Author Interviews, Geriatrics, Hearing Loss, JAMA, Race/Ethnic Diversity, Social Issues / 10.12.2020

MedicalResearch.com Interview with: Nicholas S. Reed, AuD Assistant Professor | Department of Epidemiology Core Faculty  | Cochlear Center for Hearing and Public Health Johns Hopkins University Bloomberg School of Public Health MedicalResearch.com: What is the background for this study? Response: It is known that hearing aid ownership is relatively low in the United States at less than 20% of adults with hearing loss owning and using hearing aids. However, many national estimates of hearing aid ownership are based on data that is over 10 years old. Our team was interested in trying to understand whether ownership in hearing aids had changed over time. We used data from 2011 to 2018 in a nationally representative (United States) observational cohort (The National Health and Aging Trends Study) of Medicare Beneficiaries aged 70 years and older to estimate the change in hearing aid ownership. In our analysis, the proportion of Medicare beneficiaries 70 years and older who reported owning and using their hearing aids increased 23.3% from 2011 to 2018. However, this growth in ownership was not equal across all older adults. For example, while White males saw a 28.7% increase in hearing aid ownership, Black females saw only a 5.8% increase over the same 8-year period. Moreover, adults living at less than 100% federal poverty level actually saw an overall 13.0% decrease in hearing aid ownership while those living at more than 200% federal poverty line saw an overall 30.6% increase.   (more…)
Author Interviews, JAMA, Social Issues / 04.12.2020

MedicalResearch.com Interview with: Amal Trivedi, MD, MPH Professor of Health Services, Policy & Practice Director of Graduate Studies, Health Services Research Brown University School of Public Health MedicalResearch.com: What is the background for this study? Response: Nearly all hospitals in the United States, including all Veterans Affairs Medical Centers (VAMCs), report mortality rates for patients hospitalized for common medical and surgical conditions. But these mortality rates do not adjust for socioeconomic factors that are associated with worse outcomes following hospitalization. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Prostate Cancer, Social Issues / 18.11.2020

MedicalResearch.com Interview with: David-Dan Nguyen, MPH Research Fellow | Center for Surgery and Public Health Brigham and Women's Hospital Medical Student | McGill University  MedicalResearch.com: What is the background for this study? Response: In 2017, the US Preventive Services Task Force updated its recommendation for PSA screening for prostate cancer from a grade D to a grade C for men aged 55 to 69 years. This updated recommendation endorsed shared decision making and harmonizes with the guidelines of the American Urological Association and the American Cancer Society which also recommend shared decision making for PSA screening. Shared decision making is a meaningful dialogue between the physician and the patient that namely includes a review of risks and expected outcomes of screening as well as the patient’s preferences and values. Understandably, the patient’s ability to critically assess the medical information provided (i.e. their health literacy) likely influences this process. We sought to characterize the effect of health literacy on shared decision making for PSA screening. We used data from 2016 when PSA screening for prostate cancer was not recommended by the US Preventive Services Task Force — in other words, we also sought to understand how health literacy impacted screening rates in the context of countervailing guidelines on PSA screening. (more…)
Author Interviews, Cannabis, Ophthalmology, Race/Ethnic Diversity, Social Issues / 09.11.2020

MedicalResearch.com Interview with: Joshua Uhr MD Ophthalmologist Philadelphia, PA MedicalResearch.com: What is the background for this study? Response: Disparities in American society have been at the forefront of the public consciousness in recent months. As part of the larger discussion about inequality, disparities in health outcomes have received much attention. In light of the renewed recognition that these disparities are stark and widespread, we felt it important to evaluate disparities in our own field, ophthalmology. Previous studies have shown disparate outcomes for individual eye conditions, such as glaucoma, cataract, and retinal detachment. Although the common and relevant endpoint of these is visual impairment, few prior studies have examined disparities in visual impairment more broadly. Our aim was to provide an updated analysis of disparity in visual impairment among adults in the United States based on race and socioeconomic status.  (more…)
Author Interviews, Emergency Care, Social Issues, Technology / 23.10.2020

