Infant Mortality among Adolescent Mothers in the United States: A 5-Year Analysis of Racial and Ethnic Disparities

2020 ◽  
Author(s):  
Matthew D. Moore ◽  
Anne E. Brisendine ◽  
Martha S. Wingate
Keyword(s):  
United States ◽  
Preterm Birth ◽  
Infant Mortality ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial And Ethnic Disparities ◽  
Postneonatal Mortality ◽  
Maternal Characteristics ◽  
Race Ethnicity ◽  
Racial Ethnic

Objective This study was aimed to examine differences in infant mortality outcomes across maternal age subgroups less than 20 years in the United States with a specific focus on racial and ethnic disparities. Study Design Using National Center for Health Statistics cohort-linked live birth–infant death files (2009-2013) in this cross-sectional study, we calculated descriptive statistics by age (<15, 15–17, and 18–19 years) and racial/ethnic subgroups (non-Hispanic white [NHW], non-Hispanic black [NHB], and Hispanic) for infant, neonatal, and postneonatal mortality. Adjusted odds ratios (aOR) were calculated by race/ethnicity and age. Preterm birth and other maternal characteristics were included as covariates. Results Disparities were greatest for mothers <15 and NHB mothers. The risk of infant mortality among mothers <15 years compared to 18 to 19 years was higher regardless of race/ethnicity (NHW: aOR = 1.40, 95% confidence interval [CI]: 1.06–1.85; NHB: aOR = 1.28, 95% CI: 1.04–1.56; Hispanic: aOR = 1.36, 95%CI: 1.07–1.74). Compared to NHW mothers, NHB mothers had a consistently higher risk of infant mortality (15–17 years: aOR = 1.12, 95% CI: 1.03–1.21; 18–19 years: aOR = 1.21, 95% CI: 1.15–1.27), while Hispanic mothers had a consistently lower risk (15–17 years: aOR = 0.72, 95% CI: 0.66–0.78; 18–19 years: aOR = 0.74, 95% CI: 0.70–0.78). Adjusting for preterm birth had a greater influence than maternal characteristics on observed group differences in mortality. For neonatal and postneonatal mortality, patterns of disparities based on age and race/ethnicity differed from those of overall infant mortality. Conclusion Although infants born to younger mothers were at increased risk of mortality, variations by race/ethnicity and timing of death existed. When adjusted for preterm birth, differences in risk across age subgroups declined and, for some racial/ethnic groups, disappeared. Key Points

scholarly journals Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

2021 ◽  
Vol 18 (6) ◽  
pp. 2921
Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  
Keyword(s):  
United States ◽  
District Of Columbia ◽  
Ethnic Disparities ◽  
The United States ◽  
Attributable Mortality ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Degree Of Association ◽  
Racial Ethnic

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

scholarly journals Racial/Ethnic Disparities in Lost Earnings From Cancer Deaths in the United States

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Jingxuan Zhao ◽  
Kimberly D Miller ◽  
Farhad Islami ◽  
Zhiyuan Zheng ◽  
Xuesong Han ◽  
...  
Keyword(s):  
United States ◽  
Economic Burden ◽  
Ethnic Disparities ◽  
The United States ◽  
Pacific Islanders ◽  
Equal Access ◽  
Years Of Life Lost ◽  
Cancer Death ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Background Little is known about disparities in economic burden due to premature cancer deaths by race or ethnicity in the United States. This study aimed to compare person-years of life lost (PYLLs) and lost earnings due to premature cancer deaths by race/ethnicity. Methods PYLLs were calculated using recent national cancer death and life expectancy data. PYLLs were combined with annual median earnings to generate lost earnings. We compared PYLLs and lost earnings among individuals who died at age 16-84 years due to cancer by racial/ethnic groups (non-Hispanic [NH] White, NH Black, NH Asian or Pacific Islander, and Hispanic). Results In 2015, PYLLs due to all premature cancer deaths were 6 512 810 for NH Whites, 1 196 709 for NH Blacks, 279 721 for NH Asian or Pacific Islanders, and 665 968 for Hispanics, translating to age-standardized lost earning rates (per 100 000 person-years) of $34.9 million, $43.5 million, $22.2 million, and $24.5 million, respectively. NH Blacks had higher age-standardized PYLL and lost earning rates than NH Whites for 13 of 19 selected cancer sites. If age-specific PYLL and lost earning rates for NH Blacks were the same as those of NH Whites, 241 334 PYLLs and $3.2 billion lost earnings (22.6% of the total lost earnings among NH Blacks) would have been avoided. Disparities were also observed for average PYLLs and lost earnings per cancer death for all cancers combined and 18 of 19 cancer sites. Conclusions Improving equal access to effective cancer prevention, screening, and treatment will be important in reducing the disproportional economic burden associated with racial/ethnic disparities.

