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Health & Place Nov 2022In the United States, racial disparities in adverse maternal health outcomes remain a pressing issue, with Black women experiencing a 3-4 times higher risk of maternal... (Review)
Review
In the United States, racial disparities in adverse maternal health outcomes remain a pressing issue, with Black women experiencing a 3-4 times higher risk of maternal mortality and a 2-3 times higher risk of severe maternal morbidity. Despite recent encouraging efforts, fundamental determinants of these alarming inequities (e.g. structural racism) remain understudied. Approaches that address these structural drivers are needed to then intervene upon root causes of adverse maternal outcomes and their disparities and to ultimately improve maternal health across the U.S. In this paper, we offer a conceptual framework for studies of structural racism and maternal health disparities and systematically synthesize the current empirical epidemiologic literature on the links between structural racism measures and adverse maternal health outcomes. For the systematic review, we searched electronic databases (Pubmed, Web of Science, and EMBASE) to identify peer-reviewed U.S. based quantitative articles published between 1990 and 2021 that assessed the link between measures of structural racism and indicators of maternal morbidity/mortality. Our search yielded 2394 studies and after removing duplicates, 1408 were included in the title and abstract screening, of which 18 were included in the full text screening. Only 6 studies met all the specified inclusion criteria for this review. Results revealed that depending on population sub-group analyzed, measures used, and covariates considered, there was evidence that structural racism may increase the risk of adverse maternal health outcomes. This review also highlighted several areas for methodological and theoretical development in this body of work. Future work should more comprehensively assess structural racism in a way that informs policy and interventions, which can ameliorate its negative consequences on racial/ethnic disparities in maternal morbidity/mortality.
Topics: Humans; Female; Maternal Health; Systemic Racism; Black People; Databases, Factual; Ethnicity
PubMed: 36401939
DOI: 10.1016/j.healthplace.2022.102923 -
Annals of Epidemiology May 2019The weathering hypothesis states that chronic exposure to social and economic disadvantage leads to accelerated decline in physical health outcomes and could partially...
PURPOSE
The weathering hypothesis states that chronic exposure to social and economic disadvantage leads to accelerated decline in physical health outcomes and could partially explain racial disparities in a wide array of health conditions. This systematic review summarizes the literature empirically testing the weathering hypothesis and assesses the quality of the evidence regarding weathering as a determinant of racial disparities in health.
METHODS
Databases (Web of Science, Ovid MEDLINE, PubMed, and Embase) were searched for studies published in English up to July 1, 2017. Studies that tested the weathering hypothesis for any physical health outcome and included at least one socially or economically disadvantaged group (e.g., Blacks) for whom the weathering hypothesis applies were assessed for eligibility. Threats to validity were assessed using the Quality in Prognostic Studies tool.
RESULTS
The 41 included studies were rated as having overall good methodological quality. Most studies found evidence in support of the weathering hypothesis, although the magnitude of support varied by the health outcome and population studied.
CONCLUSIONS
Future evaluations of the weathering hypothesis should include an examination of additional health outcomes and interrogate mechanisms that could link weathering to poor health.
Topics: Ethnicity; Health Status Disparities; Healthcare Disparities; Humans; Population Groups; Social Determinants of Health
PubMed: 30987864
DOI: 10.1016/j.annepidem.2019.02.011 -
Ethnicity & Health May 2023Diabetes mellitus (DM), a significant public health problem across the nations, is among the top ten leading causes of death. More than 370 million indigenous people... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Diabetes mellitus (DM), a significant public health problem across the nations, is among the top ten leading causes of death. More than 370 million indigenous people (referred to as tribal people in India) are spread across 90 countries. India has the largest tribal people of 104 million. Tribal populations are not exceptional to the threat of type 2 DM (T2DM) and other non-communicable diseases, and hence, public health programmes are addressing this problem. This paper reports the systematic review and meta-analysis of the literature on the prevalence of T2DM.
METHODS
We conducted a systematic review and meta-analysis of the literature to understand the prevalence of T2DM among the tribal populations of India, following the guidelines of the PRISMA Statement for Reporting Systematic Reviews and Meta-Analysis. The gender-wise prevalence was recalculated by extracting the data wherever possible. Forest plots were depicted based on the prevalence, and other analyses were performed.
