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Article ReferenceAssociations between Obesity, Obesogenic Environments, and Structural Racism Vary by County-Level Racial Composition
O besity rates in the U.S. are associated with area-level, food-related characteristics. Studies have previously examined the role of structural racism (policies/practices that advantaged White Americans and deprived other racial/ethnic minority groups), but racial inequalities in socioeconomic status (SES) is a novel indicator. The aim of this study is to determine the associations between racial inequalities in SES with obesity and obesogenic environments. Data from 2007⁻2014 County Health Rankings and 2012⁻2016 County Business Patterns were combined to assess the associations between relative SES comparing Blacks to Whites with obesity, and number of grocery stores and fast food restaurants in U.S. counties. Random effects linear and Poisson regressions were used and stratified by county racial composition. Racial inequality in poverty, unemployment, and homeownership were associated with higher obesity rates. Racial inequality in median income, college graduates, and unemployment were associated with fewer grocery stores and more fast food restaurants. Associations varied by county racial composition. The results demonstrate that a novel indicator of structural racism on the county-level is associated with obesity and obesogenic environments. Associations vary by SES measure and county racial composition, suggesting the ability for targeted interventions to improve obesogenic environments and policies to eliminate racial inequalities in SES.
Located in Retired Persons / Caryn Bell, Ph.D. / Caryn Bell Publications
Article Reference Troff document (with manpage macros)Do neighborhood characteristics contribute beyond individual demographics to cancer control behaviors among African American adults?
Background Recent years have seen increased interest in the role of neighborhood factors in chronic diseases such as cancers. Less is known about the role of neighborhood factors beyond individual demographics such as age or education. It is particularly important to examine neighborhood effects on health among African American men and women, considering the disproportionate impact of cancer on this group. This study evaluated the unique contribution of neighborhood characteristics (e.g., racial/ethnic diversity, income) beyond individual demographics, to cancer control behaviors in African American men and women. Methods Individual-level data were drawn from a national survey (N = 2,222). Participants’ home addresses were geocoded and merged with neighborhood data from the American Community Survey. Multi-level regressions examined the unique contribution of neighborhood characteristics beyond individual demographics, to a variety of cancer risk, prevention, and screening behaviors. Results Neighborhood racial/ethnic diversity, median income, and percentage of home ownership made modest significant contributions beyond individual factors, in particular to smoking status where these factors were associated with lower likelihood of smoking (ps < .05). Men living in neighborhoods with older residents, and greater income and home ownership were significantly more likely to report prostate specific antigen testing (ps < .05). Regional analyses suggested different neighborhood factors were associated with smoking status depending on the region. Conclusion Findings provide a more nuanced understanding of the interplay of social determinants of health and neighborhood social environment among African American men and women, with implications for cancer control interventions to eliminate cancer disparities.
Located in Retired Persons / Caryn Bell, Ph.D. / Caryn Bell Publications
Article Reference Troff document (with manpage macros)Self-Rated Health and Structural Racism Indicated by County-Level Racial Inequalities in Socioeconomic Status: The Role of Urban-Rural Classification
Recent attention to the interrelationship between racism, socioeconomic status (SES) and health has led to a small, but growing literature of empirical work on the role of structural racism in population health. Area-level racial inequities in SES are an indicator of structural racism, and the associations between structural racism indicators and self-rated health are unknown. Further, because urban-rural differences have been observed in population health and are associated with different manifestations of structural racism, explicating the role of urban-rural classification is warranted. This study examined the associations between racial inequities in SES and self-rated health by county urban-rural classification. Using data from County Health Rankings and American Communities Surveys, black-white ratios of SES were regressed on rates of fair/poor health in U.S. counties. Racial inequities in homeownership were negatively associated with fair/poor health ( β  = −0.87, s.e. = 0.18), but racial inequities in unemployment were positively associated with fair/poor health ( β  = 0.03, s.e. = 0.01). The associations between structural racism and fair/poor health varied by county urban-rural classification. Potential mechanisms include the concentration of resources in racially segregated counties with high racial inequities that lead to better health outcomes, but are associated with extreme black SES disadvantage. Racial inequities in SES are a social justice imperative with implications for population health that can be targeted by urban-rural classification and other social contextual characteristics.
Located in Retired Persons / Caryn Bell, Ph.D. / Caryn Bell Publications
Article Reference Troff document (with manpage macros)The Role of Social Support in Moderating the Relationship between Race and Hypertension in a Low-Income, Urban, Racially Integrated Community
In the US, African Americans have a higher prevalence of hypertension than Whites. Previous studies show that social support contributes to the racial differences in hypertension but are limited in accounting for the social and environmental effects of racial residential segregation. We examined whether the association between race and hypertension varies by the level of social support among African Americans and Whites living in similar social and environmental conditions, specifically an urban, low-income, racially integrated community. Using data from the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB) sample, we hypothesized that social support moderates the relationship between race and hypertension and the racial difference in hypertension is smaller as the level of social support increases. Hypertension was defined as having systolic blood pressure greater than 140 mmHg and/or diastolic blood pressure greater than 90 mmHg, or the participant reports of taking antihypertensive medication(s). The study only included participants that self-reported as “Black/African American” or “White.” Social support was measured as functional social support and marital status. After adjusting for demographics and health-related characteristics, we found no interaction between social support and race (DUFSS score, prevalence ratio 1.00; 95% confidence interval 0.99, 1.01; marital status, prevalence ratio 1.02; 95% confidence interval 0.86, 1.21); thus the hypothesis was not supported. A plausible explanation is that the buffering factor of social support cannot overcome the social and environmental conditions which the participants live in. Further, these findings emphasize social and environmental conditions of participants in EHDIC-SWB may equally impact race and hypertension.
