-
BMC Geriatrics May 2016Multiple factors influence the end-of-life (EoL) care and experience of poor quality services by culturally- and spiritually-diverse groups. Access to EoL services e.g.... (Review)
Review
BACKGROUND
Multiple factors influence the end-of-life (EoL) care and experience of poor quality services by culturally- and spiritually-diverse groups. Access to EoL services e.g. health and social supports at home or in hospices is difficult for ethnic minorities compared to white European groups. A tool is required to empower patients and families to access culturally-safe care. This review was undertaken by the Canadian Virtual Hospice as a foundation for this tool.
METHODS
To explore attitudes, behaviours and patterns to utilization of EoL care by culturally and spiritually diverse groups and identify gaps in EoL care practice and delivery methods, a scoping review and thematic analysis of article content was conducted. Fourteen electronic databases and websites were searched between June-August 2014 to identify English-language peer-reviewed publications and grey literature (including reports and other online resources) published between 2004-2014.
RESULTS
The search identified barriers and enablers at the systems, community and personal/family levels. Primary barriers include: cultural differences between healthcare providers; persons approaching EoL and family members; under-utilization of culturally-sensitive models designed to improve EoL care; language barriers; lack of awareness of cultural and religious diversity issues; exclusion of families in the decision-making process; personal racial and religious discrimination; and lack of culturally-tailored EoL information to facilitate decision-making.
CONCLUSIONS
This review highlights that most research has focused on decision-making. There were fewer studies exploring different cultural and spiritual experiences at the EoL and interventions to improve EoL care. Interventions evaluated were largely educational in nature rather than service oriented.
Topics: Canada; Cultural Characteristics; Decision Making; Ethnicity; Family; Humans; Racial Groups; Social Support; Spirituality; Terminal Care
PubMed: 27193395
DOI: 10.1186/s12877-016-0282-6 -
BMJ (Clinical Research Ed.) Mar 2011To determine whether the ethnicity of UK trained doctors and medical students is related to their academic performance. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To determine whether the ethnicity of UK trained doctors and medical students is related to their academic performance.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
Online databases PubMed, Scopus, and ERIC; Google and Google Scholar; personal knowledge; backwards and forwards citations; specific searches of medical education journals and medical education conference abstracts.
STUDY SELECTION
The included quantitative reports measured the performance of medical students or UK trained doctors from different ethnic groups in undergraduate or postgraduate assessments. Exclusions were non-UK assessments, only non-UK trained candidates, only self reported assessment data, only dropouts or another non-academic variable, obvious sampling bias, or insufficient details of ethnicity or outcomes. Results 23 reports comparing the academic performance of medical students and doctors from different ethnic groups were included. Meta-analyses of effects from 22 reports (n = 23,742) indicated candidates of "non-white" ethnicity underperformed compared with white candidates (Cohen's d = -0.42, 95% confidence interval -0.50 to -0.34; P<0.001). Effects in the same direction and of similar magnitude were found in meta-analyses of undergraduate assessments only, postgraduate assessments only, machine marked written assessments only, practical clinical assessments only, assessments with pass/fail outcomes only, assessments with continuous outcomes only, and in a meta-analysis of white v Asian candidates only. Heterogeneity was present in all meta-analyses.
CONCLUSION
Ethnic differences in academic performance are widespread across different medical schools, different types of exam, and in undergraduates and postgraduates. They have persisted for many years and cannot be dismissed as atypical or local problems. We need to recognise this as an issue that probably affects all of UK medical and higher education. More detailed information to track the problem as well as further research into its causes is required. Such actions are necessary to ensure a fair and just method of training and of assessing current and future doctors.
