Progress in understanding the nature of health disparities requires data that are race-comparative while overcoming confounding between race, socioeconomic status, and segregation. The Exploring Health Disparities in Integrated Communities (EHDIC) study is a multisite cohort study that will address these confounders by examining the nature of health disparities within racially integrated communities without racial disparities in socioeconomic status. Data consisted of a structured questionnaire and blood pressure measurements collected from a sample of the adult population (age 18 and older) of two racially integrated contiguous census tracts. This manuscript reports on baseline results from the first EHDIC site, a low-income urban community in southwest Baltimore, Maryland (EHDIC-SWB). In the adjusted models, African Americans had lower rates of smoking and fair or poor self-rated health than whites, but no race differences in obesity, drinking, or physical inactivity. Our findings indicate that accounting for race differences in exposure to social conditions reduces or eliminates some health-related disparities. Moreover, these findings suggest that solutions to the seemingly intractable health disparities problem that target social determinants may be effective, especially those factors that are confounded with racial segregation. Future research in the area of health disparities should seek ways to account for confounding from SES and segregation.
The purpose of this study was to extend the research body, which implicates the insidious effects of racism on health outcomes. Specifically, this study tested the assumption that perception of racist experiences would predict differently for self-report symptoms (Symptom Checklist-90-Revised) compared to an objective measure of health (cardiovascular [CV] reactivity to standard laboratory stressors). It was also hypothesized that the cultural variable spirituality would moderate this relation. A total of 155 undergraduate students of African descent from a historical Black university in the mid-Atlantic region were recruited to participate in the current study. Perceived racist experiences and racial stress were commonly associated with negative health symptoms and showed an inverse relation to the CV responses. In addition, spirituality served as a significant moderator between racial stress and negative psychological health symptoms. Several implications are discussed in light of these findings.
Research exploring marijuana use patterns in students at historically Black colleges and universities (HBCUs)is relatively sparse. This study sought to empirically assess three constructs (resilient, invulnerable, and vulnerable)as they relate to marijuana use and to assess the role of spirituality and social support as potential buffering mechanisms. Participants in this study were 1,013 African American undergraduate students from two HBCUs in the mid-Atlantic region of the United States. Participants completed a 95-item survey assessing demographic and behavioral patterns of college students. The findings provide preliminary support for quantitative distinctions between marijuana risk categories based on the selected risk and protective factors. In particular, respondents who continue to use marijuana (vulnerables)were less spiritual compared to those who either halted use (resilients) or those who never used marijuana at all (invulnerables). Implications are discussed in terms of theory-building and prevention strategies.
BACKGROUND: A major public health concern is the growing incidence of the sexually transmitted human papillomavirus (HPV) infection. The highest rate of HPV is found in college-age students with persistent infection noted in young African-American women (AAW). Certain oncogenic strains of HPV can lead to cervical cancer, and in the United States, AAW are more likely to die of cervical cancer than any other racial/ethnic group. While the causes of this disparity is multifactorial, past studies indicate that young AAW have limited understanding of the etiology, modes of transmission, risk, prevention, and treatment of cervical cancer. While screening before the age of 21 is not recommended, providing appropriately-tailored education to young adult AAW can assist in achieving health-promoting behavior and provide opportunity to reduce mortality risk. As a first step, this study sought to expand the paucity of research that focuses on knowledge and attitudes toward HPV and cervical cancer among AAW attending a historically black college and university (HBCU). METHOD: We conducted a quantitative cross-sectional survey of English-speaking, self-identified AAW or African descent, 18-26 years old, recruited from a HBCU in the mid-Atlantic region of the United States. Consenting participants completed a survey battery to assess knowledge and attitudes toward HPV and cervical cancer, sexual practices, sources utilized for health literacy, and demographic characteristics. Cumulative and individual knowledge scores were calculated for each participant, and analysis was performed to identify items associated with adequate knowledge scores. Pearson's correlation analysis was computed to examine relationships between HPV and cervical cancer knowledge, attitudes and health beliefs. RESULTS: The sample included 298 AAW undergraduate respondents (25% freshmen, 22.1% sophomores, 20.5% juniors, and 31.5% seniors). The AAW in this sample reported moderate knowledge of HPV with scores ranging from 1 to 13 (M =7.84, SD=1.92); however, individual item analysis suggests there were deficits in basic knowledge (etiology and transmission of HPV, screening and prevention strategies). Approximately 40% of the respondents reported receiving the HPV vaccination. Three fourths of the participants indicated that that they have had two or more sexual partners, while 40% indicated that they do not use protection during sexual practices. The respondents felt that their best source for health literacy was from family and friends (67.8%). Cancer screening attitudes were associated with greater HPV knowledge (r=.173, p<.01). Stronger feelings of fatalism were negatively correlated with HPV knowledge (r=-.158, p<.01). These findings suggest that the more participants are in control of their health, the less likely they exhibit fatalistic or pessimistic attitudes toward cervical cancer. CONCLUSIONS: Consistent with prior research, the current findings revealed gaps in HPV/cervical cancer knowledge and preventive behaviors. Individual analysis further revealed deficits in knowledge of HPV and cervical cancer, unsafe sexual practices, and fatalistic attitudes. Recommendations for developing reliable educational programs within colleges to better equip students with preventive and positive health strategies should be encouraged. Ultimately, identifying knowledge gaps within this at-risk population would highlight where interventions need to be directed. Citation Format: Terra L. Bowen-Reid, Deborah Olumuyiwa, Natalee McFarlane, Grace Oni, Oluwafunmilayo Ayeni, Lynn Richards-McDonald, Laundette Jones. African American college women knowledge and attitudes toward human papillomavirus (HPV) and cervical cancer screening. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A61.
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