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Minority Health Issues and Health Disparities

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (15 July 2019) | Viewed by 75370

Special Issue Editor

Prof. Dr. Monica Webb Hooper

E-Mail Website
Guest Editor
Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
Interests: clinical health psychology; biobehavioral oncology; minority health; cancer health disparities; cancer prevention and control; cancer risk behaviors; health behavior change; tobacco use; obesity/weight management; stress processes

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on minority health and health disparities in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph. 

The study of minority health and disparities is important globally. Multiple “minority” groups across the world face a disproportionate incidence and undue burden of health conditions that lead to disability, low quality of life, and mortality. By definition, minority groups are smaller in proportion to the dominant social group and are assigned based on categorical characteristics, such as sex, race/ethnicity, disability, religion, sexual orientation, gender identity, geography, and citizenship status. These groups tend to experience social and health-related disadvantages relative to the dominant group, which may be exacerbated by membership in multiple minority groups (i.e., intersectionality). The definition of “health disparities” differs across institutions. The National Institutes of Health (NIH) defines health disparities as significant differences between populations. In contrast, the definitions offered by the World Health Organization (WHO), the U.S. Department of Health and Human Services, and Healthy People 2020 recognize that health disparities are closely linked with environmental, economic, and social disadvantage.

Multidisciplinary researchers, practitioners, health systems, and policy makers have focused on improving minority health and reducing health (and healthcare) disparities for decades. Given the complexity and persistence of minority health concerns and health disparities, however, continued research is needed to make significant advances toward the aspirational goal of the highest level of health for all. Such work has the potential to inform the development of multi-level strategies for improving population and global health.

This Special Issue is open to the subject area of minority health and health disparities. The keywords listed below highlight of some of the possible areas of interest.

Prof. Dr. Monica Webb Hooper
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Minority health
  • Health disparities
  • Etiology
  • Social determinants of health
  • Environmental determinants of health
  • Behavioral determinants of health
  • Access to care
  • Barriers to care
  • Policy
  • Healthcare costs
  • Discrimination
  • Mental health
  • Socioeconomic status
  • Stress processes
  • Gene–environment interaction
  • Prevention
  • Risk and protective factors
  • Treatment
  • Interventions
  • Epidemiology
  • Multi-morbidity
  • Chronic illness
  • Infant mortality and maternal health
  • Smart and connected communities
  • Systems science
  • Individual risk factors
  • Early life adversity
  • Lifespan
  • Geospatial analysis
  • Health system level factors
  • Community engaged research

Published Papers (16 papers)

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19 pages, 350 KiB  
Article
Pre- and Post-Immigration Correlates of Alcohol Misuse among Young Adult Recent Latino Immigrants: An Ecodevelopmental Approach
by Eli Levitt, Bar Ainuz, Austin Pourmoussa, Juan Acuna, Mario De La Rosa, Juan Zevallos, Weize Wang, Pura Rodriguez, Grettel Castro and Mariana Sanchez
Int. J. Environ. Res. Public Health 2019, 16(22), 4391; https://doi.org/10.3390/ijerph16224391 - 10 Nov 2019
Cited by 14 | Viewed by 4367
Abstract
Latinos in the United States experience numerous alcohol-related health disparities. There is accumulating evidence that pre-immigration factors are associated with post-immigration alcohol use, but the explanation for health disparities remains unclear. The present study is a secondary analysis of data from the Recent [...] Read more.
Latinos in the United States experience numerous alcohol-related health disparities. There is accumulating evidence that pre-immigration factors are associated with post-immigration alcohol use, but the explanation for health disparities remains unclear. The present study is a secondary analysis of data from the Recent Latino Immigrant Study (RLIS), the first community-based cohort study to examine the pre- to post-immigration alcohol use trajectories of young adult Latino immigrants during their initial years in the United States. Exploratory analysis and hierarchical multiple logistic regression were performed to assess associations between various pre- and post-immigration factors and alcohol misuse among young adult Latino immigrants early in the immigration process. Using an ecodevelopmental approach, we examined potential social and environmental determinants across multiple levels of influence associated with post-immigration alcohol misuse in this population. The study sample consisted of 474 young adult Latino immigrants between the ages of 18–34. The sample was comprised of the following national/regional origins: Cuban (43%), South American (28.7%), and Central American (28.3%). Approximately half of the sample (49.6%) reported a family history of substance use problems (FHSUP+). Participants who reported FHSUP+ and who engaged in alcohol misuse prior to immigrating to the US were more likely to engage in post-immigration alcohol misuse. Results revealed various social and environmental factors associated with pre-immigration alcohol misuse in this population. Study findings can inform culturally tailored prevention interventions aimed at mitigating problem drinking behaviors among young adult recent Latino immigrants. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
9 pages, 286 KiB  
Article
Factors Associated with General Health Screening Participation among Married Immigrant Women in Korea
by Jinhee Jeong, Yunhee Lee, Sung Hee Kwon and Jun-Pyo Myong
Int. J. Environ. Res. Public Health 2019, 16(20), 3971; https://doi.org/10.3390/ijerph16203971 - 18 Oct 2019
Cited by 3 | Viewed by 2226
Abstract
Background: The number of married female immigrants living in Korea has been increasing and is expected to increase further. This study was performed to identify factors associated with national general health screening participation among married immigrant women living in South Korea. Methods [...] Read more.
