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PubMed1997

Racial differences in retirement income: the roles of public and private income sources.

Despite great overall improvement in the elderly's economic status over the past two decades, minority elders still comprise the poorest population group of all. Nonetheless, the income security of minority elders has not been given special attention in the scrutiny in recent years of the size and the future of various federal programs affecting older persons. Based on data from the 1971, 1981, and 1991 public-use data tapes of the Current Population Survey, the racial difference in income status of the elderly and the role of Social Security and Supplemental Security income versus that of income from private sources are analyzed in terms of how income inequality among races is ameliorated or escalated. The findings show that racial/ethnic differences in income status increased between 1970 and 1990. The findings also confirm that, for both elderly singles and couples, Social Security is the most important income source. Without it, poverty rates among elderly black couples, for example, would have increased by as much as 48.5 percentage points in 1990. Policies that would help improve the income status of the low-income elderly are discussed.

Black or African American↗

PubMed1993

A racial difference in erythrocyte sedimentation.

Erythrocyte sedimentation rate (ESR) was examined in blacks and whites aged 18 to 74 years in the first National Health and Nutrition Examination Survey (NHANES I). In each age and sex group, median ESR was 2 mm/hr to 13 mm/hr higher in blacks than in whites even after exclusion of persons with extreme hemoglobin values or history of conditions affecting ESR. Apparently healthy blacks were more likely than whites to have elevated ESR greater than 20 mm/hr in women and 9 mm/hr in men. These data suggest a racial difference in ESR that is independent of age, hemoglobin concentration, and certain chronic diseases.

Adolescent↗

PubMed2003

Bioinformatics research on inter-racial difference in drug metabolism I. Analysis on frequencies of mutant alleles and poor metabolizers on CYP2D6 and CYP2C19.

The enzyme activities of CYP2D6 and CYP2C19 show a genetic polymorphism, and the frequency of poor metabolizers (PMs) on these enzymes depends on races. In the present study, the frequencies of mutant alleles and PMs in each race were analyzed based on information from published studies, considering the genetic polymorphisms of CYP2D6 and CYP2C19 as the causal factors of racial and inter-individual differences in pharmacokinetics. As a result, it was shown that there were racial differences in the frequencies of each mutant allele and PMs. The frequencies of PMs on CYP2D6 are 1.9% of Asians and 7.7% of Caucasians, and those of PMs on CYP2C19 are 15.8% of Asians and 2.2% of Caucasians. Based on the results, it was suggested that there would be racial differences in the frequencies of PM subjects whose blood concentrations might be higher for drugs metabolized by these enzymes. Additionally, it was suggested that enzyme activities would vary according to the number of functional alleles even in subjects judged to be extensive metabolizers (EMs). In the bridging study, genetic information regarding CYP2D6 and CYP2C19 of the subjects will help extrapolate foreign clinical data to a domestic population.

Journal Article↗

PubMed1994

Are racial differences in squamous cell esophageal cancer explained by alcohol and tobacco use?

BACKGROUND: In the United States, incidence rates of squamous cell esophageal cancer are more than five times higher among black men than among white men. Reasons that might explain this large racial disparity are being sought. PURPOSE: We evaluated whether differential use of alcohol and tobacco can fully account for the excess of squamous cell esophageal cancer among U.S. blacks. METHODS: We conducted a population-based, case-control study with in-person interviews with 373 squamous cell esophageal cancer case patients (124 white males and 249 black males) and 1364 control subjects (750 white males and 614 black males) from three U.S. geographic areas. Histologically confirmed cases of squamous cell esophageal cancer newly diagnosed from August 1, 1986, through April 30, 1989, among white and black men aged 30-79 years were included. RESULTS: Alcohol use of more than one drink per day and/or current cigarette use of at least one pack per day accounted for 92.7% (95% confidence interval [CI] = 86.8%-98.5%) of the squamous cell esophageal cancers in blacks, versus 86.3% (95% CI = 75.5%-97.1%) in whites, and for 94% of the difference between the black and white annual incidence rates. The interaction between race and the continuous drinking/smoking variable in a logistic regression analysis was statistically significant (two-sided, P = .02). Exposure rates among controls at all levels of combined alcohol and tobacco use examined were slightly higher among blacks and accounted for a small portion of the racial differences in incidence rates. CONCLUSION: Although the vast majority of esophageal cancers in both blacks and whites in our data can be explained by use of alcohol and tobacco, it is not clear why heavy consumption of alcohol and/or tobacco is responsible for 14.9 per 100,000 per year more cases of squamous cell esophageal cancer among blacks than among whites. The differences in the odds ratios appear to account for more of the racial differences in incidence rates than do the prevalences of exposure to alcohol and tobacco alone. The reasons for this apparent racial difference in carcinogenic risk from the same level of alcohol and tobacco use are unknown, but they may include qualitative differences in alcohol consumption, differences in other environmental exposures that interact with alcohol and/or tobacco to modify risks, or differences in susceptibility to these factors.

