Author Interviews, Race/Ethnic Diversity, Sleep Disorders, Tobacco / 12.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50639" align="alignleft" width="150"]Christine Spadola, M.S., LMHC, Ph.D.  Assistant Professor Florida Atlantic University Phyllis and Harvey Sandler School of Social Work Boca Raton, FL 33431-0991 Dr. Spadola[/caption] Christine Spadola, M.S., LMHC, Ph.D. Assistant Professor Florida Atlantic University Phyllis and Harvey Sandler School of Social Work Boca Raton, FL 33431-0991 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Short sleep duration and sleep fragmentation are associated with adverse health outcomes including cardiovascular disease, diabetes, hypertension, certain cancers, and mental health challenges such as depression and anxiety. Avoiding the use of alcohol, caffeine, and nicotine close to bedtime represent modifiable behaviors that can improve sleep. Nonetheless, among community dwelling adults (e.g., adults in their natural bedroom environment as opposed to research laboratories) and specifically African Americans, there is a lack of longitudinal research investigating the use of these substances and the associations with objective measures of sleep..
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Race/Ethnic Diversity / 05.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50551" align="alignleft" width="200"]Muhammad Ali Chaudhary, MD Research Scientist | Center for Surgery and Public Health Department of Surgery | Brigham and Women’s Hospital Harvard Medical School | Harvard T. H. Chan School of Public Health Dr. Chaudhary[/caption] Muhammad Ali Chaudhary, MD Research Scientist Center for Surgery and Public Health Department of Surgery Brigham and Women’s Hospital Harvard Medical School Harvard T. H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Many studies have documented disparities in cardiovascular care for minorities, specifically African Americans compared to white patients. Coronary artery bypass grafting (CABG) is a common procedure in the United States, and the outcomes and post-surgical care for African Americans tend to be worse. We examined whether patients insured through TRICARE — a universal insurance and equal-access integrated healthcare system that covers more than 9 million active-duty members, veterans and their families — experienced these disparities. We found no racial disparities in quality-of-care outcomes, providing insights about the potential impacts of universal insurance and an equal-access health care system. The study included 8,183 TRICARE patients, aged 18-64, who had undergone CABG. The study took its data from TRICARE health care claims from the Military Health System Data Repository for the years of 2006 to 2014.
Author Interviews, JAMA, NIH, Race/Ethnic Diversity / 25.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50397" align="alignleft" width="200"]Lan N. Đoàn, MPH CPH PhD Candidate, School of Social and Behavioral Health Sciences College of College of Public Health and Human Sciences Oregon State University, Corvallis Lan N. Doan[/caption] Lan N. Đoàn, MPH CPH PhD Candidate, School of Social and Behavioral Health Sciences College of College of Public Health and Human Sciences Oregon State University, Corvallis MedicalResearch.com: What is the background for this study? Response: There is a prevailing stereotype that Asian American, Native Hawaiian, and Pacific Islander (AA/NHPI) populations are a model minority group - healthier than all other racial/ethnic groups. As a result, health researchers often consider AA/NHPI so similar that their data is typically grouped together which masks their cultural and health differences. However, AA/NHPI populations represent more than 50 countries or cultures of origin and 100 different languages and have unique health needs and cultural preferences. Prior research has found minimal financial investments in AA/NHPI populations by federal agencies and philanthropy, even though AA/NHPI individuals represent more than 5.0% of the total US population and are the fastest-growing racial/ethnic group in the United States. The purpose of study was to conduct a review of clinical research funded by the National Institutes of Health (NIH) for AA/NHPI populations and to determine the level of NIH investment in serving these populations. We queried the NIH Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) system for extramural AA/NHPI focused clinical research projects conducted in the United States from January 1, 1992, to December 31, 2018. We included clinical research funded under research project grants, centers, cooperative awards, research career awards, training grants, and fellowships was included, with an advanced text search for AA/NHPI countries and cultures of origin. 