Background: The number of married female immigrants living in Korea has been increasing and is expected to increase further. This study was performed to identify factors associated with national general health screening participation among married immigrant women living in South Korea. Methods: The Korean National Health Insurance System’s (NHIS) customized database for the years 2014 and 2015 was used. The targets of this study were women aged 19 years old and above. To identify factors associated with national general health screening participation, the following analyses were employed: frequency, chi-square, simple regression, and multiple regression. Results: A total of 11,213 women were identified in the NHIS database. Overall, 67.4% participated in national general health screenings, lower than the 74.6% participation rate of the entire women’s health screening program. Married immigrant women with a job had higher health screening participation than those without a job (OR = 2.822, p < 0.0001). Age, socioeconomic status, and duration of stay were related to health screening behaviors among employed married immigrant women. Nationality, socioeconomic status, duration of stay, and disease status were associated with general health screening behaviors among unemployed immigrant women. The odds ratios decreased as the length of stay increased, regardless of employment status. Conclusion: The results of this study showed that employment status and duration of stay in Korea are significantly associated with general health screening participation. Accordingly, to improve awareness about health screening and health care disparities, programs promoting health screening participation for socially vulnerable classes, including immigrant women and unemployed women, should be instigated. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
12 pages, 302 KiB  
Article
Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia
by Abbey Diaz, Brenda Vo, Peter D. Baade, Veronica Matthews, Barbara Nattabi, Jodie Bailie, Lisa J. Whop, Ross Bailie and Gail Garvey
Int. J. Environ. Res. Public Health 2019, 16(19), 3630; https://doi.org/10.3390/ijerph16193630 - 27 Sep 2019
Cited by 6 | Viewed by 3488
Abstract
Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level [...] Read more.
Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level factors associated with between-centre variation in screening coverage. We analysed 3801 clinical audit records for PHC clients aged 20–64 years from 135 Indigenous PHC centres participating in the Audit for Best Practice in Chronic Disease (ABCD) continuous quality improvement (CQI) program across five Australian states/territories during 2005 to 2014. Multilevel logistic regression models were used to identify service-level factors associated with screening, while accounting for differences in client-level factors. There was substantial variation in the proportion of clients who had a documented cervical screen in the previous two years across the participating PHC centres (median 50%, interquartile range (IQR): 29–67%), persisting over years and audit cycle. Centre-level factors explained 40% of the variation; client-level factors did not reduce the between-centre variation. Screening coverage was associated with longer time enrolled in the CQI program and very remote location. Indigenous PHC centres play an important role in providing cervical screening to Aboriginal and Torres Strait Islander women. Thus, their leadership is essential to ensure that Australia’s public health commitment to the elimination of cervical cancer includes Aboriginal and Torres Strait Islander women. A sustained commitment to CQI may improve PHC centres delivery of cervical screening; however, factors that may impact on service delivery, such as organisational, geographical and environmental factors, warrant further investigation. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
16 pages, 323 KiB  
Article
Understanding Multilevel Factors Related to Urban Community Trust in Healthcare and Research
by Monica Webb Hooper, Charlene Mitchell, Vanessa J. Marshall, Chesley Cheatham, Kristina Austin, Kimberly Sanders, Smitha Krishnamurthi and Lena L. Grafton
Int. J. Environ. Res. Public Health 2019, 16(18), 3280; https://doi.org/10.3390/ijerph16183280 - 06 Sep 2019
Cited by 50 | Viewed by 6686
Abstract
Background: Community and patient engagement in the healthcare system and biomedical research are prerequisites for eliminating health disparities. We conducted a “listening tour” to enhance our understanding of multilevel factors associated with community trust. Methods: Using community-based participatory research (CBPR) methods, we conducted [...] Read more.
