Browsing by Subject "Race/ethnicity"
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Item 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 MedicineBackground: 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.Item Bias crimes charges in the United States: bias homicides in the U.S. between 1990 and 2016(Center for Research on Inclusion and Social Policy at IU, 2019-03) Beckman, Wyatt; Buran, SamanthaThe Indiana General Assembly introduced 10 bills related to bias (or hate) crimes in the 2019 session. Indiana is 1 of 5 states in the U.S. without a bias crimes statute. The 10 bills are similar in that each of them allows for a criminal penalty enhancement for bias crimes offenses. Penalty enhancement statutes enable courts to impose a longer sentence if the predicate crime—the underlying crime committed by an offender—is proven to have been motivated by bias as defined by the particular statute. Marginalized communities are convicted of predicate crimes at higher rates. Given that racial disparities also exist within sentencing decisions for equal crimes, there is evidence of discretion within the legal process that disproportionately (and negatively) impacts marginalized groups. The following brief presents an objective analysis of bias homicide charges in the U.S. with the goal of understanding possible policy implications of Indiana’s proposed bias crimes legislation.Item Black death rates from COVID-19 in Marion County (2020)(Center for Research on Inclusion and Social Policy at IU, 2020-04) Merritt, BreancaCOVID-19 has resulted in a disproportionate number of deaths among black, Hispanic/Latinx, and indigenous Americans across the nation. Where data is available for various states and cities, these groups consistently experience worse outcomes. This trend holds true for Indiana’s black residents. On April 13, 2020, the Indiana State Department of Health began including racial/ethnic demographics of diagnosed cases and deaths in its online dashboard. On that date, black Hoosiers comprised about 10 percent of Indiana’s population, but 20 percent of COVID-19 deaths. This brief looks beyond differences in racial health disparities to understand the structural and social sources for these trends.Item COVID-19: Implications for Physical Activity, Health Disparities, and Health Equity(Sage, 2021-07-27) Hasson, Rebecca; Sallis, James F.; Coleman, Nailah; Kaushal, Navin; Nocera, Vincenzo G.; Keith, NiCole; Exercise & Kinesiology, School of Health and Human SciencesPhysical activity is one of the most efficacious pathways to promoting mental and physical health, preventing disease, and, most important during the COVID-19 pandemic, bolstering a stronger immune system. Efforts to “flatten the curve” have resulted in the temporary closure of exercise facilities and gyms, suspension of sport activities, and advisories to avoid public recreational spaces. All of these changes have made traditional opportunities to be physically active difficult to access. These changes have also exacerbated existing disparities in access to social and environmental supports for physical activity, potentially contributing to a widening gap in physical activity participation among those at greatest risk for COVID-19. Physical activity can play a special role in reducing the inequitable consequences of COVID-19; however, expansion and better targeting of evidence-informed interventions are needed that address the unique barriers present in communities that have been economically and socially marginalized to achieve health equity in COVID-19 outcomes. This review highlights effective and feasible strategies that provide more equitable access to physical activity programs and spaces across the United States. With a renewed investment in physical activity, this behavior can play a crucial role in improving population health and reducing disparities during the COVID-19 pandemic and beyond.Item (Dis)Incentivizing Patient Satisfaction Metrics: The Unintended Consequences of Institutional Bias(Mary Ann Liebert, 2019-02-04) Sotto-Santiago, Sylk; Slaven, James E.; Rohr-Kirchgraber, Theresa; Medicine, School of MedicineBackground: Patient satisfaction surveys as a metric for quality-based financial incentives carry a risk of bias toward women and underrepresented physicians. Previous assessments in our department of medicine found that most women faculty were rated in the bottom quartile of patient satisfaction scores, whereas analysis of scores for underrepresented physicians had not been performed. To investigate, we compared patient satisfaction scores and relevant demographics of faculty physicians during 1 year when quality-related financial incentives were offered based on this metric. Methods: Patient satisfaction and communication scores collected during academic year 2015-2016 were obtained for 369 physicians (119 women and 250 men) at Indiana University Health system. Independent variables included physician gender, race, ethnicity, and subspecialty or division; 190 physicians constituted the study cohort for whom data were available for comparison. Statistical analyses were performed to determine if there were differences between gender and race in patient satisfaction scores (mean, median, t-tests, and Chi-square tests). A factorial analysis of variance model was performed to incorporate both main effects and to determine if there was a significant interaction between them. Results: Median and mean of scores were lower for women physicians and underrepresented physicians. Analysis demonstrated nonsignificant effect between