Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “racial differences”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMed1995

Theories explaining racial differences in the utilization of diagnostic and therapeutic procedures for cerebrovascular disease.

Despite a higher risk of stroke, blacks are less likely than whites to receive the invasive procedures that are used to diagnose and treat cerebrovascular disease, particularly carotid endarterectomy. Explanations for the lower rate of procedural use include racial bias, racial differences in pathophysiology of cerebrovascular disease, affordability, and racial variation in patient decisions regarding care. Studies consistently indicate that blacks are less likely to have severe atherosclerotic lesions of the carotid arteries, reducing their likelihood of being appropriate candidates for carotid endarterectomy. Although ability to pay does not explain the observed variation in use of carotid endarterectomy, it may influence the evaluation process prior to hospitalization. A racial difference in patients' decisions about health care for cerebrovascular disease has never been investigated; it should be a topic of future studies.

Black or African American↗
PubMed1996

Racial differences in adolescent drug use: the impact of religion.

Contrary to popular stereotypes, current studies of adolescent populations suggest that Black teens are less likely to use illicit drugs than are White teens. This study investigates the extent to which differences in religiosity are responsible for racial differences in drug use. Using data from a national survey of United States high school seniors, our results indicate that religion does provide some protection from drug use by adolescents. However, religiosity has less of an impact on the drug use of Black adolescents, perhaps as a result of the diverse roles of the Black church.

Adolescent↗
PubMed2005

A review of the epidemiology and pathophysiology of pelvic floor dysfunction: do racial differences matter?

OBJECTIVE: To describe the current state of knowledge regarding etiology of pelvic floor dysfunction with special consideration to the effect of racial background on the epidemiology and pathophysiology of this disease. METHODS: We performed a nonsystematic review of the literature to detail the current knowledge of the etiology of pelvic floor dysfunction. Additionally, we performed a systematic search of MEDLINE, Cinahl, and the Cochrane database for English-language articles registered from January 1, 1989, to June 31, 2003, that evaluated racial differences in the epidemiology and pathophysiology of pelvic floor dysfunction. We also reviewed the references of identified articles. RESULTS: We identified 11 articles that examined the effect of racial background on stress urinary incontinence (SUI), urodynamic stress incontinence, and (or) pelvic organ prolapse. We identified 2 studies that measured the prevalence of subjective stress urinary incontinence. Six cross-sectional studies compared the prevalence of urodynamically confirmed SUI and (or) pelvic organ prolapse among different groups. White women had a higher risk of developing urodynamic stress incontinence. Three studies noted anatomical and physiological differences among the different groups. CONCLUSIONS: Both quantitative and qualitative defects in collagen (endopelvic fascia) and compromised levator ani muscle function have been identified as important etiologic factors in the development of pelvic floor dysfunction. Parity, vaginal delivery, menopause, and aging have been most clearly associated with collagen defects and levator ani muscle dysfunction. The literature suggests that white women are at increased risk for SUI. At present, there is insufficient evidence to draw any conclusions regarding the role of racial differences in pelvic organ prolapse. It is possible that differences in prevalence rates for both SUI and pelvic organ prolapse may be attributed to inherent anatomical and physiological differences among racial groups.

Aging↗
PubMed2005

Racial differences in analgesic/anti-inflammatory medication adherence among patients with osteoarthritis.

OBJECTIVES: This study examined the prevalence of self-reported adherence to medications for osteoarthritis (OA) and racial differences in adherence. METHODS: This was a cross-sectional survey of 156 Black and White veterans who were taking medications for OA. RESULTS: One quarter of participants reported sometimes forgetting to take their OA medications, 16% were sometimes careless about taking medications, and 27% sometimes stopped taking their medications when they felt better. Overall, 44% of participants reported at least one of these three behaviors. In a multivariable logistic regression model adjusting for demographic factors, OA severity, participatory decision making (PDM), and side effects, Black patients were more likely to report at least one nonadherent behavior (odds ratio [OR] = 2.25, 95% CI = 1.03-4.91). Patients with greater PDM scores were slightly less likely to report nonadherent behavior (OR = 0.95, 95% CI = 0.91-0.99). DISCUSSION: Additional research is needed to examine factors underlying racial differences in adherence, to guide effective interventions.

