scholarly journals Racial/Ethnic Disparities in State-Level COVID-19 Vaccination Rates and Their Association with Structural Racism

2021 ◽  
Author(s):  
Michael Siegel ◽  
Isabella Critchfield-Jain ◽  
Matthew Boykin ◽  
Alicia Owens ◽  
Rebeckah Muratore ◽  
...  
Keyword(s):  
Ethnic Disparities ◽  
State Level ◽  
Structural Racism ◽  
Vaccination Rates ◽  
Racial Ethnic

scholarly journals Culture Change Initiatives in High Medicaid Nursing Homes: Does Time of Adoption Make a Difference?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 22-23
Author(s):  
Latarsha Chisholm ◽  
Akbar Ghiasi ◽  
Justin Lord ◽  
Robert Weech-Maldonado
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Culture Change ◽  
Fixed Effects ◽  
Ethnic Disparities ◽  
State Level ◽  
Change Initiatives ◽  
Term Care ◽  
Star Rating ◽  
Racial Ethnic

Abstract Racial/ethnic disparities have been well documented in long-term care literature. As the population ages and becomes more diverse over time, it is essential to identify mechanisms that may eliminate or mitigate racial/ethnic disparities. Culture change is a movement to transition nursing homes to more home-like environments. The literature on culture change initiatives and quality has been mixed, with little to no literature on the use of culture change initiatives in high Medicaid nursing homes and quality. The purpose of this study was to examine how the involvement of culture change initiatives among high Medicaid facilities was associated with nursing home quality. The study relied on both survey and secondary nursing home data for the years 2017-2018. The sample included high Medicaid (85% or higher) nursing homes. The outcome of interest was the overall nursing home star rating obtained from the Nursing Home Compare Five-Star Quality Rating System. The primary independent variable of interest was the years of involvement in culture change initiatives among nursing homes, which was obtained from the nursing home administrator survey. The final model consisted of an ordinal logistic regression with state-level fixed effects. High-Medicaid nursing homes with six or more years in culture change initiatives had higher odds of having a higher star rating, while facilities with one year or less had significantly lower odds of having a higher star rating. Culture change initiatives may require some time to effectively implement, but these initiatives are potential mechanisms to improve quality in high Medicaid nursing homes.

scholarly journals Racial/Ethnic Disparities in Influenza Vaccination Coverage Among US Adolescents, 2010-2016

2018 ◽  
Vol 133 (6) ◽  
pp. 667-676 ◽  
Author(s):  
Noah S. Webb ◽  
Benjamin Dowd-Arrow ◽  
Miles G. Taylor ◽  
Amy M. Burdette
Keyword(s):  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Black Adolescents ◽  
Ethnic Disparities ◽  
White Adolescents ◽  
Hispanic Adolescents ◽  
Vaccination Rates ◽  
Targeted Interventions ◽  
Race Ethnicity ◽  
Racial Ethnic

Objective: Although research suggests racial/ethnic disparities in influenza vaccination and mortality rates, few studies have examined racial/ethnic trends among US adolescents. We used national cross-sectional data to determine (1) trends in influenza vaccination rates among non-Hispanic white (hereinafter, white), non-Hispanic black (hereinafter, black), and Hispanic adolescents over time and (2) whether influenza vaccination rates among adolescents varied by race/ethnicity. Methods: We analyzed provider-reported vaccination histories for 2010-2016 from the National Immunization Survey–Teen. We used binary logistic regression models to determine trends in influenza vaccination rates by race/ethnicity for 117 273 adolescents, adjusted for sex, age, health insurance, physician visit in the previous 12 months, vaccination facility type, poverty status, maternal education level, children in the household, maternal marital status, maternal age, and census region of residence. We calculated adjusted probabilities for influenza vaccination for each racial/ethnic group, adjusted for the same demographic characteristics. Results: Compared with white adolescents, Hispanic adolescents had higher odds (adjusted odds ratio [aOR] = 1.11; 95% confidence interval [CI], 1.06-1.16) and black adolescents had lower odds (aOR = 0.95; 95% CI, 0.90-1.00) of vaccination. Compared with white adolescents, Hispanic adolescents had significantly higher adjusted probabilities of vaccination for 2011-2013 (2011: 0.22, P < .001; 2012: 0.23, P < .001; 2013: 0.26, P < .001). Compared with white adolescents, black adolescents had significantly lower probabilities of vaccination for 2016 (2016: 0.21, P < .001). Conclusions: Targeted interventions are needed to improve adolescent influenza vaccination rates and reduce racial/ethnic disparities in adolescent vaccination coverage.

