racial/ethnic disparities

种族 / 民族差异
  • 文章类型: Journal Article
    这项专家审查旨在强调医疗保健中的隐性偏见,移植医学,和小儿心脏移植,将注意力集中在这些偏见可能在小儿心脏移植中注意到的种族/族裔和社会经济差异中发挥的作用。这篇评论分解了移植决策过程,以突出显示隐含偏见可能影响结果的要点,并讨论了人类决策科学如何帮助理解这些复杂的过程。
    This expert review seeks to highlight implicit bias in health care, transplant medicine, and pediatric heart transplantation to focus attention on the role these biases may play in the racial/ethnic and socioeconomic disparities noted in pediatric heart transplantation. This review breaks down the transplant decision making process to highlight points at which implicit bias may affect outcomes and discuss how the science of human decision making may help understand these complex processes.
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  • 文章类型: Journal Article
    背景:我们着手绘制阿尔茨海默病和阿尔茨海默病相关痴呆症医疗保健差异的证据,包括访问问题,质量,以及种族/族裔少数族裔痴呆症患者(PLWD)和家庭护理人员的结果。
    方法:我们对2000年至2022年在PubMed上发表的文献进行了范围审查,PsycINFO,和CINAHL。纳入标准为:(1)侧重于PLWD和/或家庭护理人员,(2)检查医疗保健方面的差异或差异,(3)在美国进行,(4)比较两个或两个以上的种族/民族,(5)报告定量或定性结果。
    结果:主要发现包括积累的证据表明,少数人群不太可能获得准确及时的诊断,被处方抗痴呆药物,并使用临终关怀护理,并且更有可能有更高的住院风险,并在生命结束时接受更积极的维持生命的治疗。
    结论:未来的研究需要检查潜在的过程,并制定干预措施,以减少差异,同时更广泛地包括不同的人群。
    BACKGROUND: We set out to map evidence of disparities in Alzheimer\'s disease and Alzheimer\'s disease related dementias healthcare, including issues of access, quality, and outcomes for racial/ethnic minoritized persons living with dementia (PLWD) and family caregivers.
    METHODS: We conducted a scoping review of the literature published from 2000 to 2022 in PubMed, PsycINFO, and CINAHL. The inclusion criteria were: (1) focused on PLWD and/or family caregivers, (2) examined disparities or differences in healthcare, (3) were conducted in the United States, (4) compared two or more racial/ethnic groups, and (5) reported quantitative or qualitative findings.
    RESULTS: Key findings include accumulating evidence that minoritized populations are less likely to receive an accurate and timely diagnosis, be prescribed anti-dementia medications, and use hospice care, and more likely to have a higher risk of hospitalization and receive more aggressive life-sustaining treatment at the end-of-life.
    CONCLUSIONS: Future studies need to examine underlying processes and develop interventions to reduce disparities while also being more broadly inclusive of diverse populations.
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  • 文章类型: Review
    目标:邻里环境可能是认知功能中种族/民族差异的重要决定因素。要了解社区如何与跨种族/族裔群体的认知联系在一起,本范围综述组织了调查美国中年人和老年人不同样本中多个邻域与认知功能之间关系的研究.方法:PubMed/MEDLINE,WebofScience,和CAHL用于提取定量差异为重点的研究(n=17),包括美国50岁以上的成年人,种族/族裔人口化,认知因变量,以及2010年1月至2021年10月发布的邻域级自变量。结果:研究表明,种族/族裔群体内部和之间在邻里因素如何与认知相关方面存在差异。经济和社会优势社区与更好的认知相关。建筑和邻里构成措施的调查结果好坏参半。讨论:需要进行更多的种族/族裔代表性研究,以理清社区的哪些方面对于不同人群的特定认知功能领域最为突出。
    Objectives: The neighborhood environment may be an important determinant of racial/ethnic disparities in cognitive function. To understand how neighborhoods are linked to cognition across racial/ethnic groups, this scoping review organizes research investigating relationships between multiple neighborhood domains and cognitive function in diverse samples of US midlife and older adults. Methods: PubMed/MEDLINE, Web of Science, and CAHL were used to extract quantitative disparities-focused studies (n = 17) that included US adults ages 50+, racial/ethnic minoritized populations, cognitive dependent variable(s), and neighborhood-level independent variable(s) published from January 2010 to October 2021. Results: Studies demonstrate variation within and between racial/ethnic groups in how neighborhood factors are associated with cognition. Economically and socially advantaged neighborhoods were associated with better cognition. Findings were mixed for built and neighborhood composition measures. Discussion: More research with greater racial/ethnic representation is needed to disentangle which aspects of the neighborhood are most salient for specific cognitive function domains across diverse populations.
