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Thorne T, Nishioka S, Wong K, Lawton DRY, Lim SY, Nakasone CK. Examining racial disparities in utilization rate and perioperative outcomes following knee and hip arthroplasty. Arch Orthop Trauma Surg 2024; 144:1937-1944. [PMID: 38536508 DOI: 10.1007/s00402-024-05272-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/05/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Previous arthroplasty utilization research predominantly examined Black and White populations within the US. This is the first known study to examine utilization and complications in poorly studied minority racial groups such as Asians and Native Hawaiian/Pacific-Islanders (NHPI) as compared to Whites. RESULTS Data from 3304 primary total hip and knee arthroplasty patients (2011 to 2019) were retrospectively collected, involving 1789 Asians (52.2%), 1164 Whites (34%) and 320 Native Hawaiians/Pacific Islanders (NHPI) (9.3%). The 2012 arthroplasty utilization rates for Asian, White, and NHPI increased by 32.5%, 11.2%, and 86.5%, respectively, by 2019. Compared to Asians, Whites more often underwent hip arthroplasty compared to knee arthroplasty (odds ratio (OR) 1.755; p < 0.001). Compared to Asians, Whites and NHPI more often received total knee compared to unicompartmental knee arthroplasty (White: OR 1.499; NHPI: OR 2.013; p < 0.001). White patients had longer hospitalizations (2.66 days) compared to Asians (2.19 days) (p = 0.005) following bilateral procedures. Medicare was the most common insurance for Asians (66.2%) and Whites (54.2%) while private insurance was most common for NHPI (49.4%). Compared to Asians, economic status was higher for Whites (White OR 0.695; p < 0.001) but lower for NHPI (OR 1.456; p < 0.001). After controlling for bilateral procedures, NHPI had a lower risk of transfusion compared to Asians (OR 0.478; p < 0.001) and Whites had increased risk of wound or systemic complications compared to Asians (OR 2.086; p = 0.045). CONCLUSIONS Despite NHPI demonstrating a significantly poorer health profile and lower socioeconomic status, contrary to previous literature involving minority racial groups, no significant overall differences in arthroplasty utilization rates or perioperative complications could be demonstrated amongst the racial groups examined.
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Affiliation(s)
- Tyler Thorne
- John A Burns School of Medicine, University of Hawai'i at Manoa, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Scott Nishioka
- John A Burns School of Medicine, University of Hawai'i at Manoa, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Krystin Wong
- John A Burns School of Medicine, University of Hawai'i at Manoa, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Dylan R Y Lawton
- John A Burns School of Medicine, University of Hawai'i at Manoa, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Sian Yik Lim
- Straub Medical Center, Bone and Joint Center, 888 South King Street, Honolulu, HI, 96813, USA
| | - Cass K Nakasone
- John A Burns School of Medicine, University of Hawai'i at Manoa, 651 Ilalo Street, Honolulu, HI, 96813, USA.
- Straub Medical Center, Bone and Joint Center, 888 South King Street, Honolulu, HI, 96813, USA.
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Chang C, Siu A, Kimata C, Sawada H, Mak VP, Lim SY. Gout in Native Hawaiian Patients in Hawai'i: Clinical Characteristics and Disparities. Arthritis Care Res (Hoboken) 2024; 76:712-719. [PMID: 38163751 DOI: 10.1002/acr.25289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/05/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The purpose of this study was to investigate differences in clinical characteristics and health care use of Native Hawaiian and White patients with gout. METHODS We performed a retrospective chart review of Native Hawaiian and White patients with gout treated from 2011 to 2017 within a large health care system in Hawai'i. We compared demographic characteristics, clinical outcomes, and risk factors for gout. We used multivariable logistic regression to identify predictive factors of emergency department visits. RESULTS We identified 270 Native Hawaiian patients with gout and 239 White patients with gout. The Native Hawaiian patients were younger on average (54.0 vs 64.0 years; P < 0.0001) and had an earlier onset of disease (50.0 vs 57.0 years; P < 0.0001). Native Hawaiian patients with gout had higher mean (7.58 vs 6.87 mg/dL; P < 0.0001) and maximum (10.30 vs 9.50 mg/dL; P < 0.0001) serum urate levels compared to White patients with gout. Native Hawaiian patients with gout also had a greater number of tophi (median 2.00 vs 1.00; P < 0.0001). Native Hawaiians patients with gout were 2.7 times more likely to have frequent (≥1) emergency department visits than White patients with gout. Native Hawaiian patients with gout were less likely to have a therapeutic serum urate ≤6.0 mg/dL and had lower rates of rheumatology specialty care. CONCLUSION Native Hawaiian patients have a higher disease burden of gout, with earlier disease onset and more tophi. Native Hawaiian patients with gout are more likely to use emergency services for gout and have lower rates of rheumatology specialty care compared to White patients. Future studies are needed to promote culturally appropriate preventive care and management of gout in Native Hawaiians.