Racial and Ethnic Disparities in Prison Admissions Across Counties: An Evaluation of Racial/Ethnic Threat, Socioeconomic Inequality, and Political Climate Explanations

2017 ◽  
Vol 10 (2) ◽  
pp. 176-202 ◽  
Author(s):  
Katherine A. Durante
Keyword(s):  
Hierarchical Linear Modeling ◽  
Socioeconomic Inequality ◽  
Ethnic Disparities ◽  
State Level ◽  
Racial And Ethnic Disparities ◽  
Political Climate ◽  
Linear Modeling ◽  
Admission Rates ◽  
Racial Ethnic ◽  
Prison Admission

Previous macro-level studies of racial and ethnic disparities in prison admissions have focused narrowly on differences in offending and have limited their analyses to national- and state-level data. This study explores three alternative explanations for inequality in prison admissions for Blacks and Latinos compared to Whites: racial/ethnic threat, socioeconomic inequality, and the political and legal climate. I analyze data from multiple county- and state-level sources and employ hierarchical linear modeling techniques to examine the role of both county- and state-level factors in producing inequality in county-level prison admission rates. Findings indicate that Black–White disparities are lower in jurisdictions with greater shares of Black citizens; however, the reverse is true for Latino–White inequality. For both comparisons, political conservatism is associated with less inequality. Results also indicate that counties with greater parity in income and employment across race/ethnicity and that are located in the South have reduced racial/ethnic disparities in prison admissions. I argue that the presence of large shares of African Americans and of Republican voters, in addition to southern location, are likely better indicators of total prison admission rates than of racial/ethnic disparities in prison admissions.

Racial Disparities in Use of Chiropractic Services by Medicare Beneficiaries Aged 65 to 99 in Los Angeles County, California

2015 ◽  
Vol 21 (2) ◽  
pp. 131-137 ◽  
Author(s):  
James M. Whedon ◽  
Melissa N. Kimura ◽  
Reed B. Phillips
Keyword(s):  
Los Angeles ◽  
Racial Disparities ◽  
Los Angeles County ◽  
Local Level ◽  
Ethnic Disparities ◽  
State Level ◽  
Chiropractic Care ◽  
Geographic Variations ◽  
Racial Ethnic ◽  
Zip Code

Racial and ethnic disparities in utilization of chiropractic services have been described at the state level, but little is known about such local disparities. We analyzed Medicare data for the year 2008 to evaluate by ZIP code for utilization of chiropractic services among older adults in Los Angeles County, California. We evaluated for availability and use of chiropractic services by racial/ethnic category, quantified geographic variations by coefficient of variation, and mapped utilization by selected racial/ethnic categories. Among 7502 beneficiaries who used chiropractic services, 72% were white, 12% Asian, 1% black, 1% Hispanic, and 14% other/unknown. Variation in the number of beneficiaries per ZIP code who used chiropractic services was highest among Hispanics, blacks, and Asians. We found evidence of racial disparities in use of chiropractic services at the local level in Los Angeles County. Older blacks and Hispanics in Los Angeles County may be underserved with regard to chiropractic care.

scholarly journals Changing the Narrative: Structural Barriers and Racial and Ethnic Inequities in COVID-19 Vaccination

2021 ◽  
Vol 18 (18) ◽  
pp. 9904
Author(s):  
Anuli Njoku ◽  
Marcelin Joseph ◽  
Rochelle Felix
Keyword(s):  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Structural Barriers ◽  
Structural Racism ◽  
Vaccination Rates ◽  
Promising Solution ◽  
The Impact

The COVID-19 pandemic has disproportionately affected racial and ethnic minority groups in the United States. Although a promising solution of the COVID-19 vaccination offers hope, disparities in access again threaten the health of these communities. Various explanations have arisen for the cause of disparate vaccination rates among racial and ethnic minorities, including discussion of vaccine hesitancy. Conversely, the role of vaccine accessibility rooted in structural racism as a driver in these disparities should be further explored. This paper discusses the impact of structural barriers on racial and ethnic disparities in COVID-19 vaccine uptake. We also recommend public health, health system, and community-engaged approaches to reduce racial disparities in COVID-19 disease and mortality.

