Racial Demographics Research Articles

Census Tract and Neighborhood Racial Change and the Locational Decisions of Financial Services in Metro Detroit

Scholarship on the geography of US retail financial services consistently finds racialized patterns in the locations of traditional (e.g. banks, credit unions) and higher-cost or alternative (e.g. payday lenders, check cashers) financial services. While scholars tend to offer explanations based on spatial void and market segmentation hypotheses, we theorize these racialized patterns as consistent with a social reproduction of investment and divestment. We use a novel, longitudinal dataset that follows census tract- and neighborhood-level changes in racial demographics and financial services in Detroit during the pre- and post-Recession periods. Changes in the locations of financial services follow changes in racial demographics, which occur in addition to the well-documented practice of targeting or avoiding tracts and neighborhoods based on their racial majority. These racialized patterns are heightened in the post-Great Recession period.

ID: 341899 Health Equity: Characterization of Racial, Ethnic and Payor Demographics across Neuromodulation Therapies

ID: 341899 Health Equity: Characterization of Racial, Ethnic and Payor Demographics across Neuromodulation Therapies

Language-based exclusion associations with racial and ethnic disparities in thyroid cancer clinical trials

BackgroundRacial and ethnic disparities in thyroid cancer care may be mitigated by improving enrollment of more diverse patient populations in clinical trials. We studied trial eligibility criteria and enrollment to assess barriers to equitable representation. MethodsClinicalTrials.gov was searched for studies on thyroid cancer treatment conducted between 1993 and 2023. The inclusion and exclusion criteria of each study were examined. For published studies, reported demographic information was collected. Observed enrollment by race was compared with the expected distribution as determined using data from the US Census and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) databases. Over- and under-representation was defined as the ratio of observed to expected (O/E) enrollment by the race and ethnicity group. ResultsOf 309 thyroid cancer–related trials, 23 (7.4%) used language as an exclusion criterion. Most were interventional (n = 239, 77.3%), university-initiated (194, 62.8%), and drug/device-focused (195, 63.1%). Of studies that excluded by language, 20 (87.0%) were university-initiated. Eighty-eight trials were subsequently published, with 16 (18.2%) reporting race and/or ethnicity distributions. When comparing O/E ratios, White American participants were over-represented (O/E ratio: 1.2, P < .0001). Under-represented groups included Asian/Native Hawaiian (O/E ratio: 0.6, P = .0085), Black (0.6, P = .014), Native American (0.2, P = .072), and Hispanic patients (0.2, P < .0001). ConclusionOver the last 3 decades, 1 in 13 thyroid cancer–related clinical trials excluded patients based on language. In the fraction of published studies to report on racial and ethnic demographics, Asian/Native Hawaiian, Black, and Hispanic patients were under-represented. Improved reporting of demographics in published studies and elimination of exclusion criteria such as language that hinder enrollment of minority patients could improve equitable representation of patients in thyroid cancer clinical trials.

Exposing disparities in flood adaptation for equitable future interventions in the USA

As governments race to implement new climate adaptation solutions that prepare for more frequent flooding, they must seek policies that are effective for all communities and uphold climate justice. This requires evaluating policies not only on their overall effectiveness but also on whether they benefit all communities. Using the USA as an example, we illustrate the importance of considering such disparities for flood adaptation through a FEMA dataset of ~ 2.5 million flood insurance claims. We use CausalFlow, a causal inference method based on deep generative models, to estimate the treatment effect of flood adaptation interventions based on a community’s income, racial demographics, population, flood risk, educational attainment, and precipitation. We find that the program saves communities $5,000–15,000 per household. However, these savings are not evenly spread across communities. For example, for low-income communities savings sharply decline as flood-risk increases in contrast to their high-income counterparts. Even among low-income communities, savings are >$6,000 per household higher in predominantly white communities. Future flood adaptation efforts should go beyond reducing losses overall and aim to equitably support communities in the race for climate adaptation.

Do Racial Disparities Impact Healthcare Costs and Resource Utilization after Total Joint Replacements?

