Racial-Ethnic Disparities and Segmentation in Communication Campaigns
In: American behavioral scientist: ABS, Band 49, Heft 6, S. 868
ISSN: 0002-7642
In: American behavioral scientist: ABS, Band 49, Heft 6, S. 868
ISSN: 0002-7642
In: American behavioral scientist: ABS, Band 49, Heft 6, S. 868-884
ISSN: 1552-3381
There are disturbing racial disparities in many health outcomes. However, do health communicators know how to do interventions that redress disadvantage? This article describes what communication campaigns do to address disparities, looks for evidence that segmented campaigns reduce disparities, and describes evidence that might support segmentation decisions (about behaviors, messages, channels, or message executions). The authors note arguments that segmentation can risk negative effects yet find no evidence about whether race or ethnicity-conscious segmentation reduces disparities. Nonetheless, with evidence, some approaches to segmentation are justified on commonsense grounds and for their political legitimacy.
In: NBER working paper series 16578
"The NBER Bulletin on Aging and Health provides summaries of publications like this. You can sign up to receive the NBER Bulletin on Aging and Health by email. This paper studies racial/ethnic disparities in awareness of chronic diseases using biomarker data from the 2006 HRS. We estimate a 3-step sequential probit model which accounts for selection into: (1) participating in biomarker collection; (2) having illness (hypertension or diabetes); (3) being aware of illness. Contrary to studies reporting that African-Americans are more aware of having hypertension than non-Latino whites, we do not find this conclusion holds after self-selection and severity are considered. Likewise, African-Americans and Latinos are less aware of having diabetes compared to non-Latino whites. Disparities in unawareness are exacerbated when we limit the sample to untreated respondents"--National Bureau of Economic Research web site
In: NBER Working Paper No. w16578
SSRN
In: Law & policy, Band 42, Heft 1, S. 56-77
ISSN: 1467-9930
Although misdemeanors make up the bulk of criminal cases in the United States, the majority of research on court decision‐making examines felony sentencing. In contrast to felony courts, lower‐level courts are characterized by higher case volumes and increased reliance on informal sanctions, which may contribute to greater racial–ethnic disparities. To assess this possibility, we examine pretrial detention and case processing outcomes for misdemeanants in Miami‐Dade County, Florida. Utilizing temporal (detention time) and monetary (bond amount) measures of pretrial detention, we assess whether and to what extent there are racial–ethnic disparities in formal and informal sanctions facing misdemeanants. Results indicate that black defendants, especially black Latinx defendants, face greater informal sanctions (longer detention and higher bond amounts), are more likely to be convicted, and experience more severe formal sanctions than do white non‐Latinx defendants. These findings complicate Feeley's (1979) argument about lower‐level cases, revealing that black defendants are punished by both the court process and formal sanctions. In this way, "the process is the punishment" for lower‐level white and nonwhite defendants, while the punishment is also the punishment for black defendants.
In: Medical care research and review, Band 67, Heft 5, S. 574-589
ISSN: 1552-6801
With increasing attention paid to reducing racial/ethnic disparities in care and the growth of pay-for-performance programs, policy makers and payers are considering the use of such incentive mechanisms to target disparities reduction. This article describes the results of qualitative interviews with hospital executives to assess the potential impact that such programs would have on hospitals and their minority patients. The authors find that executives have significant concerns regarding funding mechanisms and implementation costs, financial risks for safety net hospitals, and resource constraints, as well as how such programs can be used to create incentives to care for minority patients. The findings suggest that payers should be hesitant to use pay-for-performance as a mechanism for reducing disparities until a wide variety of concerns about the design of such programs can be addressed.
In: Law & Policy, Band 42, Heft 1, S. 56-77
SSRN
In: Medical care research and review, Band 75, Heft 3, S. 263-291
ISSN: 1552-6801
Racial and ethnic disparities in cardiovascular disease (CVD) outcomes are widely reported, but research has largely focused on differences in quality of inpatient and urgent care to explain these disparate outcomes. The objective of this review is to synthesize recent evidence on racial and ethnic disparities in management of CVD in the ambulatory setting. Database searches yielded 550 articles of which 25 studies met the inclusion criteria. Reviewed studies were categorized into non-interventional studies examining the association between race and receipt of ambulatory CVD services with observational designs, and interventional studies evaluating specific clinical courses of action intended to ameliorate disparities. Based on the Donabedian framework, this review demonstrates that significant racial/ethnic disparities persist in process and outcome measures of quality of ambulatory CVD care. Multimodal interventions were most effective in reducing disparities in CVD outcomes.