MedicalResearch.com Interview with: Susan Lu PhD Gerald Lyles Rising Star Associate Professor of Management Krannert School of Management Purdue University  MedicalResearch.com: What is the background for this study? Response: We started this project in 2016. Overcrowding in emergency rooms (ERs) is a common yet nagging problem. It not only is costly for hospitals but also compromises care quality and patient experience. Hence, finding effective ways to improve ER care delivery is of great importance. Meanwhile, the advancement of healthcare technologies including electronic medical records, online doctor ratings and 4G mobile network motivates us to think about the impact of telemedicine on ER operations in the near future.  (more…)
Author Interviews, JAMA, Social Issues / 20.10.2020

MedicalResearch.com Interview with: Aaron Baum, PhD Assistant Professor, Department of Health System Design & Global Health Economist, Arnhold Institute for Global Health Icahn School of Medicine at Mount Sinai Health System MedicalResearch.com: What is the background for this study? Response: To what degree are geographic health disparities in the leading risk factors for morbidity and mortality in the United States – including elevated blood pressure and blood sugar, obesity, and poor mental health – driven by the place where people live versus by characteristics of the people who live in different places? For example, male adults in Mississippi are 33% more likely to have uncontrolled blood pressure and 54% more likely to be obese than male adults in Colorado. One explanation is that male adults who live in Mississippi are different is many other ways from male adults in Colorado, some of which can't be directly measured and adjusted for, and that those unobserved differences cause the health disparity. Another possibility is that the place where a person lives actually contributes to the health disparity. Using national electronic health records from the Veterans Health Administration, we conducted a retrospective cohort study of 5 million adults, including 1 million who moved zip codes exactly once between 2008-2018. Our goal was to isolate how a movers' likelihood of uncontrolled blood pressure, uncontrolled diabetes, obesity and depression changed in response to changes in the prevalence of each outcome in his or her environment. (more…)
Author Interviews, Baylor College of Medicine Houston, Heart Disease, Social Issues, Tobacco Research / 19.10.2020

MedicalResearch.com Interview with: Mahmoud Al Rifai MD MPH Section of Cardiology, Department of Medicine Baylor College of Medicine Houston Salim S. Virani, MD, PhD Section of Cardiology Michael E. DeBakey Veterans Affairs Medical Center Section of Cardiology, Department of Medicine Baylor College of Medicine Houston    MedicalResearch.com: What is the background for this study? Response: E-cigarettes typically cost more than combustible cigarettes and there is more variability in cost due to a wide variety of flavors, e-cigarette liquid, and vaping device that are available in the market. Therefore, use of e-cigarettes may vary depending on income with potentially higher use among higher income individuals. (more…)
Author Interviews, COVID -19 Coronavirus, Nutrition, Social Issues / 07.10.2020

MedicalResearch.com Interview with: Jason Nagata, MD, MSc Assistant Professor of Pediatrics University of California, San Francisco San Francisco, California, USA MedicalResearch.com: What is the background for this study? Response: During the COVID-19 pandemic, food insecurity is expected to rise given economic uncertainty and job losses. Vulnerable and marginalized populations are disproportionately affected by both COVID-19 and food insecurity. MedicalResearch.com: What are the main findings? Response: In this perspective, we argue that food insecurity and COVID-19 can exacerbate one another via bidirectional links. Experiencing food insecurity can lead to nutritional deficiencies and weakened host defenses, increasing susceptibility to COVID-19 infection. Food insecurity is also associated with chronic medical conditions which may lead to a higher risk of severe COVID-19 illness. Conversely, people with COVID-19 may not be able to work, generate income, or procure food while quarantined, which may worsen food insecurity. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Social Issues / 01.10.2020

MedicalResearch.com Interview with: Dr. Madhur Garg, MD MBA Clinical director, Radiation Oncology Montefiore Health System and Professor Departments of Otorhinolaryngology - Head & Neck Surgery - and Urology Albert Einstein College of Medicine  MedicalResearch.com: What is the background for this study? Response: ​The Bronx was hit particularly hard with Covid-19 - making up one of the highest per capita cases and deaths in the country. Montefiore Health System and Albert Einstein College of Medicine, care for a large population of ethnic minorities (non-Hispanic Black and Hispanic individuals make up 65% of our patient population). (more…)
Author Interviews, Electronic Records, Race/Ethnic Diversity, Social Issues / 22.09.2020

