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Rezaee ME, Elias R, Li HL, Agrawal P, Pallauf M, Enikeev D, Ged Y, Eggener S, Singla N. Survival outcomes and molecular drivers of testicular cancer in hispanic men. Urol Oncol 2024; 42:293.e1-293.e7. [PMID: 38821727 DOI: 10.1016/j.urolonc.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/04/2024] [Accepted: 04/26/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVE To examine survival outcomes and molecular drivers in testis cancer among Hispanic men using a large national sample and molecular database. METHODS We reviewed the SEER registry for testicular cancer from 2000 to 2020. Cox proportional hazards models were used to examine the relationship between race/ethnicity and cancer-specific survival (CSS) by tumor type (seminoma vs. nonseminomatous germ cell tumors [NSGCT]). All models were adjusted for demographic, socioeconomic, and treatment variables. We accessed somatic mutations for testicular cancers through AACR Project GENIE v13.1 and compared mutational frequencies by ethnicity. RESULTS Our cohort consisted of 43,709 patients (23.3% Hispanic) with median follow-up 106 months (interquartile range: 45-172). Compared to Non-Hispanic Whites (NWH), Hispanics presented at a younger age but with more advanced disease. Hispanics experienced worse CSS for NSGCT (HR 1.7, 95% CI: 1.5-2.0, P < 0.01) but not seminoma. Somatic mutation data was available for 699 patients. KIT and KRAS mutations occurred in 24.2% and 16.9% of seminoma patients (n = 178), respectively. TP53 and KRAS mutations occurred in 12.1% and 7.9% of NSGCT patients (n = 521), respectively. No differences in mutational frequencies were observed between ethnic groups. There was significant heterogeneity in primary ancestral group for Hispanic patients with available data (n = 53); 14 (26.4%) patients had primary Native American ancestry and 30 (56.6%) had primary European ancestry. CONCLUSIONS Cancer-specific survival is worse for Hispanic men with non-seminoma of the testicle. Somatic mutation analysis suggests no differences by ethnicity, though genetic ancestry is heterogeneous among patients identifying as Hispanic.
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Affiliation(s)
- Michael E Rezaee
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Roy Elias
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Howard L Li
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Pranjal Agrawal
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Maximilian Pallauf
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Urology, University of Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Yasser Ged
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Nirmish Singla
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD.
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Ibanez A, Maito M, Botero-Rodríguez F, Fittipaldi S, Coronel C, Migeot J, Lacroix A, Lawlor B, Duran-Aniotz C, Baez S, Santamaria-Garcia H. Healthy aging meta-analyses and scoping review of risk factors across Latin America reveal large heterogeneity and weak predictive models. NATURE AGING 2024:10.1038/s43587-024-00648-6. [PMID: 38886210 DOI: 10.1038/s43587-024-00648-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 05/13/2024] [Indexed: 06/20/2024]
Abstract
Models of healthy aging are typically based on the United States and Europe and may not apply to diverse and heterogeneous populations. In this study, our objectives were to conduct a meta-analysis to assess risk factors of cognition and functional ability across aging populations in Latin America and a scoping review focusing on methodological procedures. Our study design included randomized controlled trials and cohort, case-control and cross-sectional studies using multiple databases, including MEDLINE, the Virtual Health Library and Web of Science. From an initial pool of 455 studies, our meta-analysis included 38 final studies (28 assessing cognition and 10 assessing functional ability, n = 146,000 participants). Our results revealed significant but heterogeneous effects for cognition (odds ratio (OR) = 1.20, P = 0.03, confidence interval (CI) = (1.0127, 1.42); heterogeneity: I2 = 92.1%, CI = (89.8%, 94%)) and functional ability (OR = 1.20, P = 0.01, CI = (1.04, 1.39); I2 = 93.1%, CI = (89.3%, 95.5%)). Specific risk factors had limited effects, especially on functional ability, with moderate impacts for demographics and mental health and marginal effects for health status and social determinants of health. Methodological issues, such as outliers, inter-country differences and publication bias, influenced the results. Overall, we highlight the specific profile of risk factors associated with healthy aging in Latin America. The heterogeneity in results and methodological approaches in studying healthy aging call for greater harmonization and further regional research to understand healthy aging in Latin America.
