Racial Composition Research Articles

School Segregation and Health Across Racial Groups: A Life Course Study

PurposeContemporary school racial segregation is a manifestation of structural racism shown to harm Black children's health. Yet, evidence on its long-term impacts throughout life, as well as effects among children of other racial backgrounds, is sparse. MethodsData on Black and White children were drawn from the National Longitudinal Study of Adolescent to Adult Health. Using multilevel models, we estimated associations between district-level school segregation and measures of short-term and long-term health, including self-reported outcomes and biomarkers. Models were run separately for Black and White children, adjusting for individual- and district-level covariates. We further carried out subgroup analyses by school racial composition (i.e., majority White vs. majority non-White schools). ResultsSchool segregation was associated with worsened short- and long-term risk factors of chronic disease among both Black and White students in terms of exercise and body mass index, but only in majority non-White schools. Moreover, Black students in these schools demonstrated less adolescent drinking and smoking with increased racial segregation and better self-reported health in young adulthood. DiscussionOur findings suggest that segregated majority non-White schools may be targets of systemic disinvestment and may therefore lack sufficient resources for physical education or nutrition. Improvements in some outcomes among Black children may reflect peer influence (i.e., Black adolescents generally drink less than White adolescents), reduced exposure to interpersonal racism from White peers, or positive health fostered by feelings of belonging in Black community. Ensuring all students go to schools with the resources they need to thrive may have positive spillovers for population health.

Reconsidering Household Food Insecurity: Assessing the Impact of Neighborhood and Household Characteristics

ABSTRACT Motivated by substantial public health implications of food insecurity, this study systematically reexamined its determinants beyond household disadvantages. Utilizing data from the Panel Study of Income Dynamics and American Community Survey, hierarchical linear modeling was employed. The findings underscored notable between-neighborhood variations in food insecurity after adjusting for household-specific characteristics, revealing residing in high-poverty or nonmetropolitan areas heightened the risk. Demographic disparities were evident, with Black and Hispanic households experiencing elevated food insecurity, despite neighborhood racial composition. Additional household factors exacerbating food insecurity included financial constraints, limited education, vehicle inaccessibility, and single-living arrangements. These findings inform interventions in similar contexts.

Increasing Voter Participation Through Health Care–Based Voter Registration

Young people and historically marginalized racial and ethnic groups are poorly represented in the democratic process. Addressing voting inequities can make policy more responsive to the needs of these communities. To assess whether leveraging health care settings as venues for voter registration and mobilization is useful, particularly for historically underrepresented populations in elections. In 2020, nonpartisan nonprofit Vot-ER partnered with health care professionals and institutions to register people to vote. This cross-sectional study analyzed the demographics and voting behavior of people mobilized to register to vote in health care settings, including hospitals, community health centers, and medical schools across the US. The age and racial and ethnic identity data of individuals engaged through Vot-ER were compared to 2 national surveys of US adults, including the 2020 Cooperative Election Study (CES) and the 2020 American National Election Study (ANES). Health care-based voter registration. The main outcomes were age composition, racial and ethnic composition, and voting history. Of the 12 441 voters contacted in health care settings, 41.9% were aged 18 to 29 years, 15.9% were identified as African American, 9.6% as Asian, 12.7% as Hispanic, and 60.4% as White. This distribution was significantly more diverse than the racial and ethnic distribution of the ANES (N = 5447) and CES (N = 39 014) samples, of which 72.5% and 71.19% self-identified as White, respectively. Voter turnout among health care-based contacts increased from 61.0% in 2016 to 79.8% in 2020, a turnout gain (18.8-percentage point gain) that was 7.7 percentage points higher than that of the ANES sample (11.1-percentage point gain). Demographically, the age distribution of voters contacted in health care settings was significantly different from the ANES and CES samples, with approximately double the proportion of young voters aged 18 to 29 years. This cross-sectional study suggests that health care-based voter mobilization reaches a distinctly younger and more racially and ethnically diverse population relative to those who reported contact from political campaigns. This analysis of the largest health care-based voter mobilization effort points to the unique impact that medical professionals may have on voter registration and turnout in the 2024 US elections. In the long term, health equity initiatives should prioritize expanding voting access to address the upstream determinants of health in historically marginalized communities.

