National Healthcare Quality and Disparities Report
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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
51 to 75 of 87 Research Studies DisplayedStepanikova I, Bateman LB, Oates GR
Systemic inflammation in midlife: race, socioeconomic status, and perceived discrimination.
This study investigates social determinants of systemic inflammation, focusing on race, SES, and perceived discrimination. 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. It suggests that inflammation-reducing interventions should focus on blacks and individuals facing socioeconomic disadvantages, especially low education.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Bateman LB, Oates GR .
Systemic inflammation in midlife: race, socioeconomic status, and perceived discrimination.
Am J Prev Med 2017 Jan;52(1s1):S63-s76. doi: 10.1016/j.amepre.2016.09.026.
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Keywords: Disparities, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Rice LJ, Hughes B, Briggs V
Perceived efficacy and control for neighborhood change: the cross-cutting role of collective efficacy.
The authors characterized perceived neighborhood control and efficacy for neighborhood change and evaluated independent associations between efficacy and control beliefs and sociodemographic factors, community involvement, and perceptions of social environment. They concluded that efforts are needed to improve residents' ability to become positive agents of change in their community, and that creating a research infrastructure within academic community partnerships that focus on strengthening advocacy and public policy may improve resident's efficacy and ability to seek and encourage neighborhood change.
AHRQ-funded; HS019339.
Citation: Rice LJ, Hughes B, Briggs V .
Perceived efficacy and control for neighborhood change: the cross-cutting role of collective efficacy.
J Racial Ethn Health Disparities 2016 Dec;3(4):667-75. doi: 10.1007/s40615-015-0185-9.
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Keywords: Disparities, Racial and Ethnic Minorities, Social Determinants of Health
Fiscella K, Sanders MR
Racial and ethnic disparities in the quality of health care.
The annual National Healthcare Quality and Disparities Reports document widespread and persistent racial and ethnic disparities. Recent data suggest slow progress in many areas but have documented a few notable successes in eliminating these disparities. To eliminate these disparities, continued progress will require a collective national will to ensure health care equity through expanded health insurance coverage, support for primary care, and public accountability.
AHRQ-funded; HS022440.
Citation: Fiscella K, Sanders MR .
Racial and ethnic disparities in the quality of health care.
Annu Rev Public Health 2016;37:375-94. doi: 10.1146/annurev-publhealth-032315-021439.
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Keywords: Disparities, Quality of Care, Racial and Ethnic Minorities, Social Determinants of Health
Heerman WJ, Mitchell SJ, Thompson J
Parental perception of built environment characteristics and built environment use among Latino families: a cross-sectional study.
The researchers examined the association of perceived availability, condition, and safety of the built environment with its self-reported use for physical activity among underserved families with children at risk for obesity. In their sample of underserved families, perceived availability and condition of built environment structures were associated with use rather than perceived safety.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Mitchell SJ, Thompson J .
Parental perception of built environment characteristics and built environment use among Latino families: a cross-sectional study.
BMC Public Health 2016 Nov 22;16(1):1180. doi: 10.1186/s12889-016-3854-7.
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Keywords: Obesity, Social Determinants of Health, Children/Adolescents, Racial and Ethnic Minorities, Vulnerable Populations
Sharifi M, Sequist TD, Rifas-Shiman SL
The role of neighborhood characteristics and the built environment in understanding racial/ethnic disparities in childhood obesity.
The authors sought to examine the extent to which racial/ethnic disparities in elevated child body mass index (BMI) are explained by neighborhood socioeconomic status (SES) and the built environment. They concluded that SES and the built environment may be important drivers of childhood obesity disparities and that interventions must be tailored to the neighborhood contexts in which families live.
AHRQ-funded; HS022986.
Citation: Sharifi M, Sequist TD, Rifas-Shiman SL .
The role of neighborhood characteristics and the built environment in understanding racial/ethnic disparities in childhood obesity.
Prev Med 2016 Oct;91:103-09. doi: 10.1016/j.ypmed.2016.07.009.
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Keywords: Children/Adolescents, Disparities, Obesity, Racial and Ethnic Minorities, Social Determinants of Health
Goodman SM, Mandl LA, Parks ML
Disparities in TKA outcomes: census tract data show interactions between race and poverty.
Race is an important predictor of total knee arthroplasty (TKA) outcomes in the United States; however, analyses of race can be confounded by socioeconomic factors, which can result in difficulty determining the root cause of disparate outcomes after TKA. This study found that blacks and whites living in communities with little poverty have similar patient-reported TKA outcomes, whereas in communities with high levels of poverty, there are important racial disparities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandl LA, Parks ML .
