Determinants of racial/ethnic differences in blood pressure management among hypertensive patients

Background

Prior literature has shown that racial/ethnic minorities with hypertension may receive less aggressive treatment for their high blood pressure. However, to date there are few data available regarding the confounders of racial/ethnic disparities in the intensity of hypertension treatment.

Methods

We reviewed the medical records of 1,205 patients who had a minimum of two hypertension-related outpatient visits to 12 general internal medicine clinics during 7/1/01-6/30/02. Using logistic regression, we determined the odds of having therapy intensified by patient race/ethnicity after adjustment for clinical characteristics.

Results

Blacks (81.9%) and Whites (80.3%) were more likely than Latinos (71.5%) to have therapy intensified (P = 0.03). After adjustment for racial differences in the number of outpatient visits and presence of diabetes, there were no racial differences in rates of intensification.

Conclusion

We found that racial/ethnic differences in therapy intensification were largely accounted for by differences in frequency of clinic visits and in the prevalence of diabetes. Given the higher rates of diabetes and hypertension related mortality among Hispanics in the U.S., future interventions to reduce disparities in cardiovascular outcomes should increase physician awareness of the need to intensify drug therapy more agressively in patients without waiting for multiple clinic visits, and should remind providers to treat hypertension more aggressively among diabetic patients.     

Topographic pattern of the rearrangement of the dystrophin gene in Japanese Duchenne muscular dystrophy

To compare the frequency and distribution of rearrangements in the dystrophin gene in Duchenne muscular dystrophy (DMD) between Japanese DMD patients and those in North America and Europe, Southern blot analyses of the dystrophin gene were carried out in 88 probands classified as DMD. Gene rearrangements were found in 61 (69%) subjects, and they were composed of partial gene deletions in 53 (60%) probands and partial duplications in 7 (8%) probands. A total deletion of the gene was found in 1 (1%) patient. Among 53 patients with deletions, 34 (64%) had breakpoints between introns 44 and 52 and 7 (13%) had breakpoints between introns 2 and 11. Both the frequency and the distribution of gene rearrangements found in this study were similar to those reported in North America and Europe. These data suggest that there are no ethnic or racial differences in the frequency and distribution of rearrangements thought to be caused by similar mechanisms in the dystrophin gene in all human racial groupings.     

Gendered measures,gendered models: toward an intersectional analysis of interpersonal racial discrimination

In this paper we draw from black and multiracial feminist theories to argue that interpersonal racial discrimination should be understood as a potentially gendered phenomenon. While there are some discriminatory practices that are directed at both black men and black women, some forms of racial discrimination affect men more than women, and some affect women more than men. Still other forms may be gender-specific. Our review of existing literature shows that most survey research has utilized measures and models of racial discrimination that fail to account for these gender differences. Drawing on the 2001–2003 National Survey of American Life (NSAL) we demonstrate the importance of gender for understanding and analysing interpersonal racial discrimination. We offer concrete ways for social researchers to centralize gender in their analyses. By doing so, we hope to advance the development of an intersectional approach to racial discrimination.     

Colloquium on the role and behavior of sex chromosomes in mammalian development and reproduction: Basel,May 6–8, 1965

Abstract

There are significant mortality disparities across racial and socioeconomic (SES) groups. Although the mechanisms behind these disparities remain vague, there is a clear connection between the mortality disparities across racial and SES groups. It is less clear, though, if the relationship between SES and racial mortality disparities varies across the life course. Prior research indicates that both racial and SES mortality disparities decline over the life course. These results suggest that if we standardize mortality rates for age‐variation in the SES‐mortality relationship, then the age‐pattern of racial mortality disparities will be attenuated. Using data from the National Longitudinal Mortality Study, I analyze the relationship between SES and racial disparities in age‐specific mortality among adults aged 25 and over. The results suggest that racial differences in SES are most important early in the adult life, and are minimally related to the convergence in racial mortality disparities at the oldest ages.     