Background: Community and patient engagement in the healthcare system and biomedical research are prerequisites for eliminating health disparities. We conducted a “listening tour” to enhance our understanding of multilevel factors associated with community trust. Methods: Using community-based participatory research (CBPR) methods, we conducted a phenomenological qualitative study. “Town-hall” style discussions were held at nine sites across an urban, Midwestern city. We recruited adults (N = 130) via community networks, social media, flyers, and word-of-mouth. Demographic assessments were self-administered and listening tour sessions were conducted by trained moderators. Themes were framed within the social ecological model (SEM; intrapersonal, interpersonal, institutional, community, and policy levels). Results: Participants were mostly female (68%), African American (80%), had health coverage (97%) and were diagnosed with a chronic health condition (71%). The overarching theme was sociodemographic differences in distrust, such that African Americans and deaf/hearing impaired participants perceived disparities in healthcare, a lower quality of care, and skepticism about biomedical research, relative to Whites. Conclusions: The depth of distrust for healthcare providers, systems, and researchers in underserved communities remains strong and complex. Findings highlight the need to understand the lived experiences of community members, and how distrust is maintained. Multilevel interventions to increase trust and the accrual of underrepresented populations into clinical trials are needed. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
12 pages, 709 KiB  
Article
Racial/Ethnic Differences in Physiological Stress and Relapse among Treatment Seeking Tobacco Smokers
by Monica Webb Hooper
Int. J. Environ. Res. Public Health 2019, 16(17), 3090; https://doi.org/10.3390/ijerph16173090 - 25 Aug 2019
Cited by 8 | Viewed by 2786
Abstract
Stress is robustly associated with tobacco smoking and relapse. African Americans experience greater difficulty quitting compared to whites, yet no studies have examined race differences in physiological stress biomarkers during a quit attempt. This pilot study compared cortisol levels among treatment-seeking African American [...] Read more.
Stress is robustly associated with tobacco smoking and relapse. African Americans experience greater difficulty quitting compared to whites, yet no studies have examined race differences in physiological stress biomarkers during a quit attempt. This pilot study compared cortisol levels among treatment-seeking African American and white smokers, and relapse rates. Adult smokers (N = 115; n = 72 African American, n = 43 White) received eight sessions of group cognitive behavioral therapy plus transdermal nicotine patches. Assessments included demographics, salivary cortisol (collected at session 1, the end-of-therapy [EOT], and one-month post-therapy), and carbon monoxide-verified smoking relapse. Overall, cortisol levels declined over the course of the day at baseline, the EOT, and the one-month follow-up. African Americans exhibited lower cortisol levels compared to Whites at baseline and the EOT, but not at the one-month follow-up. In addition, African American smokers exhibited flatter slopes compared to Whites at each time point. Relapse rates were greater among African Americans at the EOT and one-month follow-up. The attenuated cortisol pattern observed in African Americans may indicate hypothalamic-pituitary-adrenal axis (HPA) exhaustion and aid our understanding of tobacco-related disparities. There is a need to focus on stress mechanisms and specific intervention approaches in order to eliminate racial/ethnic differences. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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18 pages, 329 KiB  
Article
The Evaluation of IDEAL-REACH Program to Improve Nutrition among Asian American Community Members in the Philadelphia Metropolitan Area
by Grace X. Ma, Lin Zhu, Steven E. Shive, Guo Zhang, Yvette R. Senter, Pablo Topete, Brenda Seals, Shumenghui Zhai, MinQi Wang and Yin Tan
Int. J. Environ. Res. Public Health 2019, 16(17), 3054; https://doi.org/10.3390/ijerph16173054 - 23 Aug 2019
Cited by 5 | Viewed by 3286
Abstract
Objective Asian Americans’ food purchasing, cooking, and eating patterns are not well understood. Greater insight into these behaviors is urgently needed to guide public health interventions of dietary behaviors in this population. The present study aims to examine the effects of a community-level [...] Read more.