Topics: Education, Medical, Graduate; Education, Medical, Undergraduate; Educational Measurement; Educational Status; Humans; Prospective Studies; Racial Groups; Retrospective Studies; Students, Medical; United Kingdom
PubMed: 21385802
DOI: 10.1136/bmj.d901 -
PloS One 2016The Other-Race Effect (ORE) is the robust and well-established finding that people are generally poorer at facial recognition of individuals of another race than of... (Comparative Study)
Comparative Study
The Other-Race Effect (ORE) is the robust and well-established finding that people are generally poorer at facial recognition of individuals of another race than of their own race. Over the past four decades, much research has focused on the ORE because understanding this phenomenon is expected to elucidate fundamental face processing mechanisms and the influence of experience on such mechanisms. Several recent studies of the ORE in which the eye-movements of participants viewing own- and other-race faces were tracked have, however, reported highly conflicting results regarding the presence or absence of differential patterns of eye-movements to own- versus other-race faces. This discrepancy, of course, leads to conflicting theoretical interpretations of the perceptual basis for the ORE. Here we investigate fixation patterns to own- versus other-race (African and Chinese) faces for Caucasian participants using different analysis methods. While we detect statistically significant, though subtle, differences in fixation pattern using an Area of Interest (AOI) approach, we fail to detect significant differences when applying a spatial density map approach. Though there were no significant differences in the spatial density maps, the qualitative patterns matched the results from the AOI analyses reflecting how, in certain contexts, Area of Interest (AOI) analyses can be more sensitive in detecting the differential fixation patterns than spatial density analyses, due to spatial pooling of data with AOIs. AOI analyses, however, also come with the limitation of requiring a priori specification. These findings provide evidence that the conflicting reports in the prior literature may be at least partially accounted for by the differences in the statistical sensitivity associated with the different analysis methods employed across studies. Overall, our results suggest that detection of differences in eye-movement patterns can be analysis-dependent and rests on the assumptions inherent in the given analysis.
Topics: Adolescent; Adult; Eye Movements; Face; Female; Fixation, Ocular; Humans; Male; Racial Groups; Recognition, Psychology; Spatial Analysis; Young Adult
PubMed: 26849447
DOI: 10.1371/journal.pone.0148253 -
Scientific Reports Dec 2019People often recognize and remember faces of individuals within their own race more easily than those of other races. While behavioral research has long suggested that...
People often recognize and remember faces of individuals within their own race more easily than those of other races. While behavioral research has long suggested that the Other-Race Effect (ORE) is due to extensive experience with one's own race group, the neural mechanisms underlying the effect have remained elusive. Predominant theories of the ORE have argued that the effect is mainly caused by processing disparities between same and other-race faces during early stages of perceptual encoding. Our findings support an alternative view that the ORE is additionally shaped by mnemonic processing mechanisms beyond perception and attention. Using a "pattern separation" paradigm based on computational models of episodic memory, we report evidence that the ORE may be driven by differences in successful memory discrimination across races as a function of degree of interference or overlap between face stimuli. In contrast, there were no ORE-related differences on a comparable match-to-sample task with no long-term memory load, suggesting that the effect is not simply attributable to visual and attentional processes. These findings suggest that the ORE may emerge in part due to "tuned" memory mechanisms that may enhance same-race, at the expense of other-race face detection.
Topics: Adolescent; Adult; Attention; Behavior; Face; Female; Humans; Male; Memory; Memory, Long-Term; Mental Recall; Pattern Recognition, Visual; Racial Groups; Recognition, Psychology; Social Perception; Young Adult
PubMed: 31853093
DOI: 10.1038/s41598-019-55350-0 -
Journal of Applied Gerontology : the... May 2023We examined the association between history of incarceration (HOI) and food insecurity (FI) among older adults using pooled data from 12,702 respondents aged 51+ who...
We examined the association between history of incarceration (HOI) and food insecurity (FI) among older adults using pooled data from 12,702 respondents aged 51+ who participated in the 2012 and 2014 waves of the Health and Retirement Study. In our sample, 12.8% of participants reported FI. Those with a HOI had an increased odds of FI (OR 1.83; 95% CI 1.52-2.21). Race/ethnicity moderated the association between HOI and FI. The positive and statistically significant association was concentrated among Non-Hispanic Black and Non-Hispanic White participants. No statistically significant association was found among Hispanic participants or among those from other racial/ethnic groups. Income, depressive symptoms, and functional limitations mediated the association between HOI and FI, with the largest indirect effects observed for income. FI is an important issue among older adults with a HOI. Programs and policy initiatives to increase food access and/or improve earnings in this population may be needed.
Topics: Aged; Humans; Ethnicity; Food Insecurity; Prisoners; Racial Groups
PubMed: 36749644
DOI: 10.1177/07334648231152152 -
Genetics in Medicine : Official Journal... Aug 2021Asian Americans have been understudied in the literature on genetic and genomic services. The current study systematically identified, evaluated, and summarized findings...
PURPOSE
Asian Americans have been understudied in the literature on genetic and genomic services. The current study systematically identified, evaluated, and summarized findings from relevant qualitative and quantitative studies on genetic health care for Asian Americans.
METHODS
A search of five databases (1990 to 2018) returned 8,522 unique records. After removing duplicates, abstract/title screening, and full text review, 47 studies met inclusion criteria. Data from quantitative studies were converted into "qualitized data" and pooled together with thematic data from qualitative studies to produce a set of integrated findings.
