Minority Health and Health Equity Archive

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10 best resources for . . . health research capacity strengthening
(2007) Nuyens, Yvo
Health research capacity strengthening (RCS) is widely recognized as a major unmet need, particularly in low- and middle-income countries (Lansang and Dennis 2006). It has been high on both national and international agendas for the past 20 years, as evidenced by a steady stream of peer-reviewed and grey literature, training tools, programmes, grants, workshops, task forces and conferences. Defined as ‘. . . the ongoing process of empowering individuals, institutions, organizations and nations to define and prioritize problems systematically, to develop and scientifically evaluate appropriate solutions, and share and apply the knowledge generated’ (Lansang and Dennis 2004), RCS encompasses a broad and complex spectrum of activities, including training programmes, tools and grants. In addition, anyone embarking on an RCS programme needs to address broader issues of which and whose capacities to strengthen, to do what, in which context and with which purpose.
100 Years Later, a Painful Episode Is Observed at Last
(The New York Times, 2006) Dewan, Shaila
Two years ago, Saudia Muwwakkil, the director of communications for the Martin Luther King Jr. National Historic Site, invited community leaders to discuss how to mark the 100th anniversary of a 1906 race riot in which mobs of whites descended on the city's black residents. The racial strife shut down Atlanta for four days and ended with the bodies of black men hanging from trees and streetlights. But of those Ms. Muwwakkil called, almost none had heard of it.
20-Year Outcomes Following Conservative Management of Clinically Localized Prostate Cancer
(2005) Albertson, Peter C; Hanley, James A; Fine, Judith
Context: The appropriate therapy for men with clinically localized prostate cancer is uncertain. A recent study suggested an increasing prostate cancer mortality rate for men who are alive more than 15 years following diagnosis. Objective: To estimate 20-year survival based on a competing risk analysis of men who were diagnosed with clinically localized prostate cancer and treated with observation or androgen withdrawal therapy alone, stratified by age at diagnosis and histological findings. Design, Setting, and Patients: A retrospective population-based cohort study using Connecticut Tumor Registry data supplemented by hospital record and histology review of 767 men aged 55 to 74 years with clinically localized prostate cancer diagnosed between January 1, 1971, and December 31, 1984. Patients were treated with either observation or immediate or delayed androgen withdrawal therapy, with a median observation of 24 years. Main Outcome Measures: Probability of mortality from prostate cancer or other competing medical conditions, given a patient’s age at diagnosis and tumor grade. Results: The prostate cancer mortality rate was 33 per 1000 person-years during the first 15 years of follow-up (95% confidence interval [CI], 28-38) and 18 per 1000 personyears after 15 years of follow-up (95% CI, 10-29). The mortality rates for these 2 follow-up periods were not statistically different, after adjusting for differences in tumor histology (rate ratio, 1.1; 95% CI, 0.6-1.9). Men with low-grade prostate cancers have a minimal risk of dying from prostate cancer during 20 years of follow-up (Gleason score of 2-4, 6 deaths per 1000 person-years; 95% CI, 2-11). Men with high-grade prostate cancers have a high probability of dying from prostate cancer within 10 years of diagnosis (Gleason score of 8-10, 121 deaths per 1000 person-years; 95% CI, 90-156). Men with Gleason score of 5 or 6 tumors have an intermediate risk of prostate cancer death. Conclusion: The annual mortality rate from prostate cancer appears to remain stable after 15 years from diagnosis, which does not support aggressive treatment for localized low-grade prostate cancer.
2005 National Healthcare Disparities Report
(Agency for Healthcare Research and Quality, 2005) UNSPECIFIED
Key Themes and Highlights From the National Healthcare Disparities Report Twenty years ago, the Department of Health and Human Services (HHS) released the Report of the Secretary’s Task Force on Black and Minority Health. That report documented many disparities in health and led to interventions to improve the health and health care of minorities. This year, the Agency for Healthcare Research and Quality (AHRQ) is pleased to release the third National Healthcare Disparities Report (NHDR). This annual report provides a comprehensive national overview of disparities in health care among racial, ethnic, and socioeconomic groups in the general U.S. population and within priority populations and tracks the success of activities to reduce disparities. It is a companion report to the National Healthcare Quality Report (NHQR), a comprehensive overview of quality of health care in America. A major advantage of an annual report series is its ability to track changes over time. This year, data are presented that begin tracking trends across a broad array of measures of health care quality and access for many racial, ethnic, and socioeconomic groups. In addition, the 2005 report begins to examine the issue of whether the Nation is making progress toward eliminating health care disparities. The NHDR tracks disparities in both quality of health care and access to health care. Measures of health care quality mirror those in the NHQR and encompass four dimensions of quality—effectiveness, patient safety, timeliness, and patient centeredness. Measures of health care access are unique to this report and encompass two dimensions of access—facilitators and barriers to care and health care utilization.