Analgesics↗
PubMed2000

Racial differences in insulin secretion and sensitivity in prepubertal children: role of physical fitness and physical activity.

OBJECTIVE: To investigate in prepubertal children whether physical fitness and/or physical activity are: 1) associated with insulin secretion and sensitivity and 2) account for racial differences in insulin secretion and sensitivity. RESEARCH METHODS AND PROCEDURES: Subjects included 34 African American and 34 white nondiabetic children aged 5 to 11 years. Data were divided into two sets according to the availability of VO2max and physical activity data. Body composition was measured by dual-energy X-ray absorptiometry. Subcutaneous abdominal adipose tissue and intra-abdominal adipose tissue were examined by computed tomography. Insulin sensitivity (S1) and acute insulin response (AIR) were determined by a frequently sampled intravenous glucose tolerance test. An all-out, progressive treadmill exercise test was used for measuring VO2max. Physical activity data were collected by questionnaire. RESULTS: African American children had lower SI and higher AIR than white children, after adjusting for total body fat mass. African Americans reported higher levels of physical activity (hours/wk) than whites, but had a lower VO2max. In multiple linear regression analysis, hours/wk of activity and hours/wk of vigorous activity, but not moderate activity, were independently related to SI and AIR after adjusting for race, total body fat mass or fat distribution, and total lean tissue mass. VO2max was not related to AIR, and was inversely related to SI, after adjusting for body composition. Race remained significantly associated with both SI and AIR, even after adjusting for body composition, fat distribution, and hours/wk of activity or hours/wk of vigorous activity. DISCUSSION: In summary, overall physical activity and, especially, vigorous activity were associated with insulin secretion and sensitivity. However, neither physical activity nor VO2max explained the racial difference in insulin secretion (higher in African Americans) and sensitivity (lower in African Americans). Thus, racial (African American to white) differences in aspects of insulin action seem to be due to factors other than body composition, fat distribution, cardiovascular fitness, and amount of physical activity.

Absorptiometry, Photon↗
PubMedDate not supplied

Racial differences in low-density lipoprotein particle size in families at high risk for premature coronary heart disease.

OBJECTIVE: Although small, dense low-density lipoprotein (LDL) has been implicated in atherogenesis and coronary heart disease (CHD) events, little is known about possible racial differences in LDL particle size. This study was designed to examine racial differences in the prevalence of small, dense LDL among 159 African-American and 477 White siblings of persons with premature (<60 years of age) CHD. METHODS AND RESULTS: This study examined fasting levels of total cholesterol, LDL cholesterol, high-density lipoprotein cholesterol, apolipoprotein B (ApoB), apolipoprotein A-1, and triglycerides, as well as factors known to be associated with small, dense LDL, including age, sex, obesity, hypertension, and diabetes. Relative LDL particle size was defined by the LDL cholesterol to ApoB ratio. Direct measurement of LDL particle size was obtained by proton NMR spectroscopy in a subset of 64 siblings. Despite similar levels of total and LDL cholesterol, White siblings were more likely to have low LDL cholesterol to ApoB ratios, indicative of atherogenic small, dense LDL, compared with African-American siblings. Multiple logistic regression analysis predicting the presence of LDL cholesterol/ApoB < or = 1.0 demonstrated that race (P = .009), triglyceride level (P = .0001), and diabetes (P = .02) were independent predictors, controlling for age and all other variables. Direct measurement of LDL particle size by NMR spectroscopy supported these findings. CONCLUSION: These findings provide the first known evidence that White individuals from a population at high risk for premature CHD have a greater probability of having a preponderance of small, dense LDL particles than do African Americans, independent of triglyceride levels, and despite comparable levels of total and LDL cholesterol.

Adult↗
PubMed1985

Racial differences in cephalometric measurements and incidence of cleft lip with or without cleft palate.