Disparities in TKA outcomes: census tract data show interactions between race and poverty.
Clin Orthop Relat Res 2016 Sep;474(9):1986-95. doi: 10.1007/s11999-016-4919-8.
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Keywords: Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Patient-Centered Outcomes Research, Surgery
Nieman CL, Tunkel DE, Boss EF
Do race/ethnicity or socioeconomic status affect why we place ear tubes in children?
The study’s objective was to analyze the association of patient- and neighborhood-level demographics and SES with clinical indications for tympanostomy tube (TT). It found that among children receiving tubes, those from high poverty areas were more likely than those from low poverty neighborhoods to receive tubes for the indication of chronic otitis media with effusion (OME) as opposed to recurrent acute otitis media (RAOM).
AHRQ-funded; HS022932.
Citation: Nieman CL, Tunkel DE, Boss EF .
Do race/ethnicity or socioeconomic status affect why we place ear tubes in children?
Int J Pediatr Otorhinolaryngol 2016 Sep;88:98-103. doi: 10.1016/j.ijporl.2016.06.029.
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Keywords: Children/Adolescents, Ear Infections, Racial and Ethnic Minorities, Social Determinants of Health, Surgery, Low-Income
Martsolf GR, Barrett ML, Weiss AJ
AHRQ Author: Steiner CA, Coffey R
Impact of race/ethnicity and socioeconomic status on risk-adjusted hospital readmission rates following hip and knee arthroplasty.
This study examined the extent to which risk-adjusting for race/ethnicity and socioeconomic status affected hospital performance in terms of readmission rates following total hip arthroplasty (THA) and total knee arthroplasty (TKA). It found that inclusion of race/ethnicity and socioeconomic status in the risk-adjustment algorithm led to a relative-performance change in readmission rates following THA and TKA at less than 3 percent of the hospitals.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Martsolf GR, Barrett ML, Weiss AJ .
Impact of race/ethnicity and socioeconomic status on risk-adjusted hospital readmission rates following hip and knee arthroplasty.
J Bone Joint Surg Am 2016 Aug 17;98(16):1385-91. doi: 10.2106/jbjs.15.00884.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Social Determinants of Health, Hospital Readmissions, Surgery
Yaghjyan L, Carlsson NP, Ghita GL
Associations of individual characteristics and lifestyle factors with metabolism of di-2-ethylhexyl phthalate in NHANES 2001-2012.
The authors examined associations of several individual characteristics and lifestyle factors with the ratio of mono-2-ethylhexyl phthalate to mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHP:MEHHP) and %MEHP (the ratio of MEHP to the sum of the secondary metabolites). They found that non-Caucasian individuals had higher %MEHP, that age was inversely associated, that overweight individuals had lower MEHP:MEHHP, and that alcohol consumption was inversely associated with %MEHP among men. They concluded that individual and lifestyle characteristics are associated with differences in DEHP metabolism.
AHRQ-funded; HS022330.
Citation: Yaghjyan L, Carlsson NP, Ghita GL .
Associations of individual characteristics and lifestyle factors with metabolism of di-2-ethylhexyl phthalate in NHANES 2001-2012.
Environ Res 2016 Aug;149:23-31. doi: 10.1016/j.envres.2016.05.002.
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Keywords: Lifestyle Changes, Racial and Ethnic Minorities, Social Determinants of Health
Caldwell JT, Ford CL, Wallace SP
Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States.
The researchers examined whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. They cocluded that rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply.
AHRQ-funded; HS022811.
Citation: Caldwell JT, Ford CL, Wallace SP .
Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States.
Am J Public Health 2016 Aug;106(8):1463-9. doi: 10.2105/ajph.2016.303212.
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Keywords: Rural Health, Urban Health, Racial and Ethnic Minorities, Access to Care, Social Determinants of Health
Steve SL, Tung EL, Schlichtman JJ
Social disorder in adults with type 2 diabetes: building on race, place, and poverty.
The authors reported on their narrative review of the literature that explores the associations between social disorder and diabetes-related health outcomes within vulnerable communities. They also proposed a multilevel ecosocial model for conceptualizing social disorder, specifically focusing on its role in racial disparities and its pathways to mediating diabetes outcomes.
AHRQ-funded; HS000078.
