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Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches

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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 (31 May 2017) | Viewed by 72295

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Prof. Dr. Marinelle Payton

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Department of Epidemiology and Biostatistics, Center of Excellence in Minority Health and Health Disparities, Institute of Epidemiology and Health Services Research School of Public Health Jackson State University, USA

Prof. Dr. Felix A. Okojie

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Center of Excellence in Minority Health and Health Disparities, Institute of Epidemiology and Health Services Research Jackson State University

Special Issue Information

Dear Colleagues,

The Jackson State University Center of Excellence in Minority Health and Health Disparities (CEMHD), Institute of Epidemiology and Health Services Research, School of Public Health Initiative invites submission of papers from former presenters of our Annual Eliminating Health Disparities Conference, as well as other researchers in the field of health disparities. The mission of the CEMHD is to address and eliminate health disparities through multidisciplinary approaches including research, community engagement and outreach, and research training and education.

This Special Issue aims to highlight the latest multidisciplinary and innovative research, tools, methods and approaches to assess, reduce and prevent health disparities, addressing health inequalities affecting minorities through innovative programs in 1) community outreach and information sharing; 2) health disparities research; 3) education; and 4) career development training. Our aim is to advance health disparity research and help accelerate efforts designed to eliminate health disparities for vulnerable and historically underserved populations.

Please go to www.ijerph.com to register and submit your manuscript by 21 December 2016. With this submission, the CEMHD will pay for each accepted paper.

Marinelle Payton, MD, PhD, MS, MPH

Chair and Professor, Department of Epidemiology and Biostatistics
Principal Investigator and Director, Center of Excellence in Minority Health and Health Disparities/Institute of Epidemiology and Health Services Research
Principal Investigator and Director, Jackson Heart Study Graduate Training and Education Center
School of Public Health
Jackson State University

Felix A. Okojie, EdD, MA, MPH, CRA

Professor of Public Health and Education
Research Core Director, Center of Excellence in Minority Health and Health Disparities, Institute of Epidemiology and Health Services Research
Jackson State University

Guest Editors

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

health disparities
social determinants of health
public health
inequality

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Published Papers (11 papers)

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Research

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286 KiB

Open AccessArticle

Factors Affecting Dietary Practices in a Mississippi African American Community

by Monique White, Clifton Addison, Brenda W. Campbell Jenkins, Frances Henderson, Dorothy McGill, Marinelle Payton and Donna Antoine‐LaVigne

Int. J. Environ. Res. Public Health 2017, 14(7), 718; https://doi.org/10.3390/ijerph14070718 - 3 Jul 2017

Cited by 9 | Viewed by 5646

Abstract

This study examined the practices, personal motivation, and barriers of African American communities in Mississippi regarding their dietary practices. We selected the Metro Jackson Area comprised of Hinds, Madison and Rankin Counties because it is a combination of urban and rural communities. The sample consisted of 70 participants from seven sites. A total of seven focus groups responded to six questions to assess practices, personal motivation, and barriers to dietary practices: (1) Where in your community can you access fresh fruits and vegetables? (2) How many meals a day should a person eat? (3) What would you consider to be a healthy breakfast, lunch and dinner? (4) What would you consider to be a healthy snack? (5) What do you consider to be your motivations for eating healthy? (6) What do you consider to be your barriers to eating healthy? Each of the seven focus groups consisted of 6 to 12 participants and provided details of their dietary practices. The focus group interviews were digitally‐recorded. The recorded interviews were transcribed. The majority of the participants stated that there is a limited availability of fresh fruits/vegetables in rural areas because of a shortage of grocery stores. When they do find fruits, they are priced very high and are unaffordable. Even though health conditions dictate food frequency and portion size, community members feel that individuals should eat three good balanced meals per day with snacks, and they should adhere to small portion sizes. While the desire to attain overall good health and eliminate associative risks for heart disease (e.g., diabetes, obesity) are personal motivations, the cost of food, transportation, age, and time required for food preparation were seen as barriers to healthy eating. Decisions regarding meal choice and meal frequency can have an impact on long‐term health outcomes. Health promotion programs should become an integral part of academic‐ community collaborative agreements. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