A study was made to search for the morphological basis and, indirectly, the developmental basis for racial differences in risk of cleft lip with or without cleft palate CL(P) in Hawaii. A total of ten linear and three angular measurements read from anterior-posterior cephalographs were examined on 210 healthy adult Caucasian, Hawaiian, Japanese, Chinese, and Filipino subjects. Racial comparisons were made on these variables after adjusting for age and sex. Generally, the CL(P) high-risk group consisting of Japanese, Chinese, and Filipinos had smaller dimensions than Caucasians and Hawaiians in the variables (S-N, N-Ba) representing size of cranial base and the measurements of face height (N-A, N-ANS), palatal length (ANS-PNS), and mandibular length (Ar-Gn). Facial width relative to palatal length as measured by the ratio of bizygomatic diameter to palatal length showed a marked consistency with the racial differences in CL(P) risk. Possible significance of this finding is discussed in relation to development of the orofacial structure.

Adolescent↗
PubMed1991

Racial differences in the incidence and progression of renal diseases.

There is an excess incidence of ESRD treatment among non-White North Americans that is not completely explained by the racial prevalences of the underlying diseases, including hypertension, which can potentially cause renal disease. The racial difference is particularly striking for presumed nephrosclerosis from hypertension and for nephropathy from Type II diabetes, but is not yet substantiated for ESRD attributed to polycystic kidney disease or Type I diabetes. The existing data are insufficient to support the notion that poorer blood pressure control alone is responsible for the racial differences in incident ESRD. Black race (and possibly Mexican or Native American heritage) may be a specific risk factor for ESRD, independent of hypertension and its treatment.

Black People↗
PubMed2004

No racial differences in mortality found among Veterans Health Administration out-patients.

OBJECTIVE: Health care delivery systems that offer equal access to ambulatory care may hold promise for preventing and correcting racial disparities that exist in our health care system as a whole. We examined whether racial differences in mortality rates exist among patients receiving outpatient care within the Veterans Health Administration. STUDY DESIGN AND SETTING: This study used data from the 1998 National Survey of Ambulatory Care Patients, a prospective monitoring system of patient outcomes. We used an outpatient care system in the Veterans Health Administration. We followed 25,172 Whites and 3,517 African-Americans for 48 months. The main study outcome measures were unadjusted and adjusted mortality rates over a 48-month period. RESULTS: African-Americans had significantly lower unadjusted 48-month mortality rates than Whites (33 vs. 40 deaths per 1,000 person-year, hazard ratio, 0.84; 95% confidence interval [CI], 0.75-0.95). After risk adjustment, the mortality rates became similar for African-Americans and Whites (hazard ratio, 0.99; 95% CI, 0.89-1.09). These findings were consistent across all time points evaluated during the 48-month follow-up. CONCLUSIONS: The lack of racial differences in mortality in patients receiving ambulatory care in the Veterans Health Administration is reassuring, given the emphasis on equal access within this health care system. This warrants further research to determine whether efforts to improve access in other settings have the potential to reduce racial disparities in health care.

Adult↗
PubMed1994

Racial differences in myocardial ischemia and coronary flow reserve in hypertension.

