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Research Studies is a compilation of published research articles funded by ´óÏóAPPor authored by ´óÏóAPPresearchers.

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76 to 100 of 773 Research Studies Displayed
Griesemer I, Birken SA, Rini C
Mechanisms to enhance racial equity in health care: developing a model to facilitate translation of the ACCURE intervention.
The purpose of this study was to explore the Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) program, which altered systems of care at two United States cancer centers and eliminated the Black-White racial disparity in treatment completion in patients with early-stage breast and lung cancer. The study objective was to identify and document critical characteristics of ACCURE to enable translation of the intervention to other care settings. The researchers conducted semi-structured interviews with 18 participants who were involved in the design and implementation of ACCURE. The study found that participants described transparency and accountability as mechanisms of change that were operationalized through ACCURE's key features. Intervention features were designed to improve either institutional transparency or accountability of the care system to community values and patient needs for minimally biased, tailored communication, and support.
AHRQ-funded; HS000032.
Citation: Griesemer I, Birken SA, Rini C . Mechanisms to enhance racial equity in health care: developing a model to facilitate translation of the ACCURE intervention. SSM Qual Res Health 2023 Jun; 3:100204. doi: 10.1016/j.ssmqr.2022.100204..
Keywords: Racial and Ethnic Minorities, Disparities, Quality Improvement, Quality of Care
Roberts ET, Kwon Y, Hames AG
Racial and ethnic disparities in health care use and access associated with loss of Medicaid supplemental insurance eligibility above the federal poverty level.
The purpose of this study was to examine whether exceeding the income threshold for Medicaid, which causes a sudden loss of Medicaid eligibility, is related with higher racial and ethnic disparities in access to and use of care. The researchers evaluated Medicare beneficiaries with incomes 0% to 200% of FPL from the 2008 to 2018 biennial waves of the Health and Retirement Study linked to Medicare administrative data. To identify racial and ethnic disparities related with the loss of Medicaid eligibility, the researchers compared discontinuities in outcomes among Black and Hispanic beneficiaries and White beneficiaries. Analyses were conducted between January 1, 2022, and October 1, 2022. The primary outcomes were patient-reported challenges accessing care due to cost and outpatient service use, medication fills, and hospitalizations measured from Medicare administrative data. The study included 8,144 participants representing 151,282, 957 weighted person-years in the community-dwelling population of Medicare beneficiaries aged 50 years and older and incomes less than 200% of the federal poverty level (FPL). Study findings indicate that exceeding the Medicaid eligibility threshold was related with a 43.8 percentage point (pp) lower probability of Medicaid enrollment among Black and Hispanic Medicare beneficiaries and a 31.0 pp lower probability of Medicaid enrollment among White beneficiaries. Among Black and Hispanic beneficiaries, exceeding the threshold was associated with increased cost-related barriers to care, lower outpatient use, and fewer medication fills, but it was not associated with a statistically significant discontinuity in hospitalizations. Discontinuities in these outcomes were smaller or nonsignificant among White beneficiaries. Consequently, exceeding the threshold was associated with widened disparities, including greater reductions in outpatient service use and medication fills among Black and Hispanic vs White beneficiaries.
AHRQ-funded; HS026727.
Citation: Roberts ET, Kwon Y, Hames AG . Racial and ethnic disparities in health care use and access associated with loss of Medicaid supplemental insurance eligibility above the federal poverty level. JAMA Intern Med 2023 Jun; 183(6):534-43. doi: 10.1001/jamainternmed.2023.0512..
Keywords: Disparities, Racial and Ethnic Minorities, Medicaid, Access to Care, Health Insurance, Low-Income, Access to Care
Feyman Y, Avila CJ, Auty S
Racial and ethnic disparities in excess mortality among U.S. veterans during the COVID-19 pandemic.
This study examined whether minority veterans experienced higher rates of all-cause mortality than White veterans during the COVID-19 pandemic. The authors used administrative data from the Veterans Health Administration’s Corporate Data Warehouse. Veterans were excluded in the analysis if they were missing county of residence or race-ethnicity data. Overall, veteran mortality rates were 16% above normal during March-December 2020 which equates to 42,348 excess deaths. Non-Hispanic White veterans experienced the smallest relative increase in mortality (17%), while Native American veterans had the highest increase (40%). Black Veterans (32%) and Hispanic Veterans (26%) had somewhat lower excess mortality, although these changes were significantly higher compared to White veterans. Disparities were smaller compared to the general population.