Author Interviews, JAMA, Johns Hopkins, OBGYNE, Race/Ethnic Diversity / 20.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50337" align="alignleft" width="175"]Alison Gemmill, PhD Assistant Professor Johns Hopkins Bloomberg School of Public Health Dr. Gemmill[/caption] Alison Gemmill, PhD Assistant Professor Johns Hopkins Bloomberg School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A growing body of evidence suggests that the circumstances surrounding the 2016 presidential election may have had a uniquely negative impact on the health of U.S. Latino population. Few studies, however, have evaluated the population health implications of the election for Latina mothers and their children. We used national data and methods that control for temporal patterning to test the hypothesis that preterm birth rose above otherwise expected levels among Latina women in the U.S. following the election of Donald Trump. We find that the number of preterm births among Latina women increased above expected levels following the election. Specifically, we find 3.5 percent more preterm births among Latinas than projected for nine months following election.
ASCO, Author Interviews, Cancer Research, Cost of Health Care, Race/Ethnic Diversity / 06.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49644" align="alignleft" width="161"]Blythe J.S. Adamson, PhD, MPH Senior Quantitative Scientist Flatiron Health Dr. Adamson[/caption] Blythe J.S. Adamson, PhD, MPH Senior Quantitative Scientist Flatiron Health MedicalResearch.com: What is the background for this study? Response: Racial disparities in access and outcomes have been documented across the full trajectory of cancer-related care. This includes access to prevention and screening, to early diagnosis, treatment, survival and other health outcomes. While these disparities have been well documented, finding mechanisms to reduce disparities is more challenging. One potential mechanism to reduce treatment disparities is to improve access to insurance coverage. The Affordable Care Act (ACA), passed in March 2010, included as its overall goals the improvement in healthcare quality and access, and enhancing equity in treatment and outcomes. The ACA allowed states to expand Medicaid to poor and near-poor adults, and this was implemented by many states starting in 2014. In addition, the ACA established private insurance marketplaces with income-based premium subsidies and limits on out-of-pocket spending for qualifying low-income enrollees. Prior research has demonstrated that ACA Medicaid expansions are associated with increased coverage and improved overall access for cancer survivors; and for newly diagnosed patients, the ACA was associated with increased coverage and shifts to earlier stage diagnosis for some cancers. To our knowledge, no research has yet demonstrated that the ACA coverage expansions affected the process of cancer care, specific cancer treatments received or specific treatment outcomes, let alone whether disparities were reduced.  In this study we looked at the time from advanced/metastatic diagnosis to start of systemic treatment for black vs. white patients and based on whether they were diagnosed at a time and in a state that had vs. had not implemented Medicaid expansion. Our study hypothesis was that Medicaid expansion reduced disparity in timely treatment of black patients compared to white patients with advanced cancer. We defined timely treatment as start of systemic therapy within 30 days of advanced/metastatic diagnosis. This is a retrospective observational study, not a randomized controlled trial. In other words, we selected a cohort of patients diagnosed with advanced or metastatic cancers over time and observed whether they received timely treatment. The Flatiron Health EHR-derived database was the principal data source for this research. Flatiron contributing practices include 280 cancer community based clinics and academic hospital outpatient settings (~800 sites of care) representing more than 2.2 million patients with cancer in the United States. Practices are located in 40 states. To produce the database, Flatiron extracted data from structured fields, including demographics, and recorded medication orders and administrations. Flatiron also abstracted unstructured data, using technology assisted review by highly trained clinicians. Abstracted data include diagnosis date, stage, and prescribed oral anticancer medications. The database used for research purposes was de-identified. We also used data from the Kaiser Family Foundation which has tracked Medicaid implementation policies for over twenty years, and the US Bureau of Labor Statistics from which we pulled state-year unemployment rates.
Author Interviews, Environmental Risks, Nutrition, Race/Ethnic Diversity / 04.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49576" align="alignleft" width="200"]Joe F. Bozeman III, MS, CEM, Ph.D. Candidate Chair, Gordon Research Seminar (Industrial Ecology) University of Illinois at Chicago (UIC) Institute for Environmental Science and Policy Joe F. Bozeman III[/caption] Joe F. Bozeman III, MS, CEM, Ph.D. Candidate Chair, Gordon Research Seminar (Industrial Ecology) University of Illinois at Chicago (UIC) Institute for Environmental Science and Policy MedicalResearch.com: What is the background for this study?   Response: This study is actually a part of my dissertation which explores how climate change, human health, and other socioecological factors can be used to manage food-energy-water impacts. After establishing environmental impact and climate change adaptation implications of food consumption across major U.S. demographic groups in a previous study, my colleagues and I decided it would be interesting to investigate how food spending and household income correlate with food-consumption environmental impacts. Our efforts led to the development of a novel quantitative metric (i.e., food-consumption impact per dollar spent [FCI$]) which encompasses land, water, and greenhouse gas emission impacts of basic foods; the amount spent on food; and socioeconomic status. All major food groups are included in this study.
