Minority Health and Health Equity Archive

Permanent URI for this collectionhttp://hdl.handle.net/1903/21769

Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.

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Author: search.filters.author.Fine, Michael J.Subject: search.filters.subject.Disparities

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Now showing 1 - 5 of 5
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    Racial Differences in 30-Day Mortality for Pulmonary Embolism
    (2006) Ibrahim, Said A.; Stone, Roslyn A.; Obrosky, D. Scott; Sartorius, Jennifer; Fine, Michael J.; Aujesky, Drahomir
    Objectives. Previous studies reported a higher incidence of in-hospital mortality for Black patients who had pulmonary embolism than for White patients. We used a large statewide database to compare 30-day mortality (defined as death within 30 days from the date of latest hospital admission) for Black and White patients who were hospitalized because of pulmonary embolism. Methods. The study cohort consisted of 15531 discharged patients who had been treated for pulmonary embolism at 186 Pennsylvania hospitals between January 2000 and November 2002. We used random-effects logistic regression to model 30-day mortality for Black and White patients, and adjusted for patient demographic and clinical characteristics. Results. The unadjusted 30-day mortality rates were 9.0% for White patients, 10.3% for Blacks, and 10.9% for patients of other or unknown race. When adjustedfor severity of disease using a validated clinical prognostic model for pulmonary embolism, Black patients had 30% higher odds of 30-day mortality compared with White patients at the same site (adjusted odds ratio = 1.3; 95% confidence interval, 1.1,1.6). Neither insurance status nor hospital volume was a significant predictor of 30-day mortality. Conclusion. Black patients who had pulmonary embolism had significantly higher odds of 30-day mortality compared with White patients.
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    Understanding Racial Disparities in HIV Using Data From the Veterans Aging Cohort 3-Site Study and VA Administrative Data
    (2003) McGinnis, Kathleen A.; Fine, Michael J.; Sharma, Ravi K.; Skanderson, Melissa; Wagner, Joseph H.; Rodriguez-Barradas, Maria C.; Rabeneck, Linda; Justice, Amy C.
    Objectives. We identified race-associated differences in survival among HIV-positive US veterans to examine possible etiologies for these differences. Methods. We used national administrative data to compare survival by race and used data from the Veterans Aging Cohort 3-Site Study (VACS 3) to compare patients’ health status, clinical management, and adherence to medication by race. Results. Nationally, minority veterans had higher mortality rates than did white veterans with HIV. Minority veterans had poorer health than white veterans with HIV. No significant differences were found in clinical management or adherence. Conclusions. HIV-positive minority veterans experience poorer survival than white veterans. This difference may derive from differences in comorbidities and in the severity of illness of HIV-related disease.
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    The Veterans Health Administration’s Promotion of Health Equity for Racial and Ethnic Minorities
    (2003) Fine, Michael J.; Demakis, John G.
    The Department of Veterans Affairs(VA) Health Services Research and Development Service( HSRD) is proud to collaborate with the Journal to publish this special edition highlighting the Third Annual National Minority Health Leadership Summit. The summit, held in Pittsburgh, Pa, in January 2003, was titled “Eliminating Racial and Ethnic Health Disparities: The Role of Community- Based Participatory Research.” It was organized by the Center for Minority Health at the University of Pittsburgh Graduate School of Public Health and was cosponsored by the US Department of Health and Human Services Office for Civil Rights (Region III) and the VA Center for Health Equity Research and Promotion. During a special VA panel session at the summit, we described the VA’s comprehensive response to the national initiative to eliminate disparities in health and health care among racial and ethnic minorities. The audience, a diverse group of health professionals, public health workers, and community service providers, was largely unaware of the leading role the VA has played in promoting equality in health and health care among these traditionally underserved populations.
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    Advancing Health Disparities Research Within the Health Care System: A Conceptual Framework
    (2006) Kilbourne, Amy M.; Switzer, Galen; Hyman, Kelly; Crowley-Matoka, Megan; Fine, Michael J.
    We provide a framework for health services-related researchers, practitioners, and policy makers to guide future health disparities research in areas ranging from detecting differences in health and health care to understanding the determinants that underlie disparities to ultimately designing interventions that reduce and eliminate these disparities. To do this, we identify potential selection biases and definitions of vulnerable groups when detecting disparities. The key factors to understanding disparities were multilevel determinants of health disparities, including individual beliefs and preferences, effective patient-provider communication, and the organizational culture of the health care system. We encourage interventions that yield generalizable data on their effectiveness, and that promote further engagement of communities, providers, and policy makers to ultimately enhance the application and the impact of health disparities research.
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    Health Disparities: The Importance of Culture and Health Communication
    (2004) Thomas, Stephen B.; Fine, Michael J.; Ibrahim, Said A.
    The root causes of health disparities are numerous and relate to individual behaviors, provider knowledge and attitudes, organization of the health care system, and societal and cultural values. Disparities have been well documented,even in systems that provide unencumbered access to health care, such as the VA Healthcare System, suggesting that factors other than access to care (e.g., culture and health communication) are responsible. Efforts to eliminate health disparities must be informed by the influence of culture on the attitudes, beliefs, and practices of not only minority populations but also public health policymakers and the health professionals responsible for the delivery of medical services and public health interventions designed to close the health gap. There is credible evidence suggesting that cultural norms within Western societies contribute to lifestyles and behaviors associated with risk factors for chronic diseases (e.g., diabetes and cardiovascular disease). This is the context in which smoking cessation, increased physical activity, and dietary regulation are prime targets for intervention.