Author Interviews, CDC, Gender Differences, HIV, Race/Ethnic Diversity / 05.03.2015

MedicalResearch.com Interview with: Dr. Ndidi Nwangwu-Ike Center Disease Control MedicalResearch: What is the background for this study? What are the main findings? Response: CDC data has shown encouraging signs of a decrease in new HIV infections among black women in recent years.  However, African American women continue to be far more affected by HIV than women of any other race or ethnicity, with a rate of new infection 20 times that of white women and nearly five times that of Hispanic women.  Ensuring people with HIV are diagnosed and remain in care is key to controlling HIV in the nation. When used consistently, antiretroviral medication can keep HIV controlled at very low levels in the body (known as viral suppression), allowing people with HIV to live longer, healthier lives and reducing the likelihood they will transmit HIV to others. Our study finds that viral suppression among women diagnosed with HIV is low, with young women and black women the least likely to achieve viral suppression. Specifically, we found that: o   Of women newly diagnosed with HIV in 2012, 83 percent were linked to care within three months of diagnosis. o   Retention in care varied by age and race/ethnicity; overall, just over half of women (52 percent) diagnosed and living with HIV in 2011 received ongoing HIV care. o   Overall, only 44 percent of women diagnosed and living with HIV in 2011 had a suppressed viral load. (more…)
Author Interviews, Cancer Research, JAMA, Race/Ethnic Diversity, Vanderbilt / 24.02.2015

Dr. Wei Zheng, MD, PhD Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TennesseeMedicalResearch.com Interview with: Dr. Wei Zheng, MD, PhD Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee   Medical Research: What is the background for this study? What are the main findings? Dr. Wei Zheng: Substantial progress has been made in the diagnosis and treatment of cancer, resulting in a steady improvement in cancer survival. However, the degree of improvement by age, race and sex remains unclear. We quantified the differences in the improvement of cancer survival by race, age, and sex over the last two decades. We used cancer diagnosis and follow-up data from more than 1 million cancer patients, collected in nine SEER registries, to investigate trends in improved survival for seven major cancers in the United States by age, race, and sex between 1990 and 2010. We found that elderly patients experienced a smaller improvement in survival for cancers of the colon/rectum, breast, prostate, lung, and liver than their younger counterparts. In particular, the age-related disparities were most pronounced for those cancers with the greatest advancements in diagnosis and treatment over the past two decades, including cancers of colon/rectum, breast and prostate. African Americans experienced poorer survival than whites for all cancers. Because of a greater improvement in prostate cancer survival in African Americans than for whites, the racial difference in the survival of this cancer decreased during the study period. For ovarian cancer, however, the survival rate declined in African Americans but slightly increased in whites, leading to a wider racial gap in the survival of this deadly cancer. No apparent disparities in survival improvement by sex were noted. (more…)
Author Interviews, Connective Tissue Disease, Emory, Kidney Disease, Race/Ethnic Diversity / 20.02.2015

Laura Plantinga, PhD Assistant Professor Division of Renal Medicine, Department of Medicine Emory University School of Medicine Atlanta, GA 30322MedicalResearch.com Interview with: Laura Plantinga, PhD Assistant Professor Division of Renal Medicine, Department of Medicine Emory University School of Medicine Atlanta, GA 30322 Medical Research: What is the background for this study? What are the main findings? Dr. Plantinga: Quality of care for end-stage renal disease (ESRD), which is treated with dialysis or kidney transplantation, is a high priority for the U.S. healthcare system, given universal coverage of these services. However, quality of ESRD care remains relatively unexplored in lupus patients, who have multiple providers and may have greater access to care. We found that, overall, nearly three-quarters of U.S. ESRD patients with lupus had pre-ESRD nephrology care and about 20% of lupus patients on dialysis were waitlisted for kidney transplant per year; however, fewer than one-quarter of those who started on dialysis had a permanent vascular access in place, which is associated with better outcomes than a temporary catheter. Furthermore, patients who were black or Hispanic were nearly a third less likely to have pre-ESRD care and were also less likely to be placed on the kidney transplant waitlist in the first year of dialysis than white patients. Having Medicaid or no insurance at the start of ESRD were both associated with lower likelihood of quality ESRD care by all measures, despite universal Medicare coverage after the start of ESRD. While there was geographic variation in quality of ESRD care, patterns were not consistent across quality measures. (more…)
Author Interviews, Disability Research, Pediatrics, Race/Ethnic Diversity / 14.02.2015