scholarly journals The Ethical Imperative of Equity in Oncology: Lessons Learned From 2020 and a Path Forward

2021 ◽  
pp. e13-e19
Author(s):  
Jonathan M. Marron ◽  
Marjory Charlot ◽  
Jacquelyne Gaddy ◽  
Abby R. Rosenberg
Keyword(s):  
Health Care ◽  
Ethnic Disparities ◽  
The United States ◽  
Lessons Learned ◽  
Ethical Responsibility ◽  
Structural Racism ◽  
Call To Action ◽  
Ethical Imperative ◽  
Racial Ethnic ◽  
Shed Light

The COVID-19 pandemic and the simultaneous increased focus on structural racism and racial/ethnic disparities across the United States have shed light on glaring inequities in U.S. health care, both in oncology and more generally. In this article, we describe how, through the lens of fundamental ethical principles, an ethical imperative exists for the oncology community to overcome these inequities in cancer care, research, and the oncology workforce. We first explain why this is an ethical imperative, centering the discussion on lessons learned during 2020. We continue by describing ongoing equity-focused efforts by ASCO and other related professional medical organizations. We end with a call to action—all members of the oncology community have an ethical responsibility to take steps to address inequities in their clinical and academic work—and with guidance to practicing oncologists looking to optimize equity in their research and clinical practice.

Mandatory Minimum Reforms, Sentencing, and Racial-Ethnic Disparities

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Terry-Ann Craigie ◽  
Mariyana Zapryanova
Keyword(s):  
Ethnic Disparities ◽  
State Level ◽  
Experimental Methods ◽  
Ethnic Bias ◽  
Mandatory Minimums ◽  
Quasi Experimental ◽  
Lower Drug ◽  
Lowering Drug ◽  
The Impact ◽  
Racial Ethnic

Abstract Over the last 20 years, numerous states and the federal government enacted mandatory minimum reforms, especially for drug offenses. Yet little is known about how effective these reforms have been at the state-level in lowering drug sentences. Using quasi-experimental methods and administrative data, this study evaluates the impact of state-level mandatory minimum reforms on drug sentences and their concomitant racial-ethnic disparities. We find that state-level mandatory minimum reforms do not lower drug sentences in general or change racial-ethnic disparities statistically significantly. These findings suggest that the profound racial-ethnic bias sparked by state-level mandatory minimums are not fully ameliorated by subsequent state-level reforms.

scholarly journals Improved measurement of racial/ethnic disparities in COVID-19 mortality in the United States

2020 ◽  
Author(s):  
Joshua R. Goldstein ◽  
Serge Atherwood
Keyword(s):  
United States ◽  
New York ◽  
National Level ◽  
Ethnic Disparities ◽  
State Level ◽  
The United States ◽  
Estimation Methods ◽  
Death Rates ◽  
Population Distributions ◽  
Racial Ethnic

AbstractDifferent estimation methods produce diverging accounts of racial/ethnic disparities in COVID-19 mortality in the United States. The CDC’s decision to present the racial/ethnic distribution of COVID-19 deaths at the state level alongside re-weighted racial/ethnic population distributions—in effect, a geographic adjustment—makes it seem that Whites have the highest death rates. Age adjustment procedures used by others, including the New York City Department of Health and Mental Hygiene, lead to the opposite conclusion that Blacks and Hispanics are dying from COVID-19 at higher rates than Whites. In this paper, we use indirect standardization methods to adjust per-capita death rates for both age and geography simultaneously, avoiding the one-sided adjustment procedures currently in use. Using CDC data, we find age-and-place-adjusted COVID-19 death rates are 80% higher for Blacks and more than 50% higher for Hispanics, relative to Whites, on a national level, while there is almost no disparity for Asians. State-specific estimates show wide variation in mortality disparities. Comparison with non-epidemic mortality reveals potential roles for pre-existing health disparities and differential rates of infection and care.

Study finds racial/ethnic disparities in depressive trajectories among middle-aged or older adults

2012 ◽  
Author(s):  
J. Liang ◽  
X. Xu ◽  
A. R. Quinones ◽  
J. M. Bennett ◽  
W. Ye
Keyword(s):  
Older Adults ◽  
Ethnic Disparities ◽  
Middle Aged ◽  
Racial Ethnic
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