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.
Browse
15 results
Search Results
Item Utilization of health care services and willingness to participate in future medical research: the role of race and social support.(2011) Sellars, Besangie; Garza, Mary A; Fryer, Craig S; Thomas, Stephen BItem Using a Family History Intervention to Improve Cancer Risk Perception in a Black Community.(2011) Murthy, Vinaya S; Garza, Mary A; Almario, Donna A; Vogel, Kristen J; Grubs, Robin E; Gettig, Elizabeth A; Wilson, John W; Thomas, Stephen BFew studies examine the use of family history to influence risk perceptions in the African American population. This study examined the influence of a family health history (FHH) intervention on risk perceptions for breast (BRCA), colon (CRC), and prostate cancers (PRCA) among African Americans in Pittsburgh, PA. Participants (n = 665) completed pre- and post-surveys and FHHs. We compared their objective and perceived risks, classified as average, moderate, or high, and examined the accuracy of risk perceptions before and after the FHH intervention. The majority of participants had accurate risk perceptions post-FHH. Of those participants who were inaccurate pre-FHH, 43.3%, 43.8%, and 34.5% for BRCA, CRC, and PRCA, respectively, adopted accurate risk perceptions post-FHH intervention. The intervention was successful in a community setting. It has the potential to lead to healthy behavior modifications because participants adopted accurate risk perceptions. We identified a substantial number of at-risk individuals who could benefit from targeted prevention strategies, thus decreasing racial/ethnic cancer disparities.Item Beyond the cathedral: building trust to engage the African American community in health promotion and disease prevention.(2009) Ford, Angela F; Reddick, Karen; Browne, Mario C; Robins, Anthony; Thomas, Stephen B; Crouse Quinn, SandraEffective efforts to eliminate health disparities must be grounded in strong community partnerships and trusting relationships between academic institutions and minority communities. However, there are often barriers to such efforts, including the frequent need to rely on time-limited funding mechanisms that take categorical approaches. This article provides an overview of health promotion and disease prevention projects implemented through the Community Outreach and Information Dissemination Core (COID) of the Center for Minority Health, within the Graduate School of Public Health at the University of Pittsburgh. The COID is one of five Cores that comprised the University of Pittsburgh's NIH Excellence in Partnerships for Community Outreach, and Research on Disparities in Health and Training (EXPORT Health) funded from 2002 to 2007 by the National Center on Minority Health and Health Disparities. Based in large part on the success of the community engagement activities, in 2007, the National Center on Minority Health and Health Disparities, National Institutes of Health, designated the CMH as a Research Center of Excellence on Minority Health Disparities. COID major initiatives included the Community Research Advisory Board, Health Disparity Working Groups, Health Advocates in Reach, Healthy Class of 2010, and the Healthy Black Family Project. Lessons learned may provide guidance to other academic institutions, community-based organizations, and health departments who seek to engage minority communities in changing social norms to support health promotion and disease prevention.Item The impact of race/ethnicity on baseline characteristics and the burden of coronary atherosclerosis in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial.(2011) Beohar, Nirat; Davidson, Charles J; Massaro, Elaine M; Srinivas, V S; Sansing, Veronica V; Zonszein, Joel; Davis, Andrew M; Helmy, Tarek; Lopes, Neuza H; Thomas, Stephen B; Brooks, Maria MOBJECTIVES: We aimed to test the impact of race/ethnicity on coronary artery disease (CAD) after adjusting for baseline risk factors. BACKGROUND: Whether race/ethnicity remains an important determinant of the burden of CAD even among patients with long-standing type 2 diabetes (diabetes mellitus) and established CAD is unknown. METHODS: Analysis of baseline data from the BARI 2D trial (January 1, 2001, to March 31, 2005) was performed. Myocardial jeopardy index (MJI) was evaluated by a blinded core angiographic laboratory. Multivariate regression analysis was performed to determine the independent association of race/ethnicity on the burden of CAD after adjusting for baseline risk factors. Data were collected from US and Canadian academic and community hospitals. The baseline analysis was performed on patients with long-standing diabetes and documented CAD with no prior revascularization at study entry (n = 1,331). The main outcome measure was MJI, which represents the percentage of myocardium jeopardized by significant lesions (≥50%). The secondary outcome measure was ≥2 lesions with ≥50% stenosis. RESULTS: Risk factors varied significantly among racial/ethnic groups. Blacks were significantly more likely to be women, have no health insurance, be current smokers, have higher body mass index, have hypertension, have a longer duration of diabetes, a higher hemoglobin A(1c) level, and were more likely to be taking insulin. Their mean total, low-density lipid, and high-density lipid cholesterol levels were higher, whereas their triglycerides were lower than others. After controlling for baseline risk factors, blacks had a significantly lower burden of CAD; the adjusted MJI was 5.43 U lower (95% CI -9.13 to -1.72), and the adjusted number of lesions was 0.53 fewer (95% CI -0.88 to -0.18) in blacks compared to whites. CONCLUSIONS: In the BARI 2D trial, self-reported race/ethnicity is associated with important differences in baseline risk factors and is a powerful predictor of the burden of CAD adjusting for such baseline differences. These findings may help direct medical intervention and resources and further investigation into the basis of racial/ethnic differences in CAD burden.Item Mobilizing a region to redesign a local system of care: lessons from a community-based learning collaborative.