Adult↗

PubMed1984

Human platelet phenol sulfotransferase: stability of two forms of the enzyme with time and presence of a racial difference.

Thermolabile (TL) and thermostable (TS) forms of human platelet phenol sulfotransferase (PST) were measured over various periods of time. TL PST was assayed with dopamine as the substrate and TS PST was measured with phenol and with p-nitrophenol. Levels of TL and TS PST from the same subjects did not change significantly over 1 day, 1 week, 4 weeks, and 8.5 months. Interassay coefficients of variation of PST activities over 3-4 weeks measured in samples from 8-12 subjects with dopamine, phenol and p-nitrophenol were 13.96%, 13.60% and 13.30%, respectively. There was a significant correlation between PST activity measured in the same samples with phenol and with p-nitrophenol (r = 0.946, n = 18, p less than 0.0001). TS PST activity measured with p-nitrophenol was significantly higher (p less than 0.0001) in platelets from 51 black subjects than the level of TS PST in samples from 52 white subjects (0.72 +/- 0.06 vs 0.42 +/- 0.04 units/10(8) platelets, respectively; mean +/- SEM). These results demonstrate the 'stability' of the levels of both forms of the enzyme with time. They also point out the usefulness of a reproducible assay for the detection of a racial difference in the levels of TS PST.

Adult↗

PubMed2000

Racial differences in attitudes toward protease inhibitors among older HIV-infected men.

Recent advances in the treatment of HIV infection, particularly those associated with the advent of a new class of medications--protease inhibitors (PIs)--have focused interest on the problem of medication non-adherence. Earlier research on antivirals suggests that patient attitudes toward a medication or treatment play an important role in influencing its use. Attitudes toward PIs were explored using data from a study of late middle-aged and older adults (ages 50-67) living with HIV/AIDS (N = 38) who had been or were currently users of PIs at the time of accrual in late 1997. Comparisons were made between African American and White men with regard to perceptions of: medication efficacy, self-efficacy, physician competence, quality of life, side effects, skipping medication doses and the timing of protease initiation. Results of these analyses suggest significant differences between White and African American men. African American men not only expressed significantly more doubt regarding their ability to utilize PIs and adhere to PI treatment regimens than Whites, but also reported significantly more doubt regarding physician competence with regard to PIs. African American men were also more likely than Whites to question the timing of their initiation of treatment with PIs. The findings suggest that these racial differences may be important for creating patient education strategies and the targeting of non-adherence prevention efforts.

Black or African American↗

PubMed1976

Reflection on the 1976 Toronto Olympiad for the physically disabled.

A report is given on the various aspects of the 1976 Olympiad of the Physically Disabled. The aspects discussed are the historical background, planning and preparation of the Games, accommodation for amputees, blind and paraplegics, transport, games site, organisation of sports events, medical supervision, publicity of the Games, standards of performance and records and last, but by no means least, politics and sport.

Canada↗

PubMedDate not supplied

Racial differences in salivary sIgA concentrations in postmenopausal women.

The purpose of this study was to compare sIgA salivary concentrations between Caucasian and African-American postmenopausal women. The age, height, weight and history of hormone replacement therapy were recorded and the BMI was calculated for each individual. Whole, stimulated saliva was assayed for sIgA and total protein. Logistic regression analysis evaluated the relationships between the outcome variables. Total salivary sIgA and adjusted sIgA (adjusted for protein) concentrations were significantly higher in the African-American women (p<0.01). There were significant statistical correlations between sIgA concentrations and race (p<0.01). Our data suggest that racial differences in salivary sIgA concentrations in elderly women could be an important variable for planning future studies utilizing salivary samples as biological markers.

