Trends In Racial Disparities Research Articles

Positive Trends in Racial Disparities for Head and Neck Microvascular Reconstructive Surgery.

To evaluate national trends in racial disparities for patients undergoing head and neck reconstructive surgery. Retrospective analysis using the 2008 to 2021 American College of Surgeons National Surgical Quality Improvement Program database. Patients receiving microvascular free tissue transfer were eligible for inclusion. Pediatric patients and those treated by non-otolaryngologists were excluded. Outcomes were analyzed with univariate and multivariable models. A total of 5831 head and neck free flap cases were analyzed, 4869 (83.5%) were White, 560 (9.6%) were Black or African American, and 402 (6.9%) were Asian, Native American, or other groups (ANAOG). The proportion of Black or African American patients and ANAOG patients undergoing free tissue transfer increased significantly over the time period (p = 0.047 and p = 0.010, respectively). However, there was a downtrend that started around 2017. In a multivariable model, Black or African American race was not associated with readmission (OR = 0.99 [95% CI 0.74, 1.31], p > 0.05), returning to the operating room (OR = 1.20 [95% CI 0.96, 1.49], p > 0.05), or any post-operative complication (OR = 0.83 [95% CI 0.68, 1.01], p > 0.05). There were also no significant associations found in the ANAOG population on multivariate analysis (p > 0.05 for all). The percentage of free tissue transfer performed in patients from minority backgrounds with head and neck cancer has been increasing in the United States. Outcomes after head and neck microvascular reconstruction are similar when stratified by race. However, racial disparities remain and further work is necessary to reduce these disparities. Level IV Laryngoscope, 2024.

Trends in Racial Disparities in the Treatment and Management of Ruptured Abdominal Aortic Aneurysms

Trends in Racial Disparities in the Treatment and Management of Ruptured Abdominal Aortic Aneurysms

Recent Trends In Racial Disparities And Cardiovascular Disease Burden In Patients With Polysubstance Abuse Among Hospitalizations In The United States

Recent Trends In Racial Disparities And Cardiovascular Disease Burden In Patients With Polysubstance Abuse Among Hospitalizations In The United States

National Trends In Racial Disparities Among Hospitalizations And Outcomes In Patients With Dilated Cardiomyopathy

National Trends In Racial Disparities Among Hospitalizations And Outcomes In Patients With Dilated Cardiomyopathy

Trends in Racial Disparities in Healthcare Expenditures Among Senior Medicare Fee-for-service Enrollees in 2007-2020.

Despite the universal healthcare coverages, racial disparities in healthcare expenditures among senior Medicare beneficiaries exist. A few studies explored how racial disparities in healthcare expenditures changed over past decades and how it affected differently across 4 minoritized races, by type of Medicare and poverty levels. We conducted a longitudinal study of 21 healthcare expenditures from senior Medicare fee-for-service enrollees to determine overall and secular trends in racial disparities in healthcare expenditures between 2007 and 2020, during which the Affordable Care Act (ACA) came into full force and the COVID-19 pandemic had begun. We found important disparities in healthcare expenditures across 4 minoritized races compared to Whites, even after adjusting for possible confounders for such disparities. Disparities between Hispanics/Asians and Whites were much greater than disparities between Blacks and Whites, in all Parts A, B, and D expenditures. This reality has not been sufficiently emphasized in the literature. Importantly, Black-White disparities in total Part B expenditure gradually worsened between 2007 and 2020, and Hispanic-White and Asian-White disparities worsened greatly during that time window. Health planners need to focus on these large disparities and develop methods to shrink them.

Association Between Changes in Racial Residential Segregation and Trends in Racial Disparities in Early Mortality in 220 Metropolitan Areas, 2001-2018.

Racial residential segregation has been shown to affect the absolute levels of racial disparities in a wide variety of health outcomes in the USA but it is not known whether changes in segregation also influence these racial health disparities. This study examines the relationship between changes in racial residential segregation over four decades (1980-2020) and trends in racial disparities in early mortality (under age 65) rates among non-Hispanic Black and non-Hispanic White persons across a wide range of health outcomes in 220 metropolitan statistical areas (MSAs) during the period 2001-2018. Using the CDC WONDER Underlying Cause of Death database, we derived annual estimates of race-specific death rates and rate ratios for each MSA. We used latent trajectory analysis to examine the relationship between the level of segregation and changes in segregation over time in an MSA and trends in death rate disparities in that MSA. The trajectory analysis resulted in a linear, three group model in which trajectory Groups 1 and 2 had decreasing trends in the ratios of Black to White death rates over time while in Group 3, the disparity remained almost constant over time. Increases in the level of segregation in an MSA from 1980 to 2000 were significantly associated with the likelihood that the MSA was in Group 3 and experienced no improvement in racial health disparities in mortality over time. This paper provides new evidence that changes in segregation are related to trends in racial health disparities in mortality rates over time.

