Browsing by Subject "race"
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Item Access to Care and Hospitalizations for Diabetes Complications Among Elderly Hispanics and African Americans in Texas(2005-08-01) Chaudhary, Prateek; Kristine Lykens; Julian Borejdo; Antonio A. ReneChaudhary, Prateek. Access to Care and Hospitalizations for Diabetes Complications Among Elderly Hispanics and African Americans in Texas. Master of Public Health, August 2005, 52 pp, 6 tables, bibliography. The mismanagement of diabetes care, due to disparities in access, deficiencies in health insurance, or poor quality of primary care, can lead to preventable microvascular complications which force diabetics to utilize hospital emergency departments (ED). This study uses 2002 hospital discharge data from the Texas Health Care Information Collection to determine whether diabetic and elderly (65+) African Americans and Hispanics from Texas counties with a low ratio of physicians per, 1,000 population (PPR) are more likely to be admitted through the ED with complications from diabetes. Findings indicate that while Hispanic ethnicity is significantly associated with ED use as a source of admission, diabetics from counties with higher PPR are more likely to be admitted through the ED for diabetes complications than diabetics from counties with a lower PPR.Item Defining the Prostate Cancer Population in Texas Using Hospital Discharge Data(2004-05-01) Manuel, Christopher J.; Karan Singh; Antonio A. ReneManuel, Christopher J., Defining the prostate cancer population in Texas using hospital discharge data. Masters of Public Health (Biostatistics), May 2004, 25 pp., 6 tables, bibliography, 35 titles. The Texas Health Care Information Council (THCIC) was created by the 74th Texas Legislature in 1995. THCIC’s primary purpose is to provide data that will enable Texas consumers and health plan purchasers to make informed health care decisions. This data also serves the purpose of providing information about disease trends and hospital discharges. The purpose of this study was to describe the disease status of prostate cancer in the state of Texas. Prostate cancer is the most common non-cutaneous male malignancy and ranks as the second cause of cancer-related mortality among men in the United States. Epidemiologic data was extracted from the data set for analysis looking at disease trends based on a variety of factors such as age, race, and insurance.Item EFFECT OF ETHNICITY ON THE OUTCOME OF TRAUMA PATIENTS WITH AND WITHOUT ORTHOPAEDIC INJURIES(2013-04-12) Parks, DiPurpose: There is a growing recognition of the existence of ethnic disparities in healthcare. We hypothesized that ethnic minorities would have a statistically significant increased rate of morbidity and mortality compared with non-minority groups. Our purpose is to determine if there is a relationship between the patient's ethnic background and the incidence of in-hospital complications, discharge outcomes, discharge disposition, and mortality. Methods: Utilizing our institution's trauma registry, all adult trauma activations, from January 1, 2008 through November 30, 2010, with an Injury Severity Score of 9 or greater, were identified. Our hospital categorizes ethnicity as: White, Black, Hispanic, Asian/Pacific Islander, and Other. Variables of interest included age, gender, ethnicity, injury mechanism, orthopaedic injuries, inpatient complications, Glasgow Outcome Scale, payer, discharge disposition, and mortality. Logistic regression was utilized for statistic analysis. Results: The study included 3,876 patients, average age 43 years, and average Injury Severity Scale of 17. The ethnic demographics of the study population are consistent with the current demographics of Tarrant County, Texas, where our Level I trauma center is located. 9.49% patients died and 56.20% of the patients had an identified orthopaedic injury. Logistic regression analysis did not demonstrate a statistically significant relationship between ethnicity and the mortality rate, in-hospital complication rate, Glasgow Outcome Scale assessment and discharge disposition. Conclusions: Our data are contrary to previously published studies regarding differences in outcomes for trauma patients of various ethnicities. These results are perhaps reflective of a county Level I trauma center that services patients of all ethnic and socioeconomic backgrounds.Item Emergency Department Visits and Hospitalizations for Ambulatory Care Sensitive Conditions Among Uninsured Hispanics(2005-05-01) Trevino, Elizabeth; Mains, Doug A.; Rene, Antonio; Gonzales, AdelaTrevino, Elizabeth., Emergency Department Visits and Hospitalizations for Ambulatory Care Sensitive Conditions among Uninsured Hispanics. Doctor of Public Health (Health Management and Policy), May 2005, 83 pp., 10 tables, bibliography, 87 titles. Inequalities in access to health care persist in the US health care delivery system and as the number of