Neighborhood-level variability in asthma-related emergency department visits in Central Texas

The extent to which incidence rates of asthma-related emergency department (ED) visits vary from neighborhood to neighborhood and predictors of neighborhood-level asthma ED visit burden are not well understood. We aimed to describe the census tract-level spatial distribution of asthma-related ED visits in Central Texas and identify neighborhood-level characteristics that explain variability in neighborhood-level asthma ED visit rates. Conditional autoregressive models were used to examine the spatial distribution of asthma-related ED visit incidence rates across census tracts in Travis County, Texas, and assess the contribution of census tract characteristics to their distribution. There were distinct patterns in ED visit incidence rates at the census tract scale. These patterns were largely unexplained by socioeconomic or selected built environment neighborhood characteristics. However, racial and ethnic composition explained 33% of the variability of ED visit incidence rates across census tracts. The census tract predictors of ED visit incidence rates differed by racial and ethnic group. Variability in asthma ED visit incidence rates are apparent at smaller spatial scales. Most of the variability in census tract-level asthma ED visit rates in Central Texas is not explained by racial and ethnic composition or other neighborhood characteristics.

Neighborhood factors associated with late effects among survivors of adolescent and young adult cancer.

The purpose of this study is to evaluate the associations between neighborhood income, education, and neighborhood racial composition (measured as a low percentage of white residents) and risk of developing cardiovascular diseases (CVD), diabetes (DM), and severe depression among survivors of AYA cancer and matched non-cancer peers. Two-year survivors of AYA cancers diagnosed at age 15-39 yrs at Kaiser Permanente Southern California (diagnosed 2000-2012) and individually matched (1:13) non-cancer subjects were included. The development of CVD, DM, and severe depression was ascertained via electronic health records. Neighborhood characteristics were obtained from census-based geocoded data. Cox regression evaluated associations between neighborhood characteristics and the health outcomes of interest among both the cancer survivors and the non-cancer comparison cohort and effect modification by cancer survivor status on these relationships. Among cancer survivors (n = 6774), living in mostly non-white neighborhoods, was associated with risk of CVD (hazard ratio (HR) = 1.54 (95% CI 1.00-2.36)), while lower education level (HR = 1.41 (95% CI 1.02-1.94)) was associated with risk of severe depression. None of the neighborhood characteristics were associated with risk of DM. Effect modification was found for neighborhood education and risk of DM and severe depression. When jointly considered, cancer survivors who resided in the most disadvantaged neighborhoods were at the highest risk of developing these health outcomes compared to other subgroups. Our findings may inform screening strategy and addressing social determinants of health among AYA cancer survivors.

Sex, racial, and ethnic disparities in motor neuron disease: clinical trial enrolment

Objective Motor neuron disease (MND) is a group of neurological diseases, the majority being amyotrophic lateral sclerosis (ALS), with varying clinical presentations across demographics. Clinical trial enrollment reflecting global disease burden improves understanding of diverse presentations and aids personalized therapy development. We assessed the sex, racial, and ethnic composition of MND/ALS clinical trial participants relative to global disease burdens. Methods We searched ‘motor neuron disease OR amyotrophic lateral sclerosis’ on ClinicalTrials.gov from 02/2000–04/2024. We extracted trial (start year, study site, sponsor location, phase, masking, intervention) and demographic data (sex, race, ethnicity) from randomized interventional studies. We obtained sex-based MND/ALS disease burden estimates from the Global Burden of Disease database. For females, we calculated pooled participation-to-prevalence ratio (PPR) with 95% confidence intervals (CIs), with PPR of 0.8–1.2 indicating adequate enrollment. We used Kruskal–Wallis tests to compare demographic groups across trial characteristics. Results Of 85 trials, females comprised 37.47% (n = 5011) of 13,372 participants; the pooled female PPR was 0.97 (95% CI: 0.77–1.16). Of 41 trials (9340 participants) reporting race, 121 (1.30%) participants were Black or African American, 16 (0.17%) American Indian or Alaskan Native, and 6 (0.06%) Native Hawaiian or Other Pacific Islander. 24 trials (595 participants) reported ethnicity, with a minority of Hispanic participants (n = 153; 2.57%). Conclusions MND/ALS clinical trials had adequate female enrollment relative to global disease burdens. Race and ethnicity data were underreported. However, there were enrollment disparities of racial and ethnic groups. Increased trial leadership diversity, equitable enrollment policies, and addressing barriers to participation could improve enrollment diversity.