Background Racial disparities currently exist in healthcare and can have a significant impact on patient outcomes and access to quality care. Previous studies have indicated that black patients are more likely to experience delays in treatment and increased surgical complications. Hispanic patients have more comorbidities and increased complications when undergoing orthopaedic surgeries. The purpose of this study was to evaluate the impact of racial disparities on postoperative complications and readmission rates following Total Joint Arthroplasty (TJA). Methods The largest single healthcare network database was queried to identify total joint arthroplasty patients treated in a single division between 2017 and 2021. Patient demographics including age, race, gender, and comorbidities were collected. Logistic regression and odds ratio point estimate analyses were utilized to assess for associations between race (defined as Whites, Blacks, Hispanics, Asians, and Others) and postoperative medical complications and surgical complications, which were collected for all patients. Patient outcomes included length of stay, hospital readmission status at 30 and 90 days postoperative, and emergency room (ER) visits up to 90 days. Results A total of 16,940 patients were included in this analysis consisting of 62% female, a mean age of 71 years and mean BMI of 29.4 kg/m2 . Racial demographics consisted of 61.6% White, 12.3% Black, 24.1% Hispanic, 0.8% Asian, and 1.2% Other. Race was not significantly associated with increased readmissions at 30 days (p=0.2215) and hispanic patients were 14% less likely to be readmitted within 90 days (p = 0.0208) but were not found to have differences in ER visits when compared to White patients. Black and Asian patients were not significantly more likely to visit the ER within 90 days or to be readmitted to the hospital within 90 days when compared to White patients. Race was not significantly associated with postoperative medical complications or surgical complications. Conclusions This study found a higher readmission rate of up to 20% for total joint arthroplasty patients within 90 days of follow-up. Although race did not appear to be a significant determinant of additional ER visits or readmissions, there was some variation seen amongst Hispanic patients undergoing TJR with a lower likelihood of readmission at 60 and 90 days postoperative.

Unveiling Disparities: Analyzing Hispanic Inclusion in Liver Cancer Research Databases in the United States

AbstractPrimary liver cancer, including hepatocellular carcinoma and intrahepatic cholangiocarcinoma was the sixth leading cause of cancer death in the United States in 2023. Hispanic people constitute approximately 19% of the nation’s total population according to the US Census. Hispanic patients have the highest relative incidence rates of liver cancer compared to non-Hispanic Whites and non-Hispanic Blacks, a disparity frequently overlooked in cancer research. In this study, our primary objective was to analyze the potential underrepresentation of Hispanic individuals in liver cancer research databases. We identified databases that had liver cancer-specific studies and be population-based in the United States. Our search yielded 7 cancer genomic databases, which were analyzed according to incidence percentages across ethnicity and race categories. Our study included 3104 patients; ethnic data was not reported for 13.1% (n = 406) of the patients. Samples were predominantly from individuals who identified as Not Hispanic (81.0%), Hispanic individuals represented 5.9%. Race was reported as follows: non-Hispanic Whites (61.0%), Asians (22.0%), non-Hispanic Blacks (5.4%), Other (3.1%), Native American/American Indian/Alaska Native (0.4%), Pacific Islander/Native Hawaiian (0.2%) and not reported (7.9%). These findings collectively underscore significant disparities in the representation of ethnic and racial groups, particularly Hispanics. Given the present racial and ethnic demographics of the US population and the projected surge in the Hispanic population in forthcoming years, it becomes imperative to address health disparities that may worsen without efforts to enhance proper inclusion in cancer research.

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

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

Thirty-five Years of Reporting of Sex and Race in Clinical Studies of U.S. FDA-Authorized Orthopaedic Devices.

At the U.S. Food and Drug Administration (FDA), the mission of the Center for Devices and Radiological Health (CDRH) is to ensure that all patients and providers have timely and continued access to safe, effective, and high-quality medical devices and safe radiation-emitting products. Although the CDRH has observed enrollment differences in some clinical trials, no systematic analysis has been conducted regarding enrollment differences in baseline demographics, to our knowledge. The CDRH has summarized information on study participants and their baseline demographics in public-facing documentation for all authorized medical devices that involved orthopaedic clinical studies from 1985 to 2020. Descriptive analyses and exploratory statistical testing have been conducted to investigate the reported percentages by sex and race compared with those reported in the U.S. National Census and the American Joint Replacement Registry (AJRR), respectively. We identified 94 submissions and corresponding combined clinical trials from 261 original clinical study arms with 34,193 participants. Most of the submissions reported age and sex, while only 36 submissions (38.3%) reported racial demographics. Among the 88 trials providing enrollment by sex, the female enrollment percentage ranged from 22.2% to 88.7%, with a mean of 55.0%. In the submissions that reported racial data (38.3%), White and Black patients had a mean enrollment of 89.2% (range, 64.8% to 98.7%) and 6.2% (range, 0.4% to 20.7%), respectively. The enrollment for other minority groups ranged from 0% to 3.0%. These clinical trials have shown numerically lower female representation (55.0%) but higher White representation (89.2%) than what has been reported in the AJRR. The other racial groups have participated much less than their corresponding percentages in the U.S. population, but they are similarly represented in the AJRR. The clinical trials supporting the FDA's authorization of orthopaedic devices had a wide range of sex and racial enrollments. It appears that female enrollment mirrors the percentage of women in the U.S. population. However, despite prior efforts, some racial groups are still underrepresented. The FDA has made a commitment to advancing health equity as part of the 2022-2025 Strategic Priorities of the CDRH. We hope that the results of this study will help health-care professionals make informed clinical decisions when using medical devices.