2005 Northwest Health Gap Study
(2005) Northwest Federation of, Community Organizations (NWFCO)
Between high wage earners who have comprehensive employer-based health benefits, and the low income people who are covered through public health programs, lies a rapidly growing population with no coverage or inadequate coverage. These people are in the health gap. Increasing numbers of people are falling into this gap in health coverage, where they are underinsured or uninsured. Employer-based health coverage is declining. Cost sharing is rising for those with employer-based coverage and those who purchase health care on the individual market. More people are covered by minimal plans with high deductibles.
2007 Health Disparities Report to the Michigan Legislature
(2007) UNSPECIFIED
Health disparities are differences in the incidence, prevalence, mortality, burden of disease and other adverse health conditions or outcomes that exist among specific population groups in the United States. In Michigan, as in the United States, racial and ethnic minority populations carry a disproportionately heavy burden due to health disparities. This burden is manifested in increased risk for disease, delayed diagnosis, inaccessible and inadequate care, poor health outcomes and untimely death, much of which are preventable.
2010 National Healthcare Quality & Disparities Reports
(2011) Clancy, Carolyn; Munier, William; Crosson, Katherine; Moy, Ernest; Ho, Karen; Freeman, William; Bonnett, Doreen
For the eighth year in a row, the Agency for Healthcare Research and Quality (AHRQ) has produced the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care. New this year are chapters on care coordination, health system infrastructure. The reports present, in chart form, the latest available findings on quality of and access to health care. The National Healthcare Quality Report tracks the health care system through quality measures, such as the percentage of heart attack patients who received recommended care when they reached the hospital or the percentage of children who received recommended vaccinations. The National Healthcare Disparities Report summarizes health care quality and access among various racial, ethnic, and income groups and other priority populations, such as residents of rural areas and people with disabilities. The reports have been revised based on recommendations from the Institute of Medicine that can be found in their report, Future Directions for the National Healthcare Quality and Disparities Reports.
2011 KIDS COUNT Data Book: America’s Children, America’s Challenge: Promoting Opportunity for the Next Generation
(2011) Annie E. Casey, Foundation
This year’s essay, "America’s Children, America’s Challenge: Promoting Opportunity for the Next Generation," explores how kids and families are faring in the wake of the recession and why it’s important to help children reach their full potential and become part of a robust economy and society
2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk
(Journal of American College of Cardiology, 2013) Eckel, Robert
4 things the Black population needs to know about COVID-19
(UC Davis Health, 2022-02-02) UC Davis Health
$4.8 Million Awarded to Pitt’s Center for Minority Health to Fund Health Disparities Research
(2007) UNSPECIFIED
PITTSBURGH, November 8, 2007 The Center for Minority Health (CMH) in the Graduate School of Public Health (GSPH) at the University of Pittsburgh has been awarded a five-year, $4.8 million grant to establish a Research Center of Excellence in Minority Health Disparities by the National Center on Minority Health and Health Disparities, a part of the National Institutes of Health (NIH). The new multi-year grant positions CMH as a national center of excellence in translating evidence-based research into community based interventions designed to prevent disease and promote health in Pittsburgh's African-American community.
5 Diseases More Common in Minorities
(2011) CAROLLO, KIM
Although more and more people are living longer with colorectal cancer, new research has found that black people with the disease aren't living as long as whites. In an analysis of more than 14,000 patients with stage 2 and 3 colorectal cancer who had surgery to remove tumors, followed by treatment to prevent recurrence, the 1,218 African-American patients had a lower five-year survival rate than their white counterparts, according to researchers, led by Greg Yothers of the National Surgical Adjuvant Breast and Bowel Project Biostatistical Center in Pittsburgh. Five years after diagnosis, 72.8 percent of white patients survived cancer, but…
5 health experts reveal the simple pleasures of life after being vaccinated
(The Independent, 2021-03-11) Sun, Lena H.