Author Interviews, CDC, OBGYNE, Race/Ethnic Diversity / 17.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49233" align="alignleft" width="200"]Emily Petersen, MD.Lead for the Pregnancy Mortality Surveillance SystemDivision of Reproductive Health Dr. Peterson[/caption] Emily Petersen, MD. Lead for the Pregnancy Mortality Surveillance System Division of Reproductive Health   MedicalResearch.com: What is the background for this study? Response: About 700 women die of pregnancy-related causes each year in the United States. The new analysis provides much-needed perspective on the circumstances surrounding pregnancy-related deaths and summarizes potential strategies to prevent future deaths.
Author Interviews, JAMA, OBGYNE, Pediatrics, Race/Ethnic Diversity / 24.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48728" align="alignleft" width="123"]Clare Brown, PhDHealth Systems and Services ResearchUniversity of Arkansas for Medical Sciences Dr. Brown[/caption] Clare Brown, PhD Health Systems and Services Research University of Arkansas for Medical Sciences [caption id="attachment_48727" align="alignleft" width="125"]J. Mick Tilford, PhD, Professor and ChairDepartment of Health Policy and ManagementFay W. Boozman College of Public HealthUniversity of Arkansas for Medical Science Dr. Tilford[/caption] J. Mick Tilford, PhD, Professor and Chair Department of Health Policy and Management Fay W. Boozman College of Public Health University of Arkansas for Medical Science   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Prematurity and low birthweight are associated with increased risk of infant mortality as well as increased risk of chronic conditions throughout infancy and into adulthood. Non-Hispanic black infants are twice as likely to be born low birthweight (13.9% vs 7.0%) and 1.5 times as likely to be born prematurely (13.9% vs 9.1%) compared to non-Hispanic white infants. Under the Affordable Care Act (ACA), states may expand Medicaid to adults with household income levels at or below 138% of the federal poverty level, thus extending coverage to childless adults and improving continuity. Insurance gain may ultimately improve maternal health, increased use and earlier initiation of prenatal care services, and improved access to pregnancy planning resources. Our study aimed to evaluate whether there were changes in rates of low birthweight and preterm birth outcomes among states that expanded Medicaid versus states that did not expand Medicaid.
Author Interviews, Melanoma, Pediatrics, Race/Ethnic Diversity, Stanford / 18.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48700" align="alignleft" width="200"]Susan M. Swetter, MDProfessor of DermatologyDirector, Pigmented Lesion & Melanoma ProgramPhysician Leader, Cancer Care Program in Cutaneous OncologyStanford University Medical Center and Cancer Institute Dr. Swetter[/caption] Susan M. Swetter, MD Professor of Dermatology Director, Pigmented Lesion & Melanoma Program Physician Leader, Cancer Care Program in Cutaneous Oncology Stanford University Medical Center and Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Stanford Pigmented Lesion and Melanoma and Program and Pediatric Dermatology Division participated in the long-term management of children, adolescents and young adults (<25 years of age) with melanoma and atypical melanocytic neoplasms, including atypical Spitz tumors (ASTs) that may be histopathologically challenging to differentiate from true melanoma. Over a 23-year period, we have observed increased racial-ethnic diversity in young patients with these diagnoses, especially in the presentation of young individuals with darker skin phenotypes and more clinically amelanotic (nonpigmented) lesions compared to patients with lighter skin. 
Author Interviews, Cancer Research, Race/Ethnic Diversity / 18.04.2019

MedicalResearch.com Interview with: [caption id="attachment_46733" align="alignleft" width="120"]Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303 Dr. Islami[/caption] Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303  MedicalResearch.com: What is the background for this study? Response: Despite a continuous decline in cervical cancer incidence rates, earlier studies reported an increase in cervical adenocarcinoma incidence rates. However, those reports had major limitations, as they did not account for changes in hysterectomy prevalence and used cancer occurrence data covering only 10%-12% of the U.S. population (which may not be representative of the entire population, especially racial/ethnic minorities). Further, the most recent study examined the trends by age and histology through 2010. We examined contemporary trends in cervical cancer incidence rates in the U.S. (1999-2015) by age, race/ethnicity, major histological subtypes, and stage at diagnosis using up-to-date nationwide data after accounting for hysterectomy prevalence.
