National Healthcare Quality and Disparities Report
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- (-) Social Determinants of Health (42)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 42 Research Studies DisplayedLewis MW, Khodneva Y, Redmond N
The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.
The authors investigated the association between income-education groups and incident coronary heart disease (CHD) in a national prospective cohort study. They found that, for younger individuals, low income, regardless of education, was associated with higher risk of CHD; however, this was not observed for those 65 years of age or older.
AHRQ-funded; HS023009.
Citation: Lewis MW, Khodneva Y, Redmond N .
The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.
BMC Public Health 2015 Dec 29;15:1312. doi: 10.1186/s12889-015-2630-4.
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Keywords: Cardiovascular Conditions, Racial and Ethnic Minorities, Social Determinants of Health, Stroke
Spatz ES, Jiang X, Lu J
Qingdao Port Cardiovascular Health Study: a prospective cohort study.
The Qingdao Port Cardiovascular Health Study was designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Early findings reveal a significant increase in cardiovascular risk factors (hypertension, diabetes, hyperlipidemia, and body mass index) from 2000 to 2010.
AHRQ-funded; HS023000.
Citation: Spatz ES, Jiang X, Lu J .
Qingdao Port Cardiovascular Health Study: a prospective cohort study.
BMJ Open 2015 Dec 9;5(12):e008403. doi: 10.1136/bmjopen-2015-008403.
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Keywords: Cardiovascular Conditions, Risk, Social Determinants of Health, Patient-Centered Outcomes Research, Prevention
Lairson DR, Parikh RC, Cormier JN
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
The researchers assessed the cost-effectiveness of chemotherapy regimens by age and disease stage under "real-world" conditions for patients with breast cancer. They found that anthracycline-based chemotherapy was found cost-effective for elderly patients with early stage (stage I, II, IIIa) breast cancer considering the US threshold of $100,000 per QALY.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
Value Health 2015 Dec;18(8):1070-8. doi: 10.1016/j.jval.2015.08.008..
Keywords: Cancer: Breast Cancer, Treatments, Healthcare Costs, Elderly, Social Determinants of Health
Waehrer G, Deb P, Decker SL
AHRQ Author: Decker SL
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
This paper examines the relationship between increased Supplemental Nutritional Assistance Program (SNAP) benefits following the 2009 American Recovery and Reinvestment Act (ARRA) and the diet quality of individuals from SNAP-eligible compared to ineligible (those with somewhat higher income). In the full sample, we find that these increases in SNAP benefits are not associated with changes in nutrient intake and diet quality.
AHRQ-authored.
Citation: Waehrer G, Deb P, Decker SL .
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
Econ Hum Biol 2015 Dec;19:170-83. doi: 10.1016/j.ehb.2015.08.006..
Keywords: Nutrition, Social Determinants of Health, Low-Income, Vulnerable Populations
Ray KN, Chari AV, Engberg J
Disparities in time spent seeking medical care in the United States.
The researchers assessed how time associated with medical visits varied across socioeconomic variables and visit characteristics. They determined that patients spent on average 123 minutes obtaining medical care, including 86 minutes of clinic time and 38 minutes travel time. Clinic time was significantly longer for racial/ethnic minorities, individuals with less education, and unemployed individuals.
AHRQ-funded; HS022989.
Citation: Ray KN, Chari AV, Engberg J .
Disparities in time spent seeking medical care in the United States.
JAMA Intern Med 2015 Dec;175(12):1983-6. doi: 10.1001/jamainternmed.2015.4468..
Keywords: Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Access to Care, Quality of Care
Whittle HJ, Palar K, Napoles T
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
The researchers investigated the perceived effects of food insecurity on risky sexual behaviors among a population of low-income people living with HIV/AIDS (PLHIV) in San Francisco and Alameda County, California. Their study demonstrated that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among men who have sex with men.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Napoles T .
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
J Int AIDS Soc 2015 Nov 4;18:20293. doi: 10.7448/ias.18.1.20293..
Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Lifestyle Changes, Low-Income, Social Determinants of Health
Kennedy-Hendricks A, Schwartz HL, Griffin BA
Health implications of social networks for children living in public housing.
This study sought to examine whether the health composition of the social networks of children living in subsidized housing differs from those living in public housing developments; and whether children's social network composition is associated with children's own health. The authors found no significant differences in the health characteristics of the social networks of children based on housing, but social network composition was significantly associated with several aspects of children's own health.
AHRQ-funded; HS000029.
Citation: Kennedy-Hendricks A, Schwartz HL, Griffin BA .
Health implications of social networks for children living in public housing.
Health Place 2015 Nov;36:145-51. doi: 10.1016/j.healthplace.2015.11.001.
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Keywords: Children/Adolescents, Health Status, Low-Income, Social Determinants of Health
Singal AG, El-Serag HB
Hepatocellular carcinoma from epidemiology to prevention: Translating knowledge into practice.
The effectiveness of hepatocellular carcinoma (HCC) prevention in clinical practice and at the population level has lagged behind due to patient, provider, system, and societal factors. The authors suggest that the Quality in the Continuum of Cancer Care model provides a framework for evaluating the HCC prevention processes, including potential failures that create a gap between efficacy and effectiveness.
AHRQ-funded; HS022418.
Citation: Singal AG, El-Serag HB .
Hepatocellular carcinoma from epidemiology to prevention: Translating knowledge into practice.
Clin Gastroenterol Hepatol 2015 Nov;13(12):2140-51. doi: 10.1016/j.cgh.2015.08.014.
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Keywords: Cancer, Implementation, Prevention, Social Determinants of Health
Nieman CL, Benke JR, Boss EF
Does race/ethnicity or socioeconomic status influence patient satisfaction in pediatric surgical care?
The researchers evaluated patient satisfaction in outpatient pediatric surgical care and assess differences in scores by race/ ethnicity and socioeconomic status. Their analysis found no disparities in the patient experience by individual- or community-level factors.
AHRQ-funded; HS022932.
Citation: Nieman CL, Benke JR, Boss EF .
Does race/ethnicity or socioeconomic status influence patient satisfaction in pediatric surgical care?
Otolaryngol Head Neck Surg 2015 Oct;153(4):620-8. doi: 10.1177/0194599815590592..
Keywords: Patient Experience, Social Determinants of Health, Surgery, Racial and Ethnic Minorities, Children/Adolescents
Whittle HJ, Palar K, Hufstedler LL
Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: an example of structural violence in United States public policy.
This study sought to explore the experiences and structural determinants of food insecurity among a group of low-income PLHIV in the San Francisco Bay Area. It found that the lived experience of food insecurity among participants included periods of insufficient quantity of food and resultant hunger, as well as long-term struggles with quality of food that led to concerns about the poor health effects of a cheap diet.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Hufstedler LL .
Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: an example of structural violence in United States public policy.
Soc Sci Med 2015 Oct;143:154-61. doi: 10.1016/j.socscimed.2015.08.027..
Keywords: Chronic Conditions, Policy, Social Determinants of Health, Nutrition, Vulnerable Populations
Sentell T, Miyamura J, Ahn HJ
Potentially preventable hospitalizations for congestive heart failure among Asian Americans and Pacific Islanders in Hawai'i.
The authors studied congestive heart failure (CHF) hospitalizations among racial groups. They found that high preventable CHF hospitalization rates are seen in some Asian and Pacific Islander groups, especially Native Hawaiians and Filipinos, who have these hospitalizations at younger ages than other studied groups.
AHRQ-funded; HS019990.
Citation: Sentell T, Miyamura J, Ahn HJ .
Potentially preventable hospitalizations for congestive heart failure among Asian Americans and Pacific Islanders in Hawai'i.
J Immigr Minor Health 2015 Oct;17(5):1289-97. doi: 10.1007/s10903-014-0098-4.
