Browsing by Subject "Income"

Now showing 1 - 7 of 7
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    A Global Health Reciprocal Innovation grant programme: 5-year review with lessons learnt
    (BMJ Publishing, 2023) Ruhl, Laura J.; Kiplagat, Jepchirchir; O'Brien, Rishika; Wools-Kaloustian, Kara; Scanlon, Michael; Plater, David; Thomas, Melissa R.; Pastakia, Sonak; Gopal-Srivastava, Rashmi; Morales-Soto, Nydia; Nyandiko, Winstone; Vreeman, Rachel C.; Litzelman, Debra K.; Laktabai, Jeremiah; Medicine, School of Medicine
    Unilateral approaches to global health innovations can be transformed into cocreative, uniquely collaborative relationships between low-income and middle-income countries (LMICs) and high-income countries (HIC), constituted as 'reciprocal innovation' (RI). Since 2018, the Indiana Clinical and Translational Sciences Institute (CTSI) and Indiana University (IU) Center for Global Health Equity have led a grants programme sculpted from the core elements of RI, a concept informed by a 30-year partnership started between IU (Indiana) and Moi University (Kenya), which leverages knowledge sharing, transformational learning and translational innovations to address shared health challenges. In this paper, we describe the evolution and implementation of an RI grants programme, as well as the challenges faced. We aim to share the successes of our RI engagement and encourage further funding opportunities to promote innovations grounded in the RI core elements. From the complex series of challenges encountered, three major lessons have been learnt: dedicating extensive time and resources to bring different settings together; establishing local linkages across investigators; and addressing longstanding inequities in global health research. We describe our efforts to address these challenges through educational materials and an online library of resources for RI projects. Using perspectives from RI investigators funded by this programme, we offer future directions resulting from our 5-year experience in applying this RI-focused approach. As the understanding and implementation of RI grow, global health investigators can share resources, knowledge and innovations that have the potential to significantly change the face of collaborative international research and address long-standing health inequities across diverse settings.
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    Association Between Race/Ethnicity and Income on the Likelihood of Coronary Revascularization Among Postmenopausal Women with Acute Myocardial Infarction: Women’s Health Initiative Study
    (Elsevier, 2022) Tertulien, Tarryn; Roberts, Mary B.; Eaton, Charles B.; Cene, Crystal W.; Corbie-Smith, Giselle; Manson, JoAnn E.; Allison, Matthew; Nassir, Rami; Breathett, Khadijah; Medicine, School of Medicine
    Background: Historically, race, income, and gender were associated with likelihood of receipt of coronary revascularization for acute myocardial infarction (AMI). Given public health initiatives such as Healthy People 2010, it is unclear whether race and income remain associated with the likelihood of coronary revascularization among women with AMI. Methods: Using the Women's Health Initiative Study, hazards ratio (HR) of revascularization for AMI was compared for Black and Hispanic women vs White women and among women with annual income <$20,000/year vs ≥$20,000/year over median 9.5 years follow-up(1993-2019). Proportional hazards models were adjusted for demographics, comorbidities, and AMI type. Results were stratified by revascularization type: percutaneous coronary intervention and coronary artery bypass grafting(CABG). Trends by race and income were compared pre- and post-2010 using time-varying analysis. Results: Among 5,284 individuals with AMI (9.5% Black, 2.8% Hispanic, and 87.7% White; 23.2% <$20,000/year), Black race was associated with lower likelihood of receiving revascularization for AMI compared to White race in fully adjusted analyses [HR:0.79(95% Confidence Interval:[CI]0.66,0.95)]. When further stratified by type of revascularization, Black race was associated with lower likelihood of percutaneous coronary intervention for AMI compared to White race [HR:0.72(95% CI:0.59,0.90)] but not for CABG [HR:0.97(95%CI:0.72,1.32)]. Income was associated with lower likelihood of revascularization [HR:0.90(95%CI:0.82,0.99)] for AMI. No differences were observed for other racial/ethnic groups. Time periods (pre/post-2010) were not associated with change in revascularization rates. Conclusion: Black race and income remain associated with lower likelihood of revascularization among patients presenting with AMI. There is a substantial need to disrupt the mechanisms contributing to race, sex, and income disparities in AMI management.