Racial/ethnic differences in post-migration education among adult immigrants in the USA

Despite the extensive scholarly interest in racial/ethnic differences in education among immigrants in the USA, limited research has examined the determinants of racial/ethnic gaps in post-migration adult education. Most immigrants, however, move to the USA as young adults, when education is decisive in shaping their incorporation. We use the National Household Education Survey (NHES) to examine whether pre-migration human capital and post-migration socio-economic circumstances can account for racial/ethnic differences in post-migration schooling. The results reveal that Latino/a immigrants are less likely than white and Asian immigrants to attend advanced and career-related educational programmes, but they seek general education more than Asians. These differences can be explained by racial/ethnic disparities in pre-migration human capital and post-migration employment, with pre-migration education and language training being particularly important. We conclude that education has a tendency to reproduce class structures across borders, and that social policy should counteract these cumulative disadvantage processes.     

Ethnic differences in atherosclerosis, cardiovascular disease and lipid metabolism

PURPOSE OF REVIEW: Comparison of risk factors and cardiovascular disease among racial and ethnic groups is a powerful approach to study genetics and lifestyle, or environmental interactions. RECENT FINDINGS: Most, mean or median, cardiovascular risk factor levels are similar among black and white people. There are much greater differences in the distribution of risk factor level within a specific race and ethnic group than between US populations. There are also very large differences in levels of risk factors for coronary heart disease between specific ethnic migrant populations such as comparing black people in Africa with those in the US, or Japanese people in Japan with those in Hawaii and California. Differences in distribution of risk factors and disease between race and ethnic group are a function of the frequency of specific genotypes and interaction with environmental factors. Several of the most important differences between racial groups are higher blood pressure, lower triglycerides and higher HDL cholesterol among blacks, higher prevalence of diabetes and insulin resistance among Mexican Americans and American Indians, and higher triglyceride levels among the Japanese. SUMMARY: Further studies of racial and ethnic differences should focus on unique phenotypes and genotypic differences, international and migrant studies and large enough sample sizes to provide robust results. The sprinkling of a percentage of minority participants in each study is worthless. The study of racial and ethnic differences in disease and detection of risk factor levels must be based on solid hypotheses that can evaluate the interaction of lifestyle and possible genetic attributes. Many of the reported ethnic differences in risk factors and disease in US populations are primarily a function of differences in education, socioeconomic variations, and utilization of preventive and clinical treatments.     

Human chromosomal heteromorphisms in american blacks

Summary One hundred normal American Blacks (B) were studied by sequential QFQ and RFA banding techniques in order to estimate the type and frequency of heteromorphisms. Color heteromorphisms were classified into one of six colors by RFA and intensity variation into one of five levels by QFQ. The data are compared with a previously studied Caucasian population (C). The frequencies of QFQ and RFA heteromorphisms were significantly higher in the Black than in the Caucasian population. No racial difference was noted for chromosome 21 by QFQ, while RFA demonstrated a clear difference. It is concluded that the maximum characterization of racial differences of human chromosomal heteromorphisms was far greater by RFA than with QFQ. The present study suggests differences in QFQ and RFA heteromorphisms among the two races.     

Dermatoglyphic configurations of proximal and middle phalanges in Spaniards

In this paper the dermatoglyphic configurations of proximal and middle phalanges in Spaniards have been analysed. From the data of 112 males and 135 females it is seen that on proximal phalanges the highest frequencies correspond to basic types and enclosures. On the contrary, the middle phalanges are displaying an enlarged frequency distribution. On both phalanges no significant sexual and bimanual differences were found. The hitherto reported population data do not permit to claim clear differences among the main racial groups.     

A population genetic study of cleft chin in India

The paper reports data on cleft chin in 900 individuals from Kerala. The results of all surveys in India in which the cleft chin was observed have been tabulated. Gene frequency analysis has been attempted. Wide variations in gene frequencies were found for the gene cl. The major racial groups in India tend to follow definite trends. The trait varies from dimples to furrows, and is independent of age but reveals sex differences. A plea is made to collect more family, twin and population data.     

Race, ethnicity, and health: can genetics explain disparities?

Over the past decade, numerous studies have documented profound racial and ethnic disparities in disease in the United States. This essay examines how popular and scientific concepts of race and ethnicity converge with dominant understandings of genetics to inform the design and interpretation of research, public health policy, and medical practice. Although there is some acknowledgment in the biomedical community that racial and ethnic categories are social and not genetic, ideas about race and ethnicity that circulate in biomedicine are contradictory. Thus, in practice genetic explanations for observed differences are common both in the scientific literature and in popular media accounts of biomedical research. Such explanations naturalize racial and ethnic difference and create a conceptual barrier to developing a research program that explores the complex ways in which social inequality and experiences of racial discrimination interact with human biology to influence patterns of disease. Importantly, genetically based ideas lead to disease prevention policies that are bound to be ineffective.     

