دورية أكاديمية
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Residential Structural Racism and Prevalence of Chronic Health Conditions.

التفاصيل البيبلوغرافية
العنوان: Residential Structural Racism and Prevalence of Chronic Health Conditions.
المؤلفون: Mohottige D; Institute for Health Equity Research, Department of Population Health, Icahn School of Medicine at Mount Sinai, New York, New York.; Barbara T. Murphy Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York., Davenport CA; Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina., Bhavsar N; Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina.; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina., Schappe T; Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina., Lyn MJ; Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina.; Department of Family Medicine and Community Health, Duke University, Durham, North Carolina., Maxson P; Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina., Johnson F; Center for Community and Population Health Improvement, Duke Clinical and Translational Science Institute, Duke University, Durham, North Carolina.; Department of Family Medicine and Community Health, Duke University, Durham, North Carolina., Planey AM; Department of Health Policy and Management, Gillings School of Global Public Health, Chapel Hill, North Carolina.; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill., McElroy LM; Division of Abdominal Transplant Surgery, Department of Surgery, Duke University, Durham, North Carolina.; Department of Population Health, Duke University, Durham, North Carolina., Wang V; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina.; Department of Population Health, Duke University, Durham, North Carolina., Cabacungan AN; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina., Ephraim P; Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York., Lantos P; Duke Global Health Institute, Duke University, Durham, North Carolina.; Department of Pediatrics, Duke University, Durham, North Carolina.; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina., Peskoe S; Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina., Lunyera J; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina., Bentley-Edwards K; Duke Global Health Institute, Duke University, Durham, North Carolina.; Duke Cancer Institute, Duke University, Durham, North Carolina.; Samuel DuBois Cook Center on Social Equity, Duke University, Durham, North Carolina., Diamantidis CJ; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina.; Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina., Reich B; Department of Statistics, North Carolina State University, Raleigh., Boulware LE; Wake Forest University School of Medicine, Winston Salem, North Carolina.
المصدر: JAMA network open [JAMA Netw Open] 2023 Dec 01; Vol. 6 (12), pp. e2348914. Date of Electronic Publication: 2023 Dec 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Renal Insufficiency, Chronic* , Hypertension*/epidemiology , Diabetes Mellitus*, Humans ; Cross-Sectional Studies ; Bayes Theorem ; Prevalence ; Systemic Racism ; Chronic Disease
مستخلص: Importance: Studies elucidating determinants of residential neighborhood-level health inequities are needed.
Objective: To quantify associations of structural racism indicators with neighborhood prevalence of chronic kidney disease (CKD), diabetes, and hypertension.
Design, Setting, and Participants: This cross-sectional study used public data (2012-2018) and deidentified electronic health records (2017-2018) to describe the burden of structural racism and the prevalence of CKD, diabetes, and hypertension in 150 residential neighborhoods in Durham County, North Carolina, from US census block groups and quantified their associations using bayesian models accounting for spatial correlations and residents' age. Data were analyzed from January 2021 to May 2023.
Exposures: Global (neighborhood percentage of White residents, economic-racial segregation, and area deprivation) and discrete (neighborhood child care centers, bus stops, tree cover, reported violent crime, impervious areas, evictions, election participation, income, poverty, education, unemployment, health insurance coverage, and police shootings) indicators of structural racism.
Main Outcomes and Measures: Outcomes of interest were neighborhood prevalence of CKD, diabetes, and hypertension.
Results: A total of 150 neighborhoods with a median (IQR) of 1708 (1109-2489) residents; median (IQR) of 2% (0%-6%) Asian residents, 30% (16%-56%) Black residents, 10% (4%-20%) Hispanic or Latino residents, 0% (0%-1%) Indigenous residents, and 44% (18%-70%) White residents; and median (IQR) residential income of $54 531 ($37 729.25-$78 895.25) were included in analyses. In models evaluating global indicators, greater burden of structural racism was associated with greater prevalence of CKD, diabetes, and hypertension (eg, per 1-SD decrease in neighborhood White population percentage: CKD prevalence ratio [PR], 1.27; 95% highest density interval [HDI], 1.18-1.35; diabetes PR, 1.43; 95% HDI, 1.37-1.52; hypertension PR, 1.19; 95% HDI, 1.14-1.25). Similarly in models evaluating discrete indicators, greater burden of structural racism was associated with greater neighborhood prevalence of CKD, diabetes, and hypertension (eg, per 1-SD increase in reported violent crime: CKD PR, 1.15; 95% HDI, 1.07-1.23; diabetes PR, 1.20; 95% HDI, 1.13-1.28; hypertension PR, 1.08; 95% HDI, 1.02-1.14).
Conclusions and Relevance: This cross-sectional study found several global and discrete structural racism indicators associated with increased prevalence of health conditions in residential neighborhoods. Although inferences from this cross-sectional and ecological study warrant caution, they may help guide the development of future community health interventions.
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تواريخ الأحداث: Date Created: 20231221 Date Completed: 20231222 Latest Revision: 20231224
رمز التحديث: 20231224
مُعرف محوري في PubMed: PMC10739116
DOI: 10.1001/jamanetworkopen.2023.48914
PMID: 38127347
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2023.48914