RESULTS
On initial searches from three databases, 5422 citations were identified, and ultimately 27 studies were included in the review. These studies were undertaken amongst different tribes in different parts of India. The pooled prevalence of T2DM among men, women and combined were 6.04% (95% confidence interval (CI): 5.55% to 6.57%), 6.48% (95% CI: 6.01% to 6.99%) and 4.94% (95% CI: 4.72% to 5.17%), respectively. Considerable heterogeneity was found among these studies.
CONCLUSION
This systematic review provides an overview of the prevalence of T2DM among the Indian tribal population. The pooled overall prevalence is slightly lower than the general population. This situation is worrisome as the epidemic of T2DM will affect the poor tribal communities, who can least afford to bear the health care costs. Hence, the public health care services must be strengthened in all tribal areas. This review further warrants establishing surveillance of T2DM in tribal areas.
Topics: Female; Humans; Male; Diabetes Mellitus, Type 2; India; Indigenous Peoples; Population Groups; Prevalence; Public Health; South Asian People
PubMed: 35469488
DOI: 10.1080/13557858.2022.2067836 -
Journal of Science and Medicine in Sport Sep 2016To evaluate research into the effectiveness of group-based sport and exercise programs targeting Indigenous adults on anthropometric, physiological and quality of life... (Review)
Review
OBJECTIVES
To evaluate research into the effectiveness of group-based sport and exercise programs targeting Indigenous adults on anthropometric, physiological and quality of life outcomes.
DESIGN
A systematic review with quality assessment of study design.
METHODS
A computer-based literature search of EBSCO, SPORTDiscus, CINAHL, Informit, Scopus, Web of Science, Medline, PubMed, Global Health, ProQuest and Discover databases was conducted. Methodological quality of individual articles was assessed using McMasters University Guidelines and Appraisal Forms for Critical Review for Quantitative Research. Results of the effectiveness of programs are then summarised.
RESULTS
Six articles were identified with critical appraisal scores ranging from 6 to 12 (from a possible 15 points), with a mean score of 9.6. Five articles were of moderate to good quality. Significant improvements were observed in anthropometric, physiological and quality of life outcomes across all studies. Elements of successful group-based exercise and sport programs corresponded to global recommendations on physical activity for health for 18 to 64 year olds, and were implemented over a period of time ranging from 12 to 24 weeks to exhibit results, plus community consultation in developing programs and nutrition education.
CONCLUSIONS
Group-based programs that include nutrition, exercise and/or sport components are effective in producing short to intermediate term health outcomes among Indigenous adults. Further high quality research, specifically on group-based modified sport programs for Indigenous adults that are culturally appropriate and aim to improve quality of life are needed.
Topics: Adult; Australia; Exercise; Health Promotion; Humans; Native Hawaiian or Other Pacific Islander; Program Evaluation; Quality of Life; Sports
PubMed: 26703238
DOI: 10.1016/j.jsams.2015.11.005 -
Clinical Oral Investigations Nov 2021The aim of this study was to quantify the symmetry of the facial hard tissue structures using three-dimensional radiographic imaging modalities in a normal Caucasian... (Review)
Review
OBJECTIVE
The aim of this study was to quantify the symmetry of the facial hard tissue structures using three-dimensional radiographic imaging modalities in a normal Caucasian population group.
MATERIALS AND METHODS
Electronic literature search was conducted in the following databases: PubMed, Embase, Web of Science, and Cochrane Library up to February 2021. The studies assessing symmetry of facial bones using computed tomography (CT) and cone beam CT were included.
RESULTS
The initial search revealed 8811 studies. Full-text analysis was performed on 33 studies. Only 10 studies were found eligible based on the inclusion criteria. The qualitative analysis revealed that a significant variability existed in relation to the methodologies applied for symmetry quantification.
CONCLUSION
The current review suggested that the overall relative symmetry of the normal Caucasian population group varied depending on the skeletal structure being assessed; however, majority of the observations showed a symmetry within the range of 1 mm without any significant difference between left and right sides.
CLINICAL RELEVANCE
The quantification of facial hard tissue structure symmetry is vital for the diagnosis and treatment planning of orthodontic and/or maxillofacial surgical procedures. Prospero registration number CRD42020169908.