Blurring the Lines Between Public and Nonprofit Sectors: Local Efforts to Create Inclusive Communities

Local governments and nonprofits share the common goal of enhancing local community well-being, despite variations in funding sources, governance structure, and authority. Their joint efforts in responding to increasing immigrant concerns shed light on their motivations to address emerging challenges. Through interviews, original surveys, and secondary datasets, this study unveils that both sectors respond to rising foreign-born populations, shifting local racial demographics, and an aging populace. While political context significantly shapes local government actions, nonprofits are propelled by grant opportunities. These findings underscore sector commonalities and disparities and how the two sectors can continue to work together or independently to address community issues.

Racial and Ethnic Representation in Food Allergen Immunotherapy Trial Participants

The lack of inclusion of diverse population samples in food allergy immunotherapy clinical trials not only leads to decreased applicability to the general population in terms of results and treatments but can also be seen as a broader social injustice contributing to inequity within the health care system. To investigate the racial and ethnic distribution of participants included in food allergy immunotherapy clinical trials, and determine whether the racial and ethnic representation in trials accurately reflects the patients who experience food allergy. Data were collected from articles found on PubMed and ClinicalTrials.gov using key terms of food hypersensitivity, food allergy, and immunotherapy, while also incorporating specific criteria such as clinical trials conducted within the last 5 years with children aged from birth to 18 years old. Articles were selected based on their relevance to the research question. Main outcomes were totals and percentages of trial participants by race and ethnicity, stratified by pediatric trials, site of study, and National Institutes of Health funding. Thirty-five articles were initially identified, of which 34 were classified as human clinical trials. Of these trials, 26 met criteria of an original randomized clinical trial and included racial and ethnic demographics for analysis in the study. Among trials included, the majority of the 3689 participants identified as White (2640 participants [72.0%]), followed by Black or African American (293 participants [8.0%]), Asian (239 participants [6.0%]), multiple races or other (210 participants [6.0%]), Hispanic or Latino (96 participants [3.0%]), American Indian (3 participants [<1.0%]), and Native American or Pacific Islander (3 participants [<1.0%]). We observed differences in racial and ethnic inclusion by study site (US vs external to US) and funding support (National Institutes of Health vs industry or other non-National Institutes of Health sources). In this systematic review of racial and ethnic diversity in food allergy immunotherapy trials, there was a lack of diversity relative to the overall food allergy burden among Black and Hispanic patients, indicating important gaps in the conduct of pediatric clinical trials, especially for treatments that are meant for use in broad populations where significant race- and ethnicity-related disparities exist. Working to correct this disparity will not only increase the usefulness of future clinical trial data but can further assist in alleviating public health inequities.

Beyond gender: the intersectional impact of community demographics on the continuation rates of male and female students into high school physics

This study examines the complex interplay of gender and other demographics on continuation rates in high school physics. Using a diverse dataset that combines demographics from the Canadian Census and eleven years of gendered enrolment data from the Ontario Ministry of Education, we track student cohorts as they transition from mandatory science to elective physics courses. We then employ hierarchical linear modelling to quantify the interaction effects between gender and other demographics, providing a detailed perspective on the on continuation in physics. Our results indicate the racial demographics of a school’s neighbourhood have a limited impact on continuation once controlling for other factors such as socioeconomic status, though neighbourhoods with a higher Black population were a notable exception, consistently exhibiting significantly lower continuation rates for both male and female students. A potential role model effect related to parental education was also found as the proportion of parents with science, technology, engineering, and mathematics (STEM) degrees correlates positively with increased continuation rates, whereas an increase in non-STEM degrees corresponds with a reduced student continuation rate. The most pronounced effects are school-level factors. Continuation rates in physics are very strongly correlated with continuation in chemistry or calculus — effects that much stronger for male than female students. Conversely, continuation in biology positively correlates with the continuation of female students in physics, with little to no effect found for male students. Nevertheless, the effect sizes observed for chemistry and calculus markedly outweigh that for biology. This is further evidence that considering STEM as a homogeneous subject when examining gender disparities is misguided. These insights can guide future education policies and initiatives to increase continuation rates and foster greater gender equity and inclusivity in physics education.

