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PubMed1981

Racial differences in red cell cation transport and their relationship to essential hypertension.

Red cell cation transport has been studied in normotensive and essential hypertensive groups of white and black (West Indian) subjects. In vitro uptake of the potassium analogue 86Rb was measured during short-term incubation of erythrocytes in the presence and absence of ouabain. Sodium pump activity was significantly greater (p less than 0.0005) in white hypertensives than in white normotensives. No such difference was observed between black hypertensive and normotensives. 86Rb uptake was significantly lower in black than in white normotensive individuals; this racial differences was not due to a difference in sodium pump activity.

Adult↗
PubMed2005

Explaining racial differences in prostate cancer in the United States: sociology or biology?

Black men in the United States have the highest incidence and mortality from prostate cancer in the world. Even after adjusting for stage at diagnosis, black men have higher mortality rates than white men. Multiple reasons have been postulated to explain these findings including access to care, attitudes about care, socioeconomic and education differences, differences in type and aggressiveness of treatment, dietary, and genetic differences. While each reason may contribute to the higher incidence or higher mortality, likely combinations of reasons will best explain all the findings. Racial differences in socioeconomic status have been well established and we review the significance of these findings in relationship to prostate cancer. Also, with recent advances in the understanding of genetic variation in the human genome, in general, and in the genes involved in pathways relevant to prostate cancer biology, in particular, a number of genes with alleles which differ in frequency between black and white men have been proposed as a genetic cause or contributor to the increased prostate cancer risk in black men. However, the clinical significance of these genetic differences is not fully known. Finally, we conclude with some thoughts as to how to integrate the findings from sociological as well as biological studies and touch upon methods to reduce the disparate burden of prostate cancer among blacks in the United States.

Attitude to Health↗
PubMed1998

Racial differences in functional status among elderly U.S. migrants from the South.

This study describes patterns of functional status among older blacks and whites by their history of birth in and migration out of the South. We used multivariate regression to analyze data on functional status of US-born non-Hispanic blacks (N = 1868) and whites (N = 13469) age 60 years or above. In general, the functional status of blacks who were born in the South and migrated was similar to that of blacks born outside the South and better than those born in the South who did not migrate. Whites who migrated from the South had functional status similar to those who did not migrate and worse than those born outside of the South. Socioeconomic status did not explain differences by race and migration history. These results differ sharply from mortality studies, which have found a consistent pattern of high mortality among black migrants from the South. Differences among race groups by migration history vary across health measures. Selective migration and selective survival may account for the complex patterns of racial differences in geographic distributions of function and health.

Black or African American↗
PubMed1993

Racial differences in the incidence of cardiac arrest and subsequent survival. The CPR Chicago Project.

BACKGROUND: Differences between blacks and whites have been reported in the incidence of several forms of cardiovascular disease, including hypertension and stroke. We examined racial differences in the incidence of cardiac arrest in a large urban population and in subsequent survival. METHODS: We collected data on all nontraumatic, out-of-hospital cardiac arrests in Chicago from January 1, 1987, through December 31, 1988, and compared the incidence and survival rates for blacks and whites. We examined the association between survival and race and seven other known risk factors by logistic-regression analysis. We computed incidence rates by coupling our data with U.S. Census population data. RESULTS: Our study population comprised 6451 patients: 3207 whites, 2910 blacks, and 334 persons of other races. The incidence of cardiac arrest was significantly higher for blacks than for whites in every age group. The survival rate after cardiac arrest was 2.6 percent in whites, as compared with 0.8 percent in blacks (P < 0.001). Blacks were significantly less likely to have a witnessed cardiac arrest, bystander-initiated cardiopulmonary resuscitation, or a "favorable" initial rhythm or to be admitted to the hospital. When they were admitted, blacks were half as likely to survive. The association between race and survival persisted even when other recognized risk factors were taken into account. We did not find important differences between blacks and whites in the response times of the emergency medical services. CONCLUSIONS: The black community in our study was at higher risk for cardiac arrest and subsequent death than the white community, even after we controlled for other variables.

Adolescent↗
PubMed2006

Racial differences in correlates of misreporting of energy intake in adolescent females.