MedicalResearch.com Interview with: Hailey Miller, PhD, RN Postdoctoral Associate Duke University School of Nursing Stephen P. Juraschek, MD PhD Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study?   Response: Digital tools, such as the electronic medical record (EMR), are increasingly utilized to identify and recruit participants for clinical trials. These strategies offer a strong opportunity to increase recruitment yields, however, our previous work has demonstrated that patient portal users are disproportionately White, and therefore utilizing these strategies may contribute to the under-representation of Black Americans in clinical research. This study examined multiple recruitment strategies, including EMR-based strategies and other non-EMR strategies, such as community mailing, Facebook advertisement and newspaper advertisement, to understand if recruitment strategies influenced the demographic composition of trial participants. Given our previous finding that patient portal users are disproportionately White, one of our EMR-based strategies included postal mailing to individuals without a patient portal. (more…)
Author Interviews, Cancer Research, ESMO, Race/Ethnic Diversity, Social Issues / 21.09.2020

MedicalResearch.com Interview with: Ziad Bakouny, MD, MSc Post-doctoral research fellow Lank Center for Genitourinary Oncology Dana-Farber Cancer Institute MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has disproportionately affected patients with cancer, with these patients unfortunately having worse outcomes than the general population. In fact, a recent report by the COVID-19 and Cancer Consortium (CCC19) showed that the mortality rate in patients with cancer who develop COVID-19, at 30 days median follow-up, was 16%. Although the adverse outcomes of patients with cancer who develop COVID-19 has received much attention, few studies have thus far investigated the effects of the potential disruption to cancer care delivery caused by the pandemic. Our aim in the COVID and Cancer Outcomes Study (CCOS) was therefore to evaluate this disruption to cancer care caused by the pandemic. This is a multicenter prospective cohort study that included patients seen in the outpatient setting at the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai in New York City and the Dana-Farber Cancer Institute in Boston during one week in March (between March 2 and March 6 2020). Data was collected 3 months before this index week and 3 months prospectively (during the first peak of the pandemic in the Northeastern United States). (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, JAMA, Social Issues / 21.08.2020

MedicalResearch.com Interview with: Monik Carmen Jimenez, Sc.D Assistant Professor of Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: We wanted to get a comprehensive picture of the epidemiology of COVID-19 in carceral facilities that included jails and was not restricted solely to prisons. We utilized publicly available data collected in Massachusetts, pursuant to a court order. These data included prison and jail systems and were used to calculate rates of confirmed cases of COVID-19 and testing rates among incarcerated individuals. We were also able to compare those to changes in the population size within each system. (more…)
Author Interviews, Neurology, Social Issues / 10.08.2020

MedicalResearch.com Interview with: Darren Schreiber JD PhD Senior Lecturer Exeter MedicalResearch.com: What is the background for this study? Response: My co-authors and I saw an opportunity to match existing functional brain imaging data with publicly available voter registration data so that we could look for patterns that distinguish brain activity in nonpartisans from partisans.  While a number of studies have found differences in both brain structure and function between partisans on the left and right and there is a massive amount of scholarship in political science on partisans and polarization, no brain imaging work had focused on nonpartisans. Around 40% of Americans do not affiliate with a political party and one important campaign strategy has been to persuade these voters to support party candidates.  However many political scientists are skeptical about voters claims to be nonpartisans and will instead treat them as if they were merely covert partisans. (more…)
Author Interviews, Social Issues / 10.08.2020

MedicalResearch.com Interview with: Carlota Batres, PhD Assistant Professor of Psychology Franklin & Marshall College MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many studies have examined how defendant characteristics influence jury decisions, but none have investigated the effect of makeup. We therefore examined how cosmetics influence jury decisions for young and middle-aged female defendants. We found that participants were more likely to assign guilty verdicts to middle-aged defendants than young defendants and when presented with makeup, male participants gave young defendants longer sentences and middle-aged defendants shorter sentences.  (more…)
Author Interviews, Brigham & Women's - Harvard, Exercise - Fitness, Race/Ethnic Diversity, Social Issues / 03.08.2020

MedicalResearch.com Interview with: Marc Weisskopf, PhD, ScD Cecil K. and Philip Drinker Professor of Environmental Epidemiology and Physiology Departments of Environmental Health and Epidemiology Harvard T.H. Chan School of Public Health Boston, MA 02115  MedicalResearch.com: What is the background for this study? Response: There is a long history of health disparities by race. We were interested to see whether these also show up in professional football players, with the thought that perhaps the advantages that come with being an elite athlete in a sport (e.g. related to income, potential access to carte, prestige) might minimize health disparities. (more…)
Author Interviews, JAMA, Race/Ethnic Diversity, Social Issues / 03.08.2020