Author Interviews, JAMA, Race/Ethnic Diversity, Surgical Research, Transplantation, Yale / 09.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48457" align="alignleft" width="135"]Sanjay Kulkarni, MD MHCM FACSAssociate Professor of Surgery & MedicineSurgical Director – Kidney Transplant ProgramMedical Director – Center for Living Organ DonorsScientific Director – Yale Transplant ResearchNew Haven, CT 06410 Dr. Kulkarni[/caption] Sanjay Kulkarni, MD MHCM FACS Associate Professor of Surgery & Medicine Surgical Director – Kidney Transplant Program Medical Director – Center for Living Organ Donors Scientific Director – Yale Transplant Research New Haven, CT 06410 MedicalResearch.com: What is the background for this study? Response: The kidney allocation system changed in December of 2014. The aim of the new system was to increase transplant in patients who were highly sensitized (difficult matches based on reactive antibodies) and to improve access to underserved populations.
Author Interviews, HIV, HPV, Race/Ethnic Diversity, STD, Vaccine Studies / 08.04.2019

MedicalResearch.com Interview with: Perry N Halkitis, PhD, MS, MPH Dean and Professor Department of Urban-Global Public Health Rutgers Public Health  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The rate of human papillomavirus (HPV) infection is high among young minority gay, bisexual, and other men who have sex with men despite the availability of a vaccine that can prevent the infection, a Rutgers School of Public Health study found.
Author Interviews, Cost of Health Care, General Medicine, Hospital Readmissions, JAMA, Race/Ethnic Diversity / 02.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48340" align="alignleft" width="142"]Teryl K. Nuckols, MDVice Chair, Clinical ResearchDirector, Division of General Internal MedicineCedars-Sinai Medical Center  Dr. Nuckols[/caption] Teryl K. Nuckols, MD Vice Chair, Clinical Research Director, Division of General Internal Medicine Cedars-Sinai Medical Center  MedicalResearch.com: What is the background for this study?   Response: Healthcare policymakers have long worried that value-based payment programs unfairly penalize hospitals treating many African-American patients, which could worsen health outcomes for this group. For example, policy experts have suspected that the Medicare Hospital Readmission Reduction Program unevenly punishes institutions caring for more vulnerable populations, including racial minorities. They've also feared that hospitals might be incentivized to not give patients the care they need to avoid readmissions. The study Investigators wanted to determine whether death rates following discharges increased among African-American and white patients 65 years and older after the Medicare Hospital Readmission Reduction Program started.
AACR, Author Interviews, Cancer Research, Dental Research, Pancreatic, Race/Ethnic Diversity / 28.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48243" align="alignleft" width="189"]Dr. Julie Palmer Dr. Palmer[/caption] Julie R. Palmer, ScD Professor, Boston University School of Medicine Associate Director, Slone Epidemiology Center at Boston University Boston, MA 02118  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Since 1995, 59,000 African American women from all regions of the U.S. have participated in a Boston University research study of the health of Black women.  Study participants complete mailed or online questionnaires every two years. Our major goal is to identify modifiable risk factors for cancers and nonmalignant conditions that disproportionately affect African Americans (e.g., pancreatic cancer, early-onset breast cancer, type 2 diabetes, uterine fibroids).  The reasons for the higher incidence of pancreatic cancer in African Americans relative to non-Hispanic White women in the U.S. are unknown. I was aware that several recent studies in predominantly White populations had observed a higher incidence of pancreatic cancer in those who had reported poor oral health and wondered whether the higher prevalence of poor oral health among African Americans could play a role in their higher incidence of pancreatic cancer.  We had already asked about gum disease, periodontal disease, and adult tooth loss in several rounds of data collection. After rigorous analysis, we found that women who reported any adult tooth loss had about two times the risk of future development of pancreatic cancer compared with those who had no tooth loss and had never reported periodontal disease. The estimated risk was even greater for those who had lost five or more teeth. A similar association was observed for reports of periodontal disease, but the association was not statistically significant.
