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Persisting problems related to race and ethnicity in public health and epidemiology research

Moubarac,Jean-Claude
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2013 Português
Relevância na Pesquisa
78.829736%
A recent and comprehensive review of the use of race and ethnicity in research that address health disparities in epidemiology and public health is provided. First it is described the theoretical basis upon which race and ethnicity differ drawing from previous work in anthropology, social science and public health. Second, it is presented a review of 280 articles published in high impacts factor journals in regards to public health and epidemiology from 2009-2011. An analytical grid enabled the examination of conceptual, theoretical and methodological questions related to the use of both concepts. The majority of articles reviewed were grounded in a theoretical framework and provided interpretations from various models. However, key problems identified include a) a failure from researchers to differentiate between the concepts of race and ethnicity; b) an inappropriate use of racial categories to ascribe ethnicity; c) a lack of transparency in the methods used to assess both concepts; and d) failure to address limits associated with the construction of racial or ethnic taxonomies and their use. In conclusion, future studies examining health disparities should clearly establish the distinction between race and ethnicity, develop theoretically driven research and address specific questions about the relationships between race...

Race and ethnicity in public health surveillance: criteria for the scientific use of social categories.

Hahn, R A; Stroup, D F
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //1994 Português
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68.758276%
Public health surveillance is the cornerstone of public health practice. The uses of surveillance include the identification of patterns of health among population subgroups. The assessment of race and ethnicity in public health surveillance is fundamental to the reduction of preventable excesses in poor health among racial and ethnic populations. We review the use of race and ethnic variables in national public health surveillance systems in the United States. One barrier to the use of race and ethnicity in public health surveillance is the lack of scientific consensus on the nature of race and ethnicity and the measurement of these variables. Differences in terminology, data collection procedures, perceptions of group identity, and changing demographics of the U.S. population present particular challenges for surveillance. We propose criteria for any useful variables collected through surveillance. Application of these criteria to race and ethnicity suggests that race as assessed in surveillance is not primarily associated with biological characteristics, but it is more like ethnicity--a matter of self-perceived membership in population groups. Regular evaluation of surveillance systems will contribute to the usefulness of information on race and ethnicity in the improvement of the health of minority populations.

A case study in the use of race and ethnicity in public health surveillance.

Cooper, R S
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //1994 Português
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Increased attention has been focused on the use of racial and ethnic categories in public health research and surveillance in recent years. This attention, however, has done more to increase the collective awareness of the difficulties inherent in these classification schemes than to resolve either the theoretical or practical problems. It has been recognized for many years that health outcomes for a particular ethnic population must be seen as an interaction between genetically determined factors and socially mediated exposures. The operational meaning of these concepts remains poorly defined, however. Although the general biologic construct of race and ethnicity appears straightforward, appearance is deceiving and the technical requirements that allow formulation of a rigorous and objective working definition have never been fully developed. The social factors that influence ethnic health differentials are perhaps better understood in practical terms; measurement of many of the relevant variables remains difficult, however. In this article an attempt is made to outline the implications of the new developments in molecular biology for the concept of race, and to provide an illustrative example of the continued evolution of the social determinants of ethnicity.

Delving Below the Surface: Understanding How Race and Ethnicity Influence Relationships in Health Care

Cooper, Lisa A; Beach, Mary Catherine; Johnson, Rachel L; Inui, Thomas S
Fonte: Blackwell Science Inc Publicador: Blackwell Science Inc
Tipo: Artigo de Revista Científica
Publicado em /01/2006 Português
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There is increasing evidence that racial and ethnic minority patients receive lower quality interpersonal care than white patients. Therapeutic relationships constitute the interpersonal milieu in which patients are diagnosed, given treatment recommendations, and referred for tests, procedures, or care by consultants in the health care system. This paper provides a review and perspective on the literature that explores the role of relationships and social interactions across racial and ethnic differences in health care. First, we examine the social and historical context for examining differences in interpersonal treatment in health care along racial and ethnic lines. Second, we discuss selected studies that examine how race and ethnicity influence clinician-patient relationships. While less is known about how race and ethnicity influence clinician-community, clinician-clinician, and clinician-self relationships, we briefly examine the potential roles of these relationships in overcoming disparities in health care. Finally, we suggest directions for future research on racial and ethnic health care disparities that uses a relationship-centered paradigm.