MedicalResearch.com Interview with: Nasim B. Ferdows, Ph.D. Assistant Professor, Department of Health Administration and Policy Hudson College of Public Health The University of Oklahoma Health Sciences Center Oklahoma City, OK MedicalResearch.com: What is the background for this study? Response: This half a century study of US senior men and women who died between 1968 and 2016 shows how disparities in the Black and White mortality of older US citizens have changed over time, as well as how the racial disparities differ in rural, suburban and urban areas. (more…)
Author Interviews, Blood Pressure - Hypertension, Social Issues / 01.08.2020

MedicalResearch.com Interview with: Dr. Shingo Yanagiya Hokkaido University Graduate School of Medicine Sapporo, Japan MedicalResearch.com: What is the background for this study? Response: Thank you very much for your question. Hypertension is a major risk factor for cardiovascular diseases including stroke and ischemic heart disease. Due to the relatively high prevalence of hypertension, there is an increased public burden resulting mainly from cardiovascular disease. It is well known that hypertension is associated with several lifestyle factors, including excessive intake of salt or alcohol, obesity, inactivity, and other personal attributes. Since socioeconomic status affects individual lifestyles and other factors, differences in socioeconomic status may influence the risk of hypertension. Therefore, it is important to clarify whether the risk of hypertension varies among socioeconomic classes when considering an effective strategy for preventing hypertension. Based on my research of previous reports about the relationship between household income and incident hypertension, evidence is scarce for Japan. So, we investigated this in an employed population in Japan. (more…)
Author Interviews, Emergency Care, Heart Disease, Social Issues / 28.06.2020

MedicalResearch.com Interview with: Sriman Gaddam The University of Texas at Austin Austin, TX 78705 MedicalResearch.com: What is the background for this study? Response: The quality of care that patients receive from the US healthcare system continues to be influenced by socioeconomic status (SES). Given that cardiac arrest is one of the most common causes of death in the US and that the prehospital setting has an especially high mortality for cardiac arrest, we wanted to determine if the socioeconomic disparities found in the overall US healthcare system continued into the prehospital cardiac arrest setting. MedicalResearch.com: What are the main findings? Response: We found that socioeconomic disparities were present in the prehospital cardiac arrest setting. As the SES of a patient declines, so does the patient's likelihood of achieving return of spontaneous circulation (ROSC). Between the most and least wealthy patients, there was nearly a 13% difference in the probability of achieving ROSC. However, we recognized that not all patients who achieve ROSC are equal as patients can have significantly different neurological functioning depending on the length of time spent in cardiac arrest. Consequently, this paper analyzed cardiac arrest outcomes not only through the occurrence of ROSC but also through the duration of time spent in cardiac arrest. In line with the socioeconomic disparities found in ROSC occurrence, it was found that as a patient's SES declines, the duration of time spent in cardiac arrest before ROSC is achieved increases. This indicates that patients with a low SES are both more likely to not achieve ROSC and if ROSC is achieved more likely to have neurological impairment due to longer time spent in cardiac arrest compared to patients with a high SES. (more…)
Author Interviews, JAMA, Nutrition, Social Issues / 28.06.2020

MedicalResearch.com Interview with: Erin Brantley, PhD, MPH Senior Research Associate Department of Health Policy and Management Milken Institute School of Public Health Preferred pronouns: she/her/hers  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We looked at what happened when work requirements for the Supplemental Nutrition Assistance Program Participation, or SNAP, were turned on in many places after the Great Recession. We found large drops in participation in SNAP benefits due to work requirements, and that black recipients were more likely to lose benefits than white recipients. We think this is driven by the fact that black workers face higher unemployment rates than white workers, and work requirement policies do not take this into account. We also found that some people who report having disabilities lost benefits, even though the intent of work requirements is that they apply to people without disabilities.  (more…)
Author Interviews, JAMA, Pediatrics, Social Issues, Technology / 18.05.2020

