Minority Health

Research Findings

Research Activities, August 2008:
New Spanish-language consumer guide compares oral diabetes medications
Enhancing the cultural competence of both clinicians and clinics may work synergistically to reduce care disparities
Poorer treatment and lower socioeconomic status may underlie ethnic disparities in breast cancer survival
Media coverage has boosted awareness of colorectal cancer screening, but messages need to be more targeted
Breast screenings are lower in counties with high rates of uninsured people
Studies reveal wide use of drugs and alcohol and underuse of substance abuse treatment by those with HIV disease

Research Activities, July 2008:
Studies examine racial/ethnic disparities and use patterns for nonsteroidal anti-inflammatory drugs
Minority status and vulnerable early life experiences prompt physicians' engagement in reducing care disparities
Elderly Asian Americans in traditional fee-for-service Medicare receive fewer needed services than their white counterparts
Immigrants are likely to underreport a family history of cancer
Urban, low-income adults with high blood pressure are reasonably knowledgeable about their condition
Asian-Pacific Islanders are more likely to die from serious, but treatable, hospital complications

Research Activities, June 2008:
Serious mood disorders may be underdiagnosed or undertreated among impoverished blacks

Research Activities, May 2008:
AHRQ and Ad Council encourage Hispanics to become more involved in their health care
American Indian health advocates can learn to develop multimedia health projects for rural communities
Pain varies among women with late-stage breast cancer
Poor literacy is linked to poor HIV medication adherence among blacks, and may contribute to HIV health disparities

Research Activities, April 2008:
Modest health care quality gains outpaced by spending
White children are about twice as likely to use stimulants as black and Hispanic children
Physicians tend to be more patient-centered with more positive, satisfied, and involved patients
Despite lack of evidence of benefit, PSA testing for prostate cancer screening has increased dramatically
Self-rated health may not be the best way to identify mortality risks among less-educated, black older persons
Poverty-related factors rather than frequency of primary care visits underlie racial disparities in preventive care
Studies examine the HIV/AIDS epidemic in the South
Life challenges, not discharge problems, cause repeat hospitalizations

Research Activities, March 2008:
Few nursing home residents receive medications and supplements for osteoporosis
Sensitization to indoor allergens is not linked to increased asthma problems among inner-city adults

Research Activities, February 2008:
Blacks, Hispanics, and other minority groups are less likely to get strong pain medications in hospital emergency departments
Caregivers of children with special health care needs rate Medicaid managed care as having better care access than fee-for-service
Nurse midwives deliver more babies in hospitals than homes in Washington State

Research Activities, January 2008:
Some women with breast cancer do not receive adjuvant treatments recommended by guidelines
Disadvantaged newly immigrant Hispanic women have much better birth outcomes than disadvantaged U.S. black women
Elderly cancer patients who live in minority communities use hospice care less than their counterparts in white communities
Use of complementary and alternative medicine is common among persons who have been hospitalized for coronary artery disease

Research Activities, December 2007:
Over 5 million eligible children remain uninsured, despite SCHIP enrollment gains
Women leaving the hospital against medical advice after delivering a baby should be targeted for more services
Doctors should advise Latino families about the safety, low cost, and dental health benefits of drinking tap water
Patients with HIV who share treatment decisions with their doctor have better outcomes

Research Activities, November 2007:
Study documents the health costs of being a woman
A skin condition may identify young patients at risk for developing type 2 diabetes
Black and white caregivers of rural patients with dementia have different characteristics and coping styles
Late diagnosis of HIV is a problem for older patients, many of whom aren't diagnosed until they've already developed AIDS
Mexicans' access to primary care is limited overall, but worse in nonmetropolitan areas

Research Activities, October 2007:
Strategies to improve health literacy for diverse populations should address literacy, language, and cultural barriers
Health literacy is not associated with how minorities perceive their physical or mental health status
Researchers examine link between trauma and alcohol problems as well as cardiovascular risk factors among American Indians
Black, Hispanic, and white patients with diabetes differ in performance of self-care behaviors to manage their disease
Studies show lower colorectal cancer screening rates and access to surgery among the poor, minority, and uninsured
Barriers to timely diagnosis and treatment of prostate cancer in black men arise from lower socioeconomic status
Asian Pacific American ethnic groups vary in their adherence to antihypertensive drug therapy
Three-fourths of low-income black women are dissatisfied with their body size 6 months after giving birth
Elderly blacks' higher hospitalization rates for certain conditions suggest worse quality of outpatient care
Studies examine medication adherence and group medical visits among persons with high blood pressure

