Browsing by Subject "health disparities"
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Item Adult Women and Coronary Heart Disease: Studies on Surgical Procedures and Perception(2010-12-01) Schlorke, Patricia; Bae, Sejong; Biswas, Swati; Chen, OliveSchlorke, Patricia J., Adult Women and Coronary Heart Disease: Studies on Surgical Procedures and Perception. Doctor of Public Health (Biostatistics), December 2010, 124 pp., 12 tables, 3 figures, bibliography, 95 titles. Coronary heart disease (CHD) was the number one cause of death in the United States. The main CHD symptom was a heart attack. The most common form of a heart attack was chest pain and shortness of breath, which occurred in men. However, women did not usually have chest pain, but other symptoms such as abdominal pain or indigestion. This could lead women to perceive or believe that they would not have heart disease or heart attacks. This thought could lead women to not obtaining health care, such as surgical procedures, for CHD. Health professionals knew the signs and symptoms of CHD in men, but they may be uncertain in their diagnosis in women. This could lead to women not asking their health care professional about heart attacks or other symptoms. The purpose of this dissertation analyzed CHD in two areas in all women 18 years and older. These two areas were: (a) comparing hospital length of stay between men and women who had either coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA); and (b) women’s perceptions about CHD. Data for the surgical procedures study came from the 2006 National Hospital Discharge Survey (NHDS) and for the perception study came from the 2007 Behavioral Risk Factor Surveillance System (BRFSS). The results showed for the surgical procedures men and women had increased hospital days of care (DOC) for all surgical procedures. The results for the perception study showed women varied by age, race-ethnicity, education, income, and other factors in heart attack symptom knowledge. These two studies had the following conclusions. The results for increased hospital DOC had implications, such as increased health utilization, for present and future hospitalizations. The results for heart attack symptom knowledge showed a need for more awareness and communication of heart attack symptoms among all women across the United States.Item Blood-Based Inflammation Biomarkers of Neurocognitive Impairment in People Living with HIV(2020-05) Swanta, Naomi K.; Borgmann, Kathleen; Berg, Rance E.; Cunningham, Rebecca L.; Johnson, Leigh A.; Yan, Liang-JunRace and sex minorities are disproportionately affected by HIV in the United States. Approximately 50% of people living with HIV (PLWH) experience HIV-associated neurocognitive disorders (HAND). ART has decreased incidence of HAD but the less severe forms of HAND has increased. Diagnosis of HAND is challenging as the often-subtle forms of impairment are not as overt as dementia. HIV infection promotes neurocognitive dysfunction through persistent inflammation, which correlates with the severity of impairment. The objective of this study was to identify blood-based cytokines that associate with, and could predict, neurocognitive functioning in a demographically balanced cohort of PLWH. Inflammatory biomarkers of HIV-associated neurocognitive impairment could improve current diagnosis methods and may be specific for populations disproportionately affected by the HIV. Seven neurocognitive domains were evaluated in 121 seropositive African American, Non-Hispanic White and White Hispanic men and women using computerized assessments. A panel of 26 inflammation-associated cytokines were measured in plasma and blood mononuclear cells. Significant associations among neurocognitive functioning and HIV-related parameters, relevant sociodemographic variables and cytokine panel were determined using multivariate and univariate regression analyses. Following corrections for education, CD4 T cell counts, viral load and eliminating outliers. Our results demonstrate that chemokine C-C motif ligand (CCL) 8 significantly correlated with memory, complex attention, cognitive flexibility, psychomotor speed, executive functioning and processing speed. Tissue inhibitor of metalloproteinases-1 (TIMP-1) significantly correlated with the aforementioned domains except memory and processing speed. In addition, interleukin (IL) - 23 significantly associated with executive functioning and processing speed. The biomarkers demonstrated a negative correlation to neurocognitive functioning. Race disparities were identified in memory and CCL8, furthermore, sex disparities were identified in executive functioning and TIMP-1. The plasma biomarkers were evaluated as predictive classifiers of neurocognitive functioning. Decision tree models for NCI and executive functioning predicted visit two at 67.2% accuracy. Collectively, these data identified blood-based inflammatory biomarkers of neurocognitive function with the potential to assist in the diagnosis of HIV-associated neurocognitive impairments in PLWH.Item Does Diversity Matter? Disparities in Diagnostic Delays and Contralateral Risk Factors in Slipped Capital Femoral Epiphysis(2022-12) Purcell, Maureen W.; Reeves, Rustin E.; Mayfield, Matthew; Lovely, Rehana S.; Berg, Rance E.The skeletal pathology slipped capital femoral epiphysis (SCFE) is one of the more common hip diseases that can affect adolescents. Delays in diagnosis and the risk of contralateral SCFE are recognized issues for this patient population. However, SCFE studies often do not include the groups of people most often diagnosed with this pathology, namely Black and Hispanic individuals. This project aimed to address this literature gap by investigating the recognized issues with a sizeable sample of individuals in those ethnic groups, roughly equal to the White patient group. We found that the severity of SCFE measured by Southwick slip angle (SSA) is significantly associated with both insurance type and patient status. Patients who were covered by private insurance or were already an established patient at the medical center were more likely to be diagnosed with mild