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Affiliation(s)
- Celia Chang
- Washington University in St. Louis, St. Louis, Missouri
| | | | | | | | - Victoria P Mak
- University of Hawai'i Cancer Center and University of Hawai'I, Honolulu
| | - Sian Yik Lim
- Hawai'i Pacific Health and University of Hawai'i, Honolulu
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Kop M, Kim N, Shimoda B, Unebasami E, Weldon RH, Nakasone CK. The prevalence of bilateral and ipsilateral radiographic osteoarthritis is high in White, Asian and Native Hawaiian/Pacific Islanders presenting for unilateral knee or hip arthroplasty. Arch Orthop Trauma Surg 2024; 144:1565-1573. [PMID: 38386068 DOI: 10.1007/s00402-024-05252-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND It is estimated that one-third of patients presenting with unilateral joint pain have contralateral osteoarthritis (OA) at first presentation. Most studies have primarily examined White patient cohorts. The purpose of this study was to determine the prevalence of contralateral joint OA for patients presenting for unilateral total knee (TKA), unicompartmental knee (UKA) or total hip arthroplasty (THA) among Asian, Native Hawaiian/Pacific Islander and White patients. METHODS Bilateral radiographic reports at initial presentation of 2,312 subjects who underwent unilateral arthroplasties (332 UKAs, 933 TKAs and 1,047 THAs) were reviewed. The presence of contralateral OA was recorded and compared by racial group and type of arthroplasty performed. Parametric statistical analyses were performed to determine differences between groups. Multivariable analyses were completed for each arthroplasty group to determine the influence on the presence of contralateral OA, presented as odds ratios and 95% confidence intervals. RESULTS Contralateral joint OA was present in 86.7%, 90.4% and 70.4% of UKA, TKA and THA patients, respectively. Concurrent hip OA was present in 41.6% and 59.5% of UKA and TKA patients. No racial differences in the prevalence of contralateral knee OA were found for knee arthroplasty patients. White patients (74.6%) had a greater prevalence of contralateral hip OA compared to Asians (66.5%, p = 0.037) amongst THA recipients. Increased age and body mass index were significantly associated with the presence of contralateral knee OA. Increased age, being male and being White were significant contributors for the presence of contralateral hip OA. CONCLUSION The prevalence of contralateral joint OA and concurrent hip OA is high in all three racial groups. Due to the extensive prevalence of contralateral and concurrent knee and hip OA, bilateral radiographic evaluation should be considered for all patients presenting with unilateral hip or knee pain due to OA.
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MESH Headings
- Female
- Humans
- Male
- Arthroplasty, Replacement, Hip
- Arthroplasty, Replacement, Knee
- Knee Joint/surgery
- Native Hawaiian or Other Pacific Islander
- Osteoarthritis, Hip/diagnostic imaging
- Osteoarthritis, Hip/epidemiology
- Osteoarthritis, Hip/surgery
- Osteoarthritis, Knee/diagnostic imaging
- Osteoarthritis, Knee/epidemiology
- Osteoarthritis, Knee/surgery
- Prevalence
- White
- Asian
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Affiliation(s)
- Mikaela Kop
- University of Hawai'I, John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Nathan Kim
- University of Hawai'I, John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Brent Shimoda
- University of Hawai'I, John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Emily Unebasami
- University of Hawai'I, John A Burns School of Medicine, 651 Ilalo Street, Honolulu, HI, 96813, USA
| | - Rosana Hernandez Weldon
- University of Hawai'i Office of Public Health Studies, 1960 East-West Road, Honolulu, HI, 96822, USA
| | - Cass K Nakasone
- Straub Medical Center Bone and Joint Center, 888 South King Street, Honolulu, HI, 96814, USA.
- Department of Surgery, University of Hawai'i, John A Burns School of Medicine, 1356 Lusitana Street, Honolulu, HI, 96813, USA.
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Bruno MK, Matsunaga M, Krening E, Gao F, Chen JJ, Seto T, Ross GW. The Prevalence of Hospitalized Parkinson's Disease Patients in All Case Hospitalization among Different Race/Ethnic Subgroups in Hawaii. JOURNAL OF PARKINSON'S DISEASE 2024; 14:725-735. [PMID: 38607763 PMCID: PMC11191512 DOI: 10.3233/jpd-230341] [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] [Accepted: 03/04/2024] [Indexed: 04/14/2024]
Abstract
Background Little is known about the epidemiology of Parkinson's disease (PD) patients in Native Hawaiian Or Other Pacific Islander (NHPI) and Asian American (AA) subgroups. Objective To determine if the prevalence of hospitalized PD patients is different across age groups and racial/ethnic subgroups in Hawaii. Methods We conducted a retrospective analysis of Hawaii statewide registry (2016-2020) hospitalization data for patients who were 50 years or older. PD patients were identified using an ICD 10 code: Parkinson's Disease (G20) as their primary/secondary hospitalization discharge diagnosis code. Demographic and clinical characteristics among racial/ethnic subgroups (White, Japanese, Filipino, Chinese, NHPI, or Other) were compared. Results Of 146,844 total hospitalized patients (n = 429,879 records), 1.6% (n = 2,401) had a PD diagnosis. The prevalence of hospitalized PD patients was 2.3% among Japanese and Chinese, followed by 1.7% for Whites, 1.2% for Filipinos and was lowest for NHPI with 0.9% (p < 0.001). As patient's age increased, the prevalence of hospitalized PD patients increased, with 80-84 years old for the highest age range (3.4%). The prevalence of hospitalized PD patients at 80-84 years old varied across the race/ethnic subgroups (Chinese 4.3%, Japanese 4.0%, Whites 3.7%, Filipinos 2.5%, NHPI 2.3%). Conclusions The prevalence of hospitalized PD patients among all case hospitalizations were lower for NHPI and Filipino compared to that of Japanese, Chinese, and Whites. As patients' age increased, the prevalence of hospitalized patients with PD increased, but less so in NHPI and Filipino groups. Further research is warranted to understand the reason for these observed differences among racial/ethnic subgroups.