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Open AccessArticle

Disparities in HIV Clinical Outcomes among a Cohort of HIV-Infected Persons Receiving Care—Mississippi

by Ali Dehghani Firouzabadi, Tiffany C. McDonald, Tametria R. Samms, Reza Sirous and Kendra Johnson

Int. J. Environ. Res. Public Health 2017, 14(4), 392; https://doi.org/10.3390/ijerph14040392 - 7 Apr 2017

Cited by 2 | Viewed by 4168

Abstract

Increasing patients’ cluster of differentiation 4 (CD4) count and achieving viral suppression are the ultimate goals of the human immunodeficiency virus (HIV) care and treatment, yet disparities in these HIV clinical outcomes exist among subpopulations of HIV-infected persons. We aimed to assess potential disparities in viral suppression and normal CD4 count among HIV-infected persons receiving care in Mississippi using Mississippi Medical Monitoring Project (MMP) data from 2009 to 2014 (N = 1233) in this study. Outcome variables in this study were suppressed, recent and durable viral load, and normal CD4 count. Patients’ characteristics in this study were race, gender, age, annual income, education, insurance, and length of diagnosis. Descriptive statistics, Chi square tests, and logistic regression analyses were conducted using the SAS 9.4 Proc Survey procedure. Our findings indicate that those aged 50 years or older were more likely to have suppressed recent viral load (adjusted Odds Ratio (aOR) = 2.4) and durable viral loads (aOR = 2.9), compared to those aged 18–24 years. In addition, women were more likely to have a normal CD4 count than men (aOR = 1.4). In conclusion, we found that age and gender disparities in HIV clinical outcomes may be used to develop and implement multifaceted interventions to improve health equity among all HIV-infected patients. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

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Open AccessArticle

Genomic Evidence for Bacterial Determinants Influencing Obesity Development

by Raphael D. Isokpehi, Shaneka S. Simmons, Matilda O. Johnson and Marinelle Payton

Int. J. Environ. Res. Public Health 2017, 14(4), 345; https://doi.org/10.3390/ijerph14040345 - 26 Mar 2017

Cited by 19 | Viewed by 5631

Abstract

Obesity is a major global public health problem requiring multifaceted interventional approaches including dietary interventions with probiotic bacteria. High-throughput genome sequencing of microbial communities in the mammalian gastrointestinal system continues to present diverse protein function information to understand the bacterial determinants that influence obesity development. The goal of the research reported in this article was to identify biological processes in probiotic bacteria that could influence the mechanisms for the extraction of energy from diet in the human gastrointestinal system. Our research strategy of combining bioinformatics and visual analytics methods was based on the identification of operon gene arrangements in genomes of Lactobacillus species and Akkermansia muciniphila that include at least a gene for a universal stress protein. The two major findings from this research study are related to Lactobacillus plantarum and Akkermansia muciniphila bacteria species which are associated with weight-loss. The first finding is that Lactobacillus plantarum strains have a two-gene operon that encodes a universal stress protein for stress response and the membrane translocator protein (TSPO), known to function in mitochondrial fatty acid oxidation in humans. The second finding is the presence of a three-gene operon in Akkermansia muciniphila that includes a gene whose human mitochondrial homolog is associated with waist-hip ratio and fat distribution. From a public health perspective, elucidation of the bacterial determinants influencing obesity will help in educating the public on optimal probiotic use for anti-obesity effects. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

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Open AccessArticle

Life after Stroke in an Urban Minority Population: A Photovoice Project

by Revathi Balakrishnan, Benjamin Kaplan, Rennie Negron, Kezhen Fei, Judith Z. Goldfinger and Carol R. Horowitz

Int. J. Environ. Res. Public Health 2017, 14(3), 293; https://doi.org/10.3390/ijerph14030293 - 11 Mar 2017

Cited by 21 | Viewed by 5558

Abstract

Stroke is a leading cause of disability in the United States and disproportionately affects minority populations. We sought to explore the quality of life in urban, minority stroke survivors through their own photos and narratives. Using the Photovoice method, seventeen stroke survivors were instructed to take pictures reflecting their experience living with and recovering from stroke. Key photographs were discussed in detail; participants brainstormed ways to improve their lives and presented their work in clinical and community sites. Group discussions were recorded, transcribed, and coded transcripts were reviewed with written narratives to identify themes. Participants conveyed recovery from stroke in three stages: learning to navigate the initial physical and emotional impact of the stroke; coping with newfound physical and emotional barriers; and long-term adaptation to physical impairment and/or chronic disease. Participants navigated this stage-based model to varying degrees of success and identified barriers and facilitators to this process. Barriers included limited access for disabled and limited healthy food choices unique to the urban setting; facilitators included presence of social support and community engagement. Using Photovoice, diverse stroke survivors were able to identify common challenges in adapting to life after stroke and important factors for recovery of quality of life. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

