Minority Health and Health Equity Archive
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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 HIV-Associated Anal Dysplasia: Experience from a Multiethnic-HIV Clinic in Hawaii(2011) Payam, Ahoora; Shiramizu, Bruce; Shikuma, Cecilia; Milne, Cris; Terada, Kevin; Kajioka, Eric; Ka'opua, Lana Sue; Cassel, Kevin; Chow, DominicAbstract available at publisher's web site.Item Exploring Factors That Underlie Racial/Ethnic Disparities in HIV Risk among Young Men Who Have Sex with Men(2010) Garofalo, Robert; Mustanski, Brian; Johnson, Amy; Emerson, ErinAbstract available at publisher's web site.Item New multi-year data show annual HIV infections in U.S. relatively stable: Alarming increase among young, black gay and bisexual men requires urgent action(2011) Centers for Disease Control , and PreventionThe CDC’s first multi-year estimates from its national HIV incidence surveillance find that overall, the annual number of new HIV infections in the United States was relatively stable at approximately 50,000 new infections each year between 2006 and 2009. However, HIV infections increased among young men who have sex with men (MSM) between 2006 and 2009, driven by alarming increases among young, black MSM – the only subpopulation to experience a sustained increase during the time period. The new estimates were published today in the online scientific journal PLoS ONE. The incidence estimates are based on direct measurement of new HIV …Item CDC Fact Sheet: Highlights of CDC Activities Addressing HIV Prevention Among African American Gay, Bisexual, and Other Men Who Have Sex With Men(2011) Centers for Disease Control , and PreventionAmong MSM in 2009, white MSM represented the largest number of new HIV infections (11,400),followed closely by black/African American MSM(10,800) and Hispanic MSM (6,000). Among all men in 2009, MSM accounted for 86% of new infections among white men, 73% of new infectionamong black/African American men and 81% of new infections among Hispanic men. Young black/African American MSM aged 13-29 are especially affected by the HIV/AIDS epidemic. While HIV incidence was relatively stable among MSM overall from 2006 through 2009, CDC estimates that new HIV infections among black/African American MSM aged 13 to 29 increased 48% during that four-year time period, with a statistically significant 12.2% estimated annual percentage increase.Item Estimated HIV Incidence in the United States, 2006–2009(2011) Prejean, Joseph; Song, Ruiguang; Hernandez, Angela; Ziebell, Rebecca; Green, Timothy; Walker, Frances; Lin, Lillian S.; An, Qian; Mermin, Jonathan; Lansky, Amy; Hall, H. Irene; Lee, VernonBackground The estimated number of new HIV infections in the United States reflects the leading edge of the epidemic. Previously, CDC estimated HIV incidence in the United States in 2006 as 56,300 (95% CI: 48,200–64,500). We updated the 2006 estimate and calculated incidence for 2007–2009 using improved methodology. Methodology We estimated incidence using incidence surveillance data from 16 states and 2 cities and a modification of our previously described stratified extrapolation method based on a sample survey approach with multiple imputation, stratification, and extrapolation to account for missing data and heterogeneity of HIV testing behavior among population groups. Principal Findings Estimated HIV incidence among persons aged 13 years and older was 48,600 (95% CI: 42,400–54,700) in 2006, 56,000 (95% CI: 49,100–62,900) in 2007, 47,800 (95% CI: 41,800–53,800) in 2008 and 48,100 (95% CI: 42,200–54,000) in 2009. From 2006 to 2009 incidence did not change significantly overall or among specific race/ethnicity or risk groups. However, there was a 21% (95% CI:1.9%–39.8%; p = 0.017) increase in incidence for people aged 13–29 years, driven by a 34% (95% CI: 8.4%–60.4%) increase in young men who have sex with men (MSM). There was a 48% increase among young black/African American MSM (12.3%–83.0%; p<0.001). Among people aged 13–29, only MSM experienced significant increases in incidence, and among 13–29 year-old MSM, incidence increased significantly among young, black/African American MSM. In 2009, MSM accounted for 61% of new infections, heterosexual contact 27%, injection drug use (IDU) 9%, and MSM/IDU 3%. Conclusions/Significance Overall, HIV incidence in the United States was relatively stable 2006–2009; however, among young MSM, particularly black/African American MSM, incidence increased. HIV continues to be a major public health burden, disproportionately affecting several populations in the United States, especially MSM and racial and ethnic minorities. Expanded, improved, and targeted prevention is necessary to reduce HIV incidence.Item City gets new prescription for better health: Mayor's Healthy Chicago wellness plan outlines areas needing improvement, strategies to achieve it by 2020(2011) Eng, MonicaVowing to improve the health of Chicagoans and cut the government's soaring health care costs, Mayor Rahm Emanuel went to a sweaty fitness room in Humboldt Park on Tuesday to unveil a comprehensive health agenda that includes a citywide "wellness plan." As part of Emanuel's effort to launch initiatives in his first 100 days, the mayor and Health Commissioner Bechara Choucair presented a Healthy Chicago plan that outlines 12 priority areas — and dozens of measurable health goals the leaders hope to achieve by 2020. The priorities include reduced tobacco