Lack of validity of self-reported mammography data.

This qualitative literature review aimed to describe the totality of peer-reviewed scientific evidence from 1990 to 2017 concerning validity of self-reported mammography. This review included articles about mammography containing the words accuracy, validity, specificity, sensitivity, reliability or reproducibility; titles containing self-report, recall or patient reports, and breast or 'mammo'; and references of identified citations focusing on evaluation of 2-year self-reports. Of 45 publications meeting the eligibility criteria, 2 conducted in 1993 and 1995 at health maintenance organisations in Western USA which primarily served highly educated whites provided support for self-reports of mammography over 2 years.

Neighbourhood deprivation and lung cancer risk: a nested case-control study in the USA.

Objectives: To examine the association between neighbourhood deprivation and lung cancer risk.

Design: Nested case-control study.

Setting: Southern Community Cohort Study of persons residing in 12 states in the southeastern USA.

A multifactorial obesity model developed from nationwide public health exposome data and modern computational analyses.

Statement Of The Problem: Obesity is both multifactorial and multimodal, making it difficult to identify, unravel and distinguish causative and contributing factors. The lack of a clear model of aetiology hampers the design and evaluation of interventions to prevent and reduce obesity.

Methods: Using modern graph-theoretical algorithms, we are able to coalesce and analyse thousands of inter-dependent variables and interpret their putative relationships to obesity.

Time from Screening Mammography to Biopsy and from Biopsy to Breast Cancer Treatment among Black and White, Women Medicare Beneficiaries Not Participating in a Health Maintenance Organization.

Purpose: There is a breast cancer mortality gap adversely affecting Black women in the United States. This study assessed the relationship between number of days between abnormal mammogram, biopsy, and treatment among Medicare (Part B) beneficiaries ages 65 to 74 and 75 to 84 years, accounting for race and comorbidity.

Methods: A cohort of non-Hispanic Black and non-Hispanic White women residing in the continental United States and receiving no services from a health maintenance organization was randomly selected from the Center for Medicare and Medicaid Services denominator file.

Mammography Screening Among the Elderly: A Research Challenge.

Background: Randomized trials demonstrate clear benefits of mammography screening in women through age 74 years. We explored age- and race-specific rates of mammography screening and breast cancer mortality among women aged 69 to 84 years.

Methods: We analyzed Medicare claims data for women residing within Surveillance, Epidemiology and End Results geographic areas from 1995 to 2009 from 64,384 non-Hispanic women (4886 black and 59,498 white) and ascertained all primary breast cancer cases diagnosed between ages 69 and 84 years.

Resident Physicians and Cancer Health Disparities: a Survey of Attitudes, Knowledge, and Practice.

Workforce development initiatives designed to mitigate cancer health disparities focus primarily on oncologists rather than on primary care providers (PCPs) who could be better positioned to address the issue at the preventive and community levels. The purpose of this project was to assess primary care resident physicians' self-perceived attitudes and comfort level in addressing cancer health disparities. Resident physicians in their first- through third-year of training in family, internal, preventive/occupational medicine, and obstetrics and gynecology (OB/GYN) at three academic centers responded to a 13-question survey in the spring of 2013.

The public health exposome: a population-based, exposure science approach to health disparities research.

The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death.

Exploration of preterm birth rates using the public health exposome database and computational analysis methods.

Recent advances in informatics technology has made it possible to integrate, manipulate, and analyze variables from a wide range of scientific disciplines allowing for the examination of complex social problems such as health disparities. This study used 589 county-level variables to identify and compare geographical variation of high and low preterm birth rates. Data were collected from a number of publically available sources, bringing together natality outcomes with attributes of the natural, built, social, and policy environments.

Social determinants and the classification of disease: descriptive epidemiology of selected socially mediated disease constellations.

Background: Most major diseases have important social determinants. In this context, classification of disease based on etiologic or anatomic criteria may be neither mutually exclusive nor optimal.

Methods And Findings: Units of analysis comprised large metropolitan central and fringe metropolitan counties with reliable mortality rates--(n = 416).

Scalable combinatorial tools for health disparities research.

Despite staggering investments made in unraveling the human genome, current estimates suggest that as much as 90% of the variance in cancer and chronic diseases can be attributed to factors outside an individual's genetic endowment, particularly to environmental exposures experienced across his or her life course. New analytical approaches are clearly required as investigators turn to complicated systems theory and ecological, place-based and life-history perspectives in order to understand more clearly the relationships between social determinants, environmental exposures and health disparities. While traditional data analysis techniques remain foundational to health disparities research, they are easily overwhelmed by the ever-increasing size and heterogeneity of available data needed to illuminate latent gene x environment interactions.

Demographic and geographic variations in breast cancer mortality among U.S. Hispanics.

This paper examines demographic and geographic differences in breast cancer mortality (1999 to 2009) between U.S. Hispanic and non-Hispanic women from different racial groups.

Tuskegee redux: evolution of legal mandates for human experimentation.

