White US Research Articles

Abstract 9106: Comparing the Risk of Post-Discharge Bleeding from Dual Antiplatelet Therapy, after Percutaneous Coronary Intervention, Between US Black and White Adults

Introduction: Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) reduces myocardial infarctions but increases bleeding. Guidelines recommend using risk scores to assess bleeding risk, but none have been validated in self-reported Black patients. We compared 1) post-discharge bleeding between US Black and White patients, and 2) the ability of three risk scores to predict bleeding between them. Methods: The PRiME-GGAT prospective cohort study enrolled patients (2014-2019) who underwent PCI and followed them for one year. Variables measured at PCI were included in the PRECISE-DAPT, PARIS, and ARC-HBR scores. The outcome was post-discharge BARC 2-5 events. Incidence rates were compared between Black and White patients, using incidence rate ratios (IRRs). Proportional hazards models measured the effect of self-reported Black ethnicity, adjusted for bleeding risk factors. Risk scores were compared between Black and White patients using: 1) IRRs, 2) Harrell’s C-indices, and 3) Kendall’s tau-b coefficients (τ b ). τ b was not measured for the binary ARC-HBR score. Results: Of 1529 included patients, 342 (22.4%) self-reported as Black. The incidence rate was higher among Black patients compared to White patients (22.7 versus 16.3, respectively, per 100 person-years; IRR 1.39; 95% CI, 1.01-1.90). After adjustment, self-reported Black ethnicity was not a predictor of bleeding. For both groups, IRRs were largest for PRECISE-DAPT. Between Black and White patients, respectively, C-index was 0.65 vs. 0.61 for PRECISE-DAPT, 0.63 vs. 0.61 for PARIS, and 0.60 vs. 0.59 for ARC-HBR; and τ b , respectively, was 0.71 vs. 0.64 for PRECISE-DAPT, and 0.79 vs. 0.86 for PARIS. Conclusions: Post-discharge bleeding from DAPT was greater for Black patients, compared with White patients, but this difference was not present after adjustment. PRECISE-DAPT was superior among Black patients, but PARIS was superior among White patients.

Trends in the Incidence of Early-Onset Colorectal Adenocarcinoma Among Black and White US Residents Aged 40 to 49 Years, 2000-2017

Early-onset colorectal cancer incidence rates are rising faster in White individuals than Black individuals. However, prior National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) racial stratification analyses used smaller SEER 13 databases, combined patients under age 50 years, did not stratify by sex, and did not focus on adenocarcinoma histologic subtypes (screening target). To perform a race- and sex-stratified adenocarcinoma incidence rate analysis in individuals aged 40 to 49 years using larger SEER 18 databases with expanded race data to better understand the colorectal cancer burden in those at or approaching screening age. This cross-sectional study used 2000 to 2017 SEER 18 annual age-adjusted colorectal cancer incidence rates stratified by anatomic subsite (colon or rectum), adenocarcinoma histology, race (non-Hispanic Black or non-Hispanic White), and sex for individuals aged 40 to 49 years, and yearly annual percent change (APC) incidence rates were calculated. Annual rate ratios (ARRs) between subgroups were determined. Statistical analysis was performed from January to March 2021. Early-onset colorectal cancer incidence rates, APCs, and ARRs. In this study, a total of 46 728 colorectal cancer cases were identified in 45 429 patients aged 40 to 49 years from 2000 to 2017. Among the 45 429 patients included in this study, 6480 (14.2%) were Black and 27 426 (60.4%) were White; the mean (SD) age was 45.5 (2.8) years. Among White individuals aged 40 to 49 years, colorectal adenocarcinoma incidence rates increased from 19.6 per 100 000 person-years in 2000 to 25.2 per 100 000 person-years in 2017 (APC, 1.6; 95% CI, 1.3 to 1.9). Among Black individuals aged 40 to 49 years, colorectal adenocarcinoma incidence rates were not significantly changed (26.4 per 100 000 person-years in 2000 and 25.8 per 100 000 person-years in 2017 [APC, -0.03; 95% CI, -0.5 to 0.5]). There were no significant differences in ARRs of absolute colorectal incidence rates between White and Black individuals from 2014 to 2017. Rectal-only absolute adenocarcinoma incidence rates in Black and White individuals remained similar from 2000 to 2008 but significantly diverged in 2009. As of 2017, rectal absolute incidence rates were 39% higher among White individuals than among Black individuals with increasing APC (APC, 2.2; 95% CI, 1.6 to 2.8) whereas rectal adenocarcinoma incidence rates among Black individuals were decreasing, although the APC was not statistically significant (APC, -1.4; 95% CI, -2.6 to 0.1). Absolute colonic adenocarcinoma incidence rates remained higher in Black individuals. The study subgroups with the largest divergence in APCs were rectal adenocarcinoma in White vs Black women (APC of 2.2 [95% CI, 1.6 to 2.8] vs APC of -1.7 [95% CI, -3.6 to 0.3], respectively). This study found that colorectal adenocarcinoma incidence rates in people aged 40 to 49 years were increasing among White individuals but stabilized among Black individuals with absolute incidence rates becoming equivalent. Absolute rectal adenocarcinoma incidence rates were 39% lower in Black individuals with a widening disparity in rectal cancer between White and Black women. Possible contributors include introduction of a screening threshold of age 45 years in Black individuals in 2008. Although the average-risk screening age has now shifted to age 45 years in all racial groups, these data can help motivate real-world implementation of guidelines to maximize screening rates that have historically been suboptimal in younger individuals.