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Open AccessArticle

Perception of Policy and Environmental Action to Promote Healthy Behaviors in African American Communities

by Clifton Addison, Brenda W. Campbell Jenkins, Monique White, Frances Henderson, Dorothy J. McGill, Donna Antoine-LaVigne and Marinelle Payton

Int. J. Environ. Res. Public Health 2017, 14(3), 271; https://doi.org/10.3390/ijerph14030271 - 7 Mar 2017

Cited by 2 | Viewed by 3925

Abstract

The present study aimed to examine the perceptions of African American communities regarding the involvement of political leaders in facilitating policy and environmental change promoting healthy eating and physical activity. We selected the Metro Jackson Area comprised of Hinds, Madison and Rankin Counties because it is a combination of urban and rural communities. The sample consisted of 70 participants from seven sites. A total of seven focus groups were asked to respond to one question to assess political leaders’ involvement in healthy living: “When you think about your political leaders that you have in the Jackson, Mississippi area, do any of them promote healthy eating and physical activity?” Focus groups consisted of six to 12 participants and were asked to comment on their participation in physical activity. The focus group interviews were digitally recorded. The recorded interviews were transcribed by a professional transcriptionist. Community members could not recollect much participation from political leaders in the health prevention/intervention efforts. In each of the counties, there was evidence that there was some involvement by local politicians in health promotion issues, but not on a large scale. In conclusion, making healthy foods and products available in neighborhood stores has long been associated with healthy behaviors and positive health outcomes. This can make a difference in the Mississippi communities where supermarkets are not accessible and health disparities abound. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

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Open AccessArticle

Racial Disparities in Obesity Prevalence in Mississippi: Role of Socio-Demographic Characteristics and Physical Activity

by Mina Qobadi and Marinelle Payton

Int. J. Environ. Res. Public Health 2017, 14(3), 258; https://doi.org/10.3390/ijerph14030258 - 3 Mar 2017

Cited by 11 | Viewed by 6825

Abstract

Although the etiology of obesity is complex, social disparities are gaining attention for their contribution to obesity. The aim of this study was to estimate prevalence of obesity and to explore the associations between socio-demographic characteristics and obesity by race in Mississippi. Data from the 2014 Mississippi Behavior Risk Factors Surveillance System (BRFSS) were used in this study (n = 3794). Descriptive statistics, Chi-square tests and logistic regressions were conducted using SAS Proc. Survey procedures to account for BRFSS’s multistage complex survey design and sample weights. The overall prevalence of self-reported obesity was 37%. Multiple logistic regression model showed gender was the only variable associated with increased risk of obesity among blacks. Black females were more likely to be obese (Adjusted OR [aOR] = 2.0, 95% CI: 1.4–2.7, ref = male) after controlling for confounders. Among white adults, obesity was significantly associated with physical activity, gender, age and education levels. Those aged 25–44 years (aOR = 1.7, 95% CI: 1.1–2.6, ref ≥ 64 years), those were physically inactivity (aOR = 1.8, 95% CI: 1.4–2.5, ref = physically active) or had high school education (OR = 1.6, 95% CI: 1.2–2.3, ref = college graduate) or some college (aOR = 1.5, 95% CI: 1.2–2.3, ref = college graduate) were more likely to be obese; females (aOR = 0.8; 95% CI: 0.6–0.9, ref = male) and those aged 18–24 years (aOR = 0.50, 95% CI: 0.21–0.9, ref ≥ 64 years) were less likely to be obese. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

286 KiB

Open AccessArticle

Assessment of Knowledge of Critical Cardiovascular Risk Indicators among College Students: Does Stage of Education Matter?

by Daniel F. Sarpong, India Y. Curry and Melinda Williams

Int. J. Environ. Res. Public Health 2017, 14(3), 250; https://doi.org/10.3390/ijerph14030250 - 2 Mar 2017

