Ethnic disparities in care following acute coronary syndromes among Asian Americans and Pacific Islanders during the initial hospitalization.

Despite the fact that Asian Americans and Pacific Islanders are the fastest growing minority population in the United States, little is known about their treatment patterns and outcomes, particularly for Asian American and Pacific Islander sub-groups. Multivariable logistic regression was used to compare differences in revascularization and mortality rates following acute coronary syndromes among Asian American and Pacific Islander sub-groups [Japanese (n = 1342), Chinese (n = 249), Filipino (n = 314), Native Hawaiian (n = 361)) and Caucasians (n = 569)] during the initial hospitalization using administrative (claims) data from 1997 to 1999. Analyses were stratified by gender and controlled for age, diabetes mellitus, congestive heart failure, acute myocardial infarction, ACG morbidity level and system of care. We found that the type of procedures received during the initial hospitalization differed according to patient ethnicity for male patients but not for female ones. Compared to Caucasians, male Asian Amercian and Pacific Islanders patients were less likely to undergo percutaneous coronary interventions and more likely to undergo coronary artery bypass graft surgery. In the future, a more comprehensive outcomes study is needed, to examine the impact of any interethnic differences in revascularization rates on intermediate and long-term mortality, patient satisfaction, and self-reported functioning and well-being. The trend toward higher mortality following acute coronary syndromes among Asian Americans and Pacific Islander males emphasizes the importance of such a study.     

Cognitive differences in dream content between Argentine males and females using quantitative content analysis.

This study asked the question, "Are there significant content differences between male and female dream reports obtained in seminars conducted in Argentina?" Each of the 100 female and 100 male participants contributed one recent dream report during dream seminars held in Argentina between 1990 and 1998. Dream reports were scored using Hall and Van de Castle's System of Content Analysis. Major findings revealed that Argentine males reported significantly more aggressions per character and a higher percentage of dreamers as the aggressor than reported by females. They also reported more dreams with at least one success than reported by females. In contrast, females scored significantly higher on both the Self-Negativity index and the Negative Emotions index compared to males. Although some findings were similar to past studies using American participants, others were unique to this study and may be attributable to the particular sample used, or may suggest actual underlying cultural patterns of contemporary Argentine men and women. Results are discussed in terms of Hall's continuity hypothesis and Domhoff's cognitive model of dreaming. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Larger Amounts of Visceral Adipose Tissue in Asian Americans

Objective: Excess visceral adipose tissue (VAT) is recognized as an important risk factor for the development of coronary heart disease and type 2 diabetes. Several studies have reported less VAT in African Americans compared with whites. As little is known about the levels of VAT in Asians, we compared whole‐body VAT in Asian Americans with European Americans. Research Methods and Procedures: VAT was measured using whole‐body multislice magnetic resonance imaging in 54 women (18 Asian Americans, 36 European Americans) and 53 men (19 Asian Americans, 34 European Americans) with body mass index (measured in kilograms per square meter) < 30. Data were analyzed by multiple regression modeling. Results: Asian American women had higher log‐transformed VAT compared with European American women (p < 0.05), after adjusting for age and total body fat. There was a significant age by race interaction such that race differences in VAT were most evident over the age of 30 years. No differences in VAT could be detected between Asian American and European American men, even after adjusting for potential covariates, including total adiposity. %Discussion: These data are the first to demonstrate higher amounts of VAT in healthy Asian Americans, a finding that suggests normative VAT values or standards derived from whites may not be applicable to Asians.     

More than black and white: differences in predictors of obesity among Native Hawaiian/Pacific Islanders and European Americans

Although Native Hawaiians and Pacific Islanders exhibit the highest rates of obesity and associated chronic diseases of any racial/ethnic group, they remain vastly underrepresented in health research. In a cross-sectional survey of college students (N = 402) we examined BMI and health outcomes in an ethno-racially diverse rural sample of Native Hawaiian/Pacific Islanders (25.1%), Asian Americans (39.8%), and European Americans (35.1%). Measures assessed BMI, health status, health behaviors, frequency of exercise, and symptoms of psychiatric disorders (i.e., depression, anxiety, posttraumatic stress, and substance abuse and dependence). Regression analyses revealed that an overall model of five predictors (gender, race, regular exercise, difficulty sleeping, and anxiety) was significantly associated with obesity (P < 0.001) and correctly classified 84.2% of cases. A 30.7% of Native Hawaiians/Pacific Islanders were obese as compared with 9.2% of European Americans and 10.6% of Asian Americans. These findings suggest that Native Hawaiian/ Pacific Islanders are at high risk for obesity and associated medical comorbidities, but that regular physical activity may ameliorate this risk. Further, these results support the consideration of Native Hawaiians/Pacific Islanders as a distinct racial/ethnic subgroup separate from other Asian populations.     

