African Americans Odds Research Articles

“A Dream Deferred”: How Discrimination Impacts the American Dream Achievement for African Americans

The American Dream (TAD) is an ideological symbol of achievement and success in American culture. Historical barriers to equal opportunities and economic attainment through racial discrimination have limited access to TAD for African Americans. Barriers of discrimination also reduce the perception of one’s life satisfaction, which can further affect the beliefs of ever obtaining TAD. The present research evaluated the effects of discrimination and life satisfaction on perceptions of achieving TAD among a sample of N = 1,081 African American adults. Results showed that higher levels of discrimination led to higher odds of African Americans believing that they would never achieve TAD. Income was also significantly associated with TAD attainment, as were age, marital status, and education level. Group differences were found for marital status, age, income, life satisfaction, education, and being worse off financially compared to one’s parents. These results support strain theory and racial threat theory by identifying the relationship between discrimination and perceptions of being able to achieve TAD. Those who reported having achieved TAD were more likely to have higher life satisfaction, more successful careers, more financial wealth compared to previous generations, and higher education levels, showing distinct group differences. The study concludes with recommendations for future research into the definition and measurement of TAD and the barriers to attainment for African American families.

Racial disparities in preemptive referral for kidney transplantation in Georgia.

Racial disparities persist in access to kidney transplantation. Racial differences in preemptive referral, or referral prior to dialysis start, may explain this discrepancy. Patient-level data on kidney transplant referrals (2005-2012) from all Georgia transplant centers were linked to the United States Renal Data System to examine racial disparities in preemptive referral, waitlisting, and living donor transplant. Adjusted logistic regression and Cox proportional hazard models determined the associations between race (African American vs white) and preemptive referral, and placement on the waitlist and receipt of a living donor kidney, respectively. Among 7752 adults referred for transplant evaluation, 20.38% (n=1580) were preemptively referred. The odds of African Americans being preemptively referred for transplant evaluation were 37% (OR=0.63; [95% CI: 0.55 0.71]) lower than white patients. Among preemptively referred patients, there was no racial difference (African Americans compared to white patients. HR=0.96; [95% CI: 0.88, 1.04]) in waitlisting. However, African Americans were 70% less likely than white patients to receive a living donor transplant (HR=0.30; [95% CI: 0.21, 0.42]). Racial disparities in transplant receipt may be partially explained by disparities in preemptive referral. Interventions to reduce racial disparities in kidney transplant access may need to be targeted earlier in the disease process.

Characteristics of children under 2 years of age undergoing tonsillectomy for upper airway obstruction

IntroductionTo study characteristics of children less than 2 years who underwent a tonsillectomy for sleep disordered breathing (SDB) or obstructive sleep apnea (OSA) to assess for factors associated with requesting a preoperative polysomnogram (PSG) and to identify predictors of upper airway obstruction in this group. Materials and methodsA retrospective chart review of children under 2 years who underwent a tonsillectomy over a 7-year period at a tertiary care pediatric hospital was undertaken. Patient demographics, characteristics and polysomnography results, when applicable, were collected. In order to determine if the gathered demographics of our cohort differed from the non-surgical population, we compared our data with available Colorado data for each variable. Children were stratified by OSA severity using their obstructive apnea-hypopnea index (OAHI). Results197 (2.2%) of 9038 patients who underwent tonsillectomy for SDB or OSA were ≤24 months. The proportions of male, African-American, Hispanic, obese, underweight, premature, syndromic and daycare patients in our cohort were significantly different than in the general population. In a multivariate model, the odds of African-Americans having severe OSA were 12.5 times greater than the odds of Caucasians. The odds of patients with syndromes or craniofacial anomalies were 11 times greater (p<0.0001), and the odds of patients in daycare were 2.2 times lower (p=0.04) of undergoing a PSG before tonsillectomy. Weight did not influence polysomnogram requests. ConclusionsIn children under 2 years, ethnicity seems to be a predictor of OSA severity. African-American, prematurity, daycare and Down syndrome patients were significantly more represented in our study population. PSG is more likely to be requested for syndromic children.

Asthma Burden in a Citywide, Diverse Sample of Elementary Schoolchildren in Chicago

The purposes of this study are to describe and develop preliminary models of the burden of diagnosed asthma and symptoms of possible undiagnosed asthma in a large, citywide, ethnically and socioeconomically diverse sample of Chicago elementary schoolchildren. We hypothesized that considering possible asthma would give a more complete picture of race/ethnic disparities in pediatric asthma. We studied 35,583 students aged 6 to 12 years attending Chicago Public and Archdiocese elementary schools for the Chicago Initiative to Raise Asthma Health Equity (CHIRAH) study. The full enrollments of 105 schools were surveyed for asthma and possible undiagnosed asthma by the Brief Pediatric Asthma Screen Plus (BPAS+) respiratory symptoms. The child had to be 6 to 12 years old, the valid age range for the BPAS+. Questionnaires included the BPAS+, basic demographic information, and household asthma information; they were sent home with each schoolchild for completion by the parent and returned to school for collection and scoring. Overall, 13.9% of students had diagnosed asthma. For children aged 6 to 12 years, rates of diagnosed asthma varied from 13.1% to 14.5%, whereas the rates of possible undiagnosed asthma varied from 14.8% to 10.9%. The rate of diagnosed asthma was 21.2% for African Americans, 9.7% for whites, 11.8% for Hispanics, with similar rates of possible undiagnosed asthma. By multinomial logistic regression, African Americans were more than twice as likely and Hispanics were 1.57 times more likely than whites to have diagnosed asthma at all school district income levels and controlling for other household members with asthma, type of school, age of the child, gender, and language preference. The odds of African Americans being diagnosed with asthma rather than having possible asthma were 76% higher and for Hispanics were 46% higher compared with whites, at all school district income levels and controlling for other household members with asthma, type of school, age of the child, gender, and language preference. Our study confirms national disparities in diagnosed asthma by race/ethnicity. Respiratory symptoms consistent with possible undiagnosed asthma increase the total potential burden of asthma overall to more than one-quarter of the school enrollees. Among students with respiratory symptoms, African Americans, Hispanics (controlling for language), and families where another person has asthma are more likely to have diagnosed rather than possible asthma. Improved knowledge about asthma, recognition of symptoms, and access to high-quality care are necessary to ascertain how much of the possible undiagnosed asthma represents additional cases of asthma requiring treatment.