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 Closing the circle between minority inclusion in research and health disparities.(2004) Corbie-Smith, Giselle; Moody-Ayers, Sandra; Thrasher, Angela DIncreasing participation of minorities in clinical research has been a national scientific priority. Doubt and distrust, however, characterize many minorities' concern about whether their contributions as research participants will be reflected in improved health for them and their communities. What obligations do researchers have in ensuring that the societal benefits of research are enjoyed by underserved communities? What strategies can be used? Drawing on historical examples and recent policy initiatives, we describe how researchers can close the circle between inclusion of minorities in clinical research and reduction of health disparities by fulfilling obligations to methodology and community involvement.Item Building and Maintaining Trust in a Community-Based Participatory Research Partnership(2008) Christopher, S.; Watts, V.; McCormick, A. K. H. G.; Young, S.Although intervention research is vital to eliminating health disparities, many groups with health disparities have had negative research experiences, leading to an understandable distrust of researchers and the research process. Community-based participatory research (CBPR) approaches seek to reverse this pattern by building trust between community members and researchers. We highlight strategies for building and maintaining trust from an American Indian CBPR project and focus on 2 levels of trust building and maintaining: (1) between university and community partners and (2) between the initial project team and the larger community. This article was cowritten by community and academic partners; by offering the voices of community partners, it provides a novel and distinctive contribution to the CBPR literature.Item The Tuskegee Legacy: AIDS and the Black Community(1992) Jones, JamesNo scientific experiment inflicted more damage on the collective psyche of black Americans than the Tuskegee study. After Jean Heller broke the story in 1972, news of the tragedy spread in the black community. Confronted with the experiment's moral bankruptcy, many blacks lost faith in the government and no longer believed health officials who spoke on matters of public concern. Consequently, when a terrifying new plague swept the land in the 1980s and 1990s, the Tuskegee study predisposed many blacks to distrust health authorities, a fact many whites had difficulty understanding.Item Ethnicity/Race, Paranoia, and Hospitalization for Mental Health Problems Among Men(2004) Whaley, Arthur L.Objectives. I tested the hypothesis that Black men with high levels of distrust (i.e., mild paranoia) are at greater risk of hospitalization for mental health problems than their White counterparts. Methods. Secondary analysis was conducted of data from a subsample of 180 men in an epidemiological study. Mental health hospitalization was the outcome and ethnicity/ race, mild paranoia, and their interaction were main predictors in a logistic regression analysis. The ethnicity/race by mild paranoia interaction tested the study hypothesis. Results. The ethnicity/race by mild paranoia interaction was statistically significant. Contrary to the hypothesis, Black men with mild paranoia were less likely to be hospitalized. Conclusions. Black men’s lack of trust regarding the mental health system may cause them not to seek services. Factors critical to increasing their trust are acknowledgment of racial biases in the mental health system and sincere efforts to eliminate racial disparities in mental health treatment.Item Are Racial and Ethnic Minorities Less Willing to Participate in Health Research?(2005) Wendler, David; Kington, Raynard; Madans, Jennifer; Wye, Gretchen Van; Christ-Schmidt, Heidi; Pratt, Laura A.; Brawley, Otis W.; Gross, Cary P.; Emanuel, EzekielBackground: It is widely claimed that racial and ethnic minorities, especially in the US,are less willing than non-minority individuals to participate in health research. Yet,there is a paucity of empirical data to substantiate this claim. Methods and Findings: We performed a comprehensive literature search to identify all puublished health research studies that report consent rates by race or ethnicity. We found 20 health research studies that reported consent rates by race or ethnicity. These 20 studies reported the enrollment decisions of over 70,000 individuals for a broad range of research,from interviews to drug treatment to surgical trials. Eighteen of the twenty studies were single-site studies conducted exclusively in the US or multi-site studies where the majority of sites (i.e., at least 2/3) were in the US. Of the remaining two studies, the Concorde study was conducted at 74 sites in the United Kingdom, Ireland, and France, while the Delta study was conducted at 152 sites in Europe and 23 sites in Australia and New Zealand. For the three interview or non-intervention studies, African-Americans had a nonsignificantly lower overall consent rate than non-Hispanic whites (82.2% versus 83.5%; odds ratio [OR] ¼ 0.92; 95% confidence interval [CI] 0.84–1.02). For these same three studies, Hispanics had a nonsignificantly higher overall consent rate than non-Hispanic whites (86.1% versus 83.5%; OR ¼ 1.37; 95% CI 0.94–1.98). For the ten clinical intervention studies, African-Americans’ overall consent rate was nonsignificantly higher than that of non-Hispanic whites (45.3% versus 41.8%; OR¼1.06; 95% CI 0.78–1.45). For these same ten studies, Hispanics had a statistically significant higher overall consent rate than non-Hispanic whites (55.9% versus 41.8%; OR¼1.33; 95% CI 1.08–1.65). For the seven surgery trials, which report all minority groups together, minorities as a group had a nonsignificantly higher overall consent rate than non-Hispanic whites (65.8% versus 47.8%; OR ¼ 1.26; 95% CI 0.89–1.77). Given the preponderance of US sites, the vast majority of these individuals from minority groups were African-Americans or Hispanics from the US. Conclusions We found very small differences in the willingness of minorities, most of whom were African-Americans and Hispanics in the US, to participate in health research compared to non-Hispanic whites. These findings, based on the research enrollment decisions of over 70,000 individuals, the vast majority from the US, suggest that racial and ethnic minorities in the US are as willing as non-Hispanic whites to participate in health research. Hence, efforts to increase minority participation in health research should focus on ensuring access to health research for all groups, rather than changing minority attitudes.Item Study: Many wary of health system Care often seen as lacking by poor or nonwhite Arkansans(2004) Fox, SarahMany Arkansans who are black, Hispanic, Asian or poor whites distrust doctors and hospitals, according to a study presented Tuesday at the state Capitol. After researchers talked to 148 people around Arkansas, study co-investigator Dr. Eduardo Ochoa said they found "a deep-seated suspicion of the health care system."