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  • 文章类型: Systematic Review
    亚洲人可能会经历慢性疾病的高负担,包括但不限于,糖尿病,心血管疾病,和癌症,由于生物学的差异,遗传,以及亚洲各民族的环境因素。任何慢性疾病的诊断都会增加精神健康负担,包括抑郁症,心理困扰,和创伤后应激障碍(PTSD)。然而,很少有研究在不同的亚洲族裔群体中检查这些合并症,考虑到社会差异,这是一个重要的限制,文化,以及亚洲种族内外心理健康负担的行为驱动因素。为了了解患有慢性健康状况的亚洲人在心理健康负担方面的差异,我们对相关的同行评审数据库进行了系统的文献综述,以确定报告精神健康负担的研究(例如,抑郁症,焦虑,苦恼,和PTSD)在北美不同的亚洲种族群体中。13项研究符合本综述的纳入标准,并共同证明了抑郁症的高负担。心理困扰,和患有慢性病的亚洲人的PTSD。此外,在慢性病患者和亚裔人群中,心理健康负担存在明显差异.尽管精神健康状况不佳对慢性病的具体结局有不利影响,比如死亡率和生活质量差,在生活在北美患有慢性疾病的亚裔人群中,缺乏描述心理健康结果的数据.未来的工作应优先估计亚洲种族慢性病成年人的心理健康结果的全国患病率,以告知文化上定制的干预措施,以解决这一公共卫生负担。缩写:BDI-II,贝克的抑郁量表;BRFSSS,行为危险因素监测系统;CES-D,抑郁症流行病学研究中心;CHQ-9,9问题中国健康问卷;CINAHL,护理和相关健康文献的累积指数;DSM-IV-TR,精神疾病诊断和统计手册文本修订版第四版;ESAS,埃德蒙顿症状评估量表;GDS-SF,老年抑郁量表-简表;JBI,乔安娜·布里格斯研究所;NHANES,国家健康和营养检查调查;NHIS,国家健康访谈调查;NLAAS,国家拉丁裔和亚裔美国人研究;PHQ-9,9个问题的患者健康问卷;PHQ-9K,9问题韩国患者健康问卷;PRISMA,系统评价和荟萃分析的首选报告项目;PTSD,创伤后应激障碍;SD,标准偏差;T2D,2型糖尿病;美国,美国。
    Asians are likely to experience a high burden of chronic conditions, including, but not limited to, diabetes, cardiovascular disease, and cancer, due to differences in biologic, genetic, and environmental factors across Asian ethnic groups. A diagnosis of any chronic condition can contribute to increased mental health burdens, including depression, psychological distress, and posttraumatic stress disorder (PTSD). However, few studies have examined these comorbid conditions across distinct Asian ethnic groups-an important limitation given the differences in social, cultural, and behavioral drivers of mental health burdens within and across Asian ethnicities. To understand the disparities in mental health burdens among Asians living with a chronic health condition, we conducted a systematic literature review of relevant, peer-reviewed publication databases to identify studies reporting on mental health burdens (e.g., depression, anxiety, distress, PTSD) in distinct Asian ethnic groups in North America. Thirteen studies met the inclusion criteria for this review and collectively demonstrated a high burden of depression, psychological distress, and PTSD among Asians living with chronic conditions. Moreover, there were distinct disparities in mental health burdens across chronic conditions and across Asian ethnic groups. Despite the detrimental impact of poor mental health on chronic disease-specific outcomes, such as death and poor quality of life, few data exist that characterize mental health outcomes among Asian ethnicities living in North America with chronic conditions. Future work should prioritize estimating the national prevalence of mental health outcomes among adults with chronic conditions, by Asian ethnicities, to inform culturally tailored interventions to address this public health burden.
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  • 文章类型: Journal Article
    UNASSIGNED: The purpose of this study is to review racial and ethnic inequities in the incidence and prevention of healthcare-associated infections (HAIs) in the USA, identify gaps in the literature, and recommend future directions to mitigate these inequities.
    UNASSIGNED: While some existing literature has identified the presence of racial/ethnic inequities in HAI incidence and outcomes, few studies to date have evaluated whether HAI prevention efforts have mitigated these inequities. Factors contributing to inequities in HAI prevention may include unconscious bias of healthcare professionals towards minoritized patients; socioeconomic and structural inequities disparately affecting minoritized communities; the racial segregation of quality healthcare through hospital price discrimination; divergent reimbursement rates between public and private insurers; policies or performance metrics which underfund and financially penalize safety-net hospitals; and insufficient research evaluating and addressing HAI inequities.
