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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Now showing 1 - 10 of 12
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    Using Focus Groups to Develop a Heart Disease Prevention Program for Ethnically Diverse, Low-Income Women
    (2000) Gettleman, Lynn; Winkleby, Marilyn A.
    Abstract available from publisher's web site.
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    Correlates of cervical cancer screening among underserved Hispanic and African-American women
    (2004) Bazargan, Mohsen; Bazargan, Shahrzad H; Farooq, Muhammad; Baker, Richard S
    BACKGROUND: Substantial subgroups of American women, specifically those of ethnic minorities, have not been screened for cervical cancer or are not screened at regular intervals. The rates for receipt of female-related cancer screening tests remain far below the goals set forth in Healthy People 2010. OBJECTIVE: This study applied a well-known, recently revised theoretical model of health care access and utilization, the Behavioral Model for Vulnerable Populations, to examine the correlates of the adherence to cervical cancer screening guidelines among publicly housed Hispanic and African-American women, two of the most vulnerable segments of our population. METHODS: This study conducted a cross-sectional survey of a community-based random sample of 230 African-American and Latino female heads of household, from a geographically defined area, the three urban public housing communities in Los Angeles County, CA. RESULTS: Only 62% of our sample had received a screening for cervical cancer within the past year. Yet, 29% of the sample claimed that no health care provider had ever told them that they needed a screening test for cervical cancer. Hispanic and older women are by far less likely to adhere to screening guidelines; in this study, 51% of Hispanics and 22% of African-Americans reported no screening within the last year. Multivariate analysis shows that affordability, continuity of care, and receiving advice from health care providers regarding a Papanicolaou (Pap) smear were significant predictors of up-to-date to cervical cancer screening. CONCLUSION: This study documents a significant disparity in screening for cervical cancer among underserved minorities, particularly Hispanic, uninsured, and older women. The continuity of obtaining medical services and receiving recommendations from physicians remain the core factors that are significantly associated with obtaining cervical cancer screening. These results underscore the need for continued efforts to ensure that medically underserved minority women have access to cancer screening services.
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    PART I: Long After Tuskegee, Blacks Still Leary of Clinical Trials
    (2010) Martin, Pharoh
    The general distrust that African-Americans have of clinical trial research goes back a long way. History tells them that it would be in their best interests to not participate but the reality is that Black participation in clinical research is critical because African-Americans disparately suffer from some of the highest disease rates and respond differently to many treatments. Researchers like Dr. Claudia Baquet, associate professor of epidemiology and preventive medicine at the University of Maryland School of Medicine and director of its National Bioethics Research Center, wants to not only foster public trust among African-Americans for research, but also stress the importance of participating in such research.
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    PART II: Doctors Find Ways to Stop African-American Resistance to Clinical Trials
    (2010) Martin , Pharoh
    One of history's most glaring violation of medical ethics occurred in Tuskegee, Ala. That was when federal researchers experimented on close to 400 impoverished African-American sharecroppers who suffered from syphilis. The experiments started in 1932 and lasted for 40 years. Early in the study, researchers found that penicillin was an effective treatment for the disease; yet the U.S. Public Health Service purposely withheld the treatment from its Black participants for decades. The fallout from that controversial study not only led to a total reform of medical ethics as well as an avalanche of new federal laws and regulations regarding protections for participants in clinical studies but that study and similar incidents shattered whatever trust the Black community had for such research.
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    The Legacy of Tuskegee: Investigating Trust in Medical Research and Health Disparities
    (2010) Spencer, Dennis J.
    What was done cannot be undone, but we can end the silence … We cannot be one America when a whole segment of our nation has no trust in America. We can stop turning our heads away. We can look at you in the eye, and finally say, on behalf of the American people, what the United States government did was shameful and I am sorry. (Clinton, 1997) This apology offered in 1997 by then President Bill Clinton uncovered painful sores that many would like to believe had healed long ago. It is only recently that a growing number of social scientists have appreciated that persisting disparities reflect more than simple socioeconomic and educational parity. By examining the long-term psychological effects of Tuskegee, it becomes apparent that some African-Americans have lost all trust in their former abusers—the medical establishment—unintentionally perpetuating health disparities in their communities.
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    Link between facultative melanin and tobacco use among African Americans.