Genetic determinants of lipid traits in diverse populations from the population architecture using genomics and epidemiology (PAGE) study

For the past five years, genome-wide association studies (GWAS) have identified hundreds of common variants associated with human diseases and traits, including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) levels. Approximately 95 loci associated with lipid levels have been identified primarily among populations of European ancestry. The Population Architecture using Genomics and Epidemiology (PAGE) study was established in 2008 to characterize GWAS-identified variants in diverse population-based studies. We genotyped 49 GWAS-identified SNPs associated with one or more lipid traits in at least two PAGE studies and across six racial/ethnic groups. We performed a meta-analysis testing for SNP associations with fasting HDL-C, LDL-C, and ln(TG) levels in self-identified European American (~20,000), African American (~9,000), American Indian (~6,000), Mexican American/Hispanic (~2,500), Japanese/East Asian (~690), and Pacific Islander/Native Hawaiian (~175) adults, regardless of lipid-lowering medication use. We replicated 55 of 60 (92%) SNP associations tested in European Americans at p<0.05. Despite sufficient power, we were unable to replicate ABCA1 rs4149268 and rs1883025, CETP rs1864163, and TTC39B rs471364 previously associated with HDL-C and MAFB rs6102059 previously associated with LDL-C. Based on significance (p<0.05) and consistent direction of effect, a majority of replicated genotype-phentoype associations for HDL-C, LDL-C, and ln(TG) in European Americans generalized to African Americans (48%, 61%, and 57%), American Indians (45%, 64%, and 77%), and Mexican Americans/Hispanics (57%, 56%, and 86%). Overall, 16 associations generalized across all three populations. For the associations that did not generalize, differences in effect sizes, allele frequencies, and linkage disequilibrium offer clues to the next generation of association studies for these traits.     

Polymorphism C3435T of the MDR1 gene in Central Americans and Spaniards

The human multidrug resistance gene (MDR1) encodes for P-glycoprotein (P-gp) which is a transmembrane transporter protein that acts as an efflux pump for a number of lypophilic compounds. It plays a protective role for cells against DNA damage. The wobble C3435T polymorphism at exon 26 has been associated with different expression levels and activity. Differences in allele frequency of the C3435T polymorphism have been demonstrated between distinct ethnic groups. In our study we examined these polymorphisms in 433 healthy individuals. From these, 229 were Central American mestizos from Nicaragua (n = 117) and El Salvador (n = 112) to be compared with a group of 204 North Spaniards, with the aim of detecting potential genotypic differences between these populations. The genotypes were determined by PCR-RFLP. The frequencies of the C allele were very similar among Central Americans (0.53) and Spaniards (0.52), which is consistent with the ethnic origin of Central American individuals (Amerindians and European Caucasians). In comparison to other previously studied populations, the C allele frequency in Central Americans was significantly lower than that found in African populations and higher than that observed in the Indian and Southwest Asian populations. These data may be relevant for dose recommendation of P-gp substrate drugs and also for studies of allele disease association in the Central American population.     

Mitochondrial DNA studies of Native Americans: Conceptions and misconceptions of the population prehistory of the Americas

A decade ago, the first reviews of the collective mitochondrial DNA (mtDNA) data from Native Americans concluded that the Americas were peopled through multiple migrations from different Asian populations beginning more than 30,000 years ago. 1 These reports confirmed multiple‐wave hypotheses suggested earlier by other sources and rejected the dominant Clovis‐first archeological paradigm. Consequently, it appeared that molecular biology had made a significant contribution to the study of American prehistory. As Cann 2 comments, the Americas held the greatest promise for genetics to help solve some of the mysteries of prehistoric populations. In particular, mtDNA appeared to offer real potential as a means of better understanding ancient population movements. A decade later, none of the early conclusions remain unequivocal. Nevertheless, in its maturity, the study of Native American mtDNA has produced a volume of reports that still illuminate the nature and timing of the first peopling and postcolonization population movements within the New World.     