Research Activities, September 2007:
Children with complex chronic conditions are more likely to die in their homes than in the hospital
Perceived discrimination does not appear to affect black women's adherence to screening mammography guidelines
Elderly black men are less likely than white men to seek and receive care for lower urinary tract symptoms

Research Activities, August 2007:
Location of shelters and other assistance programs impacts the incidence of violence against homeless women
Disability determinations for job-related low back pain have questionable validity and reflect racial inequities
Socioeconomically disadvantaged patients with lupus have less access to and use of health care

Research Activities, July 2007:
Greater access to physician services may narrow mortality differences among the black and white elderly
Inadequate communication of mammogram results may prevent black women from fully benefiting from screening
Urinary incontinence is common among residents of Southeastern nursing homes, especially among black residents

Research Activities, June 2007:
The State Children's Health Insurance Program can improve care access, use, and quality for children with special health care needs and adolescents
Certain medical education programs may reinforce physicians' goals to practice in disadvantaged communities

Research Activities, May 2007:
An educational and support program can improve blood pressure control among immigrant Korean American seniors
Both poor and black patients are more likely to believe that a positive self-presentation can affect the quality of their medical care

Research Activities, April 2007:
Education, income, and net worth explain more U.S. racial/ethnic health disparities than health behaviors and insurance
Racial/ethnic disparities in knee replacement rates may be partly due to due to differences in preferences for surgery
Oncologists appear to communicate differently with breast cancer patients depending on women's age, race, education, and income
Clinic-based and community-based strategies can promote the use of key preventive services by Latina women

Research Activities, March 2007:
Blacks are more distrustful of equity in the organ donor system and favor providing benefits to donor families
State Children's Health Insurance Programs have improved access to care for previously uninsured children
Dysthymia may contribute to the disparity in use of antiretroviral therapy between men and women

Research Activities, February 2007:
Racial disparities in care vary widely among Medicare health plans and are only weakly correlated with overall quality of care
Little information exists on the willingness of different racial and ethnic groups to participate in genetic research
Proportion of black residents, profit status, and community locale influence the type of care provided at U.S. nursing homes
Japanese and Filipino women are much less likely than white women to undergo breast-conserving therapy for breast cancer
Simultaneous control of risk factors for diabetes complications is difficult to achieve
A protocol for adjusting diabetes medications can improve diabetes management and patient blood-sugar levels
Advance care plans of nursing home residents vary by age, race/ethnicity, and income

Research Activities, January 2007:
Missed opportunities: Too few Americans are being screened or counseled to prevent colorectal cancer, obesity, and other conditions
Black patients tend to ask fewer questions of their doctors and receive less information than other patients
Trust in medical care does not differ by race among indigent people with diabetes, but more trust can improve their quality of life
American Indians and Alaska Natives are difficult to reach by mail for research or health care reasons
African-American physicians were much more likely than white physicians to practice in HMOs in the 1990s
Clinical and social factors predict application for Social Security disability benefits by workers with back injuries

Research Activities, December 2006:
Older American Indians often have a poorer view of their own health than their doctors
Racial differences in religiosity and religious coping styles are linked to use of health care services by low-income older women

Research Activities, November 2006:
Studies examine influence of patient race on primary care quality and hospital discharge against medical advice
Providing free blood glucose monitors to patients with diabetes initially encourages self-management, especially among blacks
Women's self-report of mammography use conflicts with verified reports using claims data

Research Activities, October 2006:
Rural children with special health care needs are more likely than their urban counterparts to lack needed dental care
Elderly patients whose physicians are white or have urban practices are more likely to use antidepressants

Research Activities, September 2006:
Bone protection therapy shifted from estrogen to nonestrogen anti-osteoporosis medicine after publication of the Women's Health Initiative study
Use of stimulant medications to treat attention deficit hyperactivity disorder in children has leveled off since 1997
Nurse-led care improves functioning for patients with heart failure in minority communities

Research Activities, August 2006:
Minority women are nearly twice as likely as white women to not receive needed postoperative treatments for early-stage breast cancer
Twice as many minority children than white children with special health care needs do not receive needed vision care
Primary care physicians often prescribe antiviral medications inappropriately or fail to prescribe them when needed

