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.Ibrahim, Said A.Subject: search.filters.subject.Research

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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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    Racial/Ethnic Variations in Physician Recommendations for Cardiac Revascularization
    (2003) Ibrahim, Said A.; Whittle, Jeff; Bean-Mayberry, Bevanne; Kelley, Mary E.; Good, Chester; Conigliaro, Joseph
    Objectives. We sought to examine whether physician recommendations for cardiac revascularization vary according to patient race. Methods. We studied patients scheduled for coronary angiography at 2 hospitals, one public and one private, between November 1997 and June 1999. Cardiologists were interviewed regarding their recommendations for cardiac resvacularization. Results. African American patients were less likely than Whites to be recommended for revascularization at the public hospital (adjusted odds ratio [OR]=0.31; 95% confidence interval [CI]=0.12, 0.77) but not at the private hospital (adjusted OR=1.69; 95% CI=0.69, 4.14). Conclusions. Physician recommendations for cardiac revascularization vary by patient race. Further studies are needed to examine physician bias as a factor in racial disparities in cardiac care and outcomes.
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    Obese African-American Women’s Perspectives on Weight Loss and Bariatric Surgery
    (2007) Lynch, Cheryl Sterling; Chang, Judy C.; Ford, Angela F.; Ibrahim, Said A.
    BACKGROUND: African-American (AA) women have higher rates of obesity and obesity-related diseases but are less likely than other women to undergo bariatric surgery or have success with conventional weight loss methods. OBJECTIVE: To explore obese AA women’s perceptions regarding barriers to weight loss and bariatric surgery. DESIGN: Focus groups to stimulate interactive dialogueabout beliefs and attitudes concerning weight management. PARTICIPANTS AND APPROACH: We partnered with acommunity organization to recruit women who were AA, were ≥18 years old, and had a body mass index (BMI) of ≥30 kg/m2. We audiotaped the 90-minute focus groups and used content analysis for generating and coding recurring themes. RESULTS: In our sample of 41 participants, the mean age was 48.8 years and mean BMI was 36.3. Most participants were unmarried, had some postsecondary education, and reported good or fair health. About 85% knew someone who had undergone bariatric surgery. Qualitative analysis of 6 focus group sessions revealed that the most common barriers to weight loss were lack of time and access to resources; issues regarding selfcontrol and extrinsic control; and identification with a larger body size. Common barriers to bariatric surgery were fears and concerns about treatment effects and perceptions that surgery was too extreme or was a method of last resort. CONCLUSIONS: Only through the elimination of barriers can AA women receive the care needed to eliminate excess weight and prevent obesity-related morbidity and mortality.