OBJECTIVE: To determine the extent of misreporting of energy intake (EI) and its anthropometric, demographic, and psychosocial correlates in a bi-racial cohort of young women. RESEARCH METHODS AND PROCEDURES: This was a cross-sectional study of 60 black and 60 white young women, 18 to 21 years old, enrolled in a longitudinal study. Total energy expenditure was assessed using doubly labeled water. Self-reported EI was obtained from 3-day food records. BMI was computed from height and weight. Fat mass was assessed by DXA. Multivariate analyses examined racial differences on the extent of misreporting and its effect on other potential correlates of misreporting. Race-specific step-wise linear regression analysis was performed to examine the effect of BMI, parental education, and drive for thinness on misreporting of EI. RESULTS: More white women tended to under-report EI than black women (22% vs. 13%, p = 0.07). In black women, under-reporting was significantly (p = 0.01) associated with drive for thinness score but was only marginally (p = 0.1) associated with BMI. Each point increase in drive for thinness score was associated with under-reporting by 40 kcal/d. In white women, under-reporting was significantly (p = 0.03) associated with higher parental education by 440 kcal/d and also only marginally (p = 0.09) with BMI. DISCUSSION: This tendency for under-reporting of EI limits the use of self-reported EI in studying energy balance in free-living subjects. Most black and almost all white women in their late teens significantly under-reported their EI, whereas under-reporting was not as evident among lean young black women.

Absorptiometry, Photon↗
PubMed1979

Racial differences in infant mortality rates: United States, 1969.

Using multiple regression analyses, we measured the effects of demographic, health, and socioeconomic variables on race-specific neonatal and postneonatal infant mortality rates. The racial difference in rates in 1969 is due to (1) effects of mean differences in black and white population characteristics, (2) differences in the impact of independent variables, and (3) differences from other causes. Higher black than white infant mortality is the result of unfavorable black means on birthweight, age of mothers at birth, education, and marital stability. Black mortality is also higher because mothers' age at birth, marital stability, and education have more favorable impact on mortality for whites than blacks.

Black or African American↗
PubMed2000

Why genes don't count (for racial differences in health).

There is a paradoxical relationship between "race" and genetics. Whereas genetic data were first used to prove the validity of race, since the early 1970s they have been used to illustrate the invalidity of biological races. Indeed, race does not account for human genetic variation, which is continuous, complexly structured, constantly changing, and predominantly within "races." Despite the disproof of race-as-biology, genetic variation continues to be used to explain racial differences. Such explanations require the acceptance of 2 disproved assumptions: that genetic variation explains variation in disease and that genetic variation explains racial variation in disease. While the former is a form of geneticization, the notion that genes are the primary determinants of biology and behavior, the latter represents a form of racialization, an exaggeration of the salience of race. Using race as a proxy for genetic differences limits understandings of the complex interactions among political-economic processes, lived experiences, and human biologies. By moving beyond studies of racialized genetics, we can clarify the processes by which varied and interwoven forms of racialization and racism affect individuals "under the skin."

Bias↗
PubMed2006

Racial differences in epidemiology of irritable bowel syndrome alone, un-investigated dyspepsia alone, and "overlap syndrome" among african americans compared to Caucasians: a population-based study.

There is A paucity of data on racial differences in epidemiology of irritable bowel syndrome (IBS) alone and un-investigated dyspepsia (UD) alone compared to "overlap syndrome" (OS). We conducted a random survey (n = 990). Subjects completed a questionnaire which included Rome II criteria for IBS and functional dyspepsia (FD). Among African Americans, the prevalence of IBS alone, UD alone, and OS was 0.6%, 17%, and 7.3%, respectively. It was 0%, 13%, and 13% among Caucasian Americans. All but four patients with IBS had UD. Among patients with UD, OS was seen in 30% of African Americans, compared to 50% among Caucasian Americans. Among African Americans, UD patients were younger compared to OS patients. African Americans with UD were more likely than OS patients to have children. Marital status, education, and household income were not a factor among Caucasians. African Americans patients below poverty level were more likely to have UD than OS (22% vs 10%). Considering patients with UD alone, race, age, sex, marital status, number of children, education, and income level were not different between African Americans and Caucasians. Compared to African Americans, Caucasians with OS were likely to be married and live in an urban area. There was a higher prevalence of OS among Caucasians with lower education. OS is 2.5 times more likely to occur among Caucasians compared to African Americans. We conclude that OS is more common among Caucasians than African Americans. IBS and OS are virtually synonymous.

Adolescent↗
PubMed1988

Racial differences in mineral intake in ambulatory normotensives and hypertensives.