Race and Superfund site remediation

Abstract Superfund is a federal program established in 1980 to manage the cleanup of hazardous waste sites across the United States. Given the health and economic costs borne by people living near these sites, any demographic disparities within the Superfund program are issues of environmental justice. We investigate whether racial demographics local to a Superfund site are associated with its cleanup status, and if so, how. Our work addresses gaps in the literature by using detailed geospatial processing, comprehensive data, and a more complete set of racial/ethnic categorizations. We study 1,688 Superfund sites across the country. Under a wide variety of modeling scenarios, we consistently find that the proportion of the nearby population that is Asian is negatively associated with the probability of a Superfund site being cleaned up. This association has remained unidentified until now, possibly because earlier research on Superfund sites did not distinguish Asian populations as a separate group. Our result underscores the need for specific measurement and inclusion of diverse populations in environmental studies.

Exploring the effectiveness of employee engagement strategies in the manufacturing industry: a South African perspective

The paint manufacturing sector has not received sufficient attention, having its unique challenges with employee engagement, despite numerous investigations on employee engagement in several industries. This study seeks to address this deficiency by performing a targeted investigation on the levels of employee involvement within the paint manufacturing sector. This study aims to assess the level of employee involvement in the paint manufacturing industry in South Africa. This study systematically assesses the strategies and practices of employee engagement implemented by paint manufacturing companies operating in the region. This study utilises a mixed methods approach and follows an exploratory research design to accomplish its objectives. This methodology utilises many research techniques to provide a thorough understanding of the complex employee engagement processes in the paint manufacturing industry. The survey instrument, comprising of 320 questionnaires, was distributed to managerial professionals, human resource practitioners, and general employees working at paint production plants in South Africa. In addition to collecting quantitative data, interviews were undertaken to further enrich the depth of insights. The findings reveal a beneficial and interconnected link between the factors studied, suggesting a reciprocal strengthening that enhances employee engagement. Moreover, the study highlights the complex interconnection between the six aspects of employee involvement in the company environment. These characteristics jointly contribute to the fundamental aspects of employee engagement within paint manufacturing firms. Industry stakeholders should work together to develop an organisational culture that is deeply ingrained in the industry's identity and resonates with all personnel. One key remedy suggested is to conduct an employee engagement survey across the entire organisation, which will help gain a thorough understanding of engagement dynamics. This study highlights a strong association between employee engagement, departmental affiliation, racial demographics, and age groups. Therefore, organisations can improve workplace engagement by carefully taking into account the impact of departmental divisions, racial origins, and age cohorts on the overall engagement picture. The study's findings shed light on the significant influence of these factors in determining the dynamics of employee engagement.

Association between blood transfusion and outcomes of free flap head and neck cancer surgery

ObjectiveInvestigate the impact of patient risk factors and blood transfusions in Head and Neck free flap surgeries. Study designRetrospective chart review. SettingSingle tertiary referral center. Methods400 patients were included undergoing free flap reconstruction from 2014 to 2020. The primary outcome measures were red blood cell transfusion and volume transfused. Race, sex, flap location and tissue type, pathology, dependent functional status, length of stay, and cancer recurrence were evaluated for association with red blood cell transfusion intraoperatively and/or postoperatively. Transfusions were indicated on patients with Hemoglobin <7–8 and/or symptomatic anemia. ANOVA and Chi2 statistical analysis were performed. The significance was set at p ≤0.05. ResultsOf the 400 patients included, 58 required red blood cell transfusion. Of these 67.8 % were males, racial demographics included 9.00 % African American, 1.30 % Asian, 1.00 % Hispanic/Latino, 87.8 % White, 1.00 % other. African American patients received a higher volume of transfused red blood cells versus white patients (855.00 mL vs. 437.07 mL, p = 0.005). Length of stay was significantly associated with red blood cell transfusion (5.95 days vs. 7.22 days, p ≤0.001). Dependent functional status and need for red blood cell transfusion were associated (p = 0.002). Type of free flap was associated with need for red blood cell transfusion (p ≤0.001) with anterolateral thigh flaps being the most common resulting in transfusion (34/58). ConclusionRed blood cell transfusion was significantly associated with race, dependent functional status and length of stay. Certain free flaps have a higher risk of blood transfusion.