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Affiliation(s)
- Michiko Kimura Bruno
- The Queen’s Medical Center, Honolulu, HI, USA
- University of Hawaii John A, Burns School of Medicine, Honolulu, HI, USA
| | - Masako Matsunaga
- University of Hawaii John A, Burns School of Medicine, Honolulu, HI, USA
| | | | - Fay Gao
- The Queen’s Medical Center, Honolulu, HI, USA
- University of Hawaii John A, Burns School of Medicine, Honolulu, HI, USA
| | - John J. Chen
- University of Hawaii John A, Burns School of Medicine, Honolulu, HI, USA
| | - Todd Seto
- The Queen’s Medical Center, Honolulu, HI, USA
- University of Hawaii John A, Burns School of Medicine, Honolulu, HI, USA
| | - G. Webster Ross
- Pacific Health Research and Education Institute, VA Pacific Islands Health CareSystem, Honolulu, HI, USA
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Lim E, Braun KL, Taira D. Resources and Methods for Examining Native Hawaiian, Pacific Islander, and Filipino Health Disparities. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:3-4. [PMID: 37901665 PMCID: PMC10612415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Affiliation(s)
- Eunjung Lim
- Center for Pacific Innovations, Knowledge, and Opportunities (PIKO), Honolulu, HI
| | - Kathryn L Braun
- Center for Pacific Innovations, Knowledge, and Opportunities (PIKO), Honolulu, HI
| | - Deborah Taira
- Center for Pacific Innovations, Knowledge, and Opportunities (PIKO), Honolulu, HI
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Sehar U, Kopel J, Reddy PH. Alzheimer's disease and its related dementias in US Native Americans: A major public health concern. Ageing Res Rev 2023; 90:102027. [PMID: 37544432 PMCID: PMC10515314 DOI: 10.1016/j.arr.2023.102027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
Alzheimer's disease (AD) and Alzheimer's related dementias (ADRD) are growing public health concerns in aged populations of all ethnic and racial groups. AD and ADRD are caused by multiple factors, such as genetic mutations, modifiable and non-modifiable risk factors, and lifestyle. Studies of postmortem brains have revealed multiple cellular changes implicated in AD and ADRD, including the accumulation of amyloid beta and phosphorylated tau, synaptic damage, inflammatory responses, hormonal imbalance, mitochondrial abnormalities, and neuronal loss. These changes occur in both early-onset familial and late-onset sporadic forms. Two-thirds of women and one-third of men are at life time risk for AD. A small proportion of total AD cases are caused by genetic mutations in amyloid precursor protein, presenilin 1, and presenilin 1 genes, and the APOE4 allele is a risk factor. Tremendous research on AD/ADRD, and other comorbidities such as diabetes, obesity, hypertension, and cancer has been done on almost all ethnic groups, however, very little biomedical research done on US Native Americans. AD/ADRD prevalence is high among all ethnic groups. In addition, US Native Americans have poorer access to healthcare and medical services and are less likely to receive a diagnosis once they begin to exhibit symptoms, which presents difficulties in treating Alzheimer's and other dementias. One in five US Native American people who are 45 years of age or older report having memory issues. Further, the impact of caregivers and other healthcare aspects on US Native Americans is not yet. In the current article, we discuss the history of Native Americans of United States (US) and health disparities, occurrence, and prevalence of AD/ADRD, and shedding light on the culturally sensitive caregiving practices in US Native Americans. This article is the first to discuss biomedical research and healthcare disparities in US Native Americans with a focus on AD and ADRD, we also discuss why US Native Americans are reluctant to participate in biomedical research.
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Affiliation(s)
- Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Jonathan Kopel
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79409, USA; Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Public Health Department of Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
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Bryant J, Freund M, Ries N, Garvey G, McGhie A, Zucca A, Hoberg H, Passey M, Sanson-Fisher R. Volume, scope, and consideration of ethical issues in Indigenous cognitive impairment and dementia research: A systematic scoping review of studies published between 2000-2021. DEMENTIA 2022; 21:2647-2676. [PMID: 36054372 DOI: 10.1177/14713012221119594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION High quality research involving Indigenous people with cognitive impairment and dementia is critical for informing evidence-based policy and practice. We examined the volume, scope and ethical considerations of research related to dementia with Indigenous populations globally from January 2000-December 2021. METHODS Studies were included if they were published in English from 2000 to 2021 and provided original data that focused on cognitive impairment or dementia in any Indigenous population. RESULTS The search yielded 13,009 papers of which, 76 met inclusion criteria. The overall number of papers increased over time. Studies were mostly conducted in Australia with Aboriginal and Torres Strait Islander people (n = 30; 39%). Twenty-six papers directly involved Indigenous participants with cognitive impairment or dementia. Of these studies, ethics approval was commonly required from two or more committees (n = 23, 88.5%). Ethical and legal governance frameworks were rarely discussed. DISCUSSION There is a clear need for further robust studies examining cognitive impairment and dementia with Indigenous populations. Future research should consider the ethical aspects of involving Indigenous participants with cognitive impairment in research.