Objective Asian Americans’ food purchasing, cooking, and eating patterns are not well understood. Greater insight into these behaviors is urgently needed to guide public health interventions of dietary behaviors in this population. The present study aims to examine the effects of a community-level intervention on food purchasing and preparation, nutrition knowledge, and health awareness in Asian Americans. Methods From 2015 to 2017, we conducted the Improving Diets with an Ecological Approach for Lifestyle (IDEAL-REACH) intervention to increase access to healthy food or beverage options for the Asian-American population in the Philadelphia metropolitan area. Participants (1110 at pre- and 1098 at post-assessment) were recruited from 31 community-based organizations (CBOs). We assessed Asian Americans’ dietary behaviors, nutrition knowledge, and awareness of heart health. Results The results of pre-post intervention comparisons showed that the IDEAL-REACH intervention was successful in promoting whole grains consumption, reducing sodium consumption, and raising knowledge and awareness related to nutrition and heart health. Conclusions To our knowledge, this is one of the first initiatives in the U.S. to engage CBOs to promote healthier dietary behaviors. The findings show that CBOs serve as a powerful platform for community-level interventions to improve healthy nutrition behaviors in Asian-American communities. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
12 pages, 592 KiB  
Article
Postpartum Tobacco Use and Perceived Stress among Alaska Native Women: MAW Phase 4 Study
by Christi A. Patten, Kathryn R. Koller, Christie A. Flanagan, Vanessa Hiratsuka, Zoe T. Merritt, Flora Sapp, Crystal D. Meade, Christine A. Hughes, Paul A. Decker, Neil Murphy and Timothy K. Thomas
Int. J. Environ. Res. Public Health 2019, 16(17), 3024; https://doi.org/10.3390/ijerph16173024 - 21 Aug 2019
Cited by 3 | Viewed by 2301
Abstract
Prior research explored reasons for tobacco use among pregnant Alaska Native (AN) women but did not address the postpartum period. This study followed up with AN women one to three years postpartum who had participated in a prenatal smoking cessation intervention study (Motivate [...] Read more.
Prior research explored reasons for tobacco use among pregnant Alaska Native (AN) women but did not address the postpartum period. This study followed up with AN women one to three years postpartum who had participated in a prenatal smoking cessation intervention study (Motivate Alaska Women (MAW) Phase 3) and had consented to be re-contacted for future studies. Of 47 eligible women, 32 (68%) participated. A semi-structured phone interview was conducted a mean of 2.0 years after delivery (range 1.6–2.8). Measures assessed self-reported tobacco use status in the 12 months after delivery, at 12 months postpartum, and at the time of the interview; reasons for maintaining abstinence, continued use, or relapse; and included the Perceived Stress Scale (PSS) and Negative Affect (NA) scale. Content analysis was used to generate themes from open-ended response items. Tobacco use was reported by 23 women (72%) at delivery, 30 (94%) within the 12 months after delivery, 27 (84%) at 12 months postpartum, and 29 (91%) at the time of the interview. Among nine women not using tobacco at delivery, seven (78%) relapsed during the 12 months after delivery. Of the 29 current tobacco users, 28 (97%) smoked cigarettes. Twenty-seven participants (84%) reported stress and 15 (52%) indicated addiction as reasons for continuing, starting, or resuming tobacco use. Types of stressors were related to parenting and traumatic experiences. Among current tobacco users, mean NA score (18.7) was significantly higher (p = 0.01) than the normative mean (14.8), but no differences were detected for PSS score. In this sample of AN women, postpartum tobacco use was highly prevalent, and stress was a primary reason that women endorsed for using tobacco. These preliminary results have several practice and research implications for exploring ways to support non-tobacco use among postpartum AN women. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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15 pages, 313 KiB  
Article
Understanding the Chinese Hui Ethnic Minority’s Information Seeking on Cardiovascular Diseases: A Focus Group Study
by Lei Yang, Yuping Mao and Jeroen Jansz
Int. J. Environ. Res. Public Health 2019, 16(15), 2784; https://doi.org/10.3390/ijerph16152784 - 04 Aug 2019
Cited by 8 | Viewed by 4271
Abstract
The Chinese Hui ethnic minority group is an Islamic minority. The Hui people comprise the third largest minority population in China and are widely distributed throughout the country. Previous research shows that the Hui had a higher prevalence of cardiovascular risk factors (CVRFs) [...] Read more.
