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 The 2007 Los Angeles Mommy and Baby Study: A Multilevel, Population-Based Study of Maternal and Infant Health in Los Angeles County

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Shin M. Chao ◽  
Fathima Wakeel ◽  
Dena Herman ◽  
Chandra Higgins ◽  
Lu Shi ◽  
...  
Keyword(s):  
Los Angeles ◽  
Los Angeles County ◽  
Ethnic Disparities ◽  
Health Department ◽  
Obstetric Outcomes ◽  
Local Health Department ◽  
Local Health ◽  
Research Database ◽  
Racial Ethnic ◽  
Successful Collaboration

Objectives. In order to comprehensively examine the risks and resources associated with racial-ethnic disparities in adverse obstetric outcomes, the Los Angeles County Department of Public Health and the University of California, Los Angeles, joined efforts to design and implement the 2007 Los Angeles Mommy and Baby (LAMB) study. This paper aims to present the conceptual frameworks underlying the study’s development, highlight the successful collaboration between a research institution and local health department, describe the distinguishing characteristics of its methodology, and discuss the study’s implications for research, programs, and policies.Methods. The LAMB study utilized a multilevel, multistage cluster design with a mixed-mode methodology for data collection. Two samples were ultimately produced: the multilevel sample (n = 4,518) and the augmented final sample (n = 6,264).Results. The LAMB study allowed us to collect multilevel data on the risks and resources associated with racial-ethnic disparities in adverse obstetric outcomes. Both samples were more likely to be Hispanic, aged 20–34 years, completed at least 12 years of schooling, and spoke English.Conclusions. The LAMB study represents the successful collaboration between an academic institution and local health department and is a theoretically based research database and surveillance system that informs effective programmatic and policy interventions to improve outcomes among LAC’s varied demographic groups.

scholarly journals Impact and Equality of Expanding Pre-Exposure Prophylaxis (PrEP) for Men who have Sex with Men in Los Angeles County

2021 ◽  
Author(s):  
Anthony Nguyen ◽  
Emmanuel Fulgence Drabo ◽  
Wendy Garland ◽  
Corrina Moucheraud ◽  
Ian W Holloway ◽  
...  
Keyword(s):  
Los Angeles ◽  
Los Angeles County ◽  
Ethnic Disparities ◽  
Base Case ◽  
Treatment Cascade ◽  
Minority Men ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Racial Ethnic ◽  
Hiv Aids

ABSTRACTBackgroundRacial and ethnic minority men who have sex with men (MSM) are disproportionately affected by HIV/AIDS in Los Angeles County (LAC), an important epicenter in the battle to end HIV.ObjectiveTo examine tradeoffs between effectiveness and equality of PrEP allocation strategies among different racial and ethnic groups of MSM in LAC.Design, Setting, and PopulationWe developed a microsimulation model of HIV among MSM in LAC using county epidemic surveillance and survey data to capture demographic trends and subgroup-specific partnership patterns, disease progression, patterns of PrEP use, and patterns for viral suppression.InterventionWe simulated interventions where an additional 3000, 6000, or 9000 PrEP prescriptions are provided annually in addition to current levels, following different allocation scenarios to each racial/ethnic group (Black, Hispanic, or White).MeasurementsWe estimated cumulative infections averted and measures of equality, after 15 years (2021-2035), relative to base case (no intervention).ResultsOf the policies evaluated, targeting PrEP preferentially to Black individuals would result in the largest reductions in incidence and disparities. This outcome was robust to different partnership preference assumptions, though the magnitude of impact differs.LimitationsWe limit analysis to MSM, who bear the majority of HIV/AIDS burden in LAC. We do not consider transmission via injection drug use or mother-to-child transmission, nor do we capture individual network transmission effects. We assume no improvements in the prevention-diagnosis-treatment cascade besides increased PrEP use.ConclusionsWe find there is little trade-off between effectiveness and equality of outcome when choosing groups to target for PrEP in LAC – by focusing on MSM with the highest HIV incidence (Black), we can reduce both overall infections and racial/ethnic disparities.

