Black/African American Health Disparities
Effects of Recent Medicaid Expansions on Infant Mortality by Race and EthnicityThe purpose of this study is to examine year-by-year effects of the 2014 Affordable Care Act Medicaid expansion on infant mortality by race and ethnicity over the first 6 years.
Social Support and Breastfeeding Outcomes Among a Racially and Ethnically Diverse PopulationSocial support is a modifiable social determinant of health that shapes breastfeeding outcomes and may contribute to racial and ethnic breastfeeding disparities. This study characterizes the relationship between social support and early breastfeeding.
Perinatal Care Changes During COVID-19: A Population-Based Analysis by Race/EthnicityThe COVID-19 public health emergency created unprecedented disruptions in the use of healthcare services, which could have affected long-standing racial‒ethnic disparities in maternal care use and outcomes. This study evaluates population-level changes in perinatal health services associated with the COVID-19 pandemic overall and by maternal race‒ethnicity.
COVID-19 Vaccination and Racial/Ethnic Inequities in Mortality at Midlife in MinnesotaRecent research underscores the exceptionally young age distribution of COVID-19 deaths in the U.S. compared with that of international peers. This paper characterizes how high levels of COVID-19 mortality at midlife ages (45–64 years) are deeply intertwined with continuing racial inequity in COVID-19 mortality.
Intersectionality of Sexual Orientation With Race and Ethnicity and Associations With E-Cigarette Use Status Among U.S. YouthAlthough structural discrimination against sexual and racial/ethnicity minorities is a putative risk factor for youth tobacco use, understanding health disparities in youth E-cigarette use at the intersection of sexual orientation, race, and ethnicity is still lacking. This study aims to examine the differences in E-cigarette use prevalence among U.S. youth at the intersections of sexual orientation with race and ethnicity.
Redlining and Neighborhood Walking in Older Adults: The 2017 National Household Travel SurveyIn the 1930s, Black, working-class, and immigrant neighborhoods were color coded on maps (i.e., redlining) indicating investment risk, which negatively impacted mortgage attainment/homeownership for these groups and led to long-standing segregation by race/ethnicity and socioeconomic status. Limited studies have investigated the health impacts of redlining, particularly among older adults who tend to stay closer to their residences. This study examines whether older adults in historically redlined neighborhoods report less neighborhood walking and whether associations vary by race/ethnicity and income.
State-Level Socioeconomic Racial Inequity and Food Insecurity in the U.S.Racial inequities in food insecurity have been documented for the past 2 decades in the U.S., with the prevalence of food insecurity among Black households being 2–3 times higher than that among White households across time. The purpose of this study was to determine the association between socioeconomic indicators of structural racism at the state level and food insecurity among White and Black households in the U.S.
Racial‒Ethnic Disparities of Buprenorphine and Vivitrol Receipt in MedicaidExpanding access to medications for opioid use disorder is a cornerstone to addressing the opioid overdose epidemic. However, recent research suggests that the distribution of medications for opioid use disorder has been inequitable. This study analyzes the racial‒ethnic disparities in the receipt of medications for opioid use disorder among Medicaid patients diagnosed with opioid use disorder.
Health Implications of Racism, Sexism, and Social Class: Reflections From Nearly 30 Years AgoIn 1993, when the article “Racism, Sexism and Social Class: Implications for Studies of Health, Disease and Well-Being” by Krieger et al.1 was originally published in the American Journal of Preventive Medicine (AJPM), I was working on my PhD at the Johns Hopkins University School of Hygiene and Public Health and making the case to often incredulous audiences that it was meaningful to examine the contextual impacts of neighborhood disadvantage on health even if individual-level socioeconomic data were available.
Breaking Through and Backlash: Advancing Awareness About Racism, Sexism, Social Class, and the People's HealthThirty years ago, the U.S. Centers for Disease Control and Prevention (CDC) held a truly pathbreaking 3-day symposium, by invitation only, that explicitly focused on racism, sexism, social class, and health.1 Titled “Preterm delivery among Black women: The symposium on psychosocial factors” (December 2–5, 1991), this meeting was organized by a visionary group of African American women researchers, led by Diane Rowley, who were based in the Pregnancy and Infant Health Branch in the Division of Reproductive Health in CDC's National Center for Chronic Disease Prevention and Health Promotion (Table 1).
U.S. Trends in Age of Cigar Smoking Initiation by Race/Ethnicity and EducationYounger age of initiating cigar smoking is associated with greater nicotine dependence and current use. Age of initiating cigarette smoking has increased over time, whereas trends in age of initiating cigar smoking remain understudied. These trends were examined by race/ethnicity, by education, and at their intersection.
A Decade of Nutrition and Health Disparities Research at NIH, 2010–2019Nutrition health disparities include differences in incidence, prevalence, morbidity, and mortality of diet-related diseases and conditions. Often, race, ethnicity, and the social determinants of health are associated with dietary intake and related health disparities. This report describes the nutrition health disparities research supported by NIH over the past decade and offers future research opportunities relevant to NIH's mission as described in the Strategic Plan for NIH Nutrition Research.
