race specificity
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This exploratory study sought to test the relationship among race, self-rated health (SRH), and colorblindness, conceptualized as the belief that race/ethnicity should not and does not matter. Independently, SRH, a multidimensional concept entailing physical and psychological health and one's affiliation in an ethnic/racial group, may contribute to racial attitudes. However, little is known about how SRH and racial/ethnic identity in combination may affect colorblind racial attitudes. It was thus hypothesized that SRH would moderate the relationship between race/ethnicity and colorblind racial attitudes. The research sample consisted of 136 autochthonous adults and "individuals with migration backgrounds" residing in Bavaria (Germany), who were divided by self-identified race (whites, n = 85; non-whites, n = 51). The results show that SRH moderates the relationship between race and racial colorblindness. More specifically, it was found that the greater the SRH of the white participants, the less they embraced a colorblind ideology. Conversely, the greater the SRH of the non-white participants, the greater their colorblind racial attitudes. These results suggest that stronger SRH may reduce colorblindness among whites and intensify it among non-whites. The implications of the obtained results may be useful in addressing how surmount barriers to data collection, measurements, and research related to racial and ethnic health disparities in "colorblind" Germany may contribute to health inequalities. Thus, this paper's contribution lies in tracking such disparities to aid their reduction or elimination.
- Klíčová slova
- Ethnicity, Moderating effect, Race, Racial colorblindness, Self-rated health,
- MeSH
- diagnostické sebehodnocení * MeSH
- disparity zdravotního stavu MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- rasové skupiny psychologie statistika a číselné údaje MeSH
- vztahy mezi rasami * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Německo MeSH
BACKGROUND: No North-American study tested the survival benefit of chemotherapy in de novo metastatic prostate cancer according to race/ethnicity. We addressed this void. METHODS: We identified de novo metastatic prostate cancer patients within the Surveillance, Epidemiology, and End Results database (2014-2015). Separate and specific Kaplan-Meier plots and Cox regression models tested for overall survival differences between chemotherapy-exposed versus chemotherapy-naïve patients in four race/ethnicity groups: Caucasian versus African-American versus Hispanic/Latino vs Asian. Race/ethnicity specific propensity score matching was applied. Here, additional landmark analysis was performed. RESULTS: Of 4232 de novo metastatic prostate cancer patients, 2690 (63.3%) were Caucasian versus 783 (18.5%) African-American versus 504 (11.8%) Hispanic/Latino versus 257 (6.1%) Asian. Chemotherapy rates were: 21.3% versus 20.8% versus 21.0% versus 20.2% for Caucasians versus African-Americans versus Hispanic/Latinos versus Asians, respectively. At 30 months of follow-up, overall survival rates between chemotherapy-exposed versus chemotherapy-naïve patients were 61.5 versus 53.2% (multivariable hazard ratio [mHR]: 0.76, 95 confidence interval [CI]: 0.63-0.92, p = 0.004) in Caucasians, 55.2 versus 51.6% (mHR: 0.76, 95 CI: 0.54-1.07, p = 0.11) in African-Americans, 62.8 versus 57.0% (mHR: 1.11, 95 CI: 0.73-1.71, p = 0.61) in Hispanic/Latinos and 77.7 versus 65.0% (mHR: 0.31, 95 CI: 0.11-0.89, p = 0.03) in Asians. Virtually the same findings were recorded after propensity score matching within each race/ethnicity group. CONCLUSIONS: Caucasian and Asian de novo metastatic prostate cancer patients exhibit the greatest overall survival benefit from chemotherapy exposure. Conversely, no overall survival benefit from chemotherapy exposure could be identified in either African-Americans or Hispanic/Latinos. Further studies are clearly needed to address these race/ethnicity specific disparities.
