified using the electronic medical record (EMR) (n=326, mean age: 59 years (SD: 17 years), M:F (188:138). Primary outcome was severity of lung disease on admission CXR, measured by modified Radiographic Assessment of Lung Edema (mRALE) score. Secondary outcome was a composite adverse clinical outcome of intubation, ICU admission, or death. Primary exposure was racial/ethnic category: White/Non-Hispanic versus Non-White [i.e., Hispanic, Black, Asian, Other]. Multivariable linear regression analyses were performed to evaluate the association between mRALE scores and race/ethnicity.ResultsNon-White patients had significantly higher mRALE scores (median 6.1, 95% CI 5.4–6.7) compared with White/Non-Hispanic patients (median 4.2, 95% CI 3.6–4.9) (unadjusted average difference 1.8, 95% CI 0.9–2.8, p<0.01). For both White (Adjusted HR, 1.3, 95%CI 1.2-1.4, p<0.001) and Non-White patients (Adjusted HR 1.2, 95%CI 1.1-1.3, p<0.001), increasing mRALE scores were associated with a higher likelihood of experiencing composite adverse outcome with no evidence of interaction (p = 0.16). Multivariable linear regression analyses demonstrated that Non-White patients presented with higher mRALE scores on admission CXR versus White/Non-Hispanic patients (adjusted average difference 1.6, 95% CI 0.5–2.7, p<0.01). Adjustment for hypothesized mediators revealed that the association between race/ethnicity and mRALE scores was mediated by limited English proficiency (p<0.01).ConclusionNon-White patients hospitalized with COVID-19 infection were more likely to present with higher severity of disease on admission CXR than White/Non-Hispanic patients, and increased severity was associated with worse outcomes for all patients.

Accessing racial privilege through property: Geographies of racial capitalism

This paper examines racial capitalism through the lens of housing and urban development. We compare two disparate places Kabul, Afghanistan and Boulder, Colorado in order to illustrate the commonalities of property rights regimes, and the (ill)logics of economic development that reinforce racial-economic privilege. By exploring housing specifically, this paper explicates the ways in which availability, affordability, and desirability are intertwined with racialized conceptualizations of space. Both Kabul and Boulder are dominated by legacies and contemporary practices of white privilege and economic inequality based on neoliberal racial capitalism. Housing in Kabul has been a key part of international and national economic development programs, while the influx of international funds and workers included a form of gentrification that significantly marginalized local-Afghans from several spaces in the capital city. In Boulder, property values have increased exponentially in recent decades due to the growth of information technology jobs and influx of wealth. The racial and economic marginalization of nonwhite and low-income persons in Boulder remains consistent within housing and work sectors. The racialization of Afghans by international development workers in Kabul, and the racialization of poverty and marginalization of nonwhite minorities in Boulder explicate the tensions and conflicts between property rights regimes and the “right” to be housed. This paper examines the ways in which discursive representations of wealth and poverty become geopolitical and geo-economic tools of racialized socioeconomic ostracism. Analyzing these disparate places through the lens of racial capitalism explicates the common forms of reductionism used to reinforce market privilege over the lives and livelihoods of bodies racialized as “other”. While the specific histories of domination differ by location, the effects of racial capitalism are visible in each, particularly through relations of private property.

Prevalence and Risk of Metastatic Thyroid Cancers and Management Outcomes: A National Perspective.

Examine the prevalence and risk of metastasis in thyroid cancers and management outcomes. Retrospective analysis of the National Cancer Database, 2004-2014. The study population included adult (≥ 18 years) patients with thyroid cancer. Analysis included multivariate logistic regression and Cox hazard ratio modeling. A total of 152,979 patients were included. Distant metastasis was reported in 1,867 (1.22%) patients. The distribution of metastatic cases based on pathology and tumor size were as follows in descending order: papillary thyroid carcinoma (PTC) 1 to 4 cm (30.53%), PTC > 4 cm (19.34%), undifferentiated (UTC) > 4 cm (14.14%), PTC < 1 cm (8.46%), follicular thyroid carcinoma (FTC) > 4 cm (7.28%), FTC 1 to 4 cm (5.52%), medullary thyroid cancer (MTC) ≤ 4 cm (3.96%), MTC > 4 cm (3.91%), UTC ≤ 4 cm (3.32%), Hürthle (HCC ) > 4 cm (2.09%), and HCC 1 to 4 cm (1.45%). Significant predictors of distant metastasis, while controlling for tumor pathology and size, included older age, male gender, non-White minorities, presence of multiple comorbidities, minimal, gross extrathyroidal extension (ETE), lymphovascular invasion (LVI), and concomitant central and lateral lymph node metastasis (LNM) (P < .05 each). The risk of distant metastasis in the absence of nodal metastasis, ETE, and LVI was highest for FTC > 4 cm. Although the risk of metastasis in well-differentiated thyroid carcinoma (WDTC) is low, the prevalence of metastatic thyroid cancer is highest in WDTC population because it is the most common type of thyroid cancer. Certain pathological features, including minimal ETE and central LNM, are associated with a higher prevalence of metastatic disease. NA Laryngoscope, 131:237-244, 2021.