This study was designed to determine dietary mineral intake of black and white normotensives and hypertensives and to identify specific food categories which contribute to observed differences. Sixty-six subjects completed 4-day dietary intake records. Nutrient intake was estimated and patterns of food intake were determined. There were racial differences in dietary mineral intake with both white normotensives and hypertensives ingesting more potassium than their black counterparts and white normotensives consuming more calcium and magnesium than white hypertensives and both groups of blacks. White normotensives also used more high sodium chloride foods than did other groups. It appears that decreased intake of potassium and calcium in blacks may account, in part, for the increased tendency to salt sensitivity and hypertension in this population.

Black People↗
PubMed1999

Racial differences in prevalence of cobalamin and folate deficiencies in disabled elderly women.

BACKGROUND: Many previous investigations of cobalamin and folate status were performed in white populations. OBJECTIVE: Our objective was to determine whether there are racial differences in the prevalence of cobalamin and folate deficiency. DESIGN: The study was a cross-sectional comparison of baseline serum cobalamin, folate, methylmalonic acid (MMA), total homocysteine (tHcy), and creatinine concentrations, complete blood count, and vitamin supplementation in 550 white and 212 African American subjects from a cohort of physically disabled older women. RESULTS: The mean (+/-SD) serum MMA concentration was significantly higher in whites than in African Americans: 284 +/- 229 compared with 218 +/- 158 nmol/L (P = 0.0001). tHcy concentration was higher in African Americans than in whites: 12.4 +/- 7.0 compared with 10.9 +/- 4.6 micromol/L (P = 0.001). Serum cobalamin was lower in whites (P = 0.0002). Cobalamin deficiency (serum cobalamin <258 pmol/L and MMA >271 nmol/L) was more frequent in the white women (19% compared with 8%; P < 0.0003). Folate deficiency (serum folate <11.4 nmol/L, tHcy >13.9 micromol/L, and MMA <271 nmol/L) was more prevalent in African Americans than in whites (5% compared with 2%; P = 0.01). Multivitamin use was associated with lower tHcy but not with MMA concentrations. Regression models showed that age >85 y, African American race, serum creatinine >90 micromol/L, and high MMA concentration were all significantly correlated with higher tHcy. Creatinine > 90 micromol/L, white race, and folate concentration were positively associated with MMA concentration. CONCLUSIONS: Cobalamin deficiency with elevated serum MMA concentration is more prevalent in elderly white than in African American women and elevated serum tHcy and folate deficiency are more prevalent in elderly African American than in white women.

Aged↗
PubMed1996

Racial differences in femoral dimensions and their relation to hip fracture.

White women have a higher rate of age-specific hip fractures than black women. Recently, femoral dimensions have been implicated in osteoporotic fractures. To study racial differences in femoral dimensions, dual X-ray absorptiometry scans were obtained for two similar groups of 50 white women and 50 black women. We measured the hip axis length (the distance from below the lateral aspect of the greater trochanter to the inner pelvic brim), the neck width and the neck/shaft angle on the scan print-out. The observer was masked to the race of the subject. The results were analyzed using the independent t-test and showed that the hip axis length and the neck width were significantly longer in the white women than in the black women (p values < 0.05 and < 0.02 respectively) but that the neck/shaft angle was not statistically different in the two groups. We conclude that femoral geometry differs among races. Whether this contributes to the lower risk of hip fracture in black women will require prospectively based studies.

Adult↗
PubMed2003

Racial differences in bone mineral density in older men.

UNLABELLED: Studies have examined factors related to BMD in older white, but not black, men. We measured BMD in older white and black men and examined factors related to racial differences in BMD. Black men had significantly higher adjusted BMD at all sites. These results may explain, in part, the lower incidence of fractures in older black men. INTRODUCTION: Several studies have examined factors associated with bone mineral density (BMD)in older men. None, however, have had sufficient numbers of black men to allow for meaningful comparisons by race. MATERIALS AND METHODS: A total of 503 white and 191 black men aged 65 and older(75.1 +/- 5.8 and 72.2 +/- 5.7 years, respectively) were recruited from the Baltimore metropolitan area. All men completed a battery of self-administered questionnaires, underwent a standardized examination, and had BMD measured at the femoral neck, lumbar spine, and total body. Data were analyzed using multiple variable linear regression models, adjusted for potential confounding variables; two-way interactions with main effects were included in models where appropriate. RESULTS: Black men had significantly higher adjusted BMD at the femoral neck (difference 0.09 [95% CI: 0.07, 0.12] mg/cm2), lumbar spine (0.07 [0.04, 0.10] mg/cm2), and total body (0.06 [0.03, 0.08] mg/cm2) than white men. CONCLUSIONS: Older black men have significantly higher BMD than older white men, even after adjustment for factors associated with BMD. These differences, especially at the femoral neck, may explain the reduced incidence of hip fracture in black compared with white men.