“We ain’t nothing but white trash”: The ethnography of poor whites and the politics of stigma in Zora Neale Hurston’s Seraph on the Suwanee.

This article aims to demonstrate the documentary value of Zora Neale, Hurston’s descriptions, in her novel Seraph on the Suwanee, of the condition of the poor white US Southerners known as “crackers.” By, depicting a “cracker” woman’s upward social trajectory through, marriage, Hurston reveals the social and existential reality of this, segment of the white population. Her novel presents an objective, analysis of the crackers as a socio-historical group distinct from other, whites. However, Hurston also explores the subjective side of belonging to this discredited group by offering an account of her heroine’s experience of stigmatization.

Melanogenesis Markers Expression in Premature Graying of Hair: A Cross-Sectional Study

Background: Studies on mice and aging human hair follicles provide compelling evidence that graying of hair results from premature differentiation of melanocyte stem cells in the niche/bulge. Objective: The aim of this study was to analyze whether differentiation of melanocyte stem cells is responsible for premature graying of hair (PGH). Methods: Twenty-five patients with PGH (n = 25) attending the dermatology department were recruited. Five unpigmented and 5 pigmented hairs were obtained per patient by separating individual follicles after 1 mm punch biopsies. The hairs were dissected at a distance of 2 mm from the bulb to separate the stem cells (upper segment – US) from the melanocytes (lower segment – LS). RNA was extracted from hair follicle US and LS, and expression of GP100, tyrosinase (TYR), and tyrosinase-related protein-1 (TYRP1) genes was quantified using Qiagen one-step RT-PCR kit. Results: We found melanogenesis gene expression in both temporary (US) and permanent (LS) segments of unpigmented and pigmented hair follicles. When compared between the US and LS of white hair, the expression of TYR and GP100 was much higher in US than LS, suggestive of melanogenesis in the bulge. Similarly, when compared between white and black US, the expression of all 3 genes was higher in white US than black US, although not statistically significant. Limitations: Low samples size and lack of data pertaining to the expression of genes at protein level are the limitations of current study. Conclusion: Even though this pilot study data yielded key information about the expression of GP100, TYR, and TYRP-1 at the mRNA level, further studies quantifying the expression of these genes at protein level are needed to provide additional clues to further address the results in detail.

