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 - 5 of 5
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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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    Equity, social determinants and public health programmes
    (World Health Organization, 2010) Blas, Erik; Kurup, Anand Sivasankara
    This book was commissioned by the Department of Ethics, Equity, Trade and Human Rights as part of the work undertaken by the Priority Public Health Conditions Knowledge Network of the Commission on Social Determinants of Health, in collaboration with 16 of the major public health programmes of WHO: alcohol-related disorders, cardiovascular diseases, child health, diabetes, food safety, HIV/AIDS, maternal health, malaria, mental health, neglected tropical diseases, nutrition, oral health, sexual and reproductive health, tobacco and health, tuberculosis, and violence and injuries. In addition to this, through collaboration with the Special Programme of Research, Development and Research Training in Human Reproduction, the Special Programme for Research and Training in Tropical Diseases, and the Alliance for Health Policy and Systems Research, 13 case studies were commissioned to examine the implementation challenges in addressing social determinants of health in low-and middle-income settings. The Priority Public Health Conditions Knowledge Network has analysed the impact of social determinants on specific health conditions, identified possible entry-points, and explored possible interventions to improve health equity by addressing social determinants of health.
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    Vitamin D, Race, and Cardiovascular Mortality: Findings From a National US Sample
    (2010) Fiscella, K.; Franks, P.
    PURPOSE: Findings are conflicting about the relationship between vitamin D levels and cardiovascular mortality. We wanted to determine the contribution of vitamin D levels to black-white disparities in cardiovascular mortality. METHODS: We examined the association of serum 25(OH)D levels with cardiovascular mortality and its contribution to elevated risk among blacks through a retrospective cohort using baseline data from the third National Health and Nutrition Examination Survey 1988-1994 and cause-specific mortality through 2001 using the National Death Index. Using piecewise Poisson regression models, we examined the risk of cardiovascular death (coronary heart disease, heart failure, and stroke) by sample 25(OH)D quartile, adjusting for cardiovascular risk factors, and compared models of adjusted race-related cardiovascular mortality with and without further adjustment for 25(OH)D levels. RESULTS: Participants with 25(OH)D levels in the lowest quartile (mean = 13.9 ng/mL) compared with those in the 3 higher quartiles (mean = 21.6, 28.4, and 41.6 ng/mL) had higher adjusted risk of cardiovascular death (incident rate ratio [IRR] = 1.40; 95% confidence interval [CI], 1.16-1.70). The higher age- and sex-adjusted cardiovascular mortality observed in blacks vs whites (IRR = 1.38; 95% CI, 1.13-1.70) was attenuated (IRR = 1.14; 95% CI, 0.91-1.44) by adjustment for 25(OH)D levels and fully eliminated with further adjustment for income (IRR=1.01; 95% CI, 0.82-1.24). CONCLUSIONS: Low serum levels of 25(OH)D are associated with increased cardiovascular mortality in a nationally representative US sample. Black-white differences in 25(OH)D levels may contribute to excess cardiovascular mortality in blacks. Interventional trials among persons with low vitamin D levels are needed to determine whether oral supplementation improves cardiovascular outcomes.
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    Cardiometabolic health disparities in native Hawaiians and other Pacific Islanders.
    (2009) Mau, Marjorie K; Sinclair, Ka'imi; Saito, Erin P; Baumhofer, Kau'i N; Kaholokula, Joseph Keawe'aimoku
    Elimination of health disparities in the United States is a national health priority. Cardiovascular disease, diabetes, and obesity are key features of what is now referred to as the "cardiometabolic syndrome," which disproportionately affects racial/ethnic minority populations, including Native Hawaiians and other Pacific Islanders (NHOPI). Few studies have adequately characterized the cardiometabolic syndrome in high-risk populations such as NHOPI. The authors systematically assessed the existing literature on cardiometabolic disorders among NHOPI to understand the best approaches to eliminating cardiometabolic health disparities in this population. Articles were identified from database searches performed in PubMed and MEDLINE from January 1998 to December 2008; 43 studies were included in the review. There is growing confirmatory evidence that NHOPI are one of the highest-risk populations for cardiometabolic diseases in the United States. Most studies found increased prevalences of diabetes, obesity, and cardiovascular risk factors among NHOPI. The few experimental intervention studies found positive results. Methodological issues included small sample sizes, sample bias, inappropriate racial/ethnic aggregation of NHOPI with Asians, and a limited number of intervention studies. Significant gaps remain in the understanding of cardiometabolic health disparities among NHOPI in the United States. More experimental intervention studies are needed to examine promising approaches to reversing the rising tide of cardiometabolic health disparities in NHOPI.
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    Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update
    (2007) Mosca, Lori; Banka, Carole L.; Benjamin, Emelia J.; Berra, Kathy; Bushnell, Cheryl; Dolor, Rowena J.; Ganiats, Theodore G.; Gomes, Antoinette S.; Gornik, Heather L.; Gracia, Clarissa; Gulati, Martha; Haan, Constance K.; Judelson, Debra R.; Keenan, Nora; Kelepouris, Ellie; Michos, Erin D.; Newby, L. Kristin; Oparil, Suzanne; Ouyang, Pamela; Oz, Mehmet C; Diana Petitti, Diana; Pinn, Vivian W.; Redberg, Rita F.; Scott, Rosalyn; Sherif, Katherine; Smith, Sidney C.; Sopko, George; Steinhorn, Robin H.; Stone, Neil J.; Taubert, Kathryn A..; Todd, Barbara A.; Urbina, Elaine; Wenger, Nanette K.
    Worldwide, cardiovascular disease (CVD) is the largest single cause of death among women, accounting for one third of all deaths. In many countries, including the United States, more women than men die every year of CVD, a fact largely unknown by physicians. The public health impact of CVD in women is not related solely to the mortality rate, given that advances in science and medicine allow many women to survive heart disease. For example, in the United States, 38.2 million women (34%) are living with CVD, and the population at risk is even larger. In China, a country with a population of approximately 1.3 billion, the age-standardized prevalence rates of dyslipidemia and hypertension in women 35 to 74 years of age are 53% and 25%, respectively, which underscores the enormity of CVD as a global health issue and the need for prevention of risk factors in the first place. As life expectancy continues to increase and economies become more industrialized, the burden of CVD on women and the global economy will continue to increase.