The impact of health disparities on peripheral vascular access outcomes in hospitalized patients: an observational study

BackgroundPlacement of peripheral intravenous catheters (PIVC) is a routine procedure in hospital settings. The primary objective is to explore the relationship between healthcare inequities and PIVC outcomes.MethodsThis study was a multicenter, observational analysis of adults with PIVC access established in the emergency department requiring inpatient admission between January 1st, 2021, and January 31st, 2023, in metro Detroit, Michigan, United States. Epidemiological, demographic, therapeutic, clinical, and outcomes data were collected. Health disparities were defined by the National Institute on Minority Health and Health Disparities. The primary outcome was the proportion of PIVC dwell time to hospitalization length of stay, expressed as the proportion of dwell time (hours) to hospital stay (hours) x 100%. Multivariable linear regression and a machine learning model were used for variable selection. Subsequently, a multivariate linear regression analysis was utilized to adjust for confounders and best estimate the true effect of each variable.ResultsBetween January 1st, 2021, and January 31st, 2023, our study analyzed 144,524 ED encounters, with an average patient age of 65.7 years and 53.4% female. Racial demographics showed 67.2% White, and 27.0% Black, with the remaining identifying as Asian, American Indian Alaska Native, or other races. The median proportion of PIVC dwell time to hospital length of stay was 0.88, with individuals identifying as Asian having the highest ratio (0.94) and Black individuals the lowest (0.82). Black females had a median dwell time to stay ratio of 0.76, significantly lower than White males at 0.93 (p < 0.001). After controlling for confounder variables, a multivariable linear regression demonstrated that Black males and White males had a 10.0% and 19.6% greater proportion of dwell to stay, respectively, compared to Black females (p < 0.001).ConclusionsBlack females face the highest risk of compromised PIVC functionality, resulting in approximately one full day of less reliable PIVC access than White males. To comprehensively address and rectify these disparities, further research is imperative to improve understanding of the clinical impact of healthcare inequities on PIVC access. Moreover, it is essential to formulate effective strategies to mitigate these disparities and ensure equitable healthcare outcomes for all individuals.

Characterization and prevalence of ocular comorbidities and risk of legal blindness across the United States.

Vision loss is a top disability in the United States (US). Patients commonly present with multiple ocular diseases, but the extent to which this places them at risk for vision loss, and if sex and race impacts this, is poorly understood. This exploratory analysis evaluated which ocular comorbidities and demographics are at highest risk for visual impairment. A retrospective cross-sectional study was conducted through the TriNetX Analytics Network, an aggregated network encompassing over 90 million insured and uninsured patients across 50 healthcare organizations from all regions in the US. Patients with diabetic retinopathy (DR), age-related macular degeneration (AMD), retinal vein occlusion (RVO), glaucoma, and uveitis were included in this study. Ocular diseases and visual impairment were determined through ICD-10 codes. Prevalence and odds ratios were calculated while stratifying by sex and racial demographics. Statistical analyses were completed using RStudio and Excel with 95% confidence intervals calculated. The comorbid conditions with the highest prevalence of visual impairment were uveitis and RVO (39.94%), uveitis and neovascular AMD (37.61%), and uveitis and glaucoma (33.23%). The comorbidity with the highest odds for visual impairment was uveitis and RVO (POR 4.86; 95% CI 4.49, 5.26). Compared to white males, Black and Hispanic males were disproportionately affected by visual impairment across ocular comorbidities. This study quantified the prevalence and odds of visual impairment for unilateral and comorbid ocular disease, with the addition of uveitis causing the greatest increase. Black and Hispanic males were disproportionately affected by visual impairment across comorbid conditions.

Critical climate awareness as a science education outcome

AbstractThis paper presents the argument that climate change should be taught in schools as a sociopolitical and scientific process, and that students should be able to use their science knowledge to think critically about climate change as a social justice issue. A necessary and achievable outcome of science education is critical climate awareness—an understanding of the systems and structures that create and sustain climate change inequities. Through a participatory design research partnership, a high school chemistry course was designed and studied that focused on this outcome. Data from a single group, mixed method pre/postdesign show how a group of Black and Latinx urban youth appropriated critical climate awareness from the curriculum they experienced and how they used this awareness to explain climate change as a scientific and sociopolitical process. The findings show that students became concerned about climate change, if they were not already, and that they improved their knowledge of scientific concepts specific to climate change. In their explanations of climate change, students foregrounded sociopolitical processes that result in changes to physical systems, assigned agency for carbon emissions to diverse social actors in ways attentive to power dynamics, and articulated differences in consequences and solutions based on the racial and socioeconomic demographics of communities. This work has implications for transforming science classrooms into incubators for climate justice.

