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Objective

To investigate the relationship between racial residential segregation and differences in Black-White disparities in overall firearm homicides across U.S states.

Methods

Using a linear regression, we evaluated the relationship between racial residential segregation, as measured by the index of dissimilarity, and the Black-White firearm homicide disparity ratio in 32 states over the period 1991-2015. To account for clustering of observations within states, we used a generalized estimating equations approach.

Results

After controlling for measures of White and Black deprivation, multivariate analysis showed that racial segregation was positively associated with the Black-White firearm homicide disparity. For each 10-point increase in the index of dissimilarity, the ratio of Black to White firearm homicide rates in a state increased by 39%. After controlling for levels of White and Black deprivation, racial segregation remained negatively associated with White firearm homicide rates and positively associated with Black firearm homicide rates.

Conclusions

These findings suggest that racial segregation may increase the disparity in firearm homicide between the Black and White population.  相似文献   

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Background

African Americans (AAs) present with cardiovascular disease (CVD) risk factors at younger ages than whites. Consequently, CVD and stroke occur at a higher incidence and at earlier decades in life in AA populations. Arterial stiffness is a predictor of CVD outcomes and partially explains the CVD risk experienced by racial minorities. We evaluated the differences in arterial stiffness observed in AAs and whites through a systematic review and meta-analysis.

Methods

We searched PubMed and SCOPUS for comparative studies published March 1995 to November 29, 2017 comparing arterial stiffness assessments (pulse wave velocity, augmentation index, and central blood pressure) between AAs and whites. Two independent reviewers examined 195 titles/abstracts, 85 full text articles and 11 articles were included in the meta-analysis using random effects modeling approaches.

Main results

A total of 5060 white and 3225 AAs were included across 11 relevant studies. Carotid-femoral pulse wave velocity (cfPWV) measures were statistically different between AAs and whites (mean difference = ?0.44, 95% confidence interval [CI]: ?[?0.67, ?0.21], p = 0.0002). Aortic femoral pulse wave velocity was significantly different between AAs and whites (mean difference = ?0.21, [95% CI] ?0.35, ?0.07, p = 0.003) regardless of sex. Augmentation index (AIx) and Augmentation index at a 75 beats per minutes heart rate (AIx @75) was also significantly different between AA and whites (mean difference = ?4.36 [95% CI] = ?6.59, ?2,12, p = 0.0001 and ?6.26, [95% CI] = ?9.19, ?3.33, p < 0.0001, respectively).

Conclusions

Racial disparities in arterial stiffness persist among African American racial groups in the United States. The lack of homogeneity in studies capturing racial disparities in cfPWV suggest that additional studies are needed to understand the magnitude of racial differences in African Americans and whites that might be clinically relevant.  相似文献   

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ObjectiveThe goal of this paper is to give a narrative review of the racial/ethnic disparities in African-Americans (AA) found in headache medicine and provide plausible responses to the National Institute of Neurological Disorders and Stroke (NINDS) issued Request for information (RFI); “Soliciting Input on Areas of Health Disparities and Inequities in Neurological Disease and/or Care in the United States (US)” as it relates to AA and headache medicine.BackgroundOn March 31, 2020 the NINDS issued a RFI “Soliciting Input on Areas of Health Disparities and Inequities in Neurological Disease and/or Care in the US Across the Lifespan”, RFI-NOT–NS–20-026, with response date ending June 15, 2020.1 However as of June 13, 2020, a PubMed search with key terms “African American Headache disparities” yielded few results.MethodsMulti-database search and literature review.Results/DiscussionAs of June 13, 2020, a PubMed search with key terms “African American (or Black) Headache disparities” yielded 13 results. Searches of “Migraine Disparities Race” and “Migraine disparities African American” both yielded three results with one non-specific for migraine. In, “Headache disparities race” yielded one result in the PsycINFO database and 23 results in Web of Science database. Key areas of adult headache disparity and/or inequity were health care services for migraine treatment are less utilized, follow-up appointments are terminated more regularly, inaccurate diagnoses are more common, acute migraine attack medications are prescribed less frequently, mistrust and lower quality communication with physicians is reported, mistrust, increased migraine burden, frequency, and severity and risk for progression more associated depression and lower quality of life in AAs compared to non-Hispanic Whites. Literature on race-based disparities is even more scarce in pediatric populations, however it has been shown that white children are significantly more likely to receive neuroimaging than others which may indicate biases in pediatric populations. Potential determinants of these race-based disparities, research strategies and approaches vary and are discussed.ConclusionsRace-based disparities exist in headache medicine in the US. Research is needed. Research strategies and approaches currently with limited use in neurology and headache medicine may be warranted and appropriate to address race-based headache disparities. Funding is paramount.  相似文献   

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Studies from Africa have demonstrated that black people have higher vitamin B12 (cobalamin) levels than do white people. The authors compared healthy white people, black people, and Latin-Americans in the United States. Their study is also the largest in which the effect of race and sex on the cobalamin levels has been examined. Analysis of 233 healthy subjects showed that black people had significantly higher (P less than 0.0001) vitamin B12 levels than did white people. Latin-Americans had levels intermediate between those of white and black people, although their levels were significantly different only in comparison with white people (P = 0.0029). Based on the study of 305 healthy subjects, no sex difference in vitamin B12 levels was noted. Conflicting claims have been made on sex difference in the past. The authors conclude that there is a racial but not a sex difference in vitamin B12 levels in the United States. Like African black people, black people and Latin-Americans in this country have significantly higher vitamin B12 levels than do white people. This finding supports the thesis that genetic factors contribute to the racial differences in vitamin B12 levels.  相似文献   