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Affiliation(s)
- Agustin Ibanez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile.
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA.
- University of Trinity Dublin, Dublin, Ireland.
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.
- Trinity College Dublin, Dublin, Ireland.
| | - Marcelo Maito
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Felipe Botero-Rodríguez
- PhD Program of Neuroscience, Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia
- Hospital Universitario San Ignacio, Center for Brain and Cognition, Intellectus, Bogotá, Colombia
- Fundación para la Ciencia, Innovación y Tecnología - Fucintec, Bogotá, Colombia
| | - Sol Fittipaldi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Trinity College Dublin, Dublin, Ireland
- Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Universidad de Valparaíso, Valparaíso, Chile
| | - Carlos Coronel
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA
- University of Trinity Dublin, Dublin, Ireland
| | - Joaquin Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Andrea Lacroix
- Herbert Wertheim School of Public Health and Human Longevity Science, Health Sciences Office of Faculty Affairs, University California, San Diego (UCSD), San Diego, CA, USA
| | - Brian Lawlor
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA
- University of Trinity Dublin, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Sandra Baez
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA
- University of Trinity Dublin, Dublin, Ireland
- Universidad de los Andes, Bogotá, Colombia
| | - Hernando Santamaria-Garcia
- PhD Program of Neuroscience, Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia.
- Hospital Universitario San Ignacio, Center for Brain and Cognition, Intellectus, Bogotá, Colombia.
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Hamilton FL, Pleasant V. Obstetrics and Gynecology Care in Latinx Communities. Obstet Gynecol Clin North Am 2024; 51:105-124. [PMID: 38267122 DOI: 10.1016/j.ogc.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
The Latinx community represents the largest racial minority population in the nation. There are significant barriers to care and treatment as it relates to obstetrics and gynecology. Understanding cultural considerations is essential to improving care in this community. Public health strategies as well as policies to address racial health disparities facing the Latinx community are explored in this article.
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Affiliation(s)
- Felicia L Hamilton
- Department of Obstetrics & Gynecology, OB/Gyn Practice Committee, MedStar Washington Hospital Center, Georgetown University Medical Center, 110 Irving Street, Northwest Room 5B-45A, Washington, DC 20010, USA.
| | - Versha Pleasant
- Department of Obstetrics and Gynecology, Cancer Genetics & Breast Health Clinic, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
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Nephew LD, Knapp SM, Mohamed KA, Ghabril M, Orman E, Patidar KR, Chalasani N, Desai AP. Trends in Racial and Ethnic Disparities in the Receipt of Lifesaving Procedures for Hospitalized Patients With Decompensated Cirrhosis in the US, 2009-2018. JAMA Netw Open 2023; 6:e2324539. [PMID: 37471085 PMCID: PMC10359964 DOI: 10.1001/jamanetworkopen.2023.24539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/04/2023] [Indexed: 07/21/2023] Open
Abstract
Importance Patients with decompensated cirrhosis are hospitalized for acute management with temporizing and lifesaving procedures. Published data to inform intervention development in this area are more than a decade old, and it is not clear whether there have been improvements in disparities in the receipt of these procedures over time. Objective To evaluate the associations of race and ethnicity with receipt of procedures to treat decompensated cirrhosis over time in the US. Design, Setting, and Participants This retrospective cross-sectional study analyzed National Inpatient Sample data on cirrhosis admissions among patients with portal hypertension-related complications from 2009 to 2018. All hospital discharges for individuals aged 18 years and older from 2009 to 2018 were assessed for inclusion. Admissions were included if they contained at least 1 cirrhosis-related International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code and at least 1 cirrhosis-related complication ICD-9-CM or ICD-10-CM code (ie, ascites, hepatic encephalopathy, variceal hemorrhage [VH], and hepatorenal syndrome [HRS]). Data were analyzed from January to June 2022. Exposure Hospitalization for decompensated cirrhosis. Main Outcomes and Measures The outcomes of interest were trends in the odds ratios (ORs) for receiving procedures (upper endoscopy, transjugular portosystemic shunt [TIPS], hemodialysis, and liver transplantation [LT]) for decompensated cirrhosis and mortality by race and ethnicity, modeled over time. Multivariable logistic regression was used to assess these outcomes. Results Among 717 580 admissions (median [IQR] age, 58 [52-67] years), 345 644 patients (9.8%) were Black, 623 991 patients (17.6%) were Hispanic, and 2 340 031 patients (47.4%) were White. Based on the modeled trends, by 2018, there were no significant differences by race or ethnicity in the odds of receiving upper endoscopy for VH. However, Black patients remained less likely than White patients to undergo TIPS for VH (OR, 0.54; 95% CI, 0.47-0.62) and ascites (OR, 0.34; 95% CI, 0.31-0.38). The disparity in receipt of LT improved for Black and Hispanic patients over the study period; however, by 2018, both groups remained less likely to undergo LT than their White counterparts (Black: OR, 0.66; 95% CI, 0.61-0.70; Hispanic: OR, 0.74; 95% CI, 0.70-0.78). The odds of death in Black and Hispanic patients declined over the study period but remained higher in Black patients than White patients in 2018 (OR, 1.08; 95% CI, 1.05-1.11). Conclusions and Relevance In this cross-sectional study of individuals hospitalized with decompensated cirrhosis, there were racial and ethnic disparities in receipt of complex lifesaving procedures and in mortality that persisted over time.
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Affiliation(s)
- Lauren D. Nephew
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis
- Indiana University Simon Comprehensive Cancer Center, Indianapolis
| | - Shannon M. Knapp
- Division of Cardiovascular Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis
| | - Kawthar A. Mohamed
- Division of Medicine, University of Minnesota School of Medicine, Minneapolis
| | - Marwan Ghabril
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis
| | - Eric Orman
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis
| | - Kavish R. Patidar
- Section of Gastroenterology, Department of Medicine, Baylor College of Medicine, Houston, Texas
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Naga Chalasani
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis
- Indiana University Simon Comprehensive Cancer Center, Indianapolis
| | - Archita P. Desai
- Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis
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Baxter T, Shenoy S, Lee HS, Griffith T, Rivas-Baxter A, Park S. Unequal outcomes: The effects of the COVID-19 pandemic on mental health and wellbeing among Hispanic/Latinos with varying degrees of 'Belonging'. Int J Soc Psychiatry 2022:207640221140285. [PMID: 36573293 PMCID: PMC9806202 DOI: 10.1177/00207640221140285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The COVID-19 pandemic has brought disparities in mental and physical health faced by ethnic minorities to the forefront. In the U.S., Hispanic/Latino communities are plagued by elevated rates of psychiatric conditions and trauma. Exacerbating this burden, common discourse often implicates Hispanic/Latino ethnicity as a causal factor, despite clear evidence of systemic causes, including lack of access to resources, and discrimination. AIMS To parse apart Hispanic/Latino ethnicity from determinants of wellbeing (such as trauma, financial status, and loneliness), we examined mental and physical health during COVID-19 via an online, anonymous survey available in both English and Spanish. METHODS We examined wellbeing across three participant groups, including two groups of Hispanic/Latino adults with varying degrees of 'belonging' to the dominant culture in their country of residence: Hispanic/Latino individuals living in Spanish-speaking and/or Central or Latin American countries (Group 1), Hispanic/Latino individuals living in the U.S. (Group 2), and non-Hispanic/Latino individuals living in the U.S. (Group 3). RESULTS Results demonstrated there were significant differences between groups in specific aspects of wellbeing. Most importantly, results showed Hispanic/Latino ethnicity does not significantly predict psychosocial wellbeing or psychosis risk, and identified several predictors of these outcomes, including U.S. residence, trauma, loneliness, and age. CONCLUSION Our results demonstrate that Hispanic/Latino ethnicity itself is not a causal factor of poor psychosocial wellbeing or elevated psychosis risk and instead identify several social and systemic causal factors commonly faced by Hispanic/Latino Americans. We suggest that language reporting on minority mental health acknowledge systemic factors as contributing to poor outcome rather than referring to ethnicity as if it were a causal factor.
