What Is Community? An Evidence-Based Definition for Participatory Public Health
Increased emphasis on community collaboration indicates the need for consensus regarding the definition of community within public health.This study examined whether members of diverse US communities described community in similar ways. To identify strategies to support community collaboration in HIV vaccine trials, qualitative interviews were conducted with 25 African Americans in Durham, NC; 26 gay men in San Francisco, Calif; 25 injection drug users in Philadelphia, Pa; and 42 HIV vaccine res
Can Public Health Researchers and Agencies Reconcile the Push From Funding Bodies and the Pull From
Responding to growing impatience with the limited application of research findings to health practices and policies, both funding bodies and communities are demanding that research show greater sensitivity to communities’ perceptions, needs, and unique circumstances. One way to assure this is to employ participatory research—to engage communities at least in formulating research questions and interpreting and applying research findings and possibly also in selecting methods and analyzing dat
Study: Many wary of health system Care often seen as lacking by poor or nonwhite Arkansans
Many Arkansans who are black, Hispanic, Asian or poor whites distrust doctors and hospitals, according to a study presented Tuesday at the state Capitol. After researchers talked to 148 people around Arkansas, study co-investigator Dr. Eduardo Ochoa said they found "a deep-seated suspicion of the health care system."
Self-Reported Experiences of Racial Discrimination and Black–White Differences in Preterm and Low-
Objectives. We examined the effects of self-reported experiences of racial discrimination on Black–White differences in preterm (less than 37 weeks gestation) and low-birthweight (less than 2500 g) deliveries. Methods. Using logistic regression models, we analyzed data on 352 births among women enrolled in the Coronary Artery Risk Development in Young Adults Study. Results. Among Black women, 50% of those with preterm deliveries and 61% of those with low-birthweight infants reported having
Experiences of Racism Among African American Parents and the Mental Health of Their Preschool-Aged C
Objectives. We examined the relationship between parents’ experiences of racism and children’s well-being and the influence of the residential neighborhood characteristics on this relationship. Methods. African American families were recruited from Baltimore neighborhoods. Parental measures included racism experiences and coping. Neighborhood measures included demographic characteristics, social cohesion, and social climate. Children’s mental health was assessed with the Child Behavior Ch
Racial Differences in Cardiac Catheterization as a Function of Patients’ Beliefs
Objectives. We examined racial differences in cardiac catheterization rates and reviewed whether patients’ beliefs or other variables were associated with observed disparities. Methods. We did a prospective observational cohort study of 1045 White and African American patients at 5 Veterans Affairs (VA) medical centers whose nuclear imaging studies indicated reversible cardiac ischemia. Results. There were few demographic differences between White and African American patients in our sample.
AMA Apologizes To Blacks For Past Racial Inequality
Transplant surgeon Clive Callender has hurtful memories of being the only black doctor at medical meetings in the 1970s, met with stark silence when he pleaded for better access to transplant organs for blacks. So when the American Medical Association formally apologized Thursday for more than a century of policies that excluded blacks from a group long considered the voice of American doctors, it was belated, but still welcome.
Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits
Objectives. We examined the association between patient race/ethnicity and patient–physician communication during medical visits. Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 African American and White patients who visited 61 physicians in the Baltimore, Md–Washington, DC–Northern Virginia metropolitan area. Outcome
The Health Impact of Resolving Racial Disparities: An Analysis of US Mortality Data
The US health system spends far more on the “technology” of care (e.g., drugs, devices) than on achieving equity in its delivery. For 1991 to 2000, we contrasted the number of lives saved by medical advances with the number of deaths attributable to excess mortality among African Americans. Medical advances averted 176 633 deaths, but equalizing the mortality rates of Whites and African Americans would have averted 886202 deaths. Achieving equity may do more for health than perfecting the te
Self-Care Among Chronically Ill African Americans: Culture, Health Disparities, and Health Insurance
Little is known about the self-care practices of chronically ill African Americans or how lack of access to health care affects self-care. Results from a qualitative interview study of 167 African Americans who had one or more chronic illnesses found that self-care practices were culturally based, and the insured reported more extensive programs of self-care. Those who had some form of health insurance much more frequently reported the influence of physicians and health education programs in sel
Asleep at the Switch: Local Public Health and Chronic Disease
Local health departments generally do a good job of monitoring and controlling conditions that killed people in the United States 100 years ago. Yet noncommunicable diseases, which accounted for less than 20% of US deaths in 1900,1 now account for about 80% of deaths.2 Our local public health infrastructure has not kept pace with this transition. Health departments must continue to handle traditional public health priorities as well as emerging infectious diseases. They must also increasingly ad
The Meaning of Translational Research and Why It Matters
Translational research means different things to different people, but it seems important to almost everyone. The National Institutes of Health (NIH) has made translational research a priority, forming centers of translational research at its institutes and launching the Clinical and Translational Science Award (CTSA) program in 2006. With 24 CTSA-funded academic centers already established, other universities are transforming themselves to compete for upcoming CTSA grants. By 2012, the NIH expe
Poverty and Elimination of Urban Health Disparities Challenge and Opportunity
The aim of this article is to examine the intersection of race and poverty, two critical factors fueling persistent racial and ethnic health disparities among urban populations. From the morass of social determinants that shape the health of racial and ethnic communities in our urban centers, we will offer promising practices and potential solutions to eliminating racial and ethnic health disparities.
Memo from UPMC Board of Directors regarding retirement of Dr. George Board
Link to issue of GSPH magazine on establishment of CMH
Reducing Racial/Ethnic Disparities in Female Breast Cancer: Screening Rates and Stage at Diagnosis
Objectives. We assessed whether population rates of mammography screening, and their changes over time, were associated with improvements in breast cancer stage at diagnosis and whether the strength of this association varied by race/ethnicity. Methods. We analyzed state cancer registry data linked to socioeconomic characteristics of patients’ areas of residence for 1990–1998 time trends in the likelihood of early stage diagnosis. We appended each cancer registry record with matching subgro
The Persistence of American Indian Health Disparities
Disparities in health status between American Indians and other groups in the United States have persisted throughout the 500 years since Europeans arrived in the Americas. Colonists, traders, missionaries, soldiers, physicians, and government officials have struggled to explain these disparities, invoking a wide range of possible causes. American Indians joined these debates, often suggesting different explanations. Europeans and Americans also struggled to respond to the disparities, sometimes
Addressing Health Care Disparities and Increasing Workforce Diversity: The Next Step for the Dental,
The racial/ethnic composition of our nation is projected to change drastically in the coming decades. It is therefore important that the health professions improve their efforts to provide culturally competent care to all patients. We reviewed literature concerning health care disparities and workforce diversity issues—particularly within the oral health field— and provide a synthesis of recommendations to address these issues. This review is highly relevant to both the medical and public he
Racial Differences in Prenatal Care Use
in the United States: Are Disparities Decreasing?
Objectives. We examined trends and racial disparities (White, African American) in trimester of prenatal care initiation and adequacy of prenatal care utilization for US women and specific high-risk subgroups, e.g., unmarried, young, or less-educated mothers. Methods. Data from 1981–1998 US natality files on singleton live births to US resident mothers were examined. Results. Overall, early and adequate use of care improved for both racial groups, and racial disparities in prenatal care use
Racial/Ethnic Disparities in Preschool Immunizations: United States, 1996–2001
Objectives. We examined current racial/ethnic differences in immunization coverage rates among US preschool children. Methods. Using National Immunization Survey data from 1996 through 2001, we compared vaccination coverage rates between non-Hispanic White, non-Hispanic Black, Hispanic, and Asian preschool children. Results. During the 6-year study period, the immunization coverage gap between White and Black children widened by an average of 1.1% each year, and the gap between White and Hispa
Compendium of HIV Prevention Interventions with Evidence of Effectiveness
The Centers for Disease Control and Prevention (CDC) developed this Compendium of HIV Prevention Interventions with Evidence of Effectiveness to respond to prevention service providers, planners, and others who request science-based interventions that work to prevent HIV transmission. All interventions selected for this Compendium came from behavioral or social studies that had both intervention and control/comparison groups and positive results for behavioral or health outcomes. We required des