The racial composition of road users, traffic citations, and police stops

This paper exploits the potential of Global Positioning System datasets sourced from mobile phones to estimate the racial composition of road users, leveraging data from their respective Census block group. The racial composition data encompasses approximately 46 million trips in the Chicago metropolitan region. The research focuses on the relationship between camera tickets and racial composition of drivers vs. police stops for traffic citations and the racial composition in these locations. Black drivers exhibit a higher likelihood of being ticketed by automated speed cameras and of being stopped for moving violations on roads, irrespective of the proportion of White drivers present. The research observes that this correlation attenuates as the proportion of White drivers on the road increases. The citation rate measured by cameras better matches the racial composition of road users on the links with cameras than do stops by police officers. This study therefore presents an important contribution to understanding racial disparities in moving violation stops, with implications for policy interventions and social justice reforms.

How Post-1965 Asian Migration Changed US Protestant Christianity

The 1965 Immigration and Nationality Act (or the Hart-Celler Act) remade the racial and ethnic composition of the nation, opening the United States to large numbers of Asian migrants for the first time. The new immigration system, based on job skills and family reunification, flipped the racial demographics of US-bound migrants from majority European to majority Asian and Latin American. It is estimated that as many as 75 percent of Asians who migrated to the United States between 1965 and 2000 had some kind of Christian background. This article provides a brief overview of how post-1965 Asian migrants have changed a range of US Protestant institutions and organizations.

Pathogenic germline variant discovery in plasma cell disorders: Insights from genetic counseling referrals and testing.

10619 Background: Our research has shown that 10% of multiple myeloma (MM) patients harbor pathogenic or likely-pathogenic germline variants (PGVs) in cancer predisposition genes, with a significant enrichment observed in BRCA1/2 genes. PGVs are notably more common in younger MM patients and those with a personal or familial cancer history. This study presents our experience in referring plasma cell disorder (PCD) patients at increased risk for carrying PGVs, due to either clinical history or suspicious tumor NGS findings, for genetic counseling and subsequent germline testing. Methods: This retrospective study reviewed patient records from our institution's PCD clinic, focusing on those referred for a genetic evaluation between 2020 and 2024 due to suspected cancer predisposition. We compiled demographic and clinical data for these patients, reasons for referral, and cancer history of patients and their families. The uptake of germline testing, identified mutations, and subsequent recommendations for advanced cancer surveillance and prevention, including cascade testing, were also analyzed. Germline testing utilized targeted hereditary cancer panels from five companies and was conducted on DNA samples extracted from peripheral blood, saliva/buccal swabs, or skin biopsies. Results: 52 PCD patients underwent a genetic evaluation and were included in this review, comprising 31 MM, 9 smoldering MM, and 12 MGUS cases. Median age at the time of referral was 63, and 54% of patients were female. Racial composition was 62% White, 15% Black/African-American, 12% Hispanic, 2% Asian, with 10% undisclosed. 8 patients were referred due to suspicious findings in tumor NGS, while the rest were referred due to clinical suspicion. A personal history of cancer was reported by 19 patients (37%), and 49 had a first- or second-degree relative with cancer (94%). 38 patients (73%) underwent germline testing, of which 15 (39%) harbored PGVs (11 had MM, 4 had smoldering MM). 8 PGV carriers had well-established founder variants. The remaining 7 had PGVs in genes including BRCA2 (n=3), PALB2 (n=1), BLM (n=1), SMAD4 (n=1) and NTHL1 (n=1). Of note, all 8 referred for suspicious findings in tumor NGS were confirmed to harbor PGVs. All PGV-positive patients were recommended for cascade testing and enhanced cancer screening. Conclusions: Our findings indicate a 39% PGV detection rate in PCD patients referred for genetic evaluation, underscoring the potential benefit of implementing screening guidelines in this population. PGV detection led to recommendations for intensified surveillance and cascade testing in all cases, impacting both patients and their families. The discovery of BRCA2PGVs in 20% (3/15) of cases reinforces its potential role as a predisposition gene in MM, corroborating our prior findings.