Race and Ethnicity in Genetic Research

Sankar, Pamela; Cho, Mildred K.; Mountain, Joanna
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 01/05/2007 Português
Relevância na Pesquisa
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Use of race and ethnicity terms in genetic research continues to generate controversy. Despite differing opinions about their basis or relevance, there is some agreement that investigators using these terms should: explain why the terms or categories were used, define them carefully, and apply them consistently. An important question is whether these recommendations are reflected in practice. Here we addressed this question based on 330 randomly selected articles published between 2001 and 2004 that reported on genetic research and used one or more words from a defined list of race, ethnicity, or population terms. The recommendation that authors using race or ethnicity terms explain the basis for assigning them to study populations was met infrequently (9.1%), and articles that used race and ethnicity as variables were no more likely than those that used them only to label a sample to provide these details. No article defined or discussed the concepts of race or ethnicity. With limited exceptions, current practice does not reflect repeated recommendations for using race or ethnicity terms in genetic research. This study provides a baseline against which to measure future trends.

Comorbid disease and the effect of race and ethnicity on in-hospital mortality from aspiration pneumonia.

Oliver, M. Norman; Stukenborg, George J.; Wagner, Douglas P.; Harrell, Frank E.; Kilbridge, Kerry L.; Lyman, Jason A.; Einbinder, Jonathan; Connors, Alfred F.
Fonte: National Medical Association Publicador: National Medical Association
Tipo: Artigo de Revista Científica
Publicado em /11/2004 Português
Relevância na Pesquisa
68.378384%
BACKGROUND: Racial and ethnic disparities in mortality have been demonstrated in several diseases. African Americans are hospitalized at a significantly higher rate than whites for aspiration pneumonia; however, no studies have investigated racial and ethnic disparities in mortality in this population. OBJECTIVE: To assess the independent effect of race and ethnicity on in-hospital mortality among aspiration pneumonia discharges while comprehensively controlling for comorbid diseases, and to assess whether the prevalence and effects of comorbid illness differed across racial and ethnic categories. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 41,581 patients admitted to California hospitals for aspiration pneumonia from 1996 through 1998, using principal and secondary diagnoses present on admission. MEASUREMENT: The primary outcome measure was in-hospital mortality. RESULTS: The adjusted odds of in-hospital death for African-American compared with white discharges [odds ratio (OR)=1.01; 95% confidence interval (CI), 0.91-1.11] was not significantly different. The odds of death for Asian compared with white discharges was significantly lower (OR=0.83; 95% CI, 0.75-0.91). Hispanics had a significantly lower odds of death (OR=0.90; 95% CI...

Perspective on Race and Ethnicity in Alzheimer’s Disease Research

Weiner, Myron F.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
68.45531%
There are adequate scientific, public health and ethical justifications for studying Alzheimer disease (AD) in persons of varying race and ethnicity, but to be meaningful variables, race and ethnicity must be examined in context. The complex interactions between race, ethnicity, life style, and environmental factors such as climate and diet, require that future studies of AD in specific racial or ethnic groups attend to measures of racial/ethnic homogeneity and assessment of the environment and the elements that comprise the ethnicity of groups under study. Instead of arbitrarily selecting specific racial or ethnic groups in the hope of finding important differences, it may be in the long run less costly and more efficient to recruit families with highly positive (or negative) family histories, to search within these groups for possible racial or ethnic differences and to then investigate the possible racial or ethnic reasons for those differences.

Associations of race and ethnicity with anemia management among patients initiating renal replacement therapy.

Weisbord, Steven D.; Fried, Linda F.; Mor, Maria K.; Resnick, Abby L.; Kimmel, Paul L.; Palevsky, Paul M.; Fine, Michael J.
Fonte: National Medical Association Publicador: National Medical Association
Tipo: Artigo de Revista Científica
Publicado em /11/2007 Português
Relevância na Pesquisa
68.138696%
BACKGROUND: Many patients initiate renal replacement therapy with suboptimal anemia management. The factors contributing to this remain largely unknown. The aim of this study was to assess the associations of race and ethnicity with anemia care prior to the initiation of renal replacement therapy. METHODS: Using data from the medical evidence form filed for patients who initiated renal replacement therapy between 1995-2003, we assessed racial and ethnic differences in pre-end-stage renal disease hematocrit levels, the use of erythropoiesis stimulation agents (ESAs), the proportion of patients with hematocrit levels > or = 33% and the proportion of patients with hematocrit levels < 33% that did not receive ESA. We also examined secular trends in racial and ethnic differences in these parameters. RESULTS: In multivariable analyses, non-Hispanic blacks had lower hematocrit levels (delta hematocrit = -0.97%, 95% CI: -1.00-0.94%), and were less likely to receive ESA (OR = 0.82, 95% CI: 0.81-0.84), to initiate renal replacement therapy with hematocrit > or = 33% (OR = 0.78, 95% CI: 0.77-0.79) or to receive ESA if the hematocrit was < 33% (OR = 0.79, 95% CI: 0.77-0.80) than non-Hispanic whites. White Hispanics also had lower hematocrit levels (delta hematocrit = -0.42%...

