Disparities and Health Equity

The differences in ability to access health care and in health outcomes across the population.

Insulin Pump Use in Children With Type 1 Diabetes: Over a Decade of Disparities

Nov. 25, 2020

Terri H. Lipman, Steven M. Willi, C.W. Lai, Jennifer A. Smith, Oona Patil, Colin P. Hawkes

Abstract [from journal]

Purpose: Racial disparities have been shown in outcomes and treatment of children with type 1 diabetes (T1D). The purpose of this study was to examine temporal trends in insulin pump use among non-Hispanic white (NHW), non-Hispanic black (NHB) and Hispanic children attending a large urban diabetes center.

This study was a retrospective chart review of insulin pump usage by race (NHW/ NHB) in 2005, and race/ethnicity (NHW/NHB/Hispanic) in 2011–2019. Demographic data (age, sex, diabetes duration, SES) and most recent

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Frailty is a Risk Factor for Post-Operative Mortality in Patients With Cirrhosis Undergoing Diverse Major Surgeries

Nov. 23, 2020

Nadim Mahmud, David E. Kaplan, Tamar H. Taddei, David S. Goldberg

Abstract [from journal]

Background: With a rising burden of cirrhosis surgeries, understanding risk factors for post-operative mortality are more salient than ever. The role of baseline frailty has not been assessed in this context. We aimed to evaluate the association between patient frailty and post-operative risk among diverse patients with cirrhosis, and to determine if frailty improves prognostication of cirrhosis surgical risk scores.

Methods: This was a retrospective cohort study of U.S. Veterans with

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Using Informational Murals and Handwashing Stations to Increase Access to Sanitation Among People Experiencing Homelessness During the COVID-19 Pandemic

Nov. 19, 2020

Yoonhee P. Ha, Nicole McDonald, Shari Hersh, Stephanie R. Fenniri, Amy HillierCarolyn C. Cannuscio

Abstract [from journal]

The coronavirus disease 2019 (COVID-19) pandemic has upended every aspect of life in the United States and forced Americans to rethink their daily activities, including how they work, attend school, secure food, obtain health care, and maintain social connections. For vulnerable populations that were already facing significant barriers to health, such as people experiencing homelessness, the pandemic has only generated new hardships and exacerbated existing inequities. 

Better Nurse Staffing is Associated With Survival for Black Patients and Diminishes Racial Disparities in Survival After In-Hospital Cardiac Arrests

Nov. 16, 2020

Margo Brooks CarthonHeather BromMatthew McHugh, Douglas M. Sloane, Robert Berg, Raina Merchant, Saket Girotra, Linda H. Aiken

Abstract [from journal]

Background: Racial disparities in survival among patients who had an in-hospital cardiac arrest (IHCA) have been linked to hospital-level factors.

Objectives: To determine whether nurse staffing is associated with survival disparities after IHCA.

Research design: Cross-sectional data from (1) the American Heart Association's Get With the Guidelines-Resuscitation database; (2) the University of Pennsylvania Multi-State Nursing Care and Patient Safety

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A Mixed-Studies Review of the School-to-Prison Pipeline and a Call to Action for School Nurses

Nov. 11, 2020

Shoshana V. Aronowitz, BoRam Kim, Teri Aronowitz

Abstract [from journal]

Zero-tolerance school disciplinary policies have contributed to the proliferation of exclusionary practices, which increase the risk that minoritized students will be harmed by the school-to-prison pipeline (STPP). The purpose of this review was to explore factors that influence the STPP and highlight the role school nurses can play in protecting students from this public health crisis. We used a systematic mixed-studies review method, and 14 studies were included. Exclusionary discipline disproportionately affects minoritized

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Racial and Ethnic Disparities in Rates of Continuous Glucose Monitor Initiation and Continued Use in Children With Type 1 Diabetes

Nov. 11, 2020

Charlene W. Lai, Terri H. Lipman, Steven M. Willi, Colin P. Hawkes

Abstract [from journal]

Objective: Racial/ethnic disparities in continuous glucose monitor (CGM) use exist among children with type 1 diabetes. It is not known whether differential rates of device initiation or sustained use are the cause of this disparity. Our objective was to compare CGM initiation rates and continued use among non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic children.

Research design and methods: We conducted a retrospective review including children with type 1 diabetes attending

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The Impact of Change in Neighborhood Poverty on BMI Trajectory of 37,544 New York City Youth: A Longitudinal Study

Nov. 10, 2020

Krista Schroeder, Sophia Day, Kevin Konty, Levent Dumenci, Terri Lipman

Abstract [from journal]

Background: Neighborhood poverty may increase childhood obesity risk. However, evidence for the neighborhood poverty-obesity relationship is limited. The purpose of this study was to examine how moving to a higher or lower poverty neighborhood impacts body mass index (BMI) z-score trajectories among youth, with the goal of informing policy change, interventions, and clinical practices to reduce childhood obesity.

Methods: Methods entailed secondary analysis of existing longitudinal data. The

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CMS’ Inpatient Psychiatric Facility Quality Reporting Program

Nov. 9, 2020

Patients in inpatient psychiatric care are especially vulnerable to physical and psychological harm, but they have largely been excluded from efforts to monitor, understand, and improve quality of care. In 2012, the Centers for Medicare and Medicaid Services (CMS) implemented the Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program to ease inpatient psychiatry into the norms and scrutiny that general hospital care has received for a long time.

