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Jia Z, Kurahashi A, Sharma RK, Mahtani R, Zagorski BM, Sanders JJ, Yarnell C, Detsky M, Lindvall C, Teno JM, Bell CM, Quinn KL. A Comparison of Palliative Care Delivery between Ethnically Chinese and Non-Chinese Canadians in the Last Year of Life. J Gen Intern Med 2024:10.1007/s11606-024-08859-8. [PMID: 38926319 DOI: 10.1007/s11606-024-08859-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Ethnically Chinese adults in Canada and the United States face multiple barriers in accessing equitable, culturally respectful care at the end-of-life. Palliative care (PC) is committed to supporting patients and families in achieving goal-concordant, high-quality serious illness care. Yet, current PC delivery may be culturally misaligned. Therefore, understanding ethnically Chinese patients' use of palliative care may uncover modifiable factors to sustained inequities at the end-of-life. OBJECTIVE To compare the use and delivery of PC in the last year of life between ethnically Chinese and non-Chinese adults. DESIGN Population-based cohort study. PARTICIPANTS All Ontario adults who died between January 1st, 2012, and October 31st, 2022, in Ontario, Canada. EXPOSURES Chinese ethnicity. MAIN MEASURES Elements of physician-delivered PC, including model of care (generalist; specialist; mixed), timing and location of initiation, and type of palliative care physician at initial consultation. KEY RESULTS The final study cohort included 527,700 non-Chinese (50.8% female, 77.9 ± 13.0 mean age, 13.0% rural residence) and 13,587 ethnically Chinese (50.8% female, 79.2 ± 13.6 mean age, 0.6% rural residence) adults. Chinese ethnicity was associated with higher likelihoods of using specialist (adjusted odds ratio [aOR] 1.53, 95%CI 1.46-1.60) and mixed (aOR 1.32, 95%CI 1.26-1.38) over generalist models of PC, compared to non-Chinese patients. Chinese ethnicity was also associated with a higher likelihood of PC initiation in the last 30 days of life (aOR 1.07, 95%CI 1.03-1.11), in the hospital setting (aOR 1.24, 95%CI 1.18-1.30), and by specialist PC physicians (aOR 1.33, 95%CI 1.28-1.38). CONCLUSIONS Chinese ethnicity was associated with a higher likelihood of mixed and specialist models of PC delivery in the last year of life compared to adults who were non-Chinese. These observed differences may be due to later initiation of PC in hospital settings, and potential differences in unmeasured needs that suggest opportunities to initiate early, community-based PC to support ethnically Chinese patients with serious illness.
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Affiliation(s)
- Zhimeng Jia
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada.
- Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
- Program in Global Palliative Care, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
| | - Allison Kurahashi
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada
| | - Rashmi K Sharma
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, USA
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ramona Mahtani
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada
- Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Justin J Sanders
- Department of Family Medicine, McGill University, Montreal, QC, Canada
- Ariadne Labs, Boston, MA, USA
| | - Christopher Yarnell
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Critical Care Medicine and Research Institute, Scarborough Health Network, Toronto, Canada
| | - Michael Detsky
- Interdepartmental Division of Critical Care Medicine, University Health Network and Sinai Health System, Toronto, Ontario, Canada
| | - Charlotta Lindvall
- Harvard Medical School, Boston, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
| | - Joan M Teno
- Department of Health Services, Policy & Practice, School of Public Health, Brown University, Providence, RI, USA
| | - Chaim M Bell
- ICES, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto and Sinai Health, Toronto, Ontario, Canada
| | - Kieran L Quinn
- Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto and Sinai Health, Toronto, Ontario, Canada
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Chin JJ, Forbes N, Lim S, Takahashi LM. Correlates of HIV Testing Among Asian Immigrant Female Sex Workers in New York City and Los Angeles County. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2024; 36:182-197. [PMID: 38917302 DOI: 10.1521/aeap.2024.36.3.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
This analysis examined correlates of HIV testing among Asian immigrant female sex workers in massage parlors. We interviewed 69 Chinese and Korean immigrant women who provided sexual services in massage parlors in New York City or Los Angeles County (2014-2016). Multivariable logistic regression results showed that participants who were younger, have lived in the U.S. for a longer period of time, had greater English proficiency, perceived higher HIV risk, or were living with an intimate partner were more likely to have had an HIV test. Disclosing sex work to a close friend was also positively associated with HIV testing at p < .1. These correlates may reflect differential access to information, systems, and social networks that would facilitate HIV testing, highlighting the importance of reducing social isolation and increasing HIV education, especially for older women who have come to the U.S. more recently. As the literature has indicated that Asian immigrant female sex workers experience high rates of intersectional stigma, efforts to mitigate these intersecting stigmas could further these objectives.