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Affiliation(s)
- Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Megan Freund
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Nola Ries
- Faculty of Law, 1994University of Technology Sydney, Sydney, NSW, Australia
| | - Gail Garvey
- Wellbeing and Preventable Chronic Diseases Division, Charles Darwin University, 10095Menzies School of Health Research, Causarina, Northern Territory, Australia
| | - Alexandra McGhie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alison Zucca
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Hana Hoberg
- Wellbeing and Preventable Chronic Diseases Division, Charles Darwin University, 10095Menzies School of Health Research, Causarina, Northern Territory, Australia
| | - Megan Passey
- University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, 5982University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Health Behaviour, 5982University of Newcastle, Callaghan, NSW, Australia.,Equity in Health & Wellbeing Research Program, 454568Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Browne CV, Muneoka S, Ka'opua LS, Wu YY, Burrage RL, Lee YJ, Mokuau NK, Braun KL. Developing a culturally responsive dementia storybook with Native Hawaiian youth. GERONTOLOGY & GERIATRICS EDUCATION 2022; 43:315-327. [PMID: 33888037 DOI: 10.1080/02701960.2021.1885398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Similar to the nation's majority and racial/ethnic minority populations, Native Hawaiian families provide the bulk of care to loved ones with dementia. Limited research has focused on youth caregivers, who are largely invisible to the eldercare service system. This knowledge gap is especially critical for Native Hawaiians who place a high value on eldercare, often provided in multigenerational homes. To address this gap, we describe the process by which a university-community center developed a culturally responsive storybook on dementia targeted to Native Hawaiian youth. The development process honored community-based participatory research principles grounded in the cultural values and practices of Native Hawaiians, active collaboration of an advisory council, and face-to-face engagement with Native Hawaiian youth. Future directions are shared about culture-based programming and evaluation in dementia care that may be useful in work with other racial/ethnic youth and families.
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Affiliation(s)
- Colette V Browne
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Shelley Muneoka
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Lana Sue Ka'opua
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Yan Yan Wu
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Rachel L Burrage
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Yeonjung Jane Lee
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Noreen K Mokuau
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Kathryn L Braun
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
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Nontuberculous mycobacterial skin and soft tissue infection in Hawai'i. BMC Infect Dis 2022; 22:360. [PMID: 35410188 PMCID: PMC9004129 DOI: 10.1186/s12879-022-07345-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/31/2022] [Indexed: 11/27/2022] Open
Abstract
Background Hawaiʻi has the highest nontuberculous mycobacterial (NTM) lung infection prevalence in the United States. Limited data regarding skin and soft tissue infections (SSTI) due to NTM in Hawaiʻi exists. This study describes patient demographics, clinical courses of infection, treatment patterns, and clinical outcomes of NTM SSTIs in Hawaiʻi.
Methods A retrospective chart review (n = 50) of patients diagnosed and treated at Hawaiʻi Pacific Health facilities for NTM SSTIs between January 2010 and July 2021 was conducted. Patient demographics, clinical course, and treatment data were collected from electronic medical records.
Results Half of the patient population consisted of females, and the average age of patients during infection was 49 years (SD = 25.6). The majority of cases (80%) were caused by rapidly growing mycobacteria (RGM), most commonly Mycobacterium abscessus. NTM SSTI by race were Asian (48%), White (28%), and Native Hawaiian and Other Pacific Islanders (16%). Almost all Asian patients with NTM SSTI were Filipino or Japanese. Diagnosis was frequently delayed. The average time to diagnosis was 116 days. Most patients achieved complete resolution (72%) following a prolonged course of antimicrobial treatment (mean = 196 days) with surgical debridement. Conclusion Increased awareness among physicians and the community of non-mycobacterial skin infections is essential in Hawaiʻi due to the high prevalence of NTM and the high percentage of predisposed populations. Increased awareness of NTM could reduce delayed diagnosis and improve patient care. Further studies are required to inform optimal treatment and diagnostic strategies, improve patient outcomes, and aid public health surveillance efforts.
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Lee YJ, Braun KL, Wu YY, Hong S, Gonzales E, Wang Y, Hossain MD, Terada TM, Browne CV. Neighborhood Social Cohesion and the Health of Native Hawaiian and Other Pacific Islander Older Adults. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2022; 65:3-23. [PMID: 33974515 DOI: 10.1080/01634372.2021.1917033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 06/12/2023]
Abstract
Native Hawaiian and other Pacific Islander (NHPI) older adults experience various social and health challenges. There is a growing literature linking neighborhood conditions with health, yet few have focused on NHPI older adults. This study examines associations between neighborhood social cohesion and health outcomes (i.e., self-rated health, psychological distress, and memory) in this population. Data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (n=1,045 with respondents aged 50+) were analyzed with logistic regression models. The level of neighborhood social cohesion was determined by responses to items on perceptions of mutual help, dependability, trust, and close relationships within the neighborhood. Higher perceived neighborhood social cohesion was associated with lower odds of having serious psychological distress or memory problems. There was no statistical association of social cohesion with self-rated health. Socially cohesive neighborhoods are important to the health of NHPI. We discuss methods to improve neighborhood social cohesion as a way to promote health equity for NHPI older adults in the United States (U.S.).