Nativity-Related Disparities in Preterm Birth and Cardiovascular Risk in a Multiracial U.S. CohortHaving a preterm birth is associated with future cardiovascular risk. Non-Hispanic Black women have higher rates of preterm birth than non-Hispanic White and Hispanic women, but nativity-related disparities in preterm birth are not well understood.
Racial Disparities in Child Exposure to Firearm Violence Before and During COVID-19Childhood exposure to neighborhood firearm violence adversely affects mental and physical health across the life course. Study objectives were to (1) quantify racial disparities in these exposures across the U.S. and (2) assess changes during the COVID-19 pandemic, when firearm violence increased.
The Interplay of Race/Ethnicity and Obesity on the Incidence of Venous ThromboembolismFactors predisposing asymptomatic individuals within the community to venous thromboembolism are not fully understood. This study characterizes the incidence and determinants of venous thromboembolism among the Multiethnic Study of Atherosclerosis cohort with a focus on race/ethnicity and obesity.
Racial Inequities in Birth Weight by Maternal Age Among College-Educated Mothers: The Role of Early DisadvantageNon-Hispanic Black infants experience disproportionately high risks of low birth weight compared with non-Hispanic White infants, particularly among mothers with high educational attainment and greater socioeconomic advantage. This study investigates how maternal early-life disadvantage contributes to ongoing racial birth weight inequities among U.S. college‒educated mothers, specifically declining birth weights with age among non-Hispanic Black mothers.
Optimism and Lipid Profiles in Midlife: A 15-Year Study of Black and White AdultsOptimism is associated with better cardiovascular health, yet little is known about the underlying mechanisms and whether protective relationships are consistently observed across diverse groups. This study examines optimism's association with lipid profiles over time and separately among Black and White men and women.
Age, Sex, Race/Ethnicity, and Income Patterns in Ideal Cardiovascular Health Among Adolescents and Adults in the U.S.Ideal cardiovascular health is present in <50% of children and <1% of adults, yet its prevalence from adolescence through adulthood has not been fully evaluated. This study characterizes the association of age with ideal cardiovascular health and compares these associations across sex, race/ethnicity, and SES subgroups.
Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children and Dietary Intake in Children: Associations With Race and EthnicityEstablishing healthy dietary intake in pediatric populations is important for prevention of chronic disease across the lifespan. Federal nutrition assistance programs can support the dietary intake of U.S. children. The objective of this study was to assess the relationship between Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation status and dietary intake within racial and ethnic groups.
Avoiding Pro Forma: A Health Equity–Conscious Approach to Cancer Control ResearchOver the last 30 years, cancer mortality rates have fallen significantly,1 but these benefits have not been experienced consistently across all populations or geographical areas. The avoidable differences or disparities in cancer outcomes are largely attributed to the historical and contemporary structures, processes, practices, and policies that create or reinforce the inequitable allocation and accessibility of resources, services, and opportunities, thereby hindering the attainment of the highest level of health for all—health equity.
Racial and Ethnic Disparities in COVID-19 Vaccination Coverage: The Contribution of Socioeconomic and Demographic FactorsHealth disparities among racial and ethnic and socioeconomic groups are pervasive, and the COVID-19 pandemic has not been an exception. This study explores the key demographic and socioeconomic factors related to racial and ethnic disparities in COVID-19 vaccination coverage.
Medicaid Expansion and Cancer Mortality by Race and Sex in LouisianaThe purpose of this study is to determine the association between Medicaid expansion in Louisiana and cancer mortality by race and sex.
The Impact of Menthol Cigarette Flavor in the U.S.: Cigarette and ENDS Transitions by Sociodemographic GroupA better understanding of how menthol cigarette flavoring and ENDS impact smoking initiation, cessation, and transitions between tobacco products could help elucidate the potential impact of a U.S. menthol ban on combustible tobacco products.
Racial/Ethnic Variation in Veterans Health Administration COVID-19 Vaccine UptakeEquitable COVID-19 vaccine access is imperative to mitigating negative COVID-19 impacts among racial/ethnic minorities. U.S. racial/ethnic minorities have lower COVID-19 vaccination rates than Whites despite higher COVID-19 death/case rates. The Veterans Health Administration provides the unique context of a managed care system with few access barriers. This study evaluates race/ethnicity as a predictor of Veterans Health Administration COVID-19 vaccination.
Law Enforcement Violence in the Black Community: A Catalyst for Clinician Engagement in Social JusticeThe murder of George Floyd by a Minneapolis police officer on May 25, 2020 triggered local, national, and international social unrest, driven by a prevailing and well-founded sense of discrimination within communities of color all over the world, especially with regard to police violence.1 There continues to be a pressing need for clinicians to understand the public health impacts of law enforcement violence that result in adverse health outcomes.