A risk-based model to assess environmental justice and coronary heart disease burden from traffic-related air pollutants

BackgroundCommunities need to efficiently estimate the burden from specific pollutants and identify those most at risk to make timely informed policy decisions. We developed a risk-based model to estimate the burden of black carbon (BC) and nitrogen dioxide (NO2) on coronary heart disease (CHD) across environmental justice (EJ) and non-EJ populations in Allegheny County, PA.MethodsExposure estimates in census tracts were modeled via land use regression and analyzed in relation to US Census data. Tracts were ranked into quartiles of exposure (Q1-Q4). A risk-based model for estimating the CHD burden attributed to BC and NO2 was developed using county health statistics, census tract level exposure estimates, and quantitative effect estimates available in the literature.ResultsFor both pollutants, the relative occurrence of EJ tracts (> 20% poverty and/or > 30% non-white minority) in Q2 – Q4 compared to Q1 progressively increased and reached a maximum in Q4. EJ tracts were 4 to 25 times more likely to be in the highest quartile of exposure compared to the lowest quartile for BC and NO2, respectively. Pollutant-specific risk values (mean [95% CI]) for CHD mortality were higher in EJ tracts (5.49 × 10− 5 [5.05 × 10− 5 – 5.92 × 10− 5]; 5.72 × 10− 5 [5.44 × 10− 5 – 6.01 × 10− 5] for BC and NO2, respectively) compared to non-EJ tracts (3.94 × 10− 5 [3.66 × 10− 5 – 4.23 × 10− 5]; 3.49 × 10− 5 [3.27 × 10− 5 – 3.70 × 10− 5] for BC and NO2, respectively). While EJ tracts represented 28% of the county population, they accounted for about 40% of the CHD mortality attributed to each pollutant. EJ tracts are disproportionately skewed toward areas of high exposure and EJ residents bear a greater risk for air pollution-related disease compared to other county residents.ConclusionsWe have combined a risk-based model with spatially resolved long-term exposure estimates to predict CHD burden from air pollution at the census tract level. It provides quantitative estimates of effects that can be used to assess possible health disparities, track temporal changes, and inform timely local community policy decisions. Such an approach can be further expanded to include other pollutants and adverse health endpoints.

American Social Liberalism and the Challenge of Ethnic Diversity: The Rise and Decline of Affirmative Action

In this article, it is argued that the progressive reform agenda of the mid-twentieth century liberal elite might have more effectively served the economic interests of non-white minorities had this generation of well-intentioned policy-makers been more attentive to the conservative criticism of the limits and pitfalls of their policies. As they turned preferential treatment into one of the mainstays of the national government’s anti-poverty strategies, and by supporting a new “welfare philosophy” that was essentially based on service provision, the social liberals in power during the sixties and seventies transformed government assistance into an even less popular approach to socioeconomic disparities. While they focused their vision of social progress on group advancement, they ended up further compromising their egalitarian agenda as their political choices and decisions gradually lost much of their early popular appeal. This liberal elite, it is argued, laid the foundation for a new egalitarian paradigm which presents racial integration through preferential treatment - or race-based affirmative action - as an ideal solution to the socioeconomic underperformance of disadvantaged non-white minorities, causing the former to definitively fall into disfavor.Keywords: Affirmative action, Laissez-faire, Public policy, US ethnic minorities, welfare

Examining the intersection of race/ethnicity and sexual orientation on suicidal ideation and suicide attempt among adolescents: Findings from the 2017 Youth Risk Behavior Survey