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Affiliation(s)
- Yeonjung Jane Lee
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Kathryn L Braun
- Thompson School of Social Work & Public Health, HI Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Yan Yan Wu
- Thompson School of Social Work & Public Health, HI Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Seunghye Hong
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Ernest Gonzales
- Silver School of Social Work, New York University, New York, New York, USA
| | - Yi Wang
- School of Social Work, The University of Iowa, Iowa City, Iowa, USA
| | - Mohammad Didar Hossain
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Tyran M Terada
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Colette V Browne
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
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Smith M, Van N, Roberts A, Hosaka KR, Choi SY, Viereck J, Carrazana E, Borman P, Chen JJ, Liow KK. Disparities in Alzheimer Disease and Mild Cognitive Impairment Among Native Hawaiians and Pacific Islanders. Cogn Behav Neurol 2021; 34:200-206. [PMID: 34473671 PMCID: PMC8425603 DOI: 10.1097/wnn.0000000000000279] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/16/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies of racial differences in Alzheimer disease (AD) presentation have not included Native Hawaiians and Pacific Islanders (NHPI). OBJECTIVE To explore the presentation of AD and mild cognitive impairment (MCI) in NHPI. METHOD We conducted a retrospective review of patient records from Hawaii with a diagnosis of unspecified AD or MCI from September 2000 to September 2019. Variables of interest included age at diagnosis, gender, race, marital status, insurance, comorbidities, and scores on the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA). RESULTS We reviewed the medical records of 598 patients, including 224 Asians, 202 Whites, 87 NHPI, and 85 Other. AD was more dominant than MCI across all of the groups, with the highest percentage in NHPI. Among the mean ages of diagnosis, NHPI were the youngest. Across all groups, a higher proportion of women than men had AD, with the highest female prevalence among NHPI. Hypertension, hyperlipidemia, and type II diabetes were highest among NHPI compared with the other groups. Of individuals with MMSE/MoCA scores, there were significant variations in scores by racial group. The mean MMSE/MoCA score was highest among Whites and lowest among NHPI. CONCLUSION Compared with other racial groups, NHPI have a higher proportion of AD than MCI at diagnosis, are diagnosed at a younger age, have a higher female prevalence, have more comorbidities that may contribute to AD/MCI onset, and present with lower MMSE scores.
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Affiliation(s)
- Maiya Smith
- Department of Medicine, John A. Burns School of Medicine, Honolulu, Hawaii
| | - Nicholas Van
- Undergraduate Education, University of Hawaii at Mānoa, Honolulu, Hawaii
| | - Alyssa Roberts
- Undergraduate Education, University of Hawaii at Mānoa, Honolulu, Hawaii
| | - Kalei R.J. Hosaka
- Department of Medicine, John A. Burns School of Medicine, Honolulu, Hawaii
| | - So Yung Choi
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, Honolulu, Hawaii
| | - Jason Viereck
- Department of Medicine, John A. Burns School of Medicine, Honolulu, Hawaii
- Clinical and Translational Research, John A. Burns School of Medicine, Honolulu, Hawaii
- Alzheimer’s Research Unit and Memory Disorders Center, Hawaii Pacific Neuroscience, Honolulu, Hawaii
| | - Enrique Carrazana
- Department of Medicine, John A. Burns School of Medicine, Honolulu, Hawaii
- Epilepsy Research Unit, Hawaii Pacific Neuroscience, Honolulu, Hawaii
| | - Pat Borman
- Alzheimer’s Research Unit and Memory Disorders Center, Hawaii Pacific Neuroscience, Honolulu, Hawaii
- Department of Geriatrics, John A. Burns School of Medicine, Honolulu, Hawaii
| | - John J. Chen
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, Honolulu, Hawaii
| | - Kore Kai Liow
- Department of Medicine, John A. Burns School of Medicine, Honolulu, Hawaii
- Clinical and Translational Research, John A. Burns School of Medicine, Honolulu, Hawaii
- Alzheimer’s Research Unit and Memory Disorders Center, Hawaii Pacific Neuroscience, Honolulu, Hawaii
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12
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Lee YJ, Braun KL, Wu YY, Burrage R, Muneoka S, Browne C, Mokuau NK, Terada TM, Hossain MD. Physical Activity and Health Among Native Hawaiian and other Pacific Islander Older Adults. J Aging Health 2021; 34:120-129. [PMID: 34376094 DOI: 10.1177/08982643211032468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Native Hawaiian and other Pacific Islander (NHPI) older adults often experience social disadvantages and poor health outcomes. Physical activity has been associated with better health in other racial groups, but limited studies have examined these associations in NHPI older adults. Methods: Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (n = 1,045), logistic regression models examined associations between physical activity and memory/psychological distress/self-rated health. Results: Sufficient levels of physical activity were associated with lower odds of memory problems, serious psychological distress, and poor/fair self-rated health. Unfortunately, only half of the sample reported sufficient physical activity and approximately 30% reported none. Also, 78% of the sample was estimated to be overweight/obese, and 29% had diabetes. Discussion: Culturally-appropriate interventions are recommended to increase physical activity in this population, which could also help reduce high rates of overweight/obesity and diabetes.