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Keywords: Heart Disease and Health, Hospitalization, Prevention, Racial and Ethnic Minorities, Social Determinants of Health
Thorpe RJ, Jr., Kennedy-Hendricks A, Griffith DM
Race, social and environmental conditions, and health behaviors in men.
The investigators examined the nature of disparities in health behaviors among African American and white men in the Exploring Health Disparities in Integrated Communities Study-Southwest Baltimore to data from the 2003 National Health Interview Survey. They found that race disparities in physical activity, drinking, and smoking were ameliorated where African American and white men were living under similar social, environmental, and socioeconomic status conditions, suggesting that social environment may be an important determinant of health behaviors among African American and white men.
AHRQ-funded; HS000029.
Citation: Thorpe RJ, Jr., Kennedy-Hendricks A, Griffith DM .
Race, social and environmental conditions, and health behaviors in men.
Fam Community Health 2015 Oct-Dec;38(4):297-306. doi: 10.1097/fch.0000000000000078.
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Keywords: Disparities, Health Status, Lifestyle Changes, Racial and Ethnic Minorities, Social Determinants of Health
Abdus S, Zuvekas SH
AHRQ Author: Abdus S, Zuvekas SH
Racial/ethnic differences in the relationship between obesity and depression treatment.
This study examined the relationship between obesity and the treatment of depression across racial/ethnic subgroups, controlling for depressive symptoms, self-rated mental health, health status, and socioeconomic characteristics. It found that the association between obesity and depression-related medication was significant for white women but not for black or Hispanic women. The results for men were, in general, mixed and inconsistent.
AHRQ-authored.
Citation: Abdus S, Zuvekas SH .
Racial/ethnic differences in the relationship between obesity and depression treatment.
J Behav Health Serv Res 2015 Oct;42(4):486-503. doi: 10.1007/s11414-014-9391-1..
Keywords: Obesity, Depression, Social Determinants of Health, Racial and Ethnic Minorities, Medical Expenditure Panel Survey (MEPS)
Hidalgo B, Kaphingst KA, Stafford J
Diagnostic accuracy of self-reported racial composition of residential neighborhood.
The purpose of this study was to examine the diagnostic accuracy of self-reported measures of individuals’ perceptions of the racial and ethnic composition of their communities with objective data (i.e., census). It found that respondents who self-identified as white were more likely to self-report racial composition of their neighborhood consistent with 2010 Census estimates.
AHRQ-funded; HS020309.
Citation: Hidalgo B, Kaphingst KA, Stafford J .
Diagnostic accuracy of self-reported racial composition of residential neighborhood.
Ann Epidemiol 2015 Aug;25(8):597-604. doi: 10.1016/j.annepidem.2015.04.003..
Keywords: Diagnostic Safety and Quality, Social Determinants of Health, Racial and Ethnic Minorities
Geissler KH, Becker C, Stearns SC
Exploring the association of homicides in northern Mexico and healthcare access for US residents.
The reesearchers analyzed whether recent increases in homicides in Mexico are associated with reduced healthcare access for US border residents. They found that, despite a decrease in border crossings, increased violence in Mexico did not appear to negatively affect healthcare access for US border residents.
AHRQ-funded; HS021074.
Citation: Geissler KH, Becker C, Stearns SC .
Exploring the association of homicides in northern Mexico and healthcare access for US residents.
J Immigr Minor Health 2015 Aug;17(4):1214-24. doi: 10.1007/s10903-014-0053-4.
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Keywords: Access to Care, Health Services Research (HSR), Social Determinants of Health
Davis AE, Mehrotra S, Friedewald JJ
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
The authors analyzed current kidney allocation and developed an alternative kidney sharing strategy using a multiperiod linear optimization model, KSHARE, which aims to improve geographic equity in kidney transplantation while also respecting transplant system constraints and priorities. They used Organ Procurement and Transplant Network data to determine that enhancing the practice of sharing kidneys by the KSHARE model may increase geographic equity in kidney transplantation.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Friedewald JJ .