Black or African American↗

PubMed2006

Racial differences in clinical progression among Medicare recipients after treatment for localized prostate cancer (United States).

OBJECTIVE: Prostate cancer recurrence impacts patient quality of life and risk of prostate-cancer specific death following definitive treatment. We investigate differences in disease-free survival among white, black, Hispanic, and Asian patients in a large, population-based database. METHODS: Merged Surveillance, Epidemiology, and End Results Program (SEER) and Medicare files provided data on 23,353 white patients, 2,814 black patients, 480 Hispanic patients, and 566 Asian patients diagnosed at age 65-84 years with clinically localized prostate cancer between 1986 and 1996 in five SEER sites. Patients were followed through 1998. Racial differences in disease-free survival were assessed using Kaplan-Meier survival curves and Cox regression models. RESULTS: The 75th percentile disease-free survival time for black patients was 13 months less than that for white patients (95% confidence interval [CI]: 6.2-19.8 months), 29.7 months less than that for Hispanic patients (95% CI: 4.4-55.0 months), and 39.1 months less than that for Asian patients (95% CI: 12.1-66.1 months). In multivariate analysis, black race predicted shorter disease-free survival among surgery patients, but not among radiation patients. CONCLUSIONS: Black patients experienced shorter disease-free survival compared to white, Hispanic, and Asian patients, and the disease-free survival of white, Hispanic, and Asian patients were not statistically different. Earlier recurrence of prostate cancer may help explain black patients' increased risk of mortality from prostate cancer.

Black or African American↗

PubMed2001

ApaI polymorphisms of the vitamin D receptor predict bone density of the lumbar spine and not racial difference in bone density in young men.

A number of previous investigations showed significant associations between polymorphisms of the vitamin D receptor (VDR) gene and bone mineral density (BMD). BMD is influenced by hormones and the rate of skeletal remodeling. A study was performed to investigate the possible relationship between Apa I, Bsm I, Taq I, and Fok I polymorphisms of the VDR gene and serum 1,25-dihydroxyvitamin D (1,25[OH]2D), osteocalcin, and propeptide of type I collagen (PICP)-markers of bone turnover, total body calcium, and BMD of the total body, radius, lumbar spine, trochanter, and femoral neck-in 39 young adult black men of 20 to 40 years of age and 44 age-, height-, and weight-matched white men. The distribution of each of the four alleles of the VDR genotypes was similar in the two racial groups. The Apa I VDR genotype was associated with serum PICP (P =.0494) but not with serum 1,25(OH)2D or serum osteocalcin. A significant association between the Apa I VDR genotype and BMD of the lumbar spine (P =.0291) was also observed. However, the Bsm I, Taq I, and Fok I genotypes were not significantly associated with BMD or serum osteocalcin, PICP, or 1,25(OH)2D. Multivariate stepwise analysis indicated that (1) the Apa I VDR genotype was associated with BMD of the lumbar spine in the two groups together; with total body calcium and BMD of the total body, radius, trochanter, and femoral neck in the black men; and with BMD of the radius in the white men; analysis also indicated that (2) race was significantly associated with total body calcium and BMD of the total body, lumbar spine, and femoral neck. In summary, the Apa I VDR genotype is associated with serum PICP and BMD at a number of sites but does not contribute to or account for racial differences in BMD in young adult men.

Adult↗

PubMed1997

Prostate-specific antigen (PSA) and PSA density: racial differences in men without prostate cancer.