Author Interviews, Blood Pressure - Hypertension, NEJM, Race/Ethnic Diversity / 20.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48022" align="alignleft" width="133"]Dike B. Ojji, M.D., Ph.D, FWACP, FACPDepartment of MedicineFaculty of Clinical SciencesUniversity of Abuja Dr. Ojji[/caption] Dike B. Ojji, M.D., Ph.D, FWACP, FACP Department of Medicine Faculty of Clinical Sciences University of Abuja MedicalResearch.com: What is the background for this study? Response: We decided to do this research because there were no large RCTs before now that have compared the efficacy of contemporary combination therapies among any black populations in spite of the high burden of hypertension and its complications (such as heart failure, cerebrovascular accident and chronic kidney) in this population, and also the fact that majority require 2 or more medications to control their blood pressure.
Author Interviews, Dermatology, Heart Disease, JAMA, Race/Ethnic Diversity / 04.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47582" align="alignleft" width="150"]Francis Alenghat, MD, PhD Assistant Professor of Medicine Section of Cardiology University of Chicago Dr. Alenghat[/caption] Francis Alenghat, MD, PhD Assistant Professor of Medicine Section of Cardiology University of Chicago MedicalResearch.com: What is the background for this study? What are the main findings? Response: Psoriasis has been associated with higher rates of atherosclerotic cardiovascular disease (ASCVD), potentially due to higher-than-normal levels of systemic inflammation. Whether this association varies by race was unknown. Also, it was unclear whether patients with psoriasis have more frequent ASCVD because of higher rates of traditional cardiovascular risk factors (smoking, diabetes, hypertension, hyperlipidemia) or because of components intrinsic to psoriasis itself. We found that, amongst a large population of patients with psoriasis, patients of both sexes and most ages had elevated ASCVD rates compared to those without psoriasis. Overall, African American patients with psoriasis had a 15% ASCVD prevalence, whereas it was 10% in white patients with psoriasis. Increased ASCVD associated with psoriasis occurred at earlier ages in African American patients compared to white patients. Traditional cardiovascular risk factors were common in patients with psoriasis and appeared to play a large role in the driving the higher rates of ASCVD in these patients, but even in patients with psoriasis but without any documented traditional risk factors, ASCVD rates were elevated compared to patients without psoriasis. 
Author Interviews, Genetic Research, JAMA, Race/Ethnic Diversity, Stroke / 11.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47440" align="alignleft" width="133"]Dr. Marini Dr. Marini[/caption] Sandro Marini, MD Research Fellow Jonathan Rosand Laboratory Massachusetts General Hospital Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The epsilon(ε) 4 allele of the Apolipoprotein E (APOE) gene increases risk for Alzheimer’s disease (AD) and intracerebral hemorrhage (ICH). In both diseases, it is believed to increase risk through the deposition of beta-amyloid within the brain and blood vessels, respectively. The effect of APOE ε4 on both AD and ICH risk changes across populations, for unclear reasons. In our study, we confirmed the role of APOE ε4 for ICH risk in whites and found that the risk-increasing effect of the 4 allele is demonstrable in Hispanics only when balancing out the effect of hypertension.
Author Interviews, Compliance, Electronic Records, Lung Cancer, Race/Ethnic Diversity / 07.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47364" align="alignleft" width="200"]Samuel Cykert, MD Professor of Medicine and Director of the Program on Health and Clinical Informatics UNC School of Medicine, and Associate Director for Medical Education, NC AHEC Program Chapel Hill, NC Dr. Cykert[/caption] Samuel Cykert, MD Professor of Medicine and Director of the Program on Health and Clinical Informatics UNC School of Medicine, and Associate Director for Medical Education, NC AHEC Program Chapel Hill, NC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reports going as far back as the early 1990’s through reports published very recently show that Black patients with early stage, curable lung cancer are not treated with aggressive, curative treatments as often as White patients. These type of results have been shown in other cancers also. It’s particularly important for lung cancer because over 90% of these patients are  dead within 4 years if left untreated. In 2010, our group published a study in the Journal of the American Medical Association that showed that Black patients who had poor perceptions of communication (with their provider), who did not understand their prognosis with vs. without treatment, and who did not have a regular source of care ( a primary care doctor) were much less likely to get curative surgery. Also our results suggested that physicians who treated lung cancer seemed less willing to take the risk of aggressive treatments in treating Black patients (who they did not identify with as well) who had other significant illnesses. Because of the persisting disparities and our 2010 findings, we worked with a community group, the Greensboro Health Disparities Collaborative to consider potential solutions.  As these omissions were not overt or intentional because of race on the part of the patients or doctors, we came up with the idea that we needed transparency to shine light on treatment that wasn’t progressing and better communication to ensure that patients were deciding on good information and not acting on mistrust or false beliefs.  We also felt the need for accountability – the care teams needed to know how things were going with patients and they needed to know this according to race. To meet these specifications, we designed a system that received data from electronic health records about patients’ scheduled appointments and procedures. If a patient missed an appointment this umbrella system triggered a warning. When a warning was triggered, a nurse navigator trained specially on communication issues, re-engaged the patient to bring him/her back into care. In the system, we also programmed the timing of expected milestones in care, and if these treatment milestones were not reached in the designated time frame, a physician leader would re-engage the clinical team to consider the care options. Using this system that combined transparency through technology, essentially our real time warning registry, and humans who were accountable for the triggered warnings, care improved for both Black and White patients and the treatment disparity for Black patients was dramatically reduced. In terms of the numbers, at baseline, before the intervention, 79% of White patients completed treatment compared to 69% of Black patients. For the group who received the intervention, the rate of completed treatment for White patients was 95% and for Black patients 96.5%. 
