Browsing by Subject "Race"
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Item A Consideration of Genetic Mechanisms Behind the Development of Hypertension in Blacks(Springer, 2013) Tu, Wanzhu; Pratt, J. Howard; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public HealthHypertension is a more serious disease in blacks. The determinants of the blood pressure (BP) may be uniquely different from those in whites. The characteristic low-renin, salt-sensitive hypertension of blacks is consistent with the kidney reabsorbing additional sodium (Na), which leads to an expanded plasma volume that drives the BP. Mechanisms considered are genetically based. These include: (1) the intra-renal renin-angiotensin system (RAS), one based on molecular variations in angiotensinogen; (2) the Na, K, 2Cl cotransporter (NKCC2) and its regulators in the thick ascending limb, which are associated with a variety of phenotypes consistent with a more active cotransporter in blacks; and (3) the genes for MYH9 and APOL 1, which have been associated with kidney disease in blacks. To achieve a state of hypertension, an increase in Na uptake in proximal nephron regions may require a distal nephron that does not fully adjust due to less than adequate suppression of aldosterone production.Item Acute myocardial infarction-related mortality among older adults (≥65 years) with malignancy in the U.S. from 1999 to 2020(Elsevier, 2025-03-07) Naveed, Muhammad Abdullah; Neppala, Sivaram; Chigurupati, Himaja Dutt; Ali, Ahila; Rehan, Muhammad Omer; Fath, Ayman; Azeem, Bazil; Iqbal, Rabia; Mubeen, Manahil; Naveed, Hamza; Zafar, Muhammad Naveed Uz; Ahmed, Mushood; Rana, Jamal S.; Patel, Brijesh; Medicine, School of MedicineBackground: Acute Myocardial Infarction (AMI) in malignancy is a global threat, causing significant mortality and economic burden. They share common risk factors, highlighting the urgency of addressing this critical issue. Objective: This study analyzed demographic trends and disparities in mortality rates due to AMI in malignancy among adults aged 65 and older from 1999 to 2020. Methods: We used the CDC WONDER database to analyze Age-adjusted mortality rates (AAMRs) for AMI in malignancy patients (ICD-10 I21, C00-C97) from 1999 to 2020, stratifying by sex, race, geography, and metropolitan status. We calculated Average Annual Percentage Changes (AAPCs) and Annual Percentage Changes (APCs) per 100,000 with 95 % confidence intervals (CI) using Joinpoint regression. Results: Between 1999 and 2020, AMI in malignancy accounted for 172,691 deaths among adults aged ≥65 years, with the majority of deaths occurring in medical facilities (56.9 %). The overall AAMR for AMI in malignancy-related deaths decreased from 30.2 in 1999 to 14.2 in 2020, with an AAPC of -3.90 (p < 0.000001). Men showed higher AAMRs than women (28.6 vs. 12.3), with a more pronounced decrease in men (AAPC: 4.22, p < 0.000001) compared to women (AAPC: 3.78, p < 0.000001). Black individuals have the highest AAMR (22.7), followed by Whites (19.3). Arkansas had the highest AAMR (32.3), while Nevada had the lowest (8.1), with the Northeastern region having the highest regional AAMR (20.2), and nonmetropolitan areas had higher AAMRs. Conclusion: This study reveals significant demographic disparities in mortality rates related to AMI in malignant older adults. These findings emphasize the need for targeted interventions and improved access to care.Item Analysis of INSPPIRE-2 Cohort: Risk Factors and Disease Burden in Children with Acute Recurrent or Chronic Pancreatitis(Wiley, 2022) Uc, Aliye; Cress, Gretchen A.; Wang, Fuchenchu; Abu-El-Haija, Maisam; Ellery, Kate M.; Fishman, Douglas S.; Gariepy, Cheryl E.; Gonska, Tanja; Lin, Tom K.; Liu, Quin Y.; Mehta, Megha; Maqbool, Asim; McFerron, Brian A.; Morinville, Veronique D.; Ooi, Chee Y.; Perito, Emily R.; Schwarzenberg, Sarah Jane; Sellers, Zachary M.; Serrano, Jose; Shah, Uzma; Troendle, David M.; Wilschanski, Michael; Zheng, Yuhua; Yuan, Ying; Lowe, Mark E.; Pediatrics, School of MedicineObjectives: The objective of this study is to investigate risk factors and disease burden in pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP). Methods: Data were obtained from INternational Study group of Pediatric Pancreatitis: In search for a cuRE-2 (INSPPIRE-2), the largest multi-center prospective cohort study in pediatric patients with ARP or CP. Results: Of 689 children, 365 had ARP (53%), 324 had CP (47%). CP was more commonly associated with female sex, younger age at first acute pancreatitis (AP) attack, Asian race, family history of CP, lower BMI%, genetic and obstructive factors, PRSS1 mutations and pancreas divisum. CFTR mutations, toxic-metabolic factors, medication use, hypertriglyceridemia, Crohn disease were more common in children with ARP. Constant or frequent abdominal pain, emergency room (ER) visits, hospitalizations, medical, endoscopic or surgical therapies were significantly more common in CP, episodic pain in ARP. A total of 33.1% of children with CP had exocrine pancreatic insufficiency (EPI), 8.7% had diabetes mellitus. Compared to boys, girls were more likely to report pain impacting socialization and school, medical therapies, cholecystectomy, but no increased opioid use. There was no difference in race, ethnicity, age at first AP episode, age at CP diagnosis, duration of disease, risk factors, prevalence of EPI or diabetes between boys and girls. Multivariate analysis revealed that family history of CP, constant pain, obstructive risk factors were predictors of CP. Conclusions: Children