Cited by 14 | Viewed by 5054

Abstract

The health risk of college students in the United States (US) is on the rise, with a significant increase in the prevalence of cardiovascular risk factors. Cardiovascular disease is the leading cause of death in the US, costing approximately $475.3 billion yearly. The goals of this “Know Your Numbers” study were to: (1) estimate the awareness of college students of their critical health numbers (CHN); and (2) compare a college of pharmacy entry class (IP1) with second semester non-commuter freshman college students (FCS) in knowing their numbers. A cross-sectional 15-item pre-test survey was conducted among a convenience sample of IP1 and FCS. All statistical tests were performed at α = 0.05. Awareness of their: cholesterol (7%), blood pressure (BP) (35%), glucose (8%), and body mass index (BMI) (42%) were low. The IP1, compared to FCS, were more knowledgeable of: (1) their BP (46% vs. 28%, p = 0.01); (2) BP normal range (74% vs. 63%, p = 0.02); and (3) BMI normal range (39% vs. 23%, p = 0.04). The IP1s maintained a healthier diet than the FCS (64% vs. 36%, p < 0.0001). Awareness of knowing CHN was very low. Knowledge of one’s CHN was significantly associated with knowledge of normal reference values for BP, glucose, and BMI. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

292 KiB

Open AccessArticle

Consumption of Sugar-Sweetened Beverages in Mississippi: Is There A Disparity? Behavioral Risk Factor Surveillance System, 2012

by Mina Qobadi and Marinelle Payton

Int. J. Environ. Res. Public Health 2017, 14(3), 228; https://doi.org/10.3390/ijerph14030228 - 24 Feb 2017

Cited by 8 | Viewed by 4078

Abstract

Although consumption of sugar-sweetened beverages (SSBs) is a key contributor to epidemic obesity and has dramatically increased over the past decade in the United States, little is known about its prevalence and associated factors. Data from the 2012 Behavior Risk Factor Surveillance System (BRFSS) were used to estimate the prevalence of SSB consumption and to explore the associations between socio-demographic characteristics, behavioral factors and SSB intake in Mississippi (n = 7220). Descriptive statistics, Chi-square tests and logistic regressions were conducted using SAS Proc Survey procedures, to account for the BRFSS′s multistage complex survey design and sample weights. Overall prevalence of self-reported daily SSB intake was 41.1%. Our findings showed that males (aOR = 1.4, 95% CI: 1.2–1.7, ref = female), blacks (aOR = 1.7, 95% CI: 1.4–2.1, ref = whites), adults aged 18–24 years (aOR = 5.0, 95% CI: 3.4–7.5, ref = 65 years or older), those with less than high school education (aOR = 1.9, 95% CI: 1.4–2.6, ref = college graduate), annual income <$25,000 (aOR = 1.3, 95% CI: 1.1–1.7, ref ≥ $50,000) and $25,000–49,999 (aOR = 1.3, 95% CI: 1.1–1.6, ref ≥ $50,000), those with no physical activity (OR = 1.3, 95% CI: 1.1–1.6, ref = physically active), daily smokers (aOR = 2.2, 95% CI: 1.7–2.7, ref = non-smokers), and those who reported eating at fast food or chain restaurants (aOR = 1.8, 95% CI: 1.2–2.5, ref = do not eat at fast food or chain restaurants) were more likely to consume SSBs, raising concerns about overweight and obesity in Mississippi. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

998 KiB

Open AccessArticle

Accelerators: Sparking Innovation and Transdisciplinary Team Science in Disparities Research

by Carol R. Horowitz, Khader Shameer, Janice Gabrilove, Ashish Atreja, Peggy Shepard, Crispin N. Goytia, Geoffrey W. Smith, Joel Dudley, Rachel Manning, Nina A. Bickell and Maida P. Galvez

Int. J. Environ. Res. Public Health 2017, 14(3), 225; https://doi.org/10.3390/ijerph14030225 - 23 Feb 2017