The Chinese Hui ethnic minority group is an Islamic minority. The Hui people comprise the third largest minority population in China and are widely distributed throughout the country. Previous research shows that the Hui had a higher prevalence of cardiovascular risk factors (CVRFs) than most other ethnic groups. Therefore, the availability of health information relating to these factors is especially important for the Hui minority’s preventive healthcare. They do, however, experience difficulties in obtaining health-related information. The current research aims to identify the needs of the Hui people on where and how they obtain cardiovascular disease (CVD) related information from the media and other sources. Six focus groups were conducted in Shenyang City. The results revealed that the participants relied on different sources to get advice about CVDs, of which the internet and television were the most prominent ones. The participants expressed a desire for credible and professional information from different sources and asked for mediated health communication programs specifically targeted at the Hui. In addition, the participants felt ignored by the Chinese mainstream media at large, which created barriers for them to get health information. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
15 pages, 1123 KiB  
Article
Decomposing Income-Related Inequalities in Self-Reported Depression and Self-Rated Health Among Married Immigrants in South Korea
by Jihyung Hong and Jaehee Lee
Int. J. Environ. Res. Public Health 2019, 16(10), 1869; https://doi.org/10.3390/ijerph16101869 - 27 May 2019
Cited by 5 | Viewed by 3204
Abstract
Health inequalities among immigrant minorities have been under-researched in South Korea. This study, therefore, measured the extent of income-related inequalities in self-reported depression and self-rated health (SRH) among married immigrants in South Korea and decomposed them into sociodemographic determinants using data from the [...] Read more.
Health inequalities among immigrant minorities have been under-researched in South Korea. This study, therefore, measured the extent of income-related inequalities in self-reported depression and self-rated health (SRH) among married immigrants in South Korea and decomposed them into sociodemographic determinants using data from the 2015 National Survey of Multicultural Families (n = 15,231). The mean age of this sample was 37.8 years (SD = 10.8) and the mean duration of residence was 10.1 years (SD = 7.4). Eighty-five percent were female, and of these, 86.5% were from low/middle-income countries. Of these married immigrants, 34.6% reported experiences of depressive symptoms in the past year, and 9.5% reported their current health to be poor or very poor (weighted). The results also indicated substantial pro-rich health inequalities with the Erreygers concentration index of −0.1298 for self-reported depression and that of −0.1231 for poor SRH. Socioeconomic positions, reflected in income, subjective social status, and employment status, alongside satisfaction with a spouse, appeared to have much greater contributions to the overall inequality than demographics and type of migration. These findings suggest that social welfare policies and programmes can play important roles in reducing health inequalities that are ‘avoidable and unnecessary’ among married immigrants in South Korea. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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12 pages, 314 KiB  
Article
Use of the Phase-Based Model of Smoking Treatment to Guide Intervention Development for Persons Living with HIV Who Self-Identify as African American Tobacco Smokers
by Rebecca Schnall, Jasmine Carcamo, Tiffany Porras, Ming-Chun Huang and Monica Webb Hooper
Int. J. Environ. Res. Public Health 2019, 16(10), 1703; https://doi.org/10.3390/ijerph16101703 - 15 May 2019
Cited by 3 | Viewed by 2463
Abstract
Cigarette smoking is highly prevalent among persons living with the human immunodeficiency virus (HIV) (PLWH), with rates as high 50% as compared to 14% in the general U.S. population. Tobacco use causes morbidity and mortality in PLWH, and tobacco-related harm is substantially higher [...] Read more.
Cigarette smoking is highly prevalent among persons living with the human immunodeficiency virus (HIV) (PLWH), with rates as high 50% as compared to 14% in the general U.S. population. Tobacco use causes morbidity and mortality in PLWH, and tobacco-related harm is substantially higher in PLWH than smokers in the general population, providing the scientific premise for developing effective tobacco cessation interventions in this population. To better address this issue, we conducted six focus group sessions with 45 African American smokers who are living with HIV to understand the barriers to smoking cessation and the strategies that would be helpful to overcome these barriers. We organized our findings by the Phase-Based Model of Smoking Treatment to understand the intervention components that are needed at each phase to help PLWH successfully quit smoking. Participants in our focus group sessions articulated key components for incorporation into tobacco cessation intervention for PLWH: a personalized plan for quitting, reminders about that plan, and a support system. Participants thought that their HIV and tobacco use were disassociated. Participants described barriers to the use of pharmacotherapy, including adverse side effects of the gum and patch and concerns about the negative health effects of some oral medications. Substance use was identified as a commonly co-occurring condition as well as a barrier to successfully ceasing to smoke tobacco products. In summary, these findings offer information on the components of a tobacco cessation intervention for PLWH, namely reminders, a support system, substance use treatment, and monitoring to prevent relapse. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
13 pages, 679 KiB  
Article
Impact of a Culturally Tailored mHealth Medication Regimen Self-Management Program upon Blood Pressure among Hypertensive Hispanic Adults
by Jessica Chandler, Luke Sox, Kinsey Kellam, Lauren Feder, Lynne Nemeth and Frank Treiber
Int. J. Environ. Res. Public Health 2019, 16(7), 1226; https://doi.org/10.3390/ijerph16071226 - 06 Apr 2019
Cited by 64 | Viewed by 7446
Abstract
Background: Uncontrolled hypertension (HTN) and medication nonadherence are more prominent among Hispanics compared to non-Hispanic whites and African Americans. Advances in wireless health technology enable real-time monitoring of medication adherence (MA) and blood pressure (BP), facilitating timely patient–provider communication including tailored reinforcement/motivational feedback [...] Read more.
