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.     

广西瑶族Heath-Carter法体型*

目的：研究广西瑶族成人的体型特点。方法：应用Heath-Carter 体型法对广西瑶族成人（ 男性275 例,女 性383 例）进行体型研究。结果：瑶族男性与女性的平均体型值分别为3.7-5.3-1.5 和5.9-5.3-0.9,体型类型分别 为偏内胚层的中胚层体型和偏中胚层的内胚层体型。线性相关分析显示,男性、女性内因子均与年龄呈正相关, 外因子与年龄呈负相关;男性中因子与年龄无相关,女性中因子与年龄呈正相关。单因素方差分析显示,男、女 性3 个因子值年龄组间的差异均具有统计学意义。结论：随着年龄增长,瑶族男性30 岁、女性40 岁以后体型出 现了明显的变化,女性年龄组间差异比男性更明显。     

Social capital and its relationship to self-perceived health: National health survey in Colombia 2007

Objective:

To analyze the self-reported perceived health related to socio-demographic characteristics, social health inequalities and social capital in Colombia.

Methods:

This study is a cross-sectional design; data was obtained from the National Health Survey of Colombia 2007. Independent variables: socio-demographic characteristics; component variables: social health inequality and social capital. Dependent variable: self-reported health. Analysis of the relationship used logistic regression through OR and its confidence interval.

Results:

The determinant factors for a negative health perceptions are related to being a female (OR: 0.49 [0.47 to 0.52]), and in both genders being older than 37 years of age (OR: 0.72 [0.61 to 0.85]), living without a partner, black ethnicity, indigenous women (0.80 [0.69 to 0.94] and low economic incomes.

Discussion:

The relationship between social determinants and social capital in the perception of health shows inequities and indirectly reflects the level of health. Given the policies and the model of health, requires a rational adjustment of the goals, programs, and national and regional strategies with the object of improving the demand and quality of services.     

Modelling foetal growth in a bi-ethnic sample: results from the Born in Bradford (BiB) birth cohort

Background: Attempts to explain the increased risk for metabolic disorders observed in South Asians have focused on the “South Asian” phenotype at birth and subsequent post-natal growth, with little research on pre-natal growth.

Aim: To identify whether divergent growth patterns exist for foetal weight, head (HC) and abdominal circumferences (AC) in a sample of Pakistani and White British foetuses.

Subjects and methods: Models were based on 5553 (weight), 5154 (HC) and 5099 (AC) foetuses from the Born in Bradford birth cohort. Fractional polynomials and mixed effects models were employed to determine growth patterns from ～15 weeks of gestation-birth.

Results: Pakistani foetuses were significantly smaller and lighter as early as 20 weeks. However, there was no ethnic difference in the growth patterns of weight and HC. For AC, Pakistani foetuses displayed a trend for reduced growth in the final trimester.

Conclusion: As the pattern of weight and HC growth was not significantly different during the period under investigation, the mechanism culminating in the reduced Pakistani size at birth may act earlier in gestation. Reduced AC growth in Pakistanis may represent reduced growth of the visceral organs, with consequences for post-natal liver metabolism and renal function.     

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.     

Communication issues in a multicomponent study of semiconductor employees

A variety of methods were used to address communication problems in the Semiconductor Health Study (SHS). The diverse employee population required investigators to consider language, ethnic, and cultural differences in planning and implementing the study design. Studies of reproductive health in the workplace raise special concerns, including the critical need to preserve confidentiality and privacy of subjects. Notification of results of epidemiological studies reporting workplace hazards requires sensitivity to needs of workers. SHS investigators directly communicated overall results of this multicomponent study to participating employees at all sites and notified subjects of results of individual industrial hygiene monitoring and endocrine hormone assays.     

Menstrual and reproductive characteristics and breast cancer risk by hormone receptor status and ethnicity: The Breast Cancer Etiology in Minorities study

We pooled multiethnic data from four population-based studies and examined associations of menstrual and reproductive characteristics with breast cancer (BC) risk by tumor hormone receptor (HR) status [defined by estrogen receptor (ER) and progesterone receptor (PR)]. We estimated odds ratios and 95% confidence intervals using multivariable logistic regression, stratified by age (<50, ≥50 years) and ethnicity, for 5,186 HR+ (ER+ or PR+) cases, 1,365 HR− (ER− and PR−) cases and 7,480 controls. For HR+ BC, later menarche and earlier menopause were associated with lower risk in non-Hispanic whites (NHWs) and Hispanics, and higher parity and longer breast-feeding were associated with lower risk in Hispanics and Asian Americans, and suggestively in NHWs. Positive associations with later first full-term pregnancy (FTP), longer interval between menarche and first FTP and shorter time since last FTP were limited to younger Hispanics and Asian Americans. Except for nulliparity, reproductive characteristics were not associated with risk in African Americans. For HR− BC, lower risk was associated with later menarche, except in African Americans and older Asian Americans and with longer breast-feeding in Hispanics and Asian Americans only. In younger African Americans, HR− BC risk associated with higher parity (≥3 vs. 1 FTP) was increased fourfold in women who never breast-fed, but not in those with a breast-feeding history, suggesting that breast-feeding may mitigate the adverse effect of higher parity in younger African American women. Further work needs to evaluate why menstrual and reproductive risk factors vary in importance according to age and ethnicity.