SCFE, and patients with no insurance had a significantly higher mean SSA than patients with insurance. Posterior sloping angle (PSA) and physeal sloping angle in the anterior-posterior view (PSA-AP) are two of the most often used measurements to estimate contralateral slip risk. They were not predictive of contralateral slip risk in our sample, except for PSA-AP in male patients. When analyzed within each ethnic subgroup, we found significant differences in the PSA and PSA-AP between males and females within the Hispanic patient sample only. This suggests that these angles are not necessarily predictive for all patients groups, and/or that there may be sex differences within patient populations that can affect the utility of these metrics. To the authors' knowledge, the above findings are the first to link SSA to insurance status and patient status, and to the first to analyze the PSA and PSA-AP angles of a Hispanic SCFE patient group.Item Examining the Relationship Between Relative Wellbeing & Health Disparities in the City of Dallas(2006-08-01) Byerly, Jerah J.; Urrutia-Rojas, XimenaByerly, Jerah J., Examining the Relationship between Relative Wellbeing & Health Disparities in the City of Dallas. Master of Public Health (Community Health), August 2006,43 pp., 8 tables, 6 illustration (figures), bibliography , 29 titles. Health disparities are studies across many diseases and demographic characteristics. This study examined health disparities in relation to geographic assets … a social determinant of health. The purpose of this project was to replicate the Relative Wellbeing Index model in Albrecht & Ramasubramanian’s 2004 study, “The Moving Target: A Geographic Index of Relative Wellbeing”. This study sought to measure well-being at the neighborhood level in Dallas. Data was collected from 2000 U.S. Census. Results indicated the presences of pockets of extreme concentration and social isolation. South Dallas and Fair Park, two of the lowest socioeconomic neighborhoods, had the lowest level of wellbeing. In conclusion, the study indicated Well being scores were not equally distributed across neighborhoods in the City of Dallas.Item Factors that Motivate Hispanics to Attend Church-Based Health Interventions(2006-05-01) Sanchez, Mary-Katherine; Gonzalez, Adela; Lykens, Kristine; Lurie, SueSanchez, Mary-Katherine, Factors that Motivate Hispanics to Participate in Church-Based Health Interventions. Doctor of Public Health (Social and Behavioral Sciences), May 2006, 80 p.p., 1 table, bibliography, 62 titles. One of the most important demographic trends taking place in the United States today is the rapid growth of the Hispanic/Latino population (Kostin, 2004). Hispanics are the fastest-growing minority group in the United States (Documet Sharma, 2004; United States Census Bureau, 2003). This rapid growth will have a major impact on social, political and economic issues as well as on the health of the people in the United States (Kostin, 2004). Throughout the country, church-based health interventions are being offered to individuals of differing cultural and ethnic backgrounds, however, retention of participants is often low. The purpose of this qualitative research study was to determine the roles that social and behavioral factors play in motivating Hispanics to attend church-based health interventions. The study used qualitative methods. Focus groups were conducted at two church sites that were participants in the fall 2005 American Heart Association De Corazon a Corazon program with the highest retention rate of participating parishes. Both focus groups were audio-recorded, and recordings and field notes were then used to translate and transcribe the collected data. All data were entered into NVivo and coded to identify important themes and concepts. Results identified key identified motivating factors that included familiarity with setting, desire to improve health, need to gain information, knowing others in the group, social and motivational factors, monetary benefits such as free health screenings and workshops and questions being answered in Spanish. It was determined that social factors play a major role in motivating Hispanics to attend church-based health interventions. Through increasing our knowledge of motivational factors and influences on Hispanics to attend a church-based intervention, more effective health prevention and intervention programs can be designed and implemented in an effort to better reach this growing minority population and lessen the burden of minority health disparities. This is an area of research that needs to be further examined in order to prevent growing health disparities among the Hispanic population.Item Synergy 2007: Annual Research Report(2007-01-01)Item Top Alzheimer's disease risk allele frequencies differ in HABS-HD Mexican- versus Non-Hispanic White Americans(John Wiley & Sons, Inc., 2024-01-02) Housini, Mohammad; Zhou, Zhengyang; Gutierrez, John; Rao, Sumedha; Jomaa, Rodwan; Subasinghe, Kumudu; Reid, Danielle M.; Silzer, Talisa; Phillips, Nicole; O'Bryant, Sid E.; Barber, Robert C.; Team, HABS-HD StudyINTRODUCTION: Here we evaluate frequencies of the top 10 Alzheimer's disease (AD) risk alleles for late-onset AD in Mexican American (MA) and non-Hispanic White (NHW) American participants enrolled in the Health and Aging Brain Study-Health Disparities Study cohort. METHODS: Using DNA extracted from this community-based diverse population, we calculated the genotype frequencies in each population to determine whether a significant difference is detected between the different ethnicities. DNA genotyping was performed per manufacturers' protocols. RESULTS: Allele and genotype frequencies for 9 of the 11 single nucleotide polymorphisms (two apolipoprotein E variants, CR1, BIN1, DRB1, NYAP1, PTK2B, FERMT2, and ABCA7) differed significantly between MAs and NHWs. DISCUSSION: The significant differences in frequencies of top AD risk alleles observed here across MAs and NHWs suggest that ethnicity-specific genetic risks for AD exist. Given our results, we are advancing additional projects to further elucidate ethnicity-specific differences in AD.