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, Stanford / 26.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46704" align="alignleft" width="200"]Fatima Rodriguez, MD, MPH, FACC Assistant Professor Cardiovascular Medicine Stanford University School of Medicine Dr. Rodriguez[/caption] Fatima Rodriguez, MD, MPH, FACC Assistant Professor Cardiovascular Medicine Stanford University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The “Hispanic Paradox” is an idea based on some epidemiological observations that Hispanics have lower disease prevalence and mortality (across a wide spectrum of disease states), despite adverse risk profiles and lower socioeconomic status than their non-Hispanic white counterparts. Our study is unique in that it includes a Hispanic population with overall high educational attainment followed longitudinally. In contrast to prior work in this area, we found no evidence in support of the Hispanic paradox for estimated atherosclerotic cardiovascular disease risk, atherosclerotic disease (as measured by CAC), or overall mortality.
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Emory, Obstructive Sleep Apnea, Race/Ethnic Diversity, Sleep Disorders / 26.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46693" align="alignleft" width="142"]Dayna A. Johnson PhD Department of Epidemiology Emory University Atlanta, GA Dr. Johnson[/caption] Dayna A. Johnson PhD Department of Epidemiology Emory University Atlanta, GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are several studies that have determined that African Americans have the highest prevalence of hypertension and are the most likely to have uncontrolled hypertension compared to other racial/ethnic groups. We were interested in studying whether sleep apnea contributed to hypertension control among African Americans. We found that participants with sleep apnea were more likely to have resistant hypertension than those without sleep apnea. In particular, individuals with severe sleep apnea had the highest risk of resistant hypertension. Most of the participants with measured sleep apnea were undiagnosed (96%). 
ADHD, Author Interviews, Pediatrics, Race/Ethnic Diversity / 05.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46390" align="alignleft" width="136"]George J. DuPaul, PhD Department of Education and Human Services Lehigh University Dr. DuPaul[/caption] George J. DuPaul, PhD Department of Education and Human Services Lehigh University [caption id="attachment_46407" align="alignleft" width="144"]Charles Barrett. Ph.D. School Psychologist Lehigh University Dr. Barrett[/caption]   Charles Barrett. Ph.D. School Psychologist Loudon County Virginia Public Schools   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous studies have shown that Black children are more likely to receive ratings that are more indicative of displaying externalizing behavior difficulties, including Attention Deficit Hyperactivity Disorder (ADHD).  However, many of these studies included teachers as the informants. Consistent with most teachers in the United States, raters have typically been White females.  For this reason, it is unclear if these outcomes would exist if the rater and child shared the same racial/ethnic background. Additionally, most research in the United States that involved cross-cultural comparisons has used White and Hispanic boys.  Few empirical studies have examined differences between Black and White boys. The present study sought to address several limitations in the field.  Most notably, cross-cultural comparisons between Black and White boys were included instead of Hispanic and White children.  Next, maternal figures, rather than teachers, were included as the informants. The present study was developed using a similar methodology that examined Hispanic and White boys’ behavior from the perspective of Hispanic and White teachers (Dominguez de Ramirez & Shapiro, 2005). In sum, we sought to determine if there were differences in how Black and White maternal figures rated Black and White boys who were demonstrating the same level/type of behavior (i.e., sub-clinical levels of ADHD).  Notably, although the boys’ behaviors were the same, maternal ratings were not identical. Specifically, using the ADHD Rating Scale, Fourth Edition (ARS-4), Black mothers assigned higher ratings to both Black and White boys.
