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Fetal Diagnosis and Therapy 2022Although maternal-fetal surgery to treat fetal anomalies such as spina bifida continues to grow more common, potential health disparities in the field remain relatively... (Review)
Review
BACKGROUND/PURPOSE
Although maternal-fetal surgery to treat fetal anomalies such as spina bifida continues to grow more common, potential health disparities in the field remain relatively unexamined. To address this gap, we identified maternal-fetal surgery studies with the highest level of evidence and analyzed the reporting of participant sociodemographic characteristics and representation of racial and ethnic groups.
METHODS
We conducted a systematic review of the scientific literature using biomedical databases. We selected randomized control trials (RCTs) and cohort studies with comparison groups published in English from 1990 to May 5, 2020. We included studies from across the globe that examined the efficacy of fetal surgery for twin-twin transfusion syndrome (TTTS), obstructive uropathy, congenital diaphragmatic hernia (CDH), myelomeningocele (MMC), thoracic lesions, cardiac malformations, or sacrococcygeal teratoma. We determined the frequency of reporting of age, gravidity/parity, race, ethnicity, education level, language spoken, insurance, income level, and relationship status. We identified whether sociodemographic factors were used as inclusion or exclusion criteria. We calculated the racial and ethnic group representation for studies in the USA using the participation-to-prevalence ratio (PPR).
RESULTS
We included 112 studies (10 RCTs, 102 cohort) published from 1990-1999 (8%), 2000-2009 (30%), and 2010-2020 (62%). Most studies were conducted in the USA (47%) or Europe (38%). The median sample size was 58. TTTS was the most common disease group (37% of studies), followed by MMC (23%), and CDH (21%). The most frequently reported sociodemographic variables were maternal age (33%) and gravidity/parity (20%). Race and/or ethnicity was only reported in 12% of studies. Less than 10% of studies reported any other sociodemographic variables. Sociodemographic variables were used as exclusion criteria in 13% of studies. Among studies conducted in the USA, White persons were consistently overrepresented relative to their prevalence in the US disease populations (PPR 1.32-2.11), while Black or African-American, Hispanic or Latino, Asian, American-Indian or Alaska-Native, and Native-Hawaiian or other Pacific Islander persons were consistently underrepresented (PPR 0-0.60).
CONCLUSIONS
Sociodemographic reporting quality in maternal-fetal surgery studies is poor and inhibits examination of potential health disparities. Participants enrolled in studies in the USA do not adequately represent the racial and ethnic diversity of the population across disease groups.
Topics: Black People; Ethnicity; Female; Hispanic or Latino; Humans; Maternal Age; Pregnancy; United States
PubMed: 35272297
DOI: 10.1159/000523867 -
Methods in Molecular Biology (Clifton,... 2022Genetic ancestry inference can be used to stratify patient cohorts and to model pharmacogenomic variation within and between populations. We provide a detailed guide to...
Genetic ancestry inference can be used to stratify patient cohorts and to model pharmacogenomic variation within and between populations. We provide a detailed guide to genetic ancestry inference using genome-wide genetic variant datasets, with an emphasis on two widely used techniques: principal components analysis (PCA) and ADMIXTURE analysis. PCA can be used for patient stratification and categorical ancestry inference, whereas ADMIXTURE is used to characterize genetic ancestry as a continuous variable. Visualization methods are critical for the interpretation of genetic ancestry inference methods, and we provide instructions for how the results of PCA and ADMIXTURE can be effectively visualized.
Topics: Genetic Techniques; Genetics, Population; Humans; Pharmacogenetics; Polymorphism, Single Nucleotide; Population Groups; Principal Component Analysis
PubMed: 36068478
DOI: 10.1007/978-1-0716-2573-6_21 -
JMIR Public Health and Surveillance Dec 2020Accurate size estimates of key populations (eg, sex workers, people who inject drugs, transgender people, and men who have sex with men) can help to ensure adequate...
Accurate size estimates of key populations (eg, sex workers, people who inject drugs, transgender people, and men who have sex with men) can help to ensure adequate availability of services to prevent or treat HIV infection; inform HIV response planning, target setting, and resource allocation; and provide data for monitoring and evaluating program outcomes and impact. A gold standard method for population size estimation does not exist, but quality of estimates could be improved by using empirical methods, multiple data sources, and sound statistical concepts. To highlight such methods, a special collection of papers in JMIR Public Health and Surveillance has been released under the title "Key Population Size Estimations." We provide a summary of these papers to highlight advances in the use of empirical methods and call attention to persistent gaps in information.