scholarly journals Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

2021 ◽  
Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  
Keyword(s):  
United States ◽  
District Of Columbia ◽  
Ethnic Disparities ◽  
The United States ◽  
Attributable Mortality ◽  
Estimation Uncertainty ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Racial Ethnic

AbstractThe coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios – anchoring comparisons to non-Hispanic Whites – in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of December 30, 2020. Using a novel Monte Carlo simulation procedure to quantify estimation uncertainty, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, observed disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

scholarly journals Racial and Ethnic Disparities in Heart and Cerebrovascular Disease Deaths During the COVID-19 Pandemic in the United States

Circulation ◽  
2021 ◽  
Author(s):  
Rishi Wadhera ◽  
Jose F. Figueroa ◽  
Fatima Rodriguez ◽  
Michael Liu ◽  
Wei Tian ◽  
...  
Keyword(s):  
United States ◽  
Heart Disease ◽  
Cerebrovascular Disease ◽  
Ethnic Minorities ◽  
Minority Group ◽  
Ethnic Disparities ◽  
The United States ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

Background: Cardiovascular deaths increased during the early phase of the COVID-19 pandemic in the United States. However, it is unclear whether racial/ethnic minorities have experienced a disproportionate rise in heart disease and cerebrovascular disease deaths. Methods: We used the National Center for Health Statistics to identify heart disease and cerebrovascular disease deaths for non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic individuals from March-August 2020 (pandemic period), as well as for the corresponding months in 2019 (historical control). We determined the age- and sex-standardized deaths per million by race/ethnicity for each year. We then fit a modified Poisson model with robust standard errors to compare change in deaths by race/ethnicity for each condition in 2020 vs. 2019. Results: There were a total of 339,076 heart disease and 76,767 cerebrovascular disease deaths from March through August 2020, compared to 321,218 and 72,190 deaths during the same months in 2019. Heart disease deaths increased during the pandemic in 2020, compared with the corresponding period in 2019, for non-Hispanic White (age-sex standardized deaths per million, 1234.2 vs. 1208.7; risk ratio for death [RR] 1.02, 95% CI 1.02-1.03), non-Hispanic Black (1783.7 vs. 1503.8; RR 1.19, 1.17-1.20), non-Hispanic Asian (685.7 vs. 577.4; RR 1.19, 1.15-1.22), and Hispanic (968.5 vs. 820.4, RR 1.18, 1.16-1.20) populations. Cerebrovascular disease deaths also increased for non-Hispanic White (268.7 vs. 258.2; RR 1.04, 95% CI 1.03-1.05), non-Hispanic Black (430.7 vs. 379.7; RR 1.13, 95% CI 1.10-1.17), non-Hispanic Asian (236.5 vs. 207.4; RR 1.15, 1.09-1.21), and Hispanic (264.4 vs. 235.9; RR 1.12, 1.08-1.16) populations. For both heart disease and cerebrovascular disease deaths, each racial and ethnic minority group experienced a larger relative increase in deaths than the non-Hispanic White population (interaction term, p<0.001). Conclusions: During the COVID-19 pandemic in the US, Black, Hispanic, and Asian populations experienced a disproportionate rise in deaths due to heart disease and cerebrovascular disease, suggesting that racial/ethnic minorities have been most impacted by the indirect effects of the pandemic. Public health and policy strategies are needed to mitigate the short- and long-term adverse effects of the pandemic on the cardiovascular health of minority populations.

