Prometheus 6

Last night I got forwarded a link to an article about the first national Black summit on AIDS.

A couple of days back Coretta Scott King wrote an editorial titled Blacks must tackle AIDS on road toward social equity

If you're all Victorian you may not want to read my post about it at The Niggerati Network. But you need to read the two articles linked above.

In fact, let me point up some documentation on what Black folks face, medically. Think of this as a continuation of the Racism is a public health issue post from the other day.

Self-Care Among Chronically Ill African Americans: Culture, Health Disparities, and Health Insurance Status

Gay Becker, PhD, Rahima Jan Gates, PhD and Edwina Newsom

Results. Physicians were 23% more verbally dominant and engaged in 33% less patient-centered communication with African American patients than with White patients. Furthermore, both African American patients and their physicians exhibited lower levels of positive affect than White patients and their physicians did.

Conclusions. Patient–physician communication during medical visits differs among African American versus White patients. Interventions that increase physicians’ patient-centeredness and awareness of affective cues with African Americans patients and that activate African American patients to participate in their health care are important strategies for addressing racial/ethnic disparities in health care.

Racial Differences in Cardiac Catheterization as a Function of Patients’ Beliefs

Nancy R. Kressin, PhD, Bei-Hung Chang, ScD, Jeff Whittle, MD, MPH, Eric D. Peterson, MD, MPH, Jack A. Clark, PhD, Amy K. Rosen, PhD, Michelle Orner, MPH, Tracie C. Collins, MD, MPH, Linda G. Alley, PhD, RN and Laura A. Petersen, MD, MPH

Results. There were few demographic differences between White and African American patients in our sample. African Americans were less likely than Whites to undergo cardiac catheterization. African Americans were more likely than Whites to indicate a strong reliance on religion and to report racial and social class discrimination and were less likely to indicate a generalized trust in people but did not differ from White patients on numerous other attitudes about health and health care. Neither sociodemographic or clinical characteristics nor patients’ beliefs explained the observed disparities, but physicians’ assessments of the procedure’s importance and patients’ likelihood of coronary disease seemed to account for differences not otherwise explained.

Conclusions. Patients’ preferences are not the likely source of racial disparities in the use of cardiac catheterization among veterans using VA care, but physicians’ assessments warrant further attention.

Endometrial Cancer: Socioeconomic Status and Racial/Ethnic Differences in Stage at Diagnosis, Treatment, and Survival

Terri Madison, PhD, MPH, David Schottenfeld, MD, MSc, Sherman A. James, PhD, Ann G. Schwartz, PhD, MPH and Stephen B. Gruber, MD, PhD, MPH

Results. Multivariate analyses showed that either race/ethnicity or income, but not both, was associated with advanced-stage disease. Age, stage at diagnosis, and income were independent predictors of hysterectomy. African American ethnicity, increased age, aggressive histology, poor tumor grade, and advanced-stage disease were associated with increased risk for death; higher income and hysterectomy were associated with decreased risk for death.

Conclusions. Lower income was associated with advanced-stage disease, lower likelihood of receiving a hysterectomy, and lower rates of survival. Earlier diagnosis and removal of barriers to optimal treatment among lower-socioeconomic status women will diminish racial/ethnic differences in endometrial cancer survival.

Experiences of Racism Among African American Parents and the Mental Health of Their Preschool-Aged Children

Margaret O'Brien Caughy, ScD, Patricia J. O'Campo, PhD and Carles Muntaner, MD, PhD

Results. Parents who denied experiences of racism also reported higher rates of behavior problems among their preschool-aged children. For families living in neighborhoods characterized by fear of victimization, parents who actively coped with racism experiences by confronting the person involved or taking some sort of action in response to racism reported lower rates of anxiety and depression for their preschool-aged children.

Conclusions. Experiences of and responses to racism among African American parents have important effects on the well-being of their young children.

Self-Reported Experiences of Racial Discrimination and Black–White Differences in Preterm and Low-Birthweight Deliveries: The CARDIA Study

Sarah Mustillo, PhD, Nancy Krieger, PhD, Erica P. Gunderson, PhD, Stephen Sidney, MD, Heather McCreath, PhD and Catarina I. Kiefe, MD, PhD

Results. Among Black women, 50% of those with preterm deliveries and 61% of those with low-birthweight infants reported having experienced racial discrimination in at least 3 situations; among White women, the corresponding percentages were 5% and 0%. The unadjusted odds ratio for preterm delivery among Black versus White women was 2.54 (95% confidence interval [CI]=1.33, 4.85), but this value decreased to 1.88 (95% CI=0.85, 4.12) after adjustment for experiences of racial discrimination and to 1.11 (95% CI=0.51, 2.41) after additional adjustment for alcohol and tobacco use, depression, education, and income. The corresponding odds ratios for low birthweight were 4.24 (95% CI=1.31, 13.67), 2.11 (95% CI=0.75, 5.93), and 2.43 (95% CI=0.79, 7.42).

Conclusions. Self-reported experiences of racial discrimination were associated with preterm and low-birthweight deliveries, and such experiences may contribute to Black–White disparities in perinatal outcomes.