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Concept: Demographics of the United States

79

Minority children have the highest US uninsurance rates; Latino and African-American children account for 53 % of uninsured American children, despite comprising only 48 % of the total US child population. The study aim was to examine parental awareness of and the reasons for lacking health insurance in Medicaid/CHIP-eligible minority children, and the impact of the children’s uninsurance on health, access to care, unmet needs, and family financial burden.

Concepts: Health care, Demographics of the United States, Sociology, Economics, Child, White American

45

To evaluate an epigenetic assay performed on tissue from negative prostate biopsies in a group of African American (AA) men undergoing repeat biopsy, and to compare accuracy for predicting repeat biopsy outcome to prior studies conducted in predominantly Caucasian populations.

Concepts: Cancer, Demographics of the United States, White American, African American, Southern United States, Prostate biopsy, Jim Crow laws, Democratic Party

42

Growing evidence indicates that immigration policy and enforcement adversely affect the well-being of Latino immigrants, but fewer studies examine ‘spillover effects’ on USA-born Latinos. Immigration enforcement is often diffuse, covert and difficult to measure. By contrast, the federal immigration raid in Postville, Iowa, in 2008 was, at the time, the largest single-site federal immigration raid in US history.

Concepts: United States, Demographics of the United States, Immigration, California, Hispanic and Latino Americans, New Jersey, Arizona, Illinois

41

The accurate description of ancestry is essential to interpret, access, and integrate human genomics data, and to ensure that these benefit individuals from all ancestral backgrounds. However, there are no established guidelines for the representation of ancestry information. Here we describe a framework for the accurate and standardized description of sample ancestry, and validate it by application to the NHGRI-EBI GWAS Catalog. We confirm known biases and gaps in diversity, and find that African and Hispanic or Latin American ancestry populations contribute a disproportionately high number of associations. It is our hope that widespread adoption of this framework will lead to improved analysis, interpretation, and integration of human genomics data.

Concepts: United States, Demographics of the United States, Spanish language, Interpretation, Latin America, European American, English American, Ancestor

28

Although the Latino American male population is increasing, the subgroup Latino men’s health remains underinvestigated. This study examined the overall pattern of Latino male health and health care utilization in major subgroups, using a nationally representative sample (N = 1,127) from the National Latino and Asian American Study. The authors evaluated rates of chronic, behavioral, and mental health service utilization in this first nationally representative survey. The results identified significant cross-subgroup differences in most physical and chronic conditions with Puerto Rican American men having high rates in 8 of 15 physical ailments, including life-altering conditions such as cardiovascular diseases. Despite differences in racial/ethnic, socioeconomic, and cultural factors, Cuban American men shared similar rates of heart diseases and cancer with Puerto Rican American men. In addition, Puerto Rican American men had higher rates of substance abuse than other Latinos. For health providers, the authors' findings encourage awareness of subgroup differences regarding overall health issues of Latino American men to provide culturally appropriate care.

Concepts: United States, Demographics of the United States, California, Hispanic and Latino Americans, Massachusetts, Mexican American, Spanish American, Cuban American

28

In this article, we report on that aspect of our ongoing simulation project which focuses on the cultural needs of a ‘virtual’ young man living with profound and multiple intellectual disabilities, who is British Asian and receives care in a residential setting. We describe our involvement with a local agency who support families from black and minority ethnic populations and who have children with a variety of intellectual disabilities. We then go on to detail the focus group we attended and how we incorporated the data generated into a more comprehensive story for our ‘virtual’ young man, Ahmed.

Concepts: Demographics of the United States, Sociology, United Kingdom, Down syndrome, Race, Ethnic group, England, Developmental disability

24

We examined 22 articles to compare Black Latinos/as' with White Latinos/as' health and highlight findings and limitations in the literature. We searched 1153 abstracts, from the earliest on record to those available in 2016. We organized the articles into domains grounded on a framework that incorporates the effects of race on Latinos/as' health and well-being: health and well-being, immigration, psychosocial factors, and contextual factors. Most studies in this area are limited by self-reported measures of health status, inconsistent use of race and skin color measures, and omission of a wider range of immigration-related and contextual factors. We give recommendations for future research to explain the complexity in the Latino/a population regarding race, and we provide insight into Black Latinos/as experiences. (Am J Public Health. Published online ahead of print October 13, 2016: e1-e6. doi:10.2105/AJPH.2016.303452).