Built Environment, Natural Environment, and Mental Health.

Mental health disorders have become a global problem, garnering considerable attention. However, the root causes of deteriorating mental health remain poorly understood, with existing literature predominantly concentrating on socioeconomic conditions and psychological factors. This study uses multi-linear and geographically weighted regressions (GWR) to examine the associations between built and natural environmental attributes and the prevalence of depression in US counties. The findings reveal that job sprawl and land mixed use are highly correlated with a lower risk of depression. Additionally, the presence of green spaces, especially in urban area, is associated with improved mental health. Conversely, higher concentrations of air pollutants, such as PM2.5 and CO, along with increased precipitation, are linked to elevated depression rates. When considering spatial correlation through GWR, the impact of population density and social capital on mental health displays substantial spatial heterogeneity. Further analysis, focused on two high depression risk clustering regions (northwestern and southeastern counties), reveals nuanced determinants. In northwestern counties, depression rates are more influenced by factors like precipitation and socioeconomic conditions, including unemployment and income segregation. In southeastern counties, population demographic characteristics, particularly racial composition, are associated with high depression prevalence, followed by built environment factors. Interestingly, job growth and crime rates only emerge as significant factors in the context of high depression risks in southeastern counties. This study underscores the robust linkages and spatial variations between built and natural environments and mental health, emphasizing the need for effective depression treatment to incorporate these multifaceted factors.

Real-world outcomes of osimertinib (Osi) vs. afatinib or erlotinib in patients with classical vs. atypical EGFR-mutated metastatic non-small cell lung cancer (mNSCLC).

8566 Background: Limited data are available on the efficacy of osi for mNSCLC with atypical EGFR mutations (AM) such as L861Q, G719X, S768I, and exon20 insertions. Afatinib is FDA approved for mNSCLC harboring L861Q, G719X, and S768I. Real-world analyses comparing osi to afatinib and erlotinib for AM have yielded mixed results. Methods: We performed a single-institution retrospective analysis of patients with EGFR-mutated mNSCLC treated from 2007-2023 with EGFRTKIs. Clinical trial patients were excluded. Patients with classical EGFRmutations (CM) were compared to those with AM. Baseline demographics, disease characteristics, treatment history, toxicity, and clinical outcomes were abstracted from the EMR. Median PFS and OS were estimated and compared via Kaplan-Meier log-rank analysis. Independent sample t-tests and chi-square analyses were used for univariate comparisons. P-values<0.05 were considered statistically significant. Results: Among 355 patients with 1L EGFR-mutated mNSCLC, 315 (90%) had CM (exon19 del [N=182; 51%] and L858R [N=119; 34%]), while 36 (10%) harbored AM in G719X (N=21; 6%), Exon 20 (N=11; 3%), L861Q (N=7; 2%), and S768I (N=4; 1%). Patients with CM vs AM had similar median age at diagnosis (63, p=0.406), gender (65% F; p=0.213), racial composition (p=0.653), and history of smoking (44%, p=0.167). At diagnosis, 45% vs 48% of patients had CNS involvement (p=0.434). 52% vs 41% received osi, 36% vs 20% patients received erlotinib, and 11% vs 37% received afatinib (p<0.001). Patients with CM had superior mPFS (29 vs 15m; p=0.021) and mOS (49 vs 13m; p<0.001) vs AM (Table). In AM patients (N=36), osi had superior mPFS (15m [7-23]) vs afatinib (11m [8-15]; p=0.005) or erlotinib (8m [6-10]; p=0.001). mOS was likewise superior for osi (29m [6-50]) vs afatinib (13m [9-17]; p<0.001) or erlotinib (14m [6-21]; p<0.001). 121 CM and 7 AM patients were rechallenged with a TKI; mPFS2 for AM was 13m for osi (N=4) vs 4m for afatinib (N=3; p=0.114). Dose-reduction due to AE was lower for osi (19%) vs afatinib (24%; p=0.003) or erlotinib (23%; p=0.002). Discontinuation due to AE was lower for osi vs afatinib (1% vs 2%; p<0.001) or erlotinib (2%; p=0.004). Conclusions: Retrospectively, AM were associated withinferior PFS and OS compared to CM. Osi demonstrated superior survival and tolerability compared to afatinib or erlotinib for AM. [Table: see text]