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
Med Decis Making 2015 Aug;35(6):797-807. doi: 10.1177/0272989x14557696.
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Keywords: Access to Care, Disparities, Health Services Research (HSR), Social Determinants of Health, Transplantation
Balaban RB, Galbraith AA, Burns ME
A patient navigator intervention to reduce hospital readmissions among high-risk safety-net patients: a randomized controlled trial.
The researchers sough to determine if an intervention by patient navigators, hospital-based Community Health Workers, reduces readmissions among high risk, low socioeconomic status patients. They found that, overall, 30-day readmission rates did not differ between intervention and control patients.
AHRQ-funded; HS020628.
Citation: Balaban RB, Galbraith AA, Burns ME .
A patient navigator intervention to reduce hospital readmissions among high-risk safety-net patients: a randomized controlled trial.
J Gen Intern Med 2015 Jul;30(7):907-15. doi: 10.1007/s11606-015-3185-x..
Keywords: Hospital Readmissions, Low-Income, Social Determinants of Health, Patient Safety
Berkowitz SA, Percac-Lima S, Ashburner JM
Building equity improvement into quality improvement: reducing socioeconomic disparities in colorectal cancer screening as part of population health management.
The aim of this study was to determine if implementation of a system-wide screening intervention could reduce disparities in the setting of improved overall screening rates. It found that a multifaceted population management intervention sensitive to the needs of vulnerable patients modestly narrowed disparities in colorectal cancer screening, while also increasing overall screening rates.
AHRQ-funded; HS018161.
Citation: Berkowitz SA, Percac-Lima S, Ashburner JM .
Building equity improvement into quality improvement: reducing socioeconomic disparities in colorectal cancer screening as part of population health management.
J Gen Intern Med 2015 Jul;30(7):942-9. doi: 10.1007/s11606-015-3227-4..
Keywords: Disparities, Screening, Social Determinants of Health, Colonoscopy
Roberts MC, Wheeler SB, Reeder-Hayes K
Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review.
The authors sought to understand factors that influence endocrine therapy (ET) adherence among racial/ethnic and socioeconomic subpopulations of breast cancer patients. They found significant underuse of ET among minority and low-income women. They further noted that both race/ethnicity and socioeconomic status are associated with ET use in most settings.
AHRQ-funded; HS021282.
Citation: Roberts MC, Wheeler SB, Reeder-Hayes K .
Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review.
Am J Public Health 2015 Jul;105 Suppl 3:e4-e15. doi: 10.2105/ajph.2014.302490.
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Keywords: Cancer: Breast Cancer, Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Determinants of Health
Buys DR, Howard VJ, McClure LA
Association between neighborhood disadvantage and hypertension prevalence, awareness, treatment, and control in older adults: results from the University of Alabama at Birmingham Study of Aging.
The investigators evaluated the effect of neighborhood disadvantage (ND) on older adults' prevalence, awareness, treatment, and control of hypertension. Using data from the University of Alabama at Birmingham Study of Aging along with US Census data, they created tertiles of ND and found that living in mid-ND and high-ND tertiles was associated with higher hypertension prevalence, and living in high-ND tertiles was further associated with lower odds of controlled hypertension.
AHRQ-funded; HS019465; HS013852.
Citation: Buys DR, Howard VJ, McClure LA .
Association between neighborhood disadvantage and hypertension prevalence, awareness, treatment, and control in older adults: results from the University of Alabama at Birmingham Study of Aging.
Am J Public Health 2015 Jun;105(6):1181-8. doi: 10.2105/ajph.2014.302048.
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Keywords: Elderly, Blood Pressure, Low-Income, Social Determinants of Health, Cardiovascular Conditions, Chronic Conditions
Sorkin DH, Billimek J, August KJ
AHRQ Author: Ngo-Metzger Q
Mental health symptoms and patient-reported diabetes symptom burden: implications for medication regimen changes.