OBJECTIVES: Using invasive measurements of endothelium-independent coronary flow reserve and stress thallium testing with or without dipyridamole, this study investigated racial differences in ischemia and coronary reserve in hypertensive left ventricular hypertrophy. BACKGROUND: African Americans compared with Caucasian Americans appear to have a higher case fatality from coronary heart disease but lesser amounts of atherosclerotic coronary artery disease. This paradox may be explainable by intrinsic or acquired racial differences in coronary arteriolar autoregulation and vasoreactivity. METHODS: The study enrolled 91 African and 81 Caucasian Americans referred for cardiac catheterization because of suspected myocardial ischemia but found to have no significant coronary stenosis. Patients were stratified by degree of left ventricular hypertrophy for comparison purposes after calculation of indexed left ventricular mass by means of echocardiographic M-mode measurements. Coronary flow reserve measurements were made using the intracoronary Doppler catheter and hyperemic doses of intravenous dipyridamole in 100 patients and intracoronary papaverine and adenosine in 72 patients. Seventy-seven percent of patients underwent adequate stress thallium testing with or without dipyridamole. RESULTS: In African Americans, mean (+/- SD) coronary flow reserve decreased from 4.4 +/- 2.3 for 38 without mass hypertrophy to 3.2 +/- 1.3 for 53 with hypertrophy (p = 0.005) to 2.7 +/- 1.1 for 12 with severe hypertrophy (p = 0.02). Thallium testing was abnormal in 31% of those without mass hypertrophy and 59% of those with hypertrophy. In Caucasian Americans, coronary flow reserve decreased from 4.1 +/- 2 for 58 without hypertrophy to 3.6 +/- 1.5 for 23 with hypertrophy (p = NS) to 3 +/- 1.5 for 6 with severe hypertrophy (p = NS). Thallium testing was abnormal in 36% without mass hypertrophy and in 39% with hypertrophy. CONCLUSIONS: This study establishes that development of left ventricular hypertrophy in hypertension carries greater physiologic morbidity for African compared with Caucasian Americans, typified by marked reduction in endothelium-independent coronary flow reserve and increased frequency of abnormal thallium tests.

Aged↗
PubMedDate not supplied

Racial differences in intact erythrocyte ion transport.

Epidemiologic studies indicate a much higher incidence of hypertension in blacks than in whites, although no clear biochemical correlates to account for such overt racial differences have been identified. In recent years, considerable evidence has linked perturbations in ion transport to the risk of developing hypertension. Potassium (K+) transport and the ouabain-sensitive component of K+ transport in the erythrocyte were measured in 54 healthy, age and sex matched black and white subjects. Blacks have a significantly (p less than 0.001) lower capacity for K+ transport (0.190 +/- 0.03 mumoles K+ per hr per 10(9) red blood cells [RBC] than whites (0.230 +/- 0.03 mumoles K+ per hr 10(9) RBC) with a significantly (p less than 0.001) higher percentage of K+ transport dependent upon ouabain-sensitive mechanisms (blacks 85.26 +/- 4.14 percent versus whites 76.69 +/- 6.67 percent). These data clearly define overt racial differences in K+ transport which suggest that blacks have a more limited capacity to exchange intracellular sodium for extracellular K+, and a higher percentage of that exchange is dependent upon ouabain-sensitive mechanisms. These findings need be kept in mind were clinical studies of ion transport are being assessed and may be germane to the increased prevalence in blacks for the development of hypertension.

Adult↗
PubMed1986

Time trends in the US racial difference in hypertension.

This paper explores time trends in racial differences in hypertension and in mortality from complications from hypertension in the United States. Mortality data were derived from death certificate data compiled by the National Center for Health Statistics and presented in the 1981 Report of the Working Group on Arteriosclerosis. Prevalence data were obtained from five populations--6,672 people screened in 1960-1962 by the National Health Examination Survey (NHES); 20,749 screened in 1971-1975 by the Health and Nutrition Examination Survey (HANES I); 158,539 screened in 1973-1974 by the Hypertension Detection and Followup Program (HDFP); 1 million persons screened in 1973-1975 by the Community Hypertension Evaluation Clinics (CHEC); and 20,325 screened in 1976-1980 by the second Health and Nutrition Examination Survey (HANES II). Mortality data indicate that the nonwhite/white ratios for mortality from complications of hypertension increased between 1940 and 1967 and decreased between 1968 and 1978. Prevalence data show a corresponding recent decrease in black minus white mean blood pressure. Some of the decrease appears to be due to a greater improvement in hypertension control for blacks than for whites. Time trends in the black/white ratio in prevalence of hypertension were examined with differential treatment effects controlled by inclusion as hypertensive those on drug therapy. The results indicate that in addition to differential changes in therapy, the ratio of black/white prevalence of hypertension may also be decreasing. Additional studies are needed to confirm this finding and to explore time changes in racial patterns of risk factors for hypertension.