- Klíčová slova
- chemotherapy, metastatic prostate cancer, race/ethnicity disparities,
- MeSH
- běloši MeSH
- černoši nebo Afroameričané MeSH
- etnicita * MeSH
- lidé MeSH
- míra přežití MeSH
- nádory prostaty * patologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: To test the effect of race/ethnicity on histological subtype, stage at presentation, and cancer specific mortality (CSM) in urethral cancer patients. MATERIAL AND METHODS: Stratified analyses (Surveillance, Epidemiology and End Results [2004-2016]) tested the effect of race/ethnicity on histology and stage. Cumulative incidence-plots and multivariable competing-risks regression models (CRR), addressed CSM, after matching for TNM-stage, histology, age, and gender. RESULTS: Of 1,904 urethral cancer patients, 71% were Caucasian, 16% African American, 7% Hispanic and 5% other. African Americans were younger (66 years) than Caucasians (73 years) and Hispanics (74 years). In African Americans, adenocarcinoma (25%) and squamous cell carcinoma (SCC; 29%) were more frequent than in Caucasians (12% and 23%) or Hispanics (15% and 20%). African Americans with adenocarcinoma exhibited higher stage than other adenocarcinoma patients. In CRR, African Americans (35%) and Hispanics (29%) exhibited highest and second highest 3-year CSM, even after matching. After further multivariable adjustment of matched CRRs, CSM was higher in Hispanics (HR: 1.93, P= 0.03) and in African Americans (Hazard ratio 1.35, P= 0.07), relative to Caucasians. CONCLUSION: Race/ethnicity impacts important differences on urethral cancer patients. African American race/ethnicity predisposes to higher rate of SCC and adenocarcinoma. Moreover, African Americans are younger and present with higher stage at diagnoses. Finally, even after most detailed matching for stage, age, gender, and adjustment for treatment and systemic therapy and socioeconomic status, African Americans and Hispanics exhibit higher CSM than Caucasians.
- Klíčová slova
- African American, Hispanic, Mortality, Race, SEER database, Urethral cancer,
- MeSH
- běloši statistika a číselné údaje MeSH
- černoši nebo Afroameričané statistika a číselné údaje MeSH
- Hispánci a Latinoameričané statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- nádory močové trubice klasifikace mortalita patologie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- staging nádorů MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: To test the effect of race/ethnicity on cancer-specific mortality (CSM) after salvage radical prostatectomy (SRP). MATERIAL AND METHODS: We relied on the Surveillance, Epidemiology and End Results database (SEER, 2004-2016) to identify SRP patients of all race/ethnicity background. Univariate and multivariate Cox regression models addressed CSM according to race/ethnicity. RESULTS: Of 426 assessable SRP patients, Caucasians accounted for 299 (69.9%) vs. 68 (15.9%) African-Americans vs. 39 (9.1%) Hispanics vs. 20 (4.7%) Asians. At diagnosis, African-Americans (64 years) were younger than Caucasians (66 years), but not younger than Hispanics (66 years) and Asians (67 years). PSA at diagnosis was significantly higher in African-Americans (13.2 ng/ml), Hispanics (13.0 ng/ml), and Asians (12.2 ng/ml) than in Caucasians (7.8 ng/ml, p = 0.01). Moreover, the distribution of African-Americans (10.3%-36.6%) and Hispanics (0%-15.8%) varied according to SEER region. The 10-year CSM was 46.5% in African-Americans vs. 22.4% in Caucasians vs. 15.4% in Hispanics vs. 15.0% in Asians. After multivariate adjustment (for age, clinical T stage, lymph node dissection status), African-American race/ethnicity was an independent predictor of higher CSM (HR: 2.2, p < 0.01), but not Hispanic or Asian race/ethnicity. The independent effect of African-American race/ethnicity did not persist after further adjustment for PSA. CONCLUSION: African-Americans treated with SRP are at higher risk of CSM than other racial/ethnic groups and also exhibited the highest baseline PSA. The independent effect of African-American race/ethnicity on higher CSM no longer applies after PSA adjustment since higher PSA represents a distinguishing feature in African-American patients.