RACIAL/ETHNIC DISPARITIES IN INFANT MORTALITY AMONG U.S. LATINOS

2013 ◽  
Vol 10 (1) ◽  
pp. 205-231 ◽  
Author(s):  
Brenda L. Henry-Sanchez ◽  
Arline T. Geronimus
Keyword(s):  
United States ◽  
Latin America ◽  
Infant Mortality ◽  
Puerto Ricans ◽  
Ethnic Disparities ◽  
Racial Diversity ◽  
The United States ◽  
Latino Population ◽  
Racial Disparities In Health ◽  
Racial Ethnic

AbstractDespite shared colonization histories between the United States and Latin America, research examining racial disparities in health in the United States has often neglected Latinos. Additionally, descendants from Latin America residing in the United States are often categorized under the pan-ethnic label of Hispanic or Latino. This categorization obscures the group's heterogeneity, which is illuminated by research showing consistent differences in health for the three largest segments of the Latino population—Mexicans, Puerto Ricans, and Cubans. We examine whether the patterns of infant mortality associated with race in the non-Latino population also follow for Latinos. We also examine whether we can attribute patterns of infant mortality between the three largest Latino sub-groups to a process we term segmented racialization. We find that race operates for Latinos the same way it does for the non-Latino population and that there seems to be some evidence to support our segmented racialization hypothesis. The results point to the need to abandon the practices of combining Latino sub-groups as well as ignoring the racial diversity within the Latino population in health research.

scholarly journals Racial and Ethnic Disparities in the Survival of Patients with Indolent Non-Hodgkin Lymphoma in the United States: A Population-Based Analysis

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 3-3
Author(s):  
John L Vaughn ◽  
Ana C. Xavier ◽  
Narendranath Epperla
Keyword(s):  
American Indians ◽  
Ethnic Disparities ◽  
Relative Survival ◽  
The United States ◽  
Population Based ◽  
Alaska Natives ◽  
Pacific Islanders ◽  
Racial And Ethnic Disparities ◽  
Race Ethnicity ◽  
Racial Ethnic

Introduction: Racial and ethnic disparities have been described for patients with aggressive non-Hodgkin lymphomas (NHLs), but few studies have investigated racial disparities in patients with indolent NHLs. Indolent NHLs are a large group of lymphoid neoplasms that include follicular lymphoma (FL), marginal zone lymphoma (MZL), mantle cell lymphoma (MCL), and Waldenstrom macroglobulinemia (WM). Differences in biologic factors (e.g., metabolism of drugs), health disparities (e.g., enrollment in clinical trials), individual factors (e.g., comorbid conditions), and structural barriers (e.g., access to novel therapies) may lead to racial and ethnic disparities in these patients. We aimed to determine whether racial and ethnic disparities exist in the survival of patients with indolent NHLs in the United States. Method: We used the population-based Surveillance, Epidemiology, and End Results (SEER)-18 database. We included adult patients with FL, MZL, MCL, and WM diagnosed between 2000-2017 who were 18-84 years old at the time of diagnosis. We excluded patients with a history of prior malignancies, missing survival times, central nervous system involvement, and unknown race/ethnicity. Race/ethnicity were categorized as Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native. Marginal relative survival (RS) was estimated using the Pohar-Perme method, which estimates net survival within a relative survival framework. Expected survival was determined by matching patients to individuals in the general population by age, sex, race/ethnicity, and year. RS was modeled using Poisson regression where the effect of follow-up time was included as restricted cubic spline with 5 knots. The primary exposure variable in our model was race/ethnicity. Interactions between the main effect and significant covariates were examined (in particular disease histology). All tests of differences were performed at a two-sided alpha of 0.05. Results: There were a total of 63,855 patients included in our study. Among these patients, 35,466 had FL, 18,188 had MZL, 7,005 had MCL, and 3,196 had WM. Table 1 shows the baseline characteristics stratified based on the race/ethnicity. The median age for all patients was 63 years (IQR = 54-72 years). The majority of patients were NHW (75%). Median length of follow-up was 5.4 years (IQR = 2.2-9.7 years). As shown in Figure 1, RS (unadjusted) for patients with indolent NHL varied according to race and ethnicity. American Indians/Alaska Natives had the lowest survival at 10 years. Estimated 10-year RS (95% CI) was 78% (77-79%) for NHW, 76% (73-79%) for NHB, 79% (77-81%) for Hispanics, 79% (76-81%) for Asians/Pacific Islanders, and 69% (59-76%) for American Indians/Alaska Natives. On multivariable Poisson regression after adjusting for differences in age, sex, stage, median household income, and disease histology, racial/ethnic minorities had significantly increased hazard for excess mortality (NHB=1.37, Hispanic=1.14, Asians/Pacific Islanders=1.20, American Indians/Alaska Natives=1.75) compared to NHW patients (Table 2). There was no significant interaction between race and disease histology (likelihood ratio test p=0.21). Conclusion: In this large population-based analysis of patients with indolent NHL in the US, we found that racial and ethnic minorities had inferior survival over the past two decades after adjusting for other confounding variables. American Indians and Alaska Natives had the highest mortality followed by NHB, Asians/Pacific Islanders, and Hispanics. One of the plausible explanations for this trend could be related to decreased access to healthcare. Our study emphasizes the need for additional research into racial/ethnic disparities for lymphoma patients. Disclosures Epperla: Verastem Oncology: Speakers Bureau; Pharmacyclics: Honoraria.