Black People↗
PubMed2004

Changes in racial differences in use of medical procedures and diagnostic tests among elderly persons: 1986-1997.

OBJECTIVES: We used 1997 Medicare data to replicate an earlier study that used data from 1986 to examine racial differences in usage of specific medical procedures or tests among elderly persons. METHODS: We used 1997 physician claims data to obtain a random sample of 5% of Medicare beneficiaries aged 65 years and older. We used this sample to study 30 procedures and tests that were analyzed in the 1986 study, as well as several new procedures that became more widely used in the early 1990s. RESULTS: Racial differences remain in the rates of use of these procedures; in general, Blacks have lower rates of use than do Whites. Between 1986 and 1997, the ratio of White to Black use moved in favor of Blacks for all but 4 of the established procedures studied. CONCLUSIONS: The White-Black gap in health care use under Medicare is narrowing.

Black or African American↗
PubMed2002

Racial differences and peritonitis in an urban peritoneal dialysis center.

Racial differences have been reported among various groups with end-stage renal disease maintained on dialysis. In particular, patient survival on dialysis has been reported to be better in African-American patients than in Caucasian patients. Peritonitis rates and dropout from chronic peritoneal dialysis (CPD) have been reported to be higher in African-American patients. We decided to review our experience with peritonitis rates in African-American and Caucasian patients. From 1994 to 2000, 403 patients were maintained on CPD in the New Haven continuous ambulatory peritoneal dialysis (CAPD) unit. Peritonitis rates were 1 episode in 14 patient-months in Caucasian patients and 1 episode in 13.6 patient-months in African-American patients. Mean ages at the start of dialysis were 52.4 +/- 16.2 years in the Caucasian patients and 62.6 +/- 14.9 years in the African-American patients. African-American patients were older. African-American and Caucasian patients had similar peritonitis rates. Time of first episode of peritonitis was not different in the two groups.

Adult↗
PubMed1994

Maternal factors, birthweight, and racial differences in infant mortality: a Georgia population-based study.

Black infant mortality rates (IMRs) are approximately twice those of whites in Georgia and nationwide. This study evaluates maternal factors, particularly marital status, that influence racial differences in infant mortality. Population-based data on 565,730 live births and 7269 infant deaths in Georgia from 1980 to 1985 were examined. The IMR ratio for unmarried compared to married mothers was calculated and adjusted singly for maternal education, age and race, and infant birthweight. In addition, racial differences in IMR were estimated using stratified analysis on the basis of four factors: infant birthweight, maternal age, marital status, and education. When only normal birthweight infants were considered, the IMR, adjusted for maternal education level, was highest for infants born to unmarried black teens (9.5/1000 live births), followed by that for infants born to married black teens (9.1), unmarried black adults (7.5), married black adults (4.8), married white teens (4.4), married white adults (3.4), unmarried white adults (2.4), and unmarried white teens (1.3). When only low birthweight infants were considered, the highest IMR per 1000 was found in infants born to married black adults (119), followed by unmarried black adults (103), married black teens (99.9), unmarried black teens (92.5), married white adults (92.1), married white teens (79.0), unmarried white adults (38.0), and unmarried white teens (26.3). These differences led to a black-to-white IMR risk ratio from 1.3 for low birthweight infants born to unmarried teen or adult mothers to 3.7 for normal birthweight infants born to unmarried teen mothers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2000

Racial differences in the influence of body size on ambulatory blood pressure in youths.