AHRQ-funded; HS026395.
Citation: Feyman Y, Avila CJ, Auty S . Racial and ethnic disparities in excess mortality among U.S. veterans during the COVID-19 pandemic. Health Serv Res 2023 Jun; 58(3):642-53. doi: 10.1111/1475-6773.14112..
Keywords: COVID-19, Mortality, Racial and Ethnic Minorities, Disparities
Khor S, Heagerty PJ, Basu A
Racial disparities in the ascertainment of cancer recurrence in electronic health records.
This study examined whether the accuracy of a proxy for colorectal cancer (CRC) recurrence differed by race/ethnicity and the possible mechanisms that drove the differences. Using data from a large integrated health care system, the authors identified a stratified random sample of 282 Black/African American (AA), Hispanic, and non-Hispanic White (NHW) patients with CRC who received primary treatment. The recurrence proxy was found to have excellent overall accuracy (positive predictive value [PPV] 89.4%; negative predictive value 96.5%; mean difference in timing 1.96 months); however, accuracy varied by race/ethnicity. Compared with NHW patients, PPV was 14.9% lower among Hispanic patients and 4.3% lower among Black/AA patients. The proxy disproportionately inflated the 5-year recurrence incidence for Hispanic patients by 10.6%. Compared with NHW patients, proxy recurrences for Hispanic patients were almost three times as likely to have been misclassified as positive (adjusted risk ratio 2.91). The authors theorize that higher false positives among racial/ethnic minorities may be related to higher prevalence of noncancerous lung-related problems and substantial delays in primary treatment because of insufficient patient-provider communication and abnormal treatment patterns.
AHRQ-funded; HS013853.
Citation: Khor S, Heagerty PJ, Basu A . Racial disparities in the ascertainment of cancer recurrence in electronic health records. JCO Clin Cancer Inform 2023 Jun; 7:e2300004. doi: 10.1200/cci.23.00004..
Keywords: Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Disparities
Enzinger AC, Ghosh K, Keating NL
Racial and ethnic disparities in opioid access and urine drug screening among older patients with poor-prognosis cancer near the end of life.
This research characterized racial and ethnic disparities and trends in opioid access and urine drug screening (UDS) among older patients dying of cancer, and to explore potential mechanisms. Among 18,549 non-Hispanic White (White), Black, and Hispanic Medicare decedents older than 65 years with poor-prognosis cancers, the authors examined 2007-2019 trends in opioid prescription fills and potency (morphine milligram equivalents [MMEs] per day [MMEDs]) near the end of life (EOL), defined as 30 days before death or hospice enrollment. They found that between 2007 and 2019, White, Black, and Hispanic decedents experienced steady declines in EOL opioid access and rapid expansion of UDS. Compared with White patients, Black and Hispanic patients were less likely to receive any opioid (Black, -4.3 percentage points; Hispanic, -3.6 percentage points) and long-acting opioids (Black, -3.1 percentage points; Hispanic, -2.2 percentage points). They also received lower daily doses (Black, -10.5 MMED; Hispanic, -9.1 MMED) and lower total doses (Black, -210 MMEs; Hispanic, -179 MMEs). Black patients were also more likely to undergo UDS (0.5 percentage points).
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL . Racial and ethnic disparities in opioid access and urine drug screening among older patients with poor-prognosis cancer near the end of life. J Clin Oncol 2023 May 10; 41(14):2511-22. doi: 10.1200/jco.22.01413..
Keywords: Elderly, Opioids, Medication, Cancer, Racial and Ethnic Minorities, Disparities, Access to Care
Laytner L, Chen P, Nash S
Perspectives on non-prescription antibiotic use among Hispanic patients in the Houston Metroplex.
This study examined non-prescription use of antibiotics among Hispanic adults in the Houston area. The study included Hispanic primary care clinic patients with different types of health insurance coverage in the Houston metroplex who endorsed non-prescription use in a previous survey. Semistructured interviews were conducted in English or Spanish with 35 participants primarily female (68.6%) and aged 27 to 66. Participants reported obtaining antibiotics through under-the-counter US markets, trusted persons, and purchased without a prescription abroad. Factors contributing to non-prescription use included beliefs that the doctor visit was unnecessary, limited access to healthcare, and communication difficulties. However, participants expressed confidence in medical recommendations from pharmacists and trusted community members.