RESULTS
Synthesis of results revealed that (1) Asian Americans are under-referred but have high uptake for genetic services, (2) linguistic/communication challenges were common and Asian Americans expected more directive genetic counseling, and (3) Asian Americans' family members were involved in testing decisions, but communication of results and risk information to family members was lower than other racial groups.
CONCLUSION
This study identified multiple barriers to genetic counseling, testing, and care for Asian Americans, as well as gaps in the research literature. By focusing on these barriers and filling these gaps, clinical genetic approaches can be tailored to meet the needs of diverse patient groups, particularly those of Asian descent.
Topics: Asian; Family; Genetic Counseling; Humans; Qualitative Research; Racial Groups
PubMed: 33972720
DOI: 10.1038/s41436-021-01169-y -
Risk of pancreatic adenocarcinoma: disparity between African Americans and other race/ethnic groups.Cancer Jan 2005African Americans have a higher incidence of pancreatic adenocarcinoma compared with non-Hispanic whites. Whether other clinical differences exist between these two... (Comparative Study)
Comparative Study
BACKGROUND
African Americans have a higher incidence of pancreatic adenocarcinoma compared with non-Hispanic whites. Whether other clinical differences exist between these two groups is not well known.
METHODS
The authors conducted a population-based retrospective analysis of all patients with pancreatic adenocarcinoma in both a regional and a statewide database between 1988 and 1998. Their goal was to evaluate differences in incidence rates, clinical presentation, including age at diagnosis, gender, and tumor characteristics, and treatment among race/ethnic groups.
RESULTS
African Americans had a higher age-adjusted incidence rate of pancreatic adenocarcinoma (8.78) compared with non-Hispanic whites (5.89), Hispanics (5.09), Asians (4.75), and all race/ethnicities combined (5.82). African Americans also presented at a later stage of disease and received less surgery than all other race/ethnicities, despite equal availability of medical insurance. The analyses also revealed gender differences. In general, males maintained a higher incidence rate of pancreatic adenocarcinoma than females across all race/ethnicities. In all race/ethnic groups, females were diagnosed at an older age and an earlier stage of disease than males. The proportional hazard mortality ratio for females age < 60 was significantly less than that for males in the same age group (P < 0.02), even after accounting for stage and treatment.
CONCLUSIONS
African Americans in California had a higher incidence rate of pancreatic adenocarcinoma, had a slightly higher risk of presenting with advanced-stage disease and with nonresectable tumors (i.e., tumors located in the body or tail of the pancreas), and underwent less surgical treatment than all other race/ethnicities. Younger females in all race/ethnic groups had a survival advantage over males of the same age.
Topics: Adenocarcinoma; Adult; Black or African American; Age Distribution; Aged; Aged, 80 and over; California; Female; Hispanic or Latino; Humans; Incidence; Male; Middle Aged; Neoplasm Staging; Pancreatic Neoplasms; Probability; Proportional Hazards Models; Racial Groups; Registries; Retrospective Studies; Risk Factors; Sex Distribution; Survival Analysis; White People
PubMed: 15593353
DOI: 10.1002/cncr.20771 -
Journal of Racial and Ethnic Health... Aug 2022Pacific Islanders (PIs), an indigenous, diverse population in the USA, have endured generational burdens of Western colonization and institutional racism that placed...
BACKGROUND
Pacific Islanders (PIs), an indigenous, diverse population in the USA, have endured generational burdens of Western colonization and institutional racism that placed this population at socioeconomic and health disadvantages, such as in poverty, chronic disease, and now COVID-19. However, little is known about the impact of COVID-19 on this historically disadvantaged population. This study assessed the extent US PIs have been adversely affected by COVID-19 across the 50 states.
METHODS
Using state-level national data as of September 9th, 2020, we conducted a secondary-data analysis of COVID-19 cases and deaths in PIs relative to their population representation and other racial groups, case odds ratios, and age-adjusted standard mortality ratios.
KEY RESULTS
Only 46% of states reported PI cases and 36% of states reported PI deaths. Of 23 states with available data on PIs, PIs were overrepresented in COVID-19 cases and deaths relative to their population representation in 21 and 14 states, respectively. The proportion of COVID-19 cases and deaths to the PI population was highest among all racial groups in 15 and 9 states, respectively. PIs had higher odds of exposure to COVID-19 than Whites in 21 of 23 states, and higher number of observed deaths than expected in 6 of 7 states with available PI data.
CONCLUSIONS
Engaging PI community-based and faith-based organizations in medical and public health outreach efforts, health workforce employment and training programs, along with granular data collection and reporting, are vital to mitigate the disproportionate effects of COVID-19 on this population.