A barber-based intervention for hypertension in African American men: Design of a group randomized trial
(2009) VICTOR, R; RAVENELL, J; FREEMAN, A; BHAT, D; STORM, J; SHAFIQ, M; KNOWLES, P; HANNAN, P; HALEY, R; LEONARD, D
BACKGROUND: Barbershops constitute potential sites for community health promotion programs targeting hypertension (HTN) in African American men but such programs previously have not been formally evaluated. METHODS: A randomized trial (ClinicalTrials.gov no. NCT00325533) will test whether a continuous HTN detection and medical referral program conducted by influential peers (barbers) in a receptive community setting (barbershops) can promote treatment-seeking behavior and thus lower blood pressure (BP) among the regular customers with HTN. Barbers will offer a BP check with each haircut and encourage appropriate medical referral using real stories of other customers modeling the desired behaviors. A cohort of 16 barbershops will go through a pretest/posttest group-randomization protocol. Serial cross-sectional data collection periods (10 weeks each) will be conducted by interviewers to obtain accurate snapshots of HTN control in each barbershop before and after 10 months of either barber-based intervention or no active intervention. The primary outcome is BP control: BP <135/85 mm Hg (nondiabetic subjects) and <130/80 mm Hg (diabetic subjects) measured in the barbershop during the 2 data collection periods. The multilevel analysis plan uses hierarchical models to assess the effect of covariates on HTN control and secondary outcomes while accounting for clustering of observations within barbershops. CONCLUSIONS: By linking community health promotion to the health care system, this program could serve as a new model for HTN control and cardiovascular risk reduction in African American men on a nationwide scale.
A call to action.
(2001) Kirschstein, R L; Ruffin, J
While the diversity of the American population is one of the nation’s greatest assets, the profound disparity in health status across racial and ethnic populations is one of its greatest challenges. The country has entered the 21st century with such scientific and technological bounty that we should and must be able to assure good health and long life to all citizens. While the promise of health and longevity is a reality for millions of Americans, it is not for others. There are many examples: the number of African American men and particularly women with AIDS has increased substantially; Hispanic women are the least likely to use preventive services such as the Pap test, mammography, and clinical breast examination; the prevalence rate of diabetes among American Indians and Alaska Natives is more than twice that for the total U.S. population.
A chronicle of racism: the effects of the white medical community on black health
(1992) Charatz-Litt, Cynthia
At no time in history has the health of black Americans equaled that of white Americans. This distinction is particularly evident in the South, where blacks have been subjected to governmental policies promoting discrimination and segregation. The explanations offered for this difference in health status are numerous. The argument presented in this article is that the health status of blacks in the United States has been greatly affected by the attitudes and perceptions of white physicians. From the days of slavery to 1992, the policies and practices of the white medical community have had an enormous impact on the health of blacks. Black physicians have played a large role in changing the delivery of health-care services to the black population. Their fight was a microcosm of the Civil Rights activities taking place in the world around them. This article describes the history of medical care as it relates to black patients and physicians. The progress that has been made over the past century is analyzed, and the need for continued education and persistence is emphasized. Legalized segregation may have been outlawed in the 1960s, but the nation's vital statistics indicate that equality has yet to be achieved.
A church-based diabetes self-management education program for African Americans with type 2 diabetes.
(2006) Samuel-Hodge, Carmen D; Keyserling, Thomas C; France, Renaé; Ingram, Allyson F; Johnston, Larry F; Pullen Davis, Lisa; Davis, Gwen; Cole, Anne S
Introduction Diabetes self-management education interventions in community gathering places have been moderately effective, but very few studies of intervention effectiveness have been conducted among African Americans with type 2 diabetes. This paper describes a church-based diabetes self-management education intervention for African Americans, a randomized controlled trial to evaluate the intervention, and baseline characteristics of study participants. Methods A New DAWN: Diabetes Awareness & Wellness Network was conducted among 24 churches of varying size in North Carolina. Each church recruited congregants with type 2 diabetes and designated a diabetes advisor, or peer counselor, to be part of the intervention team. Participants were enrolled at each church and randomized as a unit to either the special intervention or the minimal intervention. The special intervention included one individual counseling visit, twelve group sessions, three postcard messages from the participant’s diabetes care provider, and twelve monthly telephone calls from a diabetes advisor. Baseline data included measures of weight, hemoglobin A1c, blood pressure, physical activity, dietary and diabetes self-care practices, and psychosocial factors. The study to evaluate the intervention (from enrollment visit to last follow-up) began in February 2001 and ended in August 2003. Results Twenty-four churches (with 201 total participants) were randomized. Sixty-four percent of the participants were women. On average, the participants were aged 59 years and sedentary. They had an average of 12 years of education, had been diagnosed with diabetes for 9 years, had a body mass index of 35, had a hemoglobin A1c level of 7.8%, and had a reported dietary intake of 39% of calories from fat. Conclusion A New DAWN is a culturally sensitive, church-based diabetes self-management education program for African Americans with type 2 diabetes that is being evaluated for effectiveness in a randomized controlled trial. The outcomes of A New DAWN will contribute to the literature on community-based interventions for minority populations and help to inform the selection of approaches to improve diabetes care in this population.