Human health experiments systematically expose people to conditions beyond the boundaries of medical evidence. Such experiments have included legal-medical collaboration, exemplified in the U.S.

Firearms, youth homicide, and public health.

Homicide is seven times as common among U.S. non-Hispanic Black as among non-Hispanic White youth ages 15 to 24 years.

Geographic variations in percutaneous coronary interventions and coronary artery bypass graft surgery among Tennessee elders.

Objectives: Coronary heart disease often presents with ST segment elevation acute myocardial infarction (STEMI). The American College of Cardiology/American Heart Association guidelines stress prompt reperfusion for STEMI. Examining geographic variations in treatment with PPCI (percutaneous primary coronary intervention) and CABG (coronary artery bypass graft) among metropolitan, micropolitan and non-micropolitan rural residents provides a descriptive basis for generating hypotheses concerning place and receipt of guidelines-based treatment.

Alcohol diagnoses among older Tennessee Medicare beneficiaries: race and gender differences.

Background: These analyses bolster a sparse body of research focusing on the rate of alcohol disorders among older adults, particularly race and gender subgroups.

Methods: We based the study on cross-sectional data from all Medicare billed physician/patient encounters. Analyses of these data included cross-tabulations, difference of means tests, and difference of proportions tests, logistic regression and multinomial logistic regression.

The influence of religiosity on depression among low-income people with diabetes.

People with diabetes experience depression at a significantly higher rate than do their nondiabetic counterparts. The purpose of this study was to examine the impact of multiple dimensions of religiosity on depression among a lower income population of people with diabetes. Using a cross-sectional design, the study focused on a combined clinical and community sample of people with diabetes from low-income neighborhoods.

Black-white disparities in elderly breast cancer mortality before and after implementation of Medicare benefits for screening mammography.

Background: Medicare implemented reimbursement for screening mammography in 1991.

Main Findings: Post-implementation, breast cancer mortality declined faster (p< .0001) among White than among Black elderly women (65+ years).

HIV/AIDS knowledge and sexual activity: an examination of racial differences in a college sample.

The threat of HIV/AIDS to African American's health has become the focus of much concern. This study investigated the potential differences between African Americans' and white college students' current and future sexual behaviors and safer sex behaviors with HIV/AIDS awareness, condom use self-efficacy, and safer sex attitudes. A convenience sample of 156 college students from three public universities was used.

Black-White mortality from HIV in the United States before and after introduction of highly active antiretroviral therapy in 1996.

Objectives: We sought to describe Black-White differences in HIV disease mortality before and after the introduction of highly active antiretroviral treatment (HAART).

Methods: Black-White mortality from HIV is described for the nation as a whole. We performed regression analyses to predict county-level mortality for Black men aged 25-84 years and the corresponding Black:White male mortality ratios (disparities) in 140 counties with reliable Black mortality for 1999-2002.

Descriptive and analytic epidemiologic studies to identify modifiable determinants of disparities in mortality rates between Blacks and Whites.

Introduction: Descriptive and epidemiologic studies of US national data reveal no sustained decrease in disparities in mortality between Blacks and Whites since World War II. In contrast, descriptive studies of variations in racial mortality trends across comparable geographic areas might lead to the formulation of hypotheses for testing in analytical epidemiologic studies to identify modifiable determinants.

Methodology: Using the CDC Wonder system, the 41 peer-geographic areas to Davidson County, Tennessee, in which Meharry Medical College resides, were identified.

Racial disparities and trends in use of colorectal procedures among Tennessee elderly (1996-2000).

Background: Blacks are more likely to be diagnosed at a later stage of colorectal cancer (CRC), and have poorer survival than Whites. Colorectal cancer (CRC) is usually curable when diagnosed at an early stage.

Objectives: We compare the use of CRC tests for screening between Whites and Blacks and compare the use of CRC tests for either screening or diagnosis and further check the test results for a diagnosis of CRC.

Explaining race differences in mortality among the Tennessee Medicare elderly: the role of physician services.

We investigated the impact of socioeconomic conditions, patterns of morbidity, and physician service utilization on race differences in rates of mortality, and mortality associated with specific diagnoses. Longitudinal data from the Center for Medicare and Medicaid Services (CMS) Physician Billing File data and the Medicare Enrollment Database (EDB) were analyzed to assess physician-diagnosed morbidity, health service use, and mortality, among the population of Medicare beneficiaries in Tennessee (N=665,887). Proportional hazards models were used to examine the effects of race, socioeconomic status, morbidity, and physician service utilization on mortality.

Group therapy for depressed elderly women.

We describe and evaluate a group therapy program targeting depression among elderly residents (N=303) of subsidized high-rise apartments in Nashville, TN. This eclectic program was comprised of 12 sessions (a total of 24 hours) that included modules on exercise and preventive health behaviors, cognitive and re-motivation therapy, reminiscence and grief therapy, and social skills development. Our multivariate regression analyses of pre-post measures using the Geriatric Depression Scale (GDS) showed that the effects of the group therapy varied by race, age, and level of initial depression among the participants.