Conversations about race in Black and White US families: Before and after George Floyd’s death

Research has shown that Black parents are more likely than White parents to have conversations about race with their children, but few studies have directly compared the frequency and content of these conversations and how they change in response to national events. Here we examine such conversations in the United States before and after the killing of George Floyd. Black parents had conversations more often than White parents, and they had more frequent conversations post-Floyd. White parents remained mostly unchanged and, if anything, were less likely to talk about being White and more likely to send colorblind messages. Black parents were also more worried than White parents-both that their children would experience racial bias and that their children would perpetrate racial bias, a finding that held both pre- and post-Floyd. Thus, even in the midst of a national moment on race, White parents remained relatively silent and unconcerned about the topic.

Conversations about race in Black and White US families: Before and after George Floyd’s death

Research has shown that Black parents are more likely than White parents to have conversations about race with their children, but few studies have directly compared the frequency and content of these conversations and how they change in response to national events. Here we examine such conversations in the United States before and after the killing of George Floyd. Black parents had conversations more often than White parents, and they had more frequent conversations post-Floyd. White parents remained mostly unchanged and, if anything, were less likely to talk about being White and more likely to send colorblind messages. Black parents were also more worried than White parents-both that their children would experience racial bias and that their children would perpetrate racial bias, a finding that held both pre- and post-Floyd. Thus, even in the midst of a national moment on race, White parents remained relatively silent and unconcerned about the topic.

Socioeconomic status and psychological stress: Examining intersection with race, sex and US geographic region in the REasons for Geographic and Racial Differences in Stroke study.

Socioeconomic status (SES) is a well-established determinant of health. Disparities in stress are thought to partially account for SES-health disparities. We tested whether multiple indicators of SES show similar associations with psychological stress and whether race, sex, and geographic region moderate associations. Participants (n=26,451) are from a well-characterized national cohort of Black and White US adults aged 45 years or older. Psychological stress was measured using the 4-item perceived stress scale. Income was assessed as annual household income and education as highest level of education completed. Occupation was assessed during a structured interview and subsequently coded hierarchically. For all sex-race-region groups, the largest SES-stress associations were for income and the smallest were for occupation. Race moderated SES-stress associations, such that income and education were more closely associated with stress in Black adults than White adults. Additionally, education was more strongly associated with stress in individuals living in the stroke belt region. Black Americans with lower income and education reported greater psychological stress and may be at higher risk for disease through stress-related pathways. Thus, which SES indicator is examined and for whom may alter the magnitude of the association between SES and psychological stress.

Impact of Race on the In-Hospital Quality of Care Among Young Adults With Acute Myocardial Infarction.

BackgroundThe extent to which race influences in‐hospital quality of care for young adults (≤55 years) with acute myocardial infarction (AMI) is largely unknown. We examined racial disparities in in‐hospital quality of AMI care and their impact on 1‐year cardiac readmission.Methods and ResultsWe used data from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study enrolling young Black and White US adults with AMI (2008–2012). An in‐hospital quality of care score (QCS) was computed (standard AMI quality indicators divided by the total a patient is eligible for). Multivariable logistic regression was performed to identify factors associated with the lowest QCS tertile, including interactions between race and social determinants of health. Among 2846 young adults with AMI (median 48 years [interquartile range 44–52], 67.4% women, 18.8% Black race), Black individuals, especially women, exhibited a higher prevalence of cardiac risk factors and social determinants of health and were more likely to experience a non–ST‐segment–elevation myocardial infarction than White individuals. Black individuals were more likely in the lowest QCS tertile than White individuals (40.8% versus 34.7%; P=0.003). The association between Black race and low QCS (odds ratio [OR], 1.25; 95% CI, 1.02–1.54) was attenuated by adjustment for confounders. Employment was independently associated with better QCS, especially among Black participants (OR, 0.76; 95% CI, 0.62–0.92; P‐interaction=0.02). Black individuals experienced a higher rate of 1‐year cardiac readmission (29.9% versus 20.0%; P<0.0001).ConclusionsBlack individuals with AMI received lower in‐hospital quality of care and exhibited a higher rate of cardiac readmissions than White individuals. Black individuals had a lower quality of care if unemployed, highlighting the intersection of race and social determinants of health.