Investigating the Relationship between Socially-Assigned Ethnicity,Racial Discrimination and Health Advantage in New Zealand

Background

While evidence of the contribution of racial discrimination to ethnic health disparities has increased significantly, there has been less research examining relationships between ascribed racial/ethnic categories and health. It has been hypothesized that in racially-stratified societies being assigned as belonging to the dominant racial/ethnic group may be associated with health advantage. This study aimed to investigate associations between socially-assigned ethnicity, self-identified ethnicity, and health, and to consider the role of self-reported experience of racial discrimination in any relationships between socially-assigned ethnicity and health.

Methods

The study used data from the 2006/07 New Zealand Health Survey (n = 12,488), a nationally representative cross-sectional survey of adults 15 years and over. Racial discrimination was measured as reported individual-level experiences across five domains. Health outcome measures examined were self-reported general health and psychological distress.

Results

The study identified varying levels of agreement between participants'' self-identified and socially-assigned ethnicities. Individuals who reported both self-identifying and being socially-assigned as always belonging to the dominant European grouping tended to have more socioeconomic advantage and experience less racial discrimination. This group also had the highest odds of reporting optimal self-rated health and lower mean levels of psychological distress. These differences were attenuated in models adjusting for socioeconomic measures and individual-level racial discrimination.

Conclusions

The results suggest health advantage accrues to individuals who self-identify and are socially-assigned as belonging to the dominant European ethnic grouping in New Zealand, operating in part through socioeconomic advantage and lower exposure to individual-level racial discrimination. This is consistent with the broader evidence of the negative impacts of racism on health and ethnic inequalities that result from the inequitable distribution of health determinants, the harm and chronic stress linked to experiences of racial discrimination, and via the processes and consequences of racialization at a societal level.     

Decomposing racial differences in adolescent smoking in the U.S.

Despite declining smoking rates in the U.S., a substantial fraction of adolescents still smoke. In addition, there are notable racial differences in adolescent smoking. We use Add Health data and apply a nonlinear decomposition method to determine the extent to which racial differences in observable characteristics account for (i) the racial smoking gaps in adolescent smoking (ages 12–18) and (ii) racial gaps in the probability of becoming a smoker in young adulthood (ages 18–24), conditional on being a non-smoker in adolescence. The model includes a host of explanatory factors, including individual, family socioeconomics, smoke exposure, school characteristics, and county crime rate. Of the 19 (9) percentage-point gap in white-black (white-Hispanic) smoking in adolescence, these factors together account for 22–28% (39–77%) of the smoking gap; and of the 18 (13) percentage-point gap in white-black (white-Hispanic) smoking up-take in young adulthood, these factors together account for 26–50% (48–100%) of the gap, depending on which set of coefficients are used for the decomposition. The biggest drivers of racial smoking gaps in adolescence are differences in friends’ smoking and school peer smoking, while only school peer smoking contributes to the explained portion of racial gaps in smoking up-take in young adulthood.     

Fingerprint quantitative variation and asymmetry in Brazilian Whites and Blacks

A total of 432 Whites and 654 Blacks were studied in relation to the index of pattern intensity and a smaller number (296 Whites; 496 Blacks) for total ridge count. There does not exist a clear gradient in either sex when the Blacks are subdivided into three phenotypic categories according to the amount of African ancestry they seem to possess. The standard deviations and coefficients of variation are strikingly similar in all groups studied. Racial differences in the averages of these two quantitative measures and in the asymmetry of total ridge count are small and nonsignificant. Fingerprints are very sensitive indicators of disturbances in the intrauterine development, and their asymmetry has a significant hereditary component. Since there is no increased or decreased asymmetry when we consider subgroups with various amounts of racial admixture, these and other results suggest that genetic adaptation in humans is a process involving mainly the whole species, and not narrow racial specializations.     