Glucose intolerance by race and ethnicity in the U.S. Virgin Islands.

Tull, Eugene S.; LaPorte, Ronald; Kriska, Andrea; Mark, Joseph; Hatcher, Ann T.
Fonte: National Medical Association Publicador: National Medical Association
Tipo: Artigo de Revista Científica
Publicado em /03/2002 Português
Relevância na Pesquisa
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This study describes the prevalence on glucose intolerance by race and ethnicity in the United States Virgin Islands. A population-based sample of 1026 individuals 20 years of age or older was recruited on the island of St. Croix, U.S. Virgin Islands, where 80% of the population classify their race as African American and 20% indicate their ethnicity as Hispanic. American Diabetes Association (ADA) criteria was used to classify glucose tolerance for the entire sample. Persons 40 years of age or older (405) were also administered a 2-h oral glucose tolerance test. Among the major race/ethnic groups, the prevalence of diabetes in patients 20 years of age or older (age-adjusted to the 1995 world population) was 14.1% for non-Hispanic blacks (n = 712), 12.1% for Hispanic blacks (n = 145), 13.5% for Hispanic whites (n = 70) and 1.2% for non-Hispanic whites (n = 37). In each group, the prevalence of diabetes increased with age and appeared higher for men. Among individuals 40 years of age or older a slightly higher prevalence of newly diagnosed diabetes was found when using World Health Organization (WHO) criteria compared to ADA criteria (WHO 10.3%, ADA 7.7% for black non-Hispanic persons and WHO 10.4%, ADA 6.0% for all other groups combined). The prevalence of diabetes for African Americans residing in the U.S. Virgin Islands is similar to rates for the African-American population on the United States mainland and is double that of estimates for blacks on neighboring islands.

What Race and Ethnicity Measure in Pharmacologic Research

Doyle, Jamie Mihoko
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /04/2006 Português
Relevância na Pesquisa
68.622285%
Advances in genomic technology have put the utility of collecting racial and ethnic data into question. Some researchers are optimistic about the potential of moving toward “personalized medicine” by using a person’s genome to administer medications. Genetics will not erase the importance of race and ethnicity because race and ethnicity do not measure genetic composition. Unlike genes, race and ethnicity are social constructs; 2 persons with identical genetic makeup may self-identify as being of different race or ethnic origin. Race and ethnic categories have been subject to change over time; a person’s self-identification may vary according to the context, wording, and format of the question asked. Despite the fluid nature of the concept, self-identified race and ethnicity can capture something that genes cannot, namely, aspects of culture, behavior, diet, environment, and features of social status that commonly used measures of socioeconomic status, such as income, education, and occupation, cannot measure.

The Challenges of Collecting Data on Race and Ethnicity in a Diverse, Multiethnic State

Kaneshiro, Bliss; Geling, Olga; Gellert, Kapuaola; Millar, Lynnae
Fonte: University Clinical, Education & Research Associate (UCERA) Publicador: University Clinical, Education & Research Associate (UCERA)
Tipo: Artigo de Revista Científica
Publicado em /08/2011 Português
Relevância na Pesquisa
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Race and ethnicity are commonly used predictor variables in medical and public health research. Including these variables has helped researchers to describe the etiology of certain disease states. Including race and ethnicity in research has been hypothesis generating in terms of the relationship between genetic and environmental factors in the development of disease. Eliminating health disparities among different racial and ethnic groups has become a national priority. However, incorporating race and ethnicity into health research is complex because these variables are difficult to define and individuals often identify with more than one race or ethnicity. As a “minority-majority”, multiethnic, multiracial state, Hawai‘i faces unique challenges in incorporating race and ethnicity into research. As the demographics of the United States continue to evolve, many of the challenges faced in Hawai‘i will apply to the United States as a whole.