Cited by 25 | Viewed by 10307

Abstract

Development and implementation of effective, sustainable, and scalable interventions that advance equity could be propelled by innovative and inclusive partnerships. Readied catalytic frameworks that foster communication, collaboration, a shared vision, and transformative translational research across scientific and non-scientific divides are needed to foster rapid generation of novel solutions to address and ultimately eliminate disparities. To achieve this, we transformed and expanded a community-academic board into a translational science board with members from public, academic and private sectors. Rooted in team science, diverse board experts formed topic-specific “accelerators”, tasked with collaborating to rapidly generate new ideas, questions, approaches, and projects comprising patients, advocates, clinicians, researchers, funders, public health and industry leaders. We began with four accelerators—digital health, big data, genomics and environmental health—and were rapidly able to respond to funding opportunities, transform new ideas into clinical and community programs, generate new, accessible, actionable data, and more efficiently and effectively conduct research. This innovative model has the power to maximize research quality and efficiency, improve patient care and engagement, optimize data democratization and dissemination among target populations, contribute to policy, and lead to systems changes needed to address the root causes of disparities. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

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288 KiB

Open AccessArticle

Optimistic Bias, Risk Factors, and Development of High Blood Pressure and Obesity among African American Adolescents in Mississippi (USA)

by Monique S. White, Clifton C. Addison, Brenda W. Campbell Jenkins, Vanessa Bland, Adrianne Clark and Donna Antoine LaVigne

Int. J. Environ. Res. Public Health 2017, 14(2), 209; https://doi.org/10.3390/ijerph14020209 - 20 Feb 2017

Cited by 8 | Viewed by 6324

Abstract

Childhood obesity has reached epidemic proportions and is linked to hypertension among African American youth. Optimistic bias influences behavior of youth causing them to underestimate their susceptibility to negative health outcomes. This study explored adolescent behaviors and prevalence of high blood pressure and obesity in a school district. We examined the relationship between individual health risk practices and optimistic bias on health outcomes; 433 African American high school students were administered a survey and had their obesity and blood pressure measured by the school nurse. Canonical correlational analyses were used to examine relationships between health risk practices and descriptive statistics for optimistic bias and health outcomes. Engaging in moderate exercise for at least 30 min in the last 7 days and lower blood pressure was the only statistically significant relationship. Two-thirds of the students did not perceive themselves to be at risk of developing cardiovascular disease with males at greater risk than females, despite the presence of clinical risk factors for hypertension and obesity. Reducing health optimistic bias is an effective way of motivating young people to adopt more positive behaviors using educational institutions to implement intervention programs that promote positive health behavior as a way to reduce health disparities. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

Review

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942 KiB

Open AccessReview

Assessing the Racial and Ethnic Disparities in Breast Cancer Mortality in the United States

by Clement G. Yedjou, Paul B. Tchounwou, Marinelle Payton, Lucio Miele, Duber D. Fonseca, Leroy Lowe and Richard A. Alo

Int. J. Environ. Res. Public Health 2017, 14(5), 486; https://doi.org/10.3390/ijerph14050486 - 5 May 2017

Cited by 119 | Viewed by 14033

Abstract

Breast cancer is the second leading cause of cancer related deaths among women aged 40–55 in the United States and currently affects more than one in ten women worldwide. It is also one of the most diagnosed cancers in women both in wealthy and poor countries. Fortunately, the mortality rate from breast cancer has decreased in recent years due to increased emphasis on early detection and more effective treatments in White population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic populations has continued to grow. The goal of the present review article was to highlight similarities and differences in breast cancer morbidity and mortality rates primarily among African American women compared to White women in the United States. To reach our goal, we conducted a search of articles in journals with a primary focus on minority health, and authors who had published articles on racial/ethnic disparity related to breast cancer patients. A systematic search of original research was conducted using MEDLINE, PUBMED and Google Scholar databases. We found that racial/ethnic disparities in breast cancer may be attributed to a large number of clinical and non-clinical risk factors including lack of medical coverage, barriers to early detection and screening, more advanced stage of disease at diagnosis among minorities, and unequal access to improvements in cancer treatment. Many African American women have frequent unknown or unstaged breast cancers than White women. These risk factors may explain the differences in breast cancer treatment and survival rate between African American women and White women. New strategies and approaches are needed to promote breast cancer prevention, improve survival rate, reduce breast cancer mortality, and ultimately improve the health outcomes of racial/ethnic minorities. Full article

(This article belongs to the Special Issue Eliminating Health Disparities through Multi-Trans-Disciplinary Approaches)

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