Background: Uncontrolled hypertension (HTN) and medication nonadherence are more prominent among Hispanics compared to non-Hispanic whites and African Americans. Advances in wireless health technology enable real-time monitoring of medication adherence (MA) and blood pressure (BP), facilitating timely patient–provider communication including tailored reinforcement/motivational feedback to patients and quicker titration changes by providers. The purpose of the current study was to conduct a 9-month smartphone-enabled efficacy trial addressing MA and BP control among Hispanic adults with uncontrolled HTN and poor MA. Methods: The research design was a 9-month, two-arm efficacy trial including an experimental (Smartphone Med Adherence Stops Hypertension, SMASH) group and an enhanced standard care (ESC) group. SMASH participants utilized a SMASH app which interfaced with a Bluetooth-enabled BP monitor for BP self-monitoring and an electronic medication tray. The ESC participants received text messages including links to PDFs and brief video clips containing healthy lifestyle tips for attention control. Results: Participants were 54 Hispanic adults (mean age: 46.5 years) with uncontrolled HTN. They were randomly assigned to either the SMASH (n = 26) or ESC group (n = 28). At baseline, no participants had controlled systolic BP (SBP). Baseline group averages for SBP between the SC and SMASH groups did not differ (150.7 and 152.3 mmHg, respectively; p = 0.53). At the 1, 3, 6, and 9-month time points, SBP averages were significantly lower in the SMASH versus SC groups (month 1: 125.3 vs. 140.6; month 3: 120.4 vs. 137.5, month 6: 121.2 vs. 145.7 mmHg; month 9: 121.8 vs. 145.7, respectively; all p-values <0.01). At months 3, 6, and 9 there was a significant difference between the percentage of participants meeting the 7th Joint National Committee cutoffs for SBP control in the SC and SMASH groups (month 3: 62.5 vs. 92.0%; month 6: 57.9 and 94.4%, month 9: 27.8 and 92.3%, respectively; all p-values ≤0.01). Average medical regimen adherence, as indicated by timestamped medication intake and BP monitoring for the SMASH group, ranged from 89.1 to 95.2% across the 9-month trial. Conclusion: Our findings indicate that our culturally tailored smartphone-enabled medical regimen self-management program may be an effective solution for the promotion of MA, resulting in statistically and clinically significant reductions in SBP among Hispanic adults with uncontrolled HTN. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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16 pages, 551 KiB  
Article
Cigarette Smoking among Economically Disadvantaged African-American Older Adults in South Los Angeles: Gender Differences
by Shervin Assari, James L. Smith, Marc A. Zimmerman and Mohsen Bazargan
Int. J. Environ. Res. Public Health 2019, 16(7), 1208; https://doi.org/10.3390/ijerph16071208 - 04 Apr 2019
Cited by 20 | Viewed by 3739
Abstract
The current study aims to explore gender differences in the risk of cigarette smoking among African-American (AA) older adults who live in economically disadvantaged urban areas of southern Los Angeles. This cross-sectional study enrolled 576 older AA adults (age range between 65 and [...] Read more.