S264 Trends in Racial Disparities of Cecum Cancer in the Last Twenty Years

S264 Trends in Racial Disparities of Cecum Cancer in the Last Twenty Years

Poster 395: Racial Disparities in Utilization and Perioperative Metrics in Rotator Cuff Repair in a US Inpatient Database

Objectives: Previous studies have shown racial disparities in the utilization and perioperative metrics of orthopedic procedures. However, it remains unclear if similar disparities exist in rotator cuff repair (RCR). The purpose of this study was to examine trends in racial disparities between white and black patients with inpatient RCR in the United States (US). Methods: Admissions for inpatient RCR in 2008-2012 were queried from the Healthcare Cost and Utilization Project National Inpatient Sample. The primary outcome was utilization rate, defined by the number of RCRs normalized to the US population per race and year. The effect of race on utilization and perioperative metrics was assessed using a regression model correcting for race and year, with a race- year interaction term to approximate temporal trends in disparities (alpha=0.05, 1-beta>0.90). Results: Overall, 20,363 patients were included in the final analysis, 18,602 identifying as white (91%) and 1,761 (8.6%) as black. On average, white patients undergoing RCR were older (white median=67 [IQR=58-75] years; black median=60 [IQR=52-68] years, P<0.0001) and more likely on Medicare (white: 59%; black: 44%, P<0.0001). Black race was associated with a 6.6/1,000,000 lower utilization rate compared to white race (P<0.0001). Although the utilization gap narrowed over time, this trend was not significant (Ptrend=0.06). Black patients were 4% less likely to be discharged to a facility (P< 0.0001, Ptrend=0.07) and had a 0.23-day longer average length of stay (P=0.047, Ptrend=0.81). When correcting for baseline age and comorbidities, postoperative complications were not significantly different between white and black patients (beta=-2.4%, 95%CI=-13.0%-+8.3%, P=0.60). Conclusions: There is a discrepancy in inpatient RCR utilization between white and black patients. Although this disparity appears to be decreasing over time, this trend was not significant. Further studies are warranted to understand causal factors for these differences, that may serve as targets for future public health interventions. [Table: see text]

EPH201 Trends in Racial Disparities for Total Knee Arthroplasty — A US Hospital Database Analysis, 2000–2021

This observational study aimed to investigate trends in racial disparities for total knee arthroplasty (TKA) care between Black and White patients in the U.S. from 2000 to 2021.

Racial disparities in Black men with prostate cancer: A literature review.

Black men are disproportionately affected by prostate cancer (PCa), with earlier presentation, more aggressive disease, and higher mortality rates versus White men. Furthermore, Black men have less access to PCa treatment and experience longer delays between diagnosis and treatment. In this review, the authors discuss the factors contributing to racial disparities and present solutions to improve access to care and increase clinical trial participation among Black men with PCa. Racial disparities observed among Black men with PCa are multifaceted, evolving from institutional racism. Cultural factors include generalized mistrust of the health care system, poor physician-patient communication, lack of information on PCa and treatment options, fear of PCa diagnosis, and perceived societal stigma of the disease. In the United States, geographic trends in racial disparities have been observed. Economic factors, e.g., cost of care, recovery time, and cancer debt, play an important role in racial disparities observed in PCa treatment and outcomes. Racial diversity is often lacking in genomic and precision medicine studies. Black men are largely underrepresented in key phase 3 PCa trials and may be less willing to enroll in clinical trials due to lack of awareness, lack of diversity in clinical trial research teams, and bias of health care providers to recommend clinical research. The authors propose solutions to address these factors that include educating clinicians and institutions on the barriers Black men experience, increasing the diversity of health care providers and clinical research teams, and empowering Black men to be involved in their treatment, which are keys to creating equity for Black men with PCa. LAY SUMMARY: Prostate cancer negatively affects Black men more than men of other races. The history of segregation and mistreatment in the health care system may contribute to mistrust among Black men. Outcomes are worse for Black men because they are less likely to be screened or to receive treatment for prostate cancer. Black men also are unlikely to participate in clinical research, making it difficult for investigators to understand how Black men are affected by prostate cancer. Suggestions for addressing these differences include teaching physicians and nurses about the issues Black men experience getting treatment and improving how Black men get information on prostate cancer.

