National Healthcare Quality and Disparities Report
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Topics
- Access to Care (12)
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- (-) Racial and Ethnic Minorities (87)
- Research Methodologies (2)
- Respiratory Conditions (1)
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- (-) Social Determinants of Health (87)
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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
26 to 50 of 87 Research Studies DisplayedBass AR, Mehta B, Szymonifka J
Racial disparities in total knee replacement failure as related to poverty.
The authors sought to determine whether racial disparities in total knee replacement (TKR) failure are explained by poverty. Linking New York state patients to residential census tracts by geocoded addresses, they found that there was a trend toward higher TKR revision risk in blacks, but poverty did not modify the relationship between race and TKR revision or failure.
AHRQ-funded; HS016075.
Citation: Bass AR, Mehta B, Szymonifka J .
Racial disparities in total knee replacement failure as related to poverty.
Arthritis Care Res 2019 Nov;71(11):1488-94. doi: 10.1002/acr.24028..
Keywords: Disparities, Racial and Ethnic Minorities, Low-Income, Surgery, Orthopedics, Social Determinants of Health
Canedo JR, Miller ST, Myers HF
Racial and ethnic differences in knowledge and attitudes about genetic testing in the US: systematic review.
This systematic review examined racial and ethnic differences in knowledge and attitudes about genetic testing in the US. The authors found 12 articles published in 1997-2017 that met their inclusion criteria. The studies found consistent patterns of lower awareness of genetic testing in general among non-White populations, lower factual knowledge scores among Blacks and Hispanics/Latinos, and mixed findings of differences of awareness of direct-to-consumer genetic testing or the term precision medicine.
AHRQ-funded; HS026122.
Citation: Canedo JR, Miller ST, Myers HF .
Racial and ethnic differences in knowledge and attitudes about genetic testing in the US: systematic review.
J Genet Couns 2019 Jun;28(3):587-601. doi: 10.1002/jgc4.1078..
Keywords: Racial and Ethnic Minorities, Genetics, Screening, Social Determinants of Health
Jarman MP, Pollack Porter K, Curriero FC
Factors mediating demographic determinants of injury mortality.
The authors investigated the role of injury characteristics and access to trauma care as mediators of the relationships between race, ethnicity, sex, and injury mortality. They found that distance, injury characteristics, and insurance mediate the effects of demographic characteristics on injury mortality and appear to contribute to disparities in injury mortality.
AHRQ-funded; HS000029.
Citation: Jarman MP, Pollack Porter K, Curriero FC .
Factors mediating demographic determinants of injury mortality.
Ann Epidemiol 2019 Jun;34:58-64.e2. doi: 10.1016/j.annepidem.2019.03.013..
Keywords: Access to Care, Disparities, Injuries and Wounds, Mortality, Racial and Ethnic Minorities, Sex Factors, Social Determinants of Health, Trauma
Xie Z, St Clair P, Goldman DP
Racial and ethnic disparities in medication adherence among privately insured patients in the United States.
The purpose of this study was to examine the association between socioeconomic status (SES) and racial and ethnic disparities in medication adherence for three widely prescribed therapeutic classes. The investigators concluded that racial/ethnic disparities in adherence were mitigated, but persisted after controlling for detailed socioeconomic measures. They suggest that interventions should focus more on improving medication adherence of existing users, particularly in treating asymptomatic conditions.
AHRQ-funded; HS013447.
Citation: Xie Z, St Clair P, Goldman DP .
Racial and ethnic disparities in medication adherence among privately insured patients in the United States.
PLoS One 2019 Feb 14;14(2):e0212117. doi: 10.1371/journal.pone.0212117..
Keywords: Racial and Ethnic Minorities, Disparities, Patient Adherence/Compliance, Medication, Social Determinants of Health, Health Insurance
Mehta B, Szymonifka J, Dey S
Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
The objective of this study was to assess the relationship of neighborhood immigrant proportion (IP) to preoperative and 2-year postoperative pain and function after elective total knee arthroplasty (TKA) using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patients in a high-volume institutional TKA registry were analyzed retrospectively, and demographics, pre-op and 2-year post-op WOMAC pain and function scores, and addresses obtained. Patient-level variables were linked to Census Bureau tract data. Researchers conclude that patients living in high IP neighborhoods do not have worse pre-op or 2-year post-op pain and function outcomes after TKA compared to those living in lower IP neighborhoods.
AHRQ-funded; HS016075.
Citation: Mehta B, Szymonifka J, Dey S .
Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
BMC Musculoskelet Disord 2019 Feb 9;20(1):67. doi: 10.1186/s12891-019-2446-y..
Keywords: Arthritis, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Social Determinants of Health, Surgery
Stockwell DC, Landrigan CP, Toomey SL
Racial, ethnic, and socioeconomic disparities in patient safety events for hospitalized children.
Previous studies have revealed racial/ethnic and socioeconomic disparities in quality of care and patient safety. However, these disparities have not been examined in a pediatric inpatient environment by using a measure of clinically confirmed adverse events (AEs). In this study, the investigators do so using the Global Assessment of Pediatric Patient Safety (GAPPS) Trigger Tool. The investigators concluded that the GAPPS analysis revealed racial and/or ethnic and socioeconomic disparities in rates of AEs experienced by hospitalized children across a broad range of geographic and hospital settings.
AHRQ-funded; HS020513; HS025299.
Citation: Stockwell DC, Landrigan CP, Toomey SL .
Racial, ethnic, and socioeconomic disparities in patient safety events for hospitalized children.
Hosp Pediatr 2019 Jan;9(1):1-5. doi: 10.1542/hpeds.2018-0131..
Keywords: Children/Adolescents, Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Hospitalization, Patient Safety, Quality of Care, Adverse Events
Echeverria SE, Divney A, Rodriguez F
Nativity and occupational determinants of physical activity participation among Latinos.
This study examined associations of race/ethnicity; nativity; and leisure-time, transportation, and occupation-related physical activity among Latino and non-Latino white adults. Using National Health and Nutrition Examination Survey self-reported data, results showed variability in the relationship between nativity and the physical activity domain Latinos engage in compared with non-Latino whites, with occupation contributing substantially to meeting physical activity recommendations for all population groups.
AHRQ-funded; HS000066.
Citation: Echeverria SE, Divney A, Rodriguez F .
Nativity and occupational determinants of physical activity participation among Latinos.
Am J Prev Med 2019 Jan;56(1):84-92. doi: 10.1016/j.amepre.2018.07.036..
Keywords: Lifestyle Changes, Racial and Ethnic Minorities, Social Determinants of Health
Masho SW, Rozario S, Walker D
Racial differences and the role of marital status in the association between intimate partner violence and unintended pregnancy.
This study examined the association between intimate partner violence (IPV) and unintended pregnancy across racial/ethnic and marital strata among U.S. women. Among other results, the investigators found that the odds of unintended pregnancy were increased for married non-Hispanic White women who reported IPV compared to their non-abused counterparts even after controlling for sociodemographic factors, health care access, and reproductive history.
AHRQ-funded; HS021504.
Citation: Masho SW, Rozario S, Walker D .
Racial differences and the role of marital status in the association between intimate partner violence and unintended pregnancy.
J Interpers Violence 2018 Oct;33(20):3162-85. doi: 10.1177/0886260516635317..
Keywords: Domestic Violence, Pregnancy, Racial and Ethnic Minorities, Social Determinants of Health
Washington DM, Curtis LM, Waite K
Sociodemographic factors mediate race and ethnicity-associated childhood asthma health disparities: a longitudinal analysis.
This study characterized the longitudinal effects associated with being African-American/Black or Hispanic/Latino on a range of asthma outcomes, and the extent to which sociodemographic factors, caregiver health literacy, education level, and asthma knowledge mediated these associations. The investigators concluded that African-American race and Hispanic/Latino ethnicity are significantly associated with worse asthma compared to Whites in longitudinal analyses.
AHRQ-funded; HS022242.
Citation: Washington DM, Curtis LM, Waite K .
Sociodemographic factors mediate race and ethnicity-associated childhood asthma health disparities: a longitudinal analysis.
J Racial Ethn Health Disparities 2018 Oct;5(5):928-38. doi: 10.1007/s40615-017-0441-2..
Keywords: Asthma, Children/Adolescents, Disparities, Racial and Ethnic Minorities, Social Determinants of Health
Sentell TL, Shen C, Landsittel D
Racial/ethnic differences in those accompanying Medicare patients to the doctor: insights from the 2013 Medicare current beneficiary's survey.
