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AHA Journals, Author Interviews, Heart Disease, Race/Ethnic Diversity, Stroke / 05.03.2021

MedicalResearch.com Interview with: Fernando D Testai, MD, PhD, FAHA Associate Professor of Neurology and Rehabilitation Stroke Medical Director University of Illinois Health MedicalResearch.com: What is the background for this study? Response: Stroke constitutes a leading cause of disability and mortality in the United States. Large observational studies have shown that up to 90% of the strokes are caused by modifiable vascular risk factors, including hypertension, diabetes mellitus, and several others. In addition, previous history of stroke is one of the most powerful predictors of recurrent stroke. Thus, controlling vascular risk factors in patients with stroke is of paramount importance. To this end, the American Heart Association and the American Stroke Association have developed specific targets for blood pressure, glycemic, and cholesterol levels. (more…)
Author Interviews, Race/Ethnic Diversity, Weight Research / 26.01.2021

MedicalResearch.com Interview with: Raveena Chara Loma Linda University Loma Linda, CA MedicalResearch.com: What is the background for this study? latin food fried food obesityResponse: In a country struggling with an epidemic of obesity, Hispanics are one of the fastest growing population groups in the U.S. and have the highest prevalence of obesity. They are also least likely to enroll in weight reduction programs, complete them, and successfully lose weight (though reasons for this remain elusive). Obesity- a leading predisposing factor for many chronic diseases - is a complex biophysical phenomenon shaped by many factors, including a person’s social environment, health and culture. Culture permeates many aspects of one’s life including how a person views weight and behaviors associated with eating and physical activity. Indeed, for many values and norms about what is culturally acceptable and views on “body weight” vary culturally and affect their decisions about weight and weight loss. This too is the case within the Hispanic population in the US. Given the rising human and financial impact of obesity, preventing and reducing obesity, diabetes and other weight related medical conditions is a growing priority, especially for low income Hispanics.  (more…)
Author Interviews, Health Care Systems, JAMA / 22.01.2021

MedicalResearch.com Interview with: Sara Machado PhD Fellow at the Department of Health Policy London School of Economics and Political Science MedicalResearch.com: What is the background for this study? Response: Physician distribution is a determinant of health care access, so knowing how physician density patterns evolve over time is important if we are trying to address disparities in access to care. Moreover, the last 10 years have brought about changes in health care coverage, across the US. Recent evidence points to an uneven physician distribution between urban and rural communities. We examined recent trends in physician density by physician category across rural and urban US counties.  MedicalResearch.com: What are the main findings? Response: We have two main findings.
  • First, density of primary care physicians steadily decreased in more than half of rural counties (994 out of 1,976).
  • Second, medical specialist density, which would care for cardiovascular and pulmonary disease, for example, has been largely stagnant in rural counties, at the lowest density levels (less than 10 physicians per 100,000), and increasing in metropolitan counties.
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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, 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, Metabolic Syndrome, Race/Ethnic Diversity, Weight Research / 26.06.2020

MedicalResearch.com Interview with: Robert Wong, MD, MS Division of Gastroenterology and Hepatology Veterans Affairs Palo Alto Healthcare System Stanford University School of Medicine MedicalResearch.com: What is the background for this study? Response: Prior to this study, we already knew that obesity and metabolic syndrome were major public health issues in the U.S.  A previous analyses by our team which analyzed data through 2012 observed than one in three adults in the U.S. have metabolic syndrome.  The aim of our current study was to evaluate more recent trends in the prevalence of metabolic syndrome and to identify whether certain groups are at higher risk of having metabolic syndrome.  (more…)
Author Interviews, OBGYNE, Race/Ethnic Diversity / 16.01.2020

MedicalResearch.com Interview with: Elizabeth A. Howell, MD, MPP Director of The Blavatnik Family Women’s Health Research Institute Mount Sinai Health System Vice Chair for Research Professor in the Department of Obstetrics, Gynecology, and Reproductive Science Associate Dean for Academic Development Professor Department of Population Health Science and Policy Icahn Mount Sinai, New York MedicalResearch.com: What is the background for this study? Response: Previous research has demonstrated racial and ethnic disparities in severe maternal morbidity rates in hospitals and that between-hospital differences -- i.e., Black and Latina mothers receiving care at hospitals with worse outcomes -- explain a sizable portion of these disparities.  However, less attention has been paid to within-hospital disparities -- whether Black and Latina mothers have worse outcomes than White mothers who deliver in the SAME hospital. In this paper, we set out to measure within-hospital racial and ethnic disparities and to evaluate the potential contribution of insurance type to these disparities.  Our study question was based on the observation that women with Medicaid can follow different care pathways than women with private insurance. Pregnant women insured by Medicaid are often seen by resident physicians with attending coverage that may differ from attending physicians caring for commercially insured women. In addition, Medicaid reimbursement for delivery hospitalization is far less than that for commercially insured.  (more…)
Author Interviews, Emory, Health Care Systems, JAMA, Kidney Disease, Transplantation / 11.09.2019

 A retraction and replacement have been issued due to a major coding error that resulted in the reporting of incorrect data in this study surrounding the difference in transplant rates between for-profit and non-profit dialysis centers. Please see link below:

Bauchner H, Flanagin A, Fontanarosa PB. Correcting the Scientific Record—Retraction and Replacement of a Report on Dialysis Ownership and Access to Kidney Transplantation. JAMA. 2020;323(15):1455. doi:10.1001/jama.2020.4368

MedicalResearch.com Interview with: Rachel Patzer, PhD, MPH Associate Professor Director, Health Services Research Center Department of Medicine Department of Surgery Emory University School of Medicine   MedicalResearch.com: What is the background for this study? Response: We know that historically, for-profit dialysis facilities have been shown to have lower rates of kidney transplantation than patients who receive treatment in non-profit dialysis facilities. However, these studies are outdated, and did not examine access to living donor transplantation or include the entirety of the end-stage kidney disease population  (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Race/Ethnic Diversity / 05.08.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, JAMA / 04.07.2019