Historic redlining, modern neighborhood structures, and mortality in children, adolescents, and young adults with cancer.

11037 Background: Historic redlining, referring to the Home Owners Loan Corporation (HOLC) program’s racially biased risk monitoring maps in the 1930’s, has indelible impacts on modern day neighborhood characteristics and health outcomes. The impact of redlining, a form of structural racism, on children, adolescents, and young adults with cancer (CAYACs) is unknown. This retrospective cohort study evaluates the association between redlining and mortality in CAYACs. Methods: Using the California Cancer Registry, we identified cases <25 years old diagnosed with first primary malignant cancer between 2000-2019. Using merged HOLC maps and U.S. Census data we determined case redlining status (A “Best”, B “Still Desirable”, C “Declining”, D “Hazardous”, and N “Not graded”) by residence at diagnosis. We defined residents of D neighborhoods redlined-exposed and residents of A or B neighborhoods unexposed or referent. Kaplan Meier methods and multivariable Cox proportional hazard models were applied to calculate overall survival. Additional models accounted for census tract-level neighborhood SES (nSES, a composite measure incorporating seven SES domains), neighborhood racial and ethnic composition (or typology) and racialized economic segregation (via index of concentration at the extremes). Results: In total 8,210 cases were HOLC-graded, the median age was 16 years, 46% were female, and 48% had solid tumors. Overall survival at 5 years was inferior for D cases vs. A or B cases (OS 80.2%, 95% CI: 78.5-81.7 vs. OS 88.2, 95% CI: 84.0-91.3). Adjusting for individual clinical characteristics (age, sex, year of diagnosis, and cancer stage), D cases experienced greater mortality (HR 1.32, 95% CI: 1.12-1.55) compared to A or B cases. Additional adjustment for insurance and nSES attenuated the relationship (HR 1.17, 95%CI: 1.00-1.36 and HR 1.07, 95% CI: 0.92-1.24 respectively). Similar patterns were observed in models adjusting for racialized economic segregation (HR 1.07, 95% CI: 0.92-1.24) and typology (HR 1.10, 95% CI: 0.94-1.28) in place of nSES. Conclusions: In this population-based study, redlined-exposed CAYACs experienced greater mortality compared to unexposed CAYACs. Adjusting for insurance and contemporary nSES attenuated the association between redlining and mortality. Findings suggest current neighborhood attributes may be downstream manifestations of structural racism with survival implications for CAYACs.

Racial/ethnic representation and disparities in preclinical cancer models.