Racial-Ethnic Disparities In Diabetes Technology Use Among Young Adults With Type 1 Diabetes

Shivani Agarwal, MD, MPH, University of Pennsylvania
Nov. 6, 2020

Shivani Agarwal, Clyde Schechter, Jeffrey Gonzalez, Judith A. Long

Abstract [from journal]

Background: Recent studies highlight racial-ethnic disparities in insulin pump and continuous glucose monitor (CGM) use in people with type 1 diabetes (T1D), but drivers of disparities remain poorly understood beyond socioeconomic status (SES).

Methods: We recruited a diverse sample of young adults (YA) with T1D from six diabetes centers across the U.S., enrolling equal numbers of Non-Hispanic (NH) White, NH Black, and Hispanic YA. We used multivariate logistic regression to examine to what

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Racial Disparities in Preemptive Wait-listing and Deceased Donor Kidney Transplantation: Ethics and Solutions

Nov. 5, 2020

Peter P. Reese, Sumit Mohan, Kristen L. King, Winfred W. Williams, Vishnu S. Potluri, Meera N. Harhay, Nwamaka D. Eneanya

Abstract [from journal]

Kidney transplantation prior to dialysis, known as "preemptive transplant," enables patients to live longer and avoid the substantial quality of life burdens due to chronic dialysis. Deceased donor kidneys are a public resource that ought to provide health benefits equitably. Unfortunately, White, better educated, and privately-insured patients enjoy disproportionate access to preemptive transplantation using deceased donor kidneys. This problem has persisted for decades and is exacerbated by the first-come, first-served approach to

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Training Young Adult Peers In A Mobile Motivational Interviewing-Based Mentoring Approach To Upstream HIV Prevention

Nov. 2, 2020

Erin E. Bonar, James R. Wolfe, Ryan Drab, Rob Stephenson, Patrick S. Sullivan, Tanaka Chavanduka, Benyam Hailu, Jodie L. Guest, José Bauermeister

Abstract [from journal]

Mentoring relationships are characterized by a sustained, high quality, and skill-building relationship between a protégé and mentor (Handbook of Youth Mentoring, Los Angeles, SAGE, 2014). Within prevention science, youth mentoring programs emphasize creating a specific context that benefits a young person. Program-sponsored relationships between youth and adults allow for creating a mentor-mentee partnership, but do not require the establishment of a strong bond in order to deliver prevention-focused activities and experiences (

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Association of Adverse Neighborhood Exposures with HIV Viral Load in Pregnant Women at Delivery

Florence Momplaisir, MD, MSHP, University of Pennsylvania
Nov. 2, 2020

Florence M. Momplaisir, Tanner Nassau, Kari Moore, Clara Grayhack, Wanjiku F. M. Njoroge, Ana V. Diez Roux, Kathleen A. Brady

Abstract [from journal]

Importance: Racial disparities in maternal morbidity and mortality are in large part driven by poor control of chronic diseases. The association between adverse neighborhood exposures and HIV virologic control has not been well described for women with HIV during pregnancy.

Objective: To evaluate the association between adverse neighborhood exposures and HIV viral load at delivery.

Design, setting, and participants: This population-based cohort study assessed HIV

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The Hispanic/Latinx Perinatal Paradox In The United States: A Scoping Review And Recommendations To Guide Future Research

Diana Montoya-Williams, MD
Oct. 31, 2020

Diana Montoya-Williams, Victoria Guazzelli Williamson, Michelle Cardel, Elena Fuentes-Afflick, Mildred Maldonado-Molina, Lindsay Thompson

Abstract [from journal]

For decades, epidemiologists have documented a health advantage among Hispanic/Latinx individuals who live in the United States, despite their significant socioeconomic barriers. This observation is often described as the "Hispanic paradox." In this scoping review, we aimed to summarize literature published on Hispanic/Latinx perinatal outcomes over the past two decades and place these findings within the context of the overarching "Healthy Immigrant" paradox. Studies were eligible for inclusion if they utilized large population

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Racial Inequity in Fatal U.S. Police Shootings, 2015–2020

Oct. 27, 2020

Elle Lett, Emmanuella Ngozi Asabor, Theodore Corbin, Dowin Boatright

Abstract [from journal]

Introduction: Violent encounters with police represent a significant cause of morbidity and mortality in the USA, especially among Black, Indigenous, and People of Colour (BIPOC). This study characterises trends in fatal police shootings overall and by armed status and quantifies inequities in mortality burden and years of life lost (YLL) across racial/ethnic groups.

Methods: Longitudinal study of Washington Post data on fatal police shootings in the USA

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"I'm Dealing With That": Illness Concerns Of African American And White Cancer Patients While Undergoing Active Cancer Treatments

Salima Meghani, RN, PhD, Penn Nursing School researcher
Oct. 27, 2020

Salimah H. Meghani, Kristin Levoy, Kristin Corey Magan, Lauren T. Starr, Liana Yocavitch, Frances K. Barg

Abstract [from journal]

Background: National oncology guidelines recommend early integration of palliative care for patients with cancer. However, drivers for this integration remain understudied. Understanding illness concerns at the time of cancer treatment may help facilitate integration earlier in the cancer illness trajectory.

Objective: To describe cancer patients' concerns while undergoing cancer treatment, and determine if concerns differ among African Americans and Whites.

Methods: A

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