New race and ethnicity standards: elucidating health disparities in diabetes

Katzmarzyk, Peter T; Staiano, Amanda E
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 30/04/2012 Português
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The concepts of race and ethnicity are useful for understanding the distribution of disease in the population and for identifying at-risk groups for prevention and treatment efforts. The U.S. Department of Health and Human Services recently updated the race and ethnicity classifications in order to more effectively monitor health disparities. Differences in chronic disease mortality rates are contributing to race and ethnic health disparities in life expectancy in the United States. The prevalence of diabetes is higher in African Americans and Hispanics compared to white Americans, and parallel trends are seen in diabetes risk factors, including physical inactivity, dietary patterns, and obesity. Further research is required to determine the extent to which the observed differences in diabetes prevalence are attributable to differences in lifestyle versus other characteristics across race and ethnic groups.

Nonresponse to a Question on Self-Identified Sexual Orientation in a Public Health Survey and Its Relationship to Race and Ethnicity

Kim, Hyun-Jun; Fredriksen-Goldsen, Karen I.
Fonte: American Public Health Association Publicador: American Public Health Association
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
77.76177%
We examined whether nonresponse to the survey question on self-identified sexual orientation was associated with race and ethnicity, utilizing Washington State Behavioral Risk Factor Surveillance System data. The results of adjusted multinomial logistic regression indicated that the nonresponse rates of Asian Americans, Hispanics, and African Americans are higher than those of non-Hispanic Whites. Innovative ways of measuring sexual orientation to reduce racially and ethnically driven bias need to be developed and integrated into public health surveys.

Classification of Race and Ethnicity: Implications for Public Health*

Mays, Vickie M.; Ponce, Ninez A.; Washington, Donna L.; Cochran, Susan D.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
68.24472%
Emerging methods in the measurement of race and ethnicity have important implications for the field of public health. Traditionally, information on race and/or ethnicity has been integral to our understanding of the health issues affecting the U.S. population. We review some of the complexities created by new classification approaches made possible by the inclusion of multiple-race assessment in the U.S. Census and large health surveys. We discuss the importance of these classification decisions in understanding racial/ethnic health and health care access disparities. The trend toward increasing racial and ethnic diversity in the United States will put further pressure on the public health industry to develop consistent and useful approaches to racial/ethnic classifications.

The National Elder Mistreatment Study: Race and Ethnicity Findings

Hernandez-Tejada, Melba Alexandra; Amstadter, Ananda; Muzzy, Wendy; Acierno, Ron
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
Relevância na Pesquisa
68.144023%
The prevalence of elder mistreatment with respect to race and ethnicity was examined in an unweighted sample of 5,777 participants (5,776 participants in weighted sample). Random Digit Dialing methodology was used to select a representative sample of community-dwelling older adults, and the survey was available in English and Spanish. Mistreatment types included emotional, physical, and sexual abuse. Race and ethnicity based differences were largely absent, and the only observed increase was for physical mistreatment among Non-White older adults; however this association was not sustained in multivariate analyses controlling for income, health status, and social support. Findings are in contrast to prior reports of increased risk of mistreatment in minority populations, and point to correlated and modifiable factors of social support and poor health as targets for preventive intervention.

Matching on Race and Ethnicity in Case-Control Studies as a Means of Control for Population Stratification

Chokkalingam, Anand P.; Aldrich, Melinda C.; Bartley, Karen; Hsu, Ling-I; Metayer, Catherine; Barcellos, Lisa F.; Wiemels, Joseph L.; Wiencke, John K.; Buffler, Patricia A.; Selvin, Steve
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 29/09/2011 Português
Relevância na Pesquisa
68.5867%
Some investigators argue that controlling for self-reported race or ethnicity, either in statistical analysis or in study design, is sufficient to mitigate unwanted influence from population stratification. In this report, we evaluated the effectiveness of a study design involving matching on self-reported ethnicity and race in minimizing bias due to population stratification within an ethnically admixed population in California. We estimated individual genetic ancestry using structured association methods and a panel of ancestry informative markers, and observed no statistically significant difference in distribution of genetic ancestry between cases and controls (P=0.46). Stratification by Hispanic ethnicity showed similar results. We evaluated potential confounding by genetic ancestry after adjustment for race and ethnicity for 1260 candidate gene SNPs, and found no major impact (>10%) on risk estimates. In conclusion, we found no evidence of confounding of genetic risk estimates by population substructure using this matched design. Our study provides strong evidence supporting the race- and ethnicity-matched case-control study design as an effective approach to minimizing systematic bias due to differences in genetic ancestry between cases and controls

THE INFLUENCE OF RACE AND ETHNICITY IN CLIENTS’ EXPERIENCES OF MENTAL HEALTH TREATMENT

Meyer, Oanh L.; Zane, Nolan
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /09/2013 Português
Relevância na Pesquisa
68.136055%
Clinicians and researchers have pointed to the need for culturally sensitive mental health interventions. Yet it has not been determined if the inclusion of cultural elements affects the way mental health clients experience services. This study examined 102 clients who had received mental health treatment from outpatient mental health clinics to investigate whether culturally related elements involving race and ethnicity were important to clients and whether they were related to client satisfaction and perceived treatment outcomes. Ethnic minority clients generally felt that issues regarding race and ethnicity were more important than did White clients. When these elements were considered important but were not included in their care, clients were less satisfied with treatment. Consistent with the notion of cultural responsiveness, these findings provide empirical evidence that culturally relevant aspects of the mental health service experience are salient to ethnic minority clients and can affect how they respond to services.

