Minority Health and Health Equity Archive

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EDITORIAL- How Do We Evaluate and Utilize Data on Ethnic Differences?
(1999) Howard, Barbara V
Until recently, virtually all medical research was conducted on upper-middle class White men. This left health care professionals, as well as many other segments of the population, without sufficient information to deliver adequate health care to both genders and to the diverse groups of ethnic minorities in the United States. Fortunately, research policy has changed and intense efforts are now being made to collect data not only from men but also from women and majot ethnic U.S. minorities. The resultant data, however, create a dilemma concerning how we evaluate data that show differences between ethnic groups. All human beings are similar in most ways--i.e., sharing basic anatomy, physicology, and biochemistry--although there are some obvious racial distinctions such as skin color. Historically, there has been reluctance on the part of the scientific community to accept data indicating that ethnic groups may differ in certain health characteristics, especially if the data show an ethnic group to be less healthy in some respect. This sensitivity is greatest in ethnic groups who have been subjected to perjorative statements and stereotypes about their health and physical ability in the past. On the other hand, we must evaluate comparative ethnic data because they may provide information that can truly lead to better care for individual communities.
Coronary artery calcification in black women and white women
(2003) Khurana, Charanjit; Rosenbaum, Christina G; Howard, Barbara V; Adams-Campbell, Lucile L; Detrano, Robert C; Klouj, Afifa; Hsia, Judith
Background Coronary calcification is a potent independent predictor of coronary risk. Sex-specific risk categories based on calcium scores have been established, but ethnic differences in coronary calcification have been little studied. This prospective cohort study compares coronary calcification, assessed by computed tomography, in postmenopausal black women and white women. Methods and Results Computed tomographic scans were performed on 128 black women and 733 white women without known coronary artery disease (mean age 63 +/- 8 years). Although coronary risk factors were more prevalent among black women (P < .0001), total calcium scores were similar to those in white women. By use of the Framingham algorithm, higher calcium scores were associated with higher 10-year risk of myocardial infarction or coronary death. In multiple regression analysis, age was independently associated with higher calcium scores in both ethnic groups (P = .002 for black women, P < .0001 for white women). Diabetes mellitus and not exercising at least 3 times per week were independently associated with higher calcium scores in white women but not black women. Educational level, body mass index, current hormone replacement therapy, hysterectomy, dietary fat consumption, family history of premature coronary disease, hypertension, self-reported high cholesterol, and current smoking were not independently associated with coronary calcium score in black women, white women, or the combined cohort; neither was ethnicity an independent predictor of coronary calcification. Conclusions Despite higher dietary fat consumption, higher body mass index, and greater prevalence of hypertension, diabetes, and smoking, black women had coronary calcium scores similar to those of white women. Ethnicity was not an independent predictor of coronary calcification.

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