White Residents Research Articles

Abstract 4137878: Trends in Survival After Out-of-Hospital Cardiac Arrest Across Community Demographics Since the COVID-19 Pandemic

Background: The COVID-19 pandemic in 2020 was marked by a sharp decrease in out-of-hospital cardiac arrest (OHCA) survival. Whether OHCA survival has recovered to pre-pandemic levels, and whether changes in OHCA survival are similar across communities of different racial and ethnic composition, is unknown. Methods: We included adult patients with non-traumatic OHCA from 2015-2022 in the Cardiac Arrest Registry to Enhance Survival registry. Using hierarchical multivariable regression, we calculated risk-adjusted rates of survival to hospital discharge during 2015-2019 (reference period) and compared this to survival rates during 2020, 2021, and 2022. We also examined whether the trajectory of survival over this period differed based on the racial/ethnic composition of the community served by the emergency medical service (EMS) agency, defined as predominantly White (>80% White residents), majority Black or Hispanic (>50% Black or Hispanic residents), or integrated (neither). Results: Of 485,079 patients with OHCA, mean age was 61.9 years; 64% were male, and 22% were of Black race with 7% of Hispanic ethnicity. Overall, risk-adjusted survival rates to hospital discharge for OHCA decreased from 10.1% in 2015-2019 to 8.4% in 2020 (P<0.0001). The relative decrease was similar at EMS agencies serving predominantly Black and Hispanic communities (-17.2%) as compared to predominantly White (-17.5%) or integrated communities (-16.8%). Risk-adjusted survival rates recovered partially in 2021 (8.7%) and 2022 (8.9%) but remained below the pre-pandemic period. As of 2022, OHCA survival in majority Black and Hispanic communities was still 9.7% lower, as compared to pre-pandemic years, whereas it was 10.9% lower in integrated communities and 13.6% lower in predominately White communities. Moreover, the survival disparity for OHCAs in Black/Hispanic vs. White communities narrowed to 0.4% (8.4% vs. 8.8%) in 2022, as compared to 1.0% (9.3% vs. 10.3%) prior to the pandemic. Conclusions: OHCA survival has improved in the U.S. since the initial pandemic year of 2020, but remains lower than the pre-pandemic years. The survival disparity for OHCAs occurring in majority Black and Hispanic relative to predominately White communities decreased since 2020, although absolute survival remained lower in majority Black and Hispanic communities throughout the study period.

A study of Facebook comments regarding amber teething necklaces: insights into public perception.

To qualitatively analyse English-language Facebook comments pertaining to amber necklaces, aiming to explore user experiences, perceptions, and beliefs. A sample of 1000 comments, totalling 2309 sentences, was collected via CrowdTangle. Sociodemographic details and the time elapsed since comment were also recorded. Using QDAMiner software, a single investigator manually performed deductivecontent analysis, categorising each sentence based on a predefined list from the "Seeking Health-Related Information Online" model. WordStat software was employed to assess word clouds and cluster analyses. The majority of comments originated from white users (88.5%), females (92%), and residents of the United Kingdom (35.8%). Key terms included "teething," "amber," "baby," and "love," with "teething" central in four identified clusters on the main map. Predominantly, sentences were categorised as "information is useful or potentially useful" (25.29%) and "positive experiences from using the amber necklace" (17.11%). Over time, there was an increase in comments categorised as "receiver's doubts related to information" and "acquisition or intention to acquire the necklace." Conversely, comments related to safety concerns, fear of accidents, dentist contraindication, and information quality decreased. Facebook users actively engage with amber necklace content, frequently sharing positive experiences and recommending its use to other parents. Notably, concerns about associated risks appeared to diminish over time.

Shifts in Racial Inequalities and White Backlash in the 21st Century U.S.

Progress toward racial equality over the course of U.S. history has not been linear, and reductions in racial inequalities have historically been met with racist backlash. In the current research, we examine whether shifts in racial inequalities in key structural areas in recent decades can be used to predict implicit and explicit racial attitudes among White U.S. residents (N = 222,203). Consistent with the hypothesis that increasing racial equality is threatening, the majority of the statistically significant effects we observed indicated increased pro-White attitudes among White residents of states where racial inequalities decreased over time. State-level reductions in racial inequalities related to government assistance and employment-which have both been highly politicized-were predictive of greater pro-White attitudes among White U.S. residents. Overall, the current findings provide suggestive evidence that reductions in state-level racial inequalities may threaten the status quo, heightening pro-White attitudes among White U.S. residents.