Disentangling Signatures of Selection Before and After European Colonization in Latin Americans

Throughout human evolutionary history, large-scale migrations have led to intermixing (i.e., admixture) between previously separated human groups. Although classical and recent work have shown that studying admixture can yield novel historical insights, the extent to which this process contributed to adaptation remains underexplored. Here, we introduce a novel statistical model, specific to admixed populations, that identifies loci under selection while determining whether the selection likely occurred post-admixture or prior to admixture in one of the ancestral source populations. Through extensive simulations, we show that this method is able to detect selection, even in recently formed admixed populations, and to accurately differentiate between selection occurring in the ancestral or admixed population. We apply this method to genome-wide SNP data of ∼4,000 individuals in five admixed Latin American cohorts from Brazil, Chile, Colombia, Mexico, and Peru. Our approach replicates previous reports of selection in the human leukocyte antigen region that are consistent with selection post-admixture. We also report novel signals of selection in genomic regions spanning 47 genes, reinforcing many of these signals with an alternative, commonly used local-ancestry-inference approach. These signals include several genes involved in immunity, which may reflect responses to endemic pathogens of the Americas and to the challenge of infectious disease brought by European contact. In addition, some of the strongest signals inferred to be under selection in the Native American ancestral groups of modern Latin Americans overlap with genes implicated in energy metabolism phenotypes, plausibly reflecting adaptations to novel dietary sources available in the Americas.     

OPRM1 and EGFR contribute to skin pigmentation differences between Indigenous Americans and Europeans

Contemporary variation in skin pigmentation is the result of hundreds of thousands years of human evolution in new and changing environments. Previous studies have identified several genes involved in skin pigmentation differences among African, Asian, and European populations. However, none have examined skin pigmentation variation among Indigenous American populations, creating a critical gap in our understanding of skin pigmentation variation. This study investigates signatures of selection at 76 pigmentation candidate genes that may contribute to skin pigmentation differences between Indigenous Americans and Europeans. Analysis was performed on two samples of Indigenous Americans genotyped on genome-wide SNP arrays. Using four tests for natural selection--locus-specific branch length (LSBL), ratio of heterozygosities (lnRH), Tajima's D difference, and extended haplotype homozygosity (EHH)--we identified 14 selection-nominated candidate genes (SNCGs). SNPs in each of the SNCGs were tested for association with skin pigmentation in 515 admixed Indigenous American and European individuals from regions of the Americas with high ground-level ultraviolet radiation. In addition to SLC24A5 and SLC45A2, genes previously associated with European/non-European differences in skin pigmentation, OPRM1 and EGFR were associated with variation in skin pigmentation in New World populations for the first time.     

Mexican American ancestry-informative markers: examination of population structure and marker characteristics in European Americans, Mexican Americans, Amerindians and Asians

Markers with large differences in allele frequencies between ethnicities provide ancestry information that can be applied to genetic studies. We identified over 100 biallelic ancestry informative markers (AIMs) with large allele frequency differences between European Americans (EA) and Pima Amerindians from laboratory and database screens. For 35 of these markers, Mayan, Yavapai and Quechuan Amerindians were genotyped and compared with EA and Pima allele frequencies. Markers with large allele frequency differences between EA and one Amerindian tribe showed only small differences between the Amerindian tribes. Examination of structure in individuals demonstrated a clear separation of subjects of European from those of Amerindian ancestry, and similarity between individuals from disparate Amerindian populations. The AIMs demonstrated the variation in ancestral composition of individual Mexican Americans, providing evidence of applicability in admixture mapping and in controlling for structure in association tests. In addition, a high percentage of single-nucleotide polymorphisms (SNPs) selected on the basis of large frequency differences between EA and Asian populations had large allele frequency differences between EA and Amerindians, suggesting an efficient method for greatly expanding AIMs for use in admixture mapping/structure analysis in Mexican Americans. Together, these data provide additional support for the practical application of admixture mapping in the Mexican American population.Electronic Supplementary Material Supplementary material is available in the online version of this article at     

A Discourse of Relationships in Bioethics: Patient Autonomy and End-of-Life Decision Making among Elderly Korean Americans

A two-year, multidisciplinary study (N = 800) was conducted on attitudes about end-of-life decision making among elderly individuals in four ethnic groups (African American, European American, Korean American, and Mexican American). On a quantitative survey, Korean Americans reported negative attitudes about the use of life-sustaining technology for themselves but positive attitudes about its use in general. This article reports on an interview with a 79-year-old typical Korean American respondent to explain the contradiction in the survey data. Expectations among elderly Korean Americans include protecting family members with a life-threatening illness from being informed of their diagnosis and prognosis, and doing everything to keep them alive. Two conclusions, one substantive and the other methodological, are drawn: First, the bioethics discourse on individual rights (patientautonomy) is insufficient to explain the preferences of many Korean Americans and must be supplemented with a discourse on relationships. Second, the rigorous use of qualitative, narrative methods clarifies quantitative data and should not be dismissed as "anecdotal." fbioethics, endoflife decision making, ethnicity, Asian Americans, qualitative methods, narrative]     