Cardiovascular Mortality and Hospitalization Risk with LDL by CKD Stage in African-American and White US Veterans

Cardiovascular Mortality and Hospitalization Risk with LDL by CKD Stage in African-American and White US Veterans

Prognostic implications of differences in forced vital capacity in black and white US adults: Findings from NHANES III with long-term mortality follow-up.

BackgroundBecause Forced Vital Capacity (FVC) is reduced in Black relative to White Americans of the same age, sex, and height, standard lung function prediction equations assign a lower "normal" range for Black patients. The prognostic implications of this race correction are uncertain.MethodsWe analyzed 5,294 White and 3,743 Black participants age 20–80 in NHANES III, a nationally-representative US survey conducted 1988–94, which we linked to the National Death Index to assess mortality through December 31, 2015. We calculated the FVC-percent predicted among Black and White participants, first applying NHANES III White prediction equations to all persons, and then using standard race-specific prediction equations. We used Cox proportional hazard models to calculate the association between race and all-cause mortality without and with adjustment for FVC (using each FVC metric), smoking, socioeconomic factors, and comorbidities.FindingsBlack participants’ age- and sex-adjusted mortality was greater than White participants (HR 1.46; 95%CI:1.29, 1.65). With adjustment for FVC in liters (mean 3.7 L for Black participants, 4.3 L for White participants) or FVC percent-predicted using White equations for everyone, Black race was no longer independently predictive of higher mortality (HR∼1.0). When FVC-percent predicted was “corrected” for race, Black individuals again showed increased mortality hazard. Deaths attributed to chronic respiratory disease were infrequent for both Black and White individuals.InterpretationLower FVC in Black people is associated with elevated risk of all-cause mortality, challenging the standard assumption about race-based normal limits. Black-White disparities in FVC may reflect deleterious social/environmental exposures, not innate differences.FundingNo funding.

The Epidemiology of Psoriatic Arthritis Over Five Decades: A Population-Based Study.

To determine the incidence of psoriatic arthritis (PsA) in a US population and describe trends in incidence and mortality over 5 decades. The previously identified population-based cohort that included Olmsted County, Minnesota residents ≥18 years of age who fulfilled PsA criteria during 1970-1999 was extended to include patients with incident PsA during 2000-2017. Age- and sex-specific incidence rates and point prevalence, adjusted to the 2010 US White population, were reported. There were 164 incident cases of PsA in 2000-2017 (mean ± SD age 46.4 ± 12.0 years; 47% female). The overall age- and sex-adjusted annual incidence of PsA per 100,000 population was 8.5 (95% confidence interval [95% CI] 7.2-9.8) and was higher in men (9.3 [95% CI 7.4-11.3]) than women (7.7 [95% CI 5.9-9.4]) in 2000-2017. Overall incidence was highest in the 40-59 years age group. The incidence rate was relatively stable during 2000-2017, with no evidence of an overall increase or an increase in men only (but a modest increase of 3% per year in women), compared to 1970-1999 when a 4%-per-year increase in incidence was observed. Point prevalence was 181.8 per 100,000 population (95% CI 156.5-207.1) in 2015. The percentage of women among those with PsA increased from 39% in 1970-1999 and 41% in 2000-2009 to 54% in 2010-2017 (P = 0.08). Overall survival in PsA did not differ from the general population (standardized mortality ratio 0.85 [95% CI 0.61-1.15]). The incidence of PsA in this predominantly White US population was stable in 2000-2017, in contrast to previous years. However, an increasing proportion of women with PsA was found in this study.

Gastric Cancer in Alaska Native and American Indian People Living in Alaska, 1990-2017.