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Affiliation(s)
- Tatiana Baxter
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Sunil Shenoy
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Hyeon-Seung Lee
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Taylor Griffith
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | | | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Vintimilla R, Nevin T, Hall J, Johnson L, O’Bryant S. Cardiovascular Risk Factors and Cognitive Performance in Cognitively Normal Non-Hispanic Whites and Mexican Americans From the HABS-HD Cohort. Gerontol Geriatr Med 2022; 8:23337214221142958. [PMCID: PMC9742682 DOI: 10.1177/23337214221142958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022] Open
Abstract
Objectives: This study aimed to compare the impact of cardiovascular disease (CVD) and cardiovascular risk factors (CVRF) on cognition in non-Hispanic Whites (NHW) versus Mexicans Americans (MA). Methods: A cross sectional analysis was conducted on 663 NHW and 632 MA. Prevalence of specific CVRF were compared between both demographics. Cognition was tested with various neuropsychologic tests. Results: MA had a higher percentage of hypertension, abdominal circumference, diabetes, and current smoking while NHW had a higher prevalence of other CVD. However, specific CVRF impacted NHW neuropsychologic testing on cognition, executive function, and processing, while only memory was affected in MA. Discussion: MA have less access to healthcare services with a higher prevalence of specific CVRF, however previous research has cited a lower mortality compared to NHW, this is known as the Hispanic paradox effect. The Mexican American ethnicity may be a protective factor in cognition creating increased neuropsychologic resilience from CVRF.
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Affiliation(s)
- Raul Vintimilla
- University of North Texas Health Science Center, Fort Worth, USA,Raul Vintimilla, Institute for Translational Research, University of North Texas Health Science Center, 855 Montgomery Street, Fort Worth, TX 76123, USA.
| | - Thomas Nevin
- University of North Texas Health Science Center, Fort Worth, USA
| | - James Hall
- University of North Texas Health Science Center, Fort Worth, USA
| | - Leigh Johnson
- University of North Texas Health Science Center, Fort Worth, USA
| | - Sid O’Bryant
- University of North Texas Health Science Center, Fort Worth, USA
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Rada I, Oyarte M, Cabieses B. A comparative analysis of health status of international migrants and local population in Chile: a population-based, cross-sectional analysis from a social determinants of health perspective. BMC Public Health 2022; 22:1329. [PMID: 35820866 PMCID: PMC9277854 DOI: 10.1186/s12889-022-13709-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During recent decades intraregional migration has increased in Latin America. Chile became one of the main receiving countries and hosted diverse international migrant groups. Evidence have suggested a healthy migrant effect (HME) on health status, but it remains scarce, controversial and needs to be updated. This study performed a comprehensive analysis verifying the existence of HME and its association with social determinants of health (SDH). METHODS We analyzed data from the Chilean National Socioeconomic Characterization Survey (CASEN, version 2017). Unadjusted prevalence of health status indicators such as negative self-perceived health, chronic morbidity, disability, and activity limitations were described in both international migrants and local population. Adjusted associations between these outcomes and sets of demographics, socioeconomic, access to healthcare, psychosocial and migration-related SDH were tested using multivariate logistic regression in each population. The HME for each health outcome was also tested using multivariate logistic regression and sequentially adjusting for each set of SDH (ref = Chilean). RESULTS International migrants had lower unadjusted prevalence of all health indicators compared to Chileans. That is, unadjusted analysis revealed an apparent HME in all health outcomes. Age, unemployment, and health care system affiliation were associated with health outcomes in both populations. Psychosocial determinants were both risk and protective for the analysed health outcomes. After adjustment for each set of SDH, the immigrant health advantage was only significant for chronic morbidity. Being migrant was associated with 39% lower odds of having chronic diseases compared to locals (OR: 0.61; 95% CI: 0.44-0.84; P = 0.0003). For all other outcomes, HME disappeared after adjusting by SDH, particularly unemployment, type of health system and psychosocial factors. CONCLUSIONS Testing the HME in Chile revealed an advantage for chronic morbidities that remained significant after adjustment for SDH. This analysis shed light on health disparities between international migrants and local population in the Latin American region, with special relevance of unemployment, type of health system and psychosocial SDH. It also informed about differential exposures faced during migration process that could dissolve the HME over time. Evidence from this analytical approach is useful for informing health planning and intersectoral solutions from a SDH perspective.