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Affiliation(s)
- Yeonjung J Lee
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Kathryn L Braun
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Yan Yan Wu
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Rachel Burrage
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Shelley Muneoka
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Colette Browne
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Noreen K Mokuau
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Tyran M Terada
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Mohammad D Hossain
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
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13
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Ganbat U, Wu YY. Disparities of Subjective Cognitive Decline Among Native Hawaiians/Other Pacific Islanders, Asian Americans, and White Americans in Hawai'i: Behavioral Risk Factor Surveillance System 2015 and 2017. Asia Pac J Public Health 2021; 33:587-594. [PMID: 34078132 DOI: 10.1177/10105395211020902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Existing research on subjective cognitive decline (SCD) among Native Hawaiians/Other Pacific Islanders (NHOPIs) is limited even though NHOPI adults have the highest prevalence of cardiovascular risk factors. In this study, we investigated SCD disparities among NHOPIs, Asian Americans, and White Americans and its contributing factors utilizing the 2015 and 2017 survey year data from the Behavioral Risk Factor Surveillance System (BRFSS) for Hawai'i State in the United States. The SCD prevalence was 11.9%, 8.97%, and 7.86% among NHOPIs, Whites, and Asians, respectively. Adjusting for sociodemographic and health behavioral variables, the prevalence ratios (PRs) of SCD were 1.37 (95% confidence interval [CI] = 1.05-1.78) for NHOPI versus Asian and 1.15 (95% CI = 0.89-1.50) for NHOPI versus Whites. The associations were weakened after adjusting for health conditions. Depressive disorders, coronary heart disease or myocardial infarction, stroke, and diabetes were associated with cognitive decline in the multivariate-adjusted model. NHOPIs experienced more SCD-related functional difficulties than other races.
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Affiliation(s)
| | - Yan Yan Wu
- University of Hawai'i at Mānoa, Honolulu, HI, USA
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14
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You D, Xu Y, Ponich B, Ronksley P, Skeith L, Korley R, Carrier M, Schneider PS. Effect of oral anticoagulant use on surgical delay and mortality in hip fracture. Bone Joint J 2021; 103-B:222-233. [PMID: 33517730 DOI: 10.1302/0301-620x.103b2.bjj-2020-0583.r2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIMS Current guidelines recommend surgery within 48 hours among patients presenting with hip fractures; however, optimal surgical timing for patients on oral anticoagulants (OACs) remains unclear. Individual studies are limited by small sample sizes and heterogeneous outcomes. The aim of this study was to conduct a systematic review and meta-analysis to summarize the effect of pre-injury OACs on time-to-surgery (TTS) and all-cause mortality among older adults with hip fracture treated surgically. METHODS We searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to 14 October 2019 to identify studies directly comparing outcomes among hip fracture patients receiving direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs) prior to hospital admission to hip fracture patients not on OACs. Random effects meta-analyses were used to pool all outcomes (TTS, in-hospital mortality, and 30-day mortality). RESULTS A total of 34 studies (involving 39,446 patients) were included in our systematic review. TTS was 13.7 hours longer (95% confidence interval (CI) 9.8 to 17.5; p < 0.001) among hip fracture patients on OACs compared to those not on OACs. This translated to a three-fold higher odds of having surgery beyond the recommended 48 hours from admission (odds ratio (OR) 3.0 (95% CI 2.1 to 4.3); p = 0.001). In-hospital mortality was higher (OR 1.4 (95% CI 1.0 to 1.8); p < 0.03) among anticoagulated patients. Among studies comparing anticoagulants, there was no statistically significant difference in time-to-surgery between patients taking a DOAC compared to a VKA. CONCLUSION Patients presenting with a hip fracture who were taking OACs prior to injury experience a delay in time-to-surgery and higher mortality than non-anticoagulated patients. Patients on DOACs may be at risk of further delays. Evaluating expedited surgical protocols in hip fracture patients on OACs is an urgent priority, with the potential to decrease morbidity and mortality in this group of high-risk patients. Cite this article: Bone Joint J 2021;103-B(2):222-233.
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Affiliation(s)
- Daniel You
- Department of Surgery, Section of Orthopaedic Surgery, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Yan Xu
- Department of Medicine, Ottawa Hospital Research Institute at the University of Ottawa, Ottawa, Ontario, Canada
| | - Brett Ponich
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Paul Ronksley
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Leslie Skeith
- Division of Hematology & Hematological Malignancies, University of Calgary, Calgary, Alberta, Canada
| | - Robert Korley
- Department of Surgery, Section of Orthopaedic Surgery, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Marc Carrier
- Department of Medicine, Ottawa Hospital Research Institute at the University of Ottawa, Ottawa, Ontario, Canada
| | - Prism S Schneider
- Department of Surgery, Section of Orthopaedic Surgery, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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15
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Hermosura AH, Noonan CJ, Fyfe-Johnson AL, Seto TB, Kaholokula JK, MacLehose RF. Hospital Disparities between Native Hawaiian and Other Pacific Islanders and Non-Hispanic Whites with Alzheimer's Disease and Related Dementias. J Aging Health 2020; 32:1579-1590. [PMID: 32772629 PMCID: PMC8098676 DOI: 10.1177/0898264320945177] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective: To compare important indicators of quality of care between Native Hawaiians and other Pacific Islanders (NHOPIs) and non-Hispanic Whites (NHWs) with Alzheimer's disease and related dementias (ADRD). Methods: We used the Health Care Cost and Utilization Project, Hawaii State Inpatient Databases, 2010-2014. They included 10,645 inpatient encounters from 7,145 NHOPI or NHW patients age ≥ 50 years, residing in Hawaii, and with at least one ADRD diagnosis in the discharge record. Outcome variables were inpatient mortality, length of hospital stay, and hospital readmission. Results: NHOPIs with ADRD had, on average, a hospital stay of .94 days less than NHWs with ADRD but were 1.16 times more likely than NHWs to be readmitted. Discussion: These patterns have important clinical care implications for NHOPIs and NHWs with ADRD as they are important indicators of quality of care. Future studies should consider specific contributors to these differences in order to develop appropriate interventions.