Sex, Racial/Ethnic, and Regional Disparities in Pulmonary Embolism Mortality Trends in the USA, 1999-2020.

While the National Institutes of Health emphasize integrating sex as a biological variable into research, specific considerations of sex-related differences in pulmonary embolism (PE) mortality trends remain scarce. This study examines sex-based PE mortality trends across regional and demographic groups in the USA from 1999 to 2020. A retrospective analysis of National Center for Health Statistics mortality data from 1999 to 2020 was conducted. Using ICD-10 code I26, PE decedents were identified. Piecewise linear regression assessed sex-based temporal trends in PE mortality by age, race/ethnicity, and census region. Annual percentage changes and average annual percentage changes were derived using Weighted Bayesian Information Criteria. The 95% confidence intervals were estimated using the empirical quantile method. From 1999 to 2020, a total of 179,273 individuals died in the USA due to PE, resulting in an age-adjusted mortality rate of 2.5 per 100,000 persons (95% CI, 2.5-2.5). While men and women exhibited comparable rates in recent time segments and across most subcategories, a higher mortality trend among males compared to females was observed among non-Hispanic White and Hispanic individuals and residents of the Western US census region. These results remained robust even after excluding data from 2020, accounting for the potential impact of the COVID-19 pandemic. Our study highlights sex-based disparities in PE mortality trends in the USA from 1999 to 2020. Despite overall stable mortality rates, higher trends among males were evident in specific demographic groups and regions. These findings emphasize the importance of targeted interventions to mitigate PE-related mortality discrepancies across diverse populations.

The association between county-level premature cardiovascular mortality related to cardio-kidney-metabolic disease and the social determinants of health in the US.

Cardio-kidney-metabolic (CKM) syndrome is defined by the American Heart Association as the intersection between metabolic, renal and cardiovascular disease. Understanding the contemporary estimates of CKM related mortality and recent trends in the US is essential for developing targeted public interventions. We collected state-level and county-level CKM-associated age-adjusted premature cardiovascular mortality (aaCVM) (2010–2019) rates from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER). We linked the county-level aaCVM with a multi-component social deprivation metric: the Social Deprivation Index (SDI: range 0–100) and grouped them as follows: I: 0–25, II: 26–50, III: 51–75, and IV: 76–100. We conducted pair-wise comparison of aaCVM between SDI groups with the multiplicity adjusted Wilcoxon test; we compared aaCVM in men versus women, metropolitan versus nonmetropolitan counties, and non-hispanic white versus non-hispanic black residents. In 3101 analyzed counties in the US, the median CKM associated aaCVM was 61 [interquartile range (IQR): 45, 82]/100 000. Mississippi (99/100 000) and Minnesota (33/100 000) had the highest and lowest values respectively. CKM associated aaMR increased across SDI groups [I – 45 (IQR: 36, 55)/100 000, II- 61 (IQR: 49, 77)/100 000, III- 77 (IQR: 61, 94)/100 000, IV- 89 (IQR: 70, 110)/100 000; all pair-wise p-values < 0.001]. Men had higher rates [85 (64, 91)/100 000] than women [41 (28, 58)/100 000](p-value < 0.001), metropolitan counties [54 (40, 72)/100 000] had lower rates than non-metropolitan counties [66 (49, 90)/100 000](p-value < 0.001), and non-Hispanic Black [110 (86, 137)/100 000] had higher aaMR than non-Hispanic White residents [59 (44, 78)/100 000](p-value < 0.001). In the US, CKM mortality remains high and disproportionately occurs in more socially deprived counties and non-metropolitan counties. Our inability to reduce CKM mortality rates over the study period highlights the need for targeted policy interventions to curb the ongoing high burden.

Health Disparities and the Influence of Culturally Competent Care in Overall Health and Healthcare Utilization among Hispanics in a Southeastern US Community.