Although some studies have examined factors associated with suicidal behaviors, few studies have examined the intersection of sexual orientation and race/ethnicity on suicidal behaviors among adolescents. The objective of this study is to examine the intersection of sexual orientation and race/ethnicity on suicidal ideation and suicide attempt. We hypothesized that controlling for the effects of known risk factors for suicidal behaviors, there will be an interaction effect between sexual orientation and race/ethnicity on suicidal behaviors. Data for this study came from the 2017 Youth Risk Behavior Surveillance System. A sample of 13,697 adolescents aged 14–18 years (51.8% female) was analyzed using binary logistic regression. Of the 13,697 adolescents, 17.7% reported suicidal ideation and 7.7% made at least one suicide attempt during the past 12 months. In the multivariate logistic regression models, non-White sexual minority adolescents are less likely to report suicidal ideation. However, Hispanic lesbian/gay adolescents had 1.71 times higher odds of making a suicide attempt. Odds of suicide attempt are 1.2 times higher for Black or African American bisexual adolescents and American Indian/Native Hawaiian/Pacific Islander bisexual adolescents had 2.44 times higher odds of making a suicide attempt. Other significant predictors of suicidal behaviors include a history of sexual assault, a victim of bullying, depression, cigarette smoking, misuse of prescription pain medication, and illicit drug use. The findings of the present study extend past research on the intersection of sexual orientation and race/ethnicity on mental health problems among adolescents including suicidal behaviors.

Epidemiology and outcomes of sepsis among hospitalizations with systemic lupus erythematosus admitted to the ICU: a population-based cohort study

BackgroundSepsis is the most common cause of premature death among patients with systemic lupus erythematosus (SLE) aged ≤ 50 years in the United States, and infection is the most common cause of admission to the ICU among SLE patients. However, there are no population-level data on the patterns of the demand for critical care services among hospitalized septic patients with SLE or the outcomes of those admitted to the ICU.MethodsWe performed a retrospective cohort study, using the Texas Inpatient Public Use Data File, to identify SLE hospitalizations aged ≥ 18 years and the subgroups with sepsis and ICU admission during 2009–2014. The patterns of ICU admission among septic hospitalizations were examined. Logistic regression modeling was used to identify predictors of short-term mortality (defined as hospital death or discharge to hospice) among ICU admissions with sepsis and to estimate the risk-adjusted short-term mortality among ICU admissions with and without sepsis.ResultsAmong 94,338 SLE hospitalizations, 17,037 (18.1%) had sepsis and 9409 (55.2%) of the latter were admitted to the ICU. Sepsis accounted for 51.5% of the growth in volume of ICU admissions among SLE hospitalizations during the study period. Among ICU admissions with sepsis, 25.3% were aged ≥ 65 years, 88.6% were female, and 64.4% were non-white minorities. The odds of short-term mortality among septic ICU admissions were increased among those lacking health insurance (adjusted odds ratio 1.40 [95% confidence interval 1.07–1.84]), while being unaffected by gender and race/ethnicity, and remaining unchanged over the study period. On adjusted analyses among ICU admissions, the short-term mortality among those with and without sepsis was 13% (95% CI 12.6–13.3) and 2.7% (95% CI 2.6–2.8), respectively. Sepsis was associated with 63.6% of all short-term mortality events.ConclusionsSepsis is a major, incremental driver of the demand for critical care services among SLE hospitalizations. Despite its relatively low mortality, sepsis was associated with most of the short-term deaths among ICU patients with SLE.

Beyond whiteness: violence and belonging in the borderlands of North Queensland

ABSTRACTDefined as ‘borderlands’ by Tracey Banivanua-Mar, the sugar towns of North Queensland in the late nineteenth and early twentieth centuries were populated with a great variety of non-white ethnic minorities: Chinese, Indian, Japanese, ‘Malay’, Pacific Islander and later southern European. Instances of violence between these population groups have been recounted as if they were detached from the socio-historical conditions dictated by settler colonialism. Against this stance, this article examines the case of three South Sea Islanders attacking an Italian farmer in the city of Ingham in 1927. As the motive behind the incident remains unknown, the incident is recounted through the individual histories of those who were involved and against the wider context of anti-Italian migration sentiment. In doing this, this article demonstrates how these histories of presence in Ingham challenge the discursive rendition of the assault as a random act of violence and, accordingly, throw into sharp relief who could be counted as a permanent part of the Australian population. This article concludes by pointing to the necessity of examining similar instances of violence by setting them against migrants’ implication in the subjection of ‘natives’ and South Sea Islanders to the project of European replacement. When this implication is considered, violence can be theorised as much as a means that migrants, such as Italians, use to claim belonging as a technology settlers employ to manage ‘undesired’ populations.