Research Activities, July 2006:
Blacks and Hispanics receive worse care than whites, yet rate their interactions with health care providers more positively
Treatment of black adults with diabetes and depression insured through Medicaid raises quality concerns
Puerto Rican children are diagnosed with asthma more often than other children
Aggressive Medicaid and SCHIP outreach programs are needed to enroll Latino children
Enrollment in New York's State Children's Health Insurance Program improves asthma care quality and access
Reductions in primary and preventive care use under Medicaid primary care case management are more dramatic for minority children

Research Activities, June 2006:
Limited health care access impairs blood sugar control among low-income urban blacks with type 2 diabetes
Blacks are more likely than whites and Hispanics to die following cardiovascular procedures, despite hospital experience
More data are needed to better identify health care disparities among American Indians and Alaska Natives
Disadvantaged blacks differ from disadvantaged whites in beliefs about genetic testing
Interventions for primary care providers improve management of diabetes
Interventions that improve asthma outcomes in clinical trials may not translate to the practice level
A practice-based research cohort of patients may have advantages over the traditional PBRN model

Research Activities, May 2006
Medicaid may reduce racial/ethnic differences in preventable hospitalizations, but Medicaid managed care adds no extra benefit
Ethnicity, age, and living arrangements affect the use of assistive devices by people with impaired mobility
Parents of children with special health care needs identify multiple barriers to accessing care for their children
Medicaid managed care plans with case management programs may benefit children with disabilities more than fee-for-service plans
AHRQ's health care quality and disparities reports can help nurse leaders make key decisions about quality and patient safety
Researchers examine gender disparities in the quality of preventive care and management of heart disease and diabetes
The recommended dose of intravenous morphine does not control severe acute pain in patients presenting to the emergency department
Disadvantaged groups infected with hepatitis C can be effectively treated when health care providers collaborate

Research Activities, April 2006
Studies examine ways to improve the quality of diabetes care
Black patients are more likely to die after major surgery than white patients
Very low-birthweight babies treated at minority-serving hospitals have higher death rates
Dialysis patients who are black, smoke, or use illicit drugs are more likely to skip treatments
One-fourth of America's non-elderly poor go years without the protection of health insurance

Research Activities, March 2006
Interpreters are an effective communication option for patients with limited English proficiency
Minority children living in public housing are more likely to suffer from chronic health problems
Recruitment of Hawaiians and Filipinos for clinical trials should address informed consent, research safeguards, and benefits
Fewer visits to the doctor contribute to the higher mortality rates among black Medicare patients in Tennessee
Stroke rehabilitation outcomes differ for blacks, whites, and Asian Americans
Colorectal cancer screening rates are low among Latinos and people with little education
Ectopic pregnancy rates in California are declining, but the decline is slower among black women

Research Activities, February 2006:
Changes in the delivery of care are needed to reduce the burden of diabetes among ethnic minorities
Minority adults with asthma in the inner city spend more time in the emergency department and hospital
More Latinos than whites die before age 45 due to higher rates of diabetes, HIV, liver disease, and homicide
Studies suggest that ethnic differences in use of knee replacement surgery are linked to patient expectations and preferences
Low-income Hispanics and blacks use alternative health care as a substitute for conventional care
Clinical setting and physician communication style predict patient participation during medical consultations

Research Activities, January 2006:
Black patients fare worse than white patients after treatment for heart attack or unstable angina
Nearly half of urban American Indians and Alaskan Natives travel back to their reservation to visit during the year
Management of chest pain in patients with hypertension differs in men, women, and ethnic groups

Research Activities, December 2005:
Randomized trial reveals community-based case managers increase public insurance enrollment of uninsured Latino children
Neither patient HMO membership nor physician HMO participation is greatly associated with racial disparities in primary care
Black women are more likely than other women to have pregnancy and childbirth complications
Black women who live in rural areas are less likely than white women to begin mammography screening
Cytokine genotypes may identify pregnant women who are at high risk of developing preeclampsia
Acculturation, length of relationship, and physician ethnicity influence Japanese Americans' trust of doctors

Research Activities, November 2005:
Uterine artery embolization for uterine fibroids is a low-risk procedure
Black and Hispanic patients are more likely to be readmitted to hospitals for complications associated with diabetes
Studies examine rates of morbid obesity and bariatric surgery and risk of death after the surgery
Rural residents lack timely access to trauma centers that could save their lives
Patient preferences for participating in clinical decisionmaking vary by sex, ethnicity, and age