with family history of CP, constant pain, or obstructive risk factors should raise suspicion for CP.Item Analysis of pre-residency research productivity, dual degree status, and gender distribution of underrepresented minorities among a current United States radiation oncology junior resident class(Elsevier, 2019-04-05) McClelland, Shearwood, III; Woodhouse, Kristina D.; Jaboin, Jerry J.; Zellars, Richard C.; Radiation Oncology, School of MedicineBackground: Among the most competitive medical subspecialties, representation of underrepresented minorities (African-American race and/or Hispanic ethnicity) among resident trainees has historically been low compared to their United States Census general population representation. Research productivity and dual degree status may impact residency applicant competitiveness. To date, such an analysis has yet to be performed in Radiation Oncology. Methods: A list of radiation oncology residents from the graduating class of 2022 was obtained through internet searches. Demographics included were gender and dual degree status. Research productivity was calculated using the number of pre-residency peer-reviewed publications (PRP). Fisher's exact test was used for statistical analysis. Results: Of the 179 residents evaluated from the 2022 class, eleven (6.1%) were underrepresented minorities. Compared to the remainder of the class, underrepresented minorities had a lower proportion of men (63.6% versus 69.3%), a higher proportion of dual degrees (45.5% versus 28.6%), and a lower proportion of MD-PhD degrees (9.1% versus 17.2%). Underrepresented minorities had a higher proportion of residents with at least two PRP (72.7% versus 57.1%) and a lower proportion of residents with no PRP (18.2% versus 24.4%). None of these differences reached statistical significance (p > 0.05). Conclusion: Underrepresented minorities were comparable to the remainder of their Radiation Oncology resident class regarding gender distribution, dual degrees status, and likelihood of having at least two peer-reviewed publications cited in PubMed during the calendar year of residency application. Further studies will be needed to determine how these findings translate into future scholarly activity and post-graduate career choice.Item Are leader-prototypical African Americans distrusted by their ingroup? The role of identity denial(2017) Cho, Thomas; Ashburn-Nardo, LeslieBlack representation in American business leadership ranks is not proportionate to America’s demographics. Previous research into this issue has mostly focused on the relationship between majority racial group and minority racial groups. However, research in identity denial and backlash shows that ingroup members may also play a negative role in undermining leadership efforts. African Americans may react negatively to a Black business leader because of the mismatch between negative stereotypes of African Americans and the positive prototype of a leader. The current study hypothesizes that resembling a business leader as an African American leads to negative reaction from other African Americans in the form of lowered trust, lowered endorsement as leader, and lowered intention to engage in organizational citizenship behavior. The current study also hypothesizes that participant’s ingroup identification level will act as a moderator, and that perceived racial identification will act as a mediator. To test the hypotheses, participants recruited from Amazon Mechanical Turk were randomly assigned to either the strong match to leader prototype condition, weak match condition, or control condition in which no information about leader prototype was provided. The results revealed a simple main effect in which strongly matching the leader prototype led to lower levels of the outcome variables. The current study brings attention to an area of research that should be further explored and suggests that organizations should create interventions to counteract this negative ingroup effect.Item Art, Race, Space Symposium [Program](Indiana University, 2013-01-25) Museum Studies ProgramItem Asian Race and Primary Open-Angle Glaucoma: Where Do We Stand?(MDPI, 2022-04-28) Belamkar, Aditya; Harris, Alon; Oddone, Francesco; Verticchio Vercellin, Alice; Fabczak-Kubicka, Anna; Siesky, Brent; Ophthalmology, School of MedicinePrimary open-angle glaucoma (POAG) is an optic neuropathy characterized by irreversible retinal ganglion cell damage and visual field loss. The global POAG prevalence is estimated to be 3.05%, and near term is expected to significantly rise, especially within aging Asian populations. Primary angle-closure glaucoma disproportionately affects Asians, with up to four times greater prevalence of normal-tension glaucoma reported compared with high-tension glaucoma. Estimates for overall POAG prevalence in Asian populations vary, with Chinese and Indian populations representing the majority of future cases. Structural characteristics associated with glaucoma progression including the optic nerve head, retina, and cornea are distinct in Asians, serving as intermediates between African and European descent populations. Patterns in IOP suggest some similarities between races, with a significant inverse relationship between age and IOP only in Asian populations. Genetic differences have been suggested to play a role in these differences, however, a clear genetic pattern is yet to be established. POAG pathogenesis differs between Asians and other ethnicities, and it may differ within the broad classification of the Asian race. Greater awareness