Ethnic Dis
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The design, implementation, and preliminary evaluation of an enhanced community-engagement program that uses poetry, film, and photography at a film festival in south Los Angeles is described. This project is one of several Talking Wellness projects designed to develop social capital and enhance community engagement in projects designed to improve the community's capacity to communicate effectively about depression, to decrease the associated stigma, and to participate in the design and evaluation of research interventions. The high degree of collaboration in the development and evaluation of this community participatory research model is illustrated by describing the selection and design of the intervention and the development of the survey questionnaires used for data collection. The project is described from the perspective of community members involved in the process.
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Multicenter Study
Disparities by insurance status in quality of care for elderly patients with unstable angina.
Treatment disparities for socioeconomically disadvantaged populations have been widely reported, but few studies have sought explanations for these disparities. ⋯ Elderly Medicaid patients appear to receive poorer quality of care. This finding is partially, but not completely, explained by characteristics of the facilities where they are hospitalized.
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Multicenter Study
Breast and cervical cancer screening for Puerto Ricans, African Americans, and non-Hispanic whites attending inner-city family practice centers.
Disparities exist for breast and cervical cancer screening among racial/ ethnic groups and low-income women. This study determines racial/ethnic variation in: 1) staging readiness for mammography, Pap smears, and clinical breast exam (CBE); 2) identifying patterns of adherence; and 3) determining sociodemographics associated with compliance with all three exams. ⋯ Racial/ethnic differences in screening patterns exist among women attending urban family practice centers. Primary care providers must be culturally sensitive when recommending screening and can use staging as a tool to target women most receptive to intervention.
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To examine the relationship between racial/ethnic neighborhood concentration and self-reported health before and after adjustment of individual- and neighborhood-level characteristics and to determine whether this association varies by race/ethnicity and perception of neighborhood. ⋯ This study demonstrates that poor self-reported health varies with patterns of concentration of Blacks in a neighborhood, after adjusting for individual- and neighborhood-level characteristics and perception of neighborhood. The results underscore the need for elucidating the pathways by which racial/ethnic neighborhood concentration affects health.
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Metabolic syndrome (MetS) defines cardiovascular disease (CVD) risks. Despite higher rates of obesity, type 2 diabetes, and hypertension, African Americans have lower rates of MetS when compared to Caucasians, which is paradoxical, since African Americans are more insulin resistant and have higher rates of cardiovascular morbidity and mortality when compared to White Americans. We hypothesized that genetic inheritance predisposes African Americans to the greater cardiovascular risk and the associated morbidity and mortality. Therefore, we investigated the prevalence of components of MetS in obese, glucose-tolerant, first degree relatives of African American patients with type 2 diabetes. ⋯ We found that: 1) the prevalence of MetS is higher in a subgroup of African Americans who were first-degree relatives of patients with type 2 diabetes than that of African Americans in the NHANES III; and 2) waist circumference rather than metabolic parameters was the single most important parameter and was more likely to meet the MetS criteria in African American relatives.