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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Item THE ECONOMIC BURDEN OF HEALTH INEQUALITIES IN THE UNITED STATES(2009) LaVeist, Thomas A.; Gaskin, Darrell J.; Richard, PatrickWe estimated the economic burden of health disparities in the United States using three measures: (1) direct medical costs of health inequalities, (2) indirect costs of health inequalities, and (3) costs of premature death. Our analysis found: • Between 2003 and 2006 thecombined costs of health inequalitiesand premature death in the United States were $1.24 trillion. • Eliminating health disparities for minorities would havereduced direct medicalcareexpenditures by $229.4 billion for the years 2003-2006. • Between 2003 and 2006, 30.6% of direct medicalcareexpenditures for African Americans, Asians,and Hispanics were excess costs due to health inequalities. • Eliminating health inequalities for minorities would havereduced indirectcostsassociated with illnessand premature death by morethan onetrillion dollars between 2003 and 2006.Item Race/Ethnicity and Hypertension: The Role of Social Support(2010) Bell, Caryn N.; Thorpe, Roland J.; LaVeist, Thomas A.Abstract available at publisher's web site.Item Environmental and Socio-Economic Factors as Contributors to Racial Disparities in Diabetes Prevalence(2009) LaVeist, Thomas A.; Thorpe, Roland J.; Galarraga, Jessica E.; Bower, Kelly M.; Gary-Webb, Tiffany L.BACKGROUND We deployed a study design that attempts to account for racial differences in socioeconomic and environmental risk exposures to determine if the diabetes race disparity reported in national data is similar when black and white Americans live under similar social conditions. DESIGN & METHODS We compared data from the 2003 National Health Interview Survey (NHIS) with the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB) Study, which was conducted in a racially-integrated urban community without race differences in socioeconomic status. RESULTS In the NHIS, African Americans had greater adjusted odds of having diabetes compared to whites (OR: 1.61, 95% CI: 1.26−2.04); whereas, in EHDIC-SWB white and African Americans had similar odds of having diabetes (OR: 1.07, 95% CI: 0.71−1.58). Diabetes prevalence for African Americans was similar in NHIS and EHDIC-SWB (10.4%, 95%CI: 9.5−11.4 and 10.5%, 95%CI: 8.5−12.5, respectively). Diabetes prevalence among whites differed for NHIS (6.6%, 95%CI: 6.2−6.9%) and EHDIC-SWB (10.1%, 95%CI: 7.6−12.5%). CONCLUSIONS Race disparities in diabetes may stem from differences in the health risk environments that African Americans and whites live. When African Americans and whites live in similar risk environments, their health outcomes are more similar.Item Perceived Discrimination and Adherence to Medical Care in a Racially Integrated Community(2007) Casagrande, Sarah Stark; Gary, Tiffany L.; LaVeist, Thomas A.; Gaskin, Darrell J.; Cooper, Lisa A.Background Past research indicates that access to health care and utilization of services varies by sociodemographic characteristics, but little is known about racial differences in health care utilization within racially integrated communities. Objective To determine whether perceived discrimination was associated with delays in seeking medical care and adherence to medical care recommendations among African Americans and whites living in a socioeconomically homogenous and racially integrated community. Design A cross-sectional analysis from the Exploring Health Disparities in Integrated Communities Study. Participants Study participants include 1,408 African-American (59.3%) and white (40.7%) adults (≥18 years) in Baltimore, Md. Measurements An interviewer-administered questionnaire was used to assess the associations of perceived discrimination with help-seeking behavior for and adherence to medical care. Results For both African Americans and whites, a report of 1–2 and >2 discrimination experiences in one’s lifetime were associated with more medical care delays and nonadherence compared to those with no experiences after adjustment for need, enabling, and predisposing factors (odds ratio [OR]=1.8, 2.6; OR=2.2, 3.3, respectively; all P<.05). Results were similar for perceived discrimination occurring in the past year. Conclusions Experiences with discrimination were associated with delays in seeking medical care and poor adherence to medical care recommendations INDEPENDENT OF NEED, ENABLING, AND PREDISPOSING FACTORS, INCLUDING MEDICAL MISTRUST; however, a prospective study is needed. Further research in this area should include exploration of other potential mechanisms for the association between perceived discrimination and health service utilization.Item A methodological note on modeling the effects of race: the case of psychological distress(2008) Nuru-Jeter, Amani; Williams, Chyvette T.; LaVeist, Thomas A.Psychological distress is an important indicator of the mental well-being of the population. Findings regarding racial differences in distress are inconclusive but may represent an important pathway through which disparities exist across a number of physical health outcomes. We used data from the 1994 Minority Health Survey, a nationally representative multiracial/ethnic sample of adults in US households, to examine racial/ethnic differences in psychological distress (n = 3623). Our primary study aim was to examine differences between additive and multiplicative models in assessing the influence of income and gender on the race/distress relationship. We hypothesized that additive models do not suffi ciently account for potential interactions of race with income and gender, and may therefore mask important differences in distress between racial groups. The results suggest that our hypotheses were supported. After adjusting for income, there were no statistically signifi cant differences in distress levels between racial groups. However, significant differences emerge when multiplicative models are used demonstrating the complexities of the intersection of race, income and gender in predicting psychological distress. Black men and women of higher income status represent a particularly vulnerable group, whereas Hispanic men are especially hardy. We discuss the implications of our fi ndings for future work on racial health disparities.Item The Sociobiologic Integrative Model (SBIM): Enhancing the Integration of Sociobehavioral, Environmental, and Biomolecular Knowledge in Urban Health and Disparities Research(2007) Gibbons, M. Chris; Brock, Malcolm; Alberg, Anthony J.; Glass, Thomas; LaVeist, Thomas A.; Baylin, Stephen; Levine, David; Fox, C. EarlDisentangling the myriad determinants of disease, within the context of urban health or health disparities, requires a transdisciplinary approach. Transdisciplinary approaches draw on concepts from multiple scientific disciplines to develop a novel, integrated perspective from which to conduct scientific investigation. Most historic and contemporary conceptual models of health were derived either from the sociobehavioral sciences or the biomolecular sciences. Those models deriving from the sociobehavioral sciences generally lack detail on involved biological mechanisms whereas those derived from the biomolecular sciences largely do not consider socioenvironmental determinants. As such, advances in transdisciplinary characterizations of health in complex systems like the urban environment or health disparities may be impeded. This paper suggests a sociobiologic organizing model that encourages a multilevel, integrative perspective in the study of urban health and health disparities.