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Affiliation(s)
- Andrea H Hermosura
- 3949University of Hawaii at Manoa, HI, USA.,The Queen's Medical Center, Honolulu, HI, USA
| | - Carolyn J Noonan
- Institute for Research and Education to Advance Community Health (IREACH), 6760Washington State University, WA, USA
| | - Amber L Fyfe-Johnson
- Elson S. Floyd College of Medicine, Initiative for Research and Education to Advance Community Health (IREACH), 6760Washington State University, WA, USA
| | - Todd B Seto
- 3949University of Hawaii at Manoa, HI, USA.,The Queen's Medical Center, Honolulu, HI, USA
| | | | - Richard F MacLehose
- Division of Epidemiology and Community Health, 5635University of Minnesota, MN, USA
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16
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Sentell T, Choi SY, Ching L, Quensell M, Keliikoa LB, Corriveau É, Pirkle C. Prevalence of Selected Chronic Conditions Among Children, Adolescents, and Young Adults in Acute Care Settings in Hawai'i. Prev Chronic Dis 2020; 17:E67. [PMID: 32701433 PMCID: PMC7380289 DOI: 10.5888/pcd17.190448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Introduction Chronic disease prevalence among young people is understudied generally and specifically for Native Hawaiian, Filipino, and Pacific Islander youth who are at high risk for these conditions. We determined the statewide prevalence of chronic diseases in acute care for those aged 5 to 29 years, including Native Hawaiians, Filipinos, and Pacific Islanders. Methods We used Hawai‘i statewide inpatient and emergency department (ED) data across all payers from 2015–2016 to determine the presence of at least 1 of 5 chronic conditions (ie, asthma, hypertension, chronic kidney disease, diabetes, stroke) from 13,514 inpatient stays by 9,467 unique individuals and 228,548 ED visits by 127,854 individuals. Results Twenty-eight percent of youth who were hospitalized and 12% with an ED visit had at least 1 chronic condition. Medicaid covered more than half of these visits. When comparing patients with and without a chronic condition, race/ethnicity, age group, and payer varied significantly in both inpatient and ED settings. Patients with a chronic condition were disproportionately Native Hawaiian, Filipino, and Pacific Islander; 32.3% of those with an inpatient chronic condition and 34.9% of those with an ED chronic condition were Native Hawaiian. Prevalence of chronic conditions among racial/ethnic groups varied significantly by age. Conclusion Chronic diseases, including those more often seen in adulthood, are prevalent in young people in acute care settings in Hawai‘i, with notable disparities. These findings can help justify, guide, and support programs that are needed to address these changing epidemiological trends, which may be of particular interest for Medicaid.
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Affiliation(s)
- Tetine Sentell
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East West Rd, Honolulu, HI 96821.
| | - So Yung Choi
- JABSOM Biostatistics Core Facility, Department of Quantitative Health Sciences, University of Hawai'i, Honolulu, Hawai'i
| | - Lance Ching
- Surveillance, Evaluation and Epidemiology Office, Chronic Disease Prevention and Health Promotion Division, Hawai'i State Department of Health, Honolulu, Hawai'i
| | - Michelle Quensell
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | - L Brooke Keliikoa
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | - Émilie Corriveau
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | - Catherine Pirkle
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawai'i
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17
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Lim S, Mohaimin S, Min D, Roberts T, Sohn YJ, Wong J, Sivanesathurai R, Kwon SC, Trinh-Shevrin C. Alzheimer's Disease and its Related Dementias among Asian Americans, Native Hawaiians, and Pacific Islanders: A Scoping Review. J Alzheimers Dis 2020; 77:523-537. [PMID: 32675416 PMCID: PMC8638681 DOI: 10.3233/jad-200509] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) aging population is rapidly growing and the burden of Alzheimer's disease and its related dementias (ADRD) will likely mirror this demographic growth. AANHPIs face significant barriers in obtaining timely ADRD diagnosis and services; yet little is known about ADRD in this population. OBJECTIVE The study objective is to conduct a systematic review on the published literature on ADRD among AANHPIs to identify gaps and priorities to inform future research and action plans. METHODS The systematic review was conducted following the PRISMA Protocol for Systematic Reviews. Co-author (TR), an experienced Medical Librarian, searched PubMed, EMBASE, PsycINFO, Cochrane Central of Clinical Trials, Ageline, and Web of Science for peer-reviewed articles describing ADRD among AANHPIs. The search was not limited by language or publication date. Each citation was reviewed by two trained independent reviewers. Conflicts were resolved through consensus. RESULTS The title/abstract and full texts of 1,447 unique articles were screened for inclusion, yielding 168 articles for analysis. Major research topics included prevalence, risk factors, comorbidities, interventions and outreach, knowledge and attitudes, caregiving, and detection tools. A limited number of studies reported on national data, on NHPI communities generally, and on efficacy of interventions targeting AANHPI communities. CONCLUSION To our knowledge, this is the first systematic review on ADRD among AANHPI populations. Our review provides a first step in mapping the extant literature on ADRD among this underserved and under-researched population and will serve as a guide for future research, policy, and intervention.