uninsured patients in the United States continues to increase, emergency departments around the country are becoming inundated with people seeking non-acute, as well as acute medical care. This study explored whether there are differences of emergency department use and hospitalizations for ambulatory care sensitive (ACS) conditions among uninsured Hispanics as compared to other ethnicities using 2001-2002 National Hospital Ambulatory Medical Care Survey (NHAMCS) data. A weighted sample of 4,210,248 emergency department visits for years 2001-2002 was analyzed using frequencies, Pearson x2 tests, logistic regression and multiple logistic regression to determine whether Hispanics and uninsured Hispanic were visiting the emergency department more frequently than any other ethnic group; uninsured Hispanics were being hospitalized due to the severity of the disease; and determine the significant predictors for preventable hospitalizations. Significant differences among the ethnicities studied and emergency department visits during 2001-2002 were found. These differences resulted in favor of African-American. African-American had larger rates of ED visits as compared to Whites and Hispanics. Uninsured African-American were also found as the racial/ethnic group with greater visits for emergency departments. These findings changed when assessing preventable hospitalizations for ACS conditions. A similar direction was found for Whites. Uninsured Hispanics were hospitalized more frequently in triage category less than 15 minutes, indicating the severity of the disease. Age, gender, race/ethnicity and insurance status were found to be significant predictors for preventable hospitalizations. This study revealed a substantial national problem with hospitalizations among uninsured Hispanics that may be prevented with timely and appropriate ambulatory care. The significant finding in this study strongly suggests that although this group did not visit the emergency department as frequently when compared to other ethnicities between 2001-2002, they are doing so when their condition deteriorates to the point to which a visit to the emergency room and hospitalization has become inevitable.Item Obesity and Risk of Stroke in NHANES I Follow Up Study(2002-12-01) Soman, Ashwini; Umed Ajani; Antonio Rene; Karan SinghSoman, Ashwini, Obesity and risk of stroke in NHANES-I follow-up study, Masters of Public Health (Epidemiology), December 2002. 79pp., 20 tables, 3 illustrations, bibliography, 46 titles. Stroke is the third leading cause of death in the US. Role of obesity as an independent risk factor has been relatively well established for coronary heart diseases but not for stroke. Purpose of this study was to assess long-term risk of stroke due to obesity measured at baseline. The research was conducted using First National Nutritional Health and Examination Survey and its follow ups. Overall, increased risk of stroke was observed in obese individuals (BMI [greater than] 30 kg/m2). Similar association was observed in different subgroups of race, gender, those with or without diabetes and cardiovascular disease.Item Patterns of Primary Surgical Procedures Among Men Admitted to Texas Hospitals with a Diagnosis of Prostate Cancer(2001-12-01) Galdiano, Rosemary; Antonio Rene; Doug A. Mains; Sue LurieGaldiano, Rosemary, Patterns of primary surgical procedures among men admitted to Texas hospitals with a diagnosis of prostate cancer. Master of Public Health (Epidemiology), December 2001, 28 pp., 3 tables, 4 illustrations, references, 21 titles. Data for the Texas Health Care Information Council was analyzed to identify the patterns of surgical procedures among men admitted to 114 Texas hospitals with a diagnosis of prostate cancer in 1999; and to determine whether these patterns varied by race and age. In all, 4,608 cases were compared for differences between age, race and type of surgical procedure using Pearson’s chi-square test. Frequencies were tabulated for age, race, length of stay, type of surgery, and type of insurance. Radical prostatectomy and transurethral resection of the prostate are the most common procedures performed. Black and Hispanic men less than 45 years old were more likely to receive radical prostatectomy than whites. Transurethral resection of the prostate (TURP) is most commonly performed in men 75 years and older with higher proportions among black and Hispanic men. Younger men (ageyears) who received TURP were more likely to be white. White men between the ages of 45 and 84 were more likely to receive perineal prostatectomy. These findings identified patterns of treatment with defined differences between age and race.Item Potential Predictors of Hypertension Among Children in Fort Worth, Texas: A Cross-Sectional Epidemiologic Study(2002-05-01) Egbuchunam, Christie U.; Bayona, Manuel; Urrutia-Rojas, Ximena; Wilkinson, GreggEgbuchunam, Christie U., Potential Predictors of Hypertension Among