use, obesity reduction and prevention, HIV prevention, adolescent health, cancer disparity reduction, better access to health care...Item HIV Screening and Access to Care: Exploring the Impact of Policies on Access to and Provision of HIV Care(National Academies Press, 2011) Committee on HIV Screening , and Access to Care; Institute , of MedicineWith the widespread use of highly active anti-retroviral treatment (HAART), HIV has become a chronic, rather than a fatal, disease. But for their treatment to succeed, patients require uninterrupted care from a health care provider and uninterrupted access to anti-HIV medications. The IOM identifies federal, state, and private health insurance policies that inhibit HIV-positive individuals from initiating or continuing their care.Item Contribution of major diseases to disparities in mortality.(2002) Wong, Mitchell D; Shapiro, Martin F; Boscardin, W John; Ettner, Susan LBACKGROUND: Mortality from all causes is higher for persons with fewer years of education and for blacks, but it is unknown which diseases contribute most to these disparities. METHODS: We estimated cause-specific risks of death from data from the National Health Interview Survey conducted from 1986 through 1994 and from linked vital statistics. Using these risk estimates, we calculated potential years of life lost and potential gains in life expectancy related to specific causes, with stratification according to education level and race. RESULTS: Persons without a high-school education lost 12.8 potential life-years per person in the population, as compared with 3.6 for persons who graduated from high school (ratio, 3.5; P<0.001). Ischemic heart disease contributed most (11.7 percent) to the difference according to education in potential life-years lost (with all cardiovascular diseases accounting for 35.3 percent). All cancers accounted for 26.5 percent, including 7.7 percent due to lung cancer; other lung diseases and pneumonia contributed 10.1 percent of the total, whereas human immunodeficiency virus (HIV) disease accounted for none of the difference according to education. The pattern of disparities according to level of income was similar to that according to level of education. Blacks and whites lost 7.0 and 5.2 potential life-years per person, respectively, as a result of deaths from any cause (ratio, 1.35; P<0.001). Cardiovascular diseases accounted for one third of this disparity, in large part because of hypertension (15.0 percent); HIV disease (11.2 percent) contributed almost as much as ischemic heart disease (5.5 percent), stroke (2.8 percent), and cancer (3.4 percent) combined; trauma and diabetes mellitus accounted for 10.7 percent and 8.5 percent, respectively. CONCLUSIONS: Although many conditions contribute to socioeconomic and racial disparities in potential life-years lost, a few conditions account for most of these disparities - smoking-related diseases in the case of mortality among persons with fewer years of education, and hypertension, HIV, diabetes mellitus, and trauma in the case of mortality among black persons. These findings have important implications for targeting efforts to reduce existing disparities in mortality rates.Item Understanding Racial Disparities in HIV Using Data From the Veterans Aging Cohort 3-Site Study and VA Administrative Data(2003) McGinnis, Kathleen A.; Fine, Michael J.; Sharma, Ravi K.; Skanderson, Melissa; Wagner, Joseph H.; Rodriguez-Barradas, Maria C.; Rabeneck, Linda; Justice, Amy C.Objectives. We identified race-associated differences in survival among HIV-positive US veterans to examine possible etiologies for these differences. Methods. We used national administrative data to compare survival by race and used data from the Veterans Aging Cohort 3-Site Study (VACS 3) to compare patients’ health status, clinical management, and adherence to medication by race. Results. Nationally, minority veterans had higher mortality rates than did white veterans with HIV. Minority veterans had poorer health than white veterans with HIV. No significant differences were found in clinical management or adherence. Conclusions. HIV-positive minority veterans experience poorer survival than white veterans. This difference may derive from differences in comorbidities and in the severity of illness of HIV-related disease.Item The uneven impact of AIDS in a polarized society(2007) Marais, HeinLiterature on the impact of serious AIDS epidemics anticipates severe outcomes, and places special emphasis on the epidemic’s likely effects on productive and governance capacities. Implicit in many impact scenarios is the assumption that the effects are distributed more or less uniformly across society, and are channeled ‘naturally’ through and across sectors. This article examines evidence of the AIDS epidemic’s impact at household level, and in the health, education and economic sectors of South Africa. It shows that the epidemic’s impact is strongly shaped by the highly unequal distribution of power, entitlement, risk and responsibility in South Africa. The article concludes that many of the costs associated with the AIDS epidemic are being displaced into the lives, homes and neighbourhoods of poorer South Africans, especially black African women - thus deepening poverty trends, as well as reproducing and hardening the polarized character of South African society. Priority steps to remedy these trends are outlined.
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