Disparities in Diabetes: The Nexus of Race, Poverty, and Place

Gaskin, Darrell J.; Thorpe, Roland J.; McGinty, Emma E.; Bower, Kelly M.; Rohde, Charles A.; Young, J. Hunter; LaVeist, Thomas A.; Dubay, Lisa

doi:10.2105/ajph.2013.301420

Cited by 313 publications

(253 citation statements)

References 31 publications

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“…5 Gaskins et al examined the role of poverty and race on diabetes prevalence and found individual poverty increased odds of having diabetes for both black and white races, while living in areas of geographic poverty increased incidence of diabetes in the black population as a whole but only in the white population who were poor. 6 Higher incidence of preterm birth in neighborhoods with high poverty levels was reported by Margerison-Zilko et al 7 This research compared neighborhoods with low and high poverty levels, suggesting that the degree of poverty influences health outcomes.…”

Section: Introductionmentioning

confidence: 75%

Impact of a Simulation Exercise on Pharmacy Student Attitude toward Poverty

Clarke

Sedlacek

Watson

2016

American Journal of Pharmaceutical Education

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Objective. To evaluate the impact of a simulation on pharmacy student attitudes toward poverty using the Attitude toward Poverty (ATP) Short Form scale. Methods. Second-year pharmacy students participated in the 3-hour Missouri Association for Community Action Poverty Simulation. Students completed a survey of the ATP Short Form scale prior to and following participation in the simulation. Results. Significant improvements in attitude were noted in 15 of 21 ATP Short Form items. Improvements in the stigma and structural domains were significant while improvement in the personal deficiency domain was not significant. Conclusions. This poverty simulation exercise positively altered pharmacy student attitudes toward poverty. When combined with didactic and experiential curriculum, this simulation may enhance student achievement of the 2013 Center for the Advancement of Pharmacy Education (CAPE) outcome subdomain of cultural sensitivity.

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Section: Introductionmentioning

confidence: 75%

Impact of a Simulation Exercise on Pharmacy Student Attitude toward Poverty

Clarke

Sedlacek

Watson

2016

American Journal of Pharmaceutical Education

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“…For example, in a recent review of studies on segregation and cardiovascular risk conducted between 2011 and 2014, Kershaw and Albrecht found that of the three studies conducted for hypertension and diabetes (Gaskin et al, 2014;Hunt et al, 2014;, only one found a link to neighborhood-level segregation (Hunt et al, 2014). It should also be noted that although some investigators have suggested that segregation may provide protective effects for certain groups (e.g.…”

Section: Discussionmentioning

confidence: 99%

At the intersection of place, race, and health in Brazil: Residential segregation and cardio-metabolic risk factors in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Barber¹,

Roux²,

Cardoso³

et al. 2018

Social Science & Medicine

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a b s t r a c tResidential segregation is the spatial manifestation of entrenched socioeconomic and racial inequities and is considered a fundamental cause of racial inequalities in health. Despite the well-documented racialized spatial inequalities that exist in urban areas throughout Brazil, few empirical investigations have examined the link between residential segregation and health and considered its implications for racial health inequalities in this setting. In the present study, we used data from the Brazilian Longitudinal Study of Adult Health (2008e2010) to examine the association between economic residential segregation and two major cardio-metabolic risk factorsdhypertension and diabetes. We also examined whether associations were stronger for historically marginalized racial groups in Brazil. Residential segregation was calculated for study-defined neighborhoods using the Getis-Ord Local G i * statistic and was based on household income data from the 2010 IBGE demographic census. Multivariable logistic regression models were used to examine associations. In our sample, Blacks and Browns were more likely to live in economically segregated neighborhoods. After taking into account income, education, and other demographic characteristics we found that individuals living in the most economically segregated neighborhoods were 26% more likely to have hypertension and 50% more likely to have diabetes than individuals living in more affluent areas. Although Blacks and Browns living in highly segregated neighborhoods had higher prevalence of hypertension and diabetes compared to Whites, we observed no statistically significant racial differences in the associations with residential segregation. Our findings suggest that residential segregation may be an important structural determinant of cardio-metabolic risk factors in Brazil. Moreover, the systematic and disproportionate exposure of Blacks and Browns to highly segregated neighborhoods may implicate these settings as potential drivers of racial inequalities in cardio-metabolic risk factors in urban settings in Brazil.

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“…1 A growing literature documents the intersection between place and health, building on evidence that poor health outcomes tend to be concentrated in certain neighborhoods, due both to socioeconomic inequities and a lack of available health care resources. [17][18][19] Neighborhood economic and social characteristics (e.g., average household income, racial/ethnic composition) have been shown to be associated with the prevalence and quality of management of chronic conditions such as hypertension and diabetes, [20][21][22] and with factors that can undermine individual health, such as a lack of access to healthy foods 23,24 and increased exposure to poor environmental conditions. 25,26 Previously we found that in 2007, that adults living in high poverty neighborhoods had higher preventable hospitalization rates, 27 adding to the literature on neighborhood poverty and poor health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008–2013

Bocour

Tria

2016

J Urban Health

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Knowing which demographic groups have higher rates of preventable hospitalizations can help identify geographic areas where improvements in primary care access and quality can be made. This study assessed whether preventable hospitalization rates by neighborhood poverty decreased from 2008 to 2013 and whether the gap between very high and low poverty neighborhoods changed. We examined trends in age-adjusted preventable hospitalization rates and rate ratios by neighborhood poverty overall and by sex using JoinPoint regression. Prevention Quality Indicators . The rate ratios also decreased over time; however, in 2013, the rates for very high poverty neighborhoods were two to four times higher than low poverty neighborhoods (ZIP codes with G10 % of persons below the FPL). While preventable hospitalization rates have decreased over time, disparities still exist. These findings underscore the need to ensure adequate access to quality and timely primary care among individuals living in high poverty neighborhoods.

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Disparities in Diabetes: The Nexus of Race, Poverty, and Place

Cited by 313 publications

References 31 publications

Impact of a Simulation Exercise on Pharmacy Student Attitude toward Poverty

Impact of a Simulation Exercise on Pharmacy Student Attitude toward Poverty

At the intersection of place, race, and health in Brazil: Residential segregation and cardio-metabolic risk factors in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008–2013

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