MedicalResearch.com Interview with: Ying Wang, PhD, MPH Data Management, Analysis & Research Office of Primary Care and Health System Management New York State Department of Health Empire State Plaza  Albany, NY  12237 Medical Research: What is the background for this study? What are the main findings? Dr. Wang: The purpose of the study was to examine the survival of children with one or more of 21 major birth defects in the United States.  We used data from 12 population-based birth defects surveillance programs that participate in the National Birth Defects Prevention Network.  The study included nearly 100,000 infants born with birth defects between 1997 and 2007. We found that children who were born with hypoplastic left heart syndrome (a severe congenital heart defect) had the lowest chance of survival across multiple ages (up to 28 days of life, 1 year, 2 years, and 8 years of life), compared to children with any other birth defects studied.  We also found that the chances of survival up to 1 year of life was greater than 90% for babies born with spina bifida, cleft palate, cleft lip with or without cleft palate, pyloric stenosis, gastroschisis, or Down syndrome. For most birth defects, survival was poorer among non-Hispanic black mothers and Hispanic mothers compared to non-Hispanic white mothers. (more…)
AHRQ, Author Interviews, Education, NIH, Race/Ethnic Diversity / 13.02.2015

MedicalResearch.com Interview with: Robert M. Kaplan Office of Behavioral and Social Sciences Research National Institutes of Health Bethesda, MD 20892 Medical Research: What is the background for this study? What are the main findings? Response: Years of formal education is one of the strongest correlates of life expectancy. The purpose of this study was to examine the relationship between educational attainment and life expectancy with adjustments for other social, behavioral, and biological factors. Using data from a large cohort of nearly 30,000 adults, we found that education was a very strong predictor of survival and that biological and behavioral factors only partially explained the relationship. (more…)
Author Interviews, Diabetes, Diabetologia, Race/Ethnic Diversity / 12.02.2015

Dr. Therese Tillin Research Fellow, Cardiometabolic Phenotyping Group Institute of Cardiovascular Science Faculty of Pop Health SciencesMedicalResearch.com Interview with: Dr. Therese Tillin Research Fellow, Cardiometabolic Phenotyping Group Institute of Cardiovascular Science Faculty of Pop Health Sciences Medical Research: What is the background for this study? What are the main findings? Dr. Tillin: The global burden of type 2 diabetes is rising rapidly and people of South Asian origins (from the Indian subcontinent)  remain at much higher risk of developing diabetes than people of European origin.  Why is this?  Although it is  thought that increased levels of obesity around the waist level, diet, physical activity levels and genetic factors contribute, no study to date has been able to tease out fully the underlying causes for the added risk in South Asian people.  However, it is likely that complex metabolic disturbances may play an important role. We have been studying a British cohort of people of European and South Asian origin for nearly 20 years and have used nuclear magnetic resonance spectroscopy to build a profile of amino acids in blood samples that were collected at the start of the study between 1988 and 1991.  We found that higher levels of some amino acids, in particular tyrosine, were already present in non-diabetic South Asian individuals back then.  Some of these amino acids, again especially tyrosine, more strongly predicted later development of type 2 diabetes in the South Asian people than in the Europeans in our study, even after adjustment for other risk factors such as obesity and insulin resistance. A given increase (one standard deviation) in tyrosine increased risk of developing diabetes by just 10% in Europeans, while in South Asians the increase in risk was 47%. (more…)
Author Interviews, CDC, HIV, Race/Ethnic Diversity / 06.02.2015