Research Activities, October 2005:
Osteoarthritis impairs recovery from stroke
Knowledge and beliefs about lifestyle changes may contribute to ethnic differences in blood pressure control
Study identifies factors contributing to more surgical complications among black patients
Both maternal and paternal ethnicity affect preeclampsia rates
Black women experience more asthma problems during pregnancy
White patients are more likely than black patients to receive opioids to relieve chronic nonmalignant pain
Study identifies factors contributing to more surgical complications among black patients
Older and minority elderly are less willing to travel to distant hospitals for care
Study explores women's attitudes and barriers to acceptance of an HIV vaccine

Research Activities, September 2005:
Greater access to care at VA clinics lessens disparities in blood pressure control among black men
Ethnically diverse patients define what cultural competence means to them
Acculturation plays a pivotal role in the health status and behaviors of Latinos in the United States
Studies highlight the importance of providing interpreter and translating services for minorities
Patient preference may underlie ethnic variation in knee replacement surgery
Studies of two American Indian tribes reveal different rates of smoking but similarly high rates of life traumas
Black and low-income workers have worse outcomes than other workers after filing compensation claims for low back injuries
Certain sociodemographic, environmental, and clinical factors predict asthma severity in children
U.S. rates of Kawasaki syndrome are highest in Japanese American children living in Hawaii
Certain factors predict chronic pelvic pain after pelvic inflammatory disease
Elderly people commonly use herbs or vitamin-mineral supplements, but use varies by ethnicity

Research Activities, August 2005:
Medical disparities for elderly Medicare beneficiaries are narrowing
Efforts beyond expanding health coverage may be needed to improve access and quality for low-income and minority children
Black and Hispanic mothers are much more likely than white mothers to suffer from early postpartum depression
Traditional values underlie older Korean Americans' preference for informal over formal long-term care arrangements
Differences in education and health status account for virtually all racial/ethnic differences in leisure-time physical activity
Delays and missed opportunities persist in diagnosing patients with unrecognized HIV infection
Study calls for reform of policies that reject candidates for cardiac transplantation due to lack of insurance or finances

Research Activities, July 2005:
More minority and Medicaid-insured children experience perforated appendicitis than other children
Some care disparities among blacks may be due to low technology use in hospitals that treat mostly black patients
Efforts to help physicians improve care for underserved patients should address issues of communication and respect

Research Activities, June 2005:
Herbal use is common among urban primary care patients and often is not disclosed to doctors
Researchers find racial and socioeconomic disparities in compensation for work-related back injuries
Black/white disparities in time to treatment for heart attack patients depend on the admitting hospital
Study reveals racial/ethnic and income-related disparities in use of Web-based health services
Publishing report cards about a surgeon's quality influences consumer selection of surgeons

Research Activities, May 2005:
Blacks and Latinos with hypertension have trouble adhering to recommended diets
Medicaid policies and other local factors may affect disparities in use of diabetes-related health care services
Death rates for cardiovascular disease are higher among American Indians and Alaska Natives than other U.S. groups
Home routines in minority families may impede the healthy development and future school success of their children

Research Activities, April 2005:
Messages about appropriate antibiotic use must be responsive to ethnic differences and literacy issues
Sociodemographic factors affect receipt of preventive care services among women aged 65 and older
Racial/ethnic disparities found in management of patients with high blood pressure
Osteoporosis often goes undiagnosed and untreated in black patients with fragility fractures
Leisure-time exercise, which helps control diabetes, is low among all diabetes patients, particularly black women

Research Activities, March 2005:
Preventing diabetes complications could save $2.5 billion annually
Health plans take action to improve services for members with limited English proficiency
Significant exposure to tobacco smoke and underuse of controller medications exacerbate asthma symptoms among Head Start children
Ethnic differences in willingness to undergo knee replacement may explain disparities in receipt of this procedure
Race appears to be a factor in how doctors communicate with their patients during primary care visits
Minority physicians in Maryland are more likely than white physicians to be denied managed care contracts

Research Activities, February 2005:
Study confirms underuse of lipid-lowering agents by Medicaid-insured minority patients with cardiovascular disease
Differences in coexisting illness do not explain racial/ethnic disparities in inpatient deaths from aspiration pneumonia
Study finds racial disparities in receipt of state-of-the-art care for HIV disease