Concepts: United States, Black people, Demographics of the United States, Human skin color, Hispanic and Latino Americans, Mexican American, White Hispanic and Latino Americans, Spanish American

22

This cross-sectional study was designed to characterize the pornography viewing preferences of a sample of U.S.-based, urban-residing, economically disadvantaged, primarily Black and Hispanic youth (n = 72), and to assess whether pornography use was associated with experiences of adolescent dating abuse (ADA) victimization. The sample was recruited from a large, urban, safety net hospital, and participants were 53% female, 59% Black, 19% Hispanic, 14% Other race, 6% White, and 1% Native American. All were 16-17 years old. More than half (51%) had been asked to watch pornography together by a dating or sexual partner, and 44% had been asked to do something sexual that a partner saw in pornography. Adolescent dating abuse (ADA) victimization was associated with more frequent pornography use, viewing pornography in the company of others, being asked to perform a sexual act that a partner first saw in pornography, and watching pornography during or after marijuana use. Approximately 50% of ADA victims and 32% of non-victims reported that they had been asked to do a sexual act that their partner saw in pornography (p = 0.15), and 58% did not feel happy to have been asked. Results suggest that weekly pornography use among underage, urban-residing youth is common, and may be associated with ADA victimization.

Concepts: Demographics of the United States, Race, Hispanic and Latino Americans

21

Black race and Hispanic ethnicity were associated with lower rates of sustained virologic response (SVR) to interferon (IFN)-based treatments for chronic hepatitis C virus (HCV) infection whereas Asian race was associated with higher SVR rates compared to white patients. We aimed to describe the association between race/ethnicity and effectiveness of new direct-acting antiviral (DAA) regimens in the Veterans Affairs (VA) healthcare system nationally. We identified 21,095 HCV-infected patients (11,029 [52%] white, 6,171 [29%] black, 1,187 [6%] Hispanic, 348 [2%] Asian/Pacific Islander/American Indian/Alaska Native [Asian/PI/AI/AN] and 2,360 [11%] declined/missing race or ethnicity) who initiated antiviral treatment with regimens containing sofosbuvir (SOF), simeprevir + sofosbuvir (SMV+SOF), ledipasvir/sofosbuvir (LDV/SOF) or paritaprevir/ombitasvir/ritonavir/dasabuvir (PrOD), during the 18-month period from 01/01/2014 to 06/30/2015. Overall SVR rates were 89.8% (95% CI 89.2-90.4) in white, 89.8% (95% CI 89.0-90.6) in black, 86.0% (95% CI 83.7-88.0) in Hispanic, and 90.7% (95% CI 87.0-93.5) in Asian/PI/AI/AN patients. However, after adjustment for baseline characteristics, black (adjusted odds ratio [AOR] 0.77, p-value<0.001) and Hispanic patients (AOR 0.76, p-value=0.007) were less likely to achieve SVR than white patients, a difference that was not explained by early treatment discontinuations. Among genotype 1-infected patients treated with LDV/SOF monotherapy, black patients had significantly lower SVR than white patients when treated for 8 weeks but not when treated for 12 weeks.

Concepts: Demographics of the United States, Hepatitis C, Race, Ethnic group, White American, Hispanic and Latino Americans

14

The social determinants of health framework has brought a recognition of the primary importance of social forces in determining population health. Research using this framework to understand the health and mortality impact of social, economic, and political conditions, however, has rarely included religious institutions and ties. We investigate a well-measured set of social and economic determinants along with several measures of religious participation as predictors of adult mortality. Respondents (N = 18,370) aged 50 and older to the Health and Retirement Study were interviewed in 2004 and followed for all-cause mortality to 2014. Exposure variables were religious attendance, importance, and affiliation. Other social determinants of health included gender, race/ethnicity, education, household income, and net worth measured at baseline. Confounders included physical and mental health. Health behaviors and social ties were included as potential explanatory variables. Cox proportional hazards regressions were adjusted for complex sample design. After adjustment for confounders, attendance at religious services had a dose-response relationship with mortality, such that respondents who attended frequently had a 40% lower hazard of mortality (HR = 0.60, 95% CI 0.53-0.68) compared with those who never attended. Those for whom religion was “very important” had a 4% higher hazard (HR = 1.04, 95% CI 1.01-1.07); religious affiliation was not associated with risk of mortality. Higher income and net worth were associated with a reduced hazard of mortality as were female gender, Latino ethnicity, and native birth. Religious participation is multi-faceted and shows both lower and higher hazards of mortality in an adult US sample in the context of a comprehensive set of other social and economic determinants of health.

Concepts: Public health, Health disparities, Demography, Demographics of the United States, Sociology, Population health, Household income in the United States, Social determinants of health