MedicalResearch.com Interview with: Azfar-e-Alam Siddiqi, MD, PhD Associate Chief of Science (Acting) HIV Incidence and Case Surveillance Branch Division of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention Medical Research: What is the background for this study? What are the main findings? Dr. Sidiqqi: African Americans remain the population most affected by HIV in the United States -- accounting for almost half (44 percent) of all new infections and more than a third (41 percent) of people living with HIV, despite representing just 12 percent of the U.S. population. We also know that far too many African Americans living with HIV do not get the medical care and treatment they need to stay healthy and protect themselves and others. In fact, less than half (40 percent) of African Americans living with HIV are engaged in care and only one-quarter (28 percent) have the virus under control through treatment. To better understand mortality among African Americans with HIV, our team analyzed data from the National HIV Surveillance System for 2008 through 2012. Because immune suppression caused by HIV infection can result in fatal co-illnesses, our analysis estimated deaths due to all causes, rather than limiting their analysis to deaths resulting directly from HIV infection. This method allowed us to capture the fullest picture of mortality among African Americans with HIV. According to our new analysis, from 2008-2012, the death rate per 1,000 blacks living with HIV decreased 28 percent, more than the overall decline (22 percent) observed among all persons living with HIV and more than declines observed among other races/ethnicities (13 percent for whites and 25 percent for Hispanics). Despite substantial declines in mortality, the death rate per 1,000 blacks living with HIV in 2012 was 13 percent higher than the rate for whites and 47 percent higher than the rate for Hispanics. (more…)
Author Interviews, Colon Cancer, Journal Clinical Oncology, Race/Ethnic Diversity, Stanford, Surgical Research / 30.01.2015

Kim F. Rhoads, MD, MS, MPH, FACS Assistant Professor of Surgery Director, Community Partnership Program Stanford Cancer Institute Unit Based Medical Director, E3 Surgery and Surgical Subspecialties Stanford University Stanford, Ca 94305MedicalResearch.com Interview with: Kim F. Rhoads, MD, MS, MPH, FACS Assistant Professor of Surgery Director, Community Partnership Program Stanford Cancer Institute Unit Based Medical Director, E3 Surgery and Surgical Subspecialties Stanford University Stanford, Ca 94305 Medical Research: What is the background for this study? What are the main findings? Dr. Rhoads: Colon cancer is the 3rd most common cancer in US men and women and is the 2nd most common cause of cancer death. For at least 2 decades, minorities with colon cancer have suffered a 15-20% additional risk of death when compared with non-minority patients. Our study set out to understand the influence of the location where treatment was delivered and the quality of care received, on overall survival and racial disparities. We examined more than 30,000 patients who were diagnosed and treated for colon cancer in California from 2001 through 2006.  Using cancer registry data linked to state level inpatient data and hospital information, we compared the rates of National Comprehensive Cancer Network (NCCN) guideline adherence and mortality by location of care and by race. We found that patients treated within an integrated health system (IHS) received NCCN guideline based care at higher rates than those treated outside the system—about 3% higher rates of surgery; and more than 20% higher rates of stage appropriate chemotherapy. The rates of guideline based care were nearly equal between the racial groups treated inside the IHS.  Propensity score matched comparisons revealed a lower risk of death for all patients and no racial disparities associated with treatment within the Integrated system.  For patients treated outside IHS, the disparity in mortality was explained by accounting for differences in receipt of evidence based care by race. (more…)
Annals Internal Medicine, Author Interviews, Colon Cancer, Race/Ethnic Diversity, University of Pennsylvania / 30.12.2014