Topics: Cone-Beam Computed Tomography; Facial Bones; Humans; Imaging, Three-Dimensional; Population Groups; Tomography, X-Ray Computed
PubMed: 34386858
DOI: 10.1007/s00784-021-04126-w -
BMC Primary Care Nov 2023Integrated people-centred health services (IPCHS) are vital for ensuring comprehensive care towards achieving universal health coverage (UHC). The World Health... (Review)
Review
BACKGROUND
Integrated people-centred health services (IPCHS) are vital for ensuring comprehensive care towards achieving universal health coverage (UHC). The World Health Organisation (WHO) envisions IPCHS in delivery and access to health services. This scoping review aimed to synthesize available evidence on people-centred primary health care (PHC) and primary care.
METHODS
We conducted a scoping review of published literature on people-centred PHC. We searched eight databases (PubMed, Scopus, Embase, CINAHL, Cochrane, PsycINFO, Web of Science, and Google Scholar) using search terms related to people-centred and integrated PHC/primary care services. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist to select studies. We analyzed data and generated themes using Gale's framework thematic analysis method. Themes were explained under five components of the WHO IPCHS framework.
RESULTS
A total of fifty-two studies were included in the review; most were from high-income countries (HICs), primarily focusing on patient-centred primary care. Themes under each component of the framework included: engaging and empowering people and communities (engagement of community, empowerment and empathy); strengthening governance and accountability (organizational leadership, and mutual accountability); reorienting the model of care (residential care, care for multimorbidity, participatory care); coordinating services within and across sectors (partnership with stakeholders and sectors, and coordination of care); creating an enabling environment and funding support (flexible management for change; and enabling environment).
CONCLUSIONS
Several people-centred PHC and primary care approaches are implemented in HICs but have little priority in low-income countries. Potential strategies for people-centred PHC could be engaging end users in delivering integrated care, ensuring accountability, and implementing a residential model of care in coordination with communities. Flexible management options could create an enabling environment for strengthening health systems to deliver people-centred PHC services.
Topics: Humans; Patient-Centered Care; Health Services; Population Groups; Government Programs; Income
PubMed: 37946115
DOI: 10.1186/s12875-023-02194-3 -
Nutrition Reviews Jun 2022There is no systematic review on the relationship between racial discrimination and eating habits.
CONTEXT
There is no systematic review on the relationship between racial discrimination and eating habits.
OBJECTIVE
A systematic review was conducted to synthesize evidence on the association between perceived racial discrimination (PRD) and eating habits. A conceptual model was developed to depict the most common mechanisms used to explain this association.
DATA SOURCES
Articles were retrieved from the PubMed, Embase, LILACS, and PsycINFO databases from inception to January 2021.
STUDY SELECTION
Only observational studies were included, and there were no restrictions on age, racial group, or country. Two reviewers selected the articles independently.
DATA EXTRACTION
Data were extracted independently by 2 reviewers. The assessment of methodological quality was conducted using the Newcastle-Ottawa Scale.
RESULTS
All studies retrieved were conducted among the US population. Nineteen studies were included. On average, the studies showed a methodological quality of 66%. Forty-six associations were evaluated: 38 between PRD and negative eating habits, 29 between PRD and eating behavior, and 17 between PRD and food consumption.
CONCLUSIONS
PRD negatively affects eating habits. A conceptual framework based on ecosocial theory is suggested as a guide for future research. Further studies in different countries (beyond the United States) should be conducted to understand how racial discrimination affects eating habits within different ethnic, cultural, social, and economic contexts.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42019142605.
Topics: Ethnicity; Feeding Behavior; Humans; Racism; United States
PubMed: 35182155
DOI: 10.1093/nutrit/nuac001 -
Black and minority ethnic group involvement in health and social care research: A systematic review.Health Expectations : An International... Feb 2018Patient and public involvement (PPI) in research is growing internationally, but little is known about black and minority ethnic (BME) involvement and the factors...
BACKGROUND
Patient and public involvement (PPI) in research is growing internationally, but little is known about black and minority ethnic (BME) involvement and the factors influencing their involvement in health and social care research.
OBJECTIVES
To characterize and critique the empirical literature on BME-PPI involvement in health and social care research.
SEARCH STRATEGY
Systematic searches of six electronic bibliographic databases were undertaken, utilizing both MeSH and free-text terms to identify international empirical literature published between 1990 and 2016.
INCLUSION CRITERIA
All study designs that report primary data that involved BME groups in health or social care research. Screening was conducted by two reviewers.