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Affiliation(s)
- John J Chin
- Department of Urban Policy and Planning, Hunter College, City University of New York, New York, New York
| | - Nicola Forbes
- Department of Psychology, Fordham University, Bronx, New York
| | - Sahnah Lim
- Department of Population Health, NYU Grossman School of Medicine, New York University, New York, New York
| | - Lois M Takahashi
- College of Social Sciences, San Jose State University, San Jose, California
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Cox CM, Thoma ME, Tchangalova N, Mburu G, Bornstein MJ, Johnson CL, Kiarie J. Infertility prevalence and the methods of estimation from 1990 to 2021: a systematic review and meta-analysis. Hum Reprod Open 2022; 2022:hoac051. [PMID: 36483694 PMCID: PMC9725182 DOI: 10.1093/hropen/hoac051] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/26/2022] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What is the contemporary prevalence of infertility in world populations and how do they differ by methodological and study characteristics? SUMMARY ANSWER Pooled estimates of lifetime and period prevalence of 12-month infertility were 17.5% and 12.6%, respectively, but this varied by study population and methodological approach. WHAT IS KNOWN ALREADY Infertility affects millions of individuals worldwide. Accurate measures of its magnitude are needed to effectively address and manage the condition. There are distinct challenges and variation in how infertility is defined and measured, limiting comparability of estimates across studies. Further research is needed to understand whether and how differences in methodological approaches and study characteristics account for heterogeneity in estimates. STUDY DESIGN SIZE DURATION We conducted a systematic review and meta-analysis. Six electronic databases, websites of relevant organizations, and conference proceedings were systematically searched. Searches were limited to those published between 1 January 1990 and 11 March 2021, with no language restrictions. PARTICIPANTS/MATERIALS SETTING METHODS Descriptive and random-effects meta-analysis models were used to examine range of estimates and generate estimates of pooled lifetime and period prevalence of 12-month infertility, respectively, among representative populations. Meta-regression using restricted maximum likelihood was applied to account for definitional and study characteristics and to obtain adjusted estimates. Risk of bias was assessed with a validated tool. MAIN RESULTS AND THE ROLE OF CHANCE The search yielded 12 241 unique records of which 133 studies met the criteria for the systematic review. There were 65 and 69 studies that provided data for lifetime and period prevalence of 12-month infertility, respectively. Five methodological approaches were identified: prospective time-to-pregnancy (TTP) design, current duration design, retrospective TTP design, self-reported infertility measure and constructed infertility measure. Ranges for lifetime (3.3-39.7%) and period estimates (1.6-34.0%) were similar and wide even after accounting for methodological and study characteristics. Pooled estimates of lifetime and period prevalence were 17.5% (95% CI: 15.0, 20.3, n = 37 studies, I 2 = 99.5%) and 12.6% (95% CI: 10.7, 14.6, n = 43 studies, I 2 = 99.8%), respectively, with some variation in magnitude by region and methodological approach, but with most CIs overlapping. LIMITATIONS REASONS FOR CAUTION Pooled estimates generated from meta-analysis were derived from 12-month infertility prevalence estimates that were heterogeneous across different domains, even after adjusting for definitional and study characteristics. The number of studies was small for certain strata from which pooled estimates were derived (e.g. there were only two studies for lifetime prevalence in Africa). WIDER IMPLICATIONS OF THE FINDINGS While findings show a high prevalence of infertility globally and regionally, it also reveals variation in measures to ascertain and compare infertility prevalence. More systematic and comprehensive collection of data using a consistent definition is needed to improve infertility prevalence estimates at global, regional and country-levels. STUDY FUNDING/COMPETING INTERESTS This work was supported by the World Health Organization. The authors have no conflicts of interest. REGISTRATION NUMBER PROSPERO CRD42020211704.
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Affiliation(s)
- C M Cox
- Correspondence address. Independent Consultant, Shoreview, MN, USA. E-mail:
| | - M E Thoma
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - N Tchangalova
- Research, Teaching, and Learning, STEM Library, University of Maryland Libraries, College Park, MD, USA
| | - G Mburu
- Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland
| | - M J Bornstein
- Division of Epidemiology, Ohio State University, Columbus, OH, USA
| | - C L Johnson
- Department of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - J Kiarie
- Department of Sexual and Reproductive Health and Research (SRH), World Health Organization, Geneva, Switzerland
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Cho WKT, Hwang DG. Racial/Ethnic, Biomedical, and Sociodemographic Risk Factors for COVID-19 Positivity and Hospitalization in the San Francisco Bay Area. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01351-1. [DOI: 10.1007/s40615-022-01351-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
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Jia J, Nie XF, Ke L, Liu B, Wang WR. Mental Health and its Influencing Factors Among Immigrants with Chronic Diseases in China. J Immigr Minor Health 2022; 24:1269-1280. [PMID: 35000054 PMCID: PMC8742701 DOI: 10.1007/s10903-021-01311-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 12/17/2022]
Abstract
Immigrants are a special group in society, and their health is of great concern. Few studies have targeted this population in China. A cross-sectional descriptive correlational study was conducted from July to August 2018 in Hubei Province, China. Chi-square tests, Z-tests and multivariable linear regression analysis were performed to analyze the data using SPSS 24.0. A total of 1068 questionnaires were distributed. The results showed that the variables that affected the mental health of the immigrants with chronic diseases included gender, annual income, life events (L), negative emotion (NE), negative coping styles (NC) and objective support (OS) (p ≤ 0.05). Future research should focus on the physical and mental health of different immigrant groups and design effective, individualized interventions to improve the health status of immigrants, especially those with chronic diseases.