This study used multivariable models applied to Medicare Current Beneficiary's Survey Access to Care public use data in order to predict companion accompaniment to health care providers among Medicare beneficiaries; Chi square analyses compared, by race/ethnicity, who was accompanying patients and why. Black and Hispanic patients were more likely to be accompanied than whites. In all three groups, more than a third of patients brought someone with them to ‘take notes,’ ‘ask questions,’ and/or ‘explain things,’ but significantly more Hispanic patients brought a companion to ‘explain instructions,’ ‘translate,’ and/or to provide ‘moral support.’ The authors conclude that many Medicare beneficiaries are accompanied to doctors' appointments, particularly among minority racial/ethnic groups, and that this should be taken in consideration in healthcare policy and practice.
AHRQ-funded; HS023185.
Citation: Sentell TL, Shen C, Landsittel D .
Racial/ethnic differences in those accompanying Medicare patients to the doctor: insights from the 2013 Medicare current beneficiary's survey.
J Immigr Minor Health 2018 Aug;20(4):776-83. doi: 10.1007/s10903-017-0582-8..
Keywords: Caregiving, Elderly, Medicare, Racial and Ethnic Minorities, Social Determinants of Health
Childers KK, Maggard-Gibbons M, Macinko J
National distribution of cancer genetic testing in the United States: evidence for a gender disparity in hereditary breast and ovarian cancer.
Identifying mutation carriers is critical for treatment decisions, cancer prevention, and early detection. This study analyzed the 2015 US National Health Interview Survey (NHIS), a cross-sectional in-person interview gathering self-reported health data for the US population. The study found that while cancer genetic testing seems to reach a broad geographic and sociodemographic population in the national survey, there remain underrepresented groups, including Hispanics, the uninsured, noncitizens, and those with less education.
AHRQ-funded; HS025079.
Citation: Childers KK, Maggard-Gibbons M, Macinko J .
National distribution of cancer genetic testing in the United States: evidence for a gender disparity in hereditary breast and ovarian cancer.
JAMA Oncol 2018 Jun;4(6):876-79. doi: 10.1001/jamaoncol.2018.0340..
Keywords: Cancer, Cancer: Breast Cancer, Cancer: Ovarian Cancer, Genetics, Racial and Ethnic Minorities, Screening, Social Determinants of Health, Women
Wong MS, Chan KS, Jones-Smith JC
The neighborhood environment and obesity: understanding variation by race/ethnicity.
The researchers examined the relationship between soda consumption and weight status with neighborhood sociodemographic, social, and built environments by race/ethnicity. Merging data on adults from the 2011-2013 California Health Interview Survey, U.S. Census data, and InfoUSA, they found that lower neighborhood educational attainment was associated with higher odds of obesity and soda consumption in all racial/ethnic groups. They found fewer associations between study outcomes and the neighborhood, especially the built environment, among non-Hispanic African Americans and non-Hispanic Asians. They concluded that, while improvements to neighborhood environment may be promising to reduce obesity, null associations among minority subgroups suggest that changes, particularly to the built environment, may alone be insufficient to address obesity in these groups.
AHRQ-funded; HS000029.
Citation: Wong MS, Chan KS, Jones-Smith JC .
The neighborhood environment and obesity: understanding variation by race/ethnicity.
Prev Med 2018 Jun;111:371-77. doi: 10.1016/j.ypmed.2017.11.029.
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Keywords: Disparities, Obesity, Racial and Ethnic Minorities, Social Determinants of Health
Graetz I, Huang J, Brand RJ
Bridging the digital divide: mobile access to personal health records among patients with diabetes.
The authors examined personal health record (PHR) use through a computer-based Web browser or mobile device. They found that mobile-ready PHRs may increase access among patients facing a digital divide in computer use, disproportionately reaching racial/ethnic minorities and lower socioeconomic status patients. They recommend continued efforts to increase equitable access to PHRs among patients with chronic conditions.
AHRQ-funded; HS015280.
Citation: Graetz I, Huang J, Brand RJ .
Bridging the digital divide: mobile access to personal health records among patients with diabetes.
Am J Manag Care 2018 Jan;24(1):43-48..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Racial and Ethnic Minorities, Social Determinants of Health
Akwo EA, Kabagambe EK, Harrell FE, Jr.
Neighborhood deprivation predicts heart failure risk in a low-income population of blacks and whites in the southeastern United States.
The researchers investigated whether neighborhood deprivation predicts risk of incident heart failure (HF) beyond individual socioeconomic status in a low-income population. They concluded that, in a low-income population from the Southern Community Cohort Study, scant neighborhood resources compounded the risk of HF above and beyond individual socioeconomic status and traditional cardiovascular risk factors.
AHRQ-funded; HS022990.
Citation: Akwo EA, Kabagambe EK, Harrell FE, Jr. .