The current study aims to explore gender differences in the risk of cigarette smoking among African-American (AA) older adults who live in economically disadvantaged urban areas of southern Los Angeles. This cross-sectional study enrolled 576 older AA adults (age range between 65 and 96 years) who were residing in Service Planning Area 6 (SPA 6), one of the most economically challenged areas in southern Los Angeles. All participants had cardiometabolic disease (CMD). Data were collected using structured face-to-face interviews. Demographic factors (age and gender), socioeconomic status (educational attainment and financial difficulty), health (number of comorbid medical conditions and depressive symptoms), and health behaviors (current alcohol drinking and current smoking) were measured. Logistic regressions were used to analyze the data without and with interaction terms between gender and current drinking, depressive symptoms, and financial difficulty. AA men reported more smoking than AA women (25.3% versus 9.3%; p < 0.05). Drinking showed a stronger association with smoking for AA men than AA women. Depressive symptoms, however, showed stronger effects on smoking for AA women than AA men. Gender did not interact with financial difficulty with regard to current smoking. As AA older men and women differ in psychological and behavioral determinants of cigarette smoking, gender-specific smoking cessation interventions for AA older adults who live in economically deprived urban areas may be more successful than interventions and programs that do not consider gender differences in determinants of smoking. Gender-tailored smoking cessation programs that address drinking for AA men and depression for AA women may help reduce the burden of smoking in AA older adults in economically disadvantaged urban areas. Given the non-random sampling, there is a need for replication of these findings in future studies. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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16 pages, 5433 KiB  
Article
Education Policy for Migrant Children in Thailand and How It Really Happens; A Case Study of Ranong Province, Thailand
by Titiporn Tuangratananon, Rapeepong Suphanchaimat, Sataporn Julchoo, Pigunkaew Sinam and Weerasak Putthasri
Int. J. Environ. Res. Public Health 2019, 16(3), 430; https://doi.org/10.3390/ijerph16030430 - 01 Feb 2019
Cited by 12 | Viewed by 5815
Abstract
Health and education are interrelated, and it is for this reason that we studied the education of migrant children. The Thai Government has ratified ‘rights’ to education for all children in Thailand since 2005. However, there are gaps in knowledge concerning the implementation [...] Read more.
Health and education are interrelated, and it is for this reason that we studied the education of migrant children. The Thai Government has ratified ‘rights’ to education for all children in Thailand since 2005. However, there are gaps in knowledge concerning the implementation of education policy for migrants, such as whether and to what extent migrant children receive education services according to policy intentions. The objective of this study is to explore the implementation of education policy for migrants and the factors that determine education choices among them. A cross-sectional qualitative design was applied. The main data collection technique was in-depth interviews with 34 key informants. Thematic analysis with an intersectionality approach was used. Ranong province was selected as the main study site. Results found that Migrant Learning Centers (MLCs) were the preferable choice for most migrant children instead of Thai Public Schools (TPSs), even though MLCs were not recognized as formal education sites. The main reason for choosing MLCs was because MLCs provided a more culturally sensitive service. Teaching in MLCs was done in Myanmar’s language and the MLCs offer a better chance to pursue higher education in Myanmar if migrants migrate back to their homeland. However, MLCs still face budget and human resources inadequacies. School health promotion was underserviced in MLCs compared to TPSs. Dental service was underserviced in most MLCs and TPSs. Implicit discrimination against migrant children was noted. The Thai Government should view MLCs as allies in expanding education coverage to all children in the Thai territory. A participatory public policy process that engages all stakeholders, including education officials, health care providers, Non-Governmental Organizations (NGOs), MLCs’ representatives, and migrants themselves is needed to improve the education standards of MLCs, keeping their culturally-sensitive strengths. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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Review

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14 pages, 766 KiB  
Review
Beyond Binary: (Re)Defining “Gender” for 21st Century Disaster Risk Reduction Research, Policy, and Practice
by Ashleigh Rushton, Lesley Gray, Justin Canty and Kevin Blanchard
Int. J. Environ. Res. Public Health 2019, 16(20), 3984; https://doi.org/10.3390/ijerph16203984 - 18 Oct 2019
Cited by 40 | Viewed by 10613
Abstract
The dominant discourse of gender focuses on the binary of woman/man, despite the known additional risks for diverse sexualities and gender minorities in disasters. Given the small but growing body of literature concerning gender minorities in disasters, this paper sets out to explore [...] Read more.