Jeffrey H. Silber, M.D., Ph.D. The Nancy Abramson Wolfson Endowed Chair in Health Services Research Director, Center for Outcomes Research The Children's Hospital of Philadelphia Professor of Pediatrics, Anesthesiology & Critical Care The Perelman School of Medicine Professor of Health Care Management, The Wharton SchoolMedicalResearch.com Interview with: Jeffrey H. Silber, M.D., Ph.D. The Nancy Abramson Wolfson Endowed Chair in Health Services Research Director, Center for Outcomes Research The Children's Hospital of Philadelphia Professor of Pediatrics, Anesthesiology & Critical Care The Perelman School of Medicine Professor of Health Care Management, The Wharton School The University of Pennsylvania  Philadelphia, PA 19104 Medical Research: What is the background for this study? What are the main findings? Response: Differences in colon cancer survival by race is a well recognized problem among Medicare beneficiaries. We wanted to determine to what extent the racial disparity in survival is due to a racial disparity in presentation characteristics at diagnosis (such as advanced stage and the presence of chronic diseases) versus a disparity in subsequent treatment by surgeons and oncologists. To answer this question, we compared black colon cancer patients to three matched white groups: (1) “Demographics” match controlling age, sex, diagnosis year, and Survey, Epidemiology, and End Results (SEER) site; (2) “Presentation” match controlling demographics plus comorbidities and tumor characteristics including stage and grade; and (3) “Treatment” match including presentation variables plus details of surgery, radiation and chemotherapy. We studied Medicare patients 65 years of age and older diagnosed between 1991-2005 in the SEER-Medicare database. There were 7,677 black patients and 3 sets of 7,677 matched white controls. We found that difference in 5-year survival (black-white) was 9.9% in the demographics match. This disparity remained unchanged between 1991-2005. After matching on presentation characteristics, this difference fell to 4.9%. Finally, after additionally matching on treatment, this same difference hardly changed, moving to only 4.3%. So the disparity in survival attributed to treatment differences comprised only an absolute 0.6% of the overall 9.9% survival disparity. (more…)
Author Interviews, Race/Ethnic Diversity / 19.12.2014

Glenn Firebaugh, Ph.D. Roy C. Buck Professor of American Institutions, Sociology, and Demography College of the Liberal Arts The Pennsylvania State University University Park, PAMedicalResearch.com Interview with: Glenn Firebaugh, Ph.D. Roy C. Buck Professor of American Institutions, Sociology, and Demography College of the Liberal Arts The Pennsylvania State University University Park, PA Medical Research: What is the background for this study? What are the main findings? Dr. Firebaugh: Lifespans are more variable for blacks than for whites in the United States. The objective of this study was to determine why. Is it because blacks are more likely to die of causes, such as homicide, that disproportionately strike the young and middle-aged, or because age at death varies more for blacks than for whites among those who die of the same cause? It is primarily the latter. For almost all causes of death, age at death varies more among black victims than it does among white victims, especially for women. To be sure, some youthful causes of death, such as homicide and AIDS, are more prevalent among blacks, accounting for some of the greater variances in blacks' lifespans. But these causes are largely offset by higher rates of suicide and drug poisoning deaths among whites. As a result, differences in causes of death for blacks versus whites on net account for relatively little of the difference in lifespan variance for blacks and whites. (more…)
Author Interviews, OBGYNE, Race/Ethnic Diversity, UCSF / 12.11.2014

Paula Braveman, MD, MPH Director, Center on Social Disparities in Health Professor, Family and Community Medicine University of California San Francisco San Francisco, CA 94118MedicalResearch.com Interview with: Paula Braveman, MD, MPH Director, Center on Social Disparities in Health Professor, Family and Community Medicine University of California San Francisco San Francisco, CA 94118 Medical Research: What are the main findings of the study? Dr. Braveman: There were a couple of striking findings from this study of preterm birth (PTB) among non-Latino White and Black women born in the U.S.. First, we found that women who were poor or socioeconomically disadvantaged in other ways (who had not or whose parents had not graduated from high school or who lived in neighborhoods (census tracts) with highly concentrated (25% or more of residents) poverty) had similarly high preterm birth rates.  In addition, we found that while preterm birth rates among White women consistently improved as their socioeconomic status (SES) improved, higher-SES Black women generally did no better –and sometimes did worse—than lower-SES Black women. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Duke, Race/Ethnic Diversity / 29.10.2014

Kevin L Thomas, MD Assistant Professor of Medicine Division of Clinical Cardiac Electrophysiology Duke Clinical Research InstituteMedicalResearch.com Interview with: Kevin L Thomas, MD Assistant Professor of Medicine Division of Clinical Cardiac Electrophysiology Duke Clinical Research Institute   Medical Research: What are the main findings of the study? Dr. Thomas: The number of participants with controlled blood pressure (readings of less than 140/90) increased by 12 percent in the six months between the first and last readings. Mean systolic blood pressure for the population decrease by 4.7mmHg. The number of participants who had high blood pressure in the range of 140-149/90-99 decreased systolic blood pressure by a mean of  8.8mmHg and those with readings in the higher range of 150/100 or above decreased systolic blood pressure by 23.7percent. The study concluded that a program that followed this type of approach was associated with improved blood pressures across a diverse  high-risk community.” (more…)
Author Interviews, Pulmonary Disease, Race/Ethnic Diversity / 23.10.2014