Located in Retired Persons / Caryn Bell, Ph.D. / Caryn Bell Publications
Article ReferenceRacial non-equivalence of Socioeconomic Status and Health among African Americans and Whites
Racial health inequities are not fully explained by socioeconomic status (SES) measures like education, income and wealth. The largest inequities are observed among African American and white college graduates suggesting that African Americans do not receive the same health benefits of education. African Americans do not receive the same income and wealth returns of college education as their white counterparts indicating a racial non-equivalence of SES that may affect health inequities. The aim of this study is to determine whether racial non-equivalence of SES mediates race inequities in self-rated health by education and sex. Using data from the 2007–2016 National Health and Nutrition Examination Survey in the United States, the mediation of the associations between race and self-rated health through household income ≥400% federal poverty line, homeownership, and investment income were assessed among college graduates and non-college graduates by sex. Indirect associations were observed among college graduate women (odds = 0.08, standard error (s.e.) = 0.03), and non-college graduate men (odds = 0.14, s.e. = 0.02) and women (odds = 0.06, s.e. = 0.02). Direct associations between race and self-rated health remained after accounting for household income and wealth indicators suggesting that race differences in income and wealth partially mediate racial inequities in self-rated health. This study demonstrates that the racial non-equivalence of SES has implications for health inequities, but the magnitude of indirect associations varied by sex. Other factors like discrimination, health pessimism and segregation should be considered in light of the racial non-equivalence of SES and racial inequities in self-rated health.
Located in Retired Persons / Caryn Bell, Ph.D. / Caryn Bell Publications
Article Reference Troff document (with manpage macros)Racial Non-equivalence of Socioeconomic Status and Self-rated Health among African Americans and Whites
Racial health inequities are not fully explained by socioeconomic status (SES) measures like education, income and wealth. The largest inequities are observed among African American and white college graduates suggesting that African Americans do not receive the same health benefits of education. African Americans do not receive the same income and wealth returns of college education as their white counterparts indicating a racial non-equivalence of SES that may affect health inequities. The aim of this study is to determine whether racial non-equivalence of SES mediates race inequities in self-rated health by education and sex. Using data from the 2007–2016 National Health and Nutrition Examination Survey in the United States, the mediation of the associations between race and self-rated health through household income ≥400% federal poverty line, homeownership, and investment income were assessed among college graduates and non-college graduates by sex. Indirect associations were observed among college graduate women (odds = 0.08, standard error (s.e.) = 0.03), and non-college graduate men (odds = 0.14, s.e. = 0.02) and women (odds = 0.06, s.e. = 0.02). Direct associations between race and self-rated health remained after accounting for household income and wealth indicators suggesting that race differences in income and wealth partially mediate racial inequities in self-rated health. This study demonstrates that the racial non-equivalence of SES has implications for health inequities, but the magnitude of indirect associations varied by sex. Other factors like discrimination, health pessimism and segregation should be considered in light of the racial non-equivalence of SES and racial inequities in self-rated health.
Located in Retired Persons / Caryn Bell, Ph.D. / Caryn Bell Publications
Hans-Peter Kohler, University of Pennsylvania
Mortality Risk Information, Survival Expectations, Sexual Behaviors and Covid-19
Located in Coming Up
Julia Behrman, Northwestern University
Point of reference: A multi-sited exploration of African migration and fertility in France
Located in Coming Up
Article Reference Troff document (with manpage macros)Air Quality Assessment of Volatile Organic Compounds Near a Concrete Block Plant and Traffic in Bladensburg, Maryland
A concrete block plant located in Bladensburg, Maryland, wants to expand to include a concrete batching plant on the same property. This expansion could further degrade air quality and impact the health of vulnerable residents. The purpose of this study is to provide information on volatile organic compounds (VOCs) levels near residential areas close to commuter traffic and industrial activity associated with the concrete plant. Air quality monitoring was conducted in the community at five sites: (1) Kingdom Missionary Baptist Church, (2) Bladensburg Waterfront Park, (3) Confluence area, (4) Bladensburg Elementary School, and (5) Hillcrest Apartment Complex by using the Atmotube, a wearable, real-time sensor that can measure total VOCs. Sampling was conducted in 30-minute periods to capture morning onpeak, afternoon off-peak, and evening on-peak periods. Traffic counts were also conducted at the sites mentioned earlier to evaluate vehicular activity. Average 30-minute values for cars ranged from 8.33 to 1295.33 cars, whereas mean truck values ranged from 0.00 to 137.67 trucks across all sites. The highest average car count of 1295.33 cars was observed at the confluence area. Mean VOCs concentrations ranged from 0.11 to 0.54 ppm across the monitoring locations. The maximum average VOCs level of 0.54 ppm was observed at Kingdom Missionary Baptist Church on Saturday. Also, the mean VOCs levels observed at the church (0.54 and 0.31 ppm) were higher compared with other locations on Saturday. Our results revealed spatial variations of VOCs levels across all locations. There were higher total VOCs levels at the church, which is the closest location to the concrete block plant.
Located in MPRC People / Robin Puett, Ph.D. / Robin Puett Publications
Article Reference Troff document (with manpage macros)Developing population health scientists: Findings from an evaluation of the Robert Wood Johnson Foundation Health & Society Scholars Program
HIGHLIGHTS: RWJF Health & Society Scholars (HSS) program outcomes evaluated. HSS alumni have higher scholarly productivity and impact than control group. HSS alumni are more engaged in population health research than controls. HSS alumni and controls are similar on other outcome measures. Training programs can be evaluated with adequate attention to selection bias.
Located in MPRC People / Christine Bachrach, Ph.D. / Christine Bachrach Publications