Introduction: This study sought to assess disparities in health/healthcare utilization for Hispanic immigrant community in Greenville County, SC. The study also assessed the role of culturally competent care perceptions on health/healthcare utilization within this growing community. Methods: Secondary administrative data collected by a large health care system in the county facilitated the assessment of health/healthcare utilization disparities using multivariate regression. Primary purposive surveys collected among Hispanic adults assessed culturally competent care perceptions and health/healthcare utilization. Culturally competent care measures included: (1) provider understanding, (2) provider communication behaviors, (3) provider assurance, and (4) interpreter service access. Results: Health disparities were present, with Hispanic residents having lower overall health and lower routine healthcare seeking behaviors compared to non-Hispanic White residents. Moreover, culturally competent care perceptions influenced overall health and healthcare-seeking behavior within this growing Hispanic community. Hispanic residents who perceived negative communication behaviors, lack of assurance, and increased interpretive service barriers reported lower overall health and lower routine healthcare seeking behaviors. Conclusions: Addressing potential cultural competency barriers may reduce health disparities among underrepresented racial/ethnic communities as they grow and become established in the Southeast, while also improving broader health equity for all communities.

Racial differences in the quality of care interactions among nursing home residents with dementia

ABSTRACT Objective The resident population in nursing homes is increasingly racially diverse. The purpose of this study was to assess racial differences in the quality of care interactions among nursing home residents with dementia. Design The study utilized baseline data from the Testing the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD), a randomized controlled pragmatic trial. The Quality of Interaction Scale (QuIS) was used to measure quality of staff-resident care interactions. The sample included 531 residents. An analysis of covariance was conducted to address the aim. Results The majority of interactions were positive social (42%) or positive care (37%). Black residents living with dementia had higher QuIS scores (M = 5.98, SD = 1.66) than White residents with dementia (M = 5.40, SD = 1.75), whereas higher QuIS scores indicating more positive interactions. However, the results of the analysis of covariance indicated that there was not a significant difference in QuIS scores between Black versus White residents living with dementia (p =.203). Conclusion The findings suggest that care interactions in nursing homes are consistent between Black residents and White residents. Future research should evaluate the impact of staff race on the quality of care interaction among nursing home residents.

Highway Removal vs. Highway Redesign

Reconnecting The Best Planned City This is a moment in time, a crossroads even, when public planning processes will either continue to capitulate to the unilateral assumption of retaining existing highways, expressways and transportation corridors, or to insist on a common sense case-by-case approach whereby a clean slate evaluation is started for every transportation project. In Buffalo, New York, where thousands of lives and billions of dollars in future urban developments are at stake, an unbiased approach to evaluating crumbling transportation infrastructures has become an urgent and critical need. In particular, the Kensington Expressway - Route 33 (hereinafter referred to as “Expressway”) is at an advanced age; it was initially constructed as an urban renewal and racism-by-design highway that gutted the East Side of Buffalo in the 1960s. The East Side, an area that is home to over 80% of all Black Buffalonians, was once graced with the Humboldt Parkway. Landscaped by Frederick Law Olmsted, who proclaimed Buffalo to be “the best planned city, as to streets, public places, and grounds, in the United States, if not in the world,” Humboldt Parkway was an idyllic greenscape and oasis for recreation, fellowship, and active living that was demolished and replaced by the Expressway (Figure A) (Supplemental Figures 1 and 2).[1] Now, the Expressway is a constant source of noise and air pollution. These environmental hazards are deleterious to human health and wellbeing as well as the climate and sustainability. Specifically, fine particulate matter (PM2.5), a modulator and contributor of the climate crisis, is 26% to 28% above average on the East Side compared to the entire Buffalo and Niagara region.[2-6] Vehicular emissions, including PM2.5, have contributed to disparately high rates of chronic diseases and illnesses, such as asthma, heart disease, cancers, mental disorders, and even a five to ten year shorter life expectancy among Black vs. White Buffalo residents.[7, 8] The University at Buffalo (UB) Department of Architecture Small Built Works class documented these conditions specifically to Humboldt Parkway neighborhoods using the U.S. Environmental Protection Agency (U.S. EPA) Environmental Justice Screen Tool (Supplemental Figure 3-5). Furthermore, the New York State Department of Environmental Conservation (DEC) just released the Community Air Quality Initiative conducted in 2021-2022. This report revealed that levels of PM2.5 are highest in Buffalo and “Above Focus Spot Threshold” especially in Hamlin Park and Trinidad, neighborhoods that straddle the Expressway and Scajaquada Expressway - Route 198 (Supplemental Figure 6).[5] Just last year, the New York State Department of Transportation (NYSDOT) released the Expressway Draft Design Report/Environmental Assessment (DDR/EA) and in Appendix D7, projected vehicle exhaust plumes were depicted spewing 900-feet out each portal end (Supplemental Figure 7). The UB Small Built Works class overlaid these NYSDOT’s projected plumes back onto the neighborhoods with pin-mapped locations of schools, churches, medical, and youth facilities (Supplemental Figure 8). These stakes and costs, namely the health of East Side communities, are too high to default to a one-size-fits-all approach for highway remediation. Based on these unique set of circumstances in Buffalo, we developed a five tier Transportation Infrastructure Evaluation System (TIES), an objective set of criteria for the remediation and/or maintenance of any given transportation corridor, especially urban highways. “Tier One – Complete Highway Removal” describes what is needed in Buffalo for basic health, and environmental, social, and transportation justice. Building on what we have learned in our own advocacy, this paper presents TIES, which could contribute to a nationwide discussion for setting highway maintenance and evaluation criteria. Additionally, TIES could move the needle towards a standardization of criteria that will be essential for all impending human health and global sustainability issues in the upcoming decades. These intersecting points of concern, although magnifying, are not new. But, in order to fully understand the breadth and depth of said issues, it is necessary to take a step back and review how we got to this point.

