Assessing cardiovascular disease risk and social determinants of health: A comparative analysis of five risk estimation instruments using data from the Eastern Caribbean Health Outcomes Research Network.

Background: Accurate assessment of cardiovascular disease (CVD) risk is crucial for effective prevention and resource allocation. However, few CVD risk estimation tools consider social determinants of health (SDoH), despite their known impact on CVD risk. We aimed to estimate 10-year CVD risk in the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) across multiple risk estimation instruments and assess the association between SDoH and CVD risk.

Ultra-Processed Food Consumption and Hypertension Risk in the REGARDS Cohort Study.

Background: This study examined the longitudinal association between ultraprocessed food (UPF) consumption and overall hypertension risk and explored the contribution of UPF to racial disparities in hypertension risk.

Methods: We analyzed data from 5957 participants from the REGARDS cohort study (Reasons for Geographic and Racial Disparities in Stroke) who were free from hypertension during visit 1 (2003-2007), had complete dietary information at visit 1, and completed visit 2 (2013-2016). UPF consumption was measured using the Nova classification system and operationalized as percent calories and grams.

Associations Between Ultra-Processed Food Consumption and Adverse Brain Health Outcomes.

Background And Objectives: Ultra-processed foods (UPFs) are linked to cardiometabolic diseases and neurologic outcomes, such as cognitive decline and stroke. However, it is unclear whether food processing confers neurologic risk independent of dietary pattern information. We aimed to (1) investigate associations between UPFs and incident cognitive impairment and stroke and (2) compare these associations with other commonly recommended dietary patterns in the REasons for Geographic and Racial Differences in Stroke study.

Risk factors for household food insecurity in the Eastern Caribbean Health Outcomes Research Network cohort study.

Background: Globally, 1.3 billion people were considered food insecure as of 2022. In the Caribbean region, the prevalence of moderate or severe food insecurity was 71.

Development of a novel healthcare discrimination measure: PreDict.

Introduction: Patient reported quality of care measures are widely recognized tools for healthcare system performance assessment. Yet, there are few existing patient reported quality of care measures regarding health equity, and none to specifically collect patient experiences of discrimination in health care.

Objective: To develop an item pool to measure patient experiences of healthcare discrimination-the Patient-Reported Experiences of Discrimination in Care Tool (PreDict).

Prevalence of overweight and obesity in Nigeria: Systematic review and meta-analysis of population-based studies.

In Nigeria, several studies have assessed the prevalence of overweight/obesity with different reports. The purpose of this study was to use a systematic review and meta-analysis to analyze these overweight and obesity reports from different locations in Nigeria over the last ten years. In addition, there was a dearth of systematic reviews and meta-analyses on the prevalence, trends, and demographic characteristics of overweight and obesity in the country.

Consumption of sugar-sweetened beverages and T2D diabetes in the Eastern Caribbean.

Objective: Sugar-sweetened beverages (SSB) are implicated in the increasing risk of diabetes in the Caribbean. Few studies have examined associations between SSB consumption and diabetes in the Caribbean.

Design: SSB was measured as teaspoon/d using questions from the National Cancer Institute Dietary Screener Questionnaire about intake of soda, juice and coffee/tea during the past month.

Targeting Health-Related Social Risks in the Clinical Setting: New Policy Momentum and Practice Considerations.

The federal government is funding a sea change in health care by investing in interventions targeting social determinants of health, which are significant contributors to illness and health inequity. This funding power has encouraged states, professional and accreditation organizations, health care entities, and providers to focus heavily on social determinants. We examine how this shift in focus affects clinical practice in the fields of oncology and emergency medicine, and highlight potential areas of reform.

Racial disparities among older adults with acute myocardial infarction: The SILVER-AMI study.

Background: Despite an aging population, little is known about racial disparities in aging-specific functional impairments and mortality among older adults hospitalized for acute myocardial infarction (AMI).

Methods: We analyzed data from patients aged 75 years or older who were hospitalized for AMI at 94 US hospitals from 2013 to 2016. Functional impairments and geriatric conditions were assessed in-person during the AMI hospitalization.

Breast cancer screening during the COVID-19 pandemic: moving from disparities to health equity.

The COVID-19 pandemic created unprecedented disruptions to routine health care in the United States. Screening mammography, a cornerstone of breast cancer control and prevention, was completely halted in the spring of 2020, and screening programs have continued to face challenges with subsequent COVID-19 waves. Although screening mammography rates decreased for all women during the pandemic, a number of studies have now clearly documented that reductions in screening have been greater for some populations than others.

A Socio-Ecological Approach to Addressing Digital Redlining in the United States: A Call to Action for Health Equity.

Physical distancing requirements due to the coronavirus (COVID-19) pandemic has increased the need for broadband internet access. The World Health Organization defines social determinants of health as non-medical factors that impact health outcomes by affecting the conditions in which people are born, grow, work, live, and age. By this definition broadband internet access is a social determinant of health.