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Affiliation(s)
- Isabel Rada
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Av. Plaza 680, Las Condes, Región, Metropolitana, Chile
| | - Marcela Oyarte
- Instituto de Salud Pública de Chile, Subdepartamento Innovación, Desarrollo, Transferencia Tecnológica y ETESA, Departamento Agencia Nacional de Dispositivos Médicos, Innovación y Desarrollo, Santiago, Región Metropolitana, Chile
| | - Báltica Cabieses
- Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Av. Plaza 680, Las Condes, Región, Metropolitana, Chile.
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Flórez KR, Day SE, Huang TTK, Konty KJ, D'Agostino EM. Latino Children's Obesity Risk Varies by Place of Birth: Findings from New York City Public School Youth, 2006-2017. Child Obes 2022; 18:291-300. [PMID: 34788125 PMCID: PMC9248336 DOI: 10.1089/chi.2021.0056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: Research showing that place of birth (POB) predicts excess weight gain and obesity risk among Latino adults has not prompted similar research in Latino children, although childhood is a critical period for preventing obesity. Objective: To identify differences in obesity risk among Latino children by POB. Methods: Longitudinal cohort observational study on public school children self-identified by parent/guardian as Latino in grades K-12 for school years 2006-07 through 2016-17 with measured weight and height (n = 570,172students; 3,103,642observations). POB reported by parent/guardian was categorized as continental United States [not New York City (NYC)] (n = 295,693), NYC (n = 166,361), South America (n = 19,452), Central America (n = 10,241), Dominican Republic (n = 57,0880), Puerto Rico (n = 9687), and Mexico (n = 9647). Age- and sex-specific BMI percentiles were estimated based on established growth charts. Data were analyzed in 2020. Results: Prevalence of obesity was highest among US (non-NYC)-born girls (21%) and boys (27%), followed by NYC-born girls (19%) and boys (25%). Among girls, South Americans (9%) had the lowest prevalence of all levels of obesity, while Puerto Ricans (19%) and Dominicans (15%) had the highest prevalence. Among boys, South Americans also had the lowest prevalence of all levels of obesity (15%), while Puerto Ricans (22%) and Mexicans (21%) had the highest. In adjusted models, obesity risk was highest in US (non-NYC)-born children, followed by children born in NYC (p < 0.001). Immigrant Latino children exhibited an advantage even after controlling for individual and neighborhood sociodemographic features, particularly Dominicans, South Americans, and Puerto Ricans. Conclusions: The heterogeneity of obesity risk among Latino children highlights the importance of POB.