1601 Background: Patient-derived xenograft models (PDXs) recapitulate tumor characteristics credibly and have become a standard for preclinical inquiries that form the basis of clinical trials of novel therapies in oncology. While ample evidence reveals racial/ethnic disparities in cancer care delivery and clinical research, limited data exists regarding racial composition of available PDXs. We sought to define the extent of racial/ethnic representation and disparities among existing PDXs. Methods: Data regarding available PDXs was gathered from the publicly accessible CancerModels.org website ( https://www.cancermodels.org/overview ). Seven members of the research team were involved in data extraction. Information on race/ethnicity (White, Black, Hispanic, Asian), sex, age, and cancer type were recorded. The primary objective was to determine the racial/ethnic composition of PDX models and compare this to racial/ethnic demographics of cancer patients, for which we used US population-based cancer estimates calculated using National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER Incidence Data, 11/2022 Submission (1975 - 2020), SEER 22 registries). Descriptive statistics were used. Proportions were compared using Fischer’s exact test or Chi-squared tests with Yates' correction (odds-ratio [OR] and 95% confidence intervals [95%CI] or Woolf logit interval) were reported. Results: We reviewed 4597 unique PDXs across 33 SEER cancer sites spanning 11 oncology sub-specialties. Of these, 55% models were derived from males and age groups were (years): < 20: 6%; 20-70: 69% and ≥ 70: 25%. Most common cancer sites represented were colorectal (26%), lung (12%), breast (9%), melanoma (9%) and leukemia (7%). Race/ethnicity was not reported in 3395 (73.9%) cases. Racial/ethnic composition of the remaining models was Whites (80.9%), Blacks (7.3%), Hispanics (6.4%) and Asians (5.4%). Compared with their respective proportion of US cancer incidence (69.9%, 10.9%, 13.2% and 5.9%, respectively), these models were over-representative for Whites (OR: 1.82, 95%CI: 1.6-2.1, P < 0.001) and under-represented Blacks (OR: 0.64, 95%CI: 0.5-0.8, P < 0.001) and Hispanics (OR: 0.45, 95%CI: 0.4-0.6, P < 0.001) but not Asians (OR: 0.89, 95%CI: 0.7-1.2, P = 0.43). Similar trends were seen in subgroups focused by cancer site. Among colorectal (N = 1201) models, race/ethnicity was reported for 17.2% of cases and Blacks (OR: 0.52; 55.7% of expected; P = 0.014) and Hispanics (OR: 0.57; 60.8% of expected; P = 0.015) were underrepresented compared to Whites (OR: 1.82; 116% of expected; P < 0.001). Conclusions: Race/ethnicity are infrequently reported for PDX models. Minority races/ethnicities (Blacks and Hispanics) are underrepresented in preclinical models compared to their burden of cancer incidence. There is a need to develop a diverse repertoire of preclinical models to ensure inclusivity and guide equitable research.

Association Among Individual Race, Hospital Racial Composition, and Access to Minimally Invasive Hysterectomy for Patients With Uterine Leiomyomas

OBJECTIVE: To assess the relative associations of individual race and hospital racial composition on the likelihood of undergoing minimally invasive hysterectomy for the treatment of uterine leiomyomas in New York State. METHODS: We performed a retrospective cohort study that used the New York SPARCS (Statewide Planning and Research Cooperative System) database to identify women with uterine leiomyomas who underwent hysterectomy from 2000 to 2018. Hospitals were grouped by racial composition into quartiles based on the proportion of non-Hispanic Black (Black) patients, with quartile 1 corresponding to the lowest proportion of Black patients and quartile 4 corresponding to the greatest proportion of Black patients. Surgical route was characterized as minimally invasive (laparoscopic, vaginal, or robot-assisted) or abdominal hysterectomy. The contributions of individual race and hospital racial composition on route of hysterectomy were assessed with a series of logistic regression models accounting for patient and hospital characteristics. RESULTS: A total of 259,161 women with leiomyomas who underwent hysterectomies at 215 hospitals were identified. The rate of minimally invasive hysterectomy increased from 20.2% in 2000 to 65.7% in 2018. From 2000 to 2009, 29.6% of White patients underwent minimally invasive hysterectomy compared with 12.3% of Black women (P<.001). Minimally invasive hysterectomy was performed in 34.4% of patients in hospitals that served the lowest percentage of Black patients, compared with 15.9% in centers serving the highest percentage of Black patients (P<.001). Similar trends were noted for the 2010–2018 time period. In a series of models, both individual race (odds ratio [OR] 0.52; 95% CI, 0.48–0.56) and hospital racial quartile (OR 0.43; 95% CI, 0.32–0.58) remained associated with performance of minimally invasive hysterectomy. CONCLUSION: Black women and women who receive care at hospitals that serve a greater proportion of Black patients are less likely to receive minimally invasive surgery when undergoing definitive surgical management for uterine leiomyomas. These disparities are worsening.