- Klíčová slova
- cancer specific survival, ethnicity, post-radiotherapy recurrence, prostate cancer, race, salvage radical prostatectomy,
- Publikační typ
- časopisecké články MeSH
PURPOSE: to compare observed overall survival vs age-adjusted lifetable (LT) derived life expectancy (LE) in metastatic urothelial bladder cancer (MBCa) patients according to race/ethnicity. METHODS: We identified Caucasian, African American, Hispanic/Latino and Asian metastatic urothelial bladder cancer patients from 2004 to 2011 within the Surveillance, Epidemiology and End Results database. Social Security Administration tables were used to compute 5 year LE. LT-derived LE was compared to observed overall survival OS. Additionally, we relied on Poisson regression plots to display cancer-specific mortality (CSM) relative to other-cause mortality (OCM) for each race/ethnicity. RESULTS: Overall, 2286 MBCa patients were identified. Of those, 1800 (79%) were Caucasian vs 212 (9.3%) African American vs 189 (8.3%) Hispanic/Latino vs 85 (3.7%) Asians. The median age at diagnosis was 71 years for Asians vs 70 for Caucasians vs 67 for Hispanic/Latinos vs 67 for African Americans. African Americans showed the biggest difference between observed OS and LT-predicted LE at five years (- 83.8%), followed by Hispanic/Latinos (- 81%), Caucasians (- 77%) and Asian patients (- 69%). In Poisson regression plots, Hispanic/Latinos displayed the highest cancer-specific mortality rate (88%), while African/Americans showed the highest other cause mortality rate (12%). Conversely, Asian patients displayed the lowest CSM rate (83%) and second lowest OCM rate (7%). CONCLUSIONS: African Americans showed the least favorable survival profile in MBCa, despite being youngest at diagnosis. Contrarily, Asians displayed the best survival profile in MBCa, despite being oldest at diagnosis.
- Klíčová slova
- Life expectancy, Life table, Metastatic bladder cancer, SEER, Social security administration, Surveillance,
- MeSH
- běloši MeSH
- černoši nebo Afroameričané MeSH
- etnicita MeSH
- karcinom z přechodných buněk * MeSH
- lidé MeSH
- naděje dožití MeSH
- nádory močového měchýře * MeSH
- program SEER MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
A The incidence of exercise-associated hyponatremia (EAH) is higher in women than in men. We present three cases of a very mild post-race EAH in female winners of three 24-h ultra races in various weather conditions and disciplines with post-race plasma sodium [Na⁺] levels of 134 mM (Case 1), 133 mM (Case 2) and 134 mM (Case 3). Moreover, Case 1 and Case 2 showed elevated creatine kinase concentrations of >10,000 U/l with an absence of renal function abnormality. The common characteristics were female sex, veteran recreational category, long race experience in the particular sports discipline, excellent race performance, similar total weekly training hours and the presence of luteal phase of the menstrual cycle during the race. Hematocrit and hemoglobin decreased and post-race K⁺/Na⁺ ratio in urine increased in all three cases. In addition, an increased body mass and a decreased urine specific gravity and urine osmolality suggested over-drinking in Case 1. A decrease in the glomerular filtration rate and creatine clearance accompanied by an increase in urine [Na⁺] may contribute to fluid overload in Cases 2 and 3. Furthermore, urine osmolality reached a level indicating antidiuretic hormone secretion in all the present cases. Therefore, we recommend that race medical personnel should not forget to look for EAH even in fast and experienced female athletes and during races in different environmental conditions.
- Klíčová slova
- mountain biking, running, 24-h-race,
- MeSH
- cvičení fyziologie MeSH
- dospělí MeSH
- fyzická vytrvalost * MeSH
- hyponatremie etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- počasí * MeSH
- sodík krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- sodík MeSH
To facilitate the precision of clinical electrocardiographic studies of J-to-Tpeak (JTp) and Tpeak-to-Tend (Tpe) intervals, the study investigated their differences between healthy females and males, and between subjects of African and Caucasian origin. In 523 healthy subjects (254 females; 236 subjects of African origin), repeated Holter recordings were used to measure QT, JT, JTp, and Tpe intervals preceded by both stable and variable heart rates. Subject-specific curvilinear regression models were used to obtain individual QTc, JTc, JTpc and Tpec intervals. Rate hysteresis, i.e., the speed with which the intervals adapted after heart rate changes, was also investigated. In all sex-race groups, Tpe intervals were not systematically heart rate dependent. Similar to QTc intervals, women had JTc, and JTpc intervals longer than males (difference 20-30 ms, p < 0.001). However, women had Tpec intervals (and rate uncorrected Tpe intervals) shorter by approximately 10 ms compared to males (p < 0.001). Subjects of African origin had significantly shorter QTc intervals than Caucasians (p < 0.001). Gradually diminishing race-difference was found for JTc, JTpc and Tpec intervals. JTc and JTpc were moderately increasing with age but Tpe/Tpec were not. Rate hysteresis of JTp was approximately 10% longer compared to that of JT (p < 0.001). In future clinical studies, Tpe interval should not be systematically corrected for heart rate and similar to the QT interval, the differences in JT, JTp and Tpe intervals should be corrected for sex. The differences in QT and JT, and JTp intervals should also be corrected for race.