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Affiliation(s)
- Karen R. Flórez
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA.,Address correspondence to: Karen R. Flórez, DrPH, Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, 55 West 125th Street, New York, NY 10027, USA
| | - Sophia E. Day
- NYC Department of Health and Mental Hygiene, Office of School Health, Queens, NY, USA
| | - Terry T.-K. Huang
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Kevin J. Konty
- NYC Department of Health and Mental Hygiene, Office of School Health, Queens, NY, USA
| | - Emily M. D'Agostino
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
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Ricardo AC, Chen J, Toth-Manikowski SM, Meza N, Joo M, Gupta S, Lazarous DG, Leaf DE, Lash JP. Hispanic ethnicity and mortality among critically ill patients with COVID-19. PLoS One 2022; 17:e0268022. [PMID: 35584148 PMCID: PMC9116663 DOI: 10.1371/journal.pone.0268022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 04/20/2022] [Indexed: 01/22/2023] Open
Abstract
Background Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID-19 is unknown. Objective To evaluate ethnic disparities in mortality among critically ill adults with COVID-19 enrolled in the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID). Methods Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICU) at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day mortality across racial/ethnic groups. Results A total of 2153 patients were included (994 [46.2%] Hispanic and 1159 [53.8%] non-Hispanic White). The median (IQR) age was 62 (51–71) years (non-Hispanic White, 66 [57–74] years; Hispanic, 56 [46–67] years), and 1462 (67.9%) were men. Compared with non-Hispanic White patients, Hispanic patients were younger; were less likely to have hypertension, chronic obstructive pulmonary disease, coronary artery disease, or heart failure; and had longer duration of symptoms prior to ICU admission. During median (IQR) follow-up of 14 (7–24) days, 785 patients (36.5%) died. In analyses adjusted for age, sex, clinical characteristics, and hospital size, Hispanic patients had higher odds of death compared with non-Hispanic White patients (OR, 1.44; 95% CI, 1.12–1.84). Conclusions Among critically ill adults with COVID-19, Hispanic patients were more likely to die than non-Hispanic White patients, even though they were younger and had lower comorbidity burden. This finding highlights the need to provide earlier access to care to Hispanic individuals with COVID-19, especially given our finding of longer duration of symptoms prior to ICU admission among Hispanic patients. In addition, there is a critical need to address ongoing disparities in post hospital discharge care for patients with COVID-19.
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Affiliation(s)
- Ana C. Ricardo
- Department of Medicine, Division of Nephrology, University of Illinois at Chicago, Chicago, IL, United States of America
- * E-mail:
| | - Jinsong Chen
- Department of Medicine, Division of Nephrology, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Stephanie M. Toth-Manikowski
- Department of Medicine, Division of Nephrology, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Natalie Meza
- Department of Medicine, Division of Nephrology, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Min Joo
- Department of Medicine, Division of Nephrology, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Shruti Gupta
- Department of Medicine, Division of Renal Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Deepa G. Lazarous
- Department of Pulmonary Critical Care and Sleep Medicine, Georgetown University Hospital, Washington, DC, United States of America
| | - David E. Leaf
- Department of Medicine, Division of Renal Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - James P. Lash
- Department of Medicine, Division of Nephrology, University of Illinois at Chicago, Chicago, IL, United States of America
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Nava A, Estrada L, Gerchow L, Scott J, Thompson R, Squires A. Grouping people by language exacerbates health inequities-The case of Latinx/Hispanic populations in the US. Res Nurs Health 2022; 45:142-147. [PMID: 35247219 DOI: 10.1002/nur.22221] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/16/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Adrianna Nava
- National Association of Hispanic Nurses, Lexington, Kentucky, USA
| | - Leah Estrada
- School of Nursing, Columbia University, New York City, New York, USA
| | - Lauren Gerchow
- Rory Meyers College of Nursing, Nursing New York University, New York City, New York, USA
| | - Joanie Scott
- School of Nursing, Penn State University, University Park, Pennsylvania, USA
| | - Roy Thompson
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Allison Squires
- Rory Meyers College of Nursing, New York University, New York City, New York, USA.,Grossman School of Medicine, New York University, New York City, New York, USA
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