MedicalResearch.com Interview with: Pooja S. Tandon, MD, MPH Center for Child Health, Behavior and Development Seattle Children's Research Institute MedicalResearch.com: What is the background for this study? Response: Cell phone use is common among middle and high school students, yet we do not have an understanding of school cell phone policies and practices in the U.S. We conducted a survey of public schools serving grades 6-12. The survey sent to over 1,100 school principals, representing a national sample of schools across the U.S., asked questions about the presence of a cell phone policy for students and staff and restrictions on phone use. Additional questions addressed consequences of policy violation, the use of cell phones for curricular activities and principals’ attitudes toward cell phone policies. (more…)
Author Interviews, Cost of Health Care, JAMA, NIH, Social Issues / 12.03.2020

MedicalResearch.com Interview with: Dr. Adan Z. Becerra PhD Senior Epidemiologist for the  NIH Social and Scientific Systems Washington, District Of Columbia MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that disparities in insurance coverage by immigration status exist in the United States such that immigrants compared to nonimmigrants are less likely to have insurance. However, most studies have been cross sectional with few studies investigating long term trajectories of insurance coverage over time. We addressed this gap in the literature by following a cohort of adults for 24 years from before until after reaching Medicare age-eligibility. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Nutrition, Social Issues / 09.03.2020

MedicalResearch.com Interview with: Alon Peltz, MD MBA MHS  Department of Population Medicine Harvard Pilgrim Health Care Institute MedicalResearch.com: What is the background for this study? Response: Thank you for taking an interest in our study. This study represented a collaboration between investigators from Harvard Medical School and Boston University School of Medicine. SNAP is an important U.S. federal aid program that serves nearly 40 million persons annually with well-established health, nutrition, and financial benefits. Families can be eligible for the SNAP program under “federal” rules or “categorical eligibility” rules that extend SNAP support to otherwise ineligible families who receive benefits under certain social assistance programs, such as Temporary Assistance for Needy Families. In July 2019, the U.S. Department of Agriculture proposed new SNAP policies that would limit qualifications via the categorical eligibility route. Although these new policies have not been finalized, it is estimated that 1 in 10 U.S. families currently participating in SNAP may lose their benefits. We wanted to investigate the potential ramifications of these changes to help inform policymakers of the vulnerabilities of the families who receive SNAP benefits and may be at risk for disenrollment if the proposed policies are implemented. (more…)
Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, Social Issues / 27.02.2020

MedicalResearch.com Interview with: Nancy J. Donovan, M.D. Chief, Division of Geriatric Psychiatry Brigham and Women’s Hospital Assistant Professor of Psychiatry Harvard Medical School Boston, MA 02115  MedicalResearch.com: What is the background for this study? Response: Prior research has shown that widowed older adults are more likely to experience cognitive decline than those who are married. However, there have been no prior studies of widowhood as a risk factor for cognitive decline due to Alzheimer’s disease, the most common cause of severe cognitive impairment. (more…)
Author Interviews, Health Care Systems, JAMA, Social Issues / 14.01.2020

MedicalResearch.com Interview with: Elizabeth Tung MD MS Section of General Internal Medicine Instructor of Medicine University of Chicago MedicalResearch.com: What is the background for this study? Response: Medicare provides hospital ratings for all Medicare-certified hospitals in the U.S. based on quality metrics, including mortality, patient experience, hospital readmissions, and others. While ratings are important for comparing hospitals, there's been some concern that some of these quality metrics are outside a hospital's control, especially for hospitals taking care of vulnerable or socially complex patient populations. Take "timeliness of care" as a quality metric, for instance--this measure includes emergency room wait times. But in places that are medically underserved and have very few emergency rooms, these wait times will inevitably be much higher. What this means is that hospitals taking care of medically underserved populations end up getting lower quality ratings, even though they're addressing health disparities by filling an access gap. (more…)
Author Interviews, Education, JAMA, Race/Ethnic Diversity, Social Issues / 02.12.2019

MedicalResearch.com Interview with: Lynn Blewett, PhD Mayo Professor, Division of Health Policy and Management Director, State Health Access Data Assistance Center (SHADAC) University of Minnesota MedicalResearch.com: What is the background for this study? Response: We used a new set of questions about patient's perspectives of cultural competence of their providers that was added to the National Health Interview Survey and accessed through the Minnesota Population Center IPUMS Health Surveys.   MedicalResearch.com: What should readers take away from your report? Response: Most patients (97%) report being treated with respect by their providers. BUT we also found important disparities.  Black or Hispanic (vs White), uninsured (vs insured), and low income (vs >200% FPL) individuals reported being treated with respect less often, viewed a shared culture as more important, and saw providers who shared culture less often. (more…)
Author Interviews, Ophthalmology, PLoS, Social Issues / 12.09.2019