    (2009) King, Gary; Yerger, Valerie B; Whembolua, Guy-Lucien; Bendel, Robert B; Kittles, Rick; Moolchan, Eric T
    Nicotine's affinity for melanin-containing tissues may result from its precursor function in melanin synthesis or the irreversible binding of melanin and nicotine. The objective of this study was to investigate a hypothesized association of tobacco use, dependence, and nicotine exposure with melanin pigmentation among African American smokers. A criterion-based sample was employed to collect data from a study of 147 adult African American current smokers. Carbon monoxide, saliva cotinine samples, and skin reflectance measures were obtained from each participant. Questionnaire data on demographic, sociological and behavioral questions related to smoking and skin color were gathered. The three dependent measures were the average number of cigarettes per day (CPD), Fagerström Test of Nicotine Dependence (FTND) score, and cotinine concentration. Analysis of variance, Pearson Correlations, and Multiple Linear Regression were conducted to analyze findings. The mean constitutive melanin reading was 56.3 and 66.5 for facultative melanin. Respondents on average smoked 19 CPD, had a mean FTND of 5.6, and a cotinine concentration of 435 ng/ml. Facultative melanin level was correlated with CPD and cotinine concentration in the bivariate analysis. The multiple linear regression results revealed that facultative melanin was significantly and positively related to CPD, the FTND, and cotinine. The results of this analysis support the hypothesis of a positive association between melanin levels and tobacco use, dependence, and exposure among African American smokers. This analysis may have important implications for research and interventions on tobacco dependence and disease outcomes. Further research on melanin and nicotine among African Americans as well as other population groups is warranted.
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    Populations of Color in Tennessee: Health Status Report
    (2005) Robinson, Kenneth S.; Corniola, Chris; Croom, Fred; Dwivedi, Pramod; Foster, Ivan; Jackman, Robbie; Stevenson, Frank
    In 1985, Secretary Margaret Heckler of the U.S. Department of Health and Human Services issued the Report of the Secretary’s Task Force on Black and Minority Health. That landmark report – which detailed the excess mortality among blacks in America from major health conditions - became the hallmark for our nation’s rising awareness of, and distress regarding, the alarming disparities that characterized the health status of racial and ethnic minorities. Many initiatives were birthed, including here in Tennessee, to address those health disparities; disparities often even more glaring in The South. The Black Health Care Task Force of the Tennessee Department of Health was succeeded by one of the nation’s earliest Offices of Minority Health, as we wrestled with innovative, holistic, and specific approaches to improving the health outcomes of populations of color in Tennessee. Recently, health and healthcare leaders in both the public and private sectors assembled in Washington, D.C., to review the health of minorities in America – 20 years after the Heckler Report, and at the mid-point of the ten-year health agenda targeted by Healthy People 2010. To a significant extent, thanks to then Surgeon General David Satcher, M.D., one of the overarching goals of Healthy People 2010 is the elimination of health disparities in our minority populations. In the context of such interim assessments, and in concert with the efforts of our Office of Minority Health in the Tennessee Department of Health, we present this report; the second such report in the last 10 years which exclusively focuses on the health of our state’s people of color. Our first report, Narrowing the Gap, was published in 1997.
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    Genes Linked to 2 Health Problems in Blacks
    (2006) Reinberg, Steven
    New studies have found a genetic component to two health problems in blacks: premature birth and prostate cancer. The findings buttress previous research linking genetics to health problems in different racial and ethnic groups. In the case of premature birth and prostate cancer, knowing the increased risk may lead to new treatments, the researchers said. The findings were published in this week's edition of the Proceedings of the National Academy of Sciences.
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    Letter to the Editor- In Response to the 2004, Vol 27 article entitled Body and Soul: A Dietary Intervention Conducted Through African-American Churches
    (2005) Kuller, Lewis H
    The paper, “Body and Soul: A Dietary Intervention Conducted Through African-American Churches,” raises serious and important issues. First, an effectiveness study should be based on proven efficacy, usually from clinical trials. There are no clinical trials to date that show any benefit from the modest increase in fruits and vegetables.1 There has been a negative study, the Polyp Prevention Trial (PPT).2 The Women’s Health Initiative (WHI) will report shortly on whether increased fruits and vegetables in the diet arm have reduced cancer and cardiovascular disease. The National Cancer Institute and other governmental agencies can recommend increases in fruits and vegetables to the population.3 However, it is unethical to push an unproven intervention in a demonstration project, that is, that an increase in fruits and vegetables will decrease the risk of cancer, especially in potentially vulnerable populations. Did they explain carefully to the population that there is no evidence that the intervention will reduce the risk of cancer? You could argue that there is no downside from the intervention. We have learned from the betacarotene and vitamin E trials, for example, that even so-called benign interventions result, sometimes, in increased risk of disease.4,5,6,7,8 It would be important to review the consent forms.