The core of evidenced-based maternal and child health is about using the best research about the safety and effectiveness of specific tests, treatments, and other interventions to help guide MCH decisions. Females of child-bearing age especially need to be informed about the best strategies to ensure and protect their health. Evidenced-Based Maternal and Child Health: Reproductive and Perinatal Health takes several key topics on reproductive outcomes and approaches them from a population-based standpoint. Chapters include sexually transmitted infections (STIs), infertility, pregnancy and birth
BACKGROUND: Obesity prevention has become a major focus of public health efforts in the United States. The Federal Government set forth national nutrition and physical activity recommendations to prevent obesity and promote well-being among children. A succinct message developed through a program in Maine "Let's Go! 5-2-1-0" summarizes these obesity prevention behaviors including ≥5 fruit and vegetables, ≤2 hours of screen time, ≥1 hour of physical activity, and 0 sugar sweetened beverages daily. The study evaluates racial/ethnic disparities among adolescents meeting the 5-2-1-0 targets in a nationally representative sample. METHODS: The 2011-2012 NHANES dataset was used to conduct a cross sectional analysis of Hispanic (n=287), non-Hispanic Black (n=321), Asian (n=145) and non-Hispanic White (n=234) adolescents 12-19 years old. The 5-2-1-0 targets were evaluated using dietary recalls, Global Physical Activity Questionnaire, and questions about sedentary activities. Differences in the proportion of racial/ethnic groups meeting the 5-2-1-0 targets were compared using chi-square tests. Logistic models accounting for the complex sampling design were used to evaluate racial/ethnic disparities in meeting the 5-2-1-0 targets. RESULTS: There were no adolescents that met all four 5-2-1-0 targets. Meeting individual targets and meeting none of the targets differed by racial/ethnic group. The study found 28% of White, 39% of Hispanic, 44% of Black and 35% of Asian adolescents met zero 5-2-1-0 targets. Adolescents from different racial/ethnic groups had increased odds of meeting no 5-2-1-0 targets compared to their White peers (adjusted odds ratio [95% Confidence Interval] – Hispanic: 1.76 [1.04-2.98], Black: 1.82[1.04-3.17], Asian: 1.48[1.08-2.04]). CONCLUSION: Understanding the uptake of national nutrition and physical activity recommendations is necessary to reduce future obesity and health consequences in adulthood. Despite national initiatives, adolescents in the United States are far from meeting the 5-2-1-0 targets and there are racial/ethnic disparities in meeting the recommendations.
BASE
Abstract Introduction Breast cancer is the most commonly diagnosed cancer and the 2nd leading cause of cancer-related deaths among women in the U.S. Although routine screening via mammogram has been shown to increase survival through early detection and treatment of breast cancer, only 3 out of 5 women age ?40 are compliant with annual mammogram within the U.S. and the state of Florida. A breadth of literature exists on racial/ethnic disparities in compliance with mammogram; however, few such studies include data on individual Black subgroups, such as Haitians. This study assessed the association between race/ethnicity and annual mammogram compliance among randomly selected households residing in the largely Haitian community of Little Haiti, Miami-Dade County (MDC), Florida. Methods This study used cross-sectional, health data from a random-sample, population-based survey conducted within households residing in Little Haiti between November 2011 and December 2012 (n = 951). Mammogram compliance was defined as completion of mammogram by all female household members within the 12 months prior to the survey. The association between mammogram compliance and race/ethnicity was assessed using binary logistic regression models. Potential confounders were identified as factors that were conservatively associated with both compliance and race/ethnicity (P???0.20). Analyses were restricted to households containing at least 1 female member age ?40 (n = 697). Results Overall compliance with annual mammogram was 62%. Race/ethnicity was significantly associated with mammogram compliance (P = 0.030). Compliance was highest among non-Hispanic Black (NHB) households (75%), followed by Hispanic (62%), Haitian (59%), and non-Hispanic White (NHW) households (51%). After controlling for educational level, marital status, employment status, the presence of young children within the household, health insurance status, and regular doctor visits, a borderline significant disparity in mammogram compliance was observed between Haitian and NHB households (adjusted odds ratio = 1.63, P = 0.11). No other racial/ethnic disparities were observed. Discussion Compliance with annual mammogram was low among the surveyed households in Little Haiti. Haitian households underutilized screening by means of annual mammogram compared with NHB households, although this disparity was not significant. Compliance rates could be enhanced by conducting individualized, mammogram screening-based studies to identify the reasons behind low rate of compliance among households in this underserved, minority population.