Development of an interactive precision medicine dashboard to aid in completion of germline and homologous recombination deficiency (HRD) tumor testing for newly diagnosed ovarian cancer patients to improve the use of PARP inhibitor frontline maintenance (583)

Development of an interactive precision medicine dashboard to aid in completion of germline and homologous recombination deficiency (HRD) tumor testing for newly diagnosed ovarian cancer patients to improve the use of PARP inhibitor frontline maintenance (583)

An Examination of Racial Disparities in Misdemeanor Marijuana Possession Arrests Following Reforms in Four U.S. Jurisdictions

Abstract Using data from New York, NY; Los Angeles, CA; Prince George’s County, MD; and Louisville, KY, we examine trends in racial disparities in the enforcement of misdemeanor marijuana possessionbefore and after marijuana reforms. In these jurisdictions, we find that changes to marijuana enforcement were associated with reductions in arrest rates for Black, Hispanic, and White people, though the rate of decline varied by jurisdiction. Black people were arrested at the highest rates in relation to their proportion of the population. In three of the four jurisdictions where issuing criminal citations was an enforcement option, racial/ethnic disparities in arrest rates increased post-reforms; legalization and the option to issue a civil citation were associated with reductions in racial/ethnic disparities. Trends in this study provide policymakers with information to implement effective reforms that target racial disparities in marijuana possession arrests.

Facility-level national trends in racial disparities of surgical therapy for early-stage lung cancer

ObjectiveThe racial gap in surgical treatment for early-stage non–small cell lung cancer (NSCLC) has been narrowing at the population level, but it is unknown if this trend persists at the facility level. Patients and MethodsWe queried the National Cancer Database Participant User File from 2006 to 2016 for patients with stage I NSCLC. Facilities were grouped by type, location, and resection volume. The cumulative surgery rate for Black and White patients in each group was calculated, and an incidence rate difference of receipt of surgery was determined. Logistic regression with estimation of marginal effects was used to assess the probability difference of receiving surgery in Black versus White patients in each year. ResultsIn total, 315,474 patients were included; 287,585 (91.2%) were White and 27,889 (8.8%) were Black. The surgery rate was greater for White patients (60.2% vs 55.8%, P < .001). For most groups, the surgery disparity narrowed over the study period. The disparity widened in community cancer programs; facilities in the New England, West North Central, and Pacific regions; and the lowest volume facilities. The probability difference for receiving surgery was significantly smaller in 2016 versus 2006 in the Middle Atlantic region and community cancer programs; the difference was unchanged for all other groupings. ConclusionsTrends in disparities in the use of resection for early-stage NSCLC are not universal across facility groupings. As efforts are made toward addressing racial disparities in surgical care for NSCLC, it will be important to remember that population-level analyses may mask lack of progress in certain facility groups.

Trends in racial disparities of emergency department utilization for asthma in coronavirus disease 2019

Racial disparities between White and non-White patients with asthma in the United States have been documented before the coronavirus disease 2019 (COVID-19) pandemic.1,2 During the pandemic, non-White populations experienced disproportionately higher rates of COVID-19 infection, hospitalization, and mortality.3 Survey data of patients and providers also suggest that the pandemic worsened the ability of non-White patients with asthma’ to afford asthma medications and control their symptoms.4 The pandemic did, however, hasten the adoption of several societal and health care system changes, including mask use, social distancing, remote work and schooling, and expansion of telemedicine.