Accidents & Violence, Author Interviews, Mental Health Research, Race/Ethnic Diversity, Social Issues / 26.11.2018

MedicalResearch.com Interview with: "USA - NY - City of New York Police VARIATION" by conner395 is licensed under CC BY 2.0Dr. Jordan E. DeVylder, PhD Graduate School of Social Service Fordham University, New York, New York MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is intended to address the lack of empirical research on police violence from a public health perspective. The main findings are that police violence is relatively widespread in Baltimore and New York City, is disproportionately directed toward people of color and sexual or gender minorities, and is associated with psychological distress, suicidal behavior, and psychosis-like symptoms.
Annals Internal Medicine, Author Interviews, Heart Disease, Race/Ethnic Diversity, Stanford / 13.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45897" align="alignleft" width="150"]Katie Hastings MPH Stanford Medicine  Kate Hastings[/caption] Katie Hastings MPH Stanford University School of Medicine Stanford, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart disease has been the leading cause of death since the early 1900s, but recent data has suggested cancer will surpass heart disease in the upcoming decades. To date, this is the first study to examine the transition from heart disease to cancer mortality as the leading cause of death by U.S. county and sociodemographic characteristics using national mortality records from 2003 to 2015. Our main findings are:
  • Epidemiologic transition is occurring earlier in high compared to low income U.S. counties, and occurs earlier for Asian Americans, Hispanics, and NHWs compared to blacks and American Indians/Alaska Natives.
  • Data may suggest that this shift arises from larger reductions in heart disease than cancer mortality over the study period, particularly in the highest income counties.
  • Continued disparities in heart disease and cancer mortality between blacks and other racial/ethnic groups, even in the highest income quintiles. While blacks continue to have the highest overall mortality than any other group, we do show this population experienced the greatest overall improvements in mortality (i.e. mortality rate reductions over time) for all-cause, heart disease, and cancer compared to all other racial/ethnic groups (except for heart disease in Hispanics). 
Author Interviews, Nutrition, OBGYNE, Pediatrics, Race/Ethnic Diversity / 19.10.2018

MedicalResearch.com Interview with: "Tortillas di una miscela di mais azzurro tostato" by fugzu is licensed under CC BY 2.0Vijaya Kancherla, PhD Research Assistant Professor, Department of Epidemiology Epidemiologist, Center for Spina Bifida Prevention Rollins School of Public Health Emory University Atlanta GA 30322 MedicalResearch.com: What is the background for this study?  Response: The scientific evidence since 1991 has shown that folic acid prevents from 35%-95% of neural tube birth defects that are caused due to low folic acid (also known as vitamin B9) in the mother’s diet prior to conception and during early pregnancy. Neural tube defects form in the embryo at 4th week of gestation when most women are unaware they are pregnant. Taking any amount of folic acid after the 4th week of pregnancy will not prevent neural tube defects. There is no cure for these birth defects. So, it matters for women to have enough folic acid prior to conception and in the first four weeks of pregnancy. If a woman is not taking prenatal vitamins that early, folic acid fortified foods come to rescue. Foods fortified with folic acid will prevent folate deficiency for everyone, and offer the benefit to mothers who were not planning their pregnancies or were not taking folic acid pills. If corn masa flour and tortillas were fortified with folic acid, that would help millions of reproductive aged women have healthy stores of folic acid in their bodies, to prepare them for their pregnancy, irrespective of their pregnancy plans. Prior to April 2016, folic acid (also known as vitamin B9) was not allowed to be added to corn masa flour (or products made from masa such as tortillas and tortilla chips) in the US. So, there was no expectation of having folic acid in these products. The March of Dimes, Spina Bifida Foundation, the American Academy of Pediatricians, Gruma Corporation and others filed a petition with the US FDA and succeeded in allowing millers to voluntarily add folic acid to corn masa flour and tortillas as a food additive. This regulation was implemented by the US FDA in April 2016. 