Access to treatment before and after Medicare coverage of opioid treatment programs

Abstract Since January 2020, Medicare has covered opioid use disorder (OUD) treatment services at opioid treatment programs (OTPs), the only outpatient settings allowed to dispense methadone for treating OUD. This study examined policy-associated changes in Medicare acceptance and the availability of four OUD treatment services (ongoing buprenorphine, HIV/AIDS education, employment services, and comprehensive mental health assessment), by for-profit status, and county-level changes in Medicare-accepting-OTPs access, by sociodemographic characteristics (racial composition, poverty rate, and rurality). Using data from the 2019-2022 National Directory of Drug and Alcohol Abuse Treatment Facilities, we found Medicare acceptance increased from 21.31% in 2018 to 80.76% in 2021. The availability of the four treatment services increased, but no increases were significantly associated with Medicare coverage. While county-level OTP access significantly improved, counties with higher rates of non-White residents experienced an additional average increase of 0.86 Medicare-accepting-OTPs (95% CI, 0.05–1.67) compared to those without higher rates of non-White populations. Overall, Medicare coverage was associated with improved OTP access, not ancillary services.

Racial and Ethnic Composition of Departments of Health Policy & Management and Health Education & Behavioral Sciences.

The diversity of racial/ethnic representation in the health services and policy research (HSPR) workforce plays a crucial role in addressing the health needs of underserved populations. We assessed changes (between 2012 and 2022) in the racial/ethnic composition of students and faculty from departments of Health Policy & Management (HPM) and Health Education & Behavioral Sciences (HEBS) among the Association of Schools and Programs of Public Health member institutions. We analyzed annual data from over 40 institutions that reported student and faculty data in 2012 and 2022 within each department. Racial/ethnic populations included American Indian/Alaska Native (AI/AN), Asian, Hispanic, Native Hawaiian/Pacific Islander (NH/PI), Black, White, Unknown, and Multiracial. We conducted analyses by department and examined racial/ethnic composition by student status, degree level, faculty rank, and tenure status. We found statistically significant increases in Black assistant professors (HPM and HEBS) and tenured faculty (HPM), Hispanic graduates and tenure-track faculty (HPM), Asian professors (HPM: full and tenured, HEBS: associate and tenured), and Multiracial students and graduates (HPM and HEBS). Statistically significant decreases were observed in White professors (HPM: assistant and full, HEBS: all ranks) and tenure-track faculty (HPM and HEBS), AI/AN associate professors and tenured faculty (HEBS), Hispanic associate professors (HPM), Asian assistant professors (HEBS), and NH/PI students (HPM and HEBS). Our findings highlight the importance of increasing racial/ethnic representation. Strategies to achieve this include facilitating workshops to raise awareness about the structural barriers encountered by Hispanic faculty, providing research support, evaluating promotion processes, establishing more pathway programs, and fostering interdisciplinary academic environments studying AI/AN or NH/PI populations.