scholarly journals National Population-Level Disparities in COVID-19 Mortality Across the Intersection of Race/Ethnicity and Sex in the United States

2021 ◽  
Author(s):  
Jay J Xu ◽  
Jarvis T Chen ◽  
Thomas R Belin ◽  
Ronald S Brookmeyer ◽  
Marc A Suchard ◽  
...  
Keyword(s):  
United States ◽  
American Indian ◽  
Ethnic Disparities ◽  
Population Level ◽  
The United States ◽  
Mortality Rates ◽  
Hispanic American ◽  
National Population ◽  
Race Ethnicity ◽  
Racial Ethnic

Males and certain racial/ethnic minority groups have borne a disproportionate burden of COVID-19 mortality in the United States, and substantial scientific research has sought to quantify and characterize population-level disparities in COVID-19 mortality outcomes by sex and across categories of race/ethnicity. However, there has not yet been a national population-level study to quantify disparities in COVID-19 mortality outcomes across the intersection of these demographic dimensions. Here, we analyze a publicly available dataset from the National Center for Health Statistics comprising COVID-19 death counts stratified by race/ethnicity, sex, and age for the year 2020, calculating mortality rates for each race/ethnicity-sex-age stratum and age-adjusted mortality rates for each race/ethnicity-sex stratum, quantifying disparities in terms of mortality rate ratios and rate differences. Our results reveal persistently higher COVID-19 age-adjusted mortality rates for males compared to females within every racial/ethnic group, with notable variation in the magnitudes of the sex disparity by race/ethnicity. However, non-Hispanic Black, Hispanic, and non-Hispanic American Indian or Alaska Native females have higher age-adjusted mortality rates than non-Hispanic White and non-Hispanic Asian/Pacific Islander males. Moreover, persistent racial/ethnic disparities are observed among both males and females, with higher COVID-19 age-adjusted mortality rates observed for non-Hispanic Blacks, Hispanics, and non-Hispanic American Indian or Alaska Natives relative to non-Hispanic Whites.

Racial and Ethnic Disparities in Infant Mortality in the United States: The Role of Gestational Age

2012 ◽  
Vol 30 (06) ◽  
pp. 469-476 ◽  
Author(s):  
Suneet Chauhan ◽  
Nicole Rankins ◽  
Cande Ananth ◽  
Danish Siddiqui ◽  
Anthony Vintzileos ◽  
...  
Keyword(s):  
United States ◽  
Infant Mortality ◽  
Gestational Age ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial And Ethnic Disparities
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