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Affiliation(s)
- Jia Jia
- School of Nursing, Hubei University of Medicine, 30 Renmin South Rd., Shi Yan, 422000, Maojian District, China
| | - Xiao-Fei Nie
- School of Nursing, Hubei University of Medicine, 30 Renmin South Rd., Shi Yan, 422000, Maojian District, China.
| | - Li Ke
- School of Nursing, Hubei University of Medicine, 30 Renmin South Rd., Shi Yan, 422000, Maojian District, China
| | - Bing Liu
- School of Nursing, Hubei University of Medicine, 30 Renmin South Rd., Shi Yan, 422000, Maojian District, China
| | - Wen-Ru Wang
- School of Nursing, Hubei University of Medicine, 30 Renmin South Rd., Shi Yan, 422000, Maojian District, China
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Maru S, Glenn L, Belfon K, Birnie L, Brahmbhatt D, Hadler M, Janevic T, Reynolds S. Utilization of Maternal Health Care Among Immigrant Mothers in New York City, 2016-2018. J Urban Health 2021; 98:711-726. [PMID: 34811699 PMCID: PMC8688674 DOI: 10.1007/s11524-021-00584-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 11/27/2022]
Abstract
Immigrant women represent half of New York City (NYC) births, and some immigrant groups have elevated risk for poor maternal health outcomes. Disparities in health care utilization across the maternity care spectrum may contribute to differential maternal health outcomes. Data on immigrant maternal health utilization are under-explored in the literature. We conducted a cross-sectional analysis of the population-based NYC Pregnancy Risk Assessment Monitoring System survey, using 2016-2018 data linked to birth certificate variables, to explore self-reported utilization of preconception, prenatal, and postpartum health care and potential explanatory pathways. We stratified results by maternal nativity and, for immigrants, by years living in the US; geographic region of origin; and country of origin income grouping. Among immigrant women, 43% did not visit a health care provider in the year before pregnancy, compared to 27% of US-born women (risk difference [RD] = 0.16, 95% CI [0.13, 0.20]), 64% had no dental cleaning during pregnancy compared to 49% of US-born women (RD = 0.15, 95% CI [0.11, 0.18]), and 11% lost health insurance postpartum compared to 1% of US-born women (RD = 0.10, 95% CI [0.08, 0.11]). The largest disparities were among recent arrivals to the US and immigrants from countries in Central America, South America, South Asia, and sub-Saharan Africa. Utilization differences were partially explained by insurance type, paternal nativity, maternal education, and race and ethnicity. Disparities may be reduced by collaborating with community-based organizations in immigrant communities on strategies to improve utilization and by expanding health care access and eligibility for public health insurance coverage before and after pregnancy.
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Affiliation(s)
- Sheela Maru
- Department of Health System Design and Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- New York City Health + Hospitals/Elmhurst, New York, NY, USA
| | - Lily Glenn
- Center for Health Equity and Community Wellness, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY, 11101, USA.
| | - Kizzi Belfon
- Center for Health Equity and Community Wellness, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY, 11101, USA
| | - Lauren Birnie
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, Long Island City, NY, USA
| | | | - Max Hadler
- Independent Consultant, Brooklyn, NY, USA
| | - Teresa Janevic
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simone Reynolds
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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Seo JY, Strauss SM. Association of Cancer History and Health Care Utilization Among Female Immigrants Using NHANES 2007-2016 Data. J Immigr Minor Health 2020; 22:1208-1216. [PMID: 32975742 DOI: 10.1007/s10903-020-01090-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite health disparities in preventive care among adult female immigrants, the extent to which their health service utilization is influenced by a cancer history remains largely unknown. METHODS Using Andersen's behavioral model, 2007-2016 National Health and Nutrition Examination Survey data were analyzed to examine the influence of a cancer history on health service utilization among adult immigrant women. Multivariate logistic regression models assessed factors related to past year health care utilization, operationalized as an outpatient doctor's visit and an inpatient overnight hospital stay. RESULTS Once other factors were considered, a past cancer history increased the likelihood of a past year inpatient overnight hospital stay, but was not associated with a past year outpatient doctor's visit. DISCUSSION An outpatient doctor's visit for adult female immigrant cancer survivors would provide an opportunity for essential preventive health services. They must be educated about the importance of ongoing outpatient care for cancer surveillance and health maintenance.
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Affiliation(s)
- Jin Young Seo
- Hunter-Bellevue School of Nursing, Hunter College, 425 East 25th Street, Rm.416W, New York, NY, 10010, USA.
| | - Shiela M Strauss
- Hunter-Bellevue School of Nursing, Hunter College, 425 East 25th Street, Rm.416W, New York, NY, 10010, USA
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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