Race and Sex Disparities Among Emergency Medicine Chief Residents

Physicians who belong to minoritized racial and ethnic groups remain underrepresented and underpromoted. Serving as a chief resident is an important position of leadership and prestige, and indicates a benchmark for future professional success. However, it is unknown if disparities in race and/or sex exist in the chief resident selection process. To describe race, ethnicity, and sex of emergency medicine (EM) chief residents and determine the association of racial identity and the intersectionality of race and sex for selecting chief residents in US emergency medicine departments. This cohort study analyzed data collected from the Association of American Medical Colleges and the Electronic Residency Application Service in the graduating classes of 2017 and 2018. Data were analyzed between December 2021 and January 2023. Relative risk (RR) of selection for chief residency for Black, Asian, and Hispanic EM residents in comparison with White counterparts. Among 3408 studied residents, 738 (21.7%) served as chief resident (2253 male [66.1%]; 451 Asian [13.2%], 144 Black [4.2%], 158 Hispanic [4.6%], 239 more than 1 race [7.0%], 46 other [1.3%], and 2370 White [69.5%]). Of chiefs, 81 (11.0%) identified as Asian, 17 (2.3%) as Black, and 26 (3.5%) Hispanic. Asian residents were 78% (95% CI, 63%-96%) as likely to be promoted to chief resident compared with White peers, and Black residents were 51% (95% CI, 32%-80%) as likely as White residents. In our fully adjusted model, racial differences remained significant for Black residents, who were half as likely as white residents to be selected for chief residency (adjusted risk ratio [aRR], 0.55; 95% CI, 0.36-0.82). Overall, White women were most likely to be selected for chief residency and 20% more likely to be selected than White men counterparts (aRR, 1.20; 95% CI, 1.03-1.39). In comparison, women underrepresented in medicine (a category that included residents identified as Black, Hispanic, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander) were least likely to be selected for chief promotion, and 50% as likely to be selected for chief resident compared with White men (aRR, 0.50; 95% CI, 0.06-0.66). In this 2024 nationally representative study of EM residents, chief promotion was lower among residents identifying as Asian or Black, and in particular, women underrepresented in medicine. This study's findings suggest further review of chief resident selection process by residency programs and accreditation bodies is needed to ensure workforce equity for promotion and opportunities for leadership.

The Mental Health Consequences of George Floyd's Murder in Minneapolis in Black, Latine, and White Communities.