‘I'm American,not Japanese!’: the struggle for racial citizenship among later-generation Japanese Americans

Abstract

As one of the oldest Asian American groups in the USA, most Japanese Americans are of the third and fourth generations and have become well integrated in mainstream American society. However, they are still racialized as foreigners simply because of their Asian appearance. Their Asian phenotype continues to have a foreigner connotation because of large-scale immigration from Asia and an American national identity that is racially defined as white. This paper analyses how later-generation Japanese Americans are racialized as outsiders in their daily interaction with mainstream Americans, which is often accompanied by essentialized assumptions that they are also culturally foreign. In response, they engage in everyday struggles for racial citizenship by demanding inclusion in the national community as Americans despite their racial differences. It is uncertain whether such attempts to contest their racialization will cause current mono-racial notions of American identity to be reconsidered in more inclusive and multiracial ways.     

Three novel mtDNA restriction site polymorphisms allow exploration of population affinities of African Americans

To develop informative tools for the study of population affinities in African Americans, we sequenced the hypervariable segments I and II (HVS I and HVS II) of mitochondrial DNA (mtDNA) from 96 Sierra Leoneans; European Americans; rural, Gullah-speaking African Americans; urban African Americans living in Charleston, South Carolina; and Jamaicans. We identified single nucleotide polymorphisms (SNPs) exhibiting ethnic affinities, and developed restriction endonuclease tools to screen these SNPs. Here we show that three HVS restriction site polymorphisms (RSPs), EcoRV, FokI, and MfeI, exhibit appreciable differences in frequency (average delta = 0.4165) between putative African American parental populations (i.e., extant Africans living in Sierra Leone and European Americans). Estimates of European American mtDNA admixture, calculated from haplotypes composed of these three novel RSPs, show a cline of increasing admixture from Gullah-speaking African American (m = 0.0300) to urban Charleston African American (m = 0.0689) to West Coast African American (m = 0.1769) populations. This haplotype admixture in the Gullahs is the lowest recorded to date among African Americans, consistent with previous studies using autosomal markers. These RSPs may become valuable new tools in the study of ancestral affinities and admixture dynamics of African Americans.     

Beyond Socioeconomics: Explaining Ethnic Group Differences in Parenting Through Cultural and Immigration Processes

This study examined both socioeconomic and cultural factors in explaining ethnic differences in monitoring, behavioral control, and warmth—part of a series of coordinated studies presented in this special issue. Socioeconomic variables included mother's and father's educational levels, employment status, home ownership, number of siblings in the household, and single parent status. Cultural factors included nationality or ethnicity, immigrant status of child, mother's/father's age of arrival in the United States, mother's/father's English language use with the child, child's native fluency, and cultural values for independence and interdependence. The sample consisted of 591 European American, 123 African American, 1,614 Asian American, and 597 Latino students in the ninth grade. All the ethnic minority groups were higher than European Americans on behavioral control, and Latinos were also higher than European Americans on monitoring. However, European Americans were higher on parental warmth than Asian Americans and African Americans. These ethnic group differences primarily remained even after controlling for the socioeconomic factors. Finally, in analyses looking within the Asian and Latino groups, differences in parenting were found within both groups due to nationality or ethnicity, youth's fluency in the native language, and cultural values of interdependence, although values of independence were also related to the parenting of Asian Americans.     

Mortality and Potential Years of Life Lost Attributable to Alcohol Consumption by Race and Sex in the United States in 2005

Background

Alcohol has been linked to health disparities between races in the US; however, race-specific alcohol-attributable mortality has never been estimated. The objective of this article is to estimate premature mortality attributable to alcohol in the US in 2005, differentiated by race, age and sex for people 15 to 64 years of age.

Methods and Findings

Mortality attributable to alcohol was estimated based on alcohol-attributable fractions using indicators of exposure from the National Epidemiologic Survey on Alcohol and Related Conditions and risk relations from the Comparative Risk Assessment study. Consumption data were corrected for undercoverage (the observed underreporting of alcohol consumption when using survey as compared to sales data) using adult per capita consumption from WHO databases. Mortality data by cause of death were obtained from the US Department of Health and Human Services. For people 15 to 64 years of age in the US in 2005, alcohol was responsible for 55,974 deaths (46,461 for men; 9,513 for women) representing 9.0% of all deaths, and 1,288,700 PYLL (1,087,280 for men; 201,420 for women) representing 10.7% of all PYLL. Per 100,000 people, this represents 29 deaths (29 for White; 40 for Black; 82 for Native Americans; 6 for Asian/Pacific Islander) and 670 PYLL (673 for White; 808 for Black; 1,808 for Native American; 158 for Asian/Pacific Islander). Sensitivity analyses showed a lower but still substantial burden without adjusting for undercoverage.