Patterns and Trends in Elder Homicide Across Race and Ethnicity, 1985-2009

Feldmeyer, Ben; Steffensmeier, Darrell
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /05/2013 Português
Relevância na Pesquisa
68.685566%
In this report, we assess total and race/ethnicity-disaggregated patterns and temporal trends in elderly homicide (age 55-74) compared with younger age groups for the 1985-to-2009 period. To do this, we use California arrest statistics that provide annual homicide figures by race and ethnicity (including a Hispanic identifier) and by age. Major aims of our analysis are to establish whether (a) elderly homicide rates are different/similar across race/ethnic comparisons; (b) the elderly share of homicide and age-homicide distributions more generally differ across race/ethnicity; and (c) elderly rates of homicide and the share of elderly homicide relative to younger age groups is similar or different now as compared with 20 to 30 years ago. Our analysis is important and timely because some commentators have suggested that elderly homicide levels have been rising over the past one to two decades and because there is a virtual absence of research of any sort on elderly homicide trends that involve comparisons by race and ethnicity. Key findings are that elderly shares of homicide offending relative to younger ages have not increased (or decreased), that elder homicides continue to account for a small fraction of all homicides, and that these patterns persist across race/ethnicity comparisons.

Persisting problems related to race and ethnicity in public health and epidemiology research; Problemas persistentes relacionados con la raza y etnia en la investigación en salud pública y epidemiología; Problemas persistentes relacionados à raça e etnia na pesquisa em saúde pública e epidemiologia

Moubarac, Jean-Claude
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/02/2013 Português
Relevância na Pesquisa
68.76945%
Realizou-se revisão recente e abrangente da utilização de raça e etnia em pesquisas dedicadas às disparidades de saúde em epidemiologia e saúde pública. Foi descrita a base teórica sobre qual raça e etnia diferem nos métodos de trabalhos em ciência, antropologia social e de saúde pública. A revisão foi feita com base na seleção de artigos publicados em periódicos de alto fator de impacto no que diz respeito à saúde pública e epidemiologia, no período de 2009-2011. O total de artigos selecionados foi de 280. A revisão foi baseada sobre um conjunto de questões conceituais, teóricas e metodológicas relacionadas ao uso de ambos os conceitos. A maioria dos artigos revisados foi fundamentada em um referencial teórico e desde interpretações de vários modelos. No entanto, os principais problemas identificados incluem: a) falha de pesquisadores para diferenciar conceitos de raça e etnia; b) utilização indevida de categorias raciais para atribuir etnia; c) falta de transparência nos métodos utilizados para avaliar ambos os conceitos; e d) falta de limites de endereços associada à construção de taxonomias raciais ou étnicas e a sua utilização. Concluiu-se que os futuros estudos que objetivem examinar as disparidades de saúde devem estabelecer claramente a distinção entre raça e etnia...

Persisting problems related to race and ethnicity in public health and epidemiology research

Moubarac,Jean-Claude
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2013 Português
Relevância na Pesquisa
78.829736%
A recent and comprehensive review of the use of race and ethnicity in research that address health disparities in epidemiology and public health is provided. First it is described the theoretical basis upon which race and ethnicity differ drawing from previous work in anthropology, social science and public health. Second, it is presented a review of 280 articles published in high impacts factor journals in regards to public health and epidemiology from 2009-2011. An analytical grid enabled the examination of conceptual, theoretical and methodological questions related to the use of both concepts. The majority of articles reviewed were grounded in a theoretical framework and provided interpretations from various models. However, key problems identified include a) a failure from researchers to differentiate between the concepts of race and ethnicity; b) an inappropriate use of racial categories to ascribe ethnicity; c) a lack of transparency in the methods used to assess both concepts; and d) failure to address limits associated with the construction of racial or ethnic taxonomies and their use. In conclusion, future studies examining health disparities should clearly establish the distinction between race and ethnicity, develop theoretically driven research and address specific questions about the relationships between race...