A social history of racial disparities in breastfeeding in the United States

Over the past five decades in the United States, White women have breastfed at higher rates than Black women. While a small but growing body of social historical research has examined racial disparities in breastfeeding over time, empirical research, particularly quantitative research, has focused on single historical snapshots, unintentionally treating the persistent racial disparities in breastfeeding as a static phenomenon, rather than one with distinct social mechanisms at different points in time. Further, few studies on racial disparities in health deconstruct difference both within and across racial groups. But what if we thought about persistent racial disparities instead as discrete trends with distinct social mechanisms at different points in time? In a binary logistic regression of breastfeeding initiation rates from 1973 to 2015 using the National Survey of Family Growth (NSFG), I found that the persistent racial disparities were actually comprised of three distinct types of changing racial disparities: (1) increases in racial disparities that derive from improvements for Whites not captured by Blacks (1973–1982); (2) decreases in racial disparities that stem from improvements for Whites captured even more strongly by Blacks (1995–2006); and, (3) leveling off of racial disparities (2006–2015). Placing results of this quantitative analysis within the context of public policy and social movement history, I identify three distinct mechanisms that drive the different trends in racial disparities in breastfeeding. This paper contributes to the literature on motherhood, race, and health a more nuanced understanding of the social historical mechanisms that pattern breastfeeding, and more broadly, racial disparities in health.

Innovation in germline and somatic tumor testing pathways for ovarian cancer patients

<h3>Objectives:</h3> New approvals for upfront maintenance therapy with parp inhibitors in ovarian cancer now indicate a need for germline genetic testing and potentially somatic testing including homologous repair deficiency (HRD) within several months of diagnosis. However, national rates of germline testing are approximately 30%1 despite being recommended for all patients. Current practice now indicates that it is even more important to obtain results quicker and more efficiently at the time of a new diagnosis of ovarian cancer. We sought to apply novel healthcare innovation techniques to this problem space to improve rates of germline and somatic tumor testing in ovarian cancer patients. <h3>Methods:</h3> A total of 4 pilots ranging from "low to high touch" were performed in an experimental rapid cycle model, each lasting approximately 2-3 weeks. In Pilot 1, providers were "nudged" via email, text or electronic medical record (EMR) alert as per their preference that an upcoming patient was missing either genetic testing or tumor testing (HRD or somatic testing). In Pilot 2, choice architecture was used to pend orders for genetics consultation into the upcoming patient encounter in the EMR. In Pilot 3, a "Concierge Approach" was applied to capture patients in real time who were approached in person at the clinic appointment and offered immediate genetic counseling/testing. In Pilot 4, a text messaging platform was used to schedule patients for a counseling/testing appointment. Descriptive statistics were performed. <h3>Results:</h3> Results: Pilot 1: 30 "nudges" were placed but only 50% of encounters documented discussion or ordering of genetic testing. Pilot 2: 75% of pended orders were signed, with 7/12 (58.3%) of patients scheduling a genetic counseling appointment. Pilot 3: 4/6 (66.7%) of patients completed a genetic counseling appointment when offered in real time at the visit and 3/4 (75%) completed testing. Pilot 4: If patients consented to texting for scheduling (50%), the majority of patients were scheduled for counseling or obtained outside testing results (n=8/9, 88.9%). Attendance rates at appointments scheduled via text were 100% (n=5/5). Potential trends in racial disparities were identified within the n=59 patients missing germline or somatic testing, with an increased proportion of Black patients (27.1%) and Asian/Other (13.6%) missing testing, higher than the baseline practice demographics. <h3>Conclusions:</h3> Behavioral economics can be utilized to improve rates of genetic and somatic testing for ovarian cancer patients. Patients typically complete genetic counseling/testing if an appointment is offered in real time. A ‘warm hand-off' is needed for outreach via text for awareness and engagement, however once enrolled, patients participated via text for scheduling and discussion of prior results at high percentages. A ‘concierge approach' is highly successful but not scalable for all but could be used to ‘rescue' missed patients. Potential racial disparities need further exploration to ensure solutions are equitable and applicable to all patients. The growth of precision medicine could benefit from automation and choice architecture utilizing the EMR. This would allow for surfacing of missing clinical data by removing the mental burden of the work required to complete genetic and somatic testing.'

Trends in mortality among Black and White men with prostate cancer in Massachusetts and Pennsylvania: Race and neighborhood socioeconomic position.