BASE
In: Medical care research and review, Band 66, Heft 1, S. 23-48
ISSN: 1552-6801
Monitoring disparities over time is complicated by the varying disparity definitions applied in the literature. This study used data from the 1996-2005 Medical Expenditure Panel Survey (MEPS) to compare trends in disparities by three definitions of racial/ethnic disparities and to assess the influence of changes in socioeconomic status (SES) among racial/ethnic minorities on disparity trends. This study prefers the Institute of Medicine's (IOM) definition, which adjusts for health status but allows for mediation of racial/ethnic disparities through SES factors. Black—White disparities in having an office-based or outpatient visit and medical expenditure were roughly constant and Hispanic—White disparities increased for office-based or outpatient visits and for medical expenditure between 1996-1997 and 2004-2005. Estimates based on the independent effect of race/ethnicity were the most conservative accounting of disparities and disparity trends, underlining the importance of the role of SES mediation in the study of trends in disparities.
A review of key empirical findings on race, ethnicity, & criminal or delinquent behavior in the US looks at racial/ethnic disparities in three data sources: official arrest/conviction records; self-reports of victimization; & self-reports of offending. Special attention is given to why there are huge ethnic differences in official records but smaller ethnic discrepancies in self-report studies. Consideration is given to the likelihood of certain groups being omitted from self-report studies; the emphasis on minor delinquency in questionnaires; & evidence of ethnic bias in self-report studies. Possible mediators of ethnic differences in crime are examined, including IQ & the socioeconomic context of one's neighborhood. New findings from the Chicago Neighborhoods Study indicate that crime rates (as self-reported) were highest among African Americans & lowest among Mexican Americans. The results of multivariate analyses showed neighborhood disadvantage to be the most important single mediator of the violent crime difference between African Americans & Whites while neither socioeconomic status nor family structure was influential. The implications are discussed. Tables, Figures, References. J. Lindroth
In: This is a post-peer-review, pre-copyedit version of an article published in The Journal of Economic Inequality. The final authenticated version is available online at: Doi.org/10.1007/s10888-018-9400-3
SSRN
New York State (NYS) passed legislation authorizing pharmacists to administer immunizations in 2008. Racial/socioeconomic disparities persist in vaccination rates and vaccine-preventable diseases such as influenza. Many NYS pharmacies participate in the Expanded Syringe Access Program (ESAP), which allows provision of non-prescription syringes to help prevent transmission of HIV, and are uniquely positioned to offer vaccination services to low-income communities. To understand individual and neighborhood characteristics of pharmacy staff support for in-pharmacy vaccination, we combined census tract data with baseline pharmacy data from the Pharmacies as Resources Making Links to Community Services (PHARM-Link) study among ESAP-registered pharmacies. The sample consists of 437 pharmacists, non-pharmacist owners, and technicians enrolled from 103 eligible New York City pharmacies. Using multilevel analysis, pharmacy staff who expressed support of in-pharmacy vaccination services were 69% more likely to support in-pharmacy HIV testing services (OR, 1.69; 95% CI 1.39–2.04). While pharmacy staff who worked in neighborhoods with a high percent of minority residents were less likely to express support of in-pharmacy vaccination, those in neighborhoods with a high percent of foreign-born residents were marginally more likely to express support of in-pharmacy vaccination. While educational campaigns around the importance of vaccination access may be needed among some pharmacy staff and minority community residents, we have provided evidence supporting scale-up of vaccination efforts in pharmacies located in foreign-born/immigrant communities which has potential to reduce disparities in vaccination rates and preventable influenza-related mortality.
BASE