Racial equality in France and the United States: media coverage of professional tennis players

I engage debates about racial media bias by analysing newspaper coverage of professional tennis players in France and the United States. Tennis is an elite sport that typically does not have many non-white players and may be especially sensitive to racial boundaries. Tennis also offers a new solution to the methodological challenge of establishing that any difference in newspaper coverage across racial groups is due to bias and not actual differences across the groups. I use the professional tennis ranking system, which assigns an objective marker of how good a player is (and therefore the media coverage that s/he should receive) at any point in time. I explore two types of bias (the amount and tone of media coverage) and uncover no systematic racial differences in the relationship between ranking and media coverage. My findings have several implications for our understanding of racial boundaries and the media.     

The A-B-O blood groups of baboons

A new series of 188 baboons, Papio papio, Senegal, have been tested for the human type A-B-O groups with the following results: 2 group O, 27 group A, 93 group B and 66 group AB. This distribution fits the Hardy-Weinberg formula perfectly, using the allele frequencies O = 10.3%, A = 29.0%, and B = 60.8%. Up to date, five series of baboons comprising a total of 684 animals have been tested for their A-B-O groups. On these 684 baboons, from three different species, only three belonged to group O. Nevertheless, there is convincing indirect evidence that in most of the baboon species tested so far the frequency of gene O is about 10%. There are significant differences in the distribution of the blood groups in the various baboon species, comparable to the differences in racial distribution of the A-B-O blood groups in man, e.g., the frequency of gene A ranges from 18.2% in Papio ursinus, South Africa, to 48.3% in Papio cynocephalus. The usefulness of the methods of population genetics, viz, allele frequency analysis, for studies of blood groups in primates is demonstrated. The differences and similarities between the A-B-O blood groups in man and baboons are discussed.     

The colour line and the colour scale in the twentieth century

Some more recent evidence supports Du Bois’ prediction that the twentieth century would prove the century of the colour line. It indicates that men have always and everywhere shown a preference for fair complexioned women as sexual partners, whereas males seeking a mate are rarely disadvantaged by a dark complexion. In the employment market in the USA, a dark complexion is a significant disadvantage for both males and females. Though there is no properly comparable evidence from other countries, there appears to be a widespread tendency for any negative valuation of darker skin colour to be incorporated into a scale of socio-economic status. In some situations a colour scale is replacing the colour line.

Du Bois’ reference to differences of colour has been largely superseded in English-speaking countries by references to differences of race. From a policy standpoint, the switch from colour to race has had both positive and negative consequences. From a sociological standpoint, it has made it more difficult to disaggregate the dimensions of social difference and to dispel the confusions engendered by ideas of racial difference.     

Skinfold thicknesses in a national probability sample of U.S. males and females aged 6 through 17 years

Cycles II and III of the Health Examination Survey included measurements of the skinfolds of over 14,000 individuals 6 through 17 years of age, statistically weighted to provide an accurate national probability sample. Analyses of the triceps and subscapular skinfolds of Negroes and whites are reported here, utilizing the median in preference to the mean. Females of either racial group have thicker skinfolds at all ages studied. Whites have greater median triceps thicknesses than Negroes of the same sex and age, but there are no differences between the two racial groups in the subscapular. Since, between all but one pair of adjacent ages in males, from 12 years on, the median triceps fold decreases, but the estimated cross-sectional are of fat increases, it is strongly recommended that reductions in triceps thickness not be automatically interpreted as meaning a loss of subcutaneous fat. Since greater skewness is found in the subscapular distributions in whites, but not in the triceps, it is suggested that racial differences in triceps thickness at these ages occurs from the operation of hereditary factors, while differences in the subscapular skinfold arise from environmental causes.     

Construction of a nasopharyngeal carcinoma 2D/MS repository with Open Source XML Database – Xindice

Background  

Many proteomics initiatives require integration of all information with uniformcriteria from collection of samples and data display to publication of experimental results. The integration and exchanging of these data of different formats and structure imposes a great challenge to us. The XML technology presents a promise in handling this task due to its simplicity and flexibility. Nasopharyngeal carcinoma (NPC) is one of the most common cancers in southern China and Southeast Asia, which has marked geographic and racial differences in incidence. Although there are some cancer proteome databases now, there is still no NPC proteome database.