Nandita Bhan, ScD MSc MA Research Scientist & Adjunct Assistant Professor Public Health Foundation of India (PHFI)MedicalResearch.com Interview with: Nandita Bhan, ScD MSc MA Research Scientist & Adjunct Assistant Professor Public Health Foundation of India (PHFI) Medical Research: What are the main findings of the study? Dr. Bhan: We found that the last decade in the US has seen a rise in racial/ethnic disparities in asthma. Compared to Non-Hispanic White populations, greater rates of asthma were seen among African Americans and lower rates among Hispanic populations. But more importantly, we found that it is not just a question of who you are, but where you live. Results showed heterogeneity by region and place of origin - highlighting that it will be simplistic to assume that asthma rates for Hispanic populations are the same across all states in the US. While data is unable to explore further granularity by ethnicity, our results add to the developing evidence that state policies and politics have impacts on socioeconomic and racial/ethnic inequalities manifesting in health disparities in the US. (more…)
Author Interviews, Primary Care, Race/Ethnic Diversity / 19.10.2014

Arjumand Siddiqi, Sc.D., Assistant Professor Departments of Epidemiology and Social and Behavioral Sciences Dalla Lana School of Public Health University of Toronto Toronto, Ontario CanadaMedicalResearch.com Interview with: Arjumand Siddiqi, Sc.D., Assistant Professor Departments of Epidemiology and Social and Behavioral Sciences Dalla Lana School of Public Health University of Toronto Toronto, Ontario Canada MedicalResearch: What are the main findings of the study? Dr. Siddiqi: The main finding of the study is that, in a society with universal health insurance (Canada), racial disparities in access to primary care are drastically reduced, with some important exceptions. (more…)
Diabetes, Race/Ethnic Diversity / 17.09.2014

MedicalResearch.com Interview with: Dr. Adam Tabak MD Clinical Research Associate Epidemiology & Public Health Institute of Epidemiology & Health Faculty of Population Health Sciences University College London, UK Medical Research: What are the main findings of the study?   Dr. Tabak: Some of the major findings are confirmatory, such as the almost 3 times increased risk and an earlier onset of type 2 diabetes among south Asians, and a decreased insulin sensitivity in this ethnic group. The major novel finding is related to the fact that we could model events before diabetes diagnosis. We found a faster increase in fasting glucose before the diagnosis is south Asians compared to whites and that although insulin secretion increased in both ethnicities until 7 years before diagnosis, this increase was faster among whites. (more…)
Author Interviews, End of Life Care, Race/Ethnic Diversity / 25.08.2014

Holly G. Prigerson, Ph.D. Irving Sherwood Wright Professor in Geriatrics Professor of Sociology in Medicine Director, Center for Research on End of Life Care Weill Cornell Medical College 1404 Baker Pavilion, New York Presbyterian Hospital New York City, New York 10065MedicalResearch.com Interview with: Holly G. Prigerson, Ph.D. Irving Sherwood Wright Professor in Geriatrics Professor of Sociology in Medicine Director, Center for Research on End of Life Care Weill Cornell Medical College New York Presbyterian Hospital  New York City, New York 10065 Medical Research: What are the main findings of the study? Dr. Prigerson: That there are strikingly different preferences for end-of-life care based on a patient's race/ethnicity and in rates of do not resuscitate order completion.  Regardless of what those preferences are, however, they significantly influence the likelihood of completing a do not resuscitate order (dnr) across racial/ethnic groups. (more…)
Author Interviews, Diabetes, Diabetes Care, Race/Ethnic Diversity / 24.08.2014

Satyesh K Sinha, PhD Assistant Professor Charles R Drew University of Medicine and Science Los Angeles, CA-90059MedicalResearch.com Interview with: Satyesh K Sinha, PhD Assistant Professor Charles R Drew University of Medicine and Science Los Angeles, CA-90059 Medical Research: What are the main findings of the study? Dr. Sinha: Our main finding is that compared to Whites, African Americans (AAs) and Hispanics, with diabetes, have a higher prevalence of early chronic kidney disease (CKD) which is significantly associated with urinary albumin excretion (UAE) and/or C-reactive protein (CRP). (more…)
Author Interviews, Diabetes, JAMA, Macular Degeneration, Race/Ethnic Diversity / 19.08.2014