Alaska Native (AN) people experience a high burden of gastric cancer compared with other US Native and non-Native populations. Previous reports have suggested that gastric cancer in AN people occurs at a younger age and is a more aggressive pathologic type. We evaluated all cases of gastric cancer in AN people from 1990 to 2017 and compared the epidemiologic and pathologic characteristics with the gastric cancers that occurred in the same time in the US white (USW) population. Cancer data were collected by the Alaska Native Tumor Registry and National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Comparisons were performed looking at the age and sex distribution of the affected AN and USW people, as well as the cancer characteristics, including the location, stage, and pathology. The age distribution was significantly different between AN and USW patients (P < 0.001), with a greater proportion of AN people diagnosed younger than 40 years (11% vs 3%, P < 0.0001) and 40-59 years (37% vs 20%, P < 0.0001). In addition, a greater proportion of AN people were diagnosed with distant stage cancer (AN: 48% and USW: 35%, P < 0.0001). The age-adjusted rate of gastric cancer in the AN population was significantly higher than the USW population (20.8 vs 6.7 per 100,000 persons, P < 0.0001). Although there has been a significant decrease in the gastric cancer incidence rate in the USW population, no significant change in incidence was seen in the AN population. This study highlights the disproportionate burden of gastric cancer in the AN population. Further work is needed to address and understand this disparity.

Development of an unannounced standardized patient protocol to evaluate opioid use disorder treatment in pregnancy for American Indian and rural communities

BackgroundOpioid use disorder (OUD) disproportionately impacts rural and American Indian communities and has quadrupled among pregnant individuals nationwide in the past two decades. Yet, limited data are available about access and quality of care available to pregnant individuals in rural areas, particularly among American Indians (AIs). Unannounced standardized patients (USPs), or “secret shoppers” with standardized characteristics, have been used to assess healthcare access and quality when outcomes cannot be measured by conventional methods or when differences may exist between actual versus reported care. While the USP approach has shown benefit in evaluating primary care and select specialties, its use to date for OUD and pregnancy is very limited.MethodsWe used literature review, current practice guidelines for perinatal OUD management, and stakeholder engagement to design a novel USP protocol to assess healthcare access and quality for OUD in pregnancy. We developed two USP profiles—one white and one AI—to reflect our target study area consisting of three rural, predominantly white and AI US counties. We partnered with a local community health center network providing care to a large AI population to define six priority outcomes for evaluation: (1) OUD treatment knowledge among clinical staff answering telephones; (2) primary care clinic facilitation and provision of prenatal care and buprenorphine treatment; (3) appropriate completion of evidence-based screening, symptom assessment, and initial steps in management; (4) appropriate completion of risk factor screening/probing about individual circumstances that may affect care; (5) patient-directed tone, stigma, and professionalism by clinic staff; and (6) disparities in care between whites and American Indians.DiscussionThe development of this USP protocol tailored to a specific environment and high-risk patient population establishes an innovative approach to evaluate healthcare access and quality for pregnant individuals with OUD. It is intended to serve as a roadmap for our own study and for future related work within the context of substance use disorders and pregnancy.

Patient and Hospital Factors Associated With Differences in Mortality Rates Among Black and White US Medicare Beneficiaries Hospitalized With COVID-19 Infection

Black patients hospitalized with COVID-19 may have worse outcomes than White patients because of excess individual risk or because Black patients are disproportionately cared for in hospitals with worse outcomes for all. To examine differences in COVID-19 hospital mortality rates between Black and White patients and to assess whether the mortality rates reflect differences in patient characteristics by race or by the hospitals to which Black and White patients are admitted. This cohort study assessed Medicare beneficiaries admitted with a diagnosis of COVID-19 to 1188 US hospitals from January 1, 2020, through September 21, 2020. Hospital admission for a diagnosis of COVID-19. The primary composite outcome was inpatient death or discharge to hospice within 30 days of admission. We estimated the association of patient-level characteristics (including age, sex, zip code-level income, comorbidities, admission from a nursing facility, and days since January 1, 2020) with differences in mortality or discharge to hospice among Black and White patients. To examine the association with the hospital itself, we adjusted for the specific hospitals to which patients were admitted. We used simulation modeling to estimate the mortality among Black patients had they instead been admitted to the hospitals where White patients were admitted. Of the 44 217 Medicare beneficiaries included in the study, 24 281 (55%) were women; mean (SD) age was 76.3 (10.5) years; 33 459 participants (76%) were White, and 10 758 (24%) were Black. Overall, 2634 (8%) White patients and 1100 (10%) Black patients died as inpatients, and 1670 (5%) White patients and 350 (3%) Black patients were discharged to hospice within 30 days of hospitalization, for a total mortality-equivalent rate of 12.86% for White patients and 13.48% for Black patients. Black patients had similar odds of dying or being discharged to hospice (odds ratio [OR], 1.06; 95% CI, 0.99-1.12) in an unadjusted comparison with White patients. After adjustment for clinical and sociodemographic patient characteristics, Black patients were more likely to die or be discharged to hospice (OR, 1.11; 95% CI, 1.03-1.19). This difference became indistinguishable when adjustment was made for the hospitals where care was delivered (odds ratio, 1.02; 95% CI, 0.94-1.10). In simulations, if Black patients in this sample were instead admitted to the same hospitals as White patients in the same distribution, their rate of mortality or discharge to hospice would decline from the observed rate of 13.48% to the simulated rate of 12.23% (95% CI for difference, 1.20%-1.30%). This cohort study found that Black patients hospitalized with COVID-19 had higher rates of hospital mortality or discharge to hospice than White patients after adjustment for the personal characteristics of those patients. However, those differences were explained by differences in the hospitals to which Black and White patients were admitted.