Research Activities, January 2005:
Disparities in heart disease among British civil servants are not due to cardiac care differences
Controlling diet and physical activity can help obese and overweight children lose weight

Research Activities, December 2004:
Patterns of care and outcomes of pneumonia in children vary substantially by ethnicity and race
Two approaches hold promise for lowering U.S. infant mortality rates, which are particularly high for minority infants
Evidence-based care for depression is clinically effective for minority patients
Researchers compare receipt of health care from public and private providers serving one North Carolina Indian tribe
Mail surveys and telephone interviews can be used to survey Asian Americans with limited English proficiency
Improved health insurance coverage may enhance access to care among rural Hispanic elders

Research Activities, November 2004:
Blacks with diabetes are no more likely to be depressed than other blacks, but those with both problems use more health care
Differences in white and minority patients' satisfaction with care may hinge on satisfaction with physician interaction
Among elderly patients with dementia, blacks and Latinos are more likely than whites to show dementia-related behaviors

Research Activities, October 2004:
Instruments that measure the health status of children need to account for the impact of race, ethnicity, and income on health
Latinos benefit more than whites from psychotherapy-based quality improvement for depression, and they have lower costs for care
CHIRI™ study finds that SCHIP benefits low-income children, and vulnerable children share in the improvements

Research Activities, September 2004:
Decision model can help doctors identify which patients will develop a cough from taking an ACE inhibitor
Racial/ethnic composition of a county can affect residents' access to care

Research Activities, August 2004:
Studies show that obesity affects mammography accuracy and screening rates
Blacks are more likely than others to be admitted to poor quality nursing homes
Quality assurance programs are more likely to be adopted if they are compatible with the culture of the medical group practice
Ethnicity, income, and public financing all influence medical safety net providers in large urban communities
Researchers examine disparities in receipt of preventive care
Immunization rates in New Mexico have fallen significantly since the introduction of Medicaid managed care
Supplemental private insurance affects use of care and outcomes of Medicare patients who have heart attacks

Research Activities, July 2004:
Improved access to medication and therapy for depressed primary care patients improves 5-year outcomes
Higher income and coverage for dental care increase use of dental services among older adults
Inner-city parents often have limited knowledge about managed care rules and practices
Disparities in use of preventive care may be reduced by requiring Medicare HMO enrollees to select a primary care doctor

Research Activities, June 2004:  
Review illuminates women's childbirth preferences following a previous cesarean delivery
Nursing homes generally respect residents' do-not-hospitalize orders, but not always
Poorer outcomes from stroke are more common among minorities than whites
Enhancing Hispanics' access to medications through increased Medicaid eligibility may improve their use of antihypertensives
Many different subgroups make up the Hispanic population, and they have diverse health needs and barriers to care
Patient age has more influence on Medicare costs for end-of-life care than race, income, or sex

Research Activities, May 2004:
Greater severity of peripheral arterial disease among blacks may account for their high rate of amputations
Researchers find New York SCHIP improves health care access, continuity, and quality

Research Activities, April 2004:
Improving depression care has long-lasting benefits for blacks and Hispanics
Racial disparities in use of coronary angiography are due in part to variation in physician referral patterns
Researchers examine racial and ethnic disparities in emergency care
Diagnosis and treatment of depression in the elderly increased in the 1990s, but racial and other disparities persist

Research Activities, March 2004:
EXCEED projects focus on prevention and treatment of cardiovascular disease
Inconsistent use of medications by elderly Mexican Americans with diabetes may explain their greater risk of some complications
Only about half of stroke survivors living in nursing homes receive medicine to prevent another stroke

Research Activities, February 2004:
Attitude toward risk does not fully explain sociodemographic disparities in health care use
Study documents racial variations in the prescribing of opiods by ER doctors
Church attendance may serve as an additional health care safety net for impoverished black communities

Research Activities, January 2004:
Researchers find that black and Hispanic children are much more likely than other children to be overweight
Studies reveal disparities in cardiac care related to race, sex, and socioeconomic status
Disparities in cancer rates among U.S. men may be due in part to differences in occupational exposure to carcinogens
Racial differences exist in parents' opinions about the quality of primary care provided to their children
Studies focus on health care for Mexican Americans
Elderly, low-income black women need more education about the importance of breast cancer screening