Children in Fort Worth, Texas; A Cross-Sectional Epidemiologic Study. Master of Public Health (Epidemiology), May, 2002, 110 pp., 15 tables, 2 illustrations, bibliography, 84 titles. Most studies have identified obesity, gender and age as major factors that influence blood pressure increase in children. The objective of this study was to assess factors that may either directly influence hypertension in children, or interact with obesity, age and gender. A cross-sectional study was carried out to identify and assess the crude and multiple logistic regression adjusted associations between selected variables and hypertension. Obesity and Acanthosis Nigricans (AN) were importantly associated with hypertension. Reduced playing time, and excessive television watching or playing of video games were also associated with hypertension; especially among those who were obese or had AN. Hispanic and African American children had higher likelihood of hypertension than Caucasian children.Item Prevalence of Obesity and Associated Factors for Diabetes in United States - 2005(2007-04-01) Tomer, Vikas; Sejong Bae; Karan Singh; Raghbir SandhuTomer, Vikas, Prevalence of obesity and associated factors for diabetes in United States –2005, Master of Public Health (Biostatistics), May 2007, 27 pp, 9 tables. Diabetes is one of the major public health problems in the United States. The purpose of this research is to explore whether there is a relationship between obesity and diabetes and to understand the effects of some other associated factors on diabetes in the United States in the year 2005. The data studied is from the Behavioral Risk Factor Surveillance System (BRFSS) 2005. A univariate analysis for frequency distribution was used to evaluate and edit the data. Binary logistic regression was used to assess the association of diabetes and the variables through crude and adjusted odd ratio. The result of the study showed significant association between diabetes and obesity and the associated factors among US adults. The prevalence of diabetes has been found to be highest among African Americans followed by Hispanics and Others. Our results indicate that being an obese non-Hispanic black with low income level over the age of 65 years is indicative of being at the highest risk for diabetes. Therefore, for preventive measures to decrease the risk of being overweight and obesity healthy eating habits and regular exercise are recommended. As, income level increases, there is a significant decrease in the diabetes population. The strongest predictor of all appears to be obesity followed by age. Age, gender, income level, race and BMI all had significant effect on diabetes.Item Risk Factors Associated with Low Bone Mineral Density and Hip Fracture Among United States 20-90 Years of Age (NHANES III Study)(1999-06-01) Nandi, Shubhra; Antonio Rene; John Licciardone; Nelson C. FongNandi, Shubhra. Risk Factors Associated with Low Bone Mineral Diversity and Hip Fracture Among United States Females 20-29 Years of Age. (NHANES III Study). Master of Public Health, June 1999, 45p.p. Osteoporosis has become a great public health problem because of the growing segment of the elderly population. The manifestation of osteoporosis results in morbidity with disability and a diminished quality of life due to hip fracture and spine fracture. This is also the major cause of hospital expenditure. Thus, understanding the development of low bone mineral density at various skeletal sites and the prevention of the causes related to the diminished bone mineral density is of great importance. This is a descriptive study of risk factors associated with low bone mineral density and hip fracture among United States females 20-90 years of age. Data was collected by the National Center for Health Statistics from 1988-1994 in two phases. Several risk factors have been associated with low bone mineral density. They are age, race, body mass index, fat-free mass, smoking, alcohol intake, caffeine intake, calcium supplement intake, dairy intake, and the level of physical activity. The primary objective of this study was to elucidate the relationship of low bone mineral density in a specific race-ethnic population with the perceived risk factors. This cross-sectional study provides information to confirm that Non-Hispanic Whites have low bone mineral density at the end of their decade of life compared to Non-Hispanic Blacks and Hispanic Americans. A significant association between low bone mineral density and age, race ethnicity, body mass index, and milk intake was detected (P [less than] 0.05). Other factors did not display any statistically significant correlation.Item The influence of race/ethnicity and social determinants of health and HPV vaccination in vaccine-eligible adults in the U.S.