BACKGROUND: Many physicians now use serum prostate-specific antigen (PSA) to screen for prostate cancer in asymptomatic men. Whether or not a prostate biopsy should also be performed depends on an accurate definition of what constitutes a normal PSA value. Until recently, studies conducted to establish normal serum PSA values have involved study populations that have included few African-American men. PURPOSE: We sought to compare serum PSA levels and PSA density (i.e., serum PSA level/prostate volume ratio) in African-American and white men without histologic evidence of prostate cancer. METHODS: We reviewed the medical records of 826 consecutive men who underwent one or more prostate biopsies at the Veterans Affairs Medical Center in Shreveport, LA, from January 1993 through December 1995. In this retrospective review, we recorded patient's age, race, serum PSA level, digital rectal examination result, ultrasound-determined prostate volume, indications for biopsy, and biopsy results. Data from a total of 752 consecutive men who were either white or African-American and whose indication for biopsy included a serum PSA of greater than 4.0 ng/mL and/or an abnormal digital rectal examination were analyzed. To examine possible differences in serum PSA level, PSA density, prostate volume, and patient age, the two-sided Student's t test was employed. Multivariate linear regression analysis was used to determine if serum PSA levels were associated with the patient's age, race, or prostate volume in men without prostate cancer. RESULTS: Of the 752 men included in this analysis, 254 had histologic evidence of prostate cancer and 498 did not. Of the 498 men without prostate cancer, 367 (74%) men were white and 131 (26%) were black. There were no racial differences in age or calculated prostate volume. Serum PSA levels and calculated PSA density, however, were significantly (both P < .0001) higher in African-American men that in white men. A multivariate linear regression analysis indicated that race and prostate volume were independent variables associated with serum PSA level. For African-American and white men, serum PSA values of greater than 4 ng/mL were associated with prostate cancer with sensitivities of 89.5% and 81.9%, respectively, and specificities of 38.2% and 52.3%, respectively. CONCLUSION: Among biopsied men without histologic evidence of prostate cancer, African-Americans have a significantly higher PSA level and PSA density than similarly aged white men. IMPLICATIONS: Published criteria for normal PSA level and density have been derived primarily from white men and may not be directly applicable to other populations. Race-specific data are needed to fully optimize PSA as a tumor marker in racial populations that are at high risk for prostate cancer death.

Adult↗

PubMed1997

Racial differences in risk factors for atherosclerosis. The ARIC Study. Atherosclerosis Risk in Communities.

This paper describes black/white differences in risk factors for atherosclerosis in the large multicenter Atherosclerosis Risk in Communities (ARIC) Project sponsored by the National Heart, Lung, and Blood Institute. It is based on data collected at baseline in ARIC's four geographically distinct clinical centers. Participants were randomly selected (4264 black and 11,479 white men and women, ages forty-five to sixty-four years at entry). There were striking differences in obesity between black and white women, higher fasting glucose and greater prevalence of diabetes in blacks, and lower high-density lipoprotein values in white men. Not unexpectedly, blood pressure in black participants exceeded that in whites. Clustering of multiple risk factors was more common in the black population. Conversely, prevalence of no risk factors was greatest among whites. In conclusion, while African-Americans and Caucasians share much the same group of risk factors for atherosclerosis, there are clinically important racial differences in emphasis.

Arteriosclerosis↗

PubMed2006

Racial differences in the use of antidepressants and counseling for depression among homeless women.

The purpose of the current study was to examine how African American race was related to the use of antidepressants and counseling among homeless depressed women. Women were recruited in 18 homeless shelters in four counties in central North Carolina. Head of household homeless mothers with psychiatric and/or substance abuse disorders who had dependent children were eligible to participate. One hundred and sixty four women enrolled into the study. Fifty-six percent (N=92) of the homeless women were currently depressed at the time of enrollment into the study. Nineteen of the depressed women reported having received counseling during the past 3 months and there were no racial differences in counseling use. A total of 19 depressed women were currently taking antidepressants. Non-Black depressed women (60%) were significantly more likely than Black depressed women (16%) to be currently using antidepressant medication (OR=0.14, 95% CI=0.02, 0.90). Fourteen of the 92 depressed women reported needing mental health services but not receiving them during the past 3 months and all of these women were Black.

Adult↗

PubMed1999

Psychosocial mediators of racial differences in nighttime blood pressure dipping among normotensive adults.

Shallow declines in nocturnal compared with diurnal blood pressure (BP dipping) have been associated with cardiovascular disease. In U.S. samples, Blacks demonstrate less BP dipping compared with Whites. In a sample of 60 Black and 60 White normotensive adults we examined stress, social integration (including parental status), social support, and hostility as potential mediators of the association between race and BP dipping. The effect of race on diastolic BP dipping was partially mediated by parental status. The effect of race on heart rate dipping was partially mediated by stressful life events. No psychosocial factors mediated the relation between race and systolic BP dipping. Although psychosocial factors appear to account for some of the observed racial differences in nocturnal blood pressure decline, our data suggest that these differences cannot be attributed entirely to covarying psychosocial effects.