- MeSH
- dospělí MeSH
- elektrokardiografie * MeSH
- lidé MeSH
- pohlavní dimorfismus * MeSH
- převodní systém srdeční fyziologie MeSH
- rasové skupiny * MeSH
- srdeční frekvence fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
INTRODUCTION: This study investigates social determinants of systemic inflammation, focusing on race, SES, and perceived discrimination. METHODS: Data on 884 white and 170 black participants were obtained from the Survey of Midlife in the U.S., a cross-sectional observational study combining survey measures, anthropometry, and biomarker assay. Data, collected in 2004-2009, were analyzed in 2016. Main outcome measures were fasting blood concentrations of C-reactive protein, interleukin 6, fibrinogen, and E-selectin. For each biomarker, series of multivariate linear regression models were estimated for the pooled sample and separately for blacks and whites. Full models included social determinants; psychological, lifestyle, and health factors; and demographic covariates. RESULTS: Bivariate analyses indicated higher concentrations of all inflammation markers among blacks compared with whites (p<0.001). In fully adjusted models using the pooled sample, racial differences persisted for interleukin 6 (p<0.001) and fibrinogen (p<0.01). For E-selectin and C-reactive protein, racial differences were explained after adjusting for covariates. Education was linked to lower fibrinogen concentration (p<0.05) in the fully adjusted model and C-reactive protein concentration (p<0.01) after adjusting for demographic factors and income. Lifetime perceived discrimination was related to higher concentrations of fibrinogen (p<0.05) in the fully adjusted model, and higher concentrations of E-selectin and interleukin 6 (p<0.05) after adjusting for socioeconomic status (SES) and demographic factors. CONCLUSIONS: This study clarifies the contributions of race, SES, and perceived discrimination to inflammation. It suggests that inflammation-reducing interventions should focus on blacks and individuals facing socioeconomic disadvantages, especially low education.
- MeSH
- běloši psychologie statistika a číselné údaje MeSH
- biologické markery krev MeSH
- C-reaktivní protein analýza MeSH
- černoši nebo Afroameričané psychologie statistika a číselné údaje MeSH
- diskriminace (psychologie) MeSH
- disparity zdravotního stavu MeSH
- dospělí MeSH
- E-selektin krev MeSH
- fibrinogen analýza MeSH
- interleukin-6 krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- percepce MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- sociální determinanty zdraví * MeSH
- společenská třída * MeSH
- zánět krev epidemiologie psychologie MeSH
- zdravé chování MeSH
- životní styl MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Názvy látek
- biologické markery MeSH
- C-reaktivní protein MeSH
- E-selektin MeSH
- fibrinogen MeSH
- IL6 protein, human MeSH Prohlížeč
- interleukin-6 MeSH
- SELE protein, human MeSH Prohlížeč
OBJECTIVE: This study investigates the associations of body mass index (BMI) and waist circumference (WC) with markers of systemic inflammation in midlife by race and gender. DESIGN: Data were obtained from the Survey of Midlife in the United States, a cross-sectional, observational study of Americans 35 years old or older (White men: N = 410; White women: N = 490; Black men: N = 58; Black women: N = 117). Inflammation was measured by concentrations of fibrinogen and C-reactive protein (CRP) in fasting plasma and concentrations of E-selectin and interleukin-6 (IL-6) in fasting serum. Anthropometric data were used to obtain BMI and WC. Socio-demographic and health-related factors were assessed with a survey. Multivariate models by race and gender were estimated to test the roles of BMI and WC for each inflammation marker. RESULTS: Compared to White men, Black women have higher BMI and higher levels of all four inflammation markers; White women have lower BMI, lower WC, and lower E-selectin and fibrinogen but higher CRP; and Black men have higher fibrinogen. After adjusting for socio-demographic and health-related covariates as well as perceived discrimination, WC is associated with all four markers of inflammation among White men and women; with three markers (fibrinogen, CRP, and IL-6) of inflammation among Black women; and with CRP (and marginally with fibrinogen and E-selectin) among Black men. BMI is associated with higher CRP and fibrinogen among Black men (marginally so for White men) but not for women of either race. CONCLUSIONS: WC shows more consistent associations with inflammation markers than BMI, although the relationships vary by inflammation marker and population group. Our findings suggest that WC is a risk factor for systemic inflammation among White and Black men and women, and BMI is an additional risk factor for Black men.