Absorptiometry, Photon↗
PubMed2004

An assessment of racial differences in clinical practices for hypertension at primary care sites for medically underserved patients.

Ethnic disparities in hypertension-related outcomes may relate to differences in medical care. This study assessed primary care sites serving low-income patients to determine if differences in process and treatment indicators might contribute to disparities in outcomes. Eight sites were enrolled with 100,000 patients, collectively. Trained nurses abstracted a random sample of medical records for diagnoses, laboratory data, medications, and demographic variables. Data were obtained on 1250 white and 2786 African-American adults. African Americans were more likely (p<0.01) to be hypertensive (44% vs. 23%) and diabetic (16% vs. 8%) than whites. African Americans were more likely to have serum creatinine, potassium, lipid, and glycosylated hemoglobin values recorded in the medical record than whites (p<0.01). African-American hypertensives were more likely (p<0.05) than white hypertensives to receive calcium channel blockers, angiotensin-converting enzyme inhibitors, diuretics, and combination therapy. Thus, there appeared to be little difference in the level of care between the two groups. Based on the sites examined, ethnic variations in important process and treatment indicators do not explain racial differences in cardiovascular and renal outcomes.

Adolescent↗
PubMed1999

Racial differences in survival in an urban peritoneal dialysis program.

We retrospectively evaluated 233 incident patients (61% black, 27% white, and 12% Hispanic/Asian) to our peritoneal dialysis (PD) program from January 1987 to September 1997 to identify any possible racial differences in patient survival. Information collected included clinical features, comorbid conditions, nutritional status, and dialysis dose at initiation of dialysis. The average age was 52 +/- 16 (SD) years, and 49% were men. Diabetes mellitus was present in 41% of patients. Overall follow-up was 31 +/- 24 (median 26) months during which time 21% of patients underwent transplant, 29% of patients transferred to hemodialysis (HD), and 42% of patients died. The Cox proportional hazards analysis, based on intent-to-treat, identified age (RR: 1.03), race (RR: 2.35, white versus black), cardiac disease (RR: 1.97), and serum albumin (RR: 0. 44) to independently predict mortality. Further analysis was performed based on diabetic status, and the analysis identified age (RR: 1.06), race (RR: 2.45, white versus black), and peripheral vascular disease (RR: 2.88) as predictors of mortality in diabetic patients. In nondiabetic patients, age (RR: 1.03), race (RR: 2.24, white versus black), cardiac disease (RR: 2.48), cerebrovascular disease (RR: 3.17), and serum albumin (RR: 0.39) were significant predictors of mortality. The significance of race persisted even after adjusting patients transferring to hemodialysis. The adjusted patient survival at 1, 2, and 5 years was 94%, 87% and 53% for black patients, and 86%, 72%, and 23% for white patients. The adjusted patient survival in diabetics at 1, 2, and 5 years was 92%, 79%, and 37% for black patients, and 82%, 56%, and 9% for white patients. The adjusted patient survival in nondiabetics at 1, 2, and 5 years was 94%, 91%, and 63% for black patients, and 88%, 82%, and 35% for white patients. In conclusion, long-term patient survival is better for black patients than white patients in our peritoneal dialysis program. Peritoneal dialysis should be considered a viable dialytic option for black patients entering an end-stage renal disease program.

Adult↗
PubMed1988

Serial ultraviolet B exposure and serum 25 hydroxyvitamin D response in young adult American blacks and whites: no racial differences.

We tested the hypothesis that repeated whole body suberythemal ultraviolet B (UVB) exposure would result in less increase of serum 25-hydroxyvitamin D (25OHD) concentrations in black compared with white young adults with no significant change or racial differences in serum calciotropic hormones concentrations. Thirteen white and 7 black adults ranging from 22 to 35 years of age were submitted to sequential total body suberythemal doses of UVB (280-315 nm) biweekly for 6 weeks. Initial UVB dose was 5% below the minimal erythemal dose for the most sensitive skin, followed by 10% increase per exposure for 4 weeks. Blood samples were drawn weekly. Baseline 25OHD concentrations were significantly lower in blacks compared to whites, but the increases in serum 25OHD concentrations were similar in both groups; there were no significant differences by sex or age. Serum 24,25-dihydroxyvitamin D [24,25-(OH)2D] concentrations paralleled the serum 250HD response. Mean serum calcium (total and ionized), magnesium, phosphate, alkaline phosphatase, vitamin D binding protein, C-terminal parathyroid hormone, calcitonin, 1,25-dihydroxyvitamin D [1,25-(OH)2D], and osteocalcin concentrations did not differ between blacks and whites at any time. The ratio of the concentration of 1,25-(OH)2D to 25OHD in their serum was initially higher in blacks compared to whites (p less than 0.0001); the ratios decreased to levels similar to whites by the third UVB exposure. We conclude that, in blacks and whites, sequential suberythemal UVB exposure produces similar elevations of serum 25OHD concentrations and unchanged calciotropic hormones concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Racial differences in cerebrovascular disease hospitalizations.