AHRQ-funded; HS026901.
Citation: Laytner L, Chen P, Nash S . Perspectives on non-prescription antibiotic use among Hispanic patients in the Houston Metroplex. J Am Board Fam Med 2023 May 8; 36(3):390-404. doi: 10.3122/jabfm.2022.220416R1..
Keywords: Racial and Ethnic Minorities, Antibiotics, Medication, Antimicrobial Stewardship
Kim B, Troxel WM, Dubowitz T
Neighborhood built environment and sleep health: a longitudinal study in low-income and predominantly African-American neighborhoods.
The purpose of this study was to explore the relationships between physical characteristics of neighborhoods and sleep health outcomes and evaluated the mediating role of physical activity in these relationships. The researchers conducted the longitudinal Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health (PHRESH) Zzz Study in 2 low-income, primarily African-American neighborhoods in Pittsburgh, Pennsylvania (n = 1,051). The study included repeated measures of neighborhood characteristics and sleep health outcomes from 2013 to 2018, and systematic field observations captured built environment measures of walkability, urban design, and neighborhood disorder. Sleep health outcomes included insufficient sleep, sleep duration, wakefulness after sleep onset, and sleep efficiency. Urban design features were correlated with lower levels of wakefulness after sleep onset. Neighborhood disorder and crime rate were negatively related with sleep efficiency. Neighborhood walkability was not associated with sleep outcomes.
AHRQ-funded; HS026120.
Citation: Kim B, Troxel WM, Dubowitz T . Neighborhood built environment and sleep health: a longitudinal study in low-income and predominantly African-American neighborhoods. Am J Epidemiol 2023 May 5; 192(5):736-47. doi: 10.1093/aje/kwad016..
Keywords: Sleep Problems, Racial and Ethnic Minorities, Low-Income
Lundberg DJ, Wrigley-Field E, Cho A
COVID-19 mortality by race and ethnicity in US metropolitan and nonmetropolitan areas, March 2020 to February 2022.
Previous research has determined that Hispanic and non-Hispanic Black residents in the United States experienced significantly higher COVID-19 mortality rates in 2020 than non-Hispanic White residents due to structural racism. In 2021, these disparities were observed to decrease. The purpose of this study was to evaluate the extent to which national decreases in racial and ethnic disparities in COVID-19 mortality between the initial pandemic wave and the subsequent Omicron wave reflect decreases in mortality vs other factors, such as the changing geography of the pandemic. The researchers conducted this cross-sectional study using data from the United States Centers for Disease Control and Prevention for COVID-19 deaths from March 1, 2020, through February 28, 2022, in U.S. resident adults aged 25 years and older. Deaths were examined by race and ethnicity across metropolitan and nonmetropolitan areas, and the national decrease in racial and ethnic disparities between the initial wave and Omicron waves was decomposed. The study included death certificates for 977, 018 U.S. that included a mention of COVID-19. The rate of COVID-19 deaths among adults residing in nonmetropolitan areas increased 5.4% during the initial wave to a peak of 23.4% during the Delta wave; the proportion was 21.5% during the Omicron wave. The national disparity in age-standardized COVID-19 death rates per 100,000 person-years for non-Hispanic Black compared with non-Hispanic White adults decreased by 293 deaths. After standardizing for age and racial and ethnic differences by metropolitan vs nonmetropolitan residence, increases in death rates among non-Hispanic White adults explained 40.7% of the decrease (40.7%); 19.6% of the decrease was explained by shifts in mortality to nonmetropolitan areas, where a disproportionate share of non-Hispanic White adults resided. The remaining 39.6% of the decrease was explained by decreases in death rates in non-Hispanic Black adults. The researchers concluded that the majority of the national decrease in racial and ethnic disparities in COVID-19 mortality between the initial wave and Omicron waves was explained by increased mortality among non-Hispanic White adults and changes in the geographic distribution of the pandemic.
AHRQ-funded; HS013853.
Citation: Lundberg DJ, Wrigley-Field E, Cho A . COVID-19 mortality by race and ethnicity in US metropolitan and nonmetropolitan areas, March 2020 to February 2022. JAMA Netw Open 2023 May; 6(5):e2311098. doi: 10.1001/jamanetworkopen.2023.11098..