(2010) Keyser, Donna J; Pincus, Harold Alan; Thomas, Stephen B; Castle, Nicholas; Dembosky, Jacob; Firth, Raymond; Greenberg, Michael; Pollack, Nancy Kaczynski; Reis, Evelyn Cohen; Sansing, Veronica V; Scholle, SarahLocal efforts to redesign systems of care offer fertile ground for community-based participatory research approaches to take hold and flourish. Drawing on the experiences of a learning collaborative of maternal and child healthcare stakeholders in Allegheny County, Pennsylvania, this article describes 8 action steps for operationalizing key community-based participatory research principles in the context of local systems change. Highlights of the subsequent evolution of the collaborative and its work are provided, as well as comments regarding the generalizability and usefulness of this approach for other public health and community stakeholders who are interested in mobilizing collaborative action for systems change.Item Impact of season and diet on vitamin d status of african american and caucasian children.(2011) Rajakumar, Kumaravel; Holick, Michael F; Jeong, Kwonho; Moore, Charity G; Chen, Tai C; Olabopo, Flora; Haralam, Mary Ann; Nucci, Anita; Thomas, Stephen B; Greenspan, Susan LSeasonal variation of vitamin D status and adequacy of dietary vitamin D and impact of race on maintaining vitamin D sufficiency was assessed in 140 healthy 6- to 12-year-old African American (AA) and Caucasian (C) children residing in Pittsburgh, Pennsylvania during summer and winter. Vitamin D insufficiency was not rare in either group (AA vs C, summer, 17.2% vs 14.3%, nonsignificant; winter, 34.1% vs 32.5%, nonsignificant) despite a mean dietary intake of vitamin D above the American Academy of Pediatrics (AAP) recommended intake (400 IU/d; AA vs C, summer, 421 vs 456 IU/d, nonsignificant; winter, 507 vs 432 IU/d, nonsignificant). Race/season and dietary vitamin D were predictors of serum 25-hydroxyvitamin D [25(OH)D] concentrations. However, dietary vitamin D influenced 25(OH)D only in Caucasians during winter. Current AAP recommended daily intake for vitamin D is inadequate for maintaining vitamin D sufficiency in children.Item "Food is directed to the area": African Americans' perceptions of the neighborhood nutrition environment in Pittsburgh.(2011) Kumar, Supriya; Quinn, Sandra C; Kriska, Andrea M; Thomas, Stephen BStudies have shown racial disparities in neighborhood access to healthy food in the United States. We used a mixed methods approach employing geographic information systems, focus groups, and a survey to examine African Americans' perceptions of the neighborhood nutrition environment in Pittsburgh. We found that African Americans perceive that supermarkets serving their community offer produce and meats of poorer quality than branches of the same supermarket serving White neighborhoods (p<0.001). Unofficial taxis or jitneys, on which many African Americans are reliant, provide access from only certain stores; people are therefore forced to patronize these stores even though they are perceived to be of poorer quality. Community-generated ideas to tackle the situation include ongoing monitoring of supermarkets serving the Black community. We conclude that stores should make every effort to be responsive to the perceptions and needs of their clients and provide an environment that enables healthy eating.Item Racial preferences for participation in a depression prevention trial involving problem-solving therapy.(2010) Kasckow, John; Brown, Charlotte; Morse, Jennifer Q; Karpov, Irina; Bensasi, Salem; Thomas, Stephen B; Ford, Angela; Reynolds, CharlesOBJECTIVES: This study compared African Americans' and Caucasians' willingness to participate in an indicated intervention to prevent depression with problem-solving therapy. It also examined participants' problem-solving skills. Hypotheses stated that there would be no racial differences in consent rates and that social problem-solving coping skills would be lower among African Americans than Caucasians. METHODS: Proportions of African Americans and Caucasians who consented were compared, as were Social Problem Solving Inventory scores between the groups. RESULTS: Of 2,788 individuals approached, 82 (4%) of 1,970 Caucasians and 46 (6%) of 818 African Americans signed consent, and the difference was not significant (p=.09). Racial differences were observed in neither Social Problem Solving Inventory scores nor in the relationship between problem-solving skills and depressive symptoms. CONCLUSIONS: African Americans with depression demonstrated a willingness to participate in an indicated trial of depression prevention. Furthermore, both groups would appear to benefit from the problem-solving process.Item THE BLACK ORGAN AND TISSUE DONOR SHORTAGE: A REVIEW OF THE LITERATURE(2000) Thomas, Stephen BOn April 16, 1999, the Department of Health and Human Services and the United Network for Organ Sharing (UNOS) announced that the number of organ donors increased 5.6 percent in 1998, the first substantial increase since 1995. Donation increases between 1997 and 1998 were substantial for whites (up 6.6 percent from 4,139 to 4,410 donors) and Hispanics (up 7.8 percent from 552 to 595 donors). However, the number of black donors remained relatively unchanged at 654 donors in 1998, and the number of Asian donors decreased by 8.4 percent from 107 to 98 donors (HRSA, April 16, 1999).Item BCHS 2524- Overview of Minority Health and Health Disparities in the US(2006) Thomas, Stephen B; Gilbert, Keon LUnderstanding health disparities involves a critical analysis of historical, political, economic, social, cultural, and environmental conditions that have produced an inequitable health status for racial and ethnic minorities in the United States. While we also recognize that disparities exist along socio-economic status, gender, sexual orientation and other factors, this class will focus on disparities in racial and ethnic minority communities. Issues of gender, SES and other factors will be examined as they intersect race and ethnicity, and further influence disparities in health. Minority health and health disparities have gained considerable attention from the recent publication of Healthy People 2010 Report, which lists as its two goals: 1) improve the quality of life for all citizens, and 2) eliminate health disparities. The purpose of this class is to introduce basic issues that underlie health disparities. We will gain a better understanding of the relationships of social and environmental phenomena and the health of minority communities. This course will include current literature and foster discussions that will examine health disparities, explore social and environmental determinants of those disparities, critically review measurement issues, and determine public health’s response to these disparities. Students should seek to critically reflect on their personal and professional roles in eliminating health disparities. By the end of the course, students will be able to: