Is race or ethnicity associated with under-utilization of statins among women in the United States: The study of women's health across the nation

BackgroundRates of statin use among minority women are unclear.HypothesisWe hypothesized that statin use would vary by race/ethnicity with lower rates among minority women compared with Whites.MethodsData from the study of women''s health across the nation, a multiethnic cohort of women collected between 2009 to 2011 were used to examine reported statin use by race/ethnicity and risk profile. Multivariable logistic modeling was performed to estimate the odds ratio (OR) of statin treatment.ResultsOf the 2399 women included, 234 had a diagnosis of atherosclerotic disease (ASCVD), 254 were diabetic (without ASCVD), 163 had an LDL ≥190 mg/dL, and 151 had a 10 year ASCVD pooled risk score ≥7.5%. Statins were used by 49.6% of women with CVD; 59.8% of women with diabetes without known ASCVD; 42.3% of women with an LDL ≥190 mg/dL; and 19.9% of women with an ASCVD risk ≥7.5%. Rates of statin use were 43.8% for women with ≥ two prior ASCVD events and 69.4% for women with ≥ one prior ASCVD event plus multiple high‐risk conditions. Among women eligible for statins, Black women had a significantly reduced adjusted odds of being on a statin (OR 0.53, 95% confidence interval [CI] 0.36‐0.78) compared with White women.ConclusionsIn this cohort of multiethnic women, rates of statin use among women who would benefit were low, with Black women having lower odds of statin use than White women.     

Long‐term outcomes in African American kidney transplant recipients under contemporary immunosuppression: a four‐yr analysis of the Mycophenolic acid Observational REnal transplant (MORE) study

Mycophenolic acid Observational REnal transplant (MORE) was a prospective, observational study of de novo kidney transplant patients receiving mycophenolic acid (MPA). Four‐yr data on 904 patients receiving tacrolimus and enteric‐coated mycophenolate sodium (EC‐MPS) or mycophenolate mofetil (MMF) were analyzed to evaluate immunosuppression and graft outcomes in African American (AA, n = 218) vs. non‐AA (n = 686) patients. Mean tacrolimus dose was higher in AA vs. non‐AA patients but mean tacrolimus trough concentration was similar. Use of the recommended MPA dose in AA patients decreased from 78.9% at baseline to 33.1% at year 3. More AA patients received the recommended MPA dose with EC‐MPS than MMF at month 6 (56.2% vs. 35.7%, p = 0.016) and month 36 (46.6% vs. 16.7%, p = 0.029), with no safety penalty. Significantly, more AA patients received corticosteroids than non‐AA patients. Biopsy‐proven acute rejection was higher in AA vs. non‐AA patients (18.9% vs. 10.7%, p = 0.003), as was graft loss (10.9% vs. 4.4%, p = 0.003); differences were confirmed by Cox regression analysis. Patient survival was similar. Estimated GFR was comparable in AA vs. non‐AA patients. Kidney allograft survival remains lower for AA vs. non‐AA recipients even under the current standard of care.     

Correlates of affective empathy,perspective taking,and generativity among a sample of adults

Previous research suggests that empathy can be cultivated by social ideals and relationships with people. The current study examines family importance and religious importance as correlates of affective empathy, perspective taking, and generativity among a sample of adults aged 18 to 35 (N = 722). Given the ethnic and racial diversity represented by Millennials and Generation Z, the moderating role of racial group membership is explored as well. Results indicate that family importance is positively associated with affective empathy, perspective taking, and generativity for the overall sample, though the relationship is particularly strong for non-Hispanic whites. Religious importance is significantly related to affective empathy and generativity (not perspective taking), primarily among Black, Indigenous, and/or People of Color. Due to the increasing visibility of victimization towards socially vulnerable groups, it is important to understand how attitudes oriented towards helping and empathizing with others are fostered. Implications for further research are discussed.     

The reporting of race and ethnicity information in the dental public health literature

Objectives: To document how race and ethnicity are identified, categorized, and utilized in contemporary dental public health literature. Methods: Two researchers independently performed a literature review of all articles in Community Dentistry and Oral Epidemiology and the Journal of Public Health Dentistry over a 5‐year period (2004‐2009). Articles pertaining to the study of US‐based populations with any mention of race or ethnicity were included. The following data were abstracted from each article: a) how each article broadly described race and/or ethnicity; b) the terms used to specifically define the races and/or ethnicities captured; c) the location of any mention of the concept of race and/or ethnicity; d) the stated purpose for including race and/or ethnicity concepts; e) the stated analytic use of race and/or ethnicity concepts; and f) the stated method used to assess race and/or ethnicity concepts. Results: Overall, race and/or ethnicity concepts were most commonly referred to within the text of the results section. Fifty percent of articles did not state their purpose for including race and/or ethnicity concepts within their studies, while 34.3 percent omitted stating their analytic use of these concepts. When assessing these concepts, 41.4 percent relied upon subject self‐report. Conclusion: These data showed that there was inconsistent documentation of how race and ethnicity was measured. While race and ethnicity are important measures for public health studies and are frequently reported in dental public health research, there is no clear system for classifying these measures.     

Clinical Presentation of Hepatocellular Carcinoma in African Americans vs. Caucasians: A Retrospective Analysis

Hepatocellular carcinoma (HCC) remains an important form of cancer-related morbidity and mortality in the U.S. and worldwide. Previous U.S.-based studies on survival suggest ethnic disparities in HCC patients, but the complex interplay of multiple factors that contribute are still incompletely understood. Here we considered the influences of risk factors contributing towards HCC survival, including ethnic background, over ten years at a premier academic medical center with a majority (57.20%) African American (AA) population. Retrospective HCC data were collected from 2008–2018 at LSUHSC-Shreveport, an urban tertiary medical center. Data included demographics, comorbidities, liver disease characteristics, and tumor parameters. Statistical analysis was performed using Chi Square and one-way ANOVA. Results: 229 HCC patients were identified (male 78.6%). The mean HCC age at diagnosis was 61 years (SD = 7.3). Compared to non-Hispanic Caucasians (42.7%), AA patients (57.2% of total) were older at presentation, had more frequent diabetes/dyslipidemia/NAFLD (45 (34.3%) compared with 19 (19.3%) in non-Hispanic Caucasians, p = 0.02), and had a larger HCC burden at diagnosis. We conclude that compared to white patients, despite having similar BMI and MELD scores and rates of portal vein thrombosis, AA patients with HCC in our cohort were older at presentation, had a significantly increased incidence of modifiable metabolic risk factors including diabetes, higher AFP values, increased incidence of gallstones, and larger sized HCCs, and were more likely to be outside Milan criteria. These findings have important prognostic and diagnostic implications for developing a more targeted HCC surveillance program.     

Early and late survival in Hodgkin disease among whites and blacks living in the United States

Background. The independent effect of race on response to treatment and prognosis in Hodgkin disease is unclear. Methods. The study included 9482 patients with histologically confirmed Hodgkin disease reported by 1084 different hospitals and institutions in the United States. The independent effect of race on response to treatment and recurrence was estimated using the logistic model. Cox proportional hazard model was applied to determine the independent effect of race and other covariables on risk of death. Results. Complete remission occurred in more white patients (67.3%) than black patients (58.2%). Recurrences were reported more often in black patients than in white patients (40.3% and 30.9% respectively). Controlling for confounding variables, race has a significant independent effect on remission and recurrence (P < 0.05). In the first 5 years after diagnosis of Hodgkin disease, the patient age at diagnosis, clinical stage, and histologic type were significant predictors for the risk of death. At 5–10 years after a diagnosis of Hodgkin disease, age, clinical stage, and race of the patient were found to be significant risk factors (whites versus blacks: RR = 0.56; P < 0.05). Conclusions. Race is a significant predictor for remission, recurrence and survival in Hodgkin disease. Black patients have a more unfavorable prognosis than do white patients.