The dominant discourse of gender focuses on the binary of woman/man, despite the known additional risks for diverse sexualities and gender minorities in disasters. Given the small but growing body of literature concerning gender minorities in disasters, this paper sets out to explore the place of sex and gender minorities in disasters and to examine whether a binary definition needs to be extended. A five-stage rapid review was undertaken following Arksey and O’Malley’s method. Peer-reviewed journal articles in English language were sought that included disaster and gender terms in the title, abstract, and/or body of the article published between January 2015 and March 2019. The search included MEDLINE and Scopus databases. Relevant information from the studies were charted in Microsoft Excel, and results were summarized using a descriptive analytical method. In total, 729 records were identified; 248 that did not meet the inclusion criteria were excluded and 166 duplicates were removed. A total of 315 records were sourced and their full text was reviewed. Of those, only 12 journal articles included content relative to more than two genders. We also recognized that sex and gender terms were used interchangeably with no clear differentiation between the two. We recommend that disaster scholars and practitioners adopt correct terminology and expand their definition of gender beyond the binary; utilize work on gender fluidity and diversity; and apply this to disaster research, policy, and practice. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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17 pages, 562 KiB  
Review
Narrative Review: The (Mental) Health Consequences of the Northern Iraq Offensive of ISIS in 2014 for Female Yezidis
by Pia Jäger, Claudia Rammelt, Notburga Ott and Angela Brand
Int. J. Environ. Res. Public Health 2019, 16(13), 2435; https://doi.org/10.3390/ijerph16132435 - 09 Jul 2019
Cited by 9 | Viewed by 4992
Abstract
The Yezidis who represent a religious minority living in Northern Iraq were particularly affected by the persecution by ISIS (Islamic state of Iraq and Syria, syn.: ISIL—Islamic state of Iraq and the Levant) that gained power after 2013. This paper gives an overview [...] Read more.
The Yezidis who represent a religious minority living in Northern Iraq were particularly affected by the persecution by ISIS (Islamic state of Iraq and Syria, syn.: ISIL—Islamic state of Iraq and the Levant) that gained power after 2013. This paper gives an overview of the events and the mental health consequences on the Yezidi community as well as associated influences on affected female Yezidis. Based on a systematic literature search, the aspects of “Persecution by ISIS and actual situation of the Yezidi community”, “Gender-specific aspects of the persecution and its consequences”, “Mental health of the affected women”, and “Cultural–historical and religious context” are worked out. Research indicates a high burden of health strain and mental health problems in the surviving Yezidi women, especially post-traumatic stress disorders (PTSD) and depression. Concerning transgenerational trauma, the recent genocide has revived past experiences in the history of the community. Like the narrow cultural and religious rules of the community, this can be both a resource and a burden. The actual extent of the attacks is neither predictable for the affected individuals nor for the community, consequences could also be passed onto descendants. Long-term care and support of the affected persons, their descendants, and the Yezidi community seems indispensable. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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17 pages, 600 KiB  
Review
What Works? Prevention and Control of Sexually Transmitted Infections and Blood-Borne Viruses in Migrants from Sub-Saharan Africa, Northeast Asia and Southeast Asia Living in High-Income Countries: A Systematic Review
by Sajana Ghimire, Jonathan Hallett, Corie Gray, Roanna Lobo and Gemma Crawford
Int. J. Environ. Res. Public Health 2019, 16(7), 1287; https://doi.org/10.3390/ijerph16071287 - 10 Apr 2019
Cited by 16 | Viewed by 5905
Abstract
Migration is a significant risk factor for the acquisition of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and other sexually transmitted infections (STIs). An increasing proportion of these infections in high-income countries, such as Australia, are among migrants moving from low and [...] Read more.
Migration is a significant risk factor for the acquisition of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and other sexually transmitted infections (STIs). An increasing proportion of these infections in high-income countries, such as Australia, are among migrants moving from low and middle-income countries with a high prevalence of HIV, HBV and other STIs. This systematic review explored the prevention and control of HIV, HBV and other STIs in migrants (>18 years) from Southeast Asia, Northeast Asia and sub-Saharan Africa living in high-income countries with universal health care. This systematic review followed PRISMA guidelines and was registered with PROSPERO. Six academic databases were searched for articles published between 2002 and 2018. Sixteen peer-reviewed articles met the inclusion criteria, consisting of fourteen quantitative and two qualitative studies conducted in Australia, the Netherlands, Canada, Spain, Italy, and Germany. Three levels of interventions were identified: individual, community and structural interventions. Most studies addressed factors at an individual level; interventions were most commonly outreach testing for HIV, HBV and other STIs. Few studies addressed structural factors or demonstrated comprehensive evaluation of interventions. Limited population-specific findings could be determined. To prevent further transmission of HIV, HBV and other STIs, comprehensive public health approaches must consider the complex interactions between migration, health care system determinants, and broader socioeconomic and sociocultural factors. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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