The Color of Coronavirus

This study first documents robust evidence that the COVID-19 death ratio and infection ratio are positively associated with income inequality, higher non-White/White residential segregation index, and higher percentage of adults aged 65 and below without health insurance. Second, death and infection ratios also increase with the share of ethnic non-White minorities in a county’s population, possibly representing the racial bias of policy, law, governance, and culture that disadvantages ethnic minorities, leading to structural health inequalities. Finally, our results are consistent with a significant spatial-spillover effect of the novel coronavirus and the previously documented characteristics of COVID-19 decedents and patients.

Diabetes in Normal-Weight Individuals: High Susceptibility in Nonwhite Populations.

Type 2 diabetes is one of the most prevalent diseases of our time. There are an estimated 425 million people with diabetes worldwide, and 625 million people are projected to have the disease by 2045 (1). Over the next three decades, the largest increases in diabetes prevalence and overall numbers of people with the disease are expected to occur in low- and middle-income countries and among nonwhite ethnic minorities living in high-income nations (1). Overweight and obesity are well-established risk factors for diabetes; however, evidence suggests that the relationship between body weight and diabetes risk may differ by race/ethnicity (2–4), which has implications for the prevention, screening, and treatment of individuals who develop diabetes with a BMI below the overweight or obesity range. In their article in this issue of Diabetes Care , Zhu et al. (5) examined racial/ethnic disparities in the prevalence of diabetes by BMI category in a large, racially/ethnically and geographically diverse cohort of 4.9 million adults. Individuals enrolled in the cohort were members of three integrated health care systems in the U.S. in the years 2012–2013 and were from six racial/ethnic groups including white, black, Hispanic, Asian, Hawaiian/Pacific Islander, and American Indian/Alaskan Native. They found that the age-standardized prevalence of diabetes increased across BMI categories among all racial/ethnic groups. However, compared with whites, all other racial/ethnic groups had a higher prevalence of diabetes at any given BMI, and these differences were more pronounced in lower BMI categories. Strikingly, in those with a normal weight, the prevalence of diabetes was 5.0% in whites, 10.1% in Asians and American Indians/Alaskan Natives, 13.0% in …

CORESIDENCE OF OLDER PARENTS AND ADULT CHILDREN BENEFITS OLDER ADULTS’ PSYCHOLOGICAL WELL-BEING: PATH ANALYSIS

Even though the coresidence of older parents and their adult children is no longer a rare phenomenon in current society, a little is known about the benefit of living with adult children from older adults’ perspectives compared to the risk of this living situation. Previous research suggests that older adults’ psychological well-being is low when they live with their adult children, and this become more salient among single parents, such as widowed or divorced. The current paper utilizes the National Health Measurement Study with a sample of age 55 and over, and their SF-36 Mental Health Component score, and psychological well-being self-acceptance score was measured. Path analysis reveals while mental health and psychological well-being scores are lower among single older adults at the time of the survey (e.g., divorced, widowed) than non-single, coresidence of older adults and adult children completely mediates the negative relationship between being single and both mental health psychological well-being. A complete mediation effect of living with an adult child on older adults’ mental health and psychological well-being is consistent with both white and non-white minority older adults. This suggests that living with adult child benefits older adults’ mental health and psychological well-being. The current study seeks to stimulate ideas that might generate the next answer to community-based care in our current aging society.

Dougie Young and political resistance in early Aboriginal country music

AbstractCountry music has a reputation for being the music of the American white working-class South and being closely aligned with conservative politics. However, country music has also been played by non-white minorities and has been a vivid way of expressing progressive political views. In the hands of the Indigenous peoples of Australia, country music has often given voice to a form of life-writing that critiques colonial power. The songs of Dougie Young, dating from the late 1950s, provide one of the earliest and most expressive examples of this use of country music. Young's songs were a type of social-realist satire and to be fully understood should be placed within the broader socio-political context of 1950s and 1960s Australia. Young's legacy was also important for Aboriginal musicians in the 1990s and the accompanying reassessment of Australia's colonial past. Country music has provided particular opportunities for minority and Indigenous groups seeking to use popular culture to tell their stories. This use of country music provides a new dimension to more conventional understandings of its political role.