Neighborhood deprivation predicts heart failure risk in a low-income population of blacks and whites in the southeastern United States.
Circ Cardiovasc Qual Outcomes 2018 Jan;11(1):e004052. doi: 10.1161/circoutcomes.117.004052.
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Keywords: Heart Disease and Health, Low-Income, Racial and Ethnic Minorities, Risk, Social Determinants of Health
Attanasio LB, Hardeman RR, Kozhimannil KB
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
This study examined whether women's prenatal attitudes toward vaginal delivery differed by race/ethnicity or socioeconomic status, and whether attitudes were differently related to delivery mode depending on race/ethnicity or socioeconomic status. The study concluded that there are racial/ethnic differences in chances of cesarean delivery, and these differences are not explained by birth attitudes. Findings also suggested that white and high-socioeconomic status women may be more able to realize their preferences in childbirth.
AHRQ-funded; HS024215.
Citation: Attanasio LB, Hardeman RR, Kozhimannil KB .
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
Birth 2017 Dec;44(4):306-14. doi: 10.1111/birt.12305..
Keywords: Health Services Research (HSR), Labor and Delivery, Pregnancy, Racial and Ethnic Minorities, Social Determinants of Health
Oates GR, Hamby BW, Stepanikova I
Social determinants of adherence to pulmonary rehabilitation for chronic obstructive pulmonary disease.
Adherence to pulmonary rehabilitation (PR) is low. Previous studies have focused on clinical predictors of PR completion. This study aimed to identify social determinants of adherence to PR. The findings showed that, relative to high adherence, low adherence is associated with limited functional capacity and current smoking, while moderate adherence is associated with socioeconomic disadvantage. The distinction highlights different pathways to suboptimal adherence and calls for tailored intervention approaches.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Stepanikova I .
Social determinants of adherence to pulmonary rehabilitation for chronic obstructive pulmonary disease.
Copd 2017 Dec;14(6):610-17. doi: 10.1080/15412555.2017.1379070..
Keywords: Respiratory Conditions, Racial and Ethnic Minorities, Patient Adherence/Compliance, Social Determinants of Health
Tung EL, Cagney KA, Peek ME
Spatial context and health inequity: reconfiguring race, place, and poverty.
The authors build on the Chicago School of Sociology's contributions in urban research and one of its contemporary elaborations, often described as the "neighborhood effects approach," to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity. Compositional axes of race and poverty form the foundation of the model.
AHRQ-funded; HS023007.
Citation: Tung EL, Cagney KA, Peek ME .
Spatial context and health inequity: reconfiguring race, place, and poverty.
J Urban Health 2017 Dec;94(6):757-63. doi: 10.1007/s11524-017-0210-x.
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Keywords: Disparities, Low-Income, Racial and Ethnic Minorities, Social Determinants of Health, Urban Health
Taira DA, Shen C, King M
Access to medications for Medicare enrollees related to race/ethnicity: results from the 2013 Medicare Current Beneficiary Survey.
Prescription medications are taken by millions of Americans to manage chronic conditions and treat acute conditions. These medications, however, are not equally accessible to all. The purpose of this study was to examine medication access by race/ethnicity among Medicare beneficiaries. The authors found that possible interventions for non-Hispanic blacks might include assisting them in finding the best drug plan to meeting their needs, connecting them to medication assistance programs, and discussing convenience of pharmacy with patients.
AHRQ-funded; HS023185.
Citation: Taira DA, Shen C, King M .
Access to medications for Medicare enrollees related to race/ethnicity: results from the 2013 Medicare Current Beneficiary Survey.
Res Social Adm Pharm 2017 Nov;13(6):1208-13. doi: 10.1016/j.sapharm.2016.10.021..
Keywords: Access to Care, Medicare, Medication, Racial and Ethnic Minorities, Social Determinants of Health
Heerman WJ, Jackson N, Roumie CL
Recruitment methods for survey research: findings from the Mid-South Clinical Data Research Network.
The objective of this study was to report survey response rates and demographic characteristics of eight recruitment approaches to determine acceptability and effectiveness of large-scale patient recruitment among various populations. The study concluded that technology-enabled recruitment approaches such as registries and emails are effective for recruiting but may yield less racial/ethnic diversity compared to traditional, more time-intensive approaches.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Jackson N, Roumie CL .
Recruitment methods for survey research: findings from the Mid-South Clinical Data Research Network.