    UNASSIGNED: Expansion of the literature is needed to further interrogate root causes and evaluate the impact of interventions on racial/ethnic inequities in HAI incidence. Measures to mitigate inequities might include teaching healthcare workers how to recognize and mitigate unconscious biases, expanding community resources which address the social and structural determinants of health, increasing access to preventive health services, reforming federal and institutional policies to better support safety-net hospitals and disincentivize price discrimination, and improving diversity and inclusion within the health workforce.
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  • 文章类型: Journal Article
    本文报告了对COVID-19向零售等重要行业工人传播风险的文献进行快速范围审查的结果,卫生保健,制造,农业,特别是工人在不稳定的就业和社会环境中的经历。
    遵循范围界定审查方法,我们纳入了30项研究,这些研究在方法论和理论方法上有所不同。搜索内容包括2020年3月至9月发表的同行评审文章和灰色文献。
    根据所审查的研究,我们发现COVID-19的感染率和死亡率不仅随着年龄和合并症的增加而增加,还有基于种族主义和性别歧视的歧视和结构不平等。种族和少数民族工人,包括农民工,集中在高风险职业中,这种集中与较低的社会经济条件相关。COVID-19大流行出现在职业健康和安全的聚光灯下,加剧了已经存在的社会经济不平等和健康方面的社会不平等,特别是考虑到与种族主义有关的问题的交集,少数民族地位,和性别歧视。
    这篇综述提供了有关机构对大流行反应的局限性的早期证据,以及他们为所有工人提供安全和体面的工作环境的能力,无论他们的就业状况或他们在正常情况下可能享有的社会保护。在大流行后的背景下思考这些问题也很重要,当不稳定和脆弱的条件持续存在并可能恶化时。
    This article reports the results of a rapid scoping review of the literature on COVID-19 transmission risk to workers in essential sectors such as retail, health care, manufacturing, and agriculture, and more particularly the experiences of workers in precarious employment and social situations.
    Following scoping review methods, we included 30 studies that varied in terms of methodology and theoretical approaches. The search included peer-reviewed articles and grey literature published between March and September 2020.
    Based on the studies reviewed, we found that COVID-19 infection and death rates increased not only with age and comorbidities, but also with discrimination and structural inequities based on racism and sexism. Racial and ethnic minority workers, including migrant workers, are concentrated in high-risk occupations and this concentration is correlated to lower socioeconomic conditions. The COVID-19 pandemic appears in the occupational health and safety spotlight as an exacerbator of already existing socioeconomic inequalities and social inequalities in health, especially in light of the intersection of issues related to racism, ethnic minority status, and sexism.
    This review provides early evidence about the limitations of institutions\' responses to the pandemic, and their capacity to provide a safe and decent working environment for all workers, regardless of their employment status or the social protections they may enjoy under normal circumstances. It is also important to think about these issues in the postpandemic context, when conditions of precariousness and vulnerability persist and possibly worsen.
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  • 文章类型: Journal Article
    BACKGROUND: There is a growing body of evidence on racial and ethnic disparities within traumatic brain injury (TBI) care. The aim of this paper was to conduct a narrative review of the literature, demonstrating how racial and ethnic disparities manifest across the full spectrum of the TBI experience in civilian populations: injury, acute care and diagnosis, post-TBI recovery and adjustment, and long-term outcomes.
    METHODS: We searched five electronic databases (Scopus, APA PsychNet, PubMed/MEDLINE, and Google Scholar) using the search terms traumatic brain injury, head trauma, concussion, health disparities, ethnic minority, racial minority, race ethnicity, racial ethnic, prevalence, incidence, diagnosis, rehabilitation, recovery, and outcomes. Boolean search modifiers AND, NOT, and OR were used to produce relevant results. Additional resources were included by the authors, as deemed relevant to the investigation.
    RESULTS: Our narrative review of 39 articles elucidated numerous ways in which racial and ethnic disparities span the TBI continuum of care, including acute care and diagnosis, post-TBI recovery and adjustment, and long-term outcomes.
    CONCLUSIONS: Understanding racial and ethnic disparities is a first step in ensuring equitable care for all individuals with TBI, including raising awareness among clinicians and guiding the development of tailored interventions for racial and ethnic minority populations.