Keywords: COVID-19, Mortality, Racial and Ethnic Minorities
Strauss AT, Moughames E, Jackson JW
Critical interactions between race and the highly granular area deprivation index in liver transplant evaluation.
Researchers constructed a dataset for liver transplant disparities by linking individual patient-level data with the granular Area Deprivation Index. Their retrospective cohort study included 1377 adults who were referred to the researchers’ center for liver transplant evaluation. They tested for effect measure modification of the association between neighborhood socioeconomic status and transplant evaluation outcomes. They concluded that interventions that address neighborhood deprivation may benefit patients with low socioeconomic status as well as address racial and ethnic inequities.
AHRQ-funded; HS024600.
Citation: Strauss AT, Moughames E, Jackson JW . Critical interactions between race and the highly granular area deprivation index in liver transplant evaluation. Clin Transplant 2023 May; 37(5):e14938. doi: 10.1111/ctr.14938..
Keywords: Transplantation, Racial and Ethnic Minorities
Griesemer I, Lightfoot AF, Eng E
Examining ACCURE's nurse navigation through an antiracist lens: transparency and accountability in cancer care.
This paper discussed an intervention that was conducted to eliminate racial disparity in cancer treatment through a program called Accountability for Cancer Care through Undoing Racism and Equity (ACCURE). The program successfully eliminated the Black-White disparity in cancer treatment completion among patients with early-stage breast and lung cancer. It used specially trained nurse navigators who leveraged real-time data to follow-up with patients during their treatment journeys. Thematic analysis on all clinical notes that were written by ACCURE navigators after each contact with patients in the specialized navigation arm (n = 162) was conducted by community and academic research partners. The authors identified six themes in the navigator notes that demonstrated enhanced accountability of the care system to patient needs. Those themes include: (1) patient-centered advocacy, (2) addressing system barriers to care, (3) connection to resources, (4) re-engaging patients after lapsed treatment, (5) addressing symptoms and side effects, and (6) emotional support.
AHRQ-funded; HS000032.
Citation: Griesemer I, Lightfoot AF, Eng E . Examining ACCURE's nurse navigation through an antiracist lens: transparency and accountability in cancer care. Health Promot Pract 2023 May; 24(3):415-25. doi: 10.1177/15248399221136534..
Keywords: Cancer, Racial and Ethnic Minorities, Disparities, Health Promotion
Richmond J, Murray MH, Milder CM
Racial disparities in lung cancer stage of diagnosis among adults living in the southeastern United States.
The purpose of this study was to identify factors contributing to racial disparities in stage of lung cancer stage diagnosis in low-income adults. The researchers identified cases of incident lung cancer from the prospective observational Southern Community Cohort Study by linking them with state cancer registries in 12 southeastern states. A subset of participants who answered psychosocial questions such as those related to racial discrimination experiences were assessed to determine if model predictive power improved. The study identified 1,572 patients with incident lung cancer with available lung cancer stage. Compared with White participants Black participants with lung cancer reflected higher unadjusted odds of distant stage diagnosis. Higher neighborhood area deprivation was related with distant stage diagnosis. No significant differences were found in distant stage disease for Black vs White participants after controlling for individual- and area-level factors, but participants with COPD showed decreased odds of distant stage diagnosis in the primary model.
AHRQ-funded; HS026122.
Citation: Richmond J, Murray MH, Milder CM . Racial disparities in lung cancer stage of diagnosis among adults living in the southeastern United States. Chest 2023 May; 163(5):1314-27. doi: 10.1016/j.chest.2022.11.025..
Keywords: Disparities, Racial and Ethnic Minorities, Cancer: Lung Cancer, Cancer
Sanghavi P, Chen Z
Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.