A clinic and community-based approach to hypertension control for an underserved minority population: design and methods
(2000) Ward, H
Abstract available at publisher's web site.
A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops
(The New England Journal of Medicine, 2018) Victor, Ronald; Lynch, Kathleen; Li, Ning; Blyler , Ciantel
BACKGROUND Uncontrolled hypertension is a major problem among non-Hispanic black men, who are underrepresented in pharmacist intervention trials in traditional health care settings. METHODS We enrolled a cohort of 319 black male patrons with systolic blood pressure of 140 mm Hg or more from 52 black-owned barbershops (nontraditional health care setting) in a cluster-randomized trial in which barbershops were assigned to a pharmacist-led intervention (in which barbers encouraged meetings in barbershops with specialty-trained pharmacists who prescribed drug therapy under a collaborative practice agreement with the participants’ doctors) or to an active control approach (in which barbers encouraged lifestyle modification and doctor appointments). The primary outcome was reduction in systolic blood pressure at 6 months. RESULTS At baseline, the mean systolic blood pressure was 152.8 mm Hg in the intervention group and 154.6 mm Hg in the control group. At 6 months, the mean systolic blood pressure fell by 27.0 mm Hg (to 125.8 mm Hg) in the intervention group and by 9.3 mm Hg (to 145.4 mm Hg) in the control group; the mean reduction was 21.6 mm Hg greater with the intervention (95% confidence interval, 14.7 to 28.4; P<0.001). A blood-pressure level of less than 130/80 mm Hg was achieved among 63.6% of the participants in the intervention group versus 11.7% of the participants in the control group (P<0.001). In the intervention group, the rate of cohort retention was 95%, and there were few adverse events (three cases of acute kidney injury). CONCLUSIONS Among black male barbershop patrons with uncontrolled hypertension, health promotion by barbers resulted in larger blood-pressure reduction when coupled with medication management in barbershops by specialty-trained pharmacists. (Funded by the National Heart, Lung, and Blood Institute and others; ClinicalTrials.gov number, NCT02321618.)
A collaborative approach to the recruitment and retention of minority patients with diabetes in rural community health centers
(2009) DAVIS, R; HITCH, A; NICHOLS, M; RIZVI, A; SALAAM, M; MAYERDAVIS, E
CONTEXT: Recruiting and retaining minorities from rural, community health centers is a challenge. Collaboration between the researchers and health center personnel and activities to enhance trust may improve results. PURPOSE: To describe recruitment and retention strategies and report results of a 12-month clinical trial of a telemedicine-based diabetes self-management intervention, conducted within a rural community health center. METHODS: Multi-level, multi-staged recruitment process including collaborative planning, data extraction, medical record review, telephone screen, 2 in-person enrollment visits and randomization. Target sample was adults >or=35 years of age with type 2 diabetes, glycated hemoglobin (GHb)>7% with no significant comorbidities to prevent safe participation. Follow-up visits occurred at 6 and 12 months post-randomization. FINDINGS: Of those eligible from medical record review, 65% were African-American(AA)/other and female. Approximately 33% of those successfully contacted by telephone were randomized (n=165), yielding a predominately AA/other (73.9%) and female (74.5%) sample. Among those eligible at the Telephone Screen, a greater percentage of Non-Hispanic Whites (NHW) refused participation than AA/other (54.2% vs 45.8%), while a greater percentage of women refused compared to men (64.4% vs 35.6%). Significant baseline differences were found by ethnicity for education, insurance, transportation and diastolic blood pressure; by gender for income, transportation, weight, and home monitoring of blood glucose. Overall 6 and 12 month retention rates were 90.9% and 82.4%, respectively, with a greater percentage of AA/Other and female participants retained. CONCLUSIONS: Our collaborative approach was successful in recruiting and retaining ethnically diverse study participants who reside in a rural underserved area of South Carolina. Differences in baseline characteristics and retention by ethnicity and gender were found. Successful translational research must allow for a collaborative approach addressing factors at the level of the community health center, key personnel, and patients in an effort to build trust for the purpose of advancing the science of translating research to practice

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