The aim of this paper was to examine the relative contribution of glycaemic control (HbA1C) and depressive symptoms on diabetes-related symptom burden (hypoglycaemia and hyperglycaemia) in order to guide medication modification. The authors found that mental health symptoms are associated with higher levels of patient-reported diabetes-related symptoms, but the association between diabetes-related symptoms and subsequent regimen modifications is diminished in patients with greater depressive symptoms.
AHRQ-authored.
Citation: Sorkin DH, Billimek J, August KJ .
Mental health symptoms and patient-reported diabetes symptom burden: implications for medication regimen changes.
Fam Pract 2015 Jun;32(3):317-22. doi: 10.1093/fampra/cmv014.
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Keywords: Depression, Diabetes, Medication, Practice Patterns, Social Determinants of Health
Dupre ME, George LK, Liu G
Association between divorce and risks for acute myocardial infarction.
This study investigated the association between lifetime exposure to divorce and the incidence of acute myocardial infarction (AMI) in US adults. Divorce is a significant risk factor for AMI. It found that the risks associated with multiple divorces are especially high in women and are not reduced with remarriage.
AHRQ-funded; HS021092.
Citation: Dupre ME, George LK, Liu G .
Association between divorce and risks for acute myocardial infarction.
Circ Cardiovasc Qual Outcomes 2015 May;8(3):244-51. doi: 10.1161/circoutcomes.114.001291..
Keywords: Heart Disease and Health, Risk, Social Determinants of Health
Sasson C, Haukoos JS, Ben-Youssef L
Barriers to calling 911 and learning and performing cardiopulmonary resuscitation for residents of primarily Latino, high-risk neighborhoods in Denver, Colorado.
The goal of this study was to identify barriers and facilitators to calling 911, and learning and performing CPR in 5 low-income, Latino neighborhoods in Denver, CO. Six key barriers to calling 911 were identified: fear of becoming involved because of distrust of law enforcement, financial, immigration status, lack of recognition of cardiac arrest event, language, and violence.
AHRQ-funded; HS017526; HS021749.
Citation: Sasson C, Haukoos JS, Ben-Youssef L .
Barriers to calling 911 and learning and performing cardiopulmonary resuscitation for residents of primarily Latino, high-risk neighborhoods in Denver, Colorado.
Ann Emerg Med 2015 May;65(5):545-52.e2. doi: 10.1016/j.annemergmed.2014.10.028..
Keywords: Emergency Medical Services (EMS), Social Determinants of Health, Racial and Ethnic Minorities, Low-Income
Witt WP, Park H, Wisk LE
Neighborhood disadvantage, preconception stressful life events, and infant birth weight.
This study investigated the impact of neighborhood conditions on the association between stressful life events prior to pregnancy and birth weight in a national sample of women living in the United States. It found that women who experienced preconception stressful life events, who had chronic conditions, or were racial/ethnic minorities had the greatest risk of having very low birth weight infants if they lived in disadvantaged neighborhoods.
AHRQ-funded; HS000083; HS000063
Citation: Witt WP, Park H, Wisk LE .
Neighborhood disadvantage, preconception stressful life events, and infant birth weight.
Am J Public Health 2015 May;105(5):1044-52. doi: 10.2105/ajph.2015.302566.
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Keywords: Pregnancy, Social Determinants of Health, Chronic Conditions
Wang X, Du XL
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
The researchers assessed socio-demographic, geographic, and other variations in the receipt of hormone therapy among patients with hormone receptor-positive breast cancer as well as adherence to hormone therapy within 1-year follow-up. They found that found that increasing age was significantly associated with a decreased receipt of hormone therapy and aromatase inhibitors in all hormone receptor-positive breast cancer patients after adjusting for other factors regardless of whether chemotherapy was received.
AHRQ-funded; HS018956.
Citation: Wang X, Du XL .
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
Med Oncol 2015 May;32(5):154. doi: 10.1007/s12032-015-0599-6..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Determinants of Health