(2022-08) Garg, Ashvita; Thompson, Erika; Nguyen, Uyen-Sa D.T.; Luningham, Justin M.Background: Human Papillomavirus (HPV) vaccination is an essential primary prevention measure against HPV-related cancers, currently approved for catch-up for inadequately vaccinated adults by age 26 and for mid-adults aged 27-45 with shared clinical decision-making. Although HPV vaccination rates have been gradually increasing, racial/ethnic disparities and low catch-up among adults persist. Examining the Social Determinants of Health (SDOH) associated with HPV vaccination in different racial groups may help explain these disparities in lower vaccine uptake. Previous studies using national datasets have found differences in estimated prevalence of HPV vaccine uptake across datasets for racial/ethnic minorities, especially for Asian Americans, when compared to non-Hispanic White, with results varying from lower to higher uptakes. Despite Asian Americans being a very diverse racial group, most studies either combine them in one category or with other races, resulting in an incomplete picture of HPV vaccine uptake among different Asian American subgroups. Purpose: Using the SDOH framework, this study aimed to examine the racial/ethnic differences for HPV vaccination across three U.S. national databases among vaccine-eligible adults and examine the association between HPV vaccination and Asian racial subgroups. Methods: For the first aim, the study utilized 2017-2019 NHIS (n=30,788), 2017-2020 pre-pandemic NHANES (n=3,685), and 2017-2019 BRFSS (n=30,324) data, ages 18-45 years. Asian racial subgroup disparities for the second aim were assessed with 2014-2018 NHIS data (n=34,839, ages 18-38). Survey-weighted multivariable logistic regression models identified the association between HPV vaccination status (outcome) and explanatory variables: SDOH indicators, race/ethnicity, sex, nativity, and age. Results: The racial/ethnic differences in HPV vaccine uptake were not similar between the three datasets. In the NHIS dataset, compared to Non-Hispanic White, Non-Hispanic Asian and Non-Hispanic Asian males were more likely to be vaccinated. With NHANES data, Non-Hispanic Asian males were less likely to be vaccinated. While BRFSS data did not show statistically significant differences in HPV vaccination for difference races/ethnicity. However, inverse variance weighted averages indicated that compared to Non-Hispanic White, Non-Hispanic Asian individuals had higher odds of receiving HPV vaccination. Males compared to females and foreign-born compared to U.S.-born individuals were less likely to be vaccinated. Among SDOH factors, education level, time since last healthcare visit, health insurance status, and having a usual place of healthcare were significantly associated with HPV vaccination. Compared to White individuals, Asian Indian were less likely to be vaccinated while Filipino and individuals from other Asian subgroups were more likely to be vaccinated. Additionally, foreign-born Asian Indian compared to foreign-born White individuals and Asian Indian females compared to White females were less likely to be vaccinated. Regarding SDOH factors, education level, insurance status, and time since last healthcare were significantly associated with HPV vaccination. Conclusion: This study identified racial/ethnic differences in HPV vaccine uptake and SDOH indicators associated with HPV vaccination. Findings indicate that more studies are needed to assess the differences in these three surveillance systems that led to the conflicting findings and to explore the reasons for lower vaccination uptake among the Asian Indian population. Finally, tailoring HPV vaccine awareness campaigns and improving vaccination access for males, foreign-born, individuals lacking health insurance, or those failing to have regular healthcare visits could help promote HPV vaccination and reduce HPV-associated cancers.Item The Use of Osteopathic Palpatory Findings in Screening for Nephropathy in Type 2 Diabetes Mellitus: A Pilot Study(2008-05-01) Curlee, Laura Denise; John Licciardone; Hollis King; Roberto CardarelliCurlee, Laura D., The Use of Osteopathic Palpatory Findings in Screening for Neuropathy in Type 2 Diabetes Mellitus: A Pilot Study. Master of Science, May, 2008, 100 pp., 6 tables, 9 illustrations, bibliography, 40 titles. Viscerosomatic reflexes result in somatic dysfunction, which manifests as palpatory TART changes. There are two hypotheses of this study: palpatory findings will be associated with diabetes and will be associated with renal disease. An osteopathic predoctoral fellow conducted a palpatory exam on each subject at the level of T10-L2, to feel for TART changes. The results from the palpatory exam were recorded in SPSS for statistical analysis. Descriptive statistics, chi square and risk assessment were conducted. There were no statistically significant findings. Results demonstrated possible associations between type 2 diabetes mellitus and race, and tissue texture changes with control groups. Restriction of motion was found to have no difference amongst control and disease groups.