Conclusions

The burden of mortality attributable to alcohol in the US is unequal among people of different races and between men and women. Racial differences in alcohol consumption and the resulting harms explain in part the observed disparities in the premature mortality burden between races, suggesting the need for interventions for specific subgroups of the population such as Native Americans.     

Gender Differences in the Content Analysis of 240 Dream Reports from Brazilian Participants in Dream Seminars

This study asked the question, “Are there significant content differences between male and female dream reports obtained in dream seminars conducted in Brazil?” Each of the 240 (137 female, 103 male) research participants volunteered recent dream reports (one per person) during dream seminars that he or she attended between 1990 and 1998. Dreams were scored according to Hall-Van de Castle criteria. Comparative Cohen h-statistics revealed several gender differences. Further study is recommended because the dream reports did not represent Brazil's social-economic diversity, and may not have been characteristic of the totality of participants' dream lives.     

The reigning misperception about culture and Asian American achievement

ABSTRACT

Asian Americans graduate from college at higher rates than other groups, and evince educational outcomes that match or exceed those of their parents. They comprise about 25 per cent of the student body in Ivy League institutions, despite making up only 6 per cent of the U.S. population. While it may be tempting to reduce Asian American academic achievement to Asian culture, and Confucian values more specifically, we provide disconfirming evidence, both within the United States and beyond, to show the fallacy of this logic. Contemporary U.S. Asian immigrants are “hyper-selected”: they are more likely to have graduated from college than their non-migrant counterparts, and also more likely to be college-educated than the U.S. mean. Hyper-selectivity and its spillover effects explain the exceptional educational outcomes of Asian Americans. It is time that we laid to rest the reigning misperception that Asian American academic achievement can be reduced to Asian culture or Confucian values.     

Forward to the past: race,the colour scale and Michael Banton

This study examined differences in religious participation and spirituality among African Americans, Caribbean blacks (black Caribbeans) and non-Hispanic whites. Data are taken from the National Survey of American Life, a nationally representative study of African Americans, black Caribbeans and non-Hispanic whites. Selected measures of organizational, non-organizational and subjective religious participation were examined. African American and Caribbean blacks were largely similar in their reports of religious involvement; both groups generally indicated higher levels of religious participation than non-Hispanic whites. African Americans were more likely than black Caribbeans to be official members of their places of worship, engage in activities (choirs, church clubs) at their place of worship and request prayer from others. Black Caribbeans reported reading religious materials more frequently than African Americans. The discussion notes the importance of examining ethnic differences within the black American population of the United States.     

Disability status differentials across fifteen Asian and Pacific Islander groups and the effect of nativity and duration of residence in the U.S

This study examines disparities in disability status across 15 Asian and Pacific Islander American (API) subpopulations and how nativity and duration in the U.S. influence these differences. Employing three disability questions (work limitations, mobility limitations, and self-care limitations) from the 1990 PUMS, the authors find substantial heterogeneity in disability status across API subgroups: while Japanese American adults have the most favorable outcomes, Other Southeast Asian adults (Laotians, Hmong, and Cambodians), followed by Vietnamese and Pacific Islander adults, suffer from a high risk of disabilities. Many of the disparities in disability status across API subpopulation adults are attributable to differentials in demographic characteristics and SES. The inclusion of an interaction term of age and nativity/duration of residence in the U.S. in multivariate regression analyses demonstrates that the effect of nativity/duration plays a different role across age, net of demographic, and SES risk factors. The overall findings are also consistent with previous studies on the relationship between immigrant health and nativity/duration. That is, immigrants with short duration in the U.S. have superior health status, measured by risk of disability, than longer-term immigrants and their U.S.-born counterparts.     

Expressions of Anxiety in African Americans: Ethnography and the Epidemiological Catchment Area Studies

High levels of anxiety have long been reported forAfrican Americans. Recent analyses of EpidemiologicalCatchment Area (ECA) data have failed to support this,although contemporary ethnographies have discussedimportant African American folk idioms of anxiety. This study compares ethnographically reported symptomsof anxiety in African Americans to those reported inthe ECA data. A multivariate analysis of femaleAfrican American and European American differences incomparable ECA and ethnographic symptoms wasperformed. Significant differences were found not inethnicity but in education levels. Alternativeinterpretations are discussed. Methodologicalproblems are discussed highlighting limitations ofboth household survey research, such as the ECAproject, and ethnography.