Veterinary Hospital and Clinic Websites: Do They Reflect the Racial Demographics of Their Geographical Region?

Veterinary Hospital and Clinic Websites: Do They Reflect the Racial Demographics of Their Geographical Region?

The Prevalence of Acute Compartment Syndrome in Pediatric Tibial Tubercle Fractures.

Tibial tubercle fractures are a unique class of pediatric orthopaedic injuries that frequently necessitate surgical treatment and strict monitoring due to the associated risk of acute compartment syndrome (ACS). However, current literature is conspicuously limited in its ability to estimate the risk of ACS after these fractures. Therefore, the purpose of this study is to utilize a nationwide database to estimate the prevalence of ACS after pediatric tibial tubercle fractures. We utilized the Healthcare Cost and Utilization Project's Kids' Inpatient Database (2019) to identify all pediatric patients, 18 years of age and under, with isolated tibial tubercle fractures (International Classification of Diseases, 10th revision Clinical Modification S82.151-S82.156) and ACS (T79.A0, T79.A2, T79.A29). Patients were excluded if they had additional lower extremity injuries (ie, tibial shaft, plateau, etc). A subanalysis was conducted for those undergoing fasciotomy, with and without an ACS diagnosis. Among the 591 isolated tibial tubercle fractures, there were 8 ACS cases for a prevalence of 1.35%. There were 22 (3.72%) additional cases of fasciotomy without an ACS diagnosis. All ACS cases were diagnosed during the original hospitalization; all were male and had closed fractures. The cohort included 469 teenagers (13+ years) and 77 pre-teens, with 40 females and 506 males. Racial demographics: 132 white, 232 black, 112 Hispanic, 15 Asian, 4 Native American, 23 unknown, and 28 others. No significant associations were found between ACS and age, race, insurance status, mechanism of injury, or hospital region. The rate of ACS in pediatric tibial tubercle fractures appears to be much lower than previously reported, at 1.35%. However, the nearly three-fold higher prevalence of fasciotomy without an ACS diagnosis, suggests a generous use of prophylactic fasciotomies and/or an undercharacterization of actual ACS cases from miscoding. This is the first and largest study to employ a nationally representative database to investigate the prevalence of ACS after tibial tubercle fractures. Level III.

The Impact of Sociodemographic Factors on Rates of Tympanostomy Tube Placement for Pediatric Otitis Media.

To identify the impact of race, ethnicity, and socioeconomic status (SES) on the rate of tympanostomy tube placement. Retrospective medical review and population-level analyses. Tertiary referral center. Demographic and population-level characteristics (age, gender, race, insurance status, and ZIP code) compared to the regional, health system, and otolaryngology clinic demographics. Among 38,461 children diagnosed with otitis media (OM) 61.4% were white, 27.4% were black, 32.7% had private insurance, and 18.2% were Hispanic. Among patients seen in the pediatric ear, nose, and throat (ENT) clinics, 70.0% were white, 20.0% were black, 46.6% had private insurance, and 14.9% were Hispanic. Further disparity was noted among those receiving tympanostomy tubes: 75.6% white, 15.6% black, 61.9% private insurance, and 11.7% Hispanic. Higher rates of tube placement were noted for those of white race [odds ratio, OR: 1.96, (95% confidence interval, CI: 1.85-2.04), <.001] and non-Hispanic ethnicity [OR: 1.67, (95% CI: 1.56-1.75), <.001]. Geographically, rates of tube placement were significantly lower in areas with higher deprivation indices, areas with lower proportions of white residents, and areas with the lowest median incomes. These markers correlate strongly with black race and Hispanic ethnicity. Lower rates of tube placement were also seen in majority white locales with higher deprivation indices and lower median incomes. Rates of access to pediatric ENT clinics, and of tube placement, are significantly lower for those of Hispanic ethnicity and black race than for non-Hispanic white children. Higher rates of tube placement were noted among white children and those with private insurance. Lower rates of tube placement were seen in areas of lower SES regardless of racial demographics.