Evaluating Reddit as a Crowdsourcing Platform for Psychology Research Projects

Background: Online crowdsourcing platforms, such as Amazon Mechanical Turk (MTurk), have become popular alternatives to the ubiquitous student samples used in psychology research. r/SampleSize, an alternative pool on the website Reddit, allows for online participant recruitment without compulsory or immediate payment, making it potentially useful for students, research trainees, and course instructors. Objective: The current study sought to assess the viability of using r/SampleSize as a participant pool by comparing its data characteristics to MTurk and existing lab samples. Method: Two hundred and fifty-six MTurk workers and 277 r/SampleSize participants completed identical questionnaires on demographics, participation motivations, and standard psychology scales. Results: Participants recruited through r/SampleSize reported diverse ages, education levels, income, and employment, although White ethnic background and US residence were predominant. r/SampleSize participants were more internally motivated than MTurk to participate in research and had greater need for cognition but did not differ significantly in altruism or motivation to gain self-knowledge. r/SampleSize data reliability and quality were comparable to MTurk and lab samples across most analyses. Teaching Implications: r/SampleSize can be used to recruit relatively large and diverse samples for undergraduate research projects with minimal setup, labor, and cost. Conclusion: The findings suggest that r/SampleSize is a diverse and viable participant pool.

Epidemiology of cutaneous melanoma and keratinocyte cancer in white populations 1943–2036

ObjectivesCutaneous melanoma (CM) and keratinocyte cancer (KC) cause considerable morbidity and mortality. We analysed long-term trends of CM and KC in different white populations. Material and methodsAge-standardised (European Standard Population 2013) incidence and mortality rates (ASIR, ASMR) of CM were extracted from cancer registries in Denmark, New Zealand and the US SEER-Database. ASIRs of KC were sourced from registries of the German federal states Saarland and Schleswig–Holstein, and from Scotland. Age-period-cohort models were used to project melanoma incidence trends. ResultsIn Denmark between 1943 and 2016, melanoma ASIR increased from 1.1 to 46.5 in males, and from 1.0 to 48.5 in females, estimated to reach 60.0 and 73.1 in males and females by 2036. Melanoma mortality in Denmark (1951–2016) increased from 1.4 to 6.7 (males) and 1.2 to 3.7 (females). In New Zealand between 1948 and 2016, ASIR increased from 2.7 to 81.0 (males) and from 3.8 to 54.7 (females), slight declines are estimated by 2036 for both genders. Melanoma mortality increased six-fold in New Zealand males between 1950 and 2016; smaller increases were observed in females. We observed three- to four-fold increases in melanoma incidence in US whites, predicted to rise to 56.1 and 36.2 in males and females until 2036. Melanoma mortality also increased among US whites between 1970 and 2017, female melanoma mortality remained stable. Similar trends are shown for KC. ConclusionsIn white populations, incidence of CM and KC significantly increased. CM incidence continues to rise in the short term but is predicted to decline in future.