Rohit Varma, MD, MPH Grace and Emery Beardsley Professor and Chair USC Department of Ophthalmology Director, USC Eye Institute Associate Dean for Strategic Planning and Network Development Keck School of Medicine of USCMedicalResearch.com Interview with: Rohit Varma, MD, MPH Grace and Emery Beardsley Professor and Chair USC Department of Ophthalmology Director, USC Eye Institute Associate Dean for Strategic Planning and Network Development Keck School of Medicine of USC Medical Research: What are the main findings of the study? Dr. Varma: Our research demonstrates African-Americans bear a heavier burden of diabetic macular edema (DME), one of the leading causes of blindness in diabetic patients in the United States, compared to Non-Hispanic whites. The study points to a need for improved screening and greater attention to vision loss by clinicians and patients particularly those who are at high risk of developing diabetic macular edema. (more…)
Author Interviews, Breast Cancer, Race/Ethnic Diversity / 11.08.2014

Lynn Rosenberg, ScD Slone Epidemiology Center at Boston University 1010 Commonwealth Avenue Boston, MA 02215MedicalResearch.com Interview with Lynn Rosenberg, ScD Slone Epidemiology Center at Boston University 1010 Commonwealth Avenue Boston, MA 02215   Medical Research: What are the main findings of the study? Response: With prospective data from the Black Women’s Health Study, we assessed vigorous exercise and walking in relation to incidence of invasive breast cancer . We found that the overall incidence of breast cancer was lower among women who exercised vigorously or walked briskly than among women who were sedentary. The reduction was most apparent among women who exercised at least 5 hours per week. The association of exercise with breast cancer risk did not differ by estrogen receptor status of the breast tumor, but further study is needed to firmly establish this. Sitting for long periods at work or watching television was not significantly associated with breast cancer incidence. (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity / 10.08.2014

MedicalResearch.com Interview with: Sahil Khera, MD and Dhaval Kolte, MD, PhD Department of Medicine, Division of Cardiology New York Medical College, NY Medical Research: What are the main findings of the study? Answer: We used the publicly available Nationwide Inpatient Sample (NIS) databases for our study. We analyzed data on 6.5 million patients with heart attack (all types) from 2002 to 2011 in United States. Out of these 3.98 million were admitted with a diagnosis of non-ST elevation myocardial infarction (NSTEMI). Our objective was to describe how the care for patients with NSTEMI has changed over the past 10 years and whether this has resulted in better patient outcomes. We looked at the proportion of patients with NSTEMI who underwent cardiac catheterization each year. We also studied how many patients died in the hospital, how long was the hospital stay, and what was the total cost of hospitalization for this condition. Lastly, we determined if the changes in treatment and outcomes over the years were similar for different age- groups, men and women, and for different racial/ethnic groups. In this analysis, we looked at cardiac catheterization trends after NSTEMI for both within 24 hours and within 48 hours. This is the first study of its kind to analyze two different time frames of early catheterization simultaneously. Although there was an increase in the proportion of patients with NSTEMI with increase in utilization of early cardiac catheterization and decrease in in-hospital death and length of stay, age-, sex-, and race/ethnicity-specific differences in the management and outcomes of NSTEMI were observed, and further studies are needed to develop strategies to ensure more equitable care for patients with this type of heart attack. (more…)
Author Interviews, Prostate Cancer, Race/Ethnic Diversity / 04.08.2014

Isaac J. Powell MD Wayne State University/Karmanos Cancer Inst University Health Center Detroit, MI 48201.MedicalResearch.com Interview with: Isaac J. Powell MD Wayne State University/Karmanos Cancer Inst University Health Center Detroit, MI 48201. Medical Research: What is the background for your study? Dr. Powell: During the PSA testing era for prostate cancer, which is responsible for early treatment, survival disparity between African Americans and European Americans has been eliminated. (more…)
AHA Journals, Author Interviews, Race/Ethnic Diversity, Stroke / 25.06.2014