Diversity in clinical research: public health and social justice imperatives.

It is well established that demographic representation in clinical research is important for understanding the safety and effectiveness of novel therapeutics and vaccines in diverse patient populations. In recent years, the National Institutes of Health and Food and Drug Administration have issued guidelines and recommendations for the inclusion of women, older adults, and racial and ethnic minorities in research. However, these guidelines fail to provide an adequate explanation of why racial and ethnic representation in clinical research is important.

Perceptions of the local food environment and fruit and vegetable intake in the Eastern Caribbean Health Outcomes research Network (ECHORN) Cohort study.

Introduction: Studies conducted in the US and other high-income countries show that the local food environment influences dietary intakes that are protective for cardiovascular health.However, few studies have examined this relationship in the Caribbean. This study aimed to determine whether perceptions of the local food environment were associated with fruit and vegetable (FV) intake in the Eastern Caribbean, where daily FV intake remains below recommended levels.

Assessment of nutritional status in patients with chronic kidney disease in Nigeria.

In Nigeria, there is paucity of data on malnutrition among chronic kidney disease (CKD) patients especially before the initiation of dialysis therapy, necessitating this study. The study subjects consisted of 96 CKD patients recruited from the renal unit of our hospital. Forty age-and sex-matched controls were also studied.

Loneliness, sadness, and feelings of social disconnection in older adults during the COVID-19 pandemic.

Background: Public health measures to control the COVID-19 pandemic have led to feelings of loneliness among older adults, which, prior to COVID, has been associated with subsequent morbidity and mortality. We sought to identify differences in feelings of loneliness, sadness, and social disconnection early in the pandemic across racial groups, and possible mitigating factors.

Methods: We performed a cross-sectional analysis using the weighted nationally-representative Medicare Current Beneficiaries Survey COVID-19 supplement, collected summer 2020.

Racial disparities in the SOFA score among patients hospitalized with COVID-19.

Background: Sequential Organ Failure Assessment (SOFA) score predicts probability of in-hospital mortality. Many crisis standards of care suggest the use of SOFA scores to allocate medical resources during the COVID-19 pandemic.

Research Question: Are SOFA scores elevated among Non-Hispanic Black and Hispanic patients hospitalized with COVID-19, compared to Non-Hispanic White patients?

Study Design And Methods: Retrospective cohort study conducted in Yale New Haven Health System, including 5 hospitals with total of 2681 beds.

The potential impact of triage protocols on racial disparities in clinical outcomes among COVID-positive patients in a large academic healthcare system.

Background: The COVID-19 pandemic has had a devastating impact in the United States, particularly for Black populations, and has heavily burdened the healthcare system. Hospitals have created protocols to allocate limited resources, but there is concern that these protocols will exacerbate disparities. The sequential organ failure assessment (SOFA) score is a tool often used in triage protocols.

Melatonin ameliorates endocrine dysfunction and defective sperm integrity associated with high-fat diet-induced obesity in male Wistar rats.

Obesity (OBS) has been established as a link to male hypogonadism with consequent infertility. Previous studies have shown that melatonin (MEL) modulates hypothalamic-pituitary-gonadal function. The present study therefore investigated the hypothesis that MEL supplementation would attenuate spermatogenic and steroidogenic dysfunctions associated with obesity induced by high-fat diet (HFD).

Anthropometric measures of obesity and associated cardiovascular disease risk in the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study.

Background: Accurately defining obesity using anthropometric measures that best capture obesity-related risk is important for identifying high risk groups for intervention. The purpose of this study is to compare the association of different anthropometric measures of obesity with 10-year cardiovascular disease (CVD) risk in adults in the Eastern Caribbean.

Methods: Data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study (ECS) were analyzed.

Risk Factors for Chronic Kidney Disease in Newly Diagnosed Hypertensive Subjects in Southeast Nigeria.

Background: The aim of this study was to determine the prevalence and associated risk factors for chronic kidney disease (CKD) in newly diagnosed hypertensive patients.

Materials And Methods: This was a cross-sectional analytical study involving consenting newly diagnosed hypertensive patients who presented at GOPD of Federal Medical Centre, Umuahia, within 0-3 months of diagnosis; and non-hypertensive controls. A semi-structured interviewer- administered questionnaire was used to record the socio-demographic, anthropometric, clinical and bio-chemical characteristics of the respondents.

Egocentric Health Networks and Cardiovascular Risk Factors in the ECHORN Cohort Study.

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the Caribbean region.

Objective: This study explored the concept of a health network, relationships focused on health-related matters, and examined associations with CVD risk factors in the Eastern Caribbean.

Design: The Eastern Caribbean Health Outcomes Research Network Cohort Study is an ongoing longitudinal cohort being conducted in the US Virgin Islands, Puerto Rico, Trinidad and Tobago, and Barbados.