MedicalResearch.com Interview with: Lucy Schulson, MD MPH Section of General Internal Medicine Boston University School of Medicine Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: Research in the early 2000s in California demonstrated that racial and ethnic minorities, immigrants, and those with limited English proficiency (LEP) experienced high rates of discrimination in healthcare. Since those studies were published, California has made concerted efforts at the state and local level to address health equity; these efforts may have impacted perceptions of discrimination in health care. However, it is not known how perceptions of discrimination in healthcare have changed over the last ten years overall and for specific groups. This study sought to compare perceptions of discrimination in health care in 2003-2005 compared to 2015-2017 overall, for racial and ethnic minorities, among immigrants, and among those with Limited English Proficiency (LEP).  (more…)
Author Interviews, Cancer Research, Cost of Health Care, JAMA, Pain Research / 21.06.2019

MedicalResearch.com Interview with: Changchuan (Charles) Jiang MD, MPH MSSLW Internal Medicine Residency Program Class of 2020 Ichan School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Chronic pain is one of the common side effects of cancer treatments and it has been linked to low life quality, lower adherence to treatment, higher medical cost. As the population of cancer survivors grows rapidly, chronic pain will be a major public health issue in this population. We know from previous studies that chronic pain is common in certain cancers such as breast cancer. However, little was known about the epidemiology of chronic pain in the cancer survivors until our study. (more…)
Annals Internal Medicine, Author Interviews, Technology / 22.05.2019

MedicalResearch.com Interview with: Coleman Drake, PhD Assistant Professor, Health Policy and Management Pitt Public Health University of Pittsburgh Graduate School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Telemedicine is frequently proposed as a solution to improve access to care in rural areas where driving to the nearest physician can take up to several hours. However, there needs to be sufficient broadband infrastructure for patients to actually use telemedicine. We found that broadband infrastructure is often insufficient to support telemedicine in the most rural areas, particularly in areas where there is inadequate access to primary care physicians and psychiatrists.  (more…)
Author Interviews, Emergency Care, Global Health, JAMA / 12.04.2019

MedicalResearch.com Interview with: Margaret B. Greenwood-Ericksen MD, MSc Department of Emergency Medicine University of New Mexico Albuquerque, NM 87109 MedicalResearch.com: What is the background for this study?   Response: I’m an emergency physician, so I see first-hand how emergency department use patterns provide a lens into the status of health care delivery in the communities they serve. Troubling declines in the health of rural Americans coupled with rising rural hospital closures – with little access to alternative sites of care like urgent care – all led me to hypothesize that rural populations may be engaging with the health care system differently than their urban counterparts. Understanding the health care use of individuals in rural areas may yield insights into addressing rural health disparities. Further, this information may help healthcare systems and policymakers to make data-driven decisions informing new models of healthcare delivery for rural communities. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Emory, Obstructive Sleep Apnea, Race/Ethnic Diversity, Sleep Disorders / 26.12.2018

MedicalResearch.com Interview with: 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%).  (more…)
Author Interviews / 11.12.2018

MedicalResearch.com Interview with:

Virginia J. Howard,PhD, FAHA, FSCT   
 Professor of Epidemiology
The University of Alabama at Birmingham

MedicalResearch.com:  What is the background for this study?

Response: This study comes from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national cohort study of 30,239 non-Hispanic black and white community-dwelling participants aged 45 years and older who lived in the 48 contiguous US states. 

REGARDS was designed to study risk factors for the development of stroke, with a focus on black and white comparisons as well as comparisons across geographic regions of the US.

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Annals Internal Medicine, Author Interviews, Heart Disease, Race/Ethnic Diversity, Stanford / 13.11.2018

MedicalResearch.com Interview with: 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). 
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Author Interviews, Geriatrics, Race/Ethnic Diversity / 09.10.2017

MedicalResearch.com Interview with: Karen Joynt Maddox, MD, MPH Washington University School of Medicine Saint Louis MO MedicalResearch.com: What is the background for this study? What are the main findings? Response: Home health is one of the fastest-growing sectors in Medicare, and the setting of a new federal value-based payment program, yet little is known about disparities in clinical outcomes among Medicare beneficiaries receiving home health care. We found that beneficiaries who were poor or Black had worse clinical outcomes in home health care than their peers. These individuals were generally more likely to have unplanned hospitalizations, readmissions, and emergency department visits. Under Home Health Value-Based Purchasing, these patterns should be tracked carefully to ensure the program helps close the gaps rather than widening them. (more…)
Author Interviews / 14.07.2017

MedicalResearch.com Interview with: Matthew R. McGrail, PhD Monash University School of Rural Health Churchill, Victoria Australia MedicalResearch.com: What is the background for this study? Response: Rural populations continue to experience relative shortages of the supply of primary care physicians, with associated links to poorer health. Although considerable research has identified factors that facilitate or impede supply of physicians in rural areas, macro-level empirical evidence of observed rural mobility of physicians - notably, which are more likely to move and why - is limited. Improved understanding of mobility and nonretention of rural physicians is important because of its impact on training and workforce policy, and resultant physician supply to both the origin area (ie, the location from which the physician moved) and to the destination area (ie, the location to which the physician has moved). The cost of mobility and staff turnover can be large, both in direct costs but also in terms of service quality and continuity to the community. In our study, we aimed to describe the geographic mobility patterns of rural primary care physicians. This evidence will provide stronger understanding of the factors behind the observed mobility and nonretention of rural primary care physicians. (more…)