BACKGROUND: African Americans have higher night-time blood pressures than Caucasians do despite their having similar daytime blood pressures. It is well established that body size is related to casual blood pressure. OBJECTIVE: To examine the influence of body size on racial differences in patterns of ambulatory blood pressure. METHODS: Ambulatory blood pressure recordings were performed on 292 healthy children and adolescents (148 African Americans and 144 Caucasian) aged 10-18 years (mean 13+/-2 years). These blood pressures were related to height, weight, body surface area, and body mass index in separate regression models that also included race, sex, and age as factors. RESULTS: The race-by-height interaction was significant for night-time systolic blood pressure (P<0.02), with a significant relationship for African Americans (P<0. 0001), but not for Caucasians. The race-by-weight interaction was significant for night-time systolic blood pressure (P<0.04), also with a greater relationship for African Americans (P<0.0001) than for Caucasians (P<0.03). In addition, the race-by-weight interaction was significant for night-time diastolic blood pressure (P<0.04), with a significant relationship for African Americans (P<0.01), but not for Caucasians. Finally, the race-by-body-surface-area interaction was significant for night-time diastolic blood pressure (P<0.05), again with a significant relationship for African Americans (P<0.02) but not for Caucasians. CONCLUSION: Differences in the relationship between body size and blood pressure contribute to the racial differences in patterns of ambulatory blood pressure and should be considered when evaluating patterns of blood pressure in African American youths.

Adolescent↗
PubMed2006

Racial differences in colorectal cancer test use by Medicare consumers.

BACKGROUND: Lower use of colorectal cancer (CRC) screening has been suggested as a factor in higher rates of CRC incidence and mortality among African Americans. Racial differences in colorectal cancer test use are not well understood. METHODS: The study sample included respondents aged 50 to 80 to a 2001 telephone survey of Medicare consumers from two states. The analyses, initiated in 2004, were limited to respondents with no history of CRC (n = 1901). Three CRC tests were examined: fecal occult blood tests (FOBTs), sigmoidoscopy, and colonoscopy. Type of testing and testing according to Medicare coverage intervals by race were compared. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained from unadjusted and adjusted models to assess the independent associations between race and test use. RESULTS: Adherence to the Medicare-covered intervals for CRC tests was low (56.8% for whites, 39.1% for African Americans), and did not significantly differ by race after adjustment. African Americans were, however, significantly less likely to have ever been tested (OR = 0.48, 95% CI = 0.33-0.70) and more likely to have had an endoscopic test than an FOBT (OR = 3.06, 95% CI = 1.70-5.51). CONCLUSIONS: The type of test used to screen for colorectal cancer has important implications for compliance with recommended screening intervals. Understanding reasons for racial differences in CRC test use may help identify approaches to increasing test use in the Medicare population.

Aged↗
PubMed2004

[Genetic risk factors of prostate cancer in Han nationality population in Northern China and a preliminary study of the reason of racial difference in prevalence of prostate cancer].

OBJECTIVE: To investigate the genetic polymorphisms of the three major susceptibility genes, AR, VDR, and SRD5A2 genes, in the Han nationality population in Northern China with a low risk of prostate cancer (Pca) and the relationship of these polymorphisms to the susceptibility to Pca, and to discuss the possible reason causing racial difference of prevalence of PCa. METHODS: Restriction fragment length polymorphism (RFLP) technique and denaturing high-performance liquid chromatography (DHPLC) were used to detect the polymorphic sites in the DNAs from the peripheral blood samples of 116 patients with PCa and 190 normal male controls, all of Han nationality in Northern China. The distribution frequencies of different polymorphic sites were compared with those of the populations with high risk of prostate cancer. RESULTS: The frequencies of SRD5A2 and VDR genotypes were not significantly different between the Pca patients and the controls (P > 0.05). The frequency of CAG repeat < 22 was significantly higher in the Pca group than in the control group (P < 0.05). Statistical analyses of the AR genotype prevalence showed significant differences between the PCa patients and the controls (P < 0.05). The frequencies of AR, VDR, and SRD5A2 genotypes showed significant difference between the Han population in Northern China and the high-PCa risk populations in Western countries. The frequency of CAG > or = 22 was 80.4% in the Han people in Northern China, significantly higher than that in the US Caucasians (52.1%) and Afro-Americans (25%, both P < 0.001). CONCLUSION: There is a significant association between the AR gene CAG polymorphisms and PCa in the Han nationality population in Northern China. The distributions of the genotypes of AR, SRD5A2 and VDR gene are different among different ethnic population, which may be one of the reasons causing the racial difference in prostate cancer risk.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