The purpose of this study was to evaluate the relationship between nursing home characteristics and reporting of 2 of 3 specific clinical outcomes reported by the Nursing Home Care Compare (NHCC) website: major injury falls and pressure ulcers. The researchers of this quality improvement study utilized hospitalization data for all Medicare fee-for-service beneficiaries between January 1, 2011, and December 31, 2017. Hospital admission claims for major injury falls and pressure ulcers were linked with facility-reported evaluations at the nursing home resident level. For each linked hospital claim, it was determined whether the nursing home had reported the event and rates of reporting were computed. To evaluate whether nursing homes reported similarly on both measures, the researchers estimated the relationship between reporting of major injury falls and pressure ulcers within a nursing home, and explored racial and ethnic disparities that could otherwise explain the associations. The study sample included 13,179 nursing homes where 131,000 residents experienced major injury fall or pressure ulcer hospitalizations. Of the 98,669 major injury fall hospitalizations, 60.0% were reported, and of the 39,894 stage 3 or 4 pressure ulcer hospitalizations, 67.7% were reported. Underreporting for both conditions was pervasive, with 69.9% and 71.7% of nursing homes having reporting rates less than 80% for major injury fall and pressure ulcer hospitalizations, respectively. Lower reporting rates had few correlations with facility characteristics other than racial and ethnic composition. Facilities with high vs low fall reporting rates had significantly more White residents (86.9% vs 73.3%), and facilities with high vs low pressure ulcer reporting rates had significantly fewer White residents (69.7% vs 74.9%).
AHRQ-funded; HS026957.
Citation: Sanghavi P, Chen Z . Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings. JAMA Netw Open 2023 May; 6(5):e2314822. doi: 10.1001/jamanetworkopen.2023.14822..
Keywords: Quality Measures, Quality of Care, Elderly, Disparities, Racial and Ethnic Minorities, Nursing Homes, Pressure Ulcers, Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Long-Term Care
Agochukwu-Mmonu N, Qin Y, Kaufman S
Understanding the role of urology practice organization and racial composition in prostate cancer treatment disparities.
This study examined the associations between urology practice organization and racial composition and treatment patterns for Medicare beneficiaries with incident prostate cancer. The authors used a 20% sample of national Medicare data to identify beneficiaries diagnosed with prostate cancer between January 2010 and December 2015 and followed them through 2016. They then linked urologists to their practices with tax identification numbers and patients to their practices based on their primary urologist. They identified 54,443 patients with incident prostate cancer, with most (87%) White and 9% Black. They found wide variation in racial practice composition and practice segregation. Patients in practices with the highest proportion of Black patients had the lowest socioeconomic status (43.1%), highest comorbidity (9.9% with comorbidity score ≥ 3), and earlier age at prostate cancer diagnosis (33.5% age 66-69 years). Black patients had lower odds of definitive therapy and underwent less treatment than White patients in every practice context. Black patients had lower predicted probability of treatment (66%) than White patients (69%).
AHRQ-funded; HS025707.
Citation: Agochukwu-Mmonu N, Qin Y, Kaufman S . Understanding the role of urology practice organization and racial composition in prostate cancer treatment disparities. JCO Oncol Pract 2023 May; 19(5):e763-e72. doi: 10.1200/op.22.00147..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Disparities, Racial and Ethnic Minorities
Taylor Gangnon, R R, Powell WR
Association of rurality and identifying as Black with receipt of specialty care among patients hospitalized with a diabetic foot ulcer: a Medicare cohort study.
This national retrospective cohort study examined Medicare beneficiaries hospitalized with diabetic foot ulcers. Investigators sought to determine what proportion of rural patients, particularly those identifying as black, received specialty care in comparison with the national proportion. Their findings indicated that a smaller proportion of rural patients, particularly those identified as black, received specialty care compared with the overall cohort. They concluded that this might contribute to disparities in major amputations, but future studies are required to determine causality.
AHRQ-funded; HS026279.
Citation: Taylor Gangnon, R R, Powell WR . Association of rurality and identifying as Black with receipt of specialty care among patients hospitalized with a diabetic foot ulcer: a Medicare cohort study. BMJ Open Diabetes Res Care 2023 Apr; 11(2). doi: 10.1136/bmjdrc-2022-003185..
Keywords: Rural Health, Racial and Ethnic Minorities, Diabetes, Chronic Conditions, Disparities
Arcia A, Pho AT, Lor M
Comparison of newest vital sign and brief health literacy screen scores in a large, urban Hispanic cohort.
The purpose of this study was to examine the relationship between Newest Vital Sign (NVS) and Brief Health Literacy Screen (BHLS) scores in a large cohort of English- and Spanish-speaking urban Hispanic adults. Scores on both measures showed good internal consistency but NVS items had high difficulty; greater than 50% of respondents scored 0. The correlation between measures was weak. The study concluded that health literacy scores were poor predictors of objective scores.
AHRQ-funded; HS019853; HS022961.