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA, NIH, Nutrition, Race/Ethnic Diversity, Salt-Sodium / 03.10.2018

MedicalResearch.com Interview with: [caption id="attachment_44967" align="alignleft" width="133"]Dr. George Howard DPH, for the research team Professor and Chair of Biostatistics University of Alabama at Birmingham Dr. Howard[/caption] Dr. George Howard DPH, for the research team Professor and Chair of Biostatistics University of Alabama at Birmingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: Perhaps the most important distinction to draw for the readers is that this is not a paper about risk factors for hypertension, but rather a paper that looks for contributors to the black-white difference in the presence of hypertension.  This racial difference in hypertension is the single biggest contributor to the immense disparities in cardiovascular diseases (stroke, MI, etc.) that underpin the approximate 4-year difference in black-white life expectancy.  As such, this work is “going back upstream” to understand the causes that lead to blacks having a higher prevalence of hypertension than whites with hopes that changing this difference will lead to reductions in the black-white disparities in cardiovascular diseases and life expectancy.   This difference in the prevalence of hypertension is immense … in our national study of people over age 45, about 50% of whites have hypertension compared to about 70% of blacks … that is HUGE.   We think that changing this difference is (at least one of) the “holy grail” of disparities research. This study demonstrates that there are several “targets” where changes could be made to reduce the black-white difference in hypertension, and thereby the black-white difference in cardiovascular diseases and life expectancy; however, the most “potent” of these appears to be diet changes.   Even though we know what foods promote a heart healthy lifestyle, we still have major differences in terms of how that message is being adopted by various groups of Americans.  We can’t know from our data what about the Southern diet is driving these racial differences in hypertension but we can begin to design community based interventions that could possibly help to reduce these racial disparities through diet.  It is interested that diet more than being overweight was the biggest contributor to the racial disparities in hypertension.  This would suggest we might want to consider interventions to increase health foods in the diet while minimizing fried foods and processed meats. While this is not a clinical trial that “proves” that changes in diet will reduce the disparity in blood pressure, we consider the “message” of the paper to be good news, as the things that we found that contribute to this black-white difference are things that can be changed.   While it is always hard for individual people to change their diet, it can be done.   More importantly, over time we as a society have been changing what we eat … but we need to “double down” and try to change this faster.   Also, policy changes of play a role to gently make changes in these diet, where for example Great Britain has been making policy changes to slowly remove salt from the diet.   These changes are possible … and as such, we may see a day when the black-white differences in hypertension (and thereby CVD and death) may be reduced. 
Author Interviews, Breast Cancer, Race/Ethnic Diversity, Social Issues / 30.09.2018

MedicalResearch.com Interview with: Sage J. Kim, PhD Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study examined the rates at which women who received patient navigation in a randomized clinical trial reported barriers to obtaining a screening mammogram. The trial, called the Patient Navigation in Medically Underserved Areas (PNMUA) study, randomly assigned patients to one of two groups: one received a patient navigation support intervention and the other served as a control. Of the 3,754 women who received the patient navigation intervention, only 14 percent identified one or more barriers to care, which led to additional interactions with navigators who helped overcome barriers. Black women, women living in poverty, and women who reported high levels of distrust of the health care system were the least likely to report barriers. Women who reported barriers were more likely to have additional contact with navigators and obtain a subsequent screening mammogram. The extra support could help with early diagnosis and better survival and mortality outcomes.
Author Interviews, Dermatology, Gender Differences, JAMA, Race/Ethnic Diversity, Social Issues / 27.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44810" align="alignleft" width="200"]Raghav Tripathi, MPH Case Western Reserve University MD Candidate, Class of 2021 Raghav Tripathi[/caption] Raghav Tripathi, MPH Case Western Reserve University MD Candidate, Class of 2021 MedicalResearch.com: Why did you decide to perform this study? Response: Differences in the impact of dermatologic conditions on different groups have been of interest to our research group for a long time. Previously, our group had found differences in time to treatment for patients with different skin cancers. Beyond this, we had found differences in mortality and incidence of various skin conditions (controlling for other factors) in different racial groups/ethnicities, socioeconomic groups, demographic groups, and across the rural-urban continuum. The goal of this study was to investigate socioeconomic and demographic differences in utilization of outpatient dermatologic care across the United States. As demographics throughout the country become more diverse, understanding differences in utilization of dermatologic care is integral to developing policy approaches to increasing access to care across the country.