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Affiliation(s)
- Sahnah Lim
- Department of Population Health, New York University Grossman School of Medicine
| | - Sadia Mohaimin
- Department of Population Health, New York University Grossman School of Medicine
| | - Deborah Min
- Department of Population Health, New York University Grossman School of Medicine
| | - Timothy Roberts
- Health Science Library, New York University Grossman School of Medicine
| | - Young-Jin Sohn
- Department of Population Health, New York University Grossman School of Medicine
| | - Jazmine Wong
- Department of Population Health, New York University Grossman School of Medicine
| | | | - Simona C. Kwon
- Department of Population Health, New York University Grossman School of Medicine
| | - Chau Trinh-Shevrin
- Department of Population Health, New York University Grossman School of Medicine
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18
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Browne CV, Ka’opua LS, Jervis LL, Alboroto R, Trockman ML. United States Indigenous Populations and Dementia: Is There a Case for Culture-based Psychosocial Interventions? THE GERONTOLOGIST 2017; 57:1011-1019. [PMID: 27048710 PMCID: PMC6281323 DOI: 10.1093/geront/gnw059] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 02/08/2016] [Indexed: 12/14/2022] Open
Abstract
Dementia is an issue of increasing importance in indigenous populations in the United States. We begin by discussing what is known about dementia prevalence and elder family caregiving in American Indian, Alaska Native, and Native Hawaiian populations. We briefly highlight examples of culture-based programming developed to address a number of chronic diseases and conditions that disproportionately affect these communities. These programs have produced positive health outcomes in American Indian, Alaska Native, and Native Hawaiian populations and may have implications for research and practice in the dementia context of culture-based interventions. Evidence-based and culture-based psychosocial programming in dementia care for indigenous populations in the United States designed by the communities they intend to serve may offer elders and families the best potential for care that is accessible, respectful, and utilized.
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Affiliation(s)
- Colette V Browne
- Myron B. Thompson School of Social Work, Ha Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawaii, Honolulu
| | - Lana Sue Ka’opua
- Myron B. Thompson School of Social Work, Ha Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawaii, Honolulu
| | - Lori L Jervis
- Department of Anthropology and Center for Applied Social Research, University of Oklahoma, Norman
| | - Richard Alboroto
- Myron B. Thompson School of Social Work, Ha Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawaii, Honolulu
| | - Meredith L Trockman
- Myron B. Thompson School of Social Work, Ha Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawaii, Honolulu
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19
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Mayeda ER, Glymour MM, Quesenberry CP, Whitmer RA. Inequalities in dementia incidence between six racial and ethnic groups over 14 years. Alzheimers Dement 2016; 12:216-24. [PMID: 26874595 DOI: 10.1016/j.jalz.2015.12.007] [Citation(s) in RCA: 529] [Impact Index Per Article: 66.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 11/30/2015] [Accepted: 12/10/2015] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Reducing racial/ethnic disparities is a primary objective of the National Alzheimer's Plan (NAPA), yet direct comparisons within large samples representing diversity of the United States are lacking. METHODS Dementia incidence from January 1, 2000 to December 31, 2013 and a 25-year cumulative risk in 274,283 health care members aged 64+ (n = 18,778 African-American, n = 4543 American Indian/Alaska Native [AIAN], n = 21,000 Latino, n = 440 Pacific Islander, n = 206,490 white, n = 23,032 Asian-Americans). Cox proportional hazard models were adjusted for age, sex, medical utilization, and comorbidities. RESULTS Dementia incidence (n = 59,555) was highest for African-Americans (26.6/1000 person-years) and AIANs (22.2/1000 person-years); intermediate for Latinos (19.6/1000 person-years), Pacific Islanders (19.6/1000 person-years), and whites (19.3/1000 person-years) and lowest among Asian-Americans (15.2/1000 person-years). Risk was 65% greater for African-Americans (hazard ratio = 1.65; 95% confidence interval = 1.58-1.72) versus Asian-Americans. Cumulative 25-year risk at age 65 was as follows: 38% African-Americans, 35% AIANs, 32% Latino, 25% Pacific Islanders, 30% white, and 28% Asian-Americans. DISCUSSION Dementia rates varied over 60% between groups, providing a comprehensive benchmark for the NAPA goal of reducing disparities.
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Affiliation(s)
- Elizabeth Rose Mayeda
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | | | - Rachel A Whitmer
- Kaiser Permanente Division of Research, Oakland, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
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