An Examination of Racial Disparities in Misdemeanor Marijuana Possession Arrests Following Reforms in Four U.S. Jurisdictions

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kristyn A. Jones ◽  
Darren Agboh ◽  
Meredith Patten ◽  
Preeti Chauhan
Keyword(s):  
New York ◽  
Los Angeles ◽  
Racial Disparities ◽  
Black People ◽  
Ethnic Disparities ◽  
Prince George's County ◽  
Arrest Rates ◽  
Rate Of Decline ◽  
Using Data ◽  
Racial Ethnic

Abstract Using data from New York, NY; Los Angeles, CA; Prince George’s County, MD; and Louisville, KY, we examine trends in racial disparities in the enforcement of misdemeanor marijuana possessionbefore and after marijuana reforms. In these jurisdictions, we find that changes to marijuana enforcement were associated with reductions in arrest rates for Black, Hispanic, and White people, though the rate of decline varied by jurisdiction. Black people were arrested at the highest rates in relation to their proportion of the population. In three of the four jurisdictions where issuing criminal citations was an enforcement option, racial/ethnic disparities in arrest rates increased post-reforms; legalization and the option to issue a civil citation were associated with reductions in racial/ethnic disparities. Trends in this study provide policymakers with information to implement effective reforms that target racial disparities in marijuana possession arrests.

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.

What Context Matters and at What Level? A Test of Racial/Ethnic Threat, Symbolic Threat, and Structural Inequality Perspectives in Juvenile Court Decision-Making

2020 ◽  
pp. 001112872093834
Author(s):  
Michael J. Leiber ◽  
Ellen A. Donnelly ◽  
Yunmei Lu
Keyword(s):  
Decision Making ◽  
Multilevel Models ◽  
Juvenile Court ◽  
Ethnic Disparities ◽  
Court Decision ◽  
Comparative Approach ◽  
Structural Inequality ◽  
Court Proceedings ◽  
Racial Ethnic ◽  
Zip Code

Do traditional theories of conflict influence juvenile court decision-making and explain racial/ethnic disparities? Racial/ethnic threat, symbolic threat, and structural inequality perspectives purport social controls increase when groups differ in race, ethnicity, or class. Scholarship tends to test one perspective at a time and use county as a unit of analysis. Taking a comparative approach, this study evaluates whether contextual indicators of these three theories, measured at the county- and zip code-levels, contribute to Black-White and Latino-White disparities in court decisions. Multilevel models reveal weak and partial support for each perspective. More effects appear at the zip code-level, indicating conflict may occur within rather than across courts. Macro-level theories must then be reconsidered to describe modern-day juvenile court proceedings.

Racial/Ethnic Disparities in Early-Stage Hepatocellular Carcinoma Curative Treatment Rates Within Asian and Hispanics in Los Angeles

2017 ◽  
Vol 152 (5) ◽  
pp. S1197
Author(s):  
Chiranjeevi Gadiparthi ◽  
Rosann Cholankeril ◽  
Eddie L. Copelin ◽  
Mairin Joseph-Talreja ◽  
Muhammad Ali Khan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Los Angeles ◽  
Early Stage ◽  
Ethnic Disparities ◽  
Curative Treatment ◽  
Racial Ethnic

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.

Marital Status and Sexually Transmitted Infections Among African Americans

2010 ◽  
Vol 31 (9) ◽  
pp. 1147-1165 ◽  
Author(s):  
Eboni M. Taylor ◽  
Adaora A. Adimora ◽  
Victor J. Schoenbach
Keyword(s):  
African Americans ◽  
Marital Status ◽  
Racial Disparities ◽  
Racial Differences ◽  
Risk Behaviors ◽  
Ethnic Disparities ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Marriage Rates ◽  
Racial Ethnic

This article assesses the relationship between low marriage rates and racial disparities in sexually transmitted infection (STI) rates. Data from the 2002 National Survey of Family Growth was used to examine the prevalence of sexual risk behaviors by marital status. Logistic regression was used to examine whether racial differences in marriage patterns help account for racial disparities in STI rates. Results indicate that the 12-month prevalence of multiple partners and high-risk partnerships was lowest among currently married, intermediate among cohabiting, and highest among formerly and never-married respondents. Of all racial/ethnic groups, African Americans were least likely to be married. In multiple logistic analyses adjustment for marriage attenuated the association between race and STI risk behaviors for African Americans. Low marriage rates may be an important contributing factor to racial/ethnic disparities in STI rates, particularly for African Americans.

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
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