Background: The National Health and Nutrition Examination Survey data indicate that the proportion of US adults with hypertension that had controlled blood pressure (BP) declined from 2013 to 2014 through 2017 to 2018. We analyzed data from National Health and Nutrition Examination Survey 2009 to 2012, 2013 to 2016, and 2017 to 2020 to confirm this finding. Methods: Hypertension was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg or antihypertensive medication use. BP control among those with hypertension was defined as systolic BP <140 mm Hg and diastolic BP <90 mm Hg. Results: The age-adjusted prevalence of hypertension was 31.5% (95% CI, 30.3%–32.8%), 32.0% (95% CI, 30.6%–33.3%), and 32.9% (95% CI, 31.0%–34.7%) in 2009 to 2012, 2013 to 2016, and 2017 to 2020, respectively ( P trend=0.218). The age-adjusted prevalence of hypertension increased among non-Hispanic Asian adults from 27.0% in 2011 to 2012 to 33.5% in 2017 to 2020 ( P trend=0.003). Among Hispanic adults, the age-adjusted prevalence of hypertension increased from 29.4% in 2009 to 2012 to 33.2% in 2017 to 2020 ( P trend=0.029). In 2009 to 2012, 2013 to 2016, and 2017 to 2020, 52.8% (95% CI, 50.0%–55.7%), 51.3% (95% CI, 47.9%–54.6%), and 48.2% (95% CI, 45.7%–50.8%) of US adults with hypertension had controlled BP ( P trend=0.034). Among US adults taking antihypertensive medication, 69.9% (95% CI, 67.8%–72.0%), 69.3% (95% CI, 66.6%–71.9%), and 67.7% (95% CI, 65.2%–70.3%) had controlled BP in 2009 to 2012, 2013 to 2016, and 2017 to 2020, respectively ( P trend=0.189). Among all US adults with hypertension and those taking antihypertensive medication, a decline in BP control between 2009 to 2012 and 2017 to 2020 occurred among those ≥75 years, women, and non-Hispanic black adults. Conclusions: These data confirm that the proportion of US adults with hypertension who have controlled BP has declined.

This paper examines whether children of marginalized racial/ethnic groups have an awareness of race at earlier ages than youth from non-marginalized groups, documents their experiences with racial discrimination, and utilizes a modified racism-related stress model to explore the relationship between perceived racial discrimination and self-esteem. Data were collected for nonHispanic black, non-Hispanic white, and Hispanic children aged 7 -12 using face-to-face interviews (n = 175). The concept of race was measured by assessing whether children could define race, if not a standard definition was provided. Racial discrimination was measured using the Williams Every-day-Discrimination Scale, self-esteem was measured using the Rosenberg Scale, and ethnic identity was assessed using the Multi-group Ethnic Identity Measure. NonHispanic black children were able to define race more accurately, but overall, Hispanic children encountered more racial discrimination, with frequent reports of ethnic slurs. Additionally, after accounting for ethnic identity, perceived racial discrimination remained a salient stressor that contributed to low self-esteem.

Background. To date, no living donation program has simultaneously addressed the needs of both transplant candidates and living donors by separating the advocacy role from the candidate and improving potential donor comfort with the evaluation process. We hypothesized that the development of a novel program designed to promote both advocacy and systems training among transplant candidates and their potential living kidney donors would result in sustained increases in living-donor kidney transplantation (LDKT). To this end, we developed and implemented a Living Donor Navigator (LDN) Program at the University of Alabama at Birmingham. Methods. We included adult patients awaiting kidney-only transplant in a retrospective cohort analysis. Using time-varying Cox proportional hazards regression, we explored likelihood of living donor screening and approval by participation in the LDN program. Results. There were 56 LDN participants and 1948 nonparticipants (standard of care). LDN was associated with a 9-fold increased likelihood of living donor screenings (adjusted hazard ratio, 9.27; 95% confidence interval, 5.97-14.41, P < 0.001) and a 7-fold increased likelihood of having an approved living donor (adjusted hazard ratio, 7.74; 95% confidence interval, 3.54-16.93; P < 0.001) compared with the standard of care. Analyses by participant race demonstrated higher likelihood of screened donors and a similar likelihood of having an approved donor among African Americans compared with Caucasians. Conclusions. These data suggest that both advocacy and systems training are needed to increase actual LDKT rates, and that LDN programs may mitigate existing racial disparities in access to LDKT.

African Amercians afflicted with HNSCCA have a strikingly worse survival than whites. One apparent cause is an advanced stage of presentation in African Americans. This study was designed to identify barriers to early treatment among African American men.Methods-Twenty four African American male HNSCCA survivors completed structured interviews. Interviewers elicited the participants' experiences from symptom recognition to receiving definitive care.Results-Most participants presented with advanced stage HNSCCA. Overall, 10% experienced barriers to obtaining early medical care, though 30% were hesitant to seek care due to perceived barriers. Definitive treatment began for 81% within three months of initially seeking care.Conclusion-Once participants sought care, most received definitive treatment within a reasonable timeframe. To explain the advanced stage at presentation, either tumor growth rate was extremely rapid, or, participants sought care when the tumor was quite advanced. The themes suggested by this elicitation study require further validation.