#365 Dialysis centers performance: socioeconomic and environmental determinants

Abstract Background and Aims Healthcare outcomes in hemodialysis centers are intricately shaped by a myriad of factors extending beyond clinical realms. This study explores the interplay of socioeconomic and environmental determinants on the performance of 7638 hemodialysis centers in the United States during 2022. Leveraging data from the Centers for Medicare & Medicaid Services, the United States Census Bureau, and the National Center for Environmental Information, our analysis encompasses outcomes like mortality, hospitalization, readmission rates, and emergency department visit rates. Method A dataset comprising information from 7638 US hemodialysis centers, spanning January to December 2022, was obtained through the Centers for Medicare & Medicaid Services, US Census Bureau and environmental data, and from the National Center for Environmental Information. The study assessed mortality, hospitalization, readmission, and emergency department visits within one-month post-hospitalization. Independent variables included dialysis center characteristics, state-specific socioeconomic and environmental data, analysed through descriptive statistics and a linear regression model. Results Results reveal a significant correlation between racial composition and outcomes, with states having higher Latino populations exhibiting lower ED visit rates, contrasting with elevated mortality rates in states with higher African American populations. Socioeconomic factors, such as education and insurance status, influence ED visit rates. Environmental determinants, specifically average yearly state temperature, impact mortality and hospitalization rates. Operational characteristics matter: for-profit centres and those providing higher number of hemodialysis bed correlate with decreased mortality rates, while centres offering peritoneal dialysis or late-shift services demonstrate lower emergency department visit rates. Conclusion Our study unveils a nuanced interplay of factors influencing outcomes in hemodialysis centers. Disparities rooted in race and socioeconomic status underscore the need for targeted interventions. Environmental considerations further contribute to the complexity, while operational characteristics reveal intriguing trends, challenging conventional expectations. This analysis provides a foundation for tailored strategies to enhance the performance and equity of hemodialysis centers.

Are Black Offenders Disproportionately Victimizing Asian Americans During the COVID-19 Pandemic? Comparison to Expected Racial Distributions and the Pre-Pandemic Period

ABSTRACT During the COVID-19 pandemic, reports of violence against Asian Americans surged in traditional and social media, often depicting an Asian victim attacked by a Black assailant and suggesting heightened Black animosity toward Asian Americans. Scholars have challenged this Black-Asian conflict narrative by highlighting that White perpetrators commit over 75% of anti-Asian hate crimes. However, the large share of White offenders in anti-Asian hate crime may simply reflect American racial demographics, and Black offenders could be disproportionately victimizing Asian Americans relative to the size of the Black population or offender pool. The current study examined the share of Black offenders in violence against Asian victims relative to the racial composition of local populations or offender pools. Analysis using 2020 NIBRS and Census data indicated overrepresentation of Black offenders in violence against Asian victims relative to the weighted average of the Black population proportion of the 351 cities in which such incidents occurred. However, Black offenders’ share of violence against Asian victims closely matched the proportion Black in the average local potential offender pool. Comparison of 2019 and 2020 data indicated an increase in Black offenders’ share of violence against Asian victims, but this difference in the distributions was not statistically significant.

School Racial Composition and Changes in Black Children’s Academic Engagement and Motivation During Late Elementary School

School Racial Composition and Changes in Black Children’s Academic Engagement and Motivation During Late Elementary School

Friendship Homophily Trajectories among Asian American Youth from High School to College.

Friendship racial homophily, the tendency to form friendships with individuals who share the same racial background, is a normative developmental phenomenon that holds particular significance for youth of color in a racialized society. Yet, there exists a paucity of longitudinal research elucidating the stability and change of friendship racial composition across developmental span. This study aimed to examine the friendship racial homophily trajectories over a six-year period encompassing four time points. The sample comprised 437 Asian American youth (MAge = 16.52, SDAge = 1.36, 53% female), with 197 Filipino and 240 Korean participants. Using logistic multilevel modeling analyses, it was found that both Filipino and Korean American youth demonstrated an increase in friendship racial homophily from high school to college, but that Filipino youth overall reported lower levels of racial homophily compared to their Korean counterparts. The study findings also pinpointed several influential factors impacting these trajectories, including proficiency in heritage languages, ethnic identity, and encounters with racial discrimination from both White Americans and other People of Color. These results highlight the continuous evolution of friendship racial composition from high school to college and emphasize the crucial role of ethnic identity and experiences of discrimination in influencing these dynamics, with ethnic identity exerting more enduring effects and experiences of discrimination showing more situational impacts on the levels of racial homophily.