Citation: Arcia A, Pho AT, Lor M . Comparison of newest vital sign and brief health literacy screen scores in a large, urban Hispanic cohort. Patient Educ Couns 2023 Apr; 109:107628. doi: 10.1016/j.pec.2023.107628

.
Keywords: Health Literacy, Racial and Ethnic Minorities, Urban Health
Lucchini M, Rayport Y, Valeri L
Racial/ethnic disparities in sleep-disordered breathing during pregnancy in the nuMoM2b study.
This study’s aim was to assess the prevalence and severity of sleep-disordered breathing (SDB) across racial/ethnic groups in 3702 pregnant people at 6 to 15 and 22 to 31 weeks gestational age; examine whether BMI modifies the association between race/ethnicity and SDB; and investigate whether interventions to reduce weight might reduce racial/ethnic disparities in SDB. The study cohort consisted of comprised 61.2% non-Hispanic White (nHW), 11.9% non-Hispanic Black (nHB), 18.5% Hispanic, and 3.7% Asian persons. SDB prevalence was higher for nHB compared with nHW pregnant people at 6 to 15 weeks, whereas at 21 to 32 weeks, Asian pregnant people had a higher SDB prevalence than nHW. The severity of SDB differed across racial/ethnic groups in early pregnancy, with nHB pregnant people having a higher apnea-hypopnea index (AHI) compared with nHW. Having overweight/obesity was associated with a higher AHI.
AHRQ-funded; HS024274.
Citation: Lucchini M, Rayport Y, Valeri L . Racial/ethnic disparities in sleep-disordered breathing during pregnancy in the nuMoM2b study. Obesity 2023 Apr;31(4):923-33. doi: 10.1002/oby.23697.
Keywords: Racial and Ethnic Minorities, Sleep Problems, Women, Maternal Health
Eneanya ND, Adingwupu OM, Kostelanetz S
Social determinants of health and their impact on the Black race coefficient in serum creatinine-based estimation of GFR: secondary analysis of MDRD and CRIC studies.
The rationale behind the disparity in blood creatinine levels between Black and non-Black individuals factored into previous GFR prediction formulas remains unclear. The purpose of this study was to investigate if social health determinants could explain this gap. The researchers conducted a secondary examination of the initial data from the Modification of Diet in Renal Disease and Chronic Renal Insufficiency Cohort investigations. Data from these cohorts were divided based on racial characteristics (Black versus non-Black). The study initially assessed the degree to which the Black race coefficient in the GFR estimation from creatinine is influenced by the interrelation of race with social health determinants and non-GFR creatinine determinants. Researchers then assessed whether the discrepancy in adjusted mean creatinine between racial groups could be attributed to social health determinants and non-GFR creatinine determinants. The study found that in models that associated measured GFR with creatinine, age, sex, and race, the Black race coefficient was 21% in the Modification of Diet in Renal Disease study and 13% in the Chronic Renal Insufficiency Cohort, and was not weakened by the inclusion of social health determinants, either singularly or in combination. In both studies, the Black race coefficient was more pronounced at lower income levels as compared to higher ones. In models associating creatinine with measured GFR, age, and sex, average creatinine was elevated in Black participants in comparison with non-Black participants in both studies, with social health determinants having no impact.
AHRQ-funded; HS026122.
Citation: Eneanya ND, Adingwupu OM, Kostelanetz S . Social determinants of health and their impact on the Black race coefficient in serum creatinine-based estimation of GFR: secondary analysis of MDRD and CRIC studies. Clin J Am Soc Nephrol 2023 Apr; 18(4):446-54. doi: 10.2215/cjn.0000000000000109..
Keywords: Social Determinants of Health, Racial and Ethnic Minorities, Kidney Disease and Health, Disparities
Wirth AN, Cushman NA, Reilley BA
Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021.
Researchers evaluated the extent to which Indian Country Extension for Community Healthcare Outcomes (ECHO) telehealth clinics increase access to hepatitis C virus (HCV) treatment and serve American Indians/Alaska Native (AI/AN) patients holistically. They conducted a retrospective descriptive analysis of Indian Country ECHO treatment recommendations from 2017 to 2021. Most patients received recommendations for HCV treatment by their primary care providers, along with recommendations beyond the scope of HCV. The researchers concluded that Indian Country ECHO telehealth clinic provided comprehensive recommendations to effectively integrate evidence-based HCV treatment with holistic care at the primary care level.