The high-profile police murder of George Floyd is likely to have an aftermath of negative health consequences, particularly among Black people. Our study evaluates the impact of the murder of Mr. Floyd on mental health in Black, Latine, and white communities in Minneapolis, Minnesota. We constructed a panel dataset merging data from the Minnesota Hospital Association, Minnesota Department of Natural Resources, Minneapolis Police Department, and American Community Survey. First, we specify an overall and racial subgroup autoregressive interrupted time-series design to identify the impact of the murder on rates of mental health hospital discharge at the city-level. We then examine the spatial heterogeneity in the impact of the murder by specifying zip code tabulation area (ZCTA)-level panel models. We find a 0.23 per 1,000 increase in mental health conditions among Black people in the immediate post-murder period, followed by a weekly decline (-.007) in mental health diagnoses. We do not find a substantial rate increase in White or Latine residents. Further, our analyses at the ZCTA-week-level corroborate these findings, while showing that the increase for Black residents was global. These findings speak to the traumatizing effects of police violence and the short- and longer-term public health consequences for Black communities.

Evaluating the Impact of Gender and Race on Otolaryngology Resident Experiences Across the United States.

Otolaryngology residents often encounter work-related stress and challenges during training. Sociodemographic factors influence experiences during residency; however, the impact of race and gender on otolaryngology trainee well-being during residency remains understudied. Online survey. US residency programs. An anonymous online survey consisting of 59 multiple-choice questions was sent to 104 directors of Accreditation Council for Graduate Medical Education otolaryngology residency programs to distribute to residents. Respondents were queried regarding demographics and experiences with bias. Residents self-identified gender and race. Black, Hispanic/Latinx, Middle Eastern/North African, and multiracial residents were categorized as underrepresented minorities (URM). Sixty-oneUS otolaryngology residents responded to the survey, the majority of whom were women (60.7%) and white (62%). Many residents endorsed a belief that receipt of research and training opportunities was negatively impacted by bias due to race (29.5%) or gender (45.9%). More women (27%) than men (13%) reported maximal burnout, and fewer men (17.4%) than women (40.5%) expressed low confidence in ability to independently care for patients. More male (47.8%) and white (31.6%) residents strongly agreed they were thriving. 94.6% of women and 33.3% of URM residents reported being mistaken for a nonphysician, compared to 0% of white male respondents. Otolaryngology residents perceived differential treatment based on race and gender, with women and URM residents experiencing greater exclusion and bias, as well as increased misidentification and decreased ability to thrive. Future work includes increasing sample size for generalizability and developing interventions that uphold equity in residency training environments.

"Life as We Knew It": Continued Challenges in Getting Up-to-Date COVID-19 Vaccinations Amongst Black and Latinx Michigan Residents.

Minority communities are disproportionately impacted by COVID-19. In Michigan in 2024, 59% of Latinx residents, 46% of Black residents, and 57% of White residents have received at least one dose of the vaccine. However, just 7% of Black residents and 6% of Latinx residents report being up-to-date per CDC definition, versus 13% of White residents. Drawing from protection motivation theory, we aimed to identify barriers to COVID-19 vaccination. Interviews with 24 Black and 10 Latinx Michigan residents self-reported as not up-to-date (n = 15) or up-to-date (n = 19) on COVID-19 vaccines were conducted in 2022-2023. We used a community-based participatory approach in collaboration with 16 leaders from 15 organizations to develop research questions, interview protocols, and methods for data collection and analysis. Thematic coding of interviews was conducted. Findings indicate participants' lack of confidence in the COVID-19 vaccine's efficacy, with those not up-to-date expressing greater doubt. Participants were also concerned about vaccine benefits versus risks, safety, and side effects. Distrust in medicine, confusion about public health guidelines, and conspiracy theories were often reported. Younger unvaccinated individuals cited low health risk as reason to remain unvaccinated. Many participants felt that health education, especially through medical professionals, was beneficial. There is great need for more data to make informed decisions given ongoing lack of understanding of the public health benefits of COVID-19 vaccination. Identifying drivers of vaccine uptake, particularly boosters, in communities of color and developing age-appropriate and culturally responsive interventions to increase vaccination rates are of utmost importance.