Adaptation, Psychological↗

PubMed1986

Racial differences in survival of women with breast cancer.

The hypothesis that white women with breast cancer survive longer than black women with this disease was evaluated in a retrospective analysis of a population-based prospective follow-up study. All female residents of metropolitan Atlanta with a first diagnosis of primary breast cancer between 1 January 1978 and 31 December 1982 were eligible for inclusion. The study population of 2322 white and 536 black women was followed through the end of calendar year 1983 to determine vital status. Univariate, multivariate and excess death rate analyses were performed to evaluate race as a prognostic factor. Overall, the cumulative percentage of survivors at 3 years was 83% among whites, compared with 71% among blacks. The racial difference in survival was greatest among women with advanced disease, and a higher proportion of black women with advanced disease did not receive surgery. Even when the type of surgery and stage of disease were controlled, race was a significant prognostic factor.

Adult↗

PubMed1996

Racial differences in a prostate cancer screening study.

PURPOSE: We attempted to determine whether black men have a higher prostate cancer prevalence and more advanced disease. MATERIALS AND METHODS: We screened 17,157 white and 804 black men 50 years old or older by serum prostate specific antigen measurement and digital rectal examination. We recommended biopsy when either test was suspicious. RESULTS: Black men had a higher prevalence of elevated prostate specific antigen (13.1 versus 8.9%) and cancer (5.1 versus 3.2%) than white men, and a higher prevalence of clinically but not pathologically advanced cancer. Fewer black men in lower income zip codes complied with recommendations for biopsy. CONCLUSIONS: In our screening study black men had a higher prevalence of detectable cancer. However, unlike in clinical studies there was no striking racial difference in advanced cancer stage at diagnosis.

Aged↗

PubMed1987

Racial differences in survival of women with endometrial cancer.

The hypothesis that white women with endometrial cancer survive longer than black women with this disease was evaluated in a retrospective analysis of a population-based, prospective cohort study. All female residents of metropolitan Atlanta with a first diagnosis of primary endometrial cancer from 1978 through 1982 were eligible for inclusion. The 628 white and 105 black women were followed up through June 1984 to determine survivorship. Race was evaluated as a prognostic factor with univariate, multivariate, and excess death rate analyses. Overall, an estimated 89.2% of whites and 61.6% of blacks survived 3 years from the time of diagnosis. Although black women tended to have more advanced disease at the time of diagnosis and a higher proportion of undifferentiated malignancies, the racial difference in survival persisted after adjustment for these factors. When initial therapy was considered, race remained a significant prognostic determinant among women who did not receive radiation therapy.

Age Factors↗

PubMed2002

Racial difference in the activity of the amiloride-sensitive epithelial sodium channel.

Compared with whites, blacks appear to retain additional sodium that suppresses secretion of renin and aldosterone. The epithelial sodium channel (ENaC) is an aldosterone-regulated site for sodium reabsorption. ENaC activity could be higher in blacks, contributing to sodium retention or, alternatively, lower because of reduced stimulation by aldosterone. To examine the level of ENaC activity in blacks relative to whites, blood pressure (BP) responses to amiloride (5 mg/d), an inhibitor of ENaC, were measured in 20 black and 25 white normotensive young people. After 1 week, systolic BP decreased by 3.0+/-9.2 (SD) and diastolic by 2.8+/-8.3 mm Hg in the whites, whereas systolic BP increased by 2.5+/-7.1 and diastolic by 3.8+/-8.0 mm Hg in the blacks; the racial difference in the BP response was significant for both systolic (P=0.034) and diastolic BP (P=0.010). As ENaC activity increases, renal secretion of potassium increases proportionately, and in a larger sample of subjects, the urinary potassium excretion rate was lower in the blacks (n=301) than in the whites (n=461): 3.2+/-0.1 versus 3.8+/-0.1 mmol/mmol creatinine (P=0.0001). The concentration of serum potassium was higher in the blacks (n=81) than in the whites (n=167): 4.36+/-0.05 versus 4.21+/-0.03 (P=0.012). In summary, a favorable BP response to amiloride in the whites as well as the evidence for greater retention of potassium in the blacks is consistent with blacks having less ENaC activity than whites. We suggest that increased sodium retention in blacks occurring at other nephron sites suppresses aldosterone secretion and in turn ENaC function.

Adolescent↗