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    Does a Crossover Age Effect Exist for African American and Hispanic Binge Drinkers? Findings from the 2010 to 2013 National Study on Drug Use and Health
    (Wiley, 2017-06) Zapolski, Tamika C. B.; Baldwin, Patrick; Banks, Devin E.; Stump, Timothy E.; Psychology, School of Science
    BACKGROUND: Among general population studies, lower rates of binge drinking tend to be found among African Americans and Hispanics compared to Whites. However, among older adult populations, minority groups have been shown to be at higher risk for binge drinking, suggesting the presence of a crossover effect from low to high risk as a function of age. To date, limited research has examined the crossover effect among African American and Hispanic populations compared to non-Hispanic Whites across large developmental time frames or explored variation in risk based on income or gender. This study aimed to fill these gaps in the literature. METHODS: Data were compiled from the 2010 to 2013 National Survey on Drug Use and Health surveys, which provide annual, nationally representative data on substance use behaviors among individuals aged 12 and older. Hispanic, non-Hispanic African American, and non-Hispanic White respondents were included (N = 205,198) in the analyses. RESULTS: A crossover effect was found for African American males and females among the lowest income level (i.e., incomes less than $20,000). Specifically, after controlling for education and marital status, compared to Whites, risk for binge drinking was lower for African American males at ages 18 to 24 and for females at ages 18 to 34, but higher for both African American males and females at ages 50 to 64. No crossover effect was found for Hispanic respondents. CONCLUSIONS: Although African Americans are generally at lower risk for binge drinking, risk appears to increase disproportionately with age among those who are impoverished. Explanatory factors, such as social determinants of health prevalent within low-income African American communities (e.g., lower education, violence exposure, housing insecurity) and potential areas for intervention programming are discussed.
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    Examining Social Genetic Effects on Educational Attainment via Parental Educational Attainment, Income, and Parenting
    (American Psychological Association, 2022) Su, Jinni; Kuo, Sally I-Chun; Trevino, Angel; Barr, Peter B.; Aliev, Fazil; Bucholz, Kathleen; Chan, Grace; Edenberg, Howard J.; Kuperman, Samuel; Lai, Dongbing; Meyers, Jacquelyn L.; Pandey, Gayathri; Porjesz, Bernice; Dick, Danielle M.; Biochemistry and Molecular Biology, School of Medicine
    Higher parental educational attainment is associated with higher offspring educational attainment. In this study, we incorporated genotypic and phenotypic information from fathers, mothers, and offspring to disentangle the genetic and socioenvironmental pathways underlying this association. Data were drawn from a sample of individuals of European ancestry from the collaborative study on the genetics of alcoholism (n = 4,089; 51% female). Results from path analysis indicated that paternal and maternal educational attainment genome-wide polygenic scores were associated with offspring educational attainment, above and beyond the effect of offspring education polygenic score. Parental educational attainment, income, and parenting behaviors served as important socioenvironmental pathways that mediated the effect of parental education polygenic score on offspring educational attainment. Our study highlights the importance of using genetically informed family studies to disentangle the genetic and socioenvironmental pathways underlying parental influences on human development.