Topics: Computing Methodologies; Humans; Population Density; Population Groups
PubMed: 33270035
DOI: 10.2196/25076 -
Annual Review of Public Health Apr 2022Suicide is a major public health concern in the United States. Between 2000 and 2018, US suicide rates increased by 35%, contributing to the stagnation and subsequent... (Review)
Review
Suicide is a major public health concern in the United States. Between 2000 and 2018, US suicide rates increased by 35%, contributing to the stagnation and subsequent decrease in US life expectancy. During 2019, suicide declined modestly, mostly owing to slight reductions in suicides among Whites. Suicide rates, however, continued to increase or remained stable among all other racial/ethnic groups, and little is known about recent suicide trends among other vulnerable groups. This article () summarizes US suicide mortality trends over the twentieth and early twenty-first centuries, () reviews potential group-level causes of increased suicide risk among subpopulations characterized by markers of vulnerability to suicide, and () advocates for combining recent advances in population-based suicide prevention with a socially conscious perspective that captures the social, economic, and political contexts in which suicide risk unfolds over the life course of vulnerable individuals.
Topics: Ethnicity; Humans; Life Expectancy; Racial Groups; Suicide; United States; Violence
PubMed: 34705474
DOI: 10.1146/annurev-publhealth-051920-123206 -
Journal of Biosciences Jul 2019This paper takes issue with the notion behind some genetic sampling of populations that there are autochthonous groups (designated tribal) in India, and that to give a...
This paper takes issue with the notion behind some genetic sampling of populations that there are autochthonous groups (designated tribal) in India, and that to give a group, its 'anthropological name' [sic] is valid. The archaeological and textual evidence of the earliest known Indo-Europeans and Indo-Iranians is given in bare outline. Possible trails of the Indo-Aryans of Iron-age South Asia are detected in archaeological records, immigration through mountains in the northwest with horses and two-humped camels, and also incursions of small groups of horse-riders, from Vidarbha all the way south to the Tamil country.
Topics: Animals; Archaeology; Asian People; Camelus; Ethnicity; Female; Genetic Variation; Genetics, Population; History, Ancient; Horses; Human Migration; Humans; India; Male; Phylogeny; White People
PubMed: 31389345
DOI: No ID Found -
The Journals of Gerontology. Series B,... Aug 2020We estimate life expectancy with and without dementia for Americans 65 years and older by education and race to examine how these stratification systems combine to shape...
OBJECTIVES
We estimate life expectancy with and without dementia for Americans 65 years and older by education and race to examine how these stratification systems combine to shape disparities in later-life cognitive health.
METHOD
Based on the Health and Retirement Study (2000-2014), we use a multivariate, incidence-based life table approach to estimate life expectancy by cognitive health status for race-education groups. The models also simulate group differences in the prevalence of dementia implied by these rates.
RESULTS
The life table results document notable race-education differences in dementia and dementia-free life expectancy, as well as stark differences in implied dementia prevalence. At each education level, blacks can expect to live more years with dementia and they have significantly higher rates of dementia prevalence. This distribution of disparities in the older population is anchored by 2 groups-blacks without a high school diploma and whites with some college or more.
DISCUSSION
Dementia experience and dementia burden differ dramatically along race-education lines. Race and education combine to exaggerate disparities and they both have enduring effects. Future research should explicitly consider how race and education combine to influence dementia in the older American population.
Topics: Black or African American; Aged; Cognition; Dementia; Educational Status; Female; Health Status Disparities; Humans; Life Expectancy; Life Tables; Male; Prevalence; Racial Groups; Socioeconomic Factors; United States; White People
PubMed: 31111926
DOI: 10.1093/geronb/gbz046 -
Cancer Research Communications Feb 2022The difference in cancer morbidity and mortality between individuals of different racial groups is complex. Health disparities provide a framework to explore potential...
The difference in cancer morbidity and mortality between individuals of different racial groups is complex. Health disparities provide a framework to explore potential connections between poor outcomes and individuals of different racial backgrounds. This study identifies genomic changes in African-American patients with gynecologic malignancies, a population with well-established disparities in outcomes. Our data explore whether social health disparities might mediate interactions between the environment and tumor epigenomes and genomes that can be identified. Using The Cancer Genetic Ancestry Atlas, which encodes data from The Cancer Genome Atlas by ancestry and allows for systematic analyses of sequencing data by racial group, we performed large-scale, comparative analyses to identify novel targets with alterations in methylation, transcript, and microRNA expression between tumors from women of European American or African American racial groups across all gynecologic malignancies. We identify novel discrete genomic changes in these complex malignancies and suggest a framework for identifying novel therapeutic targets for future investigation.