AHRQ-funded; HS026370.
Citation: Wirth AN, Cushman NA, Reilley BA . Evaluation of treatment access and scope of a multistate hepatitis C virus Extension for Community Healthcare Outcomes telehealth service in the US Indian Health System, 2017-2021. J Rural Health 2023 Mar;39(2):358-66. doi: 10.1111/jrh.12733.
Keywords: Hepatitis, Access to Care, Racial and Ethnic Minorities, Community-Based Practice, Telehealth, Health Information Technology (HIT), Chronic Conditions
Yasui M, Choi Y, Chin M
Parental socialization of mental health in Chinese American families: what parents say and do, and how youth make meaning.
This study explored youth-reported parental socialization of mental health within Chinese American families by examining focus group data from high school and college students. The findings indicated that parents responded to youth distress in culturally consonant ways; youth engaged in active interpretation of parental messages through cultural brokering, bridging the gap between their parents' messages and mainstream concepts of mental health and help-seeking. The authors concluded that these findings revealed the significant role of culture in parental mental health socialization in Chinese American families, and emphasized the need to integrate culturally specific understandings of mental health into future interventions for Asian American youth.
AHRQ-funded; HS023007.
Citation: Yasui M, Choi Y, Chin M . Parental socialization of mental health in Chinese American families: what parents say and do, and how youth make meaning. Fam Process 2023 Mar;62(1):319-35. doi: 10.1111/famp.12766.
Keywords: Behavioral Health, Racial and Ethnic Minorities, Family Health and History
Wu AJ, Du N, Chen TY
Sociodemographic differences of hospitalization and associations of resource utilization for failure to thrive.
The objective of this study was to examine sociodemographic differences between elective and nonelective admissions for failure to thrive. Researchers investigated associations between admission type and hospital resource utilization, including length of stay and feeding tube placement. The study included data on children less than 2 years old with failure to thrive in the Kids' Inpatient Database. The findings showed differences by race and ethnicity, income, and insurance type, among other factors. Nonelective admissions had higher proportions of infants who were Black, Hispanic, and of lower-income, and were associated with longer lengths of stay. The researchers concluded that future research is needed to elucidate drivers of these differences, particularly those related to racial and ethnic disparities and structural racism.
AHRQ-funded; HS000063.
Citation: Wu AJ, Du N, Chen TY . Sociodemographic differences of hospitalization and associations of resource utilization for failure to thrive. J Pediatr Gastroenterol Nutr 2023 Mar;76(3):385-89. doi: 10.1097/mpg.0000000000003694.
Keywords: Newborns/Infants, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Healthcare Utilization, Children/Adolescents, Racial and Ethnic Minorities, Low-Income
Jetty A, Jabbarpour Y, Eden AR
´óÏóAPPAuthor: Eden AR
Female family physicians are more racially diverse than their male counterparts in federal sites.
The objective of this study was to compare the racial/ethnic composition of Federal family physicians to the entire cohort of family physicians in the US and to stratify by gender. Results showed that female family physicians who served at Federal sites were more racially/ethnically diverse than the overall population of female family physicians as well as their male Federal counterparts. The researchers concluded that this gendered trend among Federal physicians should be explored further.
AHRQ-authored.
Citation: Jetty A, Jabbarpour Y, Eden AR . Female family physicians are more racially diverse than their male counterparts in federal sites. J Am Board Fam Med 2023 Feb 8; 36(1):188-89. doi: 10.3122/jabfm.2022.220178R1..
Keywords: Provider: Physician, Racial and Ethnic Minorities
Iantorno SE, Ulugia JG, Kastenberg ZJ
Postdischarge racial and ethnic disparities in pediatric appendicitis: a mediation analysis.
This retrospective cohort study sought to explore whether racial and ethnic disparities for children presenting with acute appendicitis persist after initial management and hospital discharge. The cohort included children under 18 years who underwent treatment for acute appendicitis in 47 U.S. Children's Hospitals from 2017 to 2019. Findings showed that children of racial and ethnic minorities were more likely to visit the emergency department after treatment for acute appendicitis, but Hispanic/Latinx patients did not have a corresponding increase in readmission. These differences were mediated mainly by insurance status and urban residence.
AHRQ-funded; HS025776.