Reducing disparities in men with prostate cancer (PCa) that may be caused by racial and socioeconomic differences is a major public health priority. Few reports have studied whether these disparities have changed over time. Men diagnosed with PCa from January 1, 2000 to December 31, 2015 were identified from the Massachusetts and Pennsylvania cancer registries. All-cause mortality and PCa and cardiovascular cause-specific mortality were assessed. To estimate neighborhood socioeconomic position (nSEP), a summary score was generated using census tract-level measures of income, wealth, educational attainment, and racial and income segregation. Participants were grouped by diagnosis year (2000-2003, 2004-2007, 2008-2011, or 2012-2015), and changing trends in the mortality rate ratio by race and nSEP were estimated using covariate-adjusted Cox models with follow-up for up to 10 years, until death, or until censoring on January 1, 2018. There were 193,883 patients with PCa and 43,661 deaths over 1,404,131 person-years of follow-up. The Black-White adjusted hazard ratio (aHR) from 2000 to 2003 through 2012 to 2015 was stable for all-cause mortality (aHR, 1.14 to 0.97; P for heterogeneity = .42), decreased for PCa-specific mortality (aHR, 1.38 to 0.93; P for heterogeneity = .005), and increased for cardiovascular mortality (aHR, 1.09 to 1.28; P for heterogeneity = .034). The aHR comparing those in the lowest versus the highest nSEP quintile increased significantly for all-cause mortality (aHR, 1.54 to 1.79; P for heterogeneity = .008), but not for PCa-specific mortality (aHR, 1.60 to 1.72; P for heterogeneity = .40) or cardiovascular mortality (aHR, 1.72 to 1.89; P for heterogeneity = .085). Although Black-White disparities in prostate mortality declined in Massachusetts and Pennsylvania over the study period, nSEP mortality disparity trends were stagnant or increased, warranting further attention. Few reports have examined whether racial and socioeconomic disparities in prostate cancer mortality have widened or narrowed in recent years. Using data from 2 state registries (Massachusetts and Pennsylvania) with differing intensities of government-mandated health insurance, trends in racial and neighborhood socioeconomic disparities were studied among Black and White men diagnosed from 2000 to 2015. Overall, trends in racial disparities were stagnant for all-cause mortality, shrank for prostate mortality, and widened for cardiovascular mortality. Disparities associated with neighborhood socioeconomic status either were stagnant or widened across all mortality end points. In general, disparities were more pronounced in Pennsylvania than in Massachusetts.

220 Trends in racial disparities in adverse outcomes in influenza in pregnancy

Non-Hispanic Black (NHB) pregnant women experience higher rates of maternal morbidity compared to their non-Hispanic White (NHW) peers, regardless of influenza. Whether NHB experience worse outcomes with influenza remains to be defined. Our objective was to assess whether NHB women with influenza during pregnancy are at increased risk of severe maternal morbidity (SMM). An analysis of delivery hospitalizations with influenza during pregnancy was conducted using the 2000-2015 National Inpatient Sample. Maternal race was assessed for women of NHW, NHB, and Hispanic race. Outcomes were SMM excluding transfusion (defined by the Centers for Disease Control and Prevention), and complications of influenza, sepsis/shock, acute respiratory distress syndrome (ARDS), and mechanical ventilation/tracheostomy. Trend analysis was conducted presenting the average annual percent change (AAPC). The association between maternal race and outcomes were calculated using log linear models, adjusted for demographic, hospital, and clinical variables. Between 2000-2015, 182,228 (0.3%) deliveries were complicated by influenza and 15.7% of women were NHB. Overall, 2.1% had SMM, 4.8% sepsis/shock, 23.4% ARDS, and 4.2% mechanical ventilation/tracheostomy. The rate of SMM was higher among NHB compared to NHW patients with an AAPC 5.6% (95% CI: 0.7%, 10.7%) versus 5.1% (95% CI: 1.2%, 9.3%) (Figure). NHB women with influenza were at higher risk of SMM compared to their NHW peers (3.5% vs. 2.0%, aRR 1.64, 95% CI: 1.48, 1.81) and similarly elevated with mechanical ventilation and sepsis/shock (Table). Non-Hispanic Black women with influenza during pregnancy experience higher rates of maternal morbidity compared to their non-Hispanic White peers. Addressing racial disparities in adverse outcomes for pregnant women with influenza should be a public health priority, including improving influenza vaccination rates in minority populations.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Differences in the Risk of Health Outcomes in COVID-19 Continuum for African Americans in Healthcare Settings: A Systematic Review and Meta-Analysis

