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There is a noticeable underrepresentation of minorities in clinical trials and registries in pulmonary arterial hypertension (PAH). Prior studies evaluating the association between Hispanic ethnicity and clinical outcomes in patients with PAH have not assessed the socioeconomic profile of Hispanic individuals or the significance of social determinants of health in clinical outcomes. To determine the association between Hispanic ethnicity, social determinants of health, and clinical outcomes in PAH. This was a prospective cohort study of adult participants with PAH enrolled in the Pulmonary Hypertension Association Registry, a multicenter U.S.-based registry of patients treated at pulmonary hypertension care centers. Participants were classified as Hispanics and non-Hispanic White individuals, based on self-reported ethnicity. A comparison of baseline clinical and sociodemographic characteristics between groups was performed as well using absolute standardized differences (ASD). The primary outcome of the study was to assess transplant-free survival between Hispanics and non-Hispanic White individuals. A Cox proportional hazards model was used for the multivariable analysis after adjusting for age, sex, PAH etiology, annual income, education level, and health insurance. A total of 683 individuals were included, 98 (14.3%) of Hispanic ethnicity. Hispanic patients had impaired access to health care (31.6% vs. 12.9% Medicaid/uninsured; ASD, 0.35), lower education level (72.6% vs. 94.0% high school graduates or higher; ASD, 0.60), and lower annual income (32.0% vs. 17.4% with income <20,000 U.S. dollars; ASD, 0.47), compared with non-Hispanic White individuals. Hispanic patients had a higher frequency of emergency room visits and a higher number of hospitalizations, despite having similar disease severity (incidence rate ratio, 1.452; 95% confidence interval [CI], 1.326-1.590; and 1.428; 95% CI, 1.292-1.577, respectively). Although the unadjusted analysis showed a lower transplant/death hazard ratio for Hispanics (hazard ratio, 0.47; 95% CI, 0.24-0.94; = 0.032), there was no association between Hispanic ethnicity and outcome in the multivariable model after adjusting for social determinants of health and other covariates (HR, 0.76; 95% CI, 0.35-1.62; = 0.474). Hispanic ethnicity was not associated with differences in survival after adjusting for social determinants of health and other factors. Social determinants of health are important to consider when assessing the association between ethnicity and outcomes in PAH.
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http://dx.doi.org/10.1513/AnnalsATS.202109-1051OC | DOI Listing |
Sex Transm Dis
December 2024
Department of Epidemiology, School of Public Health, and the Center for AIDS and STD, University of Washington, Seattle, WA.
Objectives: Women who report sex with women are thought to have lower risk for Chlamydia trachomatis (CT) infection than women who report sex with men only (WSM-only), but comparisons of lifetime burden are limited.
Methods: Among 1,418 sexually-experienced women aged 18-39 years participating in the National Health and Nutrition Examination Survey (2013-2016), we estimated weighted CT seroprevalence and Wald-based 95% confidence intervals (CI) in women who reported ever having sex with a woman (all reported having sex with men also) (WSWM) compared to WSM-only. We defined seropositivity as detection of Pgp3 antibodies and used stratified Poisson regression with robust standard errors to estimate prevalence ratios.
Sex Transm Dis
December 2024
From the Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Background: The Gonococcal Isolate Surveillance Project (GISP) was established to monitor antimicrobial resistance (AR) in N. gonorrhoeae in the United States. Isolates collected in GISP undergo antimicrobial susceptibility testing allowing for estimates of resistance, based on exceeding minimum inhibitory concentrations (MICs), to be calculated.
View Article and Find Full Text PDFJ Perinat Med
December 2024
Department of Population Health and Social Medicine Charles E. Schmidt College of Medicine, 1782 Florida Atlantic University, Boca Raton, USA.
Objectives: Cannabis use disorder (CUD) among pregnant women is increasing, yet limited information exists on admissions for treatment in this population. This study examined trends in CUD admissions among pregnant women in publicly funded U.S.
View Article and Find Full Text PDFJ Pediatr
December 2024
Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA; Department of Cardiology, Boston Children's Hospital, Boston, MA, USA; Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA. Electronic address:
Objective: To study pediatric inpatient hospital capacity and resources, characterizing differences according to social determinants of health (SDoH) using market share techniques.
Study Design: This cross-sectional study uses non-elective inpatient discharges (≥1 month to ≤19 years) from Healthcare Cost and Utilization Project and American Hospital Association surveys to derive hospital capacity and resources/capability. We include US hospitals with ≥1 pediatric bed and ≥1 pediatric discharge and calculate per bed capital, expenditure, and staffing, transfer rates, payer-mix, and adjusted central line-associated blood stream infection (CLABSI) rate.
J Public Health Dent
December 2024
American Institute of Dental Public Health (AIDPH), River Forest, Illinois, USA.
Background: While recent US policies restrict access to healthcare and resulting health disparities among the transgender community, little is known about oral health access and utilization among this population. This study assessed self-reported access to dental care among transgender adults living in the United States.
Method: The study sample included 1,284,526 observations representing a weighted population of 290,000,163 from Behavioral Risk Factor and Surveillance Survey (BRFSS) datasets.
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