Citation: Iantorno SE, Ulugia JG, Kastenberg ZJ . Postdischarge racial and ethnic disparities in pediatric appendicitis: a mediation analysis. J Surg Res 2023 Feb;282:174-82. doi: 10.1016/j.jss.2022.09.027..
Keywords: Children/Adolescents, Racial and Ethnic Minorities, Disparities, Hospital Discharge, Surgery
Zuo SW, Ackenbom MF, Harris J
Racial differences in urinary catheter use among female nursing home residents.
This study assessed racial differences in prevalence of indwelling urinary catheterization and intermittent catheterization among female nursing home (NH) residents in the US. This cross-sectional analysis used the 2019 Minimum Data Set 3.0 and looked at a cohort of 597,966 women predominantly White race with a median age of 80 years. Eight percent of female residents had indwelling catheters, and 0.5% used intermittent catheterization. Black residents had a 7% lower odds of having an indwelling catheter, and a 38% lower odds of utilizing intermittent catheterization compared to White residents when controlling for common factors associated with catheter use.
AHRQ-funded; HS026943.
Citation: Zuo SW, Ackenbom MF, Harris J . Racial differences in urinary catheter use among female nursing home residents. Urology 2023 Feb; 172:105-10. doi: 10.1016/j.urology.2022.11.026..
Keywords: Elderly, Racial and Ethnic Minorities, Nursing Homes, Women
Kumar V, Encinosa W
´óÏóAPPAuthor: Encinosa W
Racial disparities in the perceived risk of COVID-19 and in getting needed medical care.
This AHRQ-authored study examined racial and ethnic disparities in eight measures on the perceived risks of COVID-19. The authors used the nationally representative Stanford University School of Medicine Coronavirus Attitudes and Behaviors Survey fielded in May of 2020. Black respondents were 15 percentage points more likely than White respondents to believe the pandemic would not end by Summer 2020 (92% vs 77%), and were 19 percentage points more likely than any other race to feel a need to protect their family from COVID-19 (81% vs 62%). Latinx respondents were 10 percentage points more fearful than White respondents of catching COVID-19 in public places (55% vs 45%). Black respondents were 20 percentage points more likely than White respondents to think they would need medical care if infected (71% vs 51%), and 18 percentage points more likely to think they would need to be hospitalized (59% vs 41%). The proportion of Black respondents believing that the hospital would not have enough capacity to treat them if infected with COVID-19 was 12 percentage points higher than White respondents (41% vs 29%).
AHRQ-authored.
Citation: Kumar V, Encinosa W . Racial disparities in the perceived risk of COVID-19 and in getting needed medical care. J Racial Ethn Health Disparities 2023 Feb; 10(1):4-13. doi: 10.1007/s40615-021-01191-5..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities
O'Donnell TFX,, Dansey KD, Marcaccio CL
Racial disparities in treatment of ruptured abdominal aortic aneurysms.
This study evaluated regional center transfer rates, turndown rates, and outcomes for Black vs White patients presenting with ruptured abdominal aortic aneurysms (rAAAs) in two large databases. All rAAA repairs in the Vascular Quality Initiative from 2003 to 2020 was used. The authors used the National Inpatient Sample from 2004 to 2015 to examine turndown rates for repair. They identified 4935 patients with rAAAs in the Vascular Quality Initiative (6.2% Black) and 48,489 in the National Inpatient Sample (6.0% Black). Transfer rates were high; however, Black patients were significantly less likely to undergo transfer before repair compared with White patients (49% Black vs 62% White). No significant differences were found in perioperative mortality or complications. However, Black patients were significantly more likely to be turned down for repair (37% vs 28%). This difference was mostly found to be due to insurance status. Patients with private insurance had undergone surgery at a similar rate. However, among patients with Medicare or Medicaid/self-pay, Black patients were less likely than were White patients to undergo repair (Medicare, 64% vs 72%; Medicaid/self-pay, 43% vs 61%). Medicaid/self-pay patients were less likely to undergo repair than were patients of the same race with either Medicare or private insurance.
AHRQ-funded; HS027285.
Citation: O'Donnell TFX,, Dansey KD, Marcaccio CL . Racial disparities in treatment of ruptured abdominal aortic aneurysms. J Vasc Surg 2023 Feb; 77(2):406-14. doi: 10.1016/j.jvs.2022.08.009..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Racial and Ethnic Minorities, Cardiovascular Conditions

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