Citation: Steve SL, Tung EL, Schlichtman JJ .
Social disorder in adults with type 2 diabetes: building on race, place, and poverty.
Curr Diab Rep 2016 Aug;16(8):72. doi: 10.1007/s11892-016-0760-4.
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Keywords: Diabetes, Low-Income, Health Status, Racial and Ethnic Minorities, Social Determinants of Health
Ancker JS, Hafeez B, Kaushal R
Socioeconomic disparities in adoption of personal health records over time.
The authors sought to track personal health record (PHR) adoption and differences by sociodemographic group over time. Using data from the Empire State Poll, they found that during a 4-year period in which federal policies incentivized medical organizations to give medical record access to patients through PHRs and electronic portals, rates of PHR use increased rapidly in all sociodemographic groups, but with a digital divide remaining, linked to Hispanic ethnicity and lower income.
AHRQ-funded; HS021531.
Citation: Ancker JS, Hafeez B, Kaushal R .
Socioeconomic disparities in adoption of personal health records over time.
Am J Manag Care 2016 Aug;22(8):539-40.
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Keywords: Disparities, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Social Determinants of Health
Peek ME, Lopez FY, Williams HS
Development of a conceptual framework for understanding shared decision making among African-American LGBT patients and their clinicians.
The purpose of this review was to understand how race, sexual orientation and gender identity can simultaneously influence shared decision making (SDM) among African-American LGBT persons. It also presents a conceptual model for understanding SDM in African-American LGBT persons, wherein multiple systems of social stratification (e.g., race, gender, sexual orientation) influence patient and provider perceptions, behaviors, and shared decision making.
AHRQ-funded; HS023050.
Citation: Peek ME, Lopez FY, Williams HS .
Development of a conceptual framework for understanding shared decision making among African-American LGBT patients and their clinicians.
J Gen Intern Med 2016 Jun;31(6):677-87. doi: 10.1007/s11606-016-3616-3.
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Keywords: Decision Making, Social Determinants of Health, Racial and Ethnic Minorities, Patient-Centered Outcomes Research
Liu Z, Zhang K, Du XL
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study.
This study aimed to determine whether median household income was associated with the risk of developing breast and colorectal cancer in Texas and to identify higher cancer risks by race/ethnicity and geographic areas. It demonstrated that higher income was associated with an increased risk of breast cancer and a decreased risk of colorectal cancer in Texas.
AHRQ-funded; HS018956.
Citation: Liu Z, Zhang K, Du XL .
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study.
BMC Cancer 2016 Apr 26;16:294. doi: 10.1186/s12885-016-2324-z.
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Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Racial and Ethnic Minorities, Risk, Social Determinants of Health
Zamora-Kapoor A, Nelson L, Buchwald D
Maternal correlates of body mass index in American Indian/Alaska Native and white adolescents: differences between mother/son and mother/daughter pairs.
This study sough to determine the influence of maternal correlates on adolescent body mass index (BMI), and the extent to which the size and significance of these correlates vary by adolescent sex and race. Its findings suggest that maternal factors are critical in the transmission of obesogenic behaviors from one generation to the next, and their effects vary between mother/son and mother/daughter pairs, and are similar for AI/ANs and Whites.
AHRQ-funded; HS021686.
Citation: Zamora-Kapoor A, Nelson L, Buchwald D .
Maternal correlates of body mass index in American Indian/Alaska Native and white adolescents: differences between mother/son and mother/daughter pairs.
Eat Behav 2016 Jan;20:43-7. doi: 10.1016/j.eatbeh.2015.11.002..
Keywords: Children/Adolescents, Obesity, Racial and Ethnic Minorities, Risk, Social Determinants of Health
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.
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
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
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
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
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
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
Wang G, Gold M, Siegel J
AHRQ Author: Siegel J
Deliberation: obtaining informed input from a diverse public.
The Deliberative Methods Demonstration was a randomized controlled experiment comparing four deliberation methods and a reading materials control group. After surveying 907 participants before and after deliberation, the researchers found that changes in knowledge about using medical evidence in decisionmaking were not associated with race, ethnicity, or education.
AHRQ-authored.
Citation: Wang G, Gold M, Siegel J .
Deliberation: obtaining informed input from a diverse public.
J Health Care Poor Underserved. 2015 Feb;26(1):223-42. doi: 10.1353/hpu.2015.0021..
Keywords: Disparities, Quality of Care, Decision Making, Racial and Ethnic Minorities, Social Determinants of Health