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  • 文章类型: Journal Article
    尽管在确保卫生公平方面取得了显著成就,睡眠中的种族/族裔差异仍然存在,并正在成为一个令人关注的主要领域。从广泛的角度来看,积累的证据尚未得到很好的表征。我们对按种族/民族划分的睡眠差异研究进行了范围审查,以总结现有研究的特征并确定证据差距。
    我们搜索了PubMed,CINAHL,PsycINFO,和WebofScience数据库,用于研究睡眠中的种族/民族差异。根据研究设计,以数据图表形式检索并组织符合纳入标准的研究,睡眠测量方法,睡眠特征,和种族/民族比较。
    这篇综述包括116项研究。大多数研究集中在白人和黑人之间的差异。不成比例的研究检查了西班牙裔的差异,亚洲人,和其他种族/族裔群体。自我报告的睡眠是最常用的。睡眠时间,整体睡眠质量,经常研究睡眠呼吸紊乱,而其他功能包括睡眠效率,延迟,连续性,对建筑的研究不足,特别是在美国的少数族裔群体中。当前关于大多数睡眠特征中种族/族裔差异的研究结果是混合且无定论的。
    这篇综述发现了关于睡眠的种族/民族差异研究中的重要证据差距。我们的结果表明,需要进行更多的研究,使用标准化和稳健的测量方法来检查不同的睡眠特征,以更有效地比较不同种族/种族群体的睡眠健康状况。
    Despite remarkable achievements in ensuring health equity, racial/ethnic disparities in sleep still persist and are emerging as a major area of concern. Accumulating evidence has not yet been well characterized from a broad perspective. We conducted a scoping review of studies on sleep disparities by race/ethnicity to summarize characteristics of existing studies and identify evidence gaps.
    We searched PubMed, CINAHL, PsycINFO, and Web of Science databases for studies of racial/ethnic disparities in sleep. Studies that met inclusion criteria were retrieved and organized in a data charting form by study design, sleep measuring methods, sleep features, and racial/ethnic comparisons.
    One hundred sixteen studies were included in this review. Most studies focused on disparities between Whites and Blacks. Disproportionately fewer studies examined disparities for Hispanic, Asian, and other racial/ethnic groups. Self-reported sleep was most frequently used. Sleep duration, overall sleep quality, and sleep disordered breathing were frequently studied, whereas other features including sleep efficiency, latency, continuity, and architecture were understudied, particularly in racial minority groups in the US. Current study findings on racial/ethnic disparities in most of sleep features is mixed and inconclusive.
    This review identified significant evidence gaps in racial/ethnic disparities research on sleep. Our results suggest a need for more studies examining diverse sleep features using standardized and robust measuring methods for more valid comparisons of sleep health in diverse race/ethnicity groups.
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  • 文章类型: Journal Article
    目的:社会经济地位(SES)长期以来一直被认为是结核病(TB)分布的关键决定因素,长期以来,社会因素的作用一直是结核病流行病学的真理。我们回顾了过去20年来美国结核病社会决定因素的研究。我们特别关注这些研究的结果如何符合根本原因理论的框架,并认为与根本原因理论更明确的联系对于理解美国结核病健康差异的现状和为美国结核病消除的途径至关重要。
    我们的综述发现,尽管在过去的20年中,有研究记录了美国社会因素与结核病之间的持续关联,很少有研究探讨社会因素继续影响结核病模式的确切机制。我们主张在理论发展和分析方面都朝着基于系统的方法迈进,允许结合更复杂的社会动态来解决结核病的长期差异。
    OBJECTIVE: Socioeconomic status (SES) has long been understood to be a key determinant of the distribution of tuberculosis (TB), and the role of social factors has long been a truism of TB epidemiology. We review studies that have examined the social determinants of TB in the USA in the past 20 years. We pay particular attention to how the findings of these studies fit within the framework of fundamental cause theory and argue that a more explicit linkage with fundamental cause theory is critical for understanding the current state of TB health disparities in the USA and for charting a way towards TB elimination in the USA.
    UNASSIGNED: Our review finds that while in the past 20 years there have been studies that have documented the ongoing association between social factors and TB disease in the USA, few studies explore the precise mechanisms through which social factors continue to influence TB patterns. We advocate for a move towards a system-based approach both in theory development and analyses, allowing for the incorporation of more complex social dynamics to address long-standing disparities in TB disease.
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  • 文章类型: Journal Article
    哮喘是儿童时期最常见的慢性疾病,也是儿童发病的主要原因,急诊部门的访问,和住院。多种因素在发展中发挥作用,儿童哮喘的治疗和预防,包括种族/族裔和社会经济差异,家庭和学校环境,和药物使用。本综述的目的是总结学龄儿童哮喘的这些方面,并提出与治疗策略相关的最新药物综述,这将有助于这些儿童的护理。我们得出的结论是,表型异质性以及适当的环境评估和干预措施是儿童哮喘管理中的重要考虑因素。
    Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity as measured by school absences, emergency department visits, and hospitalizations. Multiple factors play a role in the development, treatment and prevention of childhood asthma including racial/ethnic and socioeconomic disparities, both the home and school environments, and medication use. The goals of this review are to summarize these aspects of asthma in school-aged children and to present an updated review of medications as it relates to treatment strategies that will help in the care of these children. We conclude that phenotypic heterogeneity and appropriate environmental assessments and interventions are important considerations in the management of childhood asthma.
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