gender-segregated cohorts. Racially underrepresented physicians had significantly lower mean scores than their white colleagues [F(4, 185)=2.46, p=0.046]. Conclusion and Relevance: Our results indicate a significant difference in patient satisfaction scores between underrepresented and white physicians. These data may suggest a potential bias, among patients and institutional practices, ultimately leading to pay inequities through differences in financial incentives toward underrepresented physicians.Item Eviction trends in Marion County (2010-2016)(Center for Research on Inclusion and Social Policy at IU, 2019-05) Merritt, Breanca; Stringham-Marquis, Kelsie; Camacho-Reyes, Karla; Gibson, KrystalIndianapolis ranks 14th in eviction rates among large U.S. cities for which data is available. An eviction is when a tenant is removed from a landlord’s property, either through the court system (formal) or outside of the court system (informal). Evictions and forced relocation can lead to housing instability and homelessness for families and individuals, as well as a loss of community resources, such as neighborhood connections and transportation. Indiana has several state laws and local ordinances governing evictions and landlord-tenant relationships. However, Indiana remains one of eight states that does not protect tenants against landlord retaliation. Indiana evictions occur at the township level, adding another layer of jurisdiction for this process. Given the complexity and implications of the eviction process, this report uses research conducted in partnership with the Coalition for Homelessness and Intervention and Prevention (CHIP) to examine what eviction-related trends exist in Marion County.Item Homelessness in Indianapolis: 2020 Marion County Point-in-Time Count(Center for Research on Inclusion and Social Policy at IU, 2020-08) Stringham-Marquis, Kelsie; Bow, Brendan; Lucas, Bailee; Purcell, JacobIn partnership with Coalition for Homelessness Intervention and Prevention (CHIP) and other local organizations, CRISP helped to coordinate and conduct the annual PIT count in Marion County. The report documents the number of individuals experiencing homelessness on a single night in January 2020. The report also highlights key findings and takeaways in order to inform policymaking and service provision for individuals experiencing homelessness.Item Homeownership & home values among Black neighborhoods in Marion County (2018)(2020-02) Merritt, Breanca; Peña, Rachell; Bow, Brendan; Purcell, Jacob; Camacho-Reyes, Karla; Yang, ElleA 2018 report from the Brookings Institute found that homes in majority-black neighborhoods in the Indianapolis-Carmel-Anderson metro area were valued at $18,000 less than those in similar—yet not predominately black—neighborhoods. This follows a national trend in which homes in black neighborhoods were undervalued by $48,000 on average. In fact, in 117 of the 119 metro areas included in the Brookings report, a home in a majority-black neighborhood was valued less than those in other neighborhoods. These areas also are more likely to be more segregated and provide fewer upward mobility opportunities for black residents. This brief examines trends in black homeownership specifically for Marion County.Item Housing instability in Marion County: evictions before & during COVID-19(Center for Research on Inclusion and Social Policy, 2021-02) Martyn, Kevin; Camacho-Reyes, Karla; Merritt, Breanca; Stringham-Marquis, KelsieThe COVID-19 pandemic has highlighted housing instability as a major public health issue. Some of the primary measures used to curb the spread of COVID-19, such as shelter-in-place orders and physical distancing requirements, depend upon having access to private spaces and—in particular—safe and stable housing. Meanwhile, a recent estimate from New America found that more than 5 million people in the United States experience eviction or foreclosure each year. While federal and state measures have offered some relief to residents, there is still a predicted wave of evictions on the horizon, especially for those not living in federally funded housing. With an eye to the predicted wave of evictions, this brief examines the recent history of evictions in Marion County, Indiana. We provide a baseline assessment of the pre-pandemic status quo of evictions, as well as an assessment of the gaps in data and their implications for how trends in evictions are interpreted locally.Item Immigration policy & COVID-19 (2020)(Center for Research on Inclusion and Social Policy at IU, 2020-07) Lawrence, Roxy; Yang, Elle; Merritt, BreancaOn February 24, 2020, Congress passed the Public Charge Grounds Inadmissibility legislation, also known as the public charge rule. The rule allows the federal government to determine whether a person is likely to become a public charge—a noncitizen who receives public benefits for the total of any 12 months during a 36-month period. These benefits include cash assistance that supplements individual or household income, such as Supplemental Security Income (SSI) and Temporary Assistance for Needy Families (TANF), among other sources. Adopting the public charge rule a month before the COVID-19 pandemic began may have compromised the collective health and economic security of immigrant populations already living in the U.S. and Indiana. Executive orders have also closed nonessential businesses that disproportionately hire immigrants. Therefore, this brief examines the initial implications of the public charge rule on low-income immigrants during the COVID-19 pandemic.