Racial and Gender Disparities in Stroke Risks

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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Disparities Remain But Blacks Experience Greatest All-Cause Mortality Reductions

MedicalResearch.com Interview with:

Katie Hastings MPH Stanford Medicine 

Kate Hastings

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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Poor and Racial Minorities Have Worse Home Health Care Outcomes

MedicalResearch.com Interview with:

MedicalResearch.com Interview with: Karen Joynt Maddox, MD, MPH Washington University School of Medicine Saint Louis MO

Dr. Joynt-Maddox

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.

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Why Is It So Hard To Attract and Retain Rural Primary Care Physicians?

MedicalResearch.com Interview with:

Matthew R. McGrail, PhD Monash University School of Rural Health Churchill, Victoria Australia

Dr. McGrail

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.

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