Topics: Humans; Female; Genital Neoplasms, Female; Racial Groups; Black or African American; Genomics; White
PubMed: 35992327
DOI: 10.1158/2767-9764.crc-21-0018 -
Appetite Feb 2022Red and processed meat (RPM) consumption associates directly with several unfavorable health outcomes and with environmental impact of diet. RPM consumption differs...
Red and processed meat (RPM) consumption associates directly with several unfavorable health outcomes and with environmental impact of diet. RPM consumption differs between certain population groups, and moreover, encompasses various subjective meanings. Literature on determinants of subjective importance of meat in diet (SIM), however, is scarce. Aims of this study were to determine which sociodemographic and -economic characteristics associate with SIM and RPM consumption. The study was based on the FinHealth 2017 Study. The sample comprised 4671 participants aged 18-74 years. SIM was asked with a question including five response options from "not important at all" to "very important". Habitual dietary intake including RPM consumption was studied with a food frequency questionnaire. RPM consumption level grew in parallel with SIM categories. RPM consumption was high and SIM prevailing in men, those living in rural areas, and those with low education. Women living in household with children consumed more RPM than other women but did not find meat more important. Conversely, men living in household with children found meat more important but did not consume it more than other men. Domain analyses considering individuals within the highest RPM consumption quintile revealed that the oldest age group found meat significantly less important than the youngest group. In order to be able to lower RPM consumption at population level and to move towards healthier and climate-wiser diets, it is important to identify subgroups that consume much meat but also subgroups that find meat especially important. Such dietary transition may be especially challenging to subgroups that consume much meat and also consider it important. Actions to support the dietary transition in different population groups should be developed.
Topics: Adolescent; Adult; Aged; Child; Diet; Diet Surveys; Eating; Female; Humans; Male; Meat; Middle Aged; Population Groups; Red Meat; Young Adult
PubMed: 34871587
DOI: 10.1016/j.appet.2021.105836 -
Trends in Cancer Apr 2022Cancer death rates vary among population groups. Underserved populations continue to experience an excessive burden of lethal cancers that is largely explained by... (Review)
Review
Cancer death rates vary among population groups. Underserved populations continue to experience an excessive burden of lethal cancers that is largely explained by health-care disparities. However, the prominent role of advanced-stage disease as a driver of cancer survival disparities may indicate that some cancers are more aggressive in certain population groups than others. The tumor mutational burden can show large differences among patients with similar-stage disease but differences in race/ethnicity or residence. These dissimilarities may result from environmental or chronic inflammatory exposures, altering tumor biology and the immune response. We discuss the evidence that inflammation and immune response dissimilarities among population groups contribute to cancer disparities and how they can be targeted to reduce these disparities.
Topics: Black or African American; Healthcare Disparities; Humans; Immunity; Inflammation; Neoplasms
PubMed: 34965905
DOI: 10.1016/j.trecan.2021.11.010 -
Journal of Burn Care & Research :... Sep 2022Disparities in psychosocial outcomes after burn injury exist in patients from racial or ethnic minority groups in the United States. Peer support groups can help...
Disparities in psychosocial outcomes after burn injury exist in patients from racial or ethnic minority groups in the United States. Peer support groups can help patients with many psychosocial aspects of recovery from burns; however, access to such support among patients of racial and ethnic minority or low socioeconomic groups are unknown. The present study examined participation rates in outpatient peer support within this patient population. Patients attending outpatient clinic at an urban safety-net hospital and regional burn center with a majority minority patient population were asked about participation in burn survivor group, interest in joining a group, and given validated survey questions about managing emotions and social interactions since injury. Current or past participation in peer support was low (4.2%), and 30.3% of patients not already in support group were interested in joining. Interest in future participation in peer support was highest among Hispanic patients (37.0%) and lowest among Black patients (0%). Logistic regression models demonstrated that increased total body surface area burned, hospital length of stay, and need for surgical intervention were associated with interest in joining or having joined a peer support group. Effectiveness of management of emotions and social interactions were not associated with interest in joining peer support in the future. These findings demonstrate a considerable difference between levels of interest and participation in peer support within this population. Improving access to and education about benefits of peer support in underresourced communities may help to address the variation in psychosocial outcomes of patients across racial or ethnic minority groups recovering from burns.
Topics: Burns; Ethnicity; Hispanic or Latino; Humans; Minority Groups; Self-Help Groups; United States
PubMed: 35781574
DOI: 10.1093/jbcr/irac086