Contemp Clin Trials 2017 Nov;62:50-55. doi: 10.1016/j.cct.2017.08.006..
Keywords: Patient-Centered Outcomes Research, Research Methodologies, Racial and Ethnic Minorities, Social Determinants of Health
Leeds IL, Alimi Y, Hobson DR
Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway.
This study aims to demonstrate the association between recovery pathway implementation, process measures, and short-term surgical outcomes by population subgroup. It concluded that differences in outcomes by race and socioeconomic status did not arise following implementation of an enhanced recovery pathway. Differences in process measures by population subgroups highlight differences in care that require further investigation.
AHRQ-funded; HS024736; HS024547.
Citation: Leeds IL, Alimi Y, Hobson DR .
Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway.
Dis Colon Rectum 2017 Oct;60(10):1092-101. doi: 10.1097/dcr.0000000000000879.
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Keywords: Racial and Ethnic Minorities, Social Determinants of Health, Surgery, Outcomes, Adverse Events
Attanasio L, Kozhimannil KB
Health care engagement and follow-up after perceived discrimination in maternity care.
The authors sought to determine if perceived discrimination during the birth hospitalization is associated with postpartum follow-up care. Using data from the Listening to Mothers III survey, they found that women who experienced perceived discrimination (race/ethnicity, insurance type, difference of opinion with provider about care) had more than twice the odds of postpartum visit nonattendance, after adjusting for socioeconomic and medical characteristics.
AHRQ-funded; HS024215.
Citation: Attanasio L, Kozhimannil KB .
Health care engagement and follow-up after perceived discrimination in maternity care.
Med Care 2017 Sep;55(9):830-33. doi: 10.1097/mlr.0000000000000773.
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Keywords: Access to Care, Maternal Care, Patient Experience, Racial and Ethnic Minorities, Social Determinants of Health
Jackson BE, Oates GR, Singh KP
Disparities in chronic medical conditions in the Mid-South.
This study examined differences in socio-demographic characteristics and health behaviors relevant to chronic medical conditions (CMCs) in the Mid-South region (Alabama, Mississippi, Louisiana, Kentucky, Tennessee, and Arkansas), and identified subpopulations with increased burden of chronic disease. It concluded that in the Mid-South, race and gender disparities in the top five chronic conditions are more prominent among higher-income rather than lower-income individuals.
AHRQ-funded; HS023009.
Citation: Jackson BE, Oates GR, Singh KP .
Disparities in chronic medical conditions in the Mid-South.
Ethn Health 2017 Apr;22(2):196-208. doi: 10.1080/13557858.2016.1232805.
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Keywords: Chronic Conditions, Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Farias AJ, Du XL
Association between out-of-pocket costs, race/ethnicity, and adjuvant endocrine therapy adherence among Medicare patients with breast cancer.
This study aimed to determine whether there are racial/ethnic differences in 1-year adherence to adjuvant endocrine therapy (AET) and whether out-of-pocket costs explain the racial/ethnic disparities in adherence. It concluded that racial/ethnic disparities in AET adherence were largely explained by women's differences in socioeconomic status and out-of-pocket medication costs.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Association between out-of-pocket costs, race/ethnicity, and adjuvant endocrine therapy adherence among Medicare patients with breast cancer.
J Clin Oncol 2017 Jan;35(1):86-95.
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Keywords: Cancer: Breast Cancer, Healthcare Costs, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Determinants of Health
Stepanikova I, Oates GR
Perceived discrimination and privilege in health care: the role of socioeconomic status and race.
This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). It found that 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.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Oates GR .
Perceived discrimination and privilege in health care: the role of socioeconomic status and race.
Am J Prev Med 2017 Jan;52(1s1):S86-s94. doi: 10.1016/j.amepre.2016.09.024.
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Keywords: Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Caldwell JT, Ford CL, Wallace SP
Racial and ethnic residential segregation and access to health care in rural areas.
This study examined the relationship between racial/ethnic residential segregation and access to health care in rural areas. In rural areas, segregation contributed to worse access to a usual source of health care but higher reports of health care needs being met among African Americans and Hispanics.
AHRQ-funded; HS000078; HS022811.
Citation: Caldwell JT, Ford CL, Wallace SP .
Racial and ethnic residential segregation and access to health care in rural areas.
Health Place 2017 Jan;43:104-12. doi: 10.1016/j.healthplace.2016.11.015.
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Keywords: Access to Care, Health Services Research (HSR), Racial and Ethnic Minorities, Rural Health, Social Determinants of Health