Background: African Americans/Blacks represent the major health disparities population in the US. Thus, we performed a systematic review of published work to quantitatively assess outcome-dependent differences across the COVID-19 continuum among African Americans compared to Whites and other races.Methods: We searched the MEDLINE, Scopus, and Cochrane Library up to March 31, 2021, to identify studies that treated African Americans as an independent racial group and assessed the risk of SARS-CoV-2 infection and/or the subsequent COVID-19 outcomes in US healthcare settings. We used random-effects meta-analysis to generate unadjusted and adjusted pooled estimates of odds ratio (OR) or hazard ratio (HR)/risk ratio (RR) of the racial differences in the risk of each COVID-19 outcome. Graphs were constructed to visualize the trends in racial disparities along the COVID-19 continuum. This study is registered with PROSPERO, CRD42021239596.Findings: Of the 9863 articles identified, 78 were eligible for qualitative synthesis and 67 for meta-analysis. Compared to Whites, the higher risks of COVID-19 outcomes for Blacks continued to decrease along the continuum, from substantial disparities in SARS-CoV-2 infection (adjusted OR [95% CI], 1·96 [1·65–2·34]) and hospitalization (adjusted OR [95% CI], 1·49 [1·26–1·75]) to becoming minimal in infection fatality (adjusted OR, 1·00; adjusted HR/RR, 0·99) or reversed in in-hospital mortality (adjusted OR [95% CI], 0.83 [0·71–0·96]; adjusted HR/RR [95% CI], 0·86 [0·78–0·95]). Compared to other racial minorities, Blacks had higher risk of hospitalization or infection fatality but similar risk of infection or in-hospital mortality. Although Black COVID-19 patients had higher prevalence of most comorbidities than non-Black non-White patients, certain comorbidities or risk factors were more prevalent among White patients compared to other races.Interpretation: The magnitude and direction of COVID-19 racial disparities varied by outcomes. Once the COVID-19 patients received hospital care, there were no differences in outcomes among different races, despite pre-existing disparities.Funding: This work is supported by the US National Institute on Minority Health and Health Disparities of the National Institute of Health, award number U54 MD013376 to YCC.Declaration of Interest: None to declare.

Trends in Relative Incidence and Prevalence of Dementia Across Non-Hispanic Black and White Individuals in the United States, 2000-2016

In the US, dementia risk is higher in non-Hispanic Black individuals than in non-Hispanic White individuals. To evaluate progress toward reducing such disparities, tracking secular trends in racial disparities in dementia prevalence is essential. To examine whether relative racial disparities in dementia prevalence or incidence have changed in the US from 2000 to 2016. The Health and Retirement Study (HRS) is a nationally representative study of adults 50 years or older. New participants are recruited every 6 years, and study visits occur biennially. Approximately 17 000 to 22 000 respondents have been surveyed at each wave since 2000, achieving response rates of 81% to 89%. Data for this cohort study were obtained from non-Hispanic White and non-Hispanic Black participants aged 70 years and older from the 2000 to 2016 waves. For analyses of secular trends in racial disparities in dementia prevalence, each HRS wave was considered separately (range of participants meeting eligibility criteria in each wave, 6322-7579). For analyses of secular trends in racial disparities in dementia incidence, 7 subcohorts were created (range of participants meeting eligibility criteria in each subcohort, 5322-5961) following up people without dementia for 4 years from subcohort baseline visits in 2000, 2002, 2004, 2006, 2008, 2010, and 2012. Data were analyzed from October 2019 to August 2020. Race based on self-response to closed-ended survey questions. Dementia status was determined using 3 algorithms with similar sensitivity and specificity across non-Hispanic White and Black participants. Disparities were characterized using ratio measures. In this study, the mean age and percentage of male participants eligible for inclusion in analyses of racial disparities in dementia prevalence increased over time among non-Hispanic White participants (from 78.2 years and 40% in 2000 to 78.7 years and 44% in 2016) but remained steady in non-Hispanic Black participants during the same period (from 78.0 years and 37% in 2000 to 77.9 years and 38% in 2016). Prevalence ratios comparing Black and White participants ranged from approximately 1.5 to 1.9 across algorithms and years, whereas hazard ratios ranged from approximately 1.4 to 1.8. Although results suggest stable or declining dementia risk overall, there was no evidence suggesting change in relative racial disparities in dementia prevalence or incidence during follow-up. This study did not find evidence to suggest that the ratio of dementia risk across Black and White individuals changed in the US between 2000 and 2016. Additional efforts to identify and mitigate the source of these disparities is warranted.