Wuwei (Wayne) Feng MD MS FANA Assistant Professor, Department of Neuroscience Department of Health Science & Research Medical University of South Carolina Stroke Center The Center of Rehabilitation Research in Neurological ConditionsMedicalResearch.com Interview with: Wuwei (Wayne) Feng MD MS FANA Assistant Professor, Department of Neuroscience Department of Health Science & Research Medical University of South Carolina Stroke Center The Center of Rehabilitation Research in Neurological Conditions MedicalResearch: What are the main findings of the study? Dr. Feng: Stroke hospitalization rate is decreasing in the elderly, but increasing in the young/middle aged population, but this increase is mainly driven by the increase in blacks (not in whites) which incurred persistent racial disparity in stroke. It has tremendous economic impact as outlined in the paper. Of hospital charges totaling $2.8 billion over 10-year period, $453.2 million (16.4%) are associated with racial disparity (79.6% from patients <65 years). By way of background: 84,179 stroke hospitalizations occurred in South Carolina from 2001 to 2010. Blacks accounted for 29,846 (35.5%) and whites accounted for 54,333 (64.5%) of the strokes. Among blacks, 50.4% were <65 years of age compared to 29.6% among whites. The overall stroke hospitalization rate decreased over the 10-year period. There was a significant reduction in stroke hospitalization rate in the older (≥65 years old) populations, for both blacks and whites. Whereas, in the younger populations (<65 years old), the overall rate of stroke hospitalizations actually increased significantly; however this increase was only associated with black patients. For example, the hospitalization rate per 100,000 for young blacks was 121 in 2001, 139 in 2005 and 142 in 2010 (a 17.3% increase from 2001). This racial disparity was more severe in the younger group with the highest disparity seen in the 45-54 year age groups for both ischemic strokes (having a clot) and intra-cerebral hemorrhagic strokes. (more…)
Accidents & Violence, Author Interviews, Race/Ethnic Diversity / 23.06.2014

Krim K. Lacey, PhD Research Fellow, Research Center for Group Dynamics Program for Research on Black Americans (PRBA) Institute for Social Research University of Michigan Ann Arbor, MIMedicalResearch.com Interview with: Krim K. Lacey, PhD Research Fellow, Research Center for Group Dynamics Program for Research on Black Americans (PRBA) Institute for Social Research University of Michigan Ann Arbor, MI MedicalResearch: What are the main findings of the study? Dr. Lacey: The main findings from this nationally representative study were that U.S. Black women abused by a domestic partner, on a whole were vulnerable to various negative physical and mental health problems. While the findings of the study support the few previous studies conducted on women within this population, this study was the first population-based, predominantly black sample that used structured clinical assessments. Importantly, the study substantiates other arguments that the Black population is not culturally monolithic, that African American and Caribbean Black women are affected differently by severe intimate partner violence. Another key finding was the association identified between eating disorders and intimate partner violence, which in general, has been largely underexplored. Finally, the study provided national information on the health outcomes of Caribbean Black women; one of the fastest growing subgroups within the Black population. (more…)
Author Interviews, Breast Cancer, JAMA, MD Anderson, Race/Ethnic Diversity / 20.06.2014

Dalliah Black, MD F.A.C.S. Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, HoustonMedicalResearch.com Interview with: Dalliah Black, MD F.A.C.S. Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, Houston   MedicalResearch: What are the main findings of the study? Dr. Black: This is a retrospective study from 2002 - 2007 using the SEER/Medicare database of over 31,000 women with node negative breast cancer evaluating the utilization of sentinel node biopsy (SNB) as it transitioned from an optional method for axillary staging to the standard of care instead of complete axillary lymph node dissection (ALND).  We found that SNB use increased each year in both white and black breast cancer patients throughout the study period.  However, SNB was less often performed in black patients (62.4%)compared to white patients (73.7%) and this disparity persisted through 2007 with a 12% difference.  Appropriate black patients more often had an ALND instead of the minimally invasive sentinel node biopsy which resulted in worse patient outcomes with higher lymphedema rates in black patients.  However, when black patients received the minimally invasive SNB, their rates of lymphedema were low and comparable to white patients who received SNB. (more…)
Author Interviews, Breast Cancer, Race/Ethnic Diversity / 14.05.2014