- Klíčová slova
- Inflammation, body mass index, gender, race/ethnicity, waist circumference,
- MeSH
- běloši statistika a číselné údaje MeSH
- biologické markery MeSH
- C-reaktivní protein biosyntéza MeSH
- černoši nebo Afroameričané statistika a číselné údaje MeSH
- dospělí MeSH
- E-selektin biosyntéza MeSH
- fibrinogen biosyntéza MeSH
- index tělesné hmotnosti * MeSH
- interleukin-6 biosyntéza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mediátory zánětu MeSH
- obvod pasu * MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- sexuální faktory MeSH
- socioekonomické faktory MeSH
- tělesné váhy a míry MeSH
- zánět etnologie patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Geografické názvy
- Spojené státy americké MeSH
- Názvy látek
- biologické markery MeSH
- C-reaktivní protein MeSH
- E-selektin MeSH
- fibrinogen MeSH
- interleukin-6 MeSH
- mediátory zánětu MeSH
INTRODUCTION: This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). METHODS: The sample consisted of white, black, and Native American respondents to the Behavioral Risk Factor Surveillance System (2005-2013) who had sought health care in the past 12 months. Multiple logistic regression models of perceived racial privilege and perceived discrimination were estimated. Analyses were performed in 2016. RESULTS: Perceptions of racial privilege were less common among blacks and Native Americans compared with whites, while perceptions of racial discrimination were more common among these minorities. In whites, higher income and education contributed to increased perceptions of privileged treatment and decreased perceptions of discrimination. The pattern was reversed in blacks, who reported more discrimination and less privilege at higher income and education levels. Across racial groups, respondents who reported foregone medical care due to cost had higher risk of perceived racial discrimination. Health insurance contributed to less perceived racial discrimination and more perceived privilege only among whites. CONCLUSIONS: SES is an important social determinant of perceived privilege and perceived discrimination in health care, but its role varies by indicator and racial group. Whites with low education or no health insurance, well-educated blacks, and individuals who face cost-related barriers to care are at increased risk of perceived discrimination. Policies and interventions to reduce these perceptions should target structural and systemic factors, including society-wide inequalities in income, education, and healthcare access, and should be tailored to account for racially specific healthcare experiences.
- MeSH
- Behavioral Risk Factor Surveillance System MeSH
- běloši psychologie statistika a číselné údaje MeSH
- černoši nebo Afroameričané psychologie statistika a číselné údaje MeSH
- diskriminace (psychologie) * MeSH
- disparity zdravotní péče statistika a číselné údaje MeSH
- dospělí MeSH
- dostupnost zdravotnických služeb etika statistika a číselné údaje MeSH
- indiáni Severní Ameriky psychologie statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- menšiny psychologie statistika a číselné údaje MeSH
- mladý dospělý MeSH
- percepce * MeSH
- průřezové studie MeSH
- rasismus psychologie statistika a číselné údaje MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- společenská třída * MeSH
- zdravotní stav MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Spojené státy americké etnologie MeSH