and further research are needed to improve treatment plans and outcomes for the increasingly high prevalence of normal tension glaucoma within aging Asian populations.Item Assessing Disparities in Care Utilization and Outcomes Among Pregnant Women with T2D Based on Race and Ethnicity(2022-07-29) Pelton, Sarah; Izewski, Joanna; Scifres, ChristinaBackground/Objective: Disparities faced by individuals with type 2 diabetes (T2D) or gestational diabetes mellitus have been identified. However, because less is known about disparities faced by pregnant women with T2D and since the prevalence of T2D is increasing, we sought to investigate this issue. Methods: We performed a retrospective cohort study that included 369 women with singleton gestation and T2D that delivered from 2018-2020. Using maternal self-reported race and ethnicity abstracted from the electronic medical record, we categorized the women as Non-Hispanic White, Non-Hispanic Black, or Hispanic. Demographics, health care utilization, and maternal and neonatal outcomes were also abstracted. One way ANOVA and chi-squared tests were utilized to compare outcomes among the groups, and logistic regression was used to control for co-variates. Results: Non-Hispanic White and Non-Hispanic Black women had a higher BMI at their first prenatal visit and were more likely to be nulliparous. They were also more likely to have a prior caesarean delivery and chronic hypertension. Non-Hispanic Black women were more likely to have ≥12 prenatal visits compared to Non-Hispanic White and Hispanic women (70 vs. 43 vs. 45%, p<0.001), and non-Hispanic Black women had the lowest early pregnancy HbA1c (7.0±1.6 vs. 7.9±2.1 vs. 7.5±1.7%, p<0.001). Additionally, caesarean delivery rates were lowest for Hispanic women compared to Non-Hispanic White and Non-Hispanic Black women (45 vs. 63 vs. 71%, p<0.001); this difference persisted after controlling for co-variates (aOR 0.53, 95% CI 0.30-0.92). Conversely, there were no differences in birth weight category, preterm birth <37 weeks, hypertensive disorders of pregnancy, or NICU admission. Conclusion and Potential Impact: Pregnancies complicated by T2D have an increased risk of poor maternal and neonatal outcomes. For some outcomes, there is a significant difference among Non-Hispanic White, Non-Hispanic Black, and Hispanic women. Future studies are therefore needed to investigate causative factors and potential interventions. Presentation recording available online: https://purl.dlib.indiana.edu/iudl/media/h04d673g6hItem Assessing Unequal Airborne Exposure to Lead Associated With Race in the USA(Wiley, 2023-07-24) Laidlaw, Mark A. S.; Mielke, Howard W.; Filippelli, Gabriel M.; Earth and Environmental Sciences, School of ScienceRecent research applied the United States Environmental Protection Agency's Chemical Speciation Network and Interagency Monitoring of Protected Visual Environments monitoring stations and observed that mean concentrations of atmospheric lead (Pb) in highly segregated counties are a factor of 5 higher than in well‐integrated counties and argument is made that regulation of existing airborne Pb emissions will reduce children's Pb exposure. We argue that one of the main sources of children's current Pb exposure is from resuspension of legacy Pb in soil dust and that the racial disparity of Pb exposure is associated with Pb‐contaminated community soils.Item Attitudes Toward Advance Care Planning Among Persons with Dementia and their Caregivers(Cambridge University Press, 2020-05) Pettigrew, Corinne; Brichko, Rostislav; Black, Betty; O’Connor, Maureen K.; Guerriero Austrom, Mary; Robinson, Maisha T.; Lindauer, Allison; Shah, Raj C.; Peavy, Guerry M.; Meyer, Kayla; Schmitt, Frederick A.; Lingler, Jennifer H.; Domoto-Reilly, Kimiko; Farrar-Edwards, Dorothy; Albert, Marilyn; Psychiatry, School of MedicineObjectives: To examine factors that influence decision-making, preferences, and plans related to advance care planning (ACP) and end-of-life care among persons with dementia and their caregivers, and examine how these may differ by race. Design: Cross-sectional survey. Setting: 13 geographically dispersed Alzheimer's Disease Centers across the United States. Participants: 431 racially diverse caregivers of persons with dementia. Measurements: Survey on "Care Planning for Individuals with Dementia." Results: The respondents were knowledgeable about dementia and hospice care, indicated the person with dementia would want comfort care at the end stage of illness, and reported high levels of both legal ACP (e.g., living will; 87%) and informal ACP discussions (79%) for the person with dementia. However, notable racial differences were present. Relative to white persons with dementia, African American persons with dementia were reported to have a lower preference for comfort care (81% vs. 58%) and lower rates of completion of legal ACP (89% vs. 73%). Racial differences in ACP and care preferences were also reflected in geographic differences. Additionally, African American study partners had a lower level of knowledge about dementia and reported a greater influence of religious/spiritual beliefs on the desired types of medical treatments. Notably, all respondents indicated that more information about the stages of dementia and end-of-life health care options would be helpful. Conclusions: Educational programs may be useful in reducing racial differences in attitudes towards ACP. These programs could focus on the clinical course of dementia and issues related to end-of-life care, including the importance of ACP.