Abstract P011: Serum Adiponectin And Risk Of Incident Hypertension: The REasons For Geographic And Racial Differences In Stroke (REGARDS) Study.

Background: Hypertension is a leading cause of disability-adjusted life years lost in the United States. Adiponectin is a cytokine secreted by adipocytes that increases insulin sensitivity, maintains vascular homeostasis, and is inversely associated with adiposity. We sought to determine the risk of incident hypertension by level of adiponectin at baseline. Methods: The REasons for Geographic and Racial Differences in Stroke (REGARDS) study enrolled 30,239 Black and White US adults in 2003-2006, with a second visit ~9 years later. Adiponectin was measured at the baseline visit among a random sample of 4,400 participants who attended the second visit. Modified Poisson regression estimated the relative risk (RR) for incident hypertension by each 1 SD higher of log-transformed adiponectin level adjusting for age, race, and sex in a minimally adjusted model. The fully adjusted model added Southern Diet pattern, dietary ratio of sodium to potassium, BMI, waist circumference, and systolic blood pressure. Restricted cubic splines visualized RR of hypertension by level of adiponectin, relative to the median. Results: After excluding those with prevalent hypertension (threshold 140/90 mm Hg or blood pressure medication use; n=2477) and missing adiponectin (n =129), 1,877 participants remained (mean age 62 years, 49% male, 36% Black, with lower adiponectin in Black participants p&lt;0.001). Incident hypertension occurred in 46% (95% CI 43, 50%) of Black adults and 32% (29, 34%) of White adults. The RR for incident hypertension for each 1-SD higher log adiponectin was 0.91 (0.83, 1.00) in the demographic model and 0.99 (0.89, 1.10) in the fully adjusted model. Hypertension risk was similar across the continuum of adiponectin ( Figure ). Conclusions: In a cohort of Black and White US adults without hypertension, level of adiponectin did not associate with risk of incident hypertension 9 years later after adjusting for other hypertension risk factors.

Not a Country or a Stereotype: Latina LDS Experiences of Ethnic Homogenization and Racial Tokenism in the American West

The Church of Jesus Christ of Latter-Day Saints (LDS), also called Mormonism, has experienced rapid changes in its US demographics due to an influx of Latinx membership. The most recent growth in the US church body has been within Spanish-speaking congregations, and many of these congregant members are first or 1.5-generation immigrant Latinas. Using ethnographic data from 27 interviews with immigrant members living in Utah, Nevada, and California, LDS Latinas reported that while US Anglo members did seem to appreciate certain aspects of their cultural customs or practices, they also reported frequently experiencing ethnic homogenization or racial tokenization within US Church spaces and with White family members. Our findings indicate that the contemporary LDS church, despite some progressive policy implementations within its doctrinal parameters, still struggles in its ever-globalizing state to prioritize exposing White US members to the cultural heterogeneity of non-White, global LDS identities and perspectives. Latina LDS experiences and their religious adjacency to Whiteness provide a useful lens by which researchers can better understand the ways in which ethnic identity, gender, legal status, and language create both opportunities and challenges for immigrant incorporation and inclusion within US religious spaces and add to the existing body of scholarship on migration and religion.

Anne Case & Angus Deaton, Deaths of Despair and the Future of Capitalism

Anne Case and Angus Deaton in Deaths of Despair and the Future of Capitalism attribute much of the increase in white mortality in opioid overdose deaths to the US pharmaceutical industry and a failed US health care system. They extend human capital to health and economic progress outcomes unique to white US populations since the 1960s. Case and Deaton and Deaths of Despair add to this literature that links education, human capital, and white deaths of despair. Keywords. Monetary policy, Government, Good Government. JEL. B21, D00, D20, D40.

OP508 - Polygenic risk score-guided prostate cancer screening among white and Black US men: a Markov modeling study

OP508 - Polygenic risk score-guided prostate cancer screening among white and Black US men: a Markov modeling study