We studied the relationship of race to incidence of hospitalization for cerebrovascular disease among 74,096 white and 33,041 black persons who took health examinations in a prepaid health care program. Analyses were controlled for age, sex, body mass index, coffee use, smoking, alcohol use, systolic blood pressure, and baseline disease. Blacks were at higher hospitalization risk than whites for hemorrhagic cerebrovascular disease (relative risk = 2.4, 95% confidence interval = 1.3-5.8), cerebral thrombosis (relative risk = 1.9, 95% confidence interval = 1.2-2.9), and nonspecific cerebrovascular disease (relative risk = 1.6, 95% confidence interval = 1.2-2.2) but at lower hospitalization risk for extracranial occlusive disease (relative risk = 0.4, 95% confidence interval = 0.2-0.7). Blood pressure had a similar relation to all types of cerebrovascular disease in both races, but there were disparities in the relations of other atherosclerosis risk factors to different types of cerebrovascular disease. Educational attainment had little relation to hospitalization for extracranial occlusive disease, a finding that reduces the likelihood that selection bias explains the racial disparity. These data show unexplained racial differences in the type and location of cerebrovascular disease. The differences are important in understanding the pathogenesis of cerebrovascular disease and have practical clinical implications.

Alcohol Drinking↗
PubMed2002

Sex and racial differences in preference for a caring morality in a corporate environment that promotes diversity and equal opportunity.

This study investigated the caring moral perspective of managers in a corporation recognized as being a champion of promoting diversity and equal opportunity. Caring is described as a morality of responsibility and relationship, a sensitivity to the needs of persons. The study was based on the prediction that the attachment and caring shown elsewhere to be characteristic of the morality of females would be characteristic of all managers, regardless of sex or race in this kind of corporate environment. 121 male and female, African-American and Euro-American managers responded to a survey using three subscales of a Caring Morality Inventory: caring orientation, use of intuition and feeling to make a judgment, and concern with others in decision-making. Analysis showed female managers, regardless of race, scored significantly higher on the Caring Morality scale than the male managers, supporting other findings of sex differences in caring moral perspective and suggesting that working for a company actively promoting diversity and equal opportunity does not cancel out these differences. In addition, for this study it was assumed that, although African Americans, in general, may have been sensitized to lean more toward a caring morality, any racial differences in caring morality would be cancelled out by the fact that all of the managers work for the same prodiversity and, by assumption, more sensitive company. The Euro-American managers, regardless of sex, actually scored higher on the Caring Morality scale than did the African-American managers, with the difference being attributable solely to the greater tendency of the Euro-American managers to use intuition and feeling to make a judgment.

Adult↗
PubMed2002

Racial differences in parathyroid hormone levels in patients with secondary hyperparathyroidism.

AIM: African-Americans (AA) with normal renal function have higher parathyroid hormone (PTH) levels than Caucasians (C). This difference was also noted in cross-sectional studies of patients on dialysis. In this study, we evaluated patients with end-stage renal disease who have just began dialysis and who were not receiving any vitamin D therapy. METHODS: A total of 363 patients were recruited (C: 260; AA: 103). All patients had serum calcium, phosphorus, alkaline phosphatase and intact PTH (iPTH) levels measured within 3 months of initiating dialysis. RESULTS: Serum PTH levels were significantly higher in AA vs. C (383 +/- 33 vs. 246 +/- 19, p < 0.001). This difference was present despite similar calcium, phosphorus and alkaline phosphatase levels between the 2 groups and regardless of gender or diabetes status. However, PTH levels in patients younger than 47 years of age were similar in both groups. CONCLUSION: PTH levels in ESRD patients over 47 years of age are higher in AA compared to C. The difference is, in part, due to an age-dependent reduction in PTH seen only in C. Further studies are needed to understand the mechanisms of these racial differences and to verify whether they mirror similar alterations at the level of the end-organ tissue.

Adolescent↗