DATA EXTRACTION AND SYNTHESIS
Data extraction and quality appraisal were performed independently. Data extraction focused on the level(s) of PPI involvement and where PPI activity occurred in the research cycle. Studies were quality-assessed using the guidelines for measuring the quality and impact of user involvement in research. Data were analysed using a narrative approach.
MAIN RESULTS
Forty-five studies were included with the majority undertaken in the USA focusing on African Americans and indigenous populations. Involvement most commonly occurred during the research design phase and least in data analysis and interpretation.
CONCLUSION
This is the first systematic review investigating BME involvement in health and social care research internationally. While there is a widespread support for BME involvement, this is limited to particular phases of the research and particular ethnic subgroups. There is a need to understand factors that influence BME involvement in all parts of the research cycle.
Topics: Black People; Health Services Research; Humans; Internationality; Minority Groups; Patient Participation
PubMed: 28812330
DOI: 10.1111/hex.12597 -
American Journal of Rhinology & Allergy Mar 2021Olfactory dysfunction (OD) is common and has been reported as an early indicator of COVID-19. However, the reported prevalence of OD in the general population varies... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Olfactory dysfunction (OD) is common and has been reported as an early indicator of COVID-19. However, the reported prevalence of OD in the general population varies widely depending upon the metric used to assess olfaction. To perform a systematic review and meta-analysis of the prevalence of OD in the healthy general population, review the various assessment metrics used, and compare pooled OD prevalence rates.
RESULTS
A total of 175,073 subjects were identified (mean age 63.5 years, range 18 to 101) with an overall OD prevalence of 22.2% (95% CI 14.8-30.6). OD prevalence was significantly greater using objective olfactory assessments, compared to subjective measures (28.8%, CI 20.3-38.2 versus 9.5%, CI 6.1-13.5, p < 0.001). The prevalence of OD was greater using expanded identification tests (>8 items) compared to brief test with ≤8 items (30.3%, CI 16.2-46.5 versus 21.2%, CI 12.3-31.8). Prevalence was higher in studies with a mean age greater than 55 years compared to those with a mean age of 55 years or less (34.5%, CI 23.4-46.5 versus 7.5%, CI 2.6-14.5, p < 0.001).
CONCLUSIONS
The reported prevalence of OD in the general population depends on the testing method and population age. OD prevalence was greater in studies using objective tests, expanded identification tests, and in those with older subjects.
Topics: Age Factors; COVID-19; Humans; Middle Aged; Olfaction Disorders; Population Groups; Prevalence; Risk; SARS-CoV-2; Smell
PubMed: 32746612
DOI: 10.1177/1945892420946254 -
The Gerontologist Jul 2021Studies comparing racial/ethnic differences on measures of psychological and physical well-being for dementia caregivers have reported differences between minority and... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Studies comparing racial/ethnic differences on measures of psychological and physical well-being for dementia caregivers have reported differences between minority and white caregivers. Recruitment methods often differ for minority and white participants due to enrollment targets and may lead to biased comparisons, especially in convenience samples. We aimed to examine racial/ethnic differences in dementia caregiver outcomes and to determine whether differences vary between studies with population-based or convenience samples.
RESEARCH DESIGN AND METHODS
We systematically reviewed articles with primary data from PubMed, Google Scholar, and PsycINFO. We included studies comparing African American or Hispanic/Latino to white dementia caregivers on measures of psychological well-being or physical well-being. Reviewers screened titles and abstracts, reviewed full texts and conducted risk-of-bias assessments. Meta-analyses were conducted to assess effects by race/ethnicity and study bias.
RESULTS
A total of 159 effects were extracted from 38 studies, 2 of which were population based. Random-effects models revealed small but statistically significant effects with better psychological well-being in African American caregivers compared with white caregivers in both population-based (d = -0.22) and convenience sample studies (d = -0.21). Hispanics/Latino caregivers reported lower levels of physical well-being than white caregivers (d = 0.12), though these effects varied by level of rated study bias.
DISCUSSION AND IMPLICATIONS
Consistency across study methods raises confidence in the validity of previous reports of better psychological well-being in African American caregivers. Future studies should use population-based samples with subgroups of Hispanic/Latino, Asian American, and American Indian caregivers that are culturally distinct on factors such as country of origin and tribe.
Topics: Black or African American; Caregivers; Dementia; Hispanic or Latino; Humans; White People
PubMed: 32271380
DOI: 10.1093/geront/gnaa028