Topics: COVID-19; Chronic Disease; Humans; Native Hawaiian or Other Pacific Islander; Racial Groups; United States; White People
PubMed: 34169488
DOI: 10.1007/s40615-021-01075-8 -
JAMA Network Open May 2024An understanding of the intersectional effect of sexual identity, race, and ethnicity on disparities in cardiovascular health (CVH) has been limited.
IMPORTANCE
An understanding of the intersectional effect of sexual identity, race, and ethnicity on disparities in cardiovascular health (CVH) has been limited.
OBJECTIVE
To evaluate differences in CVH at the intersection of race, ethnicity, and sexual identity using the American Heart Association's Life's Essential 8 measure.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study was conducted from July 27 to September 6, 2023, using National Health and Nutrition Examination Survey data from 2007 to 2016. Participants were noninstitutionalized, nonpregnant adults (aged 18-59 years) without cardiovascular disease or stroke.
EXPOSURES
Self-reported sexual identity, categorized as heterosexual or sexual minority (SM; lesbian, gay, bisexual, or "something else"), and self-reported race and ethnicity, categorized as non-Hispanic Black (hereafter, Black), Hispanic, non-Hispanic White (hereafter, White), and other (Asian, multiracial, or any other race and ethnicity).
MAIN OUTCOME AND MEASURES
The primary outcome was overall CVH score, which is the unweighted mean of 8 CVH metrics, assessed from questionnaire, dietary, and physical examination data. Regression models stratified by sex, race, and ethnicity were developed for the overall CVH score and individual CVH metrics, adjusting for age, survey year, and socioeconomic status (SES) factors.
RESULTS
The sample included 12 180 adults (mean [SD] age, 39.6 [11.7] years; 6147 [50.5%] male, 2464 [20.2%] Black, 3288 [27.0%] Hispanic, 5122 [42.1%] White, and 1306 [10.7%] other race and ethnicity). After adjusting for age, survey year, and SES, Black (β, -3.2; 95% CI, -5.8 to -0.6), Hispanic (β, -5.9; 95% CI, -10.3 to -1.5), and White (β, -3.3; 95% CI, -6.2 to -0.4) SM female adults had lower overall CVH scores compared with their heterosexual counterparts. There were no statistically significant differences for female adults of other race and ethnicity (β, -2.8; 95% CI, -9.3 to 3.7) and for SM male adults of any race and ethnicity compared with their heterosexual counterparts (Black: β, 2.2 [95% CI, -1.2 to 5.7]; Hispanic: β, -0.9 [95% CI, -6.3 to 4.6]; White: β, 1.5 [95% CI, -2.2 to 5.2]; other race and ethnicity: β, -2.2 [95% CI, -8.2 to 3.8]).
CONCLUSIONS AND RELEVANCE
In this cross-sectional study, CVH differed across race and ethnicity categories in SM females, suggesting that different communities within the larger SM population require tailored interventions to improve CVH. Longitudinal studies are needed to identify the causes of CVH disparities, particularly in Black and Hispanic SM females and inclusive of other racial and ethnic identities.
Topics: Humans; Male; Female; Adult; Cross-Sectional Studies; Middle Aged; Cardiovascular Diseases; United States; Adolescent; Nutrition Surveys; Young Adult; Ethnicity; Health Status Disparities; Racial Groups; Sexual and Gender Minorities
PubMed: 38691360
DOI: 10.1001/jamanetworkopen.2024.9060 -
Hawai'i Journal of Health & Social... Oct 2023Federal race and ethnicity data standards are commonly applied within the state of Hawai'i. When a multiracial category is used, Native Hawaiians are disproportionately... (Review)
Review
Federal race and ethnicity data standards are commonly applied within the state of Hawai'i. When a multiracial category is used, Native Hawaiians are disproportionately affected since they are more likely than any other group to identify with an additional race or ethnicity group. These data conventions contribute to a phenomenon known as data genocide - the systematic erasure of Indigenous and marginalized peoples from population data. While data aggregation may be unintentional or due to real or perceived barriers, the obstacles to disaggregating data must be overcome to advance health equity. In this call for greater attention to relevant social determinants of health through disaggregation of race and ethnicity data, the history of data standards is reviewed, the implications of aggregation are discussed, and recommended disaggregation strategies are provided.
Topics: Humans; Ethnicity; Hawaii; Health Status Disparities; Native Hawaiian or Other Pacific Islander; Data Analysis; Racial Groups; Social Determinants of Health; Health Disparate Minority and Vulnerable Populations; Health Equity
PubMed: 37901675
DOI: No ID Found