Biomarkers of Psychological Stress in Health Disparities Research.

Psychological stress can contribute to health disparities in populations that are confronted with the recurring stress of everyday life. A number of biomarkers have been shown to be affected by psychological stress. These biomarkers include allostatic load, which is a summary measure of the cumulative biological burden of the repeated attempts to adapt to daily stress.

Advancing the science of health disparities research.

Research to eliminate health disparities in the United States is best approached from the perspective of population health. The objectives of this paper are to: (a) describe how ongoing research at the eight national Centers for Population Health and Health Disparities (CPHHD) is using a population health perspective and a community-based approach to advance the field of health disparities research; and (b) to discuss potential implications of such research for health policies that target some of the determinants of population health.

Early-life conditions and mechanisms of population health vulnerabilities.

The social status of groups is key to determining health vulnerability at the population level. The impact of material and psychological stresses imposed by social inequities and marginalization is felt most intensely during perinatal/early childhood and puberty/adolescent periods, when developmental genes are expressed and interact with social-physical environments. The influence of chronic psychosocial stresses on gene expression via neuroendocrine regulatory dysfunction is crucial to understanding the biological bases of adult health vulnerability.

Mailings timed to patients' appointments: a controlled trial of fecal occult blood test cards.

Background: Fecal occult blood testing (FOBT) programs cost-effectively reduce colon cancer mortality. To improve the rate of colon cancer screening with FOBT, we tested the effect of mailing FOBT cards timed to appointments on the rates of completion of FOBT.

Design: Controlled trial.

Primary care access decreases nonurgent hospital visits for indigent diabetics.

The objective was to determine the relationship between the source of primary care and utilization of health services among public hospital walk-in clinic patients. A group of 218 adults with diabetes mellitus presenting to a walk-in hospital clinic was followed prospectively with baseline and 3-, 6-, and 12-month surveys; baseline and 6-month hemoglobin A1Cs; and chart reviews. Sites of care, acquisition of primary care, and report of four diabetes services were recorded.