Admissions at the US Naval Academy: how the Military Brass Spend your Tax Dollars

The admissions process at the US Naval Academy at Annapolis is both like and unlike the admissions process at US civilian schools. It is similar in that the institution reports a low admission rate as evidence of its high quality, and dissimilar in that it inflates the number of real applicants by about a factor of four to achieve the appearance of this selectivity. It is like civilian schools in awarding slots to non-white racial minorities and recruited athletes, and unlike them in that these are categories that determine the level of academic standards applicants must meet rather than parts of a holistic decision process. It is like civilian schools in that applicants know they will take classes that are for the most part identical to classes at civilian universities and receive a bachelor's degree upon graduation, yet unlike them in that graduates are guaranteed employment for at least five years in the Navy or Marine Corps. It is unlike civilian schools in its strong "pull factor" of zero cost to students; the whole cost of about a half a million dollars per student over four years is borne by taxpayers, despite the fact that much cheaper commissioning pipelines produce 80% of new officers. Finally. admission is not by the Admissions Board, which only labels applicants "qualified" or not; it is the military brass which decide who receives this free-to-students education.

Neoliberal Fascism as the Endpoint of Casino Capitalism

This article explores neoliberal fascism as a distinctive political formation within the current historical moment. In doing so, it first analyzes neoliberalism as a project that has since the 1970s destroyed all the commanding institutions of democracy while consolidating power in the hands of a financial elite. In addition, it analyzes neoliberalism as a movement, that produces and legitimates massive economic inequality and suffering, privatizes public goods, dismantles essential government agencies, and individualizes all social problems. Under such circumstances, neoliberalism creates the conditions for right wing extremists to mobilize the anger of white disenfranchised working class populations by both appealing to the economic injustices they experience while simultaneously blaming and directing their frustrations towards non-white minority groups such as immigrants, blacks, and Muslims. It is precisely this merging of the social, political, and economic hardships produced by neoliberal capitalism and its appropriation of the discourse of white supremacy to divert attention from its worst excesses and failures that a neoliberal fascism is produced. More specifically, I argue that in the face of 40 years of neoliberalism with its production of massive inequality, a frontal attack on the welfare state, and the erosion of civic institutions and culture, there has been a resurgence of fascist discourses and a populist fascist political movement. Neoliberal fascism represents the conjoining of the most extreme elements of casino capitalism with the discourses of racial cleansing, and white nationalism. The article concludes by examining how atomization, fear, and anxiety have become the breeding grounds of fascism and what it means to revive education as a central tenet of politics so as to address the task of not simply resisting oppressive economic structures, but also what it means to engage in the massive challenge of changing individual and collective consciousness as a precondition for collective struggle and the building of new social movements.

Association of Fitness With Racial Differences in Chronic Kidney Disease

Non-white minorities are at higher risk for chronic kidney disease than non-Hispanic whites. Better cardiorespiratory fitness is associated with slower declines in estimated glomerular filtration rate and a lower incidence of chronic kidney disease. Little is known regarding associations of fitness with racial disparities in chronic kidney disease. A prospective cohort of 3,842 young adults without chronic kidney disease completed a maximal treadmill test at baseline in 1985-1986. Chronic kidney disease status was defined as estimated glomerular filtration rate of <60 mL/min/1.73 m2 during 10-, 15-, 20-, 25-, and 30-year follow-up assessments (through 2006). Analyses were completed in 2019. Multivariable Cox models were used to determine hazard ratios and 95% CI for incidence of chronic kidney disease. Multivariable models included race, gender, age, field center, education, baseline estimated glomerular filtration rate, and time-varying covariates of healthy diet index, smoking status, alcohol intake, BMI, systolic blood pressure, and fasting glucose. Percent attenuation quantified the association of fitness to racial disparities in chronic kidney disease. Chronic kidney disease incidence was higher among blacks (n=83/1,941, 1.61 per 1,000 person years) than whites (43/1,901, 0.82 per 1,000 person years). Every 1-minute shorter treadmill duration was associated with 1.14 (95% CI=1.04, 1.25) times higher risk of chronic kidney disease. Blacks were 1.72 (95% CI=1.13, 2.63) times more likely to develop chronic kidney disease compared with whites. The risk was reduced to 1.54 (95% CI=1.01, 2.39) with fitness added. This suggests that fitness is associated with 20.4% (95% CI=5.8, 43.0%) of the excess risk of chronic kidney disease attributable to race. Low fitness is a modifiable factor that may contribute to the racial disparity in chronic kidney disease.