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    Racial and Ethnic Differences in Bystander CPR for Witnessed Cardiac Arrest
    (Massachusetts Medical Society, 2022) Garcia, R. Angel; Spertus, John A.; Girotra, Saket; Nallamothu, Brahmajee K.; Kennedy, Kevin F.; McNally, Bryan F.; Breathett, Khadijah; Del Rios, Marina; Sasson, Comilla; Chan, Paul S.; Medicine, School of Medicine
    Background: Differences in the incidence of cardiopulmonary resuscitation (CPR) provided by bystanders contribute to survival disparities among persons with out-of-hospital cardiac arrest. It is critical to understand whether the incidence of bystander CPR in witnessed out-of-hospital cardiac arrests at home and in public settings differs according to the race or ethnic group of the person with cardiac arrest in order to inform interventions. Methods: Within a large U.S. registry, we identified 110,054 witnessed out-of-hospital cardiac arrests during the period from 2013 through 2019. We used a hierarchical logistic regression model to analyze the incidence of bystander CPR in Black or Hispanic persons as compared with White persons with witnessed cardiac arrests at home and in public locations. We analyzed the overall incidence as well as the incidence according to neighborhood racial or ethnic makeup and income strata. Neighborhoods were classified as predominantly White (>80% of residents), majority Black or Hispanic (>50% of residents), or integrated, and as high income (an annual median household income of >$80,000), middle income ($40,000-$80,000), or low income (<$40,000). Results: Overall, 35,469 of the witnessed out-of-hospital cardiac arrests (32.2%) occurred in Black or Hispanic persons. Black and Hispanic persons were less likely to receive bystander CPR at home (38.5%) than White persons (47.4%) (adjusted odds ratio, 0.74; 95% confidence interval [CI], 0.72 to 0.76) and less likely to receive bystander CPR in public locations than White persons (45.6% vs. 60.0%) (adjusted odds ratio, 0.63; 95% CI, 0.60 to 0.66). The incidence of bystander CPR among Black and Hispanic persons was less than that among White persons not only in predominantly White neighborhoods at home (adjusted odds ratio, 0.82; 95% CI, 0.74 to 0.90) and in public locations (adjusted odds ratio, 0.68; 95% CI, 0.60 to 0.75) but also in majority Black or Hispanic neighborhoods at home (adjusted odds ratio, 0.79; 95% CI, 0.75 to 0.83) and in public locations (adjusted odds ratio, 0.63; 95% CI, 0.59 to 0.68) and in integrated neighborhoods at home (adjusted odds ratio, 0.78; 95% CI, 0.74 to 0.81) and in public locations (adjusted odds ratio, 0.73; 95% CI, 0.68 to 0.77). Similarly, across all neighborhood income strata, the frequency of bystander CPR at home and in public locations was lower among Black and Hispanic persons with out-of-hospital cardiac arrest than among White persons. Conclusions: In witnessed out-of-hospital cardiac arrest, Black and Hispanic persons were less likely than White persons to receive potentially lifesaving bystander CPR at home and in public locations, regardless of the racial or ethnic makeup or income level of the neighborhood where the cardiac arrest occurred.
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    Social Determinants of Health and Their Impact on Mental Health and Substance Misuse
    (The Center for Health Policy, 2020-01-01) Sanner, Lindsey M.; Greene, Marion S.
    Health and wellbeing are shaped by many factors beyond healthcare and behavioral choices, including conditions that make up our social, economic, and physical environments. These factors are often referred to as social determinants of health (SDoHs). SDoHs not only affect our physical health, but they also can have an impact on a person’s mental wellbeing and substance use. These social determinants of health can be grouped into five major categories: 1. Neighborhood and built environment 2. Health and healthcare 3. Social and community context 4. Education 5. Economic stability To address SDoHs effectively, a “health in all policies” approach that integrates health considerations into policymaking across sectors is essential.
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    U.S. Alcohol Affordability and Real Tax Rates, 1950–2011
    (Elsevier, 2013) Kerr, William C.; Paterson, Deidre; Greenfield, Thomas K.; Jones, Alison Snow; McGeary, Kerry Anne; Terza, Joseph V.; Ruhm, Christopher J.; Economics, School of Liberal Arts
    Background: The affordability of alcoholic beverages, determined by the relationship of prices to incomes, may be an important factor in relation to heavy drinking, but little is known about how affordability has changed over time. Purpose: To calculate real prices and affordability measures for alcoholic beverages in the U.S. over the period from 1950 to 2011. Methods: Affordability is calculated as the percentage of mean disposable income required to purchase 1 drink per day of the cheapest spirits, as well as popular brands of spirits, beer, and wine. Alternative income and price measures also are considered. Analyses were conducted in 2012. Results: One drink per day of the cheapest brand of spirits required 0.29% of U.S. mean per capita disposable income in 2011 as compared to 1.02% in 1980, 2.24% in 1970, 3.61% in 1960, and 4.46% in 1950. One drink per day of a popular beer required 0.96% of income in 2010 compared to 4.87% in 1950, whereas a low-priced wine in 2011 required 0.36% of income compared to 1.05% in 1978. Reduced real federal and state tax rates were an important source of the declines in real prices. Conclusions: Alcoholic beverages sold for off-premises consumption are more affordable today than at any time in the past 60 years; dramatic increases in affordability occurred particularly in the 1960s and 1970s. Declines in real prices are a major component of this change. Increases in alcoholic beverage tax rates and/or implementing minimum prices, together with indexing these to inflation could be used to mitigate further declines in real prices.