COVID-19 vaccine uptake inequality among older adults: A multidimensional demographic analysis

Age, race, ethnicity, and sex are important determinants of coronavirus disease of 2019 (COVID-19) outcomes. Older adults (65 years and older) are at the highest risk of COVID-19 morbidity and mortality. Analyzing their vaccine uptake by subclassifying demographics is rare and can assist vaccination policies. This study investigates COVID-19 dose 1and 2vaccine uptakes among them by race, ethnicity, and sex. Immunization registry data were used to calculate temporal changes in older adults' COVID-19 vaccine uptake by race, ethnicity, race-sex, and ethnicity-sex in Kentucky's most populous county, Jefferson County, during the first 6 quarters of the COVID-19 vaccination program. By May 2022, the county's Asian residents had the highest dose 1 and 2 vaccination rates (97.0% and 80.4%), then White residents (90.0% and 80.2%). Black residents had one of the lowest COVID-19 vaccination rates (87.3% and 77.3%). The rate among Hispanic residents (82.0% and 66.4%) was considerably lower than non-Hispanic residents (90.2% and 80.1%). The rates were consistently lower in males. Racial, ethnic, and sex-based COVID-19 vaccine inequalities were largely maintained during the study period. Vaccine rollout practices and promotional programs should aim to boost the uptake of the COVID-19 vaccination among racial minority and male older adults.

Evaluating the Impact of Gender, Race, and Training Year on Internal Medicine Residents' Experiences Across the United States.

Prior studies have highlighted experiences of bias within resident training based on trainees' gender and race and high rates of burnout. However, few studies have addressed the intersection between bias and wellness for residents in internal medicine (IM) programs. This study explores how race, gender, and training year affect IM residents' bias experiences and well-being. An anonymous survey with questions evaluating demographics and resident experiences of bias and perceptions of wellness and self-efficacy was distributed to 596 IM programs across the United States. Sixty-nine programs sent out the survey to their IM residents. Respondents to the survey included 176 residents. Descriptive analyses and χ2 tests were performed. Responses demonstrated that gender and race impacted residents' experiences with bias and misidentification. Eighty-eight percent of women compared to 1% of men, and 89% of Black residents compared to 3% of White residents reported being misidentified as a nonphysician due to gender and race, respectively. Degrees to which residents felt they were thriving in residency, experiencing burnout, and utilizing their strengths varied significantly by gender. Residents' self-perceived burnout levels were associated with being misidentified as not being a physician due to race. Experiences with bias also increased significantly with training year. This study provides important insights into the impact of gender, race/ethnicity, and training year on IM residents' experiences with bias and self-perception. The findings emphasize the need for structural changes within IM residency programs to reduce experiences of bias and to better cultivate the wellness of residents.

Whose sidewalk is it? Street vendors and the battle for San Diego’s foodscape

ABSTRACT Urban governments have become increasingly involved in gastrodevelopment, managing and monitoring foodscapes to stimulate growth. In that context, sidewalk vendors’ access to urban space has been fiercely debated in many cities. Stressing their informality, some argue that vendors activate public space, provide valuable services, and encourage entrepreneurship, while others emphasize the threats they pose to public safety, health, and competing businesses. This paper examines the motives behind San Diego’s restrictive sidewalk vending ordinance and assesses its impact on different types of vendors and neighborhoods across the city. Using mixed methods, including analyses of city records, census and online data, stakeholder interviews, and a 2022 survey of sidewalk and food truck vendors, we map the social geographies of street vending in San Diego and analyze their unevenness in the context of neoliberal urbanism, manifested in state-sanctioned gentrification, gastrodevelopment, increased policing of public space, and racial exclusion. Our findings show that instead of improving community food security and supporting immigrant microentrepreneurs, San Diego’s sidewalk vending ordinance privileges the demands of affluent and primarily white residents, resulting in an uneven street foodscape in which vending is mostly prohibited in exclusive areas, heavily managed in gentrifying areas, and merely tolerated in low-income areas.

Demographic and geographic distribution of diabetes and pre-diabetes risk in rural settings: results from a cross-sectional, countywide rural health survey in Sullivan County, New York

ObjectiveTo perform a detailed characterisation of diabetes burden and pre-diabetes risk in a rural county with previously documented poor health outcomes in order to understand the local within-county distribution of...

Neighborhood Racial Composition and Unequal Exposure to Violent Crime in Everyday Contexts.