MedicalResearch.com Interview with: Christopher W. Tyler D.Sc., PhD Division of Optometry and Vision Sciences School of Health Sciences City University of London London, United Kingdom MedicalResearch.com: What is the background for this study? Response: The idea came from my previous  investigation of compositional regulates in paintings, which showed that there is a sense of balance  between symmetry and asymmetry in a composition, such that the asymmetry composition tends to appear more dynamic and interesting, but it needs to be anchored around a symmetric point for a comfortable sense of stability. That point in adult portraits tends to be the dominant eye, placed close to the centre line, but above the centre of the painting as a whole. Selfies are a fascinating art form and the lead author has published several papers on this topic from a cognitive neuroscience perspective. One fascinating feature of selfies is that they represent pseudo-artistic productions by individuals that do not generally have academic artistic training, making it interesting to compare them to self-portraits by real artists. If you then see the same phenomena, it is likely that these are rooted in our deep nature rather than on training and cultural conventions. (more…)
Author Interviews, Heart Disease, Social Issues / 11.09.2019

MedicalResearch.com Interview with: Dr. Heather Tulloch, C. Psych Clinical, Health, and Rehabilitation Psychologist Division of Cardiac Prevention and Rehabilitation Associate Professor, Faculty of Medicine University of Ottawa Heart Institute MedicalResearch.com: What is the background for this study? Response: It is well established that many caregivers experience distress when caring for a loved one with cardiovascular disease. For example, over 40% of caregivers in Ontario, Canada, report high psychological, emotional, physical, social, and emotional stresses imposed by the caregiving role. Ironically, caregivers are vulnerable to developing their own poor cardiovascular health. For example, chronic stress brought on by a caregiving role increases caregivers’ cardiovascular reactivity (i.e., blood pressure, heart rate) and impaired endothelial function. Many caregivers also report poor preventative health behaviours and low quality of life scores. (more…)
Author Interviews, Education, JAMA, Opiods, Social Issues / 28.08.2019

MedicalResearch.com Interview with: Isaac Sasson, PhD Department of Sociology and Anthropology and the Herczeg Institute on Aging Tel Aviv University Tel Aviv, Israel MedicalResearch.com: What is the background for this study? Response: Life expectancy at birth in the United States has been declining steadily since 2014, which is very unusual for a high-income country in times of peace. In fact, the last time that life expectancy declined in the US was in the early 1990s, and only briefly. Studies from the past few years have shown that the rise in mortality is concentrated among middle-aged Americans and particularly the lower socioeconomic classes. Our study analyzed over 4.6 million death records in 2010 and 2017 to understand which causes of death account for the rise in mortality among white and black non-Hispanic US adults. In addition, given the substantial socioeconomic inequality in health in the US, we broke down our results by level of education, which is a good proxy for socioeconomic status. Essentially, our goal was to measure how many years of life were lost, on average, to each cause of death across different social groups.  (more…)
Author Interviews, Global Health, Pediatrics, PLoS, Social Issues / 21.08.2019

MedicalResearch.com Interview with: Jayanta Kumar Bora Guest Researcher IIASA|Laxenburg, Austria & Ph.D. Scholar Indian Institute of Dalit Studies New Delhi, India  MedicalResearch.com: What is the background for this study? Response: Although under-five mortality rate (U5MR) is declining in India, it is still high in a few selected states and among the scheduled caste (SC) and scheduled tribe (ST) population of the country. We examined the disparities in under-five mortality in high focus states of India. The high-focus states in India were designated as such by the Indian government because of their persistently high child mortality and relatively poor socio-economic and health indicators. This study re-examines the association between castes and under-five mortality in high focus Indian states using the most recent Indian Demographic Health Survey data conducted in 2015-16. The study also aims to quantify the relative contribution of socioeconomic determinants to under-five deaths by explaining the gap between socially disadvantaged (SC and ST) and non-disadvantaged castes in high focus states. Identifying disadvantaged groups in high focus states can help to reduce the absolute and relative burden of under-five deaths in India. (more…)