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BACKGROUND: An estimated 361,000 persons in the United States are currently living with HIV (not AIDS), and approximately 29% are women. METHODS: Data on all HIV cases diagnosed from 1999 through 2004 for adult and adolescent women at least 13 years old and reported to the Centers for Disease Control and Prevention from 33 states with confidential name-based reporting systems were used. HIV diagnoses and rates per 100,000 women (95% confidence intervals) were analyzed by age group, race and/or ethnicity, transmission category, diagnosis year, and geographic region. RESULTS: The annual estimated rate of HIV diagnosis for black women decreased significantly, from 82.7 in 2001 to 67.0 in 2004, but remained 21 times that of white women. Rates also decreased significantly for women in all age groups except those aged 50 years and older. In 2004, rates were highest in the Mid Atlantic (23.2 per 100,000) and South Atlantic (20.8 per 100,000) regions, where rates also significantly decreased. CONCLUSIONS: Rates of HIV diagnoses remain disproportionately high for Hispanic women and especially for black women.  相似文献   

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Classic and clinical variant galactosemia (CG/CVG) are allelic, autosomal recessive disorders that result from deficiency of galactose-1-P uridylyltransferase (GALT). CG/CVG has been reported globally among patients of diverse ancestries, but most large studies of outcomes have included, almost exclusively, patients categorized as White or Caucasian. As a first step to explore whether the cohorts studied are representative of the CG/CVG population at large, we sought to define the racial and ethnic makeup of CG/CVG newborns in a diverse population with essentially universal newborn screening (NBS) for galactosemia: the United States (US). First, we estimated the predicted racial and ethnic distribution of CG/CVG by combining the reported demographics of US newborns from 2016 to 2018 with predicted homozygosity or compound heterozygosity of pathogenic, or likely pathogenic, GALT alleles from the relevant ancestral groups. Incorporating some simplifying assumptions, we predicted that of US newborns diagnosed with CG/CVG, 65% should be White (non-Hispanic), 23% should be Black (non-Hispanic), 10% should be Hispanic, and 2% should be Asian (non-Hispanic). Next, we calculated the observed racial and ethnic distribution of US newborns diagnosed with CG/CVG using available de-identified data from state NBS programs from 2016 to 2018. Of the 235 newborns in this cohort, 41 were categorized as other or unknown. Of the remaining 194, 66% were White (non-Hispanic or ethnicity unknown), 16% were Black (non-Hispanic or ethnicity unknown),15% were Hispanic, and 2% were Asian (non-Hispanic or ethnicity unknown). This observed distribution was statistically indistinguishable from the predicted distribution. To the limits of our study, these data confirm the racial and ethnic diversity of newborns with CG/CVG in the US, demonstrate an approach for estimating CG/CVG racial and ethnic diversity in other populations, and raise the troubling possibility that current understanding of long-term outcomes in CG/CVG may be skewed by ascertainment bias of the cohorts studied.  相似文献   

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美国新生儿筛查的现状与展望   总被引:2,自引:0,他引:2  
新生儿筛查(newborn screening,NBS)是指一些目前还无法在产前作出诊断的先天性疾病,在新生儿期间取少量血液进行快速地检查,从而来判别新生儿是否患有遗传性的疾病.这些疾病多数不致死,但可以严重影响患儿的智力和体格,造成痴呆和残疾.新生儿筛查的实施,有助于早期诊断及早期治疗,从而能将新生儿出生缺陷造成的损害减低到最小,例如避免夭折、减少智能发育迟缓或永久性功能丧失等.  相似文献   

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Salmonella enterica subspecies enterica serotype Dublin (S. enterica Dublin) emerged for the first time in New York, Pennsylvania, and Ohio in 1988. Since that time this host-adapted serotype has spread throughout the veal- and dairy beef-raising operations in the region; very few dairy farms have experienced clinical S. enterica Dublin infections. This study details the epidemiology of the outbreaks in cattle. During the period 1988 through 1995, nine New York and four Pennsylvania counties have been affected; 13 different locations were involved in New York, and 10 were involved in Pennsylvania. The morbidity and mortality and seasonal distribution of outbreaks, which totaled 35, is described. The antimicrobial susceptibility pattern of isolates revealed that many of the strains were resistant to a number of commonly used drugs. Clinical case details and pathology information are provided, with a caution to clinicians and microbiologists presented with suspect animals, i.e., most cases occurred in older calves, which is atypical for salmonellosis for this region (calves were 8 or more weeks old) and presented as pneumonia and septicemia rather than the primarily diarrheal syndrome that is more typically recognized for the region. The epidemiology of cases is analyzed through cluster analysis of bacterial isolates and their fatty acid methyl ester profiles; at least six clones appeared in the region during the study period. Results of the epidemiology analysis are used to support a hypothesis regarding the source of S. enterica Dublin for the region and its manner of dissemination.  相似文献   

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