Exposure to violence is a critical aspect of contemporary racial inequality in the United States. While extensive research has examined variations in violent crime rates across neighborhoods, less attention has been given to understanding individuals' everyday exposure to violent crimes. This study investigates patterns of exposure to violent crimes among neighborhood residents using cell phone mobility data and violent crime reports from Chicago. The analysis reveals a positive association between the proportion of Black residents in a neighborhood and the level of exposure to violent crimes experienced by residents. Controlling for a neighborhood's level of residential disadvantage and other neighborhood characteristics did not substantially diminish the relationship between racial composition and exposure to violent crimes in everyday life. Even after controlling for violence within residents' neighborhoods, individuals residing in Black neighborhoods continue to experience significantly higher levels of violence in their day-to-day contexts compared to those living in White neighborhoods. This suggests that racial segregation in everyday exposures, rather than residential segregation, plays a central role in racial inequality in exposure to violence. Additionally, the analysis suggests that neighborhoods with more Hispanic and Asian residents are exposed to less and more violent crime, respectively, compared to neighborhoods with more White residents. However, this is only observed when not adjusting for the volume of visits points of interest receive; otherwise, the finding is reversed. This study offers valuable insights into potentially novel sources of racial disparities in exposure to violent crimes in everyday contexts, highlighting the need for further investigation.

Neighborhood racial income inequality and cognitive health.

Neighborhood socioeconomic status (SES) has been linked to dementia, but the distribution of SES within a neighborhood may also matter. Data from 460 (47% Black, 46% White) older adults from the Michigan Cognitive Aging Project were linked to census tract-level data from the National Neighborhood Data Archive (NaNDA). Neighborhood SES included two composites reflecting disadvantage and affluence. Neighborhood racial income inequality was the ratio of median incomes for White versus Black residents. Generalized estimating equations examined associations between neighborhood factors and cognitive domains. Neighborhood racial income inequality was uniquely associated with worse cognitive health, and these associations did not differ by participant race. Neighborhood disadvantage was only associated with worse cognitive health among Black participants. Both the level and racial distribution of SES within a neighborhood may be relevant for dementia risk. Racial differences in the level and impact of neighborhood SES contribute to dementia inequalities. Black participants lived in neighborhoods with lower socioeconomic status (SES) than White participants, on average. Neighborhood SES and racial income inequality were associated with worse cognition. Effects of neighborhood racial income inequality did not differ across racial groups. Effects of neighborhood SES were only evident among Black participants.

Getting the Race Wrong: A Case Study of Sampling Bias and Black Voters in Online, Opt-In Polls

Abstract Researchers are increasingly reliant on online, opt-in surveys. But prior benchmarking exercises employ national samples, making it unclear whether such surveys can effectively represent Black respondents and other minorities nationwide. This paper presents the results of uncompensated online and in-person surveys administered chiefly in one racially diverse American city—Philadelphia—during its 2023 mayoral primary. The participation rate for online surveys promoted via Facebook and Instagram was .4%, with White residents and those with college degrees more likely to respond. Such biases help explain why neither our surveys nor public polls correctly identified the Democratic primary’s winner, an establishment-backed Black Democrat. Even weighted, geographically stratified online surveys typically underestimate the winner’s support, although an in-person exit poll does not. We identify some similar patterns in Chicago. These results indicate important gaps in the populations represented in contemporary opt-in surveys and suggest that alternative survey modes help reduce them.

Paradoxical Effects of Income and Income Inequality on Racial Health Disparities.

The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a higher percentage of White residents, indicative of greater income inequality, show stark differences in health outcomes between Black and White populations. This disparity underscores how conditions diverge more sharply between Black and White individuals in wealthier urban areas. This phenomenon suggests a complex and sometimes counterintuitive relationship among race, place, income, and income inequality in shaping racial health disparities. These dynamics have significant policy implications. Addressing health disparities requires nuanced strategies that recognize the multiplicative effects of race and income inequality on health outcomes. Policies focusing on areas with a high disease burden, such as Detroit, Philadelphia, and Baltimore can effectively mitigate disparities both locally and more broadly. Conversely, interventions targeting regions with lower disease prevalence, but higher racial disparities must be approached carefully to avoid exacerbating inequalities. In conclusion, understanding and addressing the complex drivers of health disparities demand comprehensive approaches that acknowledge the intertwined influences of race, income, and place. By prioritizing interventions that address economic disparities alongside health initiatives, policymakers can foster more equitable health outcomes across diverse communities.