dr_Helmneh SineshawMedicalResearch.com Interview with: Helmneh Sineshaw, MD, MPH Senior Epidemiologist, Health Services Researcher American Cancer Society MedicalResearch: What are the main findings of the study? Dr. Sineshaw: We found that non-Hispanic black women had nearly twofold higher odds of being diagnosed with triple-negative (TN) breast cancer subtype than did their white counterparts, regardless of their socioeconomic group. We also found higher odds of presenting with human epidermal growth factor receptor 2(HER2)-overexpressing breast cancer in Asian/Pacific Islander women compared with white women at every level of socioeconomic status. (more…)
Author Interviews, Cancer Research, MD Anderson, Race/Ethnic Diversity / 18.04.2014

Dr. Lorraine R. Reitzel Ph.D Associate Professor in the Health Program of the Department of Educational Psychology College of Education, University of Houston in Houston, Texas.MedicalResearch.com Interview with: Dr. Lorraine R. Reitzel Ph.D Associate Professor in the Health Program of the Department of Educational Psychology College of Education, University of Houston in Houston, Texas. MedicalResearch.com: Please tell us about your study. Dr. Reitzel: The current study represented a secondary analysis of data that were collected by Dr. Lorna McNeill and colleagues at The University of Texas MD Anderson Cancer Center. The parent study was focused on better understanding factors associated with cancer risk among African American adults, and several faculty members including myself contributed ideas about the variables we thought might play a role. The current study represents one of several studies emerging from these data. The current study was led by Ms. Pragati S. Advani, a graduate student on my research team, who was interested in better understanding the associations between financial strain and modifiable behavioral risk factors for cancer among African American adults. Financial strain represents an unfavorable income to needs ratio and was assessed using a questionnaire that tapped into current difficulty affording things that represent pretty basic components of life, including suitable food, clothing, and housing for the respondent and their family. The modifiable behavioral risk factors for cancer examined included smoking cigarettes, at-risk alcohol use, being overweight/obese, getting insufficient physical activity, and having inadequate fruit and vegetable intake. We also included a tally of the total number of these factors (0 to 5) as an outcome variable of interest. (more…)
Author Interviews, Endocrinology, Race/Ethnic Diversity, Thyroid Disease / 18.04.2014

MedicalResearch.com Interview with: Donald S. A. McLeod, FRACP, MPH Department of Population Health, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia MedicalResearch.com: What are the main findings of the study? Dr. McLeod: We examined the incidence of Graves’ disease and Hashimoto’s thyroiditis by race/ethnicity among U.S. active duty service personnel aged 20-54 years over a 15-year period (more than 20,000,000 person years follow-up). Cases were identified by International Classification of Diseases, Ninth Revision, Clinical Modification codes. In women, we found that Graves’ disease was almost twice as common among non-Hispanic black and Asian-Pacific Islander personnel compared with non-Hispanic white personnel.  While in men, non-Hispanic black and Asian-Pacific Islander personnel had over two-and-a-half times higher incidence compared with non-Hispanic white personnel. The opposite pattern existed for Hashimoto’s thyroiditis, with non-Hispanic white personnel having the highest incidence, and non-Hispanic black and Asian-Pacific Islander personnel the lowest incidence. Hispanic personnel did not have significantly different incidence compared to white personnel for either disorder. (more…)
Author Interviews, Gender Differences, Orthopedics, Race/Ethnic Diversity, UCLA / 08.04.2014

Dr. Carolyn Crandall, M.D. Division of General Internal Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, 90024, USAMedicalResearch.com Interview with: Dr. Carolyn Crandall, M.D. Division of General Internal Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, 90024, USA MedicalResearch.com: What are the main findings of the study? Dr. Crandall: We found that higher social class was linked with a lower risk of fractures among non-Caucasian women.  Compared with non-Caucasian